RESUMO
OBJECTIVE: Review of dementia screening case profiles that included brain blood flow imaging to determine contribution to diagnosis. DESIGN: Retrospective medical case audit. SETTING: Rural New South Wales. PARTICIPANTS: Eighty-eight rural patients who underwent investigations for dementia diagnosis. MAIN OUTCOME MEASURE: Contribution of brain blood flow imaging (single photon emission tomography, SPECT) to the dementia screening regime. RESULTS: The age range of those referred was 21-88 years, the average being 70 years. There were 44 men and 44 women. Vascular causes of dementia accounted for 27% of all those referred for brain blood imaging. Senile dementia of the Alzheimer's type accounted for 40% of all referrals. The occurrence of mixed disease was 6%. Matching neuropsychological reports and computer tomography were available for 18 of the blood flow studies. Of these, 65% were in agreement or semi-agreement for the diagnostic outcome. Only five studies failed to reach consensus. GPs were responsible for 31% of the imaging referrals, and the remaining referrals were from the regions: two gerontologists, three physicians and two neurologists. CONCLUSIONS: Brain blood flow imaging did contribute to the final diagnosis of dementia type for these patients, influencing patient management.
Assuntos
Demência/diagnóstico , Programas de Rastreamento/organização & administração , Serviços de Saúde Rural/organização & administração , Tomografia Computadorizada de Emissão de Fóton Único/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Viés , Causalidade , Demência/classificação , Demência/epidemiologia , Diagnóstico Diferencial , Medicina de Família e Comunidade , Feminino , Humanos , Masculino , Auditoria Médica , Entrevista Psiquiátrica Padronizada , Pessoa de Meia-Idade , Testes Neuropsicológicos , New South Wales/epidemiologia , Avaliação de Programas e Projetos de Saúde , Encaminhamento e Consulta , Estudos Retrospectivos , Sensibilidade e Especificidade , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Tomografia Computadorizada de Emissão de Fóton Único/estatística & dados numéricos , Tomografia Computadorizada por Raios XRESUMO
Vaginitis emphysematosa is an uncommon inflammatory condition that is aetiologically linked to trichomonal or gardenerella infection, and has been associated with immunosuppressive disorders. The disease does not have deleterious sequelae and resolves on treating the underlying infection. We describe a case in which the disease predominantly affected the cervix to an abnormal pap smear and colposcopic investigation. (AU)
Assuntos
Pessoa de Meia-Idade , Relatos de Casos , Feminino , Humanos , Esfregaço Vaginal , Vaginite/patologia , Vaginite/diagnósticoRESUMO
A review of tumours of the testis and paratesticular region at the University Hospital of the West Indies over a 30-year period revealed 14 of the former and 22 of the latter. The testicular tumours were all malignant, with 50 per cent of them being germ-cell neoplasms. Seventeen of the 22 paratesticular tumours, (77.3 percent) were benign. The histological types, racial incidence and possible aetiological factors are discussed and compared with the findings of other series (AU)
