RESUMO
INTRODUCTION: The aim of the study was to assess the strength of the online tool RiskCheck Bladder Cancer©, version 5.0 (RCBC) for early detection of bladder cancer (BC). MATERIALS AND METHODS: RCBC was evaluated retrospectively based on the data of 241 patients, of which 141 were suffering from BC. Statistical analysis was performed by descriptive statistics, nonparametric group comparison, classification tree analysis and ROC analysis. RESULTS: ROC analysis of the risk classification showed a sensitivity of 71.6%, a specificity of 56.5%, a positive predictive value of 67.8%, a negative predictive value of 52% and an accuracy of 63.5%. BC risk factors ranked by importance are time of smoking (p < 0.0001), gender (within the nonsmoking group: p < 0.009), occupational toxin exposure (within the group <35 years of smoking: p < 0.048) and amount of consumed cigarettes resulting in a 95% association with BC (within the group >35 years of smoking: p < 0.0001). CONCLUSIONS: The high predictive power of RCBC for the identification of asymptomatic patients living under risk could be demonstrated.
Assuntos
Diagnóstico por Computador/métodos , Detecção Precoce de Câncer/métodos , Neoplasias da Bexiga Urinária/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Feminino , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Valor Preditivo dos Testes , Curva ROC , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Sensibilidade e Especificidade , Fatores Sexuais , Fumar/efeitos adversos , SoftwareRESUMO
Arterial aneurysms in the forearm, wrist and hand are relatively uncommon. Penetrating injuries, arterial traumas, infections and repetitive microtraumas represent the most frequent cause of these secondary aneurysms or pseudo-aneurysms, while true nontraumaticor infective peripheral aneurysms of the upper extremities are very rarely encountered. Over the last 20 years these have been reported only sporadically, both in adults and children. We describe a case of bilateral true idiopathic saccular artery aneurysms in the hypothenar eminence, treated with excision and arterial continuity restoration by primary end-to-end anastomosis on the left side and conservatively on the right. To our knowledge, no other similar case has been documented to date. Starting from this original case we conducted a systematic review of the literature via PubMed search on peripheral aneurysms of the forearm and hand arteries from 1933 to the present, including specifically true distal ulnar and radial artery aneurysms. Etiology, clinical characteristics and management of these rare pathological entities are extensively discussed.
Assuntos
Falso Aneurisma , Antebraço/irrigação sanguínea , Mãos/irrigação sanguínea , Artéria Ulnar , Idoso de 80 Anos ou mais , Anastomose Cirúrgica , Falso Aneurisma/diagnóstico , Falso Aneurisma/cirurgia , Humanos , Angiografia por Ressonância Magnética , Masculino , Resultado do Tratamento , Artéria Ulnar/diagnóstico por imagem , Artéria Ulnar/patologia , Artéria Ulnar/cirurgia , Ultrassonografia Doppler Dupla , Procedimentos Cirúrgicos VascularesRESUMO
INTRODUCTION: 'Localized' femoral vein thrombosis (FVT) is a relatively rare condition usually associated with traumas, external compression or iatrogenic etiologies and the consequence can be pulmonary embolism. REPORT: This is the case of a 46-year-old woman who presented with pulmonary emboli secondary to 'localized' superficial FVT, coupled with post-puncture arteriovenous fistulas (AVFs), two days after trans-femoral vein radio-frequency cardiac ablation. After placing a temporary IVC-filter, the AVFs were sutured directly while the residual FVT was treated conservatively. DISCUSSION: Close local monitoring and adequate medical and surgical management are mandatory to avoid possible dangerous complications, also in apparently 'low-risk' iatrogenic AVFs.