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with CT virtual colonoscopy for colorectal cancer screening in asymptomatic adults

The Virtual Colonoscopy with computed tomography for screening of colon cancer in asymptomatic adults
J. Perry Pickhardt, MD, J. Richard Choi, Sc.D., MD, Inku Hwang, MD, James A. Butler, MD, Michael L. Puckett, MD, Hans A. Hildebrandt, MD, Roy K. Wong, MD, Pamela A. Nugent, MD, Pauline A. Mysliwiec, MD, MPH, and William R. Schindler, DO NEJM - Volume: 349 - Date: 04/12/2003 - Capacity: 23

Abstract Background We evaluated the performance characteristics of CT colonography with computed tomography (CT) in detecting colorectal cancer in a medium-risk screening population.
Methods A total of 1233 asymptomatic adults (mean age 57.8 years) underwent the same day in the virtual and optical colonoscopy. In virtual colonoscopy with CT, radiologists have used the three-dimensional endoluminal display for the initial detection of polyps. During the initial examination of each segment of the colon, the executors of optical colonoscopy were unaware of the results obtained by CT virtual colonoscopy, which were communicated to them prior to execution of any subsequent re-examination. The sensitivity and specificity of virtual colonoscopy and the sensitivity of optical colonoscopy were calculated using as a standard optical colonoscopy findings from the final, which was not performed in a blinded fashion.
Results The sensitivity of virtual colonoscopy per i polipi adenomatosi è risultata del 93,8% per polipi con un diametro di almeno 10 mm, del 93,9% per polipi con un diametro di almeno 8 mm e dell'88,7% per polipi con un diametro di almeno 6 mm La sensibilità della colonscopia ottica per i polipi adenomatosi è risultata rispettivamente pari all'87,5%, 91,5% e 92,3% per le tre dimensioni di polipi. La specificità della colonscopia virtuale per i polipi adenomatosi è risultata del 96,0% per polipi con un diametro di almeno 10 mm, del 92,2% per polipi con un diametro di almeno 8 mm e del 79,6% per polipi con un diametro di almeno 6 mm. Due polipi sono risultati maligni; entrambi sono stati rilevati dalla colonscopia virtuale, mentre uno di essi è passato inosservato alla colonscopia ottica prima che fossero stati rivelati i risultati della colonscopia virtuale.
Conclusioni La colonscopia virtuale con TC, basata su un approccio di visualizzazione tridimensionale, rappresenta un metodo di screening accurato per la rilevazione di neoplasie colorettali in adulti asintomatici a medio rischio, ed ha una resa favorevole in confronto alla colonscopia ottica nell'individuare lesioni clinicamente rilevanti.

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PROCTOLOGY

La patologia emorroidaria è una delle malattie più comuni dell'uomo e si stima che interessi sia in forma sintomatica che asintomatica l'80% della popolazione. Ma cosa sono le Emorroidi? I cuscinetti Anali sono delle strutture preposte ad ammortizzare il passaggio delle feci attraverso the anal canal. Hemorrhoids are the result of a bulging of one or more bearings anal.
But what the bearings are made anal sex? Anatomical structures are placed at the level of the anal canal and formed vascular structures (veins and arteries) supporting tissue (connective tissue) and muscle fibers. Deposits in the history of patients who suffer from hemorrhoids often complain that there is a familiar theme, are parents or children of patients who have suffered from: lower limb varices, Varicocele, and Haemorrhoids. Among the risk factors so you have to add: Familiarity

Pregnancy Diet

constipation
contraceptive use
internal hemorrhoids are defined as those that arise above the dentate line and EXTERNAL those that develop below.
What are the symptoms? Patients often complain:

Itching Discomfort in the anal secretions


Prolapse And the pain?
often confused with anal pain only hemorrhoidal disease but it is not.
The onset of pain in the anal or is related to the complication of haemorrhoids or the highly painful hemorrhoidal thrombosis almost worse than a toothache! or the presence of diseases such as anal fissure attached.
How does a diagnosis of hemorrhoids?
Imporatante and trust their general practitioner, who must refer to a specialist surgeon or proctologist Colorectal cancer patients to define the pathology and anorectal refer the patient to a clinical examination equipment useful for diagnosis. NOT ONLY hemorrhoids may bleed! Cancer of the anus to inexperienced eyes can be confused with benign! Cancer of the rectum may give sangunamento RED LIVE!! So
delay is counterproductive!
If every individual who suffers from hemorrhoids was undergoing a specialist visit once in a lifetime to solve the problem and hemorrhoidal, monitoring of patients at risk would be much easier if it was also treated surgically haemorrhoids the presence of blood would very soon the patient by the surgeon, reducing development time of other diseases or even more so we can intervene if there is neoplastic disease before and better.

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anal cancer is an uncommon malignancy, accounting for only a small percentage (2-4%) of the lower gastrointestinal tract cancers. Clinical trials have shown the role of chemotherapy, radiation therapy and surgery in treating this disease.
Chronic diseases affecting the ano-perineal district, such as fistulas, hemorrhoids and fissures, can be considered as predisposing factors to the onset of this malignancy, the risk of this cancer increases in patients with previous venereal diseases, including conditomi. In women, the presence in the neck dlell'utero increases the risk of disease from 3 to 6 times. On his debut, cancer of the anus can be misunderstood, as the symptomatic results to be similar to the most common non-cancerous disease.
itching, burning and foreign body presence are the symptoms most frequently accused. Subsequently, the volume will increase the importance of palpation by the patient, who, owing to the itching, it often results in injury treatment, ulceration with bleeding, the overlap of septic phenomena appear purulent exudation.
Belatedly, in the later stages, due to the interest of the surrounding structures, appear perianal pain, hematuria, impotence in men, metrorrhagia and vaginitis in women.