Evaluación de la disquinesia escapular con método fotográfico digital / A photographic method for identifing scapular dyskinesis

To evaluate the exactitude, precision, reliability, sensitivity and specificity of Scapular Photographic Analysis (SPA Test) for the diagnosis of scapular dyskinesis. Material and Methods: We realized a study of reproducibility and diagnostic capability of SPA test for scapular dyskinesis. Reproducibility was assessed with exactitude (correlation of pairs), precision and reability (Intraclass correlation coefficient) in 26 healthy subjects. Subsequently, two independent operators evaluated and classified a group of patients as tehe presence or absence of scapular dyskinesis, defined as scapular asymmetry. Finally, we evaluated the diagnostic capability of the test (sensitivity, specificity) in 11 patients with scapular dyskinesis and 11 healthy controls. Was considered significant p < 0,05. The data were analyzed using STATA 9. Results: The average exactitude of the method was 81,97 +/- 1,57 percent, the precision was 0,999 and the reliability was 0,9995. The sensitivity and specificity of the test for scapular dyskinesis diagnosis were 72,73 and 90,91, respectively. Conclusions: SPA test is an objective method, precise and reliable to assess the position and rotation scapula. It presents criteria with highly sensitivity and specificity for scapular dyskinesis diagnosis.

Objetivo: Evaluar la confiabilidad, precisión, exactitud, sensibilidad y especificidad del Análisis Fotográfico Escapular. Material y Método: Se realizó un estudio de reproducibilidad y capacidad diagnóstica del test AFE para disquinesia escapular. La reproducibilidad fue evaluada con la exactitud (Correlación de pares), precisión y confiabilidad (Coeficiente de Correlación Intraclase) en 26 sujetos sanos. Posteriormente, se realizó una evaluación por 2 operadores de forma independiente, clasificando a un grupo de pacientes según la presencia o ausencia de disquinesia escapular, definida como asimetría escapular. Finalmente, se evaluó la capacidad diagnóstica del test (sensibilidad, especificidad) en 11 pacientes con disquinesia escapular y 11 controles sanos. Se consideró significativo un p < 0,05. Los datos fueron analizados con STATA 9. Resultados: La exactitud promedio del método fue 81,97 +/- 1,57 por ciento, la precisión fue 0,999 y la confiabilidad fue de 0,9995. La sensibilidad y especificidad del test para el diagnóstico de disquinesia escapular fueron 72,73 y 90,91, respectivamente. Conclusiones: El test AFE es un método objetivo, preciso y confiable para evaluar la posición y la rotación de la escápula. Además, presenta criterios con capacidad diagnóstica altamente sensibles y específicos para el diagnóstico de disquinesia escapular.

Análisis de 1.017 adenocarcinomas del intestino grueso resecados en 978 pacientes / Analysis of 1.017 large bowel adenocarcinomas resected in 978 patients

Colorectal carcinoma is the fifth cause of cancer deaths among women and the sixth among men. Aim: to retrospectively analyse the distribution of age, sex, localization and the pathological features of resected large bowel adenocarcinomas at a surgical service. All biopsy reports of resected large bowel carcinomas between 1959 and 1995 were analyzed. Twenty six reports were discarded. Available histological slides were re-examined. Twenty five cases (2,5 percent) had 2 synchronous tumors and 14 subjects (1.4 percent) had 2 different resections due to cancer (metachronic tumors). Sixty percent of tumors were located in the rectum and sigmoid, 74 percent were well differentiated, 17 percent poorly differentiated. Mucinous and signet ring cell variants were found in younger subjects and in 5.1 percent and 2.3 percent of all patients respectively. Eighty four percent of tumors were beyond the muscularis at the moment of resection and 38 percent had lymph node increased from 60 to 65 years ols and rectal cancer frequency decreased from 37,8 to 25,4 percent. Colorectal carcinoma is still diagnosed at an advanced stage and the changes of the natural history of the disease observed in the 2 analyzed periods are similar to those reported in USA and Colombia