ABSTRACT
Objetivo: determinar la calidad y efectividad del trabajo realizado en el Centro Mamario del Hospital Universitario Austral, mediante la correlación entre las diferentes categorizaciones del BI-RADS, el resultado de la anatomía patológica y el cálculo del respectivo VPP. Correlacionar los resultados con los obtenidos a nivel internacional. Material y método: se realizó una revisión de todas las biopsias guiadas por ultrasonido, se seleccionaron aquellas pacientes estudiadas con algún método de diagnóstico por imágenes en el Centro Mamario del Hospital Universitario Austral y cuya categorización final de BI-RADS fuera de 4 o 5, entre junio de 2014 y mayo de 2017. Los resultados de la anatomía patológica fueron divididos en 3 categorías (benigno, maligno y alto riesgo) Resultados: de una total de 491 pacientes 223 correspondieron a la subcategoría 4a, 69 pacientes a la subcategoría 4b, 85 pacientes a la subcategoría 4c y 114 pacientes a la categoría 5. En las subcategorías 4a y 4b predominaron las lesiones benignas y en la subcategoría 4c y categoría 5 predominaron las lesiones malignas. Los VPP para cáncer de mama obtenidos fueron de 7%, 48%, 84% y 98% para las subcategorías 4a, 4b, 4c y categoría 5 respectivamente. Conclusiones: la investigación demostró que los resultados de los VPP, la calidad y efectividad del trabajo realizado en el Centro Mamario del Hospital Universitario Austral se encuentran dentro de los parámetros internacionales.
Objetive: to determine the quality and effectiveness of the work carried out in the Breast Center of the Austral University Hospital, through the correlation between the different categorizations of the BI-RADS, the result of the pathological anatomy and the calculation of the respective VPP. Correlate the results with those obtained internationally. Material and method: a review of al ultasound-guided biopsies was performed, those patients studied with some diagnostic imaging method were selected in the Breast Center of the Austral University Hospital and whose final categorization of BI-RADS was 4 or 5, between june 2014 and may 2017. The results of the pathological anatomy were divided into 3 categories (bening, malignant and high risk). Results: from a total of 491 patients, 223 corresponded to subcategory 4a, 69 patients to subcategory 4b, 85 patiens to subcategory 4c and 114 patients to category 5. In subcategories 4a and 4b benign lesions predominated and in subcategory 4c and category 5, malignant lesions predominated. The VPP for breast cáncer obtained were 7%, 48%, 84% and 98% for subcategories 4a, 4b, 4c y category 5 respectively. Conclusions: the investigation showed that the results of the PPV, the quality and effectiveness of the work carried out in the Breast Center of the Autral University Hospital are within the international parameters.
Subject(s)
Female , Breast Neoplasms , Biopsy , Punctures , Predictive Value of TestsABSTRACT
The prediction of meniscus reparability is quite useful for surgeons to optimize surgical planning. The main objective of this study was to evaluate the ability of magnetic resonance imaging (MRI) to predict the suture of meniscal lesions. This was an unicentric retrospective study that included 104 patients who underwent knee joint ligament reconstruction and / or arthroscopy for the treatment of meniscal injury at knee joint level. The MRI images of the meniscus were evaluated and later the arthroscopic findings were used as the gold standard. After the operative procedure, the cases were allocated into two groups according to the necessity of meniscus suture: Sutured Group "MSu" (n = 58) and Non sutured Group "MNSu" (n = 150). Considering the lesion detection capacity in the medial meniscus, the sensitivity, specificity and accuracy of MR were 85.3%, 63.9% and 77.9%, respectively. The positive predictive value (PPV) was 81.7% and the negative predictive value (NPV) was 69.7%. The agreement between MRI and arthroscopy was moderate. For the lateral meniscus, sensitivity, specificity and accuracy of MRI were 80.6%, 89.0% and 86.5%, respectively, with PPV of 75.7% and NPV of 91.5% and a substantial agreement. Regarding suture predictability, the sensitivity, specificity and accuracy were respectively 60.3%, 66.7% and 64.9% with PPV of 41.2% and NPV of 81.3%, with weak agreement. According to the arthroscopy, the 58 meniscal lesions of the MSu group were more frequent in the posterior horn, had the longitudinal pattern and were located in the red-red vascular zone. In our study, MRI was not a good predictor of meniscal suture, although it is an useful tool for the diagnosis of medial and lateral meniscal lesions
Subject(s)
Menisci, Tibial/diagnostic imaging , Magnetic Resonance Imaging, CineABSTRACT
Objetivo: este artículo presenta la manera de calcular, dentro de una prueba de diagnóstico clínico, la probabilidad de que un individuo, cuyo resultado para la prueba de tamizaje es positivo, esté realmente enfermo sabiendo que no se tiene su resultado con la prueba patrón de oro; probabilidad denominada Valor Predictivo Positivo (VPP). Método: se asumió el VPP como una cantidad desconocida para la que se puede construir una distribución de probabilidad. Dentro del paradigma Bayesiano de la estadística, se utilizó el método propuesto por Winkler and Smith para calcular VPP utilizando un conjunto de registros sobre coledocolitiaisis en pacientes con pancreatitis aguda. Resultados: los métodos bayesianos permitieron obtener regiones de credibilidad más estrechas que los intervalos de confianza clásicos. Discusión: el uso de métodos Bayesianos es una excelente alternativa para obtener estimaciones más precisas del VPP. Estimar los valores predictivos utilizando los datos de la tabla 2X2 conlleva a errores cuando el tamaño de la muestra no es tan grande como para asumirla cercana a la población.
Objetive: In this article we present different alternative to compute thePositive Predictive Value (PPV) for a diagnostic test. Method: we assumedtheVPP as a continuous and unknown quantity whose natural performanceis susceptible of model using a distribution of probability. We use themethod propose as Winkler and Smith to estimate the VPP using Bayesianprocedure. We illustrate our methodology with a data set of patients withacute pranceatitis taken the Magnetic Cholangiopancreatogrphy as test toscreening of Choledocoletise Results: The Bayesian approach allows to havea best estimates and the credibility regions were narrower than the confidenceintervals.Discussion:thje use of Bayesian methods is an excellent choise toobtain more accute estimates. To estimateVPPs using the observed data intable 2X2 implies mistakes when the sample size is not large enough as to thinkthat the sample close the population size.
Subject(s)
Humans , Prevalence , Sensitivity and Specificity , Bayes TheoremABSTRACT
The establishment and realization of the VPP calucation's model for the functional analytic theory are discussed in this paper. Functional analyzing method is a theoretical model of the VPP calculation which can eliminate the influence of the sail and board's size skillfully, so it can be regarded as a brief standard of the sailboard's VPP results. As a brief watery dynamical model, resistance on board can be regarded as a direct proportion to the square of the boat-velocity. The boat-velocities at the state of six wind-velocities (3 m/s-8 m/s) with angles of 25°-180° are obtained by calculating, which provides an important gist of the sailing-route's selection in upwind-sailing.
ABSTRACT
The establishment and realization of the VPP calucation's model for the functional analytic theory are discussed in this paper. Functional analyzing method is a theoretical model of the VPP calculation which can eliminate the influence of the sail and board's size skillfully, so it can be regarded as a brief standard of the sailboard's VPP results. As a brief watery dynamical model, resistance on board can be regarded as a direct proportion to the square of the boat-velocity. The boat-velocities at the state of six wind-velocities (3 m/s-8 m/s) with angles of 25°-180° are obtained by calculating, which provides an important gist of the sailing-route's selection in upwind-sailing.
ABSTRACT
BACKGROUND: To compare the efficacies and side effects of etoposide, cisplatin/cyclophosphamide, adriamycin, vincristine(VPP/CAV) with that those of carboplatin etoposide(CE) in extensive stage small cell lung cancer patients. METHOD: Patients with extensive stage small cell lung cancer who has measurable disease were eligible. VPP/CAV group(n=22) was treated with cisplatin(60mg/m2 iv. D1) etoposide(100mg/m2 iv. D1-3),after and 3 weeks later cyclophosphamide(1000mg/m2 iv. D1), adriamycin(40mg/m2 iv. D1), and vincristine(1.4mg/m2 iv. D1), were administered alternatively. CE group (n=22) was treated with carboplatin (325mg/m2 iv. D1) and etoposide (100mg/m2 iv. D1-3)(;) repeated treatment was performed every 3 weeks. RESULT: Forty four patients were eligible for the study. Overall The overall response rate was 61.4% (complete remission rate 0%, partial response rate 61.4%, stable disease rate 25%, progressive disease rate 13.6%), and median survival was 10.8 months. In VPP/CAV group, response rate was 54.5%(complete remission rate 0%, partial response rate 54.4%, stable disease rate 27.3%, progressive disease rate 18.2%), and, in carboplatin/etoposide group, the response rate was 68.2%(complete remission rate 0%, partial response rate 68.2%, stable disease rate 22.7%, progressive disease rate 9.1%). The median survival time was 9.5 months in the VPP/CAV group and 11 months in CE group. The toxicity of both group was moderate, and anemia was more frequent in the CE group. CONCLUSION: VPP/CAV regimen and CE regimen produced similar response rate and survival time rates and survival times in extensive stage small cell lung cancer patients. We may suggest that CE regimen are effective may be effective as part of the initial therapy of for extensive stage small cell lung cancer.