Value of prostate specific antigen in predicting the existence of bone metastasis in scintigraphy

OBJECTIVE: Evaluate the ability of serum concentration of prostate specific antigen (PSA) between 2 cutting points to predict the existence of bone metastasis confirmed by bone scintigraphy in man with prostate cancer. MATERIALS AND METHODS: Two hundred and fourteen consecutive patients with prostate cancer were evaluated during the present study in the period from 1998 to 2001. From all patients, PSA serum concentrations and bone scintigraphy were obtained. For the study, 2 cutting points of PSA (10 and 20 ng/mL) were adopted to predict the existence of bone metastasis. RESULTS: From the 214 patients, 35 (16.3 percent) presented positive scintigraphic examinations for the presence of bone metastasis. No patient presented bone metastasis in scintigraphy if having PSA < 10 ng/mL, and in only 1 patient (0.46 percent) with bone metastasis PSA concentration was < 20 ng/mL. Therefore, when the cutting point adopted for PSA serum concentration was 10 ng/mL, a negative predictive value for bone metastasis was 100 percent with sensitivity rates of 100 percent. Nevertheless, the positive predictive value and the specificity of the method were, respectively, 24.5 percent and 39.7 percent. When the cutting point of PSA serum concentration was 20 ng/mL, an increment was observed in rates of positive predictive value and specificity (41.5 percent and 73.2 percent), respectively, without substantial changes in negative predictive value (99.2 percent) and sensitivity (97.1 percent) of the method. CONCLUSIONS: Data of present study allow for the conclusion that PSA serum concentration over 20 ng/mL was a more accurate cutting point than PSA serum concentration over 10 ng/mL to predict the presence of bone metastasis in scintigraphy

Perfil da automedicaçäo em município do Sul do Brasil / Self-medication profile in a city in South Brazil

Caracteriza o usuário de medicamentos, especialmente aquele que se automedica. Foram entrevistadas 413 pessoas do Município de Santa Maria, Estado do Rio Grande do Sul, Brasil, sobre o consumo de medicamentos no último mês. Dos entrevistados, 69,9 por cento utilizaram medicamentos e destes 76,1 por cento o fizeram através de automedicaçäo. Cefaléia (28,8 por cento) foi a principal queixa motivadora de automedicaçäo. O ácido acetilsalicílico foi a droga mais utilizada (25,4 por cento). Dos fármacos utilizados na automedicaçäo, 51,2 por cento foram indicados por terceiros e 51,7 por cento dessas indicaçöes eram prescriçöes médicas emitidas em consultas anteriores. Idade, grau de escolaridade e acompanhamento médico periódico correlacionaram-se significativamente com automedicaçäo