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3.
Rev Clin Esp ; 205(1): 19-23, 2005 Jan.
Artigo em Espanhol | MEDLINE | ID: mdl-15718013

RESUMO

Diagnostic strategy in fever of unknown origin has been changing in recent decades. The objective of this study is to define the role of thoracoabdominal computerized axial tomography in the first diagnostic stage. A sample of 24 patients with classical fever of unknown origin from our hospital Internal Medicine department was selected between January 1995 and December 2002. Cost-effectiveness of diagnostic thoracoabdominal computerized axial tomography compared to that of abdominal echography was analyzed; the information obtained with both diagnostic techniques for the final diagnosis was also evaluated. Computerized axial tomography contributed data suggestive of the diagnosis in 10 of 24 patients (41.7%); abdominal echography only gave orienting information to the diagnosis in 2 cases (8%). In 9 (90%) of the 10 patients with computerized axial tomography specific alterations, a conclusive definitive diagnosis (with analysis of biological sample) was possible. Accordingly, the use of this technique is justified at the beginning of the study of the classical fever unknown origin in order to orient the clinician to resort to other more directed and specific diagnostic techniques and with higher diagnostic cost-effectiveness.


Assuntos
Febre de Causa Desconhecida/diagnóstico por imagem , Febre de Causa Desconhecida/etiologia , Radiografia Abdominal/economia , Radiografia Torácica/economia , Tomografia Computadorizada por Raios X/economia , Adolescente , Adulto , Idoso , Análise Custo-Benefício , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Espanha
4.
Rev. clín. esp. (Ed. impr.) ; 205(1): 19-23, ene. 2005. tab
Artigo em Es | IBECS | ID: ibc-037263

RESUMO

La estrategia diagnóstica en la fiebre de origen desconocido ha ido cambiando en las últimas décadas. El objetivo de este estudio es consolidarla tomografía axial computarizada toraco- abdominal en la primera etapa diagnóstica. Se obtuvo una muestra de 24 pacientes con fiebre de origen desconocido clásica seleccionados en el Servicio de Medicina Interna de nuestro hospital entre enero de1995 y diciembre de 2002. Se estudió la rentabilidad diagnóstica de la tomografía axialcomputarizada toracoabdominal frente ala ecografía abdominal, y la información que ambas proporcionaban para el diagnóstico final. La tomografía aportó datos sugestivos del diagnóstico en 10 de 24 pacientes (41,7%); la ecografía abdominal sólo dio información orientadora al diagnóstico en dos casos (8%). De los 10 pacientes con alteraciones específicas en la tomografía axial computarizada, se llegó a un diagnóstico definitivo concluyente (con análisis de muestra biológica) en9 de ellos (90%). Por tanto, está justificado el uso de esta técnica al inicio del estudio de la fiebre de origen desconocido clásica para orientar al clínico a recurrir de forma dirigida a otras técnicas más específicas y con mayor rentabilidad diagnóstica


Diagnostic strategy in fever of unknown origin hasbeen changing in recent decades. The objective of this study is to define the role of thoracoabdominal computerized axial tomography in the first diagnostic stage. A sample of 24 patients with classical fever of unknown origin from our hospital Internal Medicine department was selected between January 1995 and December 2002. Cost effectiveness of diagnostic thoracoabdominal computerized axial tomography compared to that of abdominal echography was analyzed; the information obtained with both diagnostic techniques for the final diagnosis was also evaluated. Computerized axial tomography contributed data suggestive of the diagnosis in10 of 24 patients (41.7%); abdominal echography only gave orienting information to the diagnosis in 2 cases (8%). In 9 (90%) of the 10 patients with computerized axial tomography specific alterations, a conclusive definitive diagnosis (with analysis of biological sample) was possible. Accordingly, the use of this technique is justified at the beginning of the study of the classical fever unknown origin in order to orient the clinician to resort to other more directed and specific diagnostic techniques and with higher diagnostic cost-effectiveness


Assuntos
Adulto , Idoso , Humanos , Febre de Causa Desconhecida/etiologia , Febre de Causa Desconhecida , Radiografia Abdominal/economia , Radiografia Torácica/economia , Tomografia Computadorizada por Raios X , Análise Custo-Benefício , Estudos Retrospectivos , Espanha
5.
Clin Imaging ; 28(5): 340-3, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15471665

RESUMO

OBJECTIVE: The aim of this study was to describe the computed tomography (CT) findings in patients with demonstrated peritoneal tuberculosis (TB) and their concordance with the three types from the traditional classification (wet, fibrotic, and dry plastic). METHODS: We reviewed the CT images of all patients with microbiologically proven peritoneal tuberculosis over a 6-year period (1996-2001). RESULTS: Seven patients were included. Ascites was present in 5 patients (free ascites in 3 patients and loculated in 2). Involvement of the mesentery was found in 5 patients, the omentum in 4, and the parietal peritoneum in 3. Tuberculous lymphadenitis was the most common associated finding (6 patients). Two patients had hepatic lesions. The fibrotic type was found in all the patients, and 5 patients had an association of the fibrotic and wet types. None of the patients had lesions consistent with the dry plastic type. CONCLUSION: Peritoneal tuberculosis is best described as a combination of ascites, peritoneal lesions, and lymphadenopathy, rather than the three types from the traditional classification.


Assuntos
Peritônio/microbiologia , Peritonite Tuberculosa/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto , Idoso , Antituberculosos/uso terapêutico , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Peritônio/diagnóstico por imagem , Peritonite Tuberculosa/tratamento farmacológico , Peritonite Tuberculosa/fisiopatologia , Estudos Retrospectivos , Medição de Risco , Estudos de Amostragem , Sensibilidade e Especificidade , Índice de Gravidade de Doença
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