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1.
Lung ; 197(5): 685, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31552480

RESUMO

The original version of this article contained an error in the usage of the term "false positive rate". The intention of the authors in those instances was simply to compare the absolute percentage of false positive results in the study vs the NLST, not to make any observations about false positive rate in the strict statistical sense (i.e. Type I error probability).

2.
J Gastrointest Surg ; 23(5): 982-989, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30390183

RESUMO

BACKGROUND: Passage of flatus after abdominal surgery signals resolution of physiological postoperative ileus (POI) and often, particularly after complex open surgeries, serves as the trigger to initiate oral feeding. To date, there is no objective tool that can predict time to flatus allowing for timely feeding and optimizing recovery. In an open, prospective study, we examine the use of a noninvasive wireless patch system that measures electrical activity from gastrointestinal smooth muscles in predicting time to first flatus. METHODS: Eighteen patients who underwent open abdominal surgery at El Camino Hospital, Mountain View, CA, were consented and studied. Immediately following surgery, wireless patches were placed on the patients' anterior abdomen. Colonic frequency peaks in the spectra were identified in select time intervals and the area under the curve of each peak times its duration was summed to calculate cumulative myoelectrical activity. RESULTS: Patients with early flatus had stronger early colonic activity than patients with late flatus. At 36 h post-surgery, a linear fit of time to flatus vs cumulative colonic myoelectrical activity predicted first flatus as much as 5 days (± 22 h) before occurrence. CONCLUSIONS: In this open, prospective pilot study, noninvasive measurement of colon activity after open abdominal surgery was feasible and predictive of time to first flatus. Interventions such as feeding can potentially be optimized based on this prediction, potentially improving outcomes, decreasing length of stay, and lowering costs.


Assuntos
Colo/fisiopatologia , Íleus/fisiopatologia , Músculo Liso/fisiopatologia , Tecnologia sem Fio , Abdome/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Flatulência/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Complicações Pós-Operatórias/fisiopatologia , Valor Preditivo dos Testes , Estudos Prospectivos , Recuperação de Função Fisiológica , Fatores de Tempo
3.
Lung ; 193(1): 135-9, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25503535

RESUMO

BACKGROUND: The National Lung Screening Trial (NLST) in 2011 showed that low-dose CT (LDCT) screening in high-risk groups reduces lung cancer deaths. Major professional organizations, as well as the U.S. Preventative Services Task Force, have endorsed LDCT screening in these select populations. However, major questions remain about whether widespread deployment of CT screening can achieve results similar to the NLST, especially in the community setting. METHODS: A prospective cohort study was initiated in November 2010. Participants at least 50 years old and with at least 20 pack-years of smoking history underwent LDCT screening in a community setting. RESULTS: One hundred and fifty four participants underwent LDCT screening with median follow-up of 2.7 years. Compared with the NLST, there was a higher rate of positive screening tests (35.7 vs. 27.3 %), higher false positive rate (100 vs. 96.4 %), and poor adherence (43 vs. 95 %). Invasive diagnostic follow-up was uncommon and uncomplicated. No interval lung cancer was detected. Late follow-up was mostly attributed to participant or primary care provider preference (67.5 %), participants lost to follow-up (17.5 %), and lack of insurance (10 %). CONCLUSIONS: These findings highlight the potential challenges of generalizing the NLST mortality benefits in the broad deployment of CT screening. Our results support current recommendations that LDCT screening be performed in a highly structured and integrated setting.


Assuntos
Serviços de Saúde Comunitária , Prestação Integrada de Cuidados de Saúde , Neoplasias Pulmonares/diagnóstico por imagem , Doses de Radiação , Tomografia Computadorizada por Raios X , Fatores Etários , Idoso , California , Serviços de Saúde Comunitária/organização & administração , Serviços de Saúde Comunitária/normas , Prestação Integrada de Cuidados de Saúde/organização & administração , Prestação Integrada de Cuidados de Saúde/normas , Reações Falso-Positivas , Feminino , Fidelidade a Diretrizes , Humanos , Neoplasias Pulmonares/etiologia , Neoplasias Pulmonares/mortalidade , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente , Guias de Prática Clínica como Assunto , Valor Preditivo dos Testes , Prognóstico , Estudos Prospectivos , Fatores de Risco , Fumar/efeitos adversos , Fatores de Tempo , Tomografia Computadorizada por Raios X/normas
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