Assuntos
Planos Médicos Alternativos/economia , Gastroenterologia/economia , Política de Saúde/economia , Programas de Assistência Gerenciada/economia , Atenção à Saúde/economia , Atenção à Saúde/tendências , Pessoas sem Cobertura de Seguro de Saúde , Administração da Prática Médica , Estados UnidosRESUMO
This study was designed to determine the prevalence of colorectal neoplasia in healthy, asymptomatic adults with an age-related risk for colorectal neoplasia. Ninety patients were studied with air contrast barium enema and colonoscopy. The study population included 61 males and 21 females, with an age range of 51-82 yr (65 +/- 2 yr). Adenomatous polyps were found in 27% of males and 14% of females or 24% of patients overall. Sixty-six percent of these neoplasms were above the rectosigmoid junction and the mean size of the polyps was 6.5 +/- 1.2 mm. In two patients, carcinoma was discovered. A linear association between age and the prevalence of colonic neoplasia was not demonstrated. This study demonstrates a relatively high prevalence of colonic neoplasia in patients with an age-related risk.
Assuntos
Adenoma/epidemiologia , Neoplasias do Colo/epidemiologia , Adenoma/diagnóstico , Adenoma/patologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Distribuição de Qui-Quadrado , Neoplasias do Colo/diagnóstico , Neoplasias do Colo/patologia , Colonoscopia , Feminino , Humanos , Pólipos Intestinais/epidemiologia , Pólipos Intestinais/patologia , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Sangue Oculto , Valor Preditivo dos Testes , Prevalência , Estudos Prospectivos , Análise de Regressão , Fatores de RiscoRESUMO
An analysis of hepatic imaging (liver-spleen scintigraphy, ultrasonography, and computed tomography) was performed in 91 patients prospectively referred for percutaneous liver biopsy for suspected chronic liver disease. Hepatic imaging was performed in 51 of 91 patients (56%). Of these 51 patients, 42 (82%) underwent radionuclide imaging, whereas only seven (14%) underwent ultrasonography and only two (4%) underwent computed tomography performed. Scintigraphy revealed evidence of diffuse liver disease in 40 of 42 patients (95%) vs 0 of 7 patients (0%) for ultrasonography (P less than 0.0001). The frequency of imaging varied significantly by prebiopsy presumptive diagnosis, but this pattern was primarily a reflection of patient age. Imaging was performed in 76% of patients over 50 years of age vs 37% of patients below this age (P less than 0.001). In the hospital, scintigraphy is still prominently used as a screening tool before referral for percutaneous liver biopsy. Justification of this use involves multiple reasons beyond simply a diagnosis.
