5 resultados para Cancro colo-rectal
em Brock University, Canada
Resumo:
In 2003, prostate cancer (PCa) is estimated to be the most commonly diagnosed cancer and third leading cause of cancer death in Canada. During PCa population screening, approximately 25% of patients with a normal digital rectal examination (DRE) and intermediate serum prostate specific antigen (PSA) level have PCa. Since all patients typically undergo biopsy, it is expected that approximately 75% of these procedures are unnecessary. The purpose of this study was to compare the degree of efficacy of clinical tests and algorithms in stage II screening for PCa while preventing unnecessary biopsies from occurring. The sample consisted of 201 consecutive men who were suspected of PCa based on the results of a DRE and serum PSA. These men were referred for venipuncture and transrectal ultrasound (TRUS). Clinical tests included TRUS, agespecific reference range PSA (Age-PSA), prostate specific antigen density (PSAD), and free-to-total prostate specific antigen ratio (%fPSA). Clinical results were evaluated individually and within algorithms. Cutoffs of 0.12 and 0.15 ng/ml/cc were employed for PSAD. Cutoffs that would provide a minimum sensitivity of 0.90 and 0.95, respectively were utilized for %fPSA. Statistical analysis included ROC curve analysis, calculated sensitivity (Sens), specificity (Spec), and positive likelihood ratio (LR), with corresponding confidence intervals (Cl). The %fPSA, at a 23% cutoff ({ Sens=0.92; CI, 0.06}, {Spec=0.4l; CI, 0.09}, {LR=1.56; CI, O.ll}), proved to be the most efficacious independent clinical test. The combination of PSAD (cutoff 0.15 ng/ml/cc) and %fPSA (cutoff 23%) ({Sens=0.93; CI, 0.06}, {Spec=0.38; CI, 0.08}, {LR=1.50; CI, 0.10}) was the most efficacious clinical algorithm. This study advocates the use of %fPSA at a cutoff of 23% when screening patients with an intermediate serum PSA and benign DRE.
Resumo:
Each colour plate is accompanied by a note preceding it.
Resumo:
Basal body temperature (BBT) and thermoeffector thresholds increase following ovulation in
many women. This study investigated if solely central thermoregulatory alterations are responsible.
Seven females in a non-contraceptive group (NCG) were compared with 5 monophasic contraceptive
users (HCG) on separate accounts: pre-ovulation (Trial I; d 2-5) and post-ovulation (Trial 2; 4-8 d
post-positive ovulation) for NCG, and active phase for HCG (d 2-5, d 18-21). During immersion in
28°C water to the axilla, participants exercised for 20-30 min on an underwater ergometer. After
steadily sweating, immersion continued until metabolism increased two-fold due to shivering. Rectal
(Tre) BBT was not different between trials for neither NCG (1: 37.34±0.16°C; 2: 37.35±0.27°C) nor
HCG. At exercise termination, Tre forehead sweating cessation increased (P<0.05) in trial 2
irrespective of group (1: 37.55±0.39°C; 2: 37.90±0,46°C). Tre shivering onset did not increase
(P>0.05) in trial 2 (1: 36.91±0.50°C; 2: 37.07±0,45°C). The widths of the interthreshold zone
increased (P<0.05) in trial 2 (1: 0.64±0.22°C; 2: 0.82±0.37°C) due to the increased sweating threshold
only. HCG cooled quicker (1: -l.15±0,43°C; 2: -1.00±0.50°C) than NCG participants (1: -
0.58±0.22°C; 2: -0.52±O.29°C), and tympanic (Tty) sweat thresholds were significantly (P<0.05)
decreased (1: 34.76±0.54°C; 2: 35.39±0.61°C) versus NCG (l: 35.57±0.77°C; 2: 35.89±1.04°C).
Lastly, Tre and Tty thresholds were significantly different (P
Resumo:
Catherine (Lemon) Everingham was the widow of James Everingham, a private with the first Battalion of Colo Delancys Regt. of the Jersey Volunteers. He died in the American Revolutionary War in 1796, leaving his wife and two children settled on two hundred acres of land in the Township of Willoughby. No certificate had been awarded to James Everingham for this land. Catherine subsequently petitioned the government to grant her the land that she had settled on with her family.
Resumo:
The interaction between local and reflexive control of skin blood flow (SkBF) is unclear. This thesis isolated the roles of rectal (Tre) and local (Tloc) temperature on forearm SkBF regulation at normal and elevated body temperatures, and to investigate the interaction between local and reflexive SkBF control. While either normothermic (Tre ~37.0°C) or hyperthermic (∆Tre +1.1°C), SkBF was assessed on the dorsal aspect of each forearm in 10 participants while Tloc was manipulated in an A-B-A-B fashion between neutral (33.0°C) and hot (38.5°C). Finally, local heating to 44°C was performed to elicit maximal SkBF. Data are presented as a percentage of maximal cutaneous vascular conductance (CVC), calculated as laser-Doppler flux divided by mean arterial pressure. Tloc manipulations performed during normothermia had significantly greater effects on CVC than during hyperthermia. The decreased modification to SkBF from the Tloc changes during hyperthermia suggests that strong reflexive vasodilation attenuates local SkBF control mechanisms.