Background: Colonoscopy is the reference standard for the detection of colorectal cancer but it is an invasive technique and has the risk of bowel perforation and bleeding. Unlike colonoscopy, sedation is not required in computed tomography colonography and requires additional reassurance endoscopy. The objectives of the study were to compare the diagnostic performance of computed tomography colonography against colonoscopy for a diagnosis of colorectal cancer. Methods: Data regarding any polyp ≥10 mm diameter (ø) and < 10 mm ø but suspicious polyps of computed tomography colonography (n = 318), colonoscopy (n = 318), and surgical pathology (n = 77) for symptomatic colorectal cancer patients were collected and analyzed. Lesion ulceration, extramural invasion, and/ or lesion shouldering was considered as a suspicious polyp. Beneficial scores for decision making of curative surgeries were evaluated for each modality. The cost of diagnosis of colorectal cancer was also evaluated. Results: Either of diagnosis showed polyps ≥10 mm ø in 27 patients and polyps of 50 patients were < 10 mm ø but suspicious. Therefore, a total of 77 patients were subjected to surgery. With respect to surgical pathology, sensitivities for computed tomographic colonography and colonoscopy were 0.961 and 0.831. For detection of ≥10 mm ø polyp, benefit score for computed tomographic colonography and colonoscopy were 0-0.906 diagnostic confidence and 0.035-0.5 diagnostic confidence. For polyps, ≥ 10 mm ø but not too many large polyps, colonoscopy had the risk of underdiagnosis. For < 10 mm ø but suspicious polyps, < 0.6 mm ø and < 2.2 mm polyps could not be detected by computed tomographic colonography and colonoscopy, respectively. The computed tomographic colonography had less cost than colonoscopy (1345 ± 135 ¥/ patient vs. 1715 ± 241 ¥/ patient, p < 0.0001) for diagnosis of colorectal cancer. Conclusion: Computed tomographic colonography would be a non-inferior alternative than colonoscopy for a diagnosis of colorectal cancer. Level of evidence: III.
Purpose Previous studies have showed that age,sex and comorbidities might be associated with severity of patients infected with COVID-19 ,which endangers public health worldwide rapidly.The characteristics and length of negative conversion of Non-severe COVID-19 patients with or without hypertension is limited.This study aims to assess whether non-severe COVID-19 patients with hypertension undergone more longer period of negative conversion .Methods This single-center, retrospective study was performed in Xiantao first People’s Hospital Affiliated to Yangtze University(xiantao, hubei,China) by using medical records.Non-severe COVID-19 patients with a history of hypertension From January 23 to February15 were enrolled as group A. A Control group(group B) was matched (1:1) according to age,sex and the admission date.Data on clinical records, laboratory results, and radiological tests was collected. we conducted all analyses with SPSS software(22.0).Results We enrolled 24 and 24 Non-severe COVID-19 patients with and without hypertension, respectively. The most common symptoms were fever and cough in both groups.The frequency of fatigue is more in patients with hypertension.The levels of AST,ALT and CRP were higher in group A.The mean periods of negative conversion for COVID-19 virus were 17 days(SD:5.5) and 15 days(SD:3.6)for patients with and without hypertension(P=0.021).The mean hospitalization periods were 16.8 days (SD:5.6) and 13.7 days (SD:3.8) , respectively (p=0.083) .Conclusion Non-severe COVID-19 patients with hypertension undergone a longer negative conversion for COVID-19 virus and spent more time on clearing COVID-19 virus.
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