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Biomedical subjects

T L Angtuaco

Publications and source records attributed to T L Angtuaco.

At least 19 recordsLinked to original sources
PubMed2001

Differing attitudes toward virtual and conventional colonoscopy for colorectal cancer screening: surveys among primary care physicians and potential patients.

OBJECTIVES: To investigate attitudes among primary care physicians and potential patients concerning "virtual" and conventional colonoscopy for colorectal cancer screening. METHODS: We sent 1000 questionnaires to primary care physicians by electronic or postal mail and administered 400 to potential patients. Questionnaires contained progressively detailed information about the tests and asked for choices based on information presented. RESULTS: One hundred eight-eight primary care physicians and 323 potential patients were included. Results indicated the following: 76.6% of potential patients and 47.3% of physicians initially preferred virtual colonoscopy because of its noninvasive nature; 23.6% of potential patients and 52.9% of physicians valued the ability of conventional colonoscopy to visualize the mucosa directly; and 67.4% of potential patients and 51.6% of physicians preferred virtual colonoscopy because it does not require sedation. Considering all information, most potential patients preferred virtual to conventional colonoscopy (60.2% vs 25.7%), whereas more physicians preferred conventional to virtual colonoscopy (44.9% vs 30.3%). Additionally, 82.3% of potential patients would comply more with recommendations for colorectal cancer screening, and 61.7% of physicians would refer more patients for screening, if virtual colonoscopy was available. CONCLUSIONS: Potential patients preferred virtual to conventional colonoscopy, whereas physicians favored conventional colonoscopy. Physicians placed more importance on the ability of conventional colonoscopy to visualize the mucosa directly, the opportunity for therapy, and cost. Potential patients were more encouraged than physicians by the availability of virtual colonoscopy for improving participation in colorectal cancer screening.

Colonoscopy↗
PubMed2001

The utility of urgent colonoscopy in the evaluation of acute lower gastrointestinal tract bleeding: a 2-year experience from a single center.

OBJECTIVE: Urgent colonoscopy is often recommended to evaluate acute rectal bleeding. However, it may not identify a source because of blood in the lumen or inadequate preparation. Our aim was to determine the utility of urgent colonoscopy as the initial test for acute rectal bleeding. METHODS: This was a retrospective chart review of all patients discharged in 1997 and 1998 with an International Classification of Diseases, 9th Revision, code for hematochezia or rectal bleeding. RESULTS: We identified 514 charts but excluded 424 because of inaccurate coding. In the 90 with confirmed acute rectal bleeding, colonoscopy was the initial test in 39; age, sex, and race distributions were similar to those who did not have colonoscopy. A definite source of bleeding was seen at colonoscopy in only three patients, a probable source in 26, and no source in 10. Therapeutic intervention in four patients with a definite or probable source was successful in three. The commonest reasons for not performing urgent colonoscopy were bleeding from presumed hemorrhoids or bleeding that was clinically insignificant. Spontaneous resolution of bleeding and length of hospital stay were not affected by urgent colonoscopy. Five patients had surgery for unrelated reasons. In-hospital mortality was 2% and was unrelated to bleeding. CONCLUSION: Urgent colonoscopy as the initial investigation in acute lower GI tract bleeding probably does not alter the outcome in most cases. Identification of a definite bleeding source leading to successful therapeutic intervention is rare. Spontaneous resolution is frequent, length of hospital stay is similar, and clinical outcome is excellent regardless of whether or not urgent colonoscopy is performed.

Acute Disease↗
PubMed1996

Cortical visual impairment caused by twin pregnancy.

PURPOSE: To report a possible relationship between twin pregnancy and cortical visual impairment. METHODS: Three children who had been the products of twin pregnancies were identified as having cortical visual impairment. One child (Patient 2), a dizygotic twin, developed cortical visual impairment after a preterm birth. Two children (Patients 1 and 3), the products of monochorionic pregnancies, developed cortical visual impairment. All children were examined ophthalmologically and neurologically. RESULTS: An evaluation of the gestations of these children indicates that twin pregnancy per se was probably etiologic in the development of cortical visual impairment. In Patient 2, twin pregnancy probably caused preterm birth and resulting cortical visual impairment. In Patients 1 and 3, twin-to-twin transfusion syndrome was the cause of cortical visual impairment. In Patient 1, fetal demise precipitated an acute twin-to-twin transfusion syndrome. CONCLUSIONS: Children who show cortical visual impairment at or shortly after birth should be evaluated for the possibility of twin pregnancy. Twin pregnancy increases the risk of neurologic damage, including damage to the visual cortex, to optic radiations, or both.

Child, Preschool↗
PubMed1996

Gestational trophoblastic disease: a spectrum of radiologic diagnosis.

Gestational trophoblastic disease (GTD) encompasses a broad spectrum of conditions that includes hydatidiform mole, invasive mole, and choriocarcinoma. Although ultrasound (US) is the examination of choice for initial diagnosis, plain radiography, angiography, computed tomography (CT), and magnetic resonance (MR) imaging all play a role in determining the presence of GTD and the extent of its complications. US shows molar gestations as alternating cystic and solid tissue that fills the entire uterus. CT and MR imaging are useful in detecting myometrial invasion, parametrial extension, and metastasis. Because each imaging technique offers a unique perspective highlighting different aspects of GTD, it is important to understand the pathophysiology and natural history of the disease. Such knowledge in turn leads to a greater understanding of the spectrum of findings seen on various kinds of radiologic images and enables the radiologist to play an important role in directing patient work-up by recognizing the implications of various findings and guiding management decisions.

Female↗
PubMed1995

Prenatal detection of anterior abdominal wall defects with US.

The size and position of an anterior abdominal wall defect, its contents, and its association with other anomalies are features that can be diagnosed in utero with ultrasound and that allow a differential diagnosis to be made. The correct prenatal diagnosis is extremely important for patient management. The key feature for sonographically distinguishing these conditions is the position of the defect in relation to the umbilical cord insertion. Omphaloceles and pentalogy of Cantrell usually involve a midline defect at the umbilical cord insertion. Gastroschisis most frequently consists of a small, right-sided paraumbilical defect. Eccentric, large lateral defects are typically present in limb-body wall complex or amniotic band syndrome. Bladder and cloacal exstrophy involve the infraumbilical region. In addition, the size of the defect, the organs eviscerated, the presence of membranes or bands, and any associated abnormalities help determine the correct diagnosis. Increased knowledge of these uncommon fetal conditions should result in better detection, more accurate diagnosis, and improved management of anterior abdominal wall defects.

Abdominal Muscles↗
PubMed1994

Ultrasound evaluation of abdominal pregnancy.

The ultrasound diagnosis of abdominal pregnancy continues to be difficult in spite of recent advances in ultrasound technology. The principal impediment is a low suspicion for the diagnosis because of its relatively asymptomatic nature and the lack of specificity of symptoms when present. In the early days of sonography when static B-mode scanning was used, a "gestalt" diagnosis was suggested, based on one's ability to have an overall perspective of the intrauterine contents. With conversion to exclusive real time imaging and the inherent limitation of the field of view, this "gestalt perception" is no longer possible. It is therefore necessary to reassess our criteria based on this change and determine those that remain reliable for diagnosis.

Adult↗
PubMed1992

MR imaging in high-risk obstetric patients: a valuable complement to US.

The accuracy of prenatal diagnosis has become increasingly critical in the field of high-risk obstetrics. Although ultrasound (US) provides adequate information in most cases and continues to be the initial prenatal examination of choice, there are instances in which the results of the US study may be equivocal. The role of magnetic resonance (MR) imaging was explored in 27 selected patients with various indications to determine its effectiveness as a complement to US. MR imaging was most helpful in the diagnosis of extrauterine gestation, evaluation of placental position, determination of extent or nature of masses associated with pregnancy, and differentiation between diaphragmatic hernia and a thoracic mass. Although MR imaging did not add information that affected the accuracy of the diagnosis of oligohydramnios, in all other cases it provided an extra dimension in diagnosis by showing clearer anatomic relationships in the pelvis. It has proved to be a valuable complement to an equivocal US study.

Diagnosis, Differential↗
PubMed1989

Technetium-99m hysterosalpingography in infertility: an accurate alternative to contrast hysterosalpingography.

Thirteen infertile women who had undergone tubal surgery within the previous year for the correction of tubal obstruction, were studied with both conventional and radionuclide hysterosalpingography. The studies were performed on the same day, were interpreted independently, and the results were then compared. Three cases were excluded from analysis because of the technical inadequacy of one of the studies. Assuming the findings of the conventional studies to represent "truth," the sensitivity, specificity and accuracy of the radionuclide studies were 100%, 60% and 80% respectively.

Fallopian Tubes↗
PubMed1988

Fetal teratomas: antenatal diagnosis and clinical management.

Four cases of fetal teratomas arising from the sacrococcygeal and oropharyngeal areas are reported. The diagnosis, method of management, and grade of tumor are compared with previous experience in the literature. Pharyngeal lesions carry a worse prognosis for survival compared to the more common sacrococcygeal type (SCT). Atraumatic delivery and early repair of the lesion contribute to prolonged survival and lack of complications in cases of sacrococcygeal teratomas.

Adult↗
PubMed1987

Uptake of indium-111-labeled leukocytes by brain metastasis.

Uptake of indium-labeled leukocytes was seen in two cases of histologically proven brain metastasis. In one, this led to misdiagnosis of the lesion as an abscess. On histological evaluation, a large number of white blood cells or macrophages was seen at the neoplastic sites. Reasons for leukocyte accumulation around metastatic brain neoplasms are discussed. In contrast to the current reports that indium-labeled leukocyte scans can differentiate intracranial infection from tumor, these cases demonstrate their lack of specificity in the detection of brain abscess.

Aged↗