The 5% 5‐fluorouracil (5‐FU) cream, considered the gold standard topical treatment, and peeling using 70% glycolic acid (GA) followed by 5% 5‐FU are methods for the treatment of actinic keratoses (AKs). However, the comparison of these two treatments had not yet been described and therefore was the objective of this study. A randomized clinical trial, intrapatient study in which 17 patients received a type of treatment in the right and left upper limb with 5% 5‐FU cream (twice daily) or a peeling application of 70% GA (every 15 days) followed by 5% 5‐FU cream. There was a significant reduction of 75% and 85.71% in the mean number of AK lesions and of 74.5% and 85.71% in the size of lesions on the upper limbs of patients treated with peeling and 5% 5‐FU cream (P‐value ≤.001), respectively. Neither treatment was superior to the other since there was no significant difference (P‐value ≥.05) between the treatments, both at the post‐intervention period as well as when comparing the difference between the pre and post‐intervention periods. The peeling with 70% GA followed by 5% 5‐FU as well as 5% 5‐FU cream are effective methods for the treatment of AKs on upper limbs.
Objective: To evaluate the diagnostic accuracy of MRI-HSG with semiquantitative dynamic contrast‐enhanced perfusion, against the virtual multi slice computed tomography hysterosalpingogram (VHSG) as a reference standard. Methods and Materials: In this prospective study, 26 women (age >18 years) searching for infertility causes and with VHSG physician request. Thereafter, the assessment performance of both techniques was determined by two reader analyses. k statistics were used for the assessment of tubal patency. Receiver operating characteristic (ROC) analysis was used to compare the capability for tubal patency assessment between both exams on a per-patient and per-tube basis. The McNemar test was used to compare the diagnostic accuracy measures. Results: Tubal patency, uterine morphological, ovarian, and extra uterine abnormalities were evaluated through both exams in all 26 women. There was no significant difference between diagnostic performance measurements between the methods. The ROC curve of VHSG was 0.852 for both per-patient and per-tube analyses, and one and 0.938 for MRI-HSG. Sensitivity and specificity for per-patient and per-tube for VHSG were 95.2 and 97.7, 80 and 87.5%, and for MRI-HSG 100% for both analyses and 100 and 87.5%, respectively. Conclusion: This study demonstrates the feasibility of diagnosing tubal patency through MRI, using a semiquantitative dynamic contrast‐enhanced perfusion sequence, and the satisfactory diagnosing of the uterine morphology, ovarian abnormalities, and ovarian and deep endometriosis. Advances in knowledge: Multiparametric MRI with a perfusion real-time sequence as a hysterosalpingography method can be used in the evaluation not only for uterine and ovarian abnormilities but also tubal patency
Objectives: This article demonstrates the virtual hysterosalpingography using computed tomography method used to perform the evaluation of tubal patency and uterine morphological alterations, which was carried out for the first time in Brazil, and our experience in this area. The techniques advantages, benefits and disadvantages compared to the traditional method are illustrated in this manuscript. Methods: 185 patients were submitted to virtual hysterosalpingography using computed tomography by a physicians indication and the results of these tests were compiled and described. Results: The advantages of virtual hysterosalpingography over X-ray hysterosalpingography are: (a) the variety of technological features offered by multi-detector tomography, (b) the injection pump and the workstations with software that allow post-processing of high-fidelity clinical images, and (c) not pinching the uterine cervix. Conclusions: Virtual hysterosalpingography is a viable alternative for the evaluation of tubal and uterine infertility factors.
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