RESUMO
Pain is a public health problem affecting more than half of cancer patients. Despite the success of the protocols currently used, pain cannot still be reduced satisfactorily in the large majority of patients. In order to improve pain management, all healthcare professionals involved with pain should have sufficient knowledge on pain assessment and treatment, and should inform patients to prevent patient-related barriers. In this compilation, the prevalence values and the treatment methods of cancer pain, and the barriers to pain management have been assessed.
Assuntos
Neoplasias/complicações , Manejo da Dor/métodos , Dor Intratável/tratamento farmacológico , Dor Intratável/epidemiologia , Analgésicos Opioides/uso terapêutico , Antidepressivos/uso terapêutico , Quimioterapia Combinada , Feminino , Humanos , Masculino , Neoplasias/diagnóstico , Medição da Dor , Dor Intratável/etiologia , Guias de Prática Clínica como Assunto , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Índice de Gravidade de Doença , Resultado do Tratamento , Organização Mundial da SaúdeRESUMO
OBJECTIVE: The purpose of this study is to compare the role of magnetic resonance imaging (MRI) with transthoracic echocardiography (TTE) for characterization of cardiac masses. METHODS: Twenty-three patients were examined with a 1.5T MRI Scanner and TTE for the evaluation of suspected intracardiac masses. MRI examinations were performed with a protocol of steady cine imaging, HASTE and 3D IR-FLASH sequence after administration of gadolinium chelate. All patients were examined with MRI within a period of 1-2 weeks after TTE. RESULTS: According to the results of MRI, 15 patients underwent cardiac surgery. All of the operated patients were proven to have cardiac tumors with no false positive diagnosis on MRI. In 3 of 8 unoperated patients who were diagnosed to have cardiac tumors on TTE, cardiac thrombi were identified on MRI. Two patients with Eustachian valve in the right atrium on MRI were misinterpreted as having cardiac masses on TTE. In one patient with known renal cancer, metastases were diagnosed within the myocardium on MRI. TTE demonstrated a mass in the left atrium in one patient with a history of myxoma operation, whereas MRI was able to show the paracardiac extension of the mass into pulmonary veins and lung metastases, which are indicators of malignant transformation. In one patient, a mediastinal mass compressing the left atrium on MRI was misinterpreted as an intracavitary lesion with TTE. CONCLUSION: Contrast enhanced MRI is a noninvasive method superior to TTE in diagnosis, differentiation, and detection of extension of cardiac masses.
