ABSTRACT
We present the case of a 40-year-old male with recent history of moderately differentiated invasive adenocarcinoma of the sigmoid in whom both respiratory and neurological disease developed simultaneously, mimicking diffuse metastatic disease. The broad differential diagnosis and pitfalls (both diagnostic and therapeutic) are described. Pulmonary sarcoidosis as well as neurosarcoidosis occur very rarely after solid cancers.
Subject(s)
Meningoencephalitis , Myelitis, Transverse , Sarcoidosis , Sigmoid Neoplasms , Adult , Humans , Magnetic Resonance Imaging , Male , Sarcoidosis/diagnosisABSTRACT
In order to reduce the number of multiple pregnancies following IVF, the Belgian government agreed to reimburse laboratory expenses for six IVF cycles up to the age of 42 years, in exchange for restriction of the number of embryos replaced. Data on assisted reproduction outcome before and after the introduction of this new legislation were analysed retrospectively in terms of implantation, pregnancy and multiple pregnancy rates. After the introduction of the new law, the percentage of single embryo transfer increased from 14 to 49%. Implantation rates were 25.9 and 23% respectively. There was no difference in the overall pregnancy rate before and after the introduction (36 versus 37%). Twin pregnancies, however, decreased from 19 to 3%. These findings indicate that elective single embryo transfer significantly decreases the twin pregnancy rate without a reduction in the overall pregnancy rate.
Subject(s)
Embryo Transfer , Fertilization in Vitro , Reproductive Techniques, Assisted/legislation & jurisprudence , Belgium , Embryo Implantation , Female , Humans , Pregnancy , Pregnancy Rate , Pregnancy, Multiple/statistics & numerical data , Retrospective Studies , Treatment Outcome , TwinsABSTRACT
Idiopathic granulomatous mastitis is a very rare benign breast disease, which mimics breast cancer both clinically and mammographically. Most cases have an unknown aetiology, however, we found an alpha-1-antitrypsin deficiency. A literature review is presented and the controversies in diagnosis and management are discussed.
Subject(s)
Breast Diseases/diagnosis , Granuloma/diagnosis , Mastitis/diagnosis , Adult , Breast Diseases/pathology , Breast Diseases/surgery , Breast Neoplasms , Diagnosis, Differential , Female , Granuloma/pathology , Granuloma/surgery , Humans , Magnetic Resonance Imaging , Mastitis/pathology , Mastitis/surgery , alpha 1-Antitrypsin Deficiency/complications , alpha 1-Antitrypsin Deficiency/diagnosisSubject(s)
Antimetabolites, Antineoplastic/adverse effects , Carcinoma, Non-Small-Cell Lung/drug therapy , Carcinoma/drug therapy , Cholestasis, Intrahepatic/chemically induced , Deoxycytidine/adverse effects , Liver Failure/chemically induced , Lung Neoplasms/drug therapy , Aged , Deoxycytidine/analogs & derivatives , Fatal Outcome , Humans , Male , Multiple Organ Failure/etiology , GemcitabineABSTRACT
OBJECTIVE: To define the clinical significance of tubal ostium membranes. DESIGN: Retrospective multivariate stepwise logistic regression analysis. SETTING: Algemene Kliniek Sint--Jan, Brussels, Belgium. PATIENTS: Three thousand forty-six hysteroscopies on 2979 patients, including 172 with infertility, over a 9-year period. MAIN OUTCOME MEASURES: Presence of tubal ostium membranes, age, infertility, endometrial thickness, and hormonal environment. RESULTS: Tubal ostial membranes were present in 74 (2.5%) patients: they were unilateral in 30 (42.1%) and bilateral in 44 (57.9%). Their presence was independent from hormonal state and from endometrial thickness. The incidence of ostial membranes was significantly higher (9.9%) in patients referred for infertility for unilateral (3.5%) as well as for bilateral presence (6.4%). Only the bilateral form was age dependent. CONCLUSIONS: Tubal ostium membranes may be one of the unknown limiting factors affecting female fertility and thus reducing the monthly fecundity rate. The present data suggest that bilateral and unilateral tubal ostium membranes may have a different clinical significance. The unilateral form is unrelated to age, hormonal state, or endometrial thickness and can be congenital. This form is most clearly related to infertility. The bilateral form is less related to infertility, is found in women of older age, and can be acquired. Further prospective analysis is needed to clarify the pathogenesis and pathophysiology of tubal ostium membranes. Tubal ostium membranes should routinely be looked for when performing a hysteroscopic examination in infertile women.
Subject(s)
Fallopian Tubes/pathology , Infertility, Female/pathology , Uterus/pathology , Endometrium/pathology , Female , Fertility , Humans , Hysteroscopy , Infertility, Female/physiopathology , Regression Analysis , Retrospective StudiesABSTRACT
OBJECTIVE: Our objective was to determine the presence of intrauterine lesions in patients with a cervical polyp. STUDY DESIGN: We performed a retrospective analysis to determine the influence of hormonal treatment and age on 165 patients with a cervical polyp and bleeding on admission. All 165 patients underwent a diagnostic hysteroscopy to rule out intrauterine lesions, including polyps, fibroids, hyperplasia, and adenocarcinoma. RESULTS: Endometrial polyps were found in up to 26.7% of patients who had a cervical polyp. In patients undergoing a combined pill treatment this incidence was much lower (8.3%). Menopausal patients had a 56.8% incidence of cervix-related endometrial polyps, and hormone replacement therapy did not significantly increase (45.7% vs 28.6%) the incidence of coexisting polyps. All cervical polyps present during tamoxifen treatment were associated with endometrial polyps. Abnormal vaginal bleeding was of no clinical significance in excluding concomitant endometrial polyps. CONCLUSIONS: All menopausal patients with a cervical polyp could benefit from a diagnostic hysteroscopy. Premenopausal patients receiving a combined pill treatment are the least likely to have coexistent endometrial polyps.