Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 11.170
Filtrar
3.
J Appl Oral Sci ; 29: e20200978, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33886944

RESUMEN

Mucopolysaccharidosis (MPS) is a group of rare and inherited metabolic disorders caused by the accumulation of macromolecule glycosaminoglycans inside lysosomes. Affected individuals may have dental and craniofacial tissue alterations, facilitating the development of several oral diseases. OBJECTIVES: To assess, with panoramic radiographic images, the frequency of dental and maxillomandibular incidental findings among MPS individuals and compare them with non-MPS individuals. METHODOLOGY: A cross-sectional study evaluating a sample of 14 MPS individuals and 28 non-MPS individuals aged from 5 to 26 years was carried out. They were matched for sex and age on a 2:1 proportion. Panoramic radiographs were assessed for the presence/absence of the following dental and maxillomandibular alterations: dental anomalies of number (hypodontia/dental agenesis, supernumerary teeth); anomalies of form (microdontia, macrodontia, conoid teeth, taurodontism, and root dilaceration); anomalies of position (impacted tooth, inverted tooth, tooth migration, partially bony teeth, complete bony teeth); periapical alterations (furcation lesion, circumscribed bone rarefaction); other alterations (radiolucent bone lesions, radiopaque bone lesions, radiopacity in the maxillary sinus, condylar hypoplasia). Differences between groups were tested by the Fisher's exact test and chi-square test (p<0.05). RESULTS: For intrarater agreement, Kappa values were 0.76 to 0.85. The presence of supernumerary teeth (p=0.003); conoid teeth (p=0.009); taurodontism (p<0.001); impacted teeth (p<0.001); partial bony teeth (p=0.040); complete bony teeth (p=0.013); and root dilaceration (p=0.047) were statistically more frequent in MPS individuals compared to non-MPS individuals. Bone rarefaction/furcation lesions (p=0.032), condylar hypoplasia (p<0.001), radiolucent bone lesions (p=0.001), and dentigerous cysts (p=0.002) were also more frequent in MPS individuals. CONCLUSION: The presence of specific oral manifestations is more common in MPS individuals than non-MPS individuals.


Asunto(s)
Mucopolisacaridosis , Anomalías Dentarias , Diente Supernumerario , Adolescente , Adulto , Niño , Preescolar , Estudios Transversales , Humanos , Hallazgos Incidentales , Mucopolisacaridosis/diagnóstico por imagen , Radiografía Panorámica , Anomalías Dentarias/diagnóstico por imagen , Adulto Joven
5.
Bratisl Lek Listy ; 122(5): 341-346, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33848185

RESUMEN

AIM: To assess how laparoscopy has altered the presentation of patients with gallbladder cancer and determine whether radical resection in patients with gallbladder cancer is beneficial. METHOD: 47 patients underwent surgery because of suspected gallbladder cancer. Cancer was found incidentally in 29 patients (61.7 %) during routine laparoscopic cholecystectomy using frozen biopsy. Gallbladder cancer had been diagnosed preoperatively in the other 18 patients (38.3 %). RESULTS: Patients in whom carcinoma was found incidentally at laparoscopic cholecystectomy had a significant increase in survival when compared with those who were admitted electively with a known diagnosis. All patients who presented with a known diagnosis had stage II or higher, and 38.3 % of these were in stage IV. However, 58.6 % of those patients who were found incidentally were in stage I or II. The overall 2-year survival for all patients was 45 %; those discovered incidentally at laparoscopic cholecystectomy (Tis-T2) had a 2-year survival of 87 %. CONCLUSION: Laparoscopic cholecystectomy resulted in an earlier discovery of gallbladder cancer in some patients, resulting in increased probability of survival. Adjunctive radical surgical resection, either at the time of cholecystectomy or subsequently, increases survival significantly in early stage disease (Tab.2, Fig. 2, Ref. 24). Text in PDF www.elis.sk Keywords: gallbladder carcinoma, laparoscopic approach.


Asunto(s)
Colecistectomía Laparoscópica , Neoplasias de la Vesícula Biliar , Laparoscopía , Colecistectomía , Colecistectomía Laparoscópica/efectos adversos , Neoplasias de la Vesícula Biliar/patología , Neoplasias de la Vesícula Biliar/cirugía , Humanos , Hallazgos Incidentales , Estadificación de Neoplasias , Estudios Retrospectivos
7.
BMC Cancer ; 21(1): 445, 2021 Apr 22.
Artículo en Inglés | MEDLINE | ID: mdl-33888088

RESUMEN

BACKGROUND: Whether patients with non-small cell lung cancer (NSCLC) with unexpected pleural dissemination (UPD) could get survival benefit from tumor resection remained controversial. METHODS: Totally, 169 patients with NSCLC with UPD were included between 2012 and 2016. Patients were divided into the tumor resection and open-close group. Progression-free survival (PFS) and overall survival (OS) were compared with a log-rank test. The multivariable Cox analysis was applied to identify prognostic factors. RESULTS: Sixty-five patients received open-close surgery and 104 patients underwent main tumor and visible pleural nodule resection. Tumor resection significantly prolonged OS (hazard ratio [HR]: 0.408, P < 0.001), local PFS (HR: 0.283, P < 0.001), regional PFS (HR: 0.506, P = 0.005), and distant metastasis (HR: 0.595, P = 0.032). Multivariable Cox analysis confirmed that surgical method was an independent prognostic factor for OS, local PFS and regional PFS, except distant metastasis. Subgroup analyses indicated that tumor resection could not improve OS in the patients who received targeted therapy (HR: 0.649, P = 0.382), however, tumor resection was beneficial for the patients who received adjuvant chemotherapy alone (HR: 0.322, P < 0.001). In the tumor resection group, lobectomy (HR: 0.960, P = 0.917) and systematic lymphadenectomy (HR: 1.512, P = 0.259) did not show survival benefit for OS. CONCLUSIONS: Main tumor and visible pleural nodule resection could improve prognosis in patients with UPD who could not receive adjuvant targeted therapy. Sublobar resection without systematic lymphadenectomy may be the optimal procedure.


Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas/patología , Carcinoma de Pulmón de Células no Pequeñas/cirugía , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/cirugía , Neoplasias Pleurales/secundario , Neoplasias Pleurales/cirugía , Anciano , Carcinoma de Pulmón de Células no Pequeñas/etiología , Carcinoma de Pulmón de Células no Pequeñas/mortalidad , Toma de Decisiones Clínicas , Terapia Combinada , Comorbilidad , Manejo de la Enfermedad , Femenino , Humanos , Hallazgos Incidentales , Periodo Intraoperatorio , Estimación de Kaplan-Meier , Neoplasias Pulmonares/etiología , Neoplasias Pulmonares/mortalidad , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Neoplasias Pleurales/mortalidad , Pronóstico , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Resultado del Tratamiento
8.
Ann R Coll Surg Engl ; 103(5): e156-e158, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33682429

RESUMEN

A variation in the usual course of great vessels during neck dissection can predispose them to inadvertent iatrogenic injury, which can lead to massive bleeding. We present a case of a male patient with oral squamous cell carcinoma who underwent inferior maxillectomy and supra-omohyoid neck dissection. Lateral coiling of the extracranial internal carotid artery was seen through fenestration of the internal jugular vein. Anomalies of great vessels in the neck are rare. Variation in the course of any of these vessels can prove to be catastrophic if control is not achieved. Careful study of radiographic imaging with special consideration given to the course of great vessels in the neck should be undertaken prior to neck surgeries.


Asunto(s)
Arterias Carótidas/patología , Venas Yugulares/patología , Disección del Cuello , Malformaciones Vasculares , Neoplasias de Cabeza y Cuello/cirugía , Humanos , Hallazgos Incidentales , Masculino , Persona de Mediana Edad , Cuello/irrigación sanguínea , Cuello/cirugía , Carcinoma de Células Escamosas de Cabeza y Cuello/cirugía , Malformaciones Vasculares/diagnóstico , Malformaciones Vasculares/patología
9.
J Med Case Rep ; 15(1): 108, 2021 Mar 03.
Artículo en Inglés | MEDLINE | ID: mdl-33653380

RESUMEN

BACKGROUND: Hypothyroidism is diagnosed on the basis of laboratory tests because of the lack of specificity of the typical clinical manifestations. There is conflicting evidence on screening for hypothyroidism. CASE PRESENTATION: We report a case of an apparently healthy 19-year-old Kuwaiti woman referred to our clinic with an incidental finding of extremely high thyroid-stimulating hormone (TSH), tested at the patient's insistence as she had a strong family history of hypothyroidism. Despite no stated complaints, the patient presented typical symptoms and signs of hypothyroidism on evaluation. Thyroid function testing was repeated by using different assays, with similar results; ultrasound imaging of the thyroid showed a typical picture of thyroiditis. Treatment with levothyroxine alleviated symptoms and the patient later became biochemically euthyroid on treatment. CONCLUSION: There is controversy regarding screening asymptomatic individuals for hypothyroidism; therefore, it is important to maintain a high index of suspicion when presented with mild signs and symptoms of hypothyroidism especially with certain ethnic groups, as they may be free of the classical symptoms of disease.


Asunto(s)
Hipotiroidismo/diagnóstico , Tiroiditis Autoinmune/diagnóstico , Alopecia/fisiopatología , Apetito , Autoanticuerpos/inmunología , Estreñimiento/fisiopatología , Depresión/fisiopatología , Fatiga/fisiopatología , Femenino , Humanos , Hipotiroidismo/sangre , Hipotiroidismo/tratamiento farmacológico , Hipotiroidismo/fisiopatología , Hallazgos Incidentales , Yoduro Peroxidasa/inmunología , Menorragia/fisiopatología , Índice de Severidad de la Enfermedad , Glándula Tiroides/diagnóstico por imagen , Tiroiditis Autoinmune/sangre , Tiroiditis Autoinmune/inmunología , Tiroiditis Autoinmune/fisiopatología , Tirotropina/sangre , Tiroxina/sangre , Tiroxina/uso terapéutico , Ultrasonografía , Aumento de Peso , Adulto Joven
10.
Radiol Oncol ; 55(2): 121-129, 2021 03 05.
Artículo en Inglés | MEDLINE | ID: mdl-33675200

RESUMEN

BACKGROUND: COVID-19 infection is particularly aggressive in frail patients, as cancer patients. Therefore, the more suitable management of the oncological patient requires a multidisciplinary assessment, to identify which patients should be treated, as inpatients or outpatients, and which treatments can be procrastinated. CONCLUSIONS: The role of radiologist is crucial, and, all cancer patients who need an imaging evaluation will need to be studied, using the most appropriate imaging tools related to the clinical question and paying a special attention to preserve public health. Guidelines are necessary in the correct organization of a radiology unit to manage patients with suspected or confirmed COVID-19 infection, and whenever possible, a satellite radiography center with dedicated equipment should be used to decrease the transmission risk.


Asunto(s)
/complicaciones , Protocolos Clínicos , Neoplasias/complicaciones , Neoplasias/diagnóstico , Servicio de Radiología en Hospital/organización & administración , /terapia , Infección Hospitalaria/prevención & control , Humanos , Hallazgos Incidentales , Neoplasias/terapia , Grupo de Atención al Paciente/organización & administración , Aislamiento de Pacientes , Equipo de Protección Personal , Triaje
11.
Medicine (Baltimore) ; 100(11): e24241, 2021 Mar 19.
Artículo en Inglés | MEDLINE | ID: mdl-33725929

RESUMEN

RATIONALE: Intraoperative neurophysiological monitoring (IONM) is widely used in spinal surgeries to prevent iatrogenic spinal cord injury (SCI). Most surgeons focus on avoiding neurological compromise intraoperatively, while ignoring the possibility of nerve damage preoperatively, such as neck positioning. Thus, this study aims to report a case with transient neurological deterioration due to improper neck position detected by IONM during cervical surgery. PATIENT CONCERNS: A 63-year-old male patient had been suffering from hypoesthesia of the upper and lower extremities for three years. DIAGNOSES: Severe cervical stenosis (C5-C7) and cervical ossification of a posterior longitudinal ligament. INTERVENTIONS: The cervical stenosis patient underwent an anterior cervical corpectomy decompression and fusion (ACDF) surgery with the assistance of IONM. When the lesion segment was exposed, the SSEP and MEP suddenly elicited difficulty indicating that the patient may have developed SCI. All the technical causes of IONM events were eliminated, and the surgeon suspended operation immediately and suspected that the IONM alerts were caused by cervical SCI due to the improper position of the neck. Subsequently, the surgeon repositioned the neck of the patient by using a thinner shoulders pad. OUTCOMES: At the end of the operation, the MEP and SSEP signals gradually returned to 75% and 80% of the baseline, respectively. Postoperatively, the muscle strength of bilateral biceps decreased from grade IV to grade III. Besides, the sensory disturbance of both upper extremities aggravated. However, the muscle power and hypoesthesia were significantly improved after three months of neurotrophic therapy and rehabilitation training, and no complications of nerve injury were found at the last follow-up visit. LESSONS: IONM, consisting of SSEP and MEP, should be applied throughout ACDF surgery from the neck positioning to suture incisions. Besides, in the ward 1to 2 days before operation, it is necessary for conscious patients with severe cervical stenosis to simulate the intraoperative neck position. If the conscious patients present signs of nerve damage, they can adjust the neck position immediately until the neurological symptoms relieve. Therefore, intraoperatively, the unconscious patient can be placed in a neck position that was confirmed preoperatively to prevent SCI.


Asunto(s)
Monitorización Neurofisiológica Intraoperatoria , Traumatismos del Cuello/diagnóstico , Cuello/inervación , Posicionamiento del Paciente/efectos adversos , Traumatismos de la Médula Espinal/diagnóstico , Vértebras Cervicales/cirugía , Humanos , Hallazgos Incidentales , Masculino , Persona de Mediana Edad , Cuello/cirugía , Traumatismos del Cuello/etiología , Osificación del Ligamento Longitudinal Posterior/cirugía , Traumatismos de la Médula Espinal/etiología , Estenosis Espinal/cirugía
12.
Ann R Coll Surg Engl ; 103(4): e116-e119, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33682446

RESUMEN

We report a 48-year-old fit and healthy woman who was incidentally diagnosed to have adenocarcinoma of gallbladder after laparoscopic cholecystectomy. Subsequent imaging showed no evidence of regional or distant spread. She was scheduled for elective laparotomy and resection of gallbladder bed, but during laparotomy frozen section analysis of an incidentally discovered peritoneal deposit confirmed metastasis, so the procedure was abandoned. Thereafter, she received cisplatin and gemcitabine chemotherapy. However, surveillance computed tomography incidentally noted a urinary bladder mass which had not been present before. Transurethral resection of the bladder lesion revealed moderately differentiated adenocarcinoma of urinary bladder. The appearance and immunoprofile of the lesion confirmed metastasis from the primary gallbladder cancer, which has not been documented in the literature to the best of our knowledge. Her disease progressed and she is being challenged with gemcitabine and carboplatin as second-line palliative chemotherapy. She is still alive two years after the initial diagnosis.


Asunto(s)
Adenocarcinoma/secundario , Neoplasias de la Vesícula Biliar/patología , Neoplasias de la Vejiga Urinaria/secundario , Adenocarcinoma/diagnóstico , Femenino , Neoplasias de la Vesícula Biliar/diagnóstico , Humanos , Hallazgos Incidentales , Persona de Mediana Edad , Neoplasias de la Vejiga Urinaria/diagnóstico
15.
Medicine (Baltimore) ; 100(9): e24760, 2021 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-33655939

RESUMEN

ABSTRACT: Radiation overexposure is common in chest X-ray (CXRs) of pediatric patients. However, overexposure may reveal incidental findings that can help to guide patient management or warrant quality improvement.To assess the prevalence of overexposure in CXRs in pediatric intensive care unit (PICU); and identify the incidental findings within overexposed areas, we conducted a retrospective cohort study of children who were admitted to PICU. Two independent evaluators reviewed patient's charts and digital CXRs according to the American College of Radiology standards; to evaluate overexposure of the anatomical parameters and incidental findings.A total of 400 CXRs of 85 patients were reviewed. The mean number of CXRs per patient was 4.7. Almost all (99.75%) CXRs met the criteria for overexposure, with the most common being upper abdomen (99.2%), upper limbs (97%) and neck (95.7%). In addition, 43% of these X-rays were cropped by the radiology technician to appear within the requested perimeter. There was a significant association between field cropping and overexposure (t-test: t = 9.8, P < .001). Incidental findings were seen in 41.5% of the radiographs; with the most common being gaseous abdominal distension (73.1%), low-positioned nasogastric tube (24.6%), and constipation (10.3%).Anatomical overexposure in routine CXRs remains high and raises a concern in PICU practice. Appropriate collimation of the X-ray beam, rather than electronically cropping the image, is highly recommended to minimize hiding incidental findings in the cropped-out areas. Redefining the anatomic boundaries of CXR in critically ill infants and children may need further studies and consideration. Quality improvement initiatives to minimize radiation overexposure in PICU are recommended, especially in younger children and those with more severe illness upon PICU admission.


Asunto(s)
Unidades de Cuidado Intensivo Pediátrico/estadística & datos numéricos , Errores Médicos/estadística & datos numéricos , Exposición a la Radiación/análisis , Traumatismos por Radiación/epidemiología , Radiografía Torácica/efectos adversos , Adolescente , Niño , Preescolar , Femenino , Humanos , Hallazgos Incidentales , Lactante , Recién Nacido , Masculino , Prevalencia , Mejoramiento de la Calidad , Estudios Retrospectivos , Tórax/diagnóstico por imagen
16.
Medicine (Baltimore) ; 100(10): e24023, 2021 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-33725814

RESUMEN

RATIONALE: Fibroadenoma (FA) is a common type of benign breast tumors but ductal carcinoma in situ (DCIS) rarely arises within this tumor type. PATIENT CONCERNS: This case report presents a non-symptomatic 61-year-old woman with FA that was coincidentally found during a breast cancer screening program performed 5 years ago by her city of residence. She had subsequently been followed-up with mammography and breast ultrasound (US). US showed a slightly enlarged tumor and dynamic magnetic resonance imaging (MRI) indicated malignancy within the FA. DIAGNOSIS: The pathological examination revealed low-grade DCIS within the FA. INTERVENTIONS: The patient underwent a core needle biopsy followed by breast-conserving therapy with sentinel lymph node biopsy and then postoperative radiation therapy. OUTCOMES: Currently, she has been followed-up for 2 years without no signs of recurrence. LESSONS: Careful observation with US followed by dynamic MRI is essential in the early diagnosis of DCIS originating in a FA.


Asunto(s)
Neoplasias de la Mama/diagnóstico , Carcinoma Intraductal no Infiltrante/diagnóstico , Fibroadenoma/diagnóstico , Neoplasias Primarias Secundarias/diagnóstico , Enfermedades Asintomáticas/terapia , Biopsia con Aguja , Mama/diagnóstico por imagen , Mama/patología , Mama/cirugía , Neoplasias de la Mama/patología , Neoplasias de la Mama/terapia , Carcinoma Intraductal no Infiltrante/patología , Carcinoma Intraductal no Infiltrante/terapia , Femenino , Fibroadenoma/patología , Fibroadenoma/terapia , Estudios de Seguimiento , Humanos , Hallazgos Incidentales , Mamografía , Mastectomía Segmentaria , Persona de Mediana Edad , Neoplasias Primarias Secundarias/patología , Neoplasias Primarias Secundarias/terapia , Radioterapia Ayuvante , Tomografía Computarizada por Rayos X , Resultado del Tratamiento
17.
Saudi Med J ; 42(3): 332-337, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33632913

RESUMEN

Pancreatic neuroendocrine tumors are rare with an incident rate of 5 cases per million individuals. Tuberous sclerosis complex is an autosomal dominant disease. This disease involves multisystem and occurs in one out of every 6,000-10,000 individuals. In this study, we describe a 47-year-old male known tuberous sclerosis patient with an insulinoma. The tumor was incidentally detected in follow-up imaging for a previous ampulla of Vater tubular adenoma. However, the patient reported symptoms of hypoglycemia. The insulinoma was enucleated successfully. Histopathology revealed a well-differentiated, grade one neuroendocrine tumor measuring around 2 cm in diameter. Seven cases were reported in the literature of tuberous sclerosis-associated insulinoma. The 7 reported cases had different hypoglycemia related symptoms. The reported tumors varied in size and location on the pancreas. This paper details the eighth case worldwide where an insulinoma occurred in a tuberous sclerosis patient.


Asunto(s)
Insulinoma/diagnóstico , Insulinoma/cirugía , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/cirugía , Esclerosis Tuberosa/complicaciones , Ampolla Hepatopancreática , Humanos , Hipoglucemia/etiología , Hallazgos Incidentales , Insulinoma/etiología , Laparotomía/métodos , Masculino , Persona de Mediana Edad , Pancreatectomía/métodos , Neoplasias Pancreáticas/etiología , Cirugía Asistida por Computador
19.
J Prim Care Community Health ; 12: 2150132720982752, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33583244

RESUMEN

CASE REPORT OF COVID 19-Recurrence We describe as case series of 7 patients who presented with a recurrence of COVID 19 by PCR test an average of 94.9 days after their initial symptomatic presentation of illness. Patients had tested negative by PCR or had evidence of antibodies in between the 2 episodes. The majority of patients were asymptomatic on the second presentation and were found incidentally on prescreen for procedures, surgery. The subsequent positive COVID-19 PCR tests resulted in cancellations of clinic, procedures, surgery, and impacted patients' home and employment status. Further studies are needed to understand the mechanisms and ultimate outcomes of these recurrences.


Asunto(s)
Recurrencia , Adulto , Anciano , Femenino , Humanos , Incidencia , Hallazgos Incidentales , Masculino , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...