RESUMO
Sarcoidosis is characterized by the presence of noncaseating granulomatous inflammation in the affected organs. Neurosarcoidosis denotes the involvement of the nervous system and can be either isolated or coexisting with extraneural systemic inflammation. The diagnosis of isolated neurosarcoidosis may be challenging due to unspecific symptoms and similar appearances with other disease processes. This report presents an uncommon case of intracranial sarcoidosis mimicking multiple meningiomas. Familiarity with the spectrum of magnetic resonance imaging findings in neurosarcoidosis is crucial to prevent interpretive errors which may in turn lead to an inappropriate diagnosis and treatment.
RESUMO
BACKGROUND: Evidence-based practice guidelines on back pain give recommendations on appropriate care in order to improve patient outcomes. One strategy used to implement practice guidelines is continuous medical education (CME). MATERIAL AND METHODS: Junior doctors working in a primary care emergency reception attended a CME programme with a lecture on back pain, a booklet on evidence-based back pain care and one day traineeship with a specialist working at a back pain clinic. Three to six months later the participants answered a questionnaire evaluating the programme. RESULTS: Ten out of the eleven participants answered the questionnaire. They felt that the CME programme had affected their professional practice; one in two thought that their practice still deviated from evidence-based recommendations, mostly because patients wanted faster interventions than the recommendations call for. INTERPRETATION: Initiatives to implement evidence-based back pain care should focus on the important deviations from recommended care and specifically seek to affect barriers that maintain such practice.
