RESUMO
OBJECTIVE: To investigate the effects of pregabalin combined with tramadol/paracetamol on acute pain in patients with CT-guided puncture localization of pulmonary nodules. MATERIALS AND METHODS: In this randomized, placebo-controlled and single-center study, 120 patients were allocated randomly to four groups: the control group (Group P), the pregabalin-placebo group (Group BP), the tramadol/paracetamol-placebo group (Group AP), and the pregabalin-tramadol/paracetamol group (Group AB). The primary outcome was the NRS (Numerical Rating Scale) score. Other outcomes included systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), pulse oxygen saturation (SpO2), the incidence of moderate to severe pain, the analgesia recovery ratio, the incidence of adverse drug reactions and patients' satisfaction. RESULTS: No significant interaction was detected between the interventions (P = 0.752). The NRS score of the Taking pregabalin group and the Taking tramadol/paracetamol group were significantly lower than those of the Not-taking pregabalin group and the Not-taking tramadol/paracetamol group respectively (P < 0.05). There was significant difference in the NRS scores among the four groups (P < 0.001). The NRS score of Group AB was significantly lower than that of Group P (P < 0.001), Group BP (P < 0.001) and Group AP (P = 0.001). At the same time, the NRS scores of Group BP (P < 0.001) and Group AP (P < 0.001) were significantly lower than those of Group P, but there was no significant difference between Group BP and Group AP (P = 1.000). The SBP, DBP, HR, the incidence of moderate to severe pain and the analgesia recovery ratio of Group AB were significantly lower than those of Group P (P < 0.05), while the SpO2 and the number of people who were very satisfied were significantly higher than those of Group P (P < 0.05). There was no significant difference in the incidence of adverse drug reactions among the four groups (P = 0.272). CONCLUSIONS: The combination or single use of pregabalin and tramadol/paracetamol can effectively relieve the acute pain after localization. Pregabalin combined with tramadol/paracetamol has the best analgesic effect and significantly reduces the hemodynamic fluctuations, with high safety and low incidence of adverse drug reactions, which has a certain clinical popularization and application value.
Assuntos
Acetaminofen , Dor Aguda , Pregabalina , Tomografia Computadorizada por Raios X , Tramadol , Humanos , Tramadol/administração & dosagem , Tramadol/uso terapêutico , Tramadol/efeitos adversos , Pregabalina/uso terapêutico , Pregabalina/administração & dosagem , Pregabalina/efeitos adversos , Masculino , Feminino , Pessoa de Meia-Idade , Acetaminofen/administração & dosagem , Acetaminofen/uso terapêutico , Acetaminofen/efeitos adversos , Dor Aguda/tratamento farmacológico , Dor Aguda/etiologia , Dor Aguda/diagnóstico , Tomografia Computadorizada por Raios X/métodos , Idoso , Quimioterapia Combinada , Adulto , Neoplasias Pulmonares/tratamento farmacológico , Analgésicos/administração & dosagem , Analgésicos/uso terapêutico , Analgésicos/efeitos adversos , Punções/efeitos adversos , Punções/métodos , Resultado do Tratamento , Analgésicos Opioides/administração & dosagem , Analgésicos Opioides/efeitos adversos , Analgésicos Opioides/uso terapêutico , Manejo da Dor/métodos , Nódulo Pulmonar Solitário/diagnóstico por imagem , Nódulo Pulmonar Solitário/tratamento farmacológico , Nódulo Pulmonar Solitário/patologia , Medição da DorRESUMO
The present study utilizes network pharmacology and molecular docking methodologies to investigate the mechanism of action behind the intervention of Polygonum capitatum Buch.-Ham.ex D. Don (THL) in treating pulmonary nodules (PN). This research aims to provide a theoretical foundation for broadening the clinical application of THL. Active components of THL were identified and screened through an extensive literature review and the PharmMapper database, followed by an analysis of their target interactions. Relevant targets associated with PN were selected using databases such as OMIM and GeneCards, with an intersection of the two sets being determined. STRING11.5 facilitated the acquisition of protein-protein interaction data, which was then imported into Cytoscape 3.7.2 to establish a protein interaction network topology. This enabled the identification of pivotal targets affected by THL intervention in PN. The study further employed the Metascape database to conduct GO and KEGG bioinformatics enrichment analyses, which illuminated core pathways involved in THL's therapeutic effects on PN. A comprehensive component-target-pathway diagram was constructed utilizing Cytoscape 3.7.2 software, with molecular docking validations carried out via Maestro software. A total of 49 active THL ingredients were discerned, implicating 67 PN-relevant targets. Subsequent software analysis pinpointed 10 key targets, including ALB, EGFR, and SRC. Molecular docking studies indicated strong binding affinities for most protein-compound pairs, with 44 out of 60 docking results exhibiting binding energies below -5 kcal/mol. Enrichment analysis highlights that key targets are mainly involved in pathways such as cancer, lipid metabolism and atherosclerosis, estrogen signaling, IL-17 signaling, complement and coagulation cascades, and chemical carcinogenesis through receptor activation. Through comprehensive network pharmacological approaches, this research delineates the synergy of THL's multiple components, targets, and pathways in mitigating PN. It posits that primary active ingredients of THL - quercetin, salidroside, and oleanolic acid - may exert effects on targets like ALB, EGFR, SRC, potentially modulating pathways associated with cancer, lipid and atherosclerosis, and IL-17 signaling in the context of PN intervention.
Assuntos
Simulação de Acoplamento Molecular , Farmacologia em Rede , Polygonum , Polygonum/química , Humanos , Farmacologia em Rede/métodos , Mapas de Interação de Proteínas , Nódulo Pulmonar Solitário/tratamento farmacológico , Medicamentos de Ervas Chinesas/farmacologia , Medicamentos de Ervas Chinesas/uso terapêutico , Medicamentos de Ervas Chinesas/químicaAssuntos
Blastomicose/diagnóstico por imagem , Linfonodos/diagnóstico por imagem , Linfadenopatia/diagnóstico por imagem , Sarcoidose/diagnóstico , Infecções dos Tecidos Moles/diagnóstico , Nódulo Pulmonar Solitário/diagnóstico por imagem , Doença Aguda , Adulto , Antifúngicos/uso terapêutico , Blastomyces/genética , Blastomyces/isolamento & purificação , Blastomicose/tratamento farmacológico , Blastomicose/patologia , Broncoscopia , California , DNA Fúngico/genética , Diagnóstico Diferencial , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico , Feminino , Febre , Humanos , Índia/etnologia , Itraconazol/uso terapêutico , Linfonodos/patologia , Linfadenopatia/patologia , Ohio , Análise de Sequência de DNA , Infecções dos Tecidos Moles/tratamento farmacológico , Nódulo Pulmonar Solitário/tratamento farmacológico , TexasRESUMO
An antibiotic ointment failed to clear the lesion on the patient's back. A more detailed history revealed the nodule's troubling genesis.
Assuntos
Antibacterianos/uso terapêutico , Carcinoma de Células Renais/diagnóstico , Carcinoma de Células Renais/fisiopatologia , Carcinoma de Células Renais/cirurgia , Nódulo Pulmonar Solitário/diagnóstico , Nódulo Pulmonar Solitário/tratamento farmacológico , Tomografia Computadorizada por Raios X/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica/terapia , Resultado do TratamentoAssuntos
Pneumopatias/diagnóstico por imagem , Pneumopatias/tratamento farmacológico , Adulto , Idoso de 80 Anos ou mais , Asma/diagnóstico por imagem , Asma/tratamento farmacológico , Gerenciamento Clínico , Medicina Baseada em Evidências , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Doença Pulmonar Obstrutiva Crônica/diagnóstico por imagem , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Nódulo Pulmonar Solitário/diagnóstico por imagem , Nódulo Pulmonar Solitário/tratamento farmacológicoRESUMO
Patients with common variable immunodeficiency (CVID) can develop granulomatous-lymphocytic interstitial lung disease (GLILD), which is associated with increased morbidity and mortality. Treating GLILD is a significant challenge because it is rare and can be pathologically heterogeneous. Here we describe two cases of patients with CVID-associated GLILD with biopsies demonstrating loosely organized tertiary lymphoid structures (TLSs). Based on the pivotal role that B cells play in TLS initiation and maintenance, we hypothesized that using rituximab monotherapy for B-cell depletion alone would be sufficient for the disruption of the pathologic process underlying GLILD. These two cases demonstrate that adapting a strategy of B cell depletion monotherapy may be effective in TLS-associated conditions such as GLILD.
Assuntos
Imunodeficiência de Variável Comum/complicações , Doenças Pulmonares Intersticiais/tratamento farmacológico , Doenças Pulmonares Intersticiais/patologia , Rituximab/uso terapêutico , Nódulo Pulmonar Solitário/tratamento farmacológico , Nódulo Pulmonar Solitário/patologia , Adulto , Antineoplásicos Imunológicos/uso terapêutico , Linfócitos B/efeitos dos fármacos , Linfócitos B/imunologia , Biópsia por Agulha , Imunodeficiência de Variável Comum/diagnóstico , Imunodeficiência de Variável Comum/imunologia , Feminino , Seguimentos , Granuloma/imunologia , Granuloma/patologia , Humanos , Imuno-Histoquímica , Doenças Pulmonares Intersticiais/diagnóstico por imagem , Doenças Pulmonares Intersticiais/etiologia , Masculino , Pneumonectomia/métodos , Estudos de Amostragem , Nódulo Pulmonar Solitário/diagnóstico por imagem , Nódulo Pulmonar Solitário/cirurgia , Tomografia Computadorizada por Raios X/métodos , Resultado do TratamentoAssuntos
Coccidioidomicose/tratamento farmacológico , Hospedeiro Imunocomprometido/imunologia , Infecções Oportunistas/tratamento farmacológico , Guias de Prática Clínica como Assunto , Nódulo Pulmonar Solitário/tratamento farmacológico , Administração Oral , Antifúngicos/uso terapêutico , Azóis/uso terapêutico , Coccidioides/efeitos dos fármacos , Coccidioidomicose/complicações , Coccidioidomicose/diagnóstico por imagem , Humanos , Infecções Oportunistas/complicações , Infecções Oportunistas/diagnóstico por imagem , Tomografia por Emissão de Pósitrons/métodos , Nódulo Pulmonar Solitário/complicações , Nódulo Pulmonar Solitário/diagnóstico por imagemAssuntos
Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/terapia , Nódulo Pulmonar Solitário/diagnóstico , Nódulo Pulmonar Solitário/terapia , China , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Nódulo Pulmonar Solitário/tratamento farmacológicoRESUMO
BACKGROUND: Extramedullary plasmacytoma is a rare plasma cell neoplasm within soft tissue and without bone marrow involvement or other systemic characteristics of multiple myeloma. Primary pulmonary plasmacytoma is a rare type of extramedullary plasmacytoma. CASE PRESENTATION: A 48-year-old male with a tumor in the right middle ear was referred to our hospital. A routine chest X-ray was arranged and showed enlargement of the left lung hilum. His bilateral breathing sounded clear. A chest CT scan revealed a well-circumscribed mass. Pathological biopsy yielded a diagnosis of isolated pulmonary plasmacytoma. CONCLUSIONS: This is the first presentation of primary pulmonary plasmacytoma with a solitary pulmonary nodule and no lymph node involvement.
Assuntos
Neoplasias Pulmonares/patologia , Plasmocitoma/patologia , Nódulo Pulmonar Solitário/patologia , Antineoplásicos/uso terapêutico , Biópsia por Agulha , Exame de Medula Óssea , Broncoscopia , Intervalo Livre de Doença , Neoplasias da Orelha/diagnóstico por imagem , Neoplasias da Orelha/patologia , Neoplasias da Orelha/cirurgia , Orelha Média/diagnóstico por imagem , Orelha Média/patologia , Orelha Média/cirurgia , Seguimentos , Humanos , Biópsia Guiada por Imagem , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Plasmocitoma/diagnóstico por imagem , Plasmocitoma/tratamento farmacológico , Nódulo Pulmonar Solitário/diagnóstico por imagem , Nódulo Pulmonar Solitário/tratamento farmacológico , Tomografia Computadorizada por Raios XRESUMO
(18)F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) plays a key role in the evaluation of undiagnosed lung nodules, when primary lung cancer is strongly suspected, or when it has already been diagnosed by other techniques. Although technical factors may compromise characterization of small or highly mobile lesions, lesions without apparent FDG uptake can generally be safely observed, whereas FDG-avid lung nodules almost always need further evaluation. FDG-PET/CT is now the primary staging imaging modality for patients with lung cancer who are being considered for curative therapy with either surgery or definitive radiation therapy.
Assuntos
Adenocarcinoma/patologia , Neoplasias Pulmonares/patologia , Tomografia por Emissão de Pósitrons/métodos , Tomografia Computadorizada por Raios X/métodos , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/radioterapia , Fluordesoxiglucose F18 , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/radioterapia , Imagem Multimodal/métodos , Estadiamento de Neoplasias , Planejamento de Assistência ao Paciente , Radiografia Intervencionista/métodos , Compostos Radiofarmacêuticos , Nódulo Pulmonar Solitário/tratamento farmacológico , Nódulo Pulmonar Solitário/patologia , Nódulo Pulmonar Solitário/radioterapiaRESUMO
Nocardiosis is a potentially life-threatening disease in renal transplant recipients. It is an uncommon infection with high lethality if left untreated. We report a case of a 67 year-old kidney transplant recipient who developed pulmonary nocardiosis and presented with pleural effusion along with an underlying lung mass, which was successfully treated with trimethoprim-sulphamethoxazole in conjunction with a reduction in immunosuppressive therapy. Five months later, graft function remains stable with complete regression of radiological abnormalities and absence of symptoms. Nocardiosis should be suspected in the presence of pulmonary symptoms in a transplant patient with unusual radiological presentation.
Assuntos
Transplante de Rim/efeitos adversos , Nocardiose/microbiologia , Infecções Oportunistas/microbiologia , Infecções Respiratórias/microbiologia , Nódulo Pulmonar Solitário/microbiologia , Idoso , Antibacterianos/uso terapêutico , Humanos , Hospedeiro Imunocomprometido , Imunossupressores/efeitos adversos , Masculino , Nocardiose/diagnóstico por imagem , Nocardiose/tratamento farmacológico , Infecções Oportunistas/diagnóstico por imagem , Infecções Oportunistas/tratamento farmacológico , Derrame Pleural/microbiologia , Infecções Respiratórias/diagnóstico por imagem , Infecções Respiratórias/tratamento farmacológico , Nódulo Pulmonar Solitário/diagnóstico por imagem , Nódulo Pulmonar Solitário/tratamento farmacológico , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Combinação Trimetoprima e Sulfametoxazol/uso terapêuticoRESUMO
BACKGROUND: A previously carried out randomized phase IIb, placebo-controlled trial of 1 year of inhaled budesonide, which was nested in a lung cancer screening study, showed that non-solid and partially solid lung nodules detected by low-dose computed tomography (LDCT), and not immediately suspicious for lung cancer, tended to regress. Because some of these nodules may be slow-growing adenocarcinoma precursors, we evaluated long-term outcomes (after stopping the 1-year intervention) by annual LDCT. PATIENTS AND METHODS: We analyzed the evolution of target and non-target trial nodules detected by LDCT in the budesonide and placebo arms up to 5 years after randomization. The numbers and characteristics of lung cancers diagnosed during follow-up were also analyzed. RESULTS: The mean maximum diameter of non-solid nodules reduced significantly (from 5.03 mm at baseline to 2.61 mm after 5 years) in the budesonide arm; there was no significant size change in the placebo arm. The mean diameter of partially solid lesions also decreased significantly, but only by 0.69 mm. The size of solid nodules did not change. Neither the number of new lesions nor the number of lung cancers differed in the two arms. CONCLUSIONS: Inhaled budesonide given for 1 year significantly decreased the size of non-solid nodules detected by screening LDCT after 5 years. This is of potential importance since some of these nodules may progress slowly to adenocarcinoma. However, further studies are required to assess clinical implications. CLINICAL TRIAL NUMBER: NCT01540552.
Assuntos
Adenocarcinoma/prevenção & controle , Antineoplásicos/administração & dosagem , Budesonida/administração & dosagem , Neoplasias Pulmonares/prevenção & controle , Nódulos Pulmonares Múltiplos/tratamento farmacológico , Lesões Pré-Cancerosas/tratamento farmacológico , Nódulo Pulmonar Solitário/tratamento farmacológico , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma de Pulmão , Administração por Inalação , Antineoplásicos/efeitos adversos , Budesonida/efeitos adversos , Ensaios Clínicos Fase II como Assunto , Detecção Precoce de Câncer/métodos , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Tomografia Computadorizada Multidetectores , Nódulos Pulmonares Múltiplos/diagnóstico por imagem , Lesões Pré-Cancerosas/diagnóstico por imagem , Valor Preditivo dos Testes , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Retrospectivos , Fatores de Risco , Nódulo Pulmonar Solitário/diagnóstico por imagem , Fatores de Tempo , Resultado do TratamentoAssuntos
Pulmão/diagnóstico por imagem , Pneumonia Bacteriana/diagnóstico por imagem , Nódulo Pulmonar Solitário/diagnóstico por imagem , Adolescente , Antibacterianos/uso terapêutico , Humanos , Masculino , Pneumonia Bacteriana/tratamento farmacológico , Radiografia , Nódulo Pulmonar Solitário/tratamento farmacológicoRESUMO
Bronchus-associated lymphoid tissue is a normal component of the lung's immune system and may be analogous to gut-associated lymphoid tissue, a form of mucosa-associated lymphoid tissue. Bronchial-associated lymphoid tissue lymphoma is a distinct subgroup of low-grade B-cell extranodal non-Hodgkin lymphoma, classified as marginal-zone lymphoma. It is a rare disorder and appears with a distinct clinical and radiological presentation. We report a case of a patient with a history of Sjogren's syndrome who presented with bilateral pulmonary nodules and mediastinal lymphadenopathy, and who was diagnosed as having bronchus-associated lymphoid tissue lymphoma.
Assuntos
Neoplasias Pulmonares/diagnóstico , Linfoma de Zona Marginal Tipo Células B/diagnóstico , Síndrome de Sjogren/complicações , Nódulo Pulmonar Solitário/diagnóstico , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biópsia , Diagnóstico Diferencial , Feminino , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Linfoma de Zona Marginal Tipo Células B/tratamento farmacológico , Mediastino , Nódulo Pulmonar Solitário/tratamento farmacológico , Tomografia Computadorizada por Raios XAssuntos
Neoplasias Pulmonares/cirurgia , Carcinoma de Pequenas Células do Pulmão/cirurgia , Antineoplásicos/uso terapêutico , Terapia Combinada , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Guias de Prática Clínica como Assunto , Terapia de Salvação/métodos , Carcinoma de Pequenas Células do Pulmão/tratamento farmacológico , Nódulo Pulmonar Solitário/tratamento farmacológico , Nódulo Pulmonar Solitário/cirurgiaAssuntos
Medicina Aeroespacial , Militares , Neoplasias Embrionárias de Células Germinativas/diagnóstico , Neoplasias Testiculares/diagnóstico , Avaliação da Capacidade de Trabalho , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biomarcadores Tumorais/sangue , Virilha , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/tratamento farmacológico , Masculino , Neoplasias Embrionárias de Células Germinativas/cirurgia , Orquiectomia , Dor/etiologia , Nódulo Pulmonar Solitário/diagnóstico , Nódulo Pulmonar Solitário/tratamento farmacológico , Neoplasias Testiculares/cirurgiaRESUMO
SETTING: South Korea, 2005-2007. BACKGROUND: Non-tuberculous mycobacterial diseases presenting as solitary pulmonary nodules (NTM-SPN) are rare and may be misdiagnosed as tuberculoma. DESIGN: Eleven NTM-SPN patients were enrolled retrospectively and compared with two groups each of 33 patients with upper lobe cavitary (UC) and nodular bronchiectatic (NB) type NTM diseases, respectively. RESULTS: The patients' median age was 52 years. Compared with UC-type disease, NTM-SPN patients showed female (n = 9) and never smoker (n = 8) predominance and fewer comorbidities (n = 0; P < 0.05 for each). Mycobacterium avium (n = 9) was predominant in NTM-SPN patients, followed by M. intracellulare (n = 2), whereas M. intracellulare was most frequently isolated from patients with both UC- and NB-type NTM (P < 0.05). The nodules were a median of 2.3 cm in diameter (range 1.6-6.3 cm) and were distributed evenly in all lobes. In all patients, percutaneous needle aspiration/biopsy was performed with a median 71 days of diagnostic delay. Ten patients successfully completed treatment, and one showed spontaneous reduction of nodule size without treatment. Reverse blot hybridisation assays of six DNA samples identified four subjects with M.avium-intracellulare complex (MAC), in line with conventional test data. CONCLUSION: NTM-SPN was caused exclusively by MAC. Although clinical outcome was favourable, confirmatory diagnosis was delayed. Molecular methods are needed for early diagnosis of NTM-SPN.
Assuntos
Infecções por Mycobacterium/diagnóstico , Mycobacterium/isolamento & purificação , Nódulo Pulmonar Solitário/diagnóstico , Adulto , Idoso , Antibacterianos/uso terapêutico , Biópsia por Agulha , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Mycobacterium/tratamento farmacológico , Infecções por Mycobacterium/microbiologia , Infecção por Mycobacterium avium-intracellulare/diagnóstico , Infecção por Mycobacterium avium-intracellulare/tratamento farmacológico , Infecção por Mycobacterium avium-intracellulare/microbiologia , Sistema de Registros , República da Coreia , Estudos Retrospectivos , Nódulo Pulmonar Solitário/tratamento farmacológico , Nódulo Pulmonar Solitário/microbiologia , Resultado do TratamentoRESUMO
Our objectives were to define the incidence and etiology of solitary pulmonary nodules (SPNs) in patients undergoing living donor liver transplantation (LDLT), describe a diagnostic approach to the management of SPNs in LDLT, and define the impact of SPNs on the overall survival of adult LDLT recipients. Nine patients (9/152, 5.9%) were diagnosed with an SPN on the basis of chest radiography findings during the pretransplant survey. All were male. The mean age was 52 years. All the patients had hepatitis B virus-related cirrhosis with hepatocellular carcinoma. All were asymptomatic for the lung lesion. All underwent contrast-enhanced chest computed tomography (CT) to verify the presence and possible etiology of the SPNs. In 3 cases, CT was used to definitely determine that there was no pulmonary nodule; in 2, CT led to a definite diagnosis of pulmonary tuberculosis. In 4, CT led to a definite identification of an SPN but not to an etiological diagnosis. Two patients underwent outright thoracoscopy and biopsy of their SPNs. Biopsy showed cryptococcosis in both patients. One received a therapeutic trial of an antituberculosis treatment, and repeat CT after 1 month showed a regression in the size of the SPN. A diagnosis of tuberculosis was made. One patient had an inconclusive whole body positron emission tomography scan and subsequently underwent thoracoscopy where biopsy showed tuberculosis. A concomitant malignancy, either primary lung cancer or metastasis from the liver tumor, was not identified. All patients were surviving with their original grafts and were lung infection-free. The overall mean posttransplant follow-up was 54 months (range = 33-96 months).
Assuntos
Criptococose/diagnóstico , Hepatopatias/cirurgia , Transplante de Fígado , Nódulo Pulmonar Solitário/diagnóstico , Tuberculose Pulmonar/diagnóstico , Antifúngicos/uso terapêutico , Antituberculosos/uso terapêutico , Biópsia , Protocolos Clínicos , Meios de Contraste , Criptococose/complicações , Criptococose/tratamento farmacológico , Humanos , Hepatopatias/complicações , Doadores Vivos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Tomografia por Emissão de Pósitrons , Valor Preditivo dos Testes , Estudos Retrospectivos , Nódulo Pulmonar Solitário/complicações , Nódulo Pulmonar Solitário/tratamento farmacológico , Taiwan , Toracoscopia , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Tuberculose Pulmonar/complicações , Tuberculose Pulmonar/tratamento farmacológicoRESUMO
Few studies have compared the clinical and radiographic findings of tuberculomas to those of solitary pulmonary nodules (SPNs) caused by Mycobacterium avium complex (MAC). We retrospectively analyzed clinical and radiographic findings from 26 patients with tuberculomas and 15 patients with SPNs caused by MAC. Median SPN size was 22 mm. In 26 patients (63%), the SPN was detected during a routine health checkup or evaluation of organs other than lungs. Patients with SPNs due to MAC were slightly older (median = 59 years) compared with those with tuberculomas (median = 50 years; P = 0.044). When we compared computed tomography (CT) features between patients with tuberculomas and patients with MAC, no significant differences were found in SPN location or the presence of calcification, cavitation, central low attenuation, and the satellite lesions. Although the maximum standardized uptake values were slightly higher in patients with SPNs due to MAC (median = 8.5) compared with those with tuberculomas (median = 2.2), this difference was not significant (P = 0.053). Of the 15 patients with SPNs due to MAC, 10 were initially diagnosed with "tuberculoma" and administered antituberculosis medication. MAC pulmonary disease should be considered in the differential diagnosis of SPNs, even when encountered in geographic regions with a high prevalence of pulmonary tuberculosis.