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1.
Medicine (Baltimore) ; 100(35): e26972, 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34477127

RESUMO

ABSTRACT: There are no standardized methods for collecting and reporting coronavirus disease-2019 (COVID-19) data. We aimed to compare the proportion of patients admitted for COVID-19-related symptoms and those admitted for other reasons who incidentally tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).Retrospective cohort studyData were sampled twice weekly between March 26 and June 6, 2020 from a "COVID-19 dashboard," a system-wide administrative database that includes the number of hospitalized patients with a positive SARS-CoV-2 polymerase chain reaction test. Patient charts were subsequently reviewed and the principal reason for hospitalization abstracted.Data collected during a statewide lockdown revealed that 92 hospitalized patients had positive SARS-CoV-2 test results. Among these individuals, 4.3% were hospitalized for reasons other than COVID-19-related symptoms but were incidentally found to be SARS-CoV-2-positive. After the lockdown was suspended, the total inpatient census of SARS-CoV-2-positive patients increased to 128, 20.3% of whom were hospitalized for non-COVID-19-related complaints.In the absence of a statewide lockdown, there was a significant increase in the proportion of patients admitted for non-COVID-19-related complaints who were incidentally found to be SARS-CoV-2-positive. In order to ensure data integrity, coding should distinguish between patients with COVID-19-related symptoms and asymptomatic patients carrying the SARS-CoV-2 virus.


Assuntos
Infecções Assintomáticas/epidemiologia , COVID-19/epidemiologia , Gerenciamento de Dados/normas , Hospitalização/estatística & dados numéricos , Teste de Ácido Nucleico para COVID-19/estatística & dados numéricos , Feminino , Humanos , Achados Incidentais , Masculino , Pandemias , Melhoria de Qualidade , Estudos Retrospectivos , SARS-CoV-2 , Confiança
2.
J Coll Physicians Surg Pak ; 31(9): 1030-1034, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34500516

RESUMO

OBJECTIVE: To find the frequency and significance of extraprostatic incidental findings (ep-IFs) during multiparametric-magnetic prostate resonance imaging (mp-MRI), and compare them with prostate imaging reporting and data system (PI-RADS) outcomes. STUDY DESIGN: Analytical study. Place & Duration of Study: Goztepe Education and Research Hospital, Istanbul, Turkey, from June 2019 to January 2020. METHODOLOGY: Images of 185 men, who underwent mp-MRI, were reviewed and ep-IFs were also classified as urologic or non-urologic and benign or malign. The PI-RADS score was also recorded in biopsy-naïve subjects or in whom a sufficient time (which would not impair imaging) was elapsed after the biopsy. The cases were also divided into two groups, according to the PI-RADS score (Group 1: PI-RADS 1 or 2, Group 2: PI-RADS 3 or more) and the incidental findings (IFs) were compared between the groups. RESULTS: Overall, 139 ep-IFs were detected in 88 (47.6%) patients. The remaining 97 (52.4%) cases were free of ep-IFs. The ep-IFs were benign in 85 (96.6%) and malignant in 3 (3.4%) cases. The frequency of total ep-IFs did not differ between groups 1 and 2 (47.8% vs. 47.6%, respectively, p>0.05). CONCLUSION: Extra prostatic incitental findings are frequently encountered during mp-MRI, benign ep-IFs are quite frequent; although rare malignant ep-IFs may be subject to being missed due to focused analysis and interpretation of prostate. PI-RADS scoring system does not contribute to the diagnosis of incidental mp-MRI. Key Words: Incidental findings, Multiparametric prostate MRI, Prostate cancer, MP-MRI.


Assuntos
Imageamento por Ressonância Magnética Multiparamétrica , Neoplasias da Próstata , Humanos , Achados Incidentais , Imageamento por Ressonância Magnética , Masculino , Neoplasias da Próstata/diagnóstico por imagem , Estudos Retrospectivos
3.
BMJ Case Rep ; 14(9)2021 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-34518173

RESUMO

Ischiofemoral impingement (IFI) has been described in the medical literature as a cause of hip pain. IFI occurs due to an abnormal contact or reduced space between the lesser trochanter and the lateral border of the ischium and is an often unrecognised cause of pain and snapping in the hip. Association of multiple exostoses and a skeletal dysplasia characterised by an abnormal modelling of bone metaphysis and osseous deformities is highly characteristic of this disease. Consequently, multiple exostoses may narrow the ischiofemoral space and cause impingement and pain, even in the absence of malignant transformation. Surgical excision of exostosis of the lesser trochanter is a safe and effective method of treatment for patients with IFI. We present a case of left hip pain with incidental finding of hereditary multiple osteochondroma causing IFI and discuss the predisposing factors and review of literature.


Assuntos
Neoplasias Ósseas , Exostose Múltipla Hereditária , Impacto Femoroacetabular , Exostose Múltipla Hereditária/complicações , Exostose Múltipla Hereditária/diagnóstico por imagem , Impacto Femoroacetabular/diagnóstico por imagem , Impacto Femoroacetabular/cirurgia , Articulação do Quadril/diagnóstico por imagem , Articulação do Quadril/cirurgia , Humanos , Achados Incidentais , Ísquio/diagnóstico por imagem , Ísquio/cirurgia
4.
Pan Afr Med J ; 38: 388, 2021.
Artigo em Francês | MEDLINE | ID: mdl-34381532

RESUMO

Introduction: myoma is commonly diagnosed in our hospital. It can be accidentally discovered or discovered due to metrorrhagia. The purpose of this study is to evaluate the association between the size of myomas and the circumstances under which they are detected and between the location of myomas and the occurrence of bleeding. Methods: we conducted a cross-sectional study including women aged 18 or older undergoing ultrasound at the University Teaching Hospital Bogodogo and who were diagnosed with at least one uterine myoma over a period of 6 years from January 2012 to December 2018. Binary logistic regression was used to assess metrorrhagia while multinomial logistic regression was used to assess circumstances under which they were detected and size. Results: we assessed 1049 women, among whom 2294 had myomas diagnosed on ultrasound. Each woman had two myomas. The average age of patients was 37 years. Women with myomas larger than 50 mm accounted for 29.7% (n=311). There was a strong association between interstitial, subserosal and submucosal myomas and the occurrence of metrorrhagias (p<0.001). A size less than 50 mm was significantly associated with fortuitous discovery (p=0.016) but not with revealing metrorrhagia (p=0.084). Women who had submucosal myomas (OR=3.13; CI95%= [1.45-6.76]), interstitial and submucosal myomas (OR=2.24; CI95%= [1.05-4.78] as well as interstitial, subserosal and submucosal myomas (OR=3.57; CI95%= [1.88-6.76]) were at higher risk of developing metrorrhagia. Myomas measuring less than 50 mm had twice the odds of revealing fortuitously (RRR=1.80; CI95%= [1.25-2.62]) or by metrorrhagia (RRR=1.75; CI95%= [1.04-2.95]. Conclusion: metrorrhagia is more common in women with myomas in specific locations.


Assuntos
Leiomioma/diagnóstico por imagem , Metrorragia/etiologia , Neoplasias Uterinas/diagnóstico por imagem , Adolescente , Adulto , Estudos Transversais , Feminino , Hospitais Universitários , Humanos , Achados Incidentais , Leiomioma/complicações , Leiomioma/patologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Ultrassonografia , Neoplasias Uterinas/complicações , Neoplasias Uterinas/patologia , Adulto Jovem
7.
Pan Afr Med J ; 39: 75, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34422198

RESUMO

Hyperreactio luteinalis (HL) is a rare entity in which both ovaries are multicystic and enlarged under the action of human chorionic gonadotropin (hCG), mostly seen in the third trimester of pregnancy. This benign condition is usually asymptomatic and doesn't need any specific treatment, as the ovaries spontaneously reduce in size after birth. This is a case report of a 33-year-old woman diagnosed with hyperreactio luteinalis during the second trimester of her induced pregnancy. An ultrasound scan at 22 weeks of gestation revealed bilateral multicystic enlarged ovaries along with multiple fetal malformations and hydropsfetalis. Usually, HL is most commonly seen in situations in which there are high levels of hCG, but our patient had normal levels of hCG during all her pregnancy, which makes our case even rarer. In conclusion, the most important challenge when faced with HL is to differentiate between it and other differential diagnosis especially malignant tumors, because unlike them, this benign condition doesn't need surgical treatment.


Assuntos
Gonadotropina Coriônica/sangue , Cistos Ovarianos/diagnóstico por imagem , Complicações na Gravidez/diagnóstico por imagem , Anormalidades Múltiplas/diagnóstico por imagem , Adulto , Feminino , Humanos , Achados Incidentais , Gravidez , Segundo Trimestre da Gravidez , Ultrassonografia Pré-Natal
8.
Pan Afr Med J ; 39: 20, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34394811

RESUMO

Introduction: incidental prostate cancer findings reflect the great burden of prostatic cancer across the globe. Our 10 year retrospective analysis aimed to identify the incidence and clinic-pathologic features of prostate cancer incidentally detected in patients undergoing transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH), and to estimate the clinical value of pathologic review of all TURP specimens. Methods: after excluding patients with a known diagnosis of prostate cancer prior to TURP a total of 2,386 men (ages 25-98) were identified by pathology (TURP) specimens. Yearly incidences, Gleason score, grade, pathologic stage were recorded for all incidental prostate cancer patients. Results: a total of 256 (10.7%) patients were found to have prostate cancer. Mean Age was 68.51±9.22 years. T1a and T1b stage prostatic carcinoma was found in 9.9% and 90.1% of these patients respectively. Forty-nine percent (49%) patients had higher Gleason scores (>7). After subtracting average incidences between 5-year intervals, a statistical rise of almost 4% was found. Conclusion: our analysis concludes that a large proportion (10.7%) of patients had incidental prostate cancer and the incidence was increasing in recent years in Pakistan and in comparison, to Asian countries. In Pakistan there is a scarcity of updated national cancer registries. The growing incidence of high Gleason scores requires keen and prompt attention. The diverse ethnic and socioeconomic background of patients propels their propensity towards loss of follow up with already limited tertiary healthcare institutes in Pakistan. This pathologic review of TURP specimens is valuable for Asiatic and non-Asiatic populations.


Assuntos
Hiperplasia Prostática/cirurgia , Neoplasias da Próstata/diagnóstico , Ressecção Transuretral da Próstata , Adulto , Idoso , Idoso de 80 Anos ou mais , Humanos , Incidência , Achados Incidentais , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Paquistão , Neoplasias da Próstata/epidemiologia , Neoplasias da Próstata/patologia , Estudos Retrospectivos , Centros de Atenção Terciária
10.
Nucl Med Rev Cent East Eur ; 24(2): 110-112, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34382678

RESUMO

A 31-year-old woman who had multiple orthopedic surgeries on the left lower limb and recently suffered from pain and redness in the lateral left lower thigh was referred to the hospital to rule out osteomyelitis by [99mTc]UBI scintigraphy. Except soft tissue inflammation in the mentioned region, the scan showed significant and diffuse both lungs uptake incidentally. The patient had experienced symptoms of COVID-19 disease recently. Chest HRCT scan also revealed multiple segmental ground-glass opacities (GGOs) which were typical features for lung involvement of COVID-19 associated pneumonia.


Assuntos
COVID-19/diagnóstico por imagem , Achados Incidentais , Compostos de Organotecnécio , Fragmentos de Peptídeos , Adulto , Feminino , Humanos , Cintilografia
11.
Nucl Med Rev Cent East Eur ; 24(2): 113-114, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34382679

RESUMO

This report presents a case of a 49-year-old woman with complaint of sore throat and front neck pain, who referred to a hospital for thyroid scan due to suppressed TSH level (0.005 mU/L). Diffuse and bilateral lungs uptake in the scan was noticed incidentally. The patient had positive history of COVID-19 symptoms. Multifocal and bilateral ground-glass opacities (GGOs) in both lungs were compatible with typical features of lung involvement in COVID-19-associated pneumonia.


Assuntos
COVID-19/diagnóstico por imagem , Achados Incidentais , Glândula Tireoide/diagnóstico por imagem , Feminino , Humanos , Pessoa de Meia-Idade , Cintilografia
12.
Oncology ; 99(9): 547-554, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34237725

RESUMO

PURPOSE: Esophageal cancer patients may simultaneously have resectable esophageal cancer and undiagnosable incidental minute solid pulmonary nodules. While the latter is rarely metastatic, only a few studies have reported on the outcomes of such nodules after surgery. In this retrospective study, we assessed the incidence of such nodules, the probability that they are ultimately metastatic nodules, and the prognosis of patients after esophagectomy according to the metastatic status of the nodules. METHODS: Data of 398 patients who underwent esophagectomy for resectable esophageal cancer between January 2012 and December 2016 were collected. We reviewed computed tomography (CT) images from the first visit and searched for incidental minute pulmonary nodules <10 mm in size. We followed the outcomes of these nodules and compared the characteristics of metastatic and nonmetastatic nodules. We also assessed the prognosis of patients whose minute pulmonary nodules were metastatic. RESULTS: Among the patients who underwent esophagectomy, 149 (37.4%) had one or more minute pulmonary nodules, with a total of 285 nodules. Thirteen (4.6%) of these nodules in 12 (8.1%) patients were ultimately diagnosed as being metastatic. Thirteen (8.7%) patients experienced recurrence at a different location from where the nodules were originally identified. Characteristics of the metastatic nodules were not unique in terms of size, SUVmax, or location in the lungs. Two-year and 5-year overall survival rates of patients whose nodules were metastatic were 64.2 and 32.1%, respectively. CONCLUSION: The rate of minute pulmonary nodules which were ultimately metastatic was 4.6%. Our findings suggest that esophagectomy followed by the identification of minute pulmonary nodules is an acceptable strategy even if the nodules cannot be diagnosed as being metastatic on the first visit CT due to their small size.


Assuntos
Carcinoma de Células Escamosas/patologia , Neoplasias Esofágicas/patologia , Achados Incidentais , Neoplasias Pulmonares/secundário , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/terapia , Terapia Combinada , Neoplasias Esofágicas/diagnóstico por imagem , Neoplasias Esofágicas/terapia , Esofagectomia/métodos , Feminino , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Prognóstico , Estudos Retrospectivos , Análise de Sobrevida , Tomografia Computadorizada por Raios X
13.
J Laryngol Otol ; 135(9): 765-769, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34308809

RESUMO

OBJECTIVE: Parotid incidentalomas on fluorodeoxyglucose positron emission tomography/computed tomography imaging are rare. A systematic review was performed to assess their aetiology and association with scanning indication, and to develop an evidence-based algorithm for their management. METHODS: A literature search was performed on 25 August 2020 using the keywords 'incidentaloma', 'incidental finding', 'parotid', 'parotid gland', 'salivary gland' and 'head and neck'. Articles were reviewed by two authors before their inclusion. RESULTS: Forty articles were included, totalling 558 incidentalomas. The mean incidence was 0.74 per cent. Lung cancer was the most common imaging indication. The most common aetiologies were cystadenolymphoma, pleomorphic salivary adenoma and metastases. Only cystadenolymphoma (p = 0.015) and pleomorphic salivary adenoma (p = 0.011) were significantly associated with a primary malignancy (lung). The most common further investigations were aspiration cytology, ultrasound imaging and core biopsy, usually prior to parotidectomy. CONCLUSION: If appropriate, parotid incidentalomas should be followed up with flexible endoscopy, skin examinations, and head and neck examinations. Ultrasound-guided core biopsy provides higher accuracy, avoiding repeat sampling and excision biopsy.


Assuntos
Fluordesoxiglucose F18 , Glândula Parótida/diagnóstico por imagem , Neoplasias Parotídeas/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Compostos Radiofarmacêuticos , Humanos , Incidência , Achados Incidentais , Glândula Parótida/patologia , Neoplasias Parotídeas/epidemiologia , Neoplasias Parotídeas/etiologia
14.
Asian J Psychiatr ; 63: 102761, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34271538

RESUMO

Catatonia is a rare neuropsychiatric syndrome that can accompany various medical conditions, including schizophrenia, autoimmune encephalitis, and infectious diseases. We present two cases of catatonia in males aged 12 and 17 years from Central Asia who tested positive for SARS-Cov-2 antibodies. Detailed medical assessments declined other potential precipitating factors, including schizophrenia or anti-NMDA receptor autoimmune encephalitis. FDG-PET in the younger patient demonstrated focal hypometabolism in left frontotemporal and right associative visual cortex, matching patterns previously seen in adults with catatonia. These isolated findings raise concerns about a possible causal relationship between COVID-19 infection and risk of catatonia manifestation in adolescents.


Assuntos
Encefalite Antirreceptor de N-Metil-D-Aspartato , COVID-19 , Catatonia , Adolescente , Adulto , Ásia , Catatonia/etiologia , Humanos , Achados Incidentais , Masculino , SARS-CoV-2
16.
BMC Med Ethics ; 22(1): 101, 2021 07 27.
Artigo em Inglês | MEDLINE | ID: mdl-34315465

RESUMO

BACKGROUND: Clinical genomic professionals are increasingly facing decisions about returning incidental findings (IFs) from genetic research. Although previous studies have shown that research participants are interested in receiving IFs, yet there has been an argument about the extent of researcher obligation to return IFs. We aimed in this study to explore the perspectives of clinical genomics professionals toward returning incidental findings from genomic research. METHODS: We conducted a national survey of a sample (n = 113) of clinical genomic professionals using a convenient sampling. A self-administered questionnaire was used to explore their attitudes toward disclosure of IFs, their perception of the duties to return IFs and identifying the barriers for disclosure of IFs. A descriptive analysis was employed to describe participants' responses. RESULTS: Sixty-five (57.5%) respondents had faced IFs in their practice and 31 (27.4%) were not comfortable in discussing IFs with their research subjects. Less than one-third of the respondents reported the availability of guidelines governing IFs. The majority 84 (80%) and 69 (62.7%) of the study participants indicated they would return the IFs if the risk of disease threat ≥ 50% and 6-49%, respectively and 36 (31.9%) reported they have no obligation to return IFs. CONCLUSION: Clinical genomics professionals have positive attitudes and perceptions toward the returning IFs from genomic research, yet some revealed no duty to do so. Detailed guidelines must be established to provide insights into how genomics professionals should be handled IFs.


Assuntos
Genômica , Achados Incidentais , Revelação , Humanos , Pesquisadores , Sujeitos da Pesquisa
18.
Z Gastroenterol ; 59(7): 677-682, 2021 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-34255316

RESUMO

Due to pelvic symptoms, a diagnostic sectional imaging was initiated in a 52-year-old female patient. This revealed a cystic, retrorectal mass, suspected to be a tailgut cyst. Due to the symptoms and the unclear dignity after several frustrating endosonographic punctures, a robotic-assisted resection of the cystic Tumor was performed after careful interdisciplinary consultation.The histological examination confirmed the diagnosis of a tailgut cyst but also revealed parts of an intestinally differentiated adenocarcinoma.Due to the unclear metastatic behaviour, robotic-assisted low anterior resection with total mesorectal excision was performed as oncological resection, similar to rectal carcinomas. No residuals or lymph node metastases were detectable in the histological examination, so that follow- up monitoring was recommended.Retrorectal tumours are an extremely rare entity, worldwide only 28 cases of an intestinally differentiated carcinoma in a tailgut cyst have been described so far. Since there are no clear recommendations in the literature regarding the diagnostic or therapeutic procedure, we would like to discuss a possible algorithm in case of a proven retrorectal mass in our case study.


Assuntos
Adenocarcinoma , Cistos , Neoplasias Retais , Procedimentos Cirúrgicos Robóticos , Adenocarcinoma/cirurgia , Cistos/diagnóstico por imagem , Cistos/cirurgia , Feminino , Humanos , Achados Incidentais , Pessoa de Meia-Idade
20.
Front Public Health ; 9: 697381, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34277554

RESUMO

Objectives: Discussions regarding who and how incidental findings (IFs) should be returned and the ethics behind returning IFs have increased dramatically over the years. However, information on the cost and benefits of returning IFs to patients remains scanty. Design: This study systematically reviews the economic evaluation of returning IFs in genomic sequencing. We searched for published articles on the cost-effectiveness, cost-benefit, and cost-utility of IFs in Medline, Scopus, PubMed, and Google Scholar. Results: We found six published articles that met the eligibility criteria of this study. Two articles used cost analysis only, one used cost-benefit analysis only, two used both cost analysis and cost-effectiveness, and one used both cost-benefit analysis and cost-utility to describe the cost of returning IFs in genomic sequencing. Conclusion: While individuals value the IF results and are willing to pay for them, the cost of returning IFs depends on the primary health condition of the patient. Although patients were willing to pay, there was no clear evidence that returning IFs might be cost-effective. More rigorous economic evaluation studies of IFs are needed to determine whether or not the cost of returning IFs is beneficial to the patient.


Assuntos
Genômica , Achados Incidentais , Mapeamento Cromossômico , Análise Custo-Benefício , Humanos
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