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1.
Zhonghua Bing Li Xue Za Zhi ; 48(9): 700-704, 2019 Sep 08.
Artigo em Chinês | MEDLINE | ID: mdl-31495090

RESUMO

Objective: To analyze the clinicopathological features, immunohistochemical (IHC) phentotype,diagnosis and differential diagnosis of infantile/congenital fibrosarcoma (IFS/CFS) with unusual histological features. Methods: Five IFS/CFS at Children's Hospital of Fudan University from March 2014 to July 2018 were analyzed for their diagnosis and differential diagnosis. Results: Two cases were males, three cases were females. The clinical manifestation of IFS/CFS was a rapidly-growing and painless mass. There were no specific radiologic features. Histologically, the tumor cells are arranged in intersecting or sheet-like patterns. There were focal hemangioma-like areas in four cases. There were also focal areas of primitive asteroid, short-spindled, and oval tumor cells in three cases. IHC study showed the tumor cells diffusely expressed TLE1(2/5), Vimentin(5/5), and WT1(3/5), in a cytoplastic pattern; they focally expressed CD34(3/5), CD31(3/5), and α-SMA(2/5). Fluorescence in situ hybridization (FISH) detected break-apart positivity of ETV6 gene. Conclusions: Hemangioma-like pattern, myxoid area, and TLE1 expression is very rare in IFS/CFS. Detection of ETV6 gene break-apart by FISH is very helpful in the diagnosis and differential diagnosis of IFS/CFS.


Assuntos
Fibrossarcoma , Diagnóstico Diferencial , Feminino , Humanos , Hibridização in Situ Fluorescente , Masculino , Vimentina
3.
Anticancer Res ; 39(8): 4315-4324, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31366523

RESUMO

BACKGROUND/AIM: This study aimed to obtain accurate differential diagnosis (DDx) of multicentric carcinogenesis (MC) and intrahepatic metastasis (IM) in recurrent lesions of hepatocellular carcinoma. MATERIALS AND METHODS: A total of 79 patients who underwent re-hepatectomy (2000-2013) were examined. PCR was used to analyze 13 chromosomal microsatellite loci by PCR. On the basis of this genetic analysis, the recurrent lesions were diagnosed as IM, MC or not determined (ND). Subsequently, DDx was compared with types of resection and outcome. RESULTS: The recurrent lesions were diagnosed as IM in 33 patients, MC in 44, and ND in 2. The anatomical resection group included 14 IM lesions (28%) and 36 MC lesions (72%), while the non-anatomical resection group included 19 IM lesions (70%) and 8 MC lesions (30%) (p<0.001). CONCLUSION: Anatomical resection at initial hepatectomy may reduce the likelihood of IM recurrence, leading to a better outcome for patients with HCC.


Assuntos
Carcinoma Hepatocelular/diagnóstico , Neoplasias Hepáticas/diagnóstico , Metástase Neoplásica/diagnóstico , Recidiva Local de Neoplasia/diagnóstico , Adulto , Idoso , Carcinogênese/genética , Carcinoma Hepatocelular/genética , Carcinoma Hepatocelular/patologia , Carcinoma Hepatocelular/cirurgia , Diagnóstico Diferencial , Feminino , Hepatectomia/métodos , Humanos , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/secundário , Masculino , Repetições de Microssatélites/genética , Pessoa de Meia-Idade , Metástase Neoplásica/genética , Metástase Neoplásica/patologia , Recidiva Local de Neoplasia/genética , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/cirurgia
8.
Wiad Lek ; 72(7): 1403-1407, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31398176

RESUMO

OBJECTIVE: Introduction: Cholelithiasisis diagnosed in 10-25% of the adult population. The manifestation of cholelithiasis in the form of acute cholecystitis, cholangitis, jaundice etc. occurs with a probability of 2-3% or more per year depending on the risk factors. Most often, it manifests it self as acute calculous cholecystitis. Up to 20% of such patients have additional calculi in extrahepatic bile ducts requiring simultaneous surgical intervention. Currently, the algorithm for diagnosis of concomitant choledocholithiasis in acute cholecystitis is multilevel and it needs to be simplified and improved. Conventional non-invasive diagnostic techniques have low specificity and sensitivity. A new safe diagnostic test is needed for the diagnosis of choledocholithiasis in cholecystitis in order to improve the results of surgical treatment of patients. The aim of the study - to determine the prospects for diagnosis of microRNA for differential diagnosis of obstructive diseases of the biliary tract on the basis of the literature data. PATIENTS AND METHODS: Materials and methods: The analysis of the selected international literature in the period of 1991-2018 concerning the studies of microRNA in cholestatic liver diseases was carried out. The search for literature was conducted using Google Scholar and PubMed search engines for the following keywords: microRNA, cholestasis, choledocholithiasis, acute cholecystitis, biliary obstruction in their various combinations. RESULTS: Review: MicroRNA is a specific post-transcriptional regulator of gene expression in all organs and systems of the body. There are specific types of miRNAs for different tissues. The most studied type of liver miRNA is miR-122. The studies showed better sensitivity and specificity of the detection of miR-122 both in the plasma and in the bile for the diagnosis of pathological liver conditions compared with conventional liver tests (aminotransferase, alkaline phosphatase, gamma-glutamyltransferase). Regarding the cholestatic hepatocyte injury occurring in choledocholithiasis, the following types of miRNA were identified: 122, 21, 29, 125, 222, let-7, 98 etc. Their concentrations in plasma and bile can be used as a diagnostic test for the presence of concomitant benign cholestasis in acute cholecystitis. Moreover, these markers can be used for the differential diagnosis of cholestasis of different etiology. CONCLUSION: Conclusions: Quantitative and qualitative characteristics of microRNA in bile and plasma can be used as an additional non-invasive method for diagnosis of cholestasis induced by choledocholithiasis in acute calculous cholecystitis. Further studyis needed to identify the most optimal algorithm for the administration of microRNA in clinical practice.


Assuntos
Doenças Biliares , Colelitíase , Bile , Diagnóstico Diferencial , Humanos , MicroRNAs
10.
An Bras Dermatol ; 94(3): 264-278, 2019 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-31365654

RESUMO

Pemphigus vulgaris is a chronic autoimmune bullous dermatosis that results from the production of autoantibodies against desmogleins 1 and 3. It is the most frequent and most severe form of pemphigus, occurring universally, usually between 40 and 60 years of age. It usually begins with blisters and erosions on the oral mucosa, followed by lesions on other mucous membranes and flaccid blisters on the skin, which can be disseminated. There is a clinical variant, pemphigus vegetans, which is characterized by the presence of vegetating lesions in the large folds of the skin. Clinical suspicion can be confirmed by cytological examination, histopathological examination, and direct and indirect immunofluorescence tests. The treatment is performed with systemic corticosteroids, and immunosuppressive drugs may be associated, among them azathioprine and mycophenolate mofetil. More severe cases may benefit from corticosteroids in the form of intravenous pulse therapy, and recent studies have shown a beneficial effect of rituximab, an anti-CD20 immunobiological drug. It is a chronic disease with mortality around 10%, and septicemia is the main cause of death. Patients need long-term and multidisciplinary follow-up.


Assuntos
Pênfigo/diagnóstico , Adulto , Autoanticorpos/imunologia , Desmossomos/imunologia , Diagnóstico Diferencial , Feminino , Humanos , Imunoglobulinas Intravenosas/uso terapêutico , Imunossupressores/classificação , Imunossupressores/uso terapêutico , Imunoterapia/métodos , Masculino , Pessoa de Meia-Idade , Pênfigo/classificação , Pênfigo/epidemiologia , Pênfigo/terapia , Pele/patologia , Inquéritos e Questionários
11.
An Bras Dermatol ; 94(3): 344-347, 2019 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-31365667

RESUMO

BACKGROUND: Of all nail disorders seen in dermatology offices, half of them are due to onychomycosis. The main differential diagnosis is nail psoriasis. The objective of this study was to compare the microscopic findings, other than the presence of fungi, in the clipping of onychomycosis versus normal nails and nail psoriasis. METHODS: Cross-sectional study of onychomycosis cases, analyzed by clipping and compared with data on normal nails and those with nail psoriasis. RESULTS: Sixty-two onychomycosis samples were compared with 30 normal nails and 50 nails with psoriasis. In onychomycosis, measurement of subungual region, serous lakes, neutrophils and number of layers of parakeratosis are more intense than in psoriasis. Onychocariosis is less common in psoriasis, while bacteria are more frequent. The nail transition zone is more commonly blurred and irregular in onychomycosis. CONCLUSION: Clipping helps in the differential diagnosis of onychomycosis and nail psoriasis and may be useful even when fungi are not found.


Assuntos
Doenças da Unha/patologia , Unhas/patologia , Onicomicose/patologia , Estudos Transversais , Diagnóstico Diferencial , Humanos , Doenças da Unha/microbiologia , Unhas/microbiologia , Neutrófilos , Onicomicose/microbiologia , Paraceratose , Psoríase/microbiologia , Psoríase/patologia
12.
An Bras Dermatol ; 94(3): 361-362, 2019 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-31365671

RESUMO

Perinevic dermatosis neglecta is an underestimated skin condition usually affecting children and adolescents, characterized by the appearance of dirt-like brownish pigmentation around a preexisting nevus and often a matter of concern for parents. We describe the clinical and dermoscopic findings in a case of perinaevic dermatosis neglecta and discuss the possible etiology of this phenomenon.


Assuntos
Melanoma/diagnóstico , Dermatopatias/diagnóstico , Anti-Infecciosos Locais/uso terapêutico , Criança , Dermoscopia , Diagnóstico Diferencial , Etanol/uso terapêutico , Humanos , Hiperpigmentação/complicações , Masculino , Nevo Pigmentado/complicações , Dermatopatias/tratamento farmacológico , Dermatopatias/etiologia
15.
Vet Immunol Immunopathol ; 214: 109893, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31378220

RESUMO

Differentiation between canine chronic enteropathy (CCE) and intestinal lymphoma is a diagnostic challenge as histopathology might fail to yield unequivocal results. Detection of clonal rearrangements of the T-cell-receptor gamma (TCRG) chain and IG heavy chain (IGH) V-J genes offer a useful solution. In this retrospective study, histopathology samples of 35 CCE patients and 7 healthy Beagle dogs underwent clonality testing. Patients suffered either from inflammatory bowel disease (IBD), food responsive diarrhea (FRD) or protein loosing enteropathy secondary to IBD (PLE/IBD). Healthy Beagles served as controls (CO). Canine IBD activity index (CIBDAI) and histopathological WSAVA-grading differed significantly (p<0.001) between groups. CIBDAI improved significantly after appropriate therapy (p < 0.0001). Intestinal biopsies of all CO showed polyclonal patterns for B- and T-cell primers. All samples from CCE patients showed polyclonal patterns for the B-cell primers. Targeting TCRG, 4 patients showed a monoclonal or oligoclonal pattern of the lymphocytic infiltrates in the duodenum and/or colon. Clinical improvement was observed in all dogs. Although a small cell lymphoma cannot be excluded in view of the short follow up duration, a false positive result, in the sense of a canonical rearrangement or unspecific amplification due to a antigenic stimulation in a non-neoplastic inflammatory process is possible.


Assuntos
Doenças do Cão/diagnóstico , Doenças do Cão/genética , Enteropatias Perdedoras de Proteínas/genética , Enteropatias Perdedoras de Proteínas/veterinária , Animais , Biópsia , Estudos de Casos e Controles , Doença Crônica , Diagnóstico Diferencial , Cães , Feminino , Rearranjo Gênico do Linfócito T , Doenças Inflamatórias Intestinais/imunologia , Intestinos/patologia , Linfoma/diagnóstico , Linfoma/veterinária , Masculino , Enteropatias Perdedoras de Proteínas/diagnóstico , Receptores de Antígenos de Linfócitos T gama-delta/genética , Estudos Retrospectivos
16.
Medicine (Baltimore) ; 98(32): e16379, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31393347

RESUMO

BACKGROUND: More and more automated efficient ultrasound image analysis techniques, such as ultrasound-based computer-aided diagnosis system (CAD), were developed to obtain accurate, reproducible, and more objective diagnosis results for thyroid nodules. So far, whether the diagnostic performance of existing CAD systems can reach the diagnostic level of experienced radiologists is still controversial. The aim of the meta-analysis was to evaluate the accuracy of CAD for thyroid nodules' diagnosis by reviewing current literatures and summarizing the research status. METHODS: A detailed literature search on PubMed, Embase, and Cochrane Libraries for articles published until December 2018 was carried out. The diagnostic performances of CAD systems vs radiologist were evaluated by meta-analysis. We determined the sensitivity and the specificity across studies, calculated positive and negative likelihood ratios and constructed summary receiver-operating characteristic (SROC) curves. Meta-analysis of studies was performed using a mixed-effect, hierarchical logistic regression model. RESULTS: Five studies with 536 patients and 723 thyroid nodules were included in this meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio (DOR) for CAD system were 0.87 (95% confidence interval [CI], 0.73-0.94), 0.79 (95% CI 0.63-0.89), 4.1 (95% CI 2.5-6.9), 0.17 (95% CI 0.09-0.32), and 25 (95% CI 15-42), respectively. The SROC curve indicated that the area under the curve was 0.90 (95% CI 0.87-0.92). The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and DOR for experienced radiologists were 0.82 (95% CI 0.69-0.91), 0.83 (95% CI 0.76-0.89), 4.9 (95% CI 3.4-7.0), 0.22 (95% CI 0.12-0.38), and 23 (95% CI 11-46), respectively. The SROC curve indicated that the area under the curve was 0.96 (95% CI 0.94-0.97). CONCLUSION: The sensitivity of the CAD system in the diagnosis of thyroid nodules was similar to that of experienced radiologists. However, the CAD system had lower specificity and DOR than experienced radiologists. The CAD system may play the potential role as a decision-making assistant alongside radiologists in the thyroid nodules' diagnosis. Future technical improvements would be helpful to increase the accuracy as well as diagnostic efficiency.


Assuntos
Diagnóstico por Computador/métodos , Diagnóstico por Computador/normas , Radiologistas/normas , Nódulo da Glândula Tireoide/diagnóstico , Inteligência Artificial , Diagnóstico Diferencial , Humanos , Curva ROC , Sensibilidade e Especificidade , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/patologia , Ultrassonografia
17.
Medicine (Baltimore) ; 98(33): e16846, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31415410

RESUMO

RATIONALE: Primary epiploic appendagitis (PEA) is a rare cause of acute abdomen caused by spontaneous torsion or venous thrombosis of epiploic appendices, it commonly manifests with acute lower quadrant pain, thus may mimic acute diverticulitis, appendicitis, or mesenteric infarction. PATIENT CONCERNS: In this case report, we report a 44 years old man who presented with persistent sharp pain in the left lower quadrant abdomen, Laboratory tests were mostly normal, contrast enhanced computed tomography (CECT) revealed a slightly high density shadow with fat foci in the middle was presented around the local descending colon, accompanied by the adjacent peritoneal thickening. DIAGNOSES: He was diagnosed with PEA as confirmed by an abdominal contrast enhanced computed tomography (CECT) scan. INTERVENTIONS: He was followed up in the clinic without any dietary restrictions, antibiotic or analgesic drugs use. OUTCOMES: The abdominal pain gradually subsided a week later, and there were no recurrence of the symptoms during follow-up. LESSONS: In our case, the diagnosis of PEA using CECT allows the patient to avoid surgery and other invasive treatment.


Assuntos
Abdome Agudo/diagnóstico , Colo Descendente/diagnóstico por imagem , Doenças do Colo/diagnóstico por imagem , Abdome Agudo/terapia , Adulto , Apendicite/diagnóstico , Colo Descendente/patologia , Doenças do Colo/patologia , Doenças do Colo/terapia , Tratamento Conservador , Diagnóstico Diferencial , Diverticulite/diagnóstico , Humanos , Masculino , Ultrassonografia Doppler em Cores
18.
Zhonghua Yi Xue Za Zhi ; 99(31): 2440-2444, 2019 Aug 20.
Artigo em Chinês | MEDLINE | ID: mdl-31434424

RESUMO

Objective: To explore the correlation between dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), magnetic resonance diffusion-weighted imaging (DWI) images of breast cancer and human epidermal growth factor receptor-2 (Her-2) expression. Methods: A retrospective analysis of 84 patients with breast cancer confirmed by biopsy from January 2012 to December 2016 in Zhejiang University Lishui Hospital was conducted. The data of DCE-MRI, DWI scanning were collected before surgery and Her-2 was detected by immunohistochemistry (IHC). Then, all the patients were divided into Her-2 positive group and Her-2 negative group according to Her-2 expression. There were 44 cases in the Her-2 positive group and 40 cases in the Her-2 negative group. The differences in the characteristics of the lesion morphology, time-signal intensity curve (TIC), early enhancement rate and apparent diffusion coefficient (ADC) were compared, and their correlation with Her-2 expression was analyzed. Results: Of the 84 lesions, 12 were orthotopic ductal carcinoma, 6 were lobular carcinoma, and 66 were invasive ductal carcinoma. There were significant differences in lesion morphology (P=0.012) and TIC curve morphology (P=0.038) between Her-2 positive group and negative group. At the same time, the early enhancement rate (P=0.012) and ADC value (P=0.038) of Her-2 positive group were significantly higher than those of negative group. Except morphology of segmental lesions and TIC curve morphology, other characteristic parameters were correlated to Her-2 (all P<0.05). The correlation coefficients between early enhancement rate, ADC value and Her-2 expression were as high as 0.758 and 0.809 (all P<0.05). Conclusions: The morphology of breast cancer lesions, time-signal intensity curve, early enhancement rate and ADC value are all correlated with Her-2 expression.The early enhancement rate and ADC value are significantly positively correlated with Her-2 expression.


Assuntos
Neoplasias da Mama , Neoplasias da Mama/diagnóstico por imagem , Meios de Contraste , Diagnóstico Diferencial , Feminino , Humanos , Imagem por Ressonância Magnética , Receptor ErbB-2 , Estudos Retrospectivos
19.
Rev Fac Cien Med Univ Nac Cordoba ; 76(3): 180-184, 2019 08 29.
Artigo em Espanhol | MEDLINE | ID: mdl-31465187

RESUMO

Introducction: Acute appendicitis is a pathology caused by inflammation of the cecal appendix , due tocthe obstruction of the appendicular lumen,witch leads to a venous congestion and then eventually to an arterial compromise of the appendicular wall with the consequent perforation of it.The main problem of this pathology in children under 4 years is the high index of appendicecal preforations presented by patients at the time of diagnosis,mainly driven by an unspecific clinical presentation,which leads to a low index of suspicion and a high percentage of complications in that age group. Objetive: perform a literature review on the subject and investigate what is known of appendicitis in children under four years old to date. The data were obtained through a systematic bibliographic search in the pubmed data base from 1980 to 2017 Conclussion: Conclussion the increase in morbidity of acute apendicitis in children under 4 years has a mixed origin since organic factors are mixed age,together with a temporary diagnostic delay and with it the appearance of complicated forms of the disease, there is no sign,symptom or group of them that allows early detection of appendicitis in children under 4 years of age.


Assuntos
Apendicite/diagnóstico , Doença Aguda , Apendicite/complicações , Apendicite/cirurgia , Pré-Escolar , Diagnóstico Diferencial , Humanos , Medição de Risco
20.
Rev Fac Cien Med Univ Nac Cordoba ; 76(3): 189-192, 2019 08 29.
Artigo em Espanhol | MEDLINE | ID: mdl-31465189

RESUMO

Chronic graft versus host disease (GVHD) is a major complication of the allogeneic stem cell transplant. One of most frequent manifestations of GVHD is the cutaneous compromise with the sclerodermatous variety being the most severe. We considered that the restrictive respiratory compromise and its evolution are not well characterized. We described the functional respiratory alterations of a patient with sclerodermatous chronic GVHD and considered differential diagnosis of pulmonary restriction in this type of patient. We reported the case of a 21-year-old woman with pulmonary restriction secondary to cutaneous sclerosis which was caused by chronic GVHD. This report illustrates the importance of utilizing both functional respiratory tests and diagnosis images to accurately characterize the cause of the respiratory compromise. We believe that the functional alterations described in this case could be caused by the cutaneous disorder found.


Assuntos
Dispneia/etiologia , Doença Enxerto-Hospedeiro/complicações , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Escleroderma Sistêmico/etiologia , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Leucemia Mieloide Aguda/cirurgia
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