RESUMO
Rounded atelectasis of the lung (RA) is a lesion well described in the medical literature, yet often very difficult to diagnose. In recent years, the widespread use of high-resolution imaging modalities employed in the struggle against cancer, coinciding with the peak of the asbestos epidemic, have boosted the detection frequency of RA. However, its differential diagnosis still poses a challenge to the pulmonary specialist and the radiologist, as little is known about its pathogenesis. Furthermore, the multifactorial etiology of RA and its occasional coexistence with lung cancer make the task of confidently ruling out malignancy sometimes daunting. This article attempts to provide an update on RA's etiology, radiological evaluation, clinical management, and prognosis based on recent advances in broadly available diagnostic modalities and minimally invasive interventional procedures. An exemplary case of post-tuberculous RA is illustrated, as RA often presents as an unusual finding of a fairly common disease.
Assuntos
Pulmão/patologia , Atelectasia Pulmonar/diagnóstico , Tuberculose Pulmonar/complicações , Adulto , Fluordesoxiglucose F18 , Humanos , Pulmão/diagnóstico por imagem , Imageamento por Ressonância Magnética , Masculino , Tomografia por Emissão de Pósitrons , Atelectasia Pulmonar/diagnóstico por imagem , Atelectasia Pulmonar/etiologia , Compostos Radiofarmacêuticos , Tomografia Computadorizada por Raios X , Tuberculose Pulmonar/diagnóstico por imagem , Tuberculose Pulmonar/patologia , UltrassonografiaRESUMO
OBJECTIVE: To investigate the association of retrocaval ureter with other congenital abnormalities. METHODS AND PATIENTS: Two new cases of retrocaval ureter are discussed and a detailed electronic search of the literature was mainly focused on the concomitant abnormalities. The first of our patients had also a glandular hypospadias and a supernumerary lumbar vertebra, while the second one had syndactylia (fixed toes) in both feet. Results. The review of the literature revealed that 21% of the cases of retrocaval ureter present with concomitant abnormalities mainly from the cardiovascular system and the genitourinary tract. CONCLUSION: Diagnosis of retrocaval ureter should increase the awareness of the responsible physician on the possibility of concomitant malformations where treatment could prevent future symptoms.
Assuntos
Anormalidades Múltiplas/cirurgia , Ureter/anormalidades , Anormalidades Urogenitais/cirurgia , Anormalidades Múltiplas/diagnóstico por imagem , Adolescente , Adulto , Seguimentos , Humanos , Masculino , Medição de Risco , Sindactilia/complicações , Sindactilia/diagnóstico , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Ureter/cirurgia , Anormalidades Urogenitais/diagnóstico por imagem , Procedimentos Cirúrgicos Urogenitais/métodos , Urografia/métodosRESUMO
Seasonal variations in fasting glucose and HbA1c levels in 638 diabetic patients (attending a primary care diabetic clinic during 2003-2007) were examined and found to be significantly higher in colder than in warmer months. Moreover, there were apparent peaks in fasting glucose levels after Christmas and Easter months. This study provides further evidence of monthly fluctuations in glycemic control, underscoring the need to consider seasonal/cultural effects when managing diabetic patients.
Assuntos
Glicemia/metabolismo , Diabetes Mellitus Tipo 2/sangue , Hemoglobinas Glicadas/metabolismo , Estações do Ano , Adulto , Idoso , Idoso de 80 Anos ou mais , Clima , Feminino , Grécia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
AIMS: To examine trends in the prevalence of self-reported diabetes between 2002 and 2006 among urban adults in Greece. METHODS: Data were derived from two consecutive population-based surveys conducted in Salamis, during two election days (13 October 2002 and 15 October 2006). In both surveys was used the same selection procedure and data were collected using the same questionnaire, completed by almost the same team of interviewers. There were randomly selected 2805 adults (> or =20 years) in 2002 and 3478 in 2006, with similar age and sex distribution to the target population. RESULTS: The overall crude prevalence of diabetes increased significantly, from 245 (8.7%) in 2002 to 358 (10.3%) in 2006 (P=0.037). The age-adjusted prevalence of diabetes among adults was 8.2% (men, 8.5%; women, 7.8%) in 2002 and 9.5% (men, 9.7%; women, 9.3%) in 2006. These changes correspond to a total increasing rate of 16% (4% per year). At the same time, the age-adjusted prevalence of obesity increased from 17.9 to 21.1%, giving an increase of 18% (P<0.05); however, the prevalence of overweight did not increase (43.8-42.9%). CONCLUSIONS: Our findings show that the prevalence of diabetes is rising rapidly in the Greek population and appears to be increasing in parallel with prevalence of obesity.
Assuntos
Diabetes Mellitus/epidemiologia , Adulto , Idoso , Escolaridade , Feminino , Grécia/epidemiologia , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Caracteres Sexuais , População Urbana/estatística & dados numéricosRESUMO
Pulmonary Langerhans' cell histiocytosis (LCH) represents an uncommon clinical disorder with unpredictable clinical presentation and outcome. Lung involvement may occur either in isolation or as part of a multiorgan disease. A 43-year-old woman was admitted to our hospital with acute left chest pain and shortness of breath. Spontaneous left pneumothorax was detected. All laboratory tests, including pulmonary function studies, were normal. Radiological findings posed high suspicion for LCH and lung biopsy confirmed this diagnosis. Further studies identified small cystic lesions in the scalp and liver. The diagnosis of multiple organ LCH involvement was made. Spontaneous pneumothorax might be the presenting clinical symptom of LCH. The present case emphasizes the capricious nature of LCH and the importance of an individualized therapeutic approach.