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Pesquisa : E01.370.388.100.100 [Categoria DeCS]
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  1 / 46007 MEDLINE  
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PMID:29223276
Autor:Dhakal A; Chen H; Dexter EU
Endereço:Department of Medicine, Roswell Park Cancer Institute and Department of Medicine, University at Buffalo, Buffalo, NY. Electronic address: ajaydhakal@hotmail.com.
Título:A 51-Year-Old Woman With an Increasing Chest Wall Mass Years After Resection of an Early Stage Lung Cancer.
Fonte:Chest; 152(6):e151-e154, 2017 12.
ISSN:1931-3543
País de publicação:United States
Idioma:eng
Resumo:CASE PRESENTATION: A 51-year-old woman was found to have a new 14 × 6 mm soft tissue mass under the right serratus muscle on a CT scan of the chest performed for routine surveillance due to her history of stage I lung cancer. A follow-up CT scan performed 4 months later showed that the mass had increased in size to 22 × 8 mm. The patient presents to the oncology clinic to discuss the results of the CT scan. She has no pain or swelling on the right lateral chest and no cough, fever, or shortness of breath. She is at her baseline health with good appetite and functional status.
Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE


  2 / 46007 MEDLINE  
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PMID:29361625
Autor:Ogura N; Tsunekawa S; Okabe A; Sugimoto T; Nishiyama K; Oshima Y; Hosoda Y; Kiyochi H; Komoto I; Taki Y; Katsushima U; Yanagihara K; Kawai J
Endereço:Dept. of Surgery, Kansai Electric Power Hospital.
Título:[A Case of Triple Negative Spindle Cell Carcinoma of the Breast and Improved Quality of Life Following Irinotecan Chemotherapy].
Fonte:Gan To Kagaku Ryoho; 44(13):2097-2099, 2017 Dec.
ISSN:0385-0684
País de publicação:Japan
Idioma:jpn
Resumo:We report a case of triple negative spindle cell carcinoma of the breast, responsive to irinotecan chemotherapy. A 49-year old woman who had a tumor in the chest wall with a skin ulcer visited our hospital. After being diagnosed with triple negative spindle cell carcinoma of the breast, she underwent surgery, adjuvant chemotherapy, and radiation at the other hospital. Fourteen months after the surgery, she developed an ipsilateral breast tumor as a result of local recurrence. Since eribulin and paclitaxel plus bevacizumab chemotherapies were not effective, she was transferred to our hospital, and we administered irinotecan as third-line chemotherapy. Skin lesions and effusion were reduced and her quality of life improved for 4 months.
Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE
Nome de substância:0 (Antineoplastic Agents, Phytogenic); 7673326042 (irinotecan); XT3Z54Z28A (Camptothecin)


  3 / 46007 MEDLINE  
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PMID:29357388
Autor:Han Y; Kim HJ; Kong KA; Kim SJ; Lee SH; Ryu YJ; Lee JH; Kim Y; Shim SS; Chang JH
Endereço:Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea.
Título:Diagnosis of small pulmonary lesions by transbronchial lung biopsy with radial endobronchial ultrasound and virtual bronchoscopic navigation versus CT-guided transthoracic needle biopsy: A systematic review and meta-analysis.
Fonte:PLoS One; 13(1):e0191590, 2018.
ISSN:1932-6203
País de publicação:United States
Idioma:eng
Resumo:BACKGROUND: Advances in bronchoscopy and CT-guided lung biopsy have improved the evaluation of small pulmonary lesions (PLs), leading to an increase in preoperative histological diagnosis. We aimed to evaluate the efficacy and safety of transbronchial lung biopsy using radial endobronchial ultrasound and virtual bronchoscopic navigation (TBLB-rEBUS&VBN) and CT-guided transthoracic needle biopsy (CT-TNB) for tissue diagnosis of small PLs. METHODS: A systematic search was performed in five electronic databases, including MEDLINE, EMBASE, Cochrane Library Central Register of Controlled Trials, Web of Science, and Scopus, for relevant studies in May 2016; the selected articles were assessed using meta-analysis. The articles were limited to those published after 2000 that studied small PLs ≤ 3 cm in diameter. RESULTS: From 7345 records, 9 articles on the bronchoscopic (BR) approach and 15 articles on the percutaneous (PC) approach were selected. The pooled diagnostic yield was 75% (95% confidence interval [CI], 69-80) using the BR approach and 93% (95% CI, 90-96) using the PC approach. For PLs ≤ 2 cm, the PC approach (pooled diagnostic yield: 92%, 95% CI: 88-95) was superior to the BR approach (66%, 95% CI: 55-76). However, for PLs > 2 cm but ≤ 3 cm, the diagnostic yield using the BR approach was improved to 81% (95% CI, 75-85). Complications of pneumothorax and hemorrhage were rare with the BR approach but common with the PC approach. CONCLUSIONS: CT-TNB was superior to TBLB-rEBUS&VBN for the evaluation of small PLs. However, for lesions greater than 2 cm, the BR approach may be considered considering its diagnostic yield of over 80% and the low risk of procedure-related complications.
Tipo de publicação: JOURNAL ARTICLE; META-ANALYSIS; REVIEW


  4 / 46007 MEDLINE  
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PMID:29458952
Autor:Yen P; Dumas S; Albert A; Gordon P
Endereço:Department of Diagnostic Radiology, Nanaimo Regional General Hospital, Nanaimo, British Columbia, Canada. Electronic address: peggy_yen@live.com.
Título:Post-Vacuum-Assisted Stereotactic Core Biopsy Clip Displacement: A Comparison Between Commercially Available Clips and Surgical Clip.
Fonte:Can Assoc Radiol J; 69(1):10-15, 2018 Feb.
ISSN:1488-2361
País de publicação:Canada
Idioma:eng
Resumo:PURPOSE: The placement of localization clips following percutaneous biopsy is a standard practice for a variety of situations. Subsequent clip displacement creates challenges for imaging surveillance and surgical planning, and may cause confusion amongst radiologists and between surgeons and radiologists. Many causes have been attributed for this phenomenon including the commonly accepted "accordion effect." Herein, we investigate the performance of a low cost surgical clip system against 4 commercially available clips. METHODS: We retrospectively reviewed 2112 patients who underwent stereotactic vacuum-assisted core biopsy followed by clip placement between January 2013 and June 2016. The primary performance parameter compared was displacement >10 mm following vacuum-assisted stereotactic core biopsy. Within the group of clips that had displaced, the magnitude of displacement was compared. RESULTS: There was a significant difference in displacement among the clip types (P < .0001) with significant pairwise comparisons between pediatric surgical clips and SecureMark (38% vs 28%; P = .001) and SenoMark (38% vs 27%; P = .0001) in the proportion displaced. The surgical clips showed a significant magnitude of displacement of approximately 25% greater average distance displaced. CONCLUSIONS: As a whole, the commercial clips performed better than the surgical clip after stereotactic vacuum-assisted core biopsy suggesting the surrounding outer component acts to anchor the central clip and minimizes clip displacement. The same should apply to tomosynthesis-guided biopsy.
Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE


  5 / 46007 MEDLINE  
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PMID:29390366
Autor:Wang JK; Ma WJ; Lu Q; Zheng EL; Yang Q; Hu HJ; Liu F; Li QS; Li FY
Endereço:Department of Biliary Surgery.
Título:First case report of retroperitoneal metastasis of fascioliasis after surgery.
Fonte:Medicine (Baltimore); 96(50):e9258, 2017 Dec.
ISSN:1536-5964
País de publicação:United States
Idioma:eng
Resumo:RATIONALE: Fascioliasis is a rare cause of liver abscesses, and its clinical course consists of hepatic phase and biliary phase. PATIENT CONCERNS: We describe a 58-year-old female patient who presented with a 2-month history of intermittent fever and abdominal pain. An abdominal computed tomography (CT) revealed confluent low-density lesions in the liver. Complete surgical resection of these abscesses was performed, and postoperative pathological examination and serological tests confirmed a diagnosis of fascioliasis. However, 4 months after the surgery, follow-up CT revealed a lesion in the retroperitoneal area. Meanwhile, ultrasonography-guided percutaneous needle biopsy of the retroperitoneal lesion was performed, and a parasitic infection was suspected. DIAGNOSES: Retroperitoneal metastasis of hepatic phase fascioliasis. INTERVENTIONS: The patient received parasitic resistance treatment with triclabendazole at a dose of 10 mg/kg/d for 2 consecutive days. OUTCOMES: After 2 courses of triclabendazole therapy, the retroperitoneal metastasis regressed to a minor lesion. LESSONS: To the best of our knowledge, this is the first case report of retroperitoneal metastasis of fascioliasis, aimed at helping recognize the clinical features and treatment options of this rare disease.
Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE


  6 / 46007 MEDLINE  
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PMID:27773450
Autor:Kovarik JJ; Kopecky C; Antlanger M; Domenig O; Kaltenecker CC; Werzowa J; Hecking M; Mahr S; Grömmer M; Wallner C; Aumayr K; Kain R; Zuckermann A; Poglitsch M; Säemann MD
Endereço:Department of Internal Medicine III, Clinical Division of Nephrology and Dialysis, Medical University of Vienna, Vienna, Austria.
Título:Effects of angiotensin-converting-enzyme inhibitor therapy on the regulation of the plasma and cardiac tissue renin-angiotensin system in heart transplant patients.
Fonte:J Heart Lung Transplant; 36(3):355-365, 2017 Mar.
ISSN:1557-3117
País de publicação:United States
Idioma:eng
Resumo:BACKGROUND: Angiotensin-converting enzyme (ACE) inhibitors (ACEis) are beneficial in patients with heart failure, yet their role after heart transplantation (HTx) remains ambiguous. Particularly, the effects of ACEis on plasma and cardiac metabolites of the "classical" and "alternative" renin-angiotensin system (RAS) in HTx patients are unknown. METHODS: This cross-sectional study used a novel mass spectrometry-based approach to analyze plasma and tissue RAS regulation in homogenates of heart biopsy specimens from 10 stable HTx patients without RAS blockade and in 15 patients with ACEi therapy. Angiotensin (Ang) levels in plasma and Ang formation rates in biopsy tissue homogenates were measured. RESULTS: Plasma Ang II formation is exclusively ACE dependent, whereas cardiac Ang II formation is primarily chymase dependent in HTx patients. ACEi therapy substantially increased plasma Ang-(1-7), the key effector of the alternative RAS, leaving plasma Ang II largely intact. Importantly, neprilysin and prolyl-carboxypeptidase but not angiotensin converting enzyme 2 are essential for cardiac tissue Ang-(1-7) formation. CONCLUSION: ACE is the key enzyme for the generation of plasma Ang II, whereas chymase is responsible for cardiac tissue production of Ang II. Furthermore, our findings reveal that neprilysin and prolyl-carboxypeptidase are the essential cardiac enzymes for the alternative RAS after HTx. These novel insights into the versatile regulation of the RAS in HTx patients might affect future therapeutic avenues, such as chymase and neprilysin inhibition, beyond classical Ang II blockade.
Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE
Nome de substância:0 (Angiotensin-Converting Enzyme Inhibitors)


  7 / 46007 MEDLINE  
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PMID:29390533
Autor:Xu Q; Fu L; Liu C
Endereço:Department of Radiology, Beijing Tongren Hospital, Capital Medical University.
Título:Multimodality imaging-based evaluation of Rosai-Dorfman disease in the head and neck: A retrospective observational study.
Fonte:Medicine (Baltimore); 96(51):e9372, 2017 Dec.
ISSN:1536-5964
País de publicação:United States
Idioma:eng
Resumo:Rosai-Dorfman disease (RDD) is an uncommon benign entity characterized histologically by lymphatic sinus dilatation due to histiocyte proliferation. This study was performed to delineate its imaging features, reviewed retrospectively in 12 patients (8 women and 4 men, mean age 58.2 years [range 27-84]) with pathologically confirmed RDD in the head and neck. The location, involvement, and imaging characteristics (CT, magnetic resonance imaging (MRI), and PET/CT) of all lesions were evaluated. Signal intensity on MRI images was compared to gray matter (orbital RDD) and adjacent muscle (sinonasal and cervical RDD). RDD in the head and neck involved multiple sites, primarily the sinonasal cavity (n = 7), neck (n = 3), and orbit (n = 1), with one case of simultaneous involvement of the sinonasal cavity, orbit, and neck. With sinonasal involvement, MRI signal intensity of the involved areas was isointense or slightly hyperintense relative to adjacent muscle on T1WI images and heterogeneous on T2WI images; with lacrimal involvement, it was isointense relative to gray matter on T1- and T2-weighted images; and with neck involvement, it was isointense relative to muscle on T1WI images and relatively hyperintense on T2WI images, with homogenous postcontrast enhancement in all sites of involvement. The lesions on CT were observed as enhancing masses with or without bony destruction. PET/CT showed hypermetabolism in one lesion in the neck. RDD is a rare disorder with multiple sites of involvement in the head and neck. Concomitant cervical lymphadenopathy with extranodal masses assisted by multimodal imaging may be useful in the diagnosis of RDD.
Tipo de publicação: JOURNAL ARTICLE; OBSERVATIONAL STUDY


  8 / 46007 MEDLINE  
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PMID:29390523
Autor:Freist M; Garrouste C; Szlavik N; Coppo P; Lautrette A; Heng AE
Endereço:Service de Néphrologie, Pôle REUNNIRH, CHU Clermont-Ferrand, Clermont-Ferrand.
Título:Efficacy of eculizumab in an adult patient with HIV-associated hemolytic uremic syndrome: A case report.
Fonte:Medicine (Baltimore); 96(51):e9358, 2017 Dec.
ISSN:1536-5964
País de publicação:United States
Idioma:eng
Resumo:INTRODUCTION: Hemolytic uremic syndrome (HUS) in Human Immunodeficiency Virus (HIV)-positive patients has become a rare cause of kidney injury since the era of highly active antiretroviral therapy (HAART). Plasma exchange and antiretroviral therapy were previously recommended but often failed to achieve remission. We report a case of HUS in a HIV-positive patient treated successfully with eculizumab. CASE SUMMARY: A 52-year-old woman presented to hospital with acute renal failure, thrombocytopenia, anemia, and hypoxemia. She had been diagnosed with HIV infection in 1997. Kidney biopsy showed several fibrinous microthrombi in the glomerular capillaries, formation of thrombi in arterioles, moderate parietal and mesangial deposits of C3 and Immunoglobulin M, and intense glomerular and arterial deposits of Complement component 5b9 complement component. Serum HIV viral load was 227,848 copies/mL, and CD4 lymphocyte count was 120 cells/µL. A diagnosis of HIV-associated HUS was made. The patient had no confounding cause of HUS. Initiation of eculizumab and HAART resulted in complete hematological remission on day 32 and dialysis withdrawal on day 110. The patient has not relapsed during long-term follow-up (M17). CONCLUSION: This observation suggests that eculizumab can achieve remission in HIV patients with HUS.
Tipo de publicação: JOURNAL ARTICLE
Nome de substância:0 (Antibodies, Monoclonal); 0 (Antibodies, Monoclonal, Humanized); A3ULP0F556 (eculizumab)


  9 / 46007 MEDLINE  
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PMID:29390521
Autor:Ge X; Liao J; Choo RJ; Yan J; Zhang J
Endereço:Department of Radiology, Hangzhou First People's Hospital, Zhejiang Province.
Título:Solitary fibrous tumor of the ilium: A case report.
Fonte:Medicine (Baltimore); 96(51):e9355, 2017 Dec.
ISSN:1536-5964
País de publicação:United States
Idioma:eng
Resumo:RATIONALE: Solitary fibrous tumors (SFTs) are rare spindle cell tumors that are most commonly found in the mediastinal pleura. Although there are increasingly more reports of extra-pleural SFTs, reports of SFTs in bone are very rare. To our knowledge, a SFT of the ilium has not yet been reported. With low specificity on computer tomograpy and magnetic resonance imaging, SFTs are easily misdiagnosed. PATIENT CONCERNS: A 33-year-old man visited our hospital due to repeated right ilium pain for 3 months. The pain was dull and bearable, with no hip joint dyskinesia. The relevant physical examinations are negative. The patient was healthy before and had a negative family history. Radiologically, a large mass with inhomogeneous attenuation and intensity and obvious heterogeneous enhancement was misdiagnosed as a giant cell tumor of ilium. DIAGNOSES: The man was diagnosed as the solitary fibrous tumor of right ilium. INTERVENTIONS: The patient was performed an "incision biopsy of the right ilium" and "extended resection of tumor". OUTCOMES: The pathology and immunohistochemistry was confirmed as the solitary fibrous tumors. The patient was followed-up by computed tomography of pelvis in local hospital every 6 mouths, and there is no recurrence and any symptoms. LESSONS: We learned that the solitary fibrous tumor could locate in the ilium, and when we see imaging manifestations like this case, we should think it may be SFT.
Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE


  10 / 46007 MEDLINE  
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PMID:29391087
Autor:Abou-Zamzam A; Somers S; Cora C; Pairawan S; Lum S
Endereço:Department Surgery, Loma Linda University Medical Center, Loma Linda, California, USA.
Título:Percutaneous Needle Biopsies of the Breast in Women Younger than 35 Years: Minimally or Excessively Invasive?
Fonte:Am Surg; 83(10):1019-1023, 2017 Oct 01.
ISSN:1555-9823
País de publicação:United States
Idioma:eng
Resumo:Percutaneous needle biopsy (PNB) of the breast is commonly used for diagnosis of breast pathology, but has been less studied in young women. We sought to determine the effectiveness and necessity of PNB in patients younger than 35 years of age. The charts of sequential patients <35 years who underwent PNB between February 2013 and May 2016 were reviewed; 181 PNB were performed in 127 patients. Median age was 30 years (13-34). Indications for PNB were Breast Imaging Reporting and Data System (BIRADS) ≥4 in 137 (75.7%) cases, with mass on imaging in 139 (76.8%). Carcinoma was diagnosed in 12 (6.6%), PNB in eight unique patients (6.3%). Other PNB pathology included atypia in four (2.2%) patients; papillary lesion, five (2.8%); benign lymph node, 10 (5.5%); fibroepithelial lesion, 15 (8.3%); benign breast tissue, 63 (34.8%); and fibroadenoma, 72 (39.8%). Women with atypia or malignancy were older than those with benign findings (30.9 vs 28.0 years, P = 0.002). No other patient or imaging factors were significantly associated with pathologic diagnosis on PNB. Routine PNB for all BIRADS 4 findings may be over-used in young women as most results are benign and subsequent surgical findings are concordant. Improved diagnostic accuracy of breast imaging is warranted to reduce unnecessary procedures.
Tipo de publicação: JOURNAL ARTICLE



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