ABSTRACT
O confronto com o câncer de um filho e a percepção da sua morte como inevitável dão lugar a experiências parentais relevantes para a pesquisa científica. Este estudo teve como objetivo investigar, por meio da percepção dos profissionais hospitalares, o modo como os pais experienciam a fase terminal e fim de vida do filho com câncer para melhor compreender os processos psicoemocionais experienciados por esses pais diante da cronicidade da doença e da morte do filho. No sentido de alcançar esse objetivo, realizou-se um estudo qualitativo de tipo fenomenológico envolvendo 17 profissionais de dois hospitais portugueses de referência em oncologia pediátrica. Os dados foram recolhidos com recurso a um guia de entrevista semiestruturada. Na percepção dos profissionais hospitalares, os resultados evidenciam que esses pais experienciam múltiplas dificuldades e preocupações na fase terminal da doença do filho e no pós-morte, bem como um sofrimento extremo e desestruturação biopsicossocial e espiritual na família. O conhecimento aprofundado da fenomenologia desses processos é essencial para o desenho e a implementação de intervenções emocionais, cognitivas, comportamentais e sociais mais ajustadas às dificuldades e preocupações parentais vividas no fim de vida e pós-morte.(AU)
Coping with children's cancer and the perception of their inevitable death give rise to parental experiences that are important to study. This study aimed to investigate, based on hospital professionals' perspectives, how parents experience the terminal phase and end of life of their children suffering from cancer to better understand the psycho-emotional processes these parents experienced in face of the chronicity of the disease and their children's death. To achieve this objective, a qualitative phenomenological study was carried out involving 17 professionals of two Portuguese hospitals that are reference in pediatric oncology. Data were collected using a semi-structured interview guide. From the perspective of hospital professionals, results show that these parents experience multiple difficulties and concerns in the terminal phase of their children's disease and postmortem, as well as the extreme suffering and biopsychosocial and spiritual disruption of the family. A deeper understanding of the phenomenology of these processes is essential to design and implement better adjusted emotional, cognitive, behavioral, and social interventions aimed at the parental difficulties and concerns experienced at the end of life and after death.(AU)
El enfrentamiento del cáncer de un hijo y la percepción de su muerte como inevitable dan lugar a experiencias parentales importantes que deben ser estudiadas. Este estudio pretende identificar desde la percepción de los profesionales del hospital cómo los padres viven la fase terminal y el final de la vida de su hijo con cáncer con el fin de comprender mejor los procesos psicoemocionales que viven estos padres ante la cronicidad de la enfermedad y la muerte de su hijo. Para ello, se realizó un estudio cualitativo, con enfoque fenomenológico, en el que participaron 17 profesionales de dos hospitales portugueses de referencia en oncología pediátrica. Para recoger los datos se aplicó un guion de entrevista semiestructurada. En cuanto a la percepción de los profesionales del hospital, estos padres experimentaron múltiples dificultades y preocupaciones en la fase terminal de la enfermedad de su hijo y postmuerte, así como un sufrimiento extremo y una desestructuración biopsicosocial y espiritual en la familia. El conocimiento en profundidad de la fenomenología de estos procesos es esencial para elaborar e implementar intervenciones emocionales, cognitivas, conductuales y sociales más acordes a las dificultades y preocupaciones parentales que se experimentan al final de la vida y la postmuerte.(AU)
Subject(s)
Humans , Female , Adult , Middle Aged , Parents , Pediatrics , Portugal , Expression of Concern , Neoplasms , Anxiety , Pain , Palliative Care , Parent-Child Relations , Patient Care Team , Philosophy , Psychology , Psychology, Medical , Psychophysiology , Quality of Health Care , Risk-Taking , Schools , Self Care , Sibling Relations , Speech , Stress Disorders, Post-Traumatic , Awareness , Survival , Terminal Care , Therapeutics , Vision, Ocular , Body Image , Right to Die , Activities of Daily Living , Bereavement , Leukemia , Attitude of Health Personnel , Attitude to Death , Divorce , Marriage , Patient Acceptance of Health Care , Central Nervous System , Homeopathic Cure , Child , Child Care , Psychology, Child , Child Rearing , Child Health , Family Health , Sampling Studies , Life Expectancy , Mortality , Conscious Sedation , Adolescent , Negotiating , Hospice Care , Caregivers , Health Personnel , Neoplasms, Post-Traumatic , Interview , Communication , Pain Clinics , Comprehensive Health Care , Conflict, Psychological , Crisis Intervention , Affect , Psychosocial Impact , Mind-Body Therapies , Withholding Treatment , Spirituality , Decision Making , Denial, Psychological , Depression , Diagnosis , Diet , Drug-Related Side Effects and Adverse Reactions , Dyspnea , Education, Nonprofessional , Emotions , Disease Prevention , Humanization of Assistance , User Embracement , Family Conflict , Family Relations , Early Detection of Cancer , Fatigue , Fear , Early Medical Intervention , Medicalization , Hope , Acceptance and Commitment Therapy , Courage , Optimism , Psychological Trauma , Psychiatric Rehabilitation , Psychosocial Support Systems , Psycho-Oncology , Frustration , Sadness , Respect , Emotional Regulation , Psychological Distress , Patient Care , Psychosocial Intervention , Family Support , Psychological Well-Being , Emotional Exhaustion , Health Promotion , Health Services , Hearing , Hospitalization , Anger , Leukocytes , Life Change Events , Life Support Care , Loneliness , Love , Nausea , Nursing CareABSTRACT
RESUMEN Introducción: Los tumores de células gigantes pueden originarse en el tejido óseo, sinovial o cualquier otro tejido blando. Se caracterizan por su rápido crecimiento. A pesar de ser comúnmente benignos, si se dejan evolucionar sin tratamiento, hay riesgo de que en su proceso de crecimiento destruyan el tejido adyacente y afecten la funcionalidad, estructura y apariencia de la zona anatómica afectada. Objetivo: Describir el curso clínico y manejo terapéutico de un paciente con tumor de células gigantes en el antebrazo. Caso clínico: Se presenta paciente masculino de 28 años, que se le diagnosticó tumoración ósea en tercio distal del cúbito, y a quien, por su voluntad de no atenderse, no se le realizó el abordaje y manejo quirúrgico. Un año después, regresó al servicio de urgencias. Tenía mayor volumen en las dimensiones tumorales, con cambios a nivel del tercio distal del cúbito, lesiones de patrón lítico, pérdida de la cortical, con reacción perióstica, bordes mal definidos y afectación de tejidos blandos circundantes. Se diagnóstico probable tumor de células gigantes. El manejo quirúrgico permitió la conservación del antebrazo, pero a un año de su intervención quirúrgica, dada la probabilidad de recidiva, su pronóstico permanece incierto. Conclusiones: La velocidad de crecimiento de los tumores de células gigantes amerita decisiones oportunas, dado que el tiempo que transcurre previo al tratamiento puede, como en el presente caso, traducirse en un crecimiento destructivo de los tejidos adyacentes. A más de un año de la cirugía, el pronóstico del paciente es incierto, pues la probabilidad de recidiva permanece latente(AU)
ABSTRACT Introduction: Giant cell tumors can originate in bone, synovial, or any other soft tissue. They are characterized by their rapid growth. Despite being commonly benign, if they are allowed to evolve without treatment, they may destroy adjacent tissue, in its growth process, affecting the functionality, structure and appearance of the affected anatomical area. Objective: To describe the clinical course and therapeutic management of a patient with a giant cell tumor in the forearm. Clinical case: We report the case of a 28-year-old male patient, who was diagnosed with a bone mass in the distal third of the ulna. This patient desired not to undergo surgical management. A year later, he returned to the emergency room. the tumor had greater dimensions, changes at the level of the distal third of ulna, lytic pattern lesions, loss of the cortex, periosteal reaction, poorly defined edges and involvement of surrounding soft tissues. Giant cell tumor was the probable diagnosis. Surgical management allowed the forearm preservation, but one year after surgery, the prognosis remains uncertain, given the probability of recurrence. Conclusions: The growth rate of giant cell tumors merits timely decisions, since the time that elapses prior to treatment can, as in the present case, translate into destructive growth of adjacent tissues. More than a year after surgery, the prognosis is uncertain for this patient, as the probability of recurrence remains latent(AU)
RÉSUMÉ Introduction: Les tumeurs à cellules géantes peuvent être localisées au niveau du tissu osseux, du tissu synovial ou d'un autre tissu mou quelconque. Elles sont caractérisées par une croissance rapide. Malgré leur classique bénignité, si elles évoluent sans traitement, elles risquent de détruire le tissu adjacent et d'altérer la fonction, la structure et l'apparence de la région affectée lors du processus de croissance. Objectif: Décrire l'évolution clinique et la prise en charge thérapeutique d'un patient atteint de tumeur à cellules géantes au niveau de l'avant-bras. Cas clinique: Un patient âgé de 28 ans, diagnostiqué d'une tumeur osseuse au niveau du tiers distal du cubitus, sans abord ni traitement chirurgical dû à son refus de soin, est présenté. Un an après, il est rentré au service d'urgence. La tumeur avait grandi, et présentait des changements au niveau du tiers distal du cubitus, des lésions lytiques, une perte osseuse corticale, une réaction périostée, des bords mal définis, et un dommage des tissus mous environnants. Une probable tumeur à cellules géantes a été diagnostiquée. Le traitement chirurgical a permis la conservation de l'avant-bras, mais un an après l'intervention, son pronostic reste incertain, étant donnée la probabilité de récidive. Conclusions: La rapide croissance des tumeurs exige des décisions opportunes, car le temps parcouru avant le traitement peut se traduire -comme dans ce cas- par une atteinte destructive des tissus adjacents. Plus d'un an après la chirurgie, le pronostic du patient reste incertain, parce que la probabilité de récidive est encore latente(AU)
Subject(s)
Humans , Male , Adult , Ulna/surgery , Bone Neoplasms/surgery , Neoplasms, Post-Traumatic/surgery , Giant Cell Tumor of Bone/surgery , Mexico , Neoplasm Recurrence, Local/diagnosisABSTRACT
Modificar el conocimiento sobre factores de riesgo y técnica de autoexamen de mama. Método: se realizó un estudio de intervención educativa en dos consultorios del médico de familia de Camalote, en Guáimaro, desde el 2007 al 2008. El universo de estudio fue de doscientos ochenta y tres mujeres, entre treinta y cincuenta años de edad, la muestra fue de sesenta pacientes. Se aplicó una encuesta que contiene las variables seleccionadas. Los resultados obtenidos fueron procesados por métodos automatizados, utilizándose el paquete estadístico Microstat. Resultados: los malos hábitos dietéticos (31,67 porciento) y factores hormonales (21,66 porciento) fueron factores de riesgos encontrados, el 28,33 porciento lo consideró importante y realizó el autoexamen mamario el 8,3porciento. Luego de la intervención educativa el 53,33 porciento comenzó a realizar la técnica enseñada a partir de interiorizar su importancia. Conclusiones: el programa de intervención fue eficaz al lograr aumentar de forma significativa el nivel de conocimientos de todas las variables analizadas.
To modify the knowledge about risk factors and breast autoexam technique. Method: an educational intervention study in two doctor's offices of Camalote, in Guáimaro, from 2007 to 2008 was performed. The study universe was constituted by two-hundred eighty three women, between thirty and fifty years old, the sample remain conformed by sixty patients. A survey was applied that contains the selected variables. The obtained results were processed by automated methods, being used the statistical package Microstat. Results: the bad dietetic habits with (31,67 percent) and hormonal factors (21,66 percent) were the risk factors found, the 28,33 percent considered it important and carried out the mammary autoexam the 8,3 percent. After the educational intervention 53,33 percent began to carry out the technique taught starting from interiorize its importance. Conclusions: the intervention program was effective when being able to increase in a significant way the level of knowledge of all the analyzed variables.
Subject(s)
Humans , Female , Adult , Adult , Breast Self-Examination , Neoplasms, Post-Traumatic , Risk FactorsABSTRACT
Traumatic neuroma is a rare disorder that represents a reactive proliferation of neural tissue following damage to an adjacent nerve. Clinically, oral lesions usually appear as a nodule of normal or grayish white smooth surface colouration, and patients may complain of pain as a frequent symptom. We report a case of a painless lower lip traumatic neuroma, clinically misdiagnosed as lipoma, in a 24-year old Caucasian woman. On intraoral examination, a yellowish and smooth sessile, well-delimited, painless, nodular lesion measuring 10 mm x 7 mm x 4 mm in size was observed on the mucosal lower lip. An excisional biopsy was performed and the final diagnosis was traumatic neuroma. After 18 months of follow-up, the patient is asymptomatic and there are no signs of recurrence.
El neuroma traumático es un trastorno raro que consiste en una proliferación reactiva del tejido neural tras producirse un daño en un nervio adyacente. Clínicamente, las lesiones orales normalmente aparecen como un nódulo de coloración normal o blanca grisácea, de superficie lisa, y los pacientes pueden quejarse de dolor como síntoma frecuente. Reportamos el caso de un neuroma traumático del labio inferior labio sin dolor, clínicamente mal diagnosticado como lipoma, en una mujer blanca de 24 años. En el examen intraoral, se observó una lesión nodular amarillenta, sésil, lisa, bien delimitada, e indolora, que medía 10 mm x 7 mm x 4 mm de tamaño, en la mucosa del labio inferior. Se realizó una biopsia, y el diagnóstico final fue un neuroma traumático. Después de 18 meses de seguimiento, el paciente se halla asintomático y no hay ninguna señal de recurrencia.
Subject(s)
Female , Humans , Young Adult , Lip/pathology , Mouth Neoplasms/pathology , Neoplasms, Post-Traumatic/pathology , Neuroma/pathology , White People , Neoplasms, Post-Traumatic/diagnosis , Neuroma/diagnosisABSTRACT
El cáncer cutáneo no melanoma es el tipo de neoplasia maligna más frecuente en el hombre; cada año se reportan en el mundo entre dos y tres millones de nuevos casos y se estima que mueren 66 000 personas por este tipo de enfermedad. Entre un 40 y un 50 por ciento de toda la población habrá padecido al menos un tipo de cáncer cutáneo no melanoma al llegar a los 65 años, con un incremento actual de su incidencia, que afecta de manera considerable la población adulta laboralmente activa, con su desfavorable repercusión económica, social y el consecuente deterioro en la calidad de vida, a lo que se suma el costo elevado de su tratamiento en numerosos países...
Subject(s)
Humans , Adult , Carcinoma, Basal Cell , Neoplasms, Post-Traumatic , Skin Neoplasms/diagnosisABSTRACT
A intussuscepção intestinal em adultos é rara. Ao contrário do que ocorre na faixa pediátrica, é, na maioria das vezes, secundária a uma lesão definida com potencial significativo de malignidade. O objetivo deste estudo é avaliar retrospectivamente os aspectos diagnósticos e terapêuticos da intussuscepção intestinal em adultos. Foram estudados, retrospectivamente, os dados relativos às causas, à apresentação clínica, ao diagnóstico e ao manejo da doença em 16 pacientes, sendo 10 do sexo feminino (62 percent) e com média de idade de 49 anos (variação de 19-76 anos). Os principais achados clínicos foram: dor abdominal (100 percent), náuseas e vômitos (62,5 percent), massa palpável (62,5 percent), distensão abdominal (37,5 percent) e hemorragia digestiva baixa (31,25 percent). Sete pacientes (43,75 percent) apresentaram quadro agudo, sendo seis por obstrução intestinal (37,5 percent). O diagnóstico pré-operatório foi firmado em 8 pacientes (50 percent), através de exame clínico associado a ultra-sonografia, tomografia computadorizada, trânsito intestinal ou colonoscopia. Todos os pacientes foram submetidos a tratamento cirúrgico. Em cinco pacientes (31,25 percent) o segmento acometido foi o intestino delgado; em seis (37,5 percent) o íleo terminal e a valva ileocecal e em cinco (31,25 percent) havia acometimento colônico. Causa anatômica patológica foi identificada em 14 pacientes (87,5 percent), sendo que oito (50 percent) eram portadores de neoplasias malignas. Os procedimentos de ressecção realizados foram enterectomia (18,75 percent), hemicolectomia direita com anastomose primária (31,25 percent) ou ileostomia e fístula mucosa (12,5 percent), retossigmoidectomia a Hartmann (12,5 percent), retossigmoidectomia com anastomose primária (6,25 percent) e colectomia total com anastomose íleo-retal (6,25 percent). Dois pacientes (12,5 percent) foram tratados com redução sem ressecção. Complicações pós-operatórias ocorreram em 3 pacientes (seroma,...
Intestinal intussusception in adult patients is a rare entity. Differently from pediatric patients, this condition is often secondary to a defined lesion. A significant percentage of these lesions are malignant. Therefore, an optimal treatment is necessary to this condition. The aim of this study is to determine causes and management of adult intussusception. We carried out a retrospective review of adults patients with diagnosis of intussusception from 1997 to 2007 in our institution. Details concerning presentation, diagnosis, management, and pathology were analyzed. Sixteen patients with intestinal intussusception underwent laparotomy. There were 10 women with median age of 49 years (range, 19-76). Abdominal pain was the most common clinical finding. Seven patients (46.6 percent) presented with acute symptoms, six caused by intestinal obstruction. Diagnosis of gastrointestinal intussusception was correctly done preoperatively in 8 patients (50 percent). Five patients (31.25 percent) had the lead point of the intussusception in the small bowel, two in the jejunum and three in the ileum. Six patients (37.5 percent) had the lead point in the ileocecal valve resulting in ileocolic intussusception and five patients (31.25 percent) had colonic leading points. An anatomic or pathologic cause of the intussusception was identified in 14 patients (87.5 percent). In two patients (12.5 percent) the intussusception occurred in the postoperative period without associated lesions. Malignant neoplasms accounted for eight of sixteen patients (50 percent). All patients underwent operative management. The two patients who have postoperative intussusception of the small bowel underwent reduction with no resection. The others three patients with small bowel intussusception underwent to enterectomy. Right hemicolectomy was performed in five of the six patients with ileo-colonic intussusception. Retossigmidectomy was performed in one of the two patients...
Subject(s)
Humans , Female , Adult , Intestinal Obstruction , Intussusception/diagnosis , Intussusception/therapy , Neoplasms, Post-TraumaticABSTRACT
Traumatic neuroma is a well-known disorder that occurs after trauma or surgery involving the peripheral nerve and develops from a nonneoplastic proliferation of the proximal end of a severed, partially transected, or injured nerve. We present a case of traumatic neuroma around the celiac trunk after gastrectomy in a 56-year-old man, which was confirmed by pathology. CT demonstrated the presence of a lobulated, homogeneous, hypoattenuating mass around the celiac trunk, mimicking a nodal metastasis.
Subject(s)
Humans , Male , Middle Aged , Celiac Plexus/pathology , Diagnosis, Differential , Gastrectomy , Gastric Bypass , Lymphatic Metastasis , Neoplasms, Post-Traumatic/diagnosis , Neuroma/diagnosis , Peripheral Nervous System Neoplasms/diagnosis , Positron-Emission Tomography , Tomography, X-Ray ComputedABSTRACT
We describe here a case of traumatic neuroma that developed in the pancreas head as a rare complication of pancreatic surgery for pseudocyst. A 50-year-old man presented with septic shock. The patient was a heavy drinker with history of operation for pancreatic pseudocyst 28 years ago. On the radiologic examinations, a poorly defined mass-like lesion was found in the uncinate process of pancreas, and it had features of chronic pancreatitis and a stricture of the distal common bile duct. Whipple's operation was performed due to the diagnosis of suspected pancreas head cancer. The pancreas revealed an ill-demarcated 4 cm sized firm mass with grayish white fibrotic cut surface in the head portion. On the microscopic examination, the mass was composed of haphazard proliferations of nerve fascicles in a fibrocollagenous matrix and this case was diagnosed as traumatic neuroma. Although traumatic neruoma is a rare cause of a pancreatic mass, it should be included as a differential diagnosis of pancreatic mass in patients with a history of pancreatic surgery.
Subject(s)
Humans , Middle Aged , Common Bile Duct , Constriction, Pathologic , Diagnosis , Diagnosis, Differential , Head and Neck Neoplasms , Head , Neoplasms, Post-Traumatic , Neuroma , Pancreas , Pancreatic Pseudocyst , Pancreatitis, Chronic , Shock, SepticABSTRACT
La presente publicación cubre información sobre pacientes con cáncer, atendidos en el Instituto de Enfermedades Neoplásicas, de 1985 a 1997. Aquí, se muestran las neoplasias más frecuentes clasificadas por sexo y edad, así como, el análisis de los pacientes fallecidos por año y por diagnóstico. De la misma manera, se informa sobre los años potenciales de vida perdidos, lo cual da un indicio de la magnitud y el costo que representa el cáncer para el país
Subject(s)
Carcinoma , Epidemiology, Descriptive , Data Interpretation, Statistical , Neoplasms , Neoplasms, Post-Traumatic , PeruABSTRACT
A dermatomiosite é síndrome clínica rara e que freqüentemente cursa associada a neoplasias malignas, destacando-se no sexo feminino o câncer da mama e do trato genital. O tratamento do tumor primário comumente leva do quadro, porém o prognóstico é reservado para os pacientes que apresentam associaçäo dessas enfermidades. Os autores descrevem o caso de uma mulher de 29 anos com câncer da mama e dermatomiosite, cujo diagnóstico clínico e laboratorial ocorreu no 16 mês de seguimento. É apresentada revisäo da literatura sobre as manifestações clínicas, a epidemiologia, a etiologia, o diagnóstico e o tratamento
Subject(s)
Humans , Female , Adult , Breast Neoplasms , Dermatomyositis , Neoplasms, Post-Traumatic , Paraneoplastic Syndromes/diagnosisABSTRACT
Se revisa las principales neoplasias malignas que se presentan en la cavidad oral; se describe en cada una de ellas las prncipales características clínicas, así como el diagnóstico diferencial y el tratamiento de manera sucinta. Las neoplasias discutidas son carcinoma escamocelular, y sus variantes verrucosa y linfoepitelial, carcinoma basocelular, tumor celular clínico, sarcoma de Kaposi, melanoma maligno, condosarcoma, osteosarcoma, así como tumores metastásicos.
Subject(s)
Humans , Male , Female , Sarcoma, Kaposi , Mouth Neoplasms , Carcinoma, Basal Cell , Osteosarcoma , Chondrosarcoma , Neoplasms, Post-Traumatic , Carcinoma, Verrucous , Melanoma , Carcinoma, Squamous Cell , Diagnosis, DifferentialABSTRACT
Se presentan 4 pacientes que, sobre cicatrices de quemaduras previas, desarrollaron carcinomas espinocelulares después de un tiempo suficientemente prolongado de hasta 50 años. Se realizan consideraciones terapéuticas sobre la oportunidad del uso de injerto en las secuelas de quemaduras de 3§ grado.
Subject(s)
Humans , Burns , Carcinoma, Squamous Cell , Cicatrix , Skin Neoplasms , Skin Ulcer , Carcinoma, Squamous Cell , Neoplasms, Post-Traumatic , Skin Neoplasms , Skin Ulcer , Time FactorsABSTRACT
Analisamos 105 neoplasias malignas em 94 pacientes (6,2 porcento) - 11 deles com 2 tipos diferentes de neoplasias - observados em um grupo de 1.511 pacientes transplantados renais, entrre janeiro de 1965 a dezembro de 1990. Dos 105 casos de neoplasias malignas observadas 85 casos eram da linhagem epitelial e 20 casos de linhagem mesenquimal. Das neoplasias da linhagem epitelial, 33 casos (31.41 porcento) eram de pele - 19 casos espinocelulares, (CEC) 12 casos basocelulares (CBC) e 2 casos espino-basocelulares - , 14 casos (13,3 porcento) eram de língua, lábio ou períneo e 38 casos (36,2 porcento) eram de outros tipos: Fígado (8), intestino (5), rim primitivo (5), tireóide(3), colo uterino(5),endométrtio(3), melanoma(3), mama(2), pulmäo(2) e indiferenciados(2). Das neoplasias de linhagem mesenquimal, a mais frequente foi o sarcoma de Kaposi (9 casos), seguido de linfoma (4), leucemis(3) e outros tipos(4). A incidência de neoplasia aumentou com o tempo pós-transplante: de 0 a 12 meses, 1,05 porcento; de 13 a 60 meses, 2,83 porcento; de 61 a 120 meses,3,91 porcento; de 121 a 180 meses, 6,64 porcento; e de 181 a 240 meses, 7,46 porcento. Quanto à tipagem HLA,A,B, a incidencia de CEC e CBC foi mais frequente em portadores de antígenos A3, B7 e B27. Nenhum caso desse tipo de tumor ocorreu em pacientes HLA B17 e B35 positivos. Portadores de antígenos A3, B7 e B17 estiveram associados a presença de outras neoplasias epiteliais. Os portadores de neoplasia da linhagem mesenquimal tinham mais frequentemente antígenos A9, A28 e B12. O prognóstico foi pior nos casos das neoplasias de linhagem mesenquimal, onde a mortalidade foi de 60 porcento. Concluímos que as neoplasias malignas säo um tipo de complicaçäo importante no pós-transplante renal, sendo as mais frequentes aquelas da linhagem epitelial (81 porcento).(au)
Subject(s)
Humans , HLA Antigens/immunology , Kidney Transplantation , Neoplasms, Post-Traumatic/complications , Neoplasms, Post-Traumatic/diagnosis , Neoplasms, Post-Traumatic/physiopathologyABSTRACT
A 70-year-old man with previous cholecystectomy developed progressive obstructive jaundice, 3 months before hospitalization. Intraoperatively, a 2 x 2 x 1.5-cm mass in the distal part of the right hepatic duct was excised to release complete obstruction. It was verified as traumatic (amputation) neuroma. Despite rarity, traumatic neuroma of the bile duct should be considered in patients who have antecedent surgical procedure of the biliary tract with subsequent occurrence of extrahepatic biliary obstruction.
Subject(s)
Aged , Bile Duct Neoplasms/etiology , Cholecystectomy/adverse effects , Cholestasis, Extrahepatic/etiology , Hepatic Duct, Common/innervation , Humans , Male , Neoplasms, Post-Traumatic/etiology , Neuroma/etiologySubject(s)
Diagnosis, Oral , Mouth Mucosa/injuries , Mouth Neoplasms , Acquired Immunodeficiency Syndrome , Alcoholism , Carcinogens , Chronic Disease , Mortality/trends , Neoplasms , Neoplasms, Post-Traumatic , Nutrition Disorders , Radiation , Nicotiana , Nicotiana/adverse effects , Tolonium Chloride , Toluidines , Tumor Virus InfectionsABSTRACT
A partir de uma nova rotina de atendimento implantada pelos serviços implicados, foram analisadas as representaçöes das pacientes que se submetem a tratamento cirúrgico do câncer de mama. O atendimento multidisciplinar revelou-se importante para a humanizaçäo do atendimento, fato que está presente no discursos da pacientes. Foram atendidas 57 pacientes, no período de 2 anos e meio. Os temores relativos à mutilaçäo e aos danos do tratamento, bem como outras representaçöes sobre a causa da doença, revelaram-se, em muitos casos, impeditivos da procura precoce do tratamento especializado, tendo relevância na prevençäo secundária da enfermidade