Real-world assessment of the patient-centredness of endometriosis care: European countries benchmarked by patients.

European patients cross the borders of their countries to receive more patient-centred healthcare. Benchmarking across European countries for the patient-centredness of endometriosis care had yet to be performed. This study proved the factorial structure and reliability of translation of the ENDOCARE questionnaire in nine different languages. Moreover, the benchmark potential of the ENDOCARE questionnaire was shown by the significant between-country variance for case-mix-adjusted overall and dimensional patient-centredness scores, explaining 3-9% of the total variance in patient-centredness assessed across 10 European countries. Compared with the least patient-centred country, endometriosis care was more patient-centred in Denmark, Italy and Belgium. 'Reaching a diagnosis quickly' and 'physicians demarcating the endometriosis complexity level which they can treat' were consistently rated of more-than-average importance and were experienced negatively by more than half of the European sample. National and European policymakers and specialized clinics are prompted to monitor their patient-centredness and set up improvement projects.

Carcinoma, tuberculosis and elastofibroma in one patient: is [18F]FDG-PET/CT helpful?

We present the case of a woman with persistent dorsal pain and two solid lung lesions documented on multidetector CT which showed concomitant [18F]FDG uptake. One of the lesions proved to be adenocarcinoma at biopsy and presented a lower [18F]FDG uptake when compared to the second lesion, which was smaller in size, and was postsurgically diagnosed as tuberculoma. This case portrays the paradoxical metabolic behaviour of two lesions, leading to misdiagnosis and erroneous disease staging in an oncology patient. Incidentally, the patient also had an elastofibroma dorsi, a rare benign tumour which can also be a possible source of false results in the PET exam. We provide explanations and possible solutions to these findings in order to familiarise the physician with them, and optimise patient management (AU)

Se presenta el caso de una mujer con dorsalgia persistente y 2 lesiones pulmonares de carácter sólido visualizadas en tomografía computarizada multidetector. Dichas lesiones mostraban concomitantemente captación de [18F]FDG. Una de las lesiones se diagnosticó de adenocarcinoma tras la biopsia, y presentaba una captación de [18F]FDG de menor intensidad que la mostrada por la segunda lesión, de menor tamaño, y que tras la cirugía se diagnosticó como tuberculoma. Este caso demuestra cómo el comportamiento metabólico paradójico de 2 lesiones puede suponer un diagnóstico y estadificación oncológico erróneo. Incidentalmente, la paciente también se vio afectada de un elastofibroma dorsi, un tumor benigno poco frecuente, que puede ser, a su vez, causa de falsos positivos en el examen PET (tomografía por emisión de positrones). Con este caso se pretende ofrecer razonamientos y posibles soluciones a estos hallazgos, así como familiarizar al médico con estas entidades para optimizar el tratamiento del paciente oncológico (AU)