RESUMO
Malignant peripheral nerve sheath tumor (MPNST) is a type of soft tissue sarcoma arising from peripheral nerves. They can be found in isolation, but about half of the cases are associated with neurofibromatosis type 1 (NF1), an autosomal dominant genetic disorder. They usually arise from the nerve plexus in extremities and trunk. MPNSTs arising from the viscera or internal organs are very rare. We hereby report a rare case of sporadic MPNST arising from pleural surface in a middle-aged male. The diagnosis of such a rare entity involved multimodal investigations with consideration of wide differential diagnosis.
Assuntos
Neoplasias , Neoplasias de Bainha Neural/diagnóstico por imagem , Pleura/patologia , Antineoplásicos/uso terapêutico , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias de Bainha Neural/tratamento farmacológico , Neoplasias de Bainha Neural/secundário , Neoplasias de Tecidos Moles/diagnóstico por imagem , Neoplasias de Tecidos Moles/tratamento farmacológico , Neoplasias de Tecidos Moles/patologia , Tomografia Computadorizada por Raios X , Resultado do TratamentoAssuntos
Adenocarcinoma de Pulmão/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Resistencia a Medicamentos Antineoplásicos , Neoplasias Pulmonares/tratamento farmacológico , Proteínas de Fusão Oncogênica/genética , Acrilamidas/administração & dosagem , Adenocarcinoma de Pulmão/genética , Adenocarcinoma de Pulmão/patologia , Idoso , Compostos de Anilina/administração & dosagem , Carbazóis/administração & dosagem , Humanos , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patologia , Masculino , Piperidinas/administração & dosagem , PrognósticoRESUMO
BACKGROUND: Hyperglycemia is a common comorbidity in hospitalized patients and may add to adverse outcomes. Various associations have issued guidelines for optimal management of hyperglycemia in ill patients. This study aims to assess the adherence to current guidelines in inpatient setting and the impact of educational interventions on the improvement in adherence to guidelines as well as its effect on the level of blood sugar control and patient outcomes. MATERIALS AND METHODS: It was a quasi-experimental pretest and posttest study and was done in three phases, viz., observation of current practices, intervention in the form of educational interventions, and its effect on change in practices and patient outcomes. RESULTS: There was statistically significant 22% increase in the use of recommended insulin regimens (P = 0.028). The proportion of blood sugars within recommended range in the first 48 h, mean daily blood sugars, and the incidence of severe hyperglycemia improved in phase 3 vs phase 1 and was statistically significant. On comparing the subgroups, viz., those who followed and those who did not follow the guidelines, the results of the proportion of blood sugar in recommended range and proportions of blood sugar of more than 250 were found to be statistically significant. CONCLUSION: Dedicated educational interventions help in improving healthcare practices. According to current guidelines, rapid improvement in hyperglycemia and better glycemic control occur with adherence to protocol-based management of hyperglycemia.
