RESUMO
Two patients presented with pleuritic pain and dyspnoe together with pleural thickening on the X-ray of the chest. In both a history of exposure to asbestos existed suggesting mesothelioma. A definite diagnosis could not be made and therefore therapy was symptomatic. Autopsy revealed the unexpected diagnosis of atypical carcinoid of the lung. In one case, pleural spread of tumor was seen while in the other an extensive fibrotic pleural reaction existed. To our knowledge these cases represent the first examples of atypical carcinoid causing pseudomesothelioma.
Assuntos
Tumor Carcinoide/diagnóstico , Neoplasias Pulmonares/diagnóstico , Mesotelioma/diagnóstico , Idoso , Asbestose/diagnóstico , Autopsia , Diagnóstico Diferencial , Evolução Fatal , Humanos , MasculinoRESUMO
Assessing the reproductive choices of parents of children with cystic fibrosis (CF) is important in getting a greater insight into the possible needs for counselling of carrier couples in the reproductive decision-making process. Also, parents' reproductive attitudes might indicate critical issues for discussion with regard to introducing general population screening programmes. Data were available from two groups of subjects: 287 adult patients with CF (mean age 27.5 years) and 288 parents of a child with CF (mean age of child 7.7 years) who participated in a Dutch national survey. Attitudes towards reproductive issues and carrier screening and parents' reproductive behaviour were analysed in terms of responses to questionnaires. To avoid having another child with CF, most parents decided against further pregnancies or used other reproductive options. Prenatal diagnosis was used by 72% of parents, whereas 76% of parents planning more children intended using this option. Intention to use prenatal diagnosis was associated with the strength of religious conviction, and was not associated with perceived severity of CF, health of the child, or future therapeutic possibilities. Respondents demonstrated difficulties in deciding to abort for CF. A majority of parents and adult patients supported carrier couple identification within CF families. The results suggest that those most closely involved with CF will accept the reproductive choices of carrier couples identified in population screening programmes.
Assuntos
Atitude Frente a Saúde , Fibrose Cística/genética , Fibrose Cística/psicologia , Triagem de Portadores Genéticos , Reprodução , Aborto Induzido/psicologia , Adolescente , Adulto , Idoso , Comportamento , Criança , Pré-Escolar , Fibrose Cística/diagnóstico , Feminino , Aconselhamento Genético , Humanos , Lactente , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Gravidez , Diagnóstico Pré-Natal/psicologiaAssuntos
Fibrose Cística/diagnóstico por imagem , Embolia Aérea/diagnóstico por imagem , Veia Porta/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto , Doenças do Colo/complicações , Doenças do Colo/diagnóstico por imagem , Constipação Intestinal/complicações , Constipação Intestinal/diagnóstico por imagem , Fibrose Cística/complicações , Embolia Aérea/etiologia , Feminino , Humanos , Obstrução Intestinal/complicações , Obstrução Intestinal/diagnóstico por imagem , Intestino Delgado/diagnóstico por imagem , Veia Cava Inferior/diagnóstico por imagemRESUMO
The appearance of the pancreas in 17 adult patients with cystic fibrosis was evaluated with magnetic resonance (MR) imaging. The pancreas was abnormal in 15 patients. Three patterns were observed: (a) lobulated enlarged pancreas with complete replacement by fatty tissue (n = 9), (b) small atrophic pancreas with partial replacement by fat tissue (n = 5), and (c) diffuse atrophy of the pancreas without fatty replacement (n = 1). Replacement of the pancreas by fat tissue was seen on T1-weighted images with, characteristically, a very high signal intensity. The sensitivity of MR imaging in depicting pancreatic abnormality in cystic fibrosis is 94%, which is comparable to that of computed tomography.