RESUMO
Self-administered questionnaires were completed by 314 Trinidadian women, 40 years and older, to ascertain their breast cancer knowledge, attitudes, and practices. Those with higher education had greater knowledge of the benefits of early breast cancer detection (p < .01) and knew that an abnormal mammography result (p = .01) or recall (p < .01) was not necessarily indicative of breast cancer. Inaccurate beliefs particularly that breast compression causes cancer were more likely among those with the least education (p = .04). Obesity and alcohol were identified as risk factors by 29.3% and 12.4%, respectively. Over two-thirds (70%) of mammograms were primarily the doctor's decision. Over 90% of women were satisfied post-mammography, most (94.6%) with plans for future use. Some (15.6%) reported pain and 48.7% reported discomfort, with over 70% of these finding the examination less painful than anticipated. Targeted culturally sensitive awareness campaigns are needed. Clinicians must be sensitized to their importance in recommending mammography. Data on patient satisfaction and pain perception can be publicized to encourage women who are hesitant about mammography.
Assuntos
Neoplasias da Mama/diagnóstico , Neoplasias da Mama/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Mamografia , Satisfação do Paciente , Adulto , Diagnóstico Precoce , Feminino , Humanos , Pessoa de Meia-Idade , Inquéritos e Questionários , Trinidad e TobagoRESUMO
A middle-aged female patient, previously diagnosed with asthma, presented with a large spontaneous left pneumothorax. She had a history of nephrectomy for a ruptured renal angiomyolipoma (AML) with a postoperative spontaneous pneumothorax when she was an adolescent. High-resolution CT chest revealed multiple scattered thin-walled lung parenchyma cysts consistent with lymphangioleiomyomatosis (LAM). Hepatic AMLs and adenoma sebaceum skin lesions were also noted, consistent with an overall diagnosis of tuberous sclerosis. Her acute management included lung re-expansion via chest tube insertion, antibiotics for concurrent chest infection, nebulisation and chest physiotherapy. Since discharge, the patient had only occasional shortness of breath, relieved by bronchodilators. She is considering expanded immunisation as well as enrolment in a clinical trial. Her hepatic AMLs will be monitored via ultrasound for growth. LAM treatment is generally aimed at its complications with lung transplantation reserved for severe disease; however, hormonal therapy and the mTOR inhibitor aim at targeting systemic disease.
Assuntos
Linfangioleiomiomatose/diagnóstico , Pneumotórax/etiologia , Esclerose Tuberosa/diagnóstico , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Linfangioleiomiomatose/complicações , Linfangioleiomiomatose/terapia , Pneumotórax/terapia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Esclerose Tuberosa/complicações , Esclerose Tuberosa/terapiaRESUMO
Plexiform neurofibromas are essentially pathognomonic for neurofibromatosis type 1 (NF1), occurring when there is diffuse involvement along a nerve segment and its branches. Transformation into a malignant peripheral nerve sheath tumour (MPNST) is a major cause of mortality in NF1 patients. These tumours are highly aggressive and particularly difficult to diagnose in NF1 patients due to the clinical overlap between benign and malignant lesions. We present a case of a plexiform neurofibroma and discuss the typical imaging characteristics on ultrasound, CT, and MRI, including the target sign and continuity with the parent nerve. Certain imaging features should raise suspicion for malignancy however, these modalities may not always reliably differentiate between benign and malignant lesions. Recent studies show a very high negative predictive value for FDG-PET making it quite useful in excluding malignancy. In positive scans, PET/CT aids in guiding biopsy to the most metabolically active area of the tumour.