#16
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Êàê ÿ ïîíÿëà, ýòîò àíàëèç áûë íàçíà÷åí ìíå ïîòîìó, ÷òî âñå îñòàëüíûå ïðè÷èíû ïîÿâëåíèÿ íåâðîïàòèè áûëè èñêëþ÷åíû. Îñòàëàñü òîëüêî èäèîïàòè÷åñêàÿ àìèîòðîôè÷åñêàÿ íåâðàëãèÿ (è òî â àòèïè÷íîé ôîðìå) è ñêðûòàÿ îïóõîëü.
Ê òîìó æå íåâðîëîã, êîòîðûé ìåíÿ ëå÷èò, òîæå îäèí èç êîíñóëüòàíòîâ ýòîãî ôîðóìà, ïðèäåðæèâàþùèéñÿ ïðèíöèïîâ äîêàçàòåëüíîé ìåäèöèíû, ïîýòîìó ïîëàãàþ, ÷òî äàíííûé àíàëèç áûë íàçíà÷åí íåñïðîñòà. Ñî ñëîâ âðà÷à ìîé ñëó÷àé íå ðÿäîâîé. Êàê ìíå êàæåòñÿ, âðà÷-íåâðîëîã ìîæåò çàïîäîçðèòü, íî îí íå ìîæåò èñêëþ÷èòü îïóõîëü, â âèäó äðóãîé ñïåöèàëèçàöèè, äëÿ ýòîãî è íàïðàâëÿþò çà êîíñóëüòàöèåé ê îíêîëîãàì. |
#17
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«Due to their high specificity (> 90%), the best way to diagnose a neurological disorder as paraneoplastic is to identify one of the well-characterized anti-onconeural protein antibodies in the patient's serum. In addition, as these antibodies are associated with a restricted range of cancers, they can guide the search for the underlying tumor at a stage when it is frequently not clinically overt. This is a critical point as, to date, the best way to stabilize PNS is to treat the cancer as soon as possible.»
Èñòî÷íèê: [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] |
#18
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Íå ñòîèò èñêàòü ñòàòüè ïîä ñâîå ïðåäïîëîæåíèå.
 ïðèâåäåííîì îòðûâêå ðå÷ü î ëå÷åíèè ïàðàíåîïëàñòè÷åñêîãî ñèíäðîìà ó ïàöèåíòîâ ñ óæå óñòàíîâëåííûì äèàãíîçîì. Ó Âàñ - íåò òàêîãî äèàãíîçà.  ýòîé æå ñòàòüå ãîâîðèòñÿ î òàêòèêå â òàêèõ ñëó÷àÿõ: For patient with a neurological disorder that is highly suspected to be paraneoplastic but for whom no cancer has yet been identified, detection of the tumor is essential but may be difficult since the tumors initially may be histologically small and localized [68]. If paraneoplastic antibodies are present, they direct the tumor search to specific organs. If a SCLC is suspected, the tumor is generally detected by chest CT scan [69,70]. If a gynecological tumor is suspected, careful breast and pelvic examination, mammography and pelvic CT scan are recommended. If no malignancy is revealed during initial workup, surgical exploration and removal of pelvic organs may be warranted, particularly in postmenopausal women [16]. The use of whole-body positron emission tomography with fluorodeoxyglucose (FDG-PET) should be reserved for patients with paraneoplastic antibodies for whom conventional imaging has failed to identify a tumor or when lesions are difficult to biopsy. |
#19
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Ïîíÿëà, ñïàñèáî
Ïîäñêàæèòå åù¸, ïîæàëóéñòà, êàêèå èññëåäîâàíèÿ ãðóäè â ìîåì ñëó÷àå (36 ëåò, íå ðîæàëà, ãðóäü 1,5-2 ðàçìåð) ñòîèò ïëàíîâî ïðîâîäèòü è êàê ÷àñòî? |
#20
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#21
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Çäðàâñòâóéòå! Äëÿ èñêëþ÷åíèÿ ïàðíåîïëàñòè÷åñêîãî ïðîöåññà (ðàêà ëåãêèõ è òèìîìû) áûëî ñäåëàíî ÊÒ ãðóäíîé êëåòêè, â çàêëþ÷åíèè ïîìèìî ïðî÷åãî íàïèñàíî: «ïðèçíàêè íåðåäóöèðîâàííîé âèëî÷êîâîé æåëåçû» - ÷òî ýòî ìîæåò çíà÷èòü?
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#22
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Íà âñÿêèé ñëó÷àé ññûëêà íà ÊÒ: [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
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#23
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Öèòàòà:
Âîïðîñû íàäî çàäàâàòü âðà÷ó, íàçíà÷èâøåìó îáñëåäîâàíèÿ. |
#24
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Çäðàâñòâóéòå! Ó ìåíÿ âîïðîñ ïî ïîâîäó âñå òîãî æå ìíîãîñòðàäàëüíîãî ëåâîãî ñîñêà(
Êîæà â íèæíåé ÷àñòè ñîñêà ïîòåìíåëà. È íà äíÿõ îïÿòü ïîÿâèëàñü êàïåëüêà êðîâè èç ïðîòîêà. Ãðóäü íå ò¸ðëà, îá îäåæäó íå íàòèðàëà, íèêàê íå òðàâìèðîâàëà. Íåñêîëüêî ëåò íàçàä òîæå ïîÿâëÿëèñü òàêèå ïîòåìíåíèÿ êîæè, îáðàùàëàñü òîãäà ê ìàììîëîãó â ïîëèêëèíèêå, îí íàïðàâèë ê äåðìàòîëîãó, à òîò â ñâîþ î÷åðåäü ñêàçàë, ÷òî íå çíàåò ÷òî ýòî òàêîå. Ñòîèò ëè íà ýòî îáðàùàòü âíèìàíèå? ß ìîãó îòïðàâèòü ôîòîãðàôèþ â ËÑ, ò.ê. çäåñü â îáùåì äîñòóïå íå õî÷åòñÿ ðàçìåùàòü. |
#25
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