乳腺慢性化脓性炎超声误诊乳癌1例

病例 女,28岁,发现右乳肿物1月人院,患者1月前于睡眠中突然右乳疼痛,持续约1 min,后自行缓解,自平卧位改为坐卧位时,可诱发右乳疼痛.当时自行触摸右乳,可及一肿物,大小约8 cm×6 cm,伴压痛.后偶觉右乳肿物周围及右乳头刺痛,能忍受.专科体检:双乳外观对称,无橘皮样改变,无酒窝征,局部无静脉怒张.触诊右乳于9点钟至3点钟方向,乳头旁可触及一椭圆形肿物,大小约8 cm×6 cm,局部无发红,肿块质地稍硬,表面欠光滑,边界尚清,与周围无明显粘连,活动度欠佳,伴压痛.触诊左乳未及肿物.     

超声对肉芽肿性乳腺炎与浆细胞性乳腺炎的鉴别诊断价值

<正>肉芽肿性乳腺炎(granulomatous mastitis,GM)是一种少见的乳腺慢性炎症性疾病,与较常见的浆细胞性乳腺炎(plasma cell mastitis,PCM)同属于非哺乳期乳腺炎。二者多发生于30~40岁女性,临床表现复杂多样,症状互有交叉,易误诊为同一种疾病,延误治疗。本组回顾分析我院经超声诊断为GM和PCM并行手     

Tuberculous and granulomatous mastitis

Granulomatous breast diseases are rare and may be indistinguishable clinically from carcinoma. Four cases illustrating the various modes of presentation and diagnostic difficulties are presented. Guidelines for management are suggested.     

Chronic illness: the importance of support for families caring for a child with cystic fibrosis

• ? The effect of chronic life-threatening illness on the family is one of the major problems confronting the health-care system today. Increasingly, parents have the major responsibility for the daily management of their child's condition.
• ? There is evidence that many parents lack the pofessional help and support which could ameliorate some of their problems. It is important that nurses have an understanding of how families cope with the burden of caring for a chronically ill child.
• ? Health professionals need clear guidelines on how to support these families in their role as primary care-givers.
• ? This paper examines how families of children with cystic fibrosis adapt to the illness in order to provide indicators for nursing practice and to enhance the care and support provided for these families.
• ? Effective coping strategies include: assigning meaning to the illness, sharing the burden, denial of diagnosis and incorporating therapy in a schedule.

     

Aetiology of idiopathic granulomatous mastitis

Idiopathic granulomatous mastitis is a rare chronic inflammatory lesion of the breast that can clinically and radiographically mimic breast carcinoma. The most common clinical presentation is an unilateral, discrete breast mass, nipple retraction and even a sinus formation often associated with an inflammation of the overlying skin. The etiology of idiopathic granulomatous mastitis is still obscure. Its treatment remains controversial. The cause may be the autoimmune process, infection, a chemical reaction associated with oral contraceptive pills, or even lactation. Various factors, including hormonal imbalance, autoimmunity, unknown microbiological agents, smoking and α 1-antitrypsin deficiency have been suggested to play a role in disease aetiology. In this review, causing factors in the aetiology of idiopathic granulomatous mastitis are reviewed in detail.     

Chronic Pseudomonas aeruginosa infection in cystic fibrosis airway disease: metabolic changes that unravel novel drug targets

The cystic fibrosis (CF) airways have an incompletely characterized defect in innate defense that eventually leads to bacterial infection and airway inflammation. Persistent Pseudomonas aerugionsa infection resulting from defective innate immunity and a bacterial phenotypic switch to a more intractable mucoid form inside the airway are now well established as important components of CF pathogenesis. Broad-based factors leading to chronic infection will be discussed with respect to: bacterial virulence in the context of biofilm formation, quorum sensing machinery and alginate overproduction, and failure of innate lung immunity in CF airways. In addition, a controversial question as to whether inflammation or infection comes first during CF airway disease will be addressed. Finally, a new hypothesis, that P. aeruginosa thrives as biofilms within the thickened anaerobic mucus layers, will be developed.     

Chronic Pseudomonas aeruginosa infection in cystic fibrosis airway disease: metabolic changes that unravel novel drug targets

The cystic fibrosis (CF) airways have an incompletely characterized defect in innate defense that eventually leads to bacterial infection and airway inflammation. Persistent Pseudomonas aerugionsa infection resulting from defective innate immunity and a bacterial phenotypic switch to a more intractable mucoid form inside the airway are now well established as important components of CF pathogenesis. Broad-based factors leading to chronic infection will be discussed with respect to: bacterial virulence in the context of biofilm formation, quorum sensing machinery and alginate overproduction, and failure of innate lung immunity in CF airways. In addition, a controversial question as to whether inflammation or infection comes first during CF airway disease will be addressed. Finally, a new hypothesis, that P. aeruginosa thrives as biofilms within the thickened anaerobic mucus layers, will be developed.     

Management of mastitis in breastfeeding women

Mastitis occurs in approximately 10 percent of U.S. mothers who are breastfeeding, and it can lead to the cessation of breastfeeding. The risk of mastitis can be reduced by frequent, complete emptying of the breast and by optimizing breastfeeding technique. Sore nipples can precipitate mastitis. The differential diagnosis of sore nipples includes mechanical irritation from a poor latch or infant mouth anomalies, such as cleft palate or bacterial or yeast infection. The diagnosis of mastitis is usually clinical, with patients presenting with focal tenderness in one breast accompanied by fever and malaise. Treatment includes changing breastfeeding technique, often with the assistance of a lactation consultant. When antibiotics are needed, those effective against Staphylococcus aureus (e.g., dicloxacillin, cephalexin) are preferred. As methicillin-resistant S. aureus becomes more common, it is likely to be a more common cause of mastitis, and antibiotics that are effective against this organism may become preferred. Continued breastfeeding should be encouraged in the presence of mastitis and generally does not pose a risk to the infant. Breast abscess is the most common complication of mastitis. It can be prevented by early treatment of mastitis and continued breastfeeding. Once an abscess occurs, surgical drainage or needle aspiration is needed. Breastfeeding can usually continue in the presence of a treated abscess.     

肉芽肿性小叶性乳腺炎超声表现

目的探讨肉芽肿性小叶性乳腺炎(GLM)的高频超声图像特征。方法对23例以乳腺包块就诊,经术前超声及手术病理证实为GLM患者的病例资料进行回顾性分析。在灰阶声像图上观察肿块大小、形状、边界、内部回声及后方回声。应用彩色多普勒血流成像(CDFI)观察病灶内部及其周围血流分布和供应情况。结果23例GLM患者(均经手术后病理证实)均为经产妇,年龄20～43岁。灰阶声像图显示12例表现为连续或不连续的不规则管状结构样低回声区,低回声区周围为高回声;5例表现为单发或多发、边界相对清楚、不均质低回声结节或肿块,其内可伴无回声区;5例表现为病变区腺体结构紊乱,未见明确边界,内部回声强弱不一,病变内可见无回声区;1例表现为边界模糊、形态不规则的低回声实质肿块伴后方回声衰减。23例中患处皮肤层增厚8例,6例伴有皮肤破溃,窦道形成。CDFI示22例(22/23)病变内部及周边动静脉血流信号明显增加。结论GLM病变的超声表现具有一定的特点,但这些表现不具有特征性,确诊仍需病理学检查。