ObjectivesThe aim of this study was to compare potential differences between the perception that COPD patients have of their disease and the perception that physicians have of how the disease affects their patients.MethodsSurveys in COPD patients and physicians caring for COPD patients were conducted in Spain, Italy, and Germany. Online questionnaires mirrored to explore the same domains, were administered to patients and physicians. Physicians were asked to respond to the questionnaire taking a recently seen patient who represents the majority of COPD patients usually managed, as a reference. Patients with COPD completed a survey containing the same questions offered to the physicians (Medical Investigation of Respiratory COPD Perception [MIRROR] survey). Comparisons between the responses of patients and general practitioners (GPs) and between patients and pulmonologists (PULs) were run separately using the chi-square, Fisher’s exact, or Student’s t-tests.ResultsA total of 334 COPD patients, 333 GPs, and 333 PULs participated in the surveys. The typical perception that PULs have of the COPD patient was that of an older man with more severe disease and less likely to be a smoker, than the included COPD patients. COPD was regarded as a major health problem by patients and physicians, but its impact on overall quality of life among more severe patients was less strongly perceived by physicians than by patients. Instead, physicians paid more attention to domains related to clinical features (cough, phlegm, and dyspnea), while underestimating COPD impact on leisure and social activities. The majority of patients stated not being completely frank with their doctors during visits. Both GPs and PULs seemed to recognize this issue but underestimated its extent.ConclusionTo improve the doctor–patient communication, a more frank reporting by the patients of their symptoms and feelings and an increased awareness of physicians about the impact on nonconventional domains that patients perceive as importantly affected by COPD should be encouraged.
Purpose: Evaluate the role of Magnetic Resonance Imaging (MRI) in the differential diagnosis between degenerated leiomyomas, cellular leiomyomas and uterine sarcomas.
Materials and methods:From February 2015 to August 2015, 42 patients were enrolled, aged between 18 and 75 years, suffering from uterine "mass" waiting for surgery and considered at risk and/or uncertain clinical and laboratory investigations and imaging. These patients were submitted to MRI exam of the pelvis that was performed by morphological study, DWI sequences and dynamic sequences post-contrastographic.
Results:The analysis of MRI images of the 42 patients made possible to do a diagnosis of uterine sarcomas in 8 patients with the aid of sequences weighted in diffusion and dynamic, proving a sensitivity of 100% and a specificity of 88%.
Conclusions:Based on our experience, we may consider that by morphological study with DWI sequences weighted in diffusion and dynamic post-contrastographic sequences, the MRI is a working aid in the differential diagnosis between degenerated leiomyomas and uterine sarcomas.
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