European medical Journal. Urology最新文献

{"title":"Benzodiazepines in the Treatment of Behavioural and Psychological Symptoms Associated with Dementia and Their Impact on Cognitive Impairment: Review of Clinical Evidence","authors":"Pasqualina Stranieri, Rosa Maria Cordaro","doi":"10.33590/emj/10179113","DOIUrl":"https://doi.org/10.33590/emj/10179113","url":null,"abstract":"Alzheimer’s disease (AD) is the most common form of progressively disabling degenerative dementia. In dementia in general, there are, unfortunately, even from the earliest stages of the disease, associated behavioural and psychological symptoms of dementia (BPSD), and even more pronouncedly in AD, in addition to cognitive impairment. There are no specific drugs for the treatment of BPSDs. Therefore, there remains an unmet medical need. To date, despite side effects, benzodiazepines, anti-psychotics, mood stabilisers, and anti-depressants continue to be used in the clinic. The aim of this research work is to provide an understanding of the role of benzodiazepines when used for the treatment of BPSD and cognitive impairment in AD.","PeriodicalId":90162,"journal":{"name":"European medical Journal. Urology","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90489429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of Chronic Pelvic Pain in Females Attending a Gynaecology Outpatient Department","authors":"Sadia Shoukat, M. Tasneem, T. Zahid, Jahooran Mariyah Bibi Goolamnobee","doi":"10.33590/emj/10302260","DOIUrl":"https://doi.org/10.33590/emj/10302260","url":null,"abstract":"Background and Aims: Chronic pelvic pain (CPP) is a persistent pelvic pain that\u0000leads to reduced work performance and impaired quality of life in females. Nearly\u000015% of females report time off from paid work and around 45% report reduced\u0000work productivity. There is a paucity of studies to address the issue, especially\u0000with a multidisciplinary and multifactorial view. Various gynaecological disorders\u0000are associated with CPP such as endometriosis, adenomyosis, adhesions, chronic\u0000pelvic inflammatory disease, and pelvic congestion syndrome. The objective is\u0000to determine the frequency of CPP in females attending gynaecologic outpatient\u0000departments.\u0000Materials and Methods: A total of 201 patients aged 14–48 years attending the\u0000gynaecologic outpatient department for gynaecological disorders with complaints\u0000of lower abdominal pain were included in this study. Patients enrolled in the study\u0000were assessed by a detailed history and pelvic examination, and a structured\u0000questionnaire was filled out. Data were analysed using the statistical package for\u0000social sciences version 23.0 (International Business Machines Corporation, Armonk,\u0000New York, USA).\u0000Results: The mean age of the patients was 32.39±6.98 years. The frequency of CPP\u0000in females was observed as 95.52% (95% confidence interval: 91.67–97.93%) The\u0000rate of CPP was significantly high in females with parity ≤5 and those who had a\u0000duration of pain lower than 36 months. In multivariate analysis, adjusted odds ratio\u0000by stepwise logistic regression model showed that parity (parity 0–1) and duration of\u0000pain (≤36 months) were significantly associated with CPP in females.\u0000Conclusion: The study indicates that the most common gynaecological causes of\u0000CPP in females attending the outpatient department were those with endometriosis\u0000followed by adenomyosis. The management of CPP needs patient-centred care with\u0000a multidisciplinary approach. This will lead to early and effective management.","PeriodicalId":90162,"journal":{"name":"European medical Journal. Urology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79989226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caseous Mitral Annular Calcification Presenting as Retinal Artery Occlusion","authors":"H. Gower, M. Hamilton, N. Manghat, Mohammed O A Abubakr","doi":"10.33590/emj/10305506","DOIUrl":"https://doi.org/10.33590/emj/10305506","url":null,"abstract":"Caseous mitral annular calcification (CMAC), sometimes called liquefaction necrosis of mitral annular calcification (MAC), is a rare variant of MAC, a chronic degenerative process that progresses with age. It is a degenerative abnormality of the fibrous tissue and typically involves the posterior annulus, appearing as a smooth mass with no flow or acoustic shadow artefacts. It can be differentiated from other cardiac masses by CT and MRI. Whilst benign in nature, it is associated with a range of pathologies, such as mitral valve dysfunction, arrhythmias, and systemic embolisation. Given the risk of systemic embolisation, surgery may be appropriate, but there is no clear consensus in the literature in patients who are asymptomatic. This case highlights a case of CMAC presenting with a retinal artery occlusion, and was managed conservatively.\u0000\u0000Background\u0000The mitral annulus is a key component of the mitral valve, ensuring appropriate function by facilitating complete closure of the leaflets during systole. With age, MAC can occur, potentially resulting in mitral valve dysfunction, infective endocarditis, and arrhythmias. CMAC is a rare variant of MAC, typically involving the posterior annulus. Whilst benign, the risk of complications, such as systemic embolisation, may indicate a surgical approach to management, even in patients who are asymptomatic. \u0000\u0000Case Presentation\u0000A 60-year-old female, presenting with sudden loss of vision in the lower part of her left eye due to a branch retinal artery embolus, was admitted from ophthalmology services. An outpatient transthoracic echocardiogram showed an abnormal mass on the posterior annulus of the mitral valve. Transoesophageal echocardiography identified a calcified posterior aspect of the mitral annulus with normal leaflet mobility and trivial regurgitation, and an echogenic mass attached to the ventricular aspect of the mitral annulus (at the level of posteromedial commissure), 9x4 mm in size. A cardiac CT showed a caseous mitral valve with evidence of rupture of the calcified shell. Discussion with the surgical multidisciplinary team resulted in a conservative approach, with follow-up echo for monitoring.\u0000\u0000Conclusion\u0000Whilst a benign and rare variant of MAC, CMAC is associated with a range of pathologies, including mitral valve disease, arrhythmias, and systemic embolisation. Currently, there is no standardised management approach for CMAC. Surgery is currently recommended in the context of already known surgically indicated pathologies, such as severe mitral valve disease or systemic embolisation. However, this conservatively-managed patient has had no further complications with stable echocardiographic appearance on repeat echo 3 months following initial exam.","PeriodicalId":90162,"journal":{"name":"European medical Journal. Urology","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84871244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interview: Tahir Masud","authors":"T. Masud","doi":"10.33590/emj/10300494","DOIUrl":"https://doi.org/10.33590/emj/10300494","url":null,"abstract":"","PeriodicalId":90162,"journal":{"name":"European medical Journal. Urology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90210979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interview: Peter Gill","authors":"P. Gill","doi":"10.33590/emj/10302169","DOIUrl":"https://doi.org/10.33590/emj/10302169","url":null,"abstract":"","PeriodicalId":90162,"journal":{"name":"European medical Journal. Urology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81519765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interview: Damian Roland","authors":"D. Roland","doi":"10.33590/emj/10309336","DOIUrl":"https://doi.org/10.33590/emj/10309336","url":null,"abstract":"","PeriodicalId":90162,"journal":{"name":"European medical Journal. Urology","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80591409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Evidence on Tobacco Harm Reduction in Pneumology: Interviews with Two Key Opinion Leaders","authors":"Amanda Barrell","doi":"10.33590/emj/10044289","DOIUrl":"https://doi.org/10.33590/emj/10044289","url":null,"abstract":"The negative impact of smoking on the lung is well documented. Cigarette smoke is the cause of 90% of cases of chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema. COPD is a progressive and debilitating condition with morbidity and mortality rates similar to myocardial infarction (MI) and stroke. Despite the widely recognised risks, millions of people continue to smoke, in some cases even after receiving a diagnosis of COPD and despite knowing that the habit will accelerate disease progression. While there is no doubt that smoking cessation is the most important health intervention for all cigarette smokers, it can be challenging. Nicotine addiction, social norms and culture, and the length of time it can take smokers to feel the adverse consequences of the habit all contribute to the high cessation failure rate. However, increasing clinical and epidemiological evidence indicates that for those who are unwilling or cannot stop smoking, harm reduction strategies can help reduce exposure to the harmful chemicals and carcinogens released during tobacco combustion. Electronic devices heat processed tobacco without combusting it to deliver an aerosol containing fewer toxic products or harmful and potentially harmful constituents (HPHC) than cigarette smoke. Clinical evidence to support their use is growing. In Japan, for example, a decrease in hospitalisations due to COPD exacerbation after the introduction of such heat-not-burn (HNB), or tobacco heating systems (THS), has been reported.\u0000\u0000In this article, Wolfgang Popp, Döbling Doctor’s Center, Privatklinik Döbling, Vienna, Austria, and Klara Szondy, Semmelweis University, Budapest, Hungary, discuss the impact of cigarette smoke on the lung, and how to support smoking cessation in those willing and able to quit smoking. They also explain when strategies that reduce the harmful effects of smoking may be useful, and outline the latest evidence supporting the use of HNB systems.","PeriodicalId":90162,"journal":{"name":"European medical Journal. Urology","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90537262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Children with Swallowing Problems: New Advances in Paediatric Thickeners","authors":"E. Roberts","doi":"10.33590/emj/10047359","DOIUrl":"https://doi.org/10.33590/emj/10047359","url":null,"abstract":"A satellite symposium on the evaluation and management of dysphagia in children was held during the 12th Annual Congress of the European Society for Swallowing Disorders (ESSD) in Leuven, Belgium, on 14th September 2022. Dysphagia is the impairment or difficulty in swallowing and may have an oropharyngeal or oesophageal cause. This can result in delayed transit of liquids or solid food from the mouth to the stomach. Food thickening agents can reduce regurgitation and improve swallowing mechanics, particularly in infants and young children. At this symposium, Karen van Hulst, Speech and Language Therapist and Clinical Epidemiologist at Radboud University Medical Center, Amalia’s Children’s Hospital, the Netherlands, introduced the topic of dysphagia and its complications, and the evaluation of dysphagia. She then discussed the use of thickening agents in children with dysphagia. Ben Hanson from the Department of Engineering, University College London, UK, introduced the International Dysphagia Diet Standardization Initiative (IDDSI). The IDDSI has developed a standardised and practical method of measuring the thickness of liquid and food that can be used when preparing foods at home or in the hospital, and may be applied commercially. Analou Sugar, Clinical Lead in Paediatric Speech and Language Therapy at Chelsea and Westminster Hospital Foundation Trust, London, UK, ended the symposium with a presentation of her recent clinical experience using a new thickener (ThickenUp® Junior, Nestlé Health Science, Vevey, Switzerland) in paediatric patients.","PeriodicalId":90162,"journal":{"name":"European medical Journal. Urology","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86195314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tailoring Motor Fluctuation Treatment: Beyond Levodopa Dose Adjustment","authors":"Najeeb Ashraf","doi":"10.33590/emj/10022165","DOIUrl":"https://doi.org/10.33590/emj/10022165","url":null,"abstract":"Susan Fox opened this satellite symposium at the 8th European Academy of Neurology (EAN) Congress with an overview of the concept of motor fluctuations (MF) in Parkinson’s disease (PD). She emphasised that levodopa remains the gold standard therapy for PD. However, MFs are one of the critical complications of levodopa therapy that affect many patients with advancing PD and, when diagnosed, represent a challenge in patient management. Alternative options are, therefore, needed to provide continuous dopaminergic stimulation while maximising the levodopa benefit. Despite different options, Angelo Antonini showed that neurologists often prefer to adjust levodopa dose rather than add an adjunctive agent. Market research confirms that, in patients with PD, the levodopa dose is adjusted in around 80% of patients, while only 20% have adjunct therapy as a first-line option. Adjusting the levodopa dose, either by increasing or fractionating the dose, or both, remains a valid, tried-and-tested option, although it has limitations. Joaquim Ferreira presented emerging evidence from a Phase II clinical trial, suggesting a potential benefit of adding opicapone 50 mg compared with 100 mg levodopa to treat patients with PD and end-of-dose fluctuations. This symposium aimed to present the effect of opicapone with relatively low total daily doses of levodopa; an option that may not have been traditionally considered by neurologists who are used to adjusting levodopa as a first-line response.","PeriodicalId":90162,"journal":{"name":"European medical Journal. Urology","volume":"71 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77284894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Pathophysiological Relationship Between Migraine and SARS-CoV-2 Infection: A Comprehensive Literature Review","authors":"Noor Elkurwi, Qabas Elkurwi","doi":"10.33590/emj/10054250","DOIUrl":"https://doi.org/10.33590/emj/10054250","url":null,"abstract":"People with migraine, and individuals with other neurological conditions, have suffered in multiple aspects during the COVID-19 pandemic. This paper will discuss the factors that impacted the neurology department. The emergence of severe acute respiratory syndrome coronavirus 2 in late 2019 has generated new challenges in healthcare systems across the globe. Similar to the fields of pulmonology and cardiology that saw an increase in research, the neurology department was in search of possible relationships between COVID-19 and other medical conditions. Research on the possible common pathophysiological mechanism between COVID-19 and migraine is currently being studied. The most recent hypothesis suggests the following: migraine is caused by an increased release of calcitonin gene-related peptide from the trigeminal ganglion, which will cause an increase in nitric oxide and IL-1β, resulting in vasodilation and inducing hyperalgesia. COVID-19 causes an increase in nod-like receptor protein 3, which causes the production of IL-1β and again induces an inflammatory response. This review article looks at the mechanisms of migraine and COVID-19, and tries to link a common pathophysiological pathway between the two. This report also serves as a gateway for further research regarding possible management that could potentially target both of these mechanisms.","PeriodicalId":90162,"journal":{"name":"European medical Journal. Urology","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81205137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}