European medical Journal. Urology最新文献

{"title":"Diagnostic Testing Technologies, Care, and Treatments: Best Practices and Evidence","authors":"E. Koutsouki","doi":"10.33590/emj/10140001","DOIUrl":"https://doi.org/10.33590/emj/10140001","url":null,"abstract":"","PeriodicalId":90162,"journal":{"name":"European medical Journal. Urology","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87364903","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":"Cotard’s Delusion with Sequelae of Adult Onset Failure to Thrive: A Case Report","authors":"Tammy Speir, Colton M Zeitler, T. Nguyen, Nathaniel Nevitt, Ramon Aragon, Zachary I. Merhavy, Thomas Varkey","doi":"10.33590/emj/21-00216","DOIUrl":"https://doi.org/10.33590/emj/21-00216","url":null,"abstract":"Patients can present with chief complaints and symptoms that differ from the eventual diagnoses. The differences between aetiologies versus complications must be appreciated through careful evaluation and use of clinical investigations, laboratory testing, trial of hypotheses, and clinical gestalt. Herein, this article discusses the case of a 58-year old individual who presented with impaired physical functioning, malnutrition, depression, and cognitive impairment. These four symptoms are known collectively as failure to thrive, and they often portend adverse patient outcomes. The internal medicine care team initially attributed the failure to thrive to the combination of an ongoing cervicofacial infection and a pre-existing mood disorder, but its true aetiology was more complex. In the context of various physical and psychiatric health derangements, the patient displayed clear signs of a rare disorder called Cotard’s syndrome. Due to the concern of the care team and the patient’s acting medical power of attorney, the eventual working diagnosis was made, and electroconvulsive therapy and aripiprazole combination therapy initiated, resulting in significant and improved outcomes. In addition to discussing the patient’s course of care, this case report also addresses the caution inherent in prescribing medications, the evaluation of decision making capacity, and the utilisation of a medical power of attorney. The authors also present their thoughts on minimising inefficiencies in care delivery to better the patient’s health outcomes.","PeriodicalId":90162,"journal":{"name":"European medical Journal. Urology","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83194880","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":"Umbilical Cord Haematoma and Uterine Torsion: Rare Pregnancy Complications at Tu Du Hospital in Vietnam and a Review of Literature","authors":"A. Vuong, PHUC NHON NGUYEN","doi":"10.33590/emj/10009645","DOIUrl":"https://doi.org/10.33590/emj/10009645","url":null,"abstract":"Umbilical cord haematoma (UCH) and uterine torsion are extremely rare complications in pregnancy. These abnormalities may present in acute and spontaneous conditions, however, they should not be neglected in clinical practice when monitoring an abnormal fetal heart without other suspects. The authors hereby report a rare case of UCH and uterine torsion as well as a review of the literature. A female, aged 35 years old (gravida 1, para 0), was admitted to the Emergency Department of Tu Du Hospital, Ho Chi Minh City, Vietnam, due to term gestation without complaints. They had an uncomplicated pregnancy, except a large uterine fibroid and cervical pessary which prevented pre-term birth from 28 weeks of gestational age. A very rare complication of UCH was revealed accidentally following emergency caesarean section associated with abnormal fetal heart rate tracing. Asymptomatic uterine torsion was noticed at the same time as this dramatic event. Pre-operative diagnosis of two rare complications was missed; hence, the authors timely delivered the baby based on another modality of management, computerised cardiotocography. In conclusion, UCH along with uterine torsion is difficult to diagnosis due to its rarity; it is usually an incidental finding. Moreover, no available imaging modality could investigate UCH prior to delivery. Surveillance on fetal heart rate monitoring may be helpful in this fatal situation.","PeriodicalId":90162,"journal":{"name":"European medical Journal. Urology","volume":"128 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80217376","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":"Update on New Antigens in the Pathogenesis of Membranous Nephropathy","authors":"M. Salvadori, A. Tsalouchos","doi":"10.33590/emj/22-00130","DOIUrl":"https://doi.org/10.33590/emj/22-00130","url":null,"abstract":"Previously, membranous nephropathies were divided into primary and secondary categories when the exact mechanism or pathogenetic factor were unknown.\u0000Approximately 70% accounted for primary membranous nephropathies. The\u0000remaining 30% were called secondary because they developed due to well-known\u0000diseases such as autoimmune diseases, tumours, infections, or drug assumptions.\u0000The discoveries of the M-type phospholipase A2 receptor and of thrombospondin\u0000type 1 domain containing 7A as causative antigens in a part of the so-called primary\u0000membranous nephropathies opened new knowledge on the effective causes of\u0000a large part of these diseases. The availability of novel techniques such as laser\u0000micro-dissection and tandem mass spectrometry, as well as immunochemistry with\u0000antibodies directed against novel proteins, allowed the confirmation of new antigens\u0000involved. The use of confocal microscopy and Western blot allowed detection of the\u0000new antigen on glomerular membrane, and the same antigen and relative antibodies\u0000have been detected in serum samples.\u0000Through these techniques, four new antigens were first detected, including neural\u0000epidermal growth factor 1 and semaphorin 3B in the so-called primary membranous\u0000nephropathy, and exostosin 1 and 2 and neural cell adhesion molecule 1 in lupus\u0000membranous nephropathy.\u0000The aim of this study is to describe the characteristics of the new antigens\u0000discovered and their association with other diseases. In addition, new antigens\u0000are on the horizon, and the story of primary membranous nephropathy is still to be\u0000completely written and understood.","PeriodicalId":90162,"journal":{"name":"European medical Journal. Urology","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78054609","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":"Overlapping Clinical Manifestations of Multisystem Inflammatory Syndrome in Children with Other Endemic Diseases of Pakistan: A Case Report","authors":"A. Zafar, Sughra Wahid, Asad Ullah, H. Mumtaz","doi":"10.33590/emj/10073472","DOIUrl":"https://doi.org/10.33590/emj/10073472","url":null,"abstract":"Multisystem inflammatory syndrome (MIS-C) is a challenging disease associated with COVID-19. Clinical manifestation of MIS-C may mimic many endemic illnesses of tropical and subtropical countries, making early diagnosis more difficult. The authors present the case of an 8-year-old who presented with non-specific febrile illness which was managed as extensively drug-resistant typhoid with meropenem. The patient developed abdominal pain and hypotension during the hospital stay. Surgical causes were ruled out and managed with fluid protocol of dengue shock syndrome on the basis of falling platelets and fluid leak on ultrasound. But refractory condition and new-onset cardiac dysfunction prompted alternate diagnosis. Diagnostic criteria of MIS-C were fulfilled and the patient was managed with a single dose of intravenous Ig, pulse therapy of methylprednisolone, and temporary pacemaker placement. MIS-C should be kept in the differentials of diseases with multisystem involvement in the wake of the COVID-19 pandemic, as its clinical spectrum closely mimics other endemic illnesses of tropical and subtropical regions.","PeriodicalId":90162,"journal":{"name":"European medical Journal. Urology","volume":"311 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77237276","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":"Diencephalic Syndrome: A Rare Entity with Its Anaesthetic Management and Post-operative Complications of Diabetes Insipidus and Thrombocytopenia","authors":"S. Kadian, Sarin John, S. Chakraborty, S. Agrawal","doi":"10.33590/emj/22-00037","DOIUrl":"https://doi.org/10.33590/emj/22-00037","url":null,"abstract":"Russell first described the diencephalic syndrome in 1951. It is a rare syndrome and usually presents in children as a cause of failure to thrive despite normal, or even increased appetite, with preservation of linear growth. The treatment options vary from endoscopic biopsy followed by chemotherapy to definitive surgical resection of the tumour. The authors here describe a case of an 8-year-old 10 kg emaciated child who presented with headache, vomiting, rage attacks, decreased weight, and diminution in vision. The child had bilateral optic atrophy; however, hormonal profiles were within normal limits. MRI of the brain gave an impression of craniopharyngioma.","PeriodicalId":90162,"journal":{"name":"European medical Journal. Urology","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85793630","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":"Measuring the Impact of the COVID-19 Pandemic on Diagnostic Delay in Rare Disease","authors":"Caitlin Hampson, W. Evans, Lucy McKay, L. Menzies","doi":"10.33590/emj/21-00181","DOIUrl":"https://doi.org/10.33590/emj/21-00181","url":null,"abstract":"Rare diseases are individually rare but collectively common, with a combined prevalence of 3.5–5.9%. A common feature of many diseases is a substantial delay in patients receiving a correct diagnosis; this protracted path to diagnosis is termed ‘the diagnostic odyssey’. During the COVID-19 pandemic, significant concerns have emerged from both clinicians and patients regarding a disproportionate effect of the pandemic on diagnosis and management of rare disease. Such concerns prompted a study to explore this question further, the results of which are presented here.\u0000\u0000A cross-sector multi-stakeholder coalition was formed, Action for Rare Disease Empowerment (ARDEnt), with representation from patients with rare diseases and carers, patient advocacy groups, clinicians, academics, data scientists, and industry. A mixed methods approach was used to collect and collate information about the impact of the pandemic on diagnostic delay in rare disease. Currently, there is a lack of systematic recording and reporting of rare disease diagnosis in the UK, which created challenges in directly measuring diagnosis rates. Therefore, the group was dependent on a mix of data sources to reflect healthcare provided during 2020 compared with previous years. The findings were synthesised to describe the impact of the pandemic along the path to diagnosis, from the moment of first concern and engagement with health services, to the availability of definitive testing.\u0000\u0000In conclusion, evidence suggests the pandemic has exacerbated the problem of diagnostic delay for rare diseases, affecting all points on the path to diagnosis. The authors recommend three actions to help address this: optimising remote clinical consultations; enhancing the use of health informatics in rare diseases; and proactively identifying patients with undiagnosed rare diseases missed due to the pandemic. This study also highlights the need for better reporting of rare disease diagnoses, a core metric to measure the impact of health system changes that may be put into place to address the priorities of The UK Rare Diseases Framework, also published this year.","PeriodicalId":90162,"journal":{"name":"European medical Journal. Urology","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80982067","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":"Primary Renal Hydatid in Children","authors":"J. John, B. Marais","doi":"10.33590/emj/22-00032","DOIUrl":"https://doi.org/10.33590/emj/22-00032","url":null,"abstract":"Isolated renal hydatid disease, caused by the larvae of the parasitic tapeworm Echinococcus granulosus is a rare phenomenon and accounts for only 2% of all reported cases. The authors report a case of a 12-year-old female who presented with right flank pain. Initial abdominal ultrasound revealed a complex cystic mass in the upper pole of the right kidney. A contrasted CT scan better defined it as a well-circumscribed cyst with multiple thin septations. Laboratory investigations showed eosinophilia and a positive IgG Echinococcus serology. Considering these radiological and laboratory findings, a tentative diagnosis of primary renal hydatid was made. With perioperative antihelmintic therapy, the authors used a combination of an open puncture-aspiration-injection-reaspiration technique pericystectomy to manage the isolated renal hydatid. Renal hydatid can easily be misinterpreted pre-operatively for more sinister renal cystic pathology, including cystic renal cell carcinoma. An accurate pre-operative diagnosis requires a high index of suspicion, especially in endemic regions. Surgical therapy, with perioperative antihelmintic therapy, offers the best chance of cure.","PeriodicalId":90162,"journal":{"name":"European medical Journal. Urology","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82206604","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":"Total Plasma Exchange for Hypertriglyceridaemia Complicated by Acute Pancreatitis: A Case Report","authors":"D. Sany, W. Yousry, W. Refai, W. Hassan, R. Qattan, Yasser Elsahawi","doi":"10.33590/emj/22-00101","DOIUrl":"https://doi.org/10.33590/emj/22-00101","url":null,"abstract":"Introduction: Hypertriglyceridaemia (HTG) is common and often precipitates into acute pancreatitis. Early diagnosis of HTG pancreatitis (HTGP) is essential for appropriate management to avoid recurrence of pancreatitis. Plasmapheresis was suggested as treatment modality to decline triglyceride levels, especially in critical patients with multiorgan failure. Few randomised studies are recorded regarding the value of plasmapheresis over classical therapy.\u0000\u0000Objective: To evaluate the value of plasmapheresis in patients with HTGP with worrisome signs as fever, tachycardia, high inflammatory markers, and pancreatitis.\u0000\u0000Methods: Clinical course and laboratory markers status after total plasma exchange (TPE) for HTG that is not responding to initial, traditional therapy by insulin infusion was reported.\u0000\u0000Results: The authors’ patient had an initial triglyceride level of 30 mmol/L, with a worsening clinical condition and acute pancreatitis. After TPE, there was a significant decline in their triglyceride serum levels (53%) after the first session, leading to marvellous recovery.\u0000\u0000Conclusion: The authors suggest treatment with TPE for systemic inflammation and HTGP-induced multiorgan failure. However, further research is necessary.","PeriodicalId":90162,"journal":{"name":"European medical Journal. Urology","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75083036","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 Green Radiology Department","authors":"T. Wolf","doi":"10.33590/emj/22f0616-2","DOIUrl":"https://doi.org/10.33590/emj/22f0616-2","url":null,"abstract":"GLOBALLY, hospital-based care has a substantial ecological footprint. In the USA, the health sector generates approximately 10% of the nation’s greenhouse gas emissions. Radiology departments are known to be major energy consumers, particularly through the use of CT scanners, MRI systems, reading workstations, and interventional suites. At this year’s European Congress of Radiology (ECR) 2022 Overture, 2nd–6th March, a panel of experts explored ways to make the discipline more environmentally sustainable.","PeriodicalId":90162,"journal":{"name":"European medical Journal. Urology","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86824700","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}