Erectile dysfunction

2017 ◽  
Author(s):  
Antonino Saccà ◽  
Andrea Salonia
Keyword(s):  
Erectile Dysfunction ◽  
Accurate Diagnosis ◽  
Sexual History ◽  
Basic Work ◽  
Life Threatening ◽  
Seeking Help ◽  
Common Risk Factors ◽  
Diagnostic Work ◽  
Work Up ◽  
Significant Opportunity

Erectile dysfunction (ED) has progressively emerged as an important sentinel marker of cardiovascular and overall health among men. A timely and accurate diagnosis of ED may thus represent a significant opportunity not only to diagnose the dysfunction per se, but also to comprehensively identify co-morbid and potentially life-threatening conditions. Basic work-up for a man seeking help for ED should start considering that ED may share several modifiable and unmodifiable common risk factors with cardiovascular disorders and other potential life-threatening conditions. Overall, most patients with ED can be adequately managed with a basic diagnostic work-up; this includes a comprehensive medical and sexual history, along with a physical examination and some laboratory tests. Conversely, only some selected patients may also need specific diagnostic tests.

scholarly journals Death of unknown cause? Post-mortem diagnosis of fulminant course of an EBV-associated secondary hemophagocytic lymphohistiocytosis

2021 ◽  
Author(s):  
Josia Fauser ◽  
Stefan Köck ◽  
Eberhard Gunsilius ◽  
Andreas Chott ◽  
Andreas Peer ◽  
...  
Keyword(s):  
Immune Response ◽  
Case Report ◽  
Macrophage Activation ◽  
Post Mortem ◽  
Life Threatening ◽  
Appropriate Therapy ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up ◽  
Secondary Hemophagocytic Lymphohistiocytosis

SummaryHLH is a life-threatening disease, which is characterized by a dysregulated immune response with uncontrolled T cell and macrophage activation. The often fulminant course of the disease needs a fast diagnostic work-up to initiate as soon as possible the appropriate therapy. We present herein the case of a 71-year-old patient with rapidly progressive hyperinflammatory syndrome, which post mortem resulted in the diagnosis of EBV-associated HLH. With this case report, we intend to highlight the relevance of the HScore in the diagnosis of HLH, to create a greater awareness for EBV as a trigger of HLH, and to demonstrate the importance of treating EBV-associated HLH as early as possible.

scholarly journals Adrenal Insufficiency - Aetiology, Diagnosis and Treatment

2015 ◽  
Vol 3 (1) ◽  
pp. 36-47
Author(s):  
Nazma Akter ◽  
Nazmul Kabir Qureshi
Keyword(s):  
Quality Of Life ◽  
Adrenal Insufficiency ◽  
Presenting Symptoms ◽  
Life Saving ◽  
Life Threatening ◽  
Diagnostic Work ◽  
Work Up ◽  
Term Management

Adrenal insufficiency is caused by either primary adrenal failure or by hypothalamic-pituitary impairment of the corticotropic axis. Adrenal insufficiency, first codified in 1855 by Thomas Addison, remains relevant in 2014 because of its lethal nature. Though, it is a rare disease but is life threatening when overlooked. Main presenting symptoms such as fatigue, anorexia and weight loss are nonspecific, thus diagnosis is often delayed. The diagnostic work-up is well established but some pitfalls remain. The diagnosis is adequately established by the 250 ?g ACTH (adrenocorticotropic hormone) stimulation test in most cases. Glucocorticoids provide life saving treatment but long-term quality of life is impaired, perhaps because therapy is not given in a physiologic way. Dehydroepiandrosterone-replacement therapy has been introduced that could help to restore quality of life. It may be useful in pubertal girls, but not in adults. Monitoring of glucocorticoid-replacement is difficult due to lack of objective methods of assessment and is therefore largely based on clinical grounds. Thus, long-term management of patients with adrenal insufficiency remains a challenge, requiring an experienced specialist. DOI: http://dx.doi.org/10.3329/dmcj.v3i1.22238 Delta Med Col J. Jan 2015; 3(1): 36-47

Status Epilepticus—Work-Up and Management in Children

2020 ◽  
Vol 40 (06) ◽  
pp. 661-674
Author(s):  
Cristina Barcia Aguilar ◽  
Iván Sánchez Fernández ◽  
Tobias Loddenkemper
Keyword(s):  
Status Epilepticus ◽  
Medical Emergency ◽  
First Line ◽  
Timely Manner ◽  
Treatment Protocols ◽  
Efficacious Treatment ◽  
Life Threatening ◽  
Diagnostic Work ◽  
Work Up ◽  
Medication Choice

AbstractStatus epilepticus (SE) is one of the most common neurological emergencies in children and has a mortality of 2 to 4%. Admissions for SE are very resource-consuming, especially in refractory and super-refractory SE. An increasing understanding of the pathophysiology of SE leaves room for improving SE treatment protocols, including medication choice and timing. Selecting the most efficacious medications and giving them in a timely manner may improve outcomes. Benzodiazepines are commonly used as first line and they can be used in the prehospital setting, where most SE episodes begin. The diagnostic work-up should start simultaneously to initial treatment, or as soon as possible, to detect potentially treatable causes of SE. Although most etiologies are recognized after the first evaluation, the detection of more unusual causes may become challenging in selected cases. SE is a life-threatening medical emergency in which prompt and efficacious treatment may improve outcomes. We provide a summary of existing evidence to guide clinical decisions regarding the work-up and treatment of SE in pediatric patients.

scholarly journals Postpartum Spontaneous Subcapsular Hepatic Hematoma Related to Preeclampsia

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Dimitrios Anyfantakis ◽  
Miltiades Kastanakis ◽  
Georgios Fragiadakis ◽  
Paraskevi Karona ◽  
Nikolaos Katsougris ◽  
...  
Keyword(s):  
Epigastric Pain ◽  
Emergency Caesarean Section ◽  
Maternity Ward ◽  
Hepatic Hematoma ◽  
Pregnancy And Postpartum ◽  
Life Threatening ◽  
Clinical Phenomenon ◽  
Diagnostic Work ◽  
Work Up ◽  
Severe Epigastric Pain

Subcapsular hematoma of the liver represents an unusual clinical phenomenon in the pregnancy and postpartum period with serious complications in terms of fetal and maternal mortality. Here we report a case of a 32-year-old primiparous female at 36 weeks of gestation, admitted to a maternity ward of a private clinic for preeclampsia. The woman underwent an emergency caesarean section with the extraction of an alive foetus. A few hours after delivery, she was transferred to the emergency department of our institution complaining of severe epigastric pain. Diagnostic work-up was suggestive of a subcapsular right lob hepatic hematoma which was successfully managed conservatively. Timely diagnosis is necessary for the prevention of life-threatening events in mother and fetus. For this reason acute care physicians have to be vigilant of the condition and consider this in the differential diagnosis of epigastric pain during pregnancy and postpartum.

Problem solving in clinical practice: the sick infant with low sodium and high potassium

2020 ◽  
pp. edpract-2019-317756
Author(s):  
Yincent Tse ◽  
Nidhi Singhal ◽  
Leigh McDonald ◽  
Milan Gopal ◽  
Anupam Lall ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Problem Solving ◽  
High Potassium ◽  
Initial Management ◽  
Low Sodium ◽  
Life Threatening ◽  
Diagnostic Work ◽  
Work Up ◽  
Term Management ◽  
Diagnostic Work Up

Many paediatricians will be faced with a sick infant who on investigation is found to have hyponatraemia and hyperkalaemia at some time in their career. The focus of initial management includes the treatment of potentially life-threatening hyperkalaemia with concurrent investigation aiming to elucidate whether the underlying cause reflects a primarily renal or endocrine pathology. We describe the presentation of two infants who each presented with one of the more common underlying diagnoses that led to this biochemical disturbance and discuss the approach to immediate treatment, diagnostic work-up and longer term management.

Acute heart failure: diagnosis

ESC CardioMed ◽  
2018 ◽  
pp. 1911-1917 ◽  
Author(s):  
Adriaan A. Voors ◽  
Piotr Ponikowski
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Medical Condition ◽  
Specific Treatment ◽  
Length Of Hospital Stay ◽  
Clinical History ◽  
Life Threatening ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

Acute heart failure is a life-threatening medical condition typically leading to urgent hospital admission. Early diagnosis is of great importance, since it will lead to earlier and better targeted treatment, leading to a decrease in length of hospital stay, and most importantly to improved clinical outcome. The initial diagnostic work-up includes a clinical history, evaluation of symptoms and signs, an electrocardiogram, chest X-ray, natriuretic peptide levels, echocardiography and perhaps lung ultrasound. After the initial work-up, a clinical classification according to blood pressure, congestion, and peripheral perfusion should be performed, since it will guide treatment. During the diagnostic work-up, treatable and life-threatening conditions always need to be considered since they need immediate and case-specific treatment.

scholarly journals Transthyretin Amyloidosis with Gastrointestinal Manifestation: a Case Report

2019 ◽  
Vol 28 (3) ◽  
pp. 359-361 ◽  
Author(s):  
Radislav Nakov ◽  
Stayko Sarafov ◽  
Ventsislav Nakov ◽  
Mariana Gospodinova ◽  
Tihomir Todorov ◽  
...  
Keyword(s):  
Diagnostic Challenge ◽  
Transthyretin Amyloidosis ◽  
Gi Symptoms ◽  
Peripheral Polyneuropathy ◽  
Life Threatening ◽  
Gastrointestinal Manifestation ◽  
Diagnostic Work ◽  
Biochemical Imaging ◽  
Work Up ◽  
Diarrhea Syndrome

Transthyretin amyloidosis (ATTR) is a rare, progressive, life-threatening, hereditary disorder caused by mutations in the transthyretin gene. Due to the phenotypic heterogeneity, ATTR is difficult to recognize and it is often diagnosed very late. In ATTR gastrointestinal (GI) disorders play an important role in the patients’ morbidity and mortality. In some cases, GI symptoms are present even before the onset of the peripheral polyneuropathy. However, the complaints are various and it is really difficult to differentiate them from other GI disorders. We present a 61-year old male referred for diarrhea, unintentional weight loss and early satiety. He had hypotension after longstanding hypertension, numbness and tingling in the feet. We considered a broad differential diagnosis spectrum of chronic diarrhea syndrome and performed numerous laboratory, biochemical, imaging, endoscopic, histological and genetic tests. Transthyretin amyloidosis with a Glu89Gln mutation was diagnosed. Transthyretin amyloidosis is frequently misdiagnosed, representing a diagnostic challenge in GI practice. The presence of certain clinical combinations could help gastroenterologists to include ATTR in their diagnostic work-up.

THE INTERPLAY OF BIOLOGICAL AND ENVIRONMENTAL FACTORS IN A PRESCHOOL-AGE PATIENT WITH KLINEFELTER'S SYNDROME

PEDIATRICS ◽  
1973 ◽  
Vol 52 (1) ◽  
pp. 29-37
Author(s):  
Magda Campbell ◽  
Harry Breuer ◽  
Sandra R. Wolman
Keyword(s):  
Accurate Diagnosis ◽  
Preschool Age ◽  
Behavioral Repertoire ◽  
Parent Child Relationship ◽  
Disturbed Behavior ◽  
Child Relationship ◽  
Parental Counseling ◽  
Diagnostic Work ◽  
And Behavior ◽  
Work Up

A 3-year-old male with 47XXY karyotype is presented as an example of how various genetic and environmental (including psychosocial) factors can contribute to delayed and/or disturbed behavior. The young preschool child's behavioral repertoire is so small, undifferentiated, and nonspecific that a variety of causes can evoke the same symptom(s) and behavior, and the danger of misdiagnosis, therefore, is great. Such disturbances may not be entirely or partially caused by a disturbed parent-child relationship. The pediatrician is usually the first to see such a young patient and in a position to initiate appropriate referrals for a complete diagnostic work-up, including cytological, hearing, and speech studies, not only for accurate diagnosis, but also for prognosis, treatment, and parental counseling.

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