MO325YOU CAN BE DIAGNOSED AND CURED FOR LUPUS CYSTITIS AND LUPUS PODOCYTOPATHY DESPITE BEING A POOR, VILLAGE TEENAGE GIRL IN ALBANIA

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Erjola Likaj ◽  
Myftar Barbullushi ◽  
Larisa Shehaj

Abstract Background and Aims We present the case of a 16 years old girl who was admitted to our Emergency Unit in May 2019 for diarrhea, nausea, dysuria, foamy urine, urinary incontinence, malnutrition, polyserositis, and hypertension. Her medical history started 8 months ago with diarrhea and urinary incontinence for which first was hospitalized in the Gastroenterology unit and then in the Infectious Disease Unit. There she was completed with colonoscopy, contrast CT scan and then was discharged with the diagnosis of Gastrocolitis. In January 2019 due to the persistence of symptoms they did a specialized consultation in Athens, Greece. After a series of examinations the patient was diagnosed with Anorexia Nervosa and antidepressant therapy was started. In February 2019, the patient was rehospitalized with nephritic grade proteinuria and the kidney ultrasound showed stage four bilateral hydronephrosis and urinary bladder with thick and trabecular walls. To exclude urological problems, an MRI was performed which results in no obstructive problems. Arterial hypertension and lower extremities edema were present. She was then transferred to our University Hospital “Mother Teresa”, Nephrology Department for further examinations. During hospitalization her blood investigation showed severe anemia (HGB = 6.7gr / dl), kidney failure (creatinine = 1.5mg / dl, urea = 83mg / dl), elevated liver enzymes (Alt:162u/ml, Ast:101u/ml), albuminemia: 2.9 g / dl, total proteinemia: 5.9g / dl. The lipid profile showed cholesterolemia: 300mg / dl, triglyceridemia: 170mg / dl. Electrolytes were within normal limits. Coombs test resulted positive. Urinalysis showed microscopic hematuria with leukocyturia and grave albuminuria around16gr/ 24 hours. Immunologic workup showed: AntiDna = 383.5U / ml, Ena profile SSA poz, ANA ++++, C3 101, C4 18. Tumoral markers and hepatitis resulted in negativ. Method Renal biopsy was performed which resulted: Lupus Podocytopathy Results The patient was diagnosed with a case of lupus cystitis with lupus podocytopathy. She was treated with methylprednisolone, immunosuppressive therapy, and Plaquenil. It was started with intravenous methylprednisolone 0.5 g / day for 3 days and then switched to oral methylprednisolone 0.5 mg /kg /day. Mycophenolate mofetil was started with 1 gr increased to 2 grams. After 6 months of therapy Hydroureteronephrosis completely disappeared and 24 h urinary protein became normal. The dose of therapy was tapered and switch to maintenance doses, methylprednisolone 8 mg, MMF 500gr, and Plaquenil. Laboratory examinations Hgb: 12gr / dl, Urea: 36mg / dl, Creatine: 0.6mg / dl, Alt: 23u / l, Ast: 26u / l. Urinalysis: albumin trace, RBC: 0, Wbc 8 / field. The autoimmune workup was normalized, AntiDna; C3, C4, Ana. In a realized ultrasound hydronephrosis was gone, kidney structure was in normal parameters and bladder wall was in a normal structure. Conclusion Disseminated Eritematous Lupus and its rare forms like Lupus Cystitis and Lupus Podocytopathies can be diagnosed, cured successfully, and followed up in the best way despite you are a simple teenager in a village of Albania or a noticed and famous actor or singer in the USA.

2017 ◽  
pp. 41-46
Author(s):  
Van Mao Nguyen ◽  
Thi Bich Chi Nguyen

Background: Bladder cancer is one of the most frequent type of urinary cancer which has been ever increasing. For the better treatment, the early discovery and definite diagnosis of this disease played an important role. Objective: To describe some clinical symptoms and ultrasound features of tumorlike lesions of the bladder. To diagnose and classify the histopathology of tumorlike lesions of the bladder. Materials, method: cross - sectional study on 64 cases in Hue University Hospital and Hue central hospital from April, 2016 to February, 2017. Results: Hematuria was the most common reason that patients went to hospital (79.7%). Lower abdominal pain and irritation during urination accounting for 9.4% and 6.2% respectively. Only 3 patients with bladder cancer were accidentally discovered through periodic health examination (4.7%). The characteristics of hematuria in bladder tumor was flesh red urine (62.5%) and total hematuria (60.7%). With ultrasonography, the results of 64 patients were divided in 3 groups as follow: bladder tumor, which was the highest rate 87.5%, bladder polyp was 3.1% and focal bladder wall thickening was 9.4%. Of which, the vast majority of these ultrasound images was tumor - like lesions protruding in the lumen of the bladder (75%), the rest was wall thickening lesions (25%). Tumors were different in size, the biggest tumor was 7cm in diameter and the smallest was 0.6cm. Those with the diameter 3cm or bigger accounting for 42.2%, the smaller was 57.8%. Most cases have only one lesion (62.5%) and at lateral wall (46.6%). Histopathologically, cancer was 59/64 case (92.2%): urothelial carcinoma was 98.3 %, squamous cell carcinomawas 1.7% and 5 cases (7.8%) were benign. Most cancerous cases were poorly differentiated, grade II (50.9%) and grade III (32.2%). The stage T1NxMx was 20.3% and worse than T2MxNx was 79.7%. Conclusion: hematuria was the most popular symptom, suggesting bladder cancer. Clinical diagnosing bladder cancer was not high sensitive (61.01%). Ultrasound could detect bladder tumor with high sensitive (89.8%). These patients also needed histopathology classification to diagnose and finally choose the best method for the appropriate treatment. Key words: bladder cancer, histopathology, ultrasound, uroepithelial carcinoma, hematuria


2019 ◽  
Author(s):  
Sabine Keim ◽  
Alexandra von Au ◽  
Lina Maria Matthies ◽  
Stephanie Wallwiener ◽  
Sarah Brugger ◽  
...  

BACKGROUND Background: Many women experience urinary incontinence (UI) during andafter pregnancy due to pelvic floor weakness. First-line therapy is conservative treatment, which nowadays can be facilitated by using digitalsolutions. OBJECTIVE The aim ofthe present study was to investigate the efficacy and effectiveness of pelvinain patients with existing UI. METHODS Methods: In the present observational study we analyzed the effectivenessof pelvina, a certified digital pelvic floor training course, in reducing UI symptoms by regularly applying “The Questionnaire for Urinary Incontinence Diagnosis” (QUID) and furthermore examining quality of life (QoL) by conducting the SF-6D. RESULTS Results: In this prospective study, 373 patients with a median age of 36 years (IQR 33 - 47 years) were included. At baseline the patients had a median QUID of 11 (IQR 11 - 15). During the course, incontinence improved significantly to a QUID of 5 (IQR 2 – 11; p<0.001). Additionally, the patients had also shown a significant impairment in their QoL at baseline with a value of 19 (IQR 16 - 22) in SF-6D. After completing the course, the QoL had risen to 24 (IQR 20 - 26). CONCLUSIONS Conclusion: Use of the certified digital pelvic floor course pelvinasignificantly reduces existing UI due to pelvic floor weakness over the timespan of the course. At the same time QoL is significantly improved. CLINICALTRIAL The present study was approved by the ethics committee of the Heidelberg University Hospital (S-392/2019)


2015 ◽  
Vol 9 (11-12) ◽  
pp. 834 ◽  
Author(s):  
Mohamed Tarchouli ◽  
Adil Boudhas ◽  
Moulay Brahim Ratbi ◽  
Mohamed Essarghini ◽  
Noureddine Njoumi ◽  
...  

Adrenal hemangioma is an extremely rare benign and non-functioning neoplasm of the adrenal gland. We report a case of a 71-year-old woman admitted for intermittent abdominal pain and abdominal distension associated with vomiting and chronic constipation for 5 years. Physical examination revealed a large abdominal mass. Both computed tomography scan and magnetic resonance imaging suggested hemangioma in the right lobe of the liver. Laboratory examinations and tumour markers were within normal limits, except for hypochromic microcytic anemia. The mass was removed intact by conventional surgery and histopathology revealed a cavernous hemangioma of the adrenal gland with no signs of malignancy. Surgical resection was curative, with no recurrence at the 2-year follow-up.


2008 ◽  
Vol 2 (1) ◽  
pp. 52-56 ◽  
Author(s):  
Cássio Machado de Campos Bottino ◽  
Pedro Zucollo ◽  
Maria Del Pilar Quintero Moreno ◽  
Gislaine Gil ◽  
Carla Garcia Cid ◽  
...  

Abstract Memory clinics were established in the USA and European countries as services to attend patients who complain of cognitive deficits, referred by primary care doctors, specialists and other hospitals. Objective: We aimed to describe the clinical and cognitive profile of consecutively evaluated subjects during the initial three years of service of a memory clinic from a university hospital. Methods: Subjects were submitted to a clinical work-up for dementia, which included laboratory exams, cranial computerized tomography, cognitive tests, and a comprehensive neuropsychological battery. Diagnosis was made according to ICD-10 criteria. Results: We evaluated 104 subjects (67.3% females and 32.7% males), with mean age of 59.1 years, 88.8% aged 50 years or above. Mean schooling was 9.9 years. Patients were classified into 10 different primary diagnostic categories, namely Depression (26.9%), Alzheimer's disease (17.3%), Memory complaints without objective impairment (17.3%), Mild Cognitive Disorder - MCD (14.4%), and Anxiety (12.5%) the most frequent diagnosis. Comparing patients with dementia, MCD, Depression or Anxiety and Memory complainers, by age (below and above 60 years), dementia was more commonly diagnosed in older subjects, while a higher frequency of memory complainers was found in the younger group. Conclusions: This preliminary report from an outpatient group of referred patients with cognitive complaints showed a higher frequency of psychiatric disorders in this sample. The memory clinic approach should be considered as a model of service which can evaluate subjects with cognitive complaints effectively and improve the quality of care delivered to this patient group.


Author(s):  
Ahmed SSA Rashwan

Background: The (HELLP) syndrome is a severe health hazard in pregnancy described by elevated liver enzymes, low platelet count and hemolysis. It happens in 0.4 to 0.7% of all gestations and in 10-12% of cases with severe preeclampsia. Patients and methods: The present study was a prospective observational study that was made at Department of Obstetrics and Gynecology, Kasr Al-Ainy University Hospital, Cairo University, from September 2018 – March 2019. It included One Hundred and Thirty pregnant women diagnosed with hypertension in the current pregnancy complicated with severe preeclampsia, or HELLP Syndrome associated with abdominal ascites, recruited from the attendees of the Obstetric Emergency Department. The study was approved by the local institutional review board of the Faculty of Medicine, Cairo University. All ladies signed an informed consent. Results: There were statistically significant differences between the HELLP group and the severe preeclamptic group regarding maternal ICU admission and the need of multiple drugs to control the blood pressure being less in severe preeclampsia group. The need for ICU admission was much higher in the HELLP group (43.1%) compared to the severe preeclampsia group (9.2%) showing statistical significance (P<0.001). Conclusion: Maternal and neonatal sicknesses are elevated between cases with HELLP syndrome. So, early diagnosis and definitive treatment can be made to enhance maternal and neonatal results.


2020 ◽  
Vol 8 (B) ◽  
pp. 1157-1161
Author(s):  
Lilia Koleva ◽  
Victoria Spasova ◽  
Marieta Popova ◽  
Valentina Petkova ◽  
Milen Dimitrov

BACKGROUND: Overweight and obesity are serious health problems in most developed countries. The percentage of young women with excessive weight who get pregnant continues to grow every year. This raises a concern about the risks of the mother and the baby during pregnancy and after birth. AIM: This study aims to determine health risk for overweight mothers and especially the risk for preterm birth. MATERIALS AND METHODS: This is a prospective and retrospective study taking place in the outpatient clinic of the University Hospital “Maichin Dom”. Our study included 105 pregnant women with BMI ≥25 kg/m2 as a case group and 91 pregnant women with BMI within normal limits as a control group. RESULTS: Mean BMI in the case group was 34.79 ± 3.71 kg/m2 and 20.20 ± 2.24 kg/m2 in the control group. Among 105 women in the case group, we registered 24.8% (n = 26) who gave birth before term. Preterm births among 91 women in the control group were registered in 17.6% (n = 16) patients. We found a significant correlation between increased BMI and the risk of increased systolic and diastolic blood pressure. Moreover, we found comorbidities in 43.8% of cases and 24.2% of controls. CONCLUSION: Maternal overweight and obesity during pregnancy are associated with increased risks of preterm delivery and complications of pregnancy. Extra efforts should be made to help women lose weight before this important period of life.


2017 ◽  
Vol 24 (06) ◽  
pp. 824-827
Author(s):  
Ambreen Amna ◽  
Farkhunda Nadeem ◽  
Pushpa Srichand

Background: Genitourinary fistula remains a major cause of morbidity worldwide.Approximately 2 million of women suffer from urinary leakage. Since the establishment ofGenito urinary Fistula center at Isra University Hospital –Hyderabad Sindh. We are able to shareour experience of fistulous women at the time of admission and at follow up visit. Objectives:To determine the different types of urinary incontinence in a woman after genitourinary fistularepair. Study Design: A Follow-up Descriptive study. Study Setting: This Study was done atFistula center Isra University Hospital Hyderabad GU – 11 from January 2011 to December2013. All the women who were admitted with true incontinence followed by Obstetrical andmajor gynecological surgeries were included. However women with stress incontinence andurge incontinence and women who are not willing to include in the study were excluded.Result: Out of one hundred and ten (110) women included in this study, 59 (53.6%) were foundto have obstetrical fistula, while 43 (39%) were suffering from Iatrogenic fistula. Continencestatus were explored at follow up visit. Out of 110 women, 108 (98.18%) & 96 (87.27 %) werehaving no signs of incontinence on examination at first visit and after six week and secondvisit after three month respectively. Only 7 % women fell into incontinence grade 2 at six weekfollow up and only one percent had persistent symptoms of stress incontinence at 3 monthrespectively. Women fall on incontinence grade 3, 4 and 5 were completely cured at 3 month.Conclusion: Success rate of genitor- urinary fistula repair is 98 %. Majority of women (96 %)on short term follow up at 6 weeks showed improved urinary symptoms. Moreover on follow upvisit at 3 months, these women reported improved quality of life and social reintegration afterfistula closure.


2019 ◽  
Vol 4 (1) ◽  
pp. e000227
Author(s):  
Carlos Yanez ◽  
Antonio Güemes ◽  
Ana Navarro ◽  
Jacqueline Vazquez ◽  
Alberto Moreno

BackgroundThe American College of Surgeons Bleeding Control Basic (BCon) course aimed at teaching hemorrhage control techniques in the USA had not yet been taught in Spain. The purpose of this study is to assess its implementation among students and healthcare employees in the Lozano Blesa University Hospital of Zaragoza, a middle-sized Spanish city.MethodsThe study was conducted in a University Hospital and at the University of Zaragoza, scheduling four free B-Con sessions from 2017 to 2018. Two groups were identified as forming the population: healthcare employees and medical students. An anonymous questionnaire was completed at the end of the course regarding content, applicability, usefulness, relevance, and satisfaction. Study variables were ranked from 0 to 10: poor (when graded from 0 to 3), fair (4 to 6) and good (7 to 10). Results were compared between the groups, expressed in percentages and χ2 tested to analyze significant differences if any.ResultsAmong the 83 individuals who completed the course, 46 were medical students and 37 healthcare employees; 61% women and 39% men; aged 21 years to 52 years. Attendees evaluated satisfaction with the highest grade (84%), followed by usefulness (73%), applicability (70%), and relevance (66%). There was no variable graded as poor. The comparison of perceptions between groups did not reveal statistical differences based on a 0.05 significance level.ConclusionWe concluded that the B-Con course was valued as good for relevance, usefulness, applicability, and satisfaction by the majority of the studied population.Level of evidenceLevel III.


2007 ◽  
Vol 6 (2) ◽  
pp. 258
Author(s):  
B. Albouv ◽  
C. Sambuis ◽  
A. Liard-Zmuda ◽  
P. Mitrofanoff ◽  
P. Grise ◽  
...  

1997 ◽  
Vol 4 (6) ◽  
pp. 451-464 ◽  
Author(s):  
Helena Leino-Kilpi ◽  
Tarja Nyrhinen ◽  
Jouko Katajisto

This article discusses the rights of patients who are attending hospital for the most common laboratory examinations and who may also be taking part in research studies. A distinction is made between five kinds of rights to: protection of privacy, physical integrity, mental integrity, information and self-determination. The data were collected ( n = 204) by means of a structured questionnaire specifically developed for this study in the clinical chemistry, haematological, physiological and neurophysiological laboratories of one randomly selected university hospital in Finland. The analysis of the data was statistical. On the whole, patients’ rights were realized reasonably well. This was most particularly the case with protection of privacy, as well as with the rights of physical and mental integrity. The rights to information and self-determination were less well realized. There are various steps that health care professionals and organizations can take to make sure that patients can enjoy their full rights, by counselling the patient, by giving opportunities to plan the examinations in advance, and by arranging a sufficient number of small examination rooms.


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