EPIDEMIOLOGIChESKIE ASPEKTY PERVIChNOGOGIPERPARATIREOZA V ROSSII

Primary hyperparathyroidism (PHPT) is the third most frequent endocrine disorder and has a variable clinical presentation. Asymptomatic PHPT became the predominant form of the disease with increase of its incidence after the introduction of automated serum calcium measurement in North America and Europe. Data from Russia is lacking. Aim: To present the clinical profile of PHPT in Russia. Materials and Methods: This retrospective study was conducted at endocrinology centers in 8 regions of Russia. We analyzed the clinical presentation, and treatment options in patients with confirmed PHPT (1995-2010). Results: 738 patients (F: M-8:1) with age ranging from 13 to 83,4 years (mean 54,3) were analyzed. 54% was from Moscow (n=397), 11% - from Moscow region (n=79) and 35% - from 53 regions of Russia (n=262). Symptomatic PHPT was the most common form (74%) and was revealed with osteoporosis in 56%, nephrolithiasis - in 45% and ulcer disease - in 18%. Our data showed an increase in the incidence of PHPT (especially mild PHPT) after 2005 compared with earlier period. 64,9% of patients were treated surgically, 17 patients undergone repeated parathyroid surgery. 28,3% received bisphosphonates, calcitonin and/or cinacalcet . 11,5% was observed without treatment. Conclusions: This data analyzes some causes of delayed diagnosis of PHPT in Russia, characterized age and gender distribution of patients with PHPT and demonstrates the changes in clinical profile of disease from 1995 to 2010. PHPT still remains symptomatic disorder in our country most frequently with skeletal and renal manifestations.

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Osteomyelitis of the Patella in a 10-Year-Old Girl: A Case Report and Review of the Literature

Case Reports in Orthopedics ◽

10.1155/2017/6573271 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Matthias Sperl ◽

Michael Novak ◽

Daniela Sperl ◽

Martin Svehlik ◽

Georg Singer ◽

...

Keyword(s):

Case Report ◽

Literature Review ◽

Female Patient ◽

Clinical Presentation ◽

Delayed Diagnosis ◽

Diagnostic Procedures ◽

Long Bones ◽

Review Of The Literature ◽

Present Case Report ◽

Variable Clinical Presentation

The incidence of osteomyelitis constantly declines. While the disease most commonly affects the long bones, involvement of the patella is rarely seen. Due to this rarity and the variable clinical presentation, diagnosis is often delayed. The present case report describes a 10-year-old female patient with a delayed diagnosis of patella osteomyelitis. The diagnostic procedures and the treatment regimen are described. Additionally, a detailed literature review of the available publications reporting osteomyelitis of the patella in children is presented.

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A case of endocarditis mimicking Crimean-Congo haemorrhagic fever

Tropical Doctor ◽

10.1177/0049475516660465 ◽

2016 ◽

Vol 47 (1) ◽

pp. 71-72

Author(s):

Esra Tanyel ◽

Mustafa Sunbul ◽

Tom Fletcher ◽

Hakan Leblebicioglu

Keyword(s):

Endemic Area ◽

Clinical Presentation ◽

Delayed Diagnosis ◽

Hemorrhagic Fever ◽

Diagnostic Techniques ◽

Viral Hemorrhagic Fever ◽

Threatening Condition ◽

Life Threatening ◽

Crimean Congo Haemorrhagic Fever ◽

Variable Clinical Presentation

Infective endocarditis (IE) is life-threatening condition with a highly variable clinical presentation. We report a case of acute IE with delayed diagnosis which resulted due to an initial misdiagnosis of Crimean Congo Hemorrhagic Fever (CCHF) in an endemic area. A case was due to Staphylococcus aureus and requiring valve replacement. They serve to emphasize the importance of careful history taking, physical examination and a broad range of different diagnostic techniques in the context of suspected viral hemorrhagic fever.

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Langerhan’s cell Histiocytosis of Sphenoid Sinus causing Vision Loss: A Case Report

Journal of Nepal Medical Association ◽

10.31729/jnma.3959 ◽

2019 ◽

Vol 57 (218) ◽

Cited By ~ 1

Author(s):

Suresh Mani ◽

Regi Thomas ◽

John Mathew ◽

Rajiv Michael

Keyword(s):

Sphenoid Sinus ◽

Multidisciplinary Approach ◽

Vision Loss ◽

Clinical Presentation ◽

Delayed Diagnosis ◽

Rare Entity ◽

Management Options ◽

Pertinent Literature ◽

Radiological Features ◽

Variable Clinical Presentation

Langerhan's cell histiocytosis is an uncontrolled proliferation of dendritic cells. The involvement of skull base is rare. Variable clinical presentation and multi organ involvement often warrant a multidisciplinary approach for a successful diagnosis. We are reporting a case of 16-year-old male with sphenoid sinus Langerhan’s cell histiocytosis which presented as a sudden and painless loss of vision. It is a rare entity in the diagnosis of blindness. Delayed diagnosis and treatment can result in serious complications. The radiological features and management options are discussed with a review of the pertinent literature.

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Neuroendocrine tumors of gastrointestinal tract: The paradigm that lasts

Acta chirurgica iugoslavica ◽

10.2298/aci1301039b ◽

2013 ◽

Vol 60 (1) ◽

pp. 39-45

Author(s):

Milos Bjelovic ◽

Tamara Babic

Keyword(s):

Gastrointestinal Tract ◽

Neuroendocrine Tumors ◽

Clinical Presentation ◽

Treatment Options ◽

Delayed Diagnosis ◽

Neuroendocrine Cells ◽

Biologically Active ◽

Biological Behaviour ◽

Adequate Treatment ◽

Subcellular Level

Historically, the tumors that were morphologically different and clinically less agressive than the more common gastrointestinal adenocarcinomas were clasified under carcinoid tumors. However, the development of molecular biology tehniques revealed the heterogeneity of these tumors on cellular and subcellular level and ther different biological behaviour. Neuroendocrine tumors of gastrointestinal tract originated from neuroendocrine cells scaterred across the gastrointestinal mucosa. As a result these tumors were capable of secreting many different neurotransmiters, which may or may not be biologically active. The incidence of gastrointestinal NETs has been incresing over the last 2 to 3 decades. Patients often presented with vague, nonspecific symptoms which resulted in delayed diagnosis and adequate treatment. In this article, we discuss the nature of gastrointestinal NETs, clinical presentation, treatment options and prognosis.

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Clinical profile in cases of intestinal perforation

International Surgery Journal ◽

10.18203/2349-2902.isj20170851 ◽

2017 ◽

Vol 4 (3) ◽

pp. 1002

Author(s):

Maneshwar Singh Utaal ◽

Sharadendu Bali ◽

Pooja Batra ◽

Navdeep Garg

Keyword(s):

Peptic Ulcer ◽

Mortality Rate ◽

Clinical Features ◽

Intestinal Perforation ◽

Clinical Presentation ◽

Primary Repair ◽

Clinical Profile ◽

Morbidity Rate ◽

Pathological Features ◽

Ulcer Disease

Background: Intestinal perforation is a surgical emergency with a wide variety of clinical features and causes. Regional variations are common with regards to the cause of intestinal perforation, and need to be evaluated in local settings. The study was conducted to determine the clinical profile of patients with intestinal perforation, with regard to clinical presentation, investigative results, pathological features, surgical findings, complications and outcome.Methods: Detailed information was recorded on 40 cases of intestinal perforation with regard to clinical features, investigative results, surgical findings, post-operative course and outcome. The data was analysed with appropriate statistical methods.Results: The site of perforation was gastric 27.5%, duodenum 20%, jejunum 5%, ileum 35%, appendix 10% and colon 2.5%. Main causes included peptic ulcer 42.5%, typhoid 25% and few cases of trauma, tuberculosis, appendicitis and malignancy. Peritonitis was universal. Primary repair, resection with anastomosis, appendectomy and stoma were the operative procedures. Morbidity rate was 60.0% and mortality rate was 12.5%.Conclusions: Commonest site of perforation was gastro-duodenal while commonest cause was peptic ulcer disease. Morbidity and mortality was comparable with other studies.

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Clinical Profile and Outcome of Patients with Acute Kidney Injury Requiring Hemodialysis: Two Years’ Experience at a Tertiary Hospital in Rwanda

BioMed Research International ◽

10.1155/2018/1716420 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

Grace Igiraneza ◽

Benedicte Ndayishimiye ◽

Menelas Nkeshimana ◽

Vincent Dusabejambo ◽

Onyema Ogbuagu

Keyword(s):

Acute Kidney Injury ◽

Clinical Presentation ◽

Multivariate Analyses ◽

Patient Survival ◽

Kidney Injury ◽

Tertiary Hospital ◽

Clinical Profile ◽

Patient Demographics ◽

And Gender ◽

The Impact

Introduction. Acute kidney injury (AKI) requiring renal replacement therapy is associated with high mortality. The study assessed the impact of the introduction of hemodialysis (HD) on outcomes of patients with AKI in Rwanda. Methods. A single center retrospective study that evaluated the clinical profile and survival outcomes of patients with AKI requiring HD [AKI-D] at a tertiary hospital in Rwanda. Data was collected on patients who received HD for AKI from September 2014 to December 2016. Patient demographics, comorbidities, clinical presentation, laboratory tests, and mortality were reviewed and analyzed. Predictors of mortality were assessed using age and gender adjusted multivariate analyses. Results. Of the 82 eligible patients, median age was 38 years (IQR 28–57 years). Males comprised 51% of the cohort. Infectious diseases including malaria, pneumonia, and sepsis (35.1%) and pregnancy-related conditions (26.9%) were the most frequent comorbidities. Pulmonary oedema (54.9%) and uremic encephalopathy (50%) were top indications for HD. Mortality was 34.1%. On multivariate analysis, receipt of <5 sessions of HD (OR = 4.01, 95% CI 1.185–13.61, P=0.026) and hyperkalemia (OR = 3.23, 95% CI 1.040–10.065, P=0.043) were associated with mortality. Conclusion. The availability of acute hemodialysis in Rwanda has resulted in improved patient survival and persistent hyperkalemia predicted higher mortality.

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An Overview of Dementias

Perspectives on Swallowing and Swallowing Disorders (Dysphagia) ◽

10.1044/sasd21.3.75 ◽

2012 ◽

Vol 21 (3) ◽

pp. 75-84

Author(s):

Venkata Vijaya K. Dalai ◽

Jason E. Childress ◽

Paul E Schulz

Keyword(s):

Clinical Presentation ◽

Treatment Options ◽

Current Treatment ◽

Great Variability ◽

Health Concern ◽

Public Health Concern ◽

Life Threatening ◽

The Common ◽

Neurodegenerative Dementias ◽

Made In

Dementia is a major public health concern that afflicts an estimated 24.3 million people worldwide. Great strides are being made in order to better diagnose, prevent, and treat these disorders. Dementia is associated with multiple complications, some of which can be life-threatening, such as dysphagia. There is great variability between dementias in terms of when dysphagia and other swallowing disorders occur. In order to prepare the reader for the other articles in this publication discussing swallowing issues in depth, the authors of this article will provide a brief overview of the prevalence, risk factors, pathogenesis, clinical presentation, diagnosis, current treatment options, and implications for eating for the common forms of neurodegenerative dementias.

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Phlegmasia cerulea dolens – an uncommon but alarming manifestation of deep vein thrombosis

VASA ◽

10.1024/0301-1526/a000894 ◽

2020 ◽

Vol 49 (5) ◽

pp. 422-426

Author(s):

Manuela Nickler ◽

Sebastian Haubitz ◽

Adriana Méndez ◽

Martin Gissler ◽

Peter Stierli ◽

...

Keyword(s):

Clinical Presentation ◽

Treatment Options ◽

Bleeding Risk ◽

Venous Intervention ◽

Aggressive Treatment ◽

Vein Thrombosis ◽

Prompt Treatment ◽

Surgical Thrombectomy ◽

Deep Vein ◽

Phlegmasia Cerulea Dolens

Summary: In phlegmasia cerulea dolens (PCD), immediate diagnosis and prompt treatment is crucial for limb salvage. Aggressive treatment options including venous intervention, thrombolysis and/or surgical thrombectomy should be considered. Due to the lack of data, the most appropriate intervention depends upon etiology of PCD, clinical presentation and patient’s bleeding risk.

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The impact of a physician’s recommendation and gender on informed decision making: A randomized controlled study in a simulated decision situation

10.31234/osf.io/r5vg4 ◽

2020 ◽

Cited By ~ 1

Author(s):

Marie Eggeling ◽

Anna Meinhardt ◽

Ulrike Cress ◽

Joachim Kimmerle ◽

Martina Bientzle

Keyword(s):

Decision Making ◽

Cruciate Ligament ◽

Treatment Options ◽

General Information ◽

Treatment Preference ◽

Controlled Study ◽

Treatment Preferences ◽

Hypothetical Scenario ◽

And Gender ◽

The Impact

Objective: This study examined the influence of physicians’ recommendations and gender on the decision-making process in a preference-sensitive situation. Methods: N = 201 participants were put in a hypothetical scenario in which they suffered from a rupture of the anterior cruciate ligament (ACL). They received general information on two equally successful treatment options for this injury (surgery vs. physiotherapy) and answered questions regarding their treatment preference, certainty and satisfaction regarding their decision, and attitude toward the treatment options. Then participants watched a video that differed regarding physician’s recommendation (surgery vs. physiotherapy) and physician’s gender (female vs. male voice and picture). Afterward, they indicated again their treatment preference, certainty, satisfaction, and attitude, as well as the physician’s professional and social competence.Results: Participants changed their treatment preferences in the direction of the physician’s recommendation (P<.001). Decision certainty (P<.001) and satisfaction (P<.001) increased more strongly if the physician’s recommendation was congruent with the participant’s prior attitude than if the recommendation was contrary to the participant’s prior attitude. Finally, participants’ attitudes toward the recommended treatment became more positive (surgery recommendation: P<.001; physiotherapy recommendation: P<.001). We found no influence of the physician’s gender on participants’ decisions, attitudes, or competence assessments.Conclusion: This research indicates that physicians should be careful with recommendations when aiming for shared decisions, as they might influence patients even if the patients have been made aware that they should take their personal preferences into account. This could be particularly problematic if the recommendation is not in line with the patient’s preferences.

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Educational aspects of rare and orphan lung diseases

Respiratory Research ◽

10.1186/s12931-021-01676-1 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Tiago M. Alfaro ◽

Marlies S. Wijsenbeek ◽

Pippa Powell ◽

Daiana Stolz ◽

John R. Hurst ◽

...

Keyword(s):

Lung Diseases ◽

Healthcare Professionals ◽

Treatment Options ◽

Delayed Diagnosis ◽

Reference Network ◽

Delay In Diagnosis ◽

Positive Effects ◽

European Reference Network ◽

Patient Representatives ◽

Rare Lung Diseases

AbstractPeople with rare lung diseases often suffer the burden of delayed diagnosis, limited treatment options, and difficulties in finding expert physicians. One of the reasons for the delay in diagnosis is the limited training for healthcare practitioners on rare diseases. This review explores the main concerns and needs for education on rare lung diseases from the perspectives of both patients and professionals. Despite the increasing interest in rare lung disorders and some recent breakthrough developments on the management of several diseases, healthcare professionals, including general practitioners and hospital workers, receive little education on this topic. Nonetheless, many healthcare professionals show much interest in receiving further training, especially on diagnosis. Patients and families want easier access to high-quality education materials to help them manage their own disease. Well-educated patients are better equipped to deal with chronic diseases, but patient education can be challenging as patients’ individual health issues, and diverse backgrounds can create significant barriers. Raising more awareness for rare lung diseases and further development of patient-centred international expert networks like the European Reference Network on Rare Lung Diseases (ERN-LUNG), which includes both experts and patient representatives, are essential for improving care and education on rare lung diseases. Initiatives such as the Rare Disease Day, have been successful in increasing awareness for rare conditions. The development of online tools for accessing information has had positive effects and should be further supported and extended in the future.

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