Case Report: Silicosis and IgA nephropathy, an exceptional association

A 57-year-old male who had been working in masonry for 33 years was hospitalized for renal function decline associated with exertional dyspnea. He presented with hypertension and limb edema. Urinalysis revealed an active urine sediment with glomerular proteinuria at 1.5 g/24h and the renal biopsy identified mesangial IgA Nephropathy. Chest tomography scans showed signs of silicosis. The patient received Angiotensin-Converting Enzyme Inhibitors with stable renal function. To our knowledge, the association of silicosis-IgA nephropathy has rarely been reported in the literature. This case highlights the effect of chronic exposure to silica dust and its association with both silica and renal disease.

Shaoyao Gancao Decoction for limb dysfunction after fractures around the knee: A protocol for systematic review

Review question / Objective: This study aimed to evaluate the effects of SGD on patients with limb dysfunction from the perspectives of pain, limb edema, stiffness, as well as physical dysfunction. Study designs to be included: This review only includes the intervention measures of SGD, including trials comparing SGD with standard treatment and/ or placebo. Trials of SGD combined with other therapies will be included.

A case of primary intestinal lymphangiectasia with non-Hodgkin lymphoma

Background Primary intestinal lymphangiectasia (PIL) is a rare protein-losing enteropathy characterized by the loss of proteins, lymphocytes, and immunoglobulins into the intestinal lumen. Increasing evidence has demonstrated an association between PIL and lymphoma. Case presentation A 54-year-old man with a 20-year history of abdominal distension and bilateral lower limb edema was admitted. Laboratory investigations revealed lymphopenia, hypoalbuminemia, decreased triglyceride and cholesterol level. Colonoscopy showed multiple smooth pseudo polyps in the ileocecal valve and terminal ileum and histological examination showed conspicuous dilation of the lymphatic channels in the mucosa and submucosa. A diagnosis of PIL was made. Three years later colonoscopy of the patient showed an intraluminal proliferative mass in the ascending colon and biopsy examination confirmed a malignant non-Hodgkin lymphoma. Then the patient was been underwent chemotherapy, and his clinical condition is satisfactory. Conclusion Our report supports the hypothesis that PIL is associated with lymphoma development.

MINIMALLY INVASIVE TREATMENT OF ABDOMINAL LYMPHOCELE: A REVIEW OF CONTEMPORARY OPTIONS AND HOW TO APPROACH THEM

Lymphoceles are lymphatic fluid collections resulting from lymphatic vessel disruption after surgery or trauma. They are most often described following retroperitoneal surgeries such as cystectomies, prostatectomies, renal transplants, and gynecologic surgeries. Most lymphoceles are asymptomatic and resolve spontaneously without treatment. If persistent, they can become infected or exert mass effect on adjacent structures causing pain, urinary, or lower limb edema particularly for lymphoceles in the pelvis Symptomatic lymphoceles should be treated to relieve symptoms and prevent functional compromise of vital adjacent structures. Although surgery has been traditionally accepted as the gold standard treatment, advances in imaging and interventional technology allow for less invasive, percutaneous treatment. Available minimally invasive treatment options include percutaneous aspiration, catheter drainage, sclerotherapy, and lymphangiography with lymphatic embolization. A review of these treatment options and a suggested algorithm for managing lymphoceles is presented.

Case Report: Silicosis and IgA nephropathy, an exceptional association

A 57-year-old male who had been working in masonry for 33 years was hospitalized for renal function decline associated with exertional dyspnea. He presented with hypertension and limb edema. Urinalysis revealed an active urine sediment with glomerular proteinuria at 1.5 g/24h and the renal biopsy identified mesangial IgA Nephropathy. Chest tomography scans showed signs of silicosis. The patient received Angiotensin-Converting Enzyme Inhibitors with stable renal function. To our knowledge, the association of silicosis-IgA nephropathy has rarely been reported in the literature. This case highlights the effect of chronic exposure to silica dust and its association with both silica and renal disease.

The Effect of Hemodialysis vintage on pulmonary functions in patients with End Stage Renal Disease

Background Chronic kidney disease (CKD) is an irreversible and progressive disorder characterized by loss of kidney function. CKD gradually progresses to end-stage renal disease (ESRD). ESRD patients eventually need renal replacement therapy via dialysis (subdivided into hemodialysis and peritoneal dialysis) or kidney transplantation in order to survive. Aim of the Work To see the effect of hemodialysis vintage on pulmonary function in patients with ESRD in Ain-Shams University Hospitals. Methods This was a prospective study at the Ain-Shams University hospitals for six month duration on patient with ESRD on regular dialysis, 100 patients were chosen for this study, divided into 2 groups each group consists of 50 patients. Incident group (on chronic hemodialysis for 1-6 months duration) and Prevalent group (on chronic hemodialysis for more than 2 years). Results this study reveals that there was statistically higher indices among incident compared to prevalent hemodialysis research groups before and after hemodialysis as regards improved Pulmonary Functions. Conclusion prevalent cases on hemodialysis sessions have been improved clinically as regards basal crepitations and lower limb edema but didn't improve significantly in comparison to incident cases as regards Pulmonary functions on the other hand incident cases have been improved as regards Pulmonary functions In a more significant manner then prevalent cases but didn't improve as regards clinical basis concerning lower limb edema and basal crepitations.

Childhood Varicose Veins–An Unusual Visceral “May–Thurner” Like Compression

We report the case of 8-year-old girl with left lower limb edema due to superficial venous incompetence and varicosities. Color Doppler demonstrated compression of the left common iliac vein by an ectopic left kidney, which was partly relieved in right lateral decubitus position. CT demonstrated ectopic malrotated pelvic kidney, compressing the left common iliac vein against the L5 vertebra. A “May–Thurner” like syndrome due to visceral compression needs to be suspected in children with unilateral left lower limb varicosities.

Interpretation of Clinical and Laboratory Findings of Patients with Lupus Nephritis According to the Results of Biopsy

Background: There are controversies regarding the diagnosis of lupus nephritis. Also, its clinical manifestations and severity are different from one patient to another. Objectives: The current study aimed to interpret clinical and laboratory features of lupus nephritis according to the results of the biopsy. Methods: Following a retrospective design, 30 patients with lupus, who were candidates for renal biopsy and undergoing kidney biopsy, were studied. Clinical findings (blood pressure and limb edema) and laboratory findings (Cr, ESR, CRP, BUN, C3, C4, CH50, Anti-ds DNA, and hematuria) were gathered. Finally, the diagnostic value of clinical and laboratory findings was interpreted according to the biopsies and the staging of samples in the pathology. Data were analyzed using SPSS. Quantitative variables are displayed using mean and quartiles. Fisher’s exact test was used to compare study groups. Also, independent samples t-test and Levene’s test were used to evaluate variances of quantitative variables. Results: Of 30 cases, 5 had a biopsy of 3 and FSGN. Also, 8 cases were on stages 3 and 4, 9 had a stage of 4 biopsy, and 8 cases were on stage 4 - 5, 5, and 5 - 6. The association between age, Limp edema, ESR, and biopsy was statistically significant (P < 0.05). Conclusions: This study demonstrated the usefulness of clinical and laboratory findings to determine the severity of the disease in the shortest time, mainly due to its easy, non-invasive access and early preparation of the results, which will facilitate the initiation of treatment.

Rehabilitation of Cancer Patients аfter Surgical and Combined Treatment for Breast Cancer

Radical surgical treatment, adjuvant chemotherapy and postoperative radiation therapy, used in the complex and combined treatment of breast cancer, inevitably lead to serious functional and psychosomatic disorders. One of the most common complications of breast cancer treatment is postmastectomy syndrome (PMES). That is why the study of the latter and the development of modern methods of rehabilitation of patients with an established diagnosis of PMES remain extremely relevant. To date, the pathogenetic mechanism of the development of upper limb edema and a huge range of possible methods of prevention and treatment have been described in detail. However, the choice of a rehabilitation method requires a personalized approach based on a specific clinical case, and special attention to the psychoemotional status of the patient.