scholarly journals A Rare Case of Vasculitis ANCA of Bladder and Urethra Providing to Vesicovaginal Fistula and Early Recurrence of Illness

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Teresa Gawlik-Jakubczak
Keyword(s):  
Vesicovaginal Fistula ◽  
Correct Diagnosis ◽  
Complete Response ◽  
Early Recurrence ◽  
Crucial Importance ◽  
Case Presentation ◽  
Urogenital Fistula ◽  
Incorrect Diagnosis ◽  
Complicated Process

Introduction: Vasculitis of the bladder and urethra is a rare disease. Its presentation, as a pelvis tumor, indicates the cancerous nature of the lesion. An incorrect diagnosis can result in the removal of the bladder. Case Presentation: We described a 56-year-old woman (born in 1964) with a vesicovaginal fistula, which arose from vasculitis ANCA. Establishing the correct diagnosis was a long and complicated process. During diagnosis, a urogenital fistula was created due to the deepening of inflammatory necrotic lesions. Remission was achieved by pharmacological treatment. As a result, fistula surgical treatment became possible. An unexpected relapse of vasculitis was diagnosed based on the bladder emptying symptoms. Repeating the treatment resulted in a complete response. Eventually, we obtained a cure of regional vasculitis while maintaining the bladder and urethra, which translated into an increased quality of life for the patient. Conclusions: Correct diagnosis before surgery is of crucial importance. Combined pharmacology and surgery prevents removal of the bladder. Careful observation of symptoms allowed for the early detection of recurrent vasculitis.

scholarly journals Robot-Assisted Infratrigonal Vesicovaginal Fistula Repair

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
João Pádua Manzano ◽  
Fábio da Silva Crochik ◽  
Felipe Guimarães Pugliesi ◽  
Renato Vasconcelos Souza de Almeida ◽  
Petronio Augusto de Souza Melo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cervical Cancer ◽  
Vesicovaginal Fistula ◽  
Fistula Repair ◽  
Robot Assisted ◽  
Disease Treatment ◽  
Case Presentation ◽  
Genitourinary Fistula ◽  
Vesicovaginal Fistulas

Background. Although relatively rare, vesicovaginal fistula is the most common genitourinary fistula, causing a significant decrease in patients’ quality of life. Location of fistula is major supratrigonal, with some cases located in the trigone and rarely below it. Disease treatment is surgical, and repair can be performed by several techniques, including robot-assisted. Case Presentation. We present a case of a patient who developed an infratrigonal vesicovaginal fistula after treatment of a cervical cancer. The patient was submitted to robotic repair of the vesicovaginal fistula. Conclusion. The use of robot-assisted laparoscopy is expanding over all areas of urology and its applicability to repair vesicovaginal fistulas brings good results.

scholarly journals Inappropriate surgery in a patient with misdiagnosed Robert’s uterus

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Iori Kisu ◽  
Kanako Nakamura ◽  
Tetsuro Shiraishi ◽  
Tomoko Iijima ◽  
Moito Iijima ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Uterine Wall ◽  
Septate Uterus ◽  
Case Presentation ◽  
Surgical Interventions ◽  
Unicornuate Uterus ◽  
Uterine Malformation ◽  
Mullerian Anomaly ◽  
Future Pregnancy

Abstract Background Robert’s uterus is a rare Mullerian anomaly, which can be described as an asymmetric, septate uterus with a non-communicating hemicavity. Herein, we present the case of a misdiagnosed Robert’s uterus, resulting in an invasive and disadvantageous surgery. Case presentation A 16-year-old woman was referred to our department because of dysmenorrhea and suspicion of uterine malformation. We misdiagnosed Robert’s uterus as a unicornuate uterus with a non-communicating rudimentary horn and hematometra, and performed laparoscopic hemi-hysterectomy. Although the patient’s symptoms were relieved, our surgical procedure left the lateral uterine wall weak, making the patient’s uterus susceptible to uterine rupture in any future pregnancy. Conclusions Although the early diagnosis of Robert’s uterus is challenging, it is important in order to determine appropriate surgical interventions and management for maintaining the quality of life and ensuring safety in future pregnancies.

scholarly journals 225Actinium-labeled prostate-specific membrane antigen targeting peptide induces complete response in a metastatic prostate cancer patient

2021 ◽  
Vol 10 (5) ◽  
pp. 205846012110225
Author(s):  
Omer Aras ◽  
Stefan Harmsen ◽  
Richard Ting ◽  
Haluk B Sayman
Keyword(s):  
Prostate Cancer ◽  
Standard Of Care ◽  
Complete Response ◽  
Prostate Specific Membrane Antigen ◽  
Limited Data ◽  
Castrate Resistant Prostate Cancer ◽  
Targeting Peptide ◽  
Castrate Resistant ◽  
Specific Membrane

Targeted radionuclide therapy has emerged as a promising and potentially curative strategy for high-grade prostate cancer. However, limited data are available on efficacy, quality of life, and pretherapeutic biomarkers. Here, we highlight the case of a patient with prostate-specific membrane antigen (PSMA)-positive metastatic castrate-resistant prostate cancer who displayed complete response to 225Ac-PSMA-617 after having been resistant to standard-of-care therapy, then initially partially responsive but later resistant to subsequent immunotherapy, and resistant to successive 177Lu-PSMA-617. In addition, the patient’s baseline germline mutation likely predisposed him to more aggressive disease.

Thrombosed Urethral Prolapse: a case series and review of the literature

2021 ◽  
pp. 205141582110328
Author(s):  
Abisola Oliyide ◽  
Ijeoma Chibuzo ◽  
Magda Kujawa
Keyword(s):  
Clinical Condition ◽  
Correct Diagnosis ◽  
Age Distribution ◽  
Case Series ◽  
Review Of The Literature ◽  
Level Of Evidence ◽  
Case Presentation ◽  
Urethral Prolapse ◽  
Evidence Level

Thrombosed urethral prolapse is a rare clinical condition. In this context, we describe our experience and compare our findings with the literature, following presentation of five consecutive cases over 2 years. This will hopefully improve awareness and appropriateness of specialty referrals as a correct diagnosis is rarely established prior to the patient being seen by a urologist. We also wish to highlight a case presentation of thrombosed urethral prolapse outside the bimodal age distribution which has been recorded in the literature. Level of Evidence: Level 4

scholarly journals Type Va extrahepatic bile duct duplication: a case report

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Bharat Mani Banjade ◽  
Ashish Rajbhandari ◽  
Rabin Koirala ◽  
Tuhin Shah ◽  
Chitra Lal Bhattachan
Keyword(s):  
Case Report ◽  
Bile Duct ◽  
Extrahepatic Bile Duct ◽  
Correct Diagnosis ◽  
Diagnostic Techniques ◽  
Case Presentation ◽  
Double Common Bile Duct ◽  
Unusual Variant ◽  
Rural Nepal ◽  
Calculous Cholecystitis

Abstract Background Extrahepatic bile duct duplication is an extremely rare congenital anomaly in which two common bile ducts exist. There are five different types of this anomaly and we present an unusual variant of duplication of an extrahepatic biliary system of type Va variety. Case presentation This case report describes a 63-year-old women from rural Nepal who presented with type Va of duplicated extrahepatic bile duct, with chronic calculous cholecystitis and choledocholithiasis. She was managed with cholecystectomy with hepatic ductoplasty and hepaticojejunostomy. Conclusion A rare case of double common bile duct (type Va) complicated by choledocholithiasis, cholangitis, and chronic cholecystitis is reported here. Rare cases are sometimes overlooked by modern diagnostic techniques. Correct diagnosis helps appropriate surgical intervention.

A High Prevalence of Affective Disorder Discovered in a ‘Schizophrenia Clinic’

1977 ◽  
Vol 22 (4) ◽  
pp. 181-183 ◽  
Author(s):  
Morton S. Rapp ◽  
Peggy Edwards
Keyword(s):  
Affective Disorder ◽  
Affective Disorders ◽  
Correct Diagnosis ◽  
Lithium Carbonate ◽  
Case Histories ◽  
Clinical Notes ◽  
The Past ◽  
High Prevalence ◽  
Incorrect Diagnosis

Fifty outpatients in a ‘schizophrenia clinic’ were examined, and sixteen were found to be suffering from periodic affective disorders. Nine of these were given lithium carbonate, and eight responded well. Case histories illustrate three separate reasons for incorrect diagnosis. Examination of extensive old clinical notes of five of these patients suggests that the problems of diagnosis which have been described in the literature in the past, continue to represent obstacles to correct diagnosis. Suggestions for improvement are offered.

scholarly journals Myxofibrosarcoma Mimicking Inflammatory Lesion of Temporomandibular Joint—Case Presentation

2021 ◽  
Vol 11 (10) ◽  
pp. 4373
Author(s):  
Dawid Zagacki ◽  
Krzysztof Sztychny ◽  
Marta Tyndorf ◽  
Robert Bibik ◽  
Dominik Sygut ◽  
...  
Keyword(s):  
Temporomandibular Joint ◽  
Inflammatory Lesion ◽  
Maxillofacial Region ◽  
Case Presentation ◽  
Oncologic Patients ◽  
And Function ◽  
Ultra High Molecular Weight ◽  
Methods Of Reconstruction ◽  
Disease Free

Treating oncologic patients remains a challenge for surgeons aiming to provide patients with safe margins of resection while maintaining the highest possible quality of life. The latter, in the case of malignancies, requires using sophisticated methods of reconstruction. Thus, we present a case of a 75-year-old patient treated in our department with a rare neoplasm in the region of the temporomandibular joint—a myxofibrosarcoma that was mimicking an inflammatory lesion. The patient underwent two surgeries—firstly alloplasty of the TMJ due to the suspicion of an inflammatory lesion, lately extended to the resection of glenoid fossa and subtemporal fossa contents when the mandible was reconstructed using UHMW-PE (ultra-high molecular weight polyethylene). The patient was also referred for adjuvant radiotherapy and has remained disease-free for over 96 months with very good aesthetics and function of the mandible. The presented case highlights not only the need for increased oncologic awareness but also the possible use of UHMW-PE as a reconstruction material in the broad resection of the maxillofacial region.

scholarly journals Maximizing the Benefit-Cost Ratio of Anthracyclines in Metastatic Breast Cancer: Case Report of a Patient with a Complete Response to High-Dose Doxorubicin

2016 ◽  
Vol 9 (3) ◽  
pp. 840-846 ◽  
Author(s):  
Kevin Shee ◽  
Alan T. Kono ◽  
Susan P. D'Anna ◽  
Mark A. Seltzer ◽  
Xiaoying Lu ◽  
...  
Keyword(s):  
Metastatic Breast ◽  
Breast Cancer Case ◽  
Complete Response ◽  
Cancer Case ◽  
Cost Ratio ◽  
High Dose ◽  
Benefit Cost Ratio ◽  
Benefit Cost

Despite the clinical efficacy of anthracycline agents such as doxorubicin, dose-limiting cardiac toxicities significantly limit their long-term use. Here, we present the case of a 33-year-old female patient with extensive metastatic ER+/PR+/HER2– mucinous adenocarcinoma of the breast, who was started on doxorubicin/cyclophosphamide therapy after progressing on paclitaxel and ovarian suppressor goserelin with aromatase inhibitor exemestane. The patient was comanaged by cardiology, who carefully monitored measures of cardiac function, including EKGs, serial echocardiograms, and profiling of lipids, troponin, and pro-BNP every 2 months. The patient was treated with the cardioprotective agent dexrazoxane, and changes in cardiac markers [e.g. decreases in ejection fraction (EF)] were immediately addressed by therapeutic intervention with the ACE inhibitor lisinopril and beta-blocker metoprolol. The patient had a complete response to doxorubicin therapy, with a cumulative dose of 1,350 mg/m2, which is significantly above the recommended limits, and to our knowledge, the highest dose reported in literature. Two and a half years after the last doxorubicin cycle, the patient is asymptomatic with no cardiotoxicity and an excellent quality of life. This case highlights the importance of careful monitoring and management of doxorubicin-mediated cardiotoxicity, and that higher cumulative doses of anthracyclines can be considered in patients with ongoing clinical benefit.

scholarly journals Discrepancies in interpretation of night-time emergency computed tomography scans by radiology residents

2018 ◽  
Vol 7 (10) ◽  
pp. 205846011880723
Author(s):  
Elias Vaattovaara ◽  
Marko Nikki ◽  
Mika Nevalainen ◽  
Mervi Ilmarinen ◽  
Osmo Tervonen
Keyword(s):  
Computed Tomography ◽  
Emergency Radiology ◽  
Correct Diagnosis ◽  
Anatomical Variations ◽  
Night Time ◽  
Radiology Resident ◽  
Computed Tomography Scans ◽  
Time Work ◽  
Radiology Residents

Background In many emergency radiology units, most of the night-time work is performed by radiology residents. Residents’ preliminary reports are typically reviewed by an attending radiologist. Accordingly, it is known that discrepancies in these preliminary reports exist. Purpose To evaluate the quality of night-time computed tomography (CT) interpretations made by radiology residents in the emergency department. Material and Methods Retrospectively, 1463 initial night-time CT interpretations given by a radiology resident were compared to the subspecialist’s re-interpretation given the following weekday. All discrepancies were recorded and classified into different groups regarding their possible adverse effect for the emergency treatment. The rate of discrepancies was compared between more and less experienced residents and between different anatomical regions. Results The overall rate of misinterpretations was low. In 2.3% (33/1463) of all night-time CT interpretations, an important and clinically relevant diagnosis was missed. No fatalities occurred due to CT misinterpretations during the study. The total rate of discrepancies including clinically irrelevant findings such as anatomical variations was 12.2% (179/1463). Less experienced residents were more likely to miss the correct diagnosis than more experienced residents (18.3% vs. 10.9%, odds ratio [OR] = 1.82, P = 0.001). Discrepancies were more common in body CT interpretations than in neurological CTs (18.1% vs. 9.1%, OR = 2.30, P < 0.0001). Conclusion The rate of clinically important misinterpretations in CT examinations by radiology residents was found to be low. Experience helps in lowering the rate of misinterpretations.

Cytomegalovirus Retinitis: Diagnosis and Treatment

1993 ◽  
Vol 4 (6) ◽  
pp. 322-325 ◽  
Author(s):  
Hunter Maclean ◽  
Baljean Dhillon
Keyword(s):  
Quality Of Life ◽  
Correct Diagnosis ◽  
Cytomegalovirus Retinitis ◽  
Morbidity And Mortality ◽  
Diagnosis And Treatment ◽  
Hiv Positive ◽  
Pathogenic Organism

Cytomegalovirus (CMV) is a non-pathogenic organism in the immunocompetent, but is a major cause of morbidity and mortality amongst patients with AIDS, and the retina is the commonest site of infection1. If left untreated, patients with CMVR will develop disease in their second eye and ultimately become blind2. However, with correct diagnosis and treatment useful vision can be maintained in the majority of cases. Fifteen to 20% of patients with AIDS will contract cytomegalovirus retinitis (CMVR)3−7 and this may be the AIDS-defining diagnosis though more commonly it occurs months after the diagnosis of AIDS. Given the increasing number of HIV positive patients and their longer survival, it is likely that CMVR will become an increasingly prevalent condition. In these patients loss of sight from CMVR has devastating consequences in terms of loss of independence and quality of life and therefore ophthalmologists and physicians should be aware of the presenting characteristics of CMVR, be familiar with therapy and its complications, and be able to recognize relapsing infection.

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