End-stage renal disease in a Down syndrome patient caused by delayed diagnosis of nonneurogenic bladder: A case report
Rationale: Patients with Down syndrome (DS) have a higher incidence of nonneurogenic neurogenic bladder (NNB) than do normal subjects. Renal failure may occur frequently in NNB patients. Although most of the cases of NNB patients with DS reported to date have been acute renal injuries, we report a patient with DS who was diagnosed late with urinary tract obstruction due to NNB that finally proceeded to end-stage renal disease (ESRD). This case of terminal renal failure is the first such reported case in the world. Patient concerns: A 35-year-old female patient had visited another hospital for 1 month for abdominal discomfort, nausea, constipation, and palpable mass. Cystic mass in the pelvic cavity, increased BUN, and Cr findings were observed. Residual urine was 1.8 L. She had a history of DS. Diagnoses: Based on computed tomography and urodynamic study, ESRD due to NNB was diagnosed. Interventions: An emergency hemodialysis was performed and a catheter was inserted into the bladder. Transfusion and amlodipine were administered according to the patient's condition. There was no improvement in renal function seen, and so arteriovenous fistula surgery and regular hemodialysis were performed. Outcomes: The patient was discharged from the hospital with a bladder catheter. She was visited on a regular basis for catheter replacement and hemodialysis. Lessons: Patients with DS have lower intelligence than normal people and often do not recognize or complain about i...
Authors: Di Lullo L, Bellasi A, Guastamacchia E, Triggiani V, Ronco C, Lavalle C, Di Iorio BR, Russo D, Cianciolo G, La Manna G, Settembrini S Abstract Diabetes mellitus, with its complications, is one of the major health problems in economically developed countries and its prevalence is constantly increasing. Kidneys and heart involvement represent main comorbidities in diabetic patients often leading to organ's failure. The treatments available until a few years ago are often associated with hypoglycemia, weight gain, gastro-intestinal disorders and other side effects together with serious averse effects on renal...
Conclusions: The proposed web-based deep learning approach can be very practical and accurate for spine segmentation as a diagnostic method. PMID: 32082701 [PubMed]
Authors: Dong ZX, Tian M, Li H, Wu Y, Du XG, Dong JW, Xiao HH, Dong LP, Song XH Abstract Objective: There is no consensus on the role of abnormal uric acid (UA) levels in the prognosis of patients undergoing hemodialysis. We therefore aimed to investigate the effects of changes in UA concentration on the risk of all-cause death and cardiac death in such patients. Method: In this retrospective cohort study, patients admitted to two hemodialysis centers performing maintenance hemodialysis (MHD) in Wuhan First Hospital and Fourth Hospital Hemodialysis Center from January 1, 2007, to October 31, 2017, were included...
ConclusionsComplete resection is vital for local control in pancreatic metastasis of UPS. Sites of recurrence are rare; hence, patients must be carefully followed up.
ConclusionsMost KS-ILD patients showed a tendency for chronic disease onset and long-term stabilization of pulmonary function.
ConclusionsCT angiography imaging findings have the potential to identify patients with head and neck cancer at higher risk of bleeding.
ConclusionReliable iodine quantification can be achieved using dual-source CT, but the result can be affected by patient size and dose rate. In large patients, biases may occur due to the beam-hardening and the photon-starvation effects, in which case higher dose rate and higher kVp are recommended to minimize these effects.
ConclusionHigh-quality CT and CT angiography can be achieved in ECMO patients of different ages and clinical issues considering the type of ECMO circulation, ECMO cannulation sites, preferred contrast phase and anatomy of interest. CT diagnoses affect the treatment of the patient.
ConclusionsThe absorbed dose within all radiosensitive tissues varied considerably in relation to examination type, x-ray unit, clinical settings, and patient age. The mean doses were smaller when using 2 (bilateral) 4 × 4 cm volumes than with use of one 14 × 5 cm volume.
ConclusionWith the guidance of navigation integrated with PET, CNB is a feasible and accurate diagnostic modality, which is also an alternative to open biopsy in patients with suspected primary or recurrent malignancies in deep regions of the head and neck on PET/CT.