Adenocarcinoma of the bladder following nephrogenic adenoma: a case report

<p>Abstract</p> <p>Introduction</p> <p>Nephrogenic adenomas are generally considered to be benign lesions, but there remains a risk for malignant transformation. Patients with immunosuppression in particular appear to be at a higher risk of malignant disease. We report a case of post-traumatic nephrogenic adenoma in a young patient without immunosuppression, which transformed into an adenocarcinoma of the bladder.</p> <p>Case presentation</p> <p>A 25-year-old man had a traumatic bladder perforation caused by a car accident. After physical recovery from the accident, he developed a neurogenic bladder and recurrent urinary tract infections. He presented with nephrogenic adenoma of the bladder 18 months after the accident. The adenoma was treated repeatedly with transurethral resections. The initial pathologic findings were benign, however, the last resection revealed that the former benign adenoma had transformed into a moderately differentiated adenocarcinoma of the bladder (tumor present but no invasion, multifocal, no lymph nodes involved, no metastasis, grade 2). He subsequently underwent radical cystectomy and has remained tumor-free for the last 4 years.</p> <p>Conclusion</p> <p>Nephrogenic adenoma is a rare disease with some potential for malignant transformation. However, patients with nephrogenic adenoma under immunosuppression and patients with neurogenic bladder dysfunction appear to be at a higher risk of developing bladder cancer.</p

Revisiting Weyl's calculation of the gravitational pull in Bach's two-body solution

When the mass of one of the two bodies tends to zero, Weyl's definition of the gravitational force in an axially symmetric, static two-body solution can be given an invariant formulation in terms of a force four-vector. The norm of this force is calculated for Bach's two-body solution, that is known to be in one-to-one correspondence with Schwarzschild's original solution when one of the two masses l, l' is made to vanish. In the limit when, say, l' goes to zero, the norm of the force divided by l' and calculated at the position of the vanishing mass is found to coincide with the norm of the acceleration of a test body kept at rest in Schwarzschild's field. Both norms happen thus to grow without limit when the test body (respectively the vanishing mass l') is kept at rest in a position closer and closer to Schwarzschild's two-surface.Comment: 11 pages, 2 figures. Text to appear in Classical and Quantum Gravit

The physical meaning of the "boost-rotation symmetric" solutions within the general interpretation of Einstein's theory of gravitation

The answer to the question, what physical meaning should be attributed to the so-called boost-rotation symmetric exact solutions to the field equations of general relativity, is provided within the general interpretation scheme for the ``theories of relativity'', based on group theoretical arguments, and set forth by Erich Kretschmann already in the year 1917.Comment: 9 pages, 1 figure; text to appear in General Relativity and Gravitatio

Global impact of the COVID-19 pandemic on subarachnoid haemorrhage hospitalisations, aneurysm treatment and in-hospital mortality: 1-year follow-up

Background: Prior studies indicated a decrease in the incidences of aneurysmal subarachnoid haemorrhage (aSAH) during the early stages of the COVID-19 pandemic. We evaluated differences in the incidence, severity of aSAH presentation, and ruptured aneurysm treatment modality during the first year of the COVID-19 pandemic compared with the preceding year. Methods: We conducted a cross-sectional study including 49 countries and 187 centres. We recorded volumes for COVID-19 hospitalisations, aSAH hospitalisations, Hunt-Hess grade, coiling, clipping and aSAH in-hospital mortality. Diagnoses were identified by International Classification of Diseases, 10th Revision, codes or stroke databases from January 2019 to May 2021. Results: Over the study period, there were 16 247 aSAH admissions, 344 491 COVID-19 admissions, 8300 ruptured aneurysm coiling and 4240 ruptured aneurysm clipping procedures. Declines were observed in aSAH admissions (-6.4% (95% CI -7.0% to -5.8%), p=0.0001) during the first year of the pandemic compared with the prior year, most pronounced in high-volume SAH and high-volume COVID-19 hospitals. There was a trend towards a decline in mild and moderate presentations of subarachnoid haemorrhage (SAH) (mild: -5% (95% CI -5.9% to -4.3%), p=0.06; moderate: -8.3% (95% CI -10.2% to -6.7%), p=0.06) but no difference in higher SAH severity. The ruptured aneurysm clipping rate remained unchanged (30.7% vs 31.2%, p=0.58), whereas ruptured aneurysm coiling increased (53.97% vs 56.5%, p=0.009). There was no difference in aSAH in-hospital mortality rate (19.1% vs 20.1%, p=0.12). Conclusion: During the first year of the pandemic, there was a decrease in aSAH admissions volume, driven by a decrease in mild to moderate presentation of aSAH. There was an increase in the ruptured aneurysm coiling rate but neither change in the ruptured aneurysm clipping rate nor change in aSAH in-hospital mortality