Intra-abdominal fibromatosis with vesico-colonic fistula: case of a benign disease running a malignant course

Intra-abdominal fibromatosis is a rare benign tumor which can pose challenges in its management because of its local aggressive invasion and propensity for high recurrence. Here we report the case of a young woman who presented with a large intra-abdominal tumor with bilateral ureteric compression. This case highlights the risks of surgical intervention, the limitations of radiotherapy and subsequent complications that can develop over the years in such patients

Gonadotropin-releasing hormone agonist and depot medroxyprogesterone acetate following uterine artery embolization in the management of uterine arteriovenous malformation

A young woman presenting with recurrent episodes of uterine bleeding due to an extensive uterine arteriovenous malformation was treated with two sessions of uterine artery embolization. Further bleeding was managed with a combination of gonadotropin-releasing hormone and depot medroxyprogesterone acetate. The patient remains asymptomatic with a significant decrease in uterine and pelvic vascularity at one year follow-up. These drugs may decrease the need for repeat embolization

Gonadotropin-releasing hormone agonist and depot medroxyprogesterone acetate following uterine artery embolization in the management of uterine arteriovenous malformation

A young woman presenting with recurrent episodes of uterine bleeding due to an extensive uterine arteriovenous malformation was treated with two sessions of uterine artery embolization. Further bleeding was managed with a combination of gonadotropin-releasing hormone and depot medroxyprogesterone acetate. The patient remains asymptomatic with a significant decrease in uterine and pelvic vascularity at one year follow-up. These drugs may decrease the need for repeat embolization

B-type natriuretic peptide and renal function in the diagnosis of heart failure: An analysis from the BNP multinational study

https://nsuworks.nova.edu/nsudigital_harrison/3343/thumbnail.jp

Utility of a rapid B-natriuretic peptide assay in differentiating congestive heart failure from lung disease in patients presenting with dyspnea

AbstractObjectivesSince B-type natriuretic peptide (BNP) is secreted by the left ventricle (LV) in response to volume elevated LV pressure, we sought to assess whether a rapid assay for BNP levels could differentiate cardiac from pulmonary causes of dyspnea.BackgroundDifferentiating congestive heart failure (CHF) from pulmonary causes of dyspnea is very important for patients presenting to the emergency department (ED) with acute dyspnea.MethodsB-natriuretic peptide levels were obtained in 321 patients presenting to the ED with acute dyspnea. Physicians were blinded to BNP levels and asked to give their probability of the patient having CHF and their final diagnosis. Two independent cardiologists were blinded to BNP levels and asked to review the data and evaluate which patients presented with heart failure. Patients with right heart failure from cor pulmonale were classified as having CHF.ResultsPatients with CHF (n = 134) had BNP levels of 758.5 ± 798 pg/ml, significantly higher than the group of patients with a final diagnosis of pulmonary disease (n = 85) whose BNP was 61 ± 10 pg/ml. The area under the receiver operating curve, which plots sensitivity versus specificity for BNP levels in separating cardiac from pulmonary disease, was 0.96 (p < 0.001). A breakdown of patients with pulmonary disease revealed: chronic obstructive pulmonary disease (COPD): 54 ± 71 pg/ml (n = 42); asthma: 27 ± 40 pg/ml (n = 11); acute bronchitis: 44 ± 112 pg/ml (n = 14); pneumonia: 55 ± 76 pg/ml (n = 8); tuberculosis: 93 ± 54 pg/ml (n = 2); lung cancer: 120 ± 120 pg/ml (n = 4); and acute pulmonary embolism: 207 ± 272 pg/ml (n = 3). In patients with a history of lung disease but whose current complaint of dyspnea was seen as due to CHF, BNP levels were 731 ± 764 pg/ml (n = 54). The group with a history of CHF but with a current COPD diagnosis had a BNP of 47 ± 23 pg/ml (n = 11).ConclusionsRapid testing of BNP in the ED should help differentiate pulmonary from cardiac etiologies of dyspnea

Paternal age and common mental disorders

Introduction: There is evidence in the literature that there are associations between advancing paternal age and psychosis or more specifically schizophrenia, but not enough to support a strong link between advancing paternal age and common mental disorders. Objective: This study aims to explain the association between paternal age at birth and common mental disorders in progeny during their adulthood. Methodology: This is a sub-study from a larger survey which was planned to study the epidemiology of mental disorders in Malaysia. Respondents who could remember the age of parents at birth were included in the study. The diagnosis of common mental disorders (CMD) was made using the CIS-R (Clinical Interview Schedule-Revised) instrument in the PROQSY (Programmed Questionnaire System) format. Association between paternal age at birth and CMD was studied using logistic regression, after controlling for age, gender, ethnicity and presence of family history of mental disorders. Results. Respondents with paternal age at birth of 19 and below and 50 above and had higher rates of 10 and 25% for common mental disorders (x²=7.007, P=0.072) with odds ratios of 2.89 (95% CI of OR = 1.1-7.6) and 4.28 (1.4-12.7). Discussion: Progenies of fathers under 20 and over 50 had higher risk for mental disorders. Factors such as immaturity in sperm of teenage fathers, mutation in germ line of older fathers, environmental and psychosocial factors could have contributed to increased prevalence of common mental disorders in the progeny

Common mental disorders in Malaysia: Malaysian mental health survey, 2003-2005

Introduction: Mental disorders are emerging as serious health threats in both developed and developing nations and contribute to greater Disability Adjusted Life Years (DALY) than infectious disease and unintentional injuries. This study aims to determine the prevalence and factors associated with the presence of common mental disorders in the Malaysian population. Methods: Multistage cluster sampling method was used to obtain samples, with racial proportion as the main sampling criteria. Required sample size was calculated to be 4300 at 90% confidence level. Trained enumerators carried out the interview, with the Clinical Interview Scheduled- Revised (CIS-R). Results: A total of 3666 respondents were interviewed (85% response rate). The one-week prevalence of Common Mental Disorders was 5.3% (95% CI of 4.57-6.03%). Findings from multivariate logistic regression analysis showed that associated factors were female gender (adjusted OR = 1.91,