Medicina
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A possible cause of hypophosphatemia is paraneoplastic secretion of fibroblast growth factor 23 (FGF-23). Tumors secreting FGF-23 are rare, mostly of mesenchymal origin, usually benign, and may be located anywhere in the body, including hands and feet, which are often not represented in conventional imaging. A 50-year-old woman presented with diffuse musculoskeletal pain and several fractures. ⋯ Following the resection, FGF-23 and phosphate levels normalized. In conclusion, we here describe a patient with an FGF-23-secreting phosphaturic mesenchymal tumor with an unusual morphology. Furthermore, we emphasize diagnostic pitfalls when dealing with FGF-23-induced hypophosphatemia.
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Review Case Reports
Total Exenteration En Bloc with a Nephrectomy for Locally Advanced Cervical Cancer Invading a Pelvic Kidney-a Case Report and Literature Review.
Introduction: Extended pelvic resection might be the option of choice in patients presenting locally advanced cervical cancer. However, the possibility of a co-existence of an ectopic, pelvic kidney that is invaded by such a tumor is extremely rare. ⋯ Intraoperatively, tumor invasion of the left kidney, which was found in an ectopic, pelvic position was also encountered; therefore, total pelvic exenteration in association with a left nephrectomy was successfully performed. Conclusions: The presence of an ectopic, pelvic disposition of the kidney makes it susceptible to be invaded by locally advanced pelvic tumors; in such cases, a nephrectomy might also be needed.
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To evaluate maternal and neonatal outcomes of assisted reproductive technology (ART). ⋯ This study showed that ART may reduce placental abruption and increase placenta previa. There is a possibility that the placenta attaches deeper in the myometrium because of ART.
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Background and Objectives: People employed in emergency medical services represent a professional group which encounters events beyond ordinary human experience, great work demands, the risk of professional disputes, and stressful situations. The goal of this study is to examine the presence of mobbing and violence at work, as well as their influence on work ability of emergency medical doctors. Materials and Methods: The survey is conducted in Emergency Medical Service (EMS) in Niš in the period between December 2017 and January 2018. ⋯ Results: EMS doctors were exposed to abuse in 30.4% of the cases. The decline in WAI is significantly related with exposure to violence by patients (β = 0.727), exposure to physical violence (β = 0.896), exposure to abuse several times (β = 0.691) and exposure to ill-treatment by patients (β = 0.750). Conclusion: The results indicate that in the examined doctors mobbing and workplace violence are very much present and have a negative impact on their work, and therefore on the quality of health care.
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Background and Objectives: Medical volunteering seeks to meet the clinical needs of underserved areas, but has been criticized for difficulties in addressing local health issues and resultant lack of sustainability. Our team has visited rural Cambodia annually since 2012. This study reports the illnesses encountered during the recent mission and share our experiences to improve the efficiency of medical volunteering. ⋯ Commonly prescribed drugs were antacids or mucosal protectors (31.3%), Non-steroidal anti-inflammatory drugs (NSAIDs) or other painkillers (27.6%), and antiparasites (17.7%) in adults, and NSAIDs (44.7%) and antiparasites (23.2%) in children. Among adults, 32.7% were diagnosed with hypertension, and body mass index (p = 0.003) and age (p < 0.001) were both correlated with hypertension and its grade. Conclusion: Our study offers practical help to volunteer health workers planning to visit Southeast Asia.