Postgraduate medicine
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Postgraduate medicine · Apr 2020
Prevalence of Iron Deficiency (ID) without anemia in the general population presenting to primary care clinics: a cross-sectional study.
There are no evidence-based recommendations to screen for iron deficiency in non-anemic patients, even though symptoms may be present. The aim of this study is to measure the prevalence of iron deficiency (ID) without anemia in the general population aged 18-50 presenting to primary care along with the incidence and time to develop anemia in the iron-deficient population. ⋯ Iron deficiency without anemia in childbearing females is common but only one-seventh of females developed anemia within 5 years. Guidelines should consider incorporating ferritin levels with CBC in the workup of patients presenting with symptoms suggestive of iron deficiency or anemia.
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Postgraduate medicine · Apr 2020
Surgical decision-making for rectal prolapse: one size does not fit all.
Surgery remains the only known treatment option for rectal prolapse. Although over 100 abdominal and perineal procedures are available, there is no consensus as to which intervention is best suited for an individual. This retrospective cohort study describes the patient- and disease-related factors involved in making surgical recommendations around rectal prolapse in a single surgeon experience. ⋯ With multiple options available for the treatment of rectal prolapse, treatment recommendations remain surgeon-dependent and may be influenced by many factors. In our practice, robotic ventral mesh rectopexy was the most commonly recommended operation and was offered to carefully selected patients of advanced age. Although robotic surgery and ventral mesh rectopexy may not be accessible to all patients and surgeons, this represents a single surgeon's practice bias. This study reinforces the importance of perineal procedures for higher-risk individuals.
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Postgraduate medicine · Apr 2020
Synergistic interaction of hyperuricemia and hypertension on reduced eGFR: insights from a general Chinese population.
Hyperuricemia and Hypertension are two independent risk factors of renal function damage. Our research aimed to investigate the synergistic interaction between hyperuricemia and hypertension toward reduced eGFR. ⋯ Hyperuricemia and hypertension may have a synergistic interaction toward renal function loss in addition to their independent impacts. Our findings may provide a straightforward illustration which is easy for the public to realize the hazard of coexistent hypertension and hyperuricemia on renal injury.
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Postgraduate medicine · Apr 2020
Case ReportsAdrenal insufficiency due to recurrent renal cell carcinoma in the left adrenal gland 3 years after right radical nephrectomy for renal cell carcinoma.
Primary adrenal insufficiency due to tumor involvement is very rare. We herein report a case of adrenal insufficiency caused by cancer metastasis to a remaining single adrenal gland in a renal cell carcinoma patient who had undergone radical nephrectomy including removal of the right adrenal gland. The patient presented with abdominal discomfort, nausea, and vomiting which had begun about 3 months earlier. ⋯ The patient was treated with prednisolone after diagnosis of primary adrenal insufficiency due to adrenal metastasis. The symptoms improved after prednisolone replacement. The case reminds clinicians the diagnosis of primary adrenal insufficiency due to tumor metastasis should be considered in patients with nonspecific gastrointestinal symptoms.
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Postgraduate medicine · Apr 2020
Case ReportsA rare case of intraductal tubulopapillary neoplasm of the pancreas - case report (with video).
Intraductal tubulopapillary neoplasm (ITPN) is a premalignant epithelial tumor of the pancreas. We report a case of ITPN detected incidentally during histopathology examination (HPE) from a specimen taken at the time of endosonography in a patient with pancreatitis. A 53-year-old man presented with severe recurrent epigastric pain, associated with episodic nonbilious vomiting, with a weight loss of about 7 Kg since 15 days. ⋯ There is often a difference of opinion in distinguishing and classifying such tumors when compared to the subtypes of mucinous neoplasm. Identification of this neoplasm is often challenging for pathologists as well as radiologists. We present this case since it is infrequent and atypical in routine medical practice.