Clinical medicine (London, England)
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Case Reports
Acute abdominal pain: Henoch-Schönlein purpura case in a young adult, a rare but important diagnosis.
Henoch-Schönlein purpura (HSP), also known as IgA vasculitis, is a systemic vasculitis which is the most common vasculitis in children. The incidence in adults varies from 3.4 to 14.3 cases per million.1 The classic triad of symptoms include purpuric rash, arthritis and abdominal pain. We present the case of a 20-year-old male with HSP who presented with recurrent episodes of abdominal pain, followed by classical symptoms with an identified post-infectious aetiology.
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Patients with advanced chronic kidney disease (CKD), including end-stage renal disease (ESRD), have a life-threatening illness complicated by high morbidity and mortality and, therefore, should be suitable candidates for early intervention by palliative care specialists. However, the average patient with CKD does not have an advanced care plan, has multiple debilitating symptoms, and does not utilise hospice care at the end of life. In this review, we outline the scope of the problem of unmet palliative care needs for patients with advanced CKD and ESRD, barriers to improving palliative care for patients with renal failure, and possible future directions for palliative nephrology.
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Starting with a hypothesis which postulated a simple explanation arising from the basic cause of type 2 diabetes, a series of studies has introduced a paradigm shift in our understanding of the condition. Gradual accumulation of fat in the liver and pancreas leads eventually to beta cell dedifferentiation and loss of specialised function. ⋯ For those people who used to have type 2 diabetes, the state of post-diabetes can be long term provided that weight regain is avoided. The implications for personal health and for national health economics are considerable.