Psychosomatic disorders can be described as psychosocial-derived organic disorders. The influence of depression, sleep disorders, quality of life, addictions, work environment, family situation, and stress on atrial fibrillation, palpitations, syncope, chest pain, coronary heart disease, and heart failure has been analysed in this paper. The correlation between psychosomatic disorders and the cardiovascular system has been shown. It allows us to conclude that an attending physician, while taking medical history of cardiac patients, should take into consideration factors that may have a negative impact on their mental health, which can be risk factors in the development or aggravation of an already present cardiovascular disease. StreszczenieZaburzenia psychosomatyczne to zaburzenia organiczne, w których etiopatogenezie znaczący udział mają czynniki psychospołeczne. W niniejszej pracy przeanalizowano wpływ depresji, zaburzeń snu, samopoczucia, zadowolenia z jakości życia, stosowania substancji uzależniających, sytuacji w miejscu pracy, sytuacji rodzinnej i stresu na występowanie migotania przedsionków, kołatania serca, omdleń, bólów w klatce piersiowej, a także choroby wieńcowej i niewydolności serca. Stwierdzono istnienie korelacji między zaburzeniami psychosomatycznymi a występowaniem wybranych schorzeń układu sercowo-naczyniowego. Pozwala to na wysunięcie wniosku, że podczas zbierania wywiadów u pacjentów kardiologicznych należy uwzględnić również czynniki mające potencjalnie negatywny wpływ na ich zdrowie psychiczne, będące jednocześ-nie czynnikami ryzyka wystąpienia lub zaostrzenia już istniejących chorób układu sercowo-naczyniowego.
Background: Despite many studies on COVID-19, our knowledge of it remains incomplete. In some cases, treating SARS-CoV-2 infection concomitant with other diseases can be particularly challenging, as finding an appropriate treatment may involve some risks. Case presentation: A 34-year-old SARS-CoV-2 positive patient admitted due to fever, dyspnoea, haemoptysis and pneumonia, developed alveolar haemorrhage and acute kidney injury. Due to his severe state, abnormalities in laboratory tests and rapidly progressing loss of kidney function, kidney biopsy, as well as antibody panel were carried out, in which perinuclear anti-neutrophil cytoplasmic antibodies (p-ANCA) were found with a high titer (>200; N: <1:20). The results of kidney biopsy, combined with clinical manifestation and laboratory findings prompted the diagnosis of rapidly progressing glomerulonephritis (RPGN) in the course of p-ANCA vasculitis. Initial treatment consisted of heamodialyses, remdesivir, plasmaphereses, intravenous immunoglobulins, antibiotics, corticosteroids and fraxiparine. Once the haemorrhage had subsided, kidney function had been partially retrieved and heamodialyses had no longer been necessary, cyclophosphamide treatment was initiated, despite being contraindicated in COVID-19 according to its summary of product characteristics. Immunotherapy is still continued. The patient has already received a total of 2.4g of cyclophosphamide (4 cycles of 600mg each every three weeks). Pulmonary and radiological regression, as well as improvement of renal parameters have been achieved. Conclusions: We suspect that cyclophosphamide, the drug of choice in p-ANCA vasculitis, could be a potential factor providing regression of the radiological changes in the lungs and it could have prevented the patient from developing acute respiratory distress syndrome. COVID-19 diagnosis should not exclude searching for other diseases which can have a similar course. When treating a patient in a life-threatening condition, a departure from trying to find the perfect timing of cyclophosphamide delivery should be considered, as delaying it could cause potentially greater harm.
Background: Despite many studies on COVID-19, our knowledge of it remains incomplete. In some cases, treating SARS-CoV-2 infection concomitant with other diseases can be particularly challenging, as finding an appropriate treatment may involve some risks. Case presentation: A 34-year-old SARS-CoV-2 positive patient admitted due to fever, dyspnoea, haemoptysis and pneumonia, developed alveolar haemorrhage and acute kidney injury. Due to his severe state, abnormalities in laboratory tests and rapidly progressing loss of kidney function, kidney biopsy, as well as antibody panel were carried out, in which perinuclear anti-neutrophil cytoplasmic antibodies (p-ANCA) were found with a high titer (>200; N: <1:20). The results of kidney biopsy, combined with clinical manifestation and laboratory findings prompted the diagnosis of rapidly progressing glomerulonephritis (RPGN) in the course of p-ANCA vasculitis. Initial treatment consisted of heamodialyses, remdesivir, plasmaphereses, intravenous immunoglobulins, antibiotics, corticosteroids and nadroparin. Once the haemorrhage had subsided, kidney function had been partially retrieved and heamodialyses had no longer been necessary, cyclophosphamide treatment was initiated, despite being contraindicated in COVID-19 according to its summary of product characteristics. Immunotherapy is still continued. The patient has already received a total of 2.4g of cyclophosphamide (4 cycles of 600mg each every three weeks). Pulmonary and radiological regression, as well as improvement of renal parameters have been achieved. Conclusions: We suspect that cyclophosphamide, the drug of choice in p-ANCA vasculitis, could be a potential factor providing regression of the radiological changes in the lungs and it could have prevented the patient from developing acute respiratory distress syndrome. COVID-19 diagnosis should not exclude searching for other diseases which can have a similar course. When treating a patient in a life-threatening condition, a departure from trying to find the perfect timing of cyclophosphamide delivery should be considered, as delaying it could cause potentially greater harm.
Introduction: The relationship between atrial fibrillation (AF) and chronic kidney disease (CKD) is bidirectional. Both diseases are characterised by high prevalence, additionally increasing with age. CKD, especially with glomerular filtration rate (GFR) < 60 ml/min/1.73 m² is a well-known independent risk factor of AF. However, this relationship was inadequately evaluated in elderly patients, especially females. Aim of the research: To evaluate whether there is a relationship between CKD and AF and if it is bidirectional in elderly females. Material and methods: The data was obtained from 336 female outpatients, aged 70 to 84 years, suffering from CKD. Results: Out of 336 females outpatients aged over 70 years suffering from CKD (10.12% with GFR < 60 ml/min/1.73 m²) selected to the study, 8.63% were diagnosed with AF, 21.13% with diabetes, and 63.99% with hypertension. 4.46% underwent a myocardial infraction, and 2.68% underwent a stroke. No relationship between CKD and AF was found (neither depending on stage of CKD, nor in multivariant analysis). AF correlated with diabetes and stroke but not with renal function parameters. Conclusions: In elderly females CKD does not influence on prevalence of AF, suggesting different pathogenesis of AF in this group. Further studies are required to establish this pathogenesis and potential risk factors of AF in this group of patients. Streszczenie Wprowadzenie: Zależność pomiędzy migotaniem przedsionków (AF) a przewlekłą chorobą nerek (CKD) jest dwukierunkowa. Obie choroby charakteryzują się dużą częstością występowania, zwiększającą się z wiekiem. Przewlekła choroba nerek, zwłaszcza przy współczynniku przesączania kłębuszkowego (GFR) poniżej 60 ml/min/1,73 m², jest uznanym niezależnym czynnikiem ryzyka AF. Jednak ich wzajemna relacja nie została jeszcze dokładnie zbadana u chorych w podeszłym wieku, szczególnie starszych kobiet. Cel pracy: Ocena, czy u kobiet w podeszłym wieku występuje zależność pomiędzy CKD a AF i czy jest ona dwukierunkowa. Materiał i metody: Dane pochodziły z grupy 336 kobiet w wieku od 70 do 84 lat leczonych ambulatoryjnie z powodu CKD. Wyniki: Spośród 336 pacjentek w wieku powyżej 70 lat leczonych ambulatoryjnie z powodu CKD (10,12% miało GFR < 60 ml/min/1,73 m²) włączonych do badania u 8,63% rozpoznano AF, u 21,3% cukrzycę, u 63,99% nadciś nienie tętnicze, natomiast 4,46% przebyło zawał serca, a 2,68% udar mózgu. Nie wykazano żadnego związku pomiędzy CKD a AF zarówno ze względu na stopień CKD, jak i w analizie wieloczynnikowej. Migotanie przedsionków korelowało jedynie z cukrzycą oraz udarem mózgu, ale nie z parametrami funkcji nerek. Wnioski: Choroba przewlekła nerek u kobiet w podeszłym wieku nie wpływała na występowanie AF, co sugeruje inny patomechanizm AF w tej grupie. Potrzebne są dalsze badania w celu ustalenia, w jakim mechanizmie AF rozwija się w tej grupie, oraz wyznaczenia potencjalnych czynników ryzyka.
ntroduction Microscopic polyangiitis (MPA) is an antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) that can affect any organ. Sometimes, untypical localization, together with an unusual clinical manifestation of tumour-resembling inflammatory changes, can cause a delay in diagnosis and proper treatment. Aim The aim of this study was to expose the case of very rare location of MPA manifestation. Case study In this paper, we present the case of inflammatory testicular tumour-like lesion that was a manifestation of MPA and mimicked testicular cancer. Results and discussion It is probably first desribed case of MPA mimicking testicular cancer. However, in the literature some others AAV manifestation in that location can be found. In these patients orchiectomy was recommended much more often than a testicular biopsy. Conclusions We conclude that in case of a patient with untypical features of a tumour, inflammatory processes, including vasculitis, should be taken into consideration in differential diagnosis.
Introduction: Measuring glomerular filtration rate (GFR) with the isotopic method is a gold standard. However, it is an elaborate and expensive procedure, so in everyday practice GFR is estimated with creatinine-based formulas. Despite the number of studies, it remains unclear which GFR estimating equation is the most accurate, especially in increasing elderly population. Aim: The aim of this study was to compare the commonly used formulas to assess which one of them should be used in elderly female non-diabetic patients suffering from chronic kidney disease (CKD) Material and methods: 336 non-diabetic females aged 70 and more were qualified to the study. On the basis of serum creatinine concentration, estimated GFR (eGFR) was estimated using various formulas. Results and discussion: The eGFR and CKD stages differ significantly depending on the used formula. The modification of diet in renal disease equation (MDRD) formula showed slightly, but still significantly, better correlation with creatinine concentration in serum than the CKD epidemiology collaboration equation. The Cockcroft-Gault equation formula was significantly inferior to above mentioned equations. The receiver operating characteristic curves showed that MDRD is the most sensitive equation and the differences between formulas compared in pairs were significant. Conclusions: Due to its highest correlation with creatinine and its highest sensitivity and specificity, the MDRD formula seems to be the most accurate equation to estimate GFR in elderly non-diabetic females.
We present a fatal case of the end-stage renal disease complication that is calciphylaxis. Also known as calcific uremic arteriolopathy, it is characterised by vascular calcification, necrosis of the skin and adipose tissue, and constant severe pain of the affected areas.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.