Background: There is a scarcity of literature on co-existing psoriasis (Ps) and systemic lupus erythematosus (SLE). We used a large national population database to determine if there is any association between Ps and SLE. The primary objective was to compare the odds of being admitted for SLE in patients with Ps compared to those without Ps. The secondary objective was to compare hospital outcomes of patients admitted for SLE with co-existing Ps to those without Ps. Methods: Data were abstracted from the National Inpatient Sample (NIS) 2016 and 2017 Databases. We search for hospitalizations using ICD-10 codes. Multivariate logistic and linear regression analysis was used accordingly to adjust for confounders. Results: There were over 71 million discharges included in the database. A total of 20,630 hospitalizations had SLE as the principal diagnosis. One hundred fifty (0.7%) of these SLE hospitalizations have co-existing Ps. Hospitalizations for SLE with co-existing Ps had similar length of stay (LOS), total hospital charges, need for blood transfusion, odds of having a secondary discharge diagnosis of venous thrombosis or embolism/pulmonary embolus, and acute kidney injury compared to those without Ps. Hospitalizations with a secondary diagnosis of Ps have an adjusted odds ratio (AOR)=2.73 (95% CI 1.86-4.02, P<0.0001) of SLE being the principal reason for hospitalization compared to hospitalizations without Ps. Conclusion: In our study, patients with Ps had almost three times the odds of being admitted for SLE compared to non-Ps patients. However, Ps patients admitted for SLE had similar hospital outcomes compared to non-Ps patients admitted for SLE.
Fibroadenoma is a non-cancerous tumor commonly associated with the female breast and has been known to be hormone dependent. Fibroadenomas are known to present as solitary mobile masses within the young female breast and are mostly benign. Bladder outlet obstruction from fibroadenoma in a male patient is of extreme rarity and none of the reported cases of fibroadenoma in the male urinary bladder has been associated with this presentation. We herein present this rare finding within the male bladder, and a literature review of fibroadenomatous disease in men. Cystoscopy and transurethral excision was performed for a suspected case of obstructive bladder tumor after ultrasonography showed a mass within the bladder neck region, in a patient presenting with acute urinary retention. Biopsy samples of the mass and surrounding tissue were taken and sent for histopathological examination. Pathological diagnosis of fibroadenoma of the urinary bladder was made after careful histopathological examinations. A meticulous search was made for supportive literature, which revealed two reported cases of fibroadenoma within the male urinary bladder but no association between fibroadenoma in this location and acute urinary retention or bladder outlet obstruction has ever been reported. This report aims to further establish fibroadenoma as a definitive disease entity, possible etiology for obstructive bladder tumors and encourage further study into other possible clinical presentations and sequelae.
Family members regularly mistreat the elderly who rely on them because they lack financial stability and believe that seeking aid will exacerbate their predicament. Elder abuse studies conducted in the last two years indicate that an increased number of elderly citizens have been abused since the COVID-19 outbreak, and many of them did not receive assistance from agencies responding to abuse because they did not report any incidents and did not have access to a phone, even if they desired it. Researchers think that an increase in elder maltreatment is being fuelled, in part, by directives to shelter in place in response to the COVID-19 pandemic and the ensuing restrictions and lockdowns worldwide. While the UN acknowledges domestic violence against women as a "shadow pandemic," elder abuse may be just as dangerous. This article highlights elder abuse by doing a critical review of some of the recent studies conducted preceding to and during the outbreak of COVID-19. Its purpose is to critically examine existing claims that elder abuse has increased in prevalence since the coronavirus outbreak, to highlight critical public health implications, and to suggest additional initiatives for the early detection and management of elder abuse.
Wound contamination and subsequent colonization by microbes can significantly impair tissue repair and lead to the development of chronic non-healing ulcers. Atypical Burkholderia and Actinomycetes bacterial species are common in cases of soil contamination of open wounds leading to a complex infection that is both difficult to diagnose and treat. Despite much research on the involvement of atypical organisms, including Burkholderia and Actinomycetes, in antibiotic resistance, there is no consensus on the timeline from contamination to infection and on an algorithm for early diagnosis and management. Thus, the ways in which these organisms interact in settings of co-infection and contribute to cross-resistance remains unclear. The generally low index of clinical suspicion for atypical microbial infections and the absence of clear diagnostic protocols have multiple consequences, ranging from excessive reliance on pathology, delayed treatment, expensive and ineffective investigations and treatment, and progressive wound sepsis and morbidity.We are reporting a case of Burkholderia cepacia infection, co-infection with Actinomyces spp., and resistance to ceftazidime/avibactam and co-trimoxazole in a 28-year-old previously healthy farmer following soil contamination of an open wound. This is one of only a few reported cases of Burkholderia resistance to ceftazidime/avibactam and the first reported case of B. cepacia bacteremia due to peripheral contamination.
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