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Communicable Diseases of Children
15 Communicable Diseases of Children Dennis 1. Baumgardner The communicable diseases of childhood are a source of signif from these criteria, the history, physical examination, and ap icant disruption for the family and a particular challenge to the propriate laboratory studies often define one of several other family physician. Although most of these illnesses are self more specific respiratory syndromes as summarized in limited and without significant sequelae, the socioeconomic Table 15.1.3-10 impact due to time lost from school (and work), costs of medi Key points to recall are that significant pharyngitis is not cal visits and remedies, and parental anxiety are enormous. present with most colds, that most colds are 3- to 7-day Distressed parents must be treated with sensitivity, patience, illnesses (except for lingering cough and coryza for up to and respect for their judgment, as they have often agonized for 2 weeks), and that abrupt worsening of symptoms or develop hours prior to calling the physician. They are usually greatly ment of high fever mandates prompt reevaluation. Tonsillo reassured when given a specific diagnosis and an explanation of pharyngitis (hemolytic streptococci, Epstein-Barr virus, the natural history of even the most minor syndrome. adenovirus, Corynebacterium) usually involves a sore throat, It is essential to promptly differentiate serious from benign fever, erythema of the tonsils and pharynx with swelling or disorders (e.g., acute epiglottitis versus spasmodic croup), to edema, and often headache and cervical adenitis. In addition to recognize serious complications of common illnesses (e.g., var the entities listed in Table 15.1, colds must also be differenti icella encephalitis), and to recognize febrile viral syndromes ated from allergic rhinitis, asthma, nasal or respiratory tree (e.g., herpangina), thereby avoiding antibiotic misuse. -
Urinary Stone Disease – Assessment and Management
Urology Urinary stone disease Finlay Macneil Simon Bariol Assessment and management Data from the Australian Institute of Health and Welfare Background showed an annual incidence of 131 cases of upper urinary Urinary stones affect one in 10 Australians. The majority tract stone disease per 100 000 population in 2006–2007.1 of stones pass spontaneously, but some conditions, particularly ongoing pain, renal impairment and infection, An upper urinary tract stone is the usual cause of what is mandate intervention. commonly called ‘renal colic’, although it is more technically correct to call the condition ‘ureteric colic’. Objective This article explores the role of the general practitioner in Importantly, the site of the pain is notoriously inaccurate in predicting the assessment and management of urinary stones. the site of the stone, except in the setting of new onset lower urinary Discussion tract symptoms, which may indicate distal migration of a stone. The The assessment of acute stone disease should determine majority of stones only become clinically apparent when they migrate the location, number and size of the stone(s), which to the ureter, although many are also found on imaging performed for influence its likelihood of spontaneous passage. Conservative other reasons.2,3 The best treatment of a ureteric stone is frequently management, with the addition of alpha blockers to facilitate conservative (nonoperative), because all interventions (even the more passage of lower ureteric stones, should be attempted in modern ones) carry risks. However, intervention may be indicated in cases of uncomplicated renal colic. Septic patients require urgent drainage and antibiotics. Other indications for referral certain situations. -
USMLE – What's It
Purpose of this handout Congratulations on making it to Year 2 of medical school! You are that much closer to having your Doctor of Medicine degree. If you want to PRACTICE medicine, however, you have to be licensed, and in order to be licensed you must first pass all four United States Medical Licensing Exams. This book is intended as a starting point in your preparation for getting past the first hurdle, Step 1. It contains study tips, suggestions, resources, and advice. Please remember, however, that no single approach to studying is right for everyone. USMLE – What is it for? In order to become a licensed physician in the United States, individuals must pass a series of examinations conducted by the National Board of Medical Examiners (NBME). These examinations are the United States Medical Licensing Examinations, or USMLE. Currently there are four separate exams which must be passed in order to be eligible for medical licensure: Step 1, usually taken after the completion of the second year of medical school; Step 2 Clinical Knowledge (CK), this is usually taken by December 31st of Year 4 Step 2 Clinical Skills (CS), this is usually be taken by December 31st of Year 4 Step 3, typically taken during the first (intern) year of post graduate training. Requirements other than passing all of the above mentioned steps for licensure in each state are set by each state’s medical licensing board. For example, each state board determines the maximum number of times that a person may take each Step exam and still remain eligible for licensure. -
Laryngitis from Reflux: Prevention for the Performing Singer
Laryngitis from Reflux: Prevention for the Performing Singer David G. Hanson, MD, FACS Jack J. Jiang, MD, PhD Laryngitis in General Laryngitis is the bane of performers and other professionals who depend on their voice for their art and livelihood. Almost every person has experienced acute laryngitis, usually associated with a viral upper- respiratory infection. Whenever there is inflammation of the vocal fold epithelium, there is an effect on voice quality and strength. Therefore, it is important to understand the factors that can cause laryngitis, especially the preventable causes of laryngitis. Laryngitis is a generic term for inflammation or irritation of the laryngeal tissues. The inflammation can be caused by any kind of injury, including infection, smoking, contact with caustic or acidic substance, allergic reaction, or direct trauma. Inflammatory response of the tissues includes leakage of fluid from blood vessels with edema or swelling, congregation of white blood cells, which release mediators of inflammation, and engorgement of the blood vessels. Most commonly laryngitis occurs from viral infection of the laryngeal epithelial lining associated with a typical cold. The viral infection is almost always quickly conquered by the body's immune system and lasts at most a few days. This kind of acute laryngitis rarely causes any long-term problem unless the vocal folds are damaged by overuse during the illness. Examination of the larynx will show whether the vocal folds are inflamed and allows some prediction of the degree of risk for damage. Other infections of the larynx are fortunately not common but include infections with bacteria and other organisms. -
Mimickers of Urothelial Carcinoma and the Approach to Differential Diagnosis
Review Mimickers of Urothelial Carcinoma and the Approach to Differential Diagnosis Claudia Manini 1, Javier C. Angulo 2,3 and José I. López 4,* 1 Department of Pathology, San Giovanni Bosco Hospital, 10154 Turin, Italy; [email protected] 2 Clinical Department, Faculty of Medical Sciences, European University of Madrid, 28907 Getafe, Spain; [email protected] 3 Department of Urology, University Hospital of Getafe, 28905 Getafe, Spain 4 Department of Pathology, Cruces University Hospital, Biocruces-Bizkaia Health Research Institute, 48903 Barakaldo, Spain * Correspondence: [email protected]; Tel.: +34-94-600-6084 Received: 17 December 2020; Accepted: 18 February 2021; Published: 25 February 2021 Abstract: A broad spectrum of lesions, including hyperplastic, metaplastic, inflammatory, infectious, and reactive, may mimic cancer all along the urinary tract. This narrative collects most of them from a clinical and pathologic perspective, offering urologists and general pathologists their most salient definitory features. Together with classical, well-known, entities such as urothelial papillomas (conventional (UP) and inverted (IUP)), nephrogenic adenoma (NA), polypoid cystitis (PC), fibroepithelial polyp (FP), prostatic-type polyp (PP), verumontanum cyst (VC), xanthogranulomatous inflammation (XI), reactive changes secondary to BCG instillations (BCGitis), schistosomiasis (SC), keratinizing desquamative squamous metaplasia (KSM), post-radiation changes (PRC), vaginal-type metaplasia (VM), endocervicosis (EC)/endometriosis (EM) (müllerianosis), -
Surgical Removal of Epidermoid and Pilar Cysts Policy
CLINICAL POLICY ADVISORY GROUP (CPAG) Surgical Removal of Epidermoid and Pilar Cysts Policy Statement Derby and Derbyshire CCG has deemed that the surgical removal of epidermoid/ pilar (sebaceous) cysts should not routinely be commissioned, unless one (or more) of the following criteria are met: 1. The epidermoid/ pilar (sebaceous) cyst is on the face (not scalp or neck) AND is greater than 1cm diameter, 2. The epidermoid/ pilar (sebaceous) cyst is on the the body (including scalp/ neck) AND is greater than 1cm on AND the epidermoid/ pilar (sebaceous) cyst is: • Associated with significant pain, Or, • Causing loss of function Or, • Susceptible to recurrent trauma These commissioning intentions will be reviewed periodically. This is to ensure affordability against other services commissioned by the CCG. Surgical Removal of Epidermoid Cysts Policy Updated: July 2021 Review Date: June 2024 Page 1 of 4 1. Background A skin cyst is a fluid-filled lump just underneath the skin. They are common and harmless and may disappear without treatment. Cysts can range in size from smaller than a pea to a few centimetres across. They grow slowly. Skin cysts do not usually hurt, but can become tender, sore and red if they become infected. Epidermoid cysts (commonly known as “sebaceous cysts’) are one of the main types of cysts and are always benign. They are commonly found on the face, neck, chest, shoulders or skin around the genitals. Cysts that form around hair follicles are known as pilar cysts and are often found on the scalp. Pilar cysts typically affect middle-aged adults, mostly women. -
Disclosures Objectives
1/16/2015 RbRober tLHllt L. Holley, MSMDFPMRSMSc, MD, FPMRS Professor of Obstetrics and Gynecology Division of Urogynecology and Pelvic Reconstructive Surgery Department of Obstetrics and Gynecology University of Alabama at Birmingham School of Medicine Disclosures I have no conflicts of interest pertinent to this lecture. Objectives Appreciate the history associated with the development of the cystoscope Review indications for diagnostic cystourethroscopy Become familiar with instrumentation for diagnostic and operative cystoscopy Become familiar with normal bladder/urethral anatomy and identify abnormal cystoscopic findings 1 1/16/2015 Howard Kelly Bladder distension Scope introduced using an obturator, with pt in kneeknee--chestchest position Negative intraintra--abdominalabdominal pressure allowed air to distend bladder Head mirror to reflect light Greatly improved visualization 20th Century and Today Hopkins/Kopany 1954 FiberFiber--opticoptic scope Rod lens system Angled scopes Complex instrumentation Flexible cystoscope General surgeons developed Urology subspecialty Ob/Gyn combined program decreased cystoscopy training by gynecologists Granting Of Privileges For Cystourethroscopy “Should be based on training, experience and demonstrated competence” “Implies that the physician has knowledge and compete ncy in t he inst ru me ntat io n a nd su r gi cal technique; can recognize normal and abnormal bladder and urethral findings: and has knowledge of pathology, diagnosis and treatment of specific diseases of the lower -
(CD-P-PH/PHO) Report Classification/Justifica
COMMITTEE OF EXPERTS ON THE CLASSIFICATION OF MEDICINES AS REGARDS THEIR SUPPLY (CD-P-PH/PHO) Report classification/justification of medicines belonging to the ATC group D07A (Corticosteroids, Plain) Table of Contents Page INTRODUCTION 4 DISCLAIMER 6 GLOSSARY OF TERMS USED IN THIS DOCUMENT 7 ACTIVE SUBSTANCES Methylprednisolone (ATC: D07AA01) 8 Hydrocortisone (ATC: D07AA02) 9 Prednisolone (ATC: D07AA03) 11 Clobetasone (ATC: D07AB01) 13 Hydrocortisone butyrate (ATC: D07AB02) 16 Flumetasone (ATC: D07AB03) 18 Fluocortin (ATC: D07AB04) 21 Fluperolone (ATC: D07AB05) 22 Fluorometholone (ATC: D07AB06) 23 Fluprednidene (ATC: D07AB07) 24 Desonide (ATC: D07AB08) 25 Triamcinolone (ATC: D07AB09) 27 Alclometasone (ATC: D07AB10) 29 Hydrocortisone buteprate (ATC: D07AB11) 31 Dexamethasone (ATC: D07AB19) 32 Clocortolone (ATC: D07AB21) 34 Combinations of Corticosteroids (ATC: D07AB30) 35 Betamethasone (ATC: D07AC01) 36 Fluclorolone (ATC: D07AC02) 39 Desoximetasone (ATC: D07AC03) 40 Fluocinolone Acetonide (ATC: D07AC04) 43 Fluocortolone (ATC: D07AC05) 46 2 Diflucortolone (ATC: D07AC06) 47 Fludroxycortide (ATC: D07AC07) 50 Fluocinonide (ATC: D07AC08) 51 Budesonide (ATC: D07AC09) 54 Diflorasone (ATC: D07AC10) 55 Amcinonide (ATC: D07AC11) 56 Halometasone (ATC: D07AC12) 57 Mometasone (ATC: D07AC13) 58 Methylprednisolone Aceponate (ATC: D07AC14) 62 Beclometasone (ATC: D07AC15) 65 Hydrocortisone Aceponate (ATC: D07AC16) 68 Fluticasone (ATC: D07AC17) 69 Prednicarbate (ATC: D07AC18) 73 Difluprednate (ATC: D07AC19) 76 Ulobetasol (ATC: D07AC21) 77 Clobetasol (ATC: D07AD01) 78 Halcinonide (ATC: D07AD02) 81 LIST OF AUTHORS 82 3 INTRODUCTION The availability of medicines with or without a medical prescription has implications on patient safety, accessibility of medicines to patients and responsible management of healthcare expenditure. The decision on prescription status and related supply conditions is a core competency of national health authorities. -
Intravesical Ureterocele Into Childhoods: Report of Two Cases and Review of Literature
Archives of Urology ISSN: 2638-5228 Volume 2, Issue 2, 2019, PP: 1-4 Intravesical Ureterocele into Childhoods: Report of Two Cases and Review of Literature Kouka Scn1*, Diallo Y1, Ali Mahamat M2, Jalloh M3, Yonga D4, Diop C1, Ndiaye Md1, Ly R1, Sylla C1 1 2Departement of Urology, University of N’Djamena, Tchad. Departement3Departement of Urology, of Urology, Faculty University of Health Cheikh Sciences, Anta University Diop of Dakar, of Thies, Senegal. Senegal. 4Service of surgery, County Hospital in Mbour, Senegal. [email protected] *Corresponding Author: Kouka SCN, Department of Urology, Faculty of Health Sciences, University of Thies, Senegal. Abstract Congenital ureterocele may be either ectopic or intravesical. It is a cystic dilatation of the terminal segment of the ureter that can cause urinary tract obstruction in children. The authors report two cases of intravesical ureterocele into two children: a 7 years-old girl and 8 years-old boy. Children were referred for abdominal pain. Ultrasound of the urinary tract and CT-scan showed intravesical ureterocele, hydronephrosis and dilatation of ureter. The girl presented a ureterocele affecting the upper pole in a duplex kidney and in the boy it occurred in a simplex kidney. They underwent a surgical treatment consisting of an ureterocelectomy with ureteral reimplantation according to Cohen procedure. The epidemiology, classification, diagnosis and management aspects are discussed through a review of literature. Keywords: intravesical ureterocele, urinary tract obstruction, surgery. Introduction left distal ureter associated with left hydronephrosis in a duplex kidney. The contralateral kidney was Ureterocele is an abnormal dilatation of the terminal segment of the intravesical ureter [1]. -
Dermatologists' Perceptions on the Utility and Limitations
RESEARCH/Original Article Journal of Telemedicine and Telecare 2021, Vol. 27(3) 166–173 Dermatologists’ perceptions on the ! The Author(s) 2019 utility and limitations of teledermatology Article reuse guidelines: sagepub.com/journals-permissions after examining 55,000 lesions DOI: 10.1177/1357633X19864829 journals.sagepub.com/home/jtt Mara Giavina Bianchi , Andre Santos and Eduardo Cordioli Abstract Introduction: Few studies have assessed the perception of teledermatologists about the utility and limitations of teledermatology, especially to diagnose a broad range of skin diseases. This study aimed to evaluate dermatologists’ confidence in teledermatology, its utility and limitations for dermatological conditions in primary care. Methods: An analytical study that used a survey for dermatologists who diagnosed 30,916 patients with 55,012 lesions through teledermatology during a 1-year project in S~ao Paulo, Brazil. Results: Dermatologists found teledermatology useful for triage and diagnosis, especially for xerotic eczema, pigmen- tary disorders and superficial infections. Their confidence in teledermatology was statistically higher by the end of the project (p ¼ 0.0012). Limitations included some technical issues and the impossibility to suggest how soon the patient should be assisted face-to-face by a dermatologist. The most treatable group of diseases by teledermatology was superficial infections (92%). The use of dermoscopy images would significantly increase the confidence to treat atypical naevi and malignant tumours (p < 0.0001 and p ¼ 0.0003 respectively). Follow-ups by teledermatology or feedback from primary-care physicians would be desirable, according to the dermatologists. Discussion: We found it interesting that dermatologists became increasingly confident in teledermatology after the project and how they classified teledermatology as useful for triage, diagnosis and even treatment of most types of skin conditions followed at primary care. -
WO 2014/134709 Al 12 September 2014 (12.09.2014) P O P C T
(12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (10) International Publication Number (43) International Publication Date WO 2014/134709 Al 12 September 2014 (12.09.2014) P O P C T (51) International Patent Classification: (81) Designated States (unless otherwise indicated, for every A61K 31/05 (2006.01) A61P 31/02 (2006.01) kind of national protection available): AE, AG, AL, AM, AO, AT, AU, AZ, BA, BB, BG, BH, BN, BR, BW, BY, (21) International Application Number: BZ, CA, CH, CL, CN, CO, CR, CU, CZ, DE, DK, DM, PCT/CA20 14/000 174 DO, DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, (22) International Filing Date: HN, HR, HU, ID, IL, IN, IR, IS, JP, KE, KG, KN, KP, KR, 4 March 2014 (04.03.2014) KZ, LA, LC, LK, LR, LS, LT, LU, LY, MA, MD, ME, MG, MK, MN, MW, MX, MY, MZ, NA, NG, NI, NO, NZ, (25) Filing Language: English OM, PA, PE, PG, PH, PL, PT, QA, RO, RS, RU, RW, SA, (26) Publication Language: English SC, SD, SE, SG, SK, SL, SM, ST, SV, SY, TH, TJ, TM, TN, TR, TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, (30) Priority Data: ZW. 13/790,91 1 8 March 2013 (08.03.2013) US (84) Designated States (unless otherwise indicated, for every (71) Applicant: LABORATOIRE M2 [CA/CA]; 4005-A, rue kind of regional protection available): ARIPO (BW, GH, de la Garlock, Sherbrooke, Quebec J1L 1W9 (CA). GM, KE, LR, LS, MW, MZ, NA, RW, SD, SL, SZ, TZ, UG, ZM, ZW), Eurasian (AM, AZ, BY, KG, KZ, RU, TJ, (72) Inventors: LEMIRE, Gaetan; 6505, rue de la fougere, TM), European (AL, AT, BE, BG, CH, CY, CZ, DE, DK, Sherbrooke, Quebec JIN 3W3 (CA). -
Surgical Treatment of Urinary Incontinence in Men
Committee 13 Surgical Treatment of Urinary Incontinence in Men Chairman S. HERSCHORN (Canada) Members H. BRUSCHINI (Brazil), C.COMITER (USA), P.G RISE (France), T. HANUS (Czech Republic), R. KIRSCHNER-HERMANNS (Germany) 1121 CONTENTS I. INTRODUCTION VIII. TRAUMATIC INJURIES OF THE URETHRA AND PELVIC FLOOR II. EVALUATION PRIOR TO SURGICAL THERAPY IX. CONTINUING PEDIATRIC III. INCONTINENCE AFTER RADICAL PROBLEMS INTO ADULTHOOD: THE PROSTATECTOMY FOR PROSTATE EXSTROPHY-EPISPADIAS COMPLEX CANCER X. DETRUSOR OVERACTIVITY AND IV. INCONTINENCE AFTER REDUCED BLADDER CAPACITY PROSTATECTOMY FOR BENIGN DISEASE XI. URETHROCUTANEOUS AND V. SURGERY FOR INCONTINENCE IN RECTOURETHRAL FISTULAE ELDERLY MEN VI. INCONTINENCE AFTER XII. THE ARTIFICIAL URINARY EXTERNAL BEAM RADIOTHERAPY SPHINCTER (AUS) ALONE AND IN COMBINATION WITH SURGERY FOR PROSTATE CANCER XIII. SUMMARY AND RECOMMENDATIONS VII. INCONTINENCE AFTER OTHER TREATMENT FOR PROSTATE CANCER REFERENCES 1122 Surgical Treatment of Urinary Incontinence in Men S. HERSCHORN, H. BRUSCHINI, C. COMITER, P. GRISE, T. HANUS, R. KIRSCHNER-HERMANNS high-intensity focused ultrasound, other pelvic I. INTRODUCTION operations and trauma is a particularly challenging problem because of tissue damage outside the lower Surgery for male incontinence is an important aspect urinary tract. The artificial sphincter implant is the of treatment with the changing demographics of society most widely used surgical procedure but complications and the continuing large numbers of men undergoing may be more likely than in other areas and other surgery and other treatments for prostate cancer. surgical approaches may be necessary. Unresolved problems from pediatric age and patients with Basic evaluation of the patient is similar to other areas refractory incontinence from overactive bladders may of incontinence and includes primarily a clinical demand a variety of complex reconstructive surgical approach with history, frequency-volume chart or procedures.