1/9. Asymptomatic cystic fibrosis diagnosed in an adult evaluated for hematuria.We report a case of cystic fibrosis in an asymptomatic man evaluated for hematuria with infertility. The ever-broadening spectrum of atypical adult presentations of cystic fibrosis should prompt physicians to have a lower threshold for ordering genetic screening for cystic fibrosis transmembrane regulator (CFTR) gene mutations.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/9. Cyclical haematuria sequel to uterine myomectomy: a case report.A thirty-year old married nulliparous lady had a difficult myomectomy done by a general practitioner one year prior to presentation. Two months after the operation, she had her menstruation, but with a concurrent total, painless haematuria. This combination continued for nine months before her family physician referred her to the urological clinic. Full urological work-up revealed an iatrogenic vesico-uterine fistula, but the features were not consistent with those of the classical vesico-uterine fistula syndrome. Transabdominal fistulectomy not only controlled the haematuria but also helped the patient to achieve a viable pregnancy.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/9. Juvenile renal cell carcinoma as first manifestation of von hippel-lindau disease.Von Hippel-Lindau (VHL) disease is an autosomal dominant syndrome characterized by germline mutations in the VHL tumor suppressor gene located at chromosome 3p25-26 and pleomorphic clinical picture. The major clinical manifestations include retinal angiomas, central nervous system hemangioblastomas, pheopleochromocytoma, pancreatic cysts, epididymal cystoadenomas and renal lesions. Recently, we observed a 58-year-old male patient with macrohematuria and a history of nephrectomy due to renal cell carcinoma (RCC). The patient showed retinal angiomatosis, cerebellar hemangioblastomas, multiple pancreatic cysts, right kidney with polycystic features plus two RCC. The patient's offspring, two females and one male, showed VHL lesions, such as retinal angiomatosis, cerebellar hemangioblastomas and polycystic kidney disease (PKD). The affected family members were screened for mutations in the VHL gene. Data suggested the presence of a deletion encompassing exon 1 of the VHL gene. early diagnosis of VHL disease in patients and their relatives is important for clinical and geneticreasons. VHL disease patients have an increased incidence of malignant carcinomas and the syndrome can mimic the presentation of other cystic kidney diseases. early diagnosis and molecular genetic testing of family members is essential to improve the clinical management of patients and to allow an accurate risk assessment in asymptomatic individuals. In conclusion, nephrologists and urologists must carefully evaluate patients with PKD and RCC to confirm or exclude VHL disease, and physicians must play a crucial role in the clinical process of therapeutical decisions and choices for VHL patients.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/9. hematuria and clot retention after transvaginal oocyte aspiration: a case report.OBJECTIVE: To report a case of bladder injury with hematuria and urinary retention after transvaginal oocyte aspiration. DESIGN: Case report. SETTING: Emergency room in a university medical center. PATIENT(S): A 28-year-old woman presented with urinary retention and suprapubic pain 8 hours after oocyte aspiration. INTERVENTION(S): Foley catheter, intravenous fluid bolus, bladder irrigation, and computed tomography with postvoid films that showed a blood clot in the bladder. Patient was discharged home with antibiotics and catheter in place. MAIN OUTCOME MEASURE(S): Clinical follow-up. RESULT(S): Patient passed voiding trial 4 days later and was artificially inseminated. No further hematuria or voiding problems were reported, and she had a successful pregnancy. CONCLUSION(S): patients who elect to undergo oocyte aspiration should be warned about the possibility of bladder injury because of the close proximity of the ovaries to the bladder, and physicians should have an appropriate treatment plan.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/9. The infant with a reddish diaper.The infant with a reddish diaper presents a diagnostic challenge to the primary care physician. As described by Dr Baumgardner, the cause may be benign, but more ominous disorders must be ruled out.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/9. Evaluation of gross and microscopic hematuria.In summary, hematuria, either gross or microscopic and with or without any accompanying symptoms, should always alert the clinician to the possibility of serious urologic disease and should virtually always trigger a thorough urologic investigation. This can be done by immediate referral to the urologist, or it can be done by the primary care physician initiating the diagnostic work-up in children by obtaining studies for acute poststreptococcal glomerulonephritis and in adults by obtaining excretory urograms with physiologic voiding films and also by urine cytologic studies and urine cultures. Appropriate referral to a urologist can then be made for additional studies that might be indicated, such as cystoscopy and cystourethroscopy and for meticulous follow-up of any abnormal findings. The physician who delays or defers a careful investigation into the cause of a given patient's hematuria (gross or microscopic) does the patient a disservice at best and, at worst, may inadvertently permit a significant disease process to become more extensive.- - - - - - - - - - ranking = 2keywords = physician (Clic here for more details about this article) |
7/9. Idiopathic unilateral gross hematuria in the pediatric patient.Microscopic hematuria is not an uncommon finding in the pediatric population. Since gross hematuria elicits parental and physician concern, its presence may result in extensive investigation. Unilateral hematuria is an unusual feature of gross hematuria, particularly in the pediatric patient. Although a number of structural and pathologic entities have been described to account for the laterality, in the majority of instances no overt underlying process has been uncovered. Unilateral hematuria appears to be benign, idiopathic, and has a prognosis no different than other idiopathic hematurias in the pediatric age group.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
8/9. schistosomiasis haematobium.In our patient, schistosomiasis haematobium was not diagnosed and was treated as a urinary tract infection by several physicians. physicians are urged to become increasingly aware of the need to recognize strange and exotic diseases normally not present in this country.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
9/9. Unexplained menorrhagia and hematuria: a case report of Munchausen's syndrome by proxy.Unexplained menorrhagia and hematuria occurred in a 13-year-old female with a mild inherited platelet disorder who had never experienced prior bleeding as a result of this disorder. An intensive search revealed that this patient was receiving coumadin that was given by the mother. In addition, the mother drew large volumes of blood from the patient under the pretense of following a physician's orders. The mother also falsified the laboratory data to erase from her daughter's file a laboratory result documenting warfarin in the blood.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |