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Metastatic bladder tumor from pancreatic adenocarcinoma

Case Report of International Journal of Case Reports Metastatic bladder tumor from pancreatic adenocarcinoma Konstantinos M. Skrepetis1, Ioannis Efthimiou1, Zacharias Chousianitis1, Stavros Peroukidis1 1Department of Urology, General Hospital of Messinia, Kalamata, Greece. Metastatic pancreatic adenocarcinoma to the urinary bladder is extremely rare and has only been reported 4 cases worldwide. We describe such a case presented with hematuria and dysuria after ten months of the initial diagnosis. Immunohistochemistry helped to confirm the diagnosis of metachronous metastasis. Six months after being diagnosed with the bladder metastasis, progression with severe right hydronephrosis and mild dilatation of the left pyelocaliceal system palliated with an UventaTM metallic ureteral stent and a double J ureteric catheter. Keywords: Metastasis; Pancreas; Bladder; Hydronephrosis ...

Nutritional Potential of Some Invasive Species of Macaronesia for Ruminants

Research Article of American Journal of Agricultural Research Nutritional Potential of Some Invasive Species of Macaronesia for Ruminants C.S.A.M. Maduro Dias, C.F.M. Vouzela, H.J.D. Rosa, J.S. Madruga and A.E.S. Borba University of the Azores, Faculty of Agricultural and Environmental Sciences, Institute of Agricultural and Environmental Research and Technology (IITAA). Rua Capitão João d’Ávila, 9700-042 Angra do Heroísmo, Açores, Portugal. Macaronesia islands’ invasive plant use in animal feed or composting may bring economic and environmental benefits to the region. Arundo donax, Pennisetum setaceum, Agave americana, and Ricinus communis, present in the three archipelagos (Canary, Azores and Madeira), were characterized chemically and biologically. A. donax and P. setaceum showed elevated crude protein (CP) content, 13.25 and 16.33 DM%, respectively, and extremely high NDF values, 75.87 and 80.83 DM%, with a DM digestibility of 55.02 to 59.77%. A. americana showed a low NDF value (22.78 to 27.94 DM%) and a very low CP value (4.24 to 5.61 DM%). However, its DM digestibility was high (79.89 to 86.33%). R. communis presented the best values for CP (24.62%) and NDF (26.56 DM%), however, due to the presence of toxic substances (ricin), it cannot be easily used in animal feed. The P. setaceum and R. communis were found to be the least gas-producing forage, with A. americana being the major producer. To increase these plants’ value for animal feed, treatment with urea or NaOH to A. donax and P. setaceum, and enrichment with nitrogen to Agave is proposed. Due to its toxic properties, R. communis must be used in composting. This work has been funded by Ecofibras Project (MAC/4.6d/040) and INV2MAC project (MAC2/4.6d/229), and by FEDER funds via Operational Programme Competitiveness Factors– COM-PETE and by Regional Funds from Secretaria Regional do Mar, Ciência e Tecnologia. Keywords: Invasive plants; Nutritive valorisation; Composting; Macaronesia ...

Priapism as A Warning Sign for Chronic Myeloid Leukemia

Case Report of International Journal of Case Reports Priapism as A Warning Sign for Chronic Myeloid Leukemia Boudreaux, J, BS, BA1, Haller, CN, MD2, Maslov, D, MD, MS1,2, Bateman, L, MD2 1University of Queensland/Ochsner Clinical School, New Orleans, LA. 2Ochsner Clinic Foundation, Department of Internal Medicine, New Orleans, LA. CML is a chronic myeloproliferative disorder associated with activating mutations in tyrosine kinases forming a BCR-ABL fusion gene, causing hyperproliferation of neoplastic myeloid progenitors [1,2]. The incidence of CML peaks in the fourth and fifth decades of life [3]. In the United States, nearly 4,500 cases are diagnosed annually [3]. The onset of the disease is insidious due to the nonspecific initial “B symptoms,” such as increased fatigability, weight loss and weakness. The natural history of CML is slow with a median survival of three years if untreated [3,4]. The current treatment is targeted therapies to the BCR-ABL tyrosine kinase using imatinib or nilotinib and hydroxyurea. Although B symptoms are common, priapism can be an initial presentation of CML in 1-5% of cases [5]. Priapism is a urological emergency defined by a sustained erection of four or more hours. Hyperviscous blood in leukemias, such as CML, prevents appropriate venous drainage of the corpora cavernosa, resulting in failure of detumescence [4]. This case reports highlights priapism as a presenting sign of CML and reviews the pathophysiology between the association. Keywords: Chronic myeloid leukemia; Priapism ...

Ptosis resolved after cataract surgery – A case report

Case Report of International Journal of Case Reports Ptosis resolved after cataract surgery - A case report Ming Chen, MD, MSc, FACS University of Hawaii. It is well known in the literature that adult ptosis can be induced or worsen by cataract surgery even with modern sutureless clear cornea phacoemulsification. [1, 2, 3, 4,5,6,7,8] We are presenting this unusual case was the opposite. The ptosis resolved after cataract surgery. A possible effect from the successful management of dry eye disease before cataract surgery is explained. Drooping of the unilateral upper eyelid is unilateral ptosis. Ptosis may be myogenic, neurogenic, and aponeurotic from healthy aging, injury, eye diseases. [9, 10]  Ptosis also can be associated with hard contact lens wear, immunological, degenerative, or hereditary disorders, tumors, or infections. [7] Patients with ptosis often present with a lower position of the upper eyelid, complain of a tired appearance, and defect in their superior visual field even blurred vision. The levator muscle controls the position of the eyelid and is innervated by the oculomotor nerve. The Mueller muscle also controls partially by providing sympathetic innervation. The deficiency of these two muscles may cause ptosis. [11] Hering’s law of motor correspondence of a ptosis lid can affect the contralateral lid position [5, 7] as the levator muscles work in synchrony with each other. Therefore, unilateral ptosis can induce a retraction of the contralateral lid or a pseudo retraction. When ptosis is causing visual field defects, the innervation input to both eyelids will increase to reduce the ptosis. There will be a compensatory elevation of eyebrow to reduce the amount of ptosis. [11] These phenomena need to be considered in the evaluation of unilateral ptosis for surgery. Another essential examination, such as Margin Reflex Distance 1 (MRD1), is the crucial measurement for ptosis besides levator function ...

Cultural Competence, Race, and Ethnicity in Community Based Recovery Treatment Programs

Review Article of International Journal of Addiction Research and Therapy Cultural Competence, Race, and Ethnicity in Community Based Recovery Treatment Programs Pascal Scoles, DSW,LCSW Professor, Behavioral Health and Human Services and Director, Office of Collegiate Recovery, Community College of Philadelphia, PA. Cultural competence is more than speaking the language or recognizing the cultural icons of a given group of individuals. Treating the individual is treating their culture. A culturally competent treatment professional must acknowledge an individual’s cultural strengths, values, and experiences while encouraging behavioral and attitudinal change. A significant variable in the change process is the relationship between racial or ethnic matching of clients and counselors. Successful treatment reveals a group of cultural dynamics on how this therapeutic alliance might affect treatment outcomes. To meet these complex cultural challenges, the movement towards a pluralistic cultural framework of helping with its bilingual and bicultural sensitivity appears to be a significant variable to engage the community and the individual in the healing process. Environmental exposures, such as pollution, high-crime areas, and lack of parks or playgrounds, social services, such as transportation, housing, and childcare, mental health care, significantly impact on lifestyle choices. Building strong, grassroots recovery community organizations (RCOs) and linking RCOs into a national movement to develop recovery leaders, offer many opportunities for the recovery community. It helps people in recovery, family members, friends, and allies to express their collective individual and neighborhood voices on issues of common concern by providing a forum for recovery-focused community services that support individual growth. Keywords: Cultural Competence, Race, Ethnicity, Community Based Recovery Treatment Programs ...

Consequences of Covid 19 Pandemic on Children

Research Article of International Journal of Pediatric Research and Reviews Consequences of Covid 19 Pandemic on Children Suresh K* Public Health Consultant, India The Pandemic of SARS COV 2 popularly known as ‘Corona Virus19’ has affected 213 countries and territories around the world since the beginning of year 2020. All the countries have focused their attention acutely on the higher fatality rate the virus has caused among the elderly and launched a scientific enquiry on why children have emerged relatively unaffected. This pandemic has already amplified existing social fractures and inequalities and it is expected that all most all countries may take 5-10 years to return to their socio-economic status of 2019. Most importantly people are losing trust in healthcare system. As the Global tally of cases crosses 28 million cases and nearly 0.9 million deaths on 10th September 2020, with the highest daily case of 300,683 on 4 September 2020 and deaths of 8513 on 17 April 2020. However, the proportion or absolute number of cases and deaths in children is not readily available at Global, National, or even at local levels. In the beginning it was estimated that the children under 14 years contributed less than 0.5% and therefore the Children were not the face of this pandemic. The sub-national data in states reporting desegregated data in USA and India indicate that the children contribute between 0.1% to 10% in the recent weeks. The pandemic of COVID-19 initially appeared to cause only a mild illness in children and immediate health impact, or mortality rates were not alarming. A few weeks following the peak of COVID-19 epidemic in the US and the European Union, a novel systemic illness called Multisystem inflammatory syndrome in children (MIS-C) has been reported with devastating effect. Most importantly children’s risk being among its biggest ...