{"title":"Cholestatic liver injury from Ganoderma lucidum coffee extract—a case report","authors":"Yang Zet Tay, Ann Feng Pan, K. Chiam","doi":"10.21037/amj-22-27","DOIUrl":"https://doi.org/10.21037/amj-22-27","url":null,"abstract":"","PeriodicalId":72157,"journal":{"name":"AME medical journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44862887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Literature review on the efficacy of treatments for urinary incontinence in irradiated vs. non-radiated men treated for prostate cancer","authors":"J. Griffith, L. Wiegand","doi":"10.21037/amj-22-5","DOIUrl":"https://doi.org/10.21037/amj-22-5","url":null,"abstract":"","PeriodicalId":72157,"journal":{"name":"AME medical journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43978390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A brief comment on the true origin of myocardial revascularization procedures","authors":"Yoandy López-de la Cruz, L. B. Pérez-Machado","doi":"10.21037/amj-21-36","DOIUrl":"https://doi.org/10.21037/amj-21-36","url":null,"abstract":"","PeriodicalId":72157,"journal":{"name":"AME medical journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42502747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Definitive radiation remains a mainstay of treatment for men who have been diagnosed with localized prostate cancer (PCa). Acute and chronic genitourinary (GU) toxicity after definitive radiotherapy (RT) can cause significant morbidity for patients. Furthermore, pinpointing the prostate and related prostatitis as the source of symptoms is very difficult and often comes down to a process of elimination. The pathophysiology underlying this prostatitis represents an even more frustrating challenge and is also poorly understood. When it has been identified as the source, radiation-induced prostatitis can be considered a form of chronic, non-bacterial prostatitis based on the NIH classification system. In this classification, radiationinduced prostatitis is exceedingly challenging to manage, with therapy focused on the three “A”s of chronic prostatitis: Anti-inflammatories, Antibiotics, and Alpha-blockers. Unfortunately, approximately 50% of men will have symptoms refractory to medical therapy with limited effectiveness of alternative medical and invasive options. Prostatic artery embolization (PAE) has been shown to be a minimally invasive, safe and clinically effective treatment for lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). While evidence for both the diagnosis and management of post-radiation prostatitis is significantly lacking, this review evaluates the novel role of PAE for the management of refractory, symptomatic radiation-induced prostatitis.
{"title":"A narrative review of the role of prostatic artery embolization in the management of post-radiation prostatitis","authors":"N. Parikh, B. Manley, J. Pow-Sang, K. Yamoah","doi":"10.21037/AMJ-20-189","DOIUrl":"https://doi.org/10.21037/AMJ-20-189","url":null,"abstract":"Definitive radiation remains a mainstay of treatment for men who have been diagnosed with localized prostate cancer (PCa). Acute and chronic genitourinary (GU) toxicity after definitive radiotherapy (RT) can cause significant morbidity for patients. Furthermore, pinpointing the prostate and related prostatitis as the source of symptoms is very difficult and often comes down to a process of elimination. The pathophysiology underlying this prostatitis represents an even more frustrating challenge and is also poorly understood. When it has been identified as the source, radiation-induced prostatitis can be considered a form of chronic, non-bacterial prostatitis based on the NIH classification system. In this classification, radiationinduced prostatitis is exceedingly challenging to manage, with therapy focused on the three “A”s of chronic prostatitis: Anti-inflammatories, Antibiotics, and Alpha-blockers. Unfortunately, approximately 50% of men will have symptoms refractory to medical therapy with limited effectiveness of alternative medical and invasive options. Prostatic artery embolization (PAE) has been shown to be a minimally invasive, safe and clinically effective treatment for lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). While evidence for both the diagnosis and management of post-radiation prostatitis is significantly lacking, this review evaluates the novel role of PAE for the management of refractory, symptomatic radiation-induced prostatitis.","PeriodicalId":72157,"journal":{"name":"AME medical journal","volume":"1 1","pages":"0-0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44952279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The long road to penile allotransplantation in South Africa","authors":"G. Mantica, A. van der Merwe","doi":"10.21037/AMJ-20-163","DOIUrl":"https://doi.org/10.21037/AMJ-20-163","url":null,"abstract":"","PeriodicalId":72157,"journal":{"name":"AME medical journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45177489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Surgical management of genitourinary malignancies","authors":"R. Pessoa, Simon P. Kim","doi":"10.21037/AMJ-21-11","DOIUrl":"https://doi.org/10.21037/AMJ-21-11","url":null,"abstract":"","PeriodicalId":72157,"journal":{"name":"AME medical journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68295900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Llewelyn Yi Chang Tan, Dingyuan Wang, J. Lee, B. Ho, J. H. Lim
: Eosinophilic cellulitis (EC), also known as Wells syndrome, is a rare reactive inflammatory dermatosis which may masquerade as bacterial cellulitis. A 59-year-old gentleman who presented with an acute onset of pruritic rashes affecting the chest and abdomen, along with painful induration over bilateral lower limbs, in association with blistering on his right leg. He had peripheral blood eosinophilia ranging from 0.91 to 1.17×10 9 /L with no biochemical evidence of sepsis. Skin biopsy revealed dermal interstitial lymphocytic infiltration with numerous eosinophils at various stages of degranulation, along with flame figures. EC causing pseudo-cellulitis was suspected. Three fecal samples were unyielding for ova and cysts, but Strongyloides immunoglobulin G serology was positive. The diagnosis of EC secondary to occult strongyloidiasis was made and the patient was treated with oral anti-helminthics and topical steroids with all the skin lesions resolving within 4 days. To our knowledge, this association has never been hitherto reported. This case showcases the following instructive points to the internist, namely (I) the low threshold to consider pseudo-cellulitis in apparent “bilateral lower limb cellulitis”; (II) the awareness of the entity of EC and the need to evaluate for underlying etiologies that cause this reactive dermatoses, such as including occult helminthic infections; (III) the correct way to perform a thorough evaluation for, and optimal treatment of helminthiasis.
{"title":"Eosinophilic cellulitis secondary to occult strongyloidiasis, case report","authors":"Llewelyn Yi Chang Tan, Dingyuan Wang, J. Lee, B. Ho, J. H. Lim","doi":"10.21037/AMJ-20-150","DOIUrl":"https://doi.org/10.21037/AMJ-20-150","url":null,"abstract":": Eosinophilic cellulitis (EC), also known as Wells syndrome, is a rare reactive inflammatory dermatosis which may masquerade as bacterial cellulitis. A 59-year-old gentleman who presented with an acute onset of pruritic rashes affecting the chest and abdomen, along with painful induration over bilateral lower limbs, in association with blistering on his right leg. He had peripheral blood eosinophilia ranging from 0.91 to 1.17×10 9 /L with no biochemical evidence of sepsis. Skin biopsy revealed dermal interstitial lymphocytic infiltration with numerous eosinophils at various stages of degranulation, along with flame figures. EC causing pseudo-cellulitis was suspected. Three fecal samples were unyielding for ova and cysts, but Strongyloides immunoglobulin G serology was positive. The diagnosis of EC secondary to occult strongyloidiasis was made and the patient was treated with oral anti-helminthics and topical steroids with all the skin lesions resolving within 4 days. To our knowledge, this association has never been hitherto reported. This case showcases the following instructive points to the internist, namely (I) the low threshold to consider pseudo-cellulitis in apparent “bilateral lower limb cellulitis”; (II) the awareness of the entity of EC and the need to evaluate for underlying etiologies that cause this reactive dermatoses, such as including occult helminthic infections; (III) the correct way to perform a thorough evaluation for, and optimal treatment of helminthiasis.","PeriodicalId":72157,"journal":{"name":"AME medical journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43889149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To evaluate the benefits of hyperbaric oxygen in the treatment of radiation-induced hemorrhagic cystitis (HC). Hyperbaric oxygen has been shown to be an effective long-term treatment for early and late radiationand chemotherapy-induced HC. It has been proven safe for adult and pediatric patients. Treatment typically required 10–40 “dives” for 60–120 min, making it very time intensive for patients. Complete response has been reported in up to 87% of patients with recurrence ranging from 0–35% in most studies. It works both as an initial treatment and after less time-intensive therapies have failed. Better responses have been seen with initiation within 6-month of presentation. Additional risk factors for treatment failure include: higher radiation doses, more severe hematuria, incomplete treatment, and blood thinner use. In addition to being effective for hematuria, it has also been shown to improve the lower urinary tract symptoms associated with radiation cystitis. Repeat treatments are effective for some patients, but if hematuria fails to resolve after hyperbaric oxygen therapy (HBOT), patients must be reassessed for malignancy as a source of their hematuria. The overall complication rate is low, and these tend to be self-limited with the most common adverse effects being blurred vision and ear pain which resolve after treatment. While expensive and time intensive, it may prove to be cheaper in the long run and offer a better alternative to patients otherwise facing bladder embolization or cystectomy.
{"title":"Narrative review of hyperbaric oxygen therapy for radiation induced hemorrhagic cystitis","authors":"Robert Dieu, Kevin R. Heinsimer","doi":"10.21037/AMJ-20-178","DOIUrl":"https://doi.org/10.21037/AMJ-20-178","url":null,"abstract":"To evaluate the benefits of hyperbaric oxygen in the treatment of radiation-induced hemorrhagic cystitis (HC). Hyperbaric oxygen has been shown to be an effective long-term treatment for early and late radiationand chemotherapy-induced HC. It has been proven safe for adult and pediatric patients. Treatment typically required 10–40 “dives” for 60–120 min, making it very time intensive for patients. Complete response has been reported in up to 87% of patients with recurrence ranging from 0–35% in most studies. It works both as an initial treatment and after less time-intensive therapies have failed. Better responses have been seen with initiation within 6-month of presentation. Additional risk factors for treatment failure include: higher radiation doses, more severe hematuria, incomplete treatment, and blood thinner use. In addition to being effective for hematuria, it has also been shown to improve the lower urinary tract symptoms associated with radiation cystitis. Repeat treatments are effective for some patients, but if hematuria fails to resolve after hyperbaric oxygen therapy (HBOT), patients must be reassessed for malignancy as a source of their hematuria. The overall complication rate is low, and these tend to be self-limited with the most common adverse effects being blurred vision and ear pain which resolve after treatment. While expensive and time intensive, it may prove to be cheaper in the long run and offer a better alternative to patients otherwise facing bladder embolization or cystectomy.","PeriodicalId":72157,"journal":{"name":"AME medical journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49028292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Penile cancer is a rare and serious disease. Early local and regional disease is surgically curable, but advanced regional disease portends a poor prognosis—with inguinal node metastases being the most important prognostic factor. An initial histologic diagnosis with a punch, excisional, or incisional biopsy is recommended to determine the risk of lymph node involvement prior to proceeding with surgery. Magnetic resonance imaging (MRI) or ultrasound can used adjunctively to determine the depth of invasion. Total or partial penectomy with 5mm resection margins is the standard of care for primary disease, although penilepreserving procedures—such as circumcision for preputial lesions, laser ablation, wide local excision, glans resurfacing, glansectomy, and Mohs micrographic surgery—are initially indicated for tumors of lower grade, favorable histology, and favorable location. Inguinal lymphadenectomy is required for nodal disease, but has been associated with a high rate of complications. Patients with bulky or initially unresectable nodal disease should referred to medical oncologist to consider neoadjuvant therapy prior to resection. Dynamic sentinel lymph node biopsies, modified dissection templates, and minimally invasive surgical techniques have been adopted to decrease the morbidity of the procedure. Treatment for penile cancer continues to evolve as new technologies become available, but the rarity of the disease creates knowledge gaps in the best treatment approach. Currently, surgery remains the cornerstone for treatment of penile cancer.
{"title":"Surgical principles of penile cancer for penectomy and inguinal lymph node dissection: a narrative review","authors":"N. Coddington, K. Redger, T. Higuchi","doi":"10.21037/AMJ-20-159","DOIUrl":"https://doi.org/10.21037/AMJ-20-159","url":null,"abstract":"Penile cancer is a rare and serious disease. Early local and regional disease is surgically curable, but advanced regional disease portends a poor prognosis—with inguinal node metastases being the most important prognostic factor. An initial histologic diagnosis with a punch, excisional, or incisional biopsy is recommended to determine the risk of lymph node involvement prior to proceeding with surgery. Magnetic resonance imaging (MRI) or ultrasound can used adjunctively to determine the depth of invasion. Total or partial penectomy with 5mm resection margins is the standard of care for primary disease, although penilepreserving procedures—such as circumcision for preputial lesions, laser ablation, wide local excision, glans resurfacing, glansectomy, and Mohs micrographic surgery—are initially indicated for tumors of lower grade, favorable histology, and favorable location. Inguinal lymphadenectomy is required for nodal disease, but has been associated with a high rate of complications. Patients with bulky or initially unresectable nodal disease should referred to medical oncologist to consider neoadjuvant therapy prior to resection. Dynamic sentinel lymph node biopsies, modified dissection templates, and minimally invasive surgical techniques have been adopted to decrease the morbidity of the procedure. Treatment for penile cancer continues to evolve as new technologies become available, but the rarity of the disease creates knowledge gaps in the best treatment approach. Currently, surgery remains the cornerstone for treatment of penile cancer.","PeriodicalId":72157,"journal":{"name":"AME medical journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41476469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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