BACKGROUND Urinary system tumors often cause negative psychological symptoms,such as depression and dysphoria which significantly impact immune function and indirectly affect cancer prognosis.While epirubicin(EPI)is recommended by the European Association of Urology and can improve prognosis,its long-term use can cause toxic side effects,reduce treatment compliance,and increase psycho-logical burden.Therefore,an appropriate intervention mode is necessary.METHODS This was a retrospective study including 110 patients with urinary system tumors and depression admitted to Zhumadian Central Hospital between March 2021 and July 2023.Patients were divided into conventional(n=55)and joint inter-vention(n=55)groups.The conventional group received mitomycin and routine nursing,while the joint intervention group received EPI and mindfulness intervention.Both groups underwent three cycles of chemotherapy.Immune function(CD4+cells,CD8+cells,CD4+/CD8+ratio),tumor marker levels[urinary bladder cancer antigen(UBC),bladder tumor antigen(BTA)and nuclear matrix protein 22(NMP22)],quality of life questionnaire-core 30(QLQ-C30),17-item Hamilton depression scale(HAMD-17),and cancer-related fatigue[cancer fatigue scale(CFS)]were assessed.Adverse reactions and nursing satisfaction were recorded and evaluated.RESULTS Post-intervention,CD4+,CD8+,and CD4+/CD8+levels increased in both groups,with the joint intervention group showing more significant improvement(P<0.05).Tumor marker levels(NMP22,BTA,and UBC)were lower in the joint intervention group compared to the conventional group(P<0.05).The joint intervention group also showed a greater reduction in HAMD-17 scores(9.38±3.12 vs 15.45±4.86,P<0.05),higher QLQ-C30 scores,and lower CFS scores(both P<0.05).Additionally,the joint intervention group had a lower incidence of adverse reactions and higher nursing satisfaction(P<0.05).CONCLUSION EPI combined with mindfulness intervention significantly improved clinical outcomes in patients with urinary system tumors and depression and is worthy o
BACKGROUND Cauda equina syndrome(CES)is characterized by a group of symptoms that may be caused by inflammation,spinal cord compression,venous congestion,or ischemia.This syndrome is commonly an indication for surgical intervention but has not been determined as a postoperative complication following surgery for lumbar spine disease.CASE SUMMARY To report the case of a 54-year-old male patient who had CES following spinal surgery,with no obvious compression lesions found during re-exploration,suggesting that vascular insufficiency may have contributed to the condition.Furthermore,a series of urodynamic studies on bladder recovery patterns in such complications have also been investigated.CONCLUSION Postoperative CES requires urgent imaging and exploration to rule out compression;noncompressive cases,including vascular insufficiency may performed conservative management.
Introduction: Quality of life in Parkinson disease is not necessary linked to motor symptoms. It’s correlated of overactive bladders and prostatic symptoms. Prognosis factors of urinary quality of life are unknown. Objectives: Our study aims to find prognosis factors of quality of life associated specifically of urinary disorders in PD. Patients and methods: We conducted a transversal, analytic and descriptive study in Physical Medicine, and Neurology departments, Fann Teaching Hospital, Dakar and included patients followed for treatment of PD. Urinary disorders, quality of life and functional autonomy were assessed respectively by Urinary Symptoms Profile (USP), Qualiven Short Form, Schwab and England Scale. Results: 38 patients presented PD, with a mean age of 60.89 ± 13.6 years and sex-ratio of 2.45. Mean duration of PD was 3.1 ± 2.9 years. Urinary disorders were found in 47.36% and dominated by incontinence (88.88%) and overactive bladders (88.88%) which were minor in more than 55%. Quality of life was impaired in 88.88% of cases. Minor forms (43.75%) were predominant and constraint dimension (50%) was the most severely altered. Prognosis factors for quality of life of urinary disorders were PD stages (0.046) and functional autonomy (0.042). Discussion and conclusion: Urinary disorders in PD are common, impaired quality of life, especially the constraint dimension, depends on stage of evolution of PD and functional autonomy of patients.
Introduction: The management of urinary lithiasis in our settings has long been conventional surgery. The recent introduction of endoscopy of the upper urinary tract represents a major advance in our department. The aim was to contribute to the study of the treatment of lithiasis of the upper urinary tract in Conakry and to report on our initial experience of ureteroscopy in Conakry. Methodology: This is a prospective descriptive study lasting one year, from January 1 to December 31, 2022, carried out at the Urology Department of the Ignace Deen National Hospital and at the PERCHIN Urological Clinic. The study included all patients treated surgically for lithiasis of the upper urinary tract who met the selection criteria. Results: The study included 57 patients. The mean age was 30 years, with extremes of 20 and 73 years;the most represented age group was 31 to 40 years, followed by 20 to 30 years with 29.9% and 26.3% respectively. Males predominated in 36 cases (63.15%), with a M/F sex ratio of 1.71. Left-sided renal colic was the most common, at 75.43% (n=43), and right-sided renal colic at 40.35%, associated with digestive signs at 43.85%. 77.19% had normal creatinine levels before surgery, versus 22.81% with elevated creatinine levels, i.e. 15.78% improvement in renal function after surgery. Urinary tract infection was found in 47.36%, and Escherichia coli in 31.57%, followed by staphylococcus aureus in 8.77%. Overall, 82.45% of patients had organic damage to the kidneys or ureters. Right ureterohydronephrosis was noted in 56.14%, followed by left hydronephrosis in 26.32%. Open surgery was predominant in 52.63% of cases, with endoscopic surgery (URS) accounting for a significant 47.36% during the study period. The endoscopic treatment used was laser ureteroscopy. In our study, 73.68% underwent drainage of the upper excretory tract, including 64.91% with a JJ catheter. The average length of stay was 07 days, with extremes of 02 and 28 days, and 81.4% of patients who underwent URS had a length of stay of less t
