RESUMO
Urinary tract infections (UTI) in the elderly are common. UTI ranges in severity from mild disease to severe sepsis. Many organisms can cause UTIs yet many UTIs are caused by the same few organisms. An organism that has been increasingly gaining notoriety for infections is Aerococcus urinae. Aerococcus infections are constantly misdiagnosed due to their difficulty to identify. Here we present a case of an elderly male who was found to have a urinary tract infection with Aerococcus urinaethat progressed into bacteremia, severe sepsis and ultimately death.
RESUMO
Climate change is a significant global health threat that is, underpinned by the existing issue of gender inequality. A scoping review was conducted to better understand the relationship between climate change and women's health. We found a notably higher proportion of existing studies focused on low- and middle-income countries (LMICs). Most of the studies included were published after 2010, with predominantly qualitative study designs. Four key themes were identified, including women's exposure to climate change risks, the impacts on women's health, factors contributing to the vulnerability, and responding strategies in addressing climate change. The scoping review indicates that women's health is at higher risks due to the vulnerability to climate change, especially in LMICs. Meanwhile, it is beneficial to have insights from women in terms of adaptation and mitigation strategies to build stronger resilience. Mixed methods are strongly recommended to support evidence-based policy making in responding to climate change.
RESUMO
A 56-year-old woman presented with gradually worsening shortness of breath associated with dull left leg pain over 5 days. She denied any recent travel, recent surgeries or immobilization. CT pulmonary angiography and CT venography revealed multiple bilateral pulmonary emboli and extensive left pelvic and left lower extremity deep vein thromboses. Contrast-enhanced CT showed that the right common iliac artery crossed the left common iliac vein and compressed it externally, indicative of May-Thurner syndrome. Catheter-directed thrombolysis of the left lower extremity was performed and heparin infusion was started. The patient also underwent left iliac vein balloon angioplasty with stenting and infra-renal inferior vena cava filter placement via the jugular approach to prevent further embolization. LEARNING POINTS: May-Thurner syndrome (MTS) should be suspected in patients in their second to fourth decade of life presenting with unprovoked deep venous thrombosis of the left leg.An iliac venogram is the diagnostic test of choice for MTS.MTS is treated only when it is symptomatic. The goal of treatment is to remove the clot to prevent post-thrombotic syndrome and to repair the anatomical defect.A stent was successfully deployed in the iliac vein of our patient and restoration of blood flow resulted in a dramatic improvement in the patient's symptoms.
