Increasing Severity of Haematuria with Successive Pregnancies in a Woman with Renal Angiomyolipoma

Objective To report a case of a 31-year-old woman with renal angiomyolipoma (RAML) who presented with progressive massive haematuria with successive pregnancies. Clinical presentation A 28-year-old woman presented with mild haematuria in the third trimester of her second pregnancy. This was due to bleeding from a left RAML. Patient became pregnant for a third time. The RAML increased in size and patient bled more during the third trimester. After delivery she refused partial nephrectomy or renal␣embolisation. In the third trimester of the fourth pregnancy, she presented with massive haematuria, shock, severe anaemia (haemoglobin of 6gm/l) and required a total of 26 units of blood transfusion during a 4-week period. She required emergency Caesarian section at 36 weeks and simple nephrectomy 3 months postpartum. Conclusion The risk of profuse haemorrhage from RAML may increase with successive pregnancies in women with RAML. This anomaly should be treated in between pregnancies by either angioembolisation or resectional surgery.     

Work related post-traumatic stress as described by Jordanian emergency nurses

BACKGROUND: Although there is a growing interest in the consequences of work-related stress among healthcare professionals, most of the research has concentrated on western countries. Empirical studies of work related stress among health care workers from the Middle East have rarely been performed. OBJECTIVES: The aim of the study was to identify causes of post-traumatic stress symptoms and their relationship with daily work stress exposure. This qualitative study was undertaken using hermeneutic phenomenology and involved a representative group of 25 nurses from Jordan. RESULTS: Work related stress symptoms were associated with poor social support. The findings stress the necessity for staff to support each other, for supervisors to support and counsel their staff and also for the management to promote and encourage support. Jordanian nurses are seriously at risk from high levels of stress symptoms. CONCLUSIONS: The results of this study will enable nurses to better identify and handle stressful situations in the early stages and in a timely fashion. It will help administrators, teachers and researchers to plan strategies (interventions) in the hospitals, curriculum and in knowledge needed to promote the quality of life for nurses.     

Statin use does not prevent recurrent adenomatous polyp formation in a VA population

Purpose  

To evaluate whether statin use was associated with recurrent adenomatous polyps.