Objective To investigate the clinical efficacy of hemocoagulase for severe hemorrhagic cystitis (HC) following allogeneic hemotopoietic stem cell transplantation (HSCT). Methods Twenty patients undergoing allogeneic HSCT developed severe HC with an onset time of 14 to 70 days, all patients received the treatment of hemocoagulase (1 U ivgtt q12 h × 5 d). The urine speciments reserved before and after hemocoagulase were examined by naked eye and microscope to evaluate the efficacy. Results Twenty patients received the treatment of hemocoagulase. The HC was cured in 18 patients, improved in 1 patient and uncontrolled in 1 patient. For the patients with response, macroscopic hematuria disappeared at a median of 28 days (4-127 days) after the treatment. All procedures were tolerated well and no severe adverse effect was observed. Conclusion Hemocoagulase seems to be a safe and effective drug for severe HC following HSCT.

20-year-old man presented to our emergency department after he was hit by a forklift. He developed haemorrhagic shock from a subcutaneous haematoma in his left thigh and required monitoring in the surgical intensive care unit. He stabilised with aggressive fluid resuscitation with crystalloids and blood transfusion. The recovery was complicated by an infection of the subcutaneous haematoma. Following open drainage of the infected subcutaneous haematoma, he improved and was discharged. To the best of our knowledge, this is the first reported case of a subcutaneous haematoma causing haemorrhagic shock.
Accidents, Traffic ; Diagnosis, Differential ; Hematoma ; complications ; diagnosis ; Humans ; Male ; Shock, Hemorrhagic ; diagnosis ; etiology ; Soft Tissue Injuries ; complications ; diagnosis ; Young Adult

INTRODUCTIONWeight management programmes (WMPs) can help overweight individuals lose weight, and thus prevent complications associated with obesity. Herein, we describe the demographic profile, clinical characteristics, motivations and expectations, and outcomes of patients enrolled in a nonsurgical WMP.

METHODSThis was a retrospective study of consecutive patients with a body mass index (BMI) of > 23 kg/m2 enrolled in the four-month WMP at the Health For Life Clinic, Alexandra Hospital, Singapore, between 1 and 31 August 2009. Demographic data, medical history and source of referral were recorded. Details on personal motivations and weight loss goals were obtained from the completed self-administered questionnaires of the WMP participants. Weight, waist circumference, fat percentage and BMI were measured at the start and end of the WMP. A weight loss of ≥ 5% was deemed as a successful outcome.

RESULTSA total of 58 patients (mean age 37.2 years) were included in our study. Of these 58 patients, 58.6% were of Chinese ethnicity and 55.2% were male. Many patients (32.8%) attributed their weight gain to work- or study-related stress, and a minority to poor eating habits (12.1%) or a lack of exercise (10.3%). Patients' motivations included a desire for better health (53.4%) and better fitness (15.5%). However, only 53.4% patients scored their motivation as high (i.e. a score of > 7). The mean expected weight loss was 9.9 kg at 4 months, and 14.1 kg at 12 months. Among the 40 patients (69.0%) who completed the programme, the mean percentage weight loss was 1.8 ± 4.3%. A weight loss of ≥ 5% was achieved by 8 (13.8%) patients.

CONCLUSIONAlthough the patients in our study cohort were young and educated, only a portion of them appeared to be highly motivated to lose weight, despite joining the WMP. There is a need for patients to be guided on how to set realistic weight loss goals.

Adult ; Aged ; Body Mass Index ; Female ; Humans ; Male ; Middle Aged ; Motivation ; Obesity ; psychology ; therapy ; Overweight ; psychology ; therapy ; Retrospective Studies ; Singapore ; Surveys and Questionnaires ; Treatment Outcome ; Weight Loss ; Weight Reduction Programs ; methods ; Young Adult

A 63-year-old man presented with painless jaundice, loss of appetite and significant weight loss. Cross-sectional imaging showed a diffusely enlarged pancreas, with no significant fat stranding and a hypodense rim on computed tomography, which appeared hypointense on T2-weighted magnetic resonance imaging. There was a narrowed pancreatic duct and features of common bile duct narrowing in the region of the pancreatic head. However, there was no obvious mass seen in the pancreatic head region. These features were classical of autoimmune pancreatitis with diffuse involvement of the gland. Laboratory investigation showed abnormal liver function and the classical sign of raised immunoglobulin G class 4 antibodies. The patient showed dramatic response to high-dose steroids, with resolution of both the laboratory and imaging abnormalities within one month. We discuss the classical imaging features of Type 1 autoimmune pancreatitis, an uncommon condition that needs to be differentiated from pancreatic malignancy.
Autoimmune Diseases ; diagnostic imaging ; pathology ; Diagnostic Imaging ; Humans ; Jaundice ; complications ; diagnosis ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pancreas ; diagnostic imaging ; pathology ; Pancreatitis ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed

The wrist is a common site of injury and the most frequently injured body part among professional golfers. A 37-year-old, right-handed male golfer presented with pain at the ulnar aspect of his left palm, which grew worse after an initial traumatic impact from the golf club handle. There was tenderness over the hypothenar eminence of the left palm. Computed tomography of the left wrist showed an undisplaced fracture through the base of the hamate hook. The golf-induced hamate hook fracture was managed conservatively, with cessation of physical activity involving the left hand and wrist for eight weeks. The patient made a full recovery. Repetitive trauma, exacerbated by improper wrist motion, leads to typical wrist injuries affecting golfers, such as ulnar impaction syndrome, de Quervain's disease, and tendinopathy affecting the flexor carpi ulnaris and extensor carpi ulnaris, all of which can be diagnosed on imaging.
Adult ; Fractures, Bone ; diagnostic imaging ; Golf ; injuries ; Hamate Bone ; diagnostic imaging ; injuries ; Humans ; Male ; Tendinopathy ; Tomography, X-Ray Computed ; methods ; Wrist Injuries ; diagnostic imaging