[One clip too many]. / Ein Clip zu viel.

A patient with a Mainz II pouch due to muscle invasive bladder cancer presented to our urology department with de novo hydronephrosis on the left kidney after a regular colonoscopy. In the course of diagnostic workup, it was found that the neo-ostia were removed and clipped as a "polyp". Via rendezvous technique of antegrade ureterenoscopy and colonoscopy after nephrostomy placement urine outflow was successfully reconstituted by inserting a biliary stent into the left neo-ostium, which consolidated after stent removal as a permanent state.

Correlation of affective temperament and psychiatric symptoms in palliative care cancer patients.

BACKGROUND: Psychiatric symptoms are common in terminally ill patients. Studies linking temperamental traits and psychiatric disorders in patients suffering from advanced disease are rare. This study investigated the influence of temperament on depression and anxiety in palliative care cancer patients. METHODS: A total of 53 patients at the palliative care unit (PCU) of the Medical University of Vienna were enrolled in the study. Patients filled out the TEMPS-M and the brief PHQ-9 questionnaires to examine associations between temperament, psychiatric symptoms and sociodemographic parameters. RESULTS: Pain (67%), anorexia (58%), constipation (42%) and nausea/vomiting (40%) were the most prevalent self-reported symptoms. Self-reported symptoms of depression were less commonly reported (21.8%) than unveiled by the structured assessment by the PHQ-9 questionnaire: 26.4% (n = 14) showed mild symptoms of depression and 64.1% (n = 34) had a major depressive disorder (MDD) according to PHQ-9. The depressive and cyclothymic temperaments showed significant associations with depressive (both: p < 0.001) as well as symptoms of anxiety (p = 0.002; p = 0.036). Furthermore, the anxious temperament was significantly associated with symptoms of depression (p = 0.027). CONCLUSIONS: Mood disorders are common in palliative care patients, as the majority of the patients were suffering from MDD. The depressive, cyclothymic and anxious temperaments were found to be correlated with depressive and anxious symptoms. A sensitization in this field might bring further improvements for the quality of life of palliative care patients and help to appropriately address psychiatric symptoms in palliative care.