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Primary hyperoxaluria type 1: practical and ethical issues.
[primary hyperoxaluria type 1]
Primary
hyperoxaluria
type
1
(
PH
1
)
is
a
rare
inborn
error
of
glyoxylate
metabolism
of
autosomal
recessive
inheritance
,
leading
to
progressive
systemic
oxalate
storage
(
named
'
oxalosis
'
)
with
a
high
rate
of
morbidity
and
mortality
,
as
well
as
an
unacceptable
quality
of
life
for
most
patients
.
The
adverse
outcome
,
however
,
is
partly
due
to
issues
that
can
be
overcome
.
First
,
the
diagnosis
of
PH
is
often
delayed
due
to
a
general
lack
of
knowledge
of
the
disease
among
physicians
.
This
accounts
specifically
for
patients
with
pyridoxine
sensitive
PH
,
a
group
that
is
paradoxically
most
easy
to
treat
.
Second
,
lack
of
adherence
to
a
strict
conduction
of
conservative
treatment
and
optimal
urological
management
may
enhance
an
adverse
outcome
of
the
disease
.
Third
,
specific
techniques
to
establish
PH
1
and
specific
therapies
are
currently
often
not
available
in
several
low
-resources
countries
with
a
high
prevalence
of
PH
.
The
management
of
patients
with
advanced
disease
is
extremely
difficult
and
warrants
a
tailor-made
approach
in
most
cases
.
Comprehensive
programs
for
education
of
local
physicians
,
installation
of
national
centers
of
expertise
,
European
support
of
low
-resources
countries
for
the
management
of
PH
patients
and
intensified
international
collaboration
on
the
management
of
current
patients
,
as
well
as
on
conduction
of
clinical
studies
,
may
further
improve
outcome
of
PH
.
Diseases
Validation
Diseases presenting
"low-resources countries for the management"
symptom
primary hyperoxaluria type 1
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