Underactive bladder - an underestimated entity

Introduction. The concept of underactive bladder is relatively new. Currently there is no generally accepted definition of this pathology. Diagnosis depends on urodynamic findings, and symptoms are usually rare and intricated with the symptoms of other urinary pathology. Matherials and methods. This review examines the current literature on underactive bladder regarding pathology, definition, diagnosis, current guidelines, and any further potential medical developments. Conclusions. Underactive bladder is a poorly understood pathologic condition. Only since 2002 has there been any consensus regarding the definition. The diagnosis relies only on urodynamics; clinical diagnosis is a challenge even for a consultant; and treatment does not seem to alleviate much of the suffering. This disease remains underrecognized and undertreated. More research is needed to identify less invasive diagnosis tools and treatment for this pathology

Nonalcoholic Fatty Liver Disease, Procalcitonin, and Gut Microbiota: Players in the Same Team

The study aimed to assess the link between procalcitonin (PCT) and gut dysbiosis in patients with nonalcoholic fatty liver disease (NAFLD). A total of 125 research participants, 100 patients with NAFLD (59% women and 41% men) age between 43 and 84 years and 25 healthy controls, joined this observational study. Patients were consecutively enrolled into two groups: 50 with gut dysbiosis and 50 without gut dysbiosis, after several conditions have been ruled out. Patients from dysbiotic group displayed significantly lesser use of biguanides and statins and elevation of fatty liver index (FLI), PCT, C-reactive protein (CRP), and alanine aminotransferase (ALT). Their gut microbiome was characterized by Bacteroides and Prevotella sp. dominant enterotype (74%) and by Ruminococcus sp. in only 26% of cases. The decrease of H index of biodiversity was observed in 64% of patients as well as of Firmicutes/Bacteroidetes (F/B) ratio and Akkermansia muciniphila in 60%. The increase of lipopolysaccharide positive bacteria was noted in 62% of patients. PCT strongly correlated with the level of CRP and ALT as well as to stool’s H index of biodiversity and F/B ratio. Dysbiotic patients with NAFLD exhibited significant elevation of PCT that correlated well with the H index of stool’s microbiota biodiversity, F/B ratio, CRP level, and severity of cytolytic syndrome

Using PID Controller and SDRE methods for tracking control of Spacecrafts in Closed-Rendezvous Process

Rendezvous process of spacecrafts is one of major issues in study of aerospace engineering. Tracking control in Rendezvous process is very complex due to the need to fulfill the conditions and constraints to determine the control forces to bring Chaser toward Target. The paper will implement the control of the trajectory of the relative translation movement between Chaser and Target in the Closed-Rendezvous stage through two different approaches: the first using PID Controllers, and the second using the SDRE (State Dependent Riccati Equation) technique. Then based on obtained results, a comparison between two methods is carried out

Underactive bladder - an underestimated entity

Introduction. The concept of underactive bladder is relatively new. Currently there is no generally accepted definition of this pathology. Diagnosis depends on urodynamic findings, and symptoms are usually rare and intricated with the symptoms of other urinary pathology. Matherials and methods. This review examines the current literature on underactive bladder regarding pathology, definition, diagnosis, current guidelines, and any further potential medical developments. Conclusions. Underactive bladder is a poorly understood pathologic condition. Only since 2002 has there been any consensus regarding the definition. The diagnosis relies only on urodynamics; clinical diagnosis is a challenge even for a consultant; and treatment does not seem to alleviate much of the suffering. This disease remains underrecognized and undertreated. More research is needed to identify less invasive diagnosis tools and treatment for this pathology

Efficacy and safety of baricitinib or ravulizumab in adult patients with severe COVID-19 (TACTIC-R): a randomised, parallel-arm, open-label, phase 4 trial

Background From early in the COVID-19 pandemic, evidence suggested a role for cytokine dysregulation and complement activation in severe disease. In the TACTIC-R trial, we evaluated the efficacy and safety of baricitinib, an inhibitor of Janus kinase 1 (JAK1) and JAK2, and ravulizumab, a monoclonal inhibitor of complement C5 activation, as an adjunct to standard of care for the treatment of adult patients hospitalised with COVID-19. Methods TACTIC-R was a phase 4, randomised, parallel-arm, open-label platform trial that was undertaken in the UK with urgent public health designation to assess the potential of repurposing immunosuppressants for the treatment of severe COVID-19, stratified by a risk score. Adult participants (aged ≥18 years) were enrolled from 22 hospitals across the UK. Patients with a risk score indicating a 40% risk of admission to an intensive care unit or death were randomly assigned 1:1:1 to standard of care alone, standard of care with baricitinib, or standard of care with ravulizumab. The composite primary outcome was the time from randomisation to incidence (up to and including day 14) of the first event of death, invasive mechanical ventilation, extracorporeal membrane oxygenation, cardiovascular organ support, or renal failure. The primary interim analysis was triggered when 125 patient datasets were available up to day 14 in each study group and we included in the analysis all participants who were randomly assigned. The trial was registered on ClinicalTrials.gov (NCT04390464). Findings Between May 8, 2020, and May 7, 2021, 417 participants were recruited and randomly assigned to standard of care alone (145 patients), baricitinib (137 patients), or ravulizumab (135 patients). Only 54 (39%) of 137 patients in the baricitinib group received the maximum 14-day course, whereas 132 (98%) of 135 patients in the ravulizumab group received the intended dose. The trial was stopped after the primary interim analysis on grounds of futility. The estimated hazard ratio (HR) for reaching the composite primary endpoint was 1·11 (95% CI 0·62–1·99) for patients on baricitinib compared with standard of care alone, and 1·53 (0·88–2·67) for ravulizumab compared with standard of care alone. 45 serious adverse events (21 deaths) were reported in the standard-of-care group, 57 (24 deaths) in the baricitinib group, and 60 (18 deaths) in the ravulizumab group. Interpretation Neither baricitinib nor ravulizumab, as administered in this study, was effective in reducing disease severity in patients selected for severe COVID-19. Safety was similar between treatments and standard of care. The short period of dosing with baricitinib might explain the discrepancy between our findings and those of other trials. The therapeutic potential of targeting complement C5 activation product C5a, rather than the cleavage of C5, warrants further evaluation

THE CREDITING ACTIVITY IN THE PRESENT SOCIAL AND ECONOMIC CONTEXT

This article is a summary of key elements that characterize the bank loan, which has noted an extensive development both in the West and in our country, which prompted us to address this issue, "The crediting activity in the current socio-economic context" considering that it is a subject that affects us all even if we are not players in the banking market. I chose this theme considering the fact that the market economy can not function without loans, the bank taking care to ensure, through credit, general economic equilibrium

Wild Pacific oyster Magallana gigas (Thunberg, 1793) populations in Romanian Black Sea waters – friend or foe?

A relatively small population of Magallana gigas was discovered near the Agigea harbor (Constanța, Romania) in 2017. The DNA barcoding method was used to confirm the morphological identification of the species. We consider this colony to be the first instance of a possibly stable Pacific oyster population in the Black Sea, outside of farming activities. The possible impact on native ecosystems is briefly discussed

Wild Pacific oyster Magallana gigas (Thunberg, 1793) populations in Romanian Black Sea waters – friend or foe?

A relatively small population of Magallana gigas was discovered near the Agigea harbor (Constanța, Romania) in 2017. The DNA barcoding method was used to confirm the morphological identification of the species. We consider this colony to be the first instance of a possibly stable Pacific oyster population in the Black Sea, outside of farming activities. The possible impact on native ecosystems is briefly discussed