Retrovesical hydatidosis associated with urinary tract pathology — Case report

Cystic hydatidosis (CH) is a worldwide distributed parasitic zoonosis. It is considered one of the 17 neglected parasitic tropical diseases, among cysticercosis and soil transmitted helminthiases. CH is caused by the larval stage of Echinococcus granulosus, a tapeworm that usually infects dogs and other carnivorous animals as definitive hosts and herbivorous animals and rarely humans as intermediate hosts. Main primary localizations are the liver and the lung. In less than 3% they can primarily be present in the spleen. Treatment is mainly surgical, in some cases resulting in reoccurrence. In this paper we present the case of a male 55 years old patient who underwent a surgical intervention on his spleen for a solitary hydatid cyst as primary localization. Fifteen years after the operation the patient presented macroscopic haematuria; routine laboratory findings presented soft eosinophilia, 5%, without any other modification. There was found no palpable tumour in the pelvis by rectal examination. Abdominal ultrasound investigation revealed a 2×1 cm formation in the urinary bladder at the base of the left bladder-wall and a retrovesical, inhomogeneous 10×10 cm tumour with multiple septa and transonic zones. Computed tomography (CT) scan strongly suggested the presence of a bladder tumour and a hydatid cyst. The symptoms caused by the bladder tumour revealed the co-existing non-symptomatic retrovesical secondary CH, which is a rare complication of splenic Echinococcus granulosus infection. Close follow-up and a proper pre- and postoperative anti-parasitic medication of the patient could have prevented reoccurrence of CH

A hólyagkontraktilitási index meghatározásának fontossága a csökkent hólyagműködés kezelésében | The importance of Bladder Contractility Index in the management of underactive bladder

Absztrakt: Célkitűzés: A hólyagkontraktilitási index (BCI) fontosságának felmérése a csökkent hólyagműködés kezelésében. Betegek és módszer: Retrospektív tanulmányunkban 2013. január és 2016. szeptember közötti, detrusor-alulműködéssel (BCI<100) kórismézett beteg adatait dolgoztuk fel (BCI = PdetQmax+5Qmax). Eredmények: A tanulmányozott betegek (férfi 38, nő 53) esetében a BCI átlagértéke 55 volt (17–110), urodinámiás vonatkozásban: átlag-Qmax 7 ml/s, átlag-Pdet 14 H2O-cm. A BCI csökkenő tendenciát mutat az életkor előrehaladtával, valamint összefüggés mutatható ki a BCI, a diabetes (p = 0,003), illetve a neurológiai betegségek (p = 0,015) között. Következtetések: A csökkent hólyagműködés kórismézése igazi kihívás az urológus számára, az urodinámiás vizsgálatok (a residuum értéke, Qmax, PdetQmax) és a BCI értéke nagyban elősegítik a megfelelő kezelési terv felállítását. Orv Hetil. 2017; 158(31): 1222–1227. | Abstract: Aim: To evaluate the importance of BCI in the management of underactive bladder (UB). Material and method: A retrospective study over a period of 3 years and 9 months (January 2013–September 2016) in Mureş County Hospital, Clinic of Urology, including 91 patients. Detrusor underactivity was defined by BCI less than 100 using the formula: PdetQmax+5Qmax. Results: The median of Qmax value was 7 ml/s and the median value of Pdet was 14 cm H2O. The median value of BCI was 55 with extremities between 17 and 110. BCI tends to decrease with age and there is a relation between value of BCI and diabetes (p = 0,003) and neurological diseases (p = 0,015). Conclusions: The UB diagnosis represents a real challenge for the urologist, so that, urodynamical findings such as absence of bladder obstruction, post-void residual urine, Qmax, together with BCI value, helps in setting the proper management. Orv Hetil. 2017; 158(31): 1222–1227

Fenntartható versenyképesség általános vizsgálata 9 közép- és kelet-európai ország 10 éves távlatában

At the national level, competitiveness is at the heart of economic policy decisions, but it needs to be considered alongside the concept of sustainability. This is because, in the long term, only those economic policy choices that can increase competitiveness in a sustainable way while preserving the natural, social and economic assets of the nation concerned will be the right ones. In our study, we have conducted a secondary research based on empirical research using a wide range of literature to investigate what factors have influenced the sustainable competitiveness of the 9 Central and Eastern European countries under study over a 10-year period and what are the key factors that, if ignored, could lead to a deterioration in their competitiveness prospects in the future. In a separate chapter, we have discussed the “middle-income trap” and the signs of being trapped in it. Factors to avoid and/or escape this trap are described. We believe that what is happening in the world and how we respond to it will be fundamentally determined by whether a country is looking at the basis for sustainable management and competitiveness in the short term – as a fire-fighting exercise – or in the long term, through a strategic lens. The components of the GSCI provide a clear and realistic picture of the competitiveness of countries because of its complexity. One thing is certain: the future will be very different from the past and the present. The past few years have taught all countries that they need to manage their economies in a way that is prepared for constant change, uncertainty and increasing risks at all times.  This means that the factors that underpin competitiveness must be a priority for all nations, while strengthening the resilience and crisis resilience of their countries and economies. Our study presents the issue in a casual way. It is therefore recommended to all those who, with a sense of responsibility and a long-term perspective, consider the enhancement of their country's national wealth and the well-being of all its citizens as the guiding star of their decisions. Any further decisions that come at the expense of these will fundamentally damage the nation.Nemzeti szinten a versenyképesség a gazdaságpolitikai döntések központi kérdése, de vizsgálata során a fenntarthatóság fogalmával együtt kell górcső alá vetni őket. Ennek az az oka, hogy hosszú távon csak azok a gazdaságpolitikai döntések bizonyulnak helyesnek, melyek az adott nemzet természeti, társadalmi és gazdasági értékeit megőrizve, fenntartható módon képesek a versenyképességet növelni. Tanulmányunkban empirikus kutatáson alapuló, számos szakirodalom felhasználásával szekunder kutatást végezve azt vizsgáltuk, hogy milyen tényezők befolyásolták a vizsgálatunk alá vont 9 közép- és kelet-európai ország fenntartható versenyképességét 10 év távlatában, és melyek azok az alapvető tényezők, amelyek figyelmen kívül hagyásával versenyképességi esélyei a jövőben romolhatnak. Külön fejezetben bemutattuk a „közepes jövedelem csapdáját”, és az abban való bennragadásra utaló jeleket. Ismertettük ezen csapda elkerülés és/vagy az abból való kilábalást segítő tényezőit. Úgy véljük, hogy a világban zajló események, és az azokra adandó válaszreakciókat alapjaiban meghatározza, hogy az adott ország éppen csak rövidtávon – tűzoltási jelleggel –, vagy hosszú távon, stratégiai szemüvegen keresztül vizsgálja meg fenntartható gazdálkodásának, versenyképességének alapjait. A GSCI-index összetevői annak komplexitásából kifolyóan világos és reális képet mutatnak be az országok versenyképességéről. Egy biztos, a jövő teljesen más lesz, mint a múlt és a jelen. Az elmúlt pár év megtanított minden országot, hogy gazdaságát úgy kell irányítania, hogy az az állandó változásokra, bizonytalanságokra és a növekvő kockázatokra felkészült legyen bármikor. Ez azt jelenti, hogy a versenyképesség alapjait meghatározó tényezőket minden nemzetnek kiemelt fontossággal kell kezelnie, és mindemellett országának, gazdaságának ellenálló képességét, válságálló képességét erősítenie szükséges. Tanulmányunk hétköznapi módon ismerteti a témát. Ajánljuk éppen ezért mindazok számára, akik felelősségteljesen, hosszú távon gondolkodva, az országuk nemzeti vagyonának gyarapítását és minden állampolgár jólétének növelését tarják döntéseik vezércsillagának. Minden további olyan döntés, mely ezek rovására jön létre, alapjaiban károsítja a nemzetet

Can Erectile Dysfunction Predict Major Cardiovascular Events?

It is estimated that erectile dysfunction (ED) affects more than 150 million people worldwide and this number is expected to double by the year 2025. Vascular component represents the most important etiological cause of erectile dysfunction. ED shares almost all risk factors, such as hypertension, diabetes mellitus, hyperlipidaemia and smoking, with arteriosclerosis. Moderate to severe ED is associated with a considerably increased risk for coronary heart disease (CHD). This review was conducted in May 2016, when the PubMed database was searched using the combination of the terms “erectile dysfunction” and “cardiovascular diseases”, “coronary artery diseases” and “risk factors”. In this review, we analyzed the published literature, regarding the predictive role of ED in CVD and the association of ED risk factors with CVD risk factors, aiming to draw particular attention on the role of sexual inquiry of all men to prevent or decrease major cardiovascular events. In conclusion, the early detection of ED can prevent major cardiovascular events with early management of cardiovascular risk and permits to include patients in a risk stratification group. Erectile function should be evaluated using questionnaires in all male patients to prevent and decrease the rates of major cardiovascular events

Inflammatory Markers and Thromboembolic Risk in Patients with Non-Muscle-Invasive Bladder Cancer

Introduction: Patients with bladder cancer have a high risk of venous thrombosis that represents a key challenge for physicians in the decision-making for initiating anticoagulation therapy. Non-muscle-invasive bladder cancer (NMIBC) represents more than 70% of all diagnosed bladder malignancies; therefore, we aimed to evaluate the relationship of the neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), and risk of thrombosis by using the International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) score as well as the risk of bleeding by using the IMPROVE Bleeding Risk Assessment Score in a study cohort. Material and Methods: This was a retrospective observational study involving 130 patients who met the inclusion criteria: age &gt; 18 years, stage pTa-pT1 NMIBC. The exclusion criteria were age &lt; 18 years; stage pT2 or higher; or a presentation of metastasis, inflammatory, liver or autoimmune diseases, or other systemic neoplasms. In order to evaluate the risk of thromboembolic events as well as those of bleeding, the IMPROVE scores were calculated for each patient. Subjects were categorized in a Low IMPROVE group (&lt; 4 points) or a High IMPROVE group. By using uni- and multivariate regression models, we analyzed CBC-derived parameters which could be associated with a higher risk of venous thrombosis in subjects with low or high IMPROVE scores. Results: Patients with IMPROVE score greater than 4 were associated with higher NLR, LMR and lymphocyte values (p &lt; 0.05). In a multivariate regression model, the IMPROVE score was significantly influenced by lymphocyte count (p = 0.007) as well as the NLR value (p &lt; 0.0001). Conclusions: In our study population, subjects with NMIBC with low lymphocytes and NLR &gt; 3 were at a higher risk of developing venous thromboembolic events, reflected by an IMPROVE score of greater than 4. The IMPROVE and IMPROVE Bleeding Risk Assessment Scores are easy to use, and, complemented with the CBC-derived lymphocyte to monocyte ratio as a prothrombotic marker, could aid in the decision of prophylactic anticoagulation therapy during admission

Zinner’s Syndrome – The Value of Clinical Imaging and Morphopathological Findings for Diagnosis

Introduction: Cystic congenital malformations of the seminal vesicle are unusual. More than half of them are associated with ipsilateral renal agenesis. This disease was first described by Zinner in 1914, and since then, more than 200 cases have been reported. Most of the patients with this congenital disease present few symptoms until the middle-age

Preliminary Assessment of Risk Factors for Tooth Wear

Background: Epidemiological studies have reported an increasing prevalence of tooth wear, and general dental practitioners see a greater number of patients seeking treatment with worn dentition. Improper oral hygiene, unhealthy habits, occupational hazards, and potentially erosive processed foods seem to play a major role in the non-carious loss of dental hard tissue. The aim of this study is to assess the factors and cofactors that may play a major role in the genesis of dental attrition, dental abrasion, and, especially, dental erosion