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

Ethical aspects in managing patients diagnosed with digestive cancers; a review of literature

Numerous bioethical recommendations are now available in the complex process of communication with cancer patients. In this review, we have focused on the complex process of managing patients with different types of oncologic digestive diseases, immediately after the diagnosis is made. We have analyzed the literature data on the topic. MEDSCAPE and PubMed databases have been studied. Issues such as telling the truth to patients with digestive cancer, the physician\u27s responsibility in the psychological management of patients and their relatives, the nurses’ duties, the consented death, the practice of euthanasia and physician-assisted suicide (PAS) as well as the clinical research have been the main targets of our study

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

Ethical aspects in managing patients diagnosed with digestive cancers; a review of literature

Numerous bioethical recommendations are now available in the complex process of communication with cancer patients. In this review, we have focused on the complex process of managing patients with different types of oncologic digestive diseases, immediately after the diagnosis is made. We have analyzed the literature data on the topic. MEDSCAPE and PubMed databases have been studied. Issues such as telling the truth to patients with digestive cancer, the physician\u27s responsibility in the psychological management of patients and their relatives, the nurses’ duties, the consented death, the practice of euthanasia and physician-assisted suicide (PAS) as well as the clinical research have been the main targets of our study

Ethical aspects in managing patients diagnosed with digestive cancers; a review of literature

Numerous bioethical recommendations are now available in the complex process of communication with cancer patients. In this review, we have focused on the complex process of managing patients with different types of oncologic digestive diseases, immediately after the diagnosis is made. We have analyzed the literature data on the topic. MEDSCAPE and PubMed databases have been studied. Issues such as telling the truth to patients with digestive cancer, the physician's responsibility in the psychological management of patients and their relatives, the nurses’ duties, the consented death, the practice of euthanasia and physician-assisted suicide (PAS) as well as the clinical research have been the main targets of our study

Renal sarcoma – a rare parenchymal tumor with a very poor prognosis

The aim of this paper was to analyze the prognostic features, clinical presentation, diagnosis and treatment of primary renal sarcomas. A thorough review of the literature was made using the PubMed database. Sarcomas of the kidney are very rare malignant tumors, with a very poor prognosis compared with the other urogenital sarcomas. Several histological types have been reported, with the most common type being leiomyosarcoma. Besides complete surgical resection with wide margins, anatomical, histological, molecular and genetic factors should be taken into consideration regarding the prognosis

The role of Bosniak classification in the assessment of renal cystic masses and in the therapeutical protocol

One of the most frequent kidney pathologies encountered in daily practice is represented by the presence of renal cysts. Most of them are asymptomatic and are found accidentally during periodical check-ups because they don’t have clinical signs until they grow and compress the surrounding organs. We have reviewed the current data regarding this pathology, in order to underline the risk of malignant transformation and its impact on the patient’s life. It is estimated that the prevalence rate of renal cysts in the general population is approximately 10% and it increases with age.Imaging investigations, such as contrast tomography or magnetic resonance imaging, are essential for establishing the cysts characteristics, especially when ultrasonography raises the suspicion of a modified renal cyst, as well as in guiding the therapeutical protocol. The Bosniak classification is based on contrast tomography scans and has allowed the standardization of the kidney cysts, considering their characteristics. More attention should be given to Bosniak IIF and III cystic renal masses, which contain thickened walls and more septa, but no enhanced nodules/soft tissue components, because more than half of these cysts can have a malignant component

Cardiovascular Involvement in Tuberculosis: From Pathophysiology to Diagnosis and Complications—A Narrative Review

Although primarily a lung disease, extra-pulmonary tuberculosis (TB) can affect any organ or system. Of these, cardiovascular complications associated with disease or drug toxicity significantly worsen the prognosis. Approximately 60% of patients with TB have a cardiovascular disease, the most common associated pathological entities being pericarditis, myocarditis, and coronary artery disease. We searched the electronic databases PubMed, MEDLINE, and EMBASE for studies that evaluated the impact of TB on the cardiovascular system, from pathophysiological mechanisms to clinical and paraclinical diagnosis of cardiovascular involvement as well as the management of cardiotoxicity associated with antituberculosis medication. The occurrence of pericarditis in all its forms and the possibility of developing constrictive pericarditis, the association of concomitant myocarditis with severe systolic dysfunction and complication with acute heart failure phenomena, and the long-term development of aortic aneurysms with risk of complications, as well as drug-induced toxicity, pose complex additional problems in the management of patients with TB. In the era of multidisciplinarity and polymedication, evidence-based medicine provides various tools that facilitate an integrative management that allows early diagnosis and treatment of cardiac pathologies associated with TB

Modality of tumor endothelial VEGFR2 silencing-mediated improvement in intratumoral distribution of lipid nanoparticles

The vascular endothelial growth factor (VEGF)-mediated enhancement in vascular permeability is considered to be a major factor in tumor-targeting delivery via the enhanced permeability and retention (EPR) effect. We previously reported that the silencing of the endothelial VEGF receptor (VEGFR2) by a liposomal siRNA system (RGD-MEND) resulted in an enhanced intratumoral distribution of polyethylene glycol (PEG)-modified liposomes (LPs) in a renal cell carcinoma, a type of hypervascularized cancer, although the inhibition of VEGF signaling would be expected to decrease the permeability of the tumor vasculature. We herein report that the enhancement in the intratumoral distribution of LPs by VEGFR2 inhibition was dependent on the vascular type of the tumor (stroma vessel type; SV and tumor vessel type; TV). In the case of TV-type tumors (renal cell carcinoma and hepatocellular carcinoma), inhibiting VEGFR2 improved intratumoral distribution, while no effect was found in the case of SV-type tumors (colorectal cancer). Moreover, through a comparison of the intratumoral distribution of LPs with a variety of physical properties (100 nm vs 400 nm, neutral vs negative vs positive), VEGFR2 inhibition was found to alter the tumor microenvironment, including heparan sulfate proteoglycans (HSPGs). In addition, the results regarding the effect of the size of nanoparticles indicated that VEGFR2 inhibition improved the penetration of nanoparticles through the vessel wall, but not via permeability, suggesting the involvement of an unknown mechanism. Our findings suggest that a combination of anti-angiogenic therapy and delivery via the EPR effect would be useful in certain cases, and that altering the tumor microenvironment by VEGFR2 blockade has a drastic effect on the intratumoral distribution of nanoparticles