Impact of Thyroid Disease on Heart Failure

The modern vision concerning the physiological actions and pathological relevance of endocrine cardiac system is a very complex one. Decreased or increased action of thyroid hormone (hypo‐ or hyperthyroidism) on different cellular and molecular pathways in the heart plays an important role in the development and progression of myocardial remodelling and heart failure. Cardiovascular signs and symptoms that accompany both hyperthyroidism and hypothyroidism are presented, highlighting that correction of thyroid dysfunction most often reverses the abnormal cardiovascular hemodynamics

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

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

Cardiovascular Effects of Cumulative Doses of Radioiodine in Differentiated Thyroid Cancer Patients with Type 2 Diabetes Mellitus

Radioiodine (131I) therapy for differentiated thyroid cancer (DTC) involves exposure of the whole body, including the heart, to ionizing radiation. This exposure to the subsequent risk of heart disease is uncertain, especially in patients with DTC associated with type 2 diabetes mellitus (DTC/+T2DM). The current study aimed to assess the relationship between left ventricular ejection fraction (LVEF), high cumulative 131I dose, and peripheral blood parameters in patients with DTC/−T2DM and DTC/+T2DM. The study enrolled 72 female patients with DTC/−T2DM and 24 with DTC/+T2DM who received cumulative 131I doses above 150 mCi (5.55 GBq). LVEF was lower in patients with concomitant T2DM than those without (p 131I dosage was inversely correlated with LVEF only in DTC/−T2DM patients (r = −0.57, p r = −0.67, p r = −0.76, p 131I doses has different cardiovascular effects in DTC/−T2DM and DTC/+T2DM

ACUTE ACUTE OTOMASTOIDY – CLINICAL CASE

The authors present a case with acute coalescent mastoiditis, complicated with facial nerve paralysis and masqueradind as parapharyngeal abscess (with dysphagia, sore throat, trismus, submandibular adenitis). In multiple disease environment, diferential diagnosis can prove difficultand generate therapeutic confusions

Idiotype-specific intravenous immunoglobulin for therapy of immunoglobulin kappa free light chain deficiency

Deficient antibody production in patients with common variable immunodeficiency (CVID) is accompanied by an inability to produce free light chains (FLCs), particularly kappa (κ) FLC, due to B-cell dysfunction. We found that intravenous immunoglobulin (IVIg) administration, in a patient with CVID and (κ) FLC deficiency, for o short period of only 6 months, induced after discontinuation of treatment some kind of “long-lasting active immunity”, leading to the secretion of immunoglobulin (κ) FLCs. A remarkable finding of our study is how effectively IVIg therapy led to a calculable (κ/λ) FLCs ratio, within the reference range. IVIg therapy may have functioned as an idiotype vaccine which induced a humoral response. To date, several questions remain open. For instance, from a clinical standpoint, we do not know whether this form of active immunotherapy has the potential to cure or just to control the immunoglobulin (κ) FLC deficiency. Further studies are necessary to confirm these findings

Analysis of the Correlation between the Radioactive Iodine Activity and Neutrophil-to-Lymphocyte Ratio in Patients with Differentiated Thyroid Cancer

Publications investigating the effect of radioactive iodine (131I) therapy on the circulating peripheral blood cells in patients with differentiated thyroid cancer (DTC) are limited to blood samples collected more than 92 h after 131I. Studies conducted on blood samples collected up to 92 h are rare due to the radioactive contamination risk. This research aimed to assess the relationship between the prescribed 131I activity, human whole blood activity, and peripheral blood cells at many time points (6, 22, 46, 69, and 92 h after 131I). The study enrolled 50 female patients with DTC who received a 131I median activity of 90.54 mCi (3.35 GBq). The neutrophil-to-lymphocyte ratio (NLR) was measured as an inflammatory marker. 131I uptake in the residual thyroid tissue peaked after 46 h. Blood activity decreased in the first 46 h and increased 69 h after the 131I intake. Blood activity was associated with the absolute lymphocyte count and the NLR at 69 h (r = −0.49 and r = 0.52, p < 0.001). Our results demonstrate that the time interval between 46 and 69 h should be associated with the release of hematological inflammatory mediators, such as neutrophils and lymphocytes, to eradicate tumor cells in response to 131I therapy

Maximum Exergetic Efficiency Operation of a Solar Powered H2O-LiBr Absorption Cooling System

A solar driven cooling system consisting of a single effect H2O-LiBr absorbtion cooling module (ACS), a parabolic trough collector (PTC), and a storage tank (ST) module is analyzed during one full day operation. The pressurized water is used to transfer heat from PTC to ST and to feed the ACS desorber. The system is constrained to operate at the maximum ACS exergetic efficiency, under a time dependent cooling load computed on 15 July for a one storey house located near Bucharest, Romania. To set up the solar assembly, two commercial PTCs were selected, namely PT1-IST and PTC 1800 Solitem, and a single unit ST was initially considered. The mathematical model, relying on the energy balance equations, was coded under Engineering Equation Solver (EES) environment. The solar data were obtained from the Meteonorm database. The numerical simulations proved that the system cannot cover the imposed cooling load all day long, due to the large variation of water temperature inside the ST. By splitting the ST into two units, the results revealed that the PT1-IST collector only drives the ACS between 9 am and 4:30 pm, while the PTC 1800 one covers the entire cooling period (9 am–6 pm) for optimum ST capacities of 90 kg/90 kg and 90 kg/140 kg, respectively

Eustachian Tube Teratoma: A Rare Entity

Introduction: Teratomas, tumors derived from all 3 fetal germ cell layers, are rarely located in the head and neck region and extremely rare in the Eustachian tube area. Case report: The authors present the case of a 2 years old child with chronic ear discharge. Referral diagnosis was tumor or cyst of the temporal bone. Intraoperatively, a solid, hairy tumor located inside the Eustachain tube, with extension into the middle ear space was discovered and removed. Histology revealed a mature teratoma. Review of the literature showed reports of rare similar cases of Eustachian tube teratomas, differentiating themfrom hairy polyps of the rhynopharynx. The imaging of our patient, the surgical techique for removal of the tumor and long term follow-up are detailed. Conclusions: Teratomas located inside the Eustachian tube are exceptional. Their removal should be carefully planned in view of their long term anatomical sequelae and in order to avoid long term postoperative morbidity