Benign prostatic hyperplasia - etiology, clinical features and management. Historical and contemporary aspects

Introduction. Benign prostatic hyperplasia and chronic prostatitis are the most common conditions in men, the frequency of which varies with age. Chronic prostatitis (infectious or inflammatory) has a frequency of 8-35% in patients aged 20-50 years, reaching a maximum of 60-70% in those aged over 50 years. Materials and methods. Materials for the study served the medical literature regarding benign prostatic hyperplasia and chronic inflammation, published in the local and international scientific journals. Scientific databases like Cochrane Library, Medline, Scopus, Medicus, NCBI, PubMed, Google Scholar were used to find the necessary articles. Research methods – analysis, synthesis, systematization, and description. Results. After analyzing the available data, a review of the literature was conducted which highlighted both the strong and weak points of the historical medical approaches to addressing benign prostatic hyperplasia, as well as the ontogenetics and anatomical characteristics of the prostate gland. This included examining the incidence rates, concepts of causation and development, principles of diagnosis and classification of benign prostatic hyperplasia. The review also revealed the pros and cons of using mini-invasive treatment strategies versus traditional transvesical approaches in treating this condition, as well as the ongoing and significant socioeconomic impact in underdeveloped countries. Conclusions. There remains the issue of reducing intra- and post-operative complications after benign prostatic hyperplasia surgery, especially a voluminous one, which imposes itself as a very critical problem in the development of an effective treatment strategy. For the first time, a problem was described by assessing the particularities of some biochemical criteria at local surgical site and in blood serum, histological - at the level of nodular prostatic hyperplasia and at the border of the surgical site. This requires a complex correlational study to assess the biochemical, histological and immunohistochemical parameters, including the evaluation of the associations or coexistence of benign prostatic hyperplasia and chronic prostatitis

Teeth as a sourse of stem cells

Catedra Stomatologie Teraeutică FECMF, USMF „Nicolae Testimiţanu” Laboratorul de enginerie tisulară și cultivarea celulelorTooth loss compromises human oral health. Although several prosthetic methods, such as artificial denture and dental implants, are clinical therapies to tooth loss problems, they are thought to have safety and usage time issues. Recently, tooth tissue engineering has attracted more and more attention. Stem cell based tissue engineering is thought to be a promising way to replace the missing tooth. Mesenchymal stem cells are multipotent stem cells which can differentiate into a variety of cell types. This review outlines the recent progress in mesenchymal stem cell research and use in tooth regeneration [1, 2]. Pierderea dinților compromite sănătatea umană orală. Deşi, mai multe metode de tratament cum ar fi protezele artificiale şi implanturile dentare si-au demonstrat siguranţă de utilizare in timp. Recent, ingineria tisulară a capătat o vastă amploare.Celulele stem sunt considerate a fi o modalitate promiţătoare pentru a înlocui dintele lipsă. Celulele stem mezenchimale sunt celule stem pluripotente care se pot diferenția într-o varietate de tipuri de celule. Aceast articol prezintă progresele recente în cercetarea celulelor stem mezenchimale şi utilizarea lor

Morphopatologicaf peculiarities in nodular benign prostatic hyperplasia

Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Catedra Morfopatologie, Instituţie Medico- Sanitară Publică Spitalul Clinic Municipal “ Sf. Treime”, Secţia Urologie, Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Catedra Urologie şi Nefrologie ChirurgicalăScopul studiului vizează efectuarea unei cercetări complexe macromicroscopice în estimarea particularităţilor morfopatologice ale prostatei în hiperplazia nodulară benignă, pentru soluţionarea chirurgical-terapeutică şi a pronosticului postoperatoriu. Rezultatele studiului aplicat au detectat unele particularităţi patogenetice şi histopatologice a proceselor lezionale identificate în teritoriul prostatic restructurizat nodular. Acestea aveau origine diferită, printre care predominau procesele inflamatorii cronice proliferativ-fibroplastice şi acute cu implicaţii în divers raport a parenchimului prostatic. În lanţul patogenetic al proceselor lezionale sunt unele reflecţiuni etiologice ale rolului infecţiei virale. În concluzie, explorările efectuate au permis specificarea caracterului proceselor patologice coexistente hiperplaziei nodulare de prostată, formularea unui concept evolutiv ale asocierilor patogenetice ale prostatitei şi hiperplaziei nodulare, implicaţiile directe în procesele lezionale a zonei de frontieră (enucleare) ce au permis stabilirea certă a fondalului real patologic al cavităţii reziduale de clivaj, facilitând astfel alegerea unui plan chirurgical şi terapeutic optim.The purpose of the study consist in the effectuation of some complex macroscopically researches in the estimation of morphopatological peculiarities in nodular benign prostatic hyperplasia for surgical-therapeutic solving and of the postoperative prognosy.The results of the study detected some pathogenic peculiarities and of the activity of the identified lesion processes in the nodular prostatic territory, these manifested a diverse origin, including acute and inflammatory chronic proliferative fibroplastic processes with implications in the prostatic parenchyma. In the pathogenetic chain of the lesion processes are given some ethiological reflections of the role of viral infection. In conclusion, the performed explorations allowed the specification of the character of pathological processes coexisting to prostatic nodular hyperplasia, the. formulation of an evolving concept of pathogenetic associations ofprostatitis and nodular hyperplasia, direct implications in the lesion processes of the border area that allowed the definite establishment of the real pathological fund of the residual cavity of the cleavage that facilitates the choice of the best

Dinamica schimbărilor peretelui vascular în discul intervertebral lombar în osteocondroză. Rezultate şi perspective

Ateroscleroza este unul dintre factorii etiologici care iniţiază schimbările degenerative în discul intervertebral lombar studiat prin investigaţii histologice colorate cu hematoxilină-eozină şi examinarea imunohistochimică cu anticorpi CD34, în Centru Cercetări în Angiogeneză din Timişoara, responsabil Profesorul Marius Raica. Au fost examinate arterele vertebrale lombare L1-L5 pe un eşantion de 20 de cazuri, prelevate de la cadavre în moarte cardiorespiratorie, cu diferite vârste şi sex, din spitalul “Sfânta Treime”. Ateroscleroza cu îngroşarea peretelui vascular afectează viabilitatea structurilor discului intervertebral, iniţial fiind afectate nucleul pulposus, apoi inelul fi bros printr-o serie de mecanisme cu fragmentarea şi dezorganizarea fibrelor de colagen, urmată de proliferarea fibroblastelor cu scleroza. Studiul imunohistochimic cu CD34 evidenţiază: - lipsa intimii, indică histologic discul vertebral cu formele avansate de degenerescenţă, în intima slab pozitivă se vizualizează corelativ formele medii de degenerescenţă a discului intervertebral, atunci când intima este moderat pronunţată – se evidenţiază schimbările incipiente de degenerescenţă a discului intervertebral având aspecte de degenerescenţă mixoidă iar în cazuri intime pozitive imunohistochimic se evidenţiază intima vasculară fiind bine conturată, cu persistenţa elementelor structurale din discul intervertebral. În prezent, tehnologiile moderne rămân în evaluarea unor noi metode de tratament şi de prevenire a schimbărilor degenerativ-distrofice

Lessons from Mycobacterium avium complex-associated pneumonitis: a case report

ABSTRACT: INTRODUCTION: Mycobacterium avium complex (MAC) is an increasingly recognized cause of pulmonary disease in immunocompetent individuals. An acute form of MAC lung disease, MAC-associated pneumonitis, has generally been associated with the use of hot tubs. There is controversy in the literature about whether MAC-associated pneumonitis is a classic hypersensitivity pneumonitis or is a direct manifestation of mycobacterial infection. CASE PRESENTATION: We report the second case in the literature of MAC-associated pneumonitis not related to the use of hot tubs. The source of MAC in a 52-year-old immunocompetent patient was an intrapulmonary cyst containing numerous acid-fast bacilli. The patient developed disseminated miliary nodules throughout both lung fields. Histological examination of resected lung tissue revealed well-formed, acid-fast negative granulomas composed predominantly of CD4+ T-cells and CD68+ histiocytes. The granulomas were strongly positive for tumor necrosis factor-alpha, a pro-inflammatory cytokine. CONCLUSION: The attempt to classify MAC-associated pneumonitis as either a classic hypersensitivity pneumonitis or a direct manifestation of mycobacterial infection is not particularly useful. Our case demonstrates that MAC-associated pneumonitis is characterized by a vigorous T-helper 1-like, pro-inflammatory, immune response to pulmonary mycobacterial infection. The immunopathology provides a rationale for clinical studies of anti-MAC therapy with the addition of anti-inflammatory agents (for example, corticosteroids) to hasten the resolution of infection and symptoms

Inflammation and immunohistochemical profile of the lymphocyte population in the prostate adenoma and the limit of residual prosthetic surgical capsule after adenomectomy

Catedra de morfopatologie USMF ”Nicolae Testimițanu”, Catedra de urologie și nefrologie chirurgicală USMF ”Nicolae Testimițanu”, Catedra de histologie, citologie și embriologie, Universitatea din Oradea, România, Facultatea de Medicină, IMSP Spitalul Clinic Municipal „Sf.Treime”, Secția de urologie, Al VII-lea Congres de Urologie, Dializă și Transplant Renal din Republica Moldova cu participare internațională 19-21 iunie 2019Studiul constă în: evaluarea inflamației în adenomul prostatic, rolului inflamației și profilului limfocitar ca factor predictiv în evoluția adenomului prostatic; evaluarea particularităților capsulei chirurgicale reziduale și a importanței acesteia în aplicarea hemostazei locale după adenomectomie. Studiul actual este de tip prospectiv și include un eșantion din 118 cazuri (98 cu adenom de prostată rezolvat chirurgical la vârsta medie de 68,6 ±1,05 ani și 20 de prostate de la decedați incidental la vârsta cuprinsă între 21-67 de ani în lipsa intravitală a statutului morbid urogenital stabilit. S-a stabilit prezența corelațiilor prostatitei cronice și a adenomului prostatic, pe un fundal patologic preexistent la nivelul capsulei chirurgicale fiind o prostatită marginală pozitivă cronică activă reziduală după adenomectomie. Frecvența majoră a limfocitelor-T poate rezulta din răspunsul imunologic la diverse leziuni, fiind și un marker al rolului autoimun în evoluția adenomului. Prostatita marginală pozitivă este un impact semnificativ în hemostaza locală și în evoluția perioadei intra- și post-operatorii, servind ca factor predictiv pentru necesitatea monitorizării lojei adenomului și utilizarea unui tratament complementar adecvat.The study consists of evaluation of inflammation in the prostatic adenoma, the role of inflammation and lymphocytic infiltrate as a predictive factor in the evolution of the prostatic adenoma, evaluation of the particularities of the residual surgical capsule and its importance in the application of local hemostasis after adenomectomy. The current study is a prospective study of a sample of 118 cases (98 with prostate adenoma resolved surgically at medium age of 68.6 ± 1.05 years and 20 prostates from incidental deaths at the age of 21-67 years in the absence intravital status of the established urogenital morbidity status. It has been established the presence of correlations of chronic prostatitis and prostate adenoma and the real pathological background preexisting in the surgical capsule, being a chronic active positive marginal prostatitis residual after adenomectomy. Major T-lymphocytes frequency can result from the response immunologically to various lesions as well as a marker of the autoimmune role in evolution of adenoma. Positive marginal prostatitis is a significant impact on local haemostasis and the evolution of the intra- and postoperative period, serving as a predictive factor for necessity of monitoring the adenoma lodge and using appropriate complementary therapy

Lessons from <it>Mycobacterium avium</it> complex-associated pneumonitis: a case report

Abstract Introduction Mycobacterium avium complex (MAC) is an increasingly recognized cause of pulmonary disease in immunocompetent individuals. An acute form of MAC lung disease, MAC-associated pneumonitis, has generally been associated with the use of hot tubs. There is controversy in the literature about whether MAC-associated pneumonitis is a classic hypersensitivity pneumonitis or is a direct manifestation of mycobacterial infection. Case presentation We report the second case in the literature of MAC-associated pneumonitis not related to the use of hot tubs. The source of MAC in a 52-year-old immunocompetent patient was an intrapulmonary cyst containing numerous acid-fast bacilli. The patient developed disseminated miliary nodules throughout both lung fields. Histological examination of resected lung tissue revealed well-formed, acid-fast negative granulomas composed predominantly of CD4+ T-cells and CD68+ histiocytes. The granulomas were strongly positive for tumor necrosis factor-α, a pro-inflammatory cytokine. Conclusion The attempt to classify MAC-associated pneumonitis as either a classic hypersensitivity pneumonitis or a direct manifestation of mycobacterial infection is not particularly useful. Our case demonstrates that MAC-associated pneumonitis is characterized by a vigorous T-helper 1-like, pro-inflammatory, immune response to pulmonary mycobacterial infection. The immunopathology provides a rationale for clinical studies of anti-MAC therapy with the addition of anti-inflammatory agents (for example, corticosteroids) to hasten the resolution of infection and symptoms.</p