Review of diagnostic methods for prostate cancer with consideration of MRI-TRUS fusion biopsy

Introduction and purpose of the study: Prostate cancer is one of the most common malignancies in the human population worldwide. The continuous development of imaging methods allows for its increased recognition. Conclusions have been drawn that MRI-TRUS (magnetic resonance imaging - transrectal ultrasonography) fusion biopsy is superior to other diagnostic methods. The aim of this study is to review the available studies and publications and determine which method of diagnosing prostate cancer is most effective. Materials and Evidence: We reviewed the literature available on PubMed and Google Scholar using the words "fusion biopsy"; "prostate diagnosis"; "prostate cancer"; "transrectal ultrasonography". Results: The diagnosis of prostate cancer is made possible by a range of tests such as transrectal palpation, measurement of prostate specific antigen, transrectal ultrasonography, needle biopsy and MRI. The combination of biopsy, MRI and transrectal ultrasonography has led to the development of fusion biopsy. It combines the high-resolution features of MRI and the real-time images provided by ultrasound. Conclusions: The higher cost of the test and the need for specialised equipment together with the advanced software required for fusion biopsy ultimately provides a statistically significant higher success rate for the diagnosis of prostate cancer. Mentioned the effects of this method, further development and dissemination is expected

Environmental Impact of Enhanced Geothermal Systems with Supercritical Carbon Dioxide: A Comparative Life Cycle Analysis of Polish and Norwegian Cases

Low-carbon electricity and heat production is essential for keeping the decarbonization targets and climate mitigation goals. Thus, an accurate understanding of the potential environmental impacts constitutes a key aspect not only for the reduction in greenhouse gas emissions but also for other environmental categories. Life cycle assessment allows us to conduct an overall evaluation of a given process or system through its whole lifetime across various environmental indicators. This study focused on construction, operation and maintenance, and end-of-life phases, which were analyzed based on the ReCiPe 2016 method. Within this work, authors assessed the environmental performance of one of the renewable energy sources—Enhanced Geothermal Systems, which utilize supercritical carbon dioxide as a working fluid to produce electricity and heat. Heat for the process is extracted from hot, dry rocks, typically located at depths of approximately 4–5 km, and requires appropriate stimulation to enable fluid flow. Consequently, drilling and site preparation entail significant energy and material inputs. This stage, based on conducted calculations, exhibits the highest global warming potential, with values between 5.2 and 30.1 kgCO2eq/MWhel, corresponding to approximately 65%, 86%, and 94% in terms of overall impacts for ecosystems, human health, and resources categories, respectively. Moreover, the study authors compared the EGS impacts for the Polish and Norwegian conditions. Obtained results indicated that due to much higher electricity output from the Norwegian plant, which is sited offshore, the environmental influence remains the lowest, at a level of 11.9 kgCO2eq/MWhel. Polish cases range between 38.7 and 54.1 kgCO2eq/MWhel of global warming potential in terms of electricity production. Regarding power generation only, the impacts in the case of the Norwegian facility are two to five times lower than for the installation in the Polish conditions. Keywords: enhanced geothermal systems; supercritical carbon dioxide cycles; life cycle assessment; geothermal energy; environmental performancepublishedVersio

Risk factors for postoperative infectious complications after RIRS treatment of kidney and ureteral stones

Abstract Introduction and aim of the study: Urolithiasis is a disease involving the formation of deposits in the lumen of the urinary tract. The continued development of minimally invasive treatment methods allows for more effective treatment with greater operator comfort and less risk to the patient. It has been concluded that retrograde intrarenal surgery (RIRS) is superior to other therapeutic methods in many respects. The aim of this study is to review the available studies and publications and to identify potential complications following treatment of kidney and ureteral stones by RIRS, with a particular focus on infectious complications and their risk factors.   Method and materials: We reviewed the literature available on PubMed and Google Scholar, using the words 'urolithiasis'; 'urolithiasis treatment'; 'retrograde intrarenal surgery'; 'infectious complications of retrograde intrarenal surgery'.   Results: Among the risk factors associated with infectious complications after RIRS, long duration of surgery, recent positive urine culture, urinary tract infections or antibiotic use, purulent urine, urinary nitrites, obstructed access through the ureter, struvite stones, co-morbidities play a special role.   Conclusions: Among the complications of surgical treatment of nephrolithiasis and ureteral stones by RIRS, infectious complications are of particular concern. In view of the knowledge of their risk factors, preventive measures should include limiting the duration of surgery, possible antibiotic therapy and considering the use of a larger diameter UAS. This is especially true for patients with abnormal urine results, struvite stones, a history of urinary tract infection or predisposing comorbidities.   Key words: Urolithiasis; Kidney Calculi; Retrograde Intrarenal Surgery; Urolithiasis infection

SGLT-2 inhibitors: new effective drugs for treatment of heart failure

Introduction: SGLT-2 inhibitors having selectivity to sodium glucose cotransporter 2 were introduced on the market in 2012 as drugs for the pharmacotherapy of type 2 diabetes.Aim of the work: To summarize the current state of knowledge about the drugs: SGLT-2 inhibitors and their mechanism of action and application in cardiology.Materials and Methods: A review of the literature available in PubMed and Google Scholar database was conducted.Results: In addition to glucosuria, the diuretic effect is caused by natriuresis. A study was conducted, after which it was deduced that the natriuretic effect of empagliflozin did not depend on the degree of renal dysfunction, and was exacerbated under the influence of loop diuretics.SGLT-2 inhibitors reduce cardiac preload. Flozins also lead to a reduction in afterload.The DAPA-HF study of 4744 patients with HF, taking 10 mg of dapagliflozin or placebo. The primary outcome of the study, was data in the form of death from cardiovascular causes or exacerbation of heart failure. These accounted for 16.3% in the flozin group compared to 21.2% in the control group. Adverse events were rare. Dapagliflozin was effective in 55% of subjects, in both patients and non-diabetics with type 2 diabetes.EMPEROR-REDUCED studied the effect of taking 10 mg of emagliflozin or placebo in 3730 patients. Flozin reduced the risk of cardiovascular death and hospitalizations. Fewer deaths from any cause were also observed.Summary: Both studies highlighted significant benefits of SGLT-2 inhibitors- they reduced the risk of death from any cause and from cardiovascular causes. The therapeutic benefits, regardless of the degree of renal dysfunction, the synergy with other drugs in heart failure, and the low number of serious side effects, led to the inclusion of flozins in the latest ESC 2021 guidelines for therapy in heart failure with reduced ejection fraction, regardless of the presence of diabetes

Structure and Function of Enterocyte in Intrauterine Growth Retarded Pig Neonates

The intestine of intrauterine growth retarded (IUGR) neonates showed different morphology compared to neonates born with normal body weight (NBW). The aim of the present study was to investigate the ultrastructure and proteomic profile of the gut epithelium in IUGR pig neonates with special attention to the digestive and absorptive function. Intestine tissue samples were investigated in 7-day-old IUGR and NBW littermate piglets using histometry, immunofluorescence, scanning electron microscopy (SEM), and mass spectrometry analysis. IUGR piglets have shown reduced mucosa and muscularis thickness and an enhanced number of foetal type enterocytes (FTE). SEM studies have shown the lack of the characteristic large-size vacuole in IUGR’s enterocytes. Delayed removal of FTE in IUGR neonates was probably due to the inhibited apoptosis in the apical part of villi and increased apoptosis and reduced mitosis in the crypt region. In the expression of proteins in the intestinal mucosa such as hexokinase I, histones, and prelamin A/C, carbamoyl phosphate was reduced in IUGR neonates. Finally, IUGR intestines showed higher expression of HSPA9 and HSPA5 as apoptosis markers. The data indicate modifications of gut mucosa in IUGRs that may result in slower gut mucosa maturation and reduced utilisation of nutrient as compared to NBW pig neonates

Incorporation of the sphenoid sinuses' septum / septa in the carotid canal : evaluation before the fess

The purpose of the research was to define the frequency prevalence of the incorporation of sphenoid sinuses’ septum / septa in the carotid canal of the adult population. Materials and Methods: 296 computed tomography (CT) scans of the patients (147 females, 149 males), who did not present any pathology in the sphenoid sinuses, were evaluated in this retrospective analysis. Spiral CT scanner - Siemens Somatom Sensation 16 - was used to glean the medical images. Standard procedure applied in the option Siemens CARE Dose 4D. No contrast medium was administered. Multiplans reconstruction (MPR) tool was used in order to obtain frontal and sagittal planes from the transverse planes previously received. Results: Bilateral incorporation of the main septum (MS) in the carotid canal was not present in any of the patients, whereas unilateral incorporation was noticed in 21.96% of the patients (17.68% females, 26.17% males). On the right side it occurred in 11.82% of cases (10.88% females, 12.75% males), and on the left side in 10.14% of cases (6.8% females, 13.42% males). Bilateral incorporation of the additional septum (AS) was found in 8.45% of the patients (4.08% females, 12.75% males), whereas unilateral incorporation was noted in 28.37% of the patients. It was seen on the right side in 11.82% of cases (12.93% females, 10.74% males), and on the left side in 16.55% cases (15.65% females, 17.45% males). The most common variant was the incorporation of only one of the septa (either the MS or the AS) in the wall of the carotid canal unilaterally. Such situation took place in 30.07% of the patients (29.25% females, 30.87% males). Incorporation of two septa on the same side was noticed in 4.39% of cases (4.08% females, 4.7% males), and incorporation of three septa in 0.34% of cases (0.7% males). Conclusions: The anatomy of the paranasal sinuses is varied to a great extent, hence performing a CT scan is crucial before the scheduled surgery, as it may lessen the unforeseeable surgical complications, that may result from the high prevalence of variants in the sinuses