Introduction: Clostridium difficile infection stands nowadays as one of the major emerging health problems still underestimated. Only in 2009 the European Society of Clinical Microbiology and Infection (ESCMID) was able to publish guidelines for this serious disease. Actually the guidelines were updated in 2013 so we can speak of a united action towards the resolution of this healthcare problem. Methods: This is a review article aiming to shed light in various aspects of clostridium difficile infection as clinical presentation, symptoms and signs, therapeutic options and risk factors with a focus on urologic pathology. Conclusions: This type of infection represents a challenge from many points of view like treatment, relapse approach, mortality, morbidity, germ’ s adaptability to treatment and last but not the least the outbreak of different aggressive strains like B1,NAP1 or ribotype 027 toxinotype III.
Introduction: UTI (urinary tract infections) represent a central pathology for a urological service. Antibiotic resistance is growing at a steady and alarming rate worldwide and especially in Romania. Method and materials: We have analyzed all the patients that were admitted to our clinic for continuous hospitalization between January 2015 and October 2015. All patients undergone urine culture and all cultures positive had an antibiogram worked up. We have selected all patients that had antibiotic resistance to at least an antibiotic. Results: From 1745 patients admitted for continuous hospitalization, we had 180 positive urine cultures at admission from which 125 had at least an antibiotic resistance. Conclusions: Antibiotic resistance is a serious phenomenon, with potential lethal complications, which we encounter daily in urological practice INTRODUCTION Uncomplicated UTI are probably the most common urological condition. It is estimated that at least 1 out of 3 females will develop an UTI during their lifetime. UTI frequency at young females is associated with sexual intercourse. When urological malformations, pregnancy, menopause, urolithiasis occur conditions for recurrence of the disease are met. Recurrences are defined as at least 2 episodes of UTI in 6 months or 3 episodes a year. Male patients develop UTI due to different mechanisms and at an elderly age. The most common mechanism that facilitates the development of UTI in men is bladder outlet obstruction caused mainly by prostatic enlargement. UTI are caused mainly by Gram negative enterobacteriacea. Escherichia Coli is the cause for about 80-90 % of community acquired UTI’s. In healthcare related infections E. Coli is still the leading cause but with a more modest percentage. Other pathogens that cause UTI are: Proteus mirabilis, Enterococous, Klebsiella pneumonie, Pseudomonas aeruginosa. METHOD AND MATERIALS Between January and October 2015, 1745 patients were admitted for continuous hospitalization in our Clinic. At admission all of these patients had their urine sent for culture. The urine culture was tested for antibiotic response for the following antibiotics: 1 Carol Davila Central Emergency Military Hospital, Bucharest 2 Carol Davila University of Medicine and Pharmacy, Faculty of Medicine, Bucharest 20
Introduction: Erectile dysfunction(ED) is a serious condition which can affect men of all ages, with an important impact over the quality of life. When conservative therapy fails, a viable solution is the penile prosthesis implantation (PPI). Objective: The purpose of this paper is to present data from recent literature regarding the satisfaction rates of men who have undergone penile PPI and as well as the partners satisfaction rates, ease of use, informations regarding long term survival of these prosthesis, postoperative complications and long distance complications, the effectiveness and the way that penile prosthesis have influenced the quality of life of the men who have opted for this solution. Material and methods: We have analyzed recent long term studies concerning the outcomes of the PPI, studies which were made retrospectively, over a period of time of 10 to 15 years. Results: Compared with the conservative treatment for ED, the satisfaction rates achieved after penile prosthesis implantation are higher. According to these studies, the overall patient’s satisfaction is 70-90%. The difference between patient and their partners’ satisfaction rate is negligible, this difference ranging between 2 to 8%. The satisfaction rate regarding the adequate erection for sexual intercourse is 80-90%. The overall satisfaction rates for the malleable prostheses are lower compared with inflatable devices, 30-75%, respectively 75-90% for the inflatable prosthesis. The mechanical and overall survival rates for the malleable prosthesis range between 65-80% at 10 years, and 58-75% for the inflatable devices. Overall ease of use is rated as 78%. Complications after implantation can be encountered in less than 5% of cases and infections in less than 2%. The likelihood of continued use is higher in the group of the patients with the inflatable prosthesis compared with the malleable ones 70-80%, respectively 50-60%. Up to 85- 90% of patients with inflatable prosthesis would recommend them. is a high effective treatment for erectile dysfunction, refractory to Conclusions: PPI pharmacological treatment. The inflatable penile prosthesis (IPP) provides more overall satisfaction than the malleable ones. The patients with IPP are more likely to continue using their devices than those with the malleable prosthesis. PPI improves significantly the quality of life for patients with erectile dysfunction.
