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.
Background and aim: Acne fulminans is a rare and severe form of acne which usually appears in young men with a personal history of mild to moderate acne. It is characterized by a sudden onset with nodules and ulcerative lesions mostly located on the thorax and extracutaneous manifestations (fever, weight loss, osteoarticular damage). The pathophysiologic mechanism is represented by a type III or IV hypersensitivity reaction to Propionibacterium acnes. Patient: We present the case of a 16-year old patient with acne fulminans. The lesions were accompanied by an impaired general condition with fever and weight loss. Paraclinically an inflammatory syndrome was revealed without osteoarticular changes. It was treated with prednisone 40 mg/day, erythromycin 2g/day and local antiseptic solutions. A gradual tapering of the prednisone dose (5 mg/week) and a dermatological revaluation after 3 weeks to introduce systemic treatment with retinoids were recommended at discharge. Conclusions: Acne fulminans is a severe form of acne with systemic manifestations and corticotherapy is the first line treatment.
Epilepsy is one of the world's oldest diseases. Social stigma, misunderstanding and thus, discrimination have surrounded patients and their families from the beginnings until nowadays. Approximatively up to 80% of epilepsy cases worldwide are found in developing regions. The risk of premature death is two to three times higher than for the general population. There is contradictory evidences concerning the question of whether to inform patients about the possibility of sudden unexpected death in epilepsy (SUDEP). Actual guidelines states that individuals with epilepsy and their families or careers should be given access to information on SUDEP. We have information about how, when and what to say to the patients and families about SUDEP. But it's a delicate subject, and some patients do not want to know that they are at risk for this.
From an anatomical perspective, the dental pulp is a connective tissue with a specific microcirculatory system with repairing abilities in order to preserve the vitality of the pulp15. Different therapeutic methods in treating the affected dental pulp can be compromised by different factors and can lead us to failure. Due to disorders emerged in the microcirculatory system, the treatment of the affected dental pulpin patients with type 2 diabetes is an additional challenge. Type 2 diabetes can impact different functions of the patients’ immune system, with a predisposion to chronic inflammation, progressive tissue degradation and reduced tissue repairing15. Regarding the endodontic therapy of the affected dental pulp in patients with diabetes mellitus (DM), an important role in the treatment of pulpal complications is played by the calcium hydroxide which is considered „the golden standard” because of its excellent properties, the very alkaline pH being one of the most important.
Introduction: The gastrointestinal stromal tumors (GIST) are dominated by KIT and PDGFRA mutation. The immunohistochemical detection of CD117, a protein express by KIT gene, is essential for the diagnosis and those that are negative always represented a diagnostic challenge Case reports: In this article we present a series of 4 cases of CD117 negative GIST tumors, diagnosed and surgically resected in Fundeni Clinical Institute and an overview of the histogenesis, diagnostic problems and management of c-kit negative GIST. All patients were males and the tumors were located in the stomach and small bowel. Conclusion: It is important for the pathologists to beware of the fact that a CD117 negative in the context of a typical morphological appearance does not exclude a GIST tumor and also the oncologist must be aware not to exclude the therapy with imatinib based on the negativity of CD117.
Radical prostatectomy is the gold standard treatment for patients with localized prostatic cancer, but often the pathological diagnosis reveals a locally advanced stage. The aim of this paper is to present the oncological follow-up after radical prostatectomy on a group of 42 patients, patients which have been diagnosed after surgery with a more aggressive stage, locally advanced PCa. Over a period of four years 136 patients have undergone radical prostatectomy. The pathological examination has established that 42 patients presented extracapsular invasion and/or lymph node invasion. 18 patients (pT3-4N0M0) have undergone radiotherapy alone and 24 patients (8 pN1 and 16 pT3-4N1M0) have received androgen deprivation therapy in association with radiotherapy. Over the next two years 15 patients presented biochemical recurrence. For these patients chemotherapy was initiated, but in two cases PSA increase has been observed during periodic evaluation. Although it is not uncommon that postoperatively the histopathological examination establishes a more aggressive disease stage than that established before surgery, radical prostatectomy remains the solution for the localized prostate cancer, solution that can be boosted by radiotherapy and/or androgen deprivation therapy.
There are more than one technique used to evaluate the kidney, besides the standard ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI), there is also renal scintigraphy. The renal nuclear medicine procedures are grouped as in vitro (urine counting wells, basic probe detectors for clearance studies) and in vivo procedures (static and/or dynamic examinations done with planar gamma cameras, and single-photon emission computed tomography (SPECT) to determine kidney parameters or for cortical imaging). Renal scintigraphy has been a useful tool, since the early 1950s, in the diagnosis and management of many pathological changes (e.g. obstructive/nonobstructive uropathies, renal inflammatory diseases, tumours, renal hypertension, and renal transplant viability). [1] the kidney, especially in measuring function renal in INTRODUCTION The radionuclide investigation of the kidney includes detection of renal afflictions and measurements of quantitative indices that estimate the renal perfusion and function. Ultrasound and computed tomography are commonly used for the evaluation of renal structural anatomy, and the role of nuclear renal imaging in is more for functional analysis, anatomical imaging (e.g. cortical imaging).[1,2] less radionuclide imaging" or Renal scintigraphy, also known as a "renal scan" or "renal “renography” includes various investigations that use different radioisotopes to evaluate renal blood flow, renal split function, and the renal excretion performance of both. It yields specific and often unachievable information by using other imaging procedures. [2] Clinical indications for renal scintigraphy (adapted from Nuclear Medicine: The Requisites, 4th ed): [3-5] 1. Blood flow abnormalities 26 lesion and a 2. Function quantification (reduced performance of one or both kidneys) a. Differential function b. Glomerular filtration rate (GFR), effective renal plasma flow (EPRF) 3. Cirrhosis of the kidney(s) 4. Differentiation between a mass column of Bertin 5. In infants with abnormalities of the urinary tract to study the urinary flow 6. Obstruction: ureteropelvic junction, ureteral 7. Pyelonephritis: both acute and chronic tubule- interstitial nephritis and parenchymal scarring 8. Renal failure: acute and chronic 9. Renal artery stenosis with/without renovascular hypertension 10. Renal vein thrombosis 11. Surgical: 1 Carol Davila Central Emergency Military Hospital, Bucharest
Introduction: Radical retropubic prostatectomy represents in its various forms (open, laparoscopic and robotic) the "gold standard" treatment for adenocarcinoma of the prostate. Unfortunately like al treatment solutions it has its shortcomings. Retropubic radical prostatectomy, external beam radiation therapy and brachytherapy are the curative options. Materials and Method: The experience of Clinic of Urology from Central Military Hospital representing more than 100 cases was analyzed . Classical open retropubic prostatectomy was performed in all cases. We focused in this paper on intraoperative complications and also precocious and late postoperative complications. Results: Our results are matching the other centers in terms of intraoperative complications (blood loss), early postoperative complications (hematuria, urinary tract infection, lymphatic drainage) or late postoperative complications (erectile dysfunction and urinary incontinence). However none of these complications are to be underestimated Conclusions: The limits of this intervention can be pushed a litle bit further, in our opinion the age factor is a relative one, some of these patients having a longer than 10 years life expectancy. It provides good oncological outcome with manageable complications most of the times.
49 year-old man presented to our clinic for pain in the right hypochondrium, diarrhea, and fever. The clinical examination highlights a tumoral formation in the right side of the abdomen, with firm consistency, poorly defined margins, and present mobility in the deep structures. On biological exams, leukocytosis with neutrophilia, inflammatory syndrome, and hypoalbuminaemia were identified. The first computed tomography exam described parietal thickening of the ascending colon, with infiltrative aspect, and multiple local adenopathies, lomboaortic and interaortocave. Moreover, four nodular liver tumors, with hypodense image in native examination, were identified. The lab tests for infectious diseases were all inconclusives: three hemocultures, three stool samples, and three coproparasitological exams were all negatives. Interdisciplinary examinations, internal medicine and infectious diseases, sustained the diagnosis of colonic neoplasm with peritumoral abscess and liver pseudo-tumoral masses. The colonoscopy did not revealed any bowel lesions relevant for neoplasia. This result as well as the bio-clinical context imposed abstention from surgical intervention. Wide spectrum antibiotics and symptomatic treatment were initiated. But, ten days after hospitalization, the second computed tomography exam showed reduction of the ascending colon wall thickness associated with significant increases of the liver tumors is so revealed. The investigations for other possible etiologies were so continued.
