Urinary tract infections in complicated kidney stones: Can they be correlated with Guy's stone score?

OBJECTIVE: To ascertain the existence of a connection between Guy's stone score and infectious complications after percutaneous nephrolitholapaxy. METHODS: The retrospective cohort, multi-centre study was conducted in the urology departments of Prof Dr Theodor Burghele Clinical Hospital and C.I. Parhon Clinical Hospital, Romania, and included data of patients who underwent percutaneous nephrolitholapaxy from January 1, 2017, to December 31, 2019. Based on urography, the subjects were assigned to four groups, from GSS1 to GSS4, in accordance with the Guy's stone score classification. The complication rate after percutaneous nephrolitholapaxy was classified using the modified Clavien staging classification. Demographics, preoperative urine cultures, and the rate of complications were compared. Data was analysed using SPSS 24. RESULTS: Of the 246 patients, 116(47.2%) were males and 130(52.8%) were females. The overall mean age was 53.06±13.04 years (range: 18-83). The mean Guy's stone score was 1.82±0.9. The rate of percutaneous nephrolitholapaxy success was 160(65.04%). There were 105(42.68%) patients in GSS1 group, 63(25.60%) in GSS2, 24(9.75%) in GSS3 and 54(21.95%) in GSS4. There were significantly more preoperative positive urine culture in GSS3 and GSS4 groups compared to GSS1 and GSS2 groups (p<0.05). The rates of complications were statistically different among the groups (p=0.019). CONCLUSIONS: Urinary tract infections were found more frequently in patients with higher Guy's stone scores compared to those with low scores. The Guy's stone score classification were found to be a useful tool in predicting the immediate success rate of percutaneous nephrolitholapaxy.

Preoperative C-reactive protein is related with renal cell tumor dimension? Preliminary results.

INTRODUCTION: Renal tumors do not benefit from an unanimously accepted tumor marker. We tried to evaluate the advantages of preoperative C-reactive protein (CRP) values and monitor the dynamic of CRP values from the perspective of the evolution of patients diagnosed with Grawitz tumors. PATIENTS, MATERIALS AND METHODS: We researched the medical records of patients with renal parenchymal tumors admitted to the Urological Clinic in Iasi, Romania, between 01.01.2018 and 01.08.2022. Data were collected regarding age, environment, comorbidities, paraclinical data, tumor characteristics, and treatment performed. Ninety-six patients were included. The data on the inflammatory syndrome pre- and postoperatively were evaluated comparatively. All patients were diagnosed with clear cell renal cell carcinoma (RCC). RESULTS: We found that the renal tumor dimension correlates with an increased preoperative CRP level. For other variables, the correlations regarding age, sex, tumor, node, metastasis (TNM) stage, and size in relation to the increase or decrease of CRP had no statistical significance. CONCLUSIONS: The analysis of preoperative CRP and CRP dynamics could predict the tumor's aggressiveness and the treatment's effectiveness. A clear association between CRP levels and RCC pathogenesis is not yet defined, thus, further studies are necessary.

Correlations between stones composition, dietary and comorbidities context of the lithiasic patient.

The incidence of nephrolithiasis is in full expansion, its etiology being frequently associated with lifestyle changes. The objective of this retrospective study, carried out between April and December 2019, was to identify the correlations of the known lithogenic factors with the chemical structure of the calculi in the patients from the North-Eastern region of Romania. The results obtained after the data analysis of our LAMPA questionnaire (L - liquids, A - antecedents, M - medication, P - associated pathologies, A - aliments) made in evidence a statistically relevant relationship between the heredocollateral history of lithiasis and calcium oxalate dihydrate (COD) calculi, hypertension and calcium oxalate monohydrate (COM) stones, uric lithiasis and diabetes, COD, and obesity, between predominantly uric lithiasis and meat or meat-derived products consumption, between frequent potato consumption and COD stones and the frequently consume of dairy products and predominantly COM calculi. The authors concluded that the use of a complex questionnaire, like LAMPA, together with Fourier-transform infrared (FTIR) spectroscopic and morphological analysis are essential steps for developing an efficient metaphylaxis.

A Rare Case of a Testicular Teratoma Associated with a Neuroendocrine Tumour.

Introduction: We report a rare case of testicular teratoma combined with a neuroendocrine tumour, emphasizing the difficulty of the following aspects: the clinical and laboratory diagnosis, the treatment options and the evolution of patients suffering from this disease. Case presentation: The patients with testicular neuroendocrine tumours represent a rarity, considering that as of 2017, only 22 cases had been reported in the literature. The case operated on in our clinic presents an association between a testicular teratoma and a neuroendocrine tumour. A 39-year-old patient was admitted in our Department for a non-painful abdominal tumour and concomitant testicular tumour. The serum tumour markers (-human chorionic gonadotropin, -phetoprotein and lactate dehydrogenase) were within normal limits. Lung and bone metastases were diagnosed CT scan. The histopathological diagnosis consisted of immunohistochemical study of the orchidectomy specimen as well as of the bioptic material from bone marrow puncture. Conclusions: The diagnosis of testicular carcinoids is based on immunohistochemistry study. Radical orchidectomy is the only potentially curative treatment for this type of malignancy. Adjuvant chemotherapy determined size reduction of the lung and bone metastases and the disappearance of the lymph node metastases.

Systemic inflammatory impact of periodontitis on acute coronary syndrome.

AIM: A causative relationship between acute coronary syndrome (ACS) and periodontitis has yet to be defined. The aim of this study was to assess differences in levels of serum cytokines between individuals with or without ACS or periodontal comorbidity. MATERIAL AND METHODS: In a case-control study, individuals with ACS (78 individuals, 10.3% females) and matching healthy controls (78 individuals, 28.2% females) were included. Medical and dental examinations were performed to diagnose ACS and periodontitis. Serum levels of cytokines were assessed, using Luminex technology. RESULTS: A diagnosis of periodontitis in the ACS and control group was diagnosed in 52.6% and 12.8% of the individuals, respectively. The unadjusted odds-ratio that individuals with ACS also had periodontitis was 7.5 (95% CI: 3.4, 16.8, p < 0.001). Independent of periodontal conditions, individuals with ACS had significantly higher serum levels of IL8 (mean: 44.3 and 40.0 pg/ml) and vascular endothelial growth factor (VEGF) (mean: 82.3 and 55.3 pg/ml) than control individuals. A diagnosis of periodontitis made no difference in serum cytokine expressions. CONCLUSION: Elevated serum levels of VEGF were associated with ACS. Serum cytokine expression in individuals with ACS is unrelated to periodontal conditions.

Is reproductive effort environmentally or energetically controlled? The case of the Danube crested newt (Triturus dobrogicus).

Reproductive strategies have evolved from a series of trade-offs between cost and timing of reproduction. We tested whether the reproductive effort of female Danube crested newts, Triturus dobrogicus, was environmentally or energetically constrained. We collected females migrating towards the water and kept them separately, with males. Deposited eggs were collected daily during the experiment. More eggs were deposited by older females and by females starting to reproduce earlier. Batches of eggs from females depositing more eggs had a lower hatching success, suggesting decreased viability. Oviposition lasted on average 22.7 days. Female newts showed no loss of weight during this period. At the end of the egg deposition period we injected a subset of females with hormones that triggered the deposition of additional eggs. This suggests that egg deposition in Danube crested newts is environmentally constrained, as females stopped oviposition despite having mature eggs in their ovaries.

Diversity and distribution of reptiles in Romania.

The reptile fauna of Romania comprises 23 species, out of which 12 species reach here the limit of their geographic range. We compiled and updated a national database of the reptile species occurrences from a variety of sources including our own field surveys, personal communication from specialists, museum collections and the scientific literature. The occurrence records were georeferenced and stored in a geodatabase for additional analysis of their spatial patterns. The spatial analysis revealed a biased sampling effort concentrated in various protected areas, and deficient in the vast agricultural areas of the southern part of Romania. The patterns of species richness showed a higher number of species in the warmer and drier regions, and a relatively low number of species in the rest of the country. Our database provides a starting point for further analyses, and represents a reliable tool for drafting conservation plans.

Diversity and distribution of amphibians in Romania.

Nineteen species of amphibians inhabit Romania, 9 of which reach their range limit on this territory. Based on published occurrence reports, museum collections and our own data we compiled a national database of amphibian occurrences. We georeferenced 26779 amphibian species occurrences, and performed an analysis of their spatial patterns, checking for hotspots and patterns of species richness. The results of spatial statistic analyses supported the idea of a biased sampling for Romania, with clear hotspots of increased sampling efforts. The sampling effort is biased towards species with high detectability, protected areas, and large cities. Future sampling efforts should be focused mostly on species with a high rarity score in order to accurately map their range. Our results are an important step in achieving the long-term goals of increasing the efficiency of conservation efforts and evaluating the species range shifts under climate change scenarios.