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We are presenting the case of a retroperitoneal urinoma, secondary to a spontaneous pelviureteral junction rupture that effused to the thigh. A 45-year-old female patient known with lithiasis history admitted emergently in our clinic for right lumbar pain, right thigh pain and edema, fever and chills. Ultrasound examination and contrast CT revealed right side grade II hydronephrosis, fluid accumulation in the perirenal fat surrounding the kidney and descending downwards to the pelvis and upper thigh. At retrograde pyelography a right pelviureteral rupture could be observed. We preferred a minimal invasive approach and placed a right retroperitoneal drainage tube and a double-J stent, combined with broad spectrum antibiotics. After few days the patient complained for right thigh pain and movement impairment. She was immediately operated openly for right thigh abscess. Three days postoperative the general status of the patient improved and blood analyses normalized. Lumbar urinoma is a rarely encountered complication of urinary tract obstruction that can spread along the psoas muscle into the thigh. Minimal invasive treatment is recommended as first approach for urinary tract ruptures. In medical literature there are few cases of retroperitoneal abscesses effused into the thigh most of them with gastrointestinal origin. [ABSTRACT FROM AUTHOR]

Liposarcomas are the most common retroperitoneal sarcomas, occurring more frequently in the age range of 40-60 years. The purpose of this article is to highlight the diagnostic and therapeutic modalities of retroperitoneal giant liposarcomas exemplifying by presenting a 41 year old patient with a large retroperitoneal tumor (29/24/12 cm) excised with difficulty to healthy tissue and following the histopathological result, it was shown to be a primitive liposarcoma with variable profile. The patient had a good post-operative evolution and refused any adjuvant treatment (radiotherapy). He developed a large local relapse associated with vertebral metastases, with reintervention having a very difficult tumor reduction but with unfavorable postoperative evolution, with multiple organic dysfunction syndrome leading to the patient's death. Analyzing the data from the literature, we concluded that complete surgical excision with the affected organs and structures is the gold standard of treatment, but tumor recurrences are frequent (especially for dedifferentiated subtypes) and lead to increased mortality rates; adjuvant or neoadjuvant radiotherapy can help to prevent such relapses (there are still many ongoing clinical studies). [ABSTRACT FROM AUTHOR]

The stone disease in a pelvic kidney is often difficult to treat due to the multiple anatomical anomalies. We have performed a laparoscopic pyelolithotomy for a large pelvic kidney stone with guided intraoperative flexible ureteroscopy. We have successfully performed a peritoneal transmesocolic laparoscopic pyelolitotomy to a 35-year old female patient with a 23 mm stone located in the collecting system of her right pelvic kidney. During the operation we also used a flexible ureteroscope to identify the stone due to an aberrant disposition of the right collecting system. Operative time was of 5 hours with no injury of major blood vessels. Postoperative recovery was four days with minimal abdominal pain, minimal abdominal drainage, no urine leakage in the peritoneal cavity and fast retrieval of gastrointestinal function. At this point the patient is stone free and the kidney has normal function demonstrated in a renal scintigraphy. Laparoscopic pyelolithotomy is a safe and efficient treatment option for stone disease with large calculi in ectopic pelvic kidney. The advantage of laparoscopic pyelolithotomy is that it has good functional results, with fast postoperative recovery, low complication rates and high stone free rate in one session. [ABSTRACT FROM AUTHOR]

Colon tumors in the elderly are often problematic regarding the differential diagnosis along with the appendicular plastron due to their low reactivity in case of tumor or inflammatory aggressions. The present paper presents the case of a 76-year-old patient, whose symptomatology indicated an appendicular plastron initially treated in a conservative manner, and then surgically approached and for which the anatomopathological result certified the diagnosis of a cecal mucinous adenocarcinoma. The discussions about this case stress the limitations of both the clinical examination and the imaging explorations such as colonoscopy and computed tomography for the differentiation of a benign inflammatory pathology of appendicular plastron from a possible malignant tumor localized at the level of the cecum. For uncertain cases, the surgical treatment of right radical ileohemicolectomy is the only means left to decide the proper diagnosis and to prevent the occurrence of severe complications specific to the neoplastic disease. [ABSTRACT FROM AUTHOR]

Background: The aim of the study was to present the biological prognostic factors of mortality in patients with acute pancreatitis. Methods: Several usual laboratory values were monitored: glucose, urea, partial pressure of oxygen, WBC count, hemoglobin, total bilirubin, and cholesterol. A statistical analysis was performed by using ROC curves and AUC interpretation. Results: The overall mortality rate was 21.1% and was different depending on the severity of the disease. Only 2.22% of the patients with a mild disease died, as opposed to 45.63% of the patients with a severe form. All the analyses studied were significantly elevated in the deceased patients. A close correlation between blood glucose, urea, partial pressure of oxygen, WBC, hemoglobin, total bilirubin, and cholesterol and mortality was objectified by measuring the AUC, which was of 97.1%, 95 5% 93 4% 92 1% 87.4%, 82.2%, and 79.0%. Conclusions: The usual, easy to use, fast, and cheap tests were useful in predicting mortality in patients with acute pancreatitis. Our study confirmed that the combination of several factors led to an accurate mortality prediction. [ABSTRACT FROM AUTHOR]

The article explores the concept of quality of life, nature of aging and factors affecting it. The definition of health by the World Health Organization (WHO) is used to explain wellness in all facets of life. The increase of the elderly population necessitates a new approach to healthcare including the promotion of socially active lifestyle. The role of physical and rehabilitation medicine in contributing to a good quality of life is also discussed.

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Copyright of Acta Medica Transilvanica is the property of Sciendo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Medica Transilvanica is the property of Sciendo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Medica Transilvanica is the property of Sciendo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Medica Transilvanica is the property of Sciendo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Obstetrică şi Ginecologie is the property of Societatea de Obstetrica si Ginecologie and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The current global financial crisis inevitably alters the quality of life (QoL) of many individuals, mainly (but not exclusively) concerning its fourth -- after Guelfi -- dimension: the economic one (a deeply intricate component). Under these conditions, we can only hope that the holistic and idealistic definition of health, adopted by the World Health Organization (WHO) almost 70 years ago, will keep its topicality and applicability -- as before the recession -- at least in the more developed countries/ economies. This work presents a synthetic overview on some basic issues regarding health and related QoL, focusing on their connections with the specialties of Physical & Rehabilitation Medicine and respectively, Gerontology & Geriatrics: the presence/ absence of risk factors, (especially) the ones associated to the "civilization pathology", wellness, the current thinking/ paradigm (integrating the medical and social models) of the WHO on human functioning, (di)stress -- including its relationship to premature/ pathologic ageing -- and the active prophylactic (relaxing, fitness/"mise en forme"/ anti-stress, maintaining/ re-performing of the work capacity, rejuvenation/ anti-ageing/ gero-prophylaxis) balneo-climatic courses. The construct and content of this work are framed within the very actual, leading specific concepts and outcome measurement indicators of the European Union, regarding the major global challenge represented by the accelerated demographic ageing process [and consequent endeavors, such as the European Innovation Partnership on Active and Healthy Ageing (EIPAHA), and also a most recent project/ surveys -- for doctors and for 60+ older adult patients -- of the main author and some colleagues -- endorsed by the Comité Permanent/ Standing Committee of the European Doctors (CPME) -- regarding "Health Literacy on Functional Decline and Frailty Related to Ageing" and respectively, the Healthy Life Years (HLY) and disability-adjusted life years (DALY) -- synthetic health state (macro-)indicators. Considering all above, this work documents/ ratiocinate and advocates for Romania's huge capabilities of health tourism -- its balneo-geriatric, consistent dimension -- too. [ABSTRACT FROM AUTHOR]

Introduction. Neuroendocrine renal carcinoma represents less than 1% of all primary neoplasia of the kidney. Most frequently poorly differentiated carcinoma is diagnosed in advanced stages and they have an aggressive evolution and limited survival rate. Neuroendocrine carcinomas that arise from the renal pelvis are frequently associated with squamous cell carcinoma or adenocarcinoma. Material and method. We present the case of a female patient, known for 3 years before with an undefined retroperitoneal lymph node metastasis, being diagnosed at present with a left large cell neuroendocrine renal carcinoma, who initially had lymph node metastasis. Results. Until now, 118 cases of primary neuroendocrine renal carcinomas have been reported. A limited number of poorly differentiated neuroendocrine carcinomas have been reported. Discussion. Due to the clinical and biological findings, the aggressive evolution with early metastasis of lung and bone, the patient is included in the group of poorly differentiated carcinomas. In these cases, multimodal treatment is a gold standard. After surgical treatment and palliative chemotherapy with platinum salts, we obtained a partial remission of the disease and the control of symptoms. Conclusions. Regarding large cell neuroendocrine carcinoma, the surgical treatment remains the treatment of choice. Chemotherapy can determine limited results, improve the quality of life and enhance the overall survival rate. [ABSTRACT FROM AUTHOR]

The researches performed during the last four decades did not elucidate completely the pathogenic mechanism of the renovascular hypertension. The present knowledge considers that the origins of renovascular hypertension are the imbalance between the renal hypotensive system located in the medullar renal site (antihypertensive and hypotensive substances) and the renal hypertensive system (renin-angiotensin-aldosterone) located cortically. As an additional mechanism in producing hypertension is involved the disorder of hydro electrolytic metabolism, as a result of decreased excretory function, inducing an increase of plasmatic natrium level, of volemia and interstitial liquid.

Objectives: symptoms in renovascular hypertension can be wrong interpreted, which leads to a late diagnostic, after discover the determination disease., Materials and Methods: the study on the renovascular hypertension was made on 20 patients, aged between 2 and 36 years old, diagnosed with reno-ureteral malformations, pyelonephritis, reno-ureteral reflux and renal trauma as a determination disease, leads to manifestation types that guide the diagnostic: neuro-psychiatric signs, weight loss, renal signs and digestive signs. Beginning from these signs the arterial hypertension was diagnosed and the investigations determined the causes., Results: Periodic postoperative evaluation at 3 months, during a period between 4 months and 7 years, individualised 4 evolutional clinical types: AHT with lumbar pain, AHT with no clinical signs, AHT with ophthalmologic signs and AHT with encephalitis like signs., Conclusions: symptoms in renovascular hypertension don't have pathognomonic clues and the identified signs, one type or all together, enforce the evaluation or even the monitoring of the arterial tension at least 30 days. If the values exceed the normal, complex investigations will be made in order to determine the specific cause of the AHT.