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Hemolytic-Uremic Syndrome (HUS) is a clinical syndrome with a triad of non-immune Microangiopathic Hemolytic Anemia (MAHA), thrombocytopenia and renal failure. Together with the Thrombotic Thrombocytopenic Purpura (TTP), it belongs to a group of diseases characterized as the Thrombotic Microangiopathy (TMA), which represents a microvascular occlusive disorder with the formation of a predominantly thrombocytic thrombus in the renal and/or systemic circulation. In the period starting from 2001 to 2017, 14 patients with a HUS were diagnosed at the Clinic for Nephrology (unfortunately ADAMTS 13 could not have been done due to technical reasons). In a retrospective clinical laboratory analysis and monitoring, we obtained the following results. Out of 14 patients, 10 were female (or 71.43%) and 4 were male (28.57%), the youngest patient was aged 17 and the oldest one 78, the average age of our patients was 55.33 years, the annual number of patients with the diagnosis of HUS was 0.93 patients per year, or 0.00116 in relation to the total number of patients treated. After monitoring the patients individually for the period ranging from 1 to 14 years, a stable remission was achieved in 5 patients, while a chronic renal insufficiency occurred in 3 patients. In two of our patients, a percutaneous kidney biopsy was performed with pathohistological findings described in references. Having done this retrospective analysis, we can conclude that the survival and complications of this rare, but serious disease correspond to the available world data.

Background/Aim. Monitoring the renal function following donor nephrectomy (DN) or radical nephrectomy (RN) due to kidney tumors is considered essential. The aim of this study was to compare pre-operative and post-operative renal function in patients who underwent DN in relation to patients who underwent RN due to renal malignancy. Methods. A retrospective case-control study was performed, which included 199 patients divided into two groups: group 1 (105 patients) were patients who underwent DN due to living-related/unrelated kidney transplantation, while group 2 (94 patients) was a control group, and included patients who underwent RN due to clear cell renal cell carcinoma in the T1bNoM0 clinical stage, where this surgical procedure was the final form of treatment. Results. Preoperative estimated glomerular filtration rate (eGFR) according to the Chronic Kidney Disease?Epidemiology Collaboration (EPI) equation (eGFR EPI) in the DN group was 94.95 mL/min/1.73 m2, while in the RN group, it was 71.00 mL/min/1.73 m2. Patients who underwent RN tended to have eGFR EPI below 60 mL/min/1.73 m2 after ten years of follow-up compared with patients who underwent DN. In the DN group, the average eGFR EPI was 80.40 mL/min/1.73 m2, and in the RN group, it was 56.00 mL/min/1.73 m2. A higher incidence of diabetes mellitus (DM) and arterial hypertension (AH) was also observed in the DN group of patients compared to the RN group (AH: 44.3% vs. 21.3%; DM: 22.6% vs. 9.6%, respectively). Conclusion. Comparative monitoring of these two groups showed that in both groups, the recovery of the renal reserve was achieved one year after nephrectomy due to the known adaptive mechanisms. Even though the initial renal reserve in a kidney donor is reduced after living kidney transplantation (nephrectomy, permanent loss of renal mass), kidney donors recover kidney function within the first year after surgery due to the adaptive mechanisms.

Replacement of deciduous teeth with permanent teeth is a physiological process, and as a consequence of early tooth loss in deciduous or mixed dentition, loss of space may occur. There is no doubt that the loss of space after the premature extraction of deciduous molars occurs, however, the width of the lost space and the need for their clinical use are still a topic that is up for discussion. This period is an indication for the designing and installation of space maintainers. The goal of therapy in such situations is to maintain the position of the deciduous dentition in the arch until the eruption of permanent teeth takes place and those teeth take their natural and correct positions. Depending on the method of fixation, space keepers can be fixed, cemented and mobile. These devices are divided by the way they function into active (enable the increase of space by their action) and passive. Space maintainers are a bit neglected, and they represent a very important clinical treatment whose use can bring a lot of benefits, both prophylactic and therapeutic. The development of biomaterials and digitalization in dental practice can direct us to modify and improve this therapeutic method.

Based on the role of platelets in inflammation and hemostasis it has been assumed that antiplatelet therapy could be beneficial for patients suffering from ulcerative colitis. Platelets present a link between inflammation and coagulation. They have more than 300 active mediators stored in their granules. Upon activation, platelet degranulate and release a lot of microparticles and mediators and interact with other immune and non-immune cells thereby amplifying inflammation. The most important parameters of platelet activation are P-selectin and CD40 ligand expressed on their surface upon activation, and their soluble forms presented in blood. Today, we have potent anti-platelet drugs that can inhibit platelet activation and degranulation, and thereby reduce inflammation. The most important drugs are P2Y12 receptor antagonists such as ticagrelor and clopidogrel and glycoprotein IIbIIIa inhibitors. Ticagrelor is an active drug and besides antiplatelet activity, it has bactericidal activity against Gram-positive strains and Clostridium difficile. Clopidogrel is a prodrug with less anti-inflammatory effect than ticagrelor and no proven bactericidal activity. Glycoprotein IIbIIIa inhibitors are very potent in reducing platelet aggregation but have lower anti-inflammatory potential than ticagrelor and clopidogrel.

The number of people suffering from diabetes mellitus, especially Type 2 diabetes mellitus, is increasing every year. Approximately one-third of the patients with diabetes mellitus will develop diabetic nephropathy and chronic kidney disease. Diabetic nephropathy represents the main cause of end-stage renal disease. Vitamin D deficiency is often present in patients with diabetes mellitus and could present a risk factor for a higher incidence of cardiovascular events. Vitamin D supplementation could have a renoprotective effect and the potential to delay occurrence and slow down the progression of diabetic nephropathy. The renoprotective effect is reflected in better glycoregulation, reduction of proteinuria and proinflammatory cytokines, and improved lipid regulation. New research shed the light on the important role of vitamin D in reducing renal fibrosis and stabilization of podocyte function. If we take into consideration the cost of end-stage renal disease treatment and the quality of life of patients on dialysis, any delay in end-stage renal disease is significant.

Background/Aim. Contrast-induced acute kidney injury (CI-AKI) is a common complication after the percutaneous coronary intervention, associated with a prolonged hospital stay, increased medical costs, and risk of adverse clinical outcomes. The aim of this study was to compare changes in levels of serum creatinine (sCr) and cystatin C (sCyC) 24 h after coronary angiography as an early indicator of CI-AKI. Methods. The study included 45 patients with chronic renal failure grade I?III scheduled for coronary angiography. Levels of sCr and sCyC were measured a day before and 24 h after coronary angiography. CI-AKI was defined as a 25% and 10% increase of sCr and sCyC levels from baseline within 24 h from contrast media exposure, in the absence of alternative causes. Results. Mean sCr and sCyC concentra-tions were 86.4 ? 22.6 ?mol/L and 1.18 ? 0.52 mg/dL, respectively before contrast administration, and 90.6 ? 24.1 ?mol/L and 1.24 ? 0.65 mg/dL, respectively 24 h after contrast media exposure. sCr-based CI-AKI occurred in 4 patients (8.89%) and sCyC-based CI-AKI was detected in 19 patients (42.22%) after the contrast procedure (p < 0.001). Conclusion. sCyC level measured 24 h after contrast media exposure is a more sensitive indicator of CI-AKI than sCR level.

Introduction. Kidney failure in multiple myeloma is some-times initial symptomatology and a very serious complication with an unfavorable effect on the course and prognosis of the disease. Multiple myeloma is a disease characterized by the proliferation of plasmocytes in the bone marrow, and in rare cases, it can be extramedullary in various organs and systems. Pulmonary plasmacytoma localization is a rare extramedullary localization, especially when it represents one of the initial manifestations of multiple myeloma. Case report. We present a patient with progressive acute kidney failure who has started hemodialysis treatment. On chest radiography, a homogeneous shadow was observed along the left chest wall, and the multislice computed tomography (MSCT) pointed to the tumor formation in the pulmonary parenchyma in the projection of the left upper pulmonary lobe with signs of pleural infiltration, intercostal muscles, and V rib destruction. Laboratory examination indicated the presence of Bence-Jones proteinuria in the urine sample in addition to anemia syndrome and azotemia with hyperuricemia. After bronchoscopy and needle biopsy, diffuse infiltration of mature plasma cells was demonstrated in the cytological and histopathological findings of the lungs. The histopathological finding of bone marrow biopsy indicated multiple myeloma of Lambda type with infiltration of plasma cells ? about 70%. The hematologist determined a diagnosis of multiple myeloma BJ lambda III BCS, with extramedullary lung infiltration and acute kidney failure. Further treatment was continued according to the hematological protocol while performing intermittent hemodialysis. Conclusion. Sometimes, extremely rarely, and in completely asymptomatic patients with massive pulmonary infiltration observed initially, the differential diagnosis may also represent an extramedullary presentation of multiple myeloma, which should be considered.

The interradicular septum describes area in the root furcation that separate alveoli of multi-rooted teeth. The shape and dimension depend of the topography of the extraction socket, the geometry of residual root and anatomy of molars alveoli. The clinical implications of this anatomic structure may be used in oral surgery resection procedures, periodontology and implantology. There is an opinion from the surgical and prosthodontic side that center of interradicular septum may be adequate place for immediate implantation. The aim of this study was to investigate morphological characteristics and clinical implications of upper molars interradicular septum. The studies showed that interradicular septum is important for success of resection surgery procedures: hemi-section, bisection and root amputation. It’s reported that furcation involvement in periodontal disease is clinical sign for severe bone loss. By reviewing the available literature for immediate implantation, it’s reported the clinical implications for diagnostical plan (pre-intervention), presurgical (pre-instrumentation) and intraoperative evaluation of interradicular septum for immediate implantation. The cone beam computed tomography analyze study presented mean values of septum height and wide for hypothetical plan of immediate implant placement. The presurgical studies evaluate how to assure preservation of septum and safe implant position in center of septum. The research showed varies therapy modalities that can be used, and how to choose right therapy according the socket type and initial septum width classification. According to observation of studies results, other researches should be considered for CBCT anatomical structure analyze and measures of interradicular septum for immediate implantation planning.

Introduction: Tuberous sclerosis (TS) is a rare systemic autosomal- dominant genetic disease in which multiple hamartomatous lesions occur in many organs and tissues. Kidney involvement of TS usually includes angiomyolipomas, cysts, rarely kidney tumors, but there is not much description of other kidney involvement (proteinuria, hematuria, advanced kidney failure). We present a patient with preterminal renal failure who is diagnosed with tuberous sclerosis. Case report: A 52-year-old female was admitted to the hospital, due to decreased kidney function with worsening of the general condition and crises of consciousness. During the examination, cutaneous lesions -facial angiofibrolipomas were noticed, the patient was dehydrated and pale. Laboratory analyzes showed elevated parameters of nonspecific inflammation, anemic syndrome, azotemia (Cr 578umol / l, urea 50.1mmol / l, CKD e GFR 10 ml / min / 73m2), leukocyturia, microerythrocyturia, proteinuria 1.5 g / 24h. MSCT of the abdomen indicated hemangiomas of the liver, enlarged kidneys with several hypodense and hyperdense changes - angiomyolipomas. Due to the crisis of consciousness, MSCT of the head was performed, on which cysts and calcifications of the brain were observed. During the treatment, there was a confusing state, agitation, and epilepsy seizure. MRI brain showed multi locular brain cysts with ependymal and subependymal calcified nodules in the lateral ventricles. The applied treatment resulted in a partial recovery of kidney function (CKDeGFR 17 mil / min / 1.73 m2, and further approach in the monitoring and treatment of this patient was multidisciplinary. Chronic renal failure of 4 stages was maintained for a further six-month follow-up. Conclusion: We underline the importance of a multidisciplinary approach in the treatment of patients, bearing in mind that, as in our patient, a rare genetic disease - tuberous sclerosis can be manifested by kidney failure of preterminal rank.

Background/Aim. Vitamin D insufficiency/deficiency is often present in patients with type-2 diabetes mellitus (DM) and could present a risk factor for rapid progression of diabetic nephropathy and for higher incidence of cardiovascular events. The aim of this study was to examine the influence of vitamin D supplementation on proteinuria, cholesterol, triglycerides, C-reactive protein (CRP) and hemoglobin A1c in patients with type-2 DM and vitamin D insufficiency/ deficiency. Methods. This prospective, cohort study included 90 patients with type-2 DM and vitamin D insufficiency/ deficiency divided into 3 equal groups: with normal proteinura, with microproteinuria and with macroproteinuria. Therapy included six months of supplementation with cholecalciferol drops: first two months with 20,000 IU twice weekly, than if level of vitamin D was below normal the same dose was given next four months. If the level of vitamin D was normal 5,000 IU was given twice weekly. At the begining and at the end of the study the levels of urea, creatinine, fasting blood glucose, calcium, phosphorus, cholesterol, triglycerides, CRP, hemoglobin A1c, intact parathyroid hormone, 24-hour urine protein and creatinine clearance were determined. Levels of calcium, phosphorus and vitamin D were also checked 2 months after beginning of therapy due to possible correction of cholecalciferol dose. Results. The lowest level of vitamin D before therapy was found in patients with macroproteinuria, while at the end of the study the significantly higher level of vitamin D was found in all three groups. After 6 months of therapy a significant decrease of 24-hour urine protein, cholesterol, triglycerides, hemoglobin A1c in all three groups, and CRP in patients with normal proteinuria and microproteinuria were found. Significantly negative correlation between vitamin D and 24-hour urine protein, cholesterol and CRP was found in patients with macroproteinuria. Also, significantly negative correlation was found between vitamin D and hemoglobin A1c, in patients with normal proteinuria, vitamin D and CRP in patients with microproteinuria. Conclusion. A preventive use of high-dose cholecalciferol supplementation in patients with type-2 DM (with or without proteinuria) decreases cholesterol, triglycerides, proteinuria, CRP and hemoglobin A1c.

La Serbie est l’un des pays les plus multiculturels des Balkans, puisqu’au final, seuls les deux tiers de la population sont « Serbes », les autres étant issus de minorités ethniques - et donc souvent linguistiques - diverses. Issue de l’ex-Yugoslavie, la Serbie est composée de la Serbie restreinte, et d’une province autonome, la Voïvodine : les législations ne sont pas les mêmes selon les régions. Ainsi, la Voïvodine est-elle une province où la législation concernant les langues et l’une des plus ouvertes au monde, tandis qu’en Serbie restreinte, la non législation, jusqu’à une période récente, a permis au final et de façon paradoxale, de sauvegarder aussi les langues. C’est ce paradoxe qui m’intéressera dans ce papier concernant la diversité des langues d’une part, et la variation linguistique d’autre part : on reconnait le droit à l’autre de parler une langue autre, tandis que le serbe doit lui, obéir au standard.

Background/aims To evaluate the side effects of two antiplatelet agents - ticagrelor and eptifibatide - in mice with experimentally-induced inflammatory bowel disease. Methods and material This study was designed as a controlled, animal, drug safety investigation. C57Bl/6 mice were used to establish the ulcerative colitis model by exposure to dextran sulfate sodium (DSS), and divided into three experimental groups: eptifibatide-treated (150 µg/day intraperitoneally; n = 10), ticagrelol-treated (1 mg/day via gastric tube; n = 10), and DSS-control (plain drinking water; n = 10). An unmodeled non-DSS group served as the experimental control. Complete blood count was taken for all mice at baseline (day 0, treatment initiation) and after four days of treatment. On day 4, all animals were sacrificed for autopsy. The primary outcome measure was bleeding, and the secondary outcomes were change in platelet count, hemoglobin level, and hematocrit level. Results Neither ticagrelor nor eptifibatide treatment produced a significant effect on DSS colitis mice for the safety parameters measured. Platelet count and hemoglobin and hematocrit levels were statistically similar between the three DSS groups and the non-DSS control group (P > 0.05). Autopsy found no evidence of recent bleeding in liver, spleen, central nervous system or serous cavities. Conclusion The antiplatelet agents ticagrelor and eptifibatide were safe in DSS colitis mice, suggesting their potential in humans suffering from ulcerative colitis, and supporting future safety studies.

Background/Aim. Idiopathic retroperitoneal fibrosis (IRF) is characterized by the fibroinflammatory periaortic tissue that affects the ureters, causing obstructive nephropathy and variable impairment of renal function. The findings strongly suggest an autoimmune etiology. The optimal treatment has not been established. The aim of this study was to analyze a long-term efficacy of combined corticosteroid therapy with mycophenolate mofetil (MMF) in the patients with IRF. Methods. We retrospectively followed 13 patients (8 males and 5 females) with IRF. All patients received corticosteroids and MMF. For the patients with severe renal failure, an initial ureteral decompression was made and prednisone was started orally 0.5 mg/kg with fast tapering. In cases with a mild renal failure corticosteroids were administrated as intravenous methylprednisolone pulses for 3 days, followed by oral prednisone. The dose of MMF was 1000 mg twice a day. MMF was stopped after 18 months and prednisone after 48 months. Results. Systemic symptoms resolved in all patients. Erythrocyte sedimentation (SE) rate declined from the mean of 67.6 to 26.3 mm/h and C-reactive protein (CRP) from the mean of 18.5 to 6.3 mg/L. In 7 out of 8 patients, the ureteral stents were successfully removed 13 weeks on average. Seven patients had 100% of reduction in the periaortic mass, and the average percent reduction was 76.9%. The kidney function improved and remained normal in 6 treated patients. In 4 patients a mild chronic renal failure remained due to afunction of one kidney. Three patients, with a prior chronic renal failure, did not get worse renal function. The disease recurred in 3 patients. There were no treatment side effects noted. Conclusion. Combination of corticosteroids and MMF is a potentially effective treatment in restoring the renal function and reducing the fibrotic tissue in the patients with idiopathic retroperitoneal fibrosis. It could prevent the need for ureteral stenting and surgery. Longer treatment may reduce a possibility of recurrence.

Introduction. Multiple myeloma is a hemathological malignancy characterized by the clonal proliferation of plasma cells in the bone the marrow. Extramedullary dissemination of multiple myeloma is uncommon. In several cases only, the multiple myeloma malignant plasma cells had diseminated to the lung parenchyma. Case report. We presented a case of multiple myeloma with lung plasmacytoma, in a 79-year-old patient, hospitalized for febrility and infiltrative mass in the right lung. Two months before the patient was admitted, because of developing terminal renal failure, hemodialysis treatment had started three times a week. Since then, the patient was oliguric, but because of febrility and hemoptysis that appeared, at first he was treated with dual antibiotic therapy which resulted in temporary improvement of his general condition, but pleural effusion remained. After thoracocentesis, followed by myelogram, the multiple myeloma diagnosis was established. Conclusion. In patients of middle and older age, with general weakness, exhaustion, loss of weight, renal failure which progresses to the end stage rapidly, if symptoms of respiratory tract occur, consider this uncommon disease - extramedullary dissemination of multiple myeloma.

Introduction. Renal artery stenosis (RAS) is narrowing of one or both renal arteries or their branches. Clinically significant stenosis involves narrowing of the lumen, which is approximately 80%. The two most common causes of its occurrence are atherosclerosis and fibromuscular dysplasia. Percutaneous transluminal renal angioplasty (PTRA) with stent implantation is an effective treatment modality that leads to lower blood pressure and improvement of kidney function. Case report. We presented 4 patients with significant stenosis of one or both renal arteries followed by the development of arterial hypertension and renal insufficiency. The causes of RAS were atherosclerosis in two patients and fibromuscular dysplasia in one patient. One of the patients had renal artery stenosis of transplanted kidney that developed 9 month after transplantation. In all the patients, in addition to clinical signs, doppler screening suspected the existence of significant renal artery stenosis. The definitive diagnosis was made by applying computed tomographic angiography (CTA) of renal arteries in 3 of the patients and in 1 patient by percutaneus selective angiography. All the patients were treated by application of PTRA with stent implantation followed by improvement/normalization of blood pressure and kidney function. Conclusion. Application of PTRA with stent implantation is an effective treatment of significant stenosis of one or both renal arteries followed by renal insufficiency.

Background. In countries without a national organization for retrieval and distribution of organs of the deceased donors, problem of organ shortage is still not resolved. In order to increase the number of kidney transplantations we started with the program of living unrelated - spousal donors. The aim of this study was to compare treatment outcome and renal graft function in patients receiving the graft from spousal and those receiving ghe graft from living related donors. Method. We retrospectively identified 14 patients who received renal allograft from spousal donors between 1996 and 2009 (group I). The control group consisted of 14 patients who got graft from related donor retrieved from the database and matched than with respect to sex, age, kidney disease, immunological and viral pretransplant status, the initial method of the end stage renal disease treatment and ABO compatibility. In the follow-up period of 41 ± 38 months we recorded immunosuppressive therapy, surgical complications, episodes of acute rejection, CMV infection and graft function, assessed by serum creatinine levels at the beginning and in the end of the follow-up period. All patients had pretransplant negative cross-match. In ABO incompatible patients pretransplant isoagglutinine titer was zero. Results. The patients with a spousal donor had worse HLA matching. There were no significant differences between the groups in surgical, infective, immunological complications and graft function. Two patients from the group I returned to hemodialysis after 82 and 22 months due to serious comorbidities. Conclusion. In spite of the worse HLA matching, graft survival and function of renal grafts from spousal donors were as good as those retrieved from related donors.

Background. Systemic lupus erithematodes (SLE) is chronic, often febrile, multisystemic disease unknown origin and relapsing course which affects connective tissue of the skin, joints, kidney and serous membranes. Gastrointestinal manifestations are rarely the first sign of systemic lupus erythematosus. Case report. We presented a female patient, 35 years old, whose first symptoms of SLE were paralitic ileus (chronic intestinal pseudo-obstruction) and polyserositis (pleural effusion and ascites). Except for high parameters of inflammation, leucopenia and thrombocytopenia, all immunological and laboratory tests for SLE were negative in the onset of the disease. During next six months the patient had clinical signs of paralitic ileus several times and was twice operated with progressive malabsorptive syndrome. The full picture of SLE was manifested seven months later associated with lupus nephritis. Treatment with cyclophosphamide, corticosteroids and total parenteral nutrition (30 days) induced stable remission of the disease. Conclusion. The SLE can be initially manifested with gastroenterological symptoms without any other clinical and immunologic parameters of the disease. If in patients with SLE and gastrointestinal tract involvement malabsorption syndrom is developed, a treatment success depends on both immunosupressive therapy and total parenteral nutrition.

Introduction. Renal cell carcinoma (RCC) is derived from renal tubular epithelial cells and represents approximately 3.8% of all malignancies in adults. The incidence of renal cell carcinoma has been growing steadily and ranging from 0.6 to 14.7 for every 100,000 inhabitants. Patients with end-stage renal disease and acquired cystic kidney disease are at increased risk of developing RCC while undergoing dialysis treatment or after renal transplantation. Case report. We presented 3 patients undergoing hemodialysis, with acquired cystic kidney disease accompanied by the development of RCC. In all the patients tumor was asymptomatic and discovered through ultrasound screening in 2 patients and in 1 of the patients by post-surgery pathohistological analysis of the tissue of the kidney excised using nephrectomy. All the three patients had organ-limited disease at the time of the diagnosis and they did not require additional therapy after surgical treatment. During the follow- up after nephrectomy from 6 months to 7 years, local recurrence or metastasis of RCC were not diagnosed. Conclusion. Acquired cystic kidney disease represents a predisposing factor for the development of renal cell carcinoma in dialysis patients and requires regular ultrasound examinations of the abdomen aimed at early diagnosis of malignancies. Prognosis for patients with endstage renal disease and RCC is mostly good because these tumors are usually of indolent course.

Summary Immunoglobulin (Ig)G4-related sclerosing disease (IgG4-RSD) is a new disease entity first proposed with regard to autoimmune pancreatitis. A 67-year-old male patient was examined because of weight loss and an abdominal pain. Based on the clinical characteristics, laboratory parameters and ultrasound features, we identified the diagnosis of the IgG4-related systemic disease (IgG4-RSD), that was confirmed by the histopathological analysis after the biopsy of the head of pancreas. After confirmation, we started with the corticosteroid therapy with a good clinical, biochemical and morphological response. During the previous therapy, the disturbance of glucoregulation appeared, so we had to change the modality of treatment. We decided to add Azathioprine to the therapy in a dose of 150 mg/day. We achieved a stable phase of the disease with IgG 4.37 g/l and IgG4 0.179 g/l, and with no side effects from the therapy. Learning points There are potential clinical applications of identifying subsets of patients with IgG4 thyroiditis (FVHT and Riedel thyroiditis). A trial of immunosuppressive therapy should be included if a resection is deemed inadvisable. In particular, cases of FVHT that mimic malignancy, tissue and serum IgG4 may provide supportive diagnostic information.

(francuski) L?article est une description des temps du futur en valaque, dialecte daco-roumain de Serbie orientale. Les valeurs temporelles et modales des formes ?tudi?es dans ce parler de Valakonje ont ?volu? de fa?on diff?rente du roumain standard, d?o? la n?cessit? d?une description aujourd?hui.

Introduction. Hemorrhagic fever with renal syndrome (HFRS) is acute infective multisystemic disease followed by febrility, hemorrhages and acute renal insufficiency. Bleeding in the anterior pituitary lobe leading to tissue necrosis occurs in acute stage of severe clinical forms of HFRS, while atrophy of the anterior pituitary lobe with diminution of the gland function occurs after recovery stage. Case report. We presented a patient with the development of chronic renal insufficiency and hypopituitarism as complication that had been diagnosed six years after Hantavirus infection. Magnetic resonance of the pituitary gland revealed atrophy and empty sella turcica. Conclusion. Regarding frequency of this viral infection and its endemic character in some parts of our country partial and/or complete loss of pituitary function should be considered during the late stage of HFRS.

International audience; This article examines how a given semantic unit – the event in the terminology of Desclés & Guentchéva (1997, 2003, 2011) – develops in different languages or language varieties : French, Serbian, Romanian and Vlach. Event expression is predominantly achieved in these languages through verbal forms : simple past in French, aorist in Serbian or simple perfect in Romanian and Vlach. The notion of event is explored here in connection with referential frames, two of which are considered (Desclés & Guentchéva 2011). As a result of this analysis, two linguistic groups emerge : while French and Romanian share identical features, Serbian and two varieties of Daco-Romanian, the Oltenian and Vlach dialects, are shown to exhibit a similar functioning. In the light of language contact studies, these conclusions lead to a reorganisation of usually accepted classifications of the Balkan Sprachbund.; L’objectif dans cet article est de montrer comment une unité sémantique – l’événement selon la théorie de Desclés & Guentchéva (1997, 2003, 2011) – est développée à travers plusieurs langues ou variétés de langues : le français, le serbe, le roumain et le valaque. L’expression de l’événement est le plus souvent représentée par les formes verbales étiquetées passé simple en français, aoriste en serbe, parfait simple en roumain et valaque. Cette notion, l’événement, est articulée avec les cadres référentiels, deux desquels sont pris en compte (Desclés & Guentchéva 2011). Selon cette analyse, deux groupes linguistiques apparaissent. Le français et le roumain se comportent de la même manière, tandis que le serbe, et deux variétés de daco-roumain, les dialectes olténien et valaque, ont un fonctionnement similaire. Ces conclusions rapportées au contact de langues réorganisent les classifications habituelles faites dans la Sprachbund balkanique.

Background/Aim. The most frequent method for the assessment of glomerular filtration rate GFR) in clinical practice is clearance of creatinine, clearance of chromium-51 radiolabelled ethylene diamine tetraacetic acid (51Cr-EDTA) and clearance of technetium-99m radiolabelled diethylene triamine pentaacetic acid (99mTc-DTPA). The Gates method for glomerular filtration rate assessment is based on distribution of 99mTc-DTPA in the kidney 2-3 minute after its applying. Calculation of GFR is corrected for the background and depth of the kidney and finally expressed as a percentage of the net injected counts. This value of GFR highly correlates with biexponential model as the most accurate method for the assessment of GFR. The aim of this study was to determine the influence of different background sites on GFR rate assessment using the Gates method. Methods. We analysed 50 patients who were divided into two groups: the group of healthy subjects (21 subjects, mean age 47.38 yrs) and the group of subjects with unilateral kidney damage (29 subjects, mean age 39.79 yrs). Three different background activity regions were chosen: a region drawn below the lower pole of each kidney, region drawn by the lateral side of each kidney and region drawn around the whole kidney. Results. Gromerular filtration rate calculated by the use of a region under the lower pole is statistically significantly higher than GFR calculated using a region by the lateral side and around the whole kidney (p < 0.0001). Glomerular filtration rate calculated using the region by the lateral side and region around the whole kidney did not show statistically significant difference (p > 0.05). Conclusion. The selection of background activity region has a significant influence on GFR rate measured by the Gates method. It is recommended to use only one method for choosing the region of background activity.