Low back pain (LBP) is a disease with a high socio-economic and medical impact. Recovery treatment is complex and includes medication (NSAIDs, analgesics, muscle relaxants), physiotherapy and kinesiology. Ultrasound is one of the electrotherapy procedures applied due to its analgesic effects, muscle relaxing properties and massage. The study assesses the evolution of temperature and the number of red blood cells after the application of ultrasound of different intensities and ways. The results are statistically significant for some parameters. Limitations of the study are determined by the relatively small number of study patients, but the results could form the basis of further research.

Emphysematous pyelonephritis (EPN) is a severe, necrotizing infection of the renal parenchyma, produced by gas-forming Gram-negative bacilli. Even though only few cases are reported in the literature, the disease is not so rare and can become life-threatening if the diagnose is not quick and the therapeutic messures efficient. The biochemical analysis are the first line diagnostic, indicating the severity of the infection. The aim of our study was to to evaluate the importance of biochemical parameters, as first line diagnosis and also of the microbiological parameters, as etiologic diagnosis, in severe renal infections produced by gas forming bacili mainly in diabetic patients, predominantly women, with obstructive nephrolithiasis.

Introduction. Vitamin D is well known for its role in calcium absorption and maintenance of healthy bones and its deficiency results in rickets. Serum 25-hydroxyVitamin D (25(OH) D) is the most abundant Vitamin D metabolite and its concentration reflects Vitamin D status in humans. The aim of this study was to analyse the level of 25(OH) D in children between 1 month and 24 months of age, admitted in Sibiu Children's Hospital, with various pathologies, and to give scientific evidence for the prevention and treatment of rickets. Materials and methods. We made a retrospective study on 200 children, aged between 1 month and 24 months, hospitalized in different Pediatric Departments of Sibiu Children's Hospital between 01.09.2015 and 01.11.2016, in whom we determined the level of serum 25(OH)D. The optimal level of 25(OH)D was considered to be ≥30 ng/ml; values of 25(OH) D between 20-29 ng/mL define insufficient Vitamin D and Vitamin D deficiency is characterized by levels < 20 ng/ml. Results. Overall, 111 children (55.5%), aged between 1 month and 24 months, had levels of 25 (OH) Vitamin D below 30 ng/ml, with a mean value of 28.68 ng/ml. Of these 111 patients, 87 (78%) had 25(OH)D values between 20-29 ng/ml, with a mean value of 22.61 ng/ml and only 24 children (22%) had values less 20 ng/ml, with a mean value of 17.2 ng/ml. Conclusions. Low serum 25(OH) D levels affect more than half of infants and children, aged 1 month to 24 months, suggesting that there are many children in our area who have suboptimal levels of Vitamin D and this should be a matter of concern for families with children, for medical professionals and public health authorities. Determination of 25(OH) Vitamin D is an important test for children between 1 month and 24 months of age, to be used as a starting point in efficiently preventing rickets at this age.

Urinary tract infections (UTIs) are the most common bacterial pathologies in children, but they are difficult to spot. The diagnosis relies on urine culture in order to measure the prevalence of the infection, to identify the etiology and the sensitivity of the germs to different antibiotics. Escherichia coli (E. coli) strains are the most common uro-pathogen germs. The change in sensitivity to antibiotic of these uro-pathogen bacteria should be closely monitored because the physicians should be informed about the evolution of the antibiotic resistance of E coli, for a more effective treatment in their fight against diseases. The study aimed to determine the prevalence of UTIs and the evolution of antimicrobial sensitivity for E. coli. This retrospective study was performed over a period of 4 years, 2013-2016, and included all the patients admitted in the Children�s Hospital, aged 0-18 years, with the suspicion of UTIs; also, the standard culture techniques for urine samples, the modified Kirby-Bauer disk diffusion method for the antibiotic sensitivity testing, and the disk diffusion method to confirm the ESBL production by the clinical isolates of E. coli in urine were used. The statistical analysis was performed using the proportions of sensitive, resistant and intermediates. Descriptive statistics like the total, mean and percentage were performed using the Statistical Package for the Social Sciences (SPSS), version 15.0 and Microsoft Excel. From 15389 urine cultures processed in 4 years, 1530 were positive (9.9 %). Among these positive urine cultures, 1056 (69 %) were positive for E. coli. Testing the E. coli to a range of antibiotics, according to CLSI standard, a high resistance to Ampicillin (69-96%), Amoxicillin/Clavulanic acid (32-70%), Trimethoprim/Sulfamethoxazole (36-42%) was observed and low levels of resistance to Ceftazidime, Cefuroxime, Cefpodoxime, Gentamycin, Nalidixic acid. Among E. Coli strains, 9-9.6 % were ESBL positive. Despite the low number of positive urine cultures in a paediatric population, it is very important to perform the urine culture in order to correctly identify the etiology of UTIs, recommend the right antibiotic, and avoid the wrong use of the antibiotics in children.

Antibiotherapy is the treatment of choice for the urinary tract infections in hospitalized urological patients. Antibiotic associated diarrhea (ADD) caused by the Clostridium difficile cytotoxin producer represents one of the most severe side effects of the antibiotic treatment. It is important to evaluate the risk factors for a hospitalized patient to develop a C. difficile healthcare associated infection during hospitalization in order to put in practice effective preventive measures. The aim of the study is to analyzed the risk factors associated with the demographic status: age, sex, and also risk factors related to healthcare conditions: use of antibiotics (number, type, duration of treatment), other significant medication taken prior to the onset of diarrhea (histamine-2-receptor antagonists and proton-pump inhibitors, comorbidities, possible contamination from other in-patients who developed ADD in the same period and data about in-hospital mortality.

Introducing polymer ligating clips (PLC) or Hem-o-lok clips was a useful alternative to titanium clips in order to perform a safe, efficient and rapid ligation of the vascular structures during laparoscopic and/or conventional surgical procedures. In urologic surgery they are useful during ablative laparoscopic surgery for renal tumor, urothelial tumors, non-functional kidney, bladder tumors and prostate tumors. Polymers� properties depend on the structure of molecules and vary from flexible substances to expandable rigid materials. They have a high resistance to shock, considerable abrasion resistance and precise durability. Polymers can easily take the desired shape, due to different processing modes. They also have the property of resistance to sustainable action of external forces. The aim of this paper is to evaluate the efficacy and safety of PLC used during renal pedicle ligation in retroperitoneal laparoscopic nephrectomy for renal tumors, high urothelial tumors and nonfunctional kidney.

Ureteral stents represent one of the most utilized medical device in urology, as a minimally invasive alternative to preserve urine outflow. The ideal ureteral stent which combines long-term efficacy with a very low rate of side effects is still missing from the urologist armamentarium. The main material for ureteral stents production is polyurethane. In order to improve the side-effects and complications of polyurethane stents, special coatings were developed. The aim of this study is to evaluate short-term side-effects and complications of different polyurethane stents with or without coating used in urologic field.

The aim of this study was to describe and analyze epidemiological and clinical features of children screened for COVID-19 at Sibiu Pediatric Clinical Hospital during the first 9 months (March–November) of coronavirus disease pandemic in Romania. A total of 203 pediatric patients with a confirmed diagnosis of COVID-19 were included in the study. The median age of the patients was 121 (IQR 18–181) months and 52.22% had mild clinical type with pneumonia, 35.47% were moderate cases, 3.94% severe cases, 0.99% critically ill cases and 7.39% were asymptomatic. The most common symptoms were fever (n = 130, 64.03%), nasal congestion (n = 138, 67.98%), cough (n = 128, 63.05%) followed by sore throat (n = 64, 31.52%), rhinorrhea (n = 63, 31.03%), fatigue (n = 57, 28.07%), headache (n = 47, 23.15%), diarrhea (n = 39, 19.21%), vomiting (n = 32, 15.76%), myalgia (n = 24, 11.82%), abdominal pain (n = 22, 10.83%). A higher proportion of infants with severe or critical disease was encountered with lymphopenia (n = 9, 90%), neutrophilia (n = 5, 50%), leukocytosis (n = 5, 50%) compared with asymptomatic infants (n = 10, 66.67%, n = 1, 6.67%, n = 3, 20%) or mild (n = 53, 50%, n = 19, 17.92%, n = 15, 14.15%) and moderate (n = 37, 51.39%, n = 9, 12.50%, n = 6, 8.33%) cases (p = 0.095, p = 0.042, p = 0.034). Pediatric patients generally had mild or moderate type of COVID-19, and the critically ill cases were rare. In our study, frequent symptoms were observed in both the systemic and respiratory systems, ear, nose and throat system, and less from gastrointestinal system, central nervous system or ocular system. Additionally, there is an increase in liver and myocardial enzyme levels with an increase in disease severity. Understanding the clinical and laboratory characteristics of pediatric patients is important for diagnosis, management and effective control of the disease.