Active surveillance and focal ablation for small renal masses: a better solution for comorbid patients.

The natural history of small renal masses (SRM) is still not well understood and they are frequently incidentally diagnosed in elderly patients. Therefore, there is a need for less invasive options sparing the patient from the side-effects related to conventional surgical treatment. PubMed and Medline database search was performed to look for new findings on active surveillance and focal therapy for SRM. Sixty-one articles published between 2002 and 2018 were selected for the purpose of the review. There is growing evidence confirming the safety of active surveillance in patients at surgical risk and there appears to be a satisfactory intermediate-term outcome of focal treatment of SRM. In the group of elderly patients with a decreased life expectancy active surveillance appears to be the most appropriate approach. The future of minimally invasive therapy appears bright, especially with the improvement of new imaging modalities.

[Evaluate central corneal thickness in patients from Podbeskidzie area in adult patients]. / Analiza centralnej grubosci rogówki u doroslych pacjentów w populacji Podbeskidzia.

OBJECTIVE: The aim of this study was to evaluate central corneal thickness in patients from Podbeskidzie area and to determine percentage of patients requiring correction of the intraocular pressure measured with Goldmann applanation tonometer. METHODS: We analyzed results of measurements of the central corneal thickness in 365 patients (242 females, 123 males). The study population was divided by gender and by age into 3 groups of people under 40, between 40 and 60 and over 60 years of age. The measurements of central corneal thickness were performed with ultrasonic pachymeter. RESULTS: Mean corneal thickness in examined eyes was 563.0 +/- 38.1 microm. There was no statistically significant difference in central corneal thickness between men and women (F = 0.10; p = 0.71) but there was significant difference between group of age (F = 28.4; p = < 0.001) and was interaction between gender and group of age under 40, between 40 and 60 and over 60 years of age (F = 4.60; p < 0.05). There was statistically significant difference between women and men in the group 40-60 years of age (p < 0.01). Among women there were statistically significant differences in corneal thickness among all age groups (p < 0.01), among men between group of age over 60 and under 40 and between 40-60 years of age (p < 0.001). CONCLUSIONS: 1. Measurement of central corneal thickness is necessary in order to obtain correct values of intraocular pressure measured with Goldmann applanation tonometer in 80% of patients. 2. In people over 60 year of age, especially in women, are expectet to have thinner corneas than younger individuals and it is useful to repeat measurement of central corneal thickness.

[Pathogenesis of bone involvement in patients with rheumatoid arthritis]. / Patogeneza powstawania zmian kostnych u chorych na reumatoidalne zapalenie stawów.

Mechanisms that connect immunoinflammatory disturbances with enhanced bone resorption in patients with rheumatoid arthritis and potential methods of prevention and management of bone involvement in these patients are reviewed.