Investigations on phosphorus retention in subsurface flow constructed wetlands.

62 SSF sand-based constructed wetlands in Germany, Austria and Switzerland have been evaluated for their phosphorus performance. In addition intensive investigations on the removal of phosphorus and its accumulation within the filter bed were conducted at five wetlands. For the performance of horizontal flow (HF) reed beds a regression equation could be derived. This was not possible for vertical flow (VF) reed beds. The best removal efficiency was observed from HF systems with hydraulic loading rates of 10 mm d(-1) or less. 50 percent of all investigated HF wetlands had an average P output concentration of less than 2.1 mg l(-1) in comparison to 3.3 mg l(-1) of VF wetlands. Saturation, seasonal and redox effects could be derived from time series analysis of the performance rate and further investigations of a well monitored VF reed bed. The retention of phosphorus was highest during the warm season. A small positive effect on phosphorus removal was observed with intermittent low redox levels. Soil analyses showed the highest accumulation of P within the influent zone of either HF or VF wetlands.

Lyme disease--unusual medical encounter for an urologist.

UNLABELLED: Lyme disease also called ,,the illness with a thousand faces" ("The Great Imitator") because it may mimic very well the symptoms and signs of other diseases, is an unusual medical encounter for the urologist. Every patient with Lyme disease has his own clinical feature, while the superposition over an unknown but easy to discover urological disease may lead to a misdiagnosis. CASE PRESENTATION: Male patient A. P. was an emergency transfer in our clinic with multiple system organ failure. The mirage of first imaging finding, bilateral obstructive ureteral calculi was obviated after the serological confirmation of Lyme disease suspected after the thorough history obtained from his family. The intensive care treatment, broad-spectrum antibiotics and hemodialysis sessions, together with external urinary drainage, lead to the improvement of the patient status, and subsequent proper urological treatment to urolithiasis cure. CONCLUSIONS: This case identifies several challenges faced by practitioners, challenges which involve the diagnosis and the treatment of Lyme disease associated with urolithiasis. Although Lyme disease remains a controversial clinical entity, its diagnosis is based on a history of possible exposure to ticks, the appearance of specific clinical symptoms, whether or not combined with serological tests.

[Caliceal stones:What did we learned after 10 years of ESWL (extracorporeal shock wave lithotripsy)]. / Litiaza caliceala. Ce am învatat în 10 ani de litotritie extracorporeala?

Since its first clinical application in 1980, the indication of ESWL has rapidly extended from renal pelvis stones to almost all urinary stones. The authors discuss about their experience accumulated in the past ten years, when 476 patients with caliceal stones were treated by ESWL. The global stone free rate was 60.05%, but almost a third of the patients (where fragmentation was radiological documented after ESWL) did not returned back for control. ESWL is a good solution for superior and middle calix stones less than 1.5 cm, not very opaque, with a sufficient large caliceal width. For the stones in the lower calix, the most important criteria for success are: the stone size, the opacity and, for sure, the angle between infundibulopelvic and ureteropelvic axis.

[Ureteral stenting after retrograde ureteroscopy. Experience of Iasi urological department]. / Protezarea ureterului dupa ureteroscopia retrograda. Experienta clinicii urologice Iasi.

Ureteroscopy is a well-established procedure, which has proven the efficiency for diagnostic purposes, but mostly for ureteric stone removal. The authors describe their strategy after ureteroscopic lithotripsy with Wolf 8 Ch semirigid ureteroscope. Insertion of a double J stent for 2-4 weeks was the rule when there was an important bleeding during the procedure, the fragments were big and could not be extracted, some fragments migrated in upper third of the ureter or renal pelvis, a perforation occurred or it was found a ureteral stenosis. If the stone can be extracted without any problems (in one piece) and the ureter is normal there is no need for ureteral stenting. Having in mind that many patients describe problems with the double J stent (pains, polakiuria, etc) we recommend to insert a stent at the end of ureteroscopy only for selected cases.