Tobacco use among medical students in Europe: results of a multicentre study using the Global Health Professions Student Survey.

OBJECTIVE: To examine smoking prevalence, knowledge and attitudes, and tobacco cessation training among university students attending European medical schools using the Global Health Professional Students Survey approach. METHODS: A cross-country, cross-sectional study was performed among 12 medical schools in four countries in Europe (Germany, Italy, Poland and Spain). The survey was performed during the second semester of the third year of study from March to May 2009. RESULTS: In total, 2249 subjects entered the study (overall response rate 92%). The overall prevalence of smoking among medical students was 29.3% (95% confidence interval 28.1-34.7), with percentages ranging from 28% in Germany to 31.3% in Italy. This study found that more than two-thirds of medical students believe that health professionals are role models for patients, with different beliefs in Poland (89.6%) and Germany (77.7%) vs Italy and Spain (57.2% and 54.4%, respectively) (P < 0.001). Smoking cessation training at medical school was only reported by 16.5% of students (lowest proportion in Italy, 3.5%) (P < 0.001). In terms of smoking cessation methods, the vast majority (89.8%) of medical students were aware of nicotine patches and gum (highest prevalence in Spain, 96.3%), and 24.4% were aware of the use of antidepressants (highest prevalence in Germany, 33.6%). CONCLUSION: This European survey found that the prevalence of smoking was higher among medical students than the general population. There is a strong need to provide medical students with training in smoking cessation techniques.

Urine and semen cytomorphology in patients with testicular tumors.

Our original technique of preparing urinary and seminal sediment was modified in order to identify neoplastic cells in cases of testicular malignancies. In a series of 24 patients with testicular tumor-like conditions, 18 tumors were diagnosed, 12 cytologically. In one case, the result of cytological examination was falsely positive since histopathology revealed necrosis of the testicle only. The morphology of neoplastic cells in the seminal sediment is demonstrated.

Recurrences in primarily infected and uninfected urolithiasis.

An analysis was carried out of 640 patients treated because of urolithiasis at the Urological Clinic of the Medical Academy in Warsaw in the years 1971--1974. Factors conducive to stone formation were analyzed. In infected urolithiasis, different bacterial floras were found in men and women. The importance of infections acquired in hospital by patients is emphasized. In primarily uninfected urolithiasis there were 35 per cent recurrences, as against 53 per cent recurrences in infected urolithiasis.

Plasma testosterone levels before and after stimulation with HCG in anorchism.

The authors present four cases of operatively confirmed anorchism. The plasma levels of testosterone and 11-deoxy-17-ketosteroids and dehydroisoandrosterone in urine were low in all cases. After stimulation with HCG, plasma testosterone levels increased in two cases and did not change in another two. The levels of 11-deoxy-17-ketosteroids and dehydroisoandrosterone in urine did not increase.

Heterotopic adrenal tissue.

In a group of 102 adult patients operated upon for cryptorchism heterotopic adrenal tissue was found in two cases. In one case it was present in the inguinal canal and in another case it was situated at the border between the testicle and rete testis.

Collecting (Bellini) duct carcinoma of the kidney--clinical, radiologic and immunohistochemical findings.

We present clinical and radiological findings in a case of collecting (Bellini) duct carcinoma (CDC). This is a rare and aggressive kidney cancer originating from the distal renal tubule. The patient underwent radical nephrectomy and the pathological report showed trabeculopapillary, partially solid adenocarcinoma infiltrating the renal capsule and sinus. Immunohistochemical, as well as mucinocarminic and PAS staining studies are necessary for diagnosis of CDC. Surprisingly, one year follow-up studies were negative for recurrent disease. Chromosomal findings are usually different from most often diagnosed clear cell renal cell cancers. Findings from the literature are briefly discussed.

Antibacterial prophylaxis in patients after prostatectomy.

Seventy-five patients with prostatic adenoma and sterile urine cultures were treated prophylactically after operation, with one of four antibacterial drugs (Nitrofurantoin, Mandelamine, Biseptol, Chlorocid). Administration of Nitrofurantoin and Mandelamine in the postoperative period was found to be advantageous. In patients receiving these drugs, incidence of urinary tract infections was reduced by one half compared with a control group of untreated patients.

Investigation and results of treatment in male sterility.

The authors present the results of treatment in 6548 cases of male sterility. According to their findings 598 (9.1%) men were ineligible for treatment. The various kinds of therapy resulted in an improvement of semen quality in 51.8% of the cases, 57.0% of the cases being eligible for treatment. The best results were obtained in patients with oligozoospermia, asthenozoospermia and teratozoospermia. The percentage of pregnancies was much lower (8.5%) than the improvement of semen quality.

Male infertility and its treatment: a review of over 4700 patients treated for male related infertility.

Changes in semen parameters are presented for 4708 patients treated for infertility. The largest group comprised patients with oligoasthenozoospermia of various grades (57.7%). Improvement in the seminal state was noted in 70.3%. The percentage of achieved normospermia increased proportionally to the initial semen state. Pregnancy rate also increased proportionally to the initial seminal state. Among the patients' wives 20.4% conceived: 28.2% of these pregnancies had occurred after having achieved normospermia, while in 71.8% the seminal states were still below the accepted normal values.

Relationship between semen quality improvement after varicocelectomy and preoperative levels of hypophyseal and gonadal hormones.

Evaluation of serum levels of FSH, LH, prolactin, testosterone and oestradiol is not predictive of the increases of sperm count after varicocelectomy. Increased level of oestradiol reflects the lack of possibility of sperm motility increase after varicocelectomy.

Renal arterial embolization in cases of renal neoplasms. Own experiences.

Observations of 17 embolizations of the renal artery carried out in cases of renal neoplasms are reported. In the light of intraoperative observations the optimal timing of the operation after embolization was established to be 48-72 hours. Attention is called to the possibility of complications in the form of spinal cord damage after renal arterial embolization.

Ureteral duplication with a blind-ending branch.

Three cases of ureteral duplication with blind-ending branch are described. Clinical observations are supplemented with a survey of the literature pertaining to the statistics, embryology, method of diagnosis and treatment of this urological developmental anomaly.

Late results of surgical treatment of renal clear-cell carcinoma.

Late results of surgical treatment are reported in a group of 140 patients operated for clear-cell renal carcinoma in the years 1960-1974. The mean survival time was 5.61 years for males and 6.59 years for females which is, respectively, 14.19 years and 15.39 years shorter than the mean life expectancy of their peers in the general population. The survival time of males depended in 15.7% on the age at the time of operation and in 68.7% on the tumour progression grade (T). The respective data of females were 13% and 17.6%. The 5-year survival rate was 40% and the 10-year survival rate was 28.6%.

[Diagnosis and treatment of vesicouterine fistula occurring after cesarean section]. / Diagnostyka i leczenie przetok pecherzowo-macicznych powstalych po cieciach cesarskich.

Eleven cases of vesicouterine fistula were reported. The initial diagnosis was made when urinary incontinence was occurring. The diagnosis was best confirmed by cystoscopy and hysterography, which was positive in 9 cases. The ultrasonographic examinations allow to visualize the fistula in 5 out of 6 cases examined and to establish the diagnosis. If sonographic examination visualizes the fistula, the performing of hysterography is not necessary. The management consists of the cure of the infection of the urogenital tract and abdominal operation based on the excision of the fistula and closing of the bladder and uterus. All operated patients were cured.

[Congenital malformations of the epididymis and vas deferens as reasons for male infertility]. / Wady wrodzone najadrzy i nasieniowodów jako przyczyna meskiej nieplodnosci.

Between 1966-1991 330 patients where the semen analysis revealed azoospermia and the histopathological examination of biopsy specimen of testis shown retained spermatogenesis and spermiogenesis underwent the surgical intervention. In 80% of cases congenital malformations of epididymis and vas deferens were found. The types of malformations detected during the surgery are discussed.

[Congenital abnormalities of the urinary tract in Mayer-Rokitansky-Kuster-Hauser syndrome]. / Wady wrodzone ukladu moczowego w zespole Mayer-Rokitansky-Kuster-Hauser.

Congenital abnormalities of the urinary tract were diagnosed in 28 per cent of authors' own cases of Mayer-Rokitansky-Kuster-Hauser syndrome. Different kinds of abnormalities were discussed and accurate diagnosis of urinary tract abnormalities before planned operation in that group of patients was emphasized.

[Ultrasonographic investigations in diagnosis of congenital malformations of epididymis in cases of azoospermia]. / Badanie ultrasonograficzne w diagnostyce wad wrodzonych najadrzy w przypadkach azoospermii.

Between 1984-1991 in 28 patients referred for the surgical treatment for the reason of obstruction of epididymis outlet ducts there was a suspicion of a congenital epididymis malformation put after the physical examination. The ultrasound examination of the scrotum which was performed in all cases revealed the proper view of the epididymis in 5 cases, the proper head of the epididymis with the broad tubules and the lack of the corpus and cauda in 19 cases and in 4 cases the residual head of the epididymis located in region of the upper pole of the testis. Intraoperative findings were consistent with the ultrasound results in 75.0% of cases. The highest consistency between the ultrasonographic and intraoperative findings was found in the cases with the proper view of the head of the epididymis with agenesis of corpus and cauda. In 32.1% of cases malformations of epididymis and vas deferens were associated with the malformations of the urinary tract.

[The naloxone test in the degenerative changes of seminiferous tubules]. / Test naloksonowy w zmianach zwyrodnieniowych kanalików kretych.

AIM: Are there any changes in hypophyseal and gonadal hormones levels during the naloxone test in the degenerative changes of the seminiferous tubules? MATERIAL AND METHODS: The naloxone test (0.4 mg i.v.) was performed in 13 patients with degenerative changes of the seminiferous tubules. The plasma FSH, LH, prolactin, testosterone and estradiol levels were determined before and 30, 60, 90, 120 minutes after the administration of the drug. RESULTS: In the examined group of patients the plasma FSH, prolactin and estradiol levels were significantly higher, testosterone levels significantly lower and LH levels were in the same range compared with the patients with azoospermia and normal spermatogenesis. The plasma FSH, prolactin and testosterone levels did not change significantly their values during the test. The plasma estradiol levels decreased significantly and plasma LH levels increased significantly during the test. CONCLUSION: Elevated plasma FSH, prolactin and estradiol levels, diminished testosterone levels and the decrease of plasma estradiol levels and the increase plasma LH levels during the naloxone test indicate the degenerative changes of the seminiferous tubules in the cases of azoospermia.

[The naloxone test in patients with varicocele]. / Test naloksonowy u pacjentów z zylakami powrózka nasiennego.

AIM: Is there any influence of naloxone administration on plasma levels of hypophyseal and gonadal hormones in varicocele patients? MATERIAL AND METHODS: The naloxone test (0.4 mg i.v.) was performed in 15 varicocele patients The plasma FSH, LH, prolactin, testosterone and estradiol levels were determined before and 30, 60, 90, 120 minutes after the administration of the drug. RESULTS: The prolactin levels decreased significantly, and FSH, LH, testosterone and estradiol levels did not change their values. The similar results were obtained in patients with azoospermia and normal spermatogenesis. CONCLUSION: The treatment of varicocele patients with anti-opioid drugs is not recommended because the naloxone did not increase LH and testosterone plasma levels.

[Urinary diversion to the large intestine in adults]. / Odprowadzenie moczu do jelita grubego u doroslych.

The paper presents the history of technique and concepts of urinary diversion to colon and rectum from the mid-XIXth century until today, including the contribution of Polish surgeons--Krynski, Laskownicki and Kielkiewicz. Contraindications and complications of this type of definitive urinary diversion is briefly discussed. Authors also present the outcome of ureterosigmoidostomy performed according to method proposed by Goodwin in 25 patients cystectomized for infiltrating transitional cell carcinoma of the bladder, who were operated on at the Department of Urology, Medical School in Warsaw. These patients were in poor general condition and short life expectancy, which depended upon tumour stage and grade as well as preoperative urographic evaluation of urinary tract.