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Huang J, Michaud E, Shinde-Jadhav S, Fehric S, Marcq G, Mansure JJ, Cury F, Brimo F, Piccirillo CA, Kassouf W. Effects of combined radiotherapy with immune checkpoint blockade on immunological memory in luminal-like subtype murine bladder cancer model. Cancer Biol Ther 2024; 25:2365452. [PMID: 38860746 PMCID: PMC11174127 DOI: 10.1080/15384047.2024.2365452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 06/04/2024] [Indexed: 06/12/2024] Open
Abstract
MIBC is a highly lethal disease, and the patient survival rate has not improved significantly over the last decades. UPPL is a cell line that can be used to recapitulate the luminal-like molecular subtype of bladder cancer and to discover effective treatments to be translated in patients. Here, we investigate the effects of combinational treatments of radiotherapy and immunotherapy in this recently characterized UPPL tumor-bearing mice. We first characterized the baseline tumor microenvironment and the effect of radiation, anti-PD-L1, and combinatorial treatments. Then, the mice were re-challenged with a second tumor (rechallenged tumor) in the contralateral flank of the first tumor to assess the immunological memory. Radiation slowed down the tumor growth. All treatments also decreased the neutrophil population and increased the T cell population. Anti-PD-L1 therapy was not able to synergize with radiation to further delay tumor growth. Furthermore, none of the treatments were able to generate immune memory. The treatments were not sufficient to induce a significant and lasting pool of memory cells. We show here that anti-PD-L1 treatment added to radiotherapy was not enough to achieve T cell-mediated memory in UPPL tumors. Stronger T cell activation signals may be required to enhance radiation efficacy in luminal-like bladder cancer.
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Affiliation(s)
- JiaMin Huang
- Cancer Research Program, Research Institute of McGill University Health Center, Montréal, QC, Canada
| | - Eva Michaud
- Cancer Research Program, Research Institute of McGill University Health Center, Montréal, QC, Canada
| | - Surashri Shinde-Jadhav
- Cancer Research Program, Research Institute of McGill University Health Center, Montréal, QC, Canada
| | - Sabina Fehric
- Cancer Research Program, Research Institute of McGill University Health Center, Montréal, QC, Canada
| | - Gautier Marcq
- Division of Urology, Department of Surgery, McGill University Health Center, Montréal, QC, Canada
| | - Jose Joao Mansure
- Cancer Research Program, Research Institute of McGill University Health Center, Montréal, QC, Canada
| | - Fabio Cury
- Department of Radiation Oncology, McGill University Health Center, Montréal, QC, Canada
| | - Fadi Brimo
- Department of Pathology, McGill University Health Center, Montréal, QC, Canada
| | - Ciriaco A. Piccirillo
- Department of Microbiology and Immunology, McGill University, Montréal, QC, Canada
- Infectious Diseases and Immunology in Global Health Program, The Research Institute of the McGill University Health Centre (RI-MUHC), Montréal, QC, Canada
- Centre of Excellence in Translational Immunology, Montréal, QC, Canada
| | - Wassim Kassouf
- Cancer Research Program, Research Institute of McGill University Health Center, Montréal, QC, Canada
- Division of Urology, Department of Surgery, McGill University Health Center, Montréal, QC, Canada
- Centre of Excellence in Translational Immunology, Montréal, QC, Canada
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2
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Cao C, Li F, Ding Q, Jin X, Tu W, Zhu H, Sun M, Zhu J, Yang D, Fan B. Potassium sodium hydrogen citrate intervention on gut microbiota and clinical features in uric acid stone patients. Appl Microbiol Biotechnol 2024; 108:51. [PMID: 38183479 PMCID: PMC10771603 DOI: 10.1007/s00253-023-12953-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 12/06/2023] [Accepted: 12/15/2023] [Indexed: 01/08/2024]
Abstract
The high recurrence rate of renal uric acid stone (UAS) poses a significant challenge for urologists, and potassium sodium hydrogen citrate (PSHC) has been proven to be an effective oral dissolution drug. However, no studies have investigated the impact of PSHC on gut microbiota and its metabolites during stone dissolution therapy. We prospectively recruited 37 UAS patients and 40 healthy subjects, of which 12 patients completed a 3-month pharmacological intervention. Fasting vein blood was extracted and mid-stream urine was retained for biochemical testing. Fecal samples were collected for 16S ribosomal RNA (rRNA) gene sequencing and short chain fatty acids (SCFAs) content determination. UAS patients exhibited comorbidities such as obesity, hypertension, gout, and dyslipidemia. The richness and diversity of the gut microbiota were significantly decreased in UAS patients, Bacteroides and Fusobacterium were dominant genera while Subdoligranulum and Bifidobacterium were poorly enriched. After PSHC intervention, there was a significant reduction in stone size accompanied by decreased serum uric acid and increased urinary pH levels. The abundance of pathogenic bacterium Fusobacterium was significantly downregulated following the intervention, whereas there was an upregulation observed in SCFA-producing bacteria Lachnoclostridium and Parasutterella, leading to a significant elevation in butyric acid content. Functions related to fatty acid synthesis and amino acid metabolism within the microbiota showed upregulation following PSHC intervention. The correlation analysis revealed a positive association between stone pathogenic bacteria abundance and clinical factors for stone formation, while a negative correlation with SCFAs contents. Our preliminary study revealed that alterations in gut microbiota and metabolites were the crucial physiological adaptation to PSHC intervention. Targeted regulation of microbiota and SCFA holds promise for enhancing drug therapy efficacy and preventing stone recurrence. KEY POINTS: • Bacteroides and Fusobacterium were identified as dominant genera for UAS patients • After PSHC intervention, Fusobacterium decreased and butyric acid content increased • The microbiota increased capacity for fatty acid synthesis after PSHC intervention.
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Affiliation(s)
- Cheng Cao
- Department of Urology, The Changshu Hospital Affiliated to Soochow University (Changshu No. 1 People's Hospital), Changshu, China
| | - Feng Li
- Department of Urology, The Changshu Hospital Affiliated to Soochow University (Changshu No. 1 People's Hospital), Changshu, China
| | - Qi Ding
- Department of Urology, The Changshu Hospital Affiliated to Soochow University (Changshu No. 1 People's Hospital), Changshu, China
| | - Xiaohua Jin
- Department of Urology, The Changshu Hospital Affiliated to Soochow University (Changshu No. 1 People's Hospital), Changshu, China
| | - Wenjian Tu
- Department of Urology, The Changshu Hospital Affiliated to Soochow University (Changshu No. 1 People's Hospital), Changshu, China
| | - Hailiang Zhu
- Department of Urology, The Changshu Hospital Affiliated to Soochow University (Changshu No. 1 People's Hospital), Changshu, China
| | - Mubin Sun
- Department of Urology, The Changshu Hospital Affiliated to Soochow University (Changshu No. 1 People's Hospital), Changshu, China
| | - Jin Zhu
- Department of Urology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Dongrong Yang
- Department of Urology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Bo Fan
- Department of Urology, The Changshu Hospital Affiliated to Soochow University (Changshu No. 1 People's Hospital), Changshu, China.
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Sun X, Liu C, Zhang C, Zhang Z. Nomogram for predicting postoperative ileus after radical cystectomy and urinary diversion: a retrospective single-center study. Ann Med 2024; 56:2329125. [PMID: 38498939 PMCID: PMC10949833 DOI: 10.1080/07853890.2024.2329125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 02/23/2024] [Indexed: 03/20/2024] Open
Abstract
OBJECTIVE To predict the incidence of postoperative ileus in bladder cancer patients after radical cystectomy. METHODS We retrospectively analyzed the perioperative data of 452 bladder cancer patients who underwent radical cystectomy with urinary diversion at the Second Hospital of Tianjin Medical University between 2016 and 2021. Univariate and multivariate logistic regression were used to identify the risk factors for postoperative ileus. Finally, a nomogram model was established and verified based on the independent risk factors. RESULTS Our study revealed that 96 patients (21.2%) developed postoperative ileus. Using multivariate logistic regression analysis, we found that the independent risk factors for postoperative ileus after radical cystectomy included age > 65.0 years, high or low body mass index, constipation, hypoalbuminemia, and operative time. We established a nomogram prediction model based on these independent risk factors. Validation by calibration curves, concordance index, and decision curve analysis showed a strong correlation between predicted and actual probabilities of occurrence. CONCLUSION Our nomogram prediction model provides surgeons with a simple tool to predict the incidence of postoperative ileus in bladder cancer patients undergoing radical cystectomy.
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Affiliation(s)
- Xiaoyu Sun
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Chang Liu
- Department of Urology, Renmin Hospital of Wuhan Economic and Technological Development Zone (Hannan), Wuhan, China
| | - Changwen Zhang
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Zhihong Zhang
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
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Zeng M, Zhu Z, Yuan W, Tang Z, Qing Z, Lu Q, Wu X, He J, Li Y, Li Z. Verapamil inhibits inflammation and promotes autophagy to alleviate ureteral scar by regulation of CaMK IIδ/STAT3 axis. Ren Fail 2024; 46:2387432. [PMID: 39177245 PMCID: PMC11346332 DOI: 10.1080/0886022x.2024.2387432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 07/08/2024] [Accepted: 07/29/2024] [Indexed: 08/24/2024] Open
Abstract
BACKGROUND Ureteral stricture (US) is a pathological stenosis in the urinary tract characterized by increased collagen synthesis and inflammation. Autophagy activation has been shown to ameliorate tissue fibrosis and protect against fibrotic diseases. Verapamil has beneficial therapeutic benefits on fibrotic disorders. The pharmacological effects of verapamil on fibroblast autophagy in US and the underlying mechanism need to be investigated further. METHODS US patients were recruited to isolate scar tissues, hematoxylin-eosin (HE) and Masson trichrome staining were performed to analyze histopathological changes. The US animal model was established and administered with verapamil (0.05 mg/kg) in the drinking water. Transforming growth factor (TGF)-β1 was adopted to facilitate collagen synthesis in fibroblasts. The mRNA and protein expressions were examined by qRT-PCR, western blot, immunofluorescence and immunohistochemistry. ELISA was adopted to measure interleukin (IL)-1β and IL-6 levels. Molecular interaction experiments like dual luciferase reporter and chromatin immunoprecipitation (ChIP) assays were performed to analyze the interaction between signal transducers and activators of transcription 3 (STAT3) and RNA polymerase II associated factor 1 (PAF1). RESULTS Herein, our results revealed that verapamil activated TGF-β1-treated fibroblast autophagy and inhibited inflammation and fibrosis by repressing Ca2+⁄calmodulin-dependent protein kinase II (CaMK II) δ-mediated STAT3 activation. Our following tests revealed that STAT3 activated PAF1 transcription. PAF1 upregulation abrogated the regulatory effect of verapamil on fibroblast autophagy and fibrosis during US progression. Finally, verapamil mitigated US in vivo by activating fibroblast autophagy. CONCLUSION Taken together, verapamil activated TGF-β1-treated fibroblast autophagy and inhibited fibrosis by repressing the CaMK IIδ/STAT3/PAF1 axis.
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Affiliation(s)
- Mingqiang Zeng
- Department of Urology, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan Province, P.R. China
- Hunan Provincial Institute of Geriatrics, Research Center for Lower Urinary Tract and Pelvic Floor Functional Diseases, Changsha, Hunan Province, P.R. China
| | - Zhiwei Zhu
- Department of Urology, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan Province, P.R. China
| | - Wuxiong Yuan
- Department of Urology, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan Province, P.R. China
| | - Zhengyan Tang
- Provincial Laboratory for Diagnosis and Treatment of Genitourinary System Disease, Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan Province, P.R. China
| | - Zhibiao Qing
- Department of Urology, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan Province, P.R. China
| | - Qiang Lu
- Department of Urology, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan Province, P.R. China
| | - Xuecheng Wu
- Department of Urology, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan Province, P.R. China
| | - Junhuan He
- Department of Urology, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan Province, P.R. China
| | - Yuanwei Li
- Department of Urology, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan Province, P.R. China
| | - Zhuo Li
- Department of Urology, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan Province, P.R. China
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5
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Hosseini MS, Bejnordi BE, Trinh VQH, Chan L, Hasan D, Li X, Yang S, Kim T, Zhang H, Wu T, Chinniah K, Maghsoudlou S, Zhang R, Zhu J, Khaki S, Buin A, Chaji F, Salehi A, Nguyen BN, Samaras D, Plataniotis KN. Computational pathology: A survey review and the way forward. J Pathol Inform 2024; 15:100357. [PMID: 38420608 PMCID: PMC10900832 DOI: 10.1016/j.jpi.2023.100357] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 12/21/2023] [Accepted: 12/23/2023] [Indexed: 03/02/2024] Open
Abstract
Computational Pathology (CPath) is an interdisciplinary science that augments developments of computational approaches to analyze and model medical histopathology images. The main objective for CPath is to develop infrastructure and workflows of digital diagnostics as an assistive CAD system for clinical pathology, facilitating transformational changes in the diagnosis and treatment of cancer that are mainly address by CPath tools. With evergrowing developments in deep learning and computer vision algorithms, and the ease of the data flow from digital pathology, currently CPath is witnessing a paradigm shift. Despite the sheer volume of engineering and scientific works being introduced for cancer image analysis, there is still a considerable gap of adopting and integrating these algorithms in clinical practice. This raises a significant question regarding the direction and trends that are undertaken in CPath. In this article we provide a comprehensive review of more than 800 papers to address the challenges faced in problem design all-the-way to the application and implementation viewpoints. We have catalogued each paper into a model-card by examining the key works and challenges faced to layout the current landscape in CPath. We hope this helps the community to locate relevant works and facilitate understanding of the field's future directions. In a nutshell, we oversee the CPath developments in cycle of stages which are required to be cohesively linked together to address the challenges associated with such multidisciplinary science. We overview this cycle from different perspectives of data-centric, model-centric, and application-centric problems. We finally sketch remaining challenges and provide directions for future technical developments and clinical integration of CPath. For updated information on this survey review paper and accessing to the original model cards repository, please refer to GitHub. Updated version of this draft can also be found from arXiv.
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Affiliation(s)
- Mahdi S Hosseini
- Department of Computer Science and Software Engineering (CSSE), Concordia Univeristy, Montreal, QC H3H 2R9, Canada
| | | | - Vincent Quoc-Huy Trinh
- Institute for Research in Immunology and Cancer of the University of Montreal, Montreal, QC H3T 1J4, Canada
| | - Lyndon Chan
- The Edward S. Rogers Sr. Department of Electrical & Computer Engineering (ECE), University of Toronto, Toronto, ON M5S 3G4, Canada
| | - Danial Hasan
- The Edward S. Rogers Sr. Department of Electrical & Computer Engineering (ECE), University of Toronto, Toronto, ON M5S 3G4, Canada
| | - Xingwen Li
- The Edward S. Rogers Sr. Department of Electrical & Computer Engineering (ECE), University of Toronto, Toronto, ON M5S 3G4, Canada
| | - Stephen Yang
- The Edward S. Rogers Sr. Department of Electrical & Computer Engineering (ECE), University of Toronto, Toronto, ON M5S 3G4, Canada
| | - Taehyo Kim
- The Edward S. Rogers Sr. Department of Electrical & Computer Engineering (ECE), University of Toronto, Toronto, ON M5S 3G4, Canada
| | - Haochen Zhang
- The Edward S. Rogers Sr. Department of Electrical & Computer Engineering (ECE), University of Toronto, Toronto, ON M5S 3G4, Canada
| | - Theodore Wu
- The Edward S. Rogers Sr. Department of Electrical & Computer Engineering (ECE), University of Toronto, Toronto, ON M5S 3G4, Canada
| | - Kajanan Chinniah
- The Edward S. Rogers Sr. Department of Electrical & Computer Engineering (ECE), University of Toronto, Toronto, ON M5S 3G4, Canada
| | - Sina Maghsoudlou
- Department of Computer Science and Software Engineering (CSSE), Concordia Univeristy, Montreal, QC H3H 2R9, Canada
| | - Ryan Zhang
- The Edward S. Rogers Sr. Department of Electrical & Computer Engineering (ECE), University of Toronto, Toronto, ON M5S 3G4, Canada
| | - Jiadai Zhu
- The Edward S. Rogers Sr. Department of Electrical & Computer Engineering (ECE), University of Toronto, Toronto, ON M5S 3G4, Canada
| | - Samir Khaki
- The Edward S. Rogers Sr. Department of Electrical & Computer Engineering (ECE), University of Toronto, Toronto, ON M5S 3G4, Canada
| | - Andrei Buin
- Huron Digitial Pathology, St. Jacobs, ON N0B 2N0, Canada
| | - Fatemeh Chaji
- Department of Computer Science and Software Engineering (CSSE), Concordia Univeristy, Montreal, QC H3H 2R9, Canada
| | - Ala Salehi
- Department of Electrical and Computer Engineering, University of New Brunswick, Fredericton, NB E3B 5A3, Canada
| | - Bich Ngoc Nguyen
- University of Montreal Hospital Center, Montreal, QC H2X 0C2, Canada
| | - Dimitris Samaras
- Department of Computer Science, Stony Brook University, Stony Brook, NY 11794, United States
| | - Konstantinos N Plataniotis
- The Edward S. Rogers Sr. Department of Electrical & Computer Engineering (ECE), University of Toronto, Toronto, ON M5S 3G4, Canada
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6
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Gao M, Liu M, Zhang Y, Tang L, Chen H, Zhu Z. The impact of anxiety on the risk of kidney stone disease: Insights into eGFR-mediated effects. J Affect Disord 2024; 364:125-131. [PMID: 39147144 DOI: 10.1016/j.jad.2024.08.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 06/14/2024] [Accepted: 08/12/2024] [Indexed: 08/17/2024]
Abstract
BACKGROUND Previous studies have linked kidney stone disease (KSD) with depression, but there are no reports on the relationship between anxiety and KSD, and the mechanism underlying the potential relationship remains unclear. METHODS Associations of anxiety and incident KSD were assessed in the National Health and Nutrition Examination Survey (NHENES) using multivariate logistic regression. Two-sample bidirectional Mendelian randomization studies and a two-step two-sample MR was used to estimate the mediating factors that influence KSD risk. RESULTS Examinations of NHANES data revealed that a rise in the frequency and intensity of anxiety were independently associated with incident KSD. In MR analysis, anxiety (uk-a-51 and uk-b-6519) were from the UK Biobank, with sample sizes of 328,717 and 450,765 respectively. KSD data were from the FinnGen, including 8597 cases and 333,128 controls. In the IVW analysis, genetically predicted anxieties (ukb-a-51 and ukb-b-6519) were found to be causally associated with a higher risk of KSD, with odds ratios of 6.18 (95 % CI 2.54-15.04) and 3.44 (95 % CI 1.67-7.08), respectively. There were no reverse causal effects. Further mediation analysis indicated that anxiety increases the risk of KSD by raising eGFR, through which 11.8 % of the effect of anxiety on KSD risk was mediated. LIMITATIONS The research was confined to individuals of European heritage, and there could be specific genetic variances among diverse ethnicities. CONCLUSION The current study suggests anxiety as an independent causal risk factor for KSD and unveils a new pathogenic mechanism, showing that anxiety raises eGFR, thereby increasing the risk of KSD.
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Affiliation(s)
- Meng Gao
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Minghui Liu
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Youjie Zhang
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Liang Tang
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Hequn Chen
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Zewu Zhu
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
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Galey L, Olanrewaju A, Nabi H, Paquette JS, Pouliot F, Audet-Walsh É. PSA, an outdated biomarker for prostate cancer: In search of a more specific biomarker, citrate takes the spotlight. J Steroid Biochem Mol Biol 2024; 243:106588. [PMID: 39025336 DOI: 10.1016/j.jsbmb.2024.106588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 07/12/2024] [Accepted: 07/14/2024] [Indexed: 07/20/2024]
Abstract
The prevailing biomarker employed for prostate cancer (PCa) screening and diagnosis is the prostate-specific antigen (PSA). Despite excellent sensitivity, PSA lacks specificity, leading to false positives, unnecessary biopsies and overdiagnosis. Consequently, PSA is increasingly less used by clinicians, thus underscoring the imperative for the identification of new biomarkers. An emerging biomarker in this context is citrate, a molecule secreted by the normal prostate, which has been shown to be inversely correlated with PCa. Here, we discuss about PSA and its usage for PCa diagnosis, its lack of specificity, and the various conditions that can affect its levels. We then provide our vision about what we think would be a valuable addition to our PCa diagnosis toolkit, citrate. We describe the unique citrate metabolic program in the prostate and how this profile is reprogrammed during carcinogenesis. Finally, we summarize the evidence that supports the usage of citrate as a biomarker for PCa diagnosis, as it can be measured in various patient samples and be analyzed by several methods. The unique relationship between citrate and PCa, combined with the stability of citrate levels in other prostate-related conditions and the simplicity of its detection, further accentuates its potential as a biomarker.
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Affiliation(s)
- Lucas Galey
- Endocrinology - Nephrology Research Axis, Centre de recherche du CHU de Québec - Université Laval, Québec City, Canada; Department of Molecular Medicine, Faculty of Medicine, Université Laval, Québec City, Canada; Centre de recherche sur le cancer de l'Université Laval, Québec City, Canada
| | - Ayokunle Olanrewaju
- Department of Mechanical Engineering, University of Washington, Seattle, WA, USA; Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Hermann Nabi
- Centre de recherche sur le cancer de l'Université Laval, Québec City, Canada
| | - Jean-Sébastien Paquette
- Laboratoire de recherche et d'innovation en médecine de première ligne (ARIMED), Groupe de médecine de famille universitaire de Saint-Charles-Borromée, CISSS Lanaudière, Saint-Charles-Borromée, QC, Canada; VITAM Research Centre for Sustainable Health, Québec, QC, Canada; Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Québec, QC, Canada
| | - Frédéric Pouliot
- Centre de recherche sur le cancer de l'Université Laval, Québec City, Canada; Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Québec, QC, Canada; Department of surgery, Faculty of Medicine, Université Laval, Québec, QC, Canada
| | - Étienne Audet-Walsh
- Endocrinology - Nephrology Research Axis, Centre de recherche du CHU de Québec - Université Laval, Québec City, Canada; Department of Molecular Medicine, Faculty of Medicine, Université Laval, Québec City, Canada; Centre de recherche sur le cancer de l'Université Laval, Québec City, Canada.
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8
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Huong NL, Hang DT, Duong VN, Anh NTH, Hung ND, Cong BT, Thong PM, Duc NM. Magnetic resonance imaging presentation of prostatic stromal sarcoma. Radiol Case Rep 2024; 19:4457-4463. [PMID: 39185438 PMCID: PMC11342799 DOI: 10.1016/j.radcr.2024.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 07/03/2024] [Accepted: 07/04/2024] [Indexed: 08/27/2024] Open
Abstract
Prostatic stromal sarcoma (PSS) is a rare malignant tumor that often occurs in young people. Despite the fact that their clinical pathological characteristics are well known, our understanding of the imaging characteristics still seems to be limited. In our search of the literature, PSS articles are mainly present as case reports. In this case series of PSS, we aimed to thoroughly describe the magnetic resonance imaging (MRI) features, histopathological findings, and distinguishing hallmarks from prostate cancer (PCA).
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Affiliation(s)
| | - Dinh Thu Hang
- Department of Radiology, Viet Duc Hospital, Hanoi, Vietnam
| | - Vu Ngoc Duong
- Department of Radiology, Hanoi Medical University, Hanoi, Vietnam
| | | | - Nguyen Duy Hung
- Department of Radiology, Viet Duc Hospital, Hanoi, Vietnam
- Department of Radiology, Hanoi Medical University, Hanoi, Vietnam
| | - Bui Tien Cong
- Department of Nuclear Medicine, Hanoi Medical University, Hanoi, Vietnam
| | - Pham Minh Thong
- Department of Radiology, Hanoi Medical University, Hanoi, Vietnam
| | - Nguyen Minh Duc
- Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
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9
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Jin H, Ding J, Liu H, Yang L, Li D, Han X. Chronic exposure to polystyrene microplastics induced LHR reduction and decreased testosterone levels through NF-κB pathway. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 358:124543. [PMID: 39004204 DOI: 10.1016/j.envpol.2024.124543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 06/22/2024] [Accepted: 07/12/2024] [Indexed: 07/16/2024]
Abstract
The extensive utilization of plastic products in recent years has resulted in a significant contamination of microplastics (MPs). The ingestion of MPs by aquatic and terrestrial organisms facilitates their transmission to mammals through the food chain. Therefore, the toxicity of MPs has attracted widespread attention from researchers. Previous studies have shown a connection between being exposed to polystyrene MPs (PS-MPs) and issues with male reproductive function. Testosterone, a hormone essential for male reproductive function, is produced and secreted by specialized cells known as Leydig cells, which found in the testicular interstitium. In our prior research, we confirmed that exposure to PS-MPs caused a reduction in testosterone levels by interfering with the LH-mediated LHR/cAMP/PKA/StAR pathway, with LHR being pivotal in this mechanism. However, the molecular mechanism underlying PS-MPs-induced reduction of LHR remains unclear. In this study, mice were respectively given drinking water containing 1000 μg/L PS-MPs characterized by diameters of 0.5 μm, 4 μm, and 10 μm for a period of 180 days. Our findings indicated that exposure to PS-MPs resulted in the proliferation of macrophages as well as their polarization towards the M1 phenotype. Additionally, the presence of PS-MPs triggered the release of tumor necrosis factor alpha (TNF-α) from macrophages, thereby activating nuclear factor-κB (NF-κB) signaling pathway within Leydig cells. The translocation of NF-κB into nucleus facilitated its binding to the promoter region of LHR, which consequently led to the repression of LHR transcription. This transcriptional inhibition resulted in a subsequent suppression of testosterone synthesis and secretion. Overall, this study elucidates a theoretical basis for explaining the interference of PS-MPs on the testosterone synthesis and secretion in Leydig cells from the perspective of the interaction between cells in the testicular interstitium.
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Affiliation(s)
- Haibo Jin
- State Key Laboratory of Analytical Chemistry for Life Science, Division of Anatomy and Histo-embryology, Medical School, Nanjing University, Nanjing, Jiangsu, 210093, China; Jiangsu Key Laboratory of Molecular Medicine, Nanjing University, Nanjing, Jiangsu, 210093, China; School of Public Health, Yangzhou University, Yangzhou, Jiangsu, 225000, China.
| | - Jie Ding
- State Key Laboratory of Analytical Chemistry for Life Science, Division of Anatomy and Histo-embryology, Medical School, Nanjing University, Nanjing, Jiangsu, 210093, China; Jiangsu Key Laboratory of Molecular Medicine, Nanjing University, Nanjing, Jiangsu, 210093, China.
| | - Hongru Liu
- State Key Laboratory of Analytical Chemistry for Life Science, Division of Anatomy and Histo-embryology, Medical School, Nanjing University, Nanjing, Jiangsu, 210093, China; Jiangsu Key Laboratory of Molecular Medicine, Nanjing University, Nanjing, Jiangsu, 210093, China.
| | - Lei Yang
- Department of Clinical Biobank & Institute of Oncology, Affiliated Hospital of Nantong University & Department of Pathology, Medical School of Nantong University, Nantong, Jiangsu, 226001, China.
| | - Dongmei Li
- State Key Laboratory of Analytical Chemistry for Life Science, Division of Anatomy and Histo-embryology, Medical School, Nanjing University, Nanjing, Jiangsu, 210093, China; Jiangsu Key Laboratory of Molecular Medicine, Nanjing University, Nanjing, Jiangsu, 210093, China.
| | - Xiaodong Han
- State Key Laboratory of Analytical Chemistry for Life Science, Division of Anatomy and Histo-embryology, Medical School, Nanjing University, Nanjing, Jiangsu, 210093, China; Jiangsu Key Laboratory of Molecular Medicine, Nanjing University, Nanjing, Jiangsu, 210093, China.
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10
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Diaz GM, Webb LT, Rabil MJ, Lokeshwar SD, Choksi AU, Leapman MS, Sprenkle PC. Risk Factors and Contemporary Management Options for Pain and Discomfort Experienced During a Prostate Biopsy. Curr Urol Rep 2024; 25:243-252. [PMID: 38896314 DOI: 10.1007/s11934-024-01220-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2024] [Indexed: 06/21/2024]
Abstract
PURPOSE OF REVIEW Prostate fusion biopsy, an innovative imaging modality for diagnosing prostate cancer, presents certain challenges for patients including discomfort and emotional distress, leading to nonadherence to treatment and follow-ups. To inform clinicians and offer pain relief alternatives to patients, this review delves into the risk factors for increased pain and modern management options to alleviate pain during prostate biopsy. RECENT FINDINGS Individual responses to pain vary, and the overall experience of pain during a prostate biopsy has been contributed to numerous factors such as patient age, prostate volume, previous biopsy experience, and more. As a result, several strategies aim to mitigate pain during in-office procedures. Notably, techniques including pharmacological analgesics, hand holding, heating pads, entertainment/virtual reality, and distraction have shown significant efficacy. Existing studies explore risk factors influencing pain intensity during prostate biopsy and effective pain management strategies. This review consolidates available information to guide clinicians in enhancing patient comfort and thus, encourage surveillance adherence.
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Affiliation(s)
- Gabriela M Diaz
- Department of Urology, Yale School of Medicine, New Haven, CT, USA
| | - Lindsey T Webb
- Department of Urology, Yale School of Medicine, New Haven, CT, USA
| | | | - Soum D Lokeshwar
- Department of Urology, Yale School of Medicine, New Haven, CT, USA
| | - Ankur U Choksi
- Department of Urology, Yale School of Medicine, New Haven, CT, USA
| | | | - Preston C Sprenkle
- Department of Urology, Yale School of Medicine, New Haven, CT, USA.
- Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA.
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11
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Zhang H, Wu W, Wu S, Teng X. Primary mucinous tumors of the renal pelvis: Clinical, histopathological, and molecular analysis of three cases. Ann Diagn Pathol 2024; 72:152325. [PMID: 38733673 DOI: 10.1016/j.anndiagpath.2024.152325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 05/05/2024] [Accepted: 05/07/2024] [Indexed: 05/13/2024]
Abstract
Primary mucinous tumors of the renal pelvis are extremely rare and pose challenges in terms of diagnosis and treatment. This study reviewed the clinical and pathological characteristics of mucinous tumors of the renal pelvis, including mucinous cystadenocarcinomas and mucinous cystadenomas. Immunohistochemical analysis was conducted in three cases, along with KRAS gene detection using the Amplification Refractory Mutation System (ARMS) method. The results revealed mucinous epithelium with acellular mucinous pools in all cases, and acellular mucinous pools were observed in the renal parenchyma and perirenal fat capsules. All tumors expressed CK20 and CDX2, and one case showed KRAS gene mutation. The study suggests that mucinous cystadenomas of the renal pelvis may exhibit borderline biological behaviors. This study is the first to report a KRAS gene mutation in a mucinous cystadenoma of the renal pelvis, offering valuable insights into the diagnosis and treatment of this rare condition.
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Affiliation(s)
- Huifang Zhang
- Department of Pathology, The First Affiliated Hospital, College of Medicine, Zhejiang University, 310000 Hangzhou, Zhejiang Province, China
| | - Weiqiang Wu
- Department of Pathology, The First Affiliated Hospital, College of Medicine, Zhejiang University, 310000 Hangzhou, Zhejiang Province, China
| | - Shanshan Wu
- Department of Pathology, Taizhou Hospital of Zhejiang Province affliated to Wenzhou Medical University, 318000 Taizhou, Zhejiang Province, China
| | - Xiaodong Teng
- Department of Pathology, The First Affiliated Hospital, College of Medicine, Zhejiang University, 310000 Hangzhou, Zhejiang Province, China.
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12
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Nouruzi S, Johnson F, Kumar S, Sivak O, Tabrizian N, Koistinaho M, Muona A, Zoubeidi A. Targeting adenocarcinoma and enzalutamide‑resistant prostate cancer using the novel anti‑androgen inhibitor ADA‑308. Oncol Rep 2024; 52:132. [PMID: 39129317 PMCID: PMC11332584 DOI: 10.3892/or.2024.8791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 07/04/2024] [Indexed: 08/13/2024] Open
Abstract
Prostate cancer (PCa) is the leading cause of cancer‑related death among men worldwide. PCa often develops resistance to standard androgen deprivation therapy and androgen receptor (AR) pathway inhibitors, such as enzalutamide (ENZ). Therefore, there is an urgent need to develop novel therapeutic strategies for this disease. The efficacy of ADA‑308 was evaluated through in vitro assessments of AR activity and cell proliferation, alongside in vivo studies. ADA‑308 has emerged as a promising candidate, demonstrating potent inhibition of AR‑sensitive adenocarcinoma as well as ENZ‑resistant PCa cell lines. The results of the study revealed that ADA‑308 effectively blocked AR activity, including its nuclear localization, and inhibited cell proliferation in vitro. Furthermore, ADA‑308 demonstrated notable efficacy in vivo, with a robust antitumor response in ENZ‑resistant models. These findings establish the role of ADA‑308 as a potent AR inhibitor that overcomes resistance to AR‑targeted therapies and highlights its potential as a novel therapeutic approach in advanced PCa management.
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Affiliation(s)
- Shaghayegh Nouruzi
- Vancouver Prostate Centre, Vancouver, BC V6H 3Z6, Canada
- Department of Urology, Faculty of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
| | - Fraser Johnson
- Vancouver Prostate Centre, Vancouver, BC V6H 3Z6, Canada
| | - Sahil Kumar
- Vancouver Prostate Centre, Vancouver, BC V6H 3Z6, Canada
| | - Olena Sivak
- Vancouver Prostate Centre, Vancouver, BC V6H 3Z6, Canada
| | - Nakisa Tabrizian
- Vancouver Prostate Centre, Vancouver, BC V6H 3Z6, Canada
- Department of Urology, Faculty of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
| | | | - Anu Muona
- Aranda Pharma Ltd., 70210 Kuopio, Finland
| | - Amina Zoubeidi
- Vancouver Prostate Centre, Vancouver, BC V6H 3Z6, Canada
- Department of Urology, Faculty of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
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13
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Hsu JY, Lin YS, Huang LH, Tsao TY, Hsu CY, Ou YC, Tung MC. Concurrent occurrence of adenocarcinoma and urothelial carcinoma of the prostate gland: A case report. World J Clin Cases 2024; 12:5952-5959. [DOI: 10.12998/wjcc.v12.i26.5952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 06/15/2024] [Accepted: 07/15/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND Adenocarcinoma is the most common subtype of prostate cancer. Prostatic urothelial carcinoma (UC) typically originates from the prostatic urethra. The concurrent occurrence of adenocarcinoma and UC of the prostate gland is uncommon.
CASE SUMMARY We present the case of an 82-year-old male patient with simultaneous adenocarcinoma and UC of the prostate gland. The patient underwent a transrectal ultrasound-guided biopsy, and the pathology test revealed UC. Subsequently, transurethral laser prostatectomy was performed, and the pathology test indicated adenocarcinoma of the prostate with a Gleason score of 3 + 4 and high-grade UC. Therefore, the patient was treated with androgen deprivation therapy, systemic chemotherapy, and immunotherapy. Magnetic resonance imaging performed during follow-up revealed a prostate tumor classified as cT2cN1M0, stage IVA. Therefore, the patient underwent robotic-assisted radical prostatectomy and bilateral pelvic lymph node dissection. The final pathology test of the prostate gland revealed acinar-type adenocarcinoma, Gleason pattern 4 + 3, pT2N0M0, and high-grade UC. The patient regularly presented to the clinic for postoperative follow-up evaluations. He did not experience any urinary discomfort.
CONCLUSION According to our literature review, this is the first reported case of coexisting adenocarcinoma and UC of the prostate gland.
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Affiliation(s)
- Jhe Yuan Hsu
- Division of Urology, Department of Surgery, Tungs' Taichung MetroHarbor Hospital, Taichung 435403, Taiwan
| | - Yi Sheng Lin
- Division of Urology, Department of Surgery, Tungs' Taichung MetroHarbor Hospital, Taichung 435403, Taiwan
| | - Li Hua Huang
- Division of Urology, Department of Surgery, Tungs' Taichung MetroHarbor Hospital, Taichung 435403, Taiwan
| | - Tang Yi Tsao
- Department of Pathology, Tungs' Taichung MetroHarbor Hospital, Taichung 435403, Taiwan
| | - Chao Yu Hsu
- Division of Urology, Department of Surgery, Tungs' Taichung MetroHarbor Hospital, Taichung 435403, Taiwan
| | - Yen Chuan Ou
- Division of Urology, Department of Surgery, Tungs' Taichung MetroHarbor Hospital, Taichung 435403, Taiwan
| | - Min Che Tung
- Division of Urology, Department of Surgery, Tungs' Taichung MetroHarbor Hospital, Taichung 435403, Taiwan
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14
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Afferi L, Spahn M, Hayoz S, Strebel RT, Rothschild SI, Seifert H, Özdemir BC, Kiss B, Maletzki P, Engeler D, Wirth G, Hadaschik B, Lucca I, John H, Sauer A, Müntener M, Bubendorf L, Schneider M, Musilova J, Petrausch U, Cathomas R. Safety and quality of cystectomy and pelvic lymph node dissection after neoadjuvant durvalumab and cisplatin/gemcitabine. BJU Int 2024; 134:388-397. [PMID: 38456541 DOI: 10.1111/bju.16318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
OBJECTIVE To report on the surgical safety and quality of pelvic lymph node dissection (PLND) in patients treated with radical cystectomy (RC) and PLND for muscle-invasive bladder cancer (MIBC) after neoadjuvant chemo-immunotherapy. PATIENTS AND METHODS The Swiss Group for Clinical Cancer Research (SAKK) 06/17 was an open-label single-arm phase II trial including 61 cisplatin-fit patients with clinical stage (c)T2-T4a cN0-1 operable urothelial MIBC or upper urinary tract cancer. Patients received neoadjuvant cisplatin/gemcitabine and durvalumab followed by surgery. Prospective quality assessment of surgeries was performed via central review of intraoperative photographs. Postoperative complications were assessed using the Clavien-Dindo Classification. Data were analysed descriptively. RESULTS A total of 50 patients received RC and PLND. All patients received neoadjuvant chemo-immunotherapy. The median (interquartile range) number of lymph nodes removed was 29 (23-38). No intraoperative complications were registered. Grade ≥III postoperative complications were reported in 12 patients (24%). Complete nodal dissection (100%) was performed at the level of the obturator fossa (bilaterally) and of the left external iliac region; in 49 patients (98%) at the internal iliac region and at the right external iliac region; in 39 (78%) and 38 (76%) patients at the right and left presacral level, respectively. CONCLUSION This study supports the surgical safety of RC and PLND following neoadjuvant chemo-immunotherapy in patients with MIBC. The extent and completeness of protocol-defined PLND varies between patients, highlighting the need to communicate and monitor the surgical template.
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Affiliation(s)
- Luca Afferi
- Department of Urology, Luzerner Kantonsspital, Lucerne, Switzerland
| | | | | | - Räto T Strebel
- Department of Urology, Kantonsspital Graubünden, Chur, Switzerland
| | - Sacha I Rothschild
- Department of Medical Oncology, University Hospital Basel, Basel, Switzerland
| | | | | | - Bernhard Kiss
- Department of Urology, Inselspital Bern, Bern, Switzerland
| | | | - Daniel Engeler
- Department of Urology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Gregory Wirth
- Department of Urology, University Hospital HUG, Geneva, Switzerland
| | - Boris Hadaschik
- Department of Urology, University Hospital Essen, Essen, Germany
| | - Ilaria Lucca
- Department of Urology, University Hospital CHUV, Lausanne, Switzerland
| | - Hubert John
- Department of Urology, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Andreas Sauer
- Department of Urology, Kantonsspital Aarau, Aarau, Switzerland
| | | | - Lukas Bubendorf
- Department of Pathology, University Hospital Basel, Basel, Switzerland
| | | | | | | | - Richard Cathomas
- Divison of Oncology/Hematology, Kantonsspital Graubünden, Chur, Switzerland
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15
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Fall F, Hu YY, Walker S, Baertschiger R, Gaffar I, Saltzman D, Stylianos S, Shapiro J, Wieck M, Buchmiller T, Brandt ML, Tracy T, Heiss K, Berman L. Peer Support to Promote Surgeon Well-being: The APSA Program Experience. J Pediatr Surg 2024; 59:1665-1671. [PMID: 38272766 DOI: 10.1016/j.jpedsurg.2023.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/07/2023] [Accepted: 12/26/2023] [Indexed: 01/27/2024]
Abstract
BACKGROUND Peer support programs have evolved to train physicians to provide outreach and emotional first aid to their colleagues when they experience the inevitable challenge of a serious adverse event, whether or not it is related to a medical error. Most pediatric surgeons have experienced the trauma of a medical error, yet, in a survey of APSA membership, almost half said that no one reached out to them, and few were satisfied with their institution's response to the error. Thus, the APSA Wellness Committee developed an APSA-based peer support program to meet this need. METHODS Peer supporters were nominated by fellow APSA members, and the group was vetted to ensure diversity in demographics, practice setting, and seniority. Formal virtual training was conducted before the program went live in 2020. Trained supporters were surveyed 6 months after the program launched to evaluate their experiences with providing peer support. RESULTS 15 referrals were made in the first year, 60 % of which were self-initiated. Most referrals were for distress related to adverse events or toxic work environments (33 % each). While only about 25 % of trained supporters had provided formal support through the APSA program, more than 80 % reported using the skills to support colleagues and trainees within their own institutions. CONCLUSION Our experience in the first year of the APSA peer support program demonstrates the feasibility of building and maintaining a national program to provide emotional first aid by a professional society to expand the safety net for surgeons who are suffering.
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Affiliation(s)
- Fari Fall
- Department of Surgery, Nemours Children's Health, Wilmington, DE, USA; Department of General Surgery, Sidney Kimmel Medical College at Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Yue Yung Hu
- Department of Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Sarah Walker
- Department of Surgery, Texas Tech University Health Sciences Center, El Paso, TX, USA
| | - Reto Baertschiger
- Division of Pediatric Surgery, Department of Surgery, Dartmouth Health Children's Hospital, Lebanon, NH, USA
| | | | - Daniel Saltzman
- Department of Surgery, Division of Pediatric Surgery, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Steven Stylianos
- Division of Pediatric Surgery, Columbia University Vagelos College of Physicians & Surgeons and NYP-Morgan Stanley Children's Hospital, New York, NY, USA
| | - Jo Shapiro
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA, USA
| | - Minna Wieck
- Department of Pediatric Surgery, University of California Davis Children's Hospital, Sacramento, CA, USA
| | - Terry Buchmiller
- Department of Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Mary L Brandt
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA
| | - Thomas Tracy
- Executive Director, American Pediatric Surgical Association, East Dundee, IL, USA
| | - Kurt Heiss
- Department of Surgery, Division of Pediatric Surgery, Emory University School of Medicine, Atlanta, GA, USA
| | - Loren Berman
- Department of Surgery, Nemours Children's Health, Wilmington, DE, USA; Department of General Surgery, Sidney Kimmel Medical College at Thomas Jefferson University Hospital, Philadelphia, PA, USA.
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16
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Molina J, Dabaja A, Gupta N, Alruwaii FI, Hassan O, Al-Obaidy KI. Adipocytic Differentiation in a Sertoli Cell Tumor. Int J Surg Pathol 2024; 32:1149-1153. [PMID: 38018140 DOI: 10.1177/10668969231213983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
Testicular sex cord-stromal tumors are clonal neoplasms, with the majority being of Leydig cell followed by Sertoli cell origins. In Leydig cell tumors, adipocytic differentiation has been previously reported as a possible distinguishing feature, which has not been reported in other sex cord-stromal tumors. Herein, we report a case of a 48-year-old man who presented with an incidentally discovered 1.1 cm testicular mass, for which he underwent partial orchiectomy. Microscopically, the tumor showed features consistent with sex cord-stromal tumor with strong and diffuse nuclear and cytoplasmic reaction for B-catenin immunohistochemistry, supporting the diagnosis of Sertoli cell tumor. A novel adipocytic differentiation, reported previously in Leydig cell tumors, was present in this tumor.
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Affiliation(s)
- Jordan Molina
- Department of Pathology and Laboratory Medicine, Henry Ford Health, Detroit, MI, USA
| | - Ali Dabaja
- Department of Urology, Henry Ford Health, Detroit, MI, USA
| | - Nilesh Gupta
- Department of Pathology and Laboratory Medicine, Henry Ford Health, Detroit, MI, USA
- Department of Medicine, College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Fatimah I Alruwaii
- Department of Pathology and Laboratory Medicine, Henry Ford Health, Detroit, MI, USA
| | - Oudai Hassan
- Department of Pathology and Laboratory Medicine, Henry Ford Health, Detroit, MI, USA
- Department of Medicine, College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Khaleel I Al-Obaidy
- Department of Pathology and Laboratory Medicine, Henry Ford Health, Detroit, MI, USA
- Department of Medicine, College of Human Medicine, Michigan State University, East Lansing, MI, USA
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17
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Roubaud G, Attard G, Boegemann M, Olmos D, Trevisan M, Antoni L, Pascoe K, Capone C, Van Sanden S, Hashim M, Palmer S, Chi K. Adjustment for imbalances in baseline characteristics in the MAGNITUDE phase 3 study confirms the clinical benefit of niraparib in combination with abiraterone acetate plus prednisone in patients with metastatic prostate cancer. Eur J Cancer 2024; 209:114183. [PMID: 39111209 DOI: 10.1016/j.ejca.2024.114183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 05/02/2024] [Accepted: 06/15/2024] [Indexed: 08/25/2024]
Abstract
BACKGROUND MAGNITUDE (NCT03748641) demonstrated favourable outcomes with niraparib plus abiraterone acetate plus prednisone (+AAP) versus placebo+AAP in patients with BRCA1/2-altered metastatic castration-resistant prostate cancer (mCRPC). Imbalances in prognostic variables were reported between arms, which impacts estimation of both the clinical benefit and cost‑effectiveness of niraparib+AAP for healthcare systems. A pre-specified multivariable analysis (MVA) demonstrated improved overall survival (OS) with niraparib+AAP. Here, we used an inverse probability of treatment weighting (IPTW) model to adjust for covariate imbalances and assess time-to-event outcomes. METHODS IPTW analysis of time-to-event outcomes was conducted using data from patients with BRCA1/2-altered mCRPC (N = 225) in MAGNITUDE. Patients received niraparib+AAP or placebo+AAP. OS, radiographic progression-free survival, time to symptomatic progression, time to initiation of cytotoxic chemotherapy and time to prostate-specific antigen progression were assessed. Weighted Kaplan-Meier curves were generated for each endpoint, and adjusted hazard ratios (HR) were obtained from a weighted Cox model. RESULTS Improvements in survival outcomes were estimated for niraparib+AAP versus placebo+AAP: unadjusted median OS was 30.4 months versus 28.6 months, respectively (HR: 0.79; 95 % confidence interval [CI]: 0.55, 1.12; p = 0.183). Following IPTW, median OS increased to 34.1 months with niraparib+AAP versus a decrease to 27.4 with placebo (HR: 0.65; 95 % CI: 0.46, 0.93; p = 0.017). Similar improvements were observed for other time-to-event endpoints. CONCLUSIONS IPTW adjustment provided a more precise estimate of the clinical benefit of niraparib+AAP versus placebo+AAP in patients with BRCA1/2-altered mCRPC. Results were consistent with the pre-specified MVA, and further demonstrated the value of adjusting for baseline imbalances, particularly in smaller studies. TRIAL REGISTRATION NCT03748641 (MAGNITUDE).
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Affiliation(s)
- Guilhem Roubaud
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France.
| | | | - Martin Boegemann
- Department of Urology, Muenster University Hospital, Muenster, Germany; Westgerman Cancer Center, Münster, Germany
| | - David Olmos
- Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre, Madrid, Spain
| | | | | | - Katie Pascoe
- Janssen Vaccines & Prevention B.V., Leiden, the Netherlands
| | | | | | - Mahmoud Hashim
- Janssen Vaccines & Prevention B.V., Leiden, the Netherlands
| | - Stephen Palmer
- Centre for Health Economics, University of York, York, UK
| | - Kim Chi
- BC Cancer and Vancouver Prostate Centre, University of British Columbia, Vancouver, BC, Canada
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18
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Kearney L, Bolton RE, Núñez ER, Boudreau JH, Sliwinski S, Herbst AN, Caverly TJ, Wiener RS. Tackling Guideline Non-concordance: Primary Care Barriers to Incorporating Life Expectancy into Lung Cancer Screening Decision-Making-A Qualitative Study. J Gen Intern Med 2024; 39:2284-2291. [PMID: 38459413 PMCID: PMC11347517 DOI: 10.1007/s11606-024-08705-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 02/27/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND Primary care providers (PCPs) are often the first point of contact for discussing lung cancer screening (LCS) with patients. While guidelines recommend against screening people with limited life expectancy (LLE) who are less likely to benefit, these patients are regularly referred for LCS. OBJECTIVE We sought to understand barriers PCPs face to incorporating life expectancy into LCS decision-making for patients who otherwise meet eligibility criteria, and how a hypothetical point-of-care tool could support patient selection. DESIGN Qualitative study based on semi-structured telephone interviews. PARTICIPANTS Thirty-one PCPs who refer patients for LCS, from six Veterans Health Administration facilities. APPROACH We thematically analyzed interviews to understand how PCPs incorporated life expectancy into LCS decision-making and PCPs' receptivity to a point-of-care tool to support patient selection. Final themes were organized according to the Cabana et al. framework Why Don't Physicians Follow Clinical Practice Guidelines, capturing the influence of clinician knowledge, attitudes, and behavior on LCS appropriateness determinations. KEY RESULTS PCP referrals to LCS for patients with LLE were influenced by limited knowledge of the life expectancy threshold at which patients are less likely to benefit from LCS, discomfort estimating life expectancy, fear of missing cancer at the point of early detection, and prioritization of factors such as quality of life, patient values, clinician-patient relationship, and family support. PCPs were receptive to a decision support tool to inform and communicate LCS appropriateness decisions if easy to use and integrated into clinical workflows. CONCLUSIONS Our study suggests knowledge gaps and attitudes may drive decisions to offer screening despite LLE, a behavior counter to guideline recommendations. Integrating a LCS decision support tool that incorporates life expectancy within the electronic medical record and existing clinical workflows may be one acceptable solution to improve guideline concordance and increase confidence in selecting high benefit patients for LCS.
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Affiliation(s)
- Lauren Kearney
- Center for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, MA and VA Bedford Healthcare System, Bedford, MA, USA.
- The Pulmonary Center, Boston University School of Medicine, Boston, MA, USA.
| | - Rendelle E Bolton
- Center for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, MA and VA Bedford Healthcare System, Bedford, MA, USA
- The Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA
| | - Eduardo R Núñez
- Center for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, MA and VA Bedford Healthcare System, Bedford, MA, USA
- The Pulmonary Center, Boston University School of Medicine, Boston, MA, USA
- Department of Healthcare Delivery and Population Sciences, University of Massachusetts Chan Medical School-Baystate, Springfield, MA, USA
| | - Jacqueline H Boudreau
- Center for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, MA and VA Bedford Healthcare System, Bedford, MA, USA
| | - Samantha Sliwinski
- Center for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, MA and VA Bedford Healthcare System, Bedford, MA, USA
| | - Abigail N Herbst
- Center for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, MA and VA Bedford Healthcare System, Bedford, MA, USA
| | - Tanner J Caverly
- VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
- National Center for Lung Cancer Screening, Veterans Health Administration, Washington, DC, USA
- University of Michigan School of Medicine, Ann Arbor, MI, USA
| | - Renda Soylemez Wiener
- Center for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, MA and VA Bedford Healthcare System, Bedford, MA, USA
- The Pulmonary Center, Boston University School of Medicine, Boston, MA, USA
- National Center for Lung Cancer Screening, Veterans Health Administration, Washington, DC, USA
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19
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Florea A, Zaric GS, Kang Z, Cool DW. Cost-Effectiveness Analysis Comparing Biopsy in Advance of Ablation with Concurrent Biopsy and Ablation for Small Renal Masses Measuring 1-3 cm. J Vasc Interv Radiol 2024; 35:1388-1396.e5. [PMID: 38759884 DOI: 10.1016/j.jvir.2024.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 05/01/2024] [Accepted: 05/08/2024] [Indexed: 05/19/2024] Open
Abstract
PURPOSE To analyze the cost effectiveness of performing a renal mass biopsy in advance of ablation or concurrently with a percutaneous ablation procedure for the management of small renal masses (SRMs). MATERIALS AND METHODS A decision-analytic model was developed with a cohort of 65-year-old male patients with an incidental, unilateral 1-3 cm SRM. A decision tree modeled the first year of clinical intervention, after which patients entered a Markov model with a lifetime horizon. Patients were assumed to be treated in accordance with established clinical practice guidelines, including surveillance, repeat ablation for recurrence, and systemic therapy for metastasis. Healthcare cost and utility values were determined from published literature or local hospital estimates, discounted at 1.5%. Total lifetime costs were calculated from the perspective of a Canadian healthcare payer and converted to 2022 Canadian dollars (C$). The primary outcome was incremental cost-effectiveness ratio (ICER) at a willingness-to-pay threshold of C$50,000 per quality-adjusted life year (QALY) gained. The secondary outcome was ICER at a willingness-to-pay threshold of C$50,000 per life year (LY) gained. RESULTS Concurrent biopsy and ablation resulted in a gain of 16.4 quality-adjusted days, at an incremental cost of $386, with an ICER of C$8,494/QALY. The concurrent strategy was the dominant strategy for a prevalence of benign mass of <5%. Sequential biopsy and ablation was only cost-effective when LYs were not quality-adjusted and ablation cost was >C$4,300 or benign mass prevalence was >28%. CONCLUSIONS Concurrent biopsy and ablation is cost-effective relative to pretreatment diagnostic biopsy for management of incidental SRMs.
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Affiliation(s)
- Alexandru Florea
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
| | - Gregory S Zaric
- Ivey Business School, Western University, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
| | - Ziru Kang
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Derek W Cool
- Department of Medical Imaging, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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20
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Prakash P, Verma S, Gupta S. Influence of microbiome in intraprostatic inflammation and prostate cancer. Prostate 2024; 84:1179-1188. [PMID: 38899408 DOI: 10.1002/pros.24756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 05/22/2024] [Accepted: 06/10/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Chronic infection and inflammation have been linked to the development of prostate cancer. Dysbiosis of the oral and gut microbiomes and subsequent microbial translocation can lead to pathogenic prostate infections. Microbial-produced metabolites have also been associated with signaling pathways that promote prostate cancer development. A comprehensive discussion on the mechanisms of microbiome infection and the prostate microenvironment is essential to understand prostate carcinogenesis. METHODS Published studies were used from the National Center for Biotechnology Information (NCBI) database to conduct a narrative review. No restrictions were applied in the selection of articles. RESULTS Microbiome-derived short-chain fatty acids (SCFAs) have been found to upregulate multiple signaling pathways, including MAPK and PI3K, through IGF-1 signaling and M2 macrophage polarization. SCFAs can also upregulate Toll-like receptors, leading to chronic inflammation and the creation of a pro-prostate cancer environment. Dysbiosis of oral microbiota has been correlated with prostate infection and inflammation. Additionally, pathogenic microbiomes associated with urinary tract infections have shown a link to prostate cancer, with vesicoureteral reflux potentially contributing to prostate infection. CONCLUSIONS This review offers a comprehensive understanding of the impact of microbial infections linked to intraprostatic inflammation as a causative factor for prostate cancer. Further studies involving the manipulation of the microbiome and its produced metabolites may provide a more complete understanding of the microenvironmental mechanisms that promote prostate carcinogenesis.
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Affiliation(s)
- Pranav Prakash
- College of Arts and Sciences, Case Western Reserve University, Cleveland, Ohio, USA
- Department of Urology, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Shiv Verma
- Department of Urology, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
- The Urology Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Sanjay Gupta
- Department of Urology, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
- The Urology Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
- Department of Pathology, Case Western Reserve University, Cleveland, Ohio, USA
- Department of Pharmacology, Case Western Reserve University, Cleveland, Ohio, USA
- Department of Nutrition, Case Western Reserve University, Cleveland, Ohio, USA
- Division of General Medical Sciences, Case Comprehensive Cancer Center, Cleveland, Ohio, USA
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21
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Chastek B, Carrera A, Landis C, Snyder D, Abedinzadeh L, Bancroft T, Nesheim J, Kennelly M, Staskin D. Comparative analysis of real-world adherence and persistence patterns with vibegron, mirabegron, and anticholinergics in patients with overactive bladder: A retrospective claims study. Neurourol Urodyn 2024; 43:1504-1513. [PMID: 38720543 DOI: 10.1002/nau.25478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 03/27/2024] [Accepted: 04/11/2024] [Indexed: 08/22/2024]
Abstract
INTRODUCTION Vibegron is a selective β3-adrenergic receptor agonist that was approved by the US Food and Drug Administration in December 2020 for the treatment of overactive bladder in adults. This retrospective study assessed US pharmacy claims data to evaluate the real-world adherence and persistence of vibegron compared with mirabegron and with anticholinergics. MATERIALS AND METHODS This analysis used the Optum Research Database to identify adults with ≥1 pharmacy claim for vibegron, mirabegron, or an anticholinergic from April 1, 2021, to August 31, 2022. Patients had ≥ 90 days of continuous commercial or Medicare medical and pharmacy coverage preindex and ≥ 60 days of continuous pharmacy coverage postindex. Two independent propensity-score models matched patients treated with (1) vibegron versus mirabegron and (2) vibegron versus anticholinergics on key variables such as demographics and clinical characteristics, index copay, days' supply, and time of entry into analysis (index quarter). Adherence was measured by proportion of days covered (PDC) from index to the end of follow-up and was defined as PDC ≥ 80%. Persistence was defined as days to discontinuation of index medication (first 30-day gap) or end of follow-up. RESULTS The matched vibegron and mirabegron cohorts included 4921 and 9842 patients, respectively, and the matched vibegron and anticholinergic cohorts included 4676 and 9352 patients, respectively. Patients receiving vibegron had greater mean PDC versus patients receiving mirabegron (0.67 vs. 0.64, respectively; p < 0.001) or anticholinergics (0.67 vs. 0.58; p < 0.001). A greater percentage of patients receiving vibegron were adherent versus those receiving mirabegron (49.0% vs. 45.1%, respectively; p < 0.001) or anticholinergics (49.1% vs. 38.5%; p < 0.001). Persistence was longer with vibegron compared with both mirabegron (median [95% CI], 171 [159-182] vs. 128 [122-137] days, respectively; p < 0.001) and anticholinergics (172 [159-183] vs. 91 [91] days; p < 0.001). CONCLUSION In this retrospective analysis of pharmacy claims data, patients receiving vibegron exhibited significantly higher adherence and demonstrated longer persistence in comparison to matched patient cohorts receiving either mirabegron or anticholinergics.
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Affiliation(s)
| | - Adam Carrera
- Sumitomo Pharma America, Inc. (formerly Urovant Sciences, Inc.), Marlborough, Massachusetts, USA
| | | | - Daniel Snyder
- Sumitomo Pharma America, Inc. (formerly Urovant Sciences, Inc.), Marlborough, Massachusetts, USA
| | - Laleh Abedinzadeh
- Sumitomo Pharma America, Inc. (formerly Urovant Sciences, Inc.), Marlborough, Massachusetts, USA
| | | | - Jeffrey Nesheim
- Sumitomo Pharma America, Inc. (formerly Urovant Sciences, Inc.), Marlborough, Massachusetts, USA
| | | | - David Staskin
- Tufts University School of Medicine, Boston, Massachusetts, USA
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22
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Angeli AP, Wirjopranoto S, Azmi YA, Putra AGP, Soetanto KM. Management of high-grade kidney trauma on bilateral polycystic kidney disease: A case report. Int J Surg Case Rep 2024; 122:110158. [PMID: 39142193 DOI: 10.1016/j.ijscr.2024.110158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Revised: 08/08/2024] [Accepted: 08/10/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND The kidneys are the genitourinary organs most susceptible to trauma. One case is high-grade kidney trauma that can lead to kidney failure, such as Polycystic Kidney Disease (PKD). Here, we report a case of high-grade kidney trauma on PKD. CASE REPORT A 28-year-old man was involved in a traffic accident and was diagnosed with a left kidney rupture. There was minimal free fluid in the abdominal cavum and left pleural effusion. The results of USG in the left kidney showed a rupture in the posterior part of the cortex-medulla reaching the calyx, accompanied by a left posterior peri-renal hematoma and a PKD in the right kidney. In the CT scan examination, the hematoma extended to the lower left retroperitoneum and peripancreatic. The size of the left kidney was enlarged. In the right kidney, PKD was accompanied by an enlargement of the kidney size, but no rupture was obtained. Patient had been diagnosed with high-grade kidney trauma (AAST Grade IV). The patient was given conservative therapy. He was alive and discharged from the hospital. CLINICAL DISCUSSION Non-operative management (NOM) is the standard in kidney trauma management, with good outcomes in preventing morbidity and mortality. The trend toward this procedure results in a decrease in the number of unnecessary nephrectomies and a potential improvement in the quality of patient inhalation. Ultrasound and CT scan examinations are important markers. CONCLUSION The management of high-grade kidney trauma on PKD can be carried out conservatively and show good patient outcomes.
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Affiliation(s)
| | - Soetojo Wirjopranoto
- Department of Urology, Faculty of Medicine Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
| | - Yufi Aulia Azmi
- Department of Urology, Faculty of Medicine Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia; Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
| | - Antonius Galih Pranesdha Putra
- Department of Urology, Faculty of Medicine Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Kevin Muliawan Soetanto
- Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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23
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Sevinç D, Tiryaki S, Yardım S, Erikçi VS. Paratesticular Mass in Childhood a 13-Year-Old Boy: A Case Report and Literature Review. Clin Pediatr (Phila) 2024; 63:1156-1159. [PMID: 37905514 DOI: 10.1177/00099228231208291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Affiliation(s)
- Dilnur Sevinç
- Tepecik Training and Research Hospital Clinics, Konak, Turkey
| | | | - Serdarl Yardım
- Tepecik Training and Research Hospital Clinics, Konak, Turkey
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24
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Scheggi S, Concas L, Corsi S, Carta M, Melis M, Frau R. Expanding the therapeutic potential of neuro(active)steroids: a promising strategy for hyperdopaminergic behavioral phenotypes. Neurosci Biobehav Rev 2024; 164:105842. [PMID: 39103066 DOI: 10.1016/j.neubiorev.2024.105842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 07/10/2024] [Accepted: 08/01/2024] [Indexed: 08/07/2024]
Abstract
Imbalances in dopamine activity significantly contribute to the pathophysiology of several neuropsychiatric disorders, including addiction, ADHD, schizophrenia, impulse control disorders, and Parkinson's Disease. Neuro(active)steroids, comprising endogenous steroids that finely modulate neuronal activity, are considered crucial regulators of brain function and behavior, with implications in various physiological processes and pathological conditions. Specifically, subclasses of Neuro(active)steroids belonging to the 5α reductase pathway are prominently involved in brain disorders characterized by dopaminergic signaling imbalances. This review highlights the neuromodulatory effects of Neuro(active)steroids on the dopamine system and related aberrant behavioral phenotypes. We critically appraise the role of pregnenolone, progesterone, and allopregnanolone on dopamine signaling. Additionally, we discuss the impact of pharmacological interventions targeting 5α reductase activity in neuropsychiatric conditions characterized by excessive activation of the dopaminergic system, ranging from psychotic (endo)phenotypes and motor complications to decision-making problems and addiction.
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Affiliation(s)
- Simona Scheggi
- Dept. of Molecular and Developmental Medicine, University of Siena, Italy
| | - Luca Concas
- Dept. Of Biomedical Sciences, University of Cagliari, Italy
| | - Sara Corsi
- Dept. of Developmental and Regenerative Neurobiology, Lund University, Sweden
| | - Manolo Carta
- Dept. Of Biomedical Sciences, University of Cagliari, Italy
| | - Miriam Melis
- Dept. Of Biomedical Sciences, University of Cagliari, Italy
| | - Roberto Frau
- Dept. Of Biomedical Sciences, University of Cagliari, Italy; Guy Everett Laboratory, University of Cagliari, Cagliari, Italy.
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25
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Baumer-Mouradian SH, Bradley LC, Ansari ST, Chinta SS, Mitchell ML, Nelson AM, Marusinec LE, Wake KM, Mantey KA, Cabrera IC, De Valk JA, Hanson AP, Witkowski EM, Bushee GM, Ellison JS. Applying Quality Improvement Methodology to Standardize Pediatric Urinary Tract Infection Diagnosis and Management throughout a Healthcare System. Pediatr Qual Saf 2024; 9:e756. [PMID: 39169948 PMCID: PMC11338250 DOI: 10.1097/pq9.0000000000000756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 08/06/2024] [Indexed: 08/23/2024] Open
Abstract
Background Pediatric urinary tract infections (UTIs) require early diagnosis and appropriate treatment to avoid short- and long-term morbidity. Baseline data from 13,000 children across a regional health system demonstrated wide variation in UTI management, including antibiotic choice, duration, and dosing. In 2019, the local antibiotic stewardship team recommended cephalexin as the ideal first-line UTI treatment due to its effectiveness, narrow spectrum, low cost, and palatability. This project aimed to improve first-line prescription of cephalexin as an empiric antibiotic treatment for uncomplicated UTIs from 34% to 75% in children 60 days to 18 years of age presenting to any site within the healthcare system within 6 months. Methods A multidisciplinary team of key stakeholders reviewed baseline data and developed three key drivers. These included a standardized UTI pathway, electronic health record enhancements, and provider education. Interventions were supported by a literature review and implemented via Plan-Do-Study-Act cycles with data monitored bimonthly. The primary outcome was the percentage of patients prescribed cephalexin for presumed UTI over the total number of presumed UTI diagnoses treated with empiric antibiotics throughout the healthcare system. The balancing measure included 14-day return visits for a UTI-related diagnosis across the system. Results After the release of the updated UTI pathway, first-line cephalexin prescribing for UTI improved from 34% to 66%. There was no change in 14-day revisits for UTI. Conclusions Standardizing the diagnosis and management of UTIs across the spectrum of coordinated care led to improved system-wide adherence to local antibiotic stewardship guidelines for empiric UTI treatment.
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Affiliation(s)
- Shannon H. Baumer-Mouradian
- From the Department of Pediatrics, Medical College of Wisconsin, Children’s Corporate Center, Milwaukee, Wis
| | - Lia C. Bradley
- Quality Department, Children’s Wisconsin, Wauwatosa, Wis
| | | | - Sri S. Chinta
- From the Department of Pediatrics, Medical College of Wisconsin, Children’s Corporate Center, Milwaukee, Wis
| | - Michelle L. Mitchell
- From the Department of Pediatrics, Medical College of Wisconsin, Children’s Corporate Center, Milwaukee, Wis
| | - Anika M. Nelson
- From the Department of Pediatrics, Medical College of Wisconsin, Children’s Corporate Center, Milwaukee, Wis
| | | | | | | | | | | | - Aaron P. Hanson
- From the Department of Pediatrics, Medical College of Wisconsin, Children’s Corporate Center, Milwaukee, Wis
| | | | - Glenn M. Bushee
- Department of Enterprise Safety, Children’s Wisconsin, Wauwatosa, Wis
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26
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Kucherov V, Russell T, Smith J, Zimmermann S, Johnston EK, Rana MS, Hill E, Ho CP, Pohl HG, Varda BK. Antibiotic Overtreatment of Presumed Urinary Tract Infection Among Children with Spina Bifida. J Pediatr 2024; 272:114092. [PMID: 38734134 DOI: 10.1016/j.jpeds.2024.114092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 04/26/2024] [Accepted: 05/05/2024] [Indexed: 05/13/2024]
Abstract
OBJECTIVE To identify factors associated with overtreatment of presumed urinary tract infection (UTI) among children with spina bifida using such criteria. STUDY DESIGN A retrospective review of children with spina bifida (age <21 years) evaluated in the Emergency Department (ED) at a single institution was performed. Patients with a urinalysis (UA) performed who were reliant on assisted bladder emptying were included. The primary outcome was overtreatment, defined as receiving antibiotics for presumed UTI but ultimately not meeting spina bifida UTI criteria (≥2 urologic symptoms plus pyuria and urine culture growing >100k CFU/mL). The primary exposure was whether the components of the criteria available at the time of the ED visit (≥2 urologic symptoms plus pyuria) were met when antibiotics were initiated. RESULTS Among 236 ED encounters, overtreatment occurred in 80% of cases in which antibiotics were initiated (47% of the entire cohort). Pyuria with <2 urologic symptoms was the most important factor associated with overtreatment (OR 9.6). Non-Hispanic White race was associated with decreased odds of overtreatment (OR 0.3). CONCLUSIONS Overtreatment of presumed UTI among patients with spina bifida was common. Pyuria, which is not specific to UTI in this population, was the main driver of overtreatment. Symptoms are a cornerstone of UTI diagnosis among children with spina bifida, should be collected in a standardized manner, and considered in a decision to treat.
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Affiliation(s)
- Victor Kucherov
- Children's National Hospital, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Teresa Russell
- Children's National Hospital, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Jacob Smith
- Children's National Hospital, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Sally Zimmermann
- The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Elena K Johnston
- The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Md Sohel Rana
- Children's National Hospital, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Elaise Hill
- Children's National Hospital, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Christina P Ho
- Children's National Hospital, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Hans G Pohl
- Children's National Hospital, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Briony K Varda
- Children's National Hospital, The George Washington University School of Medicine and Health Sciences, Washington, DC.
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27
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Acharya GB, Baral S, Bijukchhe SM, Mishra S, Bhusal K, Poudel S. Giant urinary bladder stone: A rare case report. Int J Surg Case Rep 2024; 122:110174. [PMID: 39146668 DOI: 10.1016/j.ijscr.2024.110174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Revised: 08/10/2024] [Accepted: 08/13/2024] [Indexed: 08/17/2024] Open
Abstract
INTRODUCTION Giant urinary bladder stones are rare phenomenon which is associated with chronic urinary infections, intravesical foreign bodies, urethral strictures, bladder diverticula etc. CASE REPORT: A 52-year-old man presented with complaints of severe dysuria, urgency, frequency, suprapubic pain, and pollakuria for the last ten years. Physical examination revealed a palpable suprapubic mass with no obvious flank masses. Ultrasonography of the abdomen and pelvis revealed right-sided gross hydroureteronephrosis and thinning of renal parenchyma along with a hyperechoic structure with posterior acoustic shadowing was noted in the region of the urinary bladder, suggesting a vesical calculus. Plain CT of the kidneys, ureters, and bladder (KUB) confirmed right nephrolithiasis in lower poly calyx and a large vesical calculus (10.6 cm × 8.6 cm x8.8 cm, +1110 HU). Open cystolithotomy with a right-sided double-J "DJ" stent insertion was performed. Post-operative period went uneventful. DISCUSSION Giant bladder stones are extremely rare, often resulting from neglected symptoms in otherwise normal individuals. They typically develop over several years and present with symptoms like severe dysuria, urgency, frequency, supra-pubic pain, and hematuria. Diagnosis is made by cystoscopy, ultrasonography and CT-KUB. Treatment includes intracorporeal cystolithotripsy using a laser, ultrasonic lithotripter, or pneumatic lithotripter, depending on availability. Endourologic procedures have been safer and more cost-effective for bladder stones, however, open removal is the treatment of choice for giant bladder stones. CONCLUSION Open cystolithotomy can be performed to remove giant bladder stone with near 100 % stone removal rate.
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Affiliation(s)
| | - Suman Baral
- Department of Surgery, Mediplus Hospital and Trauma Center, Pokhara, Nepal.
| | | | - Sushil Mishra
- Department of Surgery, Manipal College of Medical Sciences, Pokhara, Nepal
| | - Krishna Bhusal
- Department of Emergency Medicine, Lumbini Medical College, Palpa, Nepal
| | - Shasi Poudel
- Department of Emergency Medicine, Fewacity Hospital, Pokhara, Nepal
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Marka AW, Luitjens J, Gassert FT, Steinhelfer L, Burian E, Rübenthaler J, Schwarze V, Froelich MF, Makowski MR, Gassert FG. Artificial intelligence support in MR imaging of incidental renal masses: an early health technology assessment. Eur Radiol 2024; 34:5856-5865. [PMID: 38388721 DOI: 10.1007/s00330-024-10643-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 01/16/2024] [Accepted: 01/19/2024] [Indexed: 02/24/2024]
Abstract
OBJECTIVE This study analyzes the potential cost-effectiveness of integrating an artificial intelligence (AI)-assisted system into the differentiation of incidental renal lesions as benign or malignant on MR images during follow-up. MATERIALS AND METHODS For estimation of quality-adjusted life years (QALYs) and lifetime costs, a decision model was created, including the MRI strategy and MRI + AI strategy. Model input parameters were derived from recent literature. Willingness to pay (WTP) was set to $100,000/QALY. Costs of $0 for the AI were assumed in the base-case scenario. Model uncertainty and costs of the AI system were assessed using deterministic and probabilistic sensitivity analysis. RESULTS Average total costs were at $8054 for the MRI strategy and $7939 for additional use of an AI-based algorithm. The model yielded a cumulative effectiveness of 8.76 QALYs for the MRI strategy and of 8.77 for the MRI + AI strategy. The economically dominant strategy was MRI + AI. Deterministic and probabilistic sensitivity analysis showed high robustness of the model with the incremental cost-effectiveness ratio (ICER), which represents the incremental cost associated with one additional QALY gained, remaining below the WTP for variation of the input parameters. If increasing costs for the algorithm, the ICER of $0/QALY was exceeded at $115, and the defined WTP was exceeded at $667 for the use of the AI. CONCLUSIONS This analysis, rooted in assumptions, suggests that the additional use of an AI-based algorithm may be a potentially cost-effective alternative in the differentiation of incidental renal lesions using MRI and needs to be confirmed in the future. CLINICAL RELEVANCE STATEMENT These results hint at AI's the potential impact on diagnosing renal masses. While the current study urges careful interpretation, ongoing research is essential to confirm and seamlessly integrate AI into clinical practice, ensuring its efficacy in routine diagnostics. KEY POINTS • This is a model-based study using data from literature where AI has been applied in the diagnostic workup of incidental renal lesions. • MRI + AI has the potential to be a cost-effective alternative in the differentiation of incidental renal lesions. • The additional use of AI can reduce costs in the diagnostic workup of incidental renal lesions.
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Affiliation(s)
- Alexander W Marka
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Institut für diagnostische und interventionelle Radiologie, Ismaninger Str. 22, 81675, Munich, Germany.
| | - Johanna Luitjens
- Department of Radiology, Klinikum Großhadern, Ludwig-Maximilians-Universität, Marchioninistraße 15, 81377, Munich, Germany
| | - Florian T Gassert
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Institut für diagnostische und interventionelle Radiologie, Ismaninger Str. 22, 81675, Munich, Germany
| | - Lisa Steinhelfer
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Institut für diagnostische und interventionelle Radiologie, Ismaninger Str. 22, 81675, Munich, Germany
| | - Egon Burian
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Institut für diagnostische und interventionelle Radiologie, Ismaninger Str. 22, 81675, Munich, Germany
| | - Johannes Rübenthaler
- Department of Radiology, Klinikum Großhadern, Ludwig-Maximilians-Universität, Marchioninistraße 15, 81377, Munich, Germany
| | - Vincent Schwarze
- Department of Radiology, Klinikum Großhadern, Ludwig-Maximilians-Universität, Marchioninistraße 15, 81377, Munich, Germany
| | - Matthias F Froelich
- Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Marcus R Makowski
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Institut für diagnostische und interventionelle Radiologie, Ismaninger Str. 22, 81675, Munich, Germany
| | - Felix G Gassert
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Institut für diagnostische und interventionelle Radiologie, Ismaninger Str. 22, 81675, Munich, Germany
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Nada A, Jhamb A, Maingard J. Case report of right supernumerary kidneyin a 38 year old male. Radiol Case Rep 2024; 19:3975-3978. [PMID: 39050641 PMCID: PMC11267992 DOI: 10.1016/j.radcr.2024.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 05/30/2024] [Accepted: 06/03/2024] [Indexed: 07/27/2024] Open
Abstract
Supernumerary kidney is a highly uncommon congenital anomaly characterized by the presence of at least 1 or more extra kidneys in variable positions and morphology. Due to the scarcity in the medical literature, not much is known about this condition. The additional kidney typically has its own collecting system, vascular supply, and distinct encapsulated parenchyma. In this case, we present a 38-year-old male with a right supernumerary kidney who was initially investigated for a renal artery aneurysm. In the case of our patient, the discovery of a supernumerary kidney influenced the course of management and prevented unnecessary intervention and procedure. This emphasizes the importance of thorough imaging and diagnostic techniques in patients to accurately identify and characterize such anomalies.
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Affiliation(s)
- Ahmed Nada
- St Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy VIC 3065, Australia
| | - Ash Jhamb
- St Vincent's Hospital Melbourne, Interventional Radiology Department, 41 Victoria Parade, Fitzroy VIC 3065, Australia
| | - Julian Maingard
- St Vincent's Hospital Melbourne, Interventional Radiology Department, 41 Victoria Parade, Fitzroy VIC 3065, Australia
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Sinha A, Yao M, Ferrando CA. Persistent and De Novo Stress Urinary Incontinence After Minimally Invasive Sacrocolpopexy. UROGYNECOLOGY (PHILADELPHIA, PA.) 2024; 30:742-752. [PMID: 38212891 DOI: 10.1097/spv.0000000000001454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
IMPORTANCE Data on stress urinary incontinence (SUI) after minimally invasive sacrocolpopexy (SCP) with or without midurethral sling placement are limited. OBJECTIVE The aim of the study was to determine the incidence of SUI after minimally invasive sacrocolpopexy. STUDY DESIGN This was a secondary analysis of 2 randomized clinical trials of participants undergoing SCP. Participants completed symptom assessment and urodynamic testing. Participants underwent SCP with or without midurethral sling placement. Preoperatively, participants were defined as having symptomatic SUI, occult SUI, or no SUI. Participants completed the Pelvic Floor Distress Inventory-20 at 6 and 12 months postoperatively and were categorized as having persistent SUI in the setting of symptomatic or occult SUI or de novo SUI. RESULTS Eighty-one participants were included. Sixty-one participants met inclusion criteria for the persistent SUI analysis: 42 participants with symptomatic SUI and 19 participants with occult SUI. There were 20 participants in the de novo SUI group. The overall incidence of persistent SUI was 26.2% (95% confidence interval [CI], 15.8%-39.1%) with 33.3% (95% CI, 19.6%-49.6%) of symptomatic and 10.5% (95% CI, 1.5%-33.1%) of occult participants. Bothersome symptoms were defined as "moderately" or "quite a bit" bothered postoperatively. Of participants with symptomatic SUI, 14.3% participants were bothered and no participants underwent retreatment. No patient with occult SUI was bothered; however, 1 patient underwent retreatment. The incidence of de novo SUI was 45% (95% CI, 23.1%-68.5%). No patient in the de novo SUI group was bothered or underwent SUI treatment. CONCLUSIONS Approximately 1 in 4 participants reported persistent SUI. Almost 50% reported de novo SUI. However, few participants were bothered or underwent treatment.
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Affiliation(s)
- Annika Sinha
- From the Department of Urogynecology and Pelvic Reconstructive Surgery, Duke University, Durham, NC
| | - Meng Yao
- Department of Quantitative Health Sciences, Cleveland Clinic Foundation
| | - Cecile A Ferrando
- Center for Urogynecology and Pelvic Reconstructive Surgery, Obstetrics and Gynecology Institute, Cleveland Clinic, Cleveland, OH
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Gaspar B, Ramalho M, Guerra A. Seminal vesicles in focus: An illustrated overview. Curr Probl Diagn Radiol 2024; 53:624-640. [PMID: 38692935 DOI: 10.1067/j.cpradiol.2024.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 04/01/2024] [Accepted: 04/18/2024] [Indexed: 05/03/2024]
Abstract
Seminal vesicles play a crucial role in the male reproductive system, as they are responsible for secreting a fluid that forms most of the ejaculate. Seminal vesicles' pathology can present with non-specific symptoms, making imaging diagnosis essential for proper patient management. Various imaging modalities can be used to evaluate these glands, with MRI beneficial in illustrating the spectrum of seminal vesicle disease. Typical seminal vesicles appear as elongated fluid-containing structures, but congenital anomalies, inflammatory conditions, and neoplastic disorders can alter their appearance. Furthermore, differentiating mimics from actual pathology can be challenging but crucial for proper management. This article aims to provide an overview of the typical imaging appearance of the seminal vesicles and illustrate the principal imaging characteristics of conditions involving these structures. It will review the imaging characteristics of common and uncommon lesions involving the seminal vesicles by exploring congenital, infectious, and neoplastic in detail. As the seminal vesicles are often evaluated incidentally during prostate imaging, radiologists should be aware of the variability of normal findings and recognize the principal pathologies affecting these structures to ensure proper patient management.
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Affiliation(s)
- Bárbara Gaspar
- Department of Radiology, Hospital Garcia de Orta, Almada, Portugal.
| | - Miguel Ramalho
- Department of Radiology, Hospital da Luz, Lisboa, Portugal
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Georgiou LA, Scarbrough BE. PSA screening for prostate cancer in the United States: 30 years of controversy. J Public Health Policy 2024; 45:552-561. [PMID: 39090221 DOI: 10.1057/s41271-024-00502-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2024] [Indexed: 08/04/2024]
Abstract
In 1994, the United States approved the Prostate-Specific Antigen (PSA) test as a screening tool for prostate cancer. It did so despite the test's inherent weakness: not being prostate cancer specific. Subsequent randomized trials yielded conflicting results as to its benefits. Medical guideline organizations are concerned that PSA screening results in the diagnosis and treatment of clinically indolent prostate cancer. Nevertheless, PSA screening is prevalent in North America and Europe with PSA screening increasing in other regions. We provide a critical review of the major factors that led to the prevalence of PSA screening in the United States despite the debate about its benefits. Public advocacy in favor of the test and failure of the medical community to appreciate its inherent weakness led to widespread adoption. These factors persist today. Other countries need to carefully analyze the utility of the PSA test before adopting it.
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Affiliation(s)
- Loukas A Georgiou
- Kentucky College of Osteopathic Medicine, University of Pikeville, 147 Sycamore St., Pikeville, KY, 41501, USA.
| | - Brent E Scarbrough
- Ross University School of Medicine, 10315 USA Today Way, Miramar, FL, 33025, USA
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Xu H, Taylor-Cho IA, Sara Jiang X, Foo WC. Diagnostic accuracy and clinical impact of renal biopsy cytology. Diagn Cytopathol 2024; 52:505-510. [PMID: 38801188 DOI: 10.1002/dc.25357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 04/29/2024] [Accepted: 05/14/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND The role of fine needle biopsy cytology in the workup of renal mass lesions remains controversial. With advances in imaging technology and clinical management for renal masses, a critical reevaluation of the role of renal biopsy is needed. This study was designed to provide a comprehensive evaluation of the performance and clinical impact of fine needle biopsy in patients with renal masses. METHODS A 5-year retrospective study of ultrasound or computer tomography (CT)-guided fine needle biopsies of renal masses diagnosed via cytopathology was conducted. Overall diagnostic rate, sensitivity, and diagnostic accuracy were calculated. Further analysis of the impact of fine needle biopsy cytology on clinical management was performed. RESULTS A total of 227 cases of fine-needle aspiration and/or biopsy (FNA/B) of renal masses were identified, including 76 with subsequent nephrectomies. Complications were rare (<1%). The diagnostic rate and sensitivity of FNA/B were 83.3% and 89.5%, respectively. Diagnostic accuracy was 98.7% at the major categorical level and 94.7% at the tumor subtype level. Subsequent clinical actions were associated with a definitive cytologic diagnosis of malignancy/neoplasia (p < .05) and were affected by tumor subtype (p < .05). CONCLUSION This study demonstrates that FNA/B of renal masses is a safe and reliable minimally invasive diagnostic tool with excellent accuracy in confirmation of malignancy and subclassification of tumors. Diagnoses made on FNA/B play a key role in guiding a personalized clinical treatment plan.
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Affiliation(s)
- Hongzhi Xu
- Department of Pathology, Duke University Medical Center, Durham, North Carolina, USA
| | - Ian A Taylor-Cho
- Department of Pathology, Duke University Medical Center, Durham, North Carolina, USA
| | - Xiaoyin Sara Jiang
- Department of Pathology, Duke University Medical Center, Durham, North Carolina, USA
| | - Wen-Chi Foo
- Department of Pathology, Duke University Medical Center, Durham, North Carolina, USA
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Gao X, Wang W, Li F, Peng L, Di X, Chen J, Wei X. A new technique for the treatment of ureteric stricture after kidney transplantation. BJU Int 2024; 134:442-448. [PMID: 38837647 DOI: 10.1111/bju.16428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
OBJECTIVE To evaluate the safety and effectiveness of endoscopic treatments with Allium® metal ureteric stent (AMUS) for ureteric strictures after kidney transplantation (KT). PATIENTS AND METHODS In a prospective manner, we gathered clinical data from 68 patients who underwent endoscopic treatments with AMUS for ureteric strictures after KT between January 2019 and March 2022. The definition of surgical success was the unobstructed drainage of the AMUS, or in cases where there was AMUS migration, occlusion or encrustation and subsequently removed, there is no worsening of renal hydronephrosis in the patient during the follow-up period. RESULTS Based on the specific circumstances of the ureteric strictures, three distinct types of surgery were selected for treatment. The overall success rate of endoscopic treatments for ureteric strictures following KT was 90% (61/68) during a follow-up period of 1 year. Surgical complications included haematuria (18%), pain (10%), urinary tract infections (7.4%), and lower urinary tract symptoms (7.4%). The incidences of stent migration, occlusion, and encrustation were 10%, 2.9%, and 1.5%, respectively. Postoperatively, significant improvements were observed in various parameters. At 1 month after surgery, there was a notable decrease in blood creatinine levels (105.5 vs 90.4 mol/L), urea nitrogen levels (6.6 vs 5.4 mmol/L), and hydronephrosis volume (64.4 vs 43.9 mL). Additionally, the serum estimated glomerular filtration rate increased from 49.5 to 64.4 mL/min/1.73 m2. The follow-up results of patients at 1 year after surgery were similar to those observed at 1 month after surgery. CONCLUSIONS Systemic endoscopic treatments with AMUS were found to be safe and effective for ureteric strictures after KT with short-term follow-ups. This technique offers a novel option for the treatment of post-KT strictures.
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Affiliation(s)
- Xiaoshuai Gao
- Department of Urology and Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Wei Wang
- Department of Urology and Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Fei Li
- Department of Urology and Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Liao Peng
- Department of Urology and Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xingpeng Di
- Department of Urology and Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jixiang Chen
- Department of Urology and Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xin Wei
- Department of Urology and Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Melgarejo Segura MT, Yáñez Castillo Y, Lozano Lorca M, Morales Martínez A, Arrabal Polo MÁ, Arrabal Martín M. Efficacy of conduction hyperthermia in the treatment of non-muscle invasive bladder cancer: A systematic review. Urol Oncol 2024; 42:251-265. [PMID: 38670818 DOI: 10.1016/j.urolonc.2024.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 03/01/2024] [Accepted: 03/18/2024] [Indexed: 04/28/2024]
Abstract
INTRODUCTION Intravesical treatment for non-muscle invasive bladder cancer (NMIBC) aims to reduce recurrences and stop progression. Hyperthermia-enhanced chemotherapy with devices like COMBAT BRS, Unithermia, and BR-TRG-I is a promising alternative to conventional Bacillus de Calmette Guerin (BCG) therapy. OBJECTIVE To systematically review the efficacy of hyperthermia generated by conduction devices in the treatment of NMIBC. MATERIAL AND METHODS The review followed the preferred reporting items for systematic reviews and meta-analyses guidelines. A search was performed in the PubMed, Cochrane Library, Scopus, and ClinicalTrials.gov databases. Two reviewers independently assessed the eligibility of candidate studies and abstracted data from studies that met the inclusion criteria. The primary endpoint was assessment of recurrence. Secondary objectives included evaluation of treatment progression and safety. RESULTS Thirty studies meeting inclusion criteria underwent data extraction. In intermediate-risk NMIBC patients, COMBAT versus mitomycin C (MMC) in normothermia revealed no superiority in reducing recurrence or progression. High-risk NMIBC patients using COMBAT achieved similar or superior outcomes to BCG. BR-TRG-I demonstrated superior results over normothermia in intermediate- and high-risk NMIBC patients. Unithermia proved less effective than BCG in high-risk NMIBC. Progression outcomes were promising with COMBAT and BR-TRG-I, but comprehensive analysis was limited due to inconsistent assessment across studies. Adverse events were primarily mild-moderate, with some device-specific differences. CONCLUSIONS Studies on conduction hyperthermia present great variability, which do not allow us to determine the superiority of 1 device over another in terms of recurrence, progression, and/or adverse effects. Further research with consistent administration protocols is crucial for definitive conclusions.
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Affiliation(s)
| | | | - Macarena Lozano Lorca
- Department of Preventive Medicine and Public Health, University of Granada, Melilla, Spain; Institute of Biosanitary Research ibs. Granada, Granada, Spain
| | | | - Miguel Ángel Arrabal Polo
- Department of Urology, University Hospital San Cecilio, Granada, Spain; Institute of Biosanitary Research ibs. Granada, Granada, Spain
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AlShammari A, Benzouak T, Khogeer A, AlHaidey R, Arezki A, Fahmy N, Andonian S, Carrier S, Aubé-Peterkin M, Hamouche F. Understanding current ergonomics setup for urologists conducting anatomical endoscopic enucleation of the prostate surgeries: Survey analysis from the endourological society. Am J Surg 2024; 235:115701. [PMID: 38448320 DOI: 10.1016/j.amjsurg.2024.02.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/19/2024] [Accepted: 02/27/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Ensuring ergonomic posture and safety for surgeons is key to preventing work-related injuries and promoting sustained practice. We evaluated ergonomic aspects of Anatomic Endoscopic Enucleation of the Prostate (AEEP) and its relation to musculoskeletal injuries. METHOD A two-month online survey involving 119 Endourological Society members provided an in-depth analysis of AEEP practices and their musculoskeletal impacts. RESULTS The sample experienced general (65.5%), back (32.8%), neck (35.3%) and shoulder (37%) pain. Female AEEP surgeons reported greater back pain. Experience and age were inversely related to MSK injuries, and operative times over 2 h increased back pain. AEEP procedures predominantly involved sitting (86%) on backless stools (58%), with most surgeons wearing protective eyewear (75.6%) and using large resectoscopes (76.5%). Monitors were usually above eye-level (57%) and beyond 1 m (68.9%). CONCLUSION Musculoskeletal complaints are prevalent among AEEP endourologists. More awareness and further studies on risk factors are necessary to limit work-related injuries in urology.
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Affiliation(s)
- Ahmad AlShammari
- Department of Surgery, Division of Urology, McGill University Health Center, Montreal QC, Canada.
| | - Tarek Benzouak
- Department of Surgery, Division of Urology, McGill University Health Center, Montreal QC, Canada
| | - Abdulghani Khogeer
- Department of Surgery, Division of Urology, McGill University Health Center, Montreal QC, Canada; Department of Surgery, Faculty of Medicine, Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rakan AlHaidey
- Department of Surgery, Division of Urology, McGill University Health Center, Montreal QC, Canada
| | - Adel Arezki
- Department of Surgery, Division of Urology, McGill University Health Center, Montreal QC, Canada
| | - Nader Fahmy
- Department of Surgery, Division of Urology, McGill University Health Center, Montreal QC, Canada
| | - Sero Andonian
- Department of Surgery, Division of Urology, McGill University Health Center, Montreal QC, Canada
| | - Serge Carrier
- Department of Surgery, Division of Urology, McGill University Health Center, Montreal QC, Canada
| | - Mélanie Aubé-Peterkin
- Department of Surgery, Division of Urology, McGill University Health Center, Montreal QC, Canada
| | - Fadl Hamouche
- Department of Surgery, Division of Urology, McGill University Health Center, Montreal QC, Canada
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Xi Y, Cao YL, Tao LY, Gao SZ, Jin ZR, Cheng JX, Jiang H, Zhang Z. A global perspective: characteristics of infertility-related randomized clinical trials. Andrology 2024; 12:1324-1335. [PMID: 38231194 DOI: 10.1111/andr.13596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 09/09/2023] [Accepted: 01/01/2024] [Indexed: 01/18/2024]
Abstract
BACKGROUND Infertility is a prevalent global condition, and emerging reproductive technologies may enhance its evaluation and treatment. Understanding the current features of randomized clinical trials in infertility is crucial for improving study design and ensuring the translation of results for patient benefits. OBJECTIVES To investigate the primary characteristics of randomized clinical trials related to infertility and areas where require improvement. MATERIALS AND METHODS We conducted a search on the International Clinical Trials Registry platform for eligible infertility trials between 2003 and 2022. The distribution ratio of various characteristics uploaded by infertility-related studies on the platform was analyzed and compared according to sex and registration year. RESULTS Out of the total trials, 85.3% (1,906) included only women, 8.6% (192) included only men, and 6.1% (136) included couples. The majority of retrieved trials followed a parallel arm design (91.0%) and were non-industry-funded (92.2%), with a median planned sample size of 131 patients (interquartile range 75-270). Among these trials, 54.5% (1,217) were conducted in Asia. The most common primary purpose of infertility-related trials was treatment (88.8%), with over half of the investigated interventions focusing on medication (57.9%). DISCUSSION Asia is the leading region for research, and the drug therapy is still widely used and updated. However, support care for infertile couples has also received some preference. Areas that require improvement and promotion include addressing male infertility and focusing on underserved regions like Africa. The results also highlight deficiencies in trial registration and masking methods, emphasizing the need for better regulation and facilitation of infertility trials in the post-COVID-19 era. CONCLUSION Based on the current status of infertility RCT studies, greater attention should be paid to infertile men and populations in underdeveloped regions like Africa in future studies, together with a standardized registration and implementation procedures.
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Affiliation(s)
- Yu Xi
- Department of Urology, Peking University Third Hospital, Beijing, China
- Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, China
| | - Ya-Lei Cao
- Department of Urology, Peking University Third Hospital, Beijing, China
- Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, China
| | - Li-Yuan Tao
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Song-Zhan Gao
- Department of Andrology, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zi-Run Jin
- Department of Urology, Peking University Third Hospital, Beijing, China
- Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, China
| | - Jian-Xing Cheng
- Department of Urology, Peking University Third Hospital, Beijing, China
- Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, China
| | - Hui Jiang
- Department of Urology, Peking University First Hospital, Beijing, China
- Institute of Urology, Peking University, Beijing, China
| | - Zhe Zhang
- Department of Urology, Peking University Third Hospital, Beijing, China
- Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, China
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Helman TA, Browne BM. Advances in Outpatient Therapies and Treatment of Benign Prostatic Hyperplasia: A Comprehensive Review for Men's Health. Med Clin North Am 2024; 108:981-991. [PMID: 39084845 DOI: 10.1016/j.mcna.2024.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
Abstract
Benign prostate hyperplasia (BPH) affects a large number of men and can be treated with behavioral, medical, or surgical treatments. The newest addition to medical therapy is β3-agonists for overactive lower urinary tract symptoms. Multiple new surgical treatments have become available in the past decade, including several clinic-based minimally invasive surgical techniques (eg, UroLift, Rezum, Optilume BPH), OR treatments (eg, Aquablation, single port robotics), and prostate artery embolization. The growth of options allows providers to better tailor BPH treatment to the specific disease factors and patient preferences.
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Affiliation(s)
- Talia A Helman
- Division of Urology, Department of Surgery, Emory University, 1365 Clifton Road NorthEast, Building B 1st Floor, Suite 1400, Atlanta, GA 30322, USA.
| | - Brendan M Browne
- Division of Urology, Department of Surgery, Emory University, 1365 Clifton Road NorthEast, Building B 1st Floor, Suite 1400, Atlanta, GA 30322, USA
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Madendere S, Kilic M, Zoroglu H, Sarikaya AF, Veznikli M, Coskun B, Armutlu A, Kulac I, Gürses B, Kiremit MC, Baydar DE, Canda AE, Balbay MD, Vural M, Kordan Y, Esen T. Natural history of histologically benign PIRADS 4-5 lesions in multiparametric MRI: Real-life experience in an academic center. Prostate 2024; 84:1262-1267. [PMID: 38922915 DOI: 10.1002/pros.24764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 05/26/2024] [Accepted: 06/19/2024] [Indexed: 06/28/2024]
Abstract
INTRODUCTION The follow-up findings of patients who underwent prostate biopsy for prostate image reporting and data system (PIRADS) 4 or 5 multiparametric magnetic resonance imaging (mpMRI) findings and had benign histology were retrospectively reviewed. METHODS There were 190 biopsy-naive patients. Patients with at least 12 months of follow-up between 2012 and 2023 were evaluated. All MRIs were interpreted by two very experienced uroradiologists. Of the patients, 125 had either cognitive or software fusion MR-targeted biopsies with 4 + 8/10 cores. The remaining 65 patients had in-bore biopsies with 4-5 cores. Prostate-specific antigen (PSA) levels below 4 ng/mL were defined as PSA regression following biopsy. PIRADS 1-3 lesions on new MRI images were classified as MRI regression. RESULTS Median patient age and PSA were 62 (39-82) years and six (0.4-33) ng/mL, respectively, at the initial work-up. During a median follow-up period of 44 months, 37 (19.4%) patients were lost to follow-up. Of the remaining 153 patients, 82 (53.6%) had persistently high PSA. Among them, 72 (87.8%) had repeat mpMRI within 6-24 months which showed regressive findings (PIRADS 1-3) in 53 patients (73.6%) and PIRADS 4-5 index lesion persistence in 19 cases (26.4%). The latter group was recommended to have rebiopsy. Of these 19 patients, 16 underwent MRI-targeted rebiopsy. Prostate cancer was diagnosed in six (37.5%) patients and of these four (25%) were clinically significant (>Grade Group 1). Totally, clinically significant prostate cancer was detected in 4/153 (2.6%) patients followed up. CONCLUSION Patients should be warned against the relative relaxing effect of a negative biopsy after identification of PIRADS 4-5 index lesion. While PSA decrease was observed in many patients during follow-up, persistent MRI findings were present in nearly a quarter of patients with persistently high PSA. A rebiopsy is warranted in these patients, with significant prostate cancer diagnosed in a quarter of patients with rebiopsy.
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Affiliation(s)
| | - Mert Kilic
- Department of Urology, VKV American Hospital, Istanbul, Turkey
| | - Hatice Zoroglu
- Department of Urology, Gaziosmanpaşa University School of Medicine, Tokat, Turkey
| | | | - Mert Veznikli
- Department of Biostatistics, Koç University School of Medicine, Istanbul, Turkey
| | - Bilgen Coskun
- Department of Radiology, VKV American Hospital, Istanbul, Turkey
| | - Ayse Armutlu
- Department of Pathology, Koç University School of Medicine, Istanbul, Turkey
| | - Ibrahim Kulac
- Department of Pathology, Koç University School of Medicine, Istanbul, Turkey
| | - Bengi Gürses
- Department of Radiology, Koç University School of Medicine, Istanbul, Turkey
| | - Murat Can Kiremit
- Department of Urology, Koç University School of Medicine, Istanbul, Turkey
| | - Dilek Ertoy Baydar
- Department of Pathology, Koç University School of Medicine, Istanbul, Turkey
| | - Abdullah Erdem Canda
- Department of Urology, Koç University School of Medicine, Istanbul, Turkey
- RMK AIMES, Rahmi M. Koç Academy of Interventional Medicine, Education, and Simulation, Istanbul, Turkey
| | - Mevlana Derya Balbay
- Department of Urology, VKV American Hospital, Istanbul, Turkey
- Department of Urology, Koç University School of Medicine, Istanbul, Turkey
| | - Metin Vural
- Department of Radiology, VKV American Hospital, Istanbul, Turkey
| | - Yakup Kordan
- Department of Urology, Koç University School of Medicine, Istanbul, Turkey
| | - Tarik Esen
- Department of Urology, VKV American Hospital, Istanbul, Turkey
- Department of Urology, Koç University School of Medicine, Istanbul, Turkey
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Yang Q, Zhu Q, You Y, Li M, Zhang K. Incidentally findings of bilateral giant adrenal myelolipoma: Case report. Int J Surg Case Rep 2024; 122:110045. [PMID: 39053370 PMCID: PMC11320473 DOI: 10.1016/j.ijscr.2024.110045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 07/11/2024] [Accepted: 07/15/2024] [Indexed: 07/27/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Adrenal myelolipoma (AML) is a rare, benign neoplasm of the adrenal gland often found incidentally during medical examinations for unrelated conditions. This case study presents a 39-year-old male patient with a particularly large AML, weighing 11 kg upon surgical removal, potentially making it the largest documented tumor in medical literature. CASE PRESENTATION A 39-year-old male presenting with abdominal distension and clinical manifestations of Cushing syndrome was discovered to have sizable adrenal masses. Initial pre-operative fine-needle aspiration biopsy indicated lipogenic tumors, however, subsequent post-operative pathological analysis revealed the presence of adrenal myelolipoma. Following surgery, the patient developed an adrenal crisis but responded well to glucocorticoid therapy and made a successful recovery. CLINICAL DISCUSSION In contrast to previously documented instances, the present case potentially the most extensive case of its kind reported thus far. AML is an uncommon benign tumor of the adrenal gland, with diagnostic and therapeutic challenges arising from its resemblance to other adrenal neoplasms. Owing to the inherent limitations of fine needle biopsy and the propensity for misdiagnosis, the adrenal origin of the tumor was not initially considered, leading to postoperative adrenal crisis in the patient. CONCLUSION AML, a rare tumor, poses challenges in accurate diagnosis. Comprehensive imaging studies are essential to differentiate it from other neoplasms. Rigorous preoperative and postoperative pathological evaluations are crucial to avoid diagnostic errors. Additionally, thorough endocrinological assessments before and after surgery are imperative for early detection and management of any associated endocrine abnormalities.
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Affiliation(s)
- Qin Yang
- Department of General Surgery, Fuzhou First General Hospital affiliated with Fujian Medical University, Fuzhou, China; Department of General Surgery, Xinjiang Uyghur Autonomous Region Changji Hui Autonomous Prefecture Qitai County Peoples Hospital, Xinjiang, China
| | - Qiang Zhu
- Department of General Surgery, Fuzhou First General Hospital affiliated with Fujian Medical University, Fuzhou, China
| | - Yuekai You
- Department of General Surgery, Fuzhou First General Hospital affiliated with Fujian Medical University, Fuzhou, China
| | - Mingzhen Li
- Department of General Surgery, Fuzhou First General Hospital affiliated with Fujian Medical University, Fuzhou, China
| | - Kun Zhang
- Department of General Surgery, Fuzhou First General Hospital affiliated with Fujian Medical University, Fuzhou, China.
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Ghasemi V, Kiani Z, Alizadeh S, Roozbeh N, Mehrnoush V, MohammadSouri B, Saniee N, Shahrour W, Banaei M. Prevalence of stress urinary incontinence and urge urinary incontinence in multiples sclerosis patients: a systematic review and meta-analysis. Neurol Sci 2024; 45:4197-4210. [PMID: 38710988 DOI: 10.1007/s10072-024-07570-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 04/26/2024] [Indexed: 05/08/2024]
Abstract
Urinary incontinence (UI), encompassing stress urinary incontinence (SUI) and urge urinary incontinence (UUI), is a prevalent and debilitating condition in patients with multiple sclerosis (MS), profoundly impacting their quality of life. This systematic review and meta-analysis aimed to elucidate the worldwide prevalence rates of SUI and UUI among MS patients. This study was conducted by examining observational studies published between 2000 and 2023. An exhaustive literature search was conducted across databases such as PubMed, MEDLINE, Web of Science, Scopus, ProQuest, and Google Scholar. The Meta-prop method facilitated pooled prevalence estimation of UUI and SUI, while Egger tests assessed publication bias. In total, 27 studies with 15,052 participants were included in the meta-analysis. The findings revealed a high random effect pooled prevalence of UUI at 41.02% (95% Confidence Interval [CI]: 30.57-51.89; I2 = 99%, p < 0.001) and SUI at 25.67% (95% CI: 19.30-32.58%; I2 = 94.9%, P < 0.001). Additionally, the pooled prevalence of mixed urinary incontinence (MUI) was reported at 18.81% (95% CI: 7.55-33.48; I2:95.44%, p < 0.001). The high heterogeneity observed suggests variable prevalence across populations and highlights the intricate nature of UI in MS. These findings underscore the critical need for dedicated supportive, therapeutic, and rehabilitative interventions to manage this common complaint in MS patients effectively.
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Affiliation(s)
- Vida Ghasemi
- Asadabad School of Medical Sciences, Asadabad, Iran
| | - Zahra Kiani
- Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shiva Alizadeh
- Department of Midwifery & Reproductive Health, Zeynab School of Nursing & Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Nasibeh Roozbeh
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Vahid Mehrnoush
- Urology Department, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada
| | - Behzad MohammadSouri
- Urology and Nephrology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Nadia Saniee
- Asadabad School of Medical Sciences, Asadabad, Iran
| | - Walid Shahrour
- Urology Department, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada
| | - Mojdeh Banaei
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
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Zhang Y, Chen J, Liu H, Dai J, Zhao J, Zhu S, Zhang X, Liang J, Hu X, Zhao J, Liu Z, Shen P, Sun G, Zeng H. The incidence of immune-related adverse events (irAEs) and their association with clinical outcomes in advanced renal cell carcinoma and urothelial carcinoma patients treated with immune checkpoint inhibitors: A systematic review and meta-analysis. Cancer Treat Rev 2024; 129:102787. [PMID: 38905806 DOI: 10.1016/j.ctrv.2024.102787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 06/10/2024] [Accepted: 06/11/2024] [Indexed: 06/23/2024]
Abstract
BACKGROUND This study aimed to summarize the occurrence of immune-related adverse events (irAEs) and further evaluate their association with clinical outcomes in patients with advanced renal cell carcinoma (RCC) and urothelial carcinoma (UC) treated with immune checkpoint inhibitors (ICIs). METHODS A comprehensive search of PubMed, Embase, and the Cochrane Library up to December 2023 was conducted to identify eligible studies. The details of irAEs and data regarding their correlation with clinical outcomes were extracted. R software was used for meta-analysis. RESULTS A total of 27 studies involving 6148 patients with RCC or UC were included. The pooled overall incidence for any-grade and grade ≥ 3 irAEs was 44.2 % (95 % CI: 38.1 %-50.5 %) and 15.7 % (95 % CI: 11.4 %-21.1 %), respectively. Compared to those without any irAEs, patients with irAEs showed improved PFS (HR = 0.44, 95 % CI: 0.35-0.56, p < 0.01) and OS (HR = 0.47, 95 % CI: 0.42-0.51, p < 0.01), as well as higher ORR (OR = 3.59, 95 % CI: 3.01-4.29, p < 0.01) and DCR (OR = 4.23, 95 % CI: 3.06-5.84, p < 0.01). Subgroup analysis indicated that clinical outcome improvements were associated with the occurrence of irAEs, regardless of tumor type or ICI agent. Notably, patients with cutaneous irAEs, thyroid dysfunction, and grade ≤ 2 irAEs had a higher probability to achieve better survival benefits from ICI-based therapy, while pulmonary irAEs and grade ≥ 3 irAEs seemed to have a negative impact on OS. Additionally, systemic glucocorticoids administration did not affect survival outcomes. CONCLUSION Our findings suggest that the occurrence of irAEs could be considered as a potential prognostic factor for predicting the efficacy of ICIs in patients with advanced RCC and UC.
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Affiliation(s)
- Yaowen Zhang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Junru Chen
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Haoyang Liu
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Jindong Dai
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Junjie Zhao
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Sha Zhu
- Department of Urology, University of California, San Francisco, 94158, CA, USA
| | - Xingming Zhang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Jiayu Liang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xu Hu
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Jinge Zhao
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Zhenhua Liu
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Pengfei Shen
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Guangxi Sun
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China.
| | - Hao Zeng
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China.
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Das CJ, Malagi AV, Sharma R, Mehndiratta A, Kumar V, Khan MA, Seth A, Kaushal S, Nayak B, Kumar R, Gupta AK. Intravoxel incoherent motion and diffusion kurtosis imaging and their machine-learning-based texture analysis for detection and assessment of prostate cancer severity at 3 T. NMR IN BIOMEDICINE 2024; 37:e5144. [PMID: 38556777 DOI: 10.1002/nbm.5144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 02/01/2024] [Accepted: 02/20/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVES To evaluate the role of combined intravoxel incoherent motion and diffusion kurtosis imaging (IVIM-DKI) and their machine-learning-based texture analysis for the detection and assessment of severity in prostate cancer (PCa). MATERIALS AND METHODS Eighty-eight patients underwent MRI on a 3 T scanner after giving informed consent. IVIM-DKI data were acquired using 13 b values (0-2000 s/mm2) and analyzed using the IVIM-DKI model with the total variation (TV) method. PCa patients were categorized into two groups: clinically insignificant prostate cancer (CISPCa) (Gleason grade ≤ 6) and clinically significant prostate cancer (CSPCa) (Gleason grade ≥ 7). One-way analysis-of-variance, t test, and receiver operating characteristic analysis was performed to measure the discriminative ability to detect PCa using IVIM-DKI parameters. A chi-square test was used to select important texture features of apparent diffusion coefficient (ADC) and IVIM-DKI parameters. These selected texture features were used in an artificial neural network for PCa detection. RESULTS ADC and diffusion coefficient (D) were significantly lower (p < 0.001), and kurtosis (k) was significantly higher (p < 0.001), in PCa as compared with benign prostatic hyperplasia (BPH) and normal peripheral zone (PZ). ADC, D, and k showed high areas under the curves (AUCs) of 0.92, 0.89, and 0.88, respectively, in PCa detection. ADC and D were significantly lower (p < 0.05) as compared with CISPCa versus CSPCa. D for detecting CSPCa was high, with an AUC of 0.63. A negative correlation of ADC and D with GS (ADC, ρ = -0.33; D, ρ = -0.35, p < 0.05) and a positive correlation of k with GS (ρ = 0.22, p < 0.05) were observed. Combined IVIM-DKI texture showed high AUC of 0.83 for classification of PCa, BPH, and normal PZ. CONCLUSION D, f, and k computed using the IVIM-DKI model with the TV method were able to differentiate PCa from BPH and normal PZ. Texture features of combined IVIM-DKI parameters showed high accuracy and AUC in PCa detection.
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Affiliation(s)
- Chandan J Das
- Department of Radio-Diagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Archana Vadiraj Malagi
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, India
| | - Raju Sharma
- Department of Radio-Diagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Amit Mehndiratta
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, India
| | - Virendra Kumar
- Department of Nuclear Magnetic Resonance, All India Institute of Medical Sciences, New Delhi, India
| | - Maroof A Khan
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Amlesh Seth
- Department of Urology, All India Institute of Medical Sciences, New Delhi, India
| | - Seema Kaushal
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Baibaswata Nayak
- Department of Gastroenterology (Molecular Biology Division), All India Institute of Medical Sciences, New Delhi, India
| | - Rakesh Kumar
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Arun Kumar Gupta
- Department of Radio-Diagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
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Piecoro DW, Allison DB. Precision Medicine in Cytopathology. Surg Pathol Clin 2024; 17:329-345. [PMID: 39129134 DOI: 10.1016/j.path.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2024]
Abstract
Over the last decade, cancer diagnostics has undergone a notable transformation with increasing complexity. Minimally invasive diagnostic tests, driven by advanced imaging and early detection protocols, are redefining patient care and reducing the need for more invasive procedures. Modern cytopathologists now safeguard patient samples for vital biomarker and molecular testing. In this article, we explore ancillary testing modalities and the role of biomarkers in organ-specific contexts, underscoring the transformative impact of precision medicine. Finally, the advent of more than 80 Food and Drug Administration-approved predictive biomarkers signals a new era, guiding cancer care toward personalized and targeted strategies.
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Affiliation(s)
- Dava W Piecoro
- Department of Pathology and Laboratory Medicine, 800 Rose Street, MS117, University of Kentucky College of Medicine, Lexington, KY 40536, USA
| | - Derek B Allison
- Department of Pathology and Laboratory Medicine, 800 Rose Street, MS117, University of Kentucky College of Medicine, Lexington, KY 40536, USA; Markey Cancer Center, Lexington, KY 40536, USA; Department of Urology, University of Kentucky College of Medicine, Lexington, KY 40536, USA.
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45
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Abdella MK, Gebreselassie KH, Kurabachew HA. Self-inflicted penile and testicular amputation: A very rare case report and treatment dilemma in the absence of microsurgical service. Int J Surg Case Rep 2024; 122:110043. [PMID: 39043098 PMCID: PMC11318470 DOI: 10.1016/j.ijscr.2024.110043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2024] [Revised: 07/10/2024] [Accepted: 07/12/2024] [Indexed: 07/25/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Genital self-mutilation is a rare urologic surgical emergency that is usually encountered in patients with underlying psychiatric illness. Because of shortage of published data and variance in management schemes worldwide, these conditions can present a significant management dilemma. CASE PRESENTATION In this case report we present this rare phenomenon, where a known schizophrenic patient presented after he amputated both of his testes and penis under the influence of command hallucination. After 15 h of the incident, macroscopic replantation of the severed genitalia was done and psychiatric evaluation and management initiated simultaneously. But the replantation failed after 9th post operative day. DISCUSSION Initial management of patients presenting with genital amputation should be resuscitation. The severed organ has to be washed with sterile saline and placed in "double bag". There are multiple factors for the success of replantation, the major ones are cooling of the amputated organ and precise microsurgical replantation. CONCLUSION Early intervention and microscopic replantation are crucial for the successful outcome.
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Affiliation(s)
- Mejudin Kedir Abdella
- Department of Surgery, Urology unit, Worabe Comprehensive Specialized Hospital, Ethiopia.
| | | | - Henok Ababu Kurabachew
- Department of Psychiatry, College of Health and Medical Science Dilla University Dilla, Ethiopia
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Yan K, Balijepalli C, Gullapalli L, Joshy J, Kotum S, Druyts E. Efficacy and safety of interventions for metastatic castration resistant prostate cancer (mCRPC) patients progressing on androgen receptor-axis-targeted (ARAT) therapy: a systematic literature review. Curr Med Res Opin 2024:1-12. [PMID: 39166959 DOI: 10.1080/03007995.2024.2395435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 06/14/2024] [Accepted: 08/16/2024] [Indexed: 08/23/2024]
Abstract
BACKGROUND To review the literature to outline findings from clinical trials assessing interventions for metastatic castration-resistant prostate cancer (mCRPC) in patients who have progressed on androgen receptor-axis-targeted (ARAT) therapies. METHODS A systematic literature review was performed to identify trials that assessed the efficacy and safety of interventions used in patients that progressed on prior ARAT therapies. A literature search was conducted using the OVID platform that searched the EMBASE, MEDLINE, and CENTRAL bibliographic databases. RESULTS Of the 10,114 citations identified, a total of 36 studies representing 33 unique trials were included in the review. Of the 33 trials, 21 were randomized controlled trials and 12 were single-arm trials. A total of 11 were phase III trials, 13 were phase II trials, and 2 were phase I trials. The majority of included trials were open-label (n = 29) and the remaining were double-blind (n = 4). A total of 16 trials evaluated ARAT based therapies, 7 trials evaluated taxane-based treatments, 10 trials evaluated PARP inhibitors, 8 trials evaluated immunotherapies, and 8 trials evaluated other therapies (i.e. cabozantinib, mitoxantrone, radium-223,177[Lu-177]-PNT2002,177Lu-PSMA-617, samotolisib). CONCLUSIONS This systematic review demonstrated there are limited effective treatment options in this patient population. Unlike other cancer types, immunotherapy agents appear to provide little to no benefit. Conversely, agents such as taxane-based chemotherapy (e.g. cabazitaxel) and radionuclide therapy provide the most value in this patient population. Further research is needed to explore new therapies in this disease area and to optimize existing treatment strategies with more effective combination therapies.
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Affiliation(s)
- Kevin Yan
- Pharmalytics Group, Vancouver, British Columbia, Canada
| | | | | | - Juhi Joshy
- Pharmalytics Group, Vancouver, British Columbia, Canada
| | - Sharon Kotum
- Pharmalytics Group, Vancouver, British Columbia, Canada
| | - Eric Druyts
- Pharmalytics Group, Vancouver, British Columbia, Canada
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Aayush A, Darji S, Estes KM, Yeh E, Thompson DH. Development of an Elastin-like Polypeptide-Based Nucleic Acid Delivery System Targeted to EGFR+ Bladder Cancer Cells Using a Layer-by-Layer Approach. Biomacromolecules 2024. [PMID: 39185801 DOI: 10.1021/acs.biomac.4c00165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Abstract
Nucleic acid (NA)-based therapies are revolutionizing biomedical research through their ability to control cellular functions at the genetic level. This work demonstrates a versatile elastin-like polypeptide (ELP) carrier system using a layer-by-layer (LbL) formulation approach that delivers NA cargos ranging in size from siRNA to plasmids. The components of the system can be reconfigured to modulate the biochemical and biophysical characteristics of the carrier for engaging the unique features of the biological target. We show the physical characterization and biological performance of LbL ELP nucleic acid nanoparticles (LENNs) in murine and human bladder tumor cell lines. Targeting bladder tumors is difficult owing to the constant influx of urine into the bladder, leading to low contact times (typically <2 h) for therapeutic agents delivered via intravesical instillation. LENN complexes bind to bladder tumor cells within 30 min and become rapidly internalized to release their NA cargo within 60 min. Our data show that a readily adaptable NA-delivery system has been created that is flexible in its targeting ability, cargo size, and disassembly kinetics. This approach provides an alternative path to either lipid nanoparticle formulations that suffer from inefficiency and physicochemical instability or viral vectors that are plagued by manufacturing and immune rejection challenges. This agile ELP-based nanocarrier provides an alternative route for nucleic acid delivery using a biomanufacturable, biodegradable, biocompatible, and highly tunable vehicle capable of targeting cells via engagement with overexpressed cell surface receptors.
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Affiliation(s)
- Aayush Aayush
- Department of Chemistry & Purdue Institute for Cancer Research, Purdue University, Bindley Bioscience Center, West Lafayette, Indiana 47907, United States
| | - Saloni Darji
- Department of Chemistry & Purdue Institute for Cancer Research, Purdue University, Bindley Bioscience Center, West Lafayette, Indiana 47907, United States
| | - Kiera M Estes
- Department of Chemistry & Purdue Institute for Cancer Research, Purdue University, Bindley Bioscience Center, West Lafayette, Indiana 47907, United States
| | - Emily Yeh
- Department of Chemistry & Purdue Institute for Cancer Research, Purdue University, Bindley Bioscience Center, West Lafayette, Indiana 47907, United States
| | - David H Thompson
- Department of Chemistry & Purdue Institute for Cancer Research, Purdue University, Bindley Bioscience Center, West Lafayette, Indiana 47907, United States
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Falcone M, Preto M, Gül M, Şahin A, Scavone M, Cirigliano L, Peretti F, Ferro I, Plamadeala N, Gontero P. Functional outcomes of organ sparing surgery for penile cancer confined to glans and premalignant lesions. Int J Impot Res 2024:10.1038/s41443-024-00967-7. [PMID: 39187573 DOI: 10.1038/s41443-024-00967-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 08/04/2024] [Accepted: 08/13/2024] [Indexed: 08/28/2024]
Abstract
The first-line treatment of penile cancer confined to the glans (Tis-T2) is based on organ-sparing approaches. Our aim is to report functional outcomes of total glans resurfacing (TGR), wide local excision (WLE) and glansectomy. A retrospective analysis was conducted from January 2013 to October 2022. Ninety-nine patients were enrolled (22 TGR, 29 WLE, and 48 glansectomy). Sexual and urinary outcomes were explored using ad hoc and validated questionnaires (IIEF-15 and IPSS). The mean follow-up was 25.28 ± 24.87 months [95% CI: 20.38; 30.18]. 44 patients (12 TGR, 10 WLE, and 22 glansectomy) were assessed for functional outcomes. Overall, 86.36% of patients were satisfied with the surgery. The mean IIEF-15 score pre-operation was 54.91 ± 21.38 [95% CI: 48.41-61.41], and at 12 months post-operation, it was 44.39 ± 23.01 [95% CI: 37.39-51.39], with the change being statistically significant (mean difference: -10.52, (-19.15), p < 0.001). During the 0-12-month interval, IIEF-15 scores decreased across all techniques. Glansectomy and WLE showed significant decreases (Glansectomy: -12.955, -24.14%, [95% CI: -21.52, -4.38], p = 0.002; WLE: -14.1, -22.92%, [95% CI: -26.8, -1.39], p = 0.025 respectively), whereas TGR experienced a non-significant decrease (-3.083, -5.97%, CI: [-14.68, 8.51], p = 1.0). Concerning urinary function, only 18.18% of overall patients reported a negative impact of surgery. At 12-months, patients returned almost to pre-intervention IPSS values. Organ-sparing surgery guarantees a decent preservation of both erectile and voiding functions. TGR seems to provide better sexual outcomes when compared to other organ sparing approaches.
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Affiliation(s)
- Marco Falcone
- Urology Clinic-A.O.U. "Città della Salute e della Scienza" - Molinette Hospital, University of Turin, Turin, Italy.
- Neurourology Clinic-A.O.U. "Città della Salute e della Scienza"-Unità Spinale Unipolare, Turin, Italy.
- Department of Urology, Biruni University School of Medicine, İstanbul, Turkey.
| | - Mirko Preto
- Urology Clinic-A.O.U. "Città della Salute e della Scienza" - Molinette Hospital, University of Turin, Turin, Italy
| | - Murat Gül
- Department of Urology, Selcuk University School of Medicine, Konya, Turkey
| | - Ali Şahin
- Selcuk University School of Medicine, Konya, Turkey
| | - Martina Scavone
- Urology Clinic-A.O.U. "Città della Salute e della Scienza" - Molinette Hospital, University of Turin, Turin, Italy
| | - Lorenzo Cirigliano
- Urology Clinic-A.O.U. "Città della Salute e della Scienza" - Molinette Hospital, University of Turin, Turin, Italy
| | - Federica Peretti
- Urology Clinic-A.O.U. "Città della Salute e della Scienza" - Molinette Hospital, University of Turin, Turin, Italy
| | - Ilaria Ferro
- Urology Clinic-A.O.U. "Città della Salute e della Scienza" - Molinette Hospital, University of Turin, Turin, Italy
| | - Natalia Plamadeala
- Urology Clinic-A.O.U. "Città della Salute e della Scienza" - Molinette Hospital, University of Turin, Turin, Italy
| | - Paolo Gontero
- Urology Clinic-A.O.U. "Città della Salute e della Scienza" - Molinette Hospital, University of Turin, Turin, Italy
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Song J, Chang C, Zhou B, Zhang J. Renal metastatic seminoma: A rare case report. Asian J Surg 2024:S1015-9584(24)01753-6. [PMID: 39191582 DOI: 10.1016/j.asjsur.2024.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Revised: 07/24/2024] [Accepted: 08/01/2024] [Indexed: 08/29/2024] Open
Affiliation(s)
- Juan Song
- Hubei Provincial Clinical Research Center for Accurate Fetus Malformation Diagnosis, Department of Ultrasound, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, 441000, China
| | - Caihong Chang
- Department of Ultrasound imaging, Postgraduate Union training base of Xiangyang No.1 People's Hospital, School of Medicine, Wuhan University of Science and Technology, Xiangyang, 441000, Hubei, China
| | - Benzheng Zhou
- Department of Urology Surgery, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, 441000, China.
| | - Jiaqi Zhang
- Hubei Provincial Clinical Research Center for Accurate Fetus Malformation Diagnosis, Department of Ultrasound, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, 441000, China.
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Amiri S, Gholizadeh L, Rasti A, Peymani M, Mirjalili SAM, Vahidi SA, Kalantar SM. Comparison of SPAG11A gene expression in infertile men with grade 1 and 2 varicocele before and after treatment. JBRA Assist Reprod 2024; 28:405-409. [PMID: 38446746 PMCID: PMC11349264 DOI: 10.5935/1518-0557.20220060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 12/12/2023] [Indexed: 03/08/2024] Open
Abstract
OBJECTIVE Sperm Associated Antigen 11A (SPAG11A) protein is a family of the epididymis-specific secretory proteins implicated in sperm maturation and function. Varicocele might cause pathophysiological difficulties in the testis and epididymis, with a harmful effect on the environment for spermatogenesis and sperm maturation. The aim of this study was to evaluate the expression level of the SPAG11A gene and sperm parameters in infertile men with grade 1 and 2 varicocele before and after treatment. METHODS Semen specimens were collected from 20 infertile men with varicocele pre-and post-treatment and 10 healthy volunteers. Semen analysis was conducted according to world health organization guidelines. Real time PCR (qRT-PCR) reaction was applied for determination of SPAG11A mRNA expression. RESULTS The results showed that there was a significant difference between the concentration and normal morphology between pre- and post-treatment groups and the controls. There were significant differences between pre-treatment and control groups in terms of progressive and non-progressive mobility. SPAG11A mRNA levels were significantly lower in the pre-treatment group than in healthy control subjects (p=0.007). There was no statistically significant difference in the expression of SPAG11A as well as semen parameters in the post-treatment group compared to the pre-treatment group. CONCLUSIONS SPAG11A gene expression and semen parameters may be affected by varicocele. Whether varicocele treatment is an effective approach to reduce the adverse effect of this disease on SPAG11A expression and semen parameters needs further investigation.
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Affiliation(s)
- Sepide Amiri
- Department of Tissue Engineering and Applied Cell Sciences, School
of Advanced Technologies in Medicine, Shiraz University of Medical Sciences, Shiraz,
Iran
- Department of Biology, Faculty of Basic Sciences, Islamic Azad
University, Shahrekord Branch, Shahrekord, Iran
| | - Lida Gholizadeh
- Research and Clinical Center for Infertility, Yazd Reproductive
Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Azam Rasti
- Abortion Research Centre, Yazd Reproductive Sciences Institute,
Shahid Sadoughi University of Medical Science, Yazd, Iran
- Department of Medical Genetics, School of Medicine, Tehran
University of Medical Sciences, Tehran, Iran
| | - Maryam Peymani
- Department of Biology, Faculty of Basic Sciences, Islamic Azad
University, Shahrekord Branch, Shahrekord, Iran
| | - Seyed Ali Mohammad Mirjalili
- Department of Andorology, Yazd Reproduction Sciences Institute,
Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seraj-Aldin Vahidi
- Department of Andorology, Yazd Reproduction Sciences Institute,
Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seyed Mehdi Kalantar
- Abortion Research Centre, Yazd Reproductive Sciences Institute,
Shahid Sadoughi University of Medical Science, Yazd, Iran
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