Prostate cancer detection using e-nose and AI for high probability assessment

This research aims to develop a diagnostic tool that can quickly and accurately detect prostate cancer using electronic nose technology and a neural network trained on a dataset of urine samples from patients diagnosed with both prostate cancer and benign prostatic hyperplasia, which incorporates a unique data redundancy method. By analyzing signals from these samples, we were able to significantly reduce the number of unnecessary biopsies and improve the classification method, resulting in a recall rate of 91% for detecting prostate cancer. The goal is to make this technology widely available for use in primary care centers, to allow for rapid and non-invasive diagnoses.

Exploring the Microbiome in Human Reproductive Tract: High-Throughput Methods for the Taxonomic Characterization of Microorganisms

Microorganisms are important due to their widespread presence and multifaceted roles across various domains of life, ecology, and industries. In humans, they underlie the proper functioning of multiple systems crucial to well-being, including immunological and metabolic functions. Emerging research addressing the presence and roles of microorganisms within human reproduction is increasingly relevant. Studies implementing new methodologies (e.g., to investigate vaginal, uterine, and semen microenvironments) can now provide relevant insights into fertility, reproductive health, or pregnancy outcomes. In that sense, cutting-edge sequencing techniques, as well as others such as meta-metabolomics, culturomics, and meta-proteomics, are becoming more popular and accessible worldwide, allowing the characterization of microbiomes at unprecedented resolution. However, they frequently involve rather complex laboratory protocols and bioinformatics analyses, for which researchers may lack the required expertise. A suitable pipeline would successfully enable both taxonomic classification and functional profiling of the microbiome, providing easy-to-understand biological interpretations. However, the selection of an appropriate methodology would be crucial, as it directly impacts the reproducibility, accuracy, and quality of the results and observations. This review focuses on the different current microbiome-related techniques in the context of human reproduction, encompassing niches like vagina, endometrium, and seminal fluid. The most standard and reliable methods are 16S rRNA gene sequencing, metagenomics, and meta-transcriptomics, together with complementary approaches including meta-proteomics, meta-metabolomics, and culturomics. Finally, we also offer case examples and general recommendations about the most appropriate methods and workflows and discuss strengths and shortcomings for each technique.

A new systematic arrangement for the blister beetle genus Eurymeloe (Meloini, Meloidae, Coleoptera) with the description of a new species from Spain

The taxonomic status and subgeneric arrangement of the genus Eurymeloe have been debated for decades. In this work, the internal taxonomy of Eurymeloe is redefined by recognising three subgenera: Eurymeloe for the former Eurymeloebrevicollis species group, Coelomeloe for Eurymeloetuccia, and Bolognaia Ruiz, García-París, Sánchez-Vialas & Recuero, subgen. nov., to accommodate the species of the formerly recognised Eurymeloerugosus species group. Additionally, a new species of the newly described subgenus Bolognaia is described from the Iberian Peninsula based on molecular and morphological traits. The new species, Eurymeloe (Bolognaia) orobatessp. nov., can be distinguished from all other species of Eurymeloe by the following combination of morphological traits: dispersed brownish setae over the body that are arranged in small tufts on the abdominal terga; a small, very transverse pronotum that presents a unique macrosculpture; a deeply and densely punctured integument of the head and pronotum; and the very rugose elytra. The characters displayed by E.orobates suggest that the species groups that were previously defined and recognised for Eurymeloe, and that are now integrated within the newly erected subgenus Bolognaia, are non-monophyletic.

The Strait of Gibraltar is an ineffective palaeogeographic barrier for some flightless darkling beetles (Coleoptera: Tenebrionidae: Pimelia)

The geographic distribution of a species is shaped by its biology and by environmental and palaeogeographic factors that interact at different spatial-temporal scales, which leads to distributions and diversification patterns observed between and within lineages. The darkling beetle genus Pimelia has been diversifying for more than 31.2 Mya showing different colonization patterns after the opening of the Gibraltar Strait 5 Mya. Three of the 14 subgenera of Pimelia have populations on both sides of the Strait. Through extensive sampling and the analysis of three molecular markers, we determine levels of intra- and interspecific genetic variation, identify evolutionary lineages in subgenera, estimate their temporal origin and distribution ranges and discuss the historical basis for the geographic and diversification patterns of Pimelia around the Strait. This single geographical feature acted both as a barrier and as a dispersal route for different Pimelia species. The Strait has represented a strong barrier for the subgenus Magrebmelia since the Middle Miocene. However, the subgenera Amblyptera and Amblypteraca share repetitive signatures of post-Messinian colonization across the Strait, possibly driven by stochastic or ‘catastrophic’ events such as tsunamis. Our demographic analyses support Wallace’s hypothesis on insect dispersal stochasticity. Some taxonomic changes, including the designation of a lectotype for Pimelia maura, are also proposed.

Presencia de Nacerdes (Xanthochroa) raymondi (Mulsant & Godart, 1860) (Coleoptera, Oedemeridae) en el Magreb occidental (Norte de África)

Se informa de la presencia de una población establecida de Nacerdes (Xanthochroa) raymondi en la Ciudad Autónoma de Ceuta (España, extremo septentrional de la península Tingitana). Este nuevo registro confirma la presencia de N. (X.) raymondi en el Magreb occidental, tras más de medio siglo sin datos al respecto. La presencia de N. (X.) raymondi en Ceuta extiende su distribución norteafricana hacia el noroeste, completando el vacío de registros entre las poblaciones argelinas e ibéricas, y apoya la veracidad de dos antiguas citas normarroquíes dudosas (Rif y Atlas Medio). Los ejemplares estudiados fueron atraídos por luces artificiales durante la noche, en diferentes ocasiones a lo largo de los meses de julio y agosto. Los rasgos morfológicos de los ejemplares ceutíes son similares a los de los ejemplares ibéricos examinados por lo que se confirma su identidad con N. (X.) raymondi raymondi (Mulsant & Godart, 1860).

Taxonomy of the North Moroccan and Iberian species of the subgenus Amblypteraca/ (Coleoptera: Tenebrionidae: Pimeliinae: Pimelia/)

The subgenus Amblypteraca Mas-Peinado, Buckley, Ruiz García-París, 2018 of Pimelia Fabricius, 1775, is restricted to the southern Iberian Peninsula and western Maghreb (northern and western Morocco). The distribution of Amblypteraca throughout the African-European edges overlaps largely with the geographic range of the subgenus Amblyptera, which is sister to the clade grouping subgenera Amblypteraca and Ecphoroma Solier, 1836. Delimiting species boundaries in the speciose genus Pimelia is often challenging, and the taxonomic status of some groups within the aforementioned subgenera is still a matter of debate. Here, we aim to stabilize some of the available names in Amblypteraca, and to correct some previous misidentifications. For that purpose, we discuss the composition and taxonomic structure within Amblypteraca by (i) assessing the phylogenetic congruence between mitochondrial and nuclear markers, and (ii) examining external morphological traits in 568 Amblypteraca specimens under the light of the phylogenetic hypotheses proposed here. Based on our results, Amblypteraca consists of three species: P. rotundipennis Kraatz, 1865, P. fairmairii Kraatz, 1865 and P. chrysomeloides Pallas, 1781. Both molecular and morphological data revealed four lineages within P. chrysomeloides: P. chrysomeloides chrysomeloides, distributed on both sides of the Strait of Gibraltar; P. chrysomeloides fornicata Herbst, 1799 from Portugal (Troia region); P. chrysomeloides bathyglypta Antoine, 1949, restricted to a narrow strip between Larache and Arbaoua (northern atlantic Moroccan coast), and P. chrysomeloides subris Koch, 1941 from Kenitra-La Mamora forest (Morocco). We designate a neotype of Tenebrio chrysomeloides Pallas, 1781 and propose the synonymy of P. chrysomeloides (Pallas, 1781) = P. obesa Solier, 1836 syn. n. Pimelia tristis Haag-Rutenberg, 1875, previously misidentified and included in Amblypteraca, is now transferred back to Amblyptera. Further studies with ad hoc sampling designs and analytical tools would be in need to delimit the exact geographic ranges of these taxa, and to analyse the patterns of diversity within and among species and subspecies.

The regulatory genome of the malaria vector Anopheles gambiae: integrating chromatin accessibility and gene expression

Anopheles gambiae mosquitoes are primary human malaria vectors, but we know very little about their mechanisms of transcriptional regulation. We profiled chromatin accessibility by the assay for transposase-accessible chromatin by sequencing (ATAC-seq) in laboratory-reared A. gambiae mosquitoes experimentally infected with the human malaria parasite Plasmodium falciparum. By integrating ATAC-seq, RNA-seq and ChIP-seq data, we showed a positive correlation between accessibility at promoters and introns, gene expression and active histone marks. By comparing expression and chromatin structure patterns in different tissues, we were able to infer cis-regulatory elements controlling tissue-specific gene expression and to predict the in vivo binding sites of relevant transcription factors. The ATAC-seq assay also allowed the precise mapping of active regulatory regions, including novel transcription start sites and enhancers that were annotated to mosquito immune-related genes. Not only is this study important for advancing our understanding of mechanisms of transcriptional regulation in the mosquito vector of human malaria, but the information we produced also has great potential for developing new mosquito-control and anti-malaria strategies.

Chromatin Structure and Function in Mosquitoes

The principles and function of chromatin and nuclear architecture have been extensively studied in model organisms, such as Drosophila melanogaster. However, little is known about the role of these epigenetic processes in transcriptional regulation in other insects including mosquitoes, which are major disease vectors and a worldwide threat for human health. Some of these life-threatening diseases are malaria, which is caused by protozoan parasites of the genus Plasmodium and transmitted by Anopheles mosquitoes; dengue fever, which is caused by an arbovirus mainly transmitted by Aedes aegypti; and West Nile fever, which is caused by an arbovirus transmitted by Culex spp. In this contribution, we review what is known about chromatin-associated mechanisms and the 3D genome structure in various mosquito vectors, including Anopheles, Aedes, and Culex spp. We also discuss the similarities between epigenetic mechanisms in mosquitoes and the model organism Drosophila melanogaster, and advocate that the field could benefit from the cross-application of state-of-the-art functional genomic technologies that are well-developed in the fruit fly. Uncovering the mosquito regulatory genome can lead to the discovery of unique regulatory networks associated with the parasitic life-style of these insects. It is also critical to understand the molecular interactions between the vectors and the pathogens that they transmit, which could hold the key to major breakthroughs on the fight against mosquito-borne diseases. Finally, it is clear that epigenetic mechanisms controlling mosquito environmental plasticity and evolvability are also of utmost importance, particularly in the current context of globalization and climate change.

Catalogue, distribution, taxonomic notes, and conservation of the Western Palearctic endemic hunchback beetles (Tenebrionidae, Misolampus)

Hunchback darkling beetles of the Ibero-Maghrebian genus Misolampus Latreille, 1807 (Tenebrionidae, Stenochiinae) encompass six species: M. gibbulus (Herbst, 1799), M. goudotii Guérin-Méneville, 1834, M. lusitanicus Brême, 1842, M. ramburii Brême, 1842, M. scabricollis Graells, 1849, and M. subglaber Rosenhauer, 1856. Previously known distribution ranges of the species were delineated using many old records, the persistence of such populations being questionable under the current situation of global biodiversity loss. Additionally, the status of geographically isolated populations of the genus have been the subject of taxonomic controversy. An exhaustive bibliographical revision and field search was undertaken, and the Misolampus collection of the Museo Nacional de Ciencias Naturales (MNCN-CSIC) was revised. The aims are to (i) provide an updated geographic distribution range for the species of Misolampus; (ii) to determine the taxonomic status of controversial populations; (iii) to provide a catalogue for Misolampus; and (iv) to discuss the conservation status of these saproxylic beetles. As a result, a catalogue including synonymies and type localities, geographical records, diagnoses, and information on natural history for all species of Misolampus is presented. The results reveal that the distribution ranges of the species of Misolampus have not undergone a reduction in the last century, and indicate the presence of the genus in areas where it had never been recorded before. The morphological variability of M. goudotii drove the proposal of different taxa that are here formally synonymised as follows: M. goudotii Guérin-Méneville, 1834 = M. erichsoni Vauloger de Beaupré, 1900, syn. nov. = M. peyerimhoffi Antoine, 1926, syn. nov.

The second life of Plasmodium in the mosquito host: gene regulation on the move

Malaria parasites face dynamically changing environments and strong selective constraints within human and mosquito hosts. To survive such hostile and shifting conditions, Plasmodium switches transcriptional programs during development and has evolved mechanisms to adjust its phenotype through heterogeneous patterns of gene expression. In vitro studies on culture-adapted isolates have served to set the link between chromatin structure and functional gene expression. Yet, experimental evidence is limited to certain stages of the parasite in the vertebrate, i.e. blood, while the precise mechanisms underlying the dynamic regulatory landscapes during development and in the adaptation to within-host conditions remain poorly understood. In this review, we discuss available data on transcriptional and epigenetic regulation in Plasmodium mosquito stages in the context of sporogonic development and phenotypic variation, including both bet-hedging and environmentally triggered direct transcriptional responses. With this, we advocate the mosquito offers an in vivo biological model to investigate the regulatory networks, transcription factors and chromatin-modifying enzymes and their modes of interaction with regulatory sequences, which might be responsible for the plasticity of the Plasmodium genome that dictates stage- and cell type-specific blueprints of gene expression.

Patterns of morphological diversification in giant Berberomeloe blister beetles (Coleoptera: Meloidae) reveal an unexpected taxonomic diversity concordant with mtDNA phylogenetic structure

Delimiting species boundaries is a complex challenge usually hindered by overlooked morphological diversification or misinterpretation of geographically structured phenotypic variability. Independent molecular data are extremely useful to characterize and understand such morphological diversity. Morphological and molecular variability of the non-phoretic and apterous, widely distributed, giant blister beetles of the genus Berberomeloe, were investigated within and between lineages across most of the distributional range of the genus. We used two mtDNA gene fragments to characterize genetic variability and to produce a time-calibrated phylogeny of the genus. Our results reveal several mitochondrial lineages, allopatrically, parapatrically and sympatrically distributed. Most clades are not distinguishable between each other based on morphometrics. However, no morphometric overlap is observed between two closely related clades, one of them occurring in sympatry with a distantly congeneric species (B. insignis), suggesting that sympatry could trigger morphological diversification. Although most species share a morphometric space, they can be morphologically identified by a combination of easily observed characteristic qualitative features. Based on the concordance between mtDNA clades and morphological units, we describe six new species of Berberomeloe (B. castuo sp. nov., B. comunero sp. nov., B. indalo sp. nov, B. yebli sp. nov., B. payoyo sp. nov. and B. tenebrosus sp. nov.), revalidate two taxa (B. maculifrons comb. nov. and B. laevigatus comb. nov.) and redefine B. majalis.

A new singular species of Croscherichia Pardo Alcaide, 1950 (Coleoptera, Meloidae, Mylabrini) from arid zones of eastern Morocco

A new species of blister beetle (Coleoptera, Meloidae, Mylabrini), Croscherichia armass Ruiz, François & García-París, sp. nov., is described from the arid steppes of eastern Morocco (Missour, Boulemane Province). The new species presents traits shared with both Croscherichia and desert species of the genus Ammabris, making it morphologically singular. Conspicuous external similarities (coloration pattern, shape of the mandibles, setation) between C. armass sp. nov. and Ammabris allow the two to be easily confused. However, C. armass sp. nov. can be readily distinguished from all other Croscherichia species by the following traits: reddish-orange legs with dark tarsi; relatively short black antennae with the proximal-most three to four antennomeres of each antenna having a reddish-brown coloration; dense and silvery body setation that lies over most of the body integument; straight and pointed outer mandible margins that protrude from the labrum; a mesosternum with an angulate anterior margin; a short, subcylindrical, and weakly spatulate external metatibial spur that is truncated obliquely at the apex. Croscherichia armass sp. nov. is only known from three localities in the arid Hammada steppes, which are located within the Quaternary alluvial plains of the Muluya river valley. Live specimens of C. armass sp. nov. were found in flight and actively feeding on Atriplex halimus (Chenopodiaceae) flowers at the end of summer (mid-September). The phenology of C. armass sp. nov. is exceptional as no other Mylabrini species known from eastern areas of Morocco are active in late summer.

Prenatal Particulate Air Pollution and DNA Methylation in Newborns: An Epigenome-Wide Meta-Analysis

BACKGROUND

Prenatal exposure to air pollution has been associated with childhood respiratory disease and other adverse outcomes. Epigenetics is a suggested link between exposures and health outcomes.

OBJECTIVES

We aimed to investigate associations between prenatal exposure to particulate matter (PM) with diameter [Formula: see text] ([Formula: see text]) or [Formula: see text] ([Formula: see text]) and DNA methylation in newborns and children.

METHODS

We meta-analyzed associations between exposure to [Formula: see text] ([Formula: see text]) and [Formula: see text] ([Formula: see text]) at maternal home addresses during pregnancy and newborn DNA methylation assessed by Illumina Infinium HumanMethylation450K BeadChip in nine European and American studies, with replication in 688 independent newborns and look-up analyses in 2,118 older children. We used two approaches, one focusing on single cytosine-phosphate-guanine (CpG) sites and another on differentially methylated regions (DMRs). We also related PM exposures to blood mRNA expression.

RESULTS

Six CpGs were significantly associated [false discovery rate (FDR) [Formula: see text]] with prenatal [Formula: see text] and 14 with [Formula: see text] exposure. Two of the [Formula: see text] CpGs mapped to FAM13A (cg00905156) and NOTCH4 (cg06849931) previously associated with lung function and asthma. Although these associations did not replicate in the smaller newborn sample, both CpGs were significant ([Formula: see text]) in 7- to 9-y-olds. For cg06849931, however, the direction of the association was inconsistent. Concurrent [Formula: see text] exposure was associated with a significantly higher NOTCH4 expression at age 16 y. We also identified several DMRs associated with either prenatal [Formula: see text] and or [Formula: see text] exposure, of which two [Formula: see text] DMRs, including H19 and MARCH11, replicated in newborns.

CONCLUSIONS

Several differentially methylated CpGs and DMRs associated with prenatal PM exposure were identified in newborns, with annotation to genes previously implicated in lung-related outcomes. https://doi.org/10.1289/EHP4522.

Chromatin changes in Anopheles gambiae induced by Plasmodium falciparum infection

BACKGROUND

Infection by the human malaria parasite leads to important changes in mosquito phenotypic traits related to vector competence. However, we still lack a clear understanding of the underlying mechanisms and, in particular, of the epigenetic basis for these changes. We have examined genome-wide distribution maps of H3K27ac, H3K9ac, H3K9me3 and H3K4me3 by ChIP-seq and the transcriptome by RNA-seq, of midguts from Anopheles gambiae mosquitoes blood-fed uninfected and infected with natural isolates of the human malaria parasite Plasmodium falciparum in Burkina Faso.

RESULTS

We report 15,916 regions containing differential histone modification enrichment between infected and uninfected, of which 8339 locate at promoters and/or intersect with genes. The functional annotation of these regions allowed us to identify infection-responsive genes showing differential enrichment in various histone modifications, such as CLIP proteases, antimicrobial peptides-encoding genes, and genes related to melanization responses and the complement system. Further, the motif analysis of regions differentially enriched in various histone modifications predicts binding sites that might be involved in the cis-regulation of these regions, such as Deaf1, Pangolin and Dorsal transcription factors (TFs). Some of these TFs are known to regulate immunity gene expression in Drosophila and are involved in the Notch and JAK/STAT signaling pathways.

CONCLUSIONS

The analysis of malaria infection-induced chromatin changes in mosquitoes is important not only to identify regulatory elements and genes underlying mosquito responses to P. falciparum infection, but also for possible applications to the genetic manipulation of mosquitoes and to other mosquito-borne systems.

Primeros registros precisos de <em>Trox strandi</em> Balthasar, 1936 (Coleoptera: Trogidae) en Marruecos y observaciones sobre su hábitat y variabilidad morfológica

Trox strandi es una especie rara cuyo estatus taxonómico ha sido controvertido y hasta el momento únicamente se conoce de la localidad tipo, Sidi-bel-Abbes, en el noroeste de Argelia. No obstante, ha sido señalada genéricamente de Libia, Túnez y Marruecos, pero sin que se aporten localidades concretas o material adicional. En el transcurso de diversos muestreos en el sureste de Marruecos durante los últimos años, hemos hallado dos ejemplares atribuibles a esta especie en otras tantas localidades (Tameslemt, en las estribaciones nororientales del Alto Atlas, y Ksabi, en el tramo alto del río Muluya), que constituyen los primeros registros precisos para este país. Estas localidades se sitúan en regiones con bioclima árido y semiárido y escasa cobertura vegetal. Se aportan datos sobre el hábitat, caracteres diagnósticos y variabilidad morfológica de la especie.

Influence of photoperiod on carbon dioxide and methane emissions from two pilot-scale stabilization ponds

Greenhouse gas (GHG) emissions (CO(2), CH(4)) from pilot-scale algal and duckweed-based ponds (ABP and DBP) were measured using the static chamber methodology. Daylight and nocturnal variations of GHG and wastewater characteristics (e.g. chemical oxygen demand (COD), pH) were determined via sampling campaigns during midday (12:30-15:30) and midnight (00:30-03:30) periods. The results showed that under daylight conditions in ABP median emissions were -232 mg CO(2) m(-2) d(-1) and 9.9 mg CH(4) m(-2) d(-1), and in DBP median emissions were -1,654.5 mg CO(2) m(-2) d(-1) and 71.4 mg CH(4) m(-2) d(-1), respectively. During nocturnal conditions ABP median emissions were 3,949.9 mg CO(2) m(-2) d(-1), 12.7 mg CH(4) m(-2) d(-1), and DBP median emissions were 5,116 mg CO(2) m(-2) d(-1), 195.2 mg CH(4) m(-2) d(-1), respectively. Once data measured during daylight were averaged together with nocturnal data the median emissions for ABP were 1,566.8 mg CO(2) m(-2) d(-1) and 72.1 mg CH(4) m(-2) d(-1), whilst for DBP they were 3,016.9 mg CO(2) m(-2) d(-) and 178.9 mg CH(4) m(-2) d(-1), respectively. These figures suggest that there were significant differences between CO(2) emissions measured during daylight and nocturnal periods (p < 0.05). This shows a sink-like behaviour for both ABP and DBP in the presence of solar light, which indicates the influence of photosynthesis in CO(2) emissions. On the other hand, the fluxes of CH(4) indicated that DBP and ABP behave as net sources of CH(4) during day and night, although higher emissions were observed from DBP. Overall, according to the compound average (daylight and nocturnal emissions) both ABP and DBP systems might be considered as net sources of GHG.

Medical resource utilization among community-acquired pneumonia patients initially treated with levofloxacin 750 mg daily versus ceftriaxone 1000 mg plus azithromycin 500 mg daily: a US-based study

OBJECTIVE

The 2007 American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA) guidelines recommend that community-acquired pneumonia (CAP) patients admitted to hospital wards initially receive respiratory fluoroquinolone monotherapy or beta-lactam plus macrolide combination therapy. There is little evidence as to which regimen is preferred, or if differences in medical resource utilization exist between therapies. Thus, the authors compared length of hospital stay (LOS) and length of intravenous antibiotic therapy (LOIV) for patients who received initial levofloxacin 750 mg daily versus ceftriaxone 1000 mg plus azithromycin 500 mg daily ('combination therapy').

RESEARCH DESIGN AND METHODS

Adult hospital CAP cases from January 2005 to December 2007 were identified by principal discharge diagnosis code. Patients with a chest infiltrate and medical notes indicative of CAP were included. Direct intensive care unit admits and healthcare-associated cases were excluded. A propensity score technique was used to balance characteristics associated with initial antimicrobial therapy using multivariable regression to derive the scores. Propensity score categories, defined as propensity score quintiles, rather than propensity scores themselves, were used in the least squares regression model to assess the impact of LOS and LOIV.

RESULTS

A total of 495 patients from six hospitals met study criteria. Of these, 313 (63%) received levofloxacin and 182 (37%) received combination therapy. Groups were similar with respect to age, sex, most comorbidities, presenting signs and symptoms, and Pneumonia Severity Index (PSI) risk class. Patients on combination therapy were more likely to have heart failure and receive pre-admission antibiotics. Adjusted least squares mean (+/-SE) LOS and LOIV were shorter with levofloxacin versus combination therapy: LOS, 4.6 +/- 0.17 vs. 5.4 +/- 0.22 days, p < 0.01; and LOIV, 3.6 +/- 0.17 vs. 4.8 +/- 0.21 days, p < 0.01. Results for PSI risk class III or IV patients were: LOS, 5.0 +/- 0.30 vs. 5.9 +/- 0.37 days, p = 0.07; and LOIV, 3.7 +/- 0.33 vs. 5.2 +/- 0.39 days, p < 0.01. Due to the retrospective study design, limited sample size, and scope (single health-network), the authors encourage replication of this study in other data sources.

CONCLUSIONS

Given the LOS and LOIV reductions of 0.8 and 1.2 days, respectively, utilization of levofloxacin 750 mg daily for CAP patients admitted to the medical floor has the potential to result in substantial cost savings for US hospitals.

Cutaneous horn in glans penis: a new clinical case

This report presents a case of a 65-year-old male suffering from a penile cutaneous horn. This lesion is usually seen in sun-exposed areas and its occurrence on the penis is rare. One-third of cases of penile horns are associated with underlying malignancies. Standard treatment is electrosurgical excision with removal of a broad base.

Conservative treatment with transurethral resection, neoadjuvant chemotherapy followed by radiochemotherapy in stage T2-3 transitional bladder cancer

PURPOSE

Organ preservation has been investigated in patients (p) with infiltrating transitional cell carcinoma (TCC) of the bladder over the past decade as an alternative to radical cystectomy. This is a trimodal schedule study, including transurethral resection of bladder tumor (TURB), neoadjuvant chemotherapy and concomitant radiochemotherapy (RTC).

PATIENTS AND METHODS

From April 1996 until August 2005, 29 evaluable patients (p) with T2-T3NXM0 bladder cancer were enrolled. After a transurethral resection of bladder tumor (TURB), we administered 2 cycles of induction chemotherapy with CMV (15 p) or Gemcitabine-Cisplatin (14 p) followed by radiotherapy 45 Gy 1.8 Gy/fraction and two cycles of concomitant cisplatin 70 mg/m(2). 2-3 weeks later, a cystoscopy with tumor-site biopsy was performed. If complete histological response, p were treated with consolidation radiotherapy until 64.8 Gy. For p with residual or recurrent tumor, cystectomy was performed.

RESULTS

We included 28 men and 1 women (median age 63, range 39-72 years) with PS (ECOG) 0-1. The stage was: 21 p T2; 6 p T3a; and 2 p T3b. Toxicity was higher in CMV compared with Gem- Cis: grade (3/4) neutropenia 4/15 (26%) vs 1/14 (7%); febrile neutropenia 3/15 (20%) vs 1/14 (7%); grade (3/4) trombocytopenia 2/15 (13%) vs 1/14 (7%). Toxicities with concomitant RCT were low-moderate: urocystitis (26%) and enteritis (18%).

RESPONSE

microscopically complete TURB was obtained in 20 p (69%), but not in 9 p (31%) (7 microscopic, and 2 macroscopic residual tumor). We found a complete histologic response after induction RCT in 25 p (86%). After a median follow-up of 69.4 months (m) (range: 8-97.7), there were 8 deaths, with a overall survival of 72%. Furthermore 14 of 29 p (48%) were alive with intact bladder, and median survival time with intact bladder was 63.6 m (50.1-77.2); were predictive of best outcome T2 stage vs T3 (p < 0.0001), and complete histologic resection in initial TURB vs residual tumor (p = 0.0004).

CONCLUSIONS

Combined treatment provide high response rates and can be offered as an alternative option to radical cystectomy in selected patients with TCC. Patients with T2 stage and complete histologic resection in initial TURB had the best outcome.

Tissue antioxidant capacity and bacterial translocation under total parenteral nutrition

Alterations in the antioxidative system have been observed during total parenteral nutrition (TPN). Light exposure or changes in the composition of TPN formulas may affect this system. Bacterial translocation (BT) is frequent under TPN and may be related to oxidative status. The aim of this study was to determine the adverse effects of standard and glutamine-enriched TPN, with or without light exposure, on oxidative status (liver and kidney-reduced glutathione, GSH) and its relationship to BT. Thirty-three adult Wistar rats underwent central-venous cannulation and were randomly assigned to one of four groups receiving different TPN regimes for 10 days. The TPN group (n = 10) had standard TPN, the TPN(-) group (n = 8) standard TPN without light exposure, the GTPN group (n = 8) glutamine-enriched TPN, and the GTPN(-) group (n = 7) glutamine-enriched TPN without light exposure. A sham group (n = 16) receiving chow and water ad libitum and saline i.v. served as controls. At the end of the experiment, GSH was determined in liver and kidney tissue. Mesenteric lymph nodes and peripheral and portal blood samples were cultured for BT. Compared to sham rats, TPN groups had statistically significant lower GSH levels, but there were no differences between standard or glutamine-enriched groups or light-exposure groups. Sham animals had 12% BT. Significantly higher BT (P < 0.05) occurred in TPN rats: 70% in the TPN group, 88% in the TPN(-) group, 86% in GTPN (-) animals, and only 50% in the GTPN group (P = 0.06 vs TPN group). In conclusion, (1) TPN reduces antioxidant capacity; (2) glutamine supplementation or light protection does not improve tissue antioxidant capacity under TPN; (3) the absence of light exposure does not improve TPN-related BT; and (4) glutamine supplementation tends to reduce BT only in the presence of light.

2-Hydroxyacid dehydrogenase from Haloferax mediterranei, a D-isomer-specific member of the 2-hydroxyacid dehydrogenase family

An NAD-dependent D-2-hydroxyacid dehydrogenase (EC 1.1.1.) was isolated and characterized from the halophilic Archaeon Haloferax mediterranei. The enzyme is a dimer with a molecular mass of 101.4 +/- 3.3 kDa. It is strictly NAD-dependent and exhibits its highest activity in 4 M NaCl. The enzyme is characterized by a broad substrate specificity 2-ketoisocaproate and 2-ketobutyrate being the substrates with the higher Vmax/Km. When pyruvate and 2-ketobutyrate were the substrates the optimal pH was acidic (pH 5) meanwhile for 2-ketoisocaproate maximum activity was achieved at basic pH between 7.5 and 8.5. The optimum temperature was 52 degrees C and at 65 degrees C there was a pronounced activity decrease. This new enzyme can be used for the production of D-2-hydroxycarboxylic acid.

[Subacute intestinal obstruction caused by giant bladder diverticulum]

A case of a patient affected with intestinal obstruction of 4 days of evolution is presented. The diagnosis of giant bladder diverticulum due to Benign Prostatic Hypertrophy was made by abdominal ultrasound at Emergency Room, and afterwards was confirmed by cystography. A trabeculated wall and a diverticulum at the posterior side was seen with the cystography. The diverticulum full of urine couldn't be emptied due to a narrow diverticular neck and the rectum was obstructed. When a urethral catheter was put in, the symptoms of intestinal obstruction disappeared 800 ml of urine were passed through the catheter and the rectum compression was released; the gas was allowed to pass through the bowel and it's seen in plain X-Ray. This case is presented, considering its unusual this way of presentation of a giant bladder diverticulum. We have reviewed the literature en Medline since 1966 and we have not found a similar case.

[Clinical course of prostatic abscess treated with transperineal drainage]

It is true that appearance of prostate abscesses is currently not so frequent due to the antibiotic therapy available to stop any kind of infectious process which may trigger abscess formation. Even so, it is important to channel right from the beginning the correct diagnosis and treatment in order to avoid, as far as possible, any complications that may derive from the process. This paper deals with the case of a young patient diagnosed in our service with a prostate abscess, and faced with that suspicion we advocated the use of transrectal ultrasound (TRU) as the method for diagnostic imaging. Also, TRU offers great help as guidance in the transperineal puncture, so as to drain the purulent content. It should not be forgotten the valuable information provided by ultrasound to confirm that the treatment used was effective.

Renal aspergillosis and AIDS

Primary renal aspergillosis is an extremely rare entity. Only 19 cases have been reported, 3 of them in patients with AIDS. We report one new case of renal aspergillosis in a patient with AIDS. His disease pattern was multiple bilateral renal abscesses with a normal excretory pathway. The treatment established was percutaneous drainage and systemic antifungal drugs. He had a bad evolution and died 14 weeks after diagnosis. In the previously reported cases of aspergillosis in patients with AIDS, the manifestation was unilateral renal abscess.

Value of morphometry as an independent prognostic factor in renal cell carcinoma

Nuclear morphometry was performed in 159 adenocarcinomas of the kidney. The mean and SD of the following nuclear parameters were calculated: area, perimeter, major axis, minor axis and a shape factor. Median survival, including all stages, was 72 months and cumulative survival at 5, 10 and 15 years of 50, 42 and 33%, respectively. Values of morphometric parameters, except for shape factor, tend to increase in proportion to stage. Nuclear area was the best parameter to predict the variability in survival time. The Cox regression model was performed for each stage, and the relationship with length of survival time was studied. For stage T1-2 N0 M0, nuclear area was the only variable chosen as an independent significant predictor of outcome. For the rest of the stages, no variables were selected as predictors at any significant level.

Depth perception by a holographic imaging system

A holographic optical system for checking human depth perception is proposed. The system does not use any kind of dissociative element; it uses incoherent light for the reconstruction of holograms and allows the binocular disparity to vary from 0 to 650 arcsec. The depth perception of observers can be checked in conditions closer to normal life.

[Abdominal echography to determine the weight of the prostate]

The relationship of post-operatively determined prostatic gland weight and that calculated prior the procedure, by means of abdominal ultrasound techniques using the "ellipsoid method", has been studied in 88 patients undergoing retropubic adenectomy. The regression line was nearly optimal, Y = 0.946 X + 2.295, and the correlation coefficient between both weight measures was r = 0.915. Abdominal ultrasound examinations are a simple, quick and safe means to evaluate prostate weight, prior to deciding the type of surgery (open adenectomy or transurethral resection) for prostate adenoma.

[Surgical treatment of uretero-vaginal fistulae caused by gynecologic surgery]

The present paper is a review of 71 cases of uretero-vaginal fistulae secondary to pelvic surgery which were treated in the Urology Unit of our hospital. Surgical management of these fistula intrinsically depends on their number, location and severity. The results obtained by the different techniques were analyzed, emphasizing their merit when using the Turner-Warwick technique (uretero-cystoneostomy on psoic bladder) and any urodynamic troubles this technique can bring about when used bilaterally in patients from radical gynaecological surgery.

Unusual foreign bodies in the urethra and bladder

We report 8 cases of self-inserted unusual foreign bodies in the lower urinary tract, all being treated from 1976 to 1990. Three of them were located in the urethra and 5 in the bladder. Several objects were found (electric cable, tweezers, hairpin, drawing pin, pebbles, paper clip). In 4 cases the objects were inserted for masturbatory purposes. Five of the patients were psychologically ill or handicapped. The most common reason for consultation was dysuria, and the treatment procedures were endoscopy in 5 patients and cystotomy in the other 3.

[Treatment of obstruction caused by prostatic hypertrophy with prazosin. 1-year follow-up]

Since Caine demonstrated the presence of alpha-adrenergic receptors in prostate tissue in 1975, an alpha-blocker capable of producing maximum relaxation of prostatic tissue with minimum side effects has been sought. Prazosin, a selective alpha-1 blocking agent, must meet these requirements. We report the results of a study undertaken in 28 patients with benign hyperplasia of the prostate demonstrated by flowmetry, clinically and by ultrasound. A significant improvement was observed in all patients except for the ultrasound measured prostate size, which remained unchanged. Undesired effects were observed in 36% of the patients. Despite the initial improvement, 89.3% had abandoned treatment at 1 year principally owing to deterioration of the clinical picture and because they were submitted to surgery (the majority) or treatment with other drugs. We can conclude from our results that prazosin is useful for short-term therapy; i.e., until the patient can be referred for surgery.

[Dimethyl sulfoxide in the treatment of interstitial cystitis]

The paper presents the results obtained with endovesical dimethylsulphoxide in the treatment of interstitial cystitis in 30 women. Up to 80% patients showed clinical improvement with an average of 10 installations. Volume of maximal vesical capacity was increased in 24 patients (80%), the increase being greater than 100 cc in 10 cases. Presently, 24 (80%) patients remain under treatment, 14 with one instillation monthly and 10 once every six months. Six patients are fully asymptomatic without treatment after an average symptoms-free interval of 32 months. Since this is directly related to a decrease both in pain and miction frequency, the increase in vesical capacity appears to be a good improvement index. Dimethylsulphoxide in neither a healing nor a definite therapy but it seems to be effective in the management of this unknown disease.

Femoral intraosseous neurilemoma

The neurilemoma (benign schwannoma) is a benign tumor which arises from the Schwann cells of the peripheral nerves. In an intraosseous localization it is a very rare lesion, only forty cases being reported in the literature, and only two of these with the tumor located in the femur. This paper reports on a patient with a large neurilemoma in the lower part of the left femur.

Renal cell carcinoma: late recurrence in 2 cases

We present 2 patients with late recurrence 16 and 11 years after nephrectomy for renal cell carcinoma. Metastases were solitary and their location very uncommon (vastus externo muscle and colon). In the reviewed series of 5,758 patients with renal cell carcinoma only a temporal muscle metastasis and another in the colon were observed but none of them was solitary.

Urological complications associated to uterus didelphys with unilateral hematocolpos. A case report and review of the literature

Complete duplication of vagina, cervix and uterus, with imperforate hemivagina and renal agenesis is a rare condition with less than 120 cases published. In those articles, urological complications are uncommon with only a 10% of the total. We report 2 cases of uterus didelphys with unilateral hematocolpos and ipsilateral renal agenesis with urological clinical complications. One of them presented a very rare onset complaining of acute urinary retention. The other patient was referred for difficulty in micturition and abdominal pain which is the most common symptom of this entity. A description of both cases and a literature review of this congenital complex syndrome and its urological complications are reported.

[Experimental surgical model of hydrocele for the use of sclerotherapy]

Sclerosant therapy for different pathological conditions (testicular hydrocele, pneumothorax) is a little known and scantily used procedure in the clinical setting. We have developed a surgical procedure in the dog that permits reproducing adult hydrocele. This experimental model is useful for morphometric assessment of the sclerosant effects of the commonly used agents (magnesium silicate hydrate, carbolic acid, ethanolamine oleate, hydroxytetracycline chlorhydrate and quinacrine chlorhydrate). Our results show that the degree of sclerosis achieved with quinacrine and hydrotetracycline is significantly superior to that obtained with other agents.

ABO blood groups and bladder carcinoma

Following some reports concerning the possible influence of ABO blood groups on constitutional types and different features of human pathology, we have investigated if there are relationships between ABO blood groups and bladder tumors. Our findings show that tumoral behavior in patients with bladder carcinoma and blood group O has a tendency to an increased aggressivity with higher tumoral grade and more relapses than what is seen in tumors of patients with A blood group. Although this difference is not statistically significant, we believe that blood group ABO should be considered as a constitutional prognostic factor in bladder carcinoma and further investigations in this field are needed.

[Acute urinary retention caused by hematocolpos associated with uterus didelphys and ipsilateral renal agenesis]

Acute urinary retention from compressive hematocolpos is an uncommon form of presentation of the multi-malformation syndrome arising from failed fusion of the Müllerian ducts and is characterized by uterus didelphys, vaginal duplication (one with hematocolpos), and unilateral renal agenesis. A case is reported and the literature reviewed.

[Aztreonam versus tobramycin in acute pyelonephritis. A comparative study]

We performed a comparative study between the monobactam antibiotic aztreonam and the aminoglycoside tobramycin in patients diagnosed as having acute pyelonephritis. The respective doses were 1 gr. IM daily for 7 days, and 100 mgr. IM q 12 h for the same period of time. Clinically, 100% of uncomplicated acute pyelonephritis and 87.5% of complicated infections cured with aztreonam. Tobramycin achieved an 80% cure rate for both types of infections. Microbiologically aztreonam was effective in all uncomplicated acute pyelonephritis, and in 69.56% of the complicated cases (overall microbiological cure rate = 78.7%). The therapeutic failures were ascribable to infections from S. faecalis, an organism naturally resistant to aztreonam. Thus, the microbiological cure rate was 84.2% in complicated pyelonephritis from organisms sensitive to this antimicrobial. The microbiological cure rate for tobramycin was 70% in acute uncomplicated, and 80% in complicated infections. We observed a good clinical and biological tolerance to both antimicrobials. No side effects were observed. Serum and blood biochemical analyses, and coagulation tests revealed no changes.