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Epithelial-mesenchymal transition dysregulation in prostate cancer: Insights from molecular unraveling and epidemiological analyses in Tunisia, North Africa. Ann Hum Genet 2024. [PMID: 38661458 DOI: 10.1111/ahg.12563] [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: 02/11/2024] [Revised: 03/09/2024] [Accepted: 04/04/2024] [Indexed: 04/26/2024]
Abstract
INTRODUCTION The progression of prostate cancer (PCa) has been linked worldwide, including in African populations, to the dysregulation of the epithelial-mesenchymal transition (EMT). METHODS To clarify the connection among EMT markers, clinicopathological parameters, and epidemiological factors, we analyzed 35 PCa specimens from patients in Tunisia, a country in North Africa, arranged by stages. We also carried out extensive molecular and epidemiological analyses. RESULTS Significant dysregulation of EMT genes was found, with an overexpression of ZEB-1, Twist, Snail-1, and Vimentin (p < 0.05) and underexpression of E-cadherin and β-catenin (p < 0.05). Positive correlations were observed between transcription factors and the mesenchymal marker Vimentin (p < 0.001, r = 0.574; p = 0.029, r = 0.411; and p < 0.001; r = 0.506) according to Spearman correlation analyses, whereas negative correlations were found between epithelial markers (E-cadherin, β-catenin) and Vimentin (p < 0.05; r < 0). Higher PSA, Gleason scores, and metastasis were all correlated with the dysregulation of EMT (p < 0.05). Notably, there was a positive correlation between higher consumption of tobacco (≥20 Packets per year) and Vimentin expression (p < 0.001, r = 0.854), suggesting a relationship between smoking and EMT activation in the Tunisian population. Moreover, Twist showed a positive correlation with diabetes (p < 0.001, r = 0.385), whereas no significant correlations were found between EMT markers and comorbidities such as hypertension and coronary insufficiency. These results demonstrate the intricate connection between molecular changes, epidemiological factors, and disease progression, and they emphasize the crucial role that EMT plays in promoting PCa aggressiveness in African populations, particularly in Tunisia. CONCLUSION In summary, understanding these correlations could help develop focused treatment plans and enhance patient outcomes for PCa management in African settings.
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Anatomy and anatomical variations of adrenal veins and its application to adrenal venous sampling. Surg Radiol Anat 2024; 46:543-550. [PMID: 38429406 DOI: 10.1007/s00276-024-03331-y] [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: 06/30/2023] [Accepted: 02/23/2024] [Indexed: 03/03/2024]
Abstract
PURPOSE Our aim was to study the anatomy of the left and right main adrenal veins (LAV and RAV) and to identify their anatomical variations in order to see the practical application of these findings to adrenal venous sampling (AVS). METHODS Our work is based on dissection of 80 adrenal glands from fresh corpses in the forensic medicine department. We studied the number, the drainage, the direction and the level of termination of the main adrenal veins. RESULTS The average length of the LAV was 21 mm. It ended in 100% of cases at the upper edge of the left renal vein with a mean connection angle of 70° and after an anastomosis with the lower phrenic vein in 36 cases(90%). The average length of the RAV was 9 mm. It ended in 100% of cases at the level of the retro hepatic inferior vena cava (IVC) mainly on its posterior face in 21 cases (53%) and on its right lateral border in 18 cases (45%). The mean angle of the RAV in relation to the vertical axis of the IVC was 40°, with extremes ranging from 15° to 90°. CONCLUSIONS AVS seems to be easier on the left than on the right side because of the greater length of the adrenal vein (21 mm vs. 9 mm) and a greater angle of connection (70° with the left renal vein vs. 40° with the IVC), which explains the lower success rate of cannulation and the more frequent occurrence of blood sample contamination on the right side.
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An insight into the diagnostic, prognostic, and taxanes resistance of double zinc finger and homeodomain factor 's expression in naïve prostate cancer. 3 Biotech 2024; 14:106. [PMID: 38476644 PMCID: PMC10925581 DOI: 10.1007/s13205-024-03941-8] [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: 01/17/2023] [Accepted: 01/28/2024] [Indexed: 03/14/2024] Open
Abstract
Currently, clinical biomarkers are urgently needed to improve patient management to guide personal therapy for cancer. In this study, we investigate the deregulation of Zeb-1 in prostate cancer (PC) Tunisian patients. Expression patterns of the Zeb-1 were investigated in prostate adenocarcinoma and benign prostate biopsies using quantitative real-time reverse transcription-polymerase chain reaction (RT-qPCR) and 2-ΔΔCt method. Statistical analysis was used to identify differences across groups depending on gene expression level. Furthermore, we exploited a follow-up over 15 years to correlate Zeb-1 deregulation and clinical outcomes in PC patients. Based on ROC curve analyses, the AUC was found in discriminating PC patients from controls (AUC = 0.757; p < 0.001). In addition, the higher expression level was significantly associated with PSA, Digital Rectal Examination, Gleason score, tumor stage, and distant lymph node metastases. Moreover, Zeb-1 overexpression was correlated with shorter overall survival (OS) (p = 0.042), poor progression-free survival (PFS) (p = 0.007), and with resistance to taxanes (p = 0.012). Our data provide the aberrant expression of Zeb-1 in PC patients suggesting its potential diagnostic, prognostic, and theranostic role. Further functional studies are mandatory to strengthen these results and to uncover the molecular mechanism of this neoplasm. Supplementary Information The online version contains supplementary material available at 10.1007/s13205-024-03941-8.
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Antimicrobial prophylaxis protocol based on rectal swab culture before prostate biopsy to prevent infectious complications: a prospective randomized comparative study. Int Urol Nephrol 2024:10.1007/s11255-024-03998-7. [PMID: 38448785 DOI: 10.1007/s11255-024-03998-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 02/16/2024] [Indexed: 03/08/2024]
Abstract
PURPOSE To evaluate the benefit of targeted antibiotic prophylaxis (TAP) based on rectal swab culture in comparison with standard empiric antimicrobial prophylaxis in patients undergoing transrectal ultrasound-guided needle biopsy of the prostate (TRUS-BP), as well as to assess rate of fecal carriage of Fluoroquinolone-resistant Enterobacterales FQRE. PATIENTS AND METHODS We prospectively analyzed data that randomized 157 patients within two groups: (G1) TAP according to rectal swab performed 10 days before PB; (G2): empirical antibiotic prophylaxis with ciprofloxacin. Prevalence of FQRE digestive carriage and risk factors were investigated. Incidence of infectious complications after (TRUS-BP) in each group was compared. RESULTS G2 included 80 patients versus 77 in G1. There was no difference between the two groups regarding age, diabetes, prostate volume, PSA, number of biopsy cores, and risk factors for FQRE. In G2, the prevalence of FQRE digestive carriage was 56.3% all related to E. coli species. In the case of digestive carriage of FQRE, TAP according to the rectal swab culture with third-generation cephalosporins was performed in 73.3%. Patients with FQRE had history of FQ use within the last 6 months in 17.8% (p = 0.03). Rate of febrile urinary tract infection after PB was 13% in G1 and 3.8% in G2 (p = 0.02). CONCLUSIONS Incidence of FQ resistance in the intestinal flora of our local population was prevalent. Risk factor for resistance was the use of FQ within the last 6 months. TAP adapted to rectal swab, mainly with third-generation cephalosporins, significantly reduced the rate of infectious complications after (TRUS-BP).
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Correlation between E-cadherin/β-catenin, Vimentin expression, clinicopathologic features and drug resistance prediction in naïve prostate cancer: A molecular and clinical study. Genesis 2024; 62:e23543. [PMID: 37649322 DOI: 10.1002/dvg.23543] [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: 04/10/2023] [Revised: 07/17/2023] [Accepted: 08/11/2023] [Indexed: 09/01/2023]
Abstract
Although epithelial-mesenchymal markers play an important role in prostate cancer (PC), further research is needed to better understand their utility in diagnosis, cancer progression prevention, and treatment resistance prediction. Our study included 111 PC patients who underwent transurethral resection, as well as 16 healthy controls. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was used to examine the expression of E-cadherin, β-catenin, and Vimentin. We found that E-cadherin and β-catenin were underexpressed in primary PC tissues. E-cadherin expression was found to be inversely associated with prostate-specific antigen progression (PSA-P; serum marker of progression; p = 0.01; |r| = 0.262). Furthermore, the underexpression of two markers, E-cadherin and β-catenin, was found to be associated with advanced tumor stage and grade (p < 0.05). On the other hand, Vimentin was overexpressed in PC patients with a fold change of 2.141, and it was associated with the diagnosis, prognosis, and prediction of treatment resistance to androgen deprivation therapy (p = 0.002), abiraterone-acid (p = 0.001), and taxanes (p = 0.029). Moreover, the current study highlighted that poor survival could be significantly found in patients who progressed after primary surgery, did not use drugs, and expressed these genes aberrantly. In Cox regression multivariate analysis (p < 0.05), a positive correlation between the Vimentin marker and coronary heart disease in PC patients was identified (p = 0.034). In summary, the present study highlights the diagnostic (p < 0.001), prognostic (p < 0.001), and therapeutic potential of Vimentin in primary PC (p < 0.05), as well as its implications for cardiovascular disease. Furthermore, we confirm the potential prognostic value of E-cadherin and β-catenin.
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Co-expression of Twist and Snai1: predictor of poor prognosis and biomarker of treatment resistance in untreated prostate cancer. Mol Biol Rep 2024; 51:226. [PMID: 38281235 DOI: 10.1007/s11033-023-09167-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] [Received: 09/30/2023] [Accepted: 12/15/2023] [Indexed: 01/30/2024]
Abstract
BACKGROUND Prostate cancer (PCa) remains one of the most complex tumors in men. The assessment of gene expression is expected to have a profound impact on cancer diagnosis, prognosis, and treatment decisions. The aim of this study was to determine the utility of the epithelial-mesenchymal transition (EMT) transcription factors Twist and Snai1 in the treatment of naïve prostate cancer. METHODS AND RESULTS We analyzed formalin-fixed paraffin-embedded (FFPE) prostate tissues from 108 PCa patients and 20 control biopsies using real-time quantitative reverse transcription-polymerase chain reaction (RT-qPCR) and 2-ΔΔCt methods for Twist and Snail gene expression. The expression of Twist and Snai1 mRNA was significantly overexpressed in primary tissues of PCa patients compared with controls using ROC curve. Statistical analysis showed that the mRNAs of these two genes expression Snai1 and Twist were positively correlated with tumor development and prognostic parameters as Gleason score (p < 0.001; r = 0.707) and (p < 0.001; r = 0.627) respectively. The results of Kaplan-Meier analysis showed that mRNA expression of Snai1 and Twist genes expression were significant predictors of poor overall survival (OS) (Log rank p < 0.001) and progression-free survival (PFS) of patients (Log rank p < 0.001). Furthermore, our results showed that the expression of Snai1 and Twist genes expression in primary tissues of PCa patients could predict resistance to androgen deprivation therapy (p < 0.001) and resistance to the acidic drugs abiraterone or enzalutamide (p < 0.001). However, these two transcription factors failed to predict taxanes resistance at the time of diagnosis (p > 0.05). CONCLUSION These results suggest that Snai1 and Twist are overexpressed during the onset and progression of PCa malignancies and may be theranostic markers of resistance to ADT, abiraterone, or enzalutamide therapy.
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Validation of the Aldosteronoma Resolution Score as a Predictive Resolution Score of Hypertension After Unilateral Adrenalectomy for Primary Aldosteronism in a North-African Population. World J Surg 2023; 47:2776-2783. [PMID: 37667066 DOI: 10.1007/s00268-023-07155-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND Unilateral primary aldosteronism (UPA) is the most frequent surgically curable form of endocrine hypertension. Adrenalectomy is the cornerstone of treatment for UPA, but outcomes after surgery are variable. Aldosteronoma Resolution Score (ARS) is a four-item predictive score for the cure of hypertension after adrenalectomy for UPA and has been demonstrated to be valid in different populations. We aimed in this study to validate the accuracy of this score in a North-African population. METHODS Between 2000 and 2021, the charts of 71 Tunisian patients who underwent laparoscopic adrenalectomy for UPA were retrospectively reviewed. Postoperative outcomes were assessed using the primary aldosteronism surgical outcome (PASO) criterion. The accuracy of the ARS was determined retrospectively by receiver operating characteristic curve and area under the curve. RESULTS Thirty-four patients (48%) had complete clinical success according to the PASO criteria. Multivariate regression analysis revealed that the main determinants of complete clinical success were the absence of diabetes (OR: 5.205), a BMI <30 (OR: 4.930), a number of antihypertensive medications ≤2 (OR: 8.667), a plasma ARR >332 (OR: 4.554) and an ARS score ≥3 (OR: 2.056). Cure rates were, respectively, 21.1, 51.6, and 66.6% for patients with a score ARS 0-1, 2-3, and 4-5. The AUC of the ARS was 0.837. CONCLUSION The ARS is a sufficiently predictive score in our North-African population. It may be used preoperatively to predict the outcome after adrenalectomy in these populations.
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Can radiological scores predict difficulties in removal of encrusted ureteral stents? Urolithiasis 2023; 51:108. [PMID: 37612572 DOI: 10.1007/s00240-023-01482-y] [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: 07/07/2023] [Accepted: 08/09/2023] [Indexed: 08/25/2023]
Abstract
In the present study, we aimed to report our single-center experience in encrusted ureteral stent management and to compare the utility of two different scoring systems in patient management. This is a retrospective study of patients who underwent various surgical procedures to remove encrusted ureteral stent. Encrusted stent grading was performed using KUB and FECal grading sytems. FECal grading system scored from Grade 1 to Grade 5 according to stone size, location, and degree of stent incrustation and the KUB score is the sum of the stone burden scores of three different parts of an encrusted stent within the kidney, ureter, and bladder determined using a scale from 1 to 5 according to the maximal diameter of encrustation. We compared these two classifications for the prediction of perioperative outcomes. Fifty patients were included in the study (52% female, mean age 48 years). The mean time from ureteral stent insertion until diagnosis of encrustation was 11.4 ± 13.6 months. High-grade incrustations (FECal Grade 3, 4, and 5) accounted for 62% of cases. The mean KUB score was 9.8 ± 2.7. The average number of procedures required to remove the stent was 1.71 ± 1.38. Multimodal surgery was required to remove 42% of the stents. Both, a total KUB score ≥ 9 and high-grade FECal classification were found to be significant predictors of longer operative time (> 100 min), need for multiple surgeries, and need for invasive surgery. While high-grade FECal classification showed a significant association with need for multimodal surgery (OR 6.92, p = 0.008), a total KUB score ≥ 9 showed no association (OR 2.91, p = 0.086). These two scores seem to be good indicators in predicting difficulties for surgical management of encrusted ureteral stent with a clear advantage of the FECal score in terms of prediction of multimodal surgery.
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Predictors of successful outcome after adrenalectomy for unilateral primary aldosteronism. Front Endocrinol (Lausanne) 2023; 14:1205988. [PMID: 37635962 PMCID: PMC10454906 DOI: 10.3389/fendo.2023.1205988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 07/18/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction Unilateral primary aldosteronism (UPA) is the most frequent surgically curable form of endocrine hypertension. Adrenalectomy is the cornerstone of treatment for UPA, but outcomes after surgery are variable. The cause of resistant hypertension after surgery is still a matter of debate. Our aim was to investigate cure rates after surgery and to evaluate preoperative factors that might influence the surgical outcome. Methods Between 2000 and 2021, the charts of 71 Tunisian patients who underwent laparoscopic adrenalectomy for UPA were retrospectively reviewed. Preoperative medical records were collected and follow-up data (1-158 months) were registered. Antihypertensive medication doses were calculated using defined daily doses (DDD) and postoperative outcomes were assessed using the Primary Aldosteronism Surgical Outcome (PASO) criterion. Results Of 91 enrolled patients, 71 (59% women, mean age 46 years, median length of follow-up 21 months) were suitable for evaluation. Thirty-four patients (48%) had complete clinical success according to the PASO criteria. The most relevant factors associated with complete clinical success on univariate analysis were: absence of diabetes (p= 0.007), low body mass index (BMI) (p= 0.001), lower preoperative DDD (p= 0.01), preoperatively controlled blood pressure (p= 0.024), higher plasma aldosterone to renin ratio (ARR) (p= 0.001), adenoma subtyping (p <0.001) and aldosteronoma resolution score (ARS) (p= 0.002). Multivariate regression analysis showed that the major predictors of complete clinical success were absence of diabetes (OR: 5.205), a BMI < 30 (OR: 4.930), a plasma ARR > 332 (OR: 4.554) and an ARS ≥ 3 (OR: 2.056). Conclusion Complete and partial clinical response rates were achieved in respectively 48 and 43% of cases. The main predictors of complete resolution of hypertension were absence of diabetes, low BMI, high plasma ARR and high ARS. Taking these factors into account may help identify patients at risk of persistent postoperative hypertension who may require long-term surveillance and medication.
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Management of blunt renal trauma on pre-existing diseased kidneys: a cross-sectional study. Ann Med Surg (Lond) 2023; 85:2432-2436. [PMID: 37363469 PMCID: PMC10289701 DOI: 10.1097/ms9.0000000000000594] [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: 02/08/2023] [Accepted: 03/22/2023] [Indexed: 06/28/2023] Open
Abstract
Pathological kidney trauma is a special entity. Congenital or acquired lesions may interfere with clinical presentation, radiological imaging, and the therapeutic approach. Objective Our objective was to determine the clinical, radiological, and therapeutic features of this entity. Materials and methods The medical records of 37 observations were retrospectively collected from January 1992 to February 2022. All cases were explored by a kidney ultrasound and/or a computed tomography scan, and classified according to the American Association of Surgery of Trauma. Pre-existing renal abnormalities were found in 37 patients among 203 (18.2%). The most common underlying lesion were urolithiasis (37.8%) followed by pyelo-ureteral junction syndrome (32.4%). Surgical abstention was decided in 11 cases, four nephrectomies were performed as a matter of urgency, and seven nephrectomies were performed remotely. The cure of uropathy was performed after an average delay of 3 months. Conclusion Kidneys with underlying pathology are habitually more susceptible to trauma. Contusions are often benign contrasting with a high nephrectomy rate.
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Retrovesical hydatid cyst: an unusual location of hydatid disease about a case series. Ann Med Surg (Lond) 2023; 85:722-726. [PMID: 37113869 PMCID: PMC10129112 DOI: 10.1097/ms9.0000000000000380] [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: 02/06/2023] [Accepted: 02/25/2023] [Indexed: 04/29/2023] Open
Abstract
Hydatid disease is an endemic zoonosis in regions with temperate climates where pastoral farming is common. Retrovesical localization is rare. Given the rarity of this entity, the lack of personal clinical experience, and the difficulty with detecting early symptoms, the diagnosis remains elusive for years. Methods This is a 30-year retrospective, descriptive and analytic study of seven patients who were hospitalized and operated on in the Department of Urology during 30 years (1990-2019). Outcomes The average patient age was 54 years (range: 28-76). Signs of bladder irritation were the predominant presenting complaint. No cases of hydaturia were noted. Preoperative diagnosis was based on ultrasonography and serology tests. Hydatid serology was positive for three patients. In three cases, a hydatid cyst of the liver was associated. A partial cystopericystectomy was performed for five patients, it was total for one patient. The resection of the prominent dome was realized once. No cystovesical fistula was found. The mean postoperative stay was 16 days. The postoperative course was uneventful for five patients. Urinary fistula occurred in one patient. One case of infection of the residual cavity was observed. One patient had a retroperitoneal cyst recurrence requiring reoperation. Conclusion The preoperative diagnosis of retrovesical hydatid cysts is based mainly on ultrasonography. Open surgery is the treatment of choice. Different approaches are possible. Given the rarity of this entity, management should be guided by experienced experts.
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Predictors of successful outcome after adrenalectomy for primary aldosteronism. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01140-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Vascular complications of renal transplantation: Risk factors and impact on graft survival. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00462-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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2022 TUNISIAN NATIONAL CONGRESS OF MEDICINE ABSTRACTS. LA TUNISIE MEDICALE 2023; 101:62-64. [PMID: 37682263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Indexed: 09/09/2023]
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MO967: Lymphocele After Renal Transplantation: Management, Risk Factors and Impact on Transplant Survival. Nephrol Dial Transplant 2022. [DOI: 10.1093/ndt/gfac087.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND AND AIMS
Lymphocele after renal transplantation remains a common complication, despite all the technical precautions taken, in particular the ligation of lymphatic vessels. Its incidence varies according to the series, depending on the diagnostic methodology, and whether or not it is systematically screened.
This study aims to investigate the risk factors for lymphocele and its impact on transplant survival.
METHOD
We performed a retrospective longitudinal descriptive study including all patients who had a kidney transplant in a Urology department from 1986 to 2017. Clinical presentation and management of lymphocele were studied. Then, the characteristics of patients who presented a lymphocele were compared with those of the rest of the population including characteristics related to the recipient, the donor, the transplant and the procedure to identify risk factors. The impact of lymphocele on patient and transplant survival was then studied.
RESULTS
A total of 720 patients were included with a mean age of 32.7 years. The transplant was from a living donor in 79% and a brain-dead donor in 21%. Lymphocele occurred in 51 patients (7.1%). The lymphocele was asymptomatic in 80%, and clinical manifestations were related to the compression of the transplant or its important size, requiring active treatment, most often percutaneous (13.7%). The lymphocele did not require treatment in 42 cases (82.4%) with disappearance in 90.5%. Revision surgery for a lymphocele was necessary in two cases.
The risk factors for lymphocele were a cadaveric donor (P = 0.003) and an advanced age of the recipient (P < 0.001). No predictive factors related to the transplant (vascular anatomy), or procedure (location and type of anastomoses, ischemia time) were identified.
Transplant survival was 77.9% at 5 years, with a median survival of 15.9 years. The occurrence of a lymphocele did not influence the survival of the transplant (P = 0.25) (Figure 1).
CONCLUSION
Our study showed that lymphocele is usually asymptomatic, not requiring a specific treatment in most cases with a high rate of spontaneous disappearance with no impact on transplant survival. Risk factors were a cadaveric donor which may reflect the absence of careful ligation of the transplant's lymphatic vessels in the context of urgent, sometimes multi-organ, cadaveric procurement and advanced recipient age.
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MO968: Vascular Complications of Renal Transplantation: Risk Factors and Impact on Graft Survival. Nephrol Dial Transplant 2022. [DOI: 10.1093/ndt/gfac087.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
BACKGROUND AND AIMS
Despite the progress made in renal transplantation, vascular complications can occur, jeopardizing the prognosis of the transplant.
This study aims to investigate the risk factors of vascular complications and their impact on transplant survival.
METHOD
We performed a retrospective longitudinal descriptive study including all patients who had a kidney transplant in a Urology department from 1986 to 2017. Transplant Vascular complications included: Arterial thrombosis (AT), Venous thrombosis (VT), hemorrhagic complications (hemorrhage and hematoma) and arterial stenosis (AS). The potential risk factors for vascular complications that were investigated included characteristics related to the recipient, the donor, the transplant and the procedure. The impact of vascular complications on transplant survival was then studied.
RESULTS
A total of 720 patients were included with a mean age of 32.7 years. The transplant was from a living donor in 79% and a brain-dead donor in 21%.
AT occurred in 15 patients (2.1%) and VT occurred in 10 patients (1.4%). Risk factors for vascular thrombosis were recipient age >35 years (P = 0.001; OR = 10.78), recipient smoking (P = 0.005; OR = 1.8), multiple arteries (P < 0.001; OR = 1.45) and prolonged warm ischemia (P = 0.02). Perirenal hematoma occurred in 11 patients (1.5%) and hemorrhage occurred in six patients (0.8%). The risk factors for bleeding complications were a prolonged pre-transplantation dialysis time (P = 0.03; OR = 1.35), and prolonged warm ischemia (P = 0.02; OR = 1.26). AS was the most frequent vascular complication, occurring in 20 cases (2.8%) and no risk factors were identified.
Transplant survival was 77.9% at 5 years, with a median survival of 15.9 years. Vascular thrombosis led to the loss of the transplant in all cases, and externalized hemorrhage significantly reduced transplant survival (P < 0.001). Perirenal hematoma (P = 0.42) and transplant artery stenosis (P = 0.25) had no impact on transplant survival (Figure 1).
CONCLUSION
Our study showed that the vascular complications impacted the survival of the transplant and that they were related to factors related to the recipient, the transplant and the procedure insisting on a multidisciplinary and personalized management for each case.
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A cadaveric anatomical study: anatomy and anatomical variations of left adrenal vein. Surg Radiol Anat 2022; 44:689-695. [PMID: 35362770 DOI: 10.1007/s00276-022-02930-x] [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: 11/29/2021] [Accepted: 03/15/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Control of adrenal vein is the key of adrenal surgery. Its anatomy can present variations. Our aim was to study the anatomy of the main left adrenal vein (LAV) and its anatomical variations. METHODS Our work is based on dissection of 40 cadavers. We studied the number of LAV and the drainage of the main adrenal vein as well as its level of termination. We measured its length, its width and the distance between its termination level and the termination level of the gonadal vein (GV). RESULTS The average length of the LAV was 21 mm its mean width was 5 mm. It ended in 100% of cases at the upper edge of the left renal vein after an anastomosis with the lower phrenic vein in 36 cases (90%) and without anastomosis with the lower phrenic vein in four cases (10%). The left adrenal vein ended at the upper edge of the left renal vein either at the same level as the termination of the left GV in 14 cases (35%) or within the termination of the left GV in 26 cases (65%) by an average of 8 mm. The LAV was unique central vein in 22 cases (55%) and in 12 cases (30%), a major central adrenal vein with several small veins was found. CONCLUSIONS The LAV is usually unique but there are variations in number. There are also variations in the level of its termination in the left renal vein as well as its anastomosis. During surgery, in case of difficulty, the left GV and the adrenal-diaphragmatic venous trunk could be used as benchmarks.
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Predictive factors of recurrence of urethral strictures after a first internal uretrotomy. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00935-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Étude transversale de la composition corporelle d’une population de patients présentant un diabète de type 2. NUTR CLIN METAB 2022. [DOI: 10.1016/j.nupar.2021.12.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Management aspects of urinary tract infection in diabetic patients: A national survey among different specialties. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00206-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Obesity in adult woman and risk for cardiometabolic disease. Case study in Rabat city. ARCHIVES OF CARDIOVASCULAR DISEASES SUPPLEMENTS 2022. [DOI: 10.1016/j.acvdsp.2021.10.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Association of a common genetic variant (insertion/deletion) in ACE gene with prostate cancer susceptibility in a Tunisian population. J Clin Lab Anal 2021; 36:e24129. [PMID: 34799866 PMCID: PMC8761439 DOI: 10.1002/jcla.24129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/07/2021] [Accepted: 11/09/2021] [Indexed: 01/11/2023] Open
Abstract
Background Angiotensin‐converting enzyme (ACE) plays a pivotal role in several pathologies including cancers. The association of insertion/deletion (I/D) polymorphism of the ACE gene with prostate cancer (PC) risk remains controversial. We aimed to investigate for the first time, to our Knowledge, in North Africa the potential relationship between ACE I/D polymorphism with PC susceptibility and clinical outcomes of PC patients. Methods This case‐control study included 143 healthy individuals and 124 patients diagnosed with PC. Using genomic DNA, the samples were genotyped for ACE I/D polymorphism by polymerase chain reaction (PCR). Results We found that The D allele is significantly associated with an increased risk of PC and D/D + D/I genotypes were at 3 times increased risk of PC ([p = 0.005], OR = 2.95, IC 95% = 1.26–7.09) compared with I/I genotype (p = 0.003, OR = 0.3, IC 95% = 0.12–0.74). We observed an association between D/D and D/I genotypes with advanced age (≥70 years) (p = 0.014; r2 = 0.22). Furthermore, there is a significant prediction of advanced Gleason score ≥8 based on epidemiological parameters and ACE genotype (p = 0.000; R2 = 0.349), although no significant association was observed with stage and metastasis. Conclusion The ACE I/D polymorphism is likely to predispose to PC and could play a role in PC progression and aggressiveness.
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Diététique des patients porteurs de lithiase urinaire : point de vue du médecin généraliste. Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Le rôle de l’examen cyto-bactériologiquedes urines préopératoire et de l’infection urinaire symptomatique postopératoire dans la récidive d’une sténose urétrale après urétrotomie interne endoscopique. Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Study of optical properties of gold nanoparticles embedded in normal, benign, and malignant breast tissues. J Mol Struct 2021. [DOI: 10.1016/j.molstruc.2021.130979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Étude de l’écologie bactérienne des pyélonéphrites emphysémateuses. Infect Dis Now 2021. [DOI: 10.1016/j.idnow.2021.06.217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Optical and Dielectric Properties of Plasmonic Core–Shell Nanoparticles: Fe2O3/Au and Fe3O4/Au. J CLUST SCI 2021. [DOI: 10.1007/s10876-021-02133-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Predictive factors of failure of conservative management in patients with emphysemtous pyelonephritis. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00548-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Risk factors for sepsis and mortality in patients with emphysematous pyelonephritis. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00565-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Risk factors of erectile dysfunction, painful erection and morphological complications after the penile fracture. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01506-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Interest of FGSI and LRINEC prognostic scores in the management of Fournier gangrene. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00563-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Partial open tumorectomy for a renal tumor in a horseshoe kidney with a close contact with the vena cava: A case report. Int J Surg Case Rep 2021; 82:105923. [PMID: 33965759 PMCID: PMC8114110 DOI: 10.1016/j.ijscr.2021.105923] [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: 04/05/2021] [Revised: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 12/04/2022] Open
Abstract
Introduction and importance Horseshoe kidney has unique anatomical features, such as a complex blood supply. We report a patient with renal tumor in a horseshoe kidney in close contact with the vena cava, who underwent open tumorectomy. Case presentation A 72-year-old woman was referred to our hospital with a 4-cm enhancing mid-pole mass in the right moiety of a horseshoe kidney. Open tumorectomy was performed with parenchymal clamping. The warm ischemia time was 18 min. Pathologic examination confirmed a diagnosis of pT1a clear cell renal cell carcinoma with negative surgical margins. At 3 months postoperatively, computed tomography showed no local recurrence or metastasis and renal function was intact. Clinical discussion Horseshoe kidney is a rare congenital abnormality. Renal cell carcinoma is the most frequent tumor in adults having this anomaly and treatment in localised tumors if usually tumorectomy. Surgery may be challenging in some cases because of its difficulty. Conclusion Open surgery remains the standard treatment for horseshoe kidney tumors because of anatomic complexity and especially in cases where the tumor is difficult to extirpate. Renal cell carcinoma tumors in horseshoe kidneys are a very rare entity. Management of localised tumors in horseshoe kidney is surgical and surgery is challenging due to anatomical difficulties. Open surgery is usually the best option for tumors having a posterior development in the horseshoe kidney.
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An efficient approach to study membrane nano-inclusions: from the complex biological world to a simple representation. RSC Adv 2021; 11:10962-10974. [PMID: 35423551 PMCID: PMC8695885 DOI: 10.1039/d1ra00632k] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 03/04/2021] [Indexed: 01/14/2023] Open
Abstract
Membrane nano-inclusions (NIs) are of great interest in biophysics, materials science, nanotechnology, and medicine. We hypothesized that the NIs within a biological membrane bilayer interact via a simple and efficient interaction potential, inspired by previous experimental and theoretical work. This interaction implicitly treats the membrane lipids but takes into account its effect on the NIs micro-arrangement. Thus, the study of the NIs is simplified to a two-dimensional colloidal system with implicit solvent. We calculated the structural properties from Molecular Dynamics simulations (MD), and we developed a Scaling Theory to discuss their behavior. We determined the thermal properties through potential energy per NI and pressure, and we discussed their variation as a function of the NIs number density. We performed a detailed study of the NIs dynamics using two approaches, MD simulations, and Dynamics Theory. We identified two characteristic values of number density, namely a critical number density n c = 3.67 × 10-3 Å-2 corresponded to the apparition of chain-like structures along with the liquid dispersed structure and the gelation number density n g = 8.40 × 10-3 Å-2 corresponded to the jamming state. We showed that the aggregation structure of NIs is of fractal dimension d F < 2. Also, we identified three diffusion regimes of membrane NIs, namely, normal for n < n c, subdiffusive for n c ≤ n < n g, and blocked for n ≥ n g. Thus, this paper proposes a simple and effective approach for studying the physical properties of membrane NIs. In particular, our results identify scaling exponents related to the microstructure and dynamics of membrane NIs.
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Effect of hydrophobically modified PEO polymers (PEO-dodecyl) on oil/water microemulsion properties: in vitro and in silico investigations. RSC Adv 2021; 11:7059-7069. [PMID: 35423179 PMCID: PMC8694888 DOI: 10.1039/d0ra09804c] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 03/11/2021] [Accepted: 02/01/2021] [Indexed: 12/23/2022] Open
Abstract
Microemulsions are excellent systems for transdermal delivery of multifunctional drugs because they have the potential to improve drug absorption/permeation and handling limitations. Biocompatible polymers are used as a coating of microemulsions to avoid the interactions that can occur between the microemulsions and the skin. Thus, they protect and lubricate these transporter nanovesicles. In this paper, we studied decane/water microemulsions covered with hydrophobically modified PEO polymer (PEO-m). To reveal the effect of hydrophobically modified PEO (PEO-m) polymer on the shape, the micro-arrangement and the dynamics of the microemulsions, we used an integrated strategy combining Molecular Dynamics simulation (MD), Small-Angle Neutron Scattering experiments (SANS), and the Ornstein-Zernike integral equations with the Hypernetted Chain (HNC) closure relation. We determined the microemulsion shape in vitro using the renormalized intensities spectra from SANS experiments. We discussed the micro arrangements of microemulsions, in vitro and in silico, employing the pair correlation function g(r) and the structure factor S(q), obtained from the three approaches with good agreement. Thus, we used the validated MD simulations to calculate the microemulsion's dynamics properties that we discussed using the mean-squared displacement (MSD) and the diffusion coefficients. We found that the presence of moderate quantities of PEO-m, from 4 to 12 PEO-m per microemulsion, does not influence the microemulsion shape, increases the stability of the microemulsion, and slightly decrease the dynamics. Our in vitro and in silico results suggest that polymer incorporation, which has interesting in vivo implications, has no disadvantageous effects on the microemulsion properties.
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Correction: Effect of hydrophobically modified PEO polymers (PEO-dodecyl) on oil/water microemulsion properties: in vitro and in silico investigations. RSC Adv 2021; 11:10400. [PMID: 35427040 PMCID: PMC8695818 DOI: 10.1039/d1ra90089g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 03/02/2021] [Indexed: 11/24/2022] Open
Abstract
Correction for ‘Effect of hydrophobically modified PEO polymers (PEO-dodecyl) on oil/water microemulsion properties: in vitro and in silico investigations’ by M. Khatouri et al., RSC Adv., 2021, 11, 7059–7069, DOI: 10.1039/D0RA09804C.
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Sol/gel transition of oil/water microemulsions controlled by surface grafted triblock copolymer dodecyl–PEO 227–dodecyl: molecular dynamics simulations with experimentally validated interaction potential. RSC Adv 2021; 11:20824-20835. [PMID: 35479396 PMCID: PMC9034022 DOI: 10.1039/d1ra02649f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 06/01/2021] [Indexed: 11/21/2022] Open
Abstract
We studied a large range of identical spherical oil/water microemulsion (O/W-MI) volume fractions. The O/W-MIs are stabilized by cetylpyridinium chloride ionic surfactant (CpCl) and octanol cosurfactant and dispersed in salt water. We grafted different numbers of dodecyl–(polyEthylene oxide)227–dodecyl triblock copolymer that we note (n(D–PEO227–D)), where n varies from 0 to 12. We accomplished the grafting process by replacing a small amount of CpCl and octanol with the appropriate n(D–PEO227–D). The aim is to determine the interaction/structure relationship of the covered microemulsions. Precisely, we are interested in a quantitative investigation of the influence of volume fraction Φ, temperature (T), and n(D–PEO227–D) on the microemulsion sol/gel transition. To this end, we first study the uncoated microemulsion structure depending only on Φ. Second, we determine the coated microemulsions structure as a function of n(D–PEO227–D) for different Φ. Third, we examine the effect of temperature on the uncoated and coated microemulsion. We show that the sol/gel transition is controlled by the three main parameters, Φ, T, and n(D–PEO227–D). Accordingly, the uncoated microemulsion sol/gel transition, at ambient temperature, occurred for Φ ≃ 33.65%. By increasing Φ, the O/W-MIs show a glass state, which occurs, along with the gel state, at Φ ≃ 37% and arises clearly at Φ ≃ 60%. The coated O/W-MI sol/gel transition is found to be linearly dependent on n(D–PEO227–D) and takes place for Φ ≃ 26.5% for n(D–PEO227–D) = 12. Ordinarily, the decrease in temperature leads to gel formation of microemulsions for low Φ. Additionally, in this work, we found that the gelation temperature increases linearly with n(D–PEO227–D). Thus, the parameter n(D–PEO227–D) can control the sol/gel transition of the O/W-MIs at ambient temperature and moderate Φ. We studied the sol/gel transition of oil/water microemulsion (O/W-MI) covered with dodecyl–(polyEthylene oxide)227–dodecyl triblock copolymer.![]()
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Urological activity at the time of COVID-19 pandemic: is there any difference between public and private field? Pan Afr Med J 2020; 37:389. [PMID: 33796202 PMCID: PMC7992421 DOI: 10.11604/pamj.2020.37.389.25297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 12/12/2020] [Indexed: 12/19/2022] Open
Abstract
Introduction as COVID-19 pandemic is rapidly evolving, there is a whole reorganization in hospitals to concentrate more resources to face the crisis. The purpose of this study is to evaluate the impact of COVID-19 disease on urological activity in Tunisia. To assess the differences in the management of urological conditions between the private and the public field. Methods a survey was addressed to all certified urologists working in Tunisia in both the public and private sectors (n=194) using the national database of active urologists available and updated. We either called them or looked them up through email or social media. The form was open from March the 28th to April the 3rd. Results were obtained via spreadsheet and analysed using SPSS 23.0. Results one hundred and twenty urologists have filled in the form. Consultations at the outpatient office were restricted to urgent cases in 66% (n=79). Telemedicine was more used by urologists in private than in public fields p=0.03. Urologists in private sector followed more the sterilization protocol of the hospital/clinic and used more disposable materials whenever possible p=0.011. Elective surgical activity has completely stopped in 85% of the responders (n=102). Elective surgery requiring transfusion or intensive care unit was performed in 38% (n=46) and 26% (n=31) if there was a risk of disease progression. Benign Prostate Hyperplasia (BPH) surgery was more performed as usual in private sector than in public sector p=0.012. It was the only condition managed differently between both sectors. Conclusion the drop of the urological activity is essential in order to give relevant stakeholders room to act efficiently against the spread of the virus. The context of the pandemic and the hospital´s condition must be taken into consideration without compromising the patient´s outcome.
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State of the art: Open prostatectomy for benign prostate hyperplasia: Should we avoid it in all cases? LA TUNISIE MEDICALE 2020; 98:967-971. [PMID: 33479998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Surgical procedures for benign prostate hyperplasia (BPH) had considerably evolved during last decades. New techniques can nowadays treat prostate big in size, which are classically treated by open prostatectomy (OP). Therefore, the place of this procedure that has been used for over 150 years is nowadays questioned. Is it outdated? Is there emerging techniques that are more efficient, safer and cost effective? This state of the art based on literature review will assess the place of OP in BPH surgery from efficacy on functional outcomes, security, competitiveness with modern and minimally invasive techniques and socio-economic perspectives. Currently, OP has excellent functional outcomes, with low rate of retreatment after surgery, low morbidity and affordable cost in our country. It remains competitive with new surgery techniques for BPH, even if the latter offer the advantages of a minimally invasive surgery, especially in hospitalization length. Taking in consideration the social and economic context in Tunisia, it remains the most accessible and affordable surgical technique. Besides, OP is a procedure that has to be handled by every urologist given the theoretical risk of conversion during endoscopic surgery of BPH, and its use under certain circumstances (In case of bladder lithiasis ou diverticle or impossibility of lithotomy position).
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Néphrectomie différée pour rein détruit sur pyonéphrose : quels sont les facteurs prédictifs de complications ? Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Profils histologiques et corrélation radio-histologique des kystes rénaux Bosniak 3 et 4 opérés : étude monocentrique. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Oncologic results of radical prostatectomy for high-risk prostate cancer and prognostic factors for recurrence and progression-free survival. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)36209-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Quels sont les facteurs prédictifs d’échec du traitement des fistules vésicovaginales ? Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Évaluation de la prise en charge des patients sous sondage intermittent propre par les médecins généralistes. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Is the percentage of teratoma in the orchiectomy specimen predictive of teratoma in retroperitoneal residual masses after chemotherapy in nonseminomatous germ cell tumors? EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)36273-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Tubulopapillary carcinomas of the kidney: Prognostic value of the distinction between type 1 and type 2. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)36245-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Micropapillary bladder cancer: A clinicopathologic characterization and treatment analysis. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)36271-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Enquête nationale sur la pratique de la surveillance active pour cancer de la prostate en Tunisie. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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A cadaveric anatomical study of the adrenals: Relationship with the posterior abdominal wall muscles revisited. Morphologie 2020; 105:210-216. [PMID: 33071051 DOI: 10.1016/j.morpho.2020.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/29/2020] [Accepted: 09/30/2020] [Indexed: 10/23/2022]
Abstract
AIM OF THE STUDY The main difficulties during retroperitoneal laparoscopic adrenalectomies are due to its location. Our objective was to define the relationship of the adrenals with the diaphragm and the psoas muscle. METHODS Our work is an anatomical dissection of 80 fresh cadavers' adrenals. To study the right adrenal, we performed a right nephrectomy and adrenal remained attached to the Inferior vena cava by its main vein. On the left, the edges of the adrenal have been identified by needles and the adrenal was reclined to study its projection on the posterior muscular wall. RESULTS The right adrenal is located higher, 13mm [4-20mm] above the medial arcuate ligament (MAL) in 16 cases (40%). Its lower border was at the same level as the MAL in 18 cases (45%) and 11mm [10-17mm] below the MAL in 6 cases (15%). The posterior support of the right adrenal was the right crus of the diaphragm (Right-CD) in 34 cases (85%) and straddling the Right-CD and the psoas in 6 cases (15%). The study of the relationships of the left adrenal with the MAL showed that the lower edge of the gland was at its same level in 16 cases (40%) and below in 24 cases (60%) by 14mm [8-24mm]. The posterior support of the left adrenal was the left crus of the diaphragm (Left-CD) in 16 cases (40%) and straddling the Left-CD and the psoas in 24 cases (60%). CONCLUSIONS Our results showed that the right adrenal is higher. The MAL is an important posterior element to the adrenal gland that could serve as an anatomical landmark to identify the adrenal during laparoscopic adrenalectomy.
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Endoscopic meatotomy in the treatment of ureterocele: results in adult patients. Pan Afr Med J 2020; 36:243. [PMID: 33014239 PMCID: PMC7519792 DOI: 10.11604/pamj.2020.36.243.24941] [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: 07/11/2020] [Accepted: 07/20/2020] [Indexed: 11/12/2022] Open
Abstract
To evaluate the efficacy of endoscopic meatotomy in the treatment of ureterocele in adults. A retrospective study of adult patients with ureterocele, treated between January 1987 and December 2014. In 47 patients, 55 intravesical ureteroceles were diagnosed and classified as 18 right, 21 left and eight bilateral (38%, 44% and 17% respectively). According to the Bruézière classification, 41 (75%) ureteroceles were type A and 14 (25%) others were type C. These ureteroceles were complicated by calculus formation in 22 cases, moderately dilated excretory pathways in 16 cases and both complications in a total of 9 cases. Four patients had a complicated ureterocele with pyelonephritis, one of which was emphysematous. The endoscopic treatment was performed in cases of complicated and/or symptomatic ureteroceles. Fifty one cases were treated by a “smiling mouth” meatotomy consisting in a transverse horizontal incision, with the treatment of any associated complication. The mean operative time was 35 minutes (10-90). The operative follow-up was uneventful in 42 patients and complications occurred in 5 patients (2 urinary retentions, 2 infectious complications and one hematuria). The mean duration of postoperative stay was 1-2 days. The mean follow-up was 15 months. Four patients developed vesicoureteral reflux and no stenosis was noted. The endoscopic incision of the ureteroceles seems today, after reviewing the results, to be a good treatment of adult ureterocele. It is a simple, minimally invasive and has a low morbidity rate.
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Static and dynamic properties of decane/water microemulsions stabilized by cetylpyridinium chloride cationic surfactant and octanol cosurfactant. RSC Adv 2020; 10:36155-36163. [PMID: 35517086 PMCID: PMC9056973 DOI: 10.1039/d0ra06313d] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 09/07/2020] [Indexed: 01/01/2023] Open
Abstract
Molecular dynamics simulation (MD) is used to study the static and dynamic properties of positively charged decane/water microemulsions, for various volume fractions Φ (2.8%, 6.98%, 14%, and 26.5%). An effective hybrid potential combining three potentials, namely the hard-sphere repulsive potential, the van der Waals attractive potential, and the Yukawa repulsive potential, is used to describe the microemulsion interactions. The microemulsion shape is determined using the renormalized spectra in Porod representation. The appropriate potential parameters are tested using the Ornstein–Zernike integral equation approach with the Hypernetted Chain (HNC) closure relation by a comparison between the structure factor calculated from HNC and that obtained from Small Angle Neutron Scattering experiments (SANS). Thus, the micro arrangements of microemulsions have been analyzed using the pair correlation function g(r) and the structure factor S(q) obtained from HNC, SANS, and MD simulation using these parameters. The microemulsion dynamic properties were discussed using the mean-square displacement (MSD) and the diffusion coefficient Dc calculated from MD simulations. We report a molecular dynamics simulation using a proven effective interaction potential to study the physical properties of decane/water microemulsions.![]()
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