bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of an oncology sperm bank: a Canadian experience
Authors: Selk Amanda , Belej-Rak Timea , Shapiro Heather , Greenblatt Ellen
Published: December 2016

Background: We performed a retrospective chart review in 2006to review oncology patients’ use of banked semen samples infertility treatments at a tertiary care centre.Methods: From 2002 to 2005, 367 oncology patients bankedsemen. During the same period, 31 patients used banked samplesin 48 treatment cycles. Samples were used for intrauterine insemination(IUI) in 28 cycles and for in vitro fertilization (IVF) withor without intracytoplasmic sperm injection (ICSI) in 20 cycles.Results: Pregnancy rates per cycle were 21% for IUI and 50%for IVF with or without ICSI. Overall, 16 of the 31 couples achieveda pregnancy with assisted reproductive technologies (52%).Conclusion: This data indicates high pregnancy success rates withthe use of banked semen samples from men with cancer.Contexte : Une revue rétrospective de dossiers a été effectuée afind’examiner le recours à des échantillons de sperme provenantde patients cancéreux pour le traitement de l’infertilité dans uncentre de soins tertiaires.Méthodes : Entre 2002 et 2005, des échantillons de spermeprovenant d’un total de 367 patients atteints de cancer ont été misen banque. Durant la même période, 31 patientes ont utilisé ceséchantillons au cours de 48 cycles de traitement. Les échantillonsont été utilisés pour insémination intra-utérine (IIU) lors de28 cycles et pour fertilisation in vitro (FIV) avec ou sans injectionintracytoplasmique de sperme (ICSI) lors de 20 cycles.Résultats : Le taux de grossesse par cycle était de 21 % avecl’IIU et de 50 % pour la FIV avec ou sans ICSI. Au total, 16 des31 patientes sont devenues enceintes (52 %).Conclusion : Ces données montrent des taux élevés de grossesseobtenus par l’utilisation d’échantillons de sperme provenantd’hommes atteints de cancer.
Testicular dislocation: a rare consequence of blunt scrotal injury
Authors: Aslam Muhammad Z. , Thwaini Ali , Sundaram Subramaniam K.
Published: December 2016

Nous décrivons le cas d’un homme de 22 ans présentant une luxationtesticulaire unilatérale par suite d’un traumatisme scrotalfermé. Une cartographie Doppler couleur a révélé une testiculeviable ayant pénétré le canal inguinal. L’exploration inguinale aconfirmé que la testicule était saine et viable, et cette dernière aété replacée dans le scrotum par orchidopexie. Le patient s’estbien rétabli, sans aucune complication. Nous recommandons uneintervention rapide après la pose du diagnostic de luxation testiculaireafin de préserver la fonction testiculaire.Testicular dislocation is a rare clinical presentation thatoccurs most commonly as a result of blunt scrotal injury.It is immensely important to prevent any delay in diagnosisas this can lead to loss of spermatogenic function ofthe testis and increased risk of orchiectomy.1 We report acase of unilateral testicular dislocation, in which the patientpresented to the emergency department 4 months afterthe initial injury.
A case of metastatic adenocarcinoma of the prostate arising in a meningioma
Authors: Pugsley Devin , Bailly Greg , Gupta Rekha , Wilke Derek , Wood Lori
Published: December 2016

We present the case of a 70-year-old man who had a prostate adenocarcinomathat metastatized to a previously unknown cranialmeningioma. Central nervous system (CNS) metastases are veryuncommon in patients with prostate cancer, and metastases topre-existing primary CNS tumours are even more uncommon. Rareevents like this can cause diagnostic uncertainty, as shown by thiscase. This case is a reminder for clinicians to consider prostatemetastases in patients with known prostate carcinoma and focalneurological symptoms.Nous décrivons le cas d'un homme de 70 ans présentant un adénocarcinomemétastatique de la prostate secondaire à un méningiomeintra-crânien non diagnostiqué auparavant. Les métastasesau niveau du SNC sont très rares chez les patients atteints de cancerde la prostate et les métastases sont encore plus rares dansle cas de tumeurs primitives pré-existantes au niveau du SNC.La rareté de ces cas peut soulever des incertitudes au niveau dudiagnostic, comme nous le montrerons. Ce cas permet de rappeleraux cliniciens d'envisager la possibilité de métastases chezles patients atteints d'un carcinome prostatique confirmé et présentantdes signes neurologiques focaux.
The role of 5-alpha reductase inhibitors in prostate pathophysiology: Is there an additional advantage to inhibition of type 1 isoenzyme?
Authors: Goldenberg Larry , So Alan , Fleshner Neil , Rendon Ricardo , Drachenberg Darrel , Elhilali Mostafa
Published: December 2016

Normal growth and function of the prostate are contingent on the reductionof testosterone to dihydrotestosterone (DHT) by 5-alpha reductase(5-AR) enzymes types 1 and 2. It has been theorized that an overabundanceof DHT may be implicated in the pathogenesis of both benign prostatic hyperplasia(BPH) and prostate cancer. Inhibitors of 5-AR such as dutasteride andfinasteride may therefore have an important role in the prevention and treatmentof BPH and prostate cancer. Dutasteride provides greater suppression ofDHT than finasteride, thereby underlying the hypothesis that inhibition of bothtype 1 and type 2 would provide correspondingly greater protection than inhibitionof type 2 alone. We review the potential significance of the 5-ARinhibitors in reducing the risk of prostate cancer according to the basic biologyof prostate disease
Gleason grading controversies: what the chemoprevention trials have taught us
Authors: Klotz Laurence , Drachenberg Darrel , Fradet Yves , Saad Fred , Trachtenberg John , Zlotta Alexandre
Published: December 2016

The recent Prostate Chemoprevention Trial (PCPT), which assessed the efficacyof finasteride in reducing prostate cancer incidence, showed promising results.However, patients who developed cancer had higher Gleason scores than thoseon placebo. Moreover, recent evidence has shown that the biopsy Gleason scoresin patients on finasteride were actually more accurate compared with patientson placebo when matched with the final, radical prostatectomy (RP) scores. Thisaccuracy was due to a reduction in prostate volume induced by the drug, andbetter performance of prostate-specific antigen correlation for identifying menwith high-grade cancer. Re-evaluation of the results based on the pathology ofthe RP specimens and longer follow-up showed a 30% reduction in cancerincidence with finasteride and no significant differences in Gleason scorescompared with placebo
Status of robotic-assisted surgery among Canadian urology residents
Authors: Robinson Michael , MacNeily Andrew , Goldenberg Larry , Black Peter
Published: December 2016

Background: Robotic-assisted surgery (RAS) has been rapidlyadopted in urology, especially in the United States. Although lessprevalent in Canada, RAS is a growing and controversial field that has implications for resident training. We report on the status and perception of RAS among Canadian urology residents.Methods: All Canadian urology residents from anglophone programs were contacted by email and asked to participate in anonline survey. Current resident exposure to, and perception of,RAS was assessed.Results: Of the residents contacted (n = 128), 50 (39%) completed the survey. Of the respondents, 52% have been involved in RAS. Those who have not been involved in RAS express lower interest and lesser knowledge of RAS. Ninety-two percent of respondents feel the use of RAS will increase, although only 29% feel this is feasible in Canada. Just 24% and 36% feel RAS to be superior to open and laparoscopic techniques, respectively. Sixty-eight percent of residents in programs with a robot viewed it as detrimental to training, whereas 81% of residents in programs without one viewedits absence to either have no impact, or even be beneficial. Bothgroups expressed a desire for more experience with RAS.Conclusion: The resident experience with respect to RAS is mixed. Overall, residents view RAS as an expanding field with potentially negative impacts on their present training, although they appear to desire the acquisition of more experience in RAS. We plan to monitor the evolution of these perceptions over next four years.
Duplicate publications: A sample of redundancy in the Journal of
Authors: Hennessey Kiara K. , Williams Aaron R. , Afshar Kourosh , MacNeily Andrew E.
Published: December 2016

Purpose: Redundant publications occur when authors publish apartial or complete duplicate of data from an existing manuscript. The push for academic advancement in medicine may result in redundant publications that erode the quality of literature. We sampled the extent of redundancy within the Journal of Urology.Methods: Original articles published in the Journal of Urology in2006 were reviewed. MEDLINE was used to identify suspectedduplicate publications by combining the last names of the first,second and last authors with keywords provided by the article.Results were limited to 2004 to 2008. Two investigators reviewed the suspected duplicate publications and classified them as duplicate, probable duplicate and salami-slicing.Results: We screened 723 original articles. Of these originalarticles, 13 (1.8%) had some form of redundancy. One (0.1%)original article had a duplicate article, 5 (0.7%) original articleshad probable duplicates, and 7 (1%) original articles were salamisliced. The proportion of redundant articles published prior to, and following, their 2006 index article was 5/13 (38.5%) and 7/13 (53.8%), respectively. One duplicate (7.7%) was published in the same month as its index.Conclusion: Detection of redundant publications is a laboriousprocess for reviewers and editors. This sampling of the Journal of Urology revealed that the duplication rate in this journal is small, but significant. Further assessment of the urological literature is warranted.
Comparison of serum testosterone levels in prostate cancer patients
Authors: Venkateswaran Seetha , Margel David , Yap Stanley , Hersey Karen , Yip Paul , Fleshner Neil Eric
Published: December 2016

Introduction: The prostate secretes enzymes and nutrients to promote sperm motility. Recent reports suggest that the prostate may also secrete testosterone, which is believed to be a fuel for prostate tumour growth. The aim of this study was to determine if a difference in serum testosterone levels exists between men on luteinizing hormone releasing-hormone (LHRH) agonists who have undergone radical prostatectomy, radiation or hormone therapy as primary prostate cancer treatment.Methods: Serum testosterone levels were evaluated in 165 consecutive prostate cancer patients using LHRH analogues for >3 months. We excluded patients receiving either radiation or chemotherapy at time of time of testosterone measurement. Patients were classified based on primary treatment: (1) radical prostatectomy; (2) radiation; or (3) primary hormone therapy. We used one-way ANOVA to compare testosterone levels. Pearson correlation was used to correlate testosterone with prostate-specific antigen (PSA) and time on LHRH agonists. Multivariable linear regression was used to predict serum testosterone levels.Results: The median (interquartile range) serum testosterone levels were 1.4 (1-1.9), 1.3 (1-1.625) and 1.25 (0.9-1.525) nmol/L for radical prostatectomy, radiation and primary hormone therapy groups, respectively. There was no statistically significant difference in testosterone levels between the groups (p = 0.3). No correlation was found between testosterone and PSA levels or time on LHRH (r = 0.02 and r = 0.01), respectively. Multivariable linear regression showed that none of the clinical variables were predictors ofserum testosterone levels.Conclusion: Our study suggests that primary treatment does notaffect serum testosterone levels among men using LHRH analogues.
Prostate cancer screening: Attitudes and practices of family
Authors: Allard Christopher B. , Dason Shawn , Lusis Janis , Kapoor Anil
Published: December 2016

Introduction: The utility of prostate cancer screening is controversial. We sought to determine whether Ontario’s family physicians believe it is beneficial and to characterize their screening protocols.Methods: A survey was developed with input from urologists,family physicians and the Ontario Medical Association’s Sectionon General and Family Practice. Questions covered three domains: (1) demographics, (2) beliefs about screening utility and (3) screening practices. All 7302 family physicians in Ontario were invited by email to complete the online survey.Results: A total of 969 physicians completed the survey; 955(52.0% male, 48.0% female) were included. Most (80.97%) useprostate-specific antigen (PSA) and digital rectal examination (DRE) for screening; 9.4% use DRE alone and 7.15% PSA. Of the respondents, 8.3% do not offer prostate cancer screening. Most physicians begin offering screening at age 50 (72.9%) and stop at ages 70 or 80 (68.4%); 17.9% offer lifelong screening. In response to the statement “screening with DRE provides a survival benefit,” 37.6% and 32.6 agreed and disagreed, respectively. For “screening with PSA provides a survival benefit,” 43.3% agreed and 31.0% disagreed. For the statement “the benefits of prostate cancer screening outweigh the risks,” 51.4% agreed and 22.0% disagreed.Discussion: Although 91.7% of respondents offer prostate cancer screening, they are divided over its utility. Only 51.4% were convinced that the benefits outweighed the harms. There is significant variability between physicians’ screening protocols. A limitation of study is the possibility of selection bias. Nevertheless, this is the largest sample of Ontario family physicians ever surveyed about prostate cancer screening and highlights divergent physician practices and a need for more conclusive evidence on screening utility.
Penile fracture and associated urethral injury: Experience at a tertiary care hospital
Authors: Attam Amit , Kerketta Arun , Behera Bharat , Ram Navin , Trivedi Sameer , Udai Shankar Dwivedi
Published: December 2016

Introduction: Penile fracture may be associated with urethral trauma in 1% to 38% of cases. We present our experience in treating 8 such cases.Methods: Data were collected retrospectively from hospital records and from out-patient department follow-up visits.Results: The mean age of the patients was 30.4 years; trauma during coitus was the most common cause of the penile fracture. One patient presented after 7 days. Two patients had normal examination of their penis despite typical history. All fractures were repaired on an emergency basis via subcoronal incision. In 2 patients with normal findings, the urethra had to be mobilized to locate the site of the injury. In 1 patient, the site of the urethral trauma was 1 cm away from the site of the corporal injury, which was localized by injecting sterile methylene blue per urethra. Postoperatively, all patients voided with good flow and had erections with adequate rigidity.Conclusion: A high level of suspicion for urethral injury during surgical exploration is warranted, especially in the presence of suggestive history and examination.
Comparative study of laparoscopic pyelolithotomy versus percutaneous nephrolithotomy in the management of large renal pelvic stones
Authors: Haggag Yasser M. , Morsy Gamal A. , Badr Magdy M. , Al Emam Abdel Baset A. , Mourad Mourad M. , Farid Mamdouh , Etafy Mohamed
Published: December 2016

Background: The aim of the study is to investigate whether laparoscopic pyelolithotomy (LPL) could be used to manage large renal pelvic stones, generally considered excellent indications for percutaneous nephrolithotomy (PNL).Methods: This study was performed from May 2009 to March 2012 at Al-Azhar University Hospitals (Assiut and Cairo), Egypt. It included two groups of patients with large renal pelvic stones; only patients with stones 2.5 cm2 or greater were included. Group1 included 40 patients treated by PNL and Group 2 included 10 patients treated by LPL. The differences between the two procedures were compared and analyzed.Results: There was no difference between the two groups regarding patient demographics and stone size. There was a statistically significant difference between the groups regarding mean estimated blood loss (65 ± 12.25 [range: 52.75- 77.25] vs. 180 ± 20.74 [range: 159.26- 200.74] mL, p ≤ 0001), mean hospital stay (2.3 ±0.64 [range: 1.66- 2.94] vs. 3.7 ± 1.4 [range: 2.3- 5.1] days, p ≤ 0.006), rate of postoperative blood transfusion (0% vs. 4.8%,p ≤ 0.0024), and stone-free rate (80% vs. 78.6%, p ≤ 0.23). The mean operative time was significantly longer in Group 2 (LPL) (131 ± 22.11 [range: 108.89-153.11) vs. 51.19 ± 24.39 [range: 26.8-75.58] min, p ≤ 0001), respectively.Conclusion: Although PNL is the standard treatment in most cases of renal pelvic stones, LPL is another feasible surgical technique for patients with large renal pelvic stones.
Micropapillary carcinoma of the urinary bladder: a case report and review of the literature
Authors: Trabelsi Amel , Stita Wided , Soumaya Rammeh , Mestiri Sarra , Jaidene Mehdi , Mokni Moncef , Korbi Sadok
Published: December 2016

Micropapillary carcinoma is an uncommon variant of urothelial carcinoma with high metastatic potential. The presence of micropapillary carcinoma component in bladder biopsies should alert urologists to its aggressive behaviour. We report the case of a 70-year-old man who presented with macroscopic hematuria lasting 2 weeks. Magnetic resonance imaging revealed a bladder tumour in the dome area extended to perivascular adipose. The transurethral biopsy showed a high-grade micropapillary carcinoma with muscle invasion. Radical cystectomy with lymph node dissection was then performed. The pathological examination revealed a high-grade purely micropapillary carcinoma invading the perivesical adipose. No tumour recurrence or metastasis were reported at the 6-month follow-up.
A near-fatal case of sepsis with an antibiotic-resistant organism complicating a routine transrectal prostate biopsy in a health care worker
Authors: Weber Bryce , Saliken John , Jadavji Taj , Gray Robin R. , Moore Ronald
Published: December 2016

A 58-year-old physician with an elevated prostate specific antigen developed severe septic shock following a repeat transrectal prostate biopsy despite standard preoperative prophylactic protocol. This case highlights the significance of harbouring antibiotic-resistant bacteria and the risk of previous quinolone exposure. We believe this case may herald a rare but potentially serious consequence of increasingly common antibiotic resistance and that high-risk patients should be studied to determine their likelihood of carrying antibiotic-resistant flora in their genitourinary/gastrointestinal tract.
The status of pelvic floor muscle training for women
Authors: Marques Andrea , Stothers Lynn , Macnab Andrew
Published: December 2016

There is no consensus on the amount of exercise necessary toimprove pelvic floor muscle (PFM) function. We reviewed thepathophysiology of PFM dysfunction and the evolution of PFMtraining regimens since Kegel introduced the concept of pelvic floorawareness and the benefits of strength. This paper also describesthe similarities and differences between PFM and other musculargroups, reviews the physiology of muscle contraction and principlesof muscle fitness and exercise benefits and presents the rangeof protocols designed to strengthen the PFM and improve function.We also discuss the potential application of new technologyand methodologies. The design of PFM training logically requiresmultiple factors to be considered in each patient. Research thatdefines measures to objectively quantify the degree of dysfunctionand the efficacy of training would be beneficial. The applicationof new technologies may help this process.Il n’existe aucun consensus concernant la quantité d’exercicerequis pour améliorer la fonction du muscle du plancher pelvien(MPP). Nous avons examiné la physiopathologie d’un mauvaisfonctionnement du MPP et l’évolution des plans d’entraînement dece muscle depuis que Kegel a introduit le concept de la prise deconscience du MPP et les avantages de son renforcement. L’articledécrit également les similitudes et les différences entre le MPP etd’autres groupes musculaires, passe en revue la physiologie descontractions musculaires et les principes de bon fonctionnementmusculaire et les avantages liés à l’exercice. Nous présentons aussidivers protocoles visant à renforcer le MPP et à en améliorer lefonctionnement, ainsi que l’application potentielle de nouvellestechnologies et méthodologies. Le plan d’entraînement du MPPnécessite en toute logique la prise en compte de multiples facteursselon les patients. Des études cherchant à définir les mesures àutiliser pour quantifier de manière objective le niveau de dysfonctionet l’efficacité de l’entraînement seraient utiles. L’application denouvelles technologies pourrait contribuer à cet objectif.
Bilateral renal sinus myelolipomas
Authors: Cox Ashley , Offman Saul L. , Merrimen Jennifer L.O. , Kew Andrea , Norman Richard W.
Published: December 2016

Adrenal myelolipomas are benign neoplasms consisting of hematopoieticcellular elements and adipose tissue. They are uncommon,found in 0.4% to 1% of the population at autopsy. Extraadrenalmyelolipomas (EM) are extremely rare with fewer than50 cases reported. We describe the first case of bilateral EM ofthe renal sinus. They are difficult to diagnose on imaging alonewhen arising in this location and biopsies may not yield a definitiveanswer. Management options include both conservative andsurgical approaches depending upon the certainty of the diagnosis,progression of the patient’s symptoms and evidence of growth.
Polyarteritis nodosa presenting with frank hematuria
Authors: Ahmad Muhammad Shabi , Saha Aninda , Reaich David , Naisby Geoffery P. , West Alaiyi Fred
Published: December 2016

Polyarteritis nodosa (PAN) is an uncommon systemic vasculitischaracterized by necrotizing inflammation of small- or mediumsizedarteries. The disease normally presents with non-specificsymptoms. Urological symptoms at presentation are extremely rare.We report a 65-year-old man who was diagnosed with a polyarteritisnodosa having presented atypically with left testicular pain andswelling, and an intratesticular lesion. He developed painless visiblehematuria while under investigation. No gross arterio-venousfistula was seen to suggest a false aneurysm. Subsequently, laboratorystudies showed positive anti-neutrophil cytoplasmic antibodylevels and a raised erythrocyte sedimentation rate. This was anunusual presentation of PAN diagnosed with multidisciplinaryinput from the urology, radiology and nephrology teams.
Measurement of surgical wait times in a universal health care system
Authors: Kawakami Jun , Hopman Wilma M. , Smith-Tryon Rachael , Siemens D. Robert
Published: December 2016

Introduction: Reported increases in surgical wait times for cancer have intensified the focus on this quality of health care indicator and have created a very public, concerted effort by providers to decrease wait times for cancer surgeryin Ontario. Delays in access to health care are multifactorial and their measurement from existing administrative databases can lack pertinent detail. The purpose of our study was to use a real-time surgery-booking software program to examine surgical wait times at a single centre.Methods: The real-time wait list management system Axcess.Rx has been used exclusively by the department of urology at the Kingston General Hospital to book all nonemergency surgery for 4 years. We reviewed the length of time from the decision to perform surgery to the actual date of surgery for patients in our group urological practice. Variables thought to be potentially important in predicting wait time were also collected, including the surgeon’s assessment of urgency, the type of procedure (i.e., diagnostic, minor cancer, major cancer, minor benign, major benign), age and sex of the patient, inpatient versus outpatient status and year of surgery. Analysis was planned a priori to determine factors that affected wait time by using multivariate analysis to analyze variables that were significant in univariate analysis.Results: There were 960 operations for cancer and 1654 for benign conditions performed during the evaluation period. The overall mean wait time was 36 days for cancer and 47 days for benign conditions, respectively. The mean wait time for cancer surgery reached a nadir in 2004 at 29.9 days and subsequently increased every year, reaching 56 days in 2007. In comparison, benign surgery reached a nadir wait time of 33.7 days in 2004 and in 2007 reached 74 days at our institution. Multivariate analysis revealed that the year of surgery was still a significant predictor of wait time. Urgency score, type of procedure and inpatient versus outpatient status were also predictive of wait time.Conclusion: The application of a prospectively collected data set is an effective and important tool to measure and subsequently examine surgical wait times. This tool has been essential to the accurate assessment of the effect of resource allocation on wait times for priority and nonpriority surgical programs within a discipline. Such tools are necessary to more fully assess and follow wait times at an institution or across a region.
Nocturia: a blinded, randomized, parallel placebo-controlled self-study of the effect of 5 different sedatives and analgesics
Authors: Kaye Michael
Published: December 2016

Background: In a previous study I noted that, when taken occasionally as a nighttime sedative, the benzodiazepine (BZD) oxazepam decreased nocturia. The objective of the present study was, using placebo and other sedatives and analgesics, to assess whether oxazepam decreases nocturia and, if so, how?Methods: I conducted a prospective, randomized, placebo-controlled self-study over a period of 10 months using oxazepam, zopiclone and trazodone as sedatives, and naproxen and oxycodone as analgesics. I assessed each medication 10 times, for a total of 60 tests. Each test included assessment of sleep adequacy, number and volume of overnight voidings and chemistries. Every test was a “first-time” or “naive” event.Results: All medications differed in several parameters from placebo, but nocturia only showed a significant reduction with naproxen and oxazepam. Nocturia occurred a mean (standard deviation [SD]) of 1.6 (0.84) times nightly with placebo and fell to 0.6 (0.5) with oxazepam, which was a 63% decrease without any change in urine volume. Naproxen reduced nocturia to a mean (SD) of 0.7 (0.8) times nightly by reducing water, salt and potassium excretion. Compared with placebo, all medications had less urine sodium loss and decreased fractional sodium excretion (FENa), suggesting increased renal tubular sodium reabsorption. This effect was most marked with naproxen. Neither improved sleep quality with zopiclone nor pain relief with oxycodone resulted in reduced nocturia.Conclusion: The effect of naproxen was probably a direct one on the kidney. The reduction of electrolyte excretion produced by the other medications is possibly a central effect on sympathetic activity, and the effect was too small to change urine volume. The effect of oxazepam was to make the bladder less irritable and could not be attributed to a decrease in urine volume, electrolyte change, sedation or analgesia. A central γ-aminobutyric acid–mediated effect in the cord or brain could explain the results observed with oxazepam.
Treatment of adult rhabdoid renal cell carcinoma with sorafenib
Authors: Kapoor Anil , Tutino Robert , Kanaroglou Androniki , Hotte Sebastien J.
Published: December 2016

Renal cell carcinoma (RCC) with rhabdoid features is an uncommon and highly aggressive malignancy. We report a case of adult clear-cell RCC with extensive rhabdoid features treated with the tyrosine kinase inhibitor sorafenib. A review of the literature summarizes important aspects of this malignancy. We discuss clinical and histological findings as well as the patient’s response to sorafenib therapy.
Adénome surrénalien à cellules oncocytaires
Authors: Wadia Hellara , Mouni Lefi , Mounir Touffahi , Leila Njim , Samira Farhane , Radhia Saidi , Hamadi Saad
Published: December 2016

Les tumeurs surrénaliennes bénignes constituent une entité anatomopathologique souvent de découverte fortuite. Les cas d’oncocytome surrénali en sont très rares. Nous décrivons ici un cas de fortuitome surrénalien chez une femme de 37 ans, sans antécédents pathologiques, examinée par échographie abdominale en raison d’une douleur au niveau de la fosse iliaque droite. L’échographie abdominale a révélé une masse de la loge surrénalienne de 7 cm par 6 cm, bien délimitée, de densité tissulaire et absorbant faiblement le produit de contraste après injection. Le bilan hormonal est normal. L’étude anatomopathologique de la pièce prélevée par surrénalectomie a permis d’en arriverà un diagnostic d’adénome surrénali en à cellules oncocytaires. Les auteurs passent en revue la littérature sur cette pathologie rare, afin de mieux connaître son épidémiologie et ses modalités thérapeutiques.
Virtualização de Jogos Educativos: Uma Experiência no Ensino de Matemática
Authors: Oliveira dos Santos Wilk , Gomes da Silva Junior Clovis
Published: December 2016

O uso de jogos digitais na educação já está cunhado como um mecanismo capaz de auxiliar o processo de ensino e aprendizagem, tendo sua aplicação discutida em diversos aspectos. Neste sentido, um dos aspectos abordados atualmente é a Virtualização de Jogos para o ensino, tendo por objetivo criar versões digitais para jogos tradicionais, mantendo os aspectos pedagógicos e psicopedagógicos da versão tradicional do jogo, atrelados as mecânicas contemporâneas dos jogos digitais. Neste contexto, este artigo tem por objetivo apresentar os resultados do processo de Virtualização de Jogos em dois jogos tradicionais usados no ensino de Matemática. Estes jogos foram avaliados em termos de usabilidade e aspectos pedagógicos. Os resultados alcançados permitiram constatar que os jogos foram eficazes como mecanismo de apoio ao processo de ensino e aprendizagem de conteúdos específicos da disciplina de Matemática, bem como o processo de Virtualização de Jogos se mostrou eficaz para virtualizar jogos capazes de auxiliar no processo de ensino e aprendizagem.
Experimental reconstitution of chronic ER stress in the liver reveals feedback suppression of BiP mRNA expression
Authors: Gomez Javier A , Rutkowski D Thomas
Published: December 2016

Endoplasmic reticulum (ER) stress is implicated in many chronic diseases, but very little is known about how the unfolded protein response (UPR) responds to persistent ER stress in vivo. Here, we experimentally reconstituted chronic ER stress in the mouse liver, using repeated injection of a low dose of the ER stressor tunicamycin. Paradoxically, this treatment led to feedback-mediated suppression of a select group of mRNAs, including those encoding the ER chaperones BiP and GRP94. This suppression was due to both silencing of the ATF6α pathway of UPR-dependent transcription and enhancement of mRNA degradation, possibly via regulated IRE1-dependent decay (RIDD). The suppression of mRNA encoding BiP was phenocopied by ectopic overexpression of BiP protein, and was also observed in obese mice. Our findings suggest that persistent cycles of UPR activation and deactivation create an altered, quasi-stable setpoint for UPR-dependent transcriptional regulation—an outcome that could be relevant to conditions such as metabolic syndrome.
How Can Guidelines Give Clearer Guidance on Prostate Cancer Screening?
Authors: Carlsson Sigrid V. , Oh William K.
Published: September 2024

This Viewpoint explores how guideline groups can come together to agree on a framework that produces clear and unified recommendations.
CASCADES, a novel SOX2 super‐enhancer‐associated long noncoding RNA, regulates cancer stem cell specification and differentiation in glioblastoma
Authors: Shahzad Uswa , Nikolopoulos Marina , Li Christopher , Johnston Michael , Wang Jenny J. , Sabha Nesrin , Varn Frederick S. , Riemenschneider Alexandra , Krumholtz Stacey , Krishnamurthy Pranathi Meda , Smith Christian A. , Karamchandani Jason , Watts Jonathan K. , Verhaak Roel G. W. , Gallo Marco , Rutka James T. , Das Sunit
Published: September 2024

Glioblastoma is the most common primary malignant brain tumor in adults, with a median survival of just over 1 year. The failure of available treatments to achieve remission in patients with glioblastoma (GBM) has been attributed to the presence of cancer stem cells (CSCs), which are thought to play a central role in tumor development and progression and serve as a treatment‐resistant cell repository capable of driving tumor recurrence. In fact, the property of “stemness” itself may be responsible for treatment resistance. In this study, we identify a novel long noncoding RNA (lncRNA), cancer stem cell‐associated distal enhancer of SOX2 (CASCADES), that functions as an epigenetic regulator in glioma CSCs (GSCs). CASCADES is expressed in isocitrate dehydrogenase (IDH)‐wild‐type GBM and is significantly enriched in GSCs. Knockdown of CASCADES in GSCs results in differentiation towards a neuronal lineage in a cell‐ and cancer‐specific manner. Bioinformatics analysis reveals that CASCADES functions as a super‐enhancer‐associated lncRNA epigenetic regulator of SOX2. Our findings identify CASCADES as a critical regulator of stemness in GSCs that represents a novel epigenetic and therapeutic target for disrupting the CSC compartment in glioblastoma.
Silk Sericin‐based ROS‐Responsive Oxygen Generating Microneedle Platform Promotes Angiogenesis and Decreases Inflammation for Scarless Diabetic Wound Healing
Authors: Liu Huan , Qin Sumei , Zhang Hongyan , Chen Zhongyin , Zhao Yiwei , Liu Jia , Deng Yan , Liu Miaodeng , Chen Wei , Wang Zheng , Wang Lin
Published: September 2024

Diabetic foot ulcer typically undergoes a delayed wound‐healing process owing to the disordered microenvironment, including persistent inflammation, long‐term hypoxia, and excessive fibrosis, eventually leading to severe disabilities and other poor outcomes. However, current strategies cannot meet the dynamic demands during the wound‐healing process. Herein, a reactive oxygen species (ROS)–responsive oxygen‐generating microneedle platform, consisting of a sericin‐based glucose‐responsive hydrogel loaded with verteporfin, for effective diabetic wound healing is proposed. Under a highly oxidative microenvironment, the functionalized sericin protein depletes overproduced ROS to generate oxygen, which can not only alleviate the hypoxic microenvironment and promote angiogenesis by activating extracellular signal‐regulated kinase and Heme Oxygenase‐1 pathways but also decrease the expression of proinflammatory cytokines. Moreover, the hyperglycaemic condition triggers the gradual dissociation of this microneedle platform and promotes the release of verteporfin to enhance scarless re‐epithelization via inhibiting the yes‐associated protein signal. This versatile sericin microneedle system integrates advantageous features including inflammation alleviation, angiogenesis promotion, and scar inhibition capabilities, accelerates diabetic wound repair in vivo, and offers a novel approach for oxygen self‐supply and wound microenvironment remodeling.
Impact of soil spatial variability on young almond trees: A case study on heavy clay soils
Authors: Ballester Carlos , Filev‐Maia Rodrigo , Hornbuckle John
Published: September 2024

The viability of modern horticulture heavily relies on adopting sustainable practices. Understanding soil spatial variability on heavy clay soils and its impact on young trees is crucial to design suitable soil and water management strategies that guarantee the sustainability of orchards. The objective of this study was to assess in an orchard with heavy clay soils of the Riverine Plain, NSW, the impact of soil spatial variability on the development of young almond (Prunus dulcis (Mill.) D. A. Webb) trees and evaluate the use of remote and proximal sensing tools for identifying threatening factors for the sustainability of the crop. Soil and aerial surveys were used to assess the soil and crop spatial variability in an 8.3‐ha irrigation block. The site was divided into five areas based on apparent electrical conductivity (ECa) measurements where soil samples were collected. Tree growth, soil, and plant water status were monitored in two contrasting areas in ECa. In the first year of study, a significant and positive correlation was found between ECa and percentage of ground canopy cover. Soil analysis and soil moisture monitoring revealed that high values of exchangeable sodium percentage, which are indicative of sodic soils prone to dispersion, and limited water infiltration were the cause of the reduced tree growth in areas with low ECa. The impact of soil spatial variability on tree growth decreased in the second growing season due to weather and water management factors that influenced soil water content. This study showcases the usefulness of remote and proximal sensing in assessing potential soil‐spatial‐related issues in newly established orchards as well as the impact soil spatial variability can have on tree development in the first years after planting.
Aggregation‐induced circularly polarized luminescence and delayed fluorescence enabled by activating high‐level reverse intersystem crossing
Authors: Wang Ke , Ou Xinwen , Niu Xiaofei , Wang Zhenghao , Song Fengyan , Dong Xiaobin , Guo Wu‐jie , Peng Hui‐Qing , Zhao Zujin , Lam Jacky W. Y. , Sun Jianwei , Wu Hongkai , Yu Shu‐Yan , Li Fei , Tang Ben Zhong
Published: September 2024

Circularly polarized luminescence (CPL) materials with delayed fluorescence have attracted much attention due to their ability to efficiently trap triplet state excitons, thereby improving the photoluminescence quantum yields of CPL materials. However, much effort has been normally focused on the utilization of T1 excitons but seldom on the utilization of higher excited triplet state Tn (n > 1) excitons. Rational manipulation of higher excited triplet state Tn (n > 1) excitons and suppression of Kasha's rule of CPL materials remains a major challenge. Herein, two gold complex enantiomers ((R/S)‐BPAuBC) based on axially chiral binaphthyls and 3,6‐Di‐tert‐butylcarbazole groups are synthesized and systematically investigated. These materials exhibit aggregation‐induced circularly polarized delayed fluorescence. Circularly polarized delayed fluorescence was found to be enabled by activating high‐level reverse intersystem crossing (hRISC). The anti‐Kasha phosphorescence at 77 K proves that the exciton has a large population in the high‐lying triplet state T2, which allows the effective hRISC process to cross back to the singlet state S1 and emit delayed fluorescence. In addition, CPL “on–off” switching is further achieved in nanoparticles by acid–base stimulus, showing its potential as an acid–base responsive material.
The Impact of the COVID‐19 Pandemic on the Sex Ratio at Birth in Ireland
Authors: Masukume Gwinyai , Non Amy L. , Cleaver Peyton , Grech Victor
Published: September 2024

Objectives

The sex ratio at birth (SRB), calculated as male divided by total live births, is an important indicator of population health. Typically, male live births slightly outnumber female live births. Population events, including pandemics, can alter the SRB, with effects sometimes evident 9 months post‐event, potentially due to changes in sexual behavior and/or stress levels. This study investigates the impact of the COVID‐19 pandemic on the SRB in the Republic of Ireland.

Methods

Publicly available monthly live birth data for Ireland were obtained from the Central Statistics Office for the period 2015 to 2021. Time series analysis predicted the SRB for 2020 using data from 2015 to 2019, with comparisons made between observed and predicted values.

Results

In December 2020, 9 months after the March 2020 COVID‐19 declaration, the observed SRB sharply fell to 49.44% (97.80 males for every 100 females), below the 95% prediction interval of 50.31% to 52.15%, significantly deviating from the expected male predominance. December 2020 also recorded the lowest average daily number of births (n = 145) in the study period.

Conclusion

The sharp decline in the SRB in December 2020, alongside the lowest birth count, suggests reduced sexual intercourse at the population level, particularly in March 2020, aligning with recommendations from Ireland's Health Service Executive (HSE). The HSE advocated precautionary measures such as limiting partnered sex in March 2020 to mitigate the spread of COVID‐19. These findings highlight the pandemic's potential impact on population dynamics and stress the importance of SRB monitoring as a low‐cost and readily available health indicator, especially during national crises.
Associations between the multitrajectory neuroplasticity of neuronavigated rTMS‐mediated angular gyrus networks and brain gene expression in AD spectrum patients with sleep disorders
Authors: Yao Weina , Hou Xinle , Zhou Huijuan , You Shengqi , Lv Tingyu , Chen Haifeng , Yang Zhiyuan , Chen Chang , Bai Feng
Published: September 2024

INTRODUCTION

The multifactorial influence of repetitive transcranial magnetic stimulation (rTMS) on neuroplasticity in neural networks is associated with improvements in cognitive dysfunction and sleep disorders. The mechanisms of rTMS and the transcriptional‐neuronal correlation in Alzheimer's disease (AD) patients with sleep disorders have not been fully elucidated.

METHODS

Forty‐six elderly participants with cognitive impairment (23 patients with low sleep quality and 23 patients with high sleep quality) underwent 4‐week periods of neuronavigated rTMS of the angular gyrus and neuroimaging tests, and gene expression data for six post mortem brains were collected from another database. Transcription‐neuroimaging association analysis was used to evaluate the effects on cognitive dysfunction and the underlying biological mechanisms involved.

RESULTS

Distinct variable neuroplasticity in the anterior and posterior angular gyrus networks was detected in the low sleep quality group. These interactions were associated with multiple gene pathways, and the comprehensive effects were associated with improvements in episodic memory.

DISCUSSION

Multitrajectory neuroplasticity is associated with complex biological mechanisms in AD‐spectrum patients with sleep disorders.

Highlights

This was the first transcription‐neuroimaging study to demonstrate that multitrajectory neuroplasticity in neural circuits was induced via neuronavigated rTMS, which was associated with complex gene expression in AD‐spectrum patients with sleep disorders.

The interactions between sleep quality and neuronavigated rTMS were coupled with multiple gene pathways and improvements in episodic memory.

The present strategy for integrating neuroimaging, rTMS intervention, and genetic data provide a new approach to comprehending the biological mechanisms involved in AD.
Longitudinal associations between exercise and biomarkers in autosomal dominant Alzheimer's disease
Authors: Sewell Kelsey R. , Doecke James D. , Xiong Chengjie , Benzinger Tammie , Masters Colin L. , Laske Christoph , Jucker Mathias , Lopera Francisco , Gordon Brian A. , Llibre‐Guerra Jorge , Levin Johannes , Huey Edward D. , Hassenstab Jason , Schofield Peter R. , Day Gregory S. , Fox Nick C. , Chhatwal Jasmeer , Ibanez Laura , Roh Jee Hoon , Perrin Richard , Lee Jae‐Hong , Allegri Ricardo F. , Supnet‐Bell Charlene , Berman Sarah B. , Daniels Alisha , Noble James , Martins Ralph N. , Rainey‐Smith Stephanie , Peiffer Jeremiah , Gardener Samantha L. , Bateman Randall J. , Morris John C. , McDade Eric , Erickson Kirk I. , Sohrabi Hamid R. , Brown Belinda M. ,   The Dominantly Inherited Alzheimer's Network
Published: September 2024

INTRODUCTION

We investigated longitudinal associations between self‐reported exercise and Alzheimer's disease (AD)‐related biomarkers in individuals with autosomal dominant AD (ADAD) mutations.

METHODS

Participants were 308 ADAD mutation carriers aged 39.7 ± 10.8 years from the Dominantly Inherited Alzheimer's Network. Weekly exercise volume was measured via questionnaire and associations with brain volume (magnetic resonance imaging), cerebrospinal fluid biomarkers, and brain amyloid beta (Aβ) measured by positron emission tomography were investigated.

RESULTS

Greater volume of weekly exercise at baseline was associated with slower accumulation of brain Aβ at preclinical disease stages β = –0.16 [–0.23 to –0.08], and a slower decline in multiple brain regions including hippocampal volume β = 0.06 [0.03 to 0.08].

DISCUSSION

Exercise is associated with more favorable profiles of AD‐related biomarkers in individuals with ADAD mutations. Exercise may have therapeutic potential for delaying the onset of AD; however, randomized controlled trials are vital to determine a causal relationship before a clinical recommendation of exercise is implemented.

Highlights

Greater self‐reported weekly exercise predicts slower declines in brain volume in autosomal dominant Alzheimer's disease (ADAD).

Greater self‐reported weekly exercise predicts slower accumulation of brain amyloid beta in ADAD.

Associations varied depending on closeness to estimated symptom onset.
Towards Polymer Composite‐Based Transient Electronic Systems
Authors: Ko Gwan‐Jin , Naganaboina Venkata Ramesh , Goda Emad S. , Dutta Ankan , Cheng Huanyu , Hwang Suk‐Won
Published: September 2024

Biocompatible and biodegradable polymer composite systems, featuring electrical and mechanical functionalities, have been studied as a means to enable biointegrated electronics, facilitating the acquisition of diverse valuable data. This involves establishing dependable connections with the pliable, irregular surfaces of human skin and organs to obtain a range of useful information. Previously, biodegradable conductive organic/inorganic materials such as conducting polymers and metal derivatives have been reviewed as a filler for polymer composites; however, there are no reviews about the utilization of conductive, semiconductive, and dielectric composites with various electrical/functional properties as electronic components for biomedical applications. These composites show considerable functions such as biodegradability, compatibility, electrochemical properties, magnetism, and photoluminescence. This review introduces the recent advances in biodegradable electronic devices using conductors, semiconductors, and dielectric‐based composites besides their materials, and fabrication methods for monitoring physiological signals, therapeutic systems, energy storage, and drug delivery, as well as substrate and encapsulation materials.