A Family History of Lethal Prostate Cancer and Risk of Aggressive Prostate Cancer in Patients Undergoing Radical Prostatectomy.

We investigated whether a family history of lethal prostate cancer (PCa) was associated with high-risk disease or biochemical recurrence in patients undergoing radical prostatectomy. A cohort of radical prostatectomy patients was stratified into men with no family history of PCa (NFH); a first-degree relative with PCa (FH); and those with a first-degree relative who had died of PCa (FHD). Demographic, operative and pathologic outcomes were analyzed. Freedom from biochemical recurrence was examined using Kaplan-Meier log rank. A multivariate Cox logistic regression analysis was also performed. We analyzed 471 men who underwent radical prostatectomy at our institution with known family history. The three groups had: 355 patients (75%) in NFH; 97 patients (21%) in FH; and 19 patients (4%) in FHD. The prevalence of a Gleason score ≥8, higher pathologic T stage, and biochemical recurrence (BCR) rates did not significantly differ between groups. On Kaplan-Meier analysis there were no differences in short-term BCR rates (p = 0.212). In this cohort of patients undergoing radical prostatectomy, those with first-degree relatives who died of PCa did not have an increased likelihood of high-risk or aggressive PCa or shorter-term risk of BCR than those who did not

Intraperitoneally Placed Foley Catheter via Verumontanum Initially Presenting as a Bladder Rupture

Since urethral Foley catheterization is usually easy and safe, serious complications related to this procedure have been rarely reported. Herein, we describe a case of intraperitoneally placed urethral catheter via verumontanum presenting as intraperitoneal bladder perforation in a chronically debilitated elderly patient. A 82-yr-old male patient was admitted with symptoms of hematuria, lower abdominal pain after traumatic Foley catheterization. The retrograde cystography showed findings of intraperitoneal bladder perforation, but emergency laparotomy with intraoperative urethrocystoscopy revealed a tunnel-like false passage extending from the verumontanum into the rectovesical pouch between the posterior wall of the bladder and the anterior wall of the rectum with no bladder injury. The patient was treated with simple closure of the perforated rectovesical pouch and a placement of suprapubic cystostomy tube

Alzheimer’s Disease Diagnosis Using Machine Learning: A Survey

Alzheimer’s is a neurodegenerative disorder affecting the central nervous system and cognitive processes, explicitly impairing detailed mental analysis. Throughout this condition, the affected individual’s cognitive abilities to process and analyze information gradually deteriorate, resulting in mental decline. In recent years, there has been a notable increase in endeavors aimed at identifying Alzheimer’s disease and addressing its progression. Research studies have demonstrated the significant involvement of genetic factors, stress, and nutrition in developing this condition. The utilization of computer-aided analysis models based on machine learning and artificial intelligence has the potential to significantly enhance the exploration of various neuroimaging methods and non-image biomarkers. This study conducts a comparative assessment of more than 80 publications that have been published since 2017. Alzheimer’s disease detection is facilitated by utilizing fundamental machine learning architectures such as support vector machines, decision trees, and ensemble models. Furthermore, around 50 papers that utilized a specific architectural or design approach concerning Alzheimer’s disease were examined. The body of literature under consideration has been categorized and elucidated through the utilization of data-related, methodology-related, and medical-fostering components to illustrate the underlying challenges. The conclusion section of our study encompasses a discussion of prospective avenues for further investigation and furnishes recommendations for future research activities on the diagnosis of Alzheimer’s disease

Postirradiation lumbosacral radiculopathy following seminoma treatment presenting as flaccid neuropathic bladder: a case report

<p>Abstract</p> <p>Introduction</p> <p>Postirradiation lumbosacral syndrome is a radiculopathy induced by radiation injury to the spinal cord. Its usual presentation is motor deficit and or sensory loss involving the lower limbs. Visceral involvement has not been reported previously.</p> <p>Case presentation</p> <p>We describe a case of severe hypotonic bladder caused by radiation-induced spinal cord injury following treatment of stage Ι testicular seminoma in a 38-year-old Caucasian man who had undergone radical orchidectomy and prophylactic paraaortic lymph node irradiation for stage Ι seminoma. Three years later he had clinical and urodynamic findings of hypotonic bladder. The magnetic resonance imaging results suggested a radiation-induced injury.</p> <p>Conclusion</p> <p>Such an unusual presentation of the syndrome of postirradiation lumbosacral radiculopathy can impose a clinical challenge to practicing clinicians. Future studies are required to further delineate the mechanism of injury and further management plans.</p

A novel patient-derived intra-femoral xenograft model of bone metastatic prostate cancer that recapitulates mixed osteolytic and osteoblastic lesions

<p>Abstract</p> <p/> <p>Prostate cancer metastasizes to bone in the majority of patients with advanced disease leading to painfully debilitating fractures, spinal compression and rapid decline. In addition, prostate cancer bone metastases often become resistant to standard therapies including androgen deprivation, radiation and chemotherapy. There are currently few models to elucidate mechanisms of interaction between the bone microenvironment and prostate cancer. It is, thus, essential to develop new patient-derived, orthotopic models. Here we report the development and characterization of PCSD1 (Prostate Cancer San Diego 1), a novel patient-derived intra-femoral xenograft model of prostate bone metastatic cancer that recapitulates mixed osteolytic and osteoblastic lesions.</p> <p>Methods</p> <p>A femoral bone metastasis of prostate cancer was removed during hemiarthroplasty and transplanted into <it>Rag2^-/-;γ_c^-/-</it>mice either intra-femorally or sub-cutaneously. Xenograft tumors that developed were analyzed for prostate cancer biomarker expression using RT-PCR and immunohistochemistry. Osteoblastic, osteolytic and mixed lesion formation was measured using micro-computed tomography (microCT).</p> <p>Results</p> <p>PCSD1 cells isolated directly from the patient formed tumors in all mice that were transplanted intra-femorally or sub-cutaneously into <it>Rag2^-/-;γ_c^-/-</it>mice. Xenograft tumors expressed human prostate specific antigen (PSA) in RT-PCR and immunohistochemical analyses. PCSD1 tumors also expressed AR, NKX3.1, Keratins 8 and 18, and AMACR. Histologic and microCT analyses revealed that intra-femoral PCSD1 xenograft tumors formed mixed osteolytic and osteoblastic lesions. PCSD1 tumors have been serially passaged in mice as xenografts intra-femorally or sub-cutaneously as well as grown in culture.</p> <p>Conclusions</p> <p>PCSD1 xenografts tumors were characterized as advanced, luminal epithelial prostate cancer from a bone metastasis using RT-PCR and immunohistochemical biomarker analyses. PCSD1 intra-femoral xenografts formed mixed osteoblastic/osteolytic lesions that closely resembled the bone lesions in the patient. PCSD1 is a new primary prostate cancer bone metastasis-derived xenograft model to study metastatic disease in the bone and to develop novel therapies for inhibiting prostate cancer growth in the bone-niche.</p

EXAMINING AND CORRELATION ANALYZE OF THE RELATIONSHIP BETWEEN FUNCTIONAL MOVEMENT SCREENING TEST (FMS) AND UPPER LIMB FUNCTION IN ELITE BASKETBALL PLAYERS AL- RAFIDAIN SPORTS CLUB

Background Functional Movement Screening (FMS) becomes more and more popular in identifying functional limitations in basic functional movements. This experimental study was conducted to confirm the feasibility of implementing FMS among active Elite Basketball Players Al-R afidain Sports Club. The purpose of this study is to investigate the relationship between the functional sports screen (FMS) of Elite Basketball Players Al- Rafidain Sports Club and upper limb`s function Methods It is essential to have more practical and comprehensive alternatives of exercise screening for understanding human function and identifying impairments and dysfunctional exercise patterns that reduce functional quality. In many cases, weakness or tension in muscles or muscle groups is usually found, then treated with separate stretching or strengthening activities, rather than using standard exercise patterns that can solve multiple injuries at the same time. Likewise, many professionals usually focus on specific areas of complaint, rather than starting with identifying comprehensive motor characteristics and correlating that characteristic with dysfunction. The study group consisted of 60 Elite Basketball Players from Al- Rafidain Sports Club; with age between 17 and 36. Their height was 175–220 cm, weight –  65–85 kg, BMI was calculated and recorded digitally for later analysis. The inclusion criterion was absence of a history of musculoskeletal injury at least 3 months before investigation. FMS consists of 7 component tests to evaluate different basic movement modes (squat, hurdle step, overhead squat, inline lunge, shoulder flexibility, straight leg elevation test, trunk stability push-up test). Arm Disability Assessment Questionnaire (DASH) has been used to assess upper limb function as an evaluation tool for the prevention of sports injuries. Pearson correlation coefficient with significance p ≤ 0.05 was used to test the relationship between variables Resulte: The results show that there is a difference between the performance screening test scores for measuring arm disability and the high scores. (P = 0.01, R = –.068) There is a strong relationship. Conclusion It seems necessary for coaches and sports experts to choose suitable tests for athletes to prevent sports injuries. This could effectively reduce the cost of treatment and improve the level of exercise. Therefore, based on the results of this study, it can be said that the test which has been introduced could be used as an assessment tool for injury prevention. However, its relationship with other functional tests and some factors of physical fitness has not been studied

COVID-19 vaccine acceptance and hesitancy in low- and middle-income countries

Widespread acceptance of COVID-19 vaccines is crucial for achieving sufficient immunization coverage to end the global pandemic, yet few studies have investigated COVID-19 vaccination attitudes in lower-income countries, where large-scale vaccination is just beginning. We analyze COVID-19 vaccine acceptance across 15 survey samples covering 10 low- and middle-income countries (LMICs) in Asia, Africa and South America, Russia (an upper-middle-income country) and the United States, including a total of 44,260 individuals. We find considerably higher willingness to take a COVID-19 vaccine in our LMIC samples (mean 80.3%; median 78%; range 30.1 percentage points) compared with the United States (mean 64.6%) and Russia (mean 30.4%). Vaccine acceptance in LMICs is primarily explained by an interest in personal protection against COVID-19, while concern about side effects is the most common reason for hesitancy. Health workers are the most trusted sources of guidance about COVID-19 vaccines. Evidence from this sample of LMICs suggests that prioritizing vaccine distribution to the Global South should yield high returns in advancing global immunization coverage. Vaccination campaigns should focus on translating the high levels of stated acceptance into actual uptake. Messages highlighting vaccine efficacy and safety, delivered by healthcare workers, could be effective for addressing any remaining hesitancy in the analyzed LMICs.Publisher PDFPeer reviewe

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10&nbsp;years; 78.2% included were male with a median age of 37&nbsp;years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020