On the Free Energy That Drove Primordial Anabolism

A key problem in understanding the origin of life is to explain the mechanism(s) that led to the spontaneous assembly of molecular building blocks that ultimately resulted in the appearance of macromolecular structures as they are known in modern biochemistry today. An indispensable thermodynamic prerequisite for such a primordial anabolism is the mechanistic coupling to processes that supplied the free energy required. Here I review different sources of free energy and discuss the potential of each form having been involved in the very first anabolic reactions that were fundamental to increase molecular complexity and thus were essential for life

Hard flaccid syndrome: Initial report of four cases

Hard flaccid (HF) is a group of symptoms that significantly affects a man’s sexual and social life. As this syndrome has only been reported in several patient forums, exact prevalence of this rare condition is unknown. Currently, no scientific literature exists of the syndrome. We, hereby, aimed to present four cases suffering from HF and compare the common signs and symptoms with those reported in patient forums. We searched internet forums, chat groups, and private support groups to collect information about symptoms of HF patients. We have identified several complaints regarding penis, erections, libido, urination, and ejaculation. Moreover, we have also collected common findings of laboratory and imaging tests that are used in the workup of HF. The majority of the HF patients is in their 20s–30s. Patients usually seek medical advice due to the following complaints: penile sensory changes (numb or cold), semi-rigid penis at the flaccid state, decreased frequency of morning and/or nocturnal erections, loss in erectile rigidity, difficulty in achieving and maintaining their erections, need for excessive physical or visual stimulation to become erect, and pain on ejaculation and/or urination. Psychological symptoms are usually present ranging from mild anxiety to severe depression. Moreover, laboratory and imaging tests are often unremarkable. Our cases included men between the ages of 22 and 34 years of age and they all reported the onset of their symptoms after a trauma during sexual intercourse or tough masturbation. Compared with reports in patient forums, many of these symptoms (except the urination problems) were observed in our patients and the imaging/laboratory tests were inconclusive. The patients were provided daily/on-demand phosphodiesterase-5 inhibitors, which were not effective. Currently, HF syndrome has not been universally recognized by urologists and a number of patients seem to suffer from this disorder. In order to raise awareness of this clinical phenomenon, HF must be recognized by professional organizations and a better understanding of the disorder must be established. © 2019, Springer Nature Limited

PD05-12 PERSISTENT TESTOSTERONE SUPPRESSION AFTER CESSATION OF ANDROGEN DEPRIVATION THERAPY FOR LOCALIZED PROSTATE CANCER: AN ELECTRONIC HEALTH RECORDS NETWORK STUDY OF 66 MILLION PEOPLE

INTRODUCTION AND OBJECTIVE:Temporary use of Androgen Deprivation Therapy (ADT) is a cornerstone in the treatment of localized prostate cancer. While ADT is typically used for a defined period of ti..

Association between body mass index, metabolic syndrome and common urologic conditions: a cross-sectional study using a large multi-institutional database from the United States

AbstractIntroduction The study aims to determine whether body mass index (BMI), metabolic syndrome (MS) or its individual components (primary hypertension, type 2 diabetes mellitus and dyslipidemias) are risk factors for common urological diseases.Materials and methods Cross-sectional study with data collected on February 28, 2022 from the TriNetX Research Network. Patients were divided in cohorts according to their BMI, presence of MS (BMI > 30 kg/m2, type 2 diabetes mellitus, primary hypertension and disorders of lipoprotein metabolism) and its individual components and its association with common urological conditions was determined. For each analysis, odds ratio (OR) with 95% confidence intervals were calculated. Statistical significance was assessed at p  30 kg/m2 was associated with increased risk of lithiasis, kidney cancer, overactive bladder, male hypogonadism, benign prostatic hyperplasia, and erectile dysfunction (p < .05). On the contrary, BMI was inversely associated with ureteral, bladder and prostate cancer (p < .05). In all urological diseases, MS was the strongest risk factor, with prostate cancer (OR = 2.53) showing the weakest and male hypogonadism the strongest (OR = 13.00) associations.Conclusions MS and its individual components were significant risk factors for common urological conditions. Hence holistic approaches with lifestyle modification might prevent common urological disease.Key messagesOverall, metabolic syndrome is the strongest risk factor for all the analysed urological diseases.Abnormally high body mass index can be a risk or protective factor depending on the threshold and urological disease that are being evaluated.Metabolic syndrome and increased BMI should be considered important factors associated to the prevalence of common urological diseases

Impact of COVID-19 pandemic on diagnosis and surgical management of common urological conditions: results from multi-institutional database analysis from the United States

Objective To determine real life impact during the first pandemic year on diagnosis and surgical management of common urological diseases and 90-day postoperative mortality following common urological surgeries. Methods Cross-sectional study from 2016 to 2021. We used TriNetX to obtain the data. Patients with a diagnosis of six common non-oncologic and five oncologic urologic conditions were included. Twenty-four surgical interventions were also analyzed. The total number of diagnosis and surgical procedures were compared yearly from 2016 to 2021 and Chi-square test was used for statistical analysis. Additionally, monthly changes were evaluated during the first pandemic year and a z score period time was reported. The 90-day post-operative mortality rates during the first pandemic year were compared to the preceding year. Results Overall, a decrease in diagnosis and surgeries were observed during the first pandemic year, with maximum drop in April 2020. Among non-oncological conditions, the decrease in diagnosis of enlarged prostate (5.3%), nephrolithiasis (9.4%), urinary incontinence (18.7%), and evaluation for male sterilization (14.8%) reached statistical significance (P < 0.05 in all). Prostate cancer was the only cancer whose diagnosis showed statistically significant decrease (6.2%, P < 0.05). The surgical case load for benign conditions showed higher reduction (13.1-25%) than for malignant conditions (5.9-16.3%). There was no change in 90-day post-operative mortality in any of the analyzed surgeries. Conclusions Our study showed that although healthcare delivery decreased in the first pandemic year, causing a decline in the diagnosis and surgical treatment of several diseases, surgical interventions did not increase the risk of death