Prostate Cancer Microbiome: A Narrative Review of What We Know So Far

Abstract Purpose of review The role of the microbiome in mediating the pathogenesis of prostate cancer has been suggested to have a role in the carcinogenesis process. This review aimed to explore the potential role of the prostate, urinary, and gut microbiomes in prostate cancer development. Recent Findings Current literature indicates that the discovery of microbes, potentially associated with prostate cancer, raises more questions about whether their presence was merely coincidental or due to contamination. Studies have discovered bacteria and viruses in the prostate, urinary tract, and gastrointestinal tract. However, whether there is a prostate microbiome is still unclear due to the study design limitations and small sample size. Summary Even though the link between the specific microbiome and prostate cancer has not been established, findings suggest that chronic inflammation and immune system modulation associated with the microbiome are the underlying mechanisms increasing the risk of prostate cancer development

Glomus tumor-induced lower extremity pain: A case report

tINTRODUCTION: Glomus tumor located in the lower limb could be easily mistaken as lower extremitypain whether it is radiating, sciatic, or just a localized one. This could lead to misdiagnosis and impropermanagement.PRESENTATION OF CASE: This case reported a 56-year-old man complaining of pain in his left thigh. Thepain was characterized as sharp and sometimes radiated to the skin of the calf muscles region. There wasno history of trauma. Physical examination of the left thigh region revealed a small and barely palpabledeep subcutaneous mass. Ultrasound examination showed a 6 × 5.3 mm partly cystic subcutaneous massin the posteromedial region of the left distal femur. Doppler USG showed that the blood flow in the cysticlesion originated from the medial genicular artery. Surgical tumor excision through the medial femoralapproach exposed a 15 × 10 × 5 mm yellowish-white thin encapsulated subdermal tumor attached tothe vascular wall. Histopathology examination resulted in a Glomus Tumor.DISCUSSION: Glomus tumor usually occurs in areas that are rich in glomus bodies. Thigh is not a specificlocation for glomus bodies. It presented as bluish small nodule that are sensitive to touch and temperaturechanges. Glomus tumors in the thigh region rarely recurs since they are solitary and encapsulated, makingthem easily recognizable from the surrounding tissue during the operation.CONCLUSION: Meticulous history taking, physical examination, and imaging modalities are necessary todifferentiate between tumor and non-tumor lesions in less common areas

A Comparison of Osteoblast Cell Proliferation and Osteocalcin Expression in Cuttlefish Bone and Bovine Bone Xenograft

Background: Cuttlefish bone Xenograft, calcium phosphate (CaP)-based biomaterial graft, offers an alternative and has been accepted for osteoconductive and probable osteo-inductive attributes. This study aims to compare the bone healing potential between the bovine-derived (BHA) and cuttlefish bone-derived (CHA).Materials and Methods: The study compared osteoblast cell proliferation of 27 New Zealand rabbits in 2.5 mm bone defect made in the femoral bone. The samples were divided into three groups, which were control, BHA and CHA group. The chemical and physical characteristics of BHA and CHA were determined for the content of hydroxyapatite by FourierTransform Infrared Spectroscopy (FTIR) and X-Ray Diffraction (XRD), then tested by Scanning Electron Microscopy (SEM) to evaluate the porosity. In the end of the second week, histopathologic and immunohistochemistry examinations were performed to evaluate the amount of osteoblast and osteocalcin expression.Results: The FTIR, XRD and SEM analysis showed both BHA and CHA samples were hydroxyapatite according to Joint Committee on Powder Diffraction Standards (JCPDS). The CHA was significantly higher (297.22±19.772) compared to BHA (258.22±30.926) and control (131.67±34.213). Osteocalcin expression in CHA (7.82±2.230) compared to BHA (6.09±3.724) and control (4.07±3.606), was not significant (p>0.05). Conclusion: CHA group has the highest osteoblast cell proliferation and osteocalcin expression, meaning has a good potential as future source of bone graft.Keywords: cuttlefish bone, bovine, bone graft, osteoblast cel

Outcomes of ureteral stent placement for hydronephrosis in patients with ureteral stone

Abstract Background Routine ureteral stent placement after ureteroscopy (URS) for ureteral stone treatment is arguable due to the possible stent-related symptoms. Several studies claimed that its use is necessary, while others reported that its use is excessive. Hydronephrosis occurs when urine cannot drain out from the kidney to the bladder due to blockage or obstruction. We aimed to evaluate the role of ureteral stents in hydronephrosis resolution in ureteral stone patients following URS lithotripsy. Methods This was a prospective observational study using secondary data involving 130 ureteral stone patients undergoing URS lithotripsy [99 patients (76.2%) with stent placement and 31 patients (23.8%) without stent]. Data consisting of baseline characteristics, pre-operative status, intraoperative characteristics, and postoperative complications were collected from the medical record database and presented descriptively. The patients were divided into two groups based on stent placement. Comparison of hydronephrosis resolution between the groups was analyzed with Chi-square. Results Ureteral lesions were the most common indication of ureteral stent placement following URS lithotripsy (28.3%). The most bothersome symptoms were dysuria in 18 patients (18.2%); followed by frequency in eight patients (8.1%) and low back pain in six patients (6.1%). All symptoms were successfully treated with oral medications. There were 41 patients (91.1%) with pre-operative hydronephrosis significantly resolved after stent placement compared to 5 (62.5%) patients without stent placement (p=0.027). Conclusion Ureteral stenting significantly resolves pre-operative hydronephrosis after URS lithotripsy in patients with ureteral stone. Ureteral stent placement is the preferred method for the treatment of pre-operative hydronephrosis

The use of tissue sealant in reducing urethrocutaneous fistula event following hypospadias repair: A systematic review and meta-analysis

Abstract Background: One of the most frequent complications following hypospadias repair is urethrocutaneous fistula (UCF) event. Tissue sealant has been introduced as a means to reduce UCF. However, reports regarding its benefits are varied. Thus, we initiated a systematic review and meta-analysis to investigate its role in reducing UCF following hypospadias repair. Methods: We completed a systematic search through the Embase, MEDLINE, and Scopus databases for studies assessing postoperative complications in hypospadias patients undergoing urethroplasty with and without tissue sealant. Cochrane risk of bias 2 (RoB 2) tool was used to assess the quality of randomized clinical trials (RCTs), while the observational studies were assessed with Newcastle-Ottawa Scale. The primary outcome analyzed in this study was UCF, while secondary outcomes consisted of postoperative complications such as edema, infection, and wound dehiscence that increases the risk of UCF formation, measured using odds ratio (OR) with a 95% confidence interval (CI). Results: Six eligible studies comprising three RCTs and three non-randomized studies were included. Patients undergoing hypospadias repair with tissue sealant had lower UCF events (OR = 3.27; 95% CI 1.92–5.58; p < 0.0001). Likewise other post-operative complications, tissue sealant group had a lower rate of edema (OR = 2.29; 95% CI 1.38–3.78; p = 0.001) and infection (OR = 3.87; 95% CI 1.55–9.70; p = 0.004). The difference in wound dehiscence was insignificant between the groups (OR = 2.08; 95% CI 0.21–20.55; p = 0.53). Conclusion: Tissue sealant can reduce UCF events following hypospadias repair as well as edema and infection that increases the risk of UCF formation

The effectiveness of classic lecture and workshop as interventions to improve primary health care providers knowledge and skill on the management of pediatric emergencies: a case study

Abstract A preliminary study showed that most health workers in primary health care (PHC) claimed that they need a refreshing course because of their lack of updated knowledge and skill. This study enrolled 27 primary healthcare workers recruited from the PHC. The intervention used were classic lectures and workshops. The knowledge was evaluated using a paper-based test and practice, while the skill was evaluated using a practice test. Multiple questions (pre-test and post-test) based on current emergency management for pediatric were used for paper-based evaluation. Semi-structured interviews were conducted to confirm the subject's perspective on the intervention. A paired t-test was used for evaluating the pre- and post-test results, which was confirmed by a triangulation approach. There was a significant difference between the pre- and post-test results (p<0.001), and 8 of 10 subjects can demonstrate the procedure learned correctly after the intervention. A total of 14 interviewed subjects stated great effectiveness of the intervention, with several limitations on applicability in daily clinical practice. Classic lecture and workshop as an intervention in health education effectively increase health workers' knowledge and skill in PHC. This study might help other rural areas PHC apply the same method so the professionalism and quality of health workers in PHC providers can be maintained.Keywords                : primary health care, classic lecture; workshop; knowledge; skillCorrespondence     : [email protected]

Symptomatic multiple prostatic calculi: A case report and literature review

Prostatic calculi are often found incidentally during a clinical and radiological examination. However, in some instances, large or multiple calculi may cause severe lower urinary tract symptoms (LUTS). Its current significance concerning urological diseases and symptoms remains obscure. Minimal awareness regarding the disease among physicians could lead to improper assessment and treatment. In Indonesia, reports regarding prostatic calculi are still limited. We report a 50-year-old male with symptomatic multiple prostatic calculi

Doxorubicin and ifosfamide for recurrent renal synovial sarcoma: The first case report in Indonesia

Abstract Introduction and importance Synovial sarcoma (SS) is the fourth most common soft tissue sarcoma. The primary treatment for renal SS is radical surgical resection of the tumor. However, there are several stages of SS that need systemic treatment. The consensus regarding systemic treatment remains unclear. Therefore, we reported a case of an 18-year-old male with recurrent renal SS treated with doxorubicin and ifosfamide as systemic chemotherapy. Case presentation An 18-year-old male was admitted with a chief complaint of right flank pain for three months. He had a history of radical nephrectomy due to a suspicion of Wilms tumor. The histopathological and immunohistochemistry results showed a SS of the kidney. One year after the surgery, the patient came with a sign of a residual tumor. The diagnosis of recurrent renal SS was established after the physical examination, and Second-line chemotherapy was not administered because the patient refused any further treatment. However, the patient showed a partial response after the first chemotherapy session, indicating the benefit of the treatment. Clinical discussion The chemotherapy regimen is generally considered safe and can be widely used in clinical practice. Partial response was shown after six courses of treatment. Ifosfamide-based chemotherapy was also used in some reported cases. Most of the cases reported in the current literature were only managed by surgery without using chemotherapy. These cases had various RFS, ranging from 5 to 25 months. Conclusion Doxorubicin and ifosfamide are useful as first-line chemotherapy for recurrent renal synovial sarcoma

Translation validity and reliability of the Indonesian version of the 5-item International Index of Erectile Function (IIEF-5)

Abstract Objective: This study aimed to translate the IIEF-5 questionnaire into Indonesian and perform a validity and reliability assessment of the translated instrument. Material and methods: A methodological study on 106 male outpatients, recruited consecutively, was carried out in a tertiary hospital in Surabaya, East Java from January to March 2020. This study was conducted in two stages: translation and validation. Two independent sworn translators performed a forward and backward translation of the first draft. The final version was synthesized by a team of experts comprised two urologists and another sworn translator. The validity of the questionnaire is determined through a Pearson correlation analysis. Cronbach's a internal consistency measurement was used to assess its reliability. Interrater reliability between the patient and the physician was measured using the Cohen's j coefficient. Results: Pearson's "r" value is significantly higher than the critical value table and indicates a high to a very high level of validity based on Guilford's interpretation (r ¼ 0.70-1.00). A good internal consistency is shown by the Cronbach's a coefficient value (a ¼ 0.828). An almost perfect agreement between the patient's results and the assessment made by the physicians is shown by the Cohen's j coefficient value (j ¼ 0.879, P < .001). Conclusion: The Indonesian IIEF-5 is a valid and reliable patient-reported outcome measure for evaluating erectile dysfunction in the literate middle-aged and older adult male population in Indonesia