Buccal mucosa is a promising graft in Peyronie's disease surgery. Our experience and a brief literature review on autologous grafting materials

AIM: Peyronie's Disease (PD) is an under reported acquired benign condition that, at the moment, is not curable with medical therapy. Surgery represent the gold standard of treatment. Surgical approaches are several and they consist in "plication techniques" or plaque incision/excision with grafting of resulting albuginea defect. Among grafting procedures, albuginea defect substitution with autologous materials demonstrated over the years not inferior results respect to heterologous grafts. Buccal mucosa graft (BMG) is not usually emphasized in many review articles and clinical series are yet limited. METHODS: We present our experience with seventeen plaque incision procedures and BMG in surgical correction of complex penile curvatures due to PD performed in a period of 30 months. Our analyses was focused on buccal mucosa graft characteristics as major determinant of the surgical success. We also conducted a brief literature review on autologous grafting materials used in reconstructive penile surgery for PD. RESULTS: Our cosmetics and functional results consists in a 100% of functional penile straightening with no relapses and 5,8% of de novo erectile dysfunction. Mean age was 56.4 years, mean follow-up of 22.5 (6-36) months. No complications graft related were observed. Operative time was 115.3 minutes in mean. Over 94% of patients referred they were "really much better" and "much better" satisfied based on PGI-I questionnaire administrated at the last follow- up visit. CONCLUSION: BMG is revealing as an optimal choice for reconstructive surgery in PD. Anatomical characteristics consisting in the great elasticity, the quick integration time and the easy harvesting technique lead to high cosmetics and functional success rate, without omitting economical and invasiveness aspects

Botulinum-A toxin injections into the detrusor muscle decrease nerve growth factor bladder tissue levels in patients with neurogenic detrusor overactivity

Purpose: We investigated the effects of BTX-A on visceral afferent nerve transmission by measuring bladder tissue NGF levels in patients with neurogenic detrusor overactivity before and after intravesical treatment with BTX-A. We also compared the bladder tissue NGF content with clinical and urodynamic data. Materials and Methods: A total of 23 patients underwent clinical evaluation and urodynamics with detection of the UDC threshold, maximum pressure and maximum cystometric capacity before, and at the 1 and 3-month followups. Endoscopic bladder Wall biopsies were also obtained at the same time points. NGF levels were measured in tissue homogenate by enzyme-linked immunosorbent assay (Promega, Madison, Wisconsin). Results: At 1 and 3 months mean catheterization and incontinent episodes were significantly decreased (p < 0.05 and < 0.001, respectively). On urodynamics we detected a significant increase in the UDC threshold and maximum cystometric capacity, and a significant decrease in UDC maximum pressure at the 1 and 3-month followups compared to baseline (each p < 0.001). At the same time points we detected a significant decrease in NGF bladder tissue content (each p < 0.02). Conclusions: BTX-A intravesical treatment induces a state of NGF deprivation in bladder tissue that persists at least up to 4 months. As caused by BTX-A, the decrease in acetylcholine release at the presynaptic level may induce a decrease in detrusor contractility and in NGF production by the detrusor muscle. Alternatively BTX-A can decrease the bladder level of neurotransmitters that normally modulate NGF production and release

FETR-ALS Study Protocol: A Randomized Clinical Trial of Fecal Microbiota Transplantation in Amyotrophic Lateral Sclerosis

Background and Rationale: Among the key players in the pathogenesis of Amyotrophic Lateral Sclerosis (ALS), microglia and T regulatory lymphocytes (Treg) are candidate cells for modifying the course of the disease. The gut microbiota (GM) acts by shaping immune tolerance and regulating the Treg number and suppressive function, besides circulating neuropeptides, and other immune cells that play in concert through the gut-brain axis. Previous mouse models have shown an altered enteric flora in early stage ALS, pointing to a possible GM role in ALS pathogenesis. Fecal Microbial Transplantation (FMT) is a well-known therapeutic intervention used to re-establish the proper microenvironment and to modulate enteric and systemic immunity. Methods: We are going to perform a multicenter randomized double-blind clinical trial employing FMT as a therapeutic intervention for ALS patients (NCT0376632). Forty-two ALS patients, at an early stage, will be enrolled with a 2:1 allocation ratio (28 FMT-treated patients vs. 14 controls). Study duration will be 12 months per patient. Three endoscopic procedures for intestinal biopsies in FMT and control groups are predicted at baseline, month 6 and month 12; at baseline and at month 6 fresh feces from healthy donors will be infused at patients in the intervention arm. The primary outcome is a significant change in Treg number between FMT-treated patients and control arm from baseline to month 6. Secondary outcomes include specific biological aims, involving in-depth analysis of immune cells and inflammatory status changes, central and peripheral biomarkers of ALS, besides comprehensive analysis of the gut, saliva and fecal microbiota. Other secondary aims include validated clinical outcomes of ALS (survival, forced vital capacity, and modifications in ALSFRS-R), besides safety and quality of life. Expected Results: We await FMT to increase Treg number and suppressive functionality, switching the immune system surrounding motorneurons to an anti-inflammatory, neuroprotective status. Extensive analysis on immune cell populations, cytokines levels, and microbiota (gut, fecal and saliva) will shed light on early processes possibly leading the degenerative ALS course. Conclusions: This is the first trial with FMT as a potential intervention to modify immunological response to ALS and disease progression at an early stage

Variabilidade genética em populações de Anticarsia gemmatalis Hübner (Lepidoptera: Noctuidae) nas regiões produtoras de soja no Brasil.

Com o uso de ferramentas moleculares é possível sequenciar genes e caracterizar populações de insetos. Assim, este trabalho teve por objetivo estudar a variabilidade genética entre subpopulações de Anticarsia gemmatalis Hübner (Lepidoptera: Noctuidae) nas principais regiões produtoras de soja, utilizando sequências de genes mitocondriais. Foram coletadas populações de A. gemmatalis nas localidades de: Santa Helena de Goiás (GO), Luis Eduardo Magalhães (BA); Mauá da Serra (PR), Coxilha (RS) e Campo Verde (MT), seu DNA foi extraído para amplificação e sequenciamento. A Análise de Variância Molecular (AMOVA) foi aplicada para estimar a estrutura genética utilizando três fragmentos do mtDNA, o gene da subunidade de citocromo oxidase I (COI), citocromo oxidase II (COII) e citocromo B (CytB). A distribuição e frequência de haplótipos foi determinada pelo programa TCS. Foi sequenciado um total de 71 indivíduos de A. gemmatalis. A subpopulação de MT apresentou a menor variação na frequência dos haplótipos para todas as regiões estudadas. O haplótipo mais representativo foi o h2, sendo encontrado em indivíduos da Bahia (9), Paraná (1) e Rio Grande do Sul (1). A maior frequência haplotípica foi observada em MT, PR e RS. Na análise das sequencias de A. gemmatalis foi possível observar que há potencial para identificar possíveis haplótipos que possam caracterizar uma determinada subpopulação. Para isso seria necessário à utilização de outras ferramentas, como por exemplo, estudos de PCR-RFLP e análise de outras regiões gênicas, que possam contribuir na identificação de haplótipos nas subpopulações de A. gemmatalis no Brasil

Variabilidade genética em populações de Pseudoplusia includens (Walker) (Lepidoptera: Noctuidae) nas regiões produtoras de soja no Brasil.

Pseudoplusia includens (Walker) (Lepidoptera: Noctuidae) é uma importante praga, de difícil controle, na cultura da soja no Brasil. Informações sobre a distribuição da variabilidade de suas subpopulações no Brasil ainda são restritas, embora os conhecimentos da estrutura genética populacional e do fluxo gênico dessa espécie possam contribuir no delineamento do manejo da resistência a inseticidas e toxinas. Assim, este trabalho teve por objetivo estudar a variabilidade genética de P. includens nas principais regiões produtoras de soja, utilizando sequências de genes mitocondriais (mtDNA). Foram coletadas populações de P. includens nas localidades de Campo Verde (MT), Tasso Fragoso (MA), Bela Vista do Paraíso (PR), Santa Helena de Goiás (GO) e Coxilha (RS), totalizando 67 espécimes. O DNA total foi extraído individualmente, e as regiões do mtDNA, citocromo oxidase I (COI), citocromo oxidase II (COII) e citocromo B (CytB) foram amplificadas, purificadas e sequenciadas. A distribuição da variabilidade genética entre e dentro de cada subpopulação foi determinada por meio da Análise de Variância Molecular (AMOVA), usando o programa Arlequin e a frequência de haplótipos foi determinada no programa TCS. As subpopulações dos estados de Goiás e Maranhão foram as que apresentaram a maior diversidade haplotípica. O índice de fixação (&#981;ST) obtido pela AMOVA indicou que não existe estruturação nas subpopulações estudadas de P. includens. A ausência de agrupamento na análise da rede de haplótipos das sequências de mtDNA evidenciou a reduzida diferenciação entre as subpopulações

Draft genome sequence of Bacillus sp. strain CMAA 1185, a cellullolytic bacterium isolated from Stain House Lake, Antarctic Peninsula.

The aim of this study was to report the genome sequence of the cellulolytic Bacillus sp. strain CMAA 1185, isolated from Stain House Lake, Antarctica

Artificial Intelligence in Bladder Cancer Diagnosis: Current Applications and Future Perspectives

Bladder cancer (BCa) is one of the most diagnosed urological malignancies. A timely and accurate diagnosis is crucial at the first assessment as well as at the follow up after curative treatments. Moreover, in the era of precision medicine, proper molecular characterization and pathological evaluation are key drivers of a patient-tailored management. However, currently available diagnostic tools still suffer from significant operator-dependent variability. To fill this gap, physicians have shown a constantly increasing interest towards new resources able to enhance diagnostic performances. In this regard, several reports have highlighted how artificial intelligence (AI) can produce promising results in the BCa field. In this narrative review, we aimed to analyze the most recent literature exploring current experiences and future perspectives on the role of AI in the BCa scenario. We summarized the most recently investigated applications of AI in BCa management, focusing on how this technology could impact physicians’ accuracy in three widespread diagnostic areas: cystoscopy, clinical tumor (cT) staging, and pathological diagnosis. Our results showed the wide potential of AI in BCa, although larger prospective and well-designed trials are pending to draw definitive conclusions allowing AI to be routinely applied to everyday clinical practice

Older Adults’ Access to Care during the COVID-19 Pandemic: Results from the LOckdown and LifeSTyles (LOST) in Lombardia Project

The COVID-19 pandemic disproportionally affected older people in terms of clinical outcomes and care provision. We aimed to investigate older adults’ changes in access to care during the pandemic and their determinants. We used data from a cross-sectional study (LOST in Lombardia) conducted in autumn 2020 on a representative sample of 4400 older adults from the most populated region in Italy. Lifestyles, mental health, and access to healthcare services before and during the pandemic were collected. To identify factors associated with care delays, reduction in emergency department (ED) access, and hospitalisations, we estimated prevalence ratios (PR) and 95% confidence intervals (CI) using multivariable log-binomial regression models. During the pandemic, compared to the year before, 21.5% of the study population increased telephone contacts with the general practitioner (GP) and 9.6% increased self-pay visits, while 22.4% decreased GP visits, 12.3% decreased outpatient visits, 9.1% decreased diagnostic exams, 7.5% decreased ED access, and 6% decreased hospitalisations. The prevalence of care delays due to patient’s decision (overall 23.8%) was higher among men (PR 1.16, 95% CI 1.05–1.29), subjects aged 75 years or more (PR 1.12, 95% CI 1.00–1.25), and those with a higher economic status (p for trend &lt; 0.001). Participants with comorbidities more frequently cancelled visits and reduced ED access or hospitalisations, while individuals with worsened mental health status reported a higher prevalence of care delays and ED access reductions. Access to care decreased in selected sub-groups of older adults during the pandemic with likely negative impacts on mortality and morbidity in the short and long run

Development of microsatellite markers in Guineagrass (Panicum maximum Jacq.) and their transferability to other tropical forage grass species.

The Guineagrass (Panicum maximum Jacq.) is one of the most important tropical forage grasses, but genetic knowledge and tools regarding this species are still limited. Therefore, 20 novel polymorphic microsatellite markers were developed, validated, and employed in estimating genetic relationships among 25 P. maximum genotypes selected from a Brazilian germplasm collection. In addition, they were tested for cross-species amplification in four other forage grass species. The number of alleles observed for each locus ranged from 4 to 12 (average 6.7). The values of polymorphism information content (PIC) varied from 0.41 to 0.83 (average 0.61) and the discriminating power (D) ranged from 0.53 to 0.98 (average 0.72). Cross-amplification demonstrated the potential transferability of these microsatellites to four tropical forage grass species. Cluster analysis based on the unweighted pair group method revealed three distinct groups: two clusters consisted of P. maximum genotypes and a third cluster, consisted of the other tropical forage grass species. The data demonstrated that the microsatellites developed herein have potential for germplasm characterization and genetic diversity analysis in P. maximum and other forage grass species