Value of non-contrast CT examination of the urinary tract (stone protocol) in the detection of incidental findings and its impact upon the management

AbstractBackgroundUrolithiasis is one of the most common urinary tract diseases worldwide, with a wide range of affected age groups. Non-contrast CT examination of the urinary tract is the gold-standard examination for detection and characterization of urinary tract stones, with great impact upon the choice of method of management. Aside from detection of stones, non-contrast CT examination of the abdomen and pelvis also offers a valuable overlook upon the other abdominal organs, pathologies of which may simulate a stone disease, or accompany stone disease and can be detected incidentally, which may shift management plan dramatically.Aim of workTo demonstrate the use of non-contrast CT examinations (stone protocol) in the detection of abdominal pathologies other than stones, whether or not simulating the clinical picture of urolithiasis, and its impact upon patient management.Patients and methodsAssessment of the non-contrast examinations of the urinary tract of patients referred for suspected stone urolithiasis recording any incidental finding and follow-up of the impact of these incidental findings upon the management delivered to the patient.ResultsA total of 719 examinations were performed, of which 334 had urinary tract stones only, 211 had incidental finding beside urinary tract stones, 170 had an incidental finding with no urinary tract stones, and four patients had neither stones nor incidental findings. A total number of 381 patients had incidental findings, 198 (47%) of which had an impact upon the management.ConclusionNon-contrast CT examination of the urinary tract (stone protocol) is a valuable tool in the detection of incidental findings which may simulate, or coincide with urolithiasis and it has a significant impact upon the management of the patients

Schistosomiasis and Bladder Cancer in Egypt: Truths and Myths

BACKGROUND: The gathered archeopathological evidence has confirmed that Schistosomiasis has been endemic in Ancient Egypt for over 500 decades. The association between Schistosoma hematobium and increase bladder cancer risk is also well acknowledged. However, over the years, there is a proved changing pattern of bladder cancer that needs to be investigated. AIM: We aim to discuss the truths and myths about bladder cancer and its association with Schistosomiasis in Egypt. METHODS: A cross-sectional, case-control study was performed to collect recent data on the topic. RESULTS: Of the reported cancer cases, 79.3% were transitional cell carcinoma (TCC), an additional 6% showed associated squamous features. Squamous cell carcinoma (SCC) constituted only 13.8% of cancer cases. Schistosomiasis was histologically confirmed in 19 cancer cases, only one was SCC. The relative frequency of TCC is increasing, while SCC is decreasing. There is no evidence that this pattern is related to smoking or environmental factors, as the incidence of lung cancer, is not proportionately increasing. CONCLUSION: The old concept that Schistosomiasis is associated with SCC should be revaluated as most cases are associated with TCC. Relying on the histopathology for confirmation of Schistosomiasis in our research studies appears to be non-accurate and leads to irrelevant results

Synthesis and characterization of new imidazolidineiminothione and bis-imidazolidineiminothione derivatives as potential antimicrobial agents

A series of new imidazolidineiminothiones (2-4) and bis-imidazolidineiminothiones (5) were synthesized through the cycloaddition reaction of N-arylcyanothioformamides (1) with some electrophilic reagents. Structure of imidazolidineiminothione derivatives were established based on spectroscopic IR, 1H NMR, 13C NMR, MS and elemental analyses data. These compounds were screened for their antibacterial and antifungal activities. Among the synthesized compounds, imidazolidineiminothione derivative 3a showed about 25% less potent effect than Ampicillin against S. epidermidis and B. subtilis (MIC, 0.49 μg/mL) and about 50 % less potent effect than Amphotericin B against A. clavatus and G. Candidum. Bis-imidazolidineiminothione derivative 5a was equipotent to the Gentamycin in inhibiting the growth of N. gonorrhoeae (MIC, 0.49 μg/mL), and displayed 50% less active than Amphotericin B against A. clavatus

A Decade of Experience with Radical Abdominal Trachelectomy after Supracervical Hysterectomy

Background: The supracervical hysterectomy is no longer indicated for the treatment of female genital disease.Patient and Methods: All women who had trachelectomy after supracervical hysterectomy between 2010 and 2020 had their records reviewed at Cairo University's National Cancer Institute (NCI) Hospital.Results: A total of 34 trachelectomy surgeries were performed during a ten-year period. The patients were 42 to 72 years old, with a mean +SD of 55+7.5. Recurrent vaginal bleeding was the reason for trachelectomy in 67.6% of cases due to residual disease found in hysterectomy specimens, with pathologic evidence of uterine malignancy in 47.2%, and 11.7 percent of patients had cervical malignancy. Uterine stromal sarcoma was found in 5.9% of the cases. There were 11.8% of cases with uterine fibroids, 7.8% with endometrial hyperplasia, and 2.9 % with uterine adenomyosis who had true benign lesions. There were no pathology reports available in 8.8% of the cases. The pathology of the trachelectomy revealed that 26.5% of patients had no residual disease, while 73.5% had the residual disease in the cervical stump, with 32.4% having cervical squamous cell carcinoma, 20.6% having uterine adenocarcinoma, 8.8% having cervical adenocarcinoma, and 2.9% having cervical adenosquamous. Mullerian carcinoma was found in 2.9% of the cases, whereas undifferentiated carcinoma was found in 2.9%. In 61.8% of cases, bilateral pelvic lymphadenectomy was coupled with trachelectomy for radical excision of gross malignancy.Conclusions: A significant number of patients who had a subtotal hysterectomy for apparent benign illness required trachelectomy within a few months

Undiagnosed depression: An epidemiologic study in three European countries

Tesis doctoral inédita leída en la Universidad Autónoma de Madrid, Facultad de Medicina, Departamento de Psiquiatría. Fecha de lectura: 21-11-201

A hidden cause of infertility in hypothyroid patients

Methylene tetrahydrofolate reductase (MTHFR) gene mutations could be the cause of infertility in hypothyroid patients. Hence, it is worthy to screen for MTHFR gene mutations in infertile hypothyroid females and their partners if infertility persists after optimizing thyroid function

Diverse Glycosides from Gardenia latifolia with Antiviral Activity and Chemosystematic Significance

Several influenza pandemics have impacted our life, each with variable prevalence and severity. In a search for natural antivirals, further phytochemical investigation of Gardenia latifolia Aiton, Rubiaceae, was conducted. As a result, five structurally diverse glycosides were isolated, offering valuable chemotaxonomic data. Using the crystal violet technique, three isolates, canthoside C, (6R,7S,8S)-7α-[(β-d-glucopyranosyl) oxy] lyoniresinol, and ecdysanrosin A, were evaluated for their anti-influenza A (H1N1) activities. Based on previously reported anti-inflammatory activity of the guaiane class, we investigated the inhibitory effect of (1R,7R,8S,10R)-7,8,11-trihydroxy-guai-4-ene-3-one 8-O-β-d-glucopyranoside, a rare guaiane sesquiterpene glucoside, on inducible nitric oxide (NO) production by Griess assay. Regarding antiviral assay, canthoside C was the most active. It considerably inhibited H1N1 infectivity at an IC50 value of 10.93 µg/ml, showing a selectivity index (SI) of 12.88, compared with acyclovir as a standard. Besides, ecdysanrosin A displayed a moderate selective antiviral activity with an IC50 value of 28.03 µg/ml. Considering their low cytotoxicity on the host cells, canthoside C and ecdysanrosin A have additional merit as potential antiviral agents. Despite the claimed anti-inflammatory activity of guaianes, (1R,7R,8S,10R)-7,8,11-trihydroxy-guai-4-ene-3-one 8-O-β-d-glucopyranoside showed a limited anti-inflammatory activity. [Figure not available: see fulltext.

Platinum 1,10-phenanthroline: Photosensitizer for photocatalytic degradation of 4-chlorophenol

It is more economic to apply photodegradation of organic pollutants in presence of the visible light irradiation (sunlight) than applying more costfull ultraviolet lamps. Hence, platinum 1,10-phenanthroline complex has been prepared and tested as a photosensitizer for photodegrading 4-chlorophenol in water, which has been found almost completely achieved (98.5 %) after three hours of visible irradiation. Nevertheless, irradiation at 364 and 254 nm exhibits lower efficiencies. At visible irradiation, the platinum complex gives the highest activation of singlet state oxygen formation (1O2) compared to 364 and 254 nm irradiation as supported by electron para-magnetic resonance data. On the other hand, the behavior of formation and disappearance of photodegradation intermediates: hydroquinone, benzoquinone, hydroxybenzoquinone, using the platinum complex applying the three current irradiations are found to supports these findings. However, organic acids have accumulated as a function of irradiation time and hence considered to be rate-controlling

Comparative study between minimally invasive and open esophagectomy for the treatment of esophageal cancer

Background: Complete resection of the esophageal tumor is the gold standard therapy. The optimal surgical approach for esophagectomy is still controversial. This study compared the short-term outcomes of minimally invasive (MIE) and open esophagectomy for treating esophageal cancer. Methods: A prospective study was conducted on 70 consecutive patients who received esophagectomy for esophageal carcinoma between 2017 and 2019 at Henan Cancer Hospital, Zhengzhou, China. Fifty patients received MIE (Group A), and 20 received open esophagectomy (Group B). Among Group B, 17 patients had left thoracotomy, and three had three incision esophagectomy. Results: The mean age in Group A was 61.48 ± 8.06 years, and 61.3 ± 7.52 years in Group B (p= 0.932). In Group A, most of the tumors were located in the middle thoracic area (56%), while in the open esophagectomy group, most of the tumors were located in the lower thoracic-esophagogastric junction area (50%) (p<0.001). The most common stage in Group A was (T3N0M0) and (T3N0M0) in Group B (p= 0.044). Neoadjuvant therapy was used in 48% of patients in Group A and 15% in Group B (p=0.08). The mean number of resected lymph nodes in Group A was 28.8 ± 7.8 lymph nodes versus 22.4 ± 7.7 in the open esophagectomy group (p=0.003). The mean operative bleeding amount was 80±34.6 ml and 185± 46.2 ml for groups A and B, respectively (p=0.001). The mean ICU stay for Group A was 0.5± 0.7 days versus 0.4± 0.6 days for Group B (p=0.4). The mean postoperative hospital stay for Group A was 8± 3 days, while in Group B, the mean postoperative hospital stay was 14± 3 days (p=0.001). Postoperative complications occurred in 2 patients (4%) in Group A and seven in Group B (p= 0.001). No tumor recurrence was detected radiologically among the two groups in the three months follow-up period. Conclusion: Minimally invasive esophagectomy may be a feasible and safe procedure for patients with early-stage esophageal cancer or locally advanced neoplasms who have received neoadjuvant therapy