Mechanisms Predisposing Penile Fracture And Long-term Outcomes On Erectile And Voiding Functions

Purpose. To determine the mechanisms predisposing penile fracture as well as the rate of long-term penile deformity and erectile and voiding functions. Methods. All fractures were repaired on an emergency basis via subcoronal incision and absorbable suture with simultaneous repair of eventual urethral lesion. Patients' status before fracture and voiding and erectile functions at long term were assessed by periodic follow-up and phone call. Detailed history included cause, symptoms, and single-question self-report of erectile and voiding functions. Results. Among the 44 suspicious cases, 42 (95.4%) were confirmed, mean age was 34.5 years (range: 18-60), mean follow-up 59.3 months (range 9-155). Half presented the classical triad of audible crack, detumescence, and pain. Heterosexual intercourse was the most common cause (28 patients, 66.7%), followed by penile manipulation (6 patients, 14.3%), and homosexual intercourse (4 patients, 9.5%). "Woman on top" was the most common heterosexual position (n = 14, 50%), followed by "doggy style" (n = 8, 28.6%). Four patients (9.5%) maintained the cause unclear. Six (14.3%) patients had urethral injury and two (4.8%) had erectile dysfunction, treated by penile prosthesis and PDE-5i. No patient showed urethral fistula, voiding deterioration, penile nodule/curve or pain. Conclusions. "Woman on top" was the potentially riskiest sexual position (50%). Immediate surgical treatment warrants long-term very low morbidity. © 2014 Leonardo O. Reis et al.Kamdar, C., Mooppan, U.M.M., Kim, H., Gulmi, F.A., Penile fracture: Preoperative evaluation and surgical technique for optimal patient outcome (2008) BJU International, 102 (11), pp. 1640-1644. , 2-s2.0-56649083856 10.1111/j.1464-410X.2008.07902.xKramer, A.C., Penile fracture seems more likely during sex under stressful situations (2011) Journal of Sexual Medicine, 8 (12), pp. 3414-3417. , 2-s2.0-82955237445 10.1111/j.1743-6109.2011.02461.xSawh, S.L., O'Leary, M.P., Ferreira, M.D., Berry, A.M., Maharaj, D., Fractured penis: A review (2008) International Journal of Impotence Research, 20 (4), pp. 366-369. , 2-s2.0-48249147767 10.1038/ijir.2008.12Amit, A., Arun, K., Bharat, B., Navin, R., Sameer, T., Shankar, D.U., Penile fracture and associated urethral injury: Experience at a tertiary care hospital (2013) Canadian Urological Association Journal, 7, pp. E168-E170Moslemi, M.K., Evaluation of epidemiology, concomitant urethral disruption and seasonal variation of penile fracture: A report of 86 cases (2013) Canadian Urological Association Journal, 7, pp. E572-E575Hatzichristodoulou, G., Dorstewitz, A., Gschwend, J.E., Herkommer, K., Zantl, N., Surgical management of penile fracture and long-term outcome on erectile function and voiding (2013) The Journal of Sexual Medicine, 10, pp. 1424-1430Nomura, J.T., Sierzenski, P.R., Ultrasound diagnosis of penile fracture (2010) Journal of Emergency Medicine, 38 (3), pp. 362-365. , 2-s2.0-77949914168 10.1016/j.jemermed.2008.03.010Ash, A., Miller, J., Preston, D., Point-of-care ultrasound used to exclude penile fracture (2012) Critical Ultrasound Journal, 417Beysel, M., Tekin, A., Gürdal, M., Yücebaş, E., Dengör, F., Evaluation and treatment of penile fractures: Accuracy of clinical diagnosis and the value of corpus cavernosography (2002) Urology, 60 (3), pp. 492-496. , 2-s2.0-0036753673 10.1016/S0090-4295(02)01813-7Gamal, W.M., Osman, M.M., Hammady, A., Aldahshoury, M.Z., Hussein, M.M., Saleem, M., Penile fracture:;ong-term results of surgical and conservative management (2011) Journal of Trauma, 71 (2), pp. 491-493. , 2-s2.0-80051783736 10.1097/TA.0b013e318209311

Tick-borne pathogens infecting dogs from a highland swamp area

RESUMO Objetivou-se neste estudo relatar a frequência e a identidade de patógenos transmitidos por carrapatos em cães residentes de uma área caracterizada por brejo de alta altitude. Amostras sanguíneas (n=203) foram coletadas e molecularmente analisadas via PCR (Babesia spp., Hepatozoon spp., Anaplasma spp. e Ehrlichia spp.) e sequenciamento de DNA. De todas as amostras analisadas, 8,87% (18/203) foram positivas a algum patógeno transmitido por carrapato. Especificamente, 5,42% (11/203) e 3,45% (7/203) foram positivos a Anaplasma platys e Ehrlichia canis, respectivamente. Este estudo fornece, pela primeira vez, evidência científica de infecção de cães por esses patógenos nessa área de alta altitude e reforça o provável papel de R. sanguineus s.l. como vetor de A. platys, principalmente considerando.se que muitos animais positivos eram infestados por essa espécie de carrapato

Clinical presentation, histological findings, and prognosis in female dogs with mixed mammary neoplasms

ABSTRACT The aim of this study was to describe the clinical and morphological characteristics of mixed mammary neoplasms and verify what characteristics affect the prognosis of female dogs with carcinomas in mixed tumors and carcinosarcomas. This was a retrospective study of 67 female dogs that underwent mastectomies and were diagnosed with benign mixed tumors (n=13), carcinomas in mixed tumors (n=44) and carcinosarcomas (n=10). Data regarding the clinical and histological aspects of the neoplasms were collected and the relation with specific survival times, and hazard ratios (HR) in 24 months was calculated. In univariate analysis, the diagnosis of carcinosarcoma (HR 8.26, p=0.006), carcinomatous areas with micropapillary or solid patterns (HR 17.49; p=0. 001) and lymph node metastasis (HR 7.07;p=0.020) were associated with specific survival. In multivariable analysis, only micropapillary or solid pattern (HR=16.34; p=0.007) remained independent factor associated with lower specific survival. Micropapillary or solid carcinomatous patterns were associated with shorter specific survival time (p=0.002) among animals with carcinomas in mixed tumors. Among the carcinosarcomas, lymph node metastasis (p=0.010) was associated with a shorter specific survival time. In conclusion, carcinomas in mixed tumors and carcinosarcomas vary in prognosis depending on the carcinomatous proliferation patterns and spread of the disease

Gravitational field around a time-like current-carrying screwed cosmic string in scalar-tensor theories

In this paper we obtain the space-time generated by a time-like current-carrying superconducting screwed cosmic string(TCSCS). This gravitational field is obtained in a modified scalar-tensor theory in the sense that torsion is taken into account. We show that this solution is comptible with a torsion field generated by the scalar field $\phi$. The analysis of gravitational effects of a TCSCS shows up that the torsion effects that appear in the physical frame of Jordan-Fierz can be described in a geometric form given by contorsion term plus a symmetric part which contains the scalar gradient. As an important application of this solution, we consider the linear perturbation method developed by Zel'dovich, investigate the accretion of cold dark matter due to the formation of wakes when a TCSCS moves with speed $v$ and discuss the role played by torsion. Our results are compared with those obtained for cosmic strings in the framework of scalar-tensor theories without taking torsion into account.Comment: 21 pages, no figures, Revised Version, presented at the "XXIV- Encontro Nacional de Fisica de Particulas e Campos ", Caxambu, MG, Brazil, to appear in Phys. Rev.