Longitudinal SARS-CoV-2 seroprevalence in Portugal and antibody maintenance 12 months after infection.

During the COVID-19 pandemic, Portugal has experienced three distinct SARS-CoV-2 infection waves. We previously documented the prevalence of SARS-CoV-2 immunity, measured by specific antibodies, in September 2020, 6 months after the initial moderate wave. Here, we show the seroprevalence changes 6 months later, up to the second week of March 2021, shortly following the third wave, which was one of the most severe in the world, and 2 months following the start of the vaccination campaign. A longitudinal epidemiological study was conducted, with a stratified quota sample of the Portuguese population. Serological testing was performed, including ELISA determination of antibody class and titers. The proportion of seropositives, which was 2.2% in September 2020, rose sharply to 17.3% (95% CI: 15.8-18.8%) in March 2021. Importantly, circulating IgG and IgA antibody levels were very stable 6 months after the initial determination and up to a year after initial infection, indicating long-lasting infection immunity against SARS-CoV-2. Moreover, vaccinated people had higher IgG levels from 3 weeks post-vaccination when compared with previously infected people at the same time post-infection.

Diastolic dysfunction and sex-specific progression to HFpEF: current gaps in knowledge and future directions.

Diastolic dysfunction of the left ventricle (LVDD) is equally common in elderly women and men. LVDD is a condition that can remain latent for a long time but is also held responsible for elevated left ventricular filling pressures and high pulmonary pressures that may result in (exercise-induced) shortness of breath. This symptom is the hallmark of heart failure with preserved ejection fraction (HFpEF) which is predominantly found in women as compared to men within the HF spectrum. Given the mechanistic role of LVDD in the development of HFpEF, we review risk factors and mechanisms that may be responsible for this sex-specific progression of LVDD towards HFpEF from an epidemiological point-of-view and propose future research directions.

Feasibility and safety of transvaginal specimen extraction in deep endometriosis colorectal resectional surgery and analysis of risk factors for postoperative complications.

BACKGROUND: The aim of the present study was to demonstrate that transvaginal specimen extraction is a feasible and safe approach in colorectal resection for deep endometriosis (DE) and to assess the risk factors for postoperative complications. METHODS: This retrospective cohort study included all the consecutive patients undergoing segmental bowel resection for symptomatic endometriosis at "La Paz" University Hospital (Madrid, Spain) and at "Hospital General Universitario de Valencia" (Valencia, Spain) from January 2014 to December to 2017. Patients were grouped according to specimen extraction approach into those who had transvaginal extraction (Group I) and those who had suprapubic extraction (Group II). Clinic-demographical, surgical and post-surgical data were recorded. Intra- and postoperative complications were classified according to Clavien-Dindo criteria. Postoperative data were compared between groups. Risk factors associated with surgery were investigated. RESULTS: Out of 99 female patients included (average age 36.91 ± 5.36 years), 23 patients (23.2%) had transvaginal and 76 (76.8%) had suprapubic specimen extraction. The groups were comparable regarding operative time, nodule size, level of anastomosis, hospital stay and intraoperative complications. We observed no statistically significant differences in postoperative complications and rectovaginal fistula rate between the groups. Binary logistic regression analyses determined that vaginal endometriosis is an independent risk factor for postoperative complications (OR: 2.63, 95% CI [1.10-6.48], p = 0.03). CONCLUSIONS: Transvaginal specimen extraction is a safe and feasible technique in DE colorectal surgery and should be taken into consideration whenever vaginal endometriosis exists. Nevertheless, vaginal endometriosis can be an independent risk factor for postoperative complications in DE surgery.

Prevalence of SARS-CoV-2 Antibodies after First 6 Months of COVID-19 Pandemic, Portugal.

In September 2020, we tested 13,398 persons in Portugal for antibodies against severe acute respiratory syndrome coronavirus 2 by using a quota sample stratified by age and population density. We found a seroprevalence of 2.2%, 3-4 times larger than the official number of cases at the end of the first wave of the pandemic.

Toward predictive food process models: A protocol for parameter estimation.

Mathematical models, in particular, physics-based models, are essential tools to food product and process design, optimization and control. The success of mathematical models relies on their predictive capabilities. However, describing physical, chemical and biological changes in food processing requires the values of some, typically unknown, parameters. Therefore, parameter estimation from experimental data is critical to achieving desired model predictive properties. This work takes a new look into the parameter estimation (or identification) problem in food process modeling. First, we examine common pitfalls such as lack of identifiability and multimodality. Second, we present the theoretical background of a parameter identification protocol intended to deal with those challenges. And, to finish, we illustrate the performance of the proposed protocol with an example related to the thermal processing of packaged foods.

IL-6 blockade reverses the abnormal STAT activation of peripheral blood leukocytes from rheumatoid arthritis patients.

Considering the interplay of multiple STATs in response to cytokines, we investigated how IL-6 and its blocking affect STAT signaling in rheumatoid arthritis (RA). Leukocytes obtained from RA patients before and after tocilizumab treatment and healthy donors (HDs) were cytokine-stimulated and STAT phosphorylation was analyzed by cytometry. RA patients had significantly fewer pSTAT1+, pSTAT3+, and pSTAT6+ monocytes and pSTAT5+ lymphocytes than HDs. After 24weeks of treatment, percentages of IFNγ-induced pSTAT1+ and IL-10-induced pSTAT3+ monocytes in RA patients increased, reaching levels comparable to HDs. pSTAT1+ and pSTAT3+ cells correlated inversely with RA disease activity index and levels of pSTAT+ cells at baseline were higher in patients with good EULAR response to tocilizumab. IFNγ-induced pSTAT1+ cells correlated inversely with memory T cells and anti-CCP levels. IL-10-induced pSTAT3+ cells correlated with Treg/Teff ratio. Our findings suggest that IL-6 blocking reduces the inflammatory mechanisms through the correction of STAT1 and STAT3 activation status.

Amazonian fermentations: an analysis of industrial and social technology as tools for the development of bioeconomy in the region.

This review article explores the potential of fermentations in the Amazon region as catalysts for economic and social development. It highlights the rich cultural and gastronomic diversity of the Amazon, focusing on indigenous fermented products. Two main products, tucupi and caxiri, are discussed in detail, emphasizing their significance in local cuisine and culture. The review examines the challenges and opportunities for industrial applications of these products, as well as their potential for social technology initiatives, particularly in the context of family farming. The sustainable production of native fermented products in the Amazon is seen as a means to preserve biodiversity, empower local communities, and promote cultural heritage. The article concludes that both industrial and social technologies have complementary roles in promoting economic growth, cultural preservation, and the well-being of the Amazon region, making it a promising hub for innovative and sustainable fermented food products on a global scale.

[Reliability and validity of the Acquired healthy lifestyle assessment scale (E-VEVSA) in adults from Albacete and Murcia (Spain)]. / Fiabilidad y validez de la Escala de valoración del estilo de vida saludable adquirido (E-VEVSA) en adultos de Albacete y Murcia (España).

BACKGROUND: Lifestyle is a theoretical construct that is formed by the life habits of a subject. The analysis and objective quantification of lifestyle can have a great impact on people's health, as well as on the evolution of its status over the years. The objective of this research has been the validation of the Acquired Healthy Lifestyle Assessment Scale (E-VEVSA) in Spanish adults. METHOD: On an initial sample for the exploratory tests of 248 subjects and a final sample for the confirmatory tests of 780 subjects, aged between 22 and 72 years of age. Exploratory and confirmatory psychometric tests were carried out based on the Cronbach's alpha statistic (reliability) and exploratory factorial analysis with oblique rotation (oblimin) and confirmatory with varimax rotation (construct validity), which resulted in an instrument made up of 52 items and structured in 7 dimensions: individual responsibility in health care (9 items), habits of physical-sports practice (6 items), health habits in social relationships (10 items), habit of tobacco and alcohol consumption (9 items), habit of healthy eating (7 items), psychological health habits (6 items) and daily rest and sleep habits (5 items). RESULTS: All the items explained a total variance of 66.87% and a Cronbach's alpha of .894, with the partial alpha of each dimension or factor being above .700. CONCLUSIONS: The results show psychometric tests that confirm the validity of the E-VEVSA scale as a useful instrument to measure the healthy lifestyle acquired among adults.

Tapping into Tapajos: antibacterial potential of fungal strains isolated from decaying wood in the Brazilian Amazon.

The emergence of bacterial resistance to antimicrobials poses a significant health threat. To address this issue, exploring the fungal diversity in freshwater environments in the Amazon Forest has potential in the search for new antimicrobials. This study aimed to investigate the production of antibacterial metabolites by aquatic fungi from Amazon lakes, specifically Lake Juá and Lake Maicá (Brazil-PA). The fungal isolates were obtained from wood fragments submerged in these lakes, and the ethyl acetate extracts were evaluated for antibacterial activity against Staphylococcus aureus ATCC 25923, S. aureus (MRSA), ATCC 43300, Escherichia coli ATCC 25922, and E. coli (ESBL) NCTC 13353. Additionally, toxicity of the extracts (EtOAc with antimicrobial activity) against human fibroblasts MRC-5 was investigated. The study identified 40 fungal strains with antimicrobial screening, and the ethyl acetate extracts of Fluviatispora C34, Helicascus C18, Monodictys C15, and Fusarium solani LM6281 exhibited antibacterial activity. F. solani LM6281 showed the lowest minimum inhibitory concentration (MIC) of 50 µg/mL against S. aureus strains and MIC of 100 µg/mL against E. coli strains including ESBL. The cytotoxicity (IC50) of the extract (EtOAc) of F. solani LM6281 was 34.5 µg/mL. Preliminary studies of the TLC culture and RNM-H from the extract (EtOAc) of F. solani suggested the presence of substances from the class of terpenes, quinones, phenolics, and flavonoids. This study highlights the potential of submerged wood fungi in the Amazon region to produce antibacterial substances, thus identifying them as sources of novel bioactive compounds with potential use in the pharmaceutical industry and regional bioeconomy.

Chitinase 3-like 1 plasma levels are increased in patients with progressive forms of multiple sclerosis.

BACKGROUND: Chitinase 3-like 1 (CHI3L1) is upregulated in a wide variety of inflammatory conditions. Recent studies have pointed to a role of CHI3L1 in multiple sclerosis (MS) pathogenesis. OBJECTIVE: The objective of this study was to investigate the role of plasma CHI3L1 in MS clinical course and disease activity and to evaluate the effect of interferon-beta (IFNß) treatment on protein levels. METHODS: Plasma CHI3L1 levels were determined by ELISA in 57 healthy controls (HC), 220 untreated MS patients [66 primary progressive MS patients (PPMS), 30 secondary progressive MS patients (SPMS), and 124 relapsing-remitting MS patients (RRMS), 94 during clinical remission and 30 during relapse], and 32 MS patients receiving IFNß treatment. A polymorphism of the CHI3L1 gene, rs4950928, was genotyped in 3274 MS patients and 3483 HC. RESULTS: Plasma CHI3L1 levels were significantly increased in patients with progressive forms of MS compared with RRMS patients and HC. CHI3L1 levels were similar between RRMS patients in relapse and remission. A trend towards decreased CHI3L1 levels was observed in IFNß-treated patients. Allele C of rs4950928 was significantly associated with PPMS patients and with higher plasma CHI3L1 levels. CONCLUSIONS: These findings point to a role of CHI3L1 in patients with progressive forms of MS, particularly in those with PPMS.

A new piezoelectric actuator induces bone formation in vivo: a preliminary study.

This in vivo study presents the preliminary results of the use of a novel piezoelectric actuator for orthopedic application. The innovative use of the converse piezoelectric effect to mechanically stimulate bone was achieved with polyvinylidene fluoride actuators implanted in osteotomy cuts in sheep femur and tibia. The biological response around the osteotomies was assessed through histology and histomorphometry in nondecalcified sections and histochemistry and immunohistochemistry in decalcified sections, namely, through Masson's trichrome, and labeling of osteopontin, proliferating cell nuclear antigen, and tartrate-resistant acid phosphatase. After one-month implantation, total bone area and new bone area were significantly higher around actuators when compared to static controls. Bone deposition rate was also significantly higher in the mechanically stimulated areas. In these areas, osteopontin increased expression was observed. The present in vivo study suggests that piezoelectric materials and the converse piezoelectric effect may be used to effectively stimulate bone growth.

Comparative transcriptome analysis of yeast strains carrying slt2, rlm1, and pop2 deletions.

The function of the genes SLT2 (encoding the Mpk1 protein), RLM1, and POP2 have previously been related to several stress responses in yeasts. DNA arrays have been used to identify differences among the transcriptomes of a Saccharomyces cerevisiae wild type strain and its derivative Δslt2, Δrlm1, and Δpop2 mutants. Correspondence analyses indicate that the vast majority of genes that show lower expression in Δrlm1 also show lower expression in Δslt2. In contrast, there is little overlap between the results of the transcriptome analyses of the Δpop2 strain and the Δslt2 or Δrlm1 strains. The DNA array data were validated by reverse Northern blotting and chromatin immunoprecipitation (ChIp). ChIp assays demonstrate Rlm1p binding to specific regions of the promoters of two genes that show expression differences between the Δrlm1 mutant and wild type strains. Interestingly, RLM1 deletion decreases the transcription of SLT2, encoding the Mpk1p kinase that phosphorylates Rlm1p, suggesting a feedback control in the signal transduction pathway. Also, deletion of RLM1 causes a decrease in the mRNA level of KDX1, which is paralogous to SLT2. In contrast, deletion of POP2 is accompanied by an increase of both SLT2 and KDX1 levels. We show that SLT2 mRNA increase in the Δpop2 strain is due to a decrease in RNA turnover, consistent with the expected loss of RNA-deadenylase activity in this strain.

Resveratrol in Alzheimer's disease: a review of pathophysiology and therapeutic potential.

BACKGROUND: Alzheimer's disease (AD) is a neurodegenerative disorder characterized by progressive and irreversible loss of cognitive function. The presence of senile plaques is one of the pathological markers of the disease and is associated with the onset of neuroinflammatory mechanisms. The exact pathophysiology of AD has not been completely understood, and there are no curative therapies yet. Resveratrol (3,5,4'-trihydroxy-trans-stilbene) is a polyphenol that is noted for its antioxidant and anti-inflammatory properties. OBJECTIVE: To review the role of resveratrol in the pathophysiological aspects of AD. METHODS: This study carried out a literature review using PubMed/Medline, Virtual Health Library (VHL), Web of Sciences, SCOPUS and the Cochrane Library databases. Original research articles, describing both in vitro and in vivo experiments, published between 2008 and 2018, were included. RESULTS: We identified 667 articles, of which 619 were excluded because they were repeated or did not follow the inclusion criteria. The present study includes the remaining 48 articles. DISCUSSION: Resveratrol demonstrates beneficial and protective effects in AD models and seems to provide a promising therapeutic alternative. CONCLUSION: Although resveratrol appears to mitigate some pathophysiological aspects of AD, further studies are needed to prove the safety and efficacy of this compound in humans.

[Influence of a programme of therapeutic exercise on different clinical indicators related to dyslipidaemia in adult subjects aged between 26 to 73 years with a cardiovascular risk factor]. / Influencia de un programa de ejercicio físico terapéutico en diferentes indicadores clínicos relacionados con la dislipidemia en sujetos adultos de 26 a 73 años con algún factor de riesgo cardiovascular.

INTRODUCTION: A sedentary lifestyle is indicated in the international literature as one of the main causes for the onset of some cardiovascular risk factors. OBJECTIVE: To assess the effect of a therapeutic physical exercise programme on different clinical indicators related to dyslipidaemia (total cholesterol, HDL and LDL) in sedentary subjects with a cardiovascular risk factor. METHOD: Intervention study with before-and-after evaluation of a sample of 340 patients (132 males and 208 females) referred from the 2 primary care centres of the municipality of Molina de Segura (Murcia), and who participated in a 30-week programme of physical exercise combining muscle-conditioning work circuits with other cardio-respiratory resistance workouts. Regarding the clinical indicators, the health professionals collected in the medical history the health indicators corresponding to the biological evolution of the process for which the subjects studied had started the physical exercise programme. RESULTS: The statistical analyses showed a significant improvement (p<.005) in the LDL indicator and a non-significant improvement in total and HDL cholesterol indicators after a 3-month exercise programme of 3 weekly sessions. CONCLUSIONS: The prescription of physical exercise in dyslipidaemic subjects from primary care centre should be evaluated as a resource for improving the clinical indicators specific to their pathology.

Why are there ethnic differences in cardio-metabolic risk factors and cardiovascular diseases?

Europe's population is becoming increasingly ethnically diverse, and epidemiological studies indicate that there are remarkable differences in cardio-metabolic risk factors between ethnic groups living in the same area. Variations observed in the distribution of cardiovascular risk factors in these communities may therefore help explain-at least in part-the different burdens on cardiovascular diseases. So far, the underlying pathophysiology leading to ethnic variations in the prevalence of cardio-metabolic risk factors is still poorly understood but it is likely to represent the complex interactions from several innate and environmental factors. Tailored prevention and treatment strategies should therefore be implemented in those "high-risk populations," but data derived from randomized clinical trials are still limited. This article will provide an overview on the role of ethnicity on cardio-metabolic risk factors and cardiovascular diseases, focusing on type 2 diabetes and dyslipidemia based mainly on Dutch and British data.

Quantitative image analysis to characterize the dynamics of Listeria monocytogenes biofilms.

This work shows that the combination of two-dimensional (2D) and three-dimensional (3D) analyses of images acquired by confocal laser scanning microscopy facilitates the quantitative spatiotemporal characterization of architectures formed by Listeria monocytogenes biofilms. In particular, the analysis of structural features such as maximum thickness, biovolume, areal porosity and maximum diffusion distance allowed elucidating differences in biofilm formation of three L. monocytogenes strains (L1A1, CECT5873 and CECT4032). The analysis showed a common sequence for all strains. In the first phase, independent clusters evolve to interconnected clusters and honeycomb-like structures. Flat biofilms characterized the second phase. The structures disappear in the third phase. Nevertheless, the duration of the phases differed from strain to strain. L1A1 strain exhibited the slowest dynamics and the thickest biofilms while the strain CECT4032 presented the faster dynamics and the thinnest biofilms. Also, the number of dead cells varies significantly from strain to strain. From the results of the analysis, it can be concluded that 2D parameters are critical to differentiating morphological features while 3D parameters ease the interpretation and comparative study of the different phases during the life cycle of biofilms.

Influência do diabetes mellitus na qualidade de vida de indivíduos com migrânea vestibular / Influence of diabetes mellitus on the quality of life of individuals with vestibular migraine

Introdução: qualidade de vida refere-se à percepção de um indivíduo sobre o seu estado físico, emocional e social. No âmbito físico, pode ser impactada negativamente por condições como migrânea vestibular e diabetes mellitus (DM). Objetivo: descrever a qualidade de vida em pacientes com migrânea vestibular, com e sem DM. Metodologia: trata-se de um estudo transversal, descritivo, retrospectivo e secundário, realizado com pacientes com migrânea vestibular, atendidos em uma clínica-escola de Salvador-BA. Foram coletados dados sociodemográficos e clínicos, incluindo o autorrelato de DM. A qualidade de vida foi avaliada por meio do Dizziness Handicap Inventory (DHI), cuja pontuação foi classificada, quanto ao grau de incapacidade, em "leve" (0 a 30 pontos); "moderado" (31 a 60 pontos) e "severo" (61 a 100 pontos). Foram realizados procedimentos estatísticos descritivos por frequência simples e absoluta, medidas de tendência central e dispersão. Resultados: a amostra foi composta por 41 indivíduos, dotados das seguintes características: a idade média foi 42,46 anos (DP = 13,83), predominância do sexo feminino (87,80%), com diabetes (51,21%), com ansiedade (58,54%) e sem depressão (90,24%). A pontuação média do DHI foi de 47,26 pontos (DP = 21,81), classificada como impacto moderado, sendo maior entre os não diabéticos, porém a ansiedade predominou entre os não diabéticos (60%). Conclusões: acientes com migrânea vestibular apresentaram prejuízo de grau moderado na qualidade de vida, e a presença de diabetes não ocasionou um pior impacto nesse parâmetro. Além disso, a presença de ansiedade foi mais prevalente entre os não diabéticos e pode ter refletido na pior pontuação no DHI observada nesse grupo.

Introduction: quality of life refers to an individual's perception of their physical, emotional, and social status, and it can be affected by conditions such as vestibular migraine and diabetes mellitus (DM). Objective: to describe the quality of life of patients with vestibular migraine, with and without DM. Methodology: this cross-sectional, descriptive, retrospective study conducted a secondary analysis of data collected from patients with vestibular migraine treated at a school clinic in Salvador-BA. Sociodemographic and clinical data were collected, including self-reported DM. Quality of life was assessed using the Dizziness Handicap Inventory (DHI), with scores used to classify the degree of impact of the disability as "mild" (0 to 30 points); "moderate" (31 to 60 points) and "severe" (61­100 points). Descriptive statistics were computed using simple and absolute frequency, or measures of central tendency and dispersion. Results: the sample consisted of 41 individuals, with a mean age of 42.46 years (SD = 13.83 years), who were predominantly female (87.80%), with diabetes (51.21%) and anxiety (58.54%), and without depression (90.24%). The mean DHI score was 47.26 (SD = 21.81), classified as moderate impact, and it was higher among non-diabetics. Anxiety was more prevalent among non-diabetics (60.00%). Conclusions: patients with vestibular migraine showed moderate loss of quality of life, and the presence of diabetes did not reflect a worse impact on this parameter. Anxiety was more prevalent among non-diabetics, which may explain why this group had the worst DHI score.

Resveratrol in Alzheimers disease: a review of pathophysiology and therapeutic potential / Resveratrol na doença de Alzheimer: uma revisão sobre fisiopatologia e potencial terapêutico

ABSTRACT Background: Alzheimer's disease (AD) is a neurodegenerative disorder characterized by progressive and irreversible loss of cognitive function. The presence of senile plaques is one of the pathological markers of the disease and is associated with the onset of neuroinflammatory mechanisms. The exact pathophysiology of AD has not been completely understood, and there are no curative therapies yet. Resveratrol (3,5,4'-trihydroxy-trans-stilbene) is a polyphenol that is noted for its antioxidant and anti-inflammatory properties. Objective: To review the role of resveratrol in the pathophysiological aspects of AD. Methods: This study carried out a literature review using PubMed/Medline, Virtual Health Library (VHL), Web of Sciences, SCOPUS and the Cochrane Library databases. Original research articles, describing both in vitro and in vivo experiments, published between 2008 and 2018, were included. Results: We identified 667 articles, of which 619 were excluded because they were repeated or did not follow the inclusion criteria. The present study includes the remaining 48 articles. Discussion: Resveratrol demonstrates beneficial and protective effects in AD models and seems to provide a promising therapeutic alternative. Conclusion: Although resveratrol appears to mitigate some pathophysiological aspects of AD, further studies are needed to prove the safety and efficacy of this compound in humans.

RESUMO Introdução: A doença de Alzheimer (DA) é neurodegenerativa e caracterizada por perda progressiva e irreversível da função cognitiva. A presença de placas senis é um dos marcadores patológicos da doença e está associada ao aparecimento de mecanismos neuroinflamatórios. A fisiopatologia exata da DA ainda não é completamente compreendida, e ainda não existem terapias curativas. O resveratrol (3,5,4'-trihidroxi-trans-estilbeno) é um polifenol conhecido por suas propriedades antioxidantes e anti-inflamatórias. Objetivo: Revisar o papel do resveratrol nos aspectos fisiopatológicos da DA. Métodos: Este estudo realizou uma revisão narrativa da literatura a partir das bases de dados PubMed/Medline, Biblioteca Virtual em Saúde (BVS), Web of Science, SCOPUS e Cochrane Library. Foram incluídos artigos originais, realizados in vitro e in vivo, publicados entre 2008 e 2018. Resultados: Foram identificados 667 artigos, dos quais 619 foram excluídos por estarem repetidos ou não se enquadrarem nos critérios de inclusão. O presente estudo inclui os 48 artigos restantes. Discussão: O resveratrol demonstra efeitos benéficos e protetores em modelos de DA, bem como parece fornecer uma alternativa terapêutica promissora. Conclusão: Embora o resveratrol pareça atenuar alguns aspectos fisiopatológicos da DA, são necessários mais estudos para comprovar a segurança e a eficácia deste composto em seres humanos.

Interleukin-12. Opportunities for the treatment of bladder cancer.

Despite incomplete understanding of the human immune system, the rapid progress in tumor immunology provides a framework for more effective and safe interventions in the near future. Early approaches in patients with cancer that have focused on the nonspecific and broad stimulation of the immune system by interferons and IL-12 will be replaced by the highly specific stimulation of immune reactions targeting precisely defined tumor antigens. IL-12 has several biologic properties that seem useful in immune therapy for bladder cancer. The striking antitumor responses with IL-12 in preclinical animal models of bladder cancer provide optimism that future clinical trials involving this agent may impact on the risk and mortality associated with this disease.

Cavermap-assisted sural nerve interposition graft during radical prostatectomy.

Wide excision of the neurovascular bundle and interposition nerve grafting of the cavernous nerves when there is suspected extracapsular extension at the posterolateral prostatic margin are logical applications of improved understanding of pelvic neuroanatomy. Although the indications for neurovascular bundle excision will remain controversial for the foreseeable future, evidence suggests that neurovascular bundle excision improves cancer control in some patients. The ability to predict extracapsular extension reliably at the neurovascular bundle would be a powerful addition to the urologist's armamentarium. The authors have shown, as proof of principle in bilaterally resected neurovascular bundle at the time of RRP, that sural nerve grafting can restore erectile function. The authors' data also support a role for sural nerve grafting in unilateral neurovascular bundle excision. Although the side effects of sural nerve harvest are minor, the ability to predict preoperatively which patients will benefit from such grafts would reduce the number of failures. The success of the authors' interposition nerve-grafting project has resulted, in part, from the use of a multidisciplinary team approach that includes experienced oncologic surgeons and a plastic surgeon with extensive microsurgical and nerve-grafting experience. The technique for sural nerve grafting described herein gives urologists an additional tool to improve patients' quality of life without compromising the chances of success in treating prostate cancer.