Severe aortic regurgitation from aortic valve perforation in Libman-Sacks endocarditis: Incremental value of 3D TEE.

A 43-year-old woman with stroke and systemic lupus erythematosus was found to have severe eccentric aortic regurgitation. Three-dimensional transesophageal echocardiogram further defined the origin of the regurgitant jet through a perforation in the left coronary cusp next to a mass with a tiny stalk attached to the left coronary cusp.

Clinical applications of artificial intelligence and machine learning in cancer diagnosis: looking into the future.

Artificial intelligence (AI) is the use of mathematical algorithms to mimic human cognitive abilities and to address difficult healthcare challenges including complex biological abnormalities like cancer. The exponential growth of AI in the last decade is evidenced to be the potential platform for optimal decision-making by super-intelligence, where the human mind is limited to process huge data in a narrow time range. Cancer is a complex and multifaced disorder with thousands of genetic and epigenetic variations. AI-based algorithms hold great promise to pave the way to identify these genetic mutations and aberrant protein interactions at a very early stage. Modern biomedical research is also focused to bring AI technology to the clinics safely and ethically. AI-based assistance to pathologists and physicians could be the great leap forward towards prediction for disease risk, diagnosis, prognosis, and treatments. Clinical applications of AI and Machine Learning (ML) in cancer diagnosis and treatment are the future of medical guidance towards faster mapping of a new treatment for every individual. By using AI base system approach, researchers can collaborate in real-time and share knowledge digitally to potentially heal millions. In this review, we focused to present game-changing technology of the future in clinics, by connecting biology with Artificial Intelligence and explain how AI-based assistance help oncologist for precise treatment.

Procalcitonin and cellulitis: correlation of procalcitonin blood levels with measurements of severity and outcome in patients with limb cellulitis.

BACKGROUND: Procalcitonin levels may be raised in bacterial infections and have been used to guide antibiotic therapy. There is little data on procalcitonin and limb cellulitis. OBJECTIVES: Within a clinical trial of antibiotic therapy, we examined the correlation between clinical observations, blood tests and local measurements of skin damage, with serum procalcitonin levels. METHODS: The data is from a subset of the patients recruited into a clinical trial of antibiotic therapy for cellulitis (clindamycin for cellulitis, NCT01876628) whose procalcitonin levels were correlated with clinical and laboratory measurements. We selected the variables strongly correlated with procalcitonin and evaluated the predictive value of the baseline procalcitonin on the primary trial outcome. RESULTS: 136 patients provided 307 procalcitonin levels which were correlated with 8 variables. The strongest correlations (correlation coefficient of >0.5) with procalcitonin were the affected skin area (0.537), C-reactive protein (0.574) and neutrophil:lymphocyte ratio (0.567). Receiver operator characteristic curves demonstrated poor sensitivity and specificity of procalcitonin in predicting primary outcome. Procalcitonin baseline levels were low but decreased as patients recovered. CONCLUSIONS: Procalcitonin levels are generally low in limb cellulitis and cannot be used to confirm the diagnosis or the need for antibiotic therapy. Procalcitonin is a poor predictor of early improvement.

Mycotoxin patulin contamination in various fruits and estimating its dietary impact on the consumers: From orchard to table.

The present research examined patulin's presence across the whole supply chain of selected fruits. A comprehensive analysis was conducted on 442 samples of fruits (oranges, apples, apricots, lemons, and guava) to determine the presence of patulin contamination. This analysis used Liquid Chromatography (HPLC) with a UV detector. The findings indicate that 17, 23, and 28 % of selected fruit samples tested positive for patulin levels in farm, transportation, and market samples. However, the sample collected during the transportation step showed that 56 % (percentage of positive samples) of fruits have patulin levels greater than 50 µg/kg, and 41 % (percentage of positive samples) have greater levels than 50 µg/kg in market samples. The findings of the one-way analysis of variance indicated that no statistically significant variation existed between the amounts of patulin across the various stages of the food supply chain system (p > 0.05). Nevertheless, the analysis of the correlation study, namely Kendall's tau_b and Spearman's rho, denote a robust association between the levels of patulin and the food supply system. The apple samples exhibited the most significant average dietary intake of patulin, with an average value of 0.11 µg/kg bw/day. The maximum mean hazard quotient (HQ) of 0.28 was also recorded. The prevalence and incidence of patulin in specific fruits were found to be relatively high, and it was observed that market samples had elevated levels of patulin in the selected fruits.

Effect of dietary supplementation of prebiotics and probiotics on intestinal microarchitecture in broilers reared under cyclic heat stress.

This study was designed to evaluate the effect of dietary supplementation of prebiotics, mannanoligosaccharides (MOS) and/or probiotics (LBP) on intraepithelial lymphocytes (IEL) count, goblet cells (GC) count and differentiation and intestinal micro-architecture in broilers reared under cyclic heat stress. Day-old broilers (n = 250) were randomly divided into five groups. Fifty birds were reared within the thermoneutral zone (TNZ). Remaining birds were subjected to cyclic heat stress from day 21 to 42 (35° C, 75% RH, 8 h/d). The birds were fed corn-soy-based basal diet or the same diet supplemented with 0.5% MOS (HS-MOS), or 0.1% LBP (HS-LBP), or their combination (HS-SYN). The birds were slaughtered on day 42. Tissue samples were collected from mid-duodenum, jejunum and ileum, and stained with haematoxylin and eosin or combined Alcian blue and PAS technique. All differences were considered significant at p < 0.05. The IEL count increased in all intestinal segments of the HS group compared with the TNZ group and decreased in all supplemented groups compared with the HS group. Compared with the TNZ, heat stress reduced villus height, crypt depth and surface area in duodenum and ileum, and increased crypt depth in ileum. Villus width decreased in duodenum and jejunum compared with the TNZ group. Supplementation of LBP, MOS and SYN reversed all these changes in duodenum, while only increased villus height and surface area in ileum. In jejunum, the villus height and surface area increased with HS-LBP, and crypt depth increased with HS-MOS. The number of GC containing acid mucins (duodenum and ileum) and mixed mucins (ileum) were increased in the HS compared with the TNZ. Supplementation of MOS, LBP and SYN maintained the enhanced activity of goblet cells. In conclusion, dietary supplementation of MOS and/or LBP may be helpful in alleviating some of the detrimental effects of heat stress on microstructure of the broiler gut.

Frequency of impaired glucose tolerance and diabetes mellitus in subjects with fasting blood glucose below 6.1 mmol/L (110 mg/dL).

The diagnosis of diabetes mellitus by the available criteria is controversial and relies heavily on fasting glucose results. This cross-sectional study in 2010-2011 aimed to measure the frequency of impaired glucose tolerance and diabetes mellitus in 127 subjects having fasting blood glucose < 7.0 mmol/L and to measure the agreement between different standard diagnostic criteria. Subjects presenting to a laboratory for analysis of fasting blood glucose for excluding diabetes mellitus underwent a 2-hour 75 g oral glucose challenge. A total of 40.6% of subjects with fasting blood glucose from 5.6-6.0 mmol/L had abnormal glucose regulation on the basis ofthe gold standard glucose challenge. Agreement between American Diabetes Association and World Health Organization diagnostic criteria was only fair (kappa = 0.32). Abnormalities of glucose metabolism including impaired glucose tolerance and diabetes mellitus can exist at fasting blood glucose results < 6.1 mmol/L (110 mg/dL).

Online learning: an effective option for teaching ENT to medical students?

OBJECTIVE: ENT is underrepresented in the curriculum, and this has been compounded by coronavirus disease 2019. Recent restructures have removed ENT placements from the curriculum. This lack of exposure needs to be addressed, and increased use of online learning represents an opportunity to facilitate this. This study aimed to evaluate whether online learning can effectively deliver undergraduate ENT teaching. METHODS: An online ENT module was created; content was structured on the Sheffield Medical School curriculum. Pre- and post-module tests and 5-point Likert scales were used to assess student knowledge and confidence, respectively. RESULTS: A total of 115 participants were recruited. Test scores improved by 29 per cent (p < 0.001) and confidence by 66 per cent. Anatomy and ENT conditions demonstrated significant improvement in confidence, with a lower confidence score for examination. CONCLUSION: This study showed improved knowledge and confidence, whilst highlighting greater efficacy in content over practical skills teaching. Online learning is a validated educational tool; however, it should not be used as a replacement but as an adjunct to supplement learning.

Studies on the chemopreventive effect of carnitine on tumorigenesis in vivo, using two experimental murine models of colon cancer.

Carnitine is known for its essential role in intermediary metabolism. In vitro studies suggest that its antioxidant and anti-inflammatory properties are potentially beneficial toward cancer prevention. This study tested effects of carnitine on the development of colon cancer in vivo using 2 murine models: azoxymethane (AOM) treatment as a model of carcinogen-induced colon cancer and a genetically induced model using Apc (Min/+) mice. AOM and Apc (Min/+) mice divided into dietary groups varying in lipid content, with or without carnitine supplementation (0.08%). AOM-exposed mice on a high butterfat diet had significantly increased aberrant crypts (ACF) (9.3 ± 0.88 vs. 6.3 ± 0.65), and macroscopic tumors (3.8 ± 0.95 vs. 2.0 ± 0.25) compared to mice on a control diet. In AOM mice fed the high butterfat diet, carnitine supplementation inhibited ACF (4.9 ± 0.7 vs. 9.3 ± 0.88, P < 0.001), crypt multiciplicity (1.6 ± 0.08 vs. 1.92 ± 0.1, P < 0.01) and tumors (1.5 ± 0.38 vs. 3.8 ± 0.95, P < 0.001). Carnitine supplementation resulted in significantly increased tissue carnitine and acylcarnitine levels. Carnitine inhibited the development of precancerous lesions and macroscopic colonic tumors in AOM-treated mice. However, carnitine did not exert protective effects on intestinal tumors in Apc (Min/+) mice.

Response of maternally isolated rock pigeons (Columba livia domestica) to different dietary concentrations of mannan-oligosaccharide.

Prebiotics are being used as an alternative to antibiotic growth promoters in poultry industry with a variable degree of success. This trial was conducted to investigate the effect of dietary mannan-oligosaccharide (MOS) supplementation on growth performance, selected colonic bacterial population, and immune response in maternally-isolated rock pigeons. The pigeons (n = 36) were randomly distributed in 4 treatment groups (n = 9 per group) with 3 replicates or pens (n = 3) in each group. Birds were fed either a corn/wheat-based basal diet (control group/CON) or the same diet supplemented with 0.1%, 0.2%, or 0.5% MOS for 35 d. On d 35, birds were killed to collect visceral organs, colonic contents, and serum. Colonic contents were used to enumerate selected microbiota and serum was used to detect antibody titer against the Newcastle disease virus. Cell-mediated immunity was determined by measuring the skin thickness following 2,4-dinitrochlorobenzene challenge. Results showed that supplementation did not affect the BW of birds. During wk 4, feed intake was significantly higher in the 0.2% (187.9 ± 0.86) and the 0.5% (186.4 ± 0.86) MOS-supplemented groups compared with the CON group (180.7 ± 0.86). Gizzard weights (with and without digesta) were significantly higher in the MOS 0.1% (10.67 ± 0.33 and 8.22 ± 0.26) and the MOS 0.2% (9.91 ± 0.33 and 7.94 ± 0.26) groups compared with the CON group (7.56 ± 0.33 and 6.25 ± 0.26). Small intestinal weight was significantly higher in the MOS 0.2% group (14.71 ± 0.56) compared with the CON group (9.56 ± 0.56). Lengths of small intestine (MOS 0.1% = 92.56 ± 1.69, MOS 0.2% = 90.79 ± 1.69, MOS 0.5% = 90.57 ± 1.69) in all the MOS-fed groups and large intestine in the 0.1% (3.50 ± 0.02) and the 0.5% (3.47 ± 0.02) MOS-fed groups were significantly higher than the CON group (small intestine = 77.63 ± 1.69, large intestine = 2.41 ± 0.02). Weights of heart, liver, pancreas, and large intestine remained unaffected. Feeding of MOS did not influence colonic population of Escherichia coli, Clostridia, and Bifidobacteria. Lactobacilli count was significantly higher in the 0.2% MOS-fed group (9.77 ± 0.12) compared with the CON group (9.19 ± 0.16). Mannan-oligosaccharide did not affect the immune response of the birds as antibody titer against the New Castle disease virus and the cell-mediated immunity remained similar in all the treatment groups. In conclusion, dietary MOS supplementation influenced only the colonic lactobacilli population without any apparent effects on the production performance in growing pigeons.

Effect of supplementation of prebiotic mannan-oligosaccharides and probiotic mixture on growth performance of broilers subjected to chronic heat stress.

The present study was aimed at elucidating the effects of supplementing mannan-oligosaccharides (MOS) and probiotic mixture (PM) on growth performance, intestinal histology, and corticosterone concentrations in broilers kept under chronic heat stress (HS). Four hundred fifty 1-d-old chicks were divided into 5 treatment groups and fed a corn-soybean diet ad-libitum. The temperature control (CONT) group was held at the normal ambient temperature. Heat stress broilers were held at 35 ± 2°C from d 1 until the termination of the study at d 42. Heat stress groups consisted of HS-CONT fed the basal diet; HS-MOS fed the basal diet containing 0.5% MOS; HS-PM fed the basal diet containing 0.1% PM; and HS-SYN (synbiotic) fed 0.5% MOS and 0.1% PM in the basal diet. Broilers were examined at d 21 and 42 for BW gain, feed consumption, feed conversion ratio (FCR), serum corticosterone concentrations, and ileal microarchitecture. The results revealed that the CONT group had higher (P < 0.01) feed consumption, BW gain, and lower FCR on d 21 and 42, compared with the HS-CONT group. Among supplemented groups, the HS-MOS had higher (P < 0.05) BW gain and lower FCR compared with the HS-CONT group. On d 21 and 42, the HS-CONT group had higher (P < 0.05) serum corticosterone concentrations compared with the CONT and supplemented groups. The CONT group had higher (P < 0.05) villus height, width, surface area, and crypt depth compared with the HS-CONT group. On d 21, the HS-PM had higher (P < 0.05) villus width and surface area compared with HS-CONT group. On d 42, the HS-SYN had higher (P < 0.05) villus width and crypt depth compared with the HS-CONT group. These results showed that chronic HS reduces broiler production performance, intestinal microarchitecture, and increases adrenal hormone concentrations. Also, supplementation of the MOS prebiotic and the PM can partially lessen these changes.

An investigation into gamma-ray treatment of shellfish using electron paramagnetic resonance spectroscopy.

BACKGROUND: Gamma irradiation is a safe method for the decontamination of shellfish, and its technical feasibility and safety have been endorsed (FAO/IAEA/WHO). In order to implement proper food-processing regulations, the identification of radiation treatment is required. In this study, electron paramagnetic resonance (EPR) spectroscopy was employed to identify the irradiation of seven different types of commonly consumed shellfish. RESULTS: Characteristics (g factor and signal intensity) of the EPR spectra of control and irradiated samples were recorded in order to clarify the gamma-ray treatment of shellfish. Radiation-specific signals around g = 2.0038 ± 0.0006 (g1) and g = 1.9996 ± 0.0002 (g2 and g3) were observed for all shellfish samples irradiated with absorbed doses of 3 and 6 kGy. The X-ray diffraction (XRD) spectra of some shellfish samples were recorded to investigate their mineral profiles. CONCLUSION: The EPR spectroscopic results indicated that carbonate minerals were the source of the paramagnetic species that were produced upon irradiation, entrapped in the shellfish and showed radiation-specific asymmetric signals whose intensities increased quantitatively with the absorbed radiation dose. The XRD analysis revealed that aragonite and calcite minerals were present in the shells of shellfish.

Remediation of pesticides using TiO2 based photocatalytic strategies: A review.

Nowadays, pesticides are regarded as the most dangerous of the various organic pollutants, posing substantial environmental and human threats worldwide. Pesticide contamination has become one of the most crucial environmental issues due to its bio-persistence and bioaccumulation. Different conventional methods are being utilized for pesticide removal, yet pesticides are thought to be significantly present in the environment. The development and application of sophisticated wastewater treatment methods are being pursued to remove contaminants effectively, particularly pesticides. In the past several decades, nanoscience and nanotechnology have emerged as essential tools for the identification, removal, and mineralization of persistent pesticides by employing advanced nanomaterials such as pristine titanium dioxide (TiO2), doped TiO2, nanocomposites (NCs) TiO2, and ternary nanocomposites (TNCs) TiO2 by advanced oxidation processes (AOPs). Advancement in the characteristics of TiO2 by doping, co-doping, construction of NCs and TNCs has contributed to the dramatic efficiency up-gradation by reducing band gap, solar active photocatalyst, enhancing PCA, high photostability, chemically inertness and multiple time reusability. Based on previous literature, utilizing La-TiO2 NCs photocatalyst, the mineralization of pesticide (imidacloprid) attained up to 98.17% that is almost 40-53% greater than pristine TiO2. The present review attempt to discuss the recent research performed on TiO2 based nanoparticles (NPs) and NCs for photocatalytic mineralization of various pesticides. The basic mechanism of TiO2 photocatalysis, types of reactors used for photocatalysis, and optimized experimental conditions of TiO2 for pesticides mineralization are discussed.

Does postal consent for flexible cystoscopy work?

BACKGROUND: Informed consent is an integral part of the process prior to any surgical procedure [1]. Flexible cystoscopy is a common day case urological procedure and it is the gold standard investigation for visible haematuria [2]. AIM: To assess if postal consent is a suitable form of gaining informed consent for flexible cystoscopy. METHODS: Patients booked for a flexible cystoscopy are initially reviewed in clinic. An information leaflet with an attached consent form is then posted to their home 2 weeks prior to their procedure. We designed a short questionnaire, to assess patient's satisfaction and understanding of the literature, given to them after the procedure. RESULTS: Sixty-seven questionnaires were completed. The mean age was 54. Sixty patients (93%) think that postal consent is of benefit to the patient. Sixty-one patients (91%) read the information sheet and felt that there was enough information regarding the procedure on it. Fifty-four patients (81%) had no difficulty understanding the consent form. Forty patients (60%) signed the form prior to arrival in the hospital. CONCLUSION: Postal consent is commonly used for gastro-intestinal endoscopy procedures. Postal consent for flexible cystoscopy is not well reported in the literature. Our study shows postal consent to be a suitable form of gaining informed consent for flexible cystoscopy.

Single or combined effects of mannan-oligosaccharides and probiotic supplements on the total oxidants, total antioxidants, enzymatic antioxidants, liver enzymes, and serum trace minerals in cyclic heat-stressed broilers.

This study was intended to explore the oxidative status of broilers under cyclic heat stress (HS) as modulated by supplementation of mannan-oligosaccharides (MOS) and a probiotic mixture (PM). Two hundred fifty 1-d-old chicks were randomly divided into 5 groups. From d 22, birds were either kept in a thermoneutral zone (TN; 26.7°C for 24 h/d) or subjected to HS (35 ± 1.1°C and 75 ± 5% RH for 8 h/d from 1000 to 1800 h) to the conclusion of the study on d 42. Birds were fed either a corn-based diet (TN and HS groups) or the same diet supplemented with 0.5% MOS (HS-MOS group), 0.1% PM (HS-PM group), or their combination as a symbiotic (SYN; HS-SYN group). On d 42, birds were killed by cervical dislocation to collect serum for the determination of total oxidants, total antioxidants, paraoxonase, arylesterase, ceruloplasmin, aspartate aminotransferase, alanine aminotransferase, and trace minerals. Heat stress increased (P < 0.05) total oxidants and total antioxidants and decreased (P < 0.05) paraoxonase and arylesterase, with no change in ceruloplasmin, aspartate aminotransferase, and alanine aminotransferase activities. Dietary supplementation decreased (P < 0.05) total oxidants and total antioxidants, with no effect on the activities of other enzymes. Heat stress did not influence serum copper, zinc, and manganese concentrations of birds when compared with those in the TN group. However, MOS increased (P < 0.05) concentrations of all the trace minerals, whereas SYN increased (P < 0.05) concentrations of only zinc and copper. It was concluded that MOS or PM supplementation, alone or as a SYN, may reduce some of the detrimental effects of HS, whereas MOS alone or as a SYN may improve the absorption of trace minerals.

Alleviation of cyclic heat stress in broilers by dietary supplementation of mannan-oligosaccharide and Lactobacillus-based probiotic: dynamics of cortisol, thyroid hormones, cholesterol, C-reactive protein, and humoral immunity.

Heat stress (HS), one of the major problems of tropical and subtropical countries, adversely affects the production performance of poultry. Keeping this in view, the present study was designed to investigate some of the biological markers of HS in broilers as modulated by dietary supplementation of mannan-oligosaccharide (MOS) and a Lactobacillus-based probiotic (LBP), either alone or in combination. Two hundred fifty 1-d-old-chicks were randomly divided into 5 groups. From d 22, the birds were either kept at the thermoneutral zone (TN) or exposed to HS to the conclusion of study, d 42. Birds were fed either a corn-based basal diet (TN and HS groups) or the same diet supplemented with 0.5% MOS (HS-MOS group), 0.1% LBP (HS-LBP group), or their combination. Birds were immunized against Newcastle disease virus on d 4 (intraocular; live attenuated) and d 20 (drinking water; live attenuated) and infectious bursal disease virus on d 8 (intraocular; live intermediate strain) and d 24 (drinking water; live attenuated). Birds were killed on d 42 to collect serum for determination of cortisol, thyroid hormones, cholesterol, C-reactive protein, and postvaccinal antibody titers. Results revealed that dietary supplementations decreased (P < 0.05) the serum cortisol and cholesterol concentrations and increased (P < 0.05) thyroxine concentration compared with the HS group without affecting triiodothyronine concentration. The percentage of the C-reactive protein-positive birds was higher (P < 0.05) in the HS group compared with the TN group. Dietary supplementations improved humoral immunity against Newcastle disease virus and infectious bursal disease virus during HS. In conclusion, dietary supplementation of either MOS or LBP alone or in combination can reduce some of the detrimental effects of HS in broilers.

Comparison of radiation-induced hydrocarbons for the identification of irradiated perilla and sesame seeds of different origins.

BACKGROUND: Perilla and sesame seeds, a rich source of energy, are commonly utilized in different forms in many countries. During the post-harvest period, they are contaminated with insects as well as microbes that may have importance for keeping quality and quarantine, and thus they can be treated with ionizing radiation for insect disinfestation and microbial decontamination. Reliable and routine methods to identify whether or not a food has been irradiated are needed to help consumers' understanding of irradiated food and promote international trade. In the present study, fat-derived hydrocarbons from irradiated perilla seeds and sesame seeds of Korean and Chinese origin were analyzed in order to identify irradiation treatment by comparing their properties during the post-irradiation period. RESULTS: Gas chromatographic-mass spectrometric analysis showed that several saturated hydrocarbons, such as tetradecane, pentadecane, hexadecane and heptadecane, were found in the non-irradiated control samples, while four radiation-induced unsaturated hydrocarbons (R(2) = 0.647-0.997), such as 1,7,10-hexadecatriene (C(16:3)), 1,7-hexadecadiene (C(16:2)), 6,9-heptadecadiene (C(17:2)) and 8-heptadecene (C(17:1)), were detected in all irradiated samples at 0.5 kGy or higher, with variations according to sample and origin. Concentrations of all hydrocarbons were reduced during storage and could not be detected in 0.5 kGy irradiated Chinese sample of either seed after 8 months. CONCLUSION: Radiation-induced hydrocarbons (C(16:3, 16:2, 17:2, 17:1)) could be used as markers to identify irradiated perilla and sesame seeds of both Korean and Chinese origin at 1 kGy or higher for 8 months' storage at room temperature.

Ureteric stenting with magnetic retrieval: an alternative to traditional methods.

INTRODUCTION: Ureteric stents are frequently placed following endo-urological procedures. These stents cause significant morbidity for patients. Standard ureteric stents are removed by flexible cystoscopy. This procedure can be unpleasant for patients and requires additional resources. A newly designed magnetic stent allows removal in an outpatient setting. The aim of our study is to compare the magnetic stent and standard ureteric stents with regard to morbidity, pain on stent removal and cost-effectiveness. METHODS: This study was carried out across two sites between September 2016 and July 2017. In site A, a magnetic stent (Urotech, Black-Star®) is removed by magnetic retrieval device. Fifty consecutive patients completed the validated Ureteric Stent Symptom Questionnaire (USSQ) and visual analogue scale (VAS) at the time of stent removal. On site B, a soft polyurethane stent (Cook Universa) was removed by flexible cystoscopy. Fifty patients were identified retrospectively and completed questionnaires by post. Cost analysis was also performed. RESULTS: One hundred questionnaires were included for analysis. No significant difference in stent morbidity as assessed by the USSQ was shown between both groups. Median duration of stenting was significantly shorter in the magnetic stent group (5.5 versus 21.5 days, p < 0.001). Mean pain on stent removal was significantly less with magnetic retrieval (2.9 versus 3.9, p < 0.05). Complication rates were similar in both groups. Cost analysis showed a cost saving of €203 per patient with the magnetic stent group. CONCLUSION: Magnetic stents cause similar morbidity for patients compared with standard stents removed by flexible cystoscopy; they are associated with less pain at removal and are cost saving.

Intraductal carcinoma of the prostate in an Irish prostate cancer patient cohort-an aggressive pathology and a strong familial link.

BACKGROUND: The prevalence of intraductal carcinoma of the prostate (IDC-P) is poorly studied in the Irish population. This study investigated the incidence and clinicopathologic characteristics of IDC-P in an Irish prostate cancer (PCa) patient cohort. The study also discusses the rationale for genetic counseling and screening in Irish patients with familial risk factors for IDC-P. MATERIALS AND METHODS: This study investigated patients diagnosed with IDC-P on prostate biopsy from 2012 to 2016. Primary outcome measurements were incidence, management, and clinical outcomes after follow-up in patients with IDC-P. The secondary outcome measurement was to identify a familial link for IDC-P. RESULTS: A total of 1,143 patients were diagnosed with PCa on needle biopsy, of which 30 (2.3%) had concomitant IDC-P. Mean age and prostate-specific antigen at diagnosis were 68.6 ± 10.5 years (range 53-85 years) and 9.15 ± 8.65 ng/mL (range 2.1-166 ng/mL), respectively. In total, 17 of 30 patients (57%) were diagnosed with concomitant high-grade (i.e., ≥Gleason score 8) PCa. Eight patients (27%) were treated with radical prostatectomy; of which five had biochemical recurrence (BCR) after 10.55 ± 25.9 months. Eleven patients (37%) received radical radiotherapy; of which one had BCR after 36 months. Eleven patients (37%) presented with advanced PCa and were managed with androgen deprivation therapy ± chemotherapy. A family history for PCa in first-degree relatives was found in eight patients (27%). CONCLUSIONS: IDC-P is associated with more aggressive clinicopathologic features and an increased risk of BCR after treatment. In Ireland, clinical guidelines and a genetic screening pathway are required to provide early detection and appropriate multimodal management of patients with IDC-P.

Butylated hydroxytoluene inclusion in semen extender improves the post-thawed semen quality of Nili-Ravi buffalo (Bubalus bubalis).

The study was carried out to evaluate the potential impact of butylated hydroxytoluene (BHT) on the frozen-thawed semen quality of Nili-Ravi buffalo bulls. Ejaculated bull semen was extended in a Tris-citrate egg yolk extender containing various concentrations of BHT (0.5, 1.0, 2.0 and 3.0mM). Semen was frozen at -196 degrees C using 50 x 10(6) spermatozoa per 0.5 mL straws. Five straws from each treatment were thawed to assess the semen quality in terms of sperm motility, viability, plasma membrane integrity and acrosomal integrity. Post-thawed sperm motility was determined using a phase-contrast microscope. Viability, plasma membrane integrity and acrosomal integrity were evaluated by the supravital staining, hypo-osmotic swelling test and normal acrosomal reaction, respectively. The highest (P<0.05) motility, acrosomal integrity and hypo-osmotic swelling response of spermatozoa was achieved by addition of 1.0 and 2.0mM BHT to semen extender. However, highest (P<0.05) viability of spermatozoa was achieved by inclusion of 2.0mM BHT. The higher concentration of BHT (3.0mM) reduced the motility, acrosomal integrity, viability and hypo-osmotic swelling response of the spermatozoa compared to other concentration used. In conclusion, BHT when added in the semen extender can improve the semen quality of buffalo bulls.

Improvement of liquid and frozen-thawed semen quality of Nili-Ravi buffalo bulls (Bubalus bubalis) through supplementation of fat.

The aim of the study was to investigate the effects of dietary fat on quality of liquid and frozen-thawed semen of Nili-Ravi buffalo bulls. Adult bulls (n=21) were fed a balanced ration (Con; n=7) or the same ration either containing sunflower oil (SF-O; n=7) or whole sunflower seeds (SF-S; n=7) for 63 days. Body weight and body condition score of each bull was recorded on days 0, 30 and 60 of the experiment. Semen was collected on days 39, 46, 53 and 60, frozen by a fast method and stored at -196 degrees C for 24h. Sperm motility was assessed using a bright field microscope. Plasma membrane integrity of fresh and frozen-thawed spermatozoa was assessed using a hypo-osmotic swelling (HOS) assay. The concentration of spermatozoa and volume of semen was not different among groups on various days of collection. Sunflower-enriched diets did not affect the motility and number of HOS-positive spermatozoa in the fresh semen. Motility and HOS of post-thawed spermatozoa were higher (p<0.05) in bulls fed the sunflower-enriched diets. Similarly, diets did not affect the body condition score and body weight of bulls. In conclusion, feeding of sunflower oil or sunflower seed as fat sources can improve the quality of buffalo bull spermatozoa.