Aquablation of the prostate: single-center results of a non-selected, consecutive patient cohort.

PURPOSE: Aquablation of the prostate using the AquaBeam™ system promises equivalent functional outcomes, reduced learning curve, and improved sexual function compared to transurethral prostate resection as shown in prospective randomized trials. This prospective cohort study aims to evaluate if published results can be transferred into the clinical routine in a non-selected patient collective. METHODS: This study includes all patients treated between September 2017 and June 2018 with Aquablation of the prostate. Patients have been evaluated prospectively for the perioperative course and early follow-up. Besides voiding parameter and symptom score, TRUS-volume change, ejaculatory function, and adverse events have been recorded. RESULTS: 118 consecutive patients have been treated in the given time. Aquablation could be carried out successfully in all patients. IPSS, QoL, Qmax, and PVR improved significantly after the procedure and continued to improve during 3-month follow-up. Mean OR time was 20 min, TRUS volume decreased by 65%, and 73% of the patients retained antegrade ejaculation. Thirteen adverse events (> Clavien-Dindo I) occurred in 10 patients. CONCLUSION: The surgical ablation of the prostate using Aquablation achieved significant and immediate improvement of functional voiding parameters Qmax and PVR as well as symptomatic improvement of IPSS and QoL. Aquablation seems to be safe and effective with a low perioperative complication profile even in a non-selected group of patients.

Genetic analysis of the human Insulin-like 3 gene: absence of mutations in a Greek paediatric cohort with testicular maldescent.

This study investigated the hypothesis that genetic alterations of the human insulin-like 3 (INSL3) gene are associated with testicular maldescent (TMD). Genomic DNA was extracted and amplified from peripheral blood samples of 170 unrelated children with all possible phenotypical expressions of TMD and 50 volunteers with normal external genitalia from the general paediatric population (controls). PCR-single strand conformation polymorphism analysis was used to screen INSL3 gene for genetic variants. For rapid screening of a detected nonsilent genetic alteration, restriction assay using endonuclease Eag I was further employed. Products were analysed on 2% agarose gel and restriction patterns were visualised by ethidium bromide. Differences in genotype and allelic distributions of nonsilent genetic alterations were evaluated between (i) patients-controls, (ii) familial-sporadic, (iii) bilateral-unilateral and (iv) intra-abdominal-inguinal cases of TMD. No mutations were detected. Three common INSL3 gene polymorphisms (27G>A, 126G>A, 178G>A) unrelated to any particular phenotype of TMD were detected both in patients and controls. These results indicate that INSL3 gene mutations are not a common cause of TMD in the human.

Aortic arch calcification predicts the extent of coronary atherosclerosis in patients with or without type 2 diabetes: short communication.

AIM OF THE STUDY: The aim of this study was to evaluate the sensitivity and specificity of aortic arch calcification for detection of severe coronary atherosclerosis in patients suffering from coronary artery disease (CAD), with or without type 2 diabetes. PATIENTS AND METHODS: This study included 107 type 2 diabetic patients (68 men) with a mean age of 62.4 +/- 10.7 years and a mean diabetes duration of 14.2 +/- 5.9 years and 104 patients (63 men) with a mean age of 64.5 +/- 9.3 years who did not have diabetes. All patients had CAD, documented by coronary arteriography. Severe CAD was defined as atherosclerosis of the left main branch or atherosclerosis of three coronary arteries or atherosclerosis of the proximal part of the left anterior descending artery. Aortic arch calcification was assessed by means of posteroanterior chest X-rays, studied by a radiologist kept blind to the result of coronary arteriography. RESULTS: In type 2 diabetic patients, diagnosis of aortic arch calcification had 65.6% sensitivity and 86.9% specificity for detection of severe CAD. In patients without diabetes, diagnosis of aortic arch calcification had 47.7% sensitivity and 96.7% specificity for detection of severe CAD. CONCLUSIONS: Aortic arch calcification has a high specificity for detection of severe coronary atherosclerosis in patients with CAD. Sensitivity is higher in patients with type 2 diabetes, while specificity is slightly higher in non-diabetic patients.

Severity of liver echogenicity is correlated to serum c-peptide levels in type 2 diabetic patients.

AIM: To investigate the correlation between liver echogenicity and serum C-peptide levels in type 2 diabetic patients treated with oral hypoglycaemic agents. PATIENTS AND METHODS: The study included 231 type 2 diabetic patients (114 men) with a mean age of 64.3 +/- 6.9 years and a mean diabetes duration of 8.5 +/- 3.2 years. Liver echogenicity was graded by ultrasound examination as follows: Grade 0 (normal liver texture), grade 1 (slight increase of liver echogenicity), grade 2 (moderate increase of liver echogenicity with impaired visualization of intrahepatic vessels and right hemi-diaphragm), grade 3 (marked increase of liver echogenicity with very poor visualization or non-visualization of intrahepatic vessels and right hemi-diaphragm). Serum C-peptide was measured both in fasting state (Fasting C-peptide, FCP) and after glucagon administration (Glucagon-stimulated C-peptide, GCP). RESULTS: FCP (median; interquartile range) showed a significant difference (p=0.041) between patients with grade 0 (1.9 ng/dl; 1.1-2.7 ng/dl),grade 1 (2.7 ng/dl; 1.9-3.7 ng/dl), grade 2 (4.1 ng/dl; 2.6-5.1 ng/dl) and grade 3 (6.2 ng/dl; 4.6-7.5 ng/dl) liver echogenicity. GCP (median; interquartile range) also differed significantly (p=0.04) between patients with grade 0 (2.6 ng/dl; 1.8-3.3 ng/dl), grade 1 (4.3 ng/dl; 3.3-5 ng/dl), grade 2 (5.8 ng/dl; 4.6-6.9 ng/dl) and grade 3 (8.3 ng/dl; 6.6-9.5 ng/dl) liver echogenicity. In multiple regression analysis, both FCP and GCP showed significant (p < 0.05) positive correlations with waist circumference, triglycerides, WHR and liver echogenicity. CONCLUSIONS: In type 2 diabetic patients treated with oral hypoglycaemic agents, liver echogenicity shows a significant positive correlation with serum C-peptide levels, both in fasting state and after glucagon administration.

Evaluation of aortic arch calcification in type 2 diabetic patients.

BACKGROUND: The purpose of this study is to evaluate the severity of aortic arch calcification among type 2 diabetic patients in association with diabetes duration, diabetic complications, coronary artery disease and presence of cardiovascular risk factors. PATIENTS AND METHODS: This study included 207 type 2 diabetic patients (101 men) with a mean age of 61.5 +/- 8.1 years and a mean diabetes duration of 13.9 +/- 6.4 years. Aortic arch calcification was assessed by means of posteroanterior chest X-rays. Severity of calcification was graded as follows: grade 0 (no visible calcification), grade 1 (small spots of calcification or single thin calcification of the aortic knob), grade 2 (one or more areas of thick calcification), grade 3 (circular calcification of the aortic knob). RESULTS: Severity of calcification was grade 0 in 84 patients (40.58%), grade 1 in 64 patients (30.92%), grade 2 in 43 patients (20.77%) and grade 3 in 16 patients (7.73%). In simple regression analysis severity of aortic arch calcification was associated with age (p = 0.032), duration of diabetes (p = 0.026), insulin dependence (p = 0.042) and presence of coronary artery disease (p = 0.039), hypertension (p = 0.019), dyslipidaemia (p = 0.029), retinopathy (p = 0.012) and microalbuminuria (p = 0.01). In multiple regression analysis severity of aortic arch calcification was associated with age (p = 0.04), duration of diabetes (p = 0.032) and presence of hypertension (p = 0.024), dyslipidaemia (p = 0.031) and coronary artery disease (p = 0.04), while the association with retinopathy, microalbuminuria and insulin dependence was no longer significant. CONCLUSIONS: Severity of aortic arch calcification is associated with age, diabetes duration, diabetic complications (retinopath), microalbuminuria), coronary artery disease, insulin dependence, and presence of hypertension and dyslipidaemia.

Gravity of aortic arch calcification as evaluated in adult Greek patients.

BACKGROUND: The aim of the present study was to evaluate the gravity of aortic arch calcification in adult Greek patients. METHODS: A total of 1027 patients (498 men, 529 women) were included. Aortic arch calcification was assessed by means of posteroanterior chest X-rays. These were studied by two radiologists blinded to the patients' medical records. Calcification was graded as follows: grade 0 (no visible calcification), grade 1 (small spots of calcification or single thin calcification of the aortic knob), grade 2 (one or more areas of thick calcification), grade 3 (circular calcification of the aortic knob). All patients were clinically and electrocardiographically examined for coronary artery disease. The other parameters included in the analysis were age, sex, smoking, body-mass index, hypertension, dyslipidemia, diabetes mellitus and history of stroke. RESULTS: Calcification gravity was grade 0 in 421 patients (41%), grade 1 in 308 patients (30%), grade 2 in 216 patients (21%) and grade 3 in 82 patients (8%). In simple regression analysis the gravity of aortic arch calcification was positively correlated with age (p=0.01), diabetes mellitus (p=0.014), hypertension (p=0.022), dyslipidemia (p=0.038) and coronary artery disease (p=0.041). In multiple regression analysis it was associated with age (p=0.019), diabetes mellitus (p=0.02) and hypertension (p=0.03). CONCLUSIONS: Gravity of aortic arch calcification in adult Greek patients may easily be assessed on routine chest X-rays and is positively correlated with coronary artery disease, as well as important cardiovascular risk factors (age, diabetes mellitus, hypertension and dyslipidemia).

Analysis of olive oil and seed oil triglycerides by capillary gas chromatography as a tool for the detection of the adulteration of olive oil.

Individual triglyceride (TG) species of olive oil and several seed oils (corn, cottonseed, palm, peanut, soybean, and sunflower) are baseline separated on a WCOT TAP CB fused-silica capillary column by capillary gas chromatography (CGC) with a flame-ionization detector (FID) and either cold on-column or split injection. An adulteration of olive oil with a low content (< 5%) of these seed oils (except peanut oil) can be verified by the detection of the increasing levels of trilinolein or tripalmitin in olive oil in which these TG species are normally absent or present at very low levels (< 0.5%). An adulteration with over 20% peanut oil can be detected by the increasing levels of palmitodilinolein. TG species that can be coeluted with trilinolein in the reversed-phase high-performance liquid chromatographic (RP-HPLC) mode are baseline separated by the CGC technique, and their structures are identified by selective ion monitoring mass spectrometry. The following comparisons--the CGC-FID and RP-HPLC methods for detection of adulteration, cold on-column and split-injection modes for CGC-FID, and silylation or thin-layer chromatography pretreatment and simple dilution of one or more of the oil samples--are also presented. The normalized percentage area of the TG species is sufficient for the method limits used in this study. Mixtures of virgin olive oil with refined or residue olive oil could not be distinguished from the virgin type by the method used in this study.