What if gastrointestinal complications in endurance athletes were gut injuries in response to a high consumption of ultra-processed foods? Please take care of your bugs if you want to improve endurance performance: a narrative review.

To improve performance and recovery faster, athletes are advised to eat more often than usual and consume higher doses of simple carbohydrates, during and after exercise. Sports energetic supplements contain food additives, such as artificial sweeteners, emulsifiers, acidity regulators, preservatives, and salts, which could be harmful to the gut microbiota and impair the intestinal barrier function. The intestinal barrier plays a critical function in bidirectionally regulation of the selective transfer of nutrients, water, and electrolytes, while preventing at the same time, the entrance of harmful substances (selective permeability). The gut microbiota helps to the host to regulate intestinal homeostasis through metabolic, protective, and immune functions. Globally, the gut health is essential to maintain systemic homeostasis in athletes, and to ensure proper digestion, metabolization, and substrate absorption. Gastrointestinal complaints are an important cause of underperformance and dropout during endurance events. These complications are directly related to the loss of gut equilibrium, mainly linked to microbiota dysbiosis and leaky gut. In summary, athletes must be cautious with the elevated intake of ultra-processed foods and specifically those contained on sports nutrition supplements. This review points out the specific nutritional interventions that should be implemented and/or discontinued depending on individual gut functionality.

Sample collection/stabilization and DNA/RNA extraction from swab samples for microbiome or metagenome analyses.

Good preservation and storage are essential to preserving microorganisms' genetic material in microbial communities from wide array of sample inputs and accurately represent the bacterial composition for further analysis and applications. The objective is to develop a proper preservation and storage medium to preserve DNA and RNA from those microorganisms. DANAGEN-BIOTED has developed a new product to deal with this problem. Click on the To read the full Application forum, click on the View Article button above and download the PDF.

A comparison of injuries in elite male and female football players: A five-season prospective study.

The aim was to compare the epidemiology of injuries between elite male and female football players from the same club. Injuries and individual exposure time in a male team and a female team, both playing in the Spanish first division, were prospectively recorded by the club's medical staff for five seasons (2010-2015) following the FIFA consensus statement. Total, training, and match exposure hours per player-season were 20% higher for men compared to women (P<.01). Total, training, and match injury incidence were 30%-40% higher in men (P≤.04) mainly due to a 4.82 (95% confidence interval [CI] 2.30-10.08) times higher incidence of contusions, as there were no differences in the incidence of muscle and joint/ligament injuries (P≥.44). The total number of absence days was 21% larger in women owing to a 5.36 (95% CI 1.11-25.79) times higher incidence of severe knee and ankle ligament injuries. Hamstring strains and pubalgia cases were 1.93 (95% CI 1.16-3.20) and 11.10 (95% CI 1.48-83.44) times more frequent in men, respectively; whereas quadriceps strains, anterior cruciate ligament ruptures, and ankle syndesmosis injuries were 2.25 (95% CI 1.22-4.17), 4.59 (95% CI 0.93-22.76), and 5.36 (95% CI 1.11-25.79) times more common in women, respectively. In conclusion, prevention strategies should be tailored to the needs of male and female football players, with men more predisposed to hamstring strains and hip/groin injuries, and women to quadriceps strains and severe knee and ankle ligament injuries.

Morphometry of skeletal muscle capillaries: the relationship between capillary ultrastructure and ageing in humans.

AIM: To determine whether the ultrastructure of the capillary system in human skeletal muscle changes during advancing senescence, we evaluated the compartmental and subcompartmental organization of capillaries from vastus lateralis muscle (VL) biopsies of 41 non-diseased persons aged 23-75 years. METHODS: From each VL biopsy, 38-40 randomly selected capillaries were assessed by transmission electron microscopy and subsequent morphometry with a newly established tablet-based image analysis technique. RESULTS: Quantification of the compartmental organization revealed most indicators of the capillary ultrastructure to be only non-significantly altered (P > 0.05) over age. However, the peri-capillary basement membrane (BM) was thicker in the older participants than in the younger ones (P ≤ 0.05). Regression analysis revealed a bipartite relationship between the two parameters: a homogenous slight increase in BM thickness up to the age of approximately 50 years was followed by a second phase with more scattered BM thickness values. In 44.5% of the capillary profiles, projections/filopodia of the pericytes (PCs) traversed the BM and invaded endothelial cells (ECs) visible as PC pegs in pale cytoplasm holes (EC sockets). Strikingly, PC pegs were often in proximity to the EC nucleus. In PC profiles, sockets were likewise detected in 14.2% of the capillaries. Within these PC sockets, cellular profiles were frequently seen, which could be assigned to EC filopodia, internal PC curling or PC-PC interactions. Quantification of the occurrence of peg-socket junctions revealed the proportions of empty EC sockets and empty PC sockets to increase (P ≤ 0.05) during ageing. CONCLUSION: Our investigation demonstrates advancing senescence to be associated with increase in BM thickness and loss of EC and PC filopodia length in skeletal muscle capillaries.

NerveCheck: An inexpensive quantitative sensory testing device for patients with diabetic neuropathy.

AIMS: Sensory neuropathy is central to the development of painful neuropathy, and foot ulceration in patients with diabetes. Currently, available QST devices take considerable time to perform and are expensive. NerveCheck is the first inexpensive ($500), portable QST device to perform both vibration and thermal testing and hence evaluate diabetic peripheral neuropathy (DPN). This study was undertaken to establish the reproducibility and diagnostic validity of NerveCheck for detecting neuropathy. METHODS: 130 subjects (28 with DPN, 46 without DPN and 56 control subjects) underwent QST assessment with NerveCheck; vibration perception and thermal testing. DPN was defined according to the Toronto criteria. RESULTS: NerveCheck's intra correlation coefficient for vibration, cold and warm sensation testing was 0.79 (95% LOA: -4.20 to 6.60), 0.86 (95% LOA: -1.38 to 2.72) and 0.71 (95% LOA: -2.36 to 3.83), respectively. The diagnostic accuracy (AUC) for vibration, cold and warm sensation testing was 86% (SE: 0.038, 95% CI 0.79-0.94), 79% (SE: 0.058, 95% CI 0.68-0.91) and 72% (SE: 0.058, 95% CI 0.60-0.83), respectively. CONCLUSIONS: This study shows that NerveCheck has good reproducibility and comparable diagnostic accuracy to established QST equipment for the diagnosis of DPN.

Capillary growth, ultrastructure remodelling and exercise training in skeletal muscle of essential hypertensive patients.

AIM: The aim was to elucidate whether essential hypertension is associated with altered capillary morphology and density and to what extent exercise training can normalize these parameters. METHODS: To investigate angiogenesis and capillary morphology in essential hypertension, muscle biopsies were obtained from m. vastus lateralis in subjects with essential hypertension (n = 10) and normotensive controls (n = 11) before and after 8 weeks of aerobic exercise training. Morphometry was performed after transmission electron microscopy, and protein levels of several angioregulatory factors were determined. RESULTS: At baseline, capillary density and capillary-to-fibre ratio were not different between the two groups. However, the hypertensive subjects had 9% lower capillary area (12.7 ± 0.4 vs. 13.9 ± 0.2 µm(2)) and tended to have thicker capillary basement membranes (399 ± 16 vs. 358 ± 13 nm; P = 0.094) than controls. Protein expression of vascular endothelial growth factor (VEGF), VEGF receptor-2 and thrombospondin-1 were similar in normotensive and hypertensive subjects, but tissue inhibitor of matrix metalloproteinase was 69% lower in the hypertensive group. After training, angiogenesis was evident by 15% increased capillary-to-fibre ratio in the hypertensive subjects only. Capillary area and capillary lumen area were increased by 7 and 15% in the hypertensive patients, whereas capillary basement membrane thickness was decreased by 17% (P < 0.05). VEGF expression after training was increased in both groups, whereas VEGF receptor-2 was decreased by 25% in the hypertensive patients(P < 0.05). CONCLUSION: Essential hypertension is associated with decreased lumen area and a tendency for increased basement membrane thickening in capillaries of skeletal muscle. Exercise training may improve the diffusion conditions in essential hypertension by altering capillary structure and capillary number.

Evaluation of the sensitivity of two recently developed STR multiplexes for the analysis of chimerism after haematopoietic stem cell transplantation.

Forensic-oriented kits analysing short tandem repeat (STR) polymorphisms are widely used to determine the proportions of donor and recipient cells after haematopoietic stem cell transplantation. The sensitivity of this technology is crucial for the early detection of relapse and, in consequence, the adjustment of the treatment to enhance donor-origin haematopoiesis in transplant recipients. The objective of this study was to compare the performance of two recently developed STR multiplex kits, AmpFℓSTR(®) Identifiler(®) Plus PCR Amplification Kit (Applied Biosystems) and Investigator™ IDplex(®) (Qiagen), in the analysis of chimerism. Fifteen STR loci were amplified with both kits in 26 peripheral blood samples of transplantated patients showing chimerism. Peak amplitude threshold, detection limit (%DL), per cent donor chimerism and efficacy of each multiplex and STR were determined, and the results with both kits were compared. The %DL and the estimated per cent donor chimerism were similar with both kits. On the other hand, Identifiler(®) Plus kit allowed chimerism identification only in 24 (92%) of the 26 cases with chimerism detected by using the Investigator™ IDplex(®) when only 'type 5' allelic constellations (i.e. without potential interference by stutter peaks) were taken into account. However, IDplex(®) efficacy was somewhat lower than that of Identifiler Plus when only the most informative loci (D2S1338, D21S11, D18S51 and FGA) were considered. Therefore, although each system had some particular advantages and disadvantages, overall both STR multiplexes showed similar performance in qualitative and quantitative chimerism analysis.

Genetic uniqueness of the Waorani tribe from the Ecuadorian Amazon.

South America and especially the Amazon basin is known to be home to some of the most isolated human groups in the world. Here, we report on a study of mitochondrial DNA (mtDNA) in the Waorani from Ecuador, probably the most warlike human population known to date. Seeking to look in more depth at the characterization of the genetic diversity of this Native American tribe, molecular markers from the X and Y chromosomes were also analyzed. Only three different mtDNA haplotypes were detected among the Waorani sample. One of them, assigned to Native American haplogroup A2, accounted for more than 94% of the total diversity of the maternal gene pool. Our results for sex chromosome molecular markers failed to find close genetic kinship between individuals, further emphasizing the low genetic diversity of the mtDNA. Bearing in mind the results obtained for both the analysis of the mtDNA control region and complete mitochondrial genomes, we suggest the existence of a 'Waorani-specific' mtDNA lineage. According to current knowledge on the phylogeny of haplogroup A2, we propose that this lineage could be designated as subhaplogroup A2s. Its wide predominance among the Waorani people might have been conditioned by severe genetic drift episodes resulting from founding events, long-term isolation and a traditionally small population size most likely associated with the striking ethnography of this Amazonian community. In all, the Waorani constitute a fine example of how genetic imprint may mirror ethnopsychology and sociocultural features in human populations.

Chimerism detection by short tandem repeat analysis when donor and recipient genotypes are not known.

BACKGROUNDS: The analysis of chimerism after bone marrow transplantation by STR-PCR is frequently carried out with commercial kits designed for forensic purposes and including too many non informative STR. Furthermore, in routine clinical practice it is not uncommon to lack the pre-transplant genotype of the recipient or the donor, thus making it difficult to identify both components in the post-transplant genotype. The objective of this paper is to overcome these drawbacks by analyzing the informativity of STR markers from a perspective which can be applied whether the pretransplant genotypes are available or not, and selecting a minimum STR panel that allows an effective direct detection of chimerism. METHODS: DNA extraction, STR-PCR and fragment analysis of 15 STR in 90 donor-recipient pairs, 60 of which were part of the discovery set and 30 in a validation set. Loci were considered as informative when there were 3 or 4 different alleles in the combined genotypes of the recipient and the donor. RESULTS: The informativity varied between 41.6 and 76.6. The 4 most informative loci were D2S1338, D21S11, D18S51 and FGA. We could select a minimum set of 8 markers (D2S1338, D21S11, D18S51, FGA, VWA, D19S433, TH01 and D3S1358) that provided at least 3 informative loci in 95% of cases. CONCLUSION: This minimum STR panel may be an efficient way to detect and quantitate donor-recipient chimerism after transplantation.

Recent advances and considerations for the future in forensic analysis of degraded DNA by autosomic miniSTR multiplex genotyping.

STR genotyping from degraded DNA samples requires genetic profiles to be obtained from DNA fragments no bigger than 200-300 bp. It requires the use of miniSTRs, which are smaller than the STRs used in standard typing. This paper reviews recent advances in miniSTR genotyping, beginning with a brief introduction to the processes involved in DNA fragmentation and how it hinders standard STR genotyping before proceeding further to the loci included in the main DNA databases and finishing with the International Workgroups' recommended design strategies for developing miniSTR reactions. The results of the efforts of many laboratories achieving different STR multiplexes and patents are also described and compared. Finally, a consideration of the perspectives for the future in this area is presented.

Development and validation of I-DNA1: a 15-Loci multiplex system for identity testing.

This paper presents a system for the multiplex amplification of 15 loci, known as I-DNA1, which combines mini and midiSTR technology, with amplicon sizes ranging from 49 to 297 bp. I-DNA1 analyses all the STR loci included in the CODIS and the Interpol Standard Set of loci, nine of the ten European core loci and seven of the eight German core loci, making it suitable for use in identifying humans. Moreover, its high sensitivity and the small size of its amplicons mean that I-DNA1 is potentially highly useful for analysing highly degraded and/or very small DNA samples.

[Complications and incidences in our first 250 robotic radical prostatectomies]. / Incidencias y complicaciones en nuestras primeras 250 prostatéctomias radicales robóticas.

OBJECTIVE: To review the incidence of and analyze the factors contributing to perioperative complications in patients undergoing robotic radical prostatectomy in our experience of 250 procedures. MATERIALS AND METHODS: An analytical, descriptive, retrospective study was conducted of 250 consecutive patients who underwent robotic radical prostatectomy during a period of three years and two months (January 06-March 09). Data recorded included age, preoperative Gleason grade and PSA, and prostate volume. All procedures were performed by three surgeons through a transperitoneal approach using a four-arm da Vinci robotic system. Microsoft Excel support was used. Surgical variables recorded included setup time, console operation time, mean bleeding, transfusion rate, hospital stay, and urethral catheterization time. Incidences and intraoperative and postoperative late and early complications in these patients were reviewed. RESULTS: Demographic data recorded included: mean age, 61.5 years (47-74); mean preoperative PSA, 8.18 ng/mL (2.6-34 ng/mL); mean Gleason grade, 6.8 (2-9); and mean prostate volume 34.9 mL (12-124). Surgical variables recorded included: console setup time, 10.8 min (6-47): console operation time, 125 min (90-315); mean bleeding, 150 mL (50-1150); and a 3.6% (9/250) transfusion rate. There was no peroperative mortality, and no conversion to open or laparoscopic surgery was required. Ninety-six percent of patients (240/250) had an adequate postoperative course, with a mean hospital stay of 4.2 days (3-35) and urinary catheter removal after 8 (5-28) days. Overall complication rate was 10.6%, with major complications occurring in only 3.2% of patients (8/250) and consisting of five surgical and three medical complications. Repeat surgery was required in 1.6% of cases (4/250) due to late peritonitis for cecal perforation, bleeding from epigastric artery, perineal percutaneous drainage of retrovesical hematoma, and pelvic urinoma after bladder catheter dislodgment. One patient required selective arterial embolization for persistent hematuria due to vesical artery fistula. Medical complications included acute renal failure due to thrombotic purpura resolved with hemodialysis in one patient and late pulmonary embolism managed with anticoagulation in two patients. Robot malfunction with no surgical implications or need for surgical conversion occurred in four patients (1.6%). Surgical maneuvers required to resolve late complications included one umbilical hernia repair, one meatotomy for meatal stenosis, one bladder neck endoscopic incision after contracture, and one endoscopic extraction of Hem-o-lok and vascular clip following erosion-migration into the bladder. CONCLUSIONS: Robotic radical prostatectomy is a safe and reproducible procedure with optimal functional and oncological results, a shorter learning curve, greater comfort and vision for surgeons, and a complication rate similar to and even better than reported for open and laparoscopic surgery series. Complications decrease with the learning curve, but surgical team experience continues to be the key factor to achieve better results.

SNPSTR rs59186128_D7S820 polymorphism distribution in European Caucasoid, Hispanic, and Afro-American populations.

Single nucleotide polymorphisms (SNPs) in the flanking regions of microsatellite loci (SNPSTRs) help to increase the power of discrimination of short tandem repeat (STR) loci. SNPs are positions in the genome that have been well-conserved over the course of evolution, so analysing them can help distinguish between STR alleles in which the number of repetitions matches due to descent from those which match by chance. This provides support for the determination of biological paternity and other kinship analyses in which mutation needs to be ruled out as grounds for exclusion. Locus D7S820 shows a variable position, SNP rs59186128, in the 5' flanking region. This study is set out (1) to determine the frequencies of SNP rs59186128 in populations with various geographical origins and (2) to estimate the possible contribution of rs59186128 to the allele discrimination of locus D7S820. To that end, individuals from European Caucasoid, Hispanic, and Afro-American populations are studied using denaturing high-performance liquid chromatography, which enables locus rs59186128 to be quickly and highly cost-effectively screened. Moreover, a method is established for determining the haplotypes of SNPSTR rs59186128_D7820. The results show that SNP rs59186128 has a T allele frequency of more than 0.15 in one of the Afro-American populations studied, and the haplotype analysis shows that there is no preferential association between the alleles of SNPSTR rs59186128_D7S820, which supports the idea that they could be useful in forensic applications.

[Radical prostatectomy: evaluation of learning curve outcomes laparoscopic and robotic-assisted laparoscopic techniques with radical retropubic prostatectomy]. / Prostatectomía radical: comparación de los resultados obtenidos durante las curvas de aprendizaje de la técnica laparoscópica pura y de la técnica asistida por robot con la prostatectomía radical retropúbica.

INTRODUCTION/OBJECTIVE: Radical retropubic prostatectomy (RRP) is the gold standard for the surgical treatment of localized prostate cancer. New techniques are being developed with less invasive methods, including laparoscopic radical prostatectomy (LRP) and robotic-assisted laparoscopic radical prostatectomy (RALP). The aim of the study is to compare LRP and RALP outcomes during the learning curve with RRP, especially operative time and surgical complications. MATERIAL AND METHOD: We performed a retrospective observational study of all the RRP cases attended from January 2000, allthe LRPs performed at the Urology Department of the Galdakao Usansolo Hospital and the first 60 RALPs treated by the Clinic Urology group. Baseline parameters, operative and perioperative parameters (nerve preservation, positive margins, intraoperative bleeding, duration of catheterization, hospital stay) and surgical complications were assessed, and the three techniques were compared. RESULTS: The total number of patients was 192. The mean time operation was of 210 min in the RRP group, 345 min in the LRP group and 209.5 min in the RALP group (p = 0). Intraoperative bleeding was of 1500 mL in RRP, 1275 mL in LRP and 400 mL in RALP (p = 0) (Table 1). Six months after the procedure the continence rate was 60% in the RALP group, 45.90% in the RRP group and 36.40% in the group LRP (p = 0.001) (Table 2). CONCLUSIONS: Laparoscopic radical prostatectomy requires a longer learning curve than robotic-assisted prostatectomy. Operative time in RALP procedures was comparable to RRP cases. RALP showed benefits in terms of continence and intraoperative bleeding.

[Renal carcinoma and von Hippel-Lindau disease]. / Carcinoma renal y enfermedad de Von Hippel Lindau.

Von Hippel Lindau disease is a highly uncommon autosomic dominant condition characterised by the presence of cerebellar hemangioblastomas, retina angioma, pancreas, kidney and epididymal cysts, and renal cells carcinoma. This article describes the case report of a male patient with Von Hippel Lindau disease which presented as a jaundice secondary to biliary obstruction due to pancreatic cystic mass. After urological examination, bilateral cystic lesions and right renal solid lesion were detected requiring surgical treatment. A review is made of the diagnostic and therapeutic aspects, highlighting the significance of early diagnosis and treatment.

[Skin metastasis as first manifestation of prostatic adenocarcinoma]. / Metástasis cutáneas como primera manifestación de un adenocarcinoma prostático.

Incidence of prostate disease has seen a sudden boost over the last few years as a result of an increase in male life expectancy. Prostate carcinoma is the third most common cause of cancer mortality in Spain. Post-mortem studies reveal that this is the most prevalent neoplasia in the elderly. 30% of all males over 50 years could host malignant cells in their prostate, although only 20% of these neoplasias have clinical manifestations. Prostate carcinoma expansion occurs by local spreading, as well as lymph and blood dissemination. Local spreading to the urethra, bladder neck, trigonous and seminal vesicles is frequent. Lymph dissemination to obturating, hypogastric, iliac, presacral and paraaortic nodes is a major path for metastasis. Bone metastasis with increased acid phosphatase is the most illustrative sign of prostate adenocarcinoma expansion. Visceral metastasis occur more frequently in lungs, liver and renal glands. There is a 0.3% likelihood of skin metastasis from prostate adenocarcinoma. Considering the rareness of skin metastasis from prostate adenocarcinoma, the case reported in the present paper, first evidence of a prostate carcinoma, is even more exceptional.

Gastric mucosal damage in experimental diabetes in rats: role of endogenous glutathione.

BACKGROUND & AIMS: Spontaneous gastric damage occurs in diabetic rats, but the mechanism is unknown. The aim of this study was to assess the role of glutathione metabolism and gastric mucosal blood flow (GMBF) in the development of such spontaneous gastric damage. METHODS: Mucosal damage, GMBF, glutathione metabolism, and lipid peroxidation were measured in the stomach of diabetic and control rats. RESULTS: Spontaneous gastric damage occurred in fasted diabetic rats 4 weeks after streptozotocin administration or pancreatectomy. This was accompanied by a 50% decrement in mucosal content of glutathione; 48 hours after streptozotocin, the decrement of glutathione was only of 25% and no gastric damage was observed. Fed diabetic rats (4 weeks after streptozotocin) had normal glutathione levels and no damage; however, a 30% glutathione depletion achieved by buthionine-sulfoximine administration promoted significant damage. Gastric glutathione synthetic rate, levels of adenosine triphosphate, oxidized glutathione, and malonyldialdehyde were similar in all groups, whereas cysteine concentration was reduced in fasted diabetic animals. Exogenous cysteine attenuated the gastric damage. GMBF was not influenced by diabetes. CONCLUSIONS: Spontaneous gastric damage in fasted diabetic rats seems to be related to glutathione depletion as a result of limited availability of cysteine and not to increased glutathione oxidation. GMBF changes are not involved.

[Multiple giant ureteral lithiasis]. / Litiasis ureteral gigante múltiple.

OBJECTIVES: Ureteral calculi are usually small and arise from the kidney. The term 'giant' has been applied to ureteral stones that are more than 5 cms in length and/or 50 gms or more in weight. The low incidence of this condition prompted us to report this case. METHODS/RESULTS: Herein we describe a patient with multiple giant ureteral calculi with no evidence of underlying ureteral lesion, who required nephroureterectomy due to the damage caused to the renal unit by the obstructive uropathy. The literature is briefly reviewed, with special reference to the diagnostic and therapeutic aspects. CONCLUSIONS: Giant ureteral calculi are uncommon. They may cause scanty urological symptoms and might therefore be missed. If undiagnosed, renal function may be compromised by the obstructive uropathy.

[Inappropriate antidiuretic hormone secretion syndrome: a rare manifestation of prostatic adenocarcinoma]. / Síndrome de secreción inadecuada de hormona antidiurética: una rara manifestación de adenocarcinoma prostático.

OBJECTIVE: Prostatic cancer can produce signs and symptoms by local growth, direct invasion or distant metastases. In rare occasions, these tumors can show a clinical variance due to trophic factors, biologically active, secreted in neoplastic environment but with systemic relevance. These syndromes are called paraneoplastic syndromes. This uncommon condition is described herein. METHOD/RESULTS: We report a case of inappropriate antidiuretic hormone secretion as the presenting feature of advanced prostatic carcinoma. The pathogenic features, diagnostic and therapeutic aspects are reviewed. CONCLUSIONS: Although its frequency is low, we must consider prostatic carcinoma in patients with inappropriate antidiuretic hormone secretion syndrome. When the acute situation is resolved, hormonal treatment in disseminated carcinomas will return to normal the clinical and analytical parameters derived from this syndrome.

[Cryptorchidism and testicular cancer]. / Criptorquidia y cáncer testicular.

OBJECTIVE: This report underscores the higher risk of testicular cancer in cryptorchidism. METHODS/RESULTS: A patient undergoing evaluation for sterility, who was submitted to orchidopexy 15 years earlier for cryptorchidism, developed a seminoma-like tumor one year following a testicular biopsy that was compatible with testicular atrophy, but with no signs of dysplasia. The literature on the epidemiology, pathogenesis, diagnosis, and treatment is briefly reviewed. CONCLUSIONS: Cryptorchidism is the single factor that carries a higher risk of testicular cancer. This condition has been reported to have 3.5 to 5 times greater risk of progressing to malignancy compared to normal descended testes. Although orchiopexy does not prevent the risk of malignancy, it permits earlier detection. The need to follow these patients closely is underscored.