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1.
Cell ; 169(1): 161-173.e12, 2017 03 23.
Article in English | MEDLINE | ID: mdl-28340341

ABSTRACT

Generating a precise cellular and molecular cartography of the human embryo is essential to our understanding of the mechanisms of organogenesis in normal and pathological conditions. Here, we have combined whole-mount immunostaining, 3DISCO clearing, and light-sheet imaging to start building a 3D cellular map of the human development during the first trimester of gestation. We provide high-resolution 3D images of the developing peripheral nervous, muscular, vascular, cardiopulmonary, and urogenital systems. We found that the adult-like pattern of skin innervation is established before the end of the first trimester, showing important intra- and inter-individual variations in nerve branches. We also present evidence for a differential vascularization of the male and female genital tracts concomitant with sex determination. This work paves the way for a cellular and molecular reference atlas of human cells, which will be of paramount importance to understanding human development in health and disease. PAPERCLIP.


Subject(s)
Embryo, Mammalian/cytology , Fetus/cytology , Human Development , Imaging, Three-Dimensional/methods , Immunohistochemistry/methods , Microscopy/methods , Embryonic Development , Humans , Organogenesis , Peripheral Nervous System/cytology , Peripheral Nervous System/growth & development
2.
Acta Radiol ; 65(5): 513-519, 2024 May.
Article in English | MEDLINE | ID: mdl-38720456

ABSTRACT

The Ancient Greeks were great innovators in all academic fields, including medicine. Hippocrates of Kos, the Father of Medicine, established many terms for the genitourinary (GU) system, such as nephros, urethra, urogenital, and adenocarcinoma. According to Hesiod's Theogony, Aphrodite, the goddess of love and beauty, was born off the coast of Kythera, from the foam produced by Uranus's genitals, after his son Cronus had thrown them into to the sea. In this review, we present the etymology of the GU vocabulary, review the Ancient Greeks' understanding of the GU system and the origins of Greek myths related to the male genitals.


Subject(s)
Urogenital System , History, Ancient , Humans , Greece, Ancient , Male , Terminology as Topic
3.
J Obstet Gynaecol Res ; 50(1): 5-14, 2024 Jan.
Article in English | MEDLINE | ID: mdl-37922953

ABSTRACT

AIM: The concept of regaining childbearing ability via uterus transplantation (UTx) motivates many infertile women to pursue giving birth to their own children. This article provides insight into maternal and neonatal outcomes of the procedure globally and facilitates quality of care in related medical fields. METHODS: The authors searched ISI Web of Science, MEDLINE, non-PubMed-indexed journals, and common search engines to identify peer-review publications and unpublished sources in scientific reference databases. RESULTS: The feasibility of the procedure has been proven with 46 healthy children in 88 procedures so far. Success relies upon dedicated teamwork involving transplantation surgery, obstetrics and reproductive medicine, neonatology, pediatrics, psychology, and bioethics. However, challenges exist owing to donor, recipient, and fetus. Fetal growth in genetically foreign uterine allograft with altered feto-maternal interface and vascular anatomy, immunosuppressive exposure, lack of graft innervation leading to "unable-to-feel" uterine contractions and conception via assisted reproductive technology create notable risks during pregnancy. Significant portion of women are complicated by at least one or more obstetric problems. Preeclampsia, gestational hypertension and diabetes mellitus, elevated kidney indices, and preterm delivery are common complications. CONCLUSIONS: UTx has short- and long-term satisfying outcome. Advancements in the post-transplant management would undoubtedly lead this experimental procedure into mainstream clinical practice in the near future. However, both women and children of UTx need special consideration due to prematurity-related neonatal problems and the long-term effects of transplant pregnancy. Notable health risks for the recipient and fetus should be discussed with potential candidates for UTx.


Subject(s)
Infertility, Female , Pregnancy Complications , Infant, Newborn , Pregnancy , Female , Humans , Child , Infertility, Female/surgery , Uterus/transplantation , Reproductive Techniques, Assisted/adverse effects , Tissue Donors
4.
Clin Anat ; 37(4): 405-412, 2024 May.
Article in English | MEDLINE | ID: mdl-37493239

ABSTRACT

Polyorchidism, a congenital malformation characterized by supernumerary testes (SNTs), is usually revealed incidentally during ultrasound or open scrotal surgery. In the approximately 200 cases so far published in the literature, the left side is affected more often than the right. Despite the rarity of this anomaly, a surgeon must have basic knowledge of its embryological basis and classifications to implement proper treatment and avoid overlooking it, since the consequences could harm the patient. This review summarizes previous classifications. It can be assumed that determining the risk of malignancy, and the level of reproductive potential based on location, vascularization, ductus deferens drainage, and environmental factors (e.g., temperature) affecting the SNTs, indicates the best approach to management. Therefore, we have created a new classification based on previous ones, addressing the aforementioned issues, which will guide the clinician to select the most appropriate treatment.


Subject(s)
Neoplasms , Testicular Diseases , Male , Humans , Testicular Diseases/pathology , Testicular Diseases/surgery , Scrotum , Ultrasonography
5.
Occup Environ Med ; 80(5): 288-296, 2023 05.
Article in English | MEDLINE | ID: mdl-36828632

ABSTRACT

A systematic review was performed aiming to identify the various occupational risk factors of lower urinary tract symptoms (LUTS) among female workers. A systematic, comprehensive literature search of PubMed, Embase and Cochrane Library databases was conducted to identify studies published until 24 November 2021, evaluating the possible occupational risk factors of LUTS among female workers. Two reviewers assessed all articles retrieved through a computerised search for eligibility using predetermined criteria. Data on the first author, publication year, country, study design, participants, identified occupational risk factors, outcome variables and main results were extracted from the selected articles. The Newcastle-Ottawa Quality Assessment Scale guidelines were adopted to estimate the quality scores. Overall, our search yielded a total of 16 articles suitable for review. The occupational risk factors identified in the studies were strenuous physical demand and activity, prolonged sitting, occupational stress, shift work, limited use of the toilet at work and other occupational environments (eg, an unclean and uncomfortable workplace, dangerous job and probability of accidents, feeling pressed for time and awkward position for long periods). The findings of this review may raise awareness regarding the risk of LUTS among female workers with these factors. From an occupational health perspective, the implementation of tailored prevention strategies based on these occupational factors may prevent female workers from developing LUTS. PROSPERO registration number CRD42022316728.


Subject(s)
Lower Urinary Tract Symptoms , Occupational Health , Occupational Stress , Humans , Female , Workplace , Lower Urinary Tract Symptoms/epidemiology , Lower Urinary Tract Symptoms/etiology , Risk Factors
6.
Occup Environ Med ; 80(2): 93-96, 2023 02.
Article in English | MEDLINE | ID: mdl-36572527

ABSTRACT

OBJECTIVE: The association between periconceptional parental exposure to endocrine-disrupting chemicals (EDCs) and hypospadias remains inconclusive and controversial. Therefore, we conducted a hospital-based retrospective study to assess the relationship between hypospadias risk and parental occupational exposure to potential EDCs. METHODS: Incident cases (n=73) were boys between 0 and 14 years diagnosed with hypospadias with no micropenis or cryptorchidism. Controls (n=146) were an age-matched group of boys without any congenital malformations, inguinal hernia, nephrological, urological and genital disorders. Their selection was independent of exposures to EDCs. Data on parental occupation and sociodemographic variables were collected using a structured questionnaire. We evaluated parental occupational exposures using a previously validated job-exposure matrix (JEM) for EDCs. RESULTS: In our case-control study, 30.1% of all pregnancies had likely exposure to potential EDCs. The most prevalent occupations conferring possible exposure were related to activities on farms. Maternal and paternal occupational exposure to potential EDCs significantly increased the risk of mild hypospadias than moderate-to-severe hypospadias (OR=6.55 vs OR=4.63). Among various categories, parental occupational exposure to pesticides was associated with at least a twofold increased risk of hypospadias. Maternal EDC exposure during the first trimester significantly increased the risk of bearing a hypospadiac child (OR=4.72 (95% CI 2.10 to 10.60)). CONCLUSION: This study suggests that EDCs are a risk factor for hypospadias through occupational exposure during fetal life.


Subject(s)
Endocrine Disruptors , Hypospadias , Occupational Exposure , Child , Female , Humans , Male , Pregnancy , Case-Control Studies , Endocrine Disruptors/adverse effects , Hypospadias/chemically induced , Hypospadias/epidemiology , Maternal Exposure/adverse effects , Occupational Exposure/adverse effects , Retrospective Studies , Infant, Newborn , Infant , Child, Preschool , Adolescent
7.
Emerg Med J ; 40(2): 134-139, 2023 Feb.
Article in English | MEDLINE | ID: mdl-36526335

ABSTRACT

BACKGROUND: We sought to determine which demographic, clinical and ultrasonography characteristics are predictive of testicular torsion (TT) and to determine factors associated with time to treatment. METHODS: We retrospectively reviewed all medical records of patients (0-17 years) with acute scrotal syndrome (ASS) who were treated in our hospital in Lithuania between 2011 and 2020. We extracted patients' demographic data, in-hospital time intervals, clinical, US and surgical findings. TT was determined at surgery or clinically after manual detorsion. Test characteristics of demographic, clinical and US findings for the diagnosis of TT versus other causes of ASS were determined. We performed a multivariate analysis to identify independent clinical predictors of torsion, and factors associated with surgical delay. RESULTS: A search of medical records yielded 555 cases: 196 (35%) patients with TT and 359 (65%) patients with other ASS causes. Multivariate logistic regression analysis showed that age between 13 and 17 years (OR 8.39; 95% CI 5.12 to 13.76), duration of symptoms <7 hours (OR 3.41; 95% CI 2.03 to 5.72), palpated hard testis (OR 4.65; 95% CI 2.02 to 10.67), scrotal swelling (OR 2.37; 95% CI 1.31 to 4.30), nausea/vomiting (OR 4.37; 95% CI 2.03 to 9.43), abdominal pain (OR 2.38; 95% CI 1.27 to 4.45) were independent clinical predictors of TT. No testicular blood flow in Doppler US had a specificity of 98.2% and a positive predictive value of 94.6%. However, 75 (41.7%) patients with TT had normal testicular blood flow, yielding low sensitivity (58.3%) and negative predictive value of 81.3% for this US finding. In-hospital waiting time for surgery was longer in patients with TT with normal testicular blood flow by USS (195 min) compared with no blood flow (123 min), p<0.01. Higher orchiectomy rates were associated with longer duration of symptoms (p<0.001) and longer waiting time for USS (p=0.029) but not with false-negative US. CONCLUSIONS: Pubertal age, symptoms duration of <7 hours, nausea/vomiting, palpated hard testis, abdominal pain and scrotal swelling are predictive factors for TT. Time lost between symptom onset and seeking medical care, and between arrival and US are associated with the need for orchiectomy. Preserved blood flow in USS does not rule out TT and may contribute to delays to surgery.


Subject(s)
Spermatic Cord Torsion , Adolescent , Humans , Male , Abdominal Pain , Retrospective Studies , Risk Factors , Spermatic Cord Torsion/diagnostic imaging , Ultrasonography, Doppler
8.
Occup Environ Med ; 79(3): 200-206, 2022 03.
Article in English | MEDLINE | ID: mdl-34510005

ABSTRACT

OBJECTIVES: To examine age at diagnosis, prognostic factors and survival of prostate cancer (PCa) in Norwegian firefighters and three other occupations undergoing occupational health check-ups, and comparing with PCa cases in the general population. METHODS: All PCa cases diagnosed in 1960-2017 were extracted from the Cancer Registry of Norway. Firefighters, military employees, pilots and police officers were identified through occupational data from Statistics Norway. Age at diagnosis, clinical stage, prostate-specific antigen (PSA), Gleason score, performance status and overall survival and PCa-specific survival in cases in these occupations were compared with cases in the general population. RESULTS: Firefighters were significantly younger at PCa diagnosis than cases in the general population in 1960-1993 (mean difference: 2.1 years) and 2007-2017 (mean difference: 4.3 years). At diagnosis, firefighters had significantly lower PSA values, Gleason scores and performance status scores than the general population. Firefighters diagnosed in 2007-2017 had lower risk of all-cause death than the general population (crude HR 0.71 (0.53-0.95)). No difference remained after adjusting for age at diagnosis (HR 1.03 (0.77-1.37)). Firefighters were older at diagnosis in 1994-2006 (mean difference: 3.0 years), but showed no other significant differences in age at diagnosis, PSA values, Gleason scores or performance status compared with military employees, pilots and police officers. CONCLUSIONS: Younger age and better prognostic factors at PCa diagnosis among firefighters and other occupations with requirements for health check-ups than cases in the general population may indicate an increased diagnostic intensity, likely contributing to elevated PCa incidence in such occupations.


Subject(s)
Firefighters , Prostatic Neoplasms , Age of Onset , Early Detection of Cancer , Humans , Male , Norway , Occupations , Prognosis , Prostate-Specific Antigen , Prostatic Neoplasms/epidemiology
9.
Gynecol Endocrinol ; 38(7): 612-614, 2022 Jul.
Article in English | MEDLINE | ID: mdl-35532169

ABSTRACT

BACKGROUND: The presence of a rare lesion for pediatric population, encountered in twins, as far as we know, is an exceptional event. The event made the management of a pathology, for which there are no guidelines in the pediatric field, even more delicate. CASE REPORT: Two twin sisters came to our attention, a short time after each other, due to the presence of a voluminous abdominal mass. After complete resection, the histological diagnosis was that of a paraovarian cystoadenofibroma. DISCUSSION: In pediatric surgery being minimally invasive is mandatory. However in selected cases the only objective, especially speaking of pediatric patients, ais to be radical and to protect the adnexal structures.


Subject(s)
Siblings , Twins , Adolescent , Child , Humans
10.
Pediatr Radiol ; 52(5): 985-997, 2022 05.
Article in English | MEDLINE | ID: mdl-34839376

ABSTRACT

Congenital abnormalities of the kidney and urinary tract include a wide range of malformations ranging from asymptomatic to life-threatening conditions. Although pediatric urogenital system imaging is based on the use of US (pre- and postnatal), voiding cystourethrography and scintigraphic study, magnetic resonance (MR) urography plays a fundamental role in the classification and management of congenital abnormalities of the kidney and urinary tract, giving an overview of the different clinical pictures, thanks to its panoramicity and high anatomical detail. In fact the anomalies of the urinary tract are phenotypically variable because they can affect simultaneously several segments of different embryonic derivation, with complex clinical pictures; they can appear both as isolated phenotypes or as complex malformative conditions, involving renal parenchyma, collecting system and bladder. A deep knowledge of this complex embryogenesis and its possible phenotypic patterns allows a correct interpretation of MR urography images. We describe the embryology and pathophysiology of congenital abnormalities of the kidney and urinary tract as well as MR urography technique and findings. Congenital abnormalities of the kidney and urinary tract are classified into four groups: (1) obstruction (proximal, middle and distal), (2) budding with respect to the Wolffian duct (site and number of ureter), (3) ascent and rotation (ectopia, malrotation and fusion of kidney) and (4) anomaly of metanephric differentiation (dysplasia, megapolicalycosis).


Subject(s)
Urinary Tract , Urography , Child , Humans , Kidney/abnormalities , Magnetic Resonance Imaging/methods , Magnetic Resonance Spectroscopy , Radiologists , Urinary Tract/diagnostic imaging , Urography/methods
11.
Int J Urol ; 28(1): 91-97, 2021 Jan.
Article in English | MEDLINE | ID: mdl-33169456

ABSTRACT

OBJECTIVE: To report our institutional experience with treatment of primary genitourinary soft tissue sarcoma. METHODS: We retrospectively reviewed the medical records of adult soft tissue sarcoma patients treated between March 2005 and May 2019. The primary tumor sites included the prostate, kidney, urinary bladder and the paratesticular structures. RESULTS: A total of 19 patients - 16 men (84%) and three women (16%) - were enrolled in the study. The median age was 41 years (range 20-79 years). The most common primary site was the prostate (in eight patients; 42%), and prostatic sarcoma patients were younger than patients with sarcomas of other origins. The most common histological subtype was leiomyosarcoma (in five patients; 26%). The overall survival rates after 1, 3 and 5 years were 61.5%, 34.4% and 25.8%, respectively. The median survival time was 20.7 months (95% confidence interval 5.9-35.5 months). Univariate analysis showed that an absence of metastasis at diagnosis and complete surgical resection were predictive of favorable survival. In the chemotherapy group, the objective response rate was 20.5%. Pazopanib was administered to nine patients in the late-line setting, and the objective response rate was 11.1%; six grade ≥3 adverse events were observed in three patients. CONCLUSIONS: Inoperable metastatic genitourinary soft tissue sarcoma remains difficult to treat, as previously reported. Further investigation on this malignancy, including optimization of currently available antitumor drugs and the development of novel therapeutic agents, is required.


Subject(s)
Antineoplastic Agents , Sarcoma , Soft Tissue Neoplasms , Adult , Aged , Antineoplastic Agents/therapeutic use , Female , Humans , Male , Middle Aged , Retrospective Studies , Sarcoma/drug therapy , Soft Tissue Neoplasms/drug therapy , Survival Rate , Young Adult
12.
Radiologe ; 61(7): 677-688, 2021 Jul.
Article in German | MEDLINE | ID: mdl-34170363

ABSTRACT

The acute abdomen is a potentially life-threatening condition and requires a rapid diagnosis. After clinical inspection and in cases with unclear ultrasound findings or unclear serious symptoms computed tomography (CT) and in pregnant women and children magnetic resonance imaging (MRI) is usually necessary. This second part of "Imaging in the acute abdomen" focuses on frequent organ specific causes of the gastrointestinal tract and the urogenital system.


Subject(s)
Abdomen, Acute , Abdomen, Acute/diagnostic imaging , Abdomen, Acute/etiology , Child , Female , Gastrointestinal Tract/diagnostic imaging , Humans , Magnetic Resonance Imaging , Pregnancy , Tomography, X-Ray Computed , Urogenital System/diagnostic imaging
13.
Medicina (Kaunas) ; 57(3)2021 Mar 17.
Article in English | MEDLINE | ID: mdl-33802895

ABSTRACT

Interventional radiology of the male urogenital system includes percutaneous and endovascular procedures, and these last consist mostly of transcatheter arterial embolizations. At the kidney level, arterial embolizations are performed mainly for palliative treatment of parenchymal tumors, for renal traumas and, less frequently, for arteriovenous fistulas and renal aneurysms and pseudoaneurysms. These latter may often require emergency intervention as they can cause renal or peri-renal hematomas or significant hematuria. Transcatheter arterial embolization is also an effective therapy for intractable severe bladder hematuria secondary to a number of neoplastic and inflammatory conditions in the pelvis, including unresectable bladder cancer and radiation-induced or cyclophosphamide-induced hemorrhagic cystitis. Endovascular interventional procedures for the penis are indicated for the treatment of post-traumatic priapism. In this article, we review the main endovascular radiological interventions of the male urogenital system, describing the technical aspects, results, and complications of each procedure at the various anatomical districts.


Subject(s)
Aneurysm, False , Arteriovenous Fistula , Embolization, Therapeutic , Endovascular Procedures , Arteriovenous Fistula/diagnostic imaging , Arteriovenous Fistula/therapy , Humans , Male , Radiology, Interventional , Treatment Outcome
14.
Clin Genet ; 97(1): 168-178, 2020 01.
Article in English | MEDLINE | ID: mdl-31420870

ABSTRACT

The Ehlers-Danlos syndromes (EDS) and associated hypermobility spectrum disorders (HSD) are a heterogenous group of connective tissue disorders associated with significant morbidity. The urogenital aspects of these disorders are understudied and there is little guidance on the prevalence, types, or outcomes of urogenital complications in EDS/HSD. Our objective was to perform a scoping review to characterize and synthesize the literature reporting urogenital and pelvic complications in EDS/HSD patients. We performed a systematic search of three databases (Medline, CINAHL, Embase) to January 2019. English language, full-text articles reporting on urogenital or pelvic complications in EDS/HSD were included. A total of 105 studies were included (62 case reports/series, 43 observational) involving patients with hypermobile (23%), vascular (20%), classical (12%) EDS, and HSD (24%). Some studies looked at multiple subtypes (11%) or did not report subtype (33%). Reported complications included urinary (41%), gynecological (36%), obstetrical (25%), renal (9%), and men's health problems (7%), with some studies reporting on multiple areas. Urinary and gynecological complications were most prevalent in patients with HSD, while a broad range of complications were reported in EDS. While further research is required, results suggest a higher index of suspicion for urogenital problems is probably warranted in this population.


Subject(s)
Connective Tissue Diseases/epidemiology , Ehlers-Danlos Syndrome/epidemiology , Joint Instability/epidemiology , Urogenital Abnormalities/epidemiology , Connective Tissue Diseases/complications , Connective Tissue Diseases/genetics , Connective Tissue Diseases/pathology , Ehlers-Danlos Syndrome/complications , Ehlers-Danlos Syndrome/genetics , Ehlers-Danlos Syndrome/pathology , Female , Humans , Joint Instability/complications , Joint Instability/genetics , Joint Instability/pathology , Male , Urogenital Abnormalities/complications , Urogenital Abnormalities/genetics , Urogenital Abnormalities/pathology
15.
J Sex Med ; 17(4): 603-613, 2020 04.
Article in English | MEDLINE | ID: mdl-31953029

ABSTRACT

INTRODUCTION: The projection of the human male urogenital system onto the paracentral lobule has not previously been mapped comprehensively. AIM: To map specific urogenital structures onto the primary somatosensory cortex toward a better understanding of sexual response in men. METHODS: Using functional magnetic resonance imaging, we mapped primary somatosensory cortical responses to self-stimulation of the penis shaft, glans, testicles, scrotum, rectum, urethra, prostate, perineum, and nipple. We further compared neural response with erotic and prosaic touch of the penile shaft. MAIN OUTCOME MEASURE: We identified the primary mapping site of urogenital structures on the paracentral lobule and identified networks involved in perceiving touch as erotic. RESULTS: We mapped sites on the primary somatosensory cortex to which components of the urogenital structures project in men. Evidence is provided that penile cutaneous projection is different from deep penile projection. Similar to a prior report in women, we show that the nipple projects to the same somatosensory cortical region as the genitals. Evidence of differential representation of erotic and nonerotic genital self-stimulation is also provided, the former activating sensory networks other than the primary sensory cortex, indicating a role of "top-down" activity in erotic response. CLINICAL IMPLICATIONS: We map primary sites of projection of urogenital structures to the primary somatosensory cortex and differentiate cortical sites of erotic from nonerotic genital self-stimulation. STRENGTH & LIMITATIONS: To our knowledge, this is the first comprehensive mapping onto the primary somatosensory cortex of the projection of the components of the urogenital system in men and the difference in cortical activation in response to erotic vs nonerotic self-stimulation. The nipple was found to project to the same cortical region as the genitals. Evidence is provided that superficial and deep penile stimulation project differentially to the cortex, suggesting that sensory innervation of the penis is provided by more than the (pudendal) dorsal nerve. CONCLUSION: This study reconciles prior apparently conflicting findings and offers a comprehensive mapping of male genital components to the paracentral lobule. We provide evidence of differential projection of light touch vs pressure applied to the penile shaft, suggesting differential innervation of its superficial, vs deep structure. Similar to the response in women, we found nipple projection to genital areas of the paracentral lobule. We also provide evidence of differential representation of erotic and nonerotic genital self-stimulation, the former activating sensory networks other than the primary sensory cortex, indicating a role of top-down activity in erotic response. Allen K, Wise N, Frangos E, et al. Male Urogenital System Mapped Onto the Sensory Cortex: Functional Magnetic Resonance Imaging Evidence. J Sex Med 2020;17:603-613.


Subject(s)
Brain Mapping/methods , Genitalia/physiology , Magnetic Resonance Imaging , Penis/physiology , Adult , Erotica/psychology , Humans , Male , Middle Aged , Penis/innervation , Scrotum/physiology , Young Adult
16.
Urologiia ; (1): 116-120, 2020 Mar.
Article in Russian | MEDLINE | ID: mdl-32191013

ABSTRACT

A review of modern literature on the study of microbiota of the genitourinary system by methods of chromatography-mass spectrometry and sequencing of urine specimens is presented in the article. The sequencing method is used to analyze microbiota of different organs. Obtained results of the genomic analysis have revealed cases of infection by potential pathogenic microorganisms, which are often not diagnosed during standard urine culture due to specific requirements for culture media.


Subject(s)
Microbiota
17.
Article in Russian | MEDLINE | ID: mdl-32827369

ABSTRACT

The article presents the results of studying state and trends of incidence of adult urban population in the city of Moscow by the classes of diseases of the genitourinary system. The purpose of study was to analyze urogenital morbidity of population of metropolis as compared with similar indices of the Central Federal Okrug and the Russian Federation in 2014-2018. The corresponding official statistical data of the Minzdrav of Russia and research publications were studied. It was established that permanent monitoring of dynamics of urological morbidity can be considered as important methodological and informational and analytical base for planning medical care of population, that makes it possible to develop in practice the basis of development and implementation of integrated system of measures of development of community-based and hospital care, which must be taken into account by the administration of medical organizations and health care management at various levels.


Subject(s)
Female Urogenital Diseases/mortality , Male Urogenital Diseases/mortality , Urogenital System , Female , Female Urogenital Diseases/epidemiology , Humans , Incidence , Male , Male Urogenital Diseases/epidemiology , Morbidity , Moscow , Russia
18.
Rheumatol Int ; 39(7): 1269-1277, 2019 07.
Article in English | MEDLINE | ID: mdl-31073659

ABSTRACT

To present a case of prostate involvement (PI) in granulomatosis polyangiitis (GPA) and analyse related published reports. We employed the following keywords for retrieving reports indexed by MEDLINE/PubMed and/or Scopus: "granulomatosis with polyangiitis", "Wegener granulomatosis" and "prostate involvement". Additional searches were performed through Google Scholar and HINARI. All cases that fulfilled the American College of Rheumatology criteria for GPA, standards of Chapel Hill Consensus Conference, and did not match with exclusion criteria were analysed and summarised. A 35-year-old man presented with complaints of stuffy nose, difficulty breathing through the nose, swelling and pain in the left half of the nose, low-grade fever, and discomfort. The nasal mucosal biopsy did not reveal any specific changes. During the inpatient treatment, he developed eye redness, tearing, dysuria, and decreased urinary stream. Prostate-specific antigen (PSA) was elevated (2.81 µg/L; normal values ≤ 1.4 µg/L for males below 40 years). Prostate biopsy findings were consistent with diagnosis of GPA, which was confirmed by detecting elevated anti-PR3 antibodies (4.1 IU; normal values < 1.0 IU). We analysed our case in view of the clinical course of 45 published cases of PI in GPA. PI in GPA is a rare clinical manifestation of the vasculitis. Patients with atypical clinical symptoms of GPA are at risk of delayed diagnosis. The awareness of variable clinical presentations of GPA, particularly specific affection of the prostate gland, is crucial for timely diagnosis.


Subject(s)
Granulomatosis with Polyangiitis/diagnosis , Prostate/pathology , Adult , Granulomatosis with Polyangiitis/blood , Granulomatosis with Polyangiitis/pathology , Humans , Male , Prostate-Specific Antigen/blood
19.
Arch Gynecol Obstet ; 300(4): 1067-1082, 2019 10.
Article in English | MEDLINE | ID: mdl-31529363

ABSTRACT

PURPOSE: The aim of the study was to investigate the oxidative damage and inflammatory effects of sepsis on the urogenital system in the Lipopolysaccharide (LPS)-induced sepsis model and ameliorating role of Pregabalin (PGB). METHODS: Twenty-four female Wistar Albino rats (12 months old) were divided into 3 groups as follows: Sepsis group (Group S) (5 mg/kg LPS, i.p, single dose); Sepsis+ PGB group (Group SP) (5 mg/kg LPS, i.p, single dose and 30 mg/kg PGB); Control group (Group C) (0.1 ml/oral and i.p. saline, single dose), 6 h after LPS administration, the animals were killed. Subsequently, analyses of urogenital tissue oxidant/antioxidant status, histopathological and immunohistochemical analyses were performed. RESULTS: Total oxidative status (TOS) and oxidative stress index (OSI) values in the urogenital tissues were increased in Group S (Total anti-oxidative status (TAS) decreased) compared to the Control group (p < 0.05). PGB improved these values (p < 0.05). The immunohistochemical markers [Caspase-3, granulocyte colony-stimulating factor (G-CSF), interleukin-6 (IL-6), Serum Amyloid A (SAA) and inducible nitric oxide synthase (iNOS)] were significantly increased in Group S except for bladder (p < 0.001). Statistically significant immunohistochemical positiveness was found only for IL-6 in urinary bladder, though all the others values were negative. With the administration of PGB (Group SP), the expressions of these immunoreactions were markedly decreased (p < 0.001). CONCLUSIONS: These findings demonstrated that sepsis caused oxidative stress and inflammation in the urogenital tissues. We have revealed that PGB ameliorated tissue damage caused by sepsis.


Subject(s)
Antioxidants/therapeutic use , Pregabalin/therapeutic use , Sepsis/drug therapy , Urogenital System/drug effects , Animals , Biomarkers/metabolism , Caspase 3/metabolism , Female , Inflammation/metabolism , Interleukin-6 , Lipopolysaccharides , Nitric Oxide Synthase Type II/metabolism , Oxidation-Reduction , Oxidative Stress/drug effects , Rats , Rats, Wistar , Urogenital System/immunology , Urogenital System/metabolism
20.
Arch Gynecol Obstet ; 300(4): 941-955, 2019 10.
Article in English | MEDLINE | ID: mdl-31435776

ABSTRACT

PURPOSE: The aim of the study was to evaluate the harmful effects of sepsis on the urogynecological tissues and the ability of Lacosamide (LCM) on Lipopolysaccharide (LPS)-induced cytokine production, oxidative stress and apoptotic pathways, in the experimental rat sepsis model. METHODS: Twenty-four female Wistar albino rats (12 months old) were divided into 3 groups as follows: control group (Group I) (0.1 ml/oral and i.p. saline, single dose), sepsis group (Group II) (5 mg/kg LPS, i.p. single dose) and sepsis + LCM group (Group III) (5 mg/kg LPS, i.p. single dose and 40 mg/kg LCM). Six hours after the last LPS administration, the animals were sacrificed. Subsequently, the analyses of urogenital tissues total oxidant/antioxidant status, histopathological and immunohistochemical analyses were performed. RESULTS: Total oxidant capacity (TOC) and oxidative stress index (OSI) values in the urogenital tissues were increased in the urogenital tissues in Group II [Total antioxidant capacity (TAC) was decreased] compared to group I (p < 0.05). LCM improved these values (p < 0.05). The immunohistochemical markers (Tumor Necrosis Factor-alpha (TNF-α), interleukin-1 beta (IL-1ß), heat shock protein 70 (HSP-70), C-reactive protein (CRP), Malondialdehyde (MDA) were significantly increased in Group II (p < 0.001). With the administration of LCM (Group III), the expressions of above-mentioned markers were markedly decreased (p < 0.001). Marked hyperemia and slight hemorrhages with neutrophil leukocyte infiltrations were seen histopathologically in Group II. LCM treatment ameliorated the pathological findings. CONCLUSION: These findings demonstrated that sepsis caused oxidative stress, apoptosis and inflammation in the urogenital tissues. We revealed that LCM ameliorated the damage caused by sepsis in urogenital tissue.


Subject(s)
Lacosamide/therapeutic use , Sepsis/complications , Sepsis/drug therapy , Urogenital System/drug effects , Urogenital System/pathology , Voltage-Gated Sodium Channel Blockers/therapeutic use , Animals , Female , Lacosamide/pharmacology , Male , Rats , Rats, Wistar , Sepsis/pathology , Voltage-Gated Sodium Channel Blockers/pharmacology
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