Insight to urology patients' preferences regarding telemedicine.

INTRODUCTION: Due to COVID-19, telemedicine has become a common method of healthcare delivery. Our goal was to evaluate urology patients' satisfaction with telemedicine, examine patient preferences, and identify opportunities for improvement in readiness, access, and quality of care. MATERIALS AND METHODS: A total of 285 adult urology patients who completed at least one telemedicine visit from September to December 2020 were eligible. A paper survey was disseminated by postal mail with an option to complete electronically. Those who returned completed surveys received a $15 gift card. RESULTS: Seventy-six subjects completed the survey (response rate of 27%). The most common age bracket of the respondents was 70-79 years (37%). Readiness - To prepare, many subjects (49%) read the provided instructions. Most (91%) thought they were adequately prepared. A majority (82%) were satisfied with the ease of set up. Access - Types of visits included established patients (71%), new patient visits (17%), and postoperative visits (9%). Most respondents (84%) did not have difficulty accessing the visit. Quality of care - All respondents were satisfied with the length of visit, and 90% were satisfied with the overall experience. Patient preferences - Compared to office visits, most patients found telemedicine equal or superior in several areas. Preference to utilize telemedicine in the future was dependent on the nature of the complaint, length of their drive and their schedule. CONCLUSIONS: Patients reported high levels of satisfaction and a willingness to engage with telemedicine visits. To minimize future technical disruptions, we offer mock telehealth visits before their scheduled appointment and improved our clinicians' work flow.

Traumatic injury induces stress granule formation and enhances motor dysfunctions in ALS/FTD models.

Traumatic brain injury (TBI) has been predicted to be a predisposing factor for amyotrophic lateral sclerosis (ALS) and other neurological disorders. Despite the importance of TBI in ALS progression, the underlying cellular and molecular mechanisms are still an enigma. Here, we examined the contribution of TBI as an extrinsic factor and investigated whether TBI influences the susceptibility of developing neurodegenerative symptoms. To evaluate the effects of TBI in vivo, we applied mild to severe trauma to Drosophila and found that TBI leads to the induction of stress granules (SGs) in the brain. The degree of SGs induction directly correlates with the level of trauma. Furthermore, we observed that the level of mortality is directly proportional to the number of traumatic hits. Interestingly, trauma-induced SGs are ubiquitin, p62 and TDP-43 positive, and persistently remain over time suggesting that SGs might be aggregates and exert toxicity in our fly models. Intriguingly, TBI on animals expressing ALS-linked genes increased mortality and locomotion dysfunction suggesting that mild trauma might aggravate neurodegenerative symptoms associated with ALS. Furthermore, we found elevated levels of high molecular weight ubiquitinated proteins and p62 in animals expressing ALS-causing genes with TBI, suggesting that TBI may lead to the defects in protein degradation pathways. Finally, we observed that genetic and pharmacological induction of autophagy enhanced the clearance of SGs and promoted survival of flies in vivo. Together, our study demonstrates that trauma can induce SG formation in vivo and might enhance neurodegenerative phenotypes in the fly models of ALS.

Transcorporal Artificial Urinary Sphincter Technique Video.

OBJECTIVE: The artificial urethral sphincter (AUS) is the gold standard treatment for male stress urinary incontinence which commonly results from prostatectomy or pelvic radiation for prostate cancer. Patients with prior pelvic radiation history experience increased risk of developing urethral erosion. Transcorporal AUS (TAUS) placement can be used as an alternative for compromised urethras to incorporate a small portion of the corporal bodies for additional support. The inclusion of an additional tissue barrier has been shown to improve outcomes. Patients who undergo this technique require device explanation and AUS revision less often than those with AUS devices placed in the standard fashion. Additionally, TAUS placement has been shown to improve functional urinary outcomes such as postoperative Internal prostate symptom score (IPSS), and postoperative IPSS Quality of Life (QoL) scores. MATERIALS AND METHODS: A 67-year-old male with a past medical history of prostate cancer treated with surgery and radiation underwent a TAUS placement which was filmed to demonstrate placement technique and tips. Informed consent was obtained prior to filming this video. RESULTS: This technique can serve as a successful primary or salvage AUS placement technique as seen in this video. CONCLUSION: This video is used to demonstrate the technique of TAUS placement.

A case report of a proximal corporal cavernosa injury presenting with butterfly perineal ecchymosis.

This is a case of a proximal corpus cavernosa fracture presenting with scrotal edema and butterfly perineal ecchymosis sparing the penile shaft. Preoperative MRI obviated the need for circumferential incision and degloving of the penis and guided immediate incision over the area of corporal injury. The presentation, diagnostic work-up, and surgical treatment are discussed.

Knowledge of Cervical Cancer Prevention Among Women in Amazonian Peru.

Background and Purpose: Survey-based research was conducted in Yantalo, Peru, a rural Amazonian community, to assess the knowledge base among women surrounding cervical cancer, human papilloma virus (HPV), and preventative health practices as well as to gain a better understanding of barriers to accessing care. Methods: A total of 217 women were interviewed out of the 1612 female inhabitants of Yantalo utilizing a structured interview-style questionnaire with both closed and open-ended questions. Results: Our average respondent was 41.6 years old with the equivalent of some high school education. Approximately 75% of respondents reported that they had heard of HPV and/or cervical cancer, with 44.4% reporting they had received a test to check for cervical cancer within their lifetime. When given a 10-question knowledge assessment regarding safe sex practices and cervical cancer, women obtained an average score of 57.3%. When asked about receiving the HPV vaccine, 29% reported "Yes", 59.4% reported "No", and 11.6% reported "I don't know." Although 62.6% of women indicated that they have "easy access to cervical cancer screening," 37.4% of women reported experiencing at least one barrier to accessing care. The highest reported barriers include fear of the test causing them pain and/or lack of knowledge of the necessity cervical cancer testing. Cervical cancer rates in Peru are approximately three times that in developed countries. Conclusions: Gathering data surrounding knowledge and the barriers among the female population in rural communities is essential to developing targeted initiatives that address pertinent obstacles within these and other vulnerable communities.

Muscleblind acts as a modifier of FUS toxicity by modulating stress granule dynamics and SMN localization.

Mutations in fused in sarcoma (FUS) lead to amyotrophic lateral sclerosis (ALS) with varying ages of onset, progression and severity. This suggests that unknown genetic factors contribute to disease pathogenesis. Here we show the identification of muscleblind as a novel modifier of FUS-mediated neurodegeneration in vivo. Muscleblind regulates cytoplasmic mislocalization of mutant FUS and subsequent accumulation in stress granules, dendritic morphology and toxicity in mammalian neuronal and human iPSC-derived neurons. Interestingly, genetic modulation of endogenous muscleblind was sufficient to restore survival motor neuron (SMN) protein localization in neurons expressing pathogenic mutations in FUS, suggesting a potential mode of suppression of FUS toxicity. Upregulation of SMN suppressed FUS toxicity in Drosophila and primary cortical neurons, indicating a link between FUS and SMN. Our data provide in vivo evidence that muscleblind is a dominant modifier of FUS-mediated neurodegeneration by regulating FUS-mediated ALS pathogenesis.