Comparison of water vapor thermal therapy and prostate artery embolization for fragile patients with indwelling urinary catheters: Preliminary results from a multi-institutional study.

PURPOSE: To report our preliminary experience with water vapor thermal therapy with the Rezum™ System and Prostate Artery Embolization (PAE) for treatment of medically refractory, complete urinary retention to achieve successful cessation of catheter dependency in frail-patients. PATIENTS AND METHODS: A multi-institutional study was conducted including all patients who underwent Rezum™ procedure and PAE between October 2017 and June 2020. The included population focused on frail-patients unsuitable for conventional surgery with complete urinary retention. Rezum™ patients were identified and matched (1:1) with patients who underwent PAE. The matching criteria were age, Charlson score, prostate volume and duration of follow-up. The primary outcome was catheter-free survival, defined as spontaneous voiding and release from catheter dependence. RESULTS: Eleven patients from the Rezum™ group were matched to 11 embolized patients. PAE and Rezum™ patients were comparable in age (median: 77 vs. 75 years), Charlson score (median: 6 vs. 6) and prostate volume (74 vs. 60 cc). Procedures were significantly longer in the PAE group compared to the Rezum™ procedures (median: 148 vs. 8min, P<0.001). After a median follow-up of 12 months, spontaneous voiding was conserved in all cases (100%) after the Rezum™ procedure and in 5 cases (45.4%) after PAE (P=0.01). In catheter-free patients, the rate of benign prostatic hyperplasia medication use after procedure was 40% for PAE and 18.2% for Rezum™ patients (P=0.54). CONCLUSIONS: Our preliminary experience for treatment of complete urinary retention in frail-patients shows the feasibility of PAE and Rezum™ to restore spontaneous urination without being associated with the occurrence of major complications. Early data suggests that Rezum™ may provide superior results in terms of cessation of catheter dependence. Future studies are needed to definitively assess which treatment would be best suited for each patient. LEVEL OF EVIDENCE: 3.

[The experience of medical students as peer tutors]. / Rol de tutor par: experiencia de estudiantes de medicina.

BACKGROUND: Peer tutoring is a process of accompaniment carried out by a student with certain features and skills, whose objective is to support and guide, academically and emotionally, other students who may require it. AIM: To assess the experience of medical students who played the role of peer tutor. MATERIAL AND METHODS: We carried out semi-structured in-depth interviews, with prior informed consent, to a non-probabilistic and intentional sample of six students who performed the role of peer tutor, during 2017 and 2018. The data analysis followed the scheme of constant comparison and progressive reduction in a manual way, according to the comparative method, guaranteeing scientific rigor, maintaining criteria of credibility, dependence, confirmability, and transferability. RESULTS: The first level identified 234 units of meaning that originated in the third level, two qualitative domains, oriented to the contribution of peer tutors derived from their experience to strengthen both the process of peer tutor training and the management of peer tutoring. CONCLUSIONS: Peer tutoring as a teaching-learning strategy contributes to the development of generic competences and metacognitive skills, generating high levels of personal satisfaction and identification their teaching role.

Can dietary fiber improve the technological characteristics and sensory acceptance of low-fat Italian type salami?

To meet the needs of new consumers, meat researchers need to develop healthier products. Dietary fibers can be added for structural purposes, to present functional characteristics or to change the composition of the final product. In this study, mixture design was used to investigate the effects of partial substitution of pork fat by inulin, fructooligosaccharides and α-cyclodextrin on the technological and sensory quality characteristics of low-fat Italian type salami. The partial substitution of fat using dietary fibers shows no effect on weight loss, Aw and pH during ripening time. However, the addition of up to 2% α-cyclodextrin increased lightness and reduced redness and yellowness. Up to 2% of inulin or fructooligosaccharides added improved the sensory acceptance, texture parameters and redness. Healthier low-fat Italian type salami can be produced using inulin or fructooligosaccharides as fat substitute for pork fat and still obtain good technological and sensorial results.

Friction weakening by mechanical vibrations: A velocity-controlled process.

Frictional weakening by vibrations was first invoked in the 70s to explain unusual fault slips and earthquakes, low viscosity during the collapse of impact craters or the extraordinary mobility of sturzstroms, peculiar rock avalanches which travels large horizontal distances. This mechanism was further invoked to explain the remote triggering of earthquakes or the abnormally large runout of landslides or pyroclastic flows. Recent experimental and theoretical works pointed out that the key parameter which governs frictional weakening in sheared granular media is the characteristic velocity of the vibrations. Here we show that the mobility of the grains is not mandatory and that the vibration velocity governs the weakening of both granular and solid friction. The critical velocity leading to the transition from stick-slip motion to continuous sliding is in both cases of the same order of magnitude, namely a hundred microns per second. It is linked to the roughness of the surfaces in contact.

Embolization of the superior rectal arteries for chronic bleeding due to haemorrhoidal disease.

AIM: The aim of this study was to assess the safety and efficacy of the emborrhoid technique (embolization of the superior haemorrhoidal arteries) in patients ineligible for surgery. METHODS: Between January 2014 and April 2015, 30 consecutive patients (average age 58 years) suffering from disabling chronic bleeding due to haemorrhoidal disease and with a contraindication for surgery (n = 23) or with a failure of instrumental or surgical treatment (n = 7) underwent embolization. All cases were discussed at multidisciplinary meetings including a proctology specialist or a surgeon and an interventional radiologist. We performed super selective micro coil embolization (pushable 2-3 mm fibre coils) of the distal branches of the superior rectal arteries with a microcatheter, via a right femoral approach, under local anaesthesia. We assessed clinical outcome by evaluating bleeding and specific clinical scores relating to bleeding and changes in quality of life. RESULTS: Immediate technical success, with no complication, was achieved in 93% of cases. A mean of 3.1 arteries per patient was embolized, with a mean of 7.6 coils per patient. Median follow-up was 5 months. Clinical score improvement was observed in 72%, in 17 patients after a single embolization session, and in four additional patients after a second embolization session. No improvement in bleeding was observed in eight patients (28%). CONCLUSION: Distal coil embolization of the superior rectal arteries for disabling chronic bleeding due to haemorrhoidal disease is safe and effective in patients untreatable by surgery.

Morphological, molecular and phylogenetic analyses of the spirurid nematode Stegophorus macronectes (Johnston & Mawson, 1942).

Stegophorus macronectes (Johnston & Mawson, 1942) is a gastrointestinal parasite found in Antarctic seabirds. The original description of the species, which was based only on females, is poor and fragmented with some unclear diagnostic characters. This study provides new morphometric and molecular data on this previously poorly described parasite. Nuclear rDNA sequences (18S, 5.8S, 28S and internal transcribed spacer (ITS) regions) were isolated from S. macronectes specimens collected from the chinstrap penguin Pygoscelis antarctica Forster on Deception Island, Antarctica. Using 18S rDNA sequences, phylogenetic analyses (maximum likelihood, maximum parsimony and Bayesian inference) of the order Spirurida were performed to determine the phylogenetic location of this species. Primer pairs of the ITS regions were designed for genus-level identification of specimens, regardless of their cycle, as an alternative to coprological methods. The utility of this molecular method for identification of morphologically altered specimens is also discussed.

Minimal portal vein stenosis is a promising preconditioning in living donor liver transplantation in porcine model.

BACKGROUND & AIMS: The main hindrance in promoting living donor liver transplantation remains the morbi-mortality risk for the donor. Considering the opposed remodeling influence of portal and hepatic artery flows, our working hypothesis was to identify a lobar portal vein stenosis capable of inducing a contralateral liver mass compensatory enlargement, without the downstream ipsilateral atrophic response. METHODS: Twenty-four pigs entered this study. Six of them were used to establish hemodynamic changes following a progressive left portal vein (LPV) stenosis, in blood flow, pressure and vessel diameter of the LPV, main portal vein and hepatic artery. Sixteen pigs were divided into 4 groups: sham operated animals, 20% LPV stenosis, 50% LPV stenosis, and 100% LPV stenosis. Daily liver biopsies were collected until post-operative day 5 to investigate liver regeneration and atrophy (Ki67, STAT3, LC3, and activated caspase 3) according to the degree of LPV stenosis. Finally, changes in liver volumetry after 20% LPVS were investigated. RESULTS: A 20% LPV stenosis led to dilatation of the hepatic artery and a subsequent four-fold increase in hepatic arterial flow. Concomitantly, liver regeneration was triggered in the non-ligated lobe and the cell proliferation peak, 5 days after surgery, was comparable to that obtained after total LPV ligation. Moreover, 20% LPV stenosis preconditioning did not induce left liver atrophy contrary to 50 and 100% LPV stenosis. CONCLUSIONS: A 20% LPV stenosis seems to be the adequate preconditioning to get the remnant liver of living donor ready to take on graft harvesting without atrophy of the future graft.

[Pulmonary rehabilitation effects in patients with COPD according to GOLD 2020 classification in Cali, Colombia]. / Efectos de la rehabilitación pulmonar en pacientes con EPOC según la clasificación GOLD 2020 en Cali, Colombia.

INTRODUCTION: Chronic obstructive pulmonary disease has a guide in charge of prevention and treatment, called the Global Initiative for Chronic Lung Disease, which is annually updated and catalogs pulmonary rehabilitation, within the treatment options. OBJECTIVE: To describe the effects on clinical variables, functional capacity, anxiety/depression and health-related quality of life in patients with chronic obstructive pulmonary disease, after a pulmonary rehabilitation program, according to the GOLD 2020 classification in a Cali clinic. MATERIALS AND METHODS: Descriptive, longitudinal study where 79 patients divided into 3 groups were included (B, C and D). RESULTS: The mean age was 70 years, 69% men. The number of hospitalized days was greater for groups C and D with an average of 8 and 13 days, respectively (p≤0.000). The functional capacity showed a greater distance in group C (421m) and the shortest distance for group D (328m), p≤0.006. In anxiety and depression, group D managed to obtain improvements as well as in the quality of life questionnaire. CONCLUSION: Group C presented greater functional capacity and better quality of life, group B had better results in clinical variables, and group D had worse clinical condition, functional capacity and quality of life. At the end of pulmonary rehabilitation, group D presented greater changes in functional capacity and quality of life.

Writing in the European Annals of Otorhinolaryngology Head & Neck Diseases. Dos and Don'ts!

Too many articles are still rejected by scientific medical journals due to lack of preparation of the manuscript and of knowledge of the modern editorial rules that govern scientific medical writing. Therefore, the editorial board of the European Annals of Otorhinolaryngology Heads & Neck Diseases summarized studies published by its members since 2020 in the columns of the scientific journal of the French Society of Otorhinolaryngology and the International Francophone Society of Otorhinolaryngology and data from the PubMed indexed literature dedicated to scientific medical writing in otolaryngology in the 21st century. The authors hope that this review, in the form of a list of "Dos and Don'ts", will provide authors with a practical guide facilitating publication of rigorous, reproducible and transparent scientific studies, in accordance with the movement toward better science that society as a whole has been fighting for since the beginning of this century.

Sox9 induces testis development in XX transgenic mice.

Mutations in SOX9 are associated with male-to-female sex reversal in humans. To analyze Sox9 function during sex determination, we ectopically expressed this gene in XX gonads. Here, we show that Sox9 is sufficient to induce testis formation in mice, indicating that it can substitute for the sex-determining gene Sry.

Emissions of ammonia, carbon dioxide, and hydrogen sulfide from swine wastewater during and after acidification treatment: effect of pH, mixing and aeration.

This study aimed at evaluating the effect of swine slurry acidification and acidification-aeration treatments on ammonia (NH(3)), carbon dioxide (CO(2)) and hydrogen sulfide (H(2)S) emissions during slurry treatment and subsequent undisturbed storage. The study was conducted in an experimental setup consisting of nine dynamic flux chambers. Three pH levels (pH = 6.0, pH = 5.8 and pH = 5.5), combined with short-term aeration and venting (with an inert gas) treatments were studied. Acidification reduced average NH(3) emissions from swine slurry stored after acidification treatment compared to emissions during storage of non-acidified slurry. The reduction were 50%, 62% and 77% when pH was reduce to 6.0, 5.8 and 5.5, respectively. However, it had no significant effect on average CO(2) and H(2)S emissions during storage of slurry after acidification. Aeration of the slurry for 30 min had no effect on average NH(3), CO(2) and H(2)S emissions both during the process and from stored slurry after venting treatments. During aeration treatment, the NH(3), CO(2) and H(2)S release pattern observed was related to the liquid turbulence caused by the gas bubbles rather than to biological oxidation processes in this study.

[Pathological features of radiofrequency ablation (RFA) renal scar CT-imaging in a swine model]. / Cicatrice de radiofréquence rénale : corrélations anatomopathologiques-tomodensitométriques chez le porc. Applications pratiques pour le suivi en imagerie.

PURPOSE: To analyze the changes in vicinal kidney parenchyma after percutaneous RFA. MATERIALS AND METHODS: [corrected] Twenty-four CT-guided RFA procedures were performed on six pigs using 2 cm LeVeen coaxial needles. We studied volume, morphology, cavitation and enhancement of the ablation zones (AZ) before and after the procedure on contrast-injected CT-scans. The kidneys were removed four weeks later and studied in the path lab. RESULTS: All the procedures were successfully completed. Four weeks later, the CT-scans showed AZ that were either clearly circumscribed or with unclear borders, heterogenous areas associating necrosis and infarct tissue and mesenchyma showing a process of apoptosis around the edges. A treatment considered as incomplete on the CT-scan (presenting as an enhancement) was always associated with necrosis on the histology slides, although the necrotic areas behaved in various different ways on the CT-scan after injection of contrast medium: an enhancement of more than 10 HU did not mean that no necrotic tissue was present. CONCLUSION: RFA causes heterogenous tissue changes, associating necrotic and ischemic zones and an apoptotic reaction. The mechanisms of these changes and their therapeutic significance should be studied. CT-scans performed immediately after RFA procedure and one month later are not predictive of the efficacy of the treatment because an enhancement of the AZ does not mean that it is not necrotic. The value of a CT-scan performed one month after the procedure is debatable, because the tissue remodeling that occurs in the kidneys is not definitive at this time-point.

Regorafenib in patients with relapsed advanced or metastatic chordoma: results of a non-comparative, randomised, double-blind, placebo-controlled, multicentre phase II study.

BACKGROUND: REGOBONE multicohort study explored the efficacy and safety of regorafenib for patients with advanced bone sarcomas; this report details the cohort of patients with relapsed advanced or metastatic chordoma. METHODS: Patients with relapsed chordoma progressing despite 0-2 prior lines of systemic therapy, were randomised (2 : 1) to receive regorafenib (160 mg/day, 21/28 days) or placebo. Patients on placebo could cross over to receive regorafenib after centrally-confirmed progression. The primary endpoint was the progression-free rate at 6 months (PFR-6) (by RECIST 1.1). With one-sided α of 0.05, and 80% power, at least 10/24 progression-free patients at 6 months (PFR-6) were needed for success. RESULTS: From March 2016 to February 2020, 27 patients were enrolled. A total of 23 patients were assessable for efficacy: 7 on placebo, 16 on regorafenib, 16 were men, median age was 66 (32-85) years. At 6 months, in the regorafenib arm, 1 patient was not assessable, 6/14 were non-progressive (PFR-6: 42.9%; one-sided 95% CI = 20.6) 3/14 discontinued regorafenib due to toxicity; and in the placebo arm, 2/5 patients were non-progressive (PFR-6: 40.0%; one-sided 95% CI = 7.6), 2 were non-assessable. Median progression-free survival was 8.2 months (95% CI 4.5-12.9 months) on regorafenib and 10.1 months (95% CI 0.8 months-non evaluable [NE]) on placebo. Median overall survival rates were 28.3 months (95% CI 14.8 months-NE) on regorafenib but not reached in placebo arm. Four placebo patients crossed over to receive regorafenib after centrally-confirmed progression. The most common grade ≥3 regorafenib-related adverse events were hand-foot skin reaction (22%), hypertension (22%), pain (22%), and diarrhoea (17%), with no toxic death. CONCLUSION: This study failed to show any signal of benefit for regorafenib in patients with advanced/metastatic recurrent chordoma.

Keys for successful publication in Eur Ann Otorhinolaryngol Head Neck Dis: A STROBE analysis of peer reviews of articles submitted in 2020-2021.

OBJECTIVE: To evaluate reviewing and editorial decision for articles submitted to the European Annals of Otorhinolaryngology Head & Neck Diseases. MATERIALS AND METHODS: A retrospective analysis was made of reviewers' comments on 1,133 scientific articles (700 original articles, 96 literature reviews, and 337 case reports), originating from 69 countries, consecutively submitted on-line between January 1st, 2020 and December 31st, 2021. The main objective was to document the acceptance rate and decision time. Accessory objectives were to synthesize the main comments and to screen for correlations between acceptance and the main characteristics of first authors, articles and reviewers' comments. RESULTS: In total, 4.1% of submitted articles were accepted. Median decision time differed significantly (P<0.0001), at 1 month in case of refusal and 4 months in case of acceptance. Reviewers mentioned failure to adhere to the journal's authors' guide, to use the appropriate EQUATOR guidelines and to adopt the recommended P<0.005 significance threshold in 94.8%, 54.2%, and 39.9% of cases, respectively. On multivariate analysis, 3 variables significantly impacted acceptance, which increased from 1.3% to 44.6% (P<0.0001) when an appropriate EQUATOR guideline was used and from 0.3% to 57.4% (P<0.0001) when the significance threshold was set at P<0.005, and decreased from 10.5% to 1.1% (P=0.0001) when the article did not originate from a French-speaking country (member of the Francophonie organization). CONCLUSION: Adhesion to modern scientific medical writing rules increased acceptance rates for articles in the European Annals of Otorhinolaryngology Head & Neck Diseases. Teaching modern scientific medical writing needs to be enhanced in otorhinolaryngology.

Rare germline large rearrangements in the BRCA1/2 genes and eight candidate genes in 472 patients with breast cancer predisposition.

Hereditary breast cancers account for up to 5-10 % of breast cancers and a majority are related to the BRCA1 and BRCA2 genes. However, many families with breast cancer predisposition do not carry any known mutations for BRCA1 and BRCA2 genes. We explored the incidence of rare large rearrangements in the coding, noncoding and flanking regions of BRCA1/2 and in eight other candidate genes--CHEK2, BARD1, ATM, RAD50, RAD51, BRIP1, RAP80 and PALB2. A dedicated zoom-in CGH-array was applied to screen for rearrangements in 472 unrelated French individuals from breast-ovarian cancer families that were being followed in eight French oncogenetic laboratories. No new rearrangement was found neither in the genomic regions of BRCA1/2 nor in candidate genes, except for the CHEK2 and BARD1 genes. Three heterozygous deletions were detected in the 5' and 3' flanking regions of BRCA1. One large deletion introducing a frameshift was identified in the CHEK2 gene in two families and one heterozygous deletion was detected within an intron of BARD1. The study demonstrates the usefulness of CGH-array in routine genetic analysis and, aside from the CHEK2 rearrangements, indicates there is a very low incidence of large rearrangements in BRCA1/2 and in the other eight candidate genes in families already explored for BRCA1/2 mutations. Finally, next-generation sequencing should bring new information about point mutations in intronic and flanking regions and also medium size rearrangements.

Effect of consumption of tomato juice enriched with n-3 polyunsaturated fatty acids on the lipid profile, antioxidant biomarker status, and cardiovascular disease risk in healthy women.

PURPOSE: We compared the effects of consumption of n-3 polyunsaturated fatty acids (PUFA)-enriched tomato juice versus plain tomato juice on the serum lipid profile and levels of biomarkers related to antioxidant status and cardiovascular disease (CVD) risk in women. METHODS: Eighteen healthy women participated in a 2-week intervention trial involving the daily intake of 500 mL of n-3 PUFA-enriched juice (n = 11) or plain tomato juice (n = 7). Each serving of enriched juice provided 250 mg of eicosapentaenoic acid (EPA) plus docosahexanoic acid (DHA). Both juices provided natural antioxidant compounds such as phenolics (181 mg) and lycopene (26.5 mg). RESULTS: Intervention with the enriched juice had no effect on the lipid profile, and serum levels of triglycerides and cholesterol (total, LDL, and HDL) remained unchanged. The serum antioxidant status improved following juice intake, as revealed by an increase in total antioxidant capacity and a slight decrease in lipid peroxidation. The serum levels of homocysteine, a cardiovascular risk factor, decreased following n-3 PUFA-enriched juice consumption. A decrease in vascular adhesion molecule 1 (VCAM-1) levels was also noted after intake of either plain or enriched tomato juice, whereas intercellular adhesion molecule 1 (ICAM-1) levels only decreased following intake of the enriched juice. CONCLUSIONS: Overall, stronger positive amelioration of CVD risk factors was observed following the intake of n-3 PUFA-enriched juice than after plain tomato juice consumption, which suggested a possible synergistic action between n-3 PUFAs and tomato antioxidants.

Gastrointestinal parasites in Chinstrap Penguins from Deception Island, South Shetlands, Antarctica.

Knowledge about parasites of Antarctic birds is fragmented and scarce. The aim of this work is to contribute to the knowledge of gastrointestinal parasites of the Chinstrap Penguin (Pygoscelis antarctica) from Deception Island (South Shetlands, Antarctica). Gastrointestinal tracts of 64 fresh dead individuals (61 chicks and three adults) were collected from December 2006 to February 2009 and examined for macroparasites. Three adult parasite species were found: two Cestoda species (Parorchites zederi and Tetrabothrius pauliani) and one Nematoda species (Stegophorus macronectes). Also, immature acanthocephalans (Corynosoma sp.) were found in one penguin. The low parasite richness observed could be related to the stenophagic and pelagic diet of the host species. False negatives were found in coprological studies.

Validation of a French version of the Sunnybrook facial grading system.

BACKGROUND: The aim of this study was to translate the Sunnybrook Facial Grading System and its specific criteria into French and validate its use by French-speaking physicians for facial palsy evaluation. MATERIAL AND METHODS: The original English version of the Sunnybrook Facial Grading System and its specific criteria was translated into French according to international standards. Twenty videos of patients with a wide range of facial palsy in terms of duration and severity were independently rated, twice each, by 6 physicians with varied experience in facial palsy care. Internal consistency and intra- and inter-rater reliability were analyzed. RESULTS: The French version of Sunnybrook Facial Grading System and its specific criteria both showed good internal consistency, with Cronbach alpha of 0.84 and 0.86 respectively. Inter-rater reliability was excellent in both sessions for the composite score, the score of symmetry at rest and during voluntary movement and synkinesis: intraclass correlation coefficient (ICC) between 0.77 and 0.98. Intra-rater reproducibility on the composite score and subscores was also excellent and comparable for expert, experienced and novice physicians, with an average ICC of 0.95. CONCLUSION: The French version of the Sunnybrook Facial Grading System and its specific criteria is reliable, reproducible and easy to use by French-speaking teams for facial palsy evaluation.

Analysis of a Fast Control Allocation approach for nonlinear over-actuated systems.

Autonomous Robots with multiple directional thrusters are normally over-actuated systems that require nonlinear control allocation methods to map the forces that drive the robot's dynamics and act as virtual control variables to the actuators. This process demands computational efforts that, sometimes, are not available in small robotic platforms. The present paper introduces a new control allocation approach with fast convergence, high accuracy, and dealing with complex nonlinear problems, especially in embedded systems. The adopted approach divides the desired nonlinear system into coupled linear problems. For that purpose, the Real Actions (RAs) and Virtual Control Variables (VCVs) are broke in two or more sets each. While the RA subsets are designed to linearize the system according to different input subspaces, the VCV is designed to be partially coupled to overlap the output subspaces. This approach generates smaller linear systems with fast and robust convergence used sequentially to solve nonlinear allocation problems. This methodology is assessed in mathematical tutorial cases and over-actuated UAV simulations.