Management of high-grade papillary Ta or T1 bladder cancer after restaging transurethral resection: A retrospective study comparing Bacillus Calmette-Guerin therapy upfront versus a third resection.

PURPOSE: Performing restaging transurethral bladder resection (reTURB) for high-risk non-muscle invasive bladder cancer (NMIBC) reduces the risk of recurrence and tumour understaging. Management of residual high-grade papillary Ta or T1 after reTURB has changed this last 10years in international recommendations. This study aimed to compare the recurrence free survival according to the different management procedures performed. MATERIALS AND METHODS: Patients who underwent reTURB for initial high-risk NMIBC between 2011 and 2020 were included. Patients with residual high-grade papillary Ta or T1 tumour after reTURB were divided into two groups: BCG instillations upfront versus BCG following a third-look resection (3TURB). Patient and tumour characteristics, BCG instillations, recurrence-free survival were retrospectively analysed. RESULTS: A total of 162 high-risk patients were included. Sixty-one (37.7%) had residual high-grade papillary Ta or T1 at reTURB: 35 (21.6%) had BCG instillations upfront, 18 (11.2%) had a 3TURB and 8 (5%) had other management. The mean follow-up was 34.2weeks±20.2. Recurrence-free survival was significantly better in patients who underwent BCG instillations upfront (P<0.0043). Recurrence after BCG therapy following reTURB was significantly lower in patients with no residual NMIBC at 6 (92.5% vs. 72.4%, P<0.004) and 12months (85% vs. 67.3%, P<0.03). CONCLUSIONS: The efficacy of intravesical BCG is compromised in case of residual tumour following TURB. The role of a 3TURB following a positive reTURB is not yet determined. This study has confirmed that residual tumor following reTURB is a negative predictive factor but could not demonstrate the value of a 3TURB compared to upfront BCG.

[Holmium laser enucleation of the prostate: Analysis of early complications. Patient selection for day-case surgery]. / Énucléation prostatique au laser Holmium : analyse des complications précoces. Sélection des patients pour l'ambulatoire.

OBJECTIVES: To evaluate the complications and the risk factors of Holmium LASER Enucleation of the prostate (HoLEP) and to propose selection criteria for day-case surgery. MATERIAL AND METHODS: We included retrospectively all consecutive single-center HoLEP procedures performed between January 1, 2012 and December 31, 2016. We reported the pre-operative characteristics of the patients (age, BMI, ASA score, estimated prostate volume, presence of a preoperative catheter, operative indication, antiplatelet or anticoagulant intake) and the peri operative data (duration of intervention, catheterization, hospitalization, transfusion, histopathological findings, 30-day postoperative complications given to Clavien-Dindo classification, presence of a catheter at discharge, urologist experience). Uni- and multi-variate analyzes were performed to investigate risk factors for complications. RESULTS: One thousand two hundred and one patients were included. The overall complication rate was 19.15 %. The transfusion rate was 3.7%. We demonstrated that the age at procedure (P=0.019), an ASA score>2 (P=0.0019), a high prostatic volume (P=0.011), an anticoagulant intake (P=<0.0001), a poor-urologist experience (P=0.048) and a long operative time (P=0.0144) were at risks of complications. CONCLUSION: The identification of postoperative complication risk factors after HoLEP could help to better select patients who are offered day-case surgery and minimize the risk of failure or early readmission. LEVEL OF EVIDENCE: 4.

'When the dog bites': What can we learn about health geography from newspaper coverage in a 'model city' for dog-bite prevention?

Despite calls for the adoption of 'One-Health' approaches, dog-bite injuries remain neglected in healthcare and public health, and our study may help to understand why. Media coverage can influence policy directions, including policies that address dogs. We collected articles (n = 65) published in two local newspapers, 2012-2017, then carried out an ethnographically-informed discourse analysis of the dog-bite reports. The newspapers portrayed dog-bites mainly as matters of public disorder, as opposed to priorities for healthcare and public health. Even as our study took place in a city that has shown dog-bite reductions without recourse to 'breed bans' or restrictions (i.e., breed-specific legislation), journalists still tended to emphasize dog breed as a narrative element in explaining dog-bite incidents. Nonetheless, the news coverage did not reproduce a 'nature versus nurture' dichotomy. Rather, the journalists presented dog breed, and presumably associated aggressive behaviour, as entanglements with social, economic, and cultural contexts. Meanwhile, the news stories reduced contextual complexity to geographic locations, as codes for community reputation, in attributing causality and morality.

Multi-environment Evaluation of Maize Inbred Lines for Resistance to Fusarium Ear Rot and Fumonisins.

Fusarium verticillioides causes Fusarium ear rot (FER) of maize and produces fumonisins, which affects grain quality. Host-plant resistance can reduce both FER and fumonisins in maize. In this study, 18 maize inbred lines were evaluated for resistance to F. verticillioides and fumonisin accumulation at five localities in South Africa. Additive main effects and multiplicative interaction analyses revealed significant environment × genotype interactions, with inbred lines CML 390, US 2540W, RO 424W, and VO 617y-2 consistently exhibiting low FER severity (≤5.4%), fungal target DNA (≤0.1 ng µl-1), and fumonisin levels (≤5.6 ppm). Genotype main effect and genotype × environment biplots showed that inbred lines CML 390, US 2540W, and RO 424W were most resistant to FER, fungal colonization, and fumonisin accumulation, respectively, while inbred line RO 424W was most stable in its resistance response over environments. These inbred lines also demonstrated broad adaptability by consistently exhibiting resistance to FER, fungal colonization, and fumonisins across localities. The identified lines could serve as valuable sources of resistance against F. verticillioides and its fumonisins in local breeding programs.

Effects of non-fat dairy products added to the routine diet on vascular function: a randomized controlled crossover trial.

BACKGROUND AND AIMS: High consumption of low- and non-fat dairy products is associated with reduced risk of high blood pressure (BP) and central arterial stiffness. However, interventional studies to determine if the addition of non-fat dairy products to the diet is capable of reducing central BP and improving vascular function are lacking. The aim of this study was to determine if the solitary addition of non-fat dairy products to the normal routine diet would reduce central BP and improve vascular function in middle-aged and older adults with elevated BP. METHODS AND RESULTS: Using a randomized, crossover intervention study design, forty-nine adults (44% men, 53 ± 2 years, 170 ± 2 cm, 88 ± 3 kg; mean ± SEM) with elevated BP (134 ± 1/81 ± 1 mm Hg) underwent a High Dairy condition (+4 servings/day of conventional non-fat dairy products) and No Dairy condition (+4 servings/day fruit products) in which all dairy products were removed. Both dietary conditions lasted 4 weeks with a 2-week washout before crossing over into the alternate condition. The High Dairy condition produced reductions in central systolic BP (-3 ± 1 mm Hg) and carotid-femoral pulse wave velocity (-0.5 ± 0.1 m/sec), with a concomitant increase in brachial flow-mediated dilation (+1.1 ± 0.4%) and cardiovagal baroreflex sensitivity (+5 ± 1 ms/mm Hg) (P < 0.05 for all vs. baseline). In the No Dairy condition, brachial flow-mediated dilation was reduced (-1.0 ± 0.1%, P < 0.05 vs. baseline). CONCLUSIONS: The solitary manipulation of conventional dairy products in the normal routine diet modulates levels of central BP and vascular function in middle-aged and older adults with elevated BP. CLINICAL TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01577030.

Group JK corynebacterium peritonitis in a patient undergoing continuous ambulatory peritoneal dialysis.

We describe a case of peritonitis with isolation of a group JK corynebacterium from the peritoneal effluent in a patient undergoing continuous ambulatory peritoneal dialysis and treated with corticosteroids. Therapy with intraperitoneal vancomycin resulted in a rapid eradication of the organism. However, only 1 month after discontinuation of the 26-day therapy, a second episode of peritonitis with JK corynebacterium occurred. After vancomycin was restarted, the organism disappeared again from the peritoneal fluid, but the patient died a few days later from heart failure apparently unrelated to the infection. Some authors have mentioned the isolation of diphtheroids (without further identification) from peritoneal effluent of continuous ambulatory peritoneal dialysis patients, but to our knowledge, this is the first report of peritonitis associated with JK corynebacterium, an opportunistic organism that must be differentiated from other corynebacteria.