Ectopic low submuscular pressure regulating balloon placement with transfascial fixation for artificial urinary sphincter.

INTRODUCTION: To present our novel low submuscular (LSM) pressure regulating balloon (PRB) placement for artificial urinary sphincter (AUS) technique as an alternative to standard approaches with patient-reported satisfaction outcomes. MATERIAL AND METHODS: A retrospective review was conducted on patients who underwent an AUS implantation using the LSM PRB placement with transfascial fixation technique from July 2019 to August 2020. Preoperative characteristics were collected. Patients then conducted a postoperative phone interview using an adapted questionnaire to assess satisfaction of device and PRB concealment. RESULTS: During the study period, nine patients had undergone AUS placement using the LSM technique by a single surgeon at our private institution. Eight of the nine patients had undergone a radical prostatectomy while the ninth patient developed stress urinary incontinence after radiation treatment for prostate cancer. All patients were 'very satisfied' with PRB placement and concealment with no patients endorsing PRB complications. The majority of patients (78%) were satisfied with the device. One patient was able to palpate the PRB while another patient endorsed mild soreness around the PRB. No surgical revisions were required and there were no surgical complications such as bowel obstruction, herniations, bladder erosions, or vascular injuries. CONCLUSION: LSM placement of AUS PRB with transfascial fixation offers an improved technique for balloon placement with decreased risk for complications. This can be performed as a safe, alternative approach to current standard techniques with a high degree of patient satisfaction.

Biogeochemical responses to nutrient inputs in a Cuban coastal lagoon: runoff, anthropogenic, and groundwater sources.

Laguna Larga, a coastal lagoon in central Cuba, has been heavily altered by tourism infrastructure construction and sewage disposal. We hypothesize that this has decreased the circulation and caused eutrophication of the lagoon. To assess this, 12 bimonthly samplings were carried out in 2007-2008. Temperature, salinity, oxygen, nutrients and nitrogen, and phosphorous fractions (inorganic, organic, and total) were determined. Water and salt budgets, as well as biogeochemical fluxes of nitrogen and phosphorus were calculated using the LOICZ budget model for the three sections of the lagoon identified by morphological constrains and salinity patterns. Laguna Larga is a choked lagoon with restricted water circulation, low exchange, and high residence times that vary significantly along its sections. Residence time was estimated to be 0.1-0.7 years for the inner section and 1-9 days for the outer one. High levels of total nitrogen (annual means 126-137 µM, peaks up to 475 µM) and phosphorus (2.5-4.4 µM, peaks up to 14.5 µM) are evidence of eutrophication of Laguna Larga. During 2007, an average precipitation year, Laguna Larga exported water (703 m(3) d(-1)) and was a source of nitrogen (9.026 mmol m(-2) d(-1)) and phosphorus (0.112 mmol m(-2) d(-1)) to the adjacent sea. δ(15)N determinations in the seagrass Thalassia testudinum (-1.83 to +3.02 ‰) differed significantly between sites in the lagoon and offshore reference sites located W of the inlet, but were similar to those located E of the inlet. δ(15)N determinations in the seaweed Penicillus dumetosus (+1.02 to +4.2) did not show significant differences.

Angiogenesis and immunity: a bidirectional link potentially relevant for the monitoring of antiangiogenic therapy and the development of novel therapeutic combination with immunotherapy.

The immune system regulates angiogenesis in cancer with both pro- and antiangiogenic activities. The induction of angiogenesis is mediated by tumor-associated macrophages and myeloid-derived suppressor cells (MDSC) which produce proinflammatory cytokines, endothelial growth factors (VEGF, bFGF…), and protease (MMP9) implicated in neoangiogenesis. Some cytokines (IL-6, IL-17…) activated Stat3 which also led to the production of VEGF and bFGF. In contrast, other cytokines (IFN, IL-12, IL-21, and IL-27) display an antiangiogenic activity. Recently, it has been shown that some antiangiogenic molecules alleviates immunosuppression associated with cancer by decreasing immunosuppressive cells (MDSC, regulatory T cells), immunosuppressive cytokines (IL-10, TGFß), and inhibitory molecules on T cells (PD-1). Some of these broad effects may result from the ability of some antiangiogenic molecules, especially cytokines to inhibit the Stat3 transcription factor. The association often observed between angiogenesis and immunosuppression may be related to hypoxia which induces both neoangiogenesis via activation of HIF-1 and VEGF and favors the intratumor recruitment and differentiation of regulatory T cells and MDSC. Preliminary studies suggest that modulation of immune markers (intratumoral MDSC and IL-8, peripheral regulatory T cells…) may predict clinical response to antiangiogenic therapy. In preclinical models, a synergy has been observed between antiangiogenic molecules and immunotherapy which may be explained by an improvement of immune status in tumor-bearing mice after antiangiogenic therapy. In preclinical models, antiangiogenic molecules promoted intratumor trafficking of effector cells, enhance endogenous anti-tumor response, and synergyzed with immunotherapy protocols to cure established murine tumors. All these results warrant the development of clinical trials combining antiangiogenic drugs and immunotherapy.

The prevalence of metabolic syndrome in Latin America: a systematic review.

OBJECTIVE: To assess the available data on the prevalence of metabolic syndrome (MS) in Latin-American countries. DESIGN: Systematic review. Searches were carried out in PubMed, ISIWeb, SCielo and Redalyc, using 'metabolic syndrome x' and 'prevalence' as keywords for titles and/or abstracts. Articles selected were cross-sectional studies in Latin-American countries, whose main objective was to study MS and whose study population is described below. MS must be determined using Adult Treatment Panel III criteria. Twelve studies with these criteria were selected, one of which was multi-centric. SETTING: Latin America. SUBJECTS: Apparently healthy subjects aged 18-65 years (including young adult, mature adult and elderly populations) of both genders. RESULTS: The general prevalence (weighted mean) of MS in Latin-American countries was 24·9 (range: 18·8-43·3) %. MS was slightly more frequent in women (25·3 %) than in men (23·2 %), and the age group with the highest prevalence of MS consisted of those over 50 years of age. The most frequent components of MS were low HDL cholesterol levels (62·9 %) and abdominal obesity (45·8 %). Similar outcomes were obtained from the multi-centre study on Latin-American populations analysed. CONCLUSIONS: The present review brings us closer to an understanding of the prevalence of MS in Latin-American countries. However, it is not possible to know the full scope of the problem, partly because data from some countries are not available, and because the methodological differences among the studies published up to the present limit a joint analysis of their results.

A Medium-Term Field Experiment to Study the Effect of Managing Soil Chemical Properties on Fusarium Wilt in Banana (Musa AAA).

Fusarium oxysporum f. sp. cubense (Foc) is a soil-borne fungus causing Fusarium wilt (FW) in banana. It is practically impossible to eradicate Foc in soils. Our understanding of soil-Foc-banana interactions is hampered by inconsistent research results caused by agro-ecological variability and the complexity of the soil system. This study aimed to evaluate the options to manage soil chemical properties to reduce disease expression and maintain banana production. The expression of FW (Foc Race 1) and the agronomic performance of the Gros Michel (Musa AAA) banana were evaluated in two medium-term factorial field experiments at representative locations in the Costa Rican banana region. In the experiments, five soil chemical properties (pH, N, Ca, Mg, and Mn) were managed to achieve a low and a high level. Plant mortality caused by FW, soil fertility, plant nutrition, and agronomic performance were monitored during four crop cycles. After the first crop cycle, the treatments started to present differences in plant mortality. There was a significant rise of plant mortality after the second crop cycle resulting in a cumulative plant mortality exceeding 60% in both experiments. A lower soil pH consistently resulted in significantly higher plant mortality. The interactions between soil properties (pH-N, pH-CaMg, pH-Mn, N-Mn, and CaMg-Mn) also influenced plant mortality. Soil N was the most significant treatment affecting leaf nutrient concentrations, bunch weight, and clusters per bunch. The experiments confirmed the potential role of soil management in FW expression in banana. Our results suggest that the management of soil chemical properties in the conditions here studied may help to reduce the expression rate of FW, but not to control the disease in the long run.

Nitrification in paleocene shale.

Exchangeable ammonium nitrogen is present in Paleocene (Fort Union) shale below a depth of 10 meters in North Dakota and eastern Montana. Above 10 meters, exchangeable ammonium nitrogen is nitrified in situ. The lack of viable nitrifying organisms and the probable lack of oxygen prevent in situ nitrification below 10 meters. Shale samples incubated at 27 degrees C under nonsterile conditions or shales exposed to atmospheric contamination exhibited active nitrification without additional treatment.

Adherence to the Mediterranean diet and risk of metabolic syndrome and its components.

BACKGROUND AND AIMS: The role of diet in the aetiology of metabolic syndrome (MetS) is not well understood. The aim of the present study was to evaluate the relationship between adherence to the Mediterranean diet (MedDiet) and MetS. METHODS AND RESULTS: A cross-sectional study was conducted with 808 high cardiovascular risk participants of the Reus PREDIMED Centre. MetS was defined by the updated National Cholesterol and Education Program Adult Treatment Panel III criteria. An inverse association between quartiles of adherence to the MedDiet (14-point score) and the prevalence of MetS (P for trend<0.001) was observed. After adjusting for age, sex, total energy intake, smoking status and physical activity, participants with the highest score of adherence to the MedDiet (>/=9 points) had the lowest odds ratio of having MetS (OR [95% CI] of 0.44 [0.27-0.70]) compared to those in the lowest quartile. Participants with the highest MedDiet adherence had 47 and 54% lower odds of having low HDL-c and hypertriglyceridemia MetS criteria, respectively, than those in the lowest quartile. Some components of the MedDiet, such as olive oil, legumes and red wine were associated with lower prevalence of MetS. CONCLUSION: Higher adherence to a Mediterranean diet is associated with a significantly lower odds ratio of having MetS in a population with a high risk of cardiovascular disease.

Components of the Mediterranean-type food pattern and serum inflammatory markers among patients at high risk for cardiovascular disease.

OBJECTIVE: To evaluate associations between components of the Mediterranean diet and circulating markers of inflammation in a large cohort of asymptomatic subjects at high risk for cardiovascular disease. SUBJECTS/METHODS: A total of 339 men and 433 women aged between 55 and 80 years at high cardiovascular risk because of presence of diabetes or at least three classical cardiovascular risk factors, food consumption was determined by a semi-quantitative food frequency questionnaire. Serum concentrations of high-sensitivity C-reactive protein (CRP) were measured by immunonephelometry and those of interleukin-6 (IL-6), intracellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) by enzyme-linked immunosorbent assay. RESULTS: After adjusting for age, gender, body mass index, diabetes, smoking, use of statins, non-steroidal antiinflammatory drugs and aspirin, a higher consumption of fruits and cereals was associated with lower concentrations of IL-6 (P for trend 0.005;both). Subjects with the highest consumption of nuts and virgin olive oil showed the lowest concentrations of VCAM-1, ICAM-1, IL-6 and CRP; albeit only for ICAM-1 was this difference statistically significant in the case of nuts (for trend 0.003) and for VCAM-1 in the case of virgin olive oil (P for trend 0.02). Participants with higher adherence to the Mediterranean-type diet did not show significantly lower concentrations of inflammatory markers (P<0.1 for VCAM-1 and ICAM-1). CONCLUSIONS: The consumption of some typical Mediterranean foods (fruits, cereals, virgin olive oil and nuts) was associated with lower serum concentrations of inflammatory markers especially those related to endothelial function, in subjects with high cardiovascular risk living in a Mediterranean country.

Thalidomide and thalidomide transformed by pH-dependent hydrolysis or by liver enzyme treatment does Not impede the proliferation of endothelial cells.

Angiogenesis is essential for tumor growth. In the treatment of tumors with thalidomide, a rationale for its use is that it inhibits angiogenesis. To form new blood vessels, endothelial cells must proliferate. The authors were interested in describing some of the circumstances by which thalidomide may influence proliferation of endothelial cells. Human umbilical vein derived endothelial cells (HUVECs) were exposed to 4.0 or 100 microg/ml of thalidomide in dimethylsulfoxide or to 4 microg/ml of thalidomide prepared an aqueous solutions. Proliferation was determined by measuring incorporation of (3)H-thymidine. Regardless of the solvent used to dissolve thalidomide, the HUVECs treated with thalidomide were not inhibited in their ability to incorporate (3)H-thymidine.

LOX-1 activation by oxLDL triggers an epithelial mesenchymal transition and promotes tumorigenic potential in prostate cancer cells.

Obesity is related to an increased risk of developing prostate cancer with high malignancy stages or metastasis. Recent results demonstrated that LOX-1, a receptor associated with obesity and atherosclerosis, is overexpressed in advanced and metastatic prostate cancer. Furthermore, high levels of oxLDL, the main ligand for LOX-1, have been found in patients with advanced prostate cancer. However, the role of LOX-1 in prostate cancer has not been unraveled completely yet. Here, we show that LOX-1 is overexpressed in prostate cancer cells and its activation by oxLDL promotes an epithelial to mesenchymal transition, through of lowered expression of epithelial markers (E-cadherin and plakoglobin) and an increased expression of mesenchymal markers (vimentin, N-cadherin, snail, slug, MMP-2 and MMP-9). Consequently, LOX-1 activation by oxLDL promotes actin cytoskeleton restructuration and MMP-2 and MMP-9 activity inducing prostate cancer cell invasion and migration. Additionally, LOX-1 increased the tumorigenic potential of prostate cancer cells and its expression was necessary for tumor growth in nude mice. In conclusion, our results suggest that oxLDL/LOX-1 could be ones of mechanisms that explain why obese patients with prostate cancer have an accelerated tumor progression and a greater probability of developing metastasis.

Anabolic androgenic steroids induce micronuclei in buccal mucosa cells of bodybuilders.

OBJECTIVE: To evaluate genotoxicity of anabolic androgenic steroids (AAS) in male bodybuilders by a micronucleus assay in buccal mucosa cells. METHODS: 11 male bodybuilders volunteered to participate in this study and two groups were formed: group 1 (n = 6), without AAS consumption and group 2 (n = 5), with AAS consumption. A sample of buccal epithelium was taken from each participant once a week for 6 weeks. Samples were fixed, stained and analysed by a light microscope, and 2000 cells were counted from each slide. Results are expressed as micronucleated cells (MNC) per 1000 cells and were analysed by the Mann-Whitney U test and Wilcoxon's test. RESULTS: A marked increased in MNC was seen in bodybuilders with AAS consumption compared with those without AAS consumption (mean (SD) 4.1 (2.4) MNC/1000 cells vs 0.4 (0.4) MNC/1000 cells, respectively; p<0.004). Intragroup comparisons showed no differences in the MNC frequencies during the sampling time in group 1, whereas the MNC frequency in group 2 varied significantly, reaching the highest MNC frequencies in the third and fourth week of sampling (5.9 (2.4) MNC/1000 cells; 5.8 (1.8) MNC/1000 cells, respectively); frequency in the first sampled week was 1.1 (0.1) MNC/1000 cells. Significant differences in all sampled weeks were found between the two groups. CONCLUSION: AAS consumption increased the frequency of MNC from buccal mucosa in bodybuilders.

[Thoracic inestability fixed with bioabsorbable screws and plates]. / Fijación de tórax inestable con placas y tornillos bioabsorbibles. Presentación de serie de casos.

BACKGROUND: Flail chest is managed with mechanical ventilation or inhaloteraphy and analgesia. Little has been published on the use of bioabsorbable material and its evolution in flail chest fixation. METHODS: This is a descriptive study of patients with unstable chest undergoing fixation with bioabsorbable plates and screws in a period from February 2009 to December 2011. RESULTS: We report 18 cases, aged 33-74 years (mean 53), three with bilateral involvement; rib fixation was performed between 1-21 days of the accident (mean 1.5). They started walking the next day in 14 cases; postoperative stay was four days (range 3-14). The heart rate of patients prior to surgery was 90 per minute (range 82-100) and lowered to 84 after fixation (range 82-92), preoperative respiratory rate was 26 per minute (range 22-28) and below 22 per minute (range 20 to 26) in postoperative period. CONCLUSIONS: The use of bioabsorbable material for osteosynthesis of costal fractures did not show side effects in our period of study.

ANTECEDENTES: El tórax inestable se trata con ventilación mecánica o inhaloterapia y analgesia. Poco se ha publicado sobre el uso de material bioabsorbible y su evolución en la fijación de tórax inestable. MÉTODOS: Estudio descriptivo de pacientes con tórax inestable sometidos a fijación con placas y tornillos bioabsorbibles en un período comprendido de Febrero de 2009 a Diciembre de 2011. RESULTADOS: Presentamos 18 casos con edades entre 33 y 74 años (media de 53), tres con tórax inestable bilateral; la fijación costal se realizó entre 1 y 21 días del accidente (media de 1.5). Se inició deambulación al día siguiente en 14 casos; la estancia postoperatoria fue de cuatro días (rango de 3 a 14). La frecuencia cardíaca de los pacientes previa a la cirugía era de 90 por minuto (rango 82 a 100) y bajó a 84 después de la fijación (rango 82 a 92); la frecuencia respiratoria preoperatoria era 26 por minuto (rango 22 a 28) y bajó a 22 por minuto (rango 20 a 26) en el postoperatorio. CONCLUSIONES: El uso de material bioabsorbible para osteosíntesis costal no tiene efectos secundarios atribuibles al material en el corto plazo.

On the mechanism of action of polyether XXVIII at site I of the electron-transfer chain in rat liver mitochondria.

In rat liver mitochondria, the macrocyclic polyether, dibenzo-18-crown-6 (polyether XXVIII) inhibits the oxidation of NAD-dependent substrates, as stimulated by ADP, uncouplers and valinomycin plus K+. It does not inhibit the oxidation of succinate. It is concluded that polyether XXVIII inhibits electron transfer in the NADH-CoQ span of respiratory chain. This is a process that is reversed by menadione. Inhibition of oxidation of NAD-dependent substrates in K+-depleted mitochondria induced by the polyether is reversed by concentrations of K+ higher than 60 mM, and also by Li+, a cation that does not complex with polyether XXVIII. As assayed by swelling mitochondria, reversal of the inhibition of electron transfer is accompanied by influx of monovalent cations. Polyether XXVIII also inhibits in submitochondrial particles the aerobic oxidation of NADH, but not that of succinate; this inhibition is also reversed by K+ at high concentrations, and Li+. The data are consistent with the hypothesis that a monovalent cation is required for maximal rates of electron transport in the NADH-CoQ span of the respiratory chain.

Rifaximin versus ciprofloxacin for the treatment of traveler's diarrhea: a randomized, double-blind clinical trial.

Rifaximin is a poorly absorbed rifamycin derivative under investigation for treatment of infectious diarrhea. Adult students from the United States in Mexico and international tourists in Jamaica were randomized to receive either rifaximin (400 mg twice per day) or ciprofloxacin (500 mg twice per day) for 3 days, following a double-blinded model, from June 1997 to September 1998. A total of 187 subjects with diarrhea were studied. Time from initiation of therapy to passage of last unformed stool was comparable for those receiving rifaximin or ciprofloxacin (median, 25.7 hours versus 25.0 hours, respectively). There was no significant difference in the proportion of subjects in the 2 groups with respect to clinical improvement during the first 24 hours (P=.199), failure to respond to treatment (P=.411), or microbiological cure (P=.222). The incidence of adverse events was low and similar in each group. Rifaximin is a safe and effective alternative to ciprofloxacin in the treatment of traveler's diarrhea.

Ultrastructural changes of tissues produced by inhalation of thinner in rats.

Thinner is a substance that is used for industrial purposes and for drug abuse; addiction is of young people (average age, 7.5 years). Although the health problem of voluntary or nonvoluntary solvent sniffing is important, great attention has been paid to the epidemiology and pharmacology of paint thinner or industrial solvents inhalation, but studies at the morphological and biochemical level are scarce. This work describes the morphological changes in the lung, liver, kidney, adrenal glands, and central nervous system induced by short- (up to 4 weeks) and long-term (up to 14 weeks) periods of thinner inhalation in rats.

Proteolytic cleavage of ACTH in corticotropes of sexually mature axolotls (Ambystoma mexicanum).

Immunohistochemical analysis of the pituitary of sexually mature axolotls revealed both ACTH(1-39)-related and alpha-MSH-related immunoreactivity present in corticotropic cells located in the rostral anterior pituitary. Gel filtration analysis indicated that the ACTH(1-39)-sized immunoreactivity and the alpha-MSH-sized immunoreactivity detected in acid extracts of the axolotl anterior pituitary were present in a ratio in a range between 1:1 and 1:0.6. Reversed-phase HPLC analyses indicated that the alpha-MSH-sized immunoreactivity had the same retention time as synthetic ACTH(1-13)-NH2. The corticotropic activity of the ACTH(1-39)-sized immunoreactivity and the purified ACTH(1-13)-NH2 was tested in a heterologous, larval bullfrog adrenal bioassay system. As expected, the ACTH(1-39)-sized immunoreactivity stimulated corticosterone release; however, the purified ACTH(1-13)-NH2 lacked glucocorticoid activity. The proteolytic cleavage of ACTH in corticotropes of sexually mature axolotls was identical to the cleavage events observed in neotenic Ambystoma tigrinum that had not reached sexual maturity. These studies indicate that the transient expression of ACTH cleavage activity is not affected by the reproductive state of the animal. Since axolotls do not undergo metamorphosis, it is possible that events associated with metamorphosis may induce the decline in ACTH cleavage activity observed in amphibian corticotropes.

Suppressed ion chromatography for monitoring chemical impurities in steam for geothermal power plants.

A suppressed ion chromatography (IC) technique has been evaluated as a chemical monitoring tool for detecting major anions (F-, Cl-, NO3- and SO4(2-)) of condensed steam in geothermal power plants. It is shown that the suppressed IC technique provides a suitable means for preventing possible damage to generating equipment in the geothermal industry. An electrical conductivity detector (0.1 microS sensitivity) with an anion-exchange column (IonPac AS4A-SC), a micro-membrane suppressor (AMMS II), and an isocratic high-pressure pump system were successfully used for detecting low concentrations of inorganic anions. Method detection limits for the anions of interest were <0.184 mg/L. Details of the IC methodology as well as some experimental results obtained during its application for the chemical monitoring of geothermal steam pipes are also described.

Thalidomide does not modify the ability of cells in leprosy patients to incorporate [3H]-thymidine when incubated with M. leprae antigens.

The immune response in reversal reaction, (RR) and in erythema nodosum leprosum (ENL) is characterized in vitro by an enhancement in lymphocyte blast transformation against M. leprae. As thalidomide is an effective treatment for ENL, this study assessed the effect of this drug on these phenomena. Mononuclear cells from patients attending the clinic at ALERT and from healthy staff were cultured for 5 days with integral M. leprae (IMl), or a modified Dharmendra antigen (Dhar), or PPD from M. tuberculosis. In one set of cultures, thalidomide was added once at the initiation of the culture; in the other set thalidomide was added a second time (2x), 18 h prior to harvesting the cells. The mononuclear cells, in the absence of thalidomide, from healthy staff, borderline tuberculoid patients (BT) and BT patients in RR (BT/RR) incorporated [3H]-thymidine best when cultured with PPD > Dhar > M. leprae. The cells from patients with ENL did not respond well to the M. leprae antigens. Thalidomide (2x) enhanced proliferation to Dhar in the BTRR group (Wilcoxon signed rank test, P < 0.05). No significant changes occurred for the other groups. Comparing PPD-stimulated cells treated with thalidomide once to those treated with thalidomide twice, thalidomide (2x) suppressed incorporation of [H3]-thymidine by the PPD-stimulated (P < 0.05) as well as IMl-stimulated (P < 0.05) cells in the healthy staff group. In the Dhar-stimulated cells from the healthy staff thalidomide significantly suppressed TNF-alpha (P < 0.05). A mixed effect was seen within and between the other groups, but there was a trend for thalidomide to suppress TNF-alpha induced by the M. leprae, Dhar and PPD antigens.