Elective segmental ureterectomy for transitional cell carcinoma of the ureter: long-term follow-up in a series of 73 patients.

UNLABELLED: What's known on the subject? and What does the study add? Upper Urinary Tract (UUT) Transitional Cell Carcinoma (TCC) is an uncommon disease and represents approximately 5% of all urothelial carcinomas. We report our series on 73 patients treated with Kidney Sparing Surgery for UUT TCC. Good results have been achieved in terms of oncological outcome comparing this conservative approach to the radical nephrourectomy. OBJECTIVES: • To report the long-term oncological outcome in patients with transitional cell carcinoma of the ureter electively treated with kidney-sparing surgery. • To compare our data with the few series reported in the literature. PATIENTS AND METHODS: • We considered 73 patients with transitional cell carcinoma of the distal ureter treated in five Italian Departments of Urology. • The following surgeries were carried out: 38 reimplantations on psoas hitch bladder (52%), 21 end-to-end anastomoses (28.8%), 11 direct ureterocystoneostomies (15.1%) and three reimplantations on Boari flap bladder (4.1%). • The median follow-up was 87 months. RESULTS: • Tumours were pTa in 42.5% of patients, pT1 in 31.5%, pT2 in 17.8% and pT3 in 8.2%. • Recurrence of bladder urothelial carcinoma was found in 10 patients (13.7%) after a median time of 28 months. • The bladder recurrence-free survival at 5 years was 82.2%. • The overall survival at 5 years was 85.3% and the cancer-specific survival rate at 5 years was 94.1%. CONCLUSION: • Our data show that segmental ureterectomy procedures do not result in worse cancer control compared with data in the literature regarding nephroureterectomy.

Role of US in acute scrotal pain.

BACKGROUND: The acute scrotum is a common emergency department (ED) presentation and can be defined as any condition of the scrotum or intrascrotal contents requiring emergent medical or surgical intervention. Although rarely fatal, acute scrotal pathology can result in testicle infarction and necrosis, testicular atrophy, infertility, and significant morbidity. METHODS: Scrotal US is best performed with a linear 7.5- to 12-MHz transducer. In addition to imaging in the longitudinal and transverse planes, it is helpful to obtain simultaneous images of both testes for comparison. Color Doppler is used to evaluate for abnormalities of flow and to differentiate vascular from nonvascular lesions. Attention to appropriate color Doppler settings to optimize detection of slow flow is critical. RESULTS: The evaluation of acute scrotal pain can be challenging for the clinician initially examining and triaging the patient. Acute scrotal conditions due to traumatic, infectious, vascular, or neoplastic etiologies can all present with pain as the initial complaint. Additionally, the laboratory and physical examination findings in such conditions may overlap; this, coupled with potential patient guarding and lack of collaboration, may result in a limited, non-specific physical examination. Therefore, scrotal ultrasound has emerged to play a central role in the evaluation of the patient presenting with acute scrotal pain. CONCLUSIONS: In conclusion, we are firmly convinced that a scrotal ultrasound should always be performed in the presence of acute scrotal pain. Moreover, urologist should be able to perform a scrotal ultrasound but, if imaging does not supply a clear diagnosis, surgical exploration is still mandatory.

Effects of soy milk as a dietary complement during the natural aging process.

INTRODUCTION: Oxidative stress is one mechanism that could contribute to the acceleration of aging and age-related diseases. On the other hand, because of their antioxidative qualities soybean derived foods could have beneficial effects on the aging process. OBJECTIVES: The aim of our work was to study the effects of a diet supplemented with soy milk on certain biological features of aging in rats. METHODS: Male Wistar rats of 3 to 18 months of age, were assigned to one of two diets: 1) Experimental Group, commercial rat formula and soy milk; 2) Control Group, commercial rat formula and water. Every three months both lipid profile and lipid peroxidation were determined and neuronal cells of hippocampus were counted in control and experimental rats. RESULTS: The soy milk diet significantly improved the plasmatic lipid profile, decreasing serum cholesterol (total as well as LDL) and serum triglycerides, HDL-cholesterol was significatively higher in experimental animals. The LDL/HDL ratio was thus significantly lowered. The soy diet also produced decreased values of lipid peroxidation in brain, liver and kidney. These effects were significant after 6 to 9 months. The experimental animals lost fewer hippocampal neurons than the controls. Finally at 18 months of age, a greater number of surviving animals in experimental group with respect to the control one was observed. CONCLUSIONS: 1) soy intake could have beneficial effects as a complement of normal diet, but not as a replacement for animal proteins and 2) these effects are the result of a very long period (almost lifelong) of consumption of this diet.

Effects of soy milk as a dietary complement during the natural aging process / Efecto de la leche de soja como complemento dietario durante el proceso de envejecimiento natural

Introduction: Oxidative stress is one mechanism that could contribute to the acceleration of aging and age-related diseases. On the other hand, because of their antioxidative qualities soybean derived foods could have beneficial effects on the aging process. Objectives: The aim of our work was to study the effects of a diet supplemented with soy milk on certain biological features of aging in rats Methods: Male Wistar rats of 3 to 18 months of age, were assigned to one of two diets: 1) Experimental Group, commercial rat formula and soy milk; 2) Control Group, commercial rat formula and water. Every three months both lipid profile and lipid peroxidation were determined and neuronal cells of hippocampus were counted in control and experimental rats. Results: The soy milk diet significantly improved the plasmatic lipid profile, decreasing serum cholesterol (total as well as LDL) and serum triglycerides, HDL-cholesterol was significatively higher in experimental animals. The LDL/HDL ratio was thus significantly lowered. The soy diet also produced decreased values of lipid peroxidation in brain, liver and kidney. These effects were significant after 6 to 9 months. The experimental animals lost fewer hippocampal neurons than the controls. Finally at 18 months of age, a greater number of surviving animals in experimental group with respect to the control one was observed. Conclusions: 1) soy intake could have beneficial effects as a complement of normal diet, but not as a replacement for animal proteins and 2) these effects are the result of a very long period (almost lifelong) of consumption of this diet (AU)

Introducción: El estrés oxidativo es uno de los mecanismos que contribuye al envejecimiento y al desarrollo de enfermedades crónicas. Por otro lado, los alimentos a base de soja, por a sus cualidades antioxidantes podrían tener un efecto benéfico en este proceso. Objetivos: El propósito de nuestro trabajo fue estudiar el efecto de la suplementación dietaria con leche de soja sobre algunos parámetros biológicos del envejecimiento natural, en ratas. Material y métodos: Se trabajó con ratas Wistar macho, desde los 3 y hasta los 18 meses de edad. Los animales fueron asignadas a dos dietas: 1) grupo experimental: alimento balanceado para ratas y leche de soja, ad libitum; 2) grupo control: alimento balanceado y agua ad libitum. Cada tres meses, en ambos grupos se realizaron las siguientes determinaciones: a) perfil lipídico plasmático; b) lipoperoxidación (MDA) en homogenato de cerebro, hígado y riñón, y c) recuento del número de cuerpos neuronales en el hipocampo. Resultados: La alimentación con leche de soja mejoró notablemente el perfil lipídico: se encontró una disminución significativa de colesterol total, LDL-colesterol, triglicéridos y el índice LDL/HDL. Asimismo, se observó, en hígado, cerebro y riñón, una reducción de la lipoperoxidación, que alcanzó valores significativos entre los 6 y 9 meses de alimentación. Los animales alimentados con leche de soja perdieron menos neuronas en el hipocampo en relación a los controles. Finalmente, se observó un mayor número de animales sobrevivientes, a los 18 meses de edad, en el grupo experimental con respecto al control Conclusiones: La leche de soja podría ejercer efectos benéficos como complemento de la dieta normal, no en reemplazo de las proteínas animales. Estos efectos se observan después de un periodo prolongado de ingesta (casi toda la vida) (AU)