Dusting efficacy between the regular setting of holmium laser (Ho:YAG) versus Vapor Tunnel pulse modality for non-complex kidney stones.

The new pulse modality Vapor-Tunnel™ (VT) consists of a very long pulse that uses the minimum peak power, causing the energy to pass through a previously created vapor channel or tunnel. The first part of the pulse creates a vapor channel, whereas the remaining energy is discharged immediately after, passing straight through the previously created tunnel. The aim of this study is to compare the dusting efficacy between Ho:YAG laser with long pulse and Ho:YAG laser with VT for non-complex kidney stones. A retrospective comparative study of 236 patients who underwent retrograde intrarenal surgery using Ho:YAG laser (long pulse vs. VT) was performed. Stone size, stone density, laser settings, laser emission time, and total operative time were recorded. We also assessed the lithotripsy efficacy (J/mm3). The stone-free rate was defined as the absence of stone fragments in a non-contrast abdominal computed tomography 4 weeks after the procedure. A total of 118 patients were included in each group. There was no significant difference in age, gender, and body mass index. Median stone volume (737 mm3 vs. 636 mm3) and stone density (788 HU vs. 656 HU) were higher in the VT group. Total energy used (14.5 J vs. 18.2 J), the laser emission time (20 min vs. 26 min), and the total operative time (79.5 min vs. 95 min) were significantly lower in the VT group. The stone-free rate was comparable between both groups (74.5% for VT and 66.1% for the long-pulse group, p = 0.15). When we evaluated the efficacy of laser lithotripsy, a significantly lower difference was obtained in the VT group (median 12.5 J/mm3 vs. median 23.1 J/mm3). The VT pulse modality was associated with decreased laser time and operative time. Additionally, it increased lithotripsy efficacy compared to Ho:YAG long pulse laser, but with a comparable free-stone rate.

c-Abl stabilizes HDAC2 levels by tyrosine phosphorylation repressing neuronal gene expression in Alzheimer's disease.

In Alzheimer's disease (AD), there is a decrease in neuronal gene expression induced by HDAC2 increase; however, the mechanisms involved are not fully elucidated. Here, we described how the tyrosine kinase c-Abl increases HDAC2 levels, inducing transcriptional repression of synaptic genes. Our data demonstrate that (1) in neurons, c-Abl inhibition with Imatinib prevents the AßO-induced increase in HDAC2 levels; (2) c-Abl knockdown cells show a decrease in HDAC2 levels, while c-Abl overexpression increases them; (3) c-Abl inhibition reduces HDAC2-dependent repression activity and HDAC2 recruitment to the promoter of several synaptic genes, increasing their expression; (4) c-Abl induces tyrosine phosphorylation of HDAC2, a posttranslational modification, affecting both its stability and repression activity; and (5) treatment with Imatinib decreases HDAC2 levels in a transgenic mice model of AD. Our results support the participation of the c-Abl/HDAC2 signaling pathway in the epigenetic blockade of gene expression in AD pathology.

Effect of exogenous lipids on cryotolerance of Atlantic salmon (Salmo salar) spermatozoa.

The development of semen cryopreservation strategies is necessary to improve the semen storage technologies of species of great commercial interest for aquaculture. Recent studies demonstrate that lipids play an important role in the fertility and cryotolerance of fish gametes. This study investigated the effect of exogenous lipids in the freezing medium on the post-thaw functional parameters of Salmo salar spermatozoa. Semen samples (n = 12) were incubated in standard extender supplemented with different concentrations of oleic acid (OA, C18:1n9), linoleic acid (LA, C18:2n6), arachidonic acid (ARA, C20:4n6) and cholesterol-loaded cyclodextrin (CLC). Post-thaw motility, membrane integrity, mitochondrial membrane potential (ΔΨm), superoxide anion (O2•-) and fertility rates were analyzed. The results revealed that the semen incubated with 0.003 mmol/L OA increased the motility (~7%) and ΔΨm (~2%) (P < 0.05), but membrane integrity and fertility were not increased. The addition of 0.003 mmol/L LA increased the motility (~4%) and all LA extenders increased the ΔΨm (P < 0.05); however, LA increased the O2•- levels and decreased the membrane integrity and fertility (P < 0.05). Semen incubated with ARA improved sperm motility (~5%), membrane integrity (~10.5%) and fertility rates (~11%) (P < 0.05). The maximum improvement in post-thaw sperm functionality was observed by adding 0.003 mmol/L ARA. In contrast, sperm quality parameters and fertility were decreased by the CLC addition (P < 0.05). This study showed that ARA could be considered as an additive for semen cryopreservation and could be relevant in the reproductive process and reproductive management of Salmo salar.

Neuronal gene repression in Niemann-Pick type C models is mediated by the c-Abl/HDAC2 signaling pathway.

BACKGROUND: Niemann-Pick type C (NPC) disease is a fatal neurodegenerative disorder characterized by the accumulation of free cholesterol in lysosomes. There are currently no effective FDA-approved treatments for NPC, although in the last years the inhibition of histone deacetylases (HDACs) has emerged as a potential treatment for this disease. However, the molecular mechanisms that deregulate HDAC activity in NPC disease are unknown. Previously our group had shown that the proapoptotic tyrosine kinase c-Abl signaling is activated in NPC neurons. Here, we demonstrate that c-Abl activity increases HDAC2 levels inducing neuronal gene repression of key synaptic genes in NPC models. RESULTS: Our data show that: i) HDAC2 levels and activity are increased in NPC neuronal models and in Npc1(-/-) mice; ii) inhibition of c-Abl or c-Abl deficiency prevents the increase of HDAC2 protein levels and activity in NPC neuronal models; iii) c-Abl inhibition decreases the levels of HDAC2 tyrosine phosphorylation; iv) treatment with methyl-ß-cyclodextrin and vitamin E decreases the activation of the c-Abl/HDAC2 pathway in NPC neurons; v) in vivo treatment with two c-Abl inhibitors prevents the increase of HDAC2 protein levels in the brain of Npc1(-/-) mice; and vi) c-Abl inhibition prevents HDAC2 recruitment to the promoter of neuronal genes, triggering an increase in their expression. CONCLUSION: Our data show the involvement of the c-Abl/HDAC2 signaling pathway in the regulation of neuronal gene expression in NPC neuronal models. Thus, inhibition of c-Abl could be a pharmacological target for preventing the deleterious effects of increased HDAC2 levels in NPC disease.

Stent Syndrome: Does the Diameter Matter? Results of a Randomized Trial.

Introduction: Double-J (DJ) ureteral stents are used for multiple purposes in urology. Even though they temporize the subsequent treatment of lithiasis, they may cause different symptoms that impact quality of life (QoL). Purpose: In this randomized trial, we assessed whether the diameter of ureteral stents has an impact on catheter-associated symptoms, and their impact on QoL. Methods: A total of 194 consecutive patients undergoing DJ insertion between December 2018 and December 2022 were prospectively enrolled and divided into three categories: 4.7F (Group 1, n = 71), 6F (Group 2, n = 65), and 7F (Group 3, n = 58). Within 1 week after the DJ placement, patients completed the validated Spanish version of the Ureteral Stent Symptoms Questionnaire. Continuous variables were compared using analysis of variance and Student's t-tests. For categorical data, the chi-square test was used. Results: In the domain of "work" and "additional problems," there were significant differences. In the "Work" domain, Group 1 presented the lower symptoms. In the domain "additional problems," patients in Group 1 were prescribed fewer antibiotics owing to low urinary tract symptoms. In question U4 about urinary incontinence, patients in Groups 2 and 3 developed these symptoms more than patients in Group 1. In the "sexual activity" domain, specifically in question S3 (the patient has ever suffered any type of pain during sexual activity?), patients with 4.7F presented lower scores than patients with larger catheters. Conclusion: DJ-related symptoms affect QoL in most cases. Smaller catheters produced significantly less urinary incontinence, faster work reincorporation, fewer symptoms related to sexual activity, and fewer catheter-related symptoms than 7F catheters. In contrast, Group 3 presented fewer outpatient visits because of symptoms related to the DJ.

Extracted Eucalyptus globulus Bark Fiber as a Potential Substrate for Pinus radiata and Quillaja saponaria Germination.

This study aimed to explore alternative substrates for growing forest species using eucalyptus bark. It evaluated the potential of extracted Eucalyptus globulus fiber bark as a substitute for commercial growing media such as coconut fiber, moss, peat, and compost pine. We determined the physicochemical parameters of the growing media, the germination rate, and the mean fresh and dry weights of seedlings. We used the Munoo-Liisa Vitality Index (MLVI) test to evaluate the phytotoxicity of the bark alone and when mixed with commercial substrates. Generally, the best mixture for seed growth was 75% extracted eucalyptus bark fiber and 25% commercial substrates. In particular, the 75E-25P (peat) mixture is a promising substitute for seedling growth of Pinus radiata, achieving up to 3-times higher MLVI than the control peat alone. For Quillaja saponaria, the best growth substrate was the 50E-50C (coconut fiber) mixture, which had the most significant MLVI values (127%). We added chitosan and alginate-encapsulated fulvic acid phytostimulants to improve the performance of the substrate mixtures. The fulvic acid, encapsulated or not, significantly improved MLVI values in Q. saponaria species and P. radiata in concentrations between 0.05 and 0.1% w/v. This study suggests that mixtures with higher levels of extracted fiber are suitable for growing forest species, thus promoting the application of circular economy principles in forestry.

Management of Kidney Stones in Pregnancy: A Worldwide Survey of Practice Patterns.

Introduction: Kidney stones in pregnant is not a common emergency, but it is one that is extremely challenging to manage. There exists no previous survey, which maps the different practice patterns adopted. Our aim was to deliver a survey to evaluate the current status of practice patterns across different parts of the world regarding the management of stone disease in pregnancy. Methods: Through an iterative process, 19-item survey was devised. This contained the following five sections: (1) Demographics, (2) General items, (3) Diagnosis and Imaging, (4) Initial management, (5) Surgery. It was disseminated via social media and email chains. Results: A total of 355 responses were collected, and the majority (66.2%) reported no established hospital protocol for stones in pregnancy. Ultrasound was the most popular first line imaging choice (89.9%) but 8% would choose non-contrast CT. The latter was also chosen as second line choicer in 34.6% as opposed to magnetic resonance imaging. A large proportion (42.5%) had requested CT in pregnancy previously. With equivocal ultra sound results, only 19.4% would proceed to ureteroscopy (URS) but 40.9% would opt for CT. Twenty-four-48 hours were the most popular (37.6%) time period to observe before surgical intervention. Ureteral stent and nephrostomy were regarded as equally effective, and 6 weeks was most popular frequency for an exchange. Most do not use fetal heart rate monitoring intraoperatively. A total of 3.94% had previously performed percutaneous nephrolithotomy during pregnancy. Conclusion: Practice patterns vary widely for suspected kidney stones in pregnancy and use of CT appears increasingly popular. This includes when faced with equivocal ultrasound results and instead of proceeding to ureteroscopy. Most hospitals lack an established management protocol for this scenario.

TFEB.

Contreras and Puertollano introduce TFEB, a transcription factor that orchestrates cellular responses to stress via mechanisms including upregulation of lysosome biogenesis and autophagy.

Beta-coronaviruses exploit cellular stress responses by modulating TFEB and TFE3 activity.

Beta-coronaviruses have emerged as a severe threat to global health. Undercovering the interplay between host and beta-coronaviruses is essential for understanding disease pathogenesis and developing efficient treatments. Here we report that the transcription factors TFEB and TFE3 translocate from the cytosol to the nucleus in response to beta-coronavirus infection by a mechanism that requires activation of calcineurin phosphatase. In the nucleus, TFEB and TFE3 bind to the promoter of multiple lysosomal and immune genes. Accordingly, MHV-induced upregulation of immune regulators is significantly decreased in TFEB/TFE3-depleted cells. Conversely, over-expression of either TFEB or TFE3 is sufficient to increase expression of several cytokines and chemokines. The reduced immune response observed in the absence of TFEB and TFE3 results in increased cellular survival of infected cells but also in reduced lysosomal exocytosis and decreased viral infectivity. These results suggest a central role of TFEB and TFE3 in cellular response to beta-coronavirus infection.

Worldwide trends of practice and intervention in paediatric endourology: comparison of European versus Non-European responses.

Introduction: The area of paediatric endourology is unique and is recognised to be challenging, and it requires a certain level of focused training and expertise. Our aim was to conduct a worldwide survey in order to gain an overview regarding the current practice patterns for minimally invasive treatments of paediatric upper urinary tract stone patients. Material and methods: The survey was distributed between December 2021 and April 2022 through urology sections and societies in United Kingdom, Latin America and Asia. The survey was made up of 20 questions and it was distributed online using the free online Google Forms (TM). Results: 221 urologists answered the survey with 56 responses each from India, South America and UK and 53 responses from the rest of Europe (15 countries). In total, 163 responders (73.7%) managed paediatric stone patients in their daily practice. Of the responders, 60.2% were adult urologists and 39.8% were paediatric urologists. 12.9% adult urologists and 20.4% paediatric urologists run independent clinics while some run combined adult and paediatric clinics sometimes with the support of the nephrologists. Only 33.9% urologists offered all surgical treatments [extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), ureteroscopy (URS) and retrograde intrarenal surgery (RIRS)]. Conclusions: Treatment of paediatric stones can vary according to country and legislations. Based on the results of this survey, minimally invasive methods such as URS and mini PCNL seem to have become more popular. In most institutions a collaboration exists between adult and paediatric urologists, which is the key for a tailored decision making, counselling and treatment success.

Hemoperitoneum after transperineal prostate biopsy.

Bleeding is the most common complication after a prostate biopsy, commonly self-limited. We describe a case of a patient who developed a hemoperitoneum after a transperineal prostate biopsy. A 65-year-old man with a history of prostate cancer diagnosed in 2016 by transurethral resection, with no further urologic control until 2020 when a rise in the serum prostate-specific antigen was diagnosed: 4.49 ng/ml. Prostate digital rectal examination had no pathologic findings. Magnetic resonance imaging informed anequivocal lesion. A target transperineal fusion biopsy was performed, guided by ultrasound (US). Pre-surgical blood tests, including coagulogram, were normal. No immediate postoperative complications were recorded, and the patient was discharged. Hours later, he returned after a head concussion due to orthostatic hypotension and diffuse abdominal pain. Blood test showed a drop in hematocrit and hemoglobin values. Abdominal US and abdominopelvic computed tomography scan showed free intraperitoneal fluid and intraperitoneal hematic collection on top of the bladder of 104 × 86 mm with no active bleeding. The patient was admitted to intensive care unit due to persistent hypotension despite fluid restoration. He received a single-unit blood transfusion and had a good response to vasopressors. Abdominal pain decreased. He was finally discharged with stable hematocrit 48hours after admission. Clinical management with no surgery or radiologic angio-embolization was required. We found no clear origin of the intraperitoneal bleeding, but we hypothesize that maybe the previous transurethral resection of the prostate made anatomical changes that facilitated blood passage to the abdominal cavity after puncture of branches from the inferior vesical artery.

La complicación más frecuente tras una biopsia prostática es el sangrado, generalmente autolimitado. Aquí describimos un caso de hemoperitoneo secundario a dicho procedimiento. Hombre de 65 años con antecedentes de cáncer de próstata diagnosticado en 2016 por una resección transuretral de próstata, sin seguimiento urológico, consultó en 2020 por aumento del antígeno prostático específico: 4.49 ng/ml, asociado a tacto rectal normal y una resonancia multiparamétrica de próstata mostró una lesión indeterminada. Se realizó una biopsia prostática transperineal por fusión guiado por ecografía. Los análisis preoperatorios, incluido coagulograma, eran normales. No se registraron complicaciones intraquirúrgicas y se indicó el alta. Horas más tarde, consultó al hospital por hipotensión ortostática y dolor abdominal difuso. Los análisis demostraron caída del hematocrito y hemoglobina. Una ecografía y posterior tomografía computada evidenciaron una colección supravesical de 104 × 86mm sin signos de sangrado activo. Se indicó internación en sala de cuidados intensivos debido a hipotensión refractaria a expansiones con requerimiento de vasopresores. Recibió una transfusión de glóbulos rojos. Por favorable evolución, 48 horas después del ingreso recibió el alta. En este caso, fue posible un manejo conservador, sin requerimiento de cirugía o embolización. Si bien no se encontró sitio exacto del sangrado, creemos que la resección transuretral previa podría haber generado cambios anatómicos que facilitaran el pasaje de sangre, posiblemente proveniente de ramas de la arteria vesical inferior a cavidad abdominal luego de la punción.

[Moderate/severe hydronephrosis before ureteral double-j stent insertion is associated with less back pain during micturition.] / La hidronefrosis moderada/severa antes de la inserción del catéter ureteral doble J se asocia con menos dolor de espalda durante la micción.

OBJECTIVE: Symptoms related toureteral double-J stent are the most common complaintamong patients. Back pain during micturition isone of the most frequent but intensity and durationmay vary between them. This study aimed to assessthe relationship between hydronephrosis grade beforeureteral double-j stent insertion and back pain duringmicturition. PATIENTS AND METHODS: All consecutive patientsundergoing a ureteral double-j insertion secondaryto urolithiasis between 2017 and 2019 were prospectivelyenrolled. Hydronephrosis was assessed using aCT scan and was categorized according to renal pelvismeasure as 0-10 mm (low group), and ≥10 mm(moderate group). At one week postoperative, patientsymptoms were evaluated using the Spanish validatedversion of the Ureteral Stent Symptom Questionnaire(USSQ) and 10 cm visual analog scale (VAS). Meanscores for USSQ domains and mean VAS scores werecompared. RESULTS: 149 patients were included and evaluated.The mean age was 48.2±15.1 years. We found no significantdifferences in mean scores for each main domainin the USSQ or VAS. The presence of flank painduring micturition was present in 73.5% and 52.5 %for the low vs moderate hydronephrosis group respectively(p=0.01). Sub-analysis by gender was 78.7 % vs44.0 % (p=0.00) and 58.6% vs 66.6% (p=0.6) of low andmoderate group in men and women respectively.Analysis of the USSQ item score revealed thatthe moderate hydronephrosis group presented less''pain or discomfort when urinating,'' less ''presenceof back pain when urinating,'' less ''admission orprocedure because of discomfort,'' and less ''feelingabout reinsertion''. CONCLUSION: Patients in the moderate hydronephrosisgroup did not have significant advantagesin terms of voiding symptoms, pain, general health,sexual matters, or additional problems determined bythe USSQ or in VAS. However, sub-analysis reportedadvantages concerning pain and additional questions.Men with moderate hydronephrosis presented statisticallysignificantly less pain during micturition.

INTRODUCCIÓN Y OBJETIVO: Lossíntomas relacionados con el catéter ureteral doble-Json la queja más común en los pacientes. El dolor deespalda durante la micción es uno de los más frecuentes,pero la intensidad y la duración varían entre ellos.El objetivo de este estudio fue evaluar la relación entreel grado de hidronefrosis antes de la inserción del catéterureteral doble-J y el dolor de espalda durante lamicción. PACIENTES Y MÉTODOS: Se incluyeron prospectivamentetodos los pacientes consecutivos que sesometieron a la inserción de un catéter ureteral doblej debido a la urolitiasis entre 2017 y 2019. La hidronefrosisse evaluó mediante una tomografía computarizaday se clasificó según la medida de la pelvis renalcomo 0-10 mm (grupo bajo), y ≥10 mm (grupo moderado/severo). Una semana después de la operación,los síntomas del paciente se evaluaron utilizando laversión validada en español del Cuestionario de Síntomasdel Catéter Ureteral (USSQ) y la la escala visualanáloga (EVA) de 10 cm. Se compararon las puntuaciones medias de los dominios del USSQ y las puntuacionesmedias de la EVA. RESULTADOS: Se incluyeron y evaluaron 149 pacientes.La edad media fue de 48,2±15,1 años. No seencontraron diferencias significativas en las puntuacionesmedias de cada dominio principal en la USSQo la EVA. La presencia de dolor en el flanco durante lamicción estuvo presente en el 73,5% y el 52,5% parael grupo de hidronefrosis baja vs. moderada respectivamente(p=0,01). El subanálisis por género fue 78,7% vs 44,0 % (p=0,00) y 58,6 % vs 66,6 % (p=0,6) delgrupo de baja y moderada en hombres y mujeres respectivamente.El análisis de la puntuación de los ítems de laUSSQ reveló que el grupo de hidronefrosis moderadapresentó menos "dolor o molestia al orinar", menos"presencia de dolor de espalda al orinar", menos "admisióno procedimiento por molestia" y menos "sensaciónde reinserción". CONCLUSIÓN: Los pacientes del grupo de hidronefrosismoderada no ofrecen ventajas significativas encuanto a los síntomas de evacuación, el dolor, la saludgeneral, las cuestiones sexuales o los problemasdeterminados por el USSQ o en EVA. Sin embargo, elsubanálisis informó de ventajas relativas al dolor ypreguntas adicionales. Los hombres con hidronefrosismoderada presentaban un dolor estadísticamente significativodurante la micción.

[Risk factors for contrast extravasation in renal colic]. / Factores de riesgo para extravasación de contraste en cólico renal.

INTRODUCTION: Non-traumatic ruptureof the pyeloureterocaliceal system (PUC) is anuncommon clinical entity. The most frequent cause isureteral obstruction due to lithiasic pathology, whichis present in up to 75%. To our knowledge, there isno description in the literature of the possible factorsassociated with this event. Our objective is to analyzethe variables associated with intravenous contrastextravasation in patients with renal colic due to singleureteral lithiasis. MATERIALS AND METHODS: We performed aretrospective, descriptive analysis of a series ofpatients who, in the context of renal colic, presentedendovenous contrast extravasation throughthe urinary system in computed tomography (CT).Patients with single ureteral lithiasis without otherassociated pathology were included. A comparisonof the samples from the group with contrast leakage(group 1) with an equal number of consecutiveCT scans without contrast leakage (group 2) in patientswith renal colic lithiasis was performed in alogistic regression model to identify risk factors forcontrast leakage. RESULTS: There were 117 cases of contrast leakagefrom January 2013 to July 2018. Eighty-sixpercent of the lithiases were 5 mm and 79% werelocated in the lower ureter. 72% of patients presentedwith intrarenal pelvis. In the univariate analysisboth location in lower ureter, lithiasis 5 mm, andintrarenal pyelic anatomy increased the probabilityof extravasation. In multivariate model, 5 mmlithiasis increased five times the risk of extravasationcompared to larger ones, the location in distalureter increased three times and the anatomy withintrarenal pelvis increased two times compared toother location and extrarenal pelvis, respectively, ina statistically significant way the risk of presentingcontrast leakage. CONCLUSION: In this series, we found an increasedrisk of contrast leakage in a lithiasic renalcolic in patients with intrarenal pelvic anatomy,with lithiasis less than or equal to 5 mm and locatedin the lower ureter.

INTRODUCCIÓN: La ruptura no traumaticadel sistema pieloureterocalicial (PUC) es una entidadclínica poco común. La causa más frecuente esla obstrucción ureteral por patología litiásica, que sepresenta hasta en un 75%. A nuestro conocimiento, noexiste en la literatura una descripción de los posiblesfactores asociados con este evento. Nuestro objetivo esanalizar las variables asociadas con la extravasaciónde contraste endovenoso en pacientes con cólico renalpor litiasis ureteral única.MATERIALES Y MÉTODOS: Se realizó un análisis retrospectivo,descriptivo, de una serie de pacientes que,en contexto de cólico renal, presentaron extravasaciónde contraste endovenoso por el sistema urinario entomografía computada (TC). Se incluyeron pacientescon litiasis ureteral única sin otra patologia asociada.Se realizó una comparación de las muestras del grupocon fuga de contraste (grupo 1) con igual número detomografías consecutivas sin fuga de contraste (grupo2) en paciente con cólico renal litiásico, en un modelode regresión logística para identificar factores de riesgode fuga de contraste. RESULTADOS: Se registraron 117 casos de fuga decontraste desde enero de 2013 hasta julio de 2018. El86% de los litos fueron ≤ 5 mm y el 79 % se ubicaronen uréter inferior. El 72% de los pacientes presentópelvis intrarrenal. En el análisis univariado tanto ubicaciónen uréter inferior, litiasis ≤ 5 mm, como anatomíapielica intrarrenal aumentaron la probabilidad deextravasación. En el modelo multivariado, litiasis ≤ 5mm aumentaron cinco veces el riesgo de extravasacióncomparado con las mayores, la ubicación en uréterdistal aumentó en tres veces y la anatomía con pelvisintrarrenal aumentó en dos veces comparado conotra ubicación y pelvis extrarrenal, respectivamente,de manera estadísticamente significativa el riesgo depresentar fuga de contraste.CONCLUSIÓN: En esta serie, encontramos aumentode riesgo de fuga de contraste en un cólico renal litiásicoen pacientes con anatomía piélica intrarrenal,con litos menores o iguales a 5 mm y ubicados enuréter inferior.

The FACT complex facilitates expression of lysosomal and antioxidant genes through binding to TFEB and TFE3.

TFEB (transcription factor EB) and TFE3 (transcription factor binding to IGHM enhancer 3) orchestrate the cellular response to a variety of stressors, including nutrient deprivation, oxidative stress and pathogens. Here we describe a novel interaction of TFEB and TFE3 with the FAcilitates Chromatin Transcription (FACT) complex, a heterodimeric histone chaperone consisting of SSRP1 and SUPT16H that mediates nucleosome disassembly and assembly, thus facilitating transcription. Extracellular stimuli, such as nutrient deprivation or oxidative stress, induce nuclear translocation and activation of TFEB and TFE3, which then associate with the FACT complex to regulate stress-induced gene transcription. Depletion of FACT does not affect TFEB activation, stability, or binding to the promoter of target genes. In contrast, reduction of FACT levels by siRNA or treatment with the FACT inhibitor curaxin, severely impairs induction of numerous antioxidant and lysosomal genes, revealing a crucial role of FACT as a regulator of cellular homeostasis. Furthermore, upregulation of antioxidant genes induced by TFEB over-expression is significantly reduced by curaxin, consistent with a role of FACT as a TFEB transcriptional activator. Together, our data show that chromatin remodeling at the promoter of stress-responsive genes by FACT is important for efficient expression of TFEB and TFE3 targets, thus providing a link between environmental changes, chromatin modifications and transcriptional regulation.Abbreviations: ADNP2, ADNP homeobox 2; ATP6V0D1, ATPase H+ transporting V0 subunit d1; ATP6V1A, ATPase H+ transporting V1 subunit A; ATP6V1C1, ATPase H+ transporting V1 subunit C1; CSNK2/CK2, casein kinase 2; CLCN7, chloride voltage-gated channel 7; CTSD, cathepsin D; CTSZ, cathepsin Z; EBSS, earle's balanced salt solution; FACT complex, facilitates chromatin transcription complex; FOXO3, forkhead box O3; HEXA, hexosaminidase subunit alpha; HIF1A, hypoxia inducible factor 1 subunit alpha; HMOX1, heme oxygenase 1; LAMP1, lysosomal associated membrane protein 1; MAFF, MAF bZIP transcription factor F; MAFG, MAF bZIP transcription factor G; MCOLN1, mucolipin TRP cation channel 1; MTORC1, mechanistic target of rapamycin kinase complex 1; NaAsO2, sodium arsenite; POLR2, RNA polymerase II; PPARGC1A, PPARG coactivator 1 alpha; PYROXD1, pyridine nucleotide-disulfide oxidoreductase domain 1; RRAGC, Ras related GTP binding C; SEC13, SEC13 homolog, nuclear pore and COPII coat complex component; SLC38A9, solute carrier family 38 member 9; SSRP1, structure specific recognition protein 1; SUPT16H, SPT16 homolog, facilitates chromatin remodeling subunit; TFEB, transcription factor EB; TFE3, transcription factor binding to IGHM enhancer 3; TXNRD1, thioredoxin reductase 1; UVRAG, UV radiation resistance associated; WDR59, WD repeat domain 59.

Impact of Ureteral Stent Material on Stent-related Symptoms: A Systematic Review of the Literature.

Context: Ureteral stents are essential implants that are used on a daily basis. Since their invention, advances in stent design have been directed towards alleviating stent-related symptoms. It remains unclear how the material composition of the stent affects stent-related symptoms. Objective: To review the literature and define the clinical impact of ureteral stent material on stent-related symptoms. Evidence acquisition: A literature search of the Embase, MEDLINE (PubMed), and Web of Science databases was conducted on December 17, 2021 to collect articles comparing stent composition materials regarding stent-related symptoms. Thirteen publications met the inclusion criteria, of which only one met the high-quality requirements of the Cochrane Collaboration tool for assessing the risk of bias in randomized trials. Evidence synthesis: Most trials, including the highest quality trial, seem to support that silicone double-J (DJ) stents reduce stent-related symptoms compared to nonsilicone DJ stents. Regarding physical properties, it seems that "soft" or "flexible" DJ stents reduce stent-related symptoms. However, since there was only one high-quality study with a low risk of bias, it is impossible to draw a definitive conclusion owing to the lack of quality data. Conclusions: Silicone DJ stents, and by extension "soft" DJ stents, appear to reduce stent-related symptoms compared to nonsilicone polymers and "hard" DJ stents. No definitive conclusion can be drawn owing to a lack of quality evidence. Creating a standard for measuring and reporting physical stent properties should be the first step for further research. Patient summary: A ureteral stent is a small hollow tube placed inside the ureter to help urine drain from the kidney. We reviewed the literature on the impact of stent material on stent-related symptoms. We found that silicone may reduce stent-related symptoms, but no definitive conclusion can be drawn and further studies are needed.

Simultaneous Bilateral Endoscopic Surgery (SBES): Is It Ready for Prime Time?

Introduction: To date, some data available in literature on simultaneous bilateral endoscopic surgery (SBES) have shown good outcomes in terms of both effectiveness and safety. The aim of this study was to report the outcomes pertaining to the effectiveness and safety of SBES performed in our series of patients with bilateral renal stones. Materials and Methods: A prospective analysis of consecutive patients who underwent SBES for bilateral renal stones at our institution between June 2017 and September 2021 was performed. Routine preoperative and 1-month postoperative work-up included history, physical examination, urinalysis, urine culture, and blood tests, including the evaluation of estimated glomerular filtration rate using the Cockcroft-Gault equation. An abdominal noncontrast CT scan was performed in all cases preoperatively and 1 month postoperatively. Peri-/postoperative complications were reported according to the Clavien-Dindo classification system. The primary endpoint of the study was stone-free rate (SFR), and the secondary endpoints were Clavien-Dindo complications grade 1 or higher. Results: Altogether, 101 patients met the inclusion criteria and were enrolled in the study. SFR for all renal units was achieved in 82 patients (81.1%) at the 1-month follow-up. Twelve patients underwent additional flexible ureteroscopy for residual fragments, and 7 asymptomatic patients with single small residual fragment were observed. Eighteen patients (17.8%) experienced Clavien-Dindo Grade I-II complications, whereas one patient (1%) experienced Clavien-Dindo Grade IIIa complication (renal arteriovenous fistula embolization under local anesthesia). Conclusions: SBES is a safe and effective procedure for the treatment of bilateral renal stones. Further randomized studies with larger populations are needed to confirm these favorable outcomes of SBES to establish it as an alternative to staged surgeries in patients with bilateral renal stones. Appropriate patient selection is of paramount importance for achieving good outcomes without experiencing severe complications.

New Generation Pulse Modulation in Holmium:YAG Lasers: A Systematic Review of the Literature and Meta-Analysis.

(1) Background: New pulse modulation (PM) technologies in Holmium:YAG lasers are available for urinary stone treatment, but little is known about them. We aim to systematically evaluate the published evidence in terms of their lithotripsy performance. (2) Methods: A systematic electronic search was performed (MEDLINE, Scopus, and Cochrane databases). We included all relevant publications, including randomized controlled trials, non-randomized comparative and non-comparative studies, and in-vitro studies investigating Holmium:YAG lithotripsy performance employing any new PM. (3) Results: Initial search yielded 203 studies; 24 studies were included after selection: 15 in-vitro, 9 in-vivo. 10 In-vitro compared Moses with regular PM, 1 compared Quanta's, 1 Dornier MedTech's, 2 Moses with super Thulium Fiber Laser, and 1 compared Moses with Quanta PMs. Six out of seven comparative studies found a statistically significant difference in favor of new-generation PM technologies in terms of operative time and five out of six in fragmentation time; two studies evaluated retropulsion, both in favor of new-generation PM. There were no statistically significant differences regarding stone-free rate, lasing and operative time, and complications between Moses and regular PM when data were meta-analyzed. (4) Conclusions: Moses PM seems to have better lithotripsy performance than regular modes in in-vitro studies, but there are still some doubts about its in-vivo results. Little is known about the other PMs. Although some results favor Quanta PMs, further studies are needed.

The Role of Eucalyptus Species on the Structural and Thermal Performance of Cellulose Nanocrystals (CNCs) Isolated by Acid Hydrolysis.

Cellulose nanocrystals (CNCs) are attractive materials due to their renewable nature, high surface-to-volume ratio, crystallinity, biodegradability, anisotropic performance, or available hydroxyl groups. However, their source and obtaining pathway determine their subsequent performance. This work evaluates cellulose nanocrystals (CNCs) obtained from four different eucalyptus species by acid hydrolysis, i.e., E. benthamii, E. globulus, E. smithii, and the hybrid En × Eg. During preparation, CNCs incorporated sulphate groups to their structures, which highlighted dissimilar reactivities, as given by the calculated sulphate index (0.21, 0.97, 0.73 and 0.85, respectively). Although the impact of the incorporation of sulphate groups on the crystalline structure was committed, changes in the hydrophilicity and water retention ability or thermal stability were observed. These effects were also corroborated by the apparent activation energy during thermal decomposition obtained through kinetic analysis. Low-sulphated CNCs (E. benthamii) involved hints of a more crystalline structure along with less water retention ability, higher thermal stability, and greater average apparent activation energy (233 kJ·mol-1) during decomposition. Conversely, the high-sulphated species (E. globulus) involved higher reactivity during preparation that endorsed a little greater water retention ability and lower thermal stability, with subsequently less average apparent activation energy (185 kJ·mol-1). The E. smithii (212 kJ·mol-1) and En × Eg (196 kJ·mol-1) showed an intermediate behavior according to their sulphate index.

Hybridization of the Kano model and business model canvas: aeronautical and metalworking industry in Bogota, Colombia.

The aeronautical and metalworking industrial sector lies within an active environment, which is a characteristic of globalization as well as the implementation of new, innovative, and revolutionary technologies that allow for the dynamization of endogenous and exogenous processes of organizations, thus reaping benefits for such companies. This study aimed to generate a generalized methodology that led to the hybridization of the Kano model and Business Model Canvas. A Kano questionnaire was implemented in 105 organizations of the aeronautical and metalworking sector in Bogota, Colombia to assess the attributes of a technology-based product (digital platform) to be offered by the company Aerospace Business Group LLC; its results were integrated into the Business Model Canvas. It was ascertained that all attributes contributed to customer satisfaction and were distributed into three blocks of the Business Model Canvas. This hybridization aids in the development of better structured businesses, thus reducing risks and maximizing opportunities.