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Cancers May 2023Liquid biopsy (LB) for prostate cancer (PCa) detection could represent an alternative to biopsy. Seminal fluid (SF) is a source of PCa-specific biomarkers, as 40% of...
Liquid biopsy (LB) for prostate cancer (PCa) detection could represent an alternative to biopsy. Seminal fluid (SF) is a source of PCa-specific biomarkers, as 40% of ejaculate derives from the prostate. We tested the feasibility of an SF-based LB by evaluating the yield of semen self-sampling in a cohort of >750 patients with clinically localized PCa. The overall SF collection yield was 18.2% (39% when considering only compliant patients), with about a half of the patients (53.15%) not consenting to SF donation. Independent favorable predictors for SF collection were younger age and lower prostate volume. We implemented a protocol to enrich prostate-derived cells by multi-color flow cytometry and applied it on SF and urine samples from 100 patients. The number of prostate-enriched cells (SYTO-16+ PSMA+ CD45-) was variable, with higher numbers of cells isolated from SF than urine ( value < 0.001). Putative cancer cells (EpCAM) were 2% of isolated cells in both specimens. The fraction of EpCAM cells over prostate-enriched cells (PSMA+) significantly correlated with patient age in both semen and urine, but not with other clinical parameters, such as Gleason Score, ISUP, or TNM stage. Hence, enumeration of prostate-derived cells is not sufficient to guide PCa diagnosis; additional molecular analyses to detect patient-specific cancer lesions will be needed.
PubMed: 37345004
DOI: 10.3390/cancers15102666 -
Frontiers in Cell and Developmental... 2023Small extracellular vesicles (sEVs) are minute vesicles secreted by various cells that are capable of transporting cargo, including microRNAs, between donor and... (Review)
Review
Small extracellular vesicles (sEVs) are minute vesicles secreted by various cells that are capable of transporting cargo, including microRNAs, between donor and recipient cells. MicroRNAs (miRNAs), small non-coding RNAs approximately 22 nucleotides in length, have been implicated in a wide array of biological processes, including those involved in tumorigenesis. Emerging evidence highlights the pivotal role of miRNAs encapsulated in sEVs in both the diagnosis and treatment of urological tumors, with potential implications in epithelial-mesenchymal transition, proliferation, metastasis, angiogenesis, tumor microenvironment and drug resistance. This review provides a brief overview of the biogenesis and functional mechanisms of sEVs and miRNAs, followed by a summarization of recent empirical findings on miRNAs encapsulated in sEVs from three archetypal urologic malignancies: prostate cancer, clear cell renal cell carcinoma, and bladder cancer. We conclude by underscoring the potential of sEV-enclosed miRNAs as both biomarkers and therapeutic targets, with a particular focus on their detection and analysis in biological fluids such as urine, plasma, and serum.
PubMed: 37333986
DOI: 10.3389/fcell.2023.1192937 -
ACS Applied Materials & Interfaces Jun 2023Prostate malignancy represents the second leading cause of cancer-specific death among the male population worldwide. Herein, enhanced intracellular magnetic fluid...
Prostate malignancy represents the second leading cause of cancer-specific death among the male population worldwide. Herein, enhanced intracellular magnetic fluid hyperthermia is applied to treat prostate cancer (PCa) cells with minimum invasiveness and toxicity and highly specific targeting. We designed and optimized novel shape-anisotropic magnetic core-shell-shell nanoparticles (i.e., trimagnetic nanoparticles - TMNPs) with significant magnetothermal conversion following an exchange coupling effect to an external alternating magnetic field (AMF). The functional properties of the best candidate in terms of heating efficiency (i.e., FeO@MnZnFeO@CoFeO) were exploited following surface decoration with PCa cell membranes (CM) and/or LN1 cell-penetrating peptide (CPP). We demonstrated that the combination of biomimetic dual CM-CPP targeting and AMF responsiveness significantly induces caspase 9-mediated apoptosis of PCa cells. Furthermore, a downregulation of the cell cycle progression markers and a decrease of the migration rate in surviving cells were observed in response to the TMNP-assisted magnetic hyperthermia, suggesting a reduction in cancer cell aggressiveness.
Topics: Male; Humans; Cell-Penetrating Peptides; Hyperthermia, Induced; Nanoparticles; Cell Membrane; Magnetic Fields; Prostatic Neoplasms; Magnetite Nanoparticles
PubMed: 37312240
DOI: 10.1021/acsami.3c07248 -
Journal of Surgical Case Reports Jun 2023Gallstone ileus is an uncommon complication of calculus cholecystitis through the formation of a biliary enteric fistula. The risk of mechanical obstruction caused by...
Gallstone ileus is an uncommon complication of calculus cholecystitis through the formation of a biliary enteric fistula. The risk of mechanical obstruction caused by gallstones is increased with its size, in addition to chronic constipation, neoplasm and diverticulitis, to name a few. Here, we present a case of an 89-year-old male patient who presented with signs of bowel obstruction, which was found to be a gallstone impacted in the sigmoid colon. Considering the patient's stable condition and his comorbidities, a conservative approach was opted including IV fluids, fleet enema and bowel rest. Colonoscopy was performed and confirmed the passage of the stone. With no consensus regarding the management, the literature emphasizes a tailored approach to each case considering all possible operative and non-operative approaches. Some reports show promising results with non operative management. Gallstone ileus remains a challenging case, and further studies for the best treatment modalities are needed.
PubMed: 37305343
DOI: 10.1093/jscr/rjad331 -
Cureus May 2023Bilateral basal ganglia lesions can include a wide variety of etiologies, including metabolic, toxic, degenerative, vascular, inflammatory, infectious, and neoplastic...
Bilateral basal ganglia lesions can include a wide variety of etiologies, including metabolic, toxic, degenerative, vascular, inflammatory, infectious, and neoplastic etiology. We present a case of a 78-year-old man who was hospitalized with acute behavioral changes and psychomotor slowing. His medical history included diabetes mellitus, arterial hypertension, and prostate adenocarcinoma. In his spare time, he was a pigeon fancier and regularly burned waste (including diapers) outside his home. In the initial evaluation, he was hypertensive, drowsy, disoriented in time and space, dysarthric, and with global bradykinesia. From the research carried out, we stand out the following: brain magnetic resonance imaging showing bilateral hyperintensity of the basal ganglia on T2/fluid-attenuated inversion recovery, with foci of hypersignal on T1 without diffusion restriction or contrast enhancement; CSF presenting 15 cells/uL, without other alterations; analytical results presenting hypernatremia (171 mEq/L), creatinine at 3.5 mg/dL, hyperglycemia (always <300 mg/dL), and slightly elevated C-reactive protein and anticardiolipin antibodies in addition to thrombocytopenia (107,000). After correcting the metabolic disturbances and evading the identified toxic substances, magnetic resonance imaging showed regression of the lesions, and the patient returned to a normal state. The functions of the basal ganglia are complex, requiring increased use of glucose and oxygen, therefore presenting a high metabolic activity, which makes them vulnerable to various metabolic changes. We report a rare case affected by symmetrical lesions in the basal ganglia and presenting an acute onset of altered mental status with behavioral alterations, related to hyperglycemia, acute kidney injury, hypertension, and exposure to toxic substances (smoke from bonfires and/or toxic chemical components). Complete clinical recovery, remaining negative investigation, and regression of the lesions support our diagnosis.
PubMed: 37292566
DOI: 10.7759/cureus.38733 -
Arab Journal of Urology 2023To facilitate nerve preservation during robot-assisted radical prostatectomy (RP), hydrodissection (HD) using an injection catheter was performed. HD during RP is a...
To facilitate nerve preservation during robot-assisted radical prostatectomy (RP), hydrodissection (HD) using an injection catheter was performed. HD during RP is a nerve-sparing technique in which an epinephrine solution is injected into the lateral prostatic fascia to separate it from the prostatic capsule. Although the beneficial effects of HD on postoperative sexual function have been reported, HD has rarely been used in robot-assisted RP. The primary reason may be the potential benefits of robotic surgery, such as less bleeding, magnified surgical view, and fine movement of instruments; another possible reason is the difficulty of handling sharp needles in a narrow intra-abdominal surgical space of robot-assisted RP. For safe fluid injection, we performed HD using an injection catheter - commonly used for endoscopic upper gastrointestinal hemostasis - during robot-assisted RP. The required time to accomplish HD and the safety of the procedure were examined in 15 HD of 11 patients. Approximately 2 minutes (median, 118 seconds; interquartile range, 106-174 seconds) were needed for HD using the injection catheter. All patients had no complications, such as injuries to the intestine, vessels, or other organs. Postoperative bleeding did not occur in any patients. HD with an injection catheter enables surgeons to perform simple and safe nerve preservation during robot-assisted RP.
PubMed: 37234678
DOI: 10.1080/2090598X.2022.2146222 -
Frontiers in Immunology 2023Prostatitis is a common urological condition that affects almost half of all men at some point in their life. The prostate gland has a dense nerve supply that... (Review)
Review
Prostatitis is a common urological condition that affects almost half of all men at some point in their life. The prostate gland has a dense nerve supply that contributes to the production of fluid to nourish sperm and the mechanism to switch between urination and ejaculation. Prostatitis can cause frequent urination, pelvic pain, and even infertility. Long-term prostatitis increases the risk of prostate cancer and benign prostate hyperplasia. Chronic non-bacterial prostatitis presents a complex pathogenesis, which has challenged medical research. Experimental studies of prostatitis require appropriate preclinical models. This review aimed to summarize and compare preclinical models of prostatitis based on their methods, success rate, evaluation, and range of application. The objective of this study is to provide a comprehensive understanding of prostatitis and advance basic research.
Topics: Humans; Male; Prostatitis; Semen; Pelvic Pain; Prostate; Spermatozoa
PubMed: 37228599
DOI: 10.3389/fimmu.2023.1183895 -
Journal of Research in Medical Sciences... 2023Simple open prostatectomy is still the treatment of choice for removing large prostates; however, peri-surgical bleeding accompanied by this technique has always been a...
BACKGROUND
Simple open prostatectomy is still the treatment of choice for removing large prostates; however, peri-surgical bleeding accompanied by this technique has always been a challenge for urologist surgeons. Therefore, the present study aimed to investigate the effect of surgicel on reducing bleeding in trans-vesical prostatectomy.
MATERIALS AND METHODS
The present double-blinded clinical trial included 54 patients with Benign Prostatic Hyperplasia (BPH), divided into two groups of 27, and underwent trans-vesical prostatectomy. After removing the prostate, the prostate adenoma was weighed in the first group. Then, two surgicel were inserted into the prostate loge for prostate adenomas weighing 75 g or less. For larger prostates, another surgicel was inserted for each 25 g weight higher than the limit of 75 g. However, no Surgicel was inserted in the control group. Other steps of the procedure were the same in both groups. Moreover, hemoglobin and hematocrit levels were assessed in both groups; preoperation, intra-operative, 24 h, and 48 h postoperative. In addition, all the fluid used for bladder irrigation was collected, and its hemoglobin level was assessed.
RESULTS
According to our results, no intergroup difference in hemoglobin level changes, hematocrit changes, International Prostate Symptom Score (IPSS), postoperative hospital stay, and number of packed cells received. However, the postoperative blood loss in bladder lavage fluid was significantly higher in the control group (120.83 ± 46.66 g) as compared to the surgicel group (72.56 ± 32.53 g) ( < 0.001).
CONCLUSION
The present study concluded that using surgicel in trans-vesical prostatectomy could reduce postoperative bleeding without increasing the chance of postoperative complications.
PubMed: 37213452
DOI: 10.4103/jrms.jrms_618_22 -
Journal of Orthopaedic Case Reports Mar 2023Septic arthritis (SA) is a rare clinical entity that can lead to significant morbidity and mortality. Recent years have seen a rise in minimally invasive surgical...
INTRODUCTION
Septic arthritis (SA) is a rare clinical entity that can lead to significant morbidity and mortality. Recent years have seen a rise in minimally invasive surgical therapy for the treatment of benign prostatic hyperplasia, including prostatic urethral lift. We report a case of bilateral simultaneous SA of the knees, following a prostatic urethral lift procedure. SA following a urologic procedure has not previously been reported.
CASE REPORT
A 79-year-old male presented to the Emergency Department through an ambulance with bilateral knee pain with associated fever and chills. Two weeks before presentation, he had undergone a prostatic urethral lift, cystoscopy, and Foley catheter placement. The examination was remarkable for bilateral knee effusions. Arthrocentesis was performed, and the synovial fluid analysis was consistent with a diagnosis of SA.
CONCLUSION
This case emphasizes the need for frontline clinicians to consider SA in patients presenting with joint pain as a rare complication of prostatic instrumentation.
PubMed: 37187818
DOI: 10.13107/jocr.2023.v13.i03.3588