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Journal of Clinical Medicine Aug 2021Urethral strictures are a common complication after genital gender-affirming surgery (GGAS) in transmasculine patients. Studies that specifically focus on the management... (Review)
Review
BACKGROUND
Urethral strictures are a common complication after genital gender-affirming surgery (GGAS) in transmasculine patients. Studies that specifically focus on the management of urethral strictures are scarce. The aim of this systematic review is to collect all available evidence on the management of urethral strictures in transmasculine patients who underwent urethral lengthening.
METHODS
We performed a systematic review of the management of urethral strictures in transmasculine patients after phalloplasty or metoidioplasty (PROSPERO, CRD42021215811) with literature from PubMed, Embase, Web of Science and Cochrane. Preferred Reporting Items for Systematic reviews and Meta-Analysis-(PRISMA) guidelines were followed, and risk of bias was assessed for every individual study using the 5-criterion quality appraisal checklist.
RESULTS
Eight case series were included with a total of 179 transmasculine patients. Only one study discussed the management of urethral strictures after metoidioplasty. Urethral strictures were most often seen at the anastomosis between the fixed and pendulous urethra. For each stricture location, different techniques have been reported. All studies were at a high risk of bias. The current evidence is insufficient to favor one technique over another.
CONCLUSIONS
Different techniques have been described for the different clinical scenarios of urethral stricture disease after GGAS. In the absence of comparative studies, however, it is impossible to advocate for one technique over another. This calls for additional research, ideally well-designed prospective randomized controlled trials (RCTs), focusing on both surgical and functional outcome parameters.
PubMed: 34501359
DOI: 10.3390/jcm10173912 -
Clinical, Cosmetic and Investigational... 2022Melasma is a complex and multipathophysiological condition that is challenging to treat. The roles of each element in the dermis were highlighted in this recent year due... (Review)
Review
BACKGROUND
Melasma is a complex and multipathophysiological condition that is challenging to treat. The roles of each element in the dermis were highlighted in this recent year due to targeting it with emerging therapies. Although some studies have demonstrated abnormal findings in the dermis of melasma lesions, there are no integrated data regarding these findings.
PURPOSE
This article aims to discuss each finding in the dermis of melasma lesions and to provide some ideas about treatment options.
METHODS
An Internet search was completed using the MEDLINE, Embase, Scopus, and Google Scholar databases for relevant literature through June 2021 and reference lists of respective articles. Only the articles published in English language were included.
RESULTS
Several studies have focused on the dermal changes in melasma. Common findings included basement membrane disruption, pendulous melanocytes, marked solar elastosis, increased melanophages, increased mast cells, and neovascularization. In addition, each of them had the specified mechanism that may relate with the others.
CONCLUSION
Several changes in the dermis of melasma lesion may be connected with pathological changes in the epidermis. This may serve as a potential target treatment for melasma, which requires a multimodal approach.
PubMed: 35023942
DOI: 10.2147/CCID.S343332 -
Poultry Science Apr 2023Egg production performance plays an important role in the poultry industry across the world. Previous studies have shown a great difference in egg production performance...
Egg production performance plays an important role in the poultry industry across the world. Previous studies have shown a great difference in egg production performance between pendulous-comb (PC) and upright-comb (UC) chickens. However, there are no reports to identify potential candidate genes for egg production in PC and UC chickens. In the present study, 1,606 laying chickens were raised, and the egg laid by individual chicken was collected for 100 d. Moreover, the expression level of estrogen and progesterone hormones was measured at the start-laying and peak-laying periods of hens. Besides, 4 PC and 4 UC chickens were selected at 217 d of age to perform transcriptome sequencing (RNA-seq) and whole genome resequencing (WGS) to screen the potential candidate genes of egg production. The results showed that PC chicken demonstrated better egg production performance (P < 0.05) and higher estrogen and progesterone hormone expression levels than UC chicken (P < 0.05). RNA-seq analysis showed that 341 upregulated and 1,036 downregulated differentially expressed genes (DEGs) were identified in the ovary tissues of PC and UC chickens. These DEGs were mainly enriched in protein-related, lipid-related, and nucleic acids-related biological processes including ribosome, peptide biosynthetic process, lipid transport terms, and catalytic activity acting on RNA which can significantly affect egg production in chicken. The enrichment results of WGS analysis were consistent with RNA-seq. Further, joint analysis of WGS and RNA-seq data was utilized to screen 30 genes and CAMK1D, CLSTN2, MAST2, PIK3C2G, TBC1D1, STK3, ADGRB3, and PPARGC1A were identified as potential candidate genes for egg production in PC and UC chickens. In summary, our study provides a wealth of information for a better understanding of the genetic and molecular mechanism for the future breeding of PC and UC chickens for egg production.
Topics: Animals; Female; Chickens; Transcriptome; Progesterone; Estrogens; Lipids; Gene Expression Profiling
PubMed: 36739803
DOI: 10.1016/j.psj.2023.102504 -
Animal : An International Journal of... Jul 2019Small ruminants not only differ on mammary gland anatomy, milk's properties and the amount of milk yielded comparable to those of dairy cattle, but also on the milking... (Review)
Review
Small ruminants not only differ on mammary gland anatomy, milk's properties and the amount of milk yielded comparable to those of dairy cattle, but also on the milking routine strategies and machine milking settings to maximize daily milk secretion. The udder compartment is proportionally larger in dairy sheep and goats, which requires modifications in the milking machine settings, milking procedures and allows the use of different milking strategies as they better tolerate extension of milking intervals. Depending on the breed, cisternal milk in goats varies from 70% to 90%, whereas in dairy sheep it varies from 50% to 78% of the total gland capacity. This explains why these species are commonly milked without pre-milking teat preparation, while in goats it is applied only in cases of high prevalence of intramammary infection in the herd. Recent French researchers observed that 40% of the goats presented an unbalanced udder as well as unbalanced morphology (21% to 30%) and functional milk flow (around 10% to 20% more) which could induce overmilking. In dairy sheep, selection for higher milk production increases teat angle insertion. Thus, to increase machine milk fraction, it is recommended to use either the 'Sagi hook' as an alternative for lifting up the 'pendulous' udder during milking or to perform machine stripping. There are three cluster removal strategies for small ruminants: manual, timed and milk flow driven automatic cluster removal (ACR). Automatic cluster removal reduces overmilking, improves teat condition, enables labour saving and provides a consistent milking routine in small ruminants. There are three to five main milk flow profiles in ewes and goats, which result in curves with one or two peaks (or plateau) and different patterns of the milk flow decreasing phase due to the degree of mammary gland imbalance and teat characteristics. When taking into account our current knowledge, ACR recommended take-off settings for goats are: 200 g/min+10 s delay time (DT) for a long decreasing phase or two plateau curves and 500 g/min+5 s DT for a short decreasing phase and one plateau curve. The ACR take-off settings for ewes are: 150 g/min +10 s DT for long decreasing phase and 200 g /min+5 s DT for a short decreasing phase. This review is intended to be useful for scientists and producers seeking basic knowledge of milking routines and cluster detachment settings for parlour performance and milk quality.
Topics: Animals; Dairying; Female; Goats; Lactation; Mammary Glands, Animal; Milk; Ruminants; Sheep
PubMed: 31280744
DOI: 10.1017/S1751731118003488 -
Surgery Jun 2017
Topics: Aged; Colorectal Neoplasms; Early Detection of Cancer; Follow-Up Studies; Hemangioma, Cavernous; Hepatectomy; Humans; Incidental Findings; Laparoscopy; Liver Neoplasms; Male; Neoplasm Invasiveness; Neoplasm Staging; Preoperative Care; Risk Assessment; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 27072991
DOI: 10.1016/j.surg.2016.02.036 -
Technology in Cancer Research &... 2021To evaluate geometric and dosimetric effects of bra application during radiotherapy planning for breast cancer patients with large and pendulous breasts.
PURPOSE
To evaluate geometric and dosimetric effects of bra application during radiotherapy planning for breast cancer patients with large and pendulous breasts.
MATERIALS AND METHODS
Twenty patients with chest sizes >38 inches between April 2019 and July 2019 underwent radiotherapy planning with and without a radiation bra (Chabner XRT). Geometric and dosimetric parameters included the breast volume, superior-inferior (SI) distance, separation (S) as the distance of the longest diameter of the clinical target volume (CTV), conformity number (CN), and homogeneity index (HI) of CTV. The organs at risk (OARs) were defined as the lungs, heart, and liver.
RESULTS
The use of the radiation bra provided mean changes of -0.51 cm for S, -1.45 cm for SI, and -61.18 cc for breast volume (all < 0.05). Breast volume was correlated with bra-related changes in cross diameter (r = 0.641, = 0.002) and volume (r = 0.680, = 0.001). Significant dose reductions were observed for the lungs (mean V: 19.58 cc, V: 17.13 cc, D: 86.24 cGy) and heart (D: 170.23 cGy). No significant differences were observed for CN (0.62-0.67) and HI (0.19-0.20) of the CTV.
CONCLUSION
The application of a radiation bra was associated with better geometric and dosimetric planning parameters, with a smaller CTV and lower doses to the OARs (lungs and heart) in the radiotherapy field. In addition, we expect that bra use during radiotherapy would provide emotional benefits.
Topics: Adult; Aged; Breast; Breast Neoplasms; Clothing; Female; Heart; Humans; Liver; Lung; Middle Aged; Organ Size; Organs at Risk; Radiation Dosage; Radiotherapy Dosage; Radiotherapy Planning, Computer-Assisted; Retrospective Studies
PubMed: 34180303
DOI: 10.1177/15330338211027909 -
The Journal of Sexual Medicine Feb 2022Several treatment options for urethral complications following metoidioplasty in transmen are described in the literature, yet little is known with regard to the...
BACKGROUND
Several treatment options for urethral complications following metoidioplasty in transmen are described in the literature, yet little is known with regard to the surgical outcomes.
AIM
The aim of this study was to analyze the surgical outcomes after treatment of urethral strictures and urethral fistulas following metoidioplasty.
METHODS
A multicenter retrospective cohort study was conducted with transmen treated for strictures and fistulas after metoidioplasty in 3 tertiary referral centers.
OUTCOMES
The primary outcome was the recurrence-free rate after surgical treatment of urethral strictures and urethral fistulas over a time period of 3 years postoperatively.
RESULTS
Of 96 transmen included in this study with a urethral complication, 44 (46%) experienced a urethral fistula, 31 (32%) a urethral stricture, and 21 (22%) both complications simultaneously. The recurrence-free rate for urethral strictures following endoscopic management (ie, urethral dilation or direct visual internal urethrotomy) was 61% after 1, 50% after 2, and 43% after 3 years, compared to 82% following open treatment options after 1, 2, and 3 years (P = .002). Open treatment options were Heineke-Mikulicz procedure (7/9, 78% success), excision and primary anastomosis (3/3, 100%), 2-stage without graft (9/9, 100%), pedicled flap urethroplasty (1/1, 100%), and buccal mucosa graft urethroplasty (2/4 [50%] single-stage, 1/1 [100%] 2-stage). The recurrence-free rate for small urethral fistulas located at the pendulous urethra was 79% after 1, and 72% after 2 and 3 years, compared to 45% after 1, and 41% after 2 and 3 years for large fistulas, generally located at the urethral anastomoses of the fixed urethra. Treatment options for urethral fistulas were fistulectomy (26/48, 54%), fistulectomy & (redo) colpectomy (7/11, 64%), buccal mucosa graft urethroplasty (1/1, 100%), and retubularization of the urethral plate (3/4, 75%). A colpectomy before or during reoperation of a urethral fistula at the proximal urethral anastomosis showed higher success rates compared to without a colpectomy (7/11 [64%] vs 2/13 [15%] respectively, P = .03).
CLINICAL IMPLICATIONS
This study provides insight in the treatment possibilities and corresponding outcomes of urethral complications following metoidioplasty in transmen.
STRENGTHS & LIMITATIONS
Strengths were the relatively large sample size and the overview of multiple treatment options available. Limitations were the heterogeneity of the cohort, underexposure of some surgical modalities, and absence of patient-reported outcomes.
CONCLUSION
Open surgical techniques show better long-term outcomes in the management of urethral strictures compared to endoscopic options, and a colpectomy is beneficial before or during urethral fistula repair at the proximal urethral anastomosis. de Rooij FPW, Falcone M, Waterschoot M, et al. Surgical Outcomes After Treatment of Urethral Complications Following Metoidioplasty in Transgender Men. J Sex Med 2022;19:377-384.
Topics: Humans; Male; Mouth Mucosa; Retrospective Studies; Transgender Persons; Treatment Outcome; Urethra; Urethral Stricture; Urologic Surgical Procedures, Male
PubMed: 34974989
DOI: 10.1016/j.jsxm.2021.12.006 -
Poultry Science Feb 2022Pendulous crop (PC) in the turkey occurs when the crop distends from its normal position, thereby preventing the movement of feed and water from the crop down into the...
Pendulous crop (PC) in the turkey occurs when the crop distends from its normal position, thereby preventing the movement of feed and water from the crop down into the digestive system. This condition negatively impacts the turkey industry at both production and welfare levels. In this study, we estimated the genetic parameters for PC incidence and its genetic correlation with 5 production traits. Additionally, we evaluated the prediction accuracy and bias of breeding values for the selection candidates using pedigree (BLUP) or pedigree-genomic (ssGBLUP) relationships among the animals. A total of 245,783 turkey records were made available by Hybrid Turkeys, Kitchener, Canada. Of these, 6,545 were affected with PC. In addition, the data included 9,634 records for breast meat yield (BMY); 5,592 records for feed conversion ratio (FCR) and residual feed intake (RFI) in males; 170,844 records for body weight (BW) and walking score (WS) between 18 and 20 wk of age for males (71,012) and females (99,832), respectively. Among this population, 36,830 were genotyped using a 65K SNP Illumina Inc. chip. While all animals passed the quality control criteria, only 53,455 SNP markers were retained for subsequent analysis. Heritability for PC was estimated at 0.16 ± 0.00 and 0.17 ± 0.00 using BLUP and ssGBLUP, respectively. The incidence of PC was not genetically correlated with WS or FCR. Low unfavourable genetic correlations with BW (0.12 and 0.14), BMY (0.24 and 0.24) and RFI (-0.33 and -0.28) were obtained using BLUP and ssGBLUP, respectively. Using ssGBLUP showed higher prediction accuracy (0.51) for the breeding values for the selection candidates than the pedigree-based model (0.35). Whereas the bias of the prediction was slightly reduced with ssGBLUP (0.33 ± 0.05) than BLUP (0.30 ± 0.08), both models showed a regression coefficient lower than one, indicating inflation in the predictions. The results of this study suggest that PC is a heritable trait and selection for lower PC incidence rates is feasible. Although further investigation is necessary, selection for BW, BMY, and RFI may increase PC incidence. Incorporating genomic information would lead to higher accuracy in predicting the genetic merit for selection candidates.
Topics: Animals; Body Weight; Chickens; Female; Genomics; Genotype; Male; Models, Genetic; Pedigree; Phenotype; Turkeys
PubMed: 34954445
DOI: 10.1016/j.psj.2021.101601