Changes in male sexuality after urologic cancer: a narrative review

ABSTRACT Objective To describe the most common sexual problems and changes experienced by male urological cancer survivors, focusing on evidence-based practices for assessment and intervention. Materials and Methods We search the PubMed, Embase, and SciELO databases between 1994 and 2022, using the following key words: "urological cancer", "urological malignances", "genitourinary cancer", "male sexual health", and "male sexual dysfunction". Results This narrative review provides an overview of the current literature involving the impact of diagnosis and treatment of urological cancers on male sexual function. Male "genital" or "reproductive" tumors, such as prostate, penile, and testicular tumors, clearly appear to affect sexual function. However, tumors that do not involve genital parts of the body, such as the bladder and kidney, can also affect male sexual function. Conclusion Male sexual dysfunction is very common after urologic cancer diagnosis and treatment. Changes in body image and anatomical damage can be associated with impaired masculinity and sexual function, especially after prostate, penile or testicular cancer treatment. Moreover, anxiety, depression, and fear of recurrence have an impact on quality of life and sexual function regardless of the cancer location. Therefore, patients need be counseled about the likely changes in sexual function before treatment of any urological cancer.

Transmission electron microscopy of pili annulati

Abstract Background: Little is known about the ultrastructure of pili annulati. Objectives: To examine with transmission electron microscopy affected hairs of a family, whose diagnosis had been confirmed in five individuals with scanning electron microscopy, which showed surface undulations with ''curtain-like'' folding of the hair cuticula and to compare the findings with normal control. Methods: Hairs of two affected patients and one control were embedded in resin and cut lengthwise to produce ultra-thin sections. Results: The normal hair showed a parallel arrangement of dark lines associated with less electron-dense wide bands. Small cavities could be observed, mostly in the dark lines, affected hairs had a large number of cavities, associated or not with the insertion of melanosomes and loss of parallelism of the dark lines. Higher magnification showed a significant loss of this parallelism, resembling ''wood grooves''. Widened dark lines were observed in some areas. Study limitations: Only a few hairs were examined. Conclusions: The present results suggest that the microcanaliculi of the hair surface, easily found with scanning electron microscopy, may be secondary not only to the cavities seen in the sections but also to the disorder of proteins that form this region, demonstrated by the changes of the cortex dark lines.

Scanning electron microscopy of panitumumab-induced eyelash and hair alterations - Pili canaliculi

Abstract Panitumumab is a monoclonal antibody against the epidermal growth factor receptor used in metastatic colorectal cancer; in addition to tumor cells, it acts on epidermal keratinocytes and on the outer root sheath and presents skin toxicity in up to 90% of cases. A scanning electron microscope was used to examine the eyelashes and hairs of a 65-year-old patient with eyelash trichomegaly, curly hair, and paronychia undergoing treatment with panitumumab. Grooving in the hair shafts were identified, which were more evident in the eyelashes. Similar to oral epidermal growth factor inhibitors (erlotinib and gefitinib), panitumumab can cause acquired pili canaliculi.

McCune-Albright syndrome - A case report with transmission electron microscopy

Abstract McCune - Albright syndrome is a genetic disease with cutaneous mosaicism caused by post-zygotic activating mutations in GNAS locus, it has a triad of fibrous bone dysplasia, café-au-lait macules and precocious puberty. We examined a 22-year-old female patient with café au lait spot in right side of the abdomen, with a chessboard - like distribution, extending to right thigh with geographical contours, she has also an ovarian cyst, scoliosis and truncal obesity. Biopsies were taken from the hyperpigmented area and processed for light microscopy and for transmission electron microscopy. Light microscopy showed increased melanin pigment with HE staining. Immunohistochemistry with melanocytic markers (HMB-45 and Melan-A) revealed a normal number of melanocytes. Transmission electron microscopy demonstrated normal epidermal structures, such as desmosomes, cytokeratin filaments and hemidesmosomes. With high magnifications an irregular melanossomal contour was seen, with some indentations in their outline.

Case for diagnosis. Radiotherapy-induced pemphigus vegetans

Abstract A 73-year-old male patient developed a poorly differentiated squamous cell carcinoma in the anal canal nine months ago. He was treated with two cycles of 5-fluorouracil and cisplatin and concomitant radiotherapy (6 MeV linear photon accelerator, total dose of 54 Gy), with complete remission. Since forty-five days he presentes a painful perianal and intergluteal erosion with circinate pustular borders. Light microscopy showed pseudoepitheliomatous hyperplasia of the epidermis with microabscesses of inflammatory cells (neutrophils and eosinophils) and acantholytic keratinocytes . Indirect immunofluorescence was positive for IgG, with an intercellular pattern, 1:80 titer. The diagnosis of radiotherapy-induced pemphigus vegetans was established and there was significant regression with oral prednisone (40 mg) and topical betamethasone.

Ultrastructural aspects of the skin in lipoid proteinosis (Urbach-Wiethe disease)

Abstract Lipoid proteinosis is a rare autosomal recessive disease, characterized by hyaline deposits of PAS-positive material in tissues due to mutations in the ECM1 gene. This study evaluated the ultrastructure of the skin of a 6-year-old child affected by this condition. The light microscopy identified PAS-positive hyaline deposits, which were more intense in the papillary dermis. Scanning electron microscopy of the dermis showed a compact papillary dermis and fibrillar deposits in the middle dermis. Transmission electron microscopy clearly showed the deposition of fibrillar material in the dermis, forming clusters adherent to elastic fibers, between the collagen bundles and the collagen fibers, and also filling up the cytoplasm of dermal fibroblasts.

Phytosociology, successional level, and conservation of the woody component in a "restinga" of Maranhão island, Brazil / Fitosociología, nivel sucesional y conservación del componente leñoso de una "restinga" en isla Maranhão, Brasil

Abstract Introduction: The "restingas" (coast vegetation) can serve as a species corridor in ecotonal environments due to the particulars regarding the composition of the flora. The studies covering the entire length of the Maranhão state coast are necessary to understand the diversity and distribution of plant species present in the "restingas". Objective: The objective of this study was to characterize the structure and conservation of the woody vegetation of a "restinga" in Maranhão. Methods: Phytosociological sampling of woody vegetation was carried out using the quadrants method, followed by classification of species by successional group; in addition to analyzing the diametric and hypsometric data of the populations whose species presented the highest importance value (IV). Results: In total, 24 species and 16 families were identified, 72 % of which were classified in the initial stages of succession. The values of H' and J' were 2.637 nat.ind-1and 0.830, respectively. The mean height and diameter were 2.1 m and 27.66 cm, respectively. The species Coccoloba ramosissima Wedd., Byrsonima crassifolia (L.) Kunth, Anacardium occidentale L., Manilkara triflora (Allemão) Monach, and Astrocaryum vulgare Mart. presented the highest IVs. Conclusions: It was observed that characteristics such as size, power of regrowth, and ease of regeneration processes could be useful for choosing target species for recovery actions in coastal areas.

Resumen Introducción: Las "restingas" pueden servir como corredor de especies en ambientes ecotonales debido a los aspectos de la composición de la flora. Los estudios a lo largo de la costa del estado de Maranhão son necesarios para comprender la diversidad y distribución de las especies de plantas presentes en las "restingas". Objetivo: El objetivo de este estudio fue caracterizar la estructura y conservación de la vegetación leñosa de una "restinga" en Maranhão. Métodos: Se realizó un muestreo fitosociológico de la vegetación leñosa utilizando cuadrantes, seguido de la clasificación de especies por grupo sucesional; además de analizar los datos diamétricos e hipsométricos de las poblaciones cuyas especies presentaron el de mayor valor importancia (VI). Resultados: En total, se identificaron 24 especies y 16 familias, 72 % de los cuales fueron clasificados en las etapas iniciales de sucesión. Los valores de H' y J' fueron 2.637 nat.ind-1 y 0.830, respectivamente. La altura y el diámetro medios fueron de 2.1 my 27.66 cm, respectivamente. Las especies Coccoloba ramosissima Wedd., Byrsonima crassifolia (L.) Kunth, Anacardium occidentale L., Manilkara triflora (Allemão) Monach, y Astrocaryum vulgare Mart. presentaron los valores de mayor importancia (VI). Conclusiones: se observó que características como el tamaño, capacidad de rebrote y la facilidad de los procesos de regeneración podrían ser útiles para elegir las especies objetivo para las acciones de recuperación en las zonas costeras.

A new synonym for Micropholis gardneriana (Sapotaceae) with complete description, anatomy and distribution notes / Um novo sinônimo para Micropholis gardneriana (Sapotaceae) com descrição completa, anatomia e notas de distribuição

Abstract: In the present work, we synonymize Micropholis compta under M. gardneriana due to the overlap of morphoanatomical characters and the absence of distinctive attributes, verified during taxonomic and anatomical study of the genus Micropholis for Brazil. This study provides an updated description of M. gardneriana, including macro- and micro-morphological data, a distribution map, and comments on conservation status, ecological and taxonomy.

Resumo: No presente trabalho, sinonimizamos Micropholis compta sob M. gardneriana devido à sobreposição de caracteres morfoanatômicos e ausência de atributos distintivos, verificado durante estudo taxonômico e anatômico do gênero Micropholis para o Brasil. Este estudo fornece uma descrição atualizada de M. gardneriana, incluindo dados macro e micromorfológicos, um mapa de distribuição e comentários sobre status de conservação, ecologia e taxonomia.

Synopsis of the tribe Cocoseae Mart. (Arecoideae, Arecaceae) in the state of Maranhão, Brazil / Sinopse da tribo Cocoseae Mart. (Arecoideae, Arecaceae) no estado do Maranhão, Brasil

Abstract: This study presents a synopsis of the tribe Cocoseae (Arecaceae) for the Maranhão state, which was based on the descriptive analysis of voucher specimens of national and international herbaria, from loans, collection visits, digital platforms, and materials collected in expeditions. Twenty-five species belonging to seven genera were identified. The genus Bactris Jacq. ex Scop. was the most representative with seven species, followed by Attalea Kunth. (five spp.), Syagrus Mart. (five spp.), Astrocaryum G. Mey. (three spp.), Desmoncus Mart. (three spp.), Acrocomia Mart (one spp.), and Allagoptera Nees (one sp.). Four new records of occurrence were found for Maranhão: Allagoptera leucocalyx (Drude) Kuntze, Attalea barreirensis Glassman, Attalea phalerata Mart. ex Spreng. and Syagrus glazioviana (Dammer) Becc. This paper presents a taxonomic key for the species, as well as geographic distribution maps and photographic plates with the distinguishing characteristics for each taxon. Besides the taxonomic characteristics, common names, ecological data, and conservation status are included.

Resumo: Este trabalho apresenta uma sinopse da tribo Cocoseae (Arecaceae) para o estado do Maranhão, embasada na análise descritiva de amostras de herbários nacionais e internacionais, provenientes de empréstimos, visitas aos acervos e consultas em plataformas digitais, além de materiais coletados em expedições. Foram identificadas 25 espécies, pertencentes a sete gêneros. Bactris Jacq. ex Scop. foi o gênero mais representativos com sete espécies, seguido de Attalea Kunth. (cinco spp.), Syagrus Mart. (cinco spp.), Astrocaryum G. Mey. (três spp.), Desmoncus Mart. (três spp.), Acrocomia Mart. (uma spp.) e Allagoptera Nees (uma spp.). Foram encontrados quatro novos registros de ocorrência para o território maranhense: Allagoptera leucocalyx (Drude) Kuntze, Attalea barreirensis Glassman, Attalea phalerata Mart. ex Spreng. e Syagrus glazioviana (Dammer) Becc. É apresentada neste artigo uma chave taxonômica para as espécies, além de mapas de distribuição geográfica e pranchas fotográficas com características distintivas para cada táxon. São incluídos, além das características taxonômicas das espécies, nomes populares, informações ecológicas e status de conservação..

Identification of a novel UMOD mutation (c. 163G>A) in a Brazilian family with autosomal dominant tubulointerstitial kidney disease

Autosomal dominant tubulointerstitial kidney disease (ADTKD) is characterized by autosomal dominant inheritance, progressive chronic kidney disease, and a bland urinary sediment. ADTKD is most commonly caused by mutations in the UMOD gene encoding uromodulin (ADTKD-UMOD). We herein report the first confirmed case of a multi-generational Brazilian family with ADTKD-UMOD, caused by a novel heterozygous mutation (c.163G>A, GGC→AGC, p.Gly55Ser) in the UMOD gene. Of 41 family members, 22 underwent genetic analysis, with 11 individuals found to have this mutation. Three affected individuals underwent hemodialysis, one peritoneal dialysis, and one patient received a kidney transplant from a family member later found to be genetically affected. Several younger individuals affected with the mutation were also identified. Clinical characteristics included a bland urinary sediment in all tested individuals and a kidney biopsy in one individual showing tubulointerstitial fibrosis. Unlike most other reported families with ADTKD-UMOD, neither gout nor hyperuricemia was found in affected individuals. In summary, we report a novel UMOD mutation in a Brazilian family with 11 affected members, and we discuss the importance of performing genetic testing in families with inherited kidney disease of unknown cause.

Prevalência de halitose autorreferida e fatores associados em recrutas da cidade de Pelotas / Prevalence of reported halitosis and associated factors among military recruits in the city of Pelotas

Halitose é uma condição comum relacionada com fatores sistêmicos e orais que afeta diferentes grupos de idade. O objetivo deste estudo foi avaliar a prevalência de halitose autorreferida e fatores associados. Indivíduos que se apresentaram para o alistamento em Pelotas foram designados a comparecer no 9º Batalhão de Infantaria motorizado, em dia e hora previamente agendados. Na ocasião, os indivíduos responderam a um questionário com questões sobre saúde oral e geral que fazia parte de um consórcio envolvendo avaliação dermatológica e antropométrica. Dentre os avaliados, 2274 recrutas responderam ao questionário, dos quais 10,1% relataram apresentar halitose. Os indivíduos foram alertados sobre sua halitose por alguém de seu convívio próximo ou esporádico. As variáveis mais frequentemente mencionadas foram fumo, seguido de higiene oral pobre, associadas ao aumento da prevalência de halitose em 61% (PR=1.61; 95% CI: 1.18-2.20) e, aproximadamente 2.5% (PR=246; 95% CI: 1.26 ­ 4.83), respectivamente. A escolaridade também mostrou relação com halitose (p<0.001). Um total de 20,1% da amostra tentou mascarar seu mau hálito de alguma forma e 12% relatou algum tipo de preocupação com seu hálito. Concluiu-se que a halitose é uma condição comum na população estudada, estando associada ao fumo, higiene oral pobre e baixo grau de instrução. Indivíduos com halitose normalmente relatam desconforto associado com essa condição oral.

Halitosis is a common condition related to oral or systemic factors that affect different age groups. The study aimed to evaluate the prevalence of self-reported halitosis as well as associated factors to this condition. Subjects joining the Army in Pelotas were asked to be at the 9th Infantry Battalion on the day and time previously scheduled. On the occasion, the subjects answered a questionnaire containing questions on oral and general health. The questionnaire was completed by 2274 recruits and 10.1% of the subjects reported to have suffered from halitosis. They were told about it by someone living with them or by close persons who were part of their daily routine. The most often mentioned variables were related to smoking, which increased the prevalence of halitosis in 61% (PR=1.61; 95% CI: 1.18-2.20), followed by poor oral conditions which increased halitosis approximately 2.5 times (PR=2.46; 95% CI: 1. 26 ­ 4.83). Educational level was also associated with halitosis (p<0.001). A total of 20.1% from the sample tried to mask their bad breath in some way and 12% expressed some kind of concern related to it. It was concluded that halitosis is a common condition in evaluated population. It was found to be associated with smoking, poor oral health care and low education level. People with halitosis usually report some kind of discomfort caused by this oral condition.

Emergence of Trichosporon mycotoxinivorans (Apiotrichum mycotoxinivorans) invasive infections in Latin America

We report the first two cases of Trichosporon mycotoxinivorans infections in Latin America. We also conducted a literature review and a microbiological investigation, including that of clinical and environmental isolates. A 30-year-old man with chronic renal failure had disseminated infection after dialysis and a 15-year-old boy with cystic fibrosis (CF) had pulmonary exacerbations with positive respiratory samples. A review of the relevant literature revealed that deep-seated infections were related to immunosuppression or invasive devices, while most of the CF patients showed a decline in lung function after positive cultures. Phylogenetic analyses revealed three distinct circulating genotypes. MALDI-TOF mass spectrometry analysis showed similar spectral profiles and correctly identified all strains/isolates. Biofilm production was documented in a bloodstream isolate and biofilm-producing cells showed high minimum inhibitory concentrations against antifungals.

Recurrent aphthous stomatitis in 18-year-old adolescents - Prevalence and associated factors: a population-based study

Abstract: Background: Recurrent aphthous stomatitis is a painful disorder of unknown etiology. It is among the most common oral mucosal lesions with high prevalence among young adults. Objectives: To conduct a population-based study with 18-year-old army recruiters to assess its prevalence and associated factors in male adolescents. Methods: Interview during clinical examination in the army. Results: In this group (2,427 interviewed adolescents) there was a RAS prevalence of 24.9%. Smoking, herpes labialis and socioeconomic status correlated with the outcome. Study Limitations: only male adolescents were interviewed. Conclusions: Our results showed high prevalence of RAS; association with higher economic level and herpes simplex was found. Protective effect of smoking was confirmed.