[Urinary bladder microbiome analysis and probiotic treatment options for women with recurrent urinary tract infections]. / Mikrobiomanalyse der Harnblase und probiotische Therapieoptionen bei Frauen mit rezidivierenden Harnwegsinfektionen.

Novel preventive measures and therapeutic approaches are needed to reduce the frequency of recurrent urinary tract infections (rUTI) and the associated emergence of multidrug-resistant uropathogens. The aim of this review is to systematically present the available evidence on the urinary bladder microbiome of healthy women and those with rUTIs. In addition, relevant studies on the efficacy of probiotics in rUTIs are presented in a structured manner. This will provide an overview on the current state of research and an outlook on treatment strategies beyond the usual antimicrobial options.

Effect of chlorpyrifos and enrofloxacin on selected enzymes in rats.

This study examined the effect of chlorpyrifos and/or enrofloxacin on the activity of acetylcholinesterase (AChE) in the blood and brain, and the activity of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in serum. The experiment was conducted on Wistar strain rats. Chlorpyrifos was administered with a stomach tube at a dose of 0.04 LD50 for 28 days and enrofloxacin at a dose of 5 mg/kg bw for 5 consecutive days. The experiment found that enrofloxacin changed the activity of the enzymes under study only to a small extent. At the dose applied in the experiment, chlorpyrifos decreased the activity of AChE significantly, both in blood and in the brain, and increased the activity of ALT and AST in rat serum. The administration of chlorpyrifos in combination with enrofloxacin changed the activity of the enzymes under study only slightly. A weaker, but longer, inhibition of AChE activity in both blood and the brain was observed in this group compared to the animals exposed only to chlorpyrifos. However, although enrofloxacin, like chlorpyrifos, increases the activity of ALT and AST in serum, their combined administration did not increase the hepatotoxic effect.

[Malignant melanoma of the urinary bladder]. / Das maligne Melanom der Harnblase.

Primary malignant melanoma of the genitourinary tract is a rare lesion. We report the case of a 52-year-old man with primary manifestation of metastatic melanoma in the bladder. Multimodal therapy with transurethral tumor resection and systemic interferon/dacarbazine was not successful and the patient died 18 months later. Currently immune checkpoint inhibitors, CTLA-4 (cytotoxic T lymphocyte antigen-4) and PD-L1 are currently being tested in phase III studies and show long-lasting response in the case of classical melanoma manifestations.

Concentration of hepatic vitamins A and E in rats exposed to chlorpyrifos and/or enrofloxacin.

The aim of the study was to determine the level of antioxidant vitamins A and E in the liver of rats exposed to chlorpyrifos and/or enrofloxacin. Chlorpyrifos (Group I) was administered at a dose of 0.04 LD50 (6 mg/kg b.w.) for 28 days, and enrofloxacin (Group II) at a dose of 5 mg/kg b.w. for 5 consecutive days. The animals of group III were given both of the mentioned above compounds at the same manner as groups I and II, but enrofloxacin was applied to rats for the last 5 days of chlorpyrifos exposure (i.e. on day 24, 25, 26, 27 and 28). Chlorpyrifos and enrofloxacin were administered to rats intragastrically via a gastric tube. The quantitative determination of vitamins was made by the HPLC method. The results of this study indicated a reduction in the hepatic concentrations of vitamins A and E, compared to the control, which sustained for the entire period of the experiment. The four-week administration of chlorpyrifos to rats resulted in a significant decrease of vitamins in the initial period of the experiment, i.e. up to 24 hours after exposure. For vitamin A the maximum drop was observed after 24 hours (19.24%) and for vitamin E after 6 hours (23.19%). Enrofloxacin caused a slight (3-9%) reduction in the level of the analysed vitamins. In the chlorpyrifos-enrofloxacin co-exposure group reduced vitamins A and E levels were also noted, but changes in this group were less pronounced in comparison to the animals intoxicated with chlorpyrifos only. The decrease in the antioxidant vitamin levels, particularly noticeable in the chlorpyrifos- and the chlorpyrifos combined with enrofloxacin-treated groups, may result not only from the increase in the concentration of free radicals, but also from the intensification of the secondary stages of lipid peroxidation.

[Urogynaecological training situation in Germany : Gap between demand and reality]. / Urogynäkologische Aus- und Weiterbildungssituation in Deutschland : Kluft zwischen Anspruch und Realität.

BACKGROUND: With increasing life expectancy, progressive demographic change and decreasing societal stigmatization of incontinence urologists and gynaecologists are increasingly faced with urogynaecological challenges. To date however, urogynaecology is a poorly standardized area of expertise in both disciplines. Therefore, the urogynaecology training, especially in Germany, is very heterogeneous and requires evaluation as well as improvement. MATERIALS AND METHODS: The GeSRU-Academics research group "Functional urology and LUTS" evaluated this subject nationwide among urological and gynecological trainees and their chief physicians by using a comprehensive questionnaire (34/38 multiple-choice items) between April 2015 and May 2016. RESULTS: 336 urological residents and 190 chief physicians as well as 171 gynaecological residents and 175 chief physicians participated in the survey. Of all trainees, 70.0 % stated a personal interest in urogynaecology, but 45.4 % (gynaecological residents) and 52.9 % (urological residents) mention not to receive a standardized training in their own department. The chief physicians' survey resulted in discrepancies concerning the same question, <10 % of all residents do not receive a standardized urogynaecological training from their point of view. However, standardized urogynaecological training is of importance for those chief physicians. CONCLUSIONS: There is a discrepancy between expectations and reality of urogynaecological education and training. To enable a well-structured and standardized urogynaecological education and training, it is compulsory to focus on an interdisciplinary cooperation and to promote multidisciplinary development. A broad-based, well-designed training network and curricula should be established and used consistently.

Complications following Tension-Free Vaginal Tapes: Accurate Diagnosis and Complications Management.

The sling procedures are the gold standard for SUI treatment. They are highly effective but not free from complications. The most common adverse effect for the surgery with the implant insertion is: overactive bladder occurring de novo after the surgery, voiding dysfunctions, urine retention, and unsatisfactory treatment outcome. The most important question that arises after 20 years of sling procedures is how to manage the complications and what can be offered to complicated patients. The above review summarises the ultrasound findings in complicated cases and shows the scheme of management of the clinical problems concerning the tape location in suburethral region.

Management of Mesh Complications after SUI and POP Repair: Review and Analysis of the Current Literature.

PURPOSE: To evaluate the surgical treatment concepts for the complications related to the implantation of mesh material for urogynecological indications. MATERIALS AND METHODS: A review of the current literature on PubMed was performed. RESULTS: Only retrospective studies were detected. The rate of mesh-related complications is about 15-25% and mesh erosion is up to 10% for POP and SUI repair. Mesh explantation is necessary in about 1-2% of patients due to complications. The initial approach appears to be an early surgical treatment with partial or complete mesh resection. Vaginal and endoscopic access for mesh resection is favored. Prior to recurrent surgeries, a careful examination and planning for the operation strategy are crucial. CONCLUSIONS: The data on the management of mesh complication is scarce. Revisions should be performed by an experienced surgeon and a proper follow-up with prospective documentation is essential for a good outcome.

The influence of doxazosin, an alpha1-adrenergic receptor antagonist on the urinary bladder contractility in pigs.

In the present study influence of doxazosin on the porcine urinary bladder contractility has been examined. Immature pigs were treated for 30 days with: a) doxazosin (n = 5) per os at a dose of 0.1 mg/kg b.w. or b) placebo (n = 5; control group). Thereafter, animals were sacrificed and urinary bladder strips from the trigone were suspended in organ baths. The tension of the smooth musce was measured before and after exposition to acetylocholine (ACh; 10(-5) - 10(-3) M), norepinephrine (NE; 10(-9) - 10(-7) M) and 5-hydroxytryptamine (5-HT; 10(-7) - 10(-5) M). Both the ACh and 5-HT at the highest doses significantly increased the contractility in each group, but this response was weaker in doxazosin-treated animals. NE caused relaxation in both groups, but the effect was weaker in doxazosine-treated group. The results of our study have shown that long-term administration of doxazosin caused a desensitization of the detrusor smooth muscle for in vitro applied mediators of the autonomic nervous systems.

Holmium laser ablation of the prostate (HoLAP): intermediate-term results of 144 patients.

PURPOSE: To retrospectively analyse the intermediate-term outcome of holmium laser ablation of the prostate (HoLAP) of up to 4 years postoperatively in one of the largest series and to define the selection criteria for patients who benefit from potentially lower complications associated with HoLAP. METHODS: Between June 2006 and November 2010, 144 patients with benign prostatic obstruction were treated at two centres with standardised HoLAP (2.0 J/50 Hz or 3.2 J/25 Hz with Versapulse(®) 80-100 W laser Lumenis(®)). Median follow-up was 21 months (range, 1-54). International prostate symptom score and quality of life (IPSS-QoL), PSA, prostate volume, maximal flow rate (Qmax), postvoiding residual volume (Vres) were evaluated pre- and postoperatively. All complications were graded according to CTCAE (v4.03). RESULTS: Mean patient age was 70.1 ± 7.7 years (range, 46-90). With a preoperative median prostate volume of 40 ml (range, 10-130), the median operation time was 50 min (range, 9-138). We observed a median catheterisation time of 1 day (range, 0-12) and hospitalisation time of 2 days (range, 1-16). IPSS-QoL, Qmax and Vres were significantly improved after 3 months, and all parameters remained unchanged after 12, 24 and 36 months. The rate of re-operation was significantly lower in patients with prostate volume <40 ml, compared to patients with prostates ≥ 40 ml (9.1 vs. 25 %, p = 0.04). CONCLUSIONS: HoLAP is a safe and effective procedure for the treatment of prostates <40 ml. Patients benefit from HoLAP because of a low bleeding rate and short hospital stay. Due to high recurrence rates, HoLAP should be avoided in prostates >40 ml.

Activity of selected antioxidative enzymes in rats exposed to dimethoate and pyrantel tartrate.

This study presents the results of research concerning the effect of single and combined application of pyrantel tartrate and dimethoate on selected antioxidative enzymes: catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GPx), in rat erythrocytes. Pyrantel tartrate was applied twice, at a dose of 85 mg/kg bw at a two week interval, i.e. on day 14 and 28 of the experiment, orally, in a water solution with a stomach tube. Dimethoate was administered with drinking water for 28 days at a dose of 25 mg/kg bw/day. It was found that pyrantel tartrate caused only small changes in the activity of the antioxidative enzymes under analysis. Subchronic exposure of rats to dimethoate caused a significant increase in the activity of CAT, SOD and GPx in erythrocytes, indicating the existence of strong oxidative stress. In combined intoxication, no significant effects of administering pyrantel tartrate on the activity of CAT, SOD and GPx was found in animals poisoned with dimethoate. The profile of changes was similar to that observed in rats exposed only to the organophosphorus insecticide. This may indicate a lack of interaction between the compounds used in the experiment.

Evaluation of a structured report of functional prostate magnetic resonance imaging in patients with suspicion for prostate cancer or under active surveillance.

BACKGROUND: Functional magnetic resonance imaging (MRI) seems to be a useful tool for prostate cancer (PCa) detection in patients with a previous negative biopsy but persistently increased prostate-specific antigen (PSA) values. Additionally, it enables correct cancer localization in patients with known PCa under active surveillance to avoid misclassification on repeat biopsies. Nevertheless, suspicious lesions on MRI findings need verification by biopsy. The aim of the present study was to establish a standardized functional prostate MRI reporting scheme. METHODS: Prostate MRI with T(2)-weighted images, T(1)-weighted images, diffusion-weighted imaging, and dynamic contrast-enhanced MRI of 56 consecutive patients were performed on a 3-T scanner. Patients with prior negative random transrectal ultrasound (TRUS)-guided biopsy and continuous suspicion for PCa as well as patients under active surveillance were included. The MRI localization report of suspicious lesions followed a standardized scheme. TRUS-guided random biopsy with addition of targeted biopsy cores was performed afterwards based on the structured report. RESULTS: Of the 56 patients, 18 had suspicious MRI findings and subsequently underwent repeat biopsy under guidance of the standardized localization scheme. PCa was documented in 72% (13/18). CONCLUSIONS: A standardized reporting scheme of suspicious findings on prostate MRI leads to higher success rates as compared to standard random TRUS-guided biopsy.

The presence of CD25 on bovine WC1+ gammadelta T cells is positively correlated with their production of IL-10 and TGF-beta, but not IFN-gamma.

WC1+ cells in cattle exhibit both regulatory and effector activities. However, it has not been elucidated whether they are so plastic that both activities co-exist in one cell or there are separate subpopulations of effector and regulatory cells. Since the production of IFN-gamma and IL-10 seems to be related to WC1+ cells' effector and regulatory function, respectively, the main aim of this study was to determine whether those cytokines are produced by separate subpopulations of WC1+, or are co-produced by the same cells. Due to increasingly frequent emphasised role of consumption of IL-2 in the mechanism of suppressor action of mouse CD25+CD4+ T regulatory cells, expression of the receptor's alpha chain for interleukin 2 (CD25) on WC1+ lymphocytes has been evaluated. An average of 5.21% of WC1+ cells obtained from PBMCs of 12-month-old heifers show constitutive expression of the CD25 molecule, with CD25(high)WC1+ and CD25(low)WC1+ cells accounting for 1.05% and 4.10% of WC1+ lymphocytes, respectively. For detection of intracellular cytokine production, PBMCs were stimulated with concanavalin A. Both IFN-gamma(-) and IL-10-producing cells within the CD25(-)WC1+ and CD25+WC1+ subpopulations were mainly separate subpopulations. The average percentage of IFN-gamma(+)IL-10(-), IFN-gamma(-)IL-10+ and IFN-gamma(+)IL-10+ cells among CD25(-)WC1+ lymphocytes was 4.03%, 2.67% and 0.51%, respectively. A positive correlation was observed between the presence of the CD25 molecule on WC1+ lymphocytes and production of IL-10 and TGF-beta, because the average percentage of IFN-gamma(-)IL-10+ and IFN-gamma(+)IL-10+ among CD25+WC1+ lymphocytes was 3 and 4.5 times higher as compared to the corresponding cells in the CD25(-)WC1+ subpopulation, whereas the percentage of IFN-gamma(+)IL-10(-) cells in both the subpopulations was not significantly different. The percentage of TGF-beta+ cells within the CD25+WC1+ subpopulation was 2.72 times as high as that of CD25(-)WC1+ lymphocytes. Therefore, with respect to the production of IFN-gamma, IL-10 and TGF-beta, CD25+WC1+ lymphocytes turn out to have a more suppressor profile than CD25(-)WC1+.

Activity of superoxide dysmutase, catalase and glutathione peroxidase in rats exposed to chlorpyrifos and erofloxacin.

The aim of the study was to investigate the influence of administration of chlorpyrifos and/or enrofloxacin on the activity of chosen antioxidative enzymes i.e.: superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) in erythrocytes of rats. Chlorpyrifos was administered by stomach tube during 28 days at a dose of 3 mg/kg bw (0.02 LD50), and enrofloxacin was administered by stomach tube at a dose of 5 mg/kg bw during 3 subsequent days. It was stated that administration of enrofloxacin at applied dose did not cause any major changes in the activity of investigated antioxidative enzymes. The four-week exposure of rats to chlorpyrifos caused noticeable decrease in SOD and CAT activity in erythrocytes of rats at the beginning of the experiment (up to 24th hour) in comparison with the control group. The activity of GPx during all periods of the experiment was increased. In the group of animals in which both chlorpyrifos and enrofloxacin were applied, the profile of changes in activity of examined enzymes was similar to that one, which was observed after administration of chlorpyrifos exclusively, what may indicate lack of co-action between compounds used in the experiment.

[3 T MRI of the prostate in patients with symptomatic prostatic utricle cyst]. / 3-T-Prostata-MRT bei symptomatischer Utrikuluszyste.

Cystic lesions of the prostate are rare and often asymptomatic. Medial cysts are conventionally divided into so-called Müllerian duct cysts and prostatic utricle cysts which seems rather questionable in light of recent studies. We report a case of a patient with a 10-year history of dysuria. Diagnostic imaging was performed using 3 T prostate MRI with a body coil. Because of the potential risk of retrograde ejaculation with subsequent infertility and of incontinence by the transurethral resection, the interventional therapy of his utricle cyst was abandoned.

Influence of Bi 58 Nowy (38% dimethoate) on pyrantel embonate concentration in the liver of rats.

The aim of the study was to determine the concentration of pyrantel residues in the liver of rats in different time points after oral administration of pyrantel embonate as well as combined administration of the Bi 58 Nowy preparation (38% of dimethoate) and pyrantel embonate. The experiment was conducted in two stages involving different doses of compounds and modes of exposure. At the first stage, the animals were administered pyrantel embonate with a stomach tube at a dose of 1000 mg/kg b.w. twice in a two-week interval, i.e. on day 14 and 28, and the Bi 58 Nowy preparation with drinking water at a dose of 15.48 mg/kg b.w. for 28 days. At the second stage, the rats received pyrantel embonate at a dose of 400 mg/kg b.w. with a stomach tube for 3 consecutive days, whereas the Bi 58 Nowy preparation was administered at a dose of 38.7 mg/kg b.w. also with a stomach tube for 5 consecutive days. In the rats doubly administered with pyrantel embonate, its residues were present until day 14, whereas when the drug was administered for 3 consecutive days they were present until day 7 of the experiment. The maximum concentration of pyrantel embonate was found in the liver after the 3rd hour, whereas a considerable decrease occurred between the 3rd and the 12th hour. The combined administration of pyrantel embonate and the Bi 58 Nowy preparation caused a significant decrease in the concentration of pyrantel residues in the liver 3 and 6 hours after exposure, as compared to the rats receiving the drug alone.

The influence of administering "effective microorganisms" to pullets on chosen haematological and biochemical blood indexes.

"Effective Microorganisms" (EM)--a mixture of lactic acid bacteria, photosynthetic bacteria, yeasts and fungi are used mainly in agriculture and organic waste treatment. Recently, they have also been added to water and feed for animals, as well as to processing their excrements into compost and to eliminate the stench. The objective of the present study was to assess the influence of a 14-day administration of an EM solution in drinking water to layer hens on chosen haematological and biochemical indexes. The research was carried out on 120 hens divided into two equal groups. The birds in the experimental group were given drinking water with dissolved EM (5% solution), and those in the control group--water without the preparation. On the 64th day of the aviculture, the hens were weighted and their blood was taken from the wing vein for haematological and biochemical examinations. Administering EM with water to hens did not influence significantly their body weight nor chosen haematological and biochemical indexes. A significant increase was found only in the number of platelets, the level of albumins, the content of total cholesterol and the LDH activity, however, a decrease in the ALT activity was observed.

Influence of light and darkness on the behaviour of Dermanyssus gallinae on layer farms.

The behaviour of Dermanyssus gallinae was investigated on two layer farms where two different light programs were introduced in the 40th week of hen life. In layer house No. 1, light was applied continuously for 16 hours during the day, while layer house No. 2 was subjected to 4 hours of light and 2 hours of darkness applied alternately during the day. To monitor the level of red mite infestation, 30 tube traps were placed in every layer house corridor at a height of 1.5 m above the floor. In the first layer house, 280 Dermanyssus gallinae females, 50 nymph larvae and 198 eggs were found in 100 mg of tube trap material during 16 hours of the light phase, while during the 8-hour darkness phase, 1240 females, 70 nymph larvae and 110 eggs were collected. In the other layer house (with an alternating light phase of 4 hours and a darkness phase of 2 hours per day), 387 Dermanyssus gallinae females, 401 nymph larvae and 1060 eggs were found in trap tubes over the 8-hour dark phase, while 343 females, 202 nymph larvae and 1106 eggs were discovered over the 16-hour light phase.

Residues of dimethoate in the liver and AchE activity in blood of rats after exposure to dimethoate, and dimethoate and pyrantel embonate.

The study was aimed at determining the dimethoate residues in the liver and acetylcholinesterase (AChE) activity in blood of rats exposed to dimethoate (individual intoxication), and dimethoate and pyrantel embonate (simultaneous intoxication). The experiment was carried out in two stages where various doses of preparations and exposure manners were used. In the first stage of the experiment, dimethoate (1/25 LD50) was administered to animals per os for 28 days, and pyrantel embonate (1/2 LD550) twice, i.e. on the day 14th and 28th. In the second stage, dimethoate was administered for 5 days (1/10 LD50), and pyrantel embonate (1/5 LD50) on day 3, 4 and 5 from the beginning of dimethoate intoxication. The short presence of the dimethoate residues in the liver of the animals examined was found until the 2nd day after 28-day intoxication (1/25 LD50) and until 14th day after 5-day intoxication (1/10 LD50), however, a distinct decrease in this insecticide residues in the liver of (analysed groups of) rats occurred between the 3rd hour and the 2nd day after exposure. Dimethoate in both applied doses significantly reduced AChE activity in blood. After application of the higher dose, the inhibition of AChE was more pronounced, and the return of its activity to physiological values lasted considerably longer. Co-administration of pyrantel embonate and dimethoate, slightly influenced changes of the parameters analysed, which have been dependent not only on a dose and manner of pyrantel application but also on time which lapsed from exposure.