Rapid and recent changes in fungal fruiting patterns.

Information on responses of higher organisms to climate change is dominated by events in spring. Far less is known about autumnal events and virtually nothing about communities of microorganisms. We analyzed autumnal fruiting patterns of macrofungi over the past 56 years and found that average first fruiting date of 315 species is earlier, while last fruiting date is later. Fruiting of mycorrhizal species that associate with both deciduous and coniferous trees is delayed in deciduous, but not in coniferous, forests. Many species are now fruiting twice a year, indicating increased mycelial activity and possibly greater decay rates in ecosystems.

Sexual function in patients with LUTS suggestive of BPH.

BACKGROUND: Sexual function has been detected in a large sample of Italian patients affected by LUTS suggestive of BPH, by means of the ICS-Sex questionnaire. RESULTS: A number of 877 questionnaires were returned completely filled and were analyzed. Fifty percent of patients declared that their sexual life was significantly affected by their urinary symptoms. Difficulty in getting erections (58.2% of patients) and ejaculation problems (55.6%) were reported by the majority of patients, but the relevant bother was significantly different (48.3 and 33.4%, respectively). The ICS-Sex score was significantly associated with all the measures of symptoms and QoL employed in the study (IPSS and ICS-BPH). The urinary symptoms most frequently associated with sexual dysfunction were those related to incontinence. CONCLUSIONS: The QUIBUS study shows that sexual dysfunctions are commonly complained of by Italian men with LUTS and are significantly associated with urinary symptoms, in particular with urine loss. These findings support the recommendation by the 5th International Consultation on BPH to better evaluate both sexual function and incontinence symptoms in patients affected by LUTS suggestive of BPH.

Pure squamous cell carcinoma of the bladder in western countries. Report on 19 consecutive cases.

INTRODUCTION: Pure squamous carcinoma (SCC) is a rare entity in western regions. The management of SCC still remains similar to that of transitional carcinoma, although it is a different entity. A retrospective review can be helpful in understanding the biological behavior of this uncommon vesical tumour. MATERIAL AND METHODS: Nineteen consecutive cases of pure SCC of the bladder, not related to bilharziasis or spinal cord injury, are herein reported. Fifteen patients were submitted to radical cystectomy, combined with emasculation in 1 case and unilateral nephroureterectomy in another. Partial cystectomy was performed in 1 patient and transurethral resection followed by radiotherapy in 3 more cases. Involvement of prostatic urethra and upper urinary tract was evident in 9 (47.3%) and 5 patients (26.3%), respectively. Four patients were submitted to neoadjuvant chemotherapy and 1 to presurgical radiotherapy without any objective response. Adjuvant chemotherapy was performed in 3 patients. At a mean follow-up of 52 months, 6 patients (31.5%) are alive without any evidence of disease. SCC antigen was monitored in 5 patients. The possible role of this marker in bladder SCC is discussed. CONCLUSIONS: Invasion of the upper urinary tract and prostatic urethra seems more common in SCC than in transitional cell carcinoma. Distant metastases are rare. Most patients die after attempts of locoregional control of the tumor have failed. Extensive surgery is recommended. Preoperative radiotherapy should be considered since pelvic recurrences are the leading cause of progression in squamous cell carcinoma.

Urinary NMP22 for the detection of recurrence after transurethral resection of transitional cell carcinoma of the bladder: experience on 137 patients.

OBJECTIVES: To evaluate the nuclear matrix protein 22 (NMP22) test in the management of patients after transurethral resection (TUR) of recurrent transitional cell carcinoma of the bladder. METHODS: The NMP22 test was performed in 137 patients: in 42 patients, a bladder recurrence was detected by cystoscopy and histologically confirmed; 95 patients were recurrence-free at cytology and cystoscopy performed at least 3 months after TUR. RESULTS: In patients with tumoral recurrence, the mean NMP22 value was 54.8 U/mL. The false-negative rate was 28.5%. In recurrence-free patients, the mean NMP22 value was 22.8 U/mL. The specificity of the NMP22 test was 61%. Higher NMP22 mean values (29.6 versus 15.8 U/mL) were found in patients who underwent intravesical chemotherapy or immunotherapy. CONCLUSIONS: Despite its good sensitivity, the NMP22 test cannot be adopted as a routine tool in the surveillance after TUR of patients with superficial bladder cancer because of its low specificity.