[Association between influenza vaccination and mortality due to COVID-19]. / Asociación entre la vacunación contra influenza y la mortalidad por COVID-19.

Background: It has recently been suggested that influenza vaccination may be a factor associated with decreased COVID-19 mortality. Methods: An age-matched case-control study based on hospital cases. We included subjects aged 18 years and older with a diagnosis of moderate to severe COVID-19. Infection was corroborated by RT-PCR test for SARS-COV-2. Deceased subjects were considered cases, controls were patients discharged due to improvement of acute symptoms. We used bivariate analysis to determine factors associated with death from COVID-19, and calculated odds ratios and 95% confidence intervals. Results: A total of 560 patients were included in the study, 214 (38.2%) were considered cases and 346 (61.7%) controls. A significant difference was observed with the presence of type 2 diabetes mellitus [54% vs. 39.3% between cases and controls, respectively (p=.04)] and having received influenza vaccination (p= .02). Type 2 diabetes mellitus was associated with higher COVID-19 mortality [OR 1.8 (95% CI 1.2-2.5) p=.01], whereas having been immunised against influenza in 2019 was associated with lower mortality in this group of patients [OR .6 (95% CI .4-.9) p=.02]. Conclusions: Influenza vaccination in the previous year appears to be associated with lower mortality from COVID-19; whereas type 2 diabetes mellitus is confirmed as a condition associated with higher mortality.

Thermo- radio- and optically stimulated luminescence of Ce-doped KYF4 single crystals.

The goals of this work are to determine the luminescence properties of KYF4 single crystals doped with different concentrations of Ce3+ ions and to evaluate their possible application as a detector of beta radiation. In particular, thermoluminiscence, radioluminiscence and optically stimulated luminescence properties of KYF4: Ce3+ exposed to beta radiation have been studied and very good dosimetric properties have been obtained within the dose range 0.02-20 Gy.

[Prospective evaluation of the direct costs of prostate enucleation by the HoLEP® laser during the learning curve period]. / Évaluation prospective des coûts directs de l'énucléation prostatique par le laser HoLEP® pendant la courbe d'apprentissage.

OBJECTIVE: Holmium laser enucleation of the prostate (HoLEP) has been shown to be effective in treating large prostates compared to prostate transurethral resection (TURP). There are no published data evaluating specifically the impact of the learning curve on the direct costs of HoLEP. The objective of this study was to evaluate the direct costs generated by the use of HoLEP laser during the learning curve period. METHOD: The costs of all medical devices (DM) and drugs used, pre- and post-operative parameters during surgery have been prospectively collected between March and October 2016. RESULTS: A total of 32 patients were included in the study with a mean age of 70.8 years and a mean prostate volume of 68.6 cm3. The mean cost of anesthesia was 39.0 € and that of drugs and DM used for surgery was 257.95 € but could reach 470.76 € in case of conversion to bipolar resection. The mean duration of enucleation and morcellation was 150minutes with a mean weight of enucleated specimens of 40.4g. The total mean duration of patient care was 197minutes at an estimated hourly cost of € 636. CONCLUSIONS: Despite some limitations, this study makes it possible to analyze the direct costs of the management of benign prostatic hypertrophy using HoLEP, an innovative surgical technique, and to specify that these costs are more related to bipolar conversion and voluminous adenomas especially during the learning curve. LEVEL OF EVIDENCE: 5.

Probing Stereoselectivity in Ring-Opening Metathesis Polymerization Mediated by Cyclometalated Ruthenium-Based Catalysts: A Combined Experimental and Computational Study.

The microstructures of polymers produced by ring-opening metathesis polymerization (ROMP) with cyclometalated Ru-carbene metathesis catalysts were investigated. A strong bias for a cis,syndiotactic microstructure with minimal head-to-tail bias was observed. In instances where trans errors were introduced, it was determined that these regions were also syndiotactic. Furthermore, hypothetical reaction intermediates and transition structures were analyzed computationally. Combined experimental and computational data support a reaction mechanism in which cis,syndio-selectivity is a result of stereogenic metal control, while microstructural errors are predominantly due to alkylidene isomerization via rotation about the Ru═C double bond.

[Secondary recurrent haemorrhage with peristomal varices complicating a urinary derivation according to Bricker and treated efficiently by endoscopic way]. / Hémorragie récidivante secondaire à des varices péristomiales compliquant une dérivation urinaire selon Bricker et traitée efficacement par voie endoscopique.

Stomal varices developed in patients with cirrhosis and enterostomy can be source of important haemorrhages. It is a rare event but often recurrent and difficult enough to treat efficiently. In certain cases, consequences can be severe. We report the case of a 63-years-old patient with medical history of hepatic cirrhosis who underwent a radical cystoprostatectomy with urinary derivation type Bricker. Five years afterwards, he developed stomal varices very haemorrhagic treated efficiently by endoscopic way, without any recurrence 12 months later. This observation shows that stomal haemorrhages can be treated by endoscopic way.

[Case report and review of the literature: a perineal schwannoma]. / Cas clinique et revue de la littérature: un schwannome périnéal.

Schwannoma is a rare and benign peripheral nerve sheath tumor arising from Schwann cells. Perineal localisation is exceptional. It is most frequently isolated but can be associated with neurofibromatosis 2 or schwannomatosis. This article describes a case of perineal schwannoma, its management and update diagnosis modality and treatment of this tumor.

[Acute myocardial infarction associated to the Sildenafil consumption. A case report and review of the literature]. / Infarto agudo de miocardio asociado al consumo de sildenafil. Aportación de caso y revisión de la literatura.

Erectile dysfunction affects more than 30 million men in The United States. Since the FDA approved the use of Sildenafil, prescription of this medication has been raising. Adverse events of Sildenafil includes: fatigue, dyspnea, and hypotension. Reported adverse cardiac events associated with the medication use include myocardial infarction, ventricular tachycardia, angina and death, raising concerns about the safety of this agent in patients with coronary artery disease. Published guidelines regarding the management of cardiac patients with erectile dysfunction suggest that Sildenafil may be hazardous in patients with ischemic heart disease. In patients using Sildenafil, myocardial infarctions have been reported to the Food and Drug Administration. Now, we report a patient with myocardial infarction after taking 100 mg of Sildenafil without sexual activity.

[Polyorchidism: a case report and review of the literature]. / Poliorquidismo: aportación de un caso y revisión de la literatura actual.

Polyorchidism is an uncommon congenital defect. In fact, less than one hundred cases have been reported in the medical literature worldwide. This problem should be considered in the differential diagnosis of all scrotal masses. It is associated with multiple other urologic entities including malignancy. It is for this reason that it is important to be familiar with potential diagnostic and therapeutic strategies. This diagnosis is usually documented by imaging, specifically doppler ultrasound (US) and magnetic resonance imaging (MRI). The risk of malignancy approaches 6% in Polyorchidism and therefore several authors have advocated surgery as the most appropriate therapeutic approach. However, recent reports suggest that asymptomatic patients with normal imaging could be observed. We present a 14 year old boy with polyorchidism which was diagnosed clinically and confirmed with imaging. His treatment and a review of the literature are presented as well.

p53 immunodetection of liquid-based processed urinary samples helps to identify bladder tumours with a higher risk of progression.

p53 could help identify bladder tumour cases with a risk of progression from superficial to invasive disease. Semiautomatic, liquid-based cytology (LBC) techniques offer an opportunity to standardise molecular techniques. The aim of our study was to investigate whether LBC could improve p53 immunolabelling, and to assess whether urinary p53 could have a prognostic value. Immunoreactivity for p53 was studied in 198 urine samples after treatment with the Cytyc Thinprep processor. After antigen retrieval, cells were labelled with a monoclonal antibody that recognises both wild-type and mutant form of the p53 protein (Clone DO-7, Dako), 1/1000. Positivity for p53 was assessed in 17.2% of the cases. High-grade (G3) tumours were positive in 74.1% of the cases. Comparatively, low-grade (G1-2) urothelial carcinomas were positive in 23.5% of the cases. During a median follow-up period of 26 months, recurrence was observed in 52.9% of the cases with p53 overexpression, and in only 10.9% of negative cases (P < 0.001). The progression rate was 35.3% of p53-positive cases vs 5.5% of p53-negative cases (P < 0.001). Progression-free survival was significantly shorter in patients with p53 accumulation (P = 0.007). In a multivariate analysis stratified on grade and stage, p53 was an independent predictor of overall survival (P = 0.042). The results show that using Thinprep LBC, p53 immunolabelling of voided urothelial cells allows most high-grade tumours to be detected and may help identify cases with a higher risk of recurrence and progression.

Preservation of prostate during radical cystectomy: evaluation of prevalence of prostate cancer associated with bladder cancer.

OBJECTIVES: To estimate the frequency and characteristics of prostatic lesions discovered incidentally in radical cystoprostatectomy specimens and to determine whether any factors would allow for the detection of prostate cancer preoperatively. METHODS: A total of 100 radical cystoprostatectomy specimens with orthotopic bladder reconstruction were performed for malignant bladder disease between 1990 and 2000. The mean patient age at surgery was 62 +/- 8 years (range 32 to 75). Digital rectal examination and prostate-specific antigen (PSA) assay were done routinely before surgery. During the 10-year study period, the same pathologist examined the prostatic tissues from radical cystoprostatectomy specimens using McNeal's technique on fine slices every 2.5 mm. RESULTS: The overall incidence of prostate cancer discovered incidentally in radical cystoprostatectomy specimens was 51%, of which 29% were microcancers (volume less than 0.5 cm3) and 22% were significantly larger (volume 0.5 cm3 or more). The mean Gleason score was 6. Of the tumors, 24% could be considered "clinically nonsignificant" (less than 0.5 cm3 and Gleason score less than 7). The mean preoperative PSA level was 4.13 +/- 1.36 ng/mL. Of 66 patients with a PSA level of less than 4 ng/mL (mean PSA 1.5 +/- 0.8) and a normal digital rectal examination before surgery, 50% had prostate cancer, of which 69% were microcancers. CONCLUSIONS: The prevalence of prostate cancer (51%) in our series is among the highest in published reports. Furthermore, our results stress that currently no factors are available to enable the detection of "clinically significant" prostate cancer preoperatively.

Long-term recurrence of primary amyloidosis of the bladder.

An 84-year-old man presented to our department with a recurrence of a primary amyloidosis of the bladder 14 years after the first diagnosis. Follow-up had been stopped 5 years after the first procedure because no cystoscopic anomalies were noted. General evaluation confirmed the diagnosis of primary amyloidosis. The lesions were endoscopically resected. At the 3-year follow-up, the patient was free of symptoms and had remained cystoscopically free of disease. However, stable amyloidosis deposits have always been noted on the computed tomography scans. This case emphasizes the necessity of a longer follow-up, including computed tomography of the pelvis, during the 10 to 15 years after the first occurrence of the disease.

Nitric oxide- and nitric oxide donors-induced relaxation and its modulation by oxidative stress in piglet pulmonary arteries.

Inhaled nitric oxide (iNO) is widely used in the treatment of pulmonary hypertension while inhaled NO donors have been suggested as an alternative therapy. The differential susceptibility to inactivation by oxidative stress and oxyhaemoglobin of NO and two NO donors, sodium nitroprusside (SNP) and S-nitroso-N-acetyl-penicillamine (SNAP) were analysed in isolated endothelium-denuded pulmonary arteries from 2-week-old piglets stimulated with U46619. NO, SNAP and SNP relaxed the arteries (pIC(30)=7.73+/-0.12, 7.26+/-0.17 and 6.43+/-0.13, respectively) but NO was not detected electrochemically in the bath after the addition of SNP and only at concentrations at which SNAP produced more than 50% relaxation. The sGC inhibitor ODQ (10(-6) M) or the sarcoplasmic Ca(2+)-ATPase thapsigargin (2x10(-6) M) markedly inhibited the relaxation induced by NO, SNAP and SNP. Addition of oxyhaemoglobin (3x10(-7) M) or diethyldithiocarbamate (1 mM) markedly inhibited NO- (pIC(30)=6.88+/-0.07 and 6.92+/-0.18, respectively), weakly inhibited SNAP- and had no effect on SNP-induced relaxation. Xanthine oxidase (5 mu ml(-1)) plus hypoxanthine (10(-4) M) markedly inhibited NO- (pIC(30)=6.96+/-0.12) but not SNAP- or SNP-induced relaxation. Superoxide dismutase (SOD), MnCl(2), diphenileneiodonium and exposing the luminal surface of the rings outwards (inversion) potentiated the relaxant responses of NO (pIC(30)=8.52+/-0.16, 8.23+/-0.11, 8.01+/-0.11 and 8.20+/-0.10, respectively). However, SOD did not modify the NO detected by the electrode and had no effect on SNAP- or SNP-induced relaxation. Therefore, the kinetics and local distribution of NO release of NO donors influence the susceptibility to the scavenging effects of oxyhaemoglobin and superoxide.

Renormalization-group calculation of the dependence on gravity of the surface tension and bending rigidity of a fluid interface.

The surface tension and the bending rigidity of a planar liquid-vapor interface in the presence of vanishing gravity are analyzed using the renormalization group. Based on the density functional theory of inhomogeneous fluids, we show that a term, quartic in the density fluctuations, can be added to the classical capillary-wave model so that a renormalization-group calculation can be performed. By comparing the outcome of such a calculation with rigorous results relating the direct correlation function with surface tension and bending rigidity, we find the scaling dependence of the latter on gravity. The results agree with the expected fact that the interface should become unstable as gravity vanishes.

[Deferred adjustment of the tension of tension-free vaginal tape (TVT) after surgical repair of stress urinary incontinence in women]. / Ajustement différé de la tension de matériel prothétique sous-uréthral (TVT) après cure chirurgicale d'incontinence urinaire d'effort de la femme.

INTRODUCTION: Urinary retention is a frequent complication of repair of female urinary incontinence treated by tension-free vaginal tape (TVT). The authors report a modification of the original technique designed to decrease the risk of postoperative dysuria and retention. MATERIAL AND METHODS: One hundred and twenty four patients with pure stress urinary incontinence were treated by TVT. In 74 patients (group 1), the TVT was placed according to the original Swedish technique. In 50 patients (group 2), no tension was applied to the suprapubic extremities of the TVT during the operation, but they were preserved and buried in an antiseptic dressing. On the day after the operation, traction was applied to the suprapubic TVT in the case of persistent incontinence. The immediate postoperative results and the results at 3 months, in terms of continence and urethral obstruction, were compared. RESULTS: Perfect continence was obtained in 84 +/- 6.5% and 94 +/- 4.2% of patients in groups 1 and 2, respectively (p = 0.08). Acute urinary retention (15% vs 2%, p < 0.03) and post-voiding residual urine > 50 cc (38% vs 10% on D1 and 14% vs 2% at 3 months) were more frequent in group 1. At 3 months, the reduction in maximum and mean flow rate was lower in group 2 (p < 0.03). In group 2, deferred traction of the TVT was necessary in 20% of cases, without causing any major infectious complications or pain. CONCLUSION: Deferred traction of TVT appears to decrease the rate of dysuria and urinary retention following repair of female urinary incontinence by tension-free vaginal tape (TVT). This technical modification does not affect the results on continence, which appears to be at least as satisfactory. This technical variant appears to be associated with a low morbidity.

[Intravesical BCG-therapy: comparison of side effects of Connaught (Toronto) and Pasteur (Paris) strains]. / BCG-thérapie intravésicale: comparaison des effets secondaires des souches Connaught (Toronto) et Pasteur (Paris).

INTRODUCTION: Urologists have felt that the adverse effects of intravesical BCG-therapy have been more serious and more frequent since the use of the Connaught strain. The objective of this retrospective study was to compare the toxicity of this new strain with that previously used in France (Pasteur strain). MATERIAL AND METHODS: After endoscopic resection, 89 patients with stage Ta grade 1-2 recurrent or T1 grade 3 and/or CIS bladder tumour were treated with 6 instillations of 150 mg of BCG Pasteur from 1992 to 1996 (50 patients: group 1) or 81 mg of BCG Connaught from January 1997 to December 1998 (39 patients: group 2). Adverse effects were classified as minor, lasting less than 48 hours (bladder irritation syndrome and/or macroscopic haematuria and/or fever less than 38 degrees C), moderate (requiring symptomatic treatment, reduction of the dose or an increased interval between instillations), and major (contraindication to continuation of treatment). RESULTS: 74% of patients in group 1 presented at least one adverse effect versus 77% in group 2. The reasons for permanent discontinuation of BCG-therapy in groups 1 and 2, respectively, were as follows: malaise during instillation (1 vs 0), bladder irritation syndrome not controlled by symptomatic treatment (4 vs 5) and epididymitis (0 vs 1). Pulmonary tuberculosis was diagnosed in one patient from group 2, one year after the last instillation. The frequency and severity of adverse effects were not statistically different between the two groups. The number of patients discontinuing BCG-therapy because of severe complications was also not statistically different between the two groups. CONCLUSION: This study did not reveal any difference of toxicity between Connaught and Pasteur strain in intravesical BCG-therapy of superficial bladder tumours.

Relaxant effects of carbon monoxide compared with nitric oxide in pulmonary and systemic vessels of newborn piglets.

Nitric oxide (NO) has been implicated in a number of diverse physiologic processes, including regulation of vascular tone. Carbon monoxide (CO) is another endogenously generated diatomic gas that may play an important physiologic role in vascular smooth muscle homeostasis. The purpose of this study was to compare the responses to exogenous NO and CO in isolated vessels (pulmonary arteries, pulmonary veins, and mesenteric arteries) from 12- to 24-h-old and 2-wk-old piglets. Vessels precontracted with the thromboxane A(2) mimetic U46619 (10(-7) M) relaxed in response to CO (2 x 10(-6) to 2 x 10(-4) M) and NO (2 x 10(-9) to 2 x 10(-7) M); these effects were not affected by endothelium removal but were completely abolished by the soluble guanylate cyclase inhibitor ODQ (10(-5) M). In pulmonary arteries, the maximal relaxation to NO increased with postnatal age from 33 +/- 4% of the precontraction value to 56 +/- 5%, in 12- to 24-h-old and 2-week-old piglets, respectively (p < 0.01), but the response to CO decreased from 25 +/- 3% to 12 +/- 1%, respectively (p < 0.01). The maximal response to CO was greater in pulmonary veins than in pulmonary or mesenteric arteries for both age groups (p < 0.01). Vasorelaxation induced by endogenous NO (stimulated by acetylcholine) was also greater in pulmonary veins when compared with pulmonary arteries and increased with postnatal age in both vessels. In contrast, no age-related differences were observed in the vasorelaxation induced by the cGMP analog 8-bromo cGMP in pulmonary arteries. When the response to NO was analyzed under three different extracellular O(2) concentrations (PO(2) 4.51 +/- 0.03, 19. 32 +/- 0.17, and 86 +/- 0.62, kPa), no significant differences were found. However, in the presence of superoxide dismutase (100 U/mL). the response to CO remained unchanged, and the response to NO improved in pulmonary arteries from 2-week-old but not from newborn piglets. In conclusion, both NO and CO relaxed neonatal vessels through soluble guanylate cyclase activation. However, when compared with NO, CO exhibited a poor vasorelaxant activity. Pulmonary vasorelaxation induced by NO increased with postnatal age, whereas that induced by CO decreased. Changes in extracellular oxygen concentration did not alter the pulmonary vascular response to NO. However, the presence of superoxide dismutase improved the response to NO, indicating that oxidant activity limits the vasorelaxant response to NO but not to CO.

Acromioplasty: comparison of outcome in patients with and without workers' compensation.

Acromioplasty was performed on 24 shoulders in 23 patients who had a diagnosis of impingement syndrome/rotator cuff tendinopathy. Ten patients were female and 13 were male; mean age was 52.3 years. Patients were divided into two groups, depending on whether they were receiving workers' compensation benefits. Clinical outcomes were evaluated preoperatively and at follow-up postoperatively using the University of California Los Angeles (UCLA) Shoulder Rating Scale. All patients had bursectomy, anterior inferior acromioplasty, and coracoacromial ligament release. The two groups showed significantly different postoperative results in terms of pain, function, strength of forward flexion, and total score, with the workers' compensation group consistently having a lower functional score. Pain did improve significantly for workers' compensation patients over the course of treatment, but relief was not nearly as complete as in the noncompensated group. A positive response to a shoulder bursa steroid injection, even if temporary, was a good predictor of final outcome after an acromioplasty.