Comparison of different regimens of short-term antibiotic prophylaxis in transrectal prostate biopsy.

BACKGROUND: Prostate cancer is the most common malignant solid tumour in men aged >70 years and is the second most common cause of death from oncological circumstances. AIM: To evaluate the effect of different short-term prophylactic antibiotic regimens in transrectal prostate biopsy (PB) on the incidence of infectious complications. METHODS: Patients who underwent transrectal ultrasound-guided PB between January 2021 and December 2022 were included in the prospective randomized study. According to the regimen of prophylaxis, patients were randomized into three groups: (1) fosfomycin trometamol 3 g, 3 h before the procedure + ciprofloxacin 500 mg, 2 h before the procedure; (2) fosfomycin trometamol 3 g, 3 h before and 24 h after the procedure; (3) ciprofloxacin 500 mg 12, 2 h before the procedure, and 12 h after the procedure. A rectal swab was performed 1-2 weeks before PB to evaluate the culture findings. Complications were evaluated during follow-up visits within one month after PB. FINDINGS: In the monitored period, 605 PBs were performed, and 544 patients met the inclusion criteria (184, 161, and 199 in groups 1, 2, and 3). Infectious complications occurred in 10 cases (1.83%), namely 3, 4, and 3 according to patient groups. There was no statistically significant difference between the individual groups. None of the patients required hospitalization and all were free of symptoms of sepsis. CONCLUSION: Short-term antibiotic prophylaxis in PB using fosfomycin trometamol, ciprofloxacin, or their combination appears to be effective. Fosfomycin trometamol is a suitable alternative to fluoroquinolone antibiotics.

Infecciones del tracto urinario en pacientes con esclerosis múltiple y los diferentes sistemas de vaciado vesical / Urinary tract infections in patients with multiple sclerosis and different methods of bladder evacuation

Introducción y objetivos: Evaluar la incidencia y la evolución de las infecciones del tracto urinario (ITU) en pacientes con esclerosis múltiple (EM) y su relación con el sistema de vaciado vesical. Materiales y métodos: Se incluyeron en el estudio pacientes con disfunciones miccionales neurógenas debido a la EM (n=111). Durante un año de seguimiento, se realizó una evaluación clínica con cultivo de orina cada 4 meses o ante la presencia de síntomas. El grupo de control incluyó a pacientes con ITU sintomática sin enfermedad neurológica o autoinmune. Se evaluó estadísticamente la incidencia de bacteriuria sintomática y asintomática, el efecto del drenaje urinario en la incidencia de ITU y el efecto del tratamiento antibiótico. Resultados: Cincuenta y cuatro pacientes con EM completaron el protocolo. La incidencia media de bacteriuria sintomática y asintomática en el grupo de EM fue del 12,5% y del 29,6%, respectivamente. Se observó una tendencia decreciente en la incidencia de la bacteriuria sintomática y una tendencia creciente en la incidencia de la asintomática. La erradicación de la ITU en los pacientes sintomáticos con EM fue significativamente menor que en los controles (37,75% frente a 92,93%, p<0,05). Los agentes causales fueron significativamente diferentes en ambos grupos (p=0,0005). No se rechazó la hipótesis de que la incidencia de ITU en los pacientes con EM es independiente del sistema de evacuación vesical (p>0,99 en las visitas 0, 1 y 3; p=0,078 en la visita 2). Conclusiones: Existe una diferencia significativa entre los agentes causales de la ITU en ambos grupos. La erradicación de la bacteriuria en los pacientes sintomáticos con EM es difícil en comparación con la población normal. No disponemos de pruebas suficientes para confirmar la relación entre la incidencia de ITU y el sistema de evacuación vesical. (AU)

Introduction and objectives: To evaluate the incidence and course of urinary tract infections (UTI) in patients with multiple sclerosis (MS) and their relationship to the method of bladder evacuation. Materials and methods: Patients with neurogenic bladder dysfunction due to MS (n=111) were enrolled in the study. During one-year follow-up, clinical examination with urine culture was performed every 4 months or whenever symptoms occurred. The control group included patients with symptomatic UTI, without neurological or autoimmune disease. Incidence of symptomatic and asymptomatic bacteriuria, the effect of urine drainage on UTI incidence, and the effect of antibiotics were statistically evaluated. Results: Fifty-four MS patients completed the protocol. The mean incidence of symptomatic and asymptomatic bacteriuria in the MS group was 12.5% and 29.6%, respectively. A decreasing trend in the incidence of symptomatic, and an increasing trend in the incidence of asymptomatic bacteriuria was observed. Eradication of UTI in symptomatic MS patients was significantly lower than in controls (37.75% vs. 92.93%, P<.05). Causative agents significantly differed in both groups (P=.0005). The hypothesis that the incidence of UTIs in MS patients is independent of the method of bladder evacuation was not rejected (P>.99 at visit 0, 1 and 3, P=.078 at visit 2). Conclusions: There is a significant difference between the causative agents of UTI in both groups. Eradication of bacteriuria in symptomatic MS patients is difficult when compared to the normal population. We have insufficient evidence to confirm the relationship between the incidence of UTI and the method of bladder evacuation. (AU)

Urinary tract infections in patients with multiple sclerosis and different methods of bladder evacuation.

INTRODUCTION AND OBJECTIVES: To evaluate the incidence and course of urinary tract infections (UTI) in patients with multiple sclerosis (MS) and their relationship to the method of bladder evacuation. MATERIALS AND METHODS: Patients with neurogenic bladder dysfunction due to MS (n=111) were enrolled in the study. During one-year follow-up, clinical examination with urine culture was performed every 4 months or whenever symptoms occurred. The control group included patients with symptomatic UTI, without neurological or autoimmune disease. Incidence of symptomatic and asymptomatic bacteriuria, the effect of urine drainage on UTI incidence, and the effect of antibiotics were statistically evaluated. RESULTS: 54 MS patients completed the protocol. The mean incidence of symptomatic and asymptomatic bacteriuria in the MS group was 12.5% and 29.6%, respectively. A decreasing trend in the incidence of symptomatic, and an increasing trend in the incidence of asymptomatic bacteriuria was observed. Eradication of UTI in symptomatic MS patients was significantly lower than in controls (37.75% vs. 92.93%, P<0.05). Causative agents significantly differed in both groups (P=0.0005). The hypothesis that the incidence of UTIs in MS patients is independent of the method of bladder evacuation was not rejected (P>0.99 at visit 0, 1 and 3, P=0.078 at visit 2). CONCLUSIONS: There is a significant difference between the causative agents of UTI in both groups. Eradication of bacteriuria in symptomatic MS patients is difficult when compared to the normal population. We have insufficient evidence to confirm the relationship between the incidence of UTI and the method of bladder evacuation.

[Urinary MicroRNAs as Potential Biomarkers of Bladder Cancer]. / Mocové mikroRNA jako potenciální biomarkery karcinomu mocového mechýre.

BACKGROUND: Currently, there are no urinary-based tumour markers with sufficient sensitivity and specificity to replace cystoscopy in the detection of bladder cancer (BCA). Urinary microRNAs are emerging as clinically useful class of biomarkers for early and non-invasive detection of urologic malignancies. PATIENTS AND METHODS: In this study, 155 patients with BCA and 83 healthy controls were enrolled. Expression profiles of urinary miRNAs were obtained using Affymetrix miRNA microarrays and candidate miRNAs further validated in independent cohort using specific TaqMan assays and quantitative real-time polymerase chain reaction method. RESULTS: Whole-genome profiling identified miRNA signature with significantly different concentrations in urine of BCA compared to controls (p < 0.01). In the independent validation phase of the study, three miRNAs were confirmed to have significantly higher levels in urine of patients with BCA in comparison with control groups (p < 0.0001). In addition, we observed significant decrease in two miRNAs (p < 0.01) concentrations in the urinary samples collected 3 months after surgery compared to pre-operative samples. CONCLUSION: We identified and validated miRNAs to have significantly higher concentrations in urine of patients with BCA in comparison with controls. Our data have shown that urinary miRNAs could serve as sensitive and specific biomarkers enabling non-invasive detection of BCA.Key words: urinary microRNAs - biomarkers - bladder cancer The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers. This study was supported by Ministry of Health of the Czech Republic, grant No. 15-31071A. All rights reserved.Submitted: 19. 3. 2018Accepted: 20. 3. 2018.

Secretion of cytokines and modulation of function of immunologically competent cells.

Cytokines and their effects are widely studied in immunology, but the cellular mechanisms responsible for producing these substances are not yet described or proven. Antigen presenting cells (APCs), macrophages and dendritic cells are suitable subjects for such a study. One of the many papers illustrating the interplay between phagocytosis, cytokine secretion, and cell adhesion is one by Kitajima et al. The intracellular processes involve both cytokine secretion and mobilization of the membrane system of the cell. Five pieces of evidence are presented to propose that the Golgi complex is the source both of the membrane translocated and cytokine production. Morphologic evidence is cited that reverse pinicytosis does not play a significant role in the mouse macrophage system.

The functional capacity of guinea pig megakaryocytes. I. Uptake of 3H-serotonin by megakaryocytes and their physiologic and morphologic response to stimuli for the platelet release reaction.

The functional capacity of guinea pig megakaryocytes was tested by studying their ability to concentrate serotonin and their response to agents which trigger the platelet release reaction. Megakaryocytes can concentrate 3H-serotonin as demonstrated by autoradiography after exposure to 0.5 muM 3H-serotonin and by quantitative measurement of isotope incorporation within 60 minutes. Uptake of isotope is rapid and linear within the first 30 minutes and tapers off between 30 and 60 minutes. Incorporation of isotope is diminished during exposure to cold, 2 muM reserpine, and 20 muM imiprimine. The following triggering agents: 10(-5) to 10(-3) M ADP, 1 to 100 units of thrombin, 10(-5) to 10(-3)M epinephrine, and 1 to 12 muM ionophore A23187 all produce significant release of stored 3H-serotonin. In the presence of ADP, albumin and serum completely inhibit the release of serotonin. Scanning microscopic studies show that coincident with serotonin release the triggering agents produce marked changes in cell shape. Transmission electron microscopy on these cells shows that there is the appearance of a prominent contraction zone, which is composed of microfilaments, and also variable diminution of cytoplasmic granules. The specifically induced serotonin release from megakaryocytes coupled with shape change and evidence of cell contraction produced by certain agents demonstrate one aspect of the functional similarly between megakaryocytes and platelets.

The functional capacity of guinea pig megakaryocytes. II. The uptake of particles and macromolecules and the effect of rabbit antiguinea pig platelet antiserum.

The capacity of megakaryocytes to take up particles and macromolecules was tested by exposing them to homologous erythrocytes, latex particles, Micrococcus lysodeikticus, and horseradish peroxidase. Uptake of particles 1.1 to 7 mum. in size was extensive under the experimental conditions employed. After uptake of each of the three particles the addition of tannic acid and calcium to the fixative produced electron-dense deposits within the vacuole surrounding the particle; therefore, the vacuole was not closed off. This finding indicates that many of the particles could be actually trapped within the preformed elements of the demarcating membrane system. Horseradish peroxidase was concentrated within cytoplasmic vacuoles after 2 hours of exposure to 0.1 mg. per ml. The presence of surface membrane receptors was determined by the sheep cell rosette method. The presence of the C3b receptor for complement was determined by the sheep cell rosette method. The presence of the C3b receptor for complement produced rosette formation. The functional capacity of megakaryocytes to react like platelets was also tested by observing cell lytic changes and determining that there was approximately 40% release of 3H-serotonin produced by specific rabbit antiguinea pig platelet antiserum in the presence of complement. These studies demonstrate several functional capacities of megakaryocytes: the uptake of particles, pinocytosis, and the cell lytic response to specific antibody.

Tannic acid effect on membrane of cell surface origin in guinea pig megakaryocytes and platelets.

Plasma membranes in isolated guinea pig megakaryocytes and washed platelets are poorly stained with the usual methods used to outline cell membranes. The addition of tannic acid and calcium to the initial fixative is useful to enhance electron density of all surface-derived membrane systems in these cells. The method described here shows that the increased electron denisty of membrane after fixation in the presence of tannic acid occurs both at the cell surface and along the invaginated membrane systems.

Isolation of intact megakaryocytes from guinea pig femoral marrow. Successful harvest made possible with inhibitions of platelet aggregation; enrichment achieved with a two-step separation technique.

Methods have been devised to harvest megakaryocytes from guinea pig femoral marrow and to isolate them in high yield. When marrow tissue was disaggregated the megakaryocytes underwent degenerative changes characterized by the loss of cytoplasmic granules and alterations in membrane topography, similar to the changes seen in aggregating platelets. These morphologic changes were interpreted to mean that megakaryocytes possessed functional attributes of platelets. The use of agents which inhibit platelt aggregation (0.38% sodium citrate. 10(-3) M adenosine, and 2 x 10(-3) M theophylline) in a medium free of bivalent cations prevented these changes. This solution resulted in both an excellent morphologic preservation and a significantly increased recovery of megakaryocytes from marrow tissue. A two-step purification of the intact megakaryocytes was carried out on the basis of their low density and large size, with equilibrium density gradient centrifugation followed by velocity sedimentation. This sequence gave approximately a 100-fold enrichment of megakaryocytes, significantly better than that achieved with either method alone. These techniques for harvesting and concentrating megakaryocytes make it possible for the first time to study megakaryocytes in vitro.

Ultrastructure of mouse mononuclear phagocytes in bone marrow colonies grown in vitro.

Recently a new method was developed to culture bone marrow cells in a liquid medium on a glass surface. Two kinds of colonies develop in these cultures, namely mononuclear phagocyte and granulocyte colonies. The study of the ultrastructure of the cells in the mononuclear phagocyte colonies was the primary aim of the present study. The architecture of the mononuclear phagocyte colonies appeared to be quite different from that of the granulocyte colonies, since in the latter, the cells lie close together in dense clusters, whereas in mononuclear phagocyte colonies the cells are more loosely dispersed with the highest cell density at the center and stellate orientation of the cells at the periphery. However, both kind of colonies grow entirely separate from each other and mixed colonies are not observed. Electron microscopy showed that there are three types of cell in the mononuclear phagocyte colonies, i.e., monoblasts, promonocytes, and macrophages. The ultrastructure of the promonocytes and macrophages of the colonies is similar to that of the same types of cell isolated directly from the mouse. The monoblast, the most immature cell of mononuclear phagocyte colonies has not been characterized before. The ultrastructure of this cell is clearly distinct from that of the promonocyte in having a round contour without pseudopods, a nuclear to cytoplasmic ratio greater than one, a cytoplasm that contains many polyribosomes, a few small granules, and a small Golgi complex surrounded by a few short strips of rough endoplasmic reticulum.

Morphologic and functional characteristics of bone marrow macrophages from imferon-treated mice.

The iron storage macrophage has been isolated from the marrow of Imferon-treated mice and studied in vitro by morphologic, histochemical, and functional tests and isotope labeling techniques. These macrophages on stained preparations are large, many times binucleate cells (up to 150 mu), and show Prussian blue reactivity. In Epon-embedded, stained thick sections they contain elongated narrow basophilic inclusions. These macrophages are actively phagocytic and pinocytic; histochemical studies show that these cells are rich in acid phosphatase, nonspecific esterase, and PAS diastase-resistant activity. Iron storage macrophages do not incorporate the 3H-thymidine. The electron microscopic appearance of this macrophage shows that the cell has ferritin free in the cytoplasm and several types of cytoplasmic granules: those with large quantities of electron-dense ferritin and/or hemosiderin (type A), elongated granules (type B) with moderately electron dense homogeneous matrix and some ferritin at the periphery, and granules with heterogeneous content (type C). The above findings demonstrate that the iron storage cell is a mature macrophage which contains hydrolases, ferritin, and a unique population of cytoplasmic granules which are lysosomal in nature. There is some evidence to suggest that the unusual lysosome (type B granule) occurs after macrophages have ingested erythrocytes.

Loss of iron from mouse peritoneal macrophages in vitro after uptake of (55fe)ferritin and (55fe)ferritin rabbit antiferritin complexes.

Mouse peritoneal macrophages in culture for 24 h were exposed to horse [(55)Fe]ferritin and rabbit antihorse [(55)Fe]ferritin antibody complex and the amount of (55)Fe in the medium was assayed up to 2 days after the pulse uptake. Cell survival was assayed by photographing the same areas of the tissue culture Petri dish on successive days and by counting cell numbers per unit area. In experiments in which quantitative assay for cell death is negligible, about 10-20% of the iron ingested by pinocytosis or phagocytosis is released to iron-free medium containing either freshly dialyzed or deironized newborn calf serum (10%). Over the 2-day postpulse period, iron loss is linear. This loss of iron to the medium is significantly reduced by adding iron-saturated newborn calf serum in the postpulse recovery period. A significant portion of the iron released to the medium is bound to transferrin. When human serum is used in the tissue culture system, similar quantities (10-25%) of the ingested iron are lost to the medium 2 days after the pulse.

Appearance and distribution of ferritin in mouse peritoneal macrophages in vitro after uptake of heterologous erythrocytes.

Mouse peritoneal macrophages have been studied in vitro after ingestion of treated rat, rabbit, or sheep erythrocytes. Under light microscopy, phagocytic vacuoles persist up to 24 h. Macrophages lose benzidine reactivity about 5 h after red cell ingestion, and they become prussian blue positive at 2 days. Ultrastructural studies show little or no ferritin in control macrophages not fed erythrocytes. In contrast, after red cell ingestion, ferritin is widely distributed in the cytoplasmic matrix and in some cytoplasmic granules by 48 h. The Golgi complex, pinocytic vacuoles, endoplasmic reticulum, nuclei, and mitochondria do not contain ferritin. Between 2 and 4 days, ferritin in cytoplasmic granules increases, concomitant with decrease in the ferritin in the cytoplasmic matrix. Evidence is presented suggesting that ferritin in the cytoplasmic matrix is translocated into cytoplasmic granules by autophagy. Polyacrylamide gel studies on macrophages after uptake of red blood cells labeled with radioiron confirm that macrophages produce radiolabeled ferritin by 4 days.

Morphology and peroxidase cytochemistry of mouse promonocytes, monocytes, and macrophages.

Mouse promonocytes have been identified and studied in cultures of bone marrow cells. These cells have a diameter of 14-20 micro, and in stained preparations reveal a large, indented or folded nucleus, and basophilic, finely granular cytoplasm. The living promonocyte viewed by phase contrast shows additional features: nucleoli, small dense bodies, and vesicles in the cytoplasm adjacent to the nuclear hilus, and slight membrane ruffling. Prominent ultrastructural components of promonocytes include a well developed Golgi apparatus, small numbers of centrosomal granules and vacuoles, extensive ribosomal aggregates, and finger-like projections of the cell surface. Promonocytes engage in pinocytosis and phagocytosis, but they are less active in these functions than are peripheral blood monocytes of peritoneal macrophages. Promonocytes are positive for peroxidase, the reaction product being localized to granules most of which are centrally situated in the cell. Monocytes in blood or in inflammatory peritoneal exudates display much smaller numbers of peroxidase-positive granules, and various types of mature mouse macrophages are peroxidase negative.