The Enigma of Mammaglobin: Redefining the Biomarker Paradigm in Breast Carcinoma.

The continuous evolution of cancer biology has led to the discovery of mammaglobin, a potential novel biomarker for breast carcinoma. This review aims to unravel the enigmatic aspects of mammaglobin and elucidate its potential role in redefining the paradigm of breast carcinoma biomarkers. We will thoroughly examine its expression in tumoral and peritumoral tissues and its circulating levels in the blood, thereby providing insights into its possible function in cancer progression and metastasis. Furthermore, the potential application of mammaglobin as a non-invasive diagnostic tool and a target for personalized treatment strategies will be discussed. Given the increasing incidence of breast carcinoma worldwide, the exploration of novel biomarkers such as mammaglobin is crucial in advancing our diagnostic capabilities and treatment modalities, ultimately contributing to improved patient outcomes.

The correlation between the transverse rectal diameter and urodynamic findings in children with neurogenic bowel and bladder dysfunction.

Background: The aim of this study was to examine the correlation between the transverse rectal diameter and urodynamic findings in children with neurogenic bowel and bladder dysfunction. Methods: Between 2014 and 2022, we prospectively evaluated 81 consecutive spina bifida children with neurogenic bowel and bladder dysfunction (35 boys and 46 girls, mean age 9.5 ± 3.4 years). All patients underwent echosonographic measurement of transverse rectal diameter and urodynamic studies. Results: We found a strong negative correlation between transverse rectal diameter and maximum bladder capacity (r = -0.682, p < 0.001) and compliance (r = -0.690, p < 0.001). There was also a strong positive correlation between transverse rectal diameter and maximal detrusor pressure (r = 0.650, p < 0.001), leak point pressure (r = 0.793, p < 0.001), and PVR (r = 0.762, p < 0.001). In ROC analysis, transverse rectal diameter demonstrated good performance for distinguishing children with upper urinary tract deterioration, with an AUC of 0.857 (95% CI 0.761-0.953). A transverse rectal diameter ≥40 mm was 83.3% sensitive and 100% specific for the diagnosis of unfavorable urodynamic patterns. Conclusion: There is a correlation between the transverse rectal diameter and urodynamic findings in children with neurogenic bowel and bladder dysfunction. Ultrasonographically assessed transverse rectal diameter of ≥40 mm may be used as a risk factor for upper urinary tract deterioration (unfavorable urodynamic findings). We suggest the transverse rectal diameter echosonographic measurement use as an integral part of the diagnostic approach in children with neurogenic bowel and bladder dysfunction, as it can help decision-making while waiting for urodynamic testing.

Reduction of transverse rectal diameter and its effect on bladder dynamics in children with spinal dysraphism.

INTRODUCTION: To examine the reduction of transverse rectal diameter and its effect on bladder dynamics in children with spinal dysraphism. METHODS: We prospectively evaluated 61 consecutive children with spinal dysraphism, 25 (41%) boys and 36 (59%) girls, aged 4 to 16 years; mean age 9.3 ± 3.8 years, who received bowel management. All children underwent echosonographic measurement of transverse rectal diameter before and after starting bowel management. Also, all the patients had undergone urodynamic studies before and after starting bowel management, with no changes in their urological treatment. RESULTS: Bowel management caused an decrease in transverse rectal diameter by 56 ± 7.2% (p < 0.001). In addition, a decrease was observed for maximal detrusor pressure by 27.8 ± 7.8% (p < 0.001), leak point pressure by 37.2 ± 4.4% (p < 0.001), and PVR by 36.7 ± 8.0 (p < 0.001). Maximum bladder capacity was significantly increased after bowel management in both non-adjusted (36.4 ± 14.8%; p < 0.001) and adjusted analysis for age (39.4 ± 14.3%, p < 0.001). Detrusor compliance was also increased by 89.2 ± 24.8% (p < 0.001). Female gender and % change of maximal detrusor pressure were significant predictors of transversal rectal diameter change in univariate as well as in multivariate analysis (OR = 10.548, 95% CI 2.309-48.180; p = 0.002 and OR = 1.121, 95% CI 1.009-1.245; p = 0.034). CONCLUSIONS: Decrease in transverse rectal diameter may be useful for bladder function and urodynamic findings in children with spinal dysraphism. Therefore, decrease in transverse rectal diameter should be a supplement to standard urotherapy.

Syringocystadenoma Papilliferum in the External Ear Canal.

Out of all benign tumors of the ceruminous glands, syringocystadenoma papilliferum is the rarest and represents only 2% of cases. It is an extremely rare benign tumor that originates from modified apocrine sweat glands. The aim of this paper was to present, according to our findings, the 18th case of syringocystadenoma papilliferum in the external auditory canal, with a detailed review of its clinical, radiological and histomorphological characteristics. A 59-year-old man reported to our clinic due to a 5×5 mm papillomatous growth at the entrance to the right external auditory canal. Histopathology indicated, after an excisional biopsy, that it was a syringocystadenoma papilliferum. The resection lines were free of tumor tissue, and the patient has no signs of tumor recurrence. Although rare, it should be considered as a differential diagnosis of lesions in this region. Complete excision is mandatory in order to avoid recurrence and potential malignant alteration.

The Role of Psychotherapy in the Treatment of Patients with Non- alcoholic Fatty Liver Disease and Obstructive Sleep Apnea.

BACKGROUND AND AIMS: Non-alcoholic fatty liver disease (NAFLD) is a metabolic disease with extensive multi- organ involvement, whose extra-hepatic manifestations include diabetes mellitus type 2, cardiovascular disease, obstructive sleep apnea (OSA), chronic kidney disease, and polycystic ovary syndrome. Our hypothesis was that there was a strong psychological component in NAFLD and OSA suffering patients and that psychotherapy would be helpful in the treatment of the mentioned diseases. METHODS: Of 144 initially selected patients (with NAFLD, obesity and OSA), 32 patients agreed to undergo psychotherapy, and 31 therapy-naive NAFLD and OSA patients agreed to participate as controls. RESULTS: Psychological evaluation revealed that self-esteem rose significantly after one-year psychotherapy (p=0.005). Body mass index (BMI) was significantly lower after psychotherapy, followed by the changes in laboratory results. Binomial logistic regression revealed that the reduction of BMI in high probability led to self-esteem improvement (p=0.03). CONCLUSIONS: Psychotherapy was an efficient supporting method in the treatment of patients with NAFLD, obesity and OSA. It raised self-esteem and stimulated the motivation for further treatment of obesity, as one of the important factors for NAFLD and OSA. Still, it is advisable to use psychotherapy in combination with other clinical methods of treatment.

Anatomical Brain Changes and Cognitive Abilities in Patients with Obstructive Sleep Apnea Syndrome and Nonalcoholic Fatty Liver Disease.

Obstructive sleep apnea (OSA) is characterized by repetitive complete or partial collapse of the upper airway and reduction of airflow during sleep. It is associated with significantly increased daytime muscle sympathetic nerve activity thought to result from the repetitive intermittent periods of hypoxemia during sleep and brain alterations that are likely to result. Different brain regions are affected by subsequent hypoxia/anoxia. Neurodegenerative processes result in measurable atrophy of cortical gray matter in the temporal lobes and posterior cingulate cortex, as well as in subcortical structures such as the hippocampus, amygdala, and thalamus. This study involved a group of firstly diagnosed, therapy-naive, nonalcoholic fatty liver disease (NAFLD) patients, out of which 144 (96 males and 48 females), aged 34-57 (mean 47.88 ± 6.07), satisfied the recruiting criteria for the study and control groups. All the patients underwent MRI scanning, polysomnography testing, and cognitive evaluation. Cognitively, worse results were obtained in the group with OSA (p < 0.05) and NAFLD (p=0.047). A significant decrease in volumes of cortical and subcortical structures was revealed (p < 0.001). In conclusion, brain deterioration followed by cognitive impairment is, most likely, the result of intermittent hypoxia and anoxia episodes that initiate the domino process of deteriorating biochemical reactions in the brain.

Association between Chromatin Structural Organization of Peripheral Blood Neutrophils and Self-Perceived Mental Stress: Gray-Level Co-occurrence Matrix Analysis.

Methods based on the evaluation of textural patterns in microscopy, such as the "gray-level co-occurrence matrix" (GLCM) analysis are modern and innovative computer and mathematical algorithms that can be used to quantify subtle structural changes in cells and their organelles. Potential application of GLCM method in the fields of psychophysiology and psychiatry to this date has not been systematically investigated. The main objective of our study was to test the existence and strength of the association between chromatin structural organization of peripheral blood neutrophils and levels of self-perceived mental stress. The research was done on a sample of 100 healthy student athletes, and the Depression, Anxiety, and Stress Scales (DASS-21) were used for the estimation of psychological distress. Chromatin textural homogeneity and uniformity were negatively correlated (p < 0.01) with mental distress and had relatively good discriminatory power in differentiating participants with normal and elevated stress levels. As an addition, we propose the creation of a machine learning model based on binomial logistic regression that uses these and other GLCM features to predict stress elevation. To the best of our knowledge, these results are one of the first to establish the link between neutrophil chromatin structural organization quantified by the GLCM method and indicators of normal psychological functioning.

Application of artificial intelligence for detection of chemico-biological interactions associated with oxidative stress and DNA damage.

In recent years, various AI-based methods have been developed in order to uncover chemico-biological interactions associated with DNA damage and oxidative stress. Various decision trees, bayesian networks, random forests, logistic regression models, support vector machines as well as deep learning tools, have great potential in the area of molecular biology and toxicology, and it is estimated that in the future, they will greatly contribute to our understanding of molecular and cellular mechanisms associated with DNA damage and repair. In this concise review, we discuss recent attempts to build machine learning tools for assessment of radiation - induced DNA damage as well as algorithms that can analyze the data from the most frequently used DNA damage assays in molecular biology. We also review recent works on the detection of antioxidant proteins with machine learning, and the use of AI-related methods for prediction and evaluation of noncoding DNA sequences. Finally, we discuss previously published research on the potential application of machine learning tools in aging research.

Low compliance contribute to insufficient Desmopressin response of primary monosymptomatic nocturnal enuresis and the role of voiding school.

AIMS: To evaluate the impact of compliance on the therapeutic effects of Desmopressin, as well as the importance of establishing the voiding school for low-compliance children in primary monosymptomatic enuresis treatment. METHODS: Eighty-nine patients with primary monosymptomatic enuresis treated with Desmopressin were observed during the 2017-2020 at University Children's Hospital Belgrade, Serbia. The average patients age was 7.7 ± 2.4 years; 65 (73%) were boys and 24 (27%) % were girls. After the 3 months of Desmopressin treatment, the effect of therapy was evaluated according to the compliance. After the treatment, low-compliance patients and their parents were suggested to visit a voiding school. RESULTS: A significant decrease in the median enuresis frequency was noticed during the Desmopressin treatment (25.0 (20.0-26.0) vs 10.0 (2.0-17.0) per month, before vs after treatment, respectively) (p < 0.001). Patients with low compliance had a poorer response to Desmopressin (p < 0.001). An median enuresis reduction in the good compliance group was 92.3% (86.7 -95%), while in the low compliance group was 28.6% (16.7-43.3%). After attending voiding school, there was a significant increase in compliance (p < 0.001), associated with an median percent decrease in enuresis of 84.0% (75.0-95.5%) (p < 0.001). CONCLUSION: Compliance considerably influences the beneficial effects of Desmopressin. Patients with poor therapeutic effects should be evaluated for compliance and introduced to voiding school.

Antinociceptive Properties of St. John's Wort (Hypericum perforatum) and Other Hypericum Species.

This review aims at a coherent summary of the results obtained from various studies that concern analgesic-like activity of the extracts of H. preforatum L and thirteen other Hypericum L. species (Hypericaceae). Botanical origin, plant organs and extraction modes of the plant material, experimental models, routes of administration and doses used for animal treatment are summarized. Mechanisms of action and substances (and even the synergy thereof) proposed so far to be responsible for the observed activity have also been discussed. Even though St. John's wort (H. perforatum) is the most renowned plant species of this genus, it is neither the only nor the most potent one in inducing pain relief.

Resection of the Urethral Plate and Augmented Ventral Buccal Graft in Patients with Long Obliterative Urethral Strictures.

Video available at: http://www.brazjurol.com.br/videos/november_december_2015/Ignjatovic_1234_1235video.htm

Self-created transobturator tape treatment of stress urinary incontinence without prior urodynamic investigation.

OBJECTIVES: The purpose of this study was to evaluate and compare the results of tension free self-created transobturator tape (SCTOT) with the standard industrially created transobturator tape (ICTOT) in the treatment of stress urinary incontinence (SUI). STUDY DESIGN: A prospective study of the treatment of SUI with SCTOT (67 patients) and ICTOT (47 patients) was performed. SCTOT was created from polypropylene mesh and monofilament sutures. The symptoms were evaluated before and after the surgery with the following: the Incontinence Impact questionnaire (IIC-7), the urogenital distress inventory (UDI-6), and the International Continence impact questionnaire short form (ICIQ5-SF). The overactive bladder symptom score (OABSS) was used to classify patients in the SUI or the mixed urinary incontinence (MUI) group. The follow up period was 18 months. Cure was defined as a negative stress test and no need for additional surgery. RESULTS: Objective cure was achieved in 56/67 (83.5%) participants in the SCTOT group and in 40/47 (85.1%) participants in the ICTOT group (p>0.05). There was a significant improvement in IIC-7, UDI-6, ICIQ5-SF and OABSS in both groups. Improvement was better in the group with pure SUI than in patients with MUI, but this difference was not significant. Postoperative infection occurred in 5/67 (7.4%) participants and in 5/47 (10.6%) patients in the SCTOT and the ICTOT group, respectively. De novo overactive bladder symptoms occurred in 4/67 (5.9%) of the participants in the SCTOT group and in 3/47 (6.3%) of the patients in the ICTOT group. Operating time was longer in patients with SCTOT compared to those with ICTOT. CONCLUSION: The results of the treatment with SCTOT are not inferior to the results of the treatment with ICTOT and other results reported in the literature.

Protective effects of glutathione and lipoic acid against cadmium-induced oxidative stress in rat's kidney.

Cadmium is a widespread, toxic industrial pollutant. The proximal tubule of the mammalian kidney is a major target of Cd-induced toxicity. We analyzed the effects of cadmium exposure on the model system of experimental animals, the thiobarbituric acid (TBA)-reactive substance (TBARS) level, and the activity of xanthine oxidase (XO) and catalase in kidney of rats, with and without glutathione and lipoic acid (LA). The experimental animals were classified into six groups, regarding cadmium, glutathione, and LA intake. The concentration of TBARSs in the homogenate was determined by spectrophotometric method according to Nabavi et al. The specific activity of XO was determined spectrophotometrically by the method of Aygul et al. Catalase activity in tissues was determined by spectrophotometric method according to Nabavi et al. The increased level of TBARS and the increased activity of XO in kidney tissue in cadmium poisoning are statistically significant compared to control (p < 0.001). Glutathione and LA applied along with cadmium lowered TBARS concentration and reduced XO activity (p < 0.001). Catalase activity in the kidney tissue was increased in the group, which was administered cadmium (p < 0.001). In conclusion, glutathione and LA, as physiological antioxidants applied with cadmium, have reduced the level of lipid peroxide and the activity of XO, and can be used as protectors in conditions of cadmium poisoning.

[Transobturator tension-free "inside-to-out" suburethral sling procedure for the treatment of stress urinary incontinence].

INTRODUCTION: Stress urinary incontinence is an involuntary leakage of urine on a sudden increase of intra-abdominal pressure by physical activity, exercise, coughing, sneezing or laughing. OBJECTIVE: To assess symptoms, functional and anatomical status of voiding function, complications and short term success of a novel procedure, tension-free vaginal tape obturator technique (TVT-O) in the treatment of stress urinary incontinence. METHODS: A prospective study was performed on 40 female patients who underwent the TVT-O suburethral sling at the Urology Department of the Health Centre in Prokuplje and Urology Hospital in Nis between May 2009 and February 2010. The mean patients' age was 58 years (range 34-84 years). Preoperative evaluation included a detailed history and gynaecologic examination including urodynamic testing and voiding studies. UDI-6 and UIQ-7 score testing was performed before, and six months after surgery. All patients who demonstrated stress urinary incontinence with a Q-tip test-angle during maximal straining were included into the study. Postoperatively, outcomes evaluation included voiding function, anatomical parameters, complications, as well as subjective success rates. RESULTS: In 30 patients surgery was performed under spinal and in ten under general anaesthesia. The average intraoperative blood loss during theTVT-O was minimal (<50 ml). There were no vascular, bladder, bowel, and neurological injuries. Thirty-eight patients (95%) were discharged voiding satisfactorily. There was a statistically significant difference in symptoms between UDI-6 and UIQ-7 before and after surgery. CONCLUSION: Initial experience with TVT-O suburethral sling is promising. The TVT-O differs from retropubic procedures by resulting in lower postoperative morbidity, intraoperative and postoperative complications.

[Nocturia and benign prostatic hyperplasia].

BACKGROUND/AIM: Nocturia often occures in patients with benign prostata hyperplasia (BPH). The aim of the study was to investigate the frequency of nocturia in patients with BPH. Nocturia and other factors associated with it were also investigated. METHODS: Forty patients with the confirmed diagnosis of BPH were studied. Transurethral and transvesical prostatectomy were performed in all the patients. Simptoms were evaluated with the International Prostete Sypmtom Score before, as well as three and six months after the surgery. All the results were compared with the control group. RESULT: . There was no statistically significant difference between the patients before and after the surgery regarding nocturia. There was, howerer, a statistically significant difference between the operated patients and the control group regarding nocturia, as well as a statistically significant correlation between noctruia and the age of the patients in both the investigated and the control group. A correlation also existed between nocturia and the prostatic size. CONCLUSION: There was no statistically significant improvement in symptoms of nocturia after the surgery. It is necessary to be very careful in decision making in patients with nonabsolute indiction for surgery and isolated bothersome symptom of nocturia. Age of a patient should also be considered in the evaluation of favourable result of the surgery because of a significant correlation between noctura and the age of a patient.