Pub Date : 2024-08-01Epub Date: 2024-03-18DOI: 10.1177/03915603241237563
Mohomed Safwan, Bhavantha Dias, Ayomi Dilhari
Objective: As key stakeholders in educational settings, teachers' awareness on Urinary Tract Infections (UTI) will ultimately enhance its management in schools and community. This study aimed to assess the level of knowledge, attitudes, and practices (KAP) on UTIs among teachers in Sri Lanka.
Materials and methods: Conveniently selected 373 school teachers were assessed using a pre-tested questionnaire. Each of the individual was scored and categorized as either satisfactory or poor. Descriptive statistics and chi-square tests were performed to describe the outcomes.
Results: Around 80% of respondents demonstrated awareness regarding the microbial origin of UTIs, while 42% possessed knowledge of women's increased susceptibility to UTIs. Over 90% of participants had favorable attitudes toward drinking adequate amounts of water, personal hygiene, and consulting doctors for UTI symptoms. Each inquiry demonstrated significant disparities between individuals with satisfactory and poor attitudes (p = 0.000), with over 95% adhered to effective hygiene practices as a preventive measure against UTIs. The demographics of the participants did not show any significance over the KAP results of the study (p < 0.05).
Conclusions: The study revealed satisfactory levels of awareness and favorable attitudes among respondents on UTIs. However, there is a further need for increased awareness, specifically regarding the risk factors associated with UTIs.
{"title":"Degree of awareness and practices on urinary tract infections: A study of Sri Lankan school teachers selected from a chronic kidney disease high-prevalent setting.","authors":"Mohomed Safwan, Bhavantha Dias, Ayomi Dilhari","doi":"10.1177/03915603241237563","DOIUrl":"10.1177/03915603241237563","url":null,"abstract":"<p><strong>Objective: </strong>As key stakeholders in educational settings, teachers' awareness on Urinary Tract Infections (UTI) will ultimately enhance its management in schools and community. This study aimed to assess the level of knowledge, attitudes, and practices (KAP) on UTIs among teachers in Sri Lanka.</p><p><strong>Materials and methods: </strong>Conveniently selected 373 school teachers were assessed using a pre-tested questionnaire. Each of the individual was scored and categorized as either satisfactory or poor. Descriptive statistics and chi-square tests were performed to describe the outcomes.</p><p><strong>Results: </strong>Around 80% of respondents demonstrated awareness regarding the microbial origin of UTIs, while 42% possessed knowledge of women's increased susceptibility to UTIs. Over 90% of participants had favorable attitudes toward drinking adequate amounts of water, personal hygiene, and consulting doctors for UTI symptoms. Each inquiry demonstrated significant disparities between individuals with satisfactory and poor attitudes (<i>p</i> = 0.000), with over 95% adhered to effective hygiene practices as a preventive measure against UTIs. The demographics of the participants did not show any significance over the KAP results of the study (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>The study revealed satisfactory levels of awareness and favorable attitudes among respondents on UTIs. However, there is a further need for increased awareness, specifically regarding the risk factors associated with UTIs.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"574-581"},"PeriodicalIF":0.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140144151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01Epub Date: 2024-03-29DOI: 10.1177/03915603241237402
Ahmed Said Zaghloul, Elnashar A M, Sameh Fayek GamalEl Din, Mahmoud Fawzy Ghaly, Hany Mohammed Saad, Hossam Refaat Eldebs, Shady Zaki Said
Objectives: The study examined the impact of long term COVID-19 infection on the patients' erectile function and anxiety and depression in the same patients as well as the impact of daily tadalafil 5 mg supplementation on their erectile function.
Methods: Recovered 114 men were evaluated by the validated Arabic version of the international index of erectile function (ArIIEF-5) and the Arabic versions of the patient health questionnaire-9 (PHQ-9) and the generalized anxiety disorder-7 (GAD-7) at time of presentation, at 3 months and at 6 months, respectively. Forty recovered patients who still complained of ED received tadalafil 5 mg daily for 2 months then were evaluated again at 3 and 6 months by penile duplex, the Arabic versions of the patient health questionnaire-9 (PHQ-9) and the generalized anxiety disorder-7 (GAD-7) at the same periods, respectively.
Results: At the time of presentation, there was a positive correlation between the severity of COVID-19 infection, ArIIEF-5 and PHQ-9 (r = 0.249, p = 0.008; r = 0.241, p = 0.010, respectively). Most of the patients showed normal penile duplex parameters. There were 40 ED patients at presentation, 5 ED patients at 3 months and 3 ED patients at 6 months, respectively.
Conclusions: ED in COVID-19 patients who were not suffering from chronic illnesses before the affection, is primarily psychological and completely responsive to tadalafil.
{"title":"The impact of long term COVID-19 infection on the patients' erectile function and on anxiety and on depression as well as the impact of daily tadalafil 5 mg supplementation in patients with erectile dysfunction.","authors":"Ahmed Said Zaghloul, Elnashar A M, Sameh Fayek GamalEl Din, Mahmoud Fawzy Ghaly, Hany Mohammed Saad, Hossam Refaat Eldebs, Shady Zaki Said","doi":"10.1177/03915603241237402","DOIUrl":"10.1177/03915603241237402","url":null,"abstract":"<p><strong>Objectives: </strong>The study examined the impact of long term COVID-19 infection on the patients' erectile function and anxiety and depression in the same patients as well as the impact of daily tadalafil 5 mg supplementation on their erectile function.</p><p><strong>Methods: </strong>Recovered 114 men were evaluated by the validated Arabic version of the international index of erectile function (ArIIEF-5) and the Arabic versions of the patient health questionnaire-9 (PHQ-9) and the generalized anxiety disorder-7 (GAD-7) at time of presentation, at 3 months and at 6 months, respectively. Forty recovered patients who still complained of ED received tadalafil 5 mg daily for 2 months then were evaluated again at 3 and 6 months by penile duplex, the Arabic versions of the patient health questionnaire-9 (PHQ-9) and the generalized anxiety disorder-7 (GAD-7) at the same periods, respectively.</p><p><strong>Results: </strong>At the time of presentation, there was a positive correlation between the severity of COVID-19 infection, ArIIEF-5 and PHQ-9 (<i>r</i> = 0.249, <i>p</i> = 0.008; <i>r</i> = 0.241, <i>p</i> = 0.010, respectively). Most of the patients showed normal penile duplex parameters. There were 40 ED patients at presentation, 5 ED patients at 3 months and 3 ED patients at 6 months, respectively.</p><p><strong>Conclusions: </strong>ED in COVID-19 patients who were not suffering from chronic illnesses before the affection, is primarily psychological and completely responsive to tadalafil.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"604-610"},"PeriodicalIF":0.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140319389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01Epub Date: 2024-05-23DOI: 10.1177/03915603241252911
Antonio Benito Porcaro, Sonia Costantino, Claudio Brancelli, Alberto Baielli, Francesco Artoni, Francesca Montanaro, Sebastian Gallina, Alberto Bianchi, Emanuele Serafin, Alessandro Veccia, Andrea Franceschini, Riccardo Rizzetto, Matteo Brunelli, Filippo Migliorini, Riccardo Giuseppe Bertolo, Maria Angela Cerruto, Alessandro Antonelli
Background: To investigate the potential prognostic impact of Briganti's 2012 nomogram in EAU intermediate-risk patients presenting with an unfavorable tumor grade and treated with robot-assisted radical prostatectomy, eventually associated with extended pelvic lymph node dissection.
Materials and methods: From January 2013 to December 2021, the study included 179 EAU intermediate-risk patients presenting with an unfavorable tumor grade (ISUP 3), eventually associated with a PSA of 10-20 ng/ml and/or cT-2b. Briganti's 2012 nomogram was assessed as both a continuous and dichotomous variable, categorized according to the median (risk score ⩾7% vs <7%). Disease progression, defined as biochemical recurrence and/or metastatic progression, was evaluated using Cox proportional hazards in both univariate and multivariate analyses.
Results: Disease progression occurred in 43 (24%) patients after a median (95% CI) follow-up of 78 (65.7-88.4) months. The nomogram risk score predicted disease progression, evaluated both as a continuous variable (hazard ratio, HR = 1.064; 95% CI: 1.035-1.093; p < 0.0001) and as a categorical variable (HR = 3.399; 95% CI: 1.740-6.638; p < 0.0001). This association was confirmed in multivariate analysis, where hazard ratios remained consistent even after adjusting for clinical and pathological factors.
Conclusions: In EAU intermediate-risk PCa cases presenting with an unfavorable tumor grade and treated surgically, Briganti's 2012 nomogram was associated with disease progression after surgery. Consequently, as the nomogram risk score increased, patients were more likely to experience PCa progression, facilitating the stratification of the patient population into distinct prognostic subgroups.
背景研究Briganti的2012年提名图对肿瘤分级不利、接受机器人辅助根治性前列腺切除术治疗并最终伴有扩大盆腔淋巴结清扫的EAU中危患者的潜在预后影响:2013年1月至2021年12月期间,研究纳入了179例EAU中危患者,这些患者的肿瘤分级较低(ISUP 3),最终PSA为10-20 ng/ml和/或cT-2b。Briganti的2012年提名图作为连续和二分变量进行评估,根据中位数(风险评分⩾7% vs 结果)进行分类:在中位(95% CI)随访 78(65.7-88.4)个月后,43 例(24%)患者出现疾病进展。提名图风险评分可预测疾病进展,作为连续变量进行评估(危险比,HR = 1.064;95% CI:1.035-1.093;p p 结论:在肿瘤分级不佳并接受手术治疗的EAU中危PCa病例中,Briganti 2012提名图与术后疾病进展有关。因此,随着提名图风险评分的增加,患者更有可能出现PCa进展,从而有助于将患者群体分为不同的预后亚组。
{"title":"2012 Briganti nomogram predict prostate cancer progression in EAU intermediate risk with unfavorable tumor grade: A single center experience.","authors":"Antonio Benito Porcaro, Sonia Costantino, Claudio Brancelli, Alberto Baielli, Francesco Artoni, Francesca Montanaro, Sebastian Gallina, Alberto Bianchi, Emanuele Serafin, Alessandro Veccia, Andrea Franceschini, Riccardo Rizzetto, Matteo Brunelli, Filippo Migliorini, Riccardo Giuseppe Bertolo, Maria Angela Cerruto, Alessandro Antonelli","doi":"10.1177/03915603241252911","DOIUrl":"10.1177/03915603241252911","url":null,"abstract":"<p><strong>Background: </strong>To investigate the potential prognostic impact of Briganti's 2012 nomogram in EAU intermediate-risk patients presenting with an unfavorable tumor grade and treated with robot-assisted radical prostatectomy, eventually associated with extended pelvic lymph node dissection.</p><p><strong>Materials and methods: </strong>From January 2013 to December 2021, the study included 179 EAU intermediate-risk patients presenting with an unfavorable tumor grade (ISUP 3), eventually associated with a PSA of 10-20 ng/ml and/or cT-2b. Briganti's 2012 nomogram was assessed as both a continuous and dichotomous variable, categorized according to the median (risk score ⩾7% vs <7%). Disease progression, defined as biochemical recurrence and/or metastatic progression, was evaluated using Cox proportional hazards in both univariate and multivariate analyses.</p><p><strong>Results: </strong>Disease progression occurred in 43 (24%) patients after a median (95% CI) follow-up of 78 (65.7-88.4) months. The nomogram risk score predicted disease progression, evaluated both as a continuous variable (hazard ratio, HR = 1.064; 95% CI: 1.035-1.093; <i>p</i> < 0.0001) and as a categorical variable (HR = 3.399; 95% CI: 1.740-6.638; <i>p</i> < 0.0001). This association was confirmed in multivariate analysis, where hazard ratios remained consistent even after adjusting for clinical and pathological factors.</p><p><strong>Conclusions: </strong>In EAU intermediate-risk PCa cases presenting with an unfavorable tumor grade and treated surgically, Briganti's 2012 nomogram was associated with disease progression after surgery. Consequently, as the nomogram risk score increased, patients were more likely to experience PCa progression, facilitating the stratification of the patient population into distinct prognostic subgroups.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"531-537"},"PeriodicalIF":0.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: We aimed to evaluate the effect of daily 5 mg tadalafil on the neutrophil/lymphocyte ratio (NLR) and the platelet/lymphocyte ratio (PLR) in patients with erectile dysfunction (ED).
Patients and methods: 30 subjects with ED were given tadalafil as well as 30 subjects with ED who were not receiving tadalafil were recruited. 30 healthy individuals served as controls.
Results: Receiver operating characteristic curve (ROC) showed that the best cut off point of pre-treatment and post treatment NLR in the ED treatment group was found <1.51, <1.51, sensitivity of 68.3%, 58.3%, specificity of 53.3%, 53.3%, lower bound of 0.558, 0.517, upper bound of 0.789, 0.757, total accuracy of 67.4%, 63.7% and p 0.003, 0.0025, respectively. Additionally, the best cut off point of pre-treatment and post treatment PLR in the ED treatment group was found <5.89, <5.99, sensitivity of 65%, 63.3%, specificity of 63.3%, 53.3%, lower bound of 0.515, 0.435, upper bound of 0.755, 0.687, total accuracy of 63.5%, 56.1% and p 0.027, 0.341, respectively.
Conclusion: Daily 5 mg Tadalafil supplementation significantly improves erectile function through decreasing these markers as well as depression and anxiety.
研究目的患者和方法:我们招募了30名服用他达拉非的ED患者和30名未服用他达拉非的ED患者。30名健康人作为对照组:接收操作特征曲线(ROC)显示,ED 治疗组治疗前和治疗后 NLR 的最佳临界点分别为 p 0.003 和 0.0025。此外,ED 治疗组治疗前和治疗后 PLR 的最佳临界点分别为 p 0.027 和 0.341:结论:每日补充 5 毫克他达拉非能通过降低这些指标以及抑郁和焦虑,明显改善勃起功能。
{"title":"Evaluation of tadalafil supplementation on the neutrophil/lymphocyte and the platelet/lymphocyte ratios in patients with erectile dysfunction: A prospective study.","authors":"Sameh Fayek GamalEl Din, Nashaat Nabil Ismail, Hanan Hosni Moawad, Iten Mohamed Adel, Ahmad Motawi, Hisham Foaad","doi":"10.1177/03915603241240649","DOIUrl":"10.1177/03915603241240649","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to evaluate the effect of daily 5 mg tadalafil on the neutrophil/lymphocyte ratio (NLR) and the platelet/lymphocyte ratio (PLR) in patients with erectile dysfunction (ED).</p><p><strong>Patients and methods: </strong>30 subjects with ED were given tadalafil as well as 30 subjects with ED who were not receiving tadalafil were recruited. 30 healthy individuals served as controls.</p><p><strong>Results: </strong>Receiver operating characteristic curve (ROC) showed that the best cut off point of pre-treatment and post treatment NLR in the ED treatment group was found <1.51, <1.51, sensitivity of 68.3%, 58.3%, specificity of 53.3%, 53.3%, lower bound of 0.558, 0.517, upper bound of 0.789, 0.757, total accuracy of 67.4%, 63.7% and <i>p</i> 0.003, 0.0025, respectively. Additionally, the best cut off point of pre-treatment and post treatment PLR in the ED treatment group was found <5.89, <5.99, sensitivity of 65%, 63.3%, specificity of 63.3%, 53.3%, lower bound of 0.515, 0.435, upper bound of 0.755, 0.687, total accuracy of 63.5%, 56.1% and <i>p</i> 0.027, 0.341, respectively.</p><p><strong>Conclusion: </strong>Daily 5 mg Tadalafil supplementation significantly improves erectile function through decreasing these markers as well as depression and anxiety.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"598-603"},"PeriodicalIF":0.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140294738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01Epub Date: 2024-04-02DOI: 10.1177/03915603241238128
Florin V Hopland-Nechita, John R Andersen, Christian Beisland
Objective: This study aimed to identify clinical and biochemical predictors for future surgical intervention in male LUTS patients.
Materials and methods: In a prospective cohort study, parameters as International Prostate Symptom Score (IPSS) and IPSS "bother question" (IPSS-BQ), prostate volume (PV), maximal urine flow (Qmax), Prostate specific antigen (PSA), post-voidal residual urine (PVR) were assessed alongside comorbidities quantified using Charlson Comorbidity Index without age adjustment and American Society of Anesthesiology (ASA) score. For the statistical analysis, patients were categorized based on subsequent treatment approaches: Group 1: underwent surgery during follow-up; Group 2: received medical or no treatment. T-test was used to test differences between the groups. Logistic regression models were used to identify independent predictors of the need for future surgery. Following this analysis, we calculated the probability of requiring surgical intervention, with this likelihood being determined based on the accumulation of identified predictive factors.
Results: Of 63 patients, 22 underwent surgery over a median follow-up of 42 months. Significant baseline differences were observed in IPSS (p = 0.003), International Prostatic Symptom Score-Voiding subscore (IPSS-VS) (p = 0.002), IPSS-BQ (p = 0.001), Qmax (p = 0.007), and PVR (p = 0.02) between the groups. Higher IPSS-BQ, IPSS-VS, and lower Qmax are emerging as independent surgical treatment predictors in logistic regression analyses.
Conclusion: The study identified IPSS-VS, IPSS-BQ, and Qmax as baseline predictors of future surgical intervention. A clear pattern of a gradual increase in the likelihood of requiring surgery was directly proportional to the cumulative number of these identified predictive factors.
{"title":"Predictors for surgical treatment in male patients with non-neurogenic lower urinary tract symptoms (LUTS).","authors":"Florin V Hopland-Nechita, John R Andersen, Christian Beisland","doi":"10.1177/03915603241238128","DOIUrl":"10.1177/03915603241238128","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to identify clinical and biochemical predictors for future surgical intervention in male LUTS patients.</p><p><strong>Materials and methods: </strong>In a prospective cohort study, parameters as International Prostate Symptom Score (IPSS) and IPSS \"bother question\" (IPSS-BQ), prostate volume (PV), maximal urine flow (Qmax), Prostate specific antigen (PSA), post-voidal residual urine (PVR) were assessed alongside comorbidities quantified using Charlson Comorbidity Index without age adjustment and American Society of Anesthesiology (ASA) score. For the statistical analysis, patients were categorized based on subsequent treatment approaches: Group 1: underwent surgery during follow-up; Group 2: received medical or no treatment. <i>T</i>-test was used to test differences between the groups. Logistic regression models were used to identify independent predictors of the need for future surgery. Following this analysis, we calculated the probability of requiring surgical intervention, with this likelihood being determined based on the accumulation of identified predictive factors.</p><p><strong>Results: </strong>Of 63 patients, 22 underwent surgery over a median follow-up of 42 months. Significant baseline differences were observed in IPSS (<i>p</i> = 0.003), International Prostatic Symptom Score-Voiding subscore (IPSS-VS) (<i>p</i> = 0.002), IPSS-BQ (<i>p</i> = 0.001), Qmax (<i>p</i> = 0.007), and PVR (<i>p</i> = 0.02) between the groups. Higher IPSS-BQ, IPSS-VS, and lower Qmax are emerging as independent surgical treatment predictors in logistic regression analyses.</p><p><strong>Conclusion: </strong>The study identified IPSS-VS, IPSS-BQ, and Qmax as baseline predictors of future surgical intervention. A clear pattern of a gradual increase in the likelihood of requiring surgery was directly proportional to the cumulative number of these identified predictive factors.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"617-622"},"PeriodicalIF":0.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140336996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01Epub Date: 2024-03-23DOI: 10.1177/03915603241241430
Ahmed Rashad Elshahid, Amr Mohamed Zaky, Yasser Mamdouh Hasanein Goda, Nabil Fathy Ismail
Background: Over the past few decades, a number of studies have linked vitamin-D deficiency with ED (Erectile dysfunction) risk factors. There is a clear correlation between VD (vitamin-D) levels and ED, according to observational and interventional researches that have been reported in the literature. This crucial information encouraged scientists to investigate the impact of VD on erectile function in greater detail. The fact that vitamin D is a component of a healthy penis that begins in early life has just come to light, however there haven't been many research looking at the connection between vitamin D receptor gene polymorphism and erectile dysfunction.
Objective: To evaluate the relationship between arteriogenic erectile dysfunction and the vitamin D receptor gene polymorphism.
Subjects and methods: Between October 2022 and October 2023, at Al-Azhar University Hospitals, 40 patients with arteriogenic ED and 40 healthy controls underwent informed consent, a detailed history, a physical examination, a penile duplex ultrasound and the extraction of peripheral blood to determine the type of polymorphism for each of the vitamin D receptors: FokI, BsmI, ApaI and TaqI by polymerase chain reaction (PCR).
Results: There is no statistically significant association between arteriogenic erectile dysfunction and the vitamin D receptors (VDR) gene polymorphisms FokI, BsmI, ApaI and TaqI.
Conclusion: Since there is no statistically significant association between the polymorphism of the vitamin D receptor (VDR) gene and arteriogenic erectile dysfunction, it is advised to investigate other VDR gene polymorphisms as well as alternative clinical subtypes of erectile dysfunction.
背景:在过去几十年中,许多研究都将维生素 D 缺乏与 ED(勃起功能障碍)风险因素联系在一起。根据文献报道的观察性和干预性研究,VD(维生素 D)水平与 ED 之间存在明显的相关性。这一重要信息鼓励科学家们更详细地研究维生素 D 对勃起功能的影响。事实上,维生素 D 是健康阴茎的一个组成部分,而健康的阴茎始于生命早期,这一事实刚刚被人们发现,但目前还没有很多研究探讨维生素 D 受体基因多态性与勃起功能障碍之间的关系:评估动脉源性勃起功能障碍与维生素 D 受体基因多态性之间的关系:2022年10月至2023年10月期间,在爱资哈尔大学医院,40名动脉源性勃起功能障碍患者和40名健康对照者接受了知情同意、详细病史、体格检查、阴茎双相超声波检查和外周血抽取,以确定每种维生素D受体的多态性类型:通过聚合酶链式反应(PCR)确定每种维生素 D 受体的多态性类型:FokI、BsmI、ApaI 和 TaqI:结果:动脉源性勃起功能障碍与维生素 D 受体(VDR)基因多态性 FokI、BsmI、ApaI 和 TaqI 之间没有统计学意义:由于维生素 D 受体(VDR)基因多态性与动脉源性勃起功能障碍之间没有统计学意义上的显著关联,建议研究其他 VDR 基因多态性以及勃起功能障碍的其他临床亚型。
{"title":"Relationship between vitamin D receptors gene polymorphism and arteriogenic erectile dysfunction.","authors":"Ahmed Rashad Elshahid, Amr Mohamed Zaky, Yasser Mamdouh Hasanein Goda, Nabil Fathy Ismail","doi":"10.1177/03915603241241430","DOIUrl":"10.1177/03915603241241430","url":null,"abstract":"<p><strong>Background: </strong>Over the past few decades, a number of studies have linked vitamin-D deficiency with ED (Erectile dysfunction) risk factors. There is a clear correlation between VD (vitamin-D) levels and ED, according to observational and interventional researches that have been reported in the literature. This crucial information encouraged scientists to investigate the impact of VD on erectile function in greater detail. The fact that vitamin D is a component of a healthy penis that begins in early life has just come to light, however there haven't been many research looking at the connection between vitamin D receptor gene polymorphism and erectile dysfunction.</p><p><strong>Objective: </strong>To evaluate the relationship between arteriogenic erectile dysfunction and the vitamin D receptor gene polymorphism.</p><p><strong>Subjects and methods: </strong>Between October 2022 and October 2023, at Al-Azhar University Hospitals, 40 patients with arteriogenic ED and 40 healthy controls underwent informed consent, a detailed history, a physical examination, a penile duplex ultrasound and the extraction of peripheral blood to determine the type of polymorphism for each of the vitamin D receptors: FokI, BsmI, ApaI and TaqI by polymerase chain reaction (PCR).</p><p><strong>Results: </strong>There is no statistically significant association between arteriogenic erectile dysfunction and the vitamin D receptors (VDR) gene polymorphisms FokI, BsmI, ApaI and TaqI.</p><p><strong>Conclusion: </strong>Since there is no statistically significant association between the polymorphism of the vitamin D receptor (VDR) gene and arteriogenic erectile dysfunction, it is advised to investigate other VDR gene polymorphisms as well as alternative clinical subtypes of erectile dysfunction.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"592-597"},"PeriodicalIF":0.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140194681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01Epub Date: 2024-03-28DOI: 10.1177/03915603241241829
Ahmed M Reyad, Ahmed Mamdouh Abd Elhamed, Ahmed Mahmoud Elsherief, Hassan Ali Abdelhaleem, Tarek Ahmed Mahmoud
Objective: To assess the augmented anastomotic ureteral reconstruction using buccal mucosal graft based on omental flap for managing ureteral stricture.
Subjects and methods: This prospective cohort study was conducted on 13 patients with ureteric strictures of different lengths secondary to Bilhalziasis, iatrogenic (post endoscopy) and post inflammatory etiology in upper and mid ureteral segments were treated with buccal mucosal patch grafts and The graft is fixed to the undersurface or the posterior surface of the omentum before doing graft anastomosis to the ureteral walls as to ensure the process of graft take sticky to the principles of tissue transfer. All patients were subjected to full history taking, clinical examination for assessment of pain, lower or upper urinary track symptoms and laboratory investigation (complete blood count, CRP, liver function test and kidney function test (serum urea and creatinine).
Results: The mean operative time was 148.85 min and mean hospital stay was 3 days. Mean blood loss was ranged from 20 to 210 ml and Stent was removed after 8-12 weeks. The mean follow up was 13 months, all patients had a non-obstructive RI value <0.7 with a non-obstructed drainage pattern on the diuretic renogram except one patient who had severe postoperative UTI necessitating nephrostomy tube insertion his drainage curve was plateau.
Conclusion: BMG ureteroplasty is a valuable option for a carefully selected patient. The fixation of the graft on the back surface of the omentum allows for better anatomical reconstruction without any twisting to the omental pedicle.
{"title":"Augmented anastomotic ureteral reconstruction using buccal mucosal graft, initial experience.","authors":"Ahmed M Reyad, Ahmed Mamdouh Abd Elhamed, Ahmed Mahmoud Elsherief, Hassan Ali Abdelhaleem, Tarek Ahmed Mahmoud","doi":"10.1177/03915603241241829","DOIUrl":"10.1177/03915603241241829","url":null,"abstract":"<p><strong>Objective: </strong>To assess the augmented anastomotic ureteral reconstruction using buccal mucosal graft based on omental flap for managing ureteral stricture.</p><p><strong>Subjects and methods: </strong>This prospective cohort study was conducted on 13 patients with ureteric strictures of different lengths secondary to Bilhalziasis, iatrogenic (post endoscopy) and post inflammatory etiology in upper and mid ureteral segments were treated with buccal mucosal patch grafts and The graft is fixed to the undersurface or the posterior surface of the omentum before doing graft anastomosis to the ureteral walls as to ensure the process of graft take sticky to the principles of tissue transfer. All patients were subjected to full history taking, clinical examination for assessment of pain, lower or upper urinary track symptoms and laboratory investigation (complete blood count, CRP, liver function test and kidney function test (serum urea and creatinine).</p><p><strong>Results: </strong>The mean operative time was 148.85 min and mean hospital stay was 3 days. Mean blood loss was ranged from 20 to 210 ml and Stent was removed after 8-12 weeks. The mean follow up was 13 months, all patients had a non-obstructive RI value <0.7 with a non-obstructed drainage pattern on the diuretic renogram except one patient who had severe postoperative UTI necessitating nephrostomy tube insertion his drainage curve was plateau.</p><p><strong>Conclusion: </strong>BMG ureteroplasty is a valuable option for a carefully selected patient. The fixation of the graft on the back surface of the omentum allows for better anatomical reconstruction without any twisting to the omental pedicle.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"611-616"},"PeriodicalIF":0.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01Epub Date: 2024-04-22DOI: 10.1177/03915603241248014
Jonathan Lutchka, Jack Vercnocke, Emily Fisher, Codrut Radoiu, Julian Jeberaeel, Steven Lucas, Nivedita Dhar
Purpose: Chronic radiation cystitis (CRC) develops after radiation therapy and can present with symptoms like urinary frequency, urgency, pelvic pain, and nocturia. We have previously reported that amniotic bladder therapy (ABT) provides symptomatic improvement in refractory CRC patients for up to 3 months. Herein, we evaluated the durability of ABT up to 6 months.
Materials and methods: CRC patients recalcitrant to previous treatments received ABT comprised of intra-detrusor injections of 100 mg micronized AM diluted in 10 mL 0.9% preservative-free sodium chloride. Clinical evaluation and questionnaires (Interstitial Cystitis Symptom Index (ICSI), Interstitial Cystitis Problem Index (ICPI), Bladder Pain/Interstitial Cystitis Symptom Score (BPIC-SS), Overactive Bladder (OAB) Assessment Tool, SF-12 Health Survey) were repeated at pre-op and 2, 4, 8, 12, 16, 20, 24, and 36 weeks post-injection.
Results: Five consecutive patients with a mean age of 64.4 ± 20.1 years with a median CRC duration of 10 years were included and followed for 6 months. After ABT, the lower urinary tract symptoms improved as early as 2 weeks and were maintained up to 20 weeks. BPIC significantly improved from 36.6 ± 1.1 at baseline to 12.6 ± 1.5 at 16 weeks and 13.8 ± 2.9 at 20 weeks. At 24 and 36 weeks, the improvement was maintained in four (80%) of the five patients (BPIC = 13.8 ± 1.0). Uroflow assessment showed voiding volume improved two-fold in four of the five patients at 24 weeks compared to baseline.
Conclusion: Our data suggest that a significant number of CRC patients may have durable benefit after ABT. Despite this, some of them can show symptoms rebound at 24 weeks.
{"title":"Treatment of chronic post-radiation cystitis with trans-urethral amniotic bladder therapy appears durable at 9 months: A clinical study.","authors":"Jonathan Lutchka, Jack Vercnocke, Emily Fisher, Codrut Radoiu, Julian Jeberaeel, Steven Lucas, Nivedita Dhar","doi":"10.1177/03915603241248014","DOIUrl":"10.1177/03915603241248014","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic radiation cystitis (CRC) develops after radiation therapy and can present with symptoms like urinary frequency, urgency, pelvic pain, and nocturia. We have previously reported that amniotic bladder therapy (ABT) provides symptomatic improvement in refractory CRC patients for up to 3 months. Herein, we evaluated the durability of ABT up to 6 months.</p><p><strong>Materials and methods: </strong>CRC patients recalcitrant to previous treatments received ABT comprised of intra-detrusor injections of 100 mg micronized AM diluted in 10 mL 0.9% preservative-free sodium chloride. Clinical evaluation and questionnaires (Interstitial Cystitis Symptom Index (ICSI), Interstitial Cystitis Problem Index (ICPI), Bladder Pain/Interstitial Cystitis Symptom Score (BPIC-SS), Overactive Bladder (OAB) Assessment Tool, SF-12 Health Survey) were repeated at pre-op and 2, 4, 8, 12, 16, 20, 24, and 36 weeks post-injection.</p><p><strong>Results: </strong>Five consecutive patients with a mean age of 64.4 ± 20.1 years with a median CRC duration of 10 years were included and followed for 6 months. After ABT, the lower urinary tract symptoms improved as early as 2 weeks and were maintained up to 20 weeks. BPIC significantly improved from 36.6 ± 1.1 at baseline to 12.6 ± 1.5 at 16 weeks and 13.8 ± 2.9 at 20 weeks. At 24 and 36 weeks, the improvement was maintained in four (80%) of the five patients (BPIC = 13.8 ± 1.0). Uroflow assessment showed voiding volume improved two-fold in four of the five patients at 24 weeks compared to baseline.</p><p><strong>Conclusion: </strong>Our data suggest that a significant number of CRC patients may have durable benefit after ABT. Despite this, some of them can show symptoms rebound at 24 weeks.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"623-627"},"PeriodicalIF":0.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01Epub Date: 2024-04-25DOI: 10.1177/03915603241248020
Maxwell Sandberg, Mary Namugosa, Rory Ritts, Claudia Marie Costa, Davis Temple, Mitchell Hayes, Wyatt Whitman, Emily Ye, Justin Refugia, Reuben Ben-David, Parissa Alerasool, Benjamin Eilender, Rafael Ribeiro Zanotti, Thiago Camelo Mourão, Jung Kwon Kim, Patricio Garcia Marchiñena, Seok-Soo Byun, Diego Abreu, Reza Mehrazin, Philippe Spiess, Stenio de Cassio Zequi, Alejandro Rodriguez
Introduction: The objective of this study was to stratify preoperative immune cell counts by cancer specific outcomes in patients with renal cell carcinoma (RCC) and a tumor thrombus after radical nephrectomy with tumor thrombectomy.
Methods: Patients with a diagnosis of RCC with tumor thrombus that underwent radical nephrectomy with thrombectomy across an international consortium of seven institutions were included. Patients who were metastatic at diagnosis and those who received preoperative medical treatment were also included. Retrospective chart review was performed to collect demographic information, past medical history, preoperative lab work, surgical pathology, and follow up data. Neutrophil counts, lymphocyte counts, monocyte counts, neutrophil to lymphocyte ratios (NLR), lymphocyte to monocyte ratios (LMR), and neutrophil to monocyte ratios (NMR) were compared against cancer-specific outcomes using independent samples t-test, Pearson's bivariate correlation, and analysis of variance.
Results: One hundred forty-four patients were included in the study, including nine patients who were metastatic at the time of surgery. Absolute lymphocyte count preoperatively was greater in patients who died from RCC compared to those who did not (2 vs 1.4; p < 0.001). Patients with tumor pathology showing perirenal fat invasion had a greater neutrophil count compared to those who did not (7.5 vs 5.5; p = 0.010). Patients with metastatic RCC had a lower LMR compared to those without metastases after surgery (2.5 vs 3.2; p = 0.041). Tumor size, both preoperatively and on gross specimen, had an interaction with multiple immune cell metrics (p < 0.05).
Conclusions: Preoperative immune metrics have clinical utility in predicting cancer-specific outcomes for patients with RCC and a tumor thrombus. Additional study is needed to determine the added value of preoperative serum immune cell data to established prognostic risk calculators for this patient population.
导言:本研究的目的是根据肾细胞癌(RCC)和肿瘤血栓患者接受根治性肾切除术和肿瘤血栓切除术后的癌症特异性结果对术前免疫细胞计数进行分层:方法:纳入在由七家机构组成的国际联盟中接受根治性肾切除术和肿瘤血栓切除术的确诊为RCC和肿瘤血栓的患者。还包括诊断时已转移的患者和接受术前药物治疗的患者。研究人员对病历进行了回顾性审查,以收集人口统计学信息、既往病史、术前实验室检查、手术病理和随访数据。采用独立样本 t 检验、皮尔森双变量相关性和方差分析,将中性粒细胞计数、淋巴细胞计数、单核细胞计数、中性粒细胞与淋巴细胞比率(NLR)、淋巴细胞与单核细胞比率(LMR)和中性粒细胞与单核细胞比率(NMR)与癌症特异性结果进行比较:研究共纳入 144 名患者,其中包括 9 名手术时已转移的患者。死于 RCC 的患者术前绝对淋巴细胞计数高于未死患者(2 vs 1.4; p p = 0.010)。与没有转移的患者相比,转移性 RCC 患者术后的 LMR 更低(2.5 对 3.2;P = 0.041)。术前和大体标本上的肿瘤大小与多个免疫细胞指标之间存在相互作用(p 结论:术前免疫指标与大体标本上的肿瘤大小之间存在相互作用:术前免疫指标在预测RCC和肿瘤血栓患者的癌症特异性预后方面具有临床实用性。还需要进行更多研究,以确定术前血清免疫细胞数据对这一患者群体既有预后风险计算器的附加价值。
{"title":"The role of preoperative immune cell metrics in renal cell carcinoma with a tumor thrombus.","authors":"Maxwell Sandberg, Mary Namugosa, Rory Ritts, Claudia Marie Costa, Davis Temple, Mitchell Hayes, Wyatt Whitman, Emily Ye, Justin Refugia, Reuben Ben-David, Parissa Alerasool, Benjamin Eilender, Rafael Ribeiro Zanotti, Thiago Camelo Mourão, Jung Kwon Kim, Patricio Garcia Marchiñena, Seok-Soo Byun, Diego Abreu, Reza Mehrazin, Philippe Spiess, Stenio de Cassio Zequi, Alejandro Rodriguez","doi":"10.1177/03915603241248020","DOIUrl":"10.1177/03915603241248020","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this study was to stratify preoperative immune cell counts by cancer specific outcomes in patients with renal cell carcinoma (RCC) and a tumor thrombus after radical nephrectomy with tumor thrombectomy.</p><p><strong>Methods: </strong>Patients with a diagnosis of RCC with tumor thrombus that underwent radical nephrectomy with thrombectomy across an international consortium of seven institutions were included. Patients who were metastatic at diagnosis and those who received preoperative medical treatment were also included. Retrospective chart review was performed to collect demographic information, past medical history, preoperative lab work, surgical pathology, and follow up data. Neutrophil counts, lymphocyte counts, monocyte counts, neutrophil to lymphocyte ratios (NLR), lymphocyte to monocyte ratios (LMR), and neutrophil to monocyte ratios (NMR) were compared against cancer-specific outcomes using independent samples <i>t</i>-test, Pearson's bivariate correlation, and analysis of variance.</p><p><strong>Results: </strong>One hundred forty-four patients were included in the study, including nine patients who were metastatic at the time of surgery. Absolute lymphocyte count preoperatively was greater in patients who died from RCC compared to those who did not (2 vs 1.4; <i>p</i> < 0.001). Patients with tumor pathology showing perirenal fat invasion had a greater neutrophil count compared to those who did not (7.5 vs 5.5; <i>p</i> = 0.010). Patients with metastatic RCC had a lower LMR compared to those without metastases after surgery (2.5 vs 3.2; <i>p</i> = 0.041). Tumor size, both preoperatively and on gross specimen, had an interaction with multiple immune cell metrics (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>Preoperative immune metrics have clinical utility in predicting cancer-specific outcomes for patients with RCC and a tumor thrombus. Additional study is needed to determine the added value of preoperative serum immune cell data to established prognostic risk calculators for this patient population.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"477-485"},"PeriodicalIF":0.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01Epub Date: 2023-12-24DOI: 10.1177/03915603231216154
Abdolreza Haghpanah, Hooman Kamran, Dariush Irani, Erfan Kohansal, Mahdi Rahmanian, Lorenzo Defidio, Anahita Dehghani, Zahra Jahanabadi, Mohammad Reza Askarpour
Introduction: This study aimed to evaluate the effect of coronavirus disease (COVID-19) on the patients' referral in the pregnant population and also investigate each treatment approach's advantages and disadvantages for acute renal colic in pregnancy.
Methods: In this retrospective study, we included all pregnant women with ureteral stones referred to a referral center between January 2019 and March 2021.
Results: Among 53 pregnant women, 18 (33.9%) were on conservative therapy, which passed the stone without any complications. Double J stent or nephrostomy tube insertion was done for 24 patients (45.2%). Seventeen of these patients (70.8%) presented post-surgical complications, including hematuria (29.2%), pyelonephritis (20.8%), and lower urinary tract symptoms (20.8%). Transurethral lithotripsy (TUL) was done in 11 patients (20.7%). Only one of these patients developed hematuria following TUL. Thus, in our population study, double J stent or nephrostomy insertion was associated with a higher chance of postoperative complications than TUL (p-value = 0.001). Thirty-six patients were referred within 13 months before the entry of COVID-19, while 17 were referred during a similar approximate duration after the COVID-19 entry into the country. Only the initial presentation had a significant difference between these two periods (p-value = 0.034).
Conclusions: When conservative treatment fails, we recommend TUL as the second-line treatment over temporary procedures, such as double J stent or nephrostomy insertion. Of note, in a group of patients with an emergent clinical setting, including active infection, deteriorating renal function, signs of preterm labor, solitary kidney, etc., double J or nephrostomy tube insertion remains the preferred management method for its fast resolution of obstruction and infection. Besides, a decrease in visits with an increase in complicated cases after COVID-19 was observed, maybe due to a delay in referring.
{"title":"Has the COVID-19 pandemic affected ureteral stone management in pregnant women? A retrospective single-center study.","authors":"Abdolreza Haghpanah, Hooman Kamran, Dariush Irani, Erfan Kohansal, Mahdi Rahmanian, Lorenzo Defidio, Anahita Dehghani, Zahra Jahanabadi, Mohammad Reza Askarpour","doi":"10.1177/03915603231216154","DOIUrl":"10.1177/03915603231216154","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate the effect of coronavirus disease (COVID-19) on the patients' referral in the pregnant population and also investigate each treatment approach's advantages and disadvantages for acute renal colic in pregnancy.</p><p><strong>Methods: </strong>In this retrospective study, we included all pregnant women with ureteral stones referred to a referral center between January 2019 and March 2021.</p><p><strong>Results: </strong>Among 53 pregnant women, 18 (33.9%) were on conservative therapy, which passed the stone without any complications. Double J stent or nephrostomy tube insertion was done for 24 patients (45.2%). Seventeen of these patients (70.8%) presented post-surgical complications, including hematuria (29.2%), pyelonephritis (20.8%), and lower urinary tract symptoms (20.8%). Transurethral lithotripsy (TUL) was done in 11 patients (20.7%). Only one of these patients developed hematuria following TUL. Thus, in our population study, double J stent or nephrostomy insertion was associated with a higher chance of postoperative complications than TUL (<i>p</i>-value = 0.001). Thirty-six patients were referred within 13 months before the entry of COVID-19, while 17 were referred during a similar approximate duration after the COVID-19 entry into the country. Only the initial presentation had a significant difference between these two periods (<i>p</i>-value = 0.034).</p><p><strong>Conclusions: </strong>When conservative treatment fails, we recommend TUL as the second-line treatment over temporary procedures, such as double J stent or nephrostomy insertion. Of note, in a group of patients with an emergent clinical setting, including active infection, deteriorating renal function, signs of preterm labor, solitary kidney, etc., double J or nephrostomy tube insertion remains the preferred management method for its fast resolution of obstruction and infection. Besides, a decrease in visits with an increase in complicated cases after COVID-19 was observed, maybe due to a delay in referring.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"543-549"},"PeriodicalIF":0.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139032612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}