Urinary Diseases Research Articles

Histomorphological Study of Urinary Bladder Biopsies- A Retrospective Study in a Tertiary Care Centre, Kerala, India

Introduction: Urinary bladder diseases are quite frequent in clinical practices. Both non neoplastic and neoplastic lesions are quite common. Bladder malignancies are on an increasing incidence and are considered as an important cause of cancer related morbidity and mortality. To provide accurate diagnosis and treatment histopathology remains as the gold standard investigation. Aim: To study the histomorphology of lesions of bladder obtained through Trans Urethral Resection of Bladder Tumour (TURBT) and cystoscopic biopsies. Materials and Methods: The present study was a five years descriptive retrospective study conducted over a period of six months starting from July 2020 to December 2020 and data were collected from records for the period of January 2015 to December 2019 carried out in the Department of Pathology, Government Medical College, Trivandrum, Kerala, India. Record of all patients who visited to Urology Outpatient Department (OPD) with lower urinary tract symptoms and obstructive bladder symptoms and subjected to cystoscopy were included in study. The detailed clinico-histomorphological features of all biopsies were studied using World Health Organization (WHO)/ International Society of Urologic Pathologists (ISUP) 2016 histological grading and Tumour (T), Nodes (N), and Metastasis (M) (TNM) staging were used in classifying the bladder tumours. Results: The data for the present study was collected over a period of five years; during which a total of 742 lesions were histopathologically evaluated. A total of 688 cases (92.72%) were neoplastic, 46 cases (6.19%) were diagnosed as non neoplastic and 8 cases were (1.07%) were metastatic malignancy. A total of 646 cases (87.06%) were males. Most common affected age group was 61-80 years. Haematuria was the most common clinical presentation. A 332 cases (48.25%) were of non invasive papillary urothelial neoplasm low grade. Conclusion: Lesions of urinary bladder are heterogenous in nature. Detailed awareness regarding the various histological features of these lesions, their neoplastic potential, risk of recurrence and possible pitfalls can help pathologists for accurate diagnosis. The study also emphasised on inclusion of smooth muscle in the biopsy for accurate grading and staging in bladder tumours.

Measuring the Capacity of Urine in the Post Mortem Human Urinary Bladder in a Selected Medical College

Background: Urinary bladder diseases are one of the clinical problems encountered in our daily practice.The incidence of these diseases rises with advanced age. These diseases are diagnosed clinically andconfirmed by various non invasive as well as invasive procedures and wall abnormalities are themost important indicator to diagnose such diseases. All these conditions require medical and surgicalintervention. Thereby knowledge regarding normal capacity of urinary bladder is essential to determinethe physiologic variation of this organ. Therefore, full knowledge about gross and histological features ofthe urinary bladder has hard & fast implication for the investigation, diagnosis and further management.With this background the present study has been designed to evaluate the capacity of urine in postmortemhuman urinary bladder.
 Objectives: To identify the socio-demographic determinants and to determine thecapacity of urine in post mortem human urinary bladder.
 Materials and Methods: This was a descriptivetype of longitudinal study. Sample size was estimated by reviewing literatures and by expert opinion and70 human postmortem urinary bladders fulfilling the inclusion and exclusion criteria were selected in thisstudy. This study was conducted in the Department of Anatomy, Sylhet MAG Osmani Medical College,Sylhet in collaboration with the Department of Forensic Medicine, Sylhet MAG Osmani Medical College,Sylhet from 1st January 2015 to 31st December 2015.
 Results: The age of the cadaver ranged from 10 to65 years with the mean age of 32.20 (SD ± 14.38) years; 15 (21.40%) cadavers were in the age group of10-20 years, 36 (51.4%) cadavers were in the age group of 21-40 years and 19 (27.1%) cadavers werein the age group 41-65 years. There were 52 (74.3%) male and 18 (25.7%) female with a ratio of maleto female was 2.89:1. The mean capacity was 35.23 (SD ± 7.48) ml. The mean capacity of the urinarybladder was 31.20 ml (SD ± 7.28); 37.92 ml (SD ± 7.31) and 33.32 ml (SD ± 6.13) in the age group of A,B and C respectively. The difference between group A and B was highly significant (p=0.004); betweengroup B and C was significant (p=0.023); but not significant between group A and C (p=0.364). The meancapacity of urinary bladder of male and female did not differ significantly in age group A (p=0.117),group B (p=0.145) and group C (p=0.241).
 Conclusion: The gross capacity of urinary bladder was foundincreased with age up to certain limit then slightly decreased in the late age. But the capacity did not differsignificantly between male and female.
 Bangladesh Journal of Medical Science Vol.20(1) 2021 p.170-176

Optimizing of Postpartum Care that Effects on the New Mother??s Health and Infants in Primary Care

Labor and the ensuing post pregnancy time frame is an intriguing and unique beneficial experience for some ladies. Be that as it may, it is additionally a period of incredible change, truly, intellectually and socially for moms, babies and families. While many moms and babies change through this time ordinarily, others think that it’s mind-boggling or foster huge medical problems that might endure for quite a long time subsequent to conceiving an offspring. For instance, up to half of ladies report sluggishness [1-3] and spinal pain while a critical extent portray migraines [1] perineal and cesarean injury torment [4]. Numerous ladies experience issues, for example, bosom engorgement, sore areolas, mastitis, post pregnancy tension, delayed draining and urinary parcel diseases.

Integrated UPLC-MS/MS and UHPLC-Q-orbitrap HRMS Analysis to Reveal Pharmacokinetics and Metabolism of Five Terpenoids from Alpiniae oxyphyllae Fructus in Rats.

Alpiniae oxyphyllae Fructus (AOF), a traditional Chinese medicine (TCM), is widely used in the treatment of urinary, gastrointestinal and neurologic diseases in China. Although terpenoids are the main active ingredients of AOF, there are few researches on their pharmacokinetics and metabolism. In this study, a sensitive, rapid, accurate and novel ultra high performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) method was established to evaluate the pharmacokinetic behavior of five terpenoids (oxyphyllenodiol B, (4S*,5E,10R*)-7-oxo-tri-nor-eudesm-5-en-4β-ol, 7-epi-teucrenone, (+)- (4R,5S,7R)-13-hydroxynootkatone, (E)-labda-12,14-dien-15(16)-olide-17-oic acid) in rats after oral administration of AOF extracts. 27 metabolic metabolites of the five terpenoids were identified by ultra high performance liquid chromatography -Q Exactive hybrid quadrupole-orbitrap high-resolution accurate mass spectrometry (UHPLC-Q-Orbitrap HRMS) based on precise mass and fragment ions. The established pharmacokinetic analysis method showed good linearity over a wide concentration range, and the lower quantitative limit (LLOQ) ranged from 0.97 to 4.25 ng/mL. Other validation parameters were within the acceptable range. In addition, 27 metabolites were identified in plasma, urine and feces samples, and the metabolic pathways of five terpenoids were mainly focused on glucoside conjugation, dehydration, desaturation and glycine conjugation. This is the first study on the pharmacokinetics and metabolism of five terpenoids in AOF, illuminating the disposal process of terpenoids in vivo. It was expected that the results of this study would provide some references for the apprehension of the action mechanism and the further pharmacological study of five terpenoids in AOF.

Standardization parameters of modified extracts from Arctostaphylos uva-ursi L. leaves

Topicality. 25 % of the Ukrainian population is prone to the urinary system diseases and 10 % has signs of kidney and bladder chronic diseases. Common bearberry (Arctostaphylos uva-ursi L.) leaves are one of the most well-known types of the medicinal plant raw material with the uroantiseptic and diuretic activity. The method of obtaining a decoction from bearberry leaves is well known, but this dosage form is non-standardized, poorly stored, and it is difficult to maintain the accuracy of dosing. Therefore, the development of standardized medicines based on bearberry leaves is a crucial task.Aim. To determine standardization parameters of modified dry extracts from Arctostaphylos uva-ursi L. leaves in accordance with the requirements of the State Pharmacopeia of Ukraine (SPhU) and develop a draft of quality control methods (QCM) for these substances.Materials and methods. The study subjects were dry extracts of bearberry leaves modified with cysteine, phenylalanine, valine, glycine and arginine. For the analysis of the extracts obtained the pharmacopoeial methods were used in accordance with the monographs of the SPhU “Common bearberry leaves”. Identification of biologically active substances (BAS) in the extracts was performed using TLC. The content of hydroquinone derivatives and flavonoids in the extracts was determined by the spectrophotometric method according to the SPhU.Results and discussion. As a result of the research conducted the QCM drafts were developed; and according to their requirements dry extracts of bearberry modified with cysteine, phenylalanine, valine, glycine and arginine were studied. The QCM drafts for dry extracts of bearberry were developed by the following indicators: description, solubility, identification (TLC: method A (hydroquinone derivatives), B (flavonoids) and C (amino acids)), loss on drying (not more than 10 %), residual amounts of organic solvents (ethyl alcohol not more than 1.0 %), heavy metals (not more than 100 ppm), microbiological purity, the content of hydroquinone derivatives (not less than 5 % calculated with reference to arbutin) and flavonoids (not less than 2 % calculated with reference to rutin)). All extracts met the requirements of the documentation developed.Conclusions. The QCM drafts for modified dry extracts of bearberry leaves have been developed; according to their requirements, 5 dry extracts modified with cysteine, glycine, valine, phenylalanine and arginine have been studied. The standardized extracts obtained are promising substances. They can be used for developing dosage forms of new medicines with the uroantiseptic, diuretic and hypoglycemic activity.

Antimicrobial activity of Syzygium aromaticum L. essential oil on extended-spectrum beta-lactamases-producing Escherichia coli

BackgroundTo test the antimicrobial potential of clove essential oil that has been less investigated on antimicrobial-resistant organisms (extended-spectrum β-lactamase-ESBL-producing Escherichia coli), we collected 135 ESBL-producing Escherichia coli strains given that E. coli is the major organism increasingly isolated as a cause of complicated urinary and gastrointestinal tract infections, which remains an important cause of therapy failure with antibiotics for the medical sector.Then, in this study, we evaluated the relationship between the antibacterial potential activity of Syzygium aromaticum essential oil (EOSA) and the expression of antibiotic-resistant genes (SHV-2, TEM-20) in plasmidic DNA on ESBL-producing E. coli using RT-PCR technique.ResultsEOSA was obtained by hydrodistillation. Using Kirby-Baüer method, we found that EOSA presented a smaller media (mean = 15.59 mm) in comparison with chloramphenicol (mean = 17.73 mm). Thus, there were significant differences (p < 0.0001). Furthermore, EOSA had an antibacterial activity, particularly on ECB132 (MIC: 10.0 mg/mL and MBC: 80.0 mg/mL), and a bacteriostatic effect by bactericidal kinetic. We found that the expression of antibiotic-resistant gene blaTEM-20 was 23.52% (4/17 strains) and no expression of blaSHV-2.EOSA presented such as majority compounds (eugenol, caryophyllene) using the GC–MS technique.ConclusionsPlant essential oils and their active ingredients have potentially high bioactivity against a different target (membranes, cytoplasm, genetic material). In this research, EOSA might become an important adjuvant against urinary and gastrointestinal diseases caused by ESBL-producing E. coli.

Higher urinary nitrate was associated with lower prevalence of congestive heart failure: results from NHANES

BackgroundSome studies have reported that nitrate intake from vegetables was inversely associated with many vascular diseases, but few studies have paid attention to the relationship between urinary nitrate and cardiovascular diseases (CVDs). This cross-sectional study aimed to explore the connections between urinary nitrate and prevalence of CVDs.MethodsThe data of this study was collected from National Health and Nutrition Examination Survey (NHANES). Finally, several years’ data of NHANES were merged into 14,894 observations. Logistic regression models were used to examine the associations between urinary nitrate and CVDs by using the “survey” package in R software (version 3.2.3).ResultsIn the univariable logistic analysis, significant association was discovered between urinary nitrate and congestive heart failure, coronary heart disease, angina pectoris, myocardial infarction (all P < 0.001). By adjusting related covariates, the multivariable logistic analysis showed that the significant association only existed between urinary nitrate and congestive heart failure (OR = 0.651, 95% CI 0.507–0.838, P < 0.001). Compared to Q1 urinary nitrate level as reference, the risk for prevalent heart failure diminished along with increasing levels of urinary nitrates, (OR of Q2 level = 0.633, 95% CI 0.403–0.994), (OR of Q3 level = 0.425, 95% CI 0.230–0.783), (OR of Q4 level = 0.375, 95% CI 0.210–0.661), respectively. Moreover, urinary nitrate levels were associated with congestive heart failure in a dose-dependent manner in both 20–60 years group, 60+ years group and male, female group (P < 0.001, P = 0.011 and P = 0.009, P = 0.004).ConclusionsIndependent of related covariates, higher urinary nitrate was associated with lower prevalent congestive heart failure.

Genome-wide association study identifies a role for the progesterone receptor in benign prostatic hyperplasia risk.

Benign prostatic hyperplasia (BPH) is common noncancerous prostate enlargement, which is usually associated with lower urinary tract symptoms (LUTS) and can lead to complex urinary, bladder, or kidney diseases. The majority of elderly men will be affected by BPH as age increases. Here, we conducted a genome-wide association study (GWAS) of BPH using 1942 cases and 4730 controls from the Electronic Medical Records and Genomics network (eMERGE) as discovery cohort. We then used 5109 cases and 161,911 controls from UK Biobank as validation cohort. This GWAS discovered 35 genome-wide significant variants (P < 5 × 10-8), located at 22 different loci in discovery cohort. We validated four significant variants located at four different loci in validation cohort: rs8027714 at 15q11.2, rs8136152 at 22q13.2, rs10192133 at 2q24.2, and rs1237696 at 11q22.1. rs1237696 is an intronic variant on chromosome 11 in the progesterone receptor (PGR) gene (P = 4.21 ×10-8, OR [95% CI] = 1.36 [1.22-1.52]). PGR is a known drug target for BPH as the PGR agonist gestonorone caproate has been used to treat BPH in multiple countries. Our results suggest that genetic variants identified from BPH GWAS can identify pharmacologic targets for BPH treatment.

Justification of the need to normalize vitamin D status for immunoprophylaxis

Currently, there is an increase in the resistance of microorganisms to the available arsenal of antimicrobial drugs, which makes it necessary to maintain and stimulate the body's own immune-protective properties. The main extraskeletal effect of vitamin D activity is associated with the homeostasis of the immune system. The role of vitamin D in reducing the risk of infection with infectious agents has been studied for a long time. Literature search on the effective use of vitamin D for immunoprophylaxis was carried out in Scopus, Web of Science, PubMed, clinicaltrials.gov databases over the past 10 years for related keywords: vitamin D, immunoprophylaxis. Vitamin D stimulates the synthesis of antimicrobial peptides, cathelicidins and defensins, which exhibit broad-spectrum activity against viruses, bacteria and fungal infections; reduces the concentration of pro-inflammatory cytokines; increases the concentration of anti-inflammatory cytokines. Vitamin D is also involved in cell differentiation, maturation and proliferation of immune cells. The article presents the literature review in order to justify additional intake of vitamin D in case of diagnosis of its deficiency and insufficiency for the purpose of immunoprophylaxis in children and adults, especially in risk groups (elderly age, pregnant women, patients with chronic diseases of respiratory, endocrine and urinary systems, gastrointestinal tract, and infectious diseases). Inclusion of vitamin D in the diet as a dietary supplement, as well as fortification of products with it, can be an effective measure to reduce the risk of both morbidity and mortality, especially during the period of quarantine measures.

A Review A Review on Pharmacognostic and Therapeutic Uses of Rubia cordifolia

In today’s time research on plants has increased globally. There are thousands of plant species having good potential offering direct therapeutic effect individually or in combinations. Manjith a herbal drug also known as Indian madder with its botanical name Rubia cordifolia is an age old ethno-medicinal plant in India used as anti-oxidant, anti-inflammatory, anticancer, anti-bacterial, anti-androgenic, immune-modulator, hepato-protective, astringent, tonic, antiseptic, de-obstruent, anti-dysenteric and efficient blood purifier, hence is extensively used against blood, skin and urinary diseases. This study is aimed at assessing the scientific evaluation of desi Rubia cordifolia in the course of pharmacognostical analysis to identify its various parts and to differentiate it from various adulterants, which mainly covers the macroscopic and microscopic features and its medicinal properties which are due to its richness in phytoconstituents such as quinines (anthraquinones), glycosides, saponins, tanins, alkaloids, hexapeptides, triterpenoids, steroids, phenols, and saccharids.&#x0D; Keywords: Rubia cordifolia, Manjith, Fooh, ethno medicinal plant, Unani, pharmacological study

Cocculus hirsutus (L.) W.Theob. (Menispermaceae): A Review on Traditional Uses, Phytochemistry and Pharmacological Activities.

Background:Cocculus hirsutus (L.) W.Theob. (Menispermaceae) is a perennial climber distributed mostly in tropical and subtropical areas. The main aim of this article is to collect and analyze the scientific information related to traditional uses, bioactive chemical constituents and pharmacological activities. Methods: Scientific information on C. hirsutus was retrieved from the online bibliographic databases (e.g. MEDLINE/PubMed, SciFinder, Web of Science, Google Scholar and Scopus). Information regarding traditional uses was also acquired from secondary resources including books and proceedings. Results: Different plant parts of C. hirsutus were reported to be used for the treatment of fever, skin diseases, stomach disorders and urinary diseases. Alkaloids such as jasminitine, hirsutine, cohirsitine and their derivatives along with a few flavonoids, triterpene derivatives and volatile compounds were reported from whole plant or different plant parts. Extracts were evaluated for their antimicrobial, antidiabetic, immunomodulatory and hepatoprotective activities among others. Conclusion: Although widely used in traditional medicines, only a few studies have been performed related to chemical constituents. Most of the biological activity evaluations were carried out using in vitro evaluation methods and only a few studies were carried out in animal models. In the future, properly designed in vivo and clinical studies are necessary to evaluate the pharmacological activities of C. hirsutus along with bioassay-guided studies to isolate and identify the active constituents.

Research Progress of Yupingfeng Powder in Clinical Application

Yupingfeng Powder is widely used in the treatment of respiratory, digestive, urinary, dermatological and ENT diseases. The author reviewed the animal pharmacology experiments and clinical cases in recent years, and summarized and analyzed the diseases he treated, providing ideas and methods for clinical users.

Polysaccharides extract from Vaccaria segetalis seeds inhibits kidney infection by regulating cathelicidin expression

Ethnopharmacological relevanceAccording to the Chinese Pharmacopoeia, the seeds of Vaccaria segetalis, a traditional medicinal herb, can be used for treating urinary diseases. The polysaccharides extract from V. segetalis seeds (VSP) has been shown to prevent urinary tract infections (UTIs). Aim of the studyInvestigate the effects of VSP on treating kidney infection induced by uropathogenic Escherichia coli (UPEC) and the underlying mechanisms. Materials and methodsBoth in vivo and in vitro infection models were established with the UPEC strain CFT073. After oral administration of VSP, the levels of bacterial load, cathelicidin (CRAMP), Toll-like receptors (TLRs) in the kidney were evaluated. The expression of cathelicidin (LL-37) in human renal cell carcinoma cell line (A498) was tested after the treatment of VSP. ResultsIn the kidneys of infection models, high-titer bacteria was detected. In the kidney of rat model, the expression of CRAMP was down-regulated, no significant change was observed in the levels of TLRs. After oral administration of VSP, the bacterial load was significantly decreased in rat and mouse models, and the levels of CRAMP and TLRs were significantly up-regulated in rat model. In vitro, the expression of LL-37 was significantly inhibited by CFT073. VSP up-regulated the expression of LL-37 in A498 cells. ConclusionsThe up-regulation of cathelicidin expression may contribute to the therapeutic effects of VSP on kidney infection.

Metabolic fingerprinting, antioxidant characterization, and enzyme-inhibitory response of Monotheca buxifolia (Falc.) A. DC. extracts

BackgroundEthnobotanical and plant-based products allow for the isolation of active constituents against a number of maladies. Monotheca buxifolia is used by local communities due to its digestive and laxative properties, as well as its ability to cure liver, kidney, and urinary diseases. There is a need to explore the biological activities and chemical constituents of this medicinal plant.MethodsIn this work, the biochemical potential of M. buxifolia (Falc.) A. DC was explored and linked with its biological activities. Methanol and chloroform extracts from leaves and stems were investigated for total phenolic and flavonoid contents. Ultrahigh-performance liquid chromatography coupled with mass spectrometry (UHPLC–MS) was used to determine secondary-metabolite composition, while high-performance liquid chromatography coupled with photodiode array detection (HPLC–PDA) was used for polyphenolic quantification. In addition, we carried out in vitro assays to determine antioxidant potential and the enzyme-inhibitory response of M. buxifolia extracts.ResultsPhenolics (91 mg gallic-acid equivalent (GAE)/g) and flavonoids (48.86 mg quercetin equivalent (QE)/g) exhibited their highest concentration in the methanol extract of stems and the chloroform extract of leaves, respectively. UHPLC–MS analysis identified a number of important phytochemicals, belonging to the flavonoid, phenolic, alkaloid, and terpenoid classes of secondary metabolites. The methanol extract of leaves contained a diosgenin derivative and polygalacin D, while kaempferol and robinin were most abundant in the chloroform extract. The methanol extract of stems contained a greater peak area for diosgenin and kaempferol, whereas this was true for lucidumol A and 3-O-cis-coumaroyl maslinic acid in the chloroform extract. Rutin, epicatechin, and catechin were the main phenolics identified by HPLC–PDA analysis. The methanol extract of stems exhibited significant 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2′-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid (ABTS) radical-scavenging activities (145.18 and 279.04 mmol Trolox equivalent (TE)/g, respectively). The maximum cupric reducing antioxidant capacity (CUPRAC) (361.4 mg TE/g), ferric-reducing antioxidant power (FRAP) (247.19 mg TE/g), and total antioxidant potential (2.75 mmol TE/g) were depicted by the methanol extract of stems. The methanol extract of leaves exhibited stronger inhibition against acetylcholinesterase (AChE) and glucosidase, while the chloroform extract of stems was most active against butyrylcholinesterase (BChE) (4.27 mg galantamine equivalent (GALAE)/g). Similarly, the highest tyrosinase (140 mg kojic-acid equivalent (KAE)/g) and amylase (0.67 mmol acarbose equivalent (ACAE)/g) inhibition was observed for the methanol extract of stems.ConclusionsUHPLC–MS analysis and HPLC–PDA quantification identified a number of bioactive secondary metabolites of M. buxifolia, which may be responsible for its antioxidant potential and enzyme-inhibitory response. M. buxifolia can be further explored for the isolation of its active components to be used as a drug.

Amphiphilic diblock copolymers inhibit the formation of encrustation on the surface of biodegradable ureteral stents in vitro and in vivo

Ureteral stents have been used to treat a variety of urinary diseases for decades. However, the complication of encrustation often impedes its therapeutic effectiveness and service after indwelling in human body. In the present study, in order to surmount this problem, amphiphilic block copolymer, methoxypoly (ethylene glycol)-b-poly (Ɛ-caprolactone) (mPEG-PCL), was used to endow poly (l-lactide-ran-Ɛ-caprolactone) (PLACL) with hydrophilicity by solvent blending. The hydrophilicity, degradability, anti-encrustation (both in vitro and in vivo) and biocompatibility of the developed ureteral stents were assessed using water contact angle, electronic universal material testing machine, SEM, EDS, ICP-OES, dynamic urinary circulation model and a rat model. A progressive increase in the water contact angle and degradation rate was observed with the increase in mPEG-PCL concentration from 1 % to 5 % w/w in the mPEG-PLACL blends. In addition, according to ICP-OES results, approximately 38.86 % Ca and 60.55 % Mg was inhibited after 7 days immersion in dynamic urinary circulation model. Also, in the seventh week of indwelling the developed ureteral stents in rat model, compared with the hydrophobic PLACL, 71 % Ca and 93 % Mg was inhibited. Moreover, histological evaluations showed that mPEG-PCL/PLACL blends decreased tissue inflammation with favorable biocompatibility. As a result, this developed hydrophilic ureteral stents had great potential to become an ideal urological medical device.

Urogenital System Damaging Manifestations of 3 Human Infected Coronaviruses.

At present, there are no comparative studies on the damage of the 3 coronaviruses infections to the urinary system. Therefore, we reviewed the correlations and differences between invading mechanisms and resultant urogenital system damage by the 3 kinds of coronaviruses in an effort to help doctors in the prevention and treatment of these damages, which will be of significance in improving prognosis and quality of life after rehabilitation. We searched PubMed® for English language articles published since 2003 with the key words "Coronavirus disease 2019 (COVID-19)," "severe acute respiratory syndrome-2 (SARS-CoV-2)," "severe acute respiratory syndrome (SARS)-CoV" and "Middle East respiratory syndrome (MERS)-CoV "with "semen" and "kidney." We also used relevant data from websites including the World Health Organization and Centers for Disease Control and Prevention. Recent studies have revealed that both SARS-CoV and SARS-CoV-2 invade target cells through a membrane-bound angiotensin-converting enzyme 2, an important component of the renin-angiotensin system, which maintains human homeostasis, whereas MERS utilizes host cells' receptor dipeptidyl peptidase 4 for entry. While pneumonia is the most prominent symptom in patients infected by coronaviruses due to the transmission through respiratory droplets, the urogenital system can also suffer from infection with coronaviruses, resulting in renal failure, testicular atrophy etc. The impairments of the genitourinary system would be different with the 3 coronavirus infections but they still have a strong correlation. The pathogenesis and clinical symptoms of SARS-CoV, MERS-CoV and SARS-CoV-2 coronaviruses in the genitourinary system are comparable. All 3 coronaviruses have been found to affect kidney and testicular function. Therefore, both urologists and nephrologists should pay attention to the damage caused by coronavirus infection to the genitourinary system, especially monitoring renal and semen function.

A Literature Analysis on Medicinal Use and Research of Cannabis in the Meiji Era of Japan

Cannabis is a historical plant which has been used as a medicine in East Asia. These days, there are active debates about using cannabis in clinical field. Collecting and comparing cannabis research articles which had been published in the Opening of Japan to spot the interactions between the traditional medicine of Japan, Rangaku which was established in Edo Period and the European medicine which is transferred after Perry Expedition is academically meaningful. This study searched publications, which were listed on Open-Access databases by Dec. 11th, 2019. We collected research articles which had been published from January 3rd, 1867 to July 30th, 1912 also known as Meiji era and uploaded on Open-Access databases. Our searching databases were J-stage, CiNii (Scholarly and Academic Information Navigator), Tokyo Metropolitan Library, The National Diet Library, IRDB (Institutional Repositories DataBase) and KAKEN (Grant-in-Aid for Scientific Research Database). Searching keywords were cannabis, hemp and all their Japanese synonyms and available combinations. We selected final 15 studies which met every selection criteria in the 346,393 collected studies. Cannabis was prescribed in Meiji era of Japan to alleviate pain and cure the digestive, respiratory, urinary, and nervous system diseases such as indigestion, asthma, tuberculosis, gonorrhea and its complications, insomnia, and nervous prostration. Cannabis was medically used in Meiji era of Japan and the reporting and sharing of its clinical effect was published on the medical journals like present days. There were already Cannabis regulations in that era, but its medicinal use was more liberated than nowadays. It may be a chance to reconsider the current legal system, which strictly controls the use of Cannabis.

Impacts of Type 2 Diabetes on Disease Severity, Therapeutic Effect, and Mortality of Patients With COVID-19.

PurposeCoronavirus disease 2019 (COVID-19) has become a topic of concern worldwide; however, the impacts of type 2 diabetes mellitus (T2DM) on disease severity, therapeutic effect, and mortality of patients with COVID-19 are unclear.MethodsAll consecutive patients with COVID-19 admitted to the Renmin Hospital of Wuhan University from January 11 to February 6, 2020, were included in this study.ResultsA total of 663 patients with COVID-19 were included, while 67 patients with T2DM accounted for 10.1% of the total. Compared with patients with COVID-19 without T2DM, those with T2DM were older (aged 66 years vs 57 years; P < 0.001) and had a male predominance (62.7% vs 37.3%; P = 0.019) and higher prevalence of cardiovascular diseases (61.2% vs 20.6%; P < 0.001) and urinary diseases (9% vs 2.5%; P = 0.014). Patients with T2DM were prone to developing severe (58.2% vs 46.3%; P = 0.002) and critical COVID-19 (20.9% vs 13.4%; P = 0.002) and having poor therapeutic effect (76.1% vs 60.4%; P = 0.017). But there was no obvious difference in the mortality between patients with COVID-19 with and without T2DM (4.5% vs 3.7%; P = 0.732). Multivariate logistic regression analysis identified that T2DM was associated with poor therapeutic effect in patients with COVID-19 (odd ratio [OR] 2.99; 95% confidence interval [CI], 1.07-8.66; P = 0.04). Moreover, having a severe and critical COVID-19 condition (OR 3.27; 95% CI, 1.02-9.00; P = 0.029) and decreased lymphocytes (OR 1.59; 95% CI, 1.10-2.34; P = 0.016) were independent risk factors associated with poor therapeutic effect in patients with COVID-19 with T2DM.ConclusionsT2DM influenced the disease severity and therapeutic effect and was one of the independent risk factors for poor therapeutic effect in patients with COVID-19.

Epidemiology and risk factors of rectal colonization of carbapenemase-producing Enterobacteriaceae among high-risk patients from ICU and HSCT wards in a university hospital

BackgroundNosocomial carbapenemase-producing Enterobacterieceae (CPE) infections constitute a major global health concern and are associated with increased morbidity and mortality. Rectal colonization with CPE is a risk factor for bacterial translocation leading to subsequent endogenous CPE infections. This prospective observational study was aimed to investigate the prevalence and epidemiology of rectal colonization of CPE, the carbapenemase genotypes, and to identify the independent risk factors for the acquisition of CPE colonization in high-risk patients from ICU and HSCT wards in a university hospital in China.MethodsIn a prospective cohort study, 150 fecal samples from rectal swabs were consecutively obtained for inpatients from the intensive care unit (ICU) and hematopoietic stem cell transplantation (HSCT) wards from November 2018 to May 2019, and screening test for CPE was conducted by using prepared in-house trypsin soybean broth (TSB) selective media and MacConkey agar. Antimicrobial susceptibility was determined by the broth microdilution method and carbapenemase genes were characterized by both the GeneXpert Carba-R and PCR for blaKPC, blaNDM, blaIMP, blaVIM and blaOXA. Multi-locus sequence typing (MLST) was employed to characterize the genetic relationships among the carbapenemase-producing K. Pneumonia (CPKP) isolates. In order to further investigate the risk factors and clinical outcomes of CPE colonization, a prospective case-control study was also performed.ResultsTwenty-six suspected CPE strains, including 17 Klebsiella pneumoniae, 6 Escherichia coli, 1 Citrobacter freundii, 1 Enterobacter Kobe, and 1 Raoultella ornithinolytica, were identified in 25 non-duplicated rectal swab samples from 25 patients, with a carriage rate of 16.67% (25/150). Through GeneXpert Carba-R and subsequent PCR and sequencing, all the suspected CPE isolates were identified to be positive for the carbapenemase genes, of which 17 were blaKPC-carriers, and another 9 were blaNDM-producers. MLST designated all the CPKP isolates to be ST11 clone. Multivariate analysis indicated that urinary system diseases, operation of bronchoscopy, and combined use of antibiotics were independent risk factors for acquiring CPE colonization in high-risk patients from the ICU and HSCT wards.ConclusionsThis study revealed a high prevalence of rectal CPE colonization in high-risk patients from ICU and HSCT wards, and a predominant colonization of the KPC-producing K. pneumoniae clone ST11. Stricter infection control measures are urgently needed to limit the dissemination of CPE strains, especially in patients who were afflicted by urinary system diseases, have underwent bronchoscopy, and were previously exposed to combined antibiotic use.

Assessment of urinary 15-F2 -isoprostanes in dogs with urothelial carcinoma of the urinary bladder and other lower urinary tract diseases.

BackgroundThe 15‐F2‐isoprostanes are by‐products of oxidative stress and are increased in the urine of people with lower urinary tract diseases (LUTD), especially urinary neoplasia. Urothelial carcinoma (UC) is the most common urinary neoplasm in dogs. Earlier detection of UC by noninvasive means could lead to improved outcomes. Urinary 15‐F2‐isoprostanes potentially could provide this means, but have not been evaluated in dogs with UC.ObjectiveThe objective of this study was to measure urinary 15‐F2‐isoprostanes in dogs with UC and dogs with other LUTD.AnimalsOne hundred seventeen dogs: 46 dogs with UC, 30 dogs with LUTD, and 25 control dogs.MethodsAny dog that was presented with dysuria was eligible for inclusion. Diagnosis of UC was confirmed histologically. Urinalysis was performed in each case, and 15‐F2‐isoprostanes quantified by gas chromatography‐negative ion chemical ionization‐mass spectrometry (GC‐NICI‐MS) and normalized to urinary creatinine concentration.ResultsDogs with urinary diseases (UC + LUTD) had higher median urinary 15‐F2‐isoprostanes when compared to control dogs (5.92 ng/mg [range, 0.46‐31.03] vs 3.73 [range, 1.8‐7.98]; P = .02). Urinary 15‐F2‐isoprostanes were similar in dogs with UC (5.33 ng/mg [range, 0.46‐31.03]) compared to dogs with LUTD (6.29 ng/mg [range, 0.54‐18.93]; P = .47) and control dogs (P = .06). Dogs with UC had higher qualitative measures of proteinuria (P = .004), hematuria (P = .01), and epithelial cells on urinalysis (P = .002) compared to the other groups.Conclusions and Clinical ImportanceUrinary F2‐isoprostanes are not useful for the detection of UC in dogs. Future research could evaluate urinary 15‐F2‐isoprostanes as a marker of inflammation in disease progression and prognosis.