Search

The benefits of testosterone therapy (TTh) in the hypogonadal male can be dramatic. Historically, TTh has been contraindicated in prostate cancer (PCa). Current evidence has redefined our understanding of the influence serum testosterone has on prostatic androgen activity. Increasing numbers of hypogonadal men with coexisting PCa emphasizes the importance of describing those who may safely receive TTh. This review aims to present literature that evaluates the efficacy and safety of TTh in men with coexisting PCa.Our study, a comprehensive review of published literature regarding TTh in men with a history of PCa, consisted of studies conducted from the 1940s to 2022. Our review discusses evidence in accordance with previous studies that TTh has a role in patients with localized PCa as it has not been reported to increase rates of recurrence or progression of PCa.The use of TTh in hypongonadal men with a localized PCa has been shown to have positive clinical outcomes without increasing the rate of disease progression or recurrence. Further research, in a randomized controlled setting, is warranted.

The ligands BDA (2,2'-bipyridyl-6,6'-dicarboxylic acid) and PDA (1,10-phenanthroline-2,9-dicarboxylic acid) are of interest as functional group types for ion-exchange materials for extracting uranium from the oceans, reported in a previous paper for PDA Lashley, M. A. (

Resume Contexte L’injection peri-uretrale d’agents comblant est une option therapeutique peu invasive pour l’incontinence urinaire d’effort (IUE). Objectif Nous presentons une revue de la litterature a propos des agents comblant dans le traitement de l’IUE, leurs indications et les differentes techniques d’injection. Materiel et methodes La revue a ete realisee selon la strategie PRISMA en utilisant la base de donnees PubMed et les termes Mesh : « urinary », « incontinence » et « bulking ». Tous les articles publies en francais ou en anglais jusqu’a 29 juin 2020 ont ete examines. Les de toutes modalites ont ete incluses et les listes des references ont ete etudiees. La recherche a identifie 60 articles publies entre 2001 et 2020. L’etude des listes des references a identifie 40 articles supplementaires. Au total, 54 articles ont ete retenus pour l’etude descriptive. Resultats Les materiaux comblant utilises actuellement sont le collagene reticule par du glutaraldehyde, les polymeres de silicone, l’hydroxyapatite de calcium, le derme porcin, les billes de zirconium recouverts de carbone et l’hydrogel de polyacrylamide. Ils offrent des taux de guerison inferieurs par rapport a la chirurgie. C’est une alternative attirante pour les patientes qui refusent ou qui ne sont pas candidates aux interventions chirurgicales, ou apres echec de ces dernieres. Les voies d’injection para-uretrale et transuretrale sont pratiquees avec une efficacite comparable. Un controle echographique, radiologique ou endoscopique permet une meilleure precision et controle de la procedure. La voie para-uretrale necessite un volume injectable plus important, avec un cout et un risque de complications superieurs. L’efficacite des injections parait superieure lorsqu’elle est pratiquee en mi-uretral, en forme circonferentielle ou en fer a cheval. Conclusion L’identification d’un agent optimale est difficile. La selection de l’agent depend actuellement de la disponibilite du produit, la preference du medecin, le cout et la facilite d’utilisation.

Drought is a major abiotic stress limiting agricultural productivity. Previous field-level experiments have demonstrated that drought decreases microbiome diversity in the root and rhizosphere. How these changes ultimately affect plant health remains elusive. Toward this end, we combined reductionist, transitional and ecological approaches, applied to the staple cereal crop sorghum to identify key root-associated microbes that robustly affect drought-stressed plant phenotypes. Fifty-three Arabidopsis-associated bacteria were applied to sorghum seeds and their effect on root growth was monitored. Two Arthrobacter strains caused root growth inhibition (RGI) in Arabidopsis and sorghum. In the context of synthetic communities, Variovorax strains were able to protect plants from Arthrobacter-caused RGI. As a transitional system, high-throughput phenotyping was used to test the synthetic communities. During drought stress, plants colonized by Arthrobacter had reduced growth and leaf water content. Plants colonized by both Arthrobacter and Variovorax performed as well or better than control plants. In parallel, we performed a field trial wherein sorghum was evaluated across drought conditions. By incorporating data on soil properties into the microbiome analysis, we accounted for experimental noise with a novel method and were able to observe the negative correlation between the abundance of Arthrobacter and plant growth. Having validated this approach, we cross-referenced datasets from the high-throughput phenotyping and field experiments and report a list of bacteria with high confidence that positively associated with plant growth under drought stress. In conclusion, a three-tiered experimental system successfully spanned the lab-to-field gap and identified beneficial and deleterious bacterial strains for sorghum under drought.

The formation constants (log

Resume La prise en charge de patients âges en uro-oncologie augmente la morbidite peri-operatoire. En dehors de la responsabilite pour faute, la survenue de complications graves et exceptionnelles amene les notions juridiques d’etat anterieur et d’alea therapeutique. Au travers d’un cas clinique evalue en Commission de conciliation et d’indemnisation, nous vous proposons d’explorer la notion d’alea therapeutique. Cette notion a ete definie dans le cadre de la loi n°2002-303 du 4 mars 2002 dite loi Kouchner. L’article L. 1142-1-II du Code de la sante publique est le fondement de l’indemnisation des victimes par l’Office national d’indemnisation des accidents medicaux (ONIAM) en cas d’accident medical non fautif. L’objectif de cet article est d’apprehender cette notion juridique.

Plant Biotechnology Journal, 21 (2), ISSN:1467-7644, ISSN:1467-7652

Resume Apres le deces inexplique d’un patient suite a une nephrectomie elargie, il a ete propose a la famille de rechercher la cause du deces lors d’une autopsie scientifique. A l’aide de ce cas clinique, nous vous proposons de revoir les indications ainsi que les modalites de demande et de realisation des autopsies scientifiques en France.

Pesticides may harm soil organisms such as earthworms and enchytraeids, but knowledge is lacking on their relative sensitivity to these chemicals and the consequences on soil functions. The aim of this study was to assess the impact of exposure to a commercial fungicide formulation (Swing® Gold, containing dimoxystrobin and epoxiconazole) on the function of earthworms (Aporrectodea caliginosa) and enchytraeids (Enchytraeus buchholzi) in soil organic matter (SOM) mineralization. The soil organisms were incubated alone and together in a 26-day laboratory experiment. At the recommended field rate, the fungicide induced a decrease in the SOM mineralization and a delay in the maximum daily CO2 emissions compared to the control soil without fungicide. Soil fauna also influenced SOM mineralization with a higher cumulated CO2 release after 26 days in the control soil with earthworms (by 21%) than without fauna. When both earthworms and enchytraeids were present, SOM mineralization did not increase, and there was a negative effect on earthworm weight gain. Finally, an alteration of fauna influence with treatment was observed from day 19, meaning that the effect of fauna on SOM mineralization changed with fungicide treatment. Earthworms no longer promoted SOM mineralization when fungicide was present at three-fold the recommended field rate. The effects of enchytraeids on SOM mineralization were similar with and without fungicide exposure. This study underlines the importance of considering the relative sensitivity of soil organisms to environmental factors and interactions between them when assessing soil functioning.

Cytosine DNA methylation is involved in biological processes such as transposable element (TE) silencing, imprinting, and X chromosome inactivation. Plant methylation is mediated by MET1 (mammalian DNMT1), DRM2 (mammalian DNMT3), and two plant-specific DNA methyltransferases, CMT2 and CMT3 (Law and Jacobsen, 2010). De novo DNA methylation in plants is established by DRM2 via the plant specific RNA-directed DNA methylation (RdDM) pathway that depends on two DNA-dependent RNA polymerases, Pol IV and Pol V (Gallego-Bartolome et al., 2019; Law and Jacobsen, 2010; Stroud et al., 2013). The DNA methylome of cassava has been previously documented based on its haploid collapsed genome (Wang et al., 2015). Since the cassava genome is highly heterozygous, DNA methylome analysis of the haplotype-collapsed genome misses many features of the methylome. With the development of long read sequencing and chromosomal conformation capture techniques, haplotype resolved genomes are available for highly heterozygous genomes (Mansfeld et al., 2021; Qi et al., 2022; Zhou et al., 2020), which provides high-quality reference genomes facilitating studies of haplotype resolved DNA methylomes.

The first part of this article deals with accreditation of the quality of the professional practice of urologists and medical teams working in public or private health care institutions. This is a voluntary national risk management process based on the reporting and analysis of medical risk events and the development and implementation of recommendations. The fundamental objective of the system is to reduce the frequency and severity of adverse events associated with care for the patient. The second part aims to describe the mechanisms and management of surgical complications. The perception of complications by the urologist is discussed, as it may be distorted by cognitive biases leading to inappropriate actions. Two important points were also emphasized: communication with the patient following an injury, therapeutic hazard or complication following an error, and proper maintenance of the medical record. A joint effort to cultivate a culture of safety and quality in urological surgical practice should be encouraged. Collective actions by urologists in the future should help to maintain a proactive attitude: - generalization of quality accreditation of urologic physicians' professional practice; - national registry: which has demonstrated its advantages in the world of aeronautics; - creation of a specific module "Management of complications in urology" in teaching (ECU) and continuing education (SUC, website); - creation of an AFU "Complications" Committee; - management of social networks.

Resume La loi no 2002-303 du 4 mars 2002, dite loi Kouchner, a mis en place un dispositif d’indemnisation specifique des patients victimes d’accidents medicaux, d’affections iatrogenes et infections nosocomiales, systeme destine a favoriser le reglement amiable de ce type de sinistres, dont le regime d’indemnisation demeure fonde sur la faute prouvee. La demande repose sur un dossier telechargeable sur internet et sur l’evaluation de la CCI. Une demande recevable va entrainer la realisation d’une expertise collegiale, contradictoire et gratuite. L’objectif de cet article est d’apprehender le dispositif CCI, les criteres de recevabilite, son mode de fonctionnement, et les finalites previsibles en fonction des decisions.

Resume L’art medical a evolue au sein d’un environnement technique et scientifique que le droit a pu qualifier de « donnees acquises de la science » et plus recemment de « connaissances medicales averees ». Au travers d’un cas clinique et d’une evaluation expertale en commission de conciliation et d’indemnisation, nous reprenons les elements qui ont constitue le bien-fonde de la prise en charge therapeutique. Pour l’expert, il s’agit d’analyser un dossier de responsabilite medicale a la lumiere de l’etat de l’art « a l’epoque des faits », car il existe un changement perpetuel de cet etat de l’art.

In 2018, the French High Authority of Health (HAS) included a "time-out" phase in the latest version of the checklist for the operating room in order to improve the safety of operated patients. The aim of this study is to evaluate the practice of French urologists concerning the check list (CL) of the operating room.A survey of 30 items was developed by the committee of accreditation of the French Association of Urology (AFU) and other contributors. It was centered on the characteristics of the urologists, the details of application of the CL, and the evaluation of the current version. After validation, the questionnaire was emailed as an online form in July 2021 for all the members of the AFU and AFUF.Overall, 369 form the 1700 contacted urologists responded to the survey. The majority were more than 40 years old (70.11%) and less than 20 year of experience (54.49%). The engagement in individual or team accreditation was observed in 222 (60.7%) and 145 (39.84%) urologists, respectively. Almost half of them were present at the beginning of the CL (47.18%), and prescribed postoperative medication with the anesthesiologist (55.56%). The CL has modified the practice in 47.54%, however, with greater administrative burden, and 80% preferred that the AFU adapts the CL to the urology field.The practice of CL between urologists is variable. On multivariate analysis, the engagement in team accreditation was the only variable to influence the practice of time out.

Resume Les evenements indesirables graves associes aux soins (EIGAS) correspondent a des prises en charge non optimales ayant des consequences graves et inattendues et qui dans 40 % des cas seraient evitables. Ils sont souvent precedes d’evenements porteurs de risque (« presque accident »). Le dernier rapport d’activite de la demarche d’accreditation des specialites a risques confirme la necessite de declarer et de gerer les evenements indesirables graves afin d’en identifier les causes recurrentes et de mettre en œuvre des actions collectives (locales ou nationales) pour mieux les detecter et limiter leur impact. Cette etude a souligne la predominance des causes systemiques liees au travail en equipe et a la communication. Le decret de decembre 2016 fait obligation a tous les professionnels de sante de declarer sur une plateforme nationale de declaration. Cet article propose une mise au point concernant les definitions et l’evaluation des evenements indesirables associes aux soins qu’ils soient graves ou non.

The metal-ion-complexing properties of the tetradentate ligand 2,2'-bi-1,10-phenanthroline (BIPHEN) in 50% CH3OH/H2O are reported for a variety of metal ions. BIPHEN (with two reinforcing benzo groups in the backbone) was compared to other tetrapyridyls, 2,9-di(pyrid-2-yl)-1,10-phenanthroline (DPP; with one benzo group) and 2,2':6',2″:6″,2‴- quaterpyridine (QPY; with no benzo groups), with levels of preorganization BIPHEN > DPP > QPY. Formation constants were determined by following the variation of the intense π → π* transitions in the absorbance spectra of BIPHEN in the presence of metal ion as a function of the pH. The log K1 values show that the increased level of preorganization produced by the two benzo groups, reinforcing the backbone of the BIPHEN ligand, leads to increased complex stability with large metal ions (an ionic radius greater than 0.9 A) compared to the less preorganized tetrapyridines DPP and QPY. In particular, the large CdII ion [log K1(BIPHEN) = 12.7] shows unusual selectivity over the small ZnII ion [log K1(BIPHEN) = 7.78]. The order of levels of preorganization BIPHEN > DPP > QPY leads to enhanced selectivity for SmIII over GdIII with increased preorganization, which is of interest in relation to separating AmIII from GdIII in the treatment of radioactive waste. AmIII is very close in ionic radius to SmIII, so that the size-based selectivity produced by the enhanced preorganization of BIPHEN should translate into enhanced AmIII/GdIII selectivity. The chelation-enhanced fluorescence (CHEF) effect in BIPHEN complexes is discussed. The CHEF effect in the ZnII complex is somewhat smaller than that for CdII, which is discussed in terms of decreased overlap in the Zn-N bonds formed by the too small ZnII, leading to a partial photoinduced-electron-transfer quenching of fluorescence. The structure of the complex [Cd(BIPHEN)2](ClO4)2 is reported and shows that the Cd-N bonds are largely normal for the unusual 8-coordination observed, except that steric clashes between the terminal pyridyl groups of each of the BIPHEN ligands, and the rest of the orthogonal BIPHEN ligand, lead to some stretching of the outer Cd-N bonds.

Summary Erectile dysfunction varied by country, affecting between 20 to 40% of men aged 60 and 69 and more than 50% of men aged over 75. Our objective was to evaluate the habits of urologists in 2018 and also evaluate the need for additional, objective tools to aid physicians when providing care. A questionnaire was sent from the French Urology Association to 1158 physicians between November and December 2018. In all, 177 urologists (15.28%) took part in the study. Only 22% of urologists regularly used a questionnaire, such as the IIEF-5. When faced with erection problems, 56.5% of them did not carry out systematic cardiology evaluations. More than half of urologists requested fasting glucose, lipid and total testosterone levels. Twenty-seven percent did not carry out additional tests. First line treatment included a phosphodiesterase 5 inhibitor in 81% of cases. Two thirds of urologists (78%) rated themselves as being correctly trained in the area of erectile dysfunction. However, only 49% systematically inquired about erection problems when faced with benign prostatic hyperplasia and 65% thought that erectile dysfunction was not treated optimally. Despite existing recommendations, only half of urologists carry out a cardiac evaluation when a finding of erectile dysfunction is made. One third of urologists do not request additional testing. Greater training, along with the use of an objective diagnostic tool could help urologists to optimise the care they provide for patients suffering from erectile dysfunction, allowing them to keep working within current guidelines. Level of evidence 3.

Resume La torsion du cordon spermatique est une urgence fonctionnelle qui met en jeu le pronostic vital du testicule. Des formes atypiques genent l’evaluation diagnostique et la prise en charge chirurgicale. Cette problematique est a la source de nombreuses plaintes et d’expertises medicales. La mission de l’expert consiste a retracer les faits medicaux, evaluer la ou les responsabilites et evaluer le dommage. La notion de perte de chance, notion juridique, est regulierement demandee a l’expert medical qui doit s’appuyer sur un raisonnement medical et les donnees de la science afin de permettre au juriste (magistrat, regleur) de proposer une indemnisation. Au travers d’un rapport d’expertise, nous illustrerons notre propos par un cas clinique representatif.

Resume L’accreditation de la qualite de la pratique professionnelle des medecins et des equipes medicales exercant en etablissements de sante publics ou prives est une demarche nationale volontaire de gestion des risques fondee sur la declaration et l’analyse des evenements indesirables associes aux soins, l’elaboration et la mise en oeuvre de recommandations et le suivi d’activite de formation et d’evaluation de pratique. Chaque organisme agree par la Haute autorite de sante (HAS) pour l’accreditation definit la strategie nationale de gestion des risques valable pour la specialite dans toutes ses composantes, traduite par un programme d’accreditation. Ce programme definit les actions devant etre realisees annuellement par les medecins engages dans l’accreditation de facon individuelle ou en equipe. Tous les deux ans l’organisme d’accreditation met a jour le programme a suivre annuellement par les urologues. La HAS a valide le 31 janvier ce nouveau referentiel dit programme « B ».

Resume La decouverte d’un nodule renal de moins de 4 cm est frequente. La strategie diagnostique et therapeutique est bien codifiee dans les recommandations du comite de cancerologie de l’AFU. L’âge du patient, ses antecedents medicaux et chirurgicaux modulent la decision therapeutique. Notre demarche therapeutique et l’information donnee au patient sont toutes deux complexes. Au travers d’un cas clinique et de la decision medicolegale rendue par la commission de conciliation dans les suites d’un avis expertale, nous proposons d’aborder les elements juridiques qui sous-tendent le devoir d’information du patient et l’obtention de son consentement. Quelques pistes pratiques ont ete proposees afin de parfaire cette information et de la tracer dans le dossier medical.

Resume L’accreditation des medecins et des equipes medicales exercant en etablissements de sante publics ou prives est une demarche nationale volontaire de gestion des risques fondee sur la declaration et l’analyse des evenements indesirables associes aux soins, l’elaboration et la mise en œuvre de recommandations et le suivi d’activite de formation et d’evaluation de pratique. Depuis un an, l’organisme d’accreditation des urologues a mis en place l’accreditation en equipe. L’equipe est la « pierre angulaire de la construction de la securite a l’hopital ». Le programme en equipe peut etre identique a celui realise par un medecin individuellement pour une partie et differer sur certains points pour integrer la dimension collective.