Hospital-acquired infections in a tertiary hospital in Iran before and during the COVID-19 pandemic

Wiener Medizinische Wochenschrift - Infection prevention protocols are the accepted standard to control nosocomial infections. These protective measures intensified after the coronavirus 2019...     

Is antibiotic prophylaxis necessary in patients undergoing ureterolithotripsy?

Transurethral Ureterolithotripsy (TUL) is a frequently used procedure in urology departments. Many urologists perform TUL without antibiotic prophylaxis; however the use of chemoprophylaxis before TUL remains a controversial issue in urology. This study was carried out to assess the safety of omitting antibiotic prophylaxis prior to TUL. In a prospective randomized clinical trial from January 2005 to December 2007, 114 patients with ureteral stones were enrolled; Fifty seven had preoperative antibiotic prophylaxis administered before TUL and fifty seven patients underwent TUL without antibiotic prophylaxis. The rate of postoperative infectious complications (fever, positive blood culture, significant bactriuria), the length of hospital stay and overall stone free rate were compared between the two groups. There was no statistically significant difference between two groups in the operation time, length of hospital stay, postoperative bacteriuria, positive urine culture, postoperative fever and overall success rate of TUL. It appears that the incidence of infectious complications does not increase in patients undergoing TUL without antibiotic prophylaxis if they have negative pre-operative urine culture and antiseptic technique have been performed thorough the procedure.     

Endovisually guided zero radiation ureteral access sheath placement during ureterorenoscopy

Background: Almost all endourologic procedures use fluoroscopic imaging in some steps, which exposes both the patient and the surgical team to considerable amounts of radiation. Primary reports on results of a simple direct visual endoscopic access sheath placement technique which does not use fluoroscopy at all are presented.

Material and methods: First a semi-rigid ureteroscopy was carried out up to the renal pelvis, then the access sheath (36?cm, 11/13?Fr) without the obturator was placed over a 7.5?Fr semi-rigid ureteroscope and ureteroscopy was repeated over the guide wire to the point where the sheath could be inserted without force as if the ureteroscope would act as the guide wire (rod), which is controlled under direct endoscopic vision.

Results: Eighty-eight cases out of 106 procedures were successful regarding the insertion of the ureteral access sheath (UAS) under direct vision using a 36?cm 13/11?Fr sheath. Fourteen ureters had non-negotiable strictures needing stenting for passive dilation. The mean time for UAS insertion was 19?s. The stone free-rate was 78.12%. Among our 106 cases, there were six cases of the upper tract urothelial cancers.

Conclusion: Ureteral access sheath placement could be safely performed using a semi-rigid ureteroscope under direct visual control and resulted in shorter operative time, without radiation exposure during the RIRS procedure of both the patient and the surgery team.     

A highly sensitive fluorescent immunosensor for sensitive detection of nuclear matrix protein 22 as biomarker for early stage diagnosis of bladder cancer

A novel strategy is reported for highly sensitive, rapid, and selective detection of nuclear matrix protein NMP22 using two-color quantum dots based on fluorescence resonance energy transfer (FRET). Quantum dots (QDs) are highly advantageous for biological imaging and analysis, particularly when combined with (FRET) properties of semiconductor quantum dot (QDs) are ideal for biological analysis to improve sensitivity and accuracy. In this FRET system narrowly dispersed green emitting quantum dot CdTe core is used as a donor and labelled by monoclonal (mAb) antibody, while orange emitting quantum dot CdTe/CdS core shell is used as an accepter and labelled by polyclonal (pAb) antibody. The quantum dots are labelled by antibodies using EDC/NHS as crosslinking agent. Bovine serum albumin (BSA) solution was added to block nonspecific binding sites. The fluorescence intensity of QDs accepter decreased linearly with the increasing concentrations of NMP22 from 2–22 pg mL⁻¹ due to FRET system and fluoroimmunoassay reaction. This method has good regression coefficient (R² = 0.998) and detection limit was 0.05 pg mL⁻¹. The proposed FRET-based immunosensor provides a quick, simple and sensitive immunoassay tool for protein detection, and can be considered as a promising approach for clinical applications. The proposed FRET-based immunosensor provides a quick, simple and sensitive immunoassay tool for protein detection, and can be considered as a promising approach for clinical applications.

A novel strategy is reported for highly sensitive, rapid, and selective detection of nuclear matrix protein NMP22 using two-color quantum dots based on fluorescence resonance energy transfer (FRET).     

A vacuum device for penile elongation: fact or fiction?

OBJECTIVE: To assess the efficacy of a vacuum device as a noninvasive method for penile elongation. PATIENTS AND METHODS: Between September 2003 and November 2004, 37 sexually active men with a stretched penis length of <10 cm were given vacuum treatment three times a week, for 20 min on each occasion, for 6 months. RESULTS: After 6 months, the mean penile length had increased from 7.6 cm to 7.9 cm (no significant difference). The efficacy of vacuum treatment was approximately 10%, and the patient satisfaction rate was 30%. There was one case of haematoma of the penis and one of glans numbness, both resolved spontaneously without any intervention. CONCLUSION: Vacuum treatment of the penis is not an effective method for penile elongation, but provides psychological satisfaction for some men.