The use of denosumab in osteoporosis - an update on efficacy and drug safety.

Introduction: Denosumab (Prolia) is a fully human monoclonal antibody against the receptor activator of the nuclear factor kappaB ligand. It is a potent antiresorptive agent that reduces osteoclastogenesis.

Areas Covered: Denosumab has been shown to improve bone mineral density and reduce the incidence of new fractures in postmenopausal women and men.

Vitamin D for the Prevention of Disease: An Endocrine Society Clinical Practice Guideline.

Background: Numerous studies demonstrate associations between serum concentrations of 25-hydroxyvitamin D (25[OH]D) and a variety of common disorders, including musculoskeletal, metabolic, cardiovascular, malignant, autoimmune, and infectious diseases. Although a causal link between serum 25(OH)D concentrations and many disorders has not been clearly established, these associations have led to widespread supplementation with vitamin D and increased laboratory testing for 25(OH)D in the general population. The benefit-risk ratio of this increase in vitamin D use is not clear, and the optimal vitamin D intake and the role of testing for 25(OH)D for disease prevention remain uncertain.

Evaluation of the Association between Single Nucleotide Polymorphisms of Metabolizing Enzymes with the Serum Concentration of Paracetamol and Its Metabolites.

Intravenous paracetamol is a commonly administered analgesic and antipyretic in inpatient settings. Paracetamol is metabolized by cytochrome P450 (CYP) enzymes followed by conjugating enzymes to mainly glucuronide but to a lesser extent, sulphate metabolites, and oxidative metabolites. Single nucleotide polymorphisms (SNPs) in the CYP enzymes result in modified enzymatic activity.

Mannitol for prevention of acute kidney injury after liver transplantation: a randomized controlled trial.

Background: Acute kidney injury (AKI) is a common complication after liver transplantation, which is associated with increased morbidity and mortality. Therefore, this study investigated mannitol as an oxygen-free radical scavenger and its role in the prevention of early AKI after living donor liver transplantation (LDLT).

Methods: A total of 84 adult patients who underwent LDLT were randomly assigned to two equal groups: the M group, where patients received 1 g/kg mannitol 20%, or the S group, where patients received an equal volume of saline.

Improving Access and Quality of Care for Kidney Stone Patients in an Underserved Community.

There is a call to improve Medicaid patient access to health care, enhance quality and outcomes of care, and reduce overall financial burden. We sought to build a comprehensive kidney stone program to help patients navigate through the acute and preventive aspects of stone disease by increasing multidisciplinary referrals and compliance with recommendations and decreasing no-show rates at first follow-up and repeat stone encounters after initial evaluation. A collaborative multidisciplinary program was established at our single institution consisting of urology, nephrology, and dietary specialists to be piloted over a 3-year period.

Testicular Cancer Knowledge and Viewpoints of American Men.

Introduction: We sought to better understand the baseline knowledge and practices of the general population regarding testicular cancer (TC) and testicular self-examination (TSE) in an effort to understand whether current screening guidelines reflect their viewpoint. The U.S.

Is Envy Always Bad? An Examination of Benign and Malicious Envy in the Workplace.

The current study investigated workplace envy by exploring if perceived self-efficacy of negative and positive emotions could predict malicious or benign envy. This study also examined how malicious and benign envy relate to two important organizational outcomes: job engagement and turnover intentions. Malicious envy is typically associated with negative emotions toward the target of comparison as well as negative behavioral outcomes, whereas benign envy is typically associated with positive emotions toward the target of comparison as well as positive behavioral outcomes.

Implementation and Assessment of a Urology Education Curriculum for Nursing Residents.

Background: Urethral catheter placement is a common hospital procedure, and the urology service is often consulted for difficult catheterizations. Simulation-based education is used to improve procedural proficiency and could be used to increase confidence and comfort with difficult catheter placement. This study provides simulation-based education to help new nursing residents learn to perform independent Foley catheter placement and maintenance.

The Lack of Sexual Health Education in Medical Training Leaves Students and Residents Feeling Unprepared.

Background: Despite physicians frequently caring for patients with sexual health issues, only 50% of United States medical schools require formal education in sexual medicine, and there are currently no guidelines pertaining to this with research which found that medical trainees are ill-equipped to provide sexual healthcare.

Aim: This study aims to identify areas to improve sexual health training in order to increase physician confidence and competence in evaluating and training patients with sexual health problems.

Methods: A prospective survey was sent via REDCap to medical students (n = 190, 68.

Involvement of autophagy in diosgenin‑induced megakaryocyte differentiation in human erythroleukemia cells.

Natural agents have been used to restart the process of differentiation that is inhibited during leukemic transformation of hematopoietic stem or progenitor cells. Autophagy is a housekeeping pathway that maintains cell homeostasis against stress by recycling macromolecules and organelles and plays an important role in cell differentiation. In the present study, an experimental model was established to investigate the involvement of autophagy in the megakaryocyte differentiation of human erythroleukemia (HEL) cells induced by diosgenin [also known as (25)‑Spirosten‑5‑en‑3b‑ol].

Updates on Osteoporosis in Men.

Osteoporosis is less common in men than women; however, the mortality rate associated with major fragility fractures is higher in men. The diagnosis of osteoporosis is established by measurement of bone mineral density or by the presence of a fragility fracture, especially spine or hip fracture. However, many men at high risk of fracture will not meet the T-score criteria for osteoporosis, so fracture risk calculation, with a tool such as FRAX, should be performed.

Does Timing of Diagnosis and Management of Iatrogenic Ureter Injuries Affect Outcomes? Experience From a Tertiary Center.

Objective: To report urologic outcomes from a series of IUIs, sustained during nonurologic procedures, with regards to timing of diagnosis and management of the injury. Iatrogenic ureteral injury (IUI) is the most common mechanism of ureteral trauma. Injuries can be intraoperatively diagnosed (IOD) or postoperatively diagnosed (POD).

Current Knowledge and Opinions of Medical Trainees Regarding PSA Screening.

After 2008 and 2012 USPSTF recommendations against PSA screening, studies revealed a decline in screening rates and trend towards more advanced disease at presentation. After revision of this recommendation in 2017, PSA screening guidelines remain inconsistent and controversy still exists about its clinical utility. We seek to better understand the knowledge of medical trainees regarding this fundamental controversy and gain better insight into what they are being taught regarding this topic.

[Surgical treatment of infective endocarditis: Surgical indications, complications, intrahospital and long-term mortality].

Background: In addition to medical treatment, half of the patients with infective endocarditis (IE) receive surgical treatment. Despite clear recommendations on the indications and the operating delays, the decision remains difficult and must take into consideration several factors.

Methods: A retrospective study was performed at Foch Hospital.

AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS/AMERICAN COLLEGE OF ENDOCRINOLOGY CLINICAL PRACTICE GUIDELINES FOR THE DIAGNOSIS AND TREATMENT OF POSTMENOPAUSAL OSTEOPOROSIS- 2020 UPDATE .

The development of these guidelines is sponsored by the American Association of Clinical Endocrinologists (AACE) Board of Directors and American College of Endocrinology (ACE) Board of Trustees and adheres with published AACE protocols for the standardized production of clinical practice guidelines (CPGs). Recommendations are based on diligent reviews of the clinical evidence with transparent incorporation of subjective factors, according to established AACE/ACE guidelines for guidelines protocols. The Executive Summary of this 2020 updated guideline contains 52 recommendations: 21 Grade A (40%), 24 Grade B (46%), 7 Grade C (14%), and no Grade D (0%).

AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS/AMERICAN COLLEGE OF ENDOCRINOLOGY CLINICAL PRACTICE GUIDELINES FOR THE DIAGNOSIS AND TREATMENT OF POSTMENOPAUSAL OSTEOPOROSIS-2020 UPDATE.

The development of these guidelines is sponsored by the American Association of Clinical Endocrinologists (AACE) Board of Directors and American College of Endocrinology (ACE) Board of Trustees and adheres with published AACE protocols for the standardized production of clinical practice guidelines (CPGs). Recommendations are based on diligent reviews of the clinical evidence with transparent incorporation of subjective factors, according to established AACE/ACE guidelines for guidelines protocols. The Executive Summary of this 2020 updated guideline contains 52 recommendations: 21 Grade A (40%), 24 Grade B (46%), 7 Grade C (14%), and no Grade D (0%).

Passive wideband concentric rings resonator for vocal cords abnormalities detection: Application on larynx cancer pathologies.

This work addresses the study and design of a diagnostic device consisting of a thin-film sensor array based on 8-mm concentered rings, acting as an autonomous acoustic sensor covering a wide range of resonance frequencies (0.1 KHz-2 MHz). In addition to its advantageous shape, this device integrates both the active vibratory element and the embedded electronics dedicated to coding, control, and analysis.

An autonomous low-power management system for energy harvesting from a miniaturized spherical piezoelectric transducer.

A new spherical vibrational energy harvesting device with an additional low power management circuit for optimizing the power transfer from the mechanical vibrations to a storage capacitor is presented. The device is devoted to underwater wireless sensor network applications due to its broadband vibrational energy harvesting, sensing, and communicating facilities. The sensing node container consists of two acrylic glass (PMMA) half-spherical shells and a Pz26 piezoelectric ring clamped between the shells.

Intra-Articular Morphine versus Dexmedetomedine for Knee Arthroscopy under Local Anesthesia.

Background: Knee arthroscopy has both diagnostic and therapeutic applications which can be performed under general, regional, or local anesthesia. Morphine is used as an additive to local anesthetics. Dexmedetomedine, the highly selective alpha-2 (α2)-adrenoceptor agonist with the sedative and analgesic effect can be used also to augment local anesthetic effect.

Levobupivacaine versus Levobupivacaine-Dexmedetomidine in Thoracic Paravertebral Block for Laparoscopic Sympathectomy.

Background: Thoracic paravertebral block (TPVB) is a high-quality analgesic technique used for many types of surgery, trauma, and chronic pain.

Aim: The aim of this study is to assess safety and efficacy of adding dexmedetomidine to levobupivacaine in TPVB for postoperative analgesia after unilateral laparoscopic thoracic sympathectomy.

Patients And Methods: Sixty adult patients of the American Society of Anesthesiologists physical status classes I and II, aged 20-45 years, of either sex, submitted for unilateral laparoscopic thoracic sympathectomy under general anesthesia at Mansoura University Hospital.

THE USE OF VITAMINS AND MINERALS IN SKELETAL HEALTH: AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND THE AMERICAN COLLEGE OF ENDOCRINOLOGY POSITION STATEMENT.

25(OH)D = 25-hydroxyvitamin D; BMD = bone mineral density; CV = cardiovascular; GI = gastrointestinal; IOM = Institute of Medicine; PTH = parathyroid hormone; RCT = randomized controlled trial; αTF = α-tocopherol; ucOC = undercarboxylated osteocalcin; VKA = vitamin K antagonist; WHI = Women's Health Initiative.

Comparison of Intrapleural with Paravertebral Levobupivacaine Analgesia for Thoracoscopic Sympathectomy: A Randomized Controlled Study.

Background: Palmar hyperhidrosis is a benign disease of excessive sweating in the palm that exceeds the physiological state. Thoracoscopic sympathectomy is an effective surgical treatment for localized hyperhidrosis.

Aims: The aim of this study was to compare paravertebral block (PVB) with intrapleural analgesia in thoracoscopic sympathectomy.

The equatorial rainforest of Central Africa between economic needs and sustainability requirements.

This article sets out to investigate the role played by the rainforest of Central Africa in providing environmental goods and services, regulating and stabilizing the global climate as well as participating in socio-economic development of the riparian countries. This complex role offers a double status, almost confrontational, to this rainforest: it stands as an economic resource and as a major global climate regulator. Hence, there is an urgent need to question certain aspects such as climate trends in this strategic region and the use of local forest resources for economic purpose in order to suggest ecological attitudes to be adopted by policymakers, stakeholders, forest professionals and users for a sustainable development.