Animal learning may contribute to both problems and solutions for wildlife-train collisions.

Transportation infrastructure can cause an ecological trap if it attracts wildlife for foraging and travel opportunities, while increasing the risk of mortality from collisions. This situation occurs for a vulnerable population of grizzly bears (Ursus arctos) in Banff National Park, Canada, where train strikes have become a leading cause of mortality. We explored this problem with analyses of rail-associated food attractants, habitat use of GPS-collared bears and patterns of past mortality.

Hepatitis E virus (HEV) in Scotland: evidence of recent increase in viral circulation in humans.

BackgroundPrevious studies showed low levels of circulating hepatitis E virus (HEV) in Scotland. We aimed to reassess current Scottish HEV epidemiology. Blood donor samples from five Scottish blood centres, the minipools for routine HEV screening and liver transplant recipients were tested for HEV antibodies and RNA to determine seroprevalence and viraemia.

Accuracy of minimally invasive percutaneous thoracolumbar pedicle screws using 2D fluoroscopy: a retrospective review through 3D CT analysis.

Background: In the literature, there is a large variation in the reported misplacement rates of pedicle screws. The use of minimally invasive surgical techniques is increasing and as such there has only been a small amount of data to look at the misplacement rate of percutaneously inserted thoracic and lumbar pedicle screws.

Methods: A retrospective analysis of post-operative computed tomography (CT) scans were performed on 108 patients who underwent minimally invasive percutaneously inserted thoracic and lumbar pedicle screws by a single surgeon.

Operative Outcomes with Myxomatous Mitral Valve Repair: Experience with 586 Patients.

Introduction: American Heart Association (AHA) guidelines recommend mitral valve repair for myxomatous mitral regurgitation whenever possible to prevent LV dysfunction and early mortality. Here we review our early operative outcomes with mitral valve repair for myxomatous mitral regurgitation.

Methods: We collected data from 586 consecutive patients that underwent mitral repair for myxomatous disease at the Prince Henry and Prince of Wales Hospitals Sydney between 1997 and 2012.

The use of botulinum neurotoxin type a in a patient with refractory urge incontinence to facilitate the intravesical treatment of bladder carcinoma.

Intravesical Bacillus Calmette-Guérin (BCG) has become the preferred initial treatment after resection of high-grade T1 urothelial carcinoma and carcinoma in situ (CIS). We report the case of a patient with high-grade T1 urothelial carcinoma and CIS who was treated with intravesical BCG. Due to the patient's severe urge incontinence, however, the BCG solution leaked from the bladder immediately upon instillation.

Radical prostatectomy versus observation for localized prostate cancer.

Background: The effectiveness of surgery versus observation for men with localized prostate cancer detected by means of prostate-specific antigen (PSA) testing is not known.

Methods: From November 1994 through January 2002, we randomly assigned 731 men with localized prostate cancer (mean age, 67 years; median PSA value, 7.8 ng per milliliter) to radical prostatectomy or observation and followed them through January 2010.

Sebaceous hyperplasia of the vulva: case report and review of the literature.

Sebaceous hyperplasia is a cutaneous lesion consisting of soft, yellow, papular lesions usually occurring on the face in elderly patients. The occurrence of the lesion on the vulva is exceptionally rare. We were able to identify only three cases reported in the literature.

Assessment of the efficacy of Viagra (sildenafil citrate) using the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS).

Treatment satisfaction is a predictor of long-term compliance in patients with erectile dysfunction (ED). We assessed patient satisfaction with and efficacy of Viagra (sildenafil citrate) using the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) and 3 global efficacy questions. Twenty-nine men with ED who had completed a prior study of MUSE (alprostadil) versus Caverject (alprostadil) took a 50-mg dose of Viagra 1 h preceding intercourse.

Efficacy and safety of sildenafil citrate (Viagra) in black and Hispanic American men.

The objective of this study was to assess the efficacy and safety of sildenafil citrate (Viagra) in black American and Hispanic American men with erectile dysfunction (ED) of broad-spectrum etiology. A total of 246 black American and 197 Hispanic American men were randomized to sildenafil (50 mg, adjustable to 25 mg or 100 mg, depending on efficacy and tolerability; n = 124 and n = 99, respectively) or matching placebo (n = 122 and n = 98, respectively). After 6 weeks, patients were given the option of switching to the other blinded treatment for the following 6 weeks.

Chronic fatigue and sexual dysfunction in female Gulf War veterans.

Chronic fatigue (CF) is one of the most common conditions reported by Gulf War veterans. This study evaluated female sexual dysfunction (FSD) in veterans with or without complaints of CF. Subjects were screened for medical and psychiatric causes of CF.

Impact of baseline symptom severity on future risk of benign prostatic hyperplasia-related outcomes and long-term response to finasteride. The Pless Study Group.

Objectives: To evaluate the long-term effects of finasteride on symptoms, acute urinary retention (AUR), and the need for benign prostatic hyperplasia (BPH)-related surgery in relationship to baseline symptom severity.

Methods: A total of 3040 men with BPH were treated for 4 years with finasteride or placebo. The changes from baseline in symptoms and the incidence of BPH-related surgery and AUR were determined in men with mild (less than 8), low-moderate (8 to 12), high-moderate (13 to 19), and severe (greater than 19) baseline quasi-American Urological Association symptoms for all patients and for the subgroup with a baseline prostate-specific antigen (PSA) level of 1.

Waxing and waning gynecomastia: an indication of noncompliant use of prescribed medication.

We present two cases of recurrent gynecomastia in men enrolled in a placebo-controlled trial evaluating the efficacy of finasteride in treating benign prostatic hyperplasia. When the pharmacologic records were examined, it was apparent that the breast tissue hyperplasia diminished when the patients become noncompliant with their study medication and then resumed therapy. Because of the difficulty in obtaining accurate data on an individual's ability to maintain a consistent pharmacologic regimen, we believe that observing such "waxing and waning gynecomastia" may provide the physician with a clue regarding a patient's actual compliance with certain medications.

Parameatal ducts of glans penis. Structure, symptoms, and treatment of uncommon focus of infection.

It has been shown that persistent penile irritation and purulent discharge from around the urethral meatus may rarely be caused by inflammation of tiny tubular structures previously known as paraurethral ducts. They appear to be rare embryologic remnants which can be involved in the venereal disease complex. Local excision is the appropriate treatment if symptoms are not responsive to antibiotic therapy.

Fertility prospects for children with cryptorchidism.

One hundred forty-five men had undergone surgical correction of cryptorchid testes between 1936 and 1968. Eighty percent of 100 patients with unilateral cryptorchidism and 35% (16/45) of patients with bilateral cryptorchidism had reported fertility after 12 or more years of follow-up. There was no significant difference between the fertility rates of patients treated with or without preoperative human chorionic gonadotropin.

Congenital uterovesical fistula.

An example of congenital uterovesical fistula is presented. The cardinal diagnostic feature is monthly painless macroscopic hematuria with onset at menarche. It is possible that a delay in prompt diagnosis and corrective surgery may lead to undesired consequences.