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Ureteral stents with extraction strings – a review on infection risk and prevention

Cent European J Urol. 2025;78(1):94-99. doi: 10.5173/ceju.2024.0222. Epub 2025 Feb 28.

ABSTRACT

INTRODUCTION: This review aims to determine whether the use of ureteral stents with extraction strings in adult patients undergoing upper urinary tract endoscopic procedures results in a higher incidence of urinary tract infections (UTIs) compared to stents without strings.

MATERIAL AND METHODS: A systematic literature search was conducted using PubMed, Scopus, and Google Scholar. Studies evaluating differences in UTI rates among adult patients with ureteral stents with or without extraction strings were included. Data on UTI rates, antibiotic prophylaxis protocols, and stent dwell time were extracted.

RESULTS: The review included 11 trials published between 2015 and 2023. One multicenter retrospective study involving 4,392 patients reported a significantly higher UTI rate in patients with extraction strings (2.1% vs 1.1%, p = 0.006). In the remaining 10 studies, including four randomized controlled trials, the differences were not statistically significant. Antibiotic prophylaxis was described in five studies. In two studies, a single perioperative antibiotic dose was administered, with a total UTI rate of 6.8% (28/410). In contrast, three studies using prolonged prophylactic antibiotic regimens reported a total UTI rate of 3.2% (13/403). The impact of stent dwell time on UTI risk could not be determined. The risk of bias was high in 10 studies and moderate in one retrospective study.

CONCLUSIONS: Based on low-quality evidence, the difference in UTI risk between ureteral stents with and without extraction strings appears to be minimal and statistically insignificant. Well-designed studies with standardized methodologies are needed to clarify these findings.

PMID:40371425 | PMC:PMC12073513 | DOI:10.5173/ceju.2024.0222

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Camarosporidiella, a challenge

Stud Mycol. 2025 Jun;111:19-100. doi: 10.3114/sim.2025.111.02. Epub 2025 Feb 28.

ABSTRACT

The genus Camarosporidiella is here assessed with respect to its phylogenetic structure and species composition. More than 160 pure cultures from ascospores and conidia of more than 150 fresh collections, mostly from Fabaceae, were prepared as DNA sources. Molecular phylogenetic analyses of a multigene matrix of partial nuSSU-, complete ITS, partial LSU rDNA, and tef1 exon sequences of our isolates and those of previous workers revealed that these markers are insufficient to provide a complete species resolution. From this reduced data matrix, however, we propose synonyms and accept taxa for previously described species, which could not be included in the final phylogenetic tree due to lack of rpb2, tef1 intron and tub2 sequences. The final phylogenetic tree, which was inferred from a combined nuSSU-ITS-LSU-rpb2tef1tub2 sequence matrix resolved our isolates into 27 statistically supported phylogenetic species, of which 15 are new. Altogether 34 species are here accepted in Camarosporidiella. Using type studies we stabilise old names, lectotypify Cucurbitaria asparagi, Cucurbitaria caraganae, Cucurbitaria coluteae, Cucurbitaria euonymi, Dichomera elaeagni Hendersonia mori, Sphaeria elongata, Sphaeria laburni Sphaeria spartii and epitypify them as well as Cucurbitaria cytisi, Cucurbitaria retamae and Cucurbitaria steineri to place them in their correct phylogenetic positions and fix their taxonomic concepts. Morphology alone is not suitable to identify these species, and therefore no determinative key to species can be given. However, if hosts are reliably identified, many species can be determined without molecular data. Host images are included with the figures of each fungal species. Taxonomic novelties: New species: Camarosporidiella aceris Jaklitsch & Voglmayr, Camarosporidiella aetnensis Jaklitsch & Voglmayr, Camarosporidiella aragonensis Jaklitsch & Voglmayr, Camarosporidiella asparagicola Jaklitsch & Voglmayr, Camarosporidiella astragalicola Jaklitsch & Voglmayr, Camarosporidiella cretica Jaklitsch & Voglmayr, Camarosporidiella echinosparti Jaklitsch & Voglmayr, Camarosporidiella hesperolaburni Jaklitsch & Voglmayr, Camarosporidiella longipedis Jaklitsch & Voglmayr, Camarosporidiella maroccana Jaklitsch & Voglmayr, Camarosporidiella ononidis Jaklitsch & Voglmayr, Camarosporidiella radiatae Jaklitsch & Voglmayr, Camarosporidiella spartioidis Jaklitsch & Voglmayr, Camarosporidiella sphaerocarpae Jaklitsch & Voglmayr, Camarosporidiella tridentatae Jaklitsch & Voglmayr. New combinations: Camarosporidiella asparagi (Maire) Jaklitsch & Voglmayr, Camarosporidiella caraganae (P. Karst.) Jaklitsch & Voglmayr, Camarosporidiella coluteae (Rabenh.) Jaklitsch & Voglmayr, Camarosporidiella cytisi (Mirza) Jaklitsch & Voglmayr, Camarosporidiella elaeagni (P. Karst.) Jaklitsch & Voglmayr, Camarosporidiella euonymi (Cooke) Jaklitsch & Voglmayr, Camarosporidiella retamae (Pat.) Jaklitsch & Voglmayr, Camarosporidiella steineri (Petr.) Jaklitsch & Voglmayr. New names: Camarosporidiella neomori Jaklitsch & Voglmayr, Camarosporidiella neospartii Jaklitsch & Voglmayr. Citation: Jaklitsch WM, Blanco MN, Rejos FJ, Tello S, Voglmayr H (2025). Camarosporidiella, a challenge. Studies in Mycology 111: 19-100. doi: 10.3114/sim.2025.111.02.

PMID:40371417 | PMC:PMC12070158 | DOI:10.3114/sim.2025.111.02

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Evolution of metabolic disorders after resection of pheochromocytomas and paragangliomas: a single-center study

Med Pharm Rep. 2025 Apr;98(2):190-195. doi: 10.15386/mpr-2741. Epub 2025 Apr 29.

ABSTRACT

BACKGROUND AND AIMS: Pheochromocytomas and paragangliomas are rare neuroendocrine tumors, responsible for inappropriate secretion of catecholamines, inducing metabolic disorders, increasing basal metabolic rate. Our study aimed to analyze the metabolic profile pre- and post-operatively in patients undergoing surgery for pheochromocytomas and paragangliomas and additionally to determine the predictive factors of metabolic remission.

METHODS: This was a retrospective, unicentric, descriptive, and analytical study with a duration of 9 years. It includes data from 35 patients followed up for pheochromocytoma or paraganglioma in the Endocrinology-Diabetology and Nutrition Department of a University Hospital Center. All patients underwent surgery for pheochromocytoma or paraganglioma.

RESULTS: Among the 35 patients, 51.4% of the patients with pheochromocytomas had diabetes mellitus, and 42.8% had dyslipidemia. We found that high levels of catecholamines were associated with the onset of diabetes. We also noted that patients with a long history of the disease were statistically at greater risk of developing dyslipidemia. After surgery, the body mass index of our patients had statistically increased, and 50% of patients experienced resolution or improvement of their diabetes. Improvement of dyslipidemia was observed in 53% of patients. We also found that the percentage of dyslipidemia was higher in patients who did not resolve their diabetes.

CONCLUSION: Diabetes mellitus and dyslipidemia are metabolic complications that must be investigated in patients with pheochromocytoma. Post-operative monitoring of body mass index and changes in glycemic and lipid levels is essential to adapt therapeutic management.

PMID:40371414 | PMC:PMC12070968 | DOI:10.15386/mpr-2741

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The influence of different types of bevels on the fracture resistance of directly restored lower anterior teeth

Med Pharm Rep. 2025 Apr;98(2):223-229. doi: 10.15386/mpr-2773. Epub 2025 Apr 29.

ABSTRACT

BACKGROUND AND AIMS: In recent years, dental trauma has been on the rise. The most common, regarding permanent dentition, are uncomplicated fractures (involving enamel or enamel and dentin) of the maxillary central incisors, followed by maxillary lateral incisors and mandibular central incisors. In anterior teeth, high impact stresses are frequently produced and because of this it is necessary that the restoration has a high fracture resistance. The aim of this study is to evaluate the influence of marginal cavity preparations (45° bevel and chamfer bevel) on the fracture resistance of teeth treated with direct composite resins.

METHODS: For this study, 24 extracted mandibular incisors were used. All soft tissue debris and tartar were removed. During the study, the teeth were kept in saline to prevent dehydration. The teeth were divided into three groups of 8 teeth each. Group number 1 was used as a control and named C, in group number 2, named CH, incisors were prepared with a chamfer type of bevel, and in group number 3, named B45, incisors were prepared with a 45° bevel. After preparing all mandibular incisors, they were directly restored with nano-ceramic composite (Ceram.x® Duo, Dentsply Sirona). Subsequently, all three groups were fractured to determine the maximum compressive load using the Instron 3366 universal testing machine. To ensure a standardized fracturing process, all incisors were embedded in self-polymerizing acrylic resin up to the neck to replicate the conditions in the oral cavity.

RESULTS: The Student’s T-test was employed for statistical analysis, revealing a statistically insignificant difference between the CH and B45 groups. Nonetheless, it was noted that the average values of maximum compressive loads in the chamfer bevel group were higher compared to those in the 45° bevel group, indicating its superior resistance to fracture. Additionally, the results of the fracture resistance test demonstrated that intact mandibular incisors are three times more resistant to fracture than mandibular incisors prepared and restored with dental bevels.

CONCLUSION: Intact teeth present a superior fracture resistance compared to teeth that have been subjected to trauma or carious processes, requiring coronal restoration; dental restorations made with a chamfer bevel marginal preparation withstand higher forces with improved fracture resistance compared to those made with a 45° bevel marginal preparation.

PMID:40371407 | PMC:PMC12070936 | DOI:10.15386/mpr-2773

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The effect of different surface treatments on the bond strength to zirconia

J Prosthodont. 2025 May 14. doi: 10.1111/jopr.14068. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the effect of various surface treatment methods on zirconia as it affects the bond strength to its substrate.

MATERIALS AND METHODS: Sintered zirconium dioxide ceramic disks (KATANA Zirconia STML; n = 20; size 12 × 12 × 3 mm) were divided into five groups: no surface treatment (Group C), air-particle abraded with 50 µm aluminum oxide (Group AA), air-particle abraded with glass beads (Group GB), Zircos E etching solution for 2 h (Group ZE), and 48% hydrofluoric acid solution heated at 25°C for 30 min (Group HE). Cylindrical composite resin specimens (2.1 mm in diameter, 3 mm in height) were bonded to the zirconia samples with resin cement (Panavia V5) under a load of 1000 g and light cured for 80 s. Each group was divided into two subgroups, and shear bond strength (SBS) was tested at a crosshead speed of 1 mm/min after storage in distilled water for 24 h at 37°C or after 10,000 thermocycles. The fractured surfaces of specimens were inspected with a stereo microscope, and failure modes were classified as adhesive, cohesive, or mixed failures. One-way ANOVA test and paired t-test were applied for statistical analysis.

RESULTS: Highest mean SBS values [MPa] were observed for Group AA (14.98 ± 3.19) followed by Group HF (14.8 ± 0.83), Group C (8.32 ± 1.95), Group GB (9.29 ± 0.99), and Group ZE (4.83 ± 0.47). Mean SBS values (MPa) of all the groups decreased significantly after thermal cycling and were for 5.45 ± 0.8 (Group C), 13.47 ± 2.33 (Group AA), 8.56 ± 1.35 (Group GB), 4.16 ± 0.63 (Group ZE), and 13.15 ± 1.27 (Group HF).

CONCLUSIONS: Air-particle abrasion with alumina and heated 48% hydrofluoric acid provide higher bond strengths than the other surface treatments tested.

PMID:40369713 | DOI:10.1111/jopr.14068

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Evaluating anti-MRSA antibiotic stewardship with a focus on trends in consumption and resistance in a tertiary hospital in Alexandria, Egypt from 2019 to 2023

Arch Public Health. 2025 May 14;83(1):133. doi: 10.1186/s13690-025-01614-3.

ABSTRACT

BACKGROUND: The global rise of antimicrobial resistance (AMR) threatens infection treatment. Methicillin-resistant Staphylococcus species (MRSS) are particularly challenging. This study examines the relative consumption of Linezolid (Reserve antibiotic) versus Vancomycin and Teicoplanin (Watch antibiotics) for MRSS, comparing trends with resistance patterns to optimize antibiotic use and combat AMR.

METHODS: This observational retrospective study analyzed trends in the consumption of Vancomycin, Linezolid, and Teicoplanin among all patients admitted to a tertiary hospital in Alexandria, Egypt from January 2019 to December 2023. The study compared these consumption patterns with resistance rates in Staphylococcus spp., including MRSS, from January 2020 to December 2023. Data on antibiotic consumption, expressed as defined daily doses per 1000 patient days (DDD/1000PD), were retrieved from pharmacy records, while resistance data were obtained from the WHONET database. Exploratory data analysis, including time series visualization and linear regression, assessed trends and the impact of COVID-19 on antibiotic use and resistance patterns.

RESULTS: Linezolid consumption increased significantly (β = 3.72, 95% CI: 0.50 to 6.94, p = 0.027), while Teicoplanin consumption also rose but to a lesser extent (β = 1.81, 95% CI: 1.02 to 2.60, p < 0.001). Vancomycin consumption remained stable (β = -0.31, 95% CI: -0.77 to 0.15, p = 0.184). Overall, Linezolid experienced an increase in usage that was 2.5 times steeper compared to the combined use of Vancomycin and Teicoplanin. The ICU surveillance data indicated that the days of Vancomycin therapy per 1000 patient days decreased significantly (β = -5.02, 95% CI: -6.79 to -3.25, p < 0.001). Methicillin resistance remained high ranging from 47.8 to 85.2%. Throughout the study period, resistance to the three antibiotics was higher than resistance rates reported in other published studies across Egypt while remained stable and comparable between the hospital and ICU. In the hospital, resistance ranged from 4 to 23.7% for Vancomycin, 6.3-28.6% for Linezolid, and 0-41.7% for Teicoplanin. In the ICU, Vancomycin resistance ranged from 5.5 to 34.2%, Linezolid from 11.4 to 41.2%, and Teicoplanin from 7.1 to 38.8%.

CONCLUSIONS: This study underscores the urgent need for antimicrobial stewardship to reduce Linezolid overuse and address persistently high resistance rates against all anti-MRSA antibiotics.

PMID:40369693 | DOI:10.1186/s13690-025-01614-3

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The Relationship Between Sleep Quality and the Risk of Medication Errors in Nurses Working in Surgical Wards: A Multicenter Study

J Clin Nurs. 2025 May 14. doi: 10.1111/jocn.17798. Online ahead of print.

ABSTRACT

AIM: Determination of the relationship between sleep quality and the risk of medication errors in nurses working in surgical services.

METHODS: This multicenter, descriptive and correlational study was conducted with 192 nurses working in surgical wards of all training and research hospitals in Ankara, the capital of Türkiye, between January and December 2023. Data were collected using the “Nurse Information Form,” “Pittsburgh Sleep Quality Index,” “Epworth Sleepiness Scale,” and “Medication Administration Error Scale.” The suitability of numerical variables for normal distribution was examined graphically and with the Shapiro-Wilk test. Additionally, Mann-Whitney test, Kruskal-Wallis, Bonferroni, and Spearman’s Rank Correlation Coefficient tests were used in the analyses. The STROBE checklist was followed in writing the study.

RESULTS: The median age of nurses was 27.0 (IQR = 8.0) years, and 38.5% were in the 21-25 age group. Among the nurses, 81.3% stated that they had sleep problems due to working hours, and 44.3% stated that they made medication errors due to insomnia. The nurses’ Pittsburgh Sleep Quality Index total score median was 12.00 (IQR = 9.00), Epworth Sleepiness Scale score was 11.00 (IQR = 8.75), and Medication Administration Error Scale score was 85.00 (IQR = 25.75). No statistically significant relationship was found between nurses’ Epworth Sleepiness Scale and Medication Administration Error Scale scores (rs = 0.042; p = 0.565). A statistically significant low-level relationship was found between the nurses’ Epworth Sleepiness Scale score and the total Pittsburgh Sleep Quality Index score (rs = 0.387; p < 0.001). Statistically significant weak and very weak relationships were found between Medication Administration Error Scale and subjective sleep quality, sleeping pill use, and daytime dysfunction (p < 0.05).

CONCLUSION: The study found that nurses had poor sleep quality and daytime sleepiness. It was determined that nurses with sleep problems were at a higher risk of making medication errors.

PUBLIC CONTRIBUTION: Based on these results, it is recommended that nurses’ working hours be planned to support their sleep patterns, and nurses be provided with adequate rest time during shift work hours. Additionally, nurses should be educated about sleep hygiene and the effects of sleep disorders, and more research should be conducted to understand the causes of medication errors and develop preventive strategies.

RELEVANCE TO CLINICAL PRACTICE: The basic principle of healthcare is to “do no harm.” Among healthcare professionals, nurses have great responsibility in preventing medical errors. However, the excessive workload, high number of patients under their care, and working in a day-night shift system lead to fatigue and sleep deprivation. Sleep problems increases their tendency to make mistakes. This study aims to contribute evidence to the literature on the impact of sleep problems on medication errors.

PMID:40369684 | DOI:10.1111/jocn.17798

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Association between atherogenic index of plasma and all-cause mortality and cardiovascular disease among individuals with non-alcoholic fatty liver disease or metabolic dysfunction-associated steatotic liver disease

Diabetol Metab Syndr. 2025 May 14;17(1):153. doi: 10.1186/s13098-025-01715-7.

ABSTRACT

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated steatotic liver disease (MASLD) are common chronic liver diseases worldwide, both of which are closely associated with an increased risk of cardiovascular disease (CVD). Atherogenic index of plasma (AIP), as a biomarker of dyslipidemia, may predict CVD risk and mortality in these patients, but its specific role in patients with NAFLD and MASLD has not been studied in detail. This study adopted a cohort design, using data from the National Health and Nutrition Examination Survey (NHANES, 1988-1994) database, which was conducted by the Centers for Disease Control and Prevention. A total of 12,929 adult participants were analyzed. After participants were grouped according to AIP quartiles, the relationship between AIP levels and CVD risk was explored using multivariate logistic regression models and restricted cubic splines. The relationship between AIP levels and all-cause and CVD mortality was analyzed using multivariate Cox regression models.

RESULTS: Participants with the higher AIP quartiles showed high rates of CVD among participants with NAFLD (Quartile 1: 7.57%; Quartile 2: 10.00%; Quartile 3: 11.63%; Quartile 4: 15.08%). Participants with the higher AIP quartiles showed high rates of CVD among participants with MASLD (Quartile 1: 9.71%; Quartile 2: 11.30%; Quartile 3: 11.14%; Quartile 4: 15.00%). The findings suggested a linear association between the AIP index and the risk of CVD in participants with NAFLD or MASLD. AIP was significantly associated with CVD in the highest quartile of NAFLD or MASLD patients, and the adjusted hazard ratio indicated that high AIP levels were associated with high risk of CVD among participants with NAFLD (HR: 1.77, 95% CI: 1.24, 2.52) and MASLD (HR 1.76, 95% CI: 1.04, 2.98). In addition, higher AIP levels were also associated with increased all-cause mortality and CVD mortality among participants with NAFLD or MASLD.

CONCLUSION: This study showed that AIP is an effective tool for predicting CVD risk and mortality in patients with NAFLD and MASLD. Regular monitoring of AIP levels can help identify high-risk patients early and provide clinical risk assessment before intervention, thereby improving patient management and prognosis. Future studies need to further explore the role of AIP in different ethnic and economic conditions to optimize cardiovascular disease prevention and treatment strategies.

PMID:40369673 | DOI:10.1186/s13098-025-01715-7

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Behaviour Change Techniques Used in the Dietary Management of Patients With Type 2 Diabetes: A Systematic Review and Meta-Analysis

J Clin Nurs. 2025 May 14. doi: 10.1111/jocn.17782. Online ahead of print.

ABSTRACT

AIMS AND OBJECTIVE: To evaluate the effects of dietary intervention and the commonly used behaviour change techniques (BCTs) on clinical outcomes in patients with T2DM.

BACKGROUND: Effective dietary management is crucial in the management of diabetes. Behavioural change strategies are important in improving dietary adherence, but limited understanding of available evidence currently exists.

DESIGN: A systematic review and meta analysis using the PRISMA checklist were used to synthesise the evidence.

METHODS: Systematic review of five databases was completed using selected key terms. Meta-analysis was conducted to test the effects of the dietary interventions and to identify effective BCTs.

RESULTS: Nine studies were included in this research. Overall, the dietary interventions showed significant HbA1c reduction, with merits from personalised dietary interventions tailored to patient characteristics. Meanwhile, there was a sustained reduction in HbA1c after three, six, and twelve months post intervention. Moreover, significant improvements in weight and lipid profile were observed by the sixth month. Regarding employed BCTs, ‘Credible Source’ and’Conserving Mental Resources’ were deemed to be both clinically and statistically significant in reducing HbA1c (> 0.3%), while 14 other BCTs were identified as being associated with a clinically meaningful reduction in HbA1c (> 0.3%).

CONCLUSION: Comprehensive dietary interventions incorporating selective BCTs significantly improved HbA1c, weight, and lipid profiles in patients with T2DM. Identified BCTs and the commonly used intervention features tailored to patient characteristics were most effective in dietary behaviour interventions.

RELEVANCE TO CLINICAL PRACTICE: It is suggested that, besides the commonly used BCTs (e.g., ‘Goals and Planning’ and ‘Feedback on Behavior’), the application of ‘Conserving Mental Resources’ and ensuring ‘Credible Source’ should be incorporated into dietary interventions for patients with T2DM in clinical practice.

PATIENT OR PUBLIC CONTRIBUTION: The is no patient or public contribution in this paper.

TRIAL REGISTRATION: This study was registered at the International Prospective Register of Systematic Reviews.

PROSPERO ID: CRD42023459274.

PMID:40369662 | DOI:10.1111/jocn.17782

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Remaining Challenges in the Treatment of Relapsed Wilms Tumor: Children’s Oncology Group and International Society of Paediatric Oncology Perspectives

Pediatr Blood Cancer. 2025 May 14:e31790. doi: 10.1002/pbc.31790. Online ahead of print.

ABSTRACT

Wilms tumor (WT) is the most common pediatric renal tumor, and with multidisciplinary treatment overall outcomes are excellent. However, a small subset of patients with WT will relapse. The ideal treatment of relapsed WT is yet to be defined. Ongoing studies through the Children’s Oncology Group Renal Tumors Committee (COG-RTC) and the International Society of Paediatric Oncology Renal Tumor Study Group (SIOP-RTSG) aim to improve risk stratification and treatment strategies. Members met at the SIOP 55th Annual Congress 2023 to outline available data and knowledge gaps and develop future research priorities.

PMID:40369656 | DOI:10.1002/pbc.31790