This study aims to detect potential signals of interstitial lung disease (ILD) associated with antiandrogen agents by employing a multi-algorithm, dual-level (Standardized MedDRA Query [SMQ] and Preferred Term [PT]) framework combined with the updated FDA Adverse Event Reporting System (FAERS) dataset (through 2024). We analyzed data from the fourth quarter of 2003 through the fourth quarter of 2024. Disproportionality analysis employed four complementary methods: reporting odds ratio (ROR), proportional reporting ratio (PRR), Bayesian confidence propagation neural network (BCPNN), and empirical Bayes geometric mean (EBGM). Signals were evaluated at both the SMQ and PT levels. A total of 761 cases of ILD associated with antiandrogen agents were analyzed. We identified seven agents showing positive ILD signals in FAERS. They were apalutamide, bicalutamide, degarelix, darolutamide, flutamide, goserelin, and nilutamide. Among them, darolutamide stood out with a newly identified pharmacovigilance signal, whereas no such signal had been detected in prior FAERS analyses. Bicalutamide exhibited positive signals for both "Interstitial lung disease" and "Pulmonary fibrosis" at the PT level, a pattern not seen with the other drugs. Japan contributed the most reports (61.37%); death and hospitalization were the most common outcomes (54.80%). Female-related ILD reports were mainly observed with goserelin and leuprolide used for breast cancer. This study identified seven antiandrogens with pharmacovigilance signals, among which the signal for darolutamide was detected for the first time. The dual-level analysis generated the hypothesis that bicalutamide-associated ILD may have a greater tendency to evolve into a fibrotic phenotype. The observed Japanese predominance in reporting likely reflects regulatory and reporting-related factors rather than a true biologic excess risk. Female-related ILD reports represent solely a signal-generating observation. These findings are exploratory and require further validation.

Children with nephrotic syndrome (NS) receive long-term steroid therapy and hence there is an increased risk of bone mineral disease. The objective of the study was to compare the bone mineral density (BMD) in children with NS with that of healthy age-matched controls by using Dual-energy x-ray absorptiometry (DXA) and its correlation with metabolic parameters. A single-center cross-sectional study was conducted to assess the BMD using DXA scan in children aged 5-14years with NS compared to age and gender-matched healthy children in a tertiary care center. Sixty-two children were included (31 with NS and 31 healthy children as controls), and BMD's were assessed using a DXA scan. Z-scores were calculated and correlated with biochemical parameters such as serum alkaline phosphatase, calcium, phosphate, parathormone, and vitamin D. Low BMD was observed in almost 64.5% of children with NS. The mean BMD and height adjusted Z score were lower in children with NS than healthy children. The mean BMD/Z-score in NS and controls were-left femur neck (- 2.18 ± 1.49 vs - 0.461 ± 0.94), right femur neck (- 2.47 ± 1.54 vs - 0.50 ± 0.88), spine (- 1.72 ± 1.16 vs - 0.603 ± 0.80), respectively and these differences were statistically significant (p < 0.05). The correlation between cumulative steroid dose and BMD/Z-score was not statistically significant. Children with NS had lower BMD and serum vitamin D levels than healthy children despite calcium and vitamin D supplementation, and they need periodic evaluation.

Detrusor underactivity (DUA) may coexist in up to one-third of men with benign prostatic hyperplasia (BPH) and is traditionally associated with poorer surgical outcomes, as impaired contractility may limit postoperative voiding recovery. Existing evidence, however, remains conflicting. We aimed to compare perioperative and functional outcomes in men with DUA and those with normal contractility (NC) following BPH surgery. A systematic review and meta-analysis were conducted adhering to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Embase, and Scopus were systematically searched for comparative studies. Subgroup analyses were performed according to procedure type. Outcomes included perioperative events and changes in functional parameters. Fourteen studies including 4,345 patients (2060 DUA and 2,285 NC) were analyzed. HoLEP was the most common procedure, followed by TURP. Postoperative urinary retention (OR 1.63, 95% CI 1.21-2.20) and minor complications (OR 1.31, 95% CI 1.08-1.59) were more frequent in the DUA group, while major complication rates were similar (OR 1.46, 95% CI 0.81-2.65). At 6months, changes in Qmax and PVR were comparable between groups. Reduction in IPSS favored NC patients at 6months but was no longer observed at 1year. BPH surgery appears to be safe and effective in men with concomitant DUA. Although postoperative urinary retention and minor complications were more frequent in patients with DUA, major complications and functional outcomes were similar, particularly beyond the early postoperative period. Given that most available data are retrospective and definitions of DUA remain heterogeneous, further randomized studies employing a standardized DUA definition are needed.

Percutaneous needle access is a critical step in percutaneous nephrolithotomy (PCNL). Supine PCNL, favored for its anesthetic and physiological benefits, can be performed using various puncture techniques. This study compared the efficacy and radiation safety of monoplanar, cross-table bull's-eye, and a combined ultrasound (US)-fluoroscopy-guided access technique for supine PCNL. Between January 2021 and March 2025, 130 patients undergoing supine PCNL were reviewed in three groups: monoplanar (Group A, n = 41), cross-table bull's-eye (Group B, n = 45), and combined US-fluoroscopy (Group C, n = 44). In Group C, pre-procedural US established a cognitive vectorial roadmap to determine needle trajectory and depth. Punctures were performed under 0° fluoroscopy, with on-demand refinements using 0-30° rotation and cephalad angulation for depth verification. Perioperative outcomes and radiation times were compared. Total operative time, stone-free (SF) rates, complications, blood transfusion rates, creatinine (Cr) change, hemoglobin (Hb) loss, nephrostomy and hospital stay did not differ significantly among groups (p > 0.05). However, mean fluoroscopy time for successful puncture was significantly lower in the combined US-fluoroscopy group (26.59s) compared to monoplanar (42.82s) and cross-table bull's-eye (40.62s) techniques (p < 0.001). The combined US-fluoroscopy-guided technique is feasible for supine PCNL and significantly reduces radiation exposure. By integrating US-derived cognitive planning with on-demand fluoroscopic verification, this hybrid approach facilitates efficient needle puncture without compromising procedural precision or clinical success. It serves as a valuable alternative for optimizing radiation safety in urologic practice.

Acute kidney injury (AKI) is a common critical clinical syndrome among hospitalized patients, characterized by high incidence and mortality rates. Currently, the pathogenesis of AKI remains incompletely understood, and effective clinical treatments are lacking. Lactate, a metabolic byproduct of glycolysis, is involved in numerous pathophysiological processes within the kidney and functions as a regulator of lactylation, a recently identified posttranslational modification (PTM). The regulation of lactylation is closely controlled by several key enzymes and metabolic pathways, creating a dynamic and complex modification network. By modulating protein function and gene expression, lactylation significantly impacts the progression of various diseases. Recent evidence suggests that lactylation acts as a pivotal regulatory hub in the pathophysiology of AKI and is intricately linked to core AKI mechanisms, such as inflammation, metabolic reprogramming, and mitochondrial dysfunction. This review presents an investigation of renal lactate metabolism homeostasis and the disruption of this homeostasis, thoroughly discussing the biological underpinnings of lactylation, including the core enzymes involved, and focuses on elucidating the mechanisms of lactylation in AKI. Additionally, the potential of targeting the lactate-lactylation axis as a promising therapeutic strategy for AKI is discussed.

Bee venom (BV) is a well-studied nephroprotective agent, however,its efficacy against ethylene glycol (EG)-induced nephrotoxicity has not been previously investigated. Therefore, this study aimed toassess the protective effect of BV in mitigating EG-mediated alterations in renal function markers, oxidative stress, and histopathological injury in male mice. Renal toxicity was induced in adult male mice by daily oral gavage of 20% EG (2mL/kg body weight). BV was administered intraperitoneally as a co-treatment over the same exposure period. Evalautedndpoints included physiological indices (body weight, water intake, urine output, absolute and relative kidney weights), renal filtration markers (serum and urinary urea, creatinine, albumin, and creatinine clearance), urinary electrolytes (Ca2⁺, Na⁺, K⁺, Mg2⁺), oxidative stress markers (renal MDA, GSH, catalase, and GST), and histological assessment of tubular injury and inflammation. EG administration induced significant systemic and renal impairment, characterized by decreased body weight, increased water intake, urine output, absolute and relative kidney weights, along with reduced creatinine clearance, albuminuria, hypercalciuria, and decreased urinary electrolytes (Na⁺, K⁺, Mg2⁺). Pathogenesis was associated with oxidative stress, as evidenced by elevated MDA and depletion of antioxidant defenses (GSH, catalase, GST), and manifested histologically as tubular necrosis and inflammatory infiltration. BV treatmentsignificantly reduced renal and systemic alterations, enhancing renalfunction, stabilizing physiological markers, and boosting antioxidant defenses. BV confers significant but partial nephroprotection against EG-induced oxidative renal injury through suppression of lipid peroxidation, preservation of glutathione status, enhancement of catalase/GST detoxification, and attenuation of tubular and inflammatory damage. These findings support further mechanistic and dose-response optimization studies prior to clinical translation.

Observational evidence indicates an association between sleep disorders and the risk of nephrolithiasis (kidney stones), but whether this relationship reflects a causal effect remains uncertain. The causal relationship between genetically determined sleep disorders and the risk of nephrolithiasis using a two-sample Mendelian randomization (MR) approach was investigated. This two-sample MR study utilized genome-wide association summary data for both sleep disorders and nephrolithiasis. The main analysis was conducted using the inverse variance weighted method, while confirmatory analyses employed the weighted mode, weighted median, and MR-Egger regression approaches to test for consistency and robustness. Heterogeneity among instrumental variables was evaluated using Cochran's Q-test, and the potential for horizontal pleiotropy was assessed with the MR-Egger regression intercept. To further gauge the robustness and consistency of the findings, a leave-one-out sensitivity analysis was performed, systematically omitting each single-nucleotide polymorphism in turn. Genetically predicted sleep apnea was associated with nephrolithiasis (OR = 1.0032, 95% CI: 1.0011-1.0053, P = 0.0025) and nephrolithiasis intervention (OR = 1.0027, 95% CI: 1.0008-1.0046, P = 0.0057) and that combined sleep disorders were associated with nephrolithiasis (OR = 1.0042, 95% CI: 1.0014-1.0070, P = 0.0032) and nephrolithiasis intervention (OR = 1.0027, 95% CI: 1.0004-1.0050, P = 0.0240). The MR-Egger test indicated no pleiotropy, and the Q-test revealed no heterogeneity for the causal associations above. The MR-PRESSO test showed no horizontal pleiotropy among the tested SNPs for the identified causal associations. The leave-one-out analysis revealed similar results. This MR study revealed causal associations between sleep disorders and nephrolithiasis. Further studies are needed to confirm these findings and elucidate the underlying mechanisms.

To explore the efficacy and safety of a novel fine-needle percutaneous tibial nerve stimulator for the treatment of overactive bladder (OAB) in cats. The stimulator was placed on the medial malleolus of cats (n = 8, three females and five males). Stimulation was controlled through a mobile application. Serial cystometrograms (CMGs) were conducted by infusing either 0.25% acetic acid (AA) or 0.9% normal saline (NS) to evaluate the effects of percutaneous tibial nerve stimulation (PTNS) on the micturition reflex. Histologic analysis of the tibial nerve and surrounding muscle tissue was conducted to determine its safety. During NS infusion, PTNS at 2T significantly increased bladder capacity (BC) to 144.20 ± 5.85% compared with the NS control level (10.40 ± 3.19ml) (P < 0.001). During AA infusion, AA-induced OAB significantly reduced BC to 56.64 ± 1.55% compared with the control level (P < 0.001). PTNS at 2T significantly increased BC to 76.39 ± 5.47% compared with the AA level (P < 0.001). Furthermore, AA significantly reduced the contraction duration compared to the NS control level (4.39 ± 2.08min) (P < 0.001). PTNS significantly increased the contraction duration compared to the AA group (P < 0.05). However, the contraction amplitude and area under the curve showed no significant differences among the NS control, AA, and PTNS groups (P > 0.05). Histologic analysis revealed no discernible abnormalities or structural damage to nerve fibers or adjacent musculature. The novel PTNS device could inhibit OAB in cats and may offer a promising and minimally invasive treatment for OAB.

This study compared fluid control, dietary adherence, and interdialytic weight gain (IDWG) between fasting and non-fasting hemodialysis (HD) patients during Ramadan. This quasi-experimental study, data were collected from 128 HD patients (56 fasting, 72 non-fasting) at a single center. Pretest data were gathered 1month before Ramadan, and post-test data on the final day of Ramadan. Data collection tools included a Patient Information Form, the Fluid Control in Hemodialysis Patients Scale (FCHPS), and the Dialysis Diet and Fluid Non-adherence Questionnaire (DDFQ).Data were analyzed using paired and independent samples t-tests. A significant time-by-group interaction was observed.Fasting patients showed a significant decrease in IDWG from pretest to posttest (p < 0.05), whereas non-fasting patients maintained more stable IDWG. However, fasting patients also demonstrated a significant decline in FCHPS total scores and its Knowledge, Behavior, and Attitude subscales (p < 0.05), indicating poorer fluid management adherence and awareness. DDFQ scores also indicated poorer dietary adherence in the fasting group compared to the non-fasting group. Fasting patients were found to have lower adherence to fluid management, and their knowledge, behavior, and attitudes were negative. Non-fasting patients were found to have higher adherence to fluid management, diet, and fluid management than fasting patients.