Author: Radu A. Amza

Management of Urinary Dysfunction in Patients with Multiple Sclerosis

Besides the motor and sensory dysfunction that characterizes multiple sclerosis, during the disease evolution and with the accumulation of new demyelinating lesions in specific areas of the central nervous system, autonomic dysfunction be-comes more prevalent among patients suffering from multiple sclerosis. Although not usually addressed, the complex spectrum of autonomic dysfunction manifestations has the potential of a negative impact on the daily activities of multiple sclerosis patients, needing specific investigations and therapeutic measures destined to alleviate symptoms and increase the quality of life. Since urinary dysfunction is evident from the early stages of multiple sclerosis on urodynamic studies even in patients without urinary complaints, it is indicated to thoroughly screen for urinary tract dysfunction as well as other autonomic dysfunctions in all the multiple sclerosis patients.

Clinical significance of p16INK4a and p53 and their involvement in penile cancer development. A literature review

(1) Background: Human papillomavirus (HPV) E6 and E7 oncoproteins are vital for developing HPV induced penile carcinoma. The viral oncoproteins play a central role in oncogenesis by interacting with several cellular regulatory proteins, such as p16INK4a and p53. Many studies suggest that these proteins showed clinical utility in predicting nodal disease, cancer specific survival, overall survival and even tumor grade. Understanding the molecular mechanism involved in the carcinogenesis of penile cancer could offer biomarkers for disease progression, treatment response and potential targeted therapies; (2) Methods: This paper is a prospective study on a group of 100 patients who underwent prostate surgery during 2013 and 2014 in the Urology Clinic of “Carol Davila” Central Military Emergency University Hospital Bucharest. They were tested for HPV by PCR and IHC (p16) methods; (3) Results: 11 cases (22%) of HPV were found in the cluster of patients tested. PCR and P16 were the HPV diagnostic tests used. In order to determine the consistency of the 2 tests, the Cohen’s kappa coefficient was used at a p level < 0.05. The PCR method had a sensitivity of 81.8% and a specificity of 94.9%. The P16 method had a sensitivity of 63.6% and a specificity of 89.7%.