Dr Moises Adel (Centro de Uro-Andrologia SC)

Ana Obregón, ölen oğlunun spermiyle 68 yaşında yeniden anne oldu: 🔹 İspanyol oyuncu, tek oğlunu 2020’de kanserden kaybetti. 🔹 Aless Lequio, kemoterapi öncesi spermlerini dondurmuştu. 🔹 Ana, bu spermleri ABD’de taşıyıcı anne sürecinde kullandı. 🔹 Bebek, 2023’te dünyaya geldi. 🔹 Hukuken Ana Obregón’un kızı olarak kayda geçti. 🔹 Biyolojik olarak ise Ana’nın ölen oğlunun çocuğu. 🔹 Bu yüzden bebek aynı zamanda Ana’nın torunu. 🔹 Ana, oğlunun son isteğini yerine getirdiğini söyledi.

Estamos viendo cómo los cloroplastos se mueven dentro de la célula vegetal según la luz. Con poca luz se dispersan para captar más energía, pero cuando es intensa se agrupan para protegerse. Es un mecanismo activo que optimiza la fotosíntesis y evita daño celular. DOI: 10.1073/pnas.2216497120

Cuando un óvulo humano es fecundado, libera una explosión de fuegos artificiales de zinc visible al microscopio. Cada vida humana comienza con un destello de luz. El universo hizo lo mismo hace 13.000 millones de años, solo que a mayor escala

Varón de 35 años con episodios recurrentes de priapismo(2). Consulta por nuevo episodio de 1 hora de evolución. En modo B: aumento de tamaño de los cuerpos cavernosos. Al Doppler (ajustando PRF): ausencia de flujo en arterias cavernosas. Hallazgos compatibles con priapismo de bajo flujo (isquémico). Diferenciar bajo vs alto flujo con ecografía Doppler es clave: • Bajo flujo → urgencia urológica • Alto flujo → manejo conservador La ecografía no solo confirma el diagnóstico, define la conducta. #Ecografía #Doppler #Urología #Radiología

Urge incontinence trick: toe curl, heel raises, or quick pelvic floor squeezes activate the sacral reflex arc and inhibit the overactive detrusor contraction — buying time to reach the bathroom safely. Simple. Evidence-based. Life-changing for OAB patients. drgomezsancha.com

Dr. Amanda Black talks about her randomized clinical trial and how it shows that office-based laser photocoagulation is noninferior to TURBT at 12 months—offering a safe, efficient alternative that avoids general anesthesia and the OR for many patients 🔗bit.ly/4sryOud

When you start a chess game, you have 20 possible moves available. After the first full move (White then Black), there are already over 400 possible positions. By the third move, that number jumps to around 8,900, and after the fourth it reaches nearly 200,000. By the time you get to move #40, the total number of possible games explodes to roughly 10⁴⁰, a number comparable to the total number of atoms in the observable universe.

¿Cuántos ciclos cortos de prednisolona puede acumular un paciente con asma o rinosinusitis antes de que el riesgo deje de ser teórico? Meta-análisis EAACI 2026 (37 estudios) responde con un umbral concreto: 0,5–1 g acumulados de prednisolona-equivalente — equivalente a 2–5 ciclos cortos a lo largo de la vida — ya se asocia a riesgo significativo de eventos adversos retardados. Magnitudes (sGCS vs no-sGCS): - Dispepsia OR 2,68 (IC95% 1,13–6,36) - Neumonía OR 2,14 (1,56–2,94) - Enfermedad cardiovascular OR 1,53 (1,25–1,87) - Fracturas OR 1,48 (1,31–1,67) - Osteoporosis OR 1,36 (1,15–1,62) - Diabetes OR 1,20 (1,08–1,33) - Catarata OR 1,18 (1,05–1,32) Y la curva es dosis-dependiente: cada incremento acumulado eleva el OR de forma progresiva. Implicación práctica: la dosis acumulada lifetime debería entrar al razonamiento clínico igual que la dosis hoy. Priorizar local terapia + biológicos antes del umbral 0,5–1 g. DOI: 10.1111/all.70332 pulmoncritico.co · @pulmoncritico" target="_blank" rel="nofollow noopener">youtube.com/@pulmoncritico #AsmaGrave #Neumología #Corticoides #EBM

After radical prostatectomy, PSA should become undetectable by 6 weeks. Persistent PSA may signal residual disease. Timing matters. @OncoAlert @APCCC_Lugano #APCCC26 @Silke_Gillessen @AOmlin @Uroweb

📢 Exciting Read for Radiologists and Urologists🚀 📚Just came across this fantastic educational article in @RadioGraphics “PRECISE Version 2: Essential Tips for Prostate Cancer MRI Reporting” 🔔This paper is a must-read for anyone involved in prostate MRI! ✅It provides clear, practical guidance on using the updated PRECISE v2 system to standardize reporting for patients on active surveillance. 👍Key highlights include refined scoring for assessing disease stability/progression, helpful checklists, case examples, and tips to reduce ambiguity in serial MRI interpretation! 💡Whether you’re a radiologist fine-tuning your reports, a urologist discussing imaging with your patients, or a trainee building your skills — this valuable resource makes complex concepts more approachable and clinically impactful! 🥇Congrats to @giga_fra and the entire team for this nice work! 🔗 Full article: pubs.rsna.org/doi/10.1148/rg… #Radiology #ProstateCancer #MRI #ActiveSurveillance #RadioGraphics

Less anesthesia, fewer complications, same cancer control. Thank you to @BogdanaSchmidt for discussing, “In‑Office Laser Coagulation of Ta Bladder Tumor Compared With Transurethral Resection of Bladder Tumor,” published in the May issue of JU. 🔗 More: bit.ly/4sryOud

🧵April is Testicular Cancer Awareness Month, and survivorship means more than cure rates. Our new study in @UrolOncol: Testicular cancer survivors face sig higher suicide risk vs. general age-matched male population. 📊Key findings: 1⃣Risk highest in year 1 post-diagnosis (SMR 2.21) but persists up to 10 years 2⃣Risk ↑ with stage: localized 1.07 → regional 1.48 → distant 2.29 3⃣Being separated/divorced/widowed associated with 2.5x higher odds 🧠 Even after cure, the psychological burden remains. Early mental health screening & long-term psychosocial support are essential in survivorship care. Link: authors.elsevier.com/sd/article/S10… @TestesCancer @TCSupportGroup @TCSociety @martin_hofmann_ @LLU_Urology

What is next best step since patient is forming uric acid stones. He is on KCitrate currently and 24 hr was done after starting med.

Uropatia obstructiva (en donde el flujo de la orina del riñón a la vejiga se obstruye) secundario a cálculo ureteral obstructivo, una verdadera URGENCIA UROLÓGICA, en descripción gráfica 😍… Créditos: @io_voka

Casi todos damos por hecho y como simple el LUJO que tenemos de poder orinar bien… Hasta que vemos la neurofisiología de nuestro organismo que interviene para poder llevar a cabo la micción. descripción gráfica. 😮‍💨👌🏻

@GAF_Andrology Artificial Intelligence in Non-Obstructive Azoospermia: State of the Art in Sperm Retrieval #Sperm #Infertility #Fertility #Male pdf ⤵️ wjmh.org/DOIx.php?id=10…

Penetrating the Prostate. Check out this week’s KASIC pearl to learn about Antimicrobials for Acute Bacterial Prostatitis kymdro.org/kasic/?p=8900 #IDTwitter #IDXPosts #AntimicrobialResistance #antimicrobialstewardship #rxtwitter #pharmacy #FOAMed #NPs #PAs @KYHealthAlerts @KYIPTraining @KYAbxAwareness @KYHospitals @KAHCF1 @KyMedDirectors @SIDPharm @UKAbxStew @Arif_Nazir_MD @KyNPsLead @UofLDID

🩻Contrast-induced AKI: one of the biggest myths still shaping clinical decisions For decades we were taught: 👉 “Contrast damages the kidneys” 👉 “Avoid CT with contrast in CKD” 👉 “Hydrate, protect, delay imaging if needed” But what if… most of this is wrong?🤔 ->The uncomfortable reality Modern evidence shows: 👉 Low-osmolar contrast rarely causes true nephrotoxicity 👉 Even in CKD, AKI, and ICU patients 👉 The risk is often overestimated—or nonexistent So where did the fear come from? 📍 1950s high-osmolar contrast (actually toxic) 📍 Poorly controlled observational studies 📍 “Creatinine rise = contrast injury” assumption 👉 Correlation became causation 👉 And the dogma stayed ⚠️What recent data tells us ✔ No difference in AKI rates with vs without contrast ✔ No benefit from bicarbonate, NAC, or aggressive hydration ✔ Even ICU and AKI patients show no worsening outcomes ->Translation to real life 👉 The patient was going to develop AKI anyway...Not because of contrast!! ->The real problem: “Renalism” 👉 Avoiding necessary imaging 👉 Delaying diagnosis 👉 Choosing inferior tests And that leads to: ❌ Missed PE ❌ Delayed sepsis source control ❌ Worse outcomes ->Clinical mindset shift Instead of asking: 👉 “Will contrast harm the kidneys?” We should ask: 👉 “Will NOT doing the scan harm the patient?” ->Who still deserves caution? ✔ eGFR <30 ✔ Severe hemodynamic instability ✔ Multiple nephrotoxins Even then: 👉 Optimize volume 👉 Minimize dose 👉 Don’t delay critical imaging 🤓Bottom line ✔ Contrast nephrotoxicity exists… but is rare ✔ The fear is bigger than the risk ✔ The harm of NOT imaging is often greater In critical care 👉 We don’t treat creatinine 👉 We treat patients And sometimes… 👉 The most dangerous thing is NOT the contrast 👉 It’s hesitation. 📃Reference Florens N, Demiselle J. Kidney360 7: 445–449, 2026. doi: doi.org/10.34067/KID.0…

Mazindol as a temporary treatment for patients with retrograde ejaculation: case series. @MoisesAdel @drandmorat pdf ⬇️ sciencedirect.com/science/articl…

MRI before prostatectomy isn’t just staging… it’s prognostic. New meta-analysis in JAMA Oncology shows MRI predicts outcomes independently. 🧵 📌 Study: Pretreatment MRI as prognostic factor after radical prostatectomy 📊 40 studies | 24,941 patients 👨‍⚕️ Population Men undergoing radical prostatectomy with pre-treatment MRI ⚔️ Key MRI features → Strong outcome predictors 🔴 Extraprostatic extension (mrT3a) •BCR: HR 2.16 •Metastasis: HR 3.18 •Cancer-specific mortality: HR 10.9 (!!) 🔴 Seminal vesicle invasion (mrT3b) •BCR: HR 2.74 •Metastasis: HR 5.58 📊 Quantitative MRI also matters •PI-RADS 4–5 → HR ~2.1 •Tumor ≥20 mm → HR ~2.35 •Low ADC → HR ~2.4 💡 Key insight MRI adds independent prognostic value beyond PSA, Gleason, and pathology 👉 Not just imaging 👉 A biologic risk signal before surgery ⚠️ Practice-changing angle MRI T-staging may be stronger than DRE-based clinical staging → Enables better pre-op risk stratification → Potential for treatment intensification / de-escalation 🎯 Takeaway If you’re still using MRI only for staging… You’re underusing it MRI = prognosis + decision-making tool 🔖 Save this for clinic discussions 📖 Full paper in comment ⬇️ #OncoTwitter #MedTwitter #ProstateCancer #UroOncology @OncoAlert @myesmo @esmo_open @asco