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Background: Prostatic artery embolization (PAE) is an emerging treatment for benign prostatic hyperplasia (BPH). However, changes in public interest in PAE over time, especially relative to interest in alternative BPH treatments, are difficult to assess. The online tool for analysis of the popularity of top search queries (Google Trends; Alphabet Inc) provides a relative search volume (RSV) of specified keywords and insight about patterns of user searches.Purpose: The purpose of this study is to assess changes in public interest in PAE over time and compare them with changes in public interest in alternative BPH treatments as indicated by search queries.Material and Methods: Using Google Trends, we identified the RSV of specified keywords within search queries submitted between 2010 and 2019 in the United States. The RSVs of keywords with high search volume were identified and normalized on a scale of values from 0 to 100. Interest in PAE was assessed by comparing RSVs and trends of the keyword PAE as well as of other prostate-treatment-related keywords. Prostate embolization was a PAE-related, BPH-treatment-specific keyword with the highest average RSV. A linear regression analysis was performed to characterize annual search trends of the use of these keywords. Subsequently, the annual search trend of prostate embolization was compared with that of keywords related to transurethral resection of the prostate (TURP) and minimally invasive surgical treatments (MISTs).Results: The mean annual RSV of prostate embolization increased by 8.6 fold between 2010 and 2019. However, during this period, the mean RSV of the keywords transurethral resection of the prostate and TURP were 3.6 and 49.3 times higher, respectively (P

BackgroundHepatic arteriovenous malformations (AVMs) in hereditary hemorrhagic telangiectasia (HHT) patients are most commonly hepatic artery to hepatic venous shunts which can result in high-output heart failure. This condition can be debilitating and is a leading cause of liver transplantation in HHT patients. However, it is not known what characteristics can discriminate between asymptomatic patients and those who will develop heart failure symptoms.Results176 patients with HHT were evaluated with computed tomography angiography (CTA) between April 2004 and February 2019 at our HHT Center of Excellence. 63/176 (35.8%) patients were found to have hepatic AVMs on CTA. 18 of these patients were excluded because of the presence of another condition which could confound evaluation of heart failure symptoms. In the remaining 45 patients included in our cohort, 25/45 (55.6%) patients were classified as asymptomatic and 20/45 (44.4%) were classified as symptomatic, and these groups were compared. In symptomatic patients, mean common hepatic artery (CHA) diameter was significantly higher (11.1 versus 8.4 mm) and mean hemoglobin levels were significantly lower (10.7 vs 12.6 g/dL). A stepwise multiple logistic regression analysis demonstrated that both CHA diameter and hemoglobin level were independent predictors of heart failure symptoms with ORs of 2.554 (95% CI 1.372-4.754) and 0.489 (95% CI 0.299-0.799), respectively. The receiver operator characteristic (ROC) curve of our analysis demonstrated an AUC of 0.906 (95% CI 0.816-0.996), sensitivity 80.0% (95% CI 55.7-93.4%), and specificity 75.0% (95% CI 52.9-89.4%).ConclusionsCTA is an effective and easily reproducible method to evaluate hepatic involvement of HHT. Utilizing CTA, clinical, and laboratory data we determined CHA diameter and hemoglobin level were independent predictors of heart failure symptoms.

Pollution by metals may adversely affect organisms through the generation of reactive oxygen species (ROS). In this study, we examined the sublethal effects of two metals, copper and cadmium, on horseshoe crab (Limulus polyphemus) embryos. Exposure to copper or cadmium at concentrations of 0.01-10 mg/L for periods of 4, 8, 16 and 24 h had minimal effect on embryo survival except at 100 mg/L Cu. However, metal-exposed embryos took significantly longer to hatch into first instar ("trilobite") larvae than seawater controls. Levels of superoxide dismutase (SOD), believed to be important in the response to oxidative stress, were determined by Western blotting. Both the Cu/Zn and Mn cofactor forms of SOD tended to be somewhat elevated in metal-exposed embryos, but the increases were neither dose nor time-dependent. Likewise, SOD enzymatic activity showed no significant differences comparing embryos exposed to metals with seawater controls. We conclude that the protective role of SOD's against ROS produced in response to metal exposure appears to be limited in horseshoe crab embryos, at least under our experimental conditions.