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oup (52.95%) . Conclusion Chronic stress during pregnancy can not only lead to the disorder of intestinal flora in female rats, but also lead to the change of intrauterine environment, thus affecting the diversity of intestinal flora in offspring.

High risk non-muscle invasive bladder cancer (NMIBC) is a recurring and potentially lethal disease. To date, with the exception of radical surgery, there are no validated strategies for patients not responding to intravesical BCG therapy. Immune Checkpoint Inhibitors (ICI) are currently being tested for BCG-resistant NMIBC. We report current available data and ongoing trials exploring the efficacy and safety of ICI in this setting.

A narrative search was performed including the combination of the following words ((immunotherapy) AND ((BCG AND resistant) OR (non-muscle AND invasive)) AND (bladder AND cancer)). Three search engines (PubMed, Embase®, and Web of Science) were queried up to November 1, 2020. Congress abstracts reporting results and not only trials' design were also referenced. The US National Library of Medicine was queried via clinicaltrials.gov to explore ongoing trials on the subject.

Pembrolizumab demonstrated a promising 40.6% (95% CI, 30.7-51.1) complete response within the KEYNOTE-057ncologic community and will probably open a new era in the treatment of BCG-resistant NMIBC.

Pembrolizumab has received FDA approval in the treatment of BCG-resistant NMIBC. All five other ICI molecules are currently being extensively tested within clinical trials. The results of the currently ongoing studies are awaited with impatience by the uro-oncologic community and will probably open a new era in the treatment of BCG-resistant NMIBC.

The recently published guidelines of the European Academy of Andrology (EAA) recommended not to prescribe testosterone replacement therapy (TRT) in male patients with hypotestosteronemia and severe heart failure (HF) [New York Hearth Association (NYHA) class III and IV] since the risk in these patients has not been formally documented. Therefore, the aim of this study was to systematically evaluate the risk of TRT on the cardiac function and angina, in male patients with hypotestosteronemia and HF or coronary heart disease.

Randomized controlled trials (RCTs) on male patients with hypotestosteronemia and chronic HF (ejection fraction <40%) or stable angina documenting the effect of TRT on NYHA class, left ventricula ejection fraction (LVEF), adverse events, ST depression and other indexes of cardiovascular function.

Seven articles were included, for a total of 140 participants with HF (71 on TRT and 69 on placebo or no treatment). Included patients were of NYHA class II and III. TRT had no effect on g from a limited number of studies, these data could prompt to perform other RCTs on the effects of TRT in patients with hypotestosteronemia and severe HFrEF (NYHA class III).

One of the underlying reasons for shock wave lithotripsy (SWL)-resistance is the ureteral stone's impaction. This study aimed to investigate the accuracy of the hypothesis, suggesting that SWL per se can be the reason for ureteral stone impaction.

One hundred and seventy-six patients were enrolled in the study. Data of the patients (n=50) treated with SWL and subsequent semirigid ureteroscopic laser lithotripsy (SULL) in our center between January 2014 and January 2020 were retrospectively reviewed compared with the data of the patients (n=126) who underwent SULL without prior SWL treatment during the same period. Patients reported to have ureteral stone impaction during SULL were compared with those without stone impaction in terms of demographic parameters, stone characteristics, and clinical data, including symptom duration and presence or absence of SWL history.

The success rate of SULL was determined as 80.1% (141/176). Univariable analysis revealed statistically significant differences between the patients with and without stone impaction concerning stone diameter, stone volume, pre-SULL SWL history, symptom duration, and ureteral wall thickness (UWT). Multivariable logistic regression analysis revealed that symptom duration and UWT were independent predictive factors for ureteral stone impaction.

Symptom duration and UWT are independent predictors of ureteral stone impaction. Symptom duration and UWT should be considered during treatment planning and informed consent process before proceeding with SULL.

Symptom duration and UWT are independent predictors of ureteral stone impaction. Symptom duration and UWT should be considered during treatment planning and informed consent process before proceeding with SULL.

Aim of our study was to assess the impact of vacation on urinary symptoms in health care workers.

Between March 2018 to October 2019 a survey was carried out by enrolling health care system workers in three centers. Demographic and clinical characteristics of health care workers (i.e. age, smoking status, medical history) were collected. Lower Urinary tract symptoms (LUTS) and work related quality of life were assessed before and after vacation with validated questionnaires Overactive Bladder Questionnaire Short Form (OABq-sf), International Prostate Symptom Score (IPSS), Work-related Quality of Life (WRQOL) and SF-36 questionnaires. As well, Night Shift Workers (NSWs), defined as working at least one time a week from 8 pm to 8 am, were compared to traditional workers (TWs).

A total of 236 participants (118 males and 118 females) with a median of 41 (32/49 IQR) years old were included in the survey. Healthcare workers presented after vacation an improvement in LUTS, in work related quality of life and overall health. Overall, 89 (37%) were NSWs and 147 (62%) subjects were TWs. NSWs reported a significant higher median OABq total score and IPSS than TWs respectively, 27 (IQR 23-34) vs 20 (IQR 19-24) p 0,01, 2 (0/6) vs 0 (0/2) (p<0,01). No significative differences were found for WRQOL and SF36, respectively 66 (IQR 59/77) vs 67 (IQR 61/82) (p<0,29) and 98 (97/101) vs 98 (97/100) (p<0,79).

NSWs present worst urinary symptoms when compared to TWs. Vacation has a beneficial effect, particularly in NSWs, on urinary symptoms and work related quality of life.

NSWs present worst urinary symptoms when compared to TWs. OD36 RIP kinase inhibitor Vacation has a beneficial effect, particularly in NSWs, on urinary symptoms and work related quality of life.