Actas urologicas espanolas最新文献

{"title":"Experiencia clínica inicial con PET-TAC Zr-Girentuximab para valoración de masas renales en pacientes con riñones solitarios","authors":"D.A. González-Padilla , D. Sánchez Zalabardo , E.F. Fernando-Valderrama , F. Villacampa-Aubá","doi":"10.1016/j.acuro.2025.501691","DOIUrl":"10.1016/j.acuro.2025.501691","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 4","pages":"Article 501691"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AINE: ¿una alternativa a los antibióticos en el tratamiento de las infecciones urinarias en las mujeres? Una revisión basada en la evidencia","authors":"I. Milhazes Martins ,&nbsp;S.C. Dias Batista","doi":"10.1016/j.acuro.2025.501684","DOIUrl":"10.1016/j.acuro.2025.501684","url":null,"abstract":"<div><h3>Introduction</h3><div>Urinary tract infections (UTIs) remain a major cause of morbidity in otherwise healthy women. It is estimated at least 50% of women will have at least 1 UTI in their lifetime. Current guidelines recommend the use of antibiotics (ABs) for treatment, constituting the 2<!--> <!-->nd most common reason for their prescribing. However, antibiotic resistance remains a worrying problem, therefore it is almost imperative to find alternatives for UTIs. One of the most suggested alternatives are Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). Some clinical trials have shown that these are similar to ABs in resolving urinary symptoms.</div></div><div><h3>Objectives</h3><div>To evaluate the NSAIDs’ effectiveness in the treatment of uncomplicated UTIs in healthy, non-pregnant women and to prove their non-inferiority to ABs.</div></div><div><h3>Methods</h3><div>This evidence-based review study encompasses articles published between January 2010 and December 2021, in the medical databases, using the keywords MeSH: “NSAIDs”, “UTI” and “Treatment”. The Strength of Recommendation Taxonomy scale was used to classify the level of evidence.</div></div><div><h3>Results</h3><div>There were 8 articles selected and the majority concluded ABs are superior in the treatment of UTIs, as the clinical condition resolved more quickly. However, it considered NSAIDs also demonstrated effectiveness. Furthermore, it was also found that treatment with NSAIDs didn’t present as greater risk of complications.</div></div><div><h3>Conclusion</h3><div>ABs remain the most preferred therapy for treating UTIs and there is not yet sufficient evidence to support the use of NSAIDs. However, more studies are needed to evaluate its effectiveness in resolving UTIs’ symptomatology. This may be an opportunity to reduce the prescription of ABs.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 4","pages":"Article 501684"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143890501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estudio multicéntrico del impacto de la implantación de UroLift® en pacientes en tratamiento médico por sintomatología del tracto urinario inferior secundaria a hiperplasia benigna de próstata","authors":"C. González Enguita ,&nbsp;L. López Martín ,&nbsp;L.M. Herranz Fernández ,&nbsp;B. Sinues Ojas ,&nbsp;C. Barrera Rodríguez ,&nbsp;J. Extramiana Cameno ,&nbsp;J. Campá Bortoló ,&nbsp;J.M. Oscá García ,&nbsp;M. Perán Teruel ,&nbsp;V. Gimeno Argente ,&nbsp;A. Navarro Beltrán ,&nbsp;E. López Alcina ,&nbsp;I. Povo Martín ,&nbsp;Y.S. Pallás Costa ,&nbsp;A. Budía Alba ,&nbsp;J. Ortiz Salvador ,&nbsp;J.J. Salgado Plonski ,&nbsp;P. Suárez Sal ,&nbsp;M. Fernández Arjona","doi":"10.1016/j.acuro.2025.501708","DOIUrl":"10.1016/j.acuro.2025.501708","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>UroLift® is a minimally invasive treatment for patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia. The primary objective was to evaluate the impact of UroLift® system treatment on quality of life. Secondary objectives assessed the impact on urinary symptoms and sexual function.</div></div><div><h3>Patients and methods</h3><div>Patients at 7 Spanish hospitals undergoing pharmacological treatment were offered the choice to continue this treatment or accept surgical intervention. The primary outcome, impact on quality of life, was assessed using the EuroQol-5D-5L questionnaire. Secondary outcomes, including impact on symptoms, erectile function, and ejaculatory function, were evaluated using the IPSS, SHIM-5, and MSHQ-EjD-SF questionnaires, respectively. Outcomes were compared between groups.</div></div><div><h3>Results</h3><div>91 patients chose UroLift® and 45 continued with pharmacotherapy. At 6<!--> <!-->months, a positive impact on quality of life was estimated with UroLift® (0.046; SD: 0.02; <em>P</em> <!-->=<!--> <!-->.067), being significant in subgroups of patients aged &gt;<!--> <!-->65<!--> <!-->years (diff.: 0.034), PSA<!--> <!-->&gt;<!--> <!-->2.2 (diff.: 0.108), diabetes mellitus (diff.: 0.023), hypertension (diff.: 0.011) or hypercholesterolemia (diff.: 0.016). The impact on symptomatology was superior with UroLift® (−10.07; SD: 1.65; <em>P</em> <!-->&lt;<!--> <!-->.001), being significant in subgroups aged &gt;<!--> <!-->65 (diff.: 1.37), prostate &gt;<!--> <!-->40<!--> <!-->cc (diff.: 0.74), PSA<!--> <!-->&gt;<!--> <!-->2.2 (diff.: 2.63), and diabetes mellitus (diff.: 1.66), hypertension (diff.: 1.23). Erectile function was not affected (−0.33; SD: 1.99; <em>P</em> <!-->=<!--> <!-->.868) while ejaculatory function showed a favourable impact (2.98; SD: 1.26; <em>P</em> <!-->=<!--> <!-->.019).</div></div><div><h3>Conclusions</h3><div>Minimally invasive UroLift® system treatment is associated with a positive impact on quality of life and urinary symptoms without adversely affecting sexual function.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 4","pages":"Article 501708"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seguridad y viabilidad de la cirugía retrógrada intrarrenal sin fluoroscopia para la litiasis ureteral y renal no complicada: estudio unicéntrico en una serie amplia de pacientes","authors":"S. Bürlukkara,&nbsp;Ö. Baran,&nbsp;M. Cemre Cevrin","doi":"10.1016/j.acuro.2025.501709","DOIUrl":"10.1016/j.acuro.2025.501709","url":null,"abstract":"<div><h3>Introduction</h3><div>Aimed to investigate the feasibility and availability of fluoroless retrograde intrarenal surgery (fRIRS) in a large patient population.</div></div><div><h3>Methods</h3><div>Patients who underwent fRIRS for ureteral or renal calculi in our center between June 2019 and June 2024 were reviewed. Demographic data, stone characteristics, operation time, perioperative-postoperative complications, perioperative complications, and stone-free rates of patients who underwent fRIRS for ureteral or renal calculi were evaluated. Clavien-Dindo classification was used for complications. All procedures were performed under spinal or general anesthesia.</div></div><div><h3>Results</h3><div>1079 patients were included in the study. Of the 1079 patients, 352 (32.6%) were female and 727 (67.4%) were male. The mean age was 47.33<!--> <!-->±<!--> <!-->14.31 years. The mean size of the stones was 13.1<!--> <!-->±<!--> <!-->6.33 mm3. Of the patients, 208 (19.27%) received general anesthesia and 871 (80.73%) received spinal anesthesia. The mean operation time was 37.14<!--> <!-->±<!--> <!-->17.65<!--> <!-->minutes. All patients received a Double J (DJ) stent postoperatively. The rate of complications was 8% overall. The complications observed in general were minor; postoperative colic pain and hematuria were observed in 36 (3.3%) patients and 26 (2.4%) patients, respectively. Stone-free rate was 86.4%.</div></div><div><h3>Conclusion</h3><div>The fRIRS is a safe and feasible method for the treatment of uncomplicated ureteral and renal calculi. In uncomplicated patients, it has similar complication and success rates to conventional methods and eliminates radiation exposure.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 3","pages":"Article 501709"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suprarrenalectomía retroperitoneal por puerto único: el abordaje del presente","authors":"D. Vazquez-Martul","doi":"10.1016/j.acuro.2025.501694","DOIUrl":"10.1016/j.acuro.2025.501694","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 3","pages":"Article 501694"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impacto oncológico de la resección transuretral de vejiga completa antes de la quimioterapia neoadyuvante en el cáncer de vejiga músculo invasor","authors":"C. Fernandes ,&nbsp;I. Baptista ,&nbsp;M. Manso ,&nbsp;C. Ferreira ,&nbsp;F. Botelho ,&nbsp;J. Silva ,&nbsp;C. Silva ,&nbsp;L. Vale","doi":"10.1016/j.acuro.2025.501712","DOIUrl":"10.1016/j.acuro.2025.501712","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess the impact of cTURBT on pathologic response. Secondary endpoints involved survival and oncologic outcomes.</div></div><div><h3>Methods</h3><div>Tertiary centre data from patients with MIBC submitted to NAC and radical cystectomy between March 2010 and November 2022 was retrospectively analysed. Patients with complete resection (cTURBT) before NAC were compared to those with incomplete (iTURBT).</div></div><div><h3>Results</h3><div>Thirty-seven patients were included in this study. NAC regime was identical between groups. cTURBT group demonstrated a higher rate of downstaging than the iTURBT group (50% vs 20%, <em>p</em> <!-->=<!--> <!-->0.022). During the mean 49-month follow-up period, overall survival (86.4% vs. 40%, <em>p</em> <!-->=<!--> <!-->0.005), relapse-free survival (81.8% vs. 46.7% <em>p</em> <!-->=<!--> <!-->0.036), and cancer-specific survival (90.9% vs 60%, <em>p</em> <!-->=<!--> <!-->0.042) were higher in the cTURBT group. Furthermore, we observed significantly fewer relapses, higher survival rates, and lower oncological-related deaths in patients who exhibited downstaging.</div></div><div><h3>Conclusion</h3><div>cTURBT demonstrated a favourable impact on patients with MIBC undergoing NAC, enhancing pathologic downstaging and improving survival outcomes. Our results can be confounded by cTURBT being a proxy for less aggressive disease.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 3","pages":"Article 501712"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnóstico precoz del cáncer de próstata en los varones sanos portadores de mutaciones germinales en las vías de respuesta al daño del ADN (vías DNA Damage Response [DDR]). Revisión de la literatura y propuesta de protocolo","authors":"A. Rosino Sánchez ,&nbsp;E. García Torralba ,&nbsp;E. Girela Baena ,&nbsp;J.A. Macías Cerrolaza ,&nbsp;J. Tudela Pallares ,&nbsp;M. Zafra Povés ,&nbsp;I. Barceló Bayonas ,&nbsp;V. Muñoz Guillermo ,&nbsp;T. Fernández Aparicio","doi":"10.1016/j.acuro.2025.501686","DOIUrl":"10.1016/j.acuro.2025.501686","url":null,"abstract":"<div><h3>Introduction</h3><div>Men with mutations in DNA damage response (DDR) pathways have a higher risk of developing prostate neoplasia compared to the general population. The best studied alterations are mutations in BRCA1/2, ATM and MMR-Lynch s.</div></div><div><h3>Material and methods</h3><div>A review of the clinical and prognostic implications of mutations in DDR pathways, as well as an evaluation of the different screening strategies available for affected patients.</div></div><div><h3>Objective</h3><div>To propose an early diagnostic strategy for men with mutations in DDR pathways.</div></div><div><h3>Results</h3><div>Current guidelines do not provide clear, specific recommendations for this subgroup of men. Among mutations in the MMR pathway, the germline MSH2 mutation is most strongly associated with prostate cancer. Men with germline mutations in BRCA1/2, ATM, and MSH2 have a higher incidence of prostate neoplasia, tend to develop the disease at a younger age, and are more likely to have aggressive forms of the disease. Furthermore, men with BRCA1/2 mutations have a lower cancer-specific survival rate compared to the general population. In these patients, PSA levels have important limitations in detecting prostate cancer. Multiparametric MRI of the prostate may be more effective than periodic PSA testing.</div></div><div><h3>Conclusions</h3><div>Patients with mutations in DDR pathways are at increased risk for aggressive prostate neoplasms and require earlier and more intensive screening. PSA-based screening has notable limitations. A screening strategy incorporating multiparametric MRI could offer a more effective strategy for this patient group.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 3","pages":"Article 501686"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rabdomiólisis inducida por abiraterona y rosuvastatina","authors":"Ó. Porto Fuentes ,&nbsp;S. Penado Nadela ,&nbsp;S. Martínez Breijo ,&nbsp;B. San Millán Tejado","doi":"10.1016/j.acuro.2025.501689","DOIUrl":"10.1016/j.acuro.2025.501689","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 3","pages":"Article 501689"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cáncer de pene y testículo en receptores de trasplante renal: revisión sistemática sobre la epidemiología, las opciones de tratamiento y los resultados oncológicos realizada por el grupo de trabajo de cáncer de pene y testículo de la Asociación Europea de Urología (EAU-YAU)","authors":"G. Basile ,&nbsp;G. Fallara ,&nbsp;M. Bandini ,&nbsp;W. Cazzaniga ,&nbsp;F. Negri ,&nbsp;L. Dieguez ,&nbsp;F. Montorsi ,&nbsp;A. Salonia ,&nbsp;A. Breda ,&nbsp;C. Fankhauser ,&nbsp;A. Territo","doi":"10.1016/j.acuro.2025.501683","DOIUrl":"10.1016/j.acuro.2025.501683","url":null,"abstract":"<div><h3>Introduction</h3><div>Kidney transplant (KT) recipients are at an elevated risk of developing de novo cancers. However, penile (PeCa) and testis cancers have received limited attention in this setting.</div></div><div><h3>Objective</h3><div>To summarize the epidemiology, treatment options, and oncological outcomes of penile and testis cancer in KT recipients.</div></div><div><h3>Evidence acquisition</h3><div>We conducted a systematic review of prospective, retrospective and national transplant registries studies published up to December 2023. Data on the incidence of penile and testis cancers among KT recipients, diagnostic protocols, screening recommendations, and therapeutic strategies tailored for KT recipients were collected. The risk of bias (RoB) of included studies was determined using the Newcastle and Ottawa scale.</div></div><div><h3>Evidence synthesis</h3><div>Overall, 21 studies involving 67924 KT male recipients were included. PeCa was diagnosed in 33 patients, yielding an incidence ranging from 0.04% to 0.3%. Additionally, 67 cases of testicular cancer were recorded, with an incidence ranging from 0.03% to 0.55%. Most tumors were localized, and histology variants were uncommon. While the surgical treatment of the primary tumor remains consistent with that of the general population, the use of radiotherapy and cytotoxic treatments are less frequently reported in this setting. These therapies should be considered on an individualized basis to minimize the risk of graft injury.</div></div><div><h3>Conclusions</h3><div>Penile and testis cancers are relatively uncommon among KT recipients. General screening protocols and deviation from current treatment guidelines are not recommended in localized diseases. Given the risk of graft damage, any non-cytotoxic option should be preferred in locally advanced cases.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 3","pages":"Article 501683"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Derivación urinaria y calidad de vida: 6 años de seguimiento después de la cirugía para el cáncer de vejiga","authors":"N. Pyrgidis ,&nbsp;J. Hermans ,&nbsp;P. Keller,&nbsp;D. Karatas,&nbsp;B. Ebner,&nbsp;G. Schulz,&nbsp;C. Stief,&nbsp;Y. Volz","doi":"10.1016/j.acuro.2025.501699","DOIUrl":"10.1016/j.acuro.2025.501699","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate health-related quality of life (HRQOL) six years post-radical cystectomy in patients with muscle-invasive bladder cancer, comparing orthotopic ileal neobladder (ONB) and ileal conduit (IC). Therefore, the study aims to analyze the under-investigated long-term impact of standard bladder cancer treatments on HRQOL and provide insights into the HRQOL differences associated with these two common urinary diversion methods.</div></div><div><h3>Patients and methods</h3><div>This prospective study included 39 patients with urothelial carcinoma treated with ONB or IC at our center between 03/2013 and 01/2023. Patients with variant histology, metastasis, neoadjuvant chemotherapy, or benign indications for cystectomy were excluded. HRQOL was assessed using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire preoperatively, at four and six years postoperatively. Statistical analyses included Chi-square tests, T-tests, and logistic regression models.</div></div><div><h3>Results</h3><div>Of the patients, 64% (25/39) underwent ONB, and 76.9% (30/39) were male, with an average age of 69 years. No significant differences in overall good HRQOL (GHS<!--> <!-->&gt;70) were observed between ONB and IC at six years (IC: 60<!--> <!-->±<!--> <!-->22; ONB: 69<!--> <!-->±<!--> <!-->23, p<!--> <!-->=<!--> <!-->0.2). Patients with IC reported higher insomnia at both follow-ups (4 years: p<!--> <!-->=<!--> <!-->0.01; 6 years: p<!--> <!-->=<!--> <!-->0.03). Emotional function remained stable in ONB patients but declined in IC patients from the fourth to sixth years (p<!--> <!-->=<!--> <!-->0.04).</div></div><div><h3>Conclusions</h3><div>Long-term HRQOL did not significantly differ between ONB and IC up to six years post-radical cystectomy. Both urinary diversion methods can be offered to patients, with tailored discussions in terms of HRQOL.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 3","pages":"Article 501699"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}