bluuebunny/crossref_metadata_2025 huggingface dataset:
Timeline for Maximal Subjective Outcome Improvement After Anterior Cruciate Ligament Reconstruction
Authors: Agarwalla Avinesh , Puzzitiello Richard N. , Liu Joseph N. , Cvetanovich Gregory L. , Gowd Anirudh K. , Verma Nikhil N. , Cole Brian J. , Forsythe Brian
Published: November 2018

Background:

Anterior cruciate ligament (ACL) tears are one of the most common traumatic knee injuries experienced by athletes. Return to sport is considered the pinnacle endpoint among patients receiving ACL reconstruction. However, at the time of return to sport, patients may not be participating at their previous levels of function, as defined by clinical metrics.

Purpose:

To establish when patients perceive maximal subjective medical improvement according to patient-reported outcome measures (PROMs).

Study Design:

Systematic review.

Methods:

A systematic review of the PubMed database was conducted to identify studies that reported sequential PROMs up to a minimum of 2 years after ACL reconstruction. Pooled analysis was conducted for PROMs at follow-up points of 3 months, 6 months, 1 year, and 2 years. Clinically significant improvement was determined between pairs of intervals with the minimal clinically important difference.

Results:

This review contains 30 studies including 2253 patients who underwent ACL reconstruction. Clinically significant improvement in the KOOS (Knee injury and Osteoarthritis Outcome Score) was seen up to 1 year after ACL reconstruction, but no clinical significance was noted from 1 to 2 years. Clinically significant improvement in the IKDC (International Knee Documentation Committee) and Lysholm questionnaires was seen up to 6 months postoperatively, but no clinical significance was noted beyond that.

Conclusion:

After ACL reconstruction, maximal subjective medical improvement is established 1 year postoperatively, with no further perceived clinical improvement beyond this time point according to current PROMs. The KOOS may be a more responsive metric to subjective improvements in this patient cohort than other patient-reported outcomes, such as the IKDC and Lysholm.

Clinical Relevance:

After ACL reconstruction, patients perceive interval subjective improvements until 1 year postoperatively.
Amiloidosi Primitiva Localizzata Della Vescica
Authors: Marzullo F. M. , Tallarigo A.
Published: November 2018

L'amiloidosi primitiva localizzata della vescica è una affezione rara, come tutte le altre forme di amiloidosi localizzata (pseudotumore amiloide del tarso, tumore amiloide del laringe, della palpebra, ecc.). La scarsità di osservazioni consegnate alla letteratura non ha consentito di approfondire i suoi rapporti con l'amiloidosi generalizzata, sia primitiva che secondaria, forme queste di piú comune riscontro. Avendo avuto occasione di osservare un caso di amiloidosi localizzata alla vescica, abbiamo ritenuto opportuno farne oggetto di segnalazione, sia allo scopo di prospettarne i problemi di ordine diagnostico e terapeutico, che di approfondirne lo studio nei rapporti con l'amiloidosi generalizzata.
Anatomical and Physio-Pathological Basis of Neurohypophysial - Renal - Adrenal Feed-Back Systems Controlling Renal Function
Authors: Dempster W. J.
Published: November 2018

It has been established that naturally occurring pressor agents (adrenaline vasopressin and angiotensin ii) are all potent renal vasoconstrictors and, of these, vasopressin is the longer lasting and provides a back-ground of renal vasotonicity without which the kidney is unable to concentrate. The vasoconstriction affects particularly the renal outer cortical vessels and vasa recta and is associated with temporary oliguria or anuria (antidiuresis of varying degree). In association with renal outer cortical vasoconstriction there is active dilatation of the vessels supplying the adrenal gland and ovary as revealed by arteriography. Since vasopressin exerts a variable degree of renal vasotonicity according to circumstances, there appears to be an integrated feed-back system linking the neurohypophys's and hormonal responses by the adrenal and ovary through which tubular function is controlled. Since the vascular conduits between the renal artery and the adrenal gland and ovary reveal individual variation, the feed-back system induces responses which vary from modest to hyper-reactive which goes some way to explain the nature of individual responses. Taken in conjunction with other data, the evidence, strongly indicates that hormonal responses by the adrenal gland and the ovary are associated with increased blood flow. The integrated feed-back system assures that increased blood flow to the adrenal gland accompanies the appropriate signal for hormonal release. The widespread involvement of vasopressin in the systems of the body and particularly its influence on tubular function, it has been concluded, derives mainly from its vasopressor effect.

The presented evidence suggests that the medullary arteries of Flint represent the original blood supply of the chromaffin mass which migrates within the adrenal cortex during foetal life. The medullary arteries and venae comites constitute an independent vascular system within the adrenal gland.
Interleuchina 2 nel trattamento dei tumori superficiali della vescica
Authors: Gastaldi E. , Benvenuti S. , Mennini B. , Iacoviello M. , Caviglione M. , Traverso G.B.
Published: November 2018

The Authors report their experience with interleukin 2 given intralesionally and subcutaneously in superficial bladder tumours after transurethral resection. The present study was carried out to evaluate the efficacy and tollerability of a subcutaneous immunotherapy with IL-2 in these tumours.

The study included 16 patients with superficial bladder cancer (Ta-T1 G1-G2) and it showed that IL-2 is an effective and well-tolerated treatment of superficial bladder cancer but a longer follow-up period is necessary.
Impatto economico del cancro della prostata nel comprensorio dell'ULSS n. 23 di Imola
Authors: Vagliani G. , Perrone A. , Salvi G. , Misuriello G. , Di Silverio A. , Valmori V. , Mauceri G. , Creti S. , Batoumeni G. , Fini M.
Published: November 2018

An increase in the incidence of prostate cancer can be expected in proportion to the increase in the elderly population, with a relative increase in expense. In our territory about Lit. 1,275,000,000 a year are spent on managing patients with the disease (0.6% of the total health service budget). Hospitalisation and medical treatment costs account for 49.2 and 41.6% respectively. On the one hand the wide-scale use of LH-RH analogues increases the social costs of the disease (also in comparison to countries like the U.S.A. and Sweden). On the other, it will perhaps produce a saving by lengthening the quiescent stage of the disease and by reducing post radical prostatectomy morbidity. Prostate cancer costs in Western countries will probably remain very high and will be conditioned by new diagnostic techniques, their widespread use and the types of treatment. After an initial increase in expense, early diagnosis (also through mass screening) and early, radical therapy with consequently reduced morbidity, may in the future provide a better quality of life at acceptable costs.
Recidive neoplastiche vaginali di carcinoma vescicale dopo chirurgia demolitiva
Authors: Larosa M. , Ferretti S. , Simonazzi M. , Arena F. , Di Stefano C.
Published: November 2018

We report four cases of vaginal recurrence after cystectomy for bladder cancer. Vaginal recurrences are relatively rare and patients who have undergone previous surgery and radiation to pelvic organs, or patients with tumour of the bladder neck and urethra appear to be at high risk. It is very important to know the predisposing factors in order to adopt appropriate surgical therapy.
Il carcinoma in diverticolo uretrale femminile;
Authors: Turci A. , Farabegoli E. , Nuzzo F. , Martinelli A.
Published: November 2018

We describe a rare case of clear cell adenocarcinoma in urethral female diverticula at an early stage (pT1 N0 M0). Diverticulectomy is the first surgical approach after urethroscopy, C.T. and ultrasonography.
CDDP + EPB nel carcinoma prostatico D2 in progressione: Risultati a distanza
Authors: Cocimano V. , Pugno E. , Pastorini S. , Cevoli R. , Marino G. , Perolino R. Marten
Published: November 2018

The Authors present their results of the treatment of prostatic carcinoma D2 with platinum and pharmorubicin.
Nostra esperienza nell'uso delle spirali intraprostatiche
Authors: Rosa A. , Iannicelli P.
Published: November 2018

A spiral urethral prosthesis was inserted under local anesthesia in 6 patients with benign prostatic hyperplasia and 2 patients with cancer of the prostate, using ultrasonic guidance. All the patients had either refused the surgical procedure or were a high operative risk. The Authors showed the usefulness of ultrasound for insertion of the intraprostatic spiral in selected patients.
Impalamento e lesioni retto-vescicali
Authors: Bondavalli C. , Bruni T. , Pegoraro C. , Schiavon L. , Dall'Oglio B. , Luciano M. , Parma A.
Published: November 2018

Impalement with associated bladder injuries was observed in 4 patients. The treatment should be individualised but careful debridement of all necrotic tissue, urinary and fecal diversion, separation of the injured sites with wall-vascularised tissue such as peritoneum or omentum should reduce the high incidence of fistulae or bladder stones. Endoscopic or surgical exploration of the bladder is mandatory because foreign bodies risk creating calculi, like in our 2 cases.
Azoospermia Ostruttiva: Incidenza, Tecnica e Risultati
Authors: De Rose A.F. , Scotto S. , Oppezzi G.F. , Quattrini S. , Repetto U. , Lillo M. , Audino P.
Published: November 2018

From 1991 to February 1994 we observed 40 patients affected by azoospermia. The reasons for azoospermia were various: contraceptive vasectomy 2 patients, deferential agenesia 2 patients, bilateral testicular hypotrophy 12 patients, specific and aspecific infections 8 patients, hypogonadotropic hypogonadism 1 patient, Klinefelter syndrome 1 patient, 5 patients had severe oligoastenospermia (< 5 mil/ml) with mono and bilateral epididymal cysts connected with left varicocele in one patient. 9 patients with azoospermia had II and III degree varicocele. In 5 patients recanalization was carried out: epididymovasostomy in 2 cases (1 laterolateral and 1 terminoterminal) and vasovasostomy (3 cases). In the 2 patients who underwent microsurgical epididymal sperm aspiration (MESA) we took from 12 to 38 millions of spermatozoa. 40 days after the recanalization, spermatozoa appeared in the semen of all the patients. In the azoospermic patients affected by varicocele who underwent venous reflux correction, no spermatozoa were found after 18 months. Only a few azoospermic patients (12.5%) could undergo the recanalization treatment.
Neoplasia del Testicolo: La Nostra Esperienza, Opinioni a Confronto
Authors: Caotorta M. Marzotto , De Giovanni M. , Spinelli M. , Faccendini E. , Fanciullacci F. , Beretta G. , Zanollo A.
Published: November 2018

We treated 79 patients with a neoplastic pathology of the testicle between 1972 and 1993. The average age of patients was 35 (range 17-75). Seminoma were treated with precautional and/or therapeutic cycles of TCT. In the 14 cases (38.8%) of non-seminomatous germ cell tumours (NSGCT) there was a difference between the clinical and the pathological staging after retroperitoneal lymph-node dissection (RPLND). Mortality due to progression of the disease was 3.8%. The 17 patients (47.2%) who underwent RPLND had an andrological follow-up (10 patients with normal ejaculation and 7 with no ejaculation). We confirm the under-staging of preliminary diagnostic investigations. Unlike some authors, we feel that conservative action (orchiectomy alone), is not sufficient even in first stage NSGCT.
Le basi anatomiche della prevenzione dei danni neurogeni in corso di chirurgia radicale pelvica nella donna
Authors: Frea B. , Kocjancic E. , Musci R. , Meroni T.
Published: November 2018

Radical pelvic surgery in women is considerably handicapped by serious neurogenic complications, commonly due to lesions in the inferior hypogastric plexus or its branches, which cannot be easily identified in the female pelvic cavity. The pelvic cavities of 42 adult female cadavers were studied and the relations between the nervous structures and the cardinal and utero-sacral ligaments were analysed. The possibility of identifying and recognising in vivo anatomical findings of the pelvic plexus is the fulcrum of nerve sparing pelvic surgery.
Crescita e morfologia della linea cellulare prostatica umana U285 trattata con mepartricina, finasteride e suramina: Confronto tra i farmaci
Authors: De Angeli S. , Buoro S. , Favretti C. , Bonini M. , Fandella A. , Anselmo G.
Published: November 2018

The aim of this study was to compare the effects of mepartricin on the proliferation and morphology of U285 cells with those induced by suramin and finasteride, both substances which have been investigated previously. Proliferation was evaluated by the FRAME Cytotoxicity Test, exposing the cells to increasing doses of mepartricin, between 0.1 μg/ml and 5 μg/ml, from the moment of seeding for 24 hours. The morphology was evaluated by scanning electron microscope (SEM). The FRAME Test showed a statistically significant decrease (p<0.05) in proliferation at all times of observation and at all doses in those cultures exposed to mepartricin right from seeding. Those where treatment was given 24 hours later, only showed this decrease with the highest doses. SEM highlighted the reduced capacity of the cells to proliferate, confirming data from the FRAME Test. These results therefore indicate that mepartricin has an anti-proliferation effect both in the Lag phase and the logarithmic growth phase. This behaviour differs from that of suramin and finasteride, which have less marked effect on cellular growth.
Trattamento chirurgico nell'impotenza vasculogenica da fuga venosa: Esperienza e risultati
Authors: Savino A. , Cantoni C. , Pieri I. , Sacchini P. , Prati A. , Arnaudi R. , Potenzoni D.
Published: November 2018

Venous leakage is one of the most important causes of erectile dysfunction. The ligation and resection of the deep dorsal vein of the penis and all anastomoses from this vein allow considerable improvement in the rigidity of the penis and erection.
Trattamento chirurgico del serbatoio vescicale in funzione del trapianto: Esperienza clinica su 20 casi
Authors: Catanzaro F. , Zanollo A. , Cappellano F. , Pizzoccaro M. , Torelli F. , Sironi D.
Published: November 2018

15% of patients affected by severe renal insufficiency have morphological changes in the lower urinary tract with related functional impairment (low capacity, low compliance, incontinence, alterated voiding) that limit renal transplantation. We report on our experience (Desio, Magenta) in the surgical treatment of vesical reservoir in 20 patients: 17 out of 20 have restored their lower tract function and were eligible for renal transplantation. We also sum up the surgical procedures that allowed this condition.
Ecografia uretrale endoluminale
Authors: Frea B. , Kocjancic E. , Musci R. , Meroni T.
Published: November 2018

The preliminary results of an ultrasound study of the anatomy of the female urethra are presented. In this study an intraluminal probe was used and the results were compared with permicturitional transvaginal ultrasound data. Both morphometric and morphological results of the two methods coincided. The images obtained with the intraluminal ultrasound probe gave more information on the urethral mucosa, allowing a circular display of the mucous layer being examined.
Ritenzione urinaria acuta in giovani donne con sindrome uretrale. Protocollo diagnostico e terapeutico
Authors: Seveso M. , Ceresoli A. , Zanetti G. , Trinchieri A. , Guarnieri A.
Published: November 2018

The Urethral Syndrome is defined as lower urinary symptoms in women in the absence of bladder bacteriuria. Symptoms include straining to void, urgency frequency, hesitation, incontinence, retention and subpubic pain. In females affected by urethral syndrome some authors have found histological degeneration and urodynamic alterations, such as significantly higher than normal maximum urethral closure pressure, low urinary flow rates. The authors studied 5 women with urethral syndrome, and acute or chronic urinary retention. A personal therapeutic approach is presented.
Neoplasie primitive della vescica pT1-G3: Recidive e progressioni. Dieci anni di follow-up: Primitive bladder neoplasms pT1-G3: Recurrences and progression. Ten years of follow-up
Authors: De Berardinis E. , Von Heland M. , Zarrelli G. , Giulianelli R. , De Vico A. , Oke E. , Battista G. , Di Silverio F.
Published: November 2018

72 primitive bladder cancer patients pT1G3, 64 males and 8 females, mean age 62.3, underwent T.U.R. or T.V.R. In this series we evaluated the percentage of recurrences, progression and survival, with a follow-up of 10 years. Among 72 patients, 26 showed unifocal lesions and 46 multifocal lesions. In the case of progression, patients underwent radical surgery (cystectomy). After 10 years the 26 patients with unifocal lesions showed a 90% recurrence rate and 56% progression rate, while the 46 patients with multifocal lesions showed 100% recurrence rate and 71% progression rate. A multivariate analysis was done, considering patient age and sex, number of lesions (unifocal or multifocal) and DNA ploidy (diploid/aneuploid). Only the DNA pattern was a determining factor for selecting progression risk cases. PT1 bladder cancers must be considered as invasive forms. Very careful therapeutic evaluation is therefore necessary.
Importanza dei criteri di selezione nei pazienti sottoposti a terapia ormonale neoadiuvante e prostatectomia radicale per carcinoma prostatico: Selection criteria for patients undergoing neoadjuvant hormonal therapy and radical prostatectomy for prostate cancer
Authors: D'Eramo G. , Buscarini M. , Sciarra A. , Casale P. , Di Nicola S. , Loreto A. , Colella D. , Di Chiro C. , Diana M. , Di Silverio F.
Published: November 2018

From April 1989 until December 1993, 73 prostatic cancer patients underwent radical retropubic prostatectomy; 27 among the above-mentioned patients, mean age 65 years, mean follow-up 17.4 months, were treated with total androgen blockade for a period of 6 months before radical surgery. Selection criteria were: clinically locally advanced disease, high PSA levels and Gleason score ≥ 4. Stage reduction (downstaging), PSA variations, grade alterations (downgrading) and influence of DNA ploidy on recurrences has been evaluated. Overall downstaging has been 30%. In C2-D1 stages the effects of hormonal treatment have been particularly significant: only 12 of the 17 clinical C2 tumours where confirmed at pathological examination and of the 4 D1 cases, only one showed pathological involvement of the lymph nodes. PSA regression to undetectable levels has been noted in 48% of patients; preoperatively 46% of cases presented PSA levels > 10 ng/ml while the same held true for only 14.5% of patients at surgery. The so-called downgrading has been of marginal entity in our series. Nuclear ploidy seems to play a major role in disease-free survival. Aneuploid DNA content conferred a significantly higher risk of local and distant relapses in all stages. Nuclear aneuploidy also correlates well with lower PSA production.
Diagnosi e trattamento della patologia ascessuale dello psoas: Diagnosis and treatment of the psoas abscess
Authors: Longoni E. , Larcher P. , Casu M. , Tonazzi G.L. , Bonfioli C. , Motta F. , Urani A. , Bergonzi B.
Published: November 2018

Abscessual pathology of the psoas muscle is very infrequent: however it must be considered in the differential diagnosis during ultrasound examination involving the retroperitoneum. This work describes 2 cases of abscessual pathology of the psoas muscle, clinically unsuspected but diagnosed by ultrasound. In both cases drainage of the abscess was executed by means of ultrasound and computerized tomography guide.
Tavola Rotonda su: “Fattori prognostici e markers nel carcinoma della vescica”. Aspetti generali e introduttivi: Round Table on: “Prognostic factors and markers in bladder carcinoma”. General and introductory aspects
Authors: Mobilio G.
Published: November 2018

Bladder tumours are generally grouped as superficial or invasive because of their different therapeutical regimens. Superficial tumours still cause uncertainties in choosing the best treatment due to their heterogeneity and different behaviour. In the prevision of these tumours it is important to consider all the factors that could influence the prognosis: tumoral characteristics, grading and staging mistakes, effects of the therapy and immunological response. Moreover it is important for clinical studies to have appropriate end points. Prognostic factors and markers with high predictive value can allow specific treatment for the individual cases to be planned.
I parametri clinici, endoscopici e patologici nella valutazione delle potenzialità evolutive dei tumori superficiali della vescica: Clinical, endoscopic and pathological parameters in assessing the potential progression of superficial bladder tumours
Authors: Schiavone D. , Pianon R. , Comunale L. , Mobilio G.
Published: November 2018

Clinical, endoscopic and pathological assessment provides the classical factors of prevision for bladder tumours. The risk of recurrence is different among primary and recurrent tumours. The risk of recurrence for primary tumours is correlated to the number of neoformations at diagnosis and to the cystoscopy at three months. The risk of recurrence for recurrent tumours is correlated to the number of neoformations and the previous recurrence rate. It seems that the number of recurrences doesn't imply a higher risk of progression. The most important endoscopic parameters are: number, shape and size of neoformations, and appearance of the vesical mucosa. The most important pathological parameters are: growth pattern, grade, stage, histologic aspect of the vesical mucosa and invasion of lymphatic vessels. All these parameters are correlated to the risk of tumour progression for groups of patients but they cannot predict the fate of the individual case. The predictive value of these parameters could improve with a critical revision of the definitions of grade and stage.
Espressione di oncogeni di proliferazione e morte cellulare nel carcinoma superficiale della vescica: Expression of oncogenes in relation to cell proliferation and death in superficial bladder carcinoma
Authors: Ferrari G. , Castagnetti G. , Dotti A. , Galizia G. , Ferrari P. , Righi E. , Migaldi M. , De Gaetani C. , Trentini G.P.
Published: November 2018

Although superficial bladder cancer may be considered “benign”, it is still today a many-sided neoplasm with a prognosis that cannot be well-defined with known traditional parameters. Proliferation indices Ki67 and AgNOR associated with the expression of some oncogenes (p53, Rb, c-myc, BCL2, c-erbB-2) in relation to traditional parameters could help in the prognosis definition of individual patients. 111 patients with superficial bladder cancer were studied for this purpose, relating the grade, stage, follow-up and morphotype to the proliferation indices. Significant correlations were found with AgNOR, but only for grade with Ki67. The study of the oncoproteins and their different expression showed that those alterations typical of infiltration are already present in the superficial forms, with a significant correlation between oncogenic alterations and grade and stage of disease (p53, Rb) on the one hand, and above all of disease-free interval and progression (c-erbB-2) on the other. Lastly, assessment of the oncoproteins c-myc and BCL2, oncogenes connected with the programmed cell death mechanism (apoptosis), showed important correlations with the neoplastic progression of disease in relation to the p53 expression and proliferative activity.
Introduzione: Introduction
Authors: Guazzieri S.
Published: November 2018

The importance of early diagnosis is by now accepted. As urological pathologies predominantly involve men, it is natural for the urologist to seek co-operation regarding primary and secondary prevention with the Medical Corps. Paediatricians and family doctors are the other professional figures who play a fundamental role in this field. The records are given of the congress “Prevention and early diagnosis of urological diseases” between the Military Corps and the National Health Service, held at Belluno in June 1994.
Lo screening del cancro della prostata: Stato dell'arte: Screening for prostate cancer: State of the art
Authors: Zattoni F. , Vianello F.
Published: November 2018

High incidences for prostatic cancer and mortality related to tumour have a serious impact on society. In these few last years there has been an emerging interest in the opportunity and possibility of a screening programme for this cancer. At present no certain data exist on the utility of a screening programme in asymptomatic males. The only proposable programme appears to be a pilot study to evaluate the capacity to reduce mortality related to prostate cancer or at least to improve the quality of life in cases diagnosed through a screening programme.
Transitional cell carcinoma of the upper urinary tract: Follow-up and prognostic factors
Authors: Pagano F. , Tasca A. , Levorato C.A.
Published: November 2018

— Of the 176 patients treated in our Institute over the last 16 years for upper tract transitional cell carcinoma (UTTCC), 155 were included in this study, 97 of whom had undergone nephroureterectomy, 28 conservative surgery and 30 endourologic treatment. The overall survival rate at 5 and 10 years was 73% and 58%, respectively. Univariate analysis of overall survival rate (O.S.) and disease-free survival rate (D.F.S.) showed no difference between patients with superficial and with invasive tumours, while multivariate analysis highlighted a difference. No difference was evident upon univariate and multivariate analysis of the patients with superficial tumours who underwent conservative (19) vs. radical (45) surgery. The same can be said for the so-called good prognosis tumours (pTa-T1-G2) and poor prognosis tumours (pT1-G3, pT2-4, G2-3) submitted to radical surgery. Overall survival was better in patients with no recurrent tumours compared to those with recurrences; furthermore prognosis was worse for patients with more than 2 recurrences. Tumour site, mono or multifocality and associated bladder tumour did not influence prognosis. Our experience confirms the basic importance of grade as a prognostic factor for UTTCC and the favourable prognosis for patients with superficial tumours, regardless of surgical technique. A rigid follow-up is mandatory for patients with more than 2 recurrences.
Intracavernous auto-injection of prostaglandin E1 for diagnostic evaluation and treatment of diabetic patients with erectile dysfunction
Authors: Arielly J. , Guy M. , Coslovsky R.
Published: November 2018

— In this paper we describe our experience in the treatment of impotence with intracavernous self-injection of prostaglandin E1 in 55 diabetic patients. Overall results show that 49 out of the 55 (89%) patients are satisfied with this method of treatment and have continued to use it for more than 3 years. Two thirds of the partners also reported an improvement in their sexual life. Complications were no more frequent than in non-diabetic men and were all of a minor nature.
AMS 800® artificial sphincter: An unusual case of circumscribed peritonitis due to prosthethic reservoir infection
Authors: Liguori G. , De Stefani S. , Ciampalini S. , Belgrano E.
Published: November 2018

— We report the case of a patient who presented with circumscribed peritonitis due to infection of the intraperitoneal reservoir of an artificial sphincter. Although only parietal symptoms were evident, the balloon could not be removed without segmental ileal resection. This case suggests re-examining indications for intraperitoneal implantation of the reservoir.
Prolonged chemotherapy in advanced urinary cancer: Ethical considerations
Authors: Spasari A. , Scalfari A. , Falvo F. , Pirritano D. , Ventrice G.A. , Zagordi A.A. , Martino L.F. , Lanza P.
Published: November 2018

The authors report their experience with 10 patients subjected to chemotherapy for urinary cancer. The decision to prolong therapy sprang from the persistent efficacy of the same and the will to live of the actual patients, while respecting the classical moral principles of bioethics.
Post-voiding contraction (PVC): Manifestation and characterisation in over 100 patients
Authors: Di Meglio G. , Zucconelli R.
Published: November 2018

The Authors report their experience of post-voiding contraction (PVC) in 173 consecutive functional studies of the female lower urinary tract. A lack of significant correlations between the various urodynamic pictures was noted on the one hand and between the PVC and their extent on the other. It is suggested that there may be a connection between the presence of PVC and that of two clinical symptoms i.e. enuresis and mixed urinary incontinence; this was observed in 75% and 63.2% of the cases respectively. Considering PVC as not being a true form of detrusorial instability, in the genesis of which a possible reduction in pelvic muscle tone cannot be excluded, the utility of a vesico-sphincteric fuctional study is highlighted. This study aims at defining not only urethral activity, but also that of the pelvic plane musculature, due to the well-known interdependence between perineal and detrusorial activity.
Report on: “Laparoscopy in Urology. Five years experience”. Introduction
Authors: Belgrano E.
Published: November 2018

Laparoscopy first arrived in Urology five years ago. From modest diagnostic manoeuvres, laparoscopy has progressed to complex ablative and reconstructive procedures. In our regions many Urological Departments have developed different experiences in such procedures. The aim of this meeting is to evaluate results and to establish the correct indications of the various procedures.
Laparoscopic lymphadenectomy for clinical stage I nonseminomatous testicular tumour
Authors: Siracusano S. , Trombetta C. , Savoca G. , De Giorgi G. , Zanon M. , Plaino F. , D'Aloia G. , Belgrano E.
Published: November 2018

We report our experience in laparoscopic lymphadenectomy in non-seminomatous stage I testicular neoplasia. This technique is an alternative to the formal retroperitoneal lymphadenectomy. Between 1993 and 1996 we carried out 8 retroperitoneal laparoscopic lymphadenectomies in patients, aged 19–40 years, affected by non-seminomatous testicular neoplasia. We removed from 13 to 24 lymph nodes. Operating time ranged between 200 and 300 minutes. The mean stay in hospital was 5 days. Histological findings revealed micrometastatic lymph nodes in half the patients. No complications were reported except in one patient, who underwent TC-guided drain owing to voluminous lymphocele one week after the laparoscopic operation. Normal antegrade ejaculation was preserved in all cases and no retroperitoneal recurrence was noted at a mean 18 months follow-up.
Nursing nel paziente urologico, anziano, operato: Nursing of the elderly urological patient
Authors: Barbieri A. , Monica B. , Sebastio N.
Published: November 2018

There are two important issues in the postoperative management of the urological elderly patient: complications and rehabilitation. Aging is associated with a loss of homeostatic reserve that may lead to postoperative complications due to drug interaction, malnutrition, infection, defects in wound healing, and poor psychological state. Furthermore rehabilitation, if not properly planned or implemented may influence not only the quality of life, but also the whole treatment results. The authors, in relation to pathogenetic aspects, describe what to do to prevent complications and to promote patient recovery. They conclude that both urologists and nurses must have specific geriatric training and that a psychiatrist, dietician, geriatrician and physiotherapist should be part of the team caring for the elderly surgical patient. Finally discharge from hospital must not be the end of therapy: in selected patients nursing management may continue at home reducing morbidity and mortality and helping better rehabilitation.
Una Soluzione Economica per il Trattamento Della Trombosi Cavale Intraepatica Nell'anziano: Intrahepatic Tumour Trombectomy: An Economic Therapeutic Option in Elderly Patients
Authors: Trombetta C. , Liguori G. , Siracusano S. , Savoca G. , Buttazzi L. , Zingone B. , Belgrano E.
Published: November 2018

Radical excision of renal cancer with propagation into the intrahepatic and intrapericardial inferior vena cava (IVC) has become an accepted surgical approach. We present a case of left radical nephrectomy for renal cancer with IVC sovrahepatic involvement, in which we verified the possibility of approaching the intrapericardial IVC through a limited diaphragmatic incision, thereby avoiding the more invasive sternotomy. The advantages of this approach are: lesser invasiveness, simpler control of the upper extension of the thrombus and decreased blood loss.
La fibrosi retroperitoneale idiopatica. Terapia medica: Idiopathic retroperitoneal fibrosis. Medical treatment
Authors: Tallarigo C. , Puce R. , Porcaro A.B. , Curti P.
Published: November 2018

Medicai treatment of both idiopathic and secondary retroperitoneal fibrosis (RPF) aims at stopping the inflammatory process in the early stage of the disease. Glucocorticoids and non-steroidal antiestrogen drugs are used. Methylprednisolone, the most commonly used glucocorticoid, is successfully employed with different therapeutic protocols. Although based on a few cases, results of treatment with tamoxifen are also satisfactory. The authors report 25 cases of RPF, idiopathic in 14 and secondary in 11. Twelve patients underwent medical therapy, corticosteroids being used in 10 and tamoxifen in 2. All patients recovered from the fibrotic disease. Only 1 patient stopped steroid therapy due to worsening diabetes. Easy administration and the lack of side effects make tamoxifen a valid alternative to corticosteroids.
Risultati preliminari di un'indagine sul territorio sui fattori di rischio dei disturbi dell'erezione: Preliminary results of an investigation into the risk factors of erectile deficit
Authors: Piediferro G. , Sorrentino F. , Coppola A. , Cuomo M.A. , Di Palma A.
Published: November 2018

The authors report the results obtained from an investigation carried out on their territory regarding the risk factors of erectile deficit. Apart from having achieved the real purpose (publicising the matter and the activity of the Urological Andrology Centre), some interesting data were also obtained.
La Yohimbina nel deficit dell'erezione: Studio retrospettivo: Yohimbina in erectile deficit: Retrospective study
Authors: Piediferro G.
Published: November 2018

A brief literature review shows that Yohimbina gave 45-65% satisfactory results when used to treat erectile deficit. The author then makes a retrospective evaluation of 58 patients, comparing them with a control group of 12 patients treated with a placebo (vit. A+E). The effectiveness of Yohimbina, prescribed with magistral prescription, proved to be between 40 and 70%, depending on the patient's age and type of erectile deficit, and was certainly superior to the placebo.
Access and Health System Impact of an Early Intervention Treatment Program for Emerging Adults with Mood and Anxiety Disorders
Authors: Anderson Kelly K. , John-Baptiste Ava , MacDougall Arlene G. , Li Lihua , Kurdyak Paul , Osuch Elizabeth A.
Published: November 2018

Objectives:

Early intervention programs are effective for improving outcomes in first-episode psychosis; however, less is known about their effectiveness for mood and anxiety disorders. We sought to evaluate the impact of an early intervention program for emerging adults with mood and anxiety disorders in the larger health system context, relative to standard care.

Methods:

Using health administrative data, we constructed a retrospective cohort of cases of mood and anxiety disorders among emerging adults aged 16 to 25 years in the catchment of the First Episode Mood and Anxiety Program (FEMAP) in London, Ontario, between 2009 and 2014. This cohort was linked to primary data from FEMAP to identify service users. We used proportional hazards models to compare indicators of service use between FEMAP users and a propensity score–matched group of nonusers receiving care elsewhere in the health system.

Results:

FEMAP users ( n = 490) had more rapid access to a psychiatrist relative to nonusers (hazard ratio [HR], 2.82; 95% confidence interval, 2.45 to 3.26; median time, 16 vs. 71 days). In the year following admission, FEMAP users also had lower rates of emergency department use for mental health reasons (HR, 0.73; 95% CI, 0.53 to 0.99). We did not observe differences in psychiatric hospitalization rates.

Conclusions:

An early intervention model of care for mood and anxiety disorders is associated with better access to psychiatric care and lower use of the emergency department. Our findings suggest that early intervention services for mood and anxiety disorders may be beneficial from a health systems perspective, and further research on the effectiveness of this model of care is warranted.
Children Born With Congenital Zika Syndrome Display Atypical Gross Motor Development and a Higher Risk for Cerebral Palsy
Authors: Marques Fernanda J. P. , Teixeira Marta C. S. , Barra Rafael R. , de Lima Fernanda M. , Dias Bruno L. Scofano , Pupe Camila , Nascimento Osvaldo J. M. , Leyser Marcio
Published: November 2018

Importance:

Congenital Zika syndrome virus infection is said to interfere in children’s development.

Objective:

evaluate gross motor trajectories and the frequency of cerebral palsy in children with congenital Zika syndrome.

Design:

Cohort study applying the Alberta Infant Motor Scale (AIMS) and the Bayley III Scales in infants from 6 to 18 months of age.

Setting:

The SARAH network, Rio de Janeiro.

Participants:

Thirty-nine infants whose diagnoses were established through clinical history, serology tests, and neuroimaging findings. Main outcomes and measures: Congenital Zika syndrome is associated with severe motor delays and is a risk factor to the diagnosis of cerebral palsy.

Results:

The Alberta Infant Motor Scale mean raw score at 6 months was 9.74 (SD 4.80) or equivalent to 2 to 3 months of motor developmental age. At the age of 12 months, 14.13 (SD 11.90), corresponding to 3 to 4 months of motor development age; the Bayley III Scales results correlated to the Alberta Infant Motor Scale ( P < .001) at this age. At 18 months, 15.77 (SD 13.80) or a motor development equivalent to 4 to 5 months of age. Thirty-five of 39 children (89.7%) met criteria for the diagnosis of cerebral palsy. Conclusions and relevance: Gross motor development marginally progresses from 6 to 18 months of age. These individuals also displayed a high frequency of cerebral palsy.
French Validation of the Domestic Violence Myth Acceptance Scale (DVMAS)
Authors: Lelaurain Solveig , Fonte David , Graziani Pierluigi , Monaco Grégory Lo
Published: November 2018

The Domestic Violence Myth Acceptance Scale (DVMAS) was developed to study widely held stereotypical attitudes and beliefs, which contribute to the minimization and justification of intimate partner violence (IPV). This research aims to validate a French version of the DVMAS. In Study 1 ( N = 282), we tested the structure of the DVMAS. Results revealed that the scale displayed reasonable fit indices. In Study 2 ( N = 296), we assessed convergent and discriminant validity. The scale was positively correlated with belief in a just world, ambivalent sexism, and gender-specific system justification. In Study 3 ( N = 156), we tested the predictive validity of the DMAS. Results showed that participants who endorsed more myths also placed more responsibility on the victim of IPV, exonerated the aggressor more, and perceived the violence as less severe. Broadly speaking, results provide evidence of reliability of the French DVMAS and domestic violence myths are commonplace and impact the representation of violence. This scale could contribute to improve certain aspects at stake in the negative judgments against victims of IPV in France.
Compensating Tipped Work: Security Cameras as a Tool for Time Use Measurement
Authors: Campion Emily D. , Campion Michael C. , Campion Michael A.
Published: November 2018

While tipped labor is common in the United States, it presents potential issues for employers unable to demonstrate how tipped workers use their time, thus violating the Fair Labor Standards Act and attracting lawsuits. According to the Fair Labor Standards Act, if tipped employees spend more than 20% of their workweek completing non-tipped tasks (e.g., cleaning, stocking), then they are eligible for the Federal minimum wage ($7.25 in 2018) for the hours beyond 20%, rather than the minimum wage for tipped employees ($2.13 in 2018). Traditionally, employers have used self-report data or observers to determine time use, but these are problematic given self-report bias and the Hawthorne effect. In response, we conducted a study using security cameras to document employee time use in a sample of employees at a large chain restaurant. We found that the sample did not violate the 20% rule. Furthermore, we demonstrated an alternative method to study time use with technology most service-based companies already have.
Trends in Sedentary and Physical Activity Behaviors in Incarcerated Adolescent Boys During a Sports, Play, and Recreation for Kids Program
Authors: Brusseau Timothy A. , Burns Ryan D. , Hannon James C.
Published: November 2018

Purpose:

To examine the trends in total and segmented sedentary and physical activity behaviors during a Sports, Play, and Recreation for Kids (SPARK) program in incarcerated adolescent boys.

Design:

Longitudinal trend analysis.

Setting:

Two juvenile justice facilities.

Subjects:

Eighty-six adolescent boys (mean age = 17.1 ± 1.0 years).

Intervention:

Sports, Play, and Recreation for Kids implemented over 36 weeks.

Measures:

Sedentary times and physical activity were examined at baseline and at 3 follow-up time points at 12, 24, and 36 weeks after SPARK implementation. Physical activity was assessed using the percentage of accelerometer wear time within each segment for sedentary (%SED) and moderate-to-vigorous physical activity (%MVPA).

Analysis:

Trends in %SED and %MVPA were assessed using 2 × 4 doubly multivariate analysis of variance tests.

Results:

For the total week, there was a significantly lower %SED (mean difference = −10.6%, P < .001) and significantly higher %MVPA (mean difference = +3.0%, P < .001) at the 24-week follow-up compared to baseline. There were also significantly lower %SED and higher %MVPA before school, after school, and during the weekends at 24-week follow-up compared to baseline ( P < .01).

Conclusion:

There were significantly lower sedentary times and higher levels of physical activity during the middle portions of the SPARK intervention in incarcerated adolescent boys, highlighting the potential of this intervention to affect sedentary and physical activity behaviors in the population.
Experimental study of sloshing noise in a partially filled rectangular tank under periodic excitation
Authors: Golla Siva Teja , Mayur K , Venkatesham B , Banerjee R
Published: November 2018

Liquid sloshing is becoming a major source of noise in hybrid and high-end luxury cars, especially during acceleration/deceleration driving conditions. This is due to the reduction in noise from other sources, namely, engine, transmission system, road–tyre interaction and so on. Sloshing noise is highly dependent on fluid motion in the containers. Based on the fluid motion in the containers, sloshing is classified into different regimes. The present experimental study discusses the noise generation mechanisms for various sloshing regimes. It is done by emulating different sloshing regimes in a partially filled rectangular tank by imposing longitudinal periodic excitation. The effect of fill level on noise generation phenomenon in each regime is analysed, individually, using dynamic response parameters and high-speed camera images. In this study, the measured dynamic response parameters are pressure, force, acceleration and sound pressure levels as a function of time. The fundamental reasons for the cause of sloshing noise in partially filled rectangular tanks are identified in terms of fluid motion and its interaction with the surrounding objects. The excitations upto the sloshing resonance condition cause hydraulic jumps along the tank walls leading to hit noise. Excitations beyond the sloshing natural frequency cause the predominant interaction of surface waves with surrounding fluid leading to splash noise.
Field investigation and full-scale model testing of mud pumping and its effect on the dynamic properties of the slab track–subgrade interface
Authors: Huang Junjie , Su Qian , Wang Wei , Phong Pham Duc , Liu Kaiwen
Published: November 2018

Passenger comfort and safety are the most important aspects in the operation of high-speed railways. Mud pumping is a typical problem that occurs in the slab track and the subgrade interface, which influences passenger comfort and safety. In this paper, various field investigations and a full-scale model of the slab track and the subgrade are presented. The external and internal characteristics of mud pumping in the slab track–subgrade interface and the influence of mud pumping on the dynamic properties of the slab track–subgrade are analyzed. The results show that mud pumping only occurs at the expansion joints in the concrete base of the slab track structure. This happens due to the infiltration of rainwater into the subgrade bed through the cracks in the expansion joints. When the upper layer of the subgrade is kept saturated in the full-scale model, mud pumping is found to occur after 3.0 × 104 loading cycles. The vibration ratio of the subgrade surface to the concrete base gradually increases with continued cyclic loading. In addition, the cumulative settlement of the subgrade increased continuously. After 2.0 × 106 loading cycles, it was found that a large volume of slurry composed of water and fine particles was squeezed out of the subgrade bed, and mud pumping occurred on the surface of the subgrade bed leading to the formation of a mud layer between the concrete base and the subgrade bed, causing a loss of contact between the subgrade bed and the concrete base. This reduces the ability of the subgrade bed to support the slab track structure.
Experimental investigation of flow topology over a Lambda wing with varying leading edge shape
Authors: Changqing Liu , Zengjun Li , Qi Liu
Published: November 2018

In need of high lift/drag ratio design for high-speed unmanned combat aerial vehicles with the Lambda wing configuration, a wind tunnel test is conducted at Mach number 0.4 to select leading edge shapes in consideration of initial compression effect, which in fact takes place during climbout/descending stages. Flow topology over the lee side of the test model is analyzed at Mach number 0.4. Results show that leading edge shapes with a comparatively high lift/drag ratio have a consistent topological structure. Lift/drag properties at the cruise condition are investigated at Mach number 0.75. Aerodynamic forces are measured by a strain gage balance, and the oil flow technique is adopted to obtain flow patterns across the surface of the model. The visualized flow results are further used to analyze vortex formation and development within focused regions.