bluuebunny/crossref_metadata_2025 huggingface dataset:
Emotional exhaustion, burnout, and perceived stress in dental students
Authors: Jiménez-Ortiz JL , Islas-Valle RM , Jiménez-Ortiz JD , Pérez-Lizárraga E , Hernández-García ME , González-Salazar F
Published: July 2019

Objective

As in other health sciences, a career in dentistry is associated with numerous stressors in practitioners. The main objective of this research was to examine the prevalence of emotional exhaustion, burnout, and perceived stress among dental students in Mexico.

Methods

A cross-sectional study was conducted among 73 dental students attending a private university in Northern Mexico. Three scales were administered to students to identify emotional exhaustion, burnout, and perceived stress, and parametric data analysis was performed.

Results

Among participants (mean age 19.7 years), the proportion with emotional exhaustion, perceived high stress, and burnout was 52.0%, 42.3%, and 17.8%, respectively. All students with perceived stress also had burnout.

Conclusions

We found that emotional exhaustion and perceived stress are experienced by a large proportion of dentistry students enrolled in the third semester at this private university in Northern Mexico. The proportions were independent of age and sex.
Challenges facing community-dwelling adults with hemophilia: Implications for community-based adult education and nursing
Authors: Okide Charity Chinelo , Eseadi Chiedu , Koledoye Uzoamaka Lucynda , Mbagwu Felicia , Ekwealor Nwakaego Ebele , Okeke Nkechi Mercy , Osilike Chioma , Okeke Polycarp M.D.
Published: July 2019

Community-dwelling adults are members of society residing in community settings. Community-based adult education is designed for local residents and groups, to enable them to improve their quality of life within their community. Hemophilia is a bleeding disorder that can be inherited or acquired. World Hemophilia Day 2018 helped to raise awareness about the importance of sharing knowledge and the experience of hemophilia, as well as to improve access to care and treatment among people with this bleeding disorder. We used the documentary method of research, which has been adopted in recent review articles, to collect and analyze the findings of published literature on hemophilia. Our results showed that community-dwelling adults with hemophilia have concerns that merit the attention of government and non-governmental agencies. Some challenges faced by many community-dwelling adults with hemophilia include the cost of treatment and employment challenges. Herein, we discuss the implications for community-based health education and nursing with respect to patient care, adult education, nursing education, management, research, and policy. Finally, the authors note that sustainable efforts are needed in the provision of local, national and international leadership and educational resources to improve and sustain health care for community-dwelling adults with hemophilia.
Meaning and context in Job and Tobit
Authors: Kwon JiSeong James
Published: July 2019

The book of Tobit, which is dated to the Hellenistic period, is often compared with the model of the pious and innocent sufferer in the book of Job which is assumed to be the product of a late Persian or early Hellenistic scribal idea. It has been argued that in many ways, the author of Tobit directly alluded to Job’s texts and put its literary framework and themes into a new historical context, the Assyrian Diaspora. However, these literary works are quite dissimilar in how they use various Israelite and non-Israelite materials and they substantially reflect different thoughts and interests. In this article, I indicate how each book understands Jewish the literary tradition and suggest that both books reflect their own intellectual background. This will be discussed in relation to four areas: (1) suffering and theodicy; (2) dialogue; (3) retribution, law, and piety; and (4) election, eschatology, and the apocalyptic.
Polite rhetoric: Judah’s plea to Joseph in Genesis 44.18-34
Authors: Bridge Edward J
Published: July 2019

Despite recognition that Judah’s plea to the unknown-to-him Joseph in Gen. 44.18-34 is one of the most tactful yet moving pleas in the Hebrew Bible, only Joosten’s 2016 article has attempted to analyse why it is tactful yet persuasive. The present study uses a linguistic politeness analysis and interacts with Joosten’s classical rhetorical approach to affirm much of Joosten’s argument, yet also to argue that aspects of Joosten’s argument can be better covered by linguistic politeness. Ultimately, how a biblical speech is worded pragmatically is as much about persuasive rhetoric as the content, and should be considered alongside other methods of analysis when biblical speeches are studied.
Suture Button Versus Hook Plate for Acute Unstable Acromioclavicular Joint Dislocation: A Meta-analysis
Authors: Wang Cong , Meng Jia-Hong , Zhang Yi-Wen , Shi Ming-Min
Published: July 2019

Background:

Surgical treatment is indicated for unstable acromioclavicular (AC) joint dislocation. The hook plate (HP) technique is a commonly used treatment method, but the use of the suture button (SB) technique is increasing.

Purpose:

To conduct a meta-analysis of clinical studies evaluating patient outcomes between the SB and HP techniques for acute unstable AC joint dislocation.

Study Design:

Meta-analysis.

Methods:

A literature search of the Embase, PubMed, and Cochrane Library databases was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Cohort studies and case-control studies comparing the SB and HP procedures for acute unstable AC joint dislocation were included. Statistical analysis was performed with RevMan (v 5.3.5).

Results:

Eight clinical studies that met the inclusion criteria were identified and included a total of 204 patients treated with the SB technique and 195 patients with the HP technique. Patients treated with the SB technique had a higher Constant score (mean difference [MD], 3.95; 95% CI, 1.20-6.70; P = .005) and a lower visual analog scale pain score (MD, –0.75; 95% CI, –1.12 to 0.37; P < .0001) when compared with the HP technique. No significant differences in operation time (MD, –0.38; 95% CI, –7.14 to 6.37; P = .91), coracoclavicular distance (MD, –0.07; 95% CI, –0.49 to 0.35; P = .75), complications (odds ratio, 0.59; 95% CI, 0.22-1.54; P = .28), and loss of reduction (odds ratio, 2.55; 95% CI, 0.66-9.83; P = .17) were found between the SB and HP techniques. The subgroup analysis showed that the arthroscopic SB technique resulted in a higher Constant score (MD, 6.75; 95% CI, 4.21-9.29; P < .00001) as compared with the HP technique, but no differences were observed between the open SB and HP techniques (MD, 0.69; 95% CI, –0.82 to 2.20; P = .37).

Conclusion:

This meta-analysis demonstrated that the SB technique resulted in better functional outcomes and a reduced visual analog scale pain score when compared with the HP technique. However, for operation time, coracoclavicular distance, complications, and loss of reduction, there were no statistically significant differences between the techniques. Compared with the open procedure, arthroscopic SB may be superior for better functional outcomes.
Laboratory laparoscopy: Urinary diversion after cystectomy
Authors: Zanetti G. , Trinchieri A. , Maggioni A. , Montanari E. , Colombo F. , Rovera F. , Taverna G.L. , Nespoli R. , Russo R. , Dellino E. , Pisani E.
Published: July 2019

Cystectomy was performed using laparoscopic techniques in 10 pigs weighing between 25 and 30 kilograms. Urinary diversion was performed with different techniques. The types of diversion included ureterosigmoidostomy and cutaneous diversion. Clinical applications await improvements in instrumentation for implantation of ureters.
Fournier's syndrome: Our experience
Authors: Lasaponara F. , Vercesi E. , Coppola P. , Rizzello N.
Published: July 2019

Autors report their therapeutic experience of the Fournier's syndrome in 5 patients.
Intraoperative recovery of blood during TURP
Authors: Pitrolo G. , Alborghetti A. , Bano V.
Published: July 2019

In consideration of surgical case histories in their hospital and the transfusion risks to which patients operated for Benign Prostatic Hypertrophy are exposed, the authors decided to verify the possibility of applying intraoperative recovery of blood in patients undergoing transurethral resection of the prostate (TURP). The preliminary study of 31 cases provided data which were encouraging with regard to the possibility of using this method and the reinfusion of the red cells recovered. The second phase involved the successful treatment of 53 patients who thus received the blood they had lost during surgery.
Endourological treatment of large neoplasm in the lower tract of the ureter
Authors: Gramegna V. , Capizzi S. , Spalmero D. , Madaro A. , Romano O. , Scutari A.
Published: July 2019

Conservative endourological treatment of transitional cell carcinoma of renal pelvis and ureter is controversial. The treatment should be reserved for selected cases and for low grade, low stage, monofocal tumors. Personal experience with endourological treatment of a transitional cell carcinoma of the lower tract of the ureter is presented.
A randomized trial of flutamide alone versus orchidectomy and flutamide in the management of advanced prostatic cancer
Authors: Trinchieri A. , Longo G. , Mazza L. , Mandressi A. , Rovera F. , Zanetti G. , Coppi F.
Published: July 2019

We included in a controlled study 38 consecutive patients aged up to 75 with newly diagnosed cancer of the prostate suitable for hormonal treatment (stage C-D). Patients were randomized to receive either flutamide and orchidectomy or flutamide alone. After 4 years the survival rate for the orchidectomy plus flutamide group (53%) appears to be better than for the group with flutamide alone (40%).
Prospective study of post-ESWL infections of the urinary tract
Authors: Zanetti G. , Montanari E. , Guarneri A. , Seveso M. , Trinchieri A. , Rovera F. , Austoni E.
Published: July 2019

Throughout the world ESWL is nowadays the treatment of choice in renoureteral stones and ever smaller stones can be treated. We have undertaken the present study to evaluate post treatment infective complications in low-risk patients. A prospective study has been performed on 150 non-infected patients before ESWL treated for renal stones whose maximum diameter was less than 15 mm. None out of this group underwent pretreatment manoeuvres. Urinecultures were checked before and after treatment (3 days – 30 days). Out of 150 third day urine cultures 11 were positive but only 5 patients presented a symptomatic infection. All patients whose urineculture was positive received antibiotic treatment. All urinecultures were negative at the 30 days follow-up. The low incidence of urinary symptomatic and asymptomatic infections in our series and the rapid cure by antibiotic therapy suggest performing ESWL treatment in selected patients without any antibiotic prophylaxis. Antibiotic therapy will be set up just in symptomatic or asymptomatic post-treatment infections.
Prospective study to compare the efficacy of plain X-ray, renal tomography and renal ultrasound in post-ESWL follow-up
Authors: Zanetti G. , Guarneri A. , Montanari E. , Seveso M. , Trinchieri A. , Rovera F.
Published: July 2019

A prospective study was performed to compare the efficacy of plain X-ray, renal tomography and renal ultrasound for the evaluation of the presence of residual fragments and the size of the fragments on 108 patients at 1 month follow-up after ESWL. Ultrasound appeared to be sensitive in identifying the residual fragments. Renal tomography more specific in the evaluation fragment size. We suggest that the one month follow-up evaluation could be limited routinely to ultrasonography and abdominal X-ray. However in some selected patients renal tomography should be performed to confirm and evaluate the presence and size of residual stone fragments.
Extracorporeal lithotripsy: Two years experience with the Dornier MPL 9000
Authors: Zaatar C. , Tombolini P. , Ruoppolo N. , Bellorofonte C. , Beleggia F. , Dell'Acqua S. , Ferri P.M.
Published: July 2019

In this study we present our experience in extracorporeal lithotripsy using a third generation lithotripter with ultrasound localization system and tubeless shock wave coupling as in the Dornier MPL 9000. The aim was to evaluate the efficacy, range of indications and tolerance in 110 patients treated in 1990–1991. No side effects were observed. Success rate was 76% for renal stones, 70% for ureteral stones. Pain free ESWL was possibile on generator voltage (14–17) which is used in the majority of our cases.
Comparison between clinical and pathological staging in low stage non-seminomatous germ cell testicular tumors
Authors: Nicolai N. , Pizzocaro G. , Salvioni R.
Published: July 2019

Between January 1985 and December 1990, 208 consecutive patients underwent retroperitoneal lymphadenectomy (RPLND) for low-stage (negative imaging or retroperitoneal disease up to 3 cm) non-seminomatous germ cell testicular tumors. Before RPLND, patients were staged with computed tomography (CT) or magnetic resonance imaging (MRI) of abdomen and pelvis, alpha-fetoprotein (AFP) and beta submit of human chorionic gonadotropin (b-HCG) assay. Lymphangiography (LAG) was performed in 139 cases. Out of 208, 173 (83%) patients belonged to clinical stage I, 21 (10%) to clinical stage II-A (retroperitoneal disease up to 2 cm) and 14 (7%) to clinical stage ll-B (retroperitoneal disease from 2 to 3 cm). Before RPLND, serum markers AFP and b-HCG were pathological in 16 (9%) of 173 patients in clinical stage I, in 7 (33%) of 21 in clinical stage ll-A and in 6 (43%) of 14 in clinical stage ll-B < 3 cm. Retroperitoneal metastases were pathologically found in 46 (27%) of 173 patients in clinical stage I, in 15 (71%) of 21 in clinical stage ll-A and in all 14 clinical stage ll-B < 3 cm. As many as 31 (20%) of 157 in clinical stage I with negative markers and only 8 (57%) of 14 clinical stage II-A with negative markers had retroperitoneal metastases. The low reliability of clinical staging enforces RPLND as the most accurate staging procedure for marker negative clinical stage I and II-A patients.
Peritoneal dialysis in children: Review of surgical techniques
Authors: Capozza N. , Mosiello G. , De Gennaro M. , Matarazzo E. , Rinaldi S. , Leozappa G. , Caione P.
Published: July 2019

Peritoneal dialysis has become an effective and widely used technique for the treatment of patients with end-stage renal disease. Peritoneal dialysis has become more practical for use in pediatric patients since equipment and techniques have been adapted for smaller patients. In the present work we describe the surgical technique that we currently use at our institution for surgical placement of peritoneal dialysis catheter. From January 1985 to January 1992, 19 peritoneal catheters were placed in 17 children, at the Bambino Gesù Children's Hospital. At the time of catheter insertion the average weight of the children was 14.2 kg., and the average age was 4 y. 10m. Peritoneal dialysis catheters were always placed under sterile conditions, in an operating room or in a pediatric ICU, with surgical technique. Regarding our surgical technique we recommend: 1) to use Tenckhoff catheter, 2 cuffs pigtail (curled) type; 2) to perform a minilaparatomy with lateral surgical approach and a routine omentectomy; 3) to create a submuscular tunnel (rectus abdominis) to reduce the leakaqe of peritoneal dialysis fluid. Furthermore the various clinical problems encountered in our experience and some surgical guidelines for the prevention of complications are reviewed.
Growth factors in benign prostatic hyperplasia (BPH) and prostate carcinoma
Authors: Di Silverio F. , D'Eramo G. , Sciarra A. , Buscarini M. , Casale P. , Di Nicola S. , Colella D.
Published: July 2019

It has been stated that, although steroid hormones are a necessary prerequisiste for prostate cell proliferation, cell division is not an inevitable consequence of the presence of hormones. The possibility that diffusible trophic factors play an important role in the normal and pathologic regulatory process within the prostate, offers a new and exciting research initiative. In order to better clarify the relationships between Epidermal growth factor (EGF), its receptor (EGFr) and steroid receptors at target tissue levels, we have demonstrated a statistically significant linear correlation between irEGF and nuclear androgen receptor (nAR) levels in human BPH tissue. Moreover we started an investigation to analyse the stroma-epithelium ratio and to verify EGF, EGFr, AR, DHT concentrations in the periurethral, central and peripheral zone of human BPH tissue. In all BPH zones the quantitative method of image analysis showed a higher percentage content of stroma than of epithelium. The highest levels of EGF, DHT and stroma content were present in the periurethral zone, where BPH begins. Both androgen and antiandrogen treatment enhance the proliferation rate of prostate cancer cell line LNCaP. After prolonged R1881 administration, a marked increase of EGF release was observed, completely blocked by the addition of OH-flutamide. The role of Transforming growth factor beta 1 (TGF beta1) in prostate cancer has been also demonstrated in prostate cancer tissue of patients submitted to radical prostatectomy.
Linfadenectomia laparoscopica e Mini-lap: Attualità, limiti ed indicazioni
Authors: Callari S. , Bertè R. , Guaitoli P. , Zappalà L. , Mazza G.
Published: July 2019

The authors, according to their preliminary experience with laparoscopic lymphadenectomy and Mini-lap performed for the staging of 15 patients with prostatic carcinoma, have compared the morbidity, the diagnostic accuracy rate and costs of these two techniques, referring critically to international literature and evaluating the real efficacy of a delayed laparoscopic pelvic lymphadenectomy prior to radical prostatectomy. Moreover they have tested the general applicability of the equation by Roach et al., which was empirically derived from a nomogram reported by Partin et al., to predict the risk of lymph node metastasis, applying it to a selected group of patients who underwent radical prostatectomy from 1992 to 1994 in order to maximize the utility of lymphadenectomy for prostatic cancer staging.
La crioablazione della prostata per adenocarcinoma
Authors: Lugnani F.
Published: July 2019

Physiopathological bases of cryosurgical damage are described: hypothermia, freezing, thawing are all disruptive moments causing necrosis. Last-generation cryosurgical apparatus allows the use of liquid nitrogen circulating through thin probes that are inserted percutaneously under u.s. guidance. Also thermosensors are used to monitor the procedure placing them in selected spots. 404 patients were treated in 3 different but homogeneous groups. Results of control biopsies were available at 3 months for 298 (15 pos.) and for 141 at 12 months (13 pos.). Cryoablation appears to be an interesting procedure, but its complexity requires accurate training with a steep “learning curve”; only long-term follow-up will test in the future its real efficacy.
Ipertrofia prostatica benigna: Panorama delle terapie alternative non mediche
Authors: Consoli C
Published: July 2019

The steadily growing number of elderly persons has led to a considerable increase in patients with benign prostatic hypertrophy. The Author reviews all the so-called mininvasive methods aimed at canalising the urethral cervix more or less satisfactorily and for varying lengths of time.
Il valore predittivo della citometria a flusso nei carcinomi superficiall della vescica di basso grado
Authors: Cosentino A. , Dammino S. , Piazza G. , Amico F. , Grasso G. , Bartolotta G.
Published: July 2019

Flow cytometry (FCM) enables ploidy and proliferative tissue activity (PHASE S) to be quickly and objectively measured. This method is of predictive value regarding the biological behaviour of bladder tumours. The authors used FCM in a 5-year-follow-up study of 75 patients with papillary bladder carcinoma, who underwent therapeutic or staging transurethral resection in 1989. Results show a strict correlation between stage-ploidy-Progression as well as the significance of S-PHASE cells in relation to low-grade diploid tumours.
Voluminose masse addominali: Diagnosi differenziale e soluzione chirurgica adottata
Authors: Giardina M. Curti , Viola G. , Ocello F. , Orestano F.
Published: July 2019

Masses involving the abdominal organs present the problem of differential diagnosis and the symptomatology can be extremely varied in relation to their manifestation. The authors report their experience in a few cases, showing that the histopathological examination often plays an important role in leading to a correct diagnosis.
Valore della trasfusione di sangue autologo in regime di predeposito nella chirurgia di elezione
Authors: La Rosa P. , Rotondo S. , Molino F. , Maccarrone G.
Published: July 2019

The risks associated with the transfusion of homologous blood, plus a chronic lack of blood, have led doctors and patients to consider auto-transfusion schedules. In our opinion the pre-operative collection of blood is of primary social importance, as it involves a low percentage of risk with acceptable costs and countless advantages, not least that of avoiding homologous transfusions. The aim of this work is to show that autologous blood collections and transfusions in elective surgery must be rationalised in order to avoid a high percentage of autologous bags remaining unused in low-risk operations and conversely patients being obliged to receive homologous blood in high-risk operations.
Carcinoma renale bilaterale in sindrome di von Hippel-Lindau: Presentazione di un caso
Authors: Nicolosi D. , Castiglione B. , Salvia G. , Amuso G.
Published: July 2019

Renal carcinoma in von Hippel-Lindau disease is to be greatly feared. The authors describe a clinical case and their therapeutic management, which consisted of an enlarged right nephrectomy and a left tumorectomy by trans-peritoneal approach.
Management of recurring vesi-covaginal fistulas by vaginal flap technique
Authors: Torelli F. , Pizzoccaro M. , Cappellano F. , Sironi D. , Pozzoli G.L. , Catanzaro F.
Published: July 2019

— Since 1990 9 patients with vesi-covaginal fistulae located in the trigonal area of the bladder have been treated using the Leach, Raz transvaginal approach (1983). 6 women had been operated previously (4 women once / 2 women twice). Although it is customary to recommend the transabdominal route when operative repair fails, we preferred the transvaginal technique. When the urethral catheter was removed on the tenth to fifteenth postoperative day, all patients were dry. The outpatient voiding diary documented urgency/frequency syndrome in 2 cases and urinary retention in 1 due to psychosocial causes and neurogenic etiology (previous abdominoperineal resection). This technique is certainly interesting and we recommend it before attempting any abdominal surgical repair in particularly unsuccessful cases because it offers several advantages: excellent exposure, no opening of the bladder, minimal dissection, multilayer closure, reduced postoperative discomfort and shorter hospital stay.
Transureteral treatment and ESWL of upper urinary tract calculosis
Authors: Cauda F. , De Natale A. , Alladio F. , Guermani P. , Pigato M. , Manzo M. , Ferrando U.
Published: July 2019

— The authors report on the treatment of kidney staghorn stones by a transureteral approach. Endoscopic debulking can be followed by ESWL. The methods, results and advantages versus other techniques (PUL) are evaluated.
Transureteral endopyelotomy in the treatment of UPG stenosis: Our experience
Authors: Cauda F. , De Natale A. , Alladio F. , Pigato M. , Guermani P. , Manzo M. , Ferrando U.
Published: July 2019

— The authors describe a transureteral backward approach to the endoscopic treatment of UPG stenoses. Methods and results are described. They discuss the indications, and the advantages compared to other techniques.
Urinary schistosomiasis: Description of a ciinical case
Authors: Borsa R. , Aimé G. , Ambruoso G. , Cordara G. , Fontana G.
Published: July 2019

— The Authors report a case of bladder schistosomiasis successfully treated with Pranziquantel. They discuss the etiopathogenesis, followed by the diagnostic routine used, pointing out the importance of urinary investigations, and the therapeutic possibilities for this serious parasitic infection of the bladder.
Use of the Gunter temporary cavai filter in supra-diaphragmatic inferior cava thrombotic involvement in left renal cell carcinoma
Authors: Ferrando U. , Arena G. , Pigato M. , Morabito F. , Cucchiarale G. , Tasso M. , De Natale A.
Published: July 2019

— The Authors describe the surgical technique used in a case of left renal cell carcinoma with thrombosis of the renal vein and supra-diaphragmatic inferior cava using a Gunter's temporary cavai filter.
Microscopic venous invasion in pT3aN0M0 renal cell cancer
Authors: Drei G.N. , Bertoldin R. , D'Incà G. , Meneguolo M. , Guazzieri S. , Camagna T. , Davolt C. , Bassani R.
Published: July 2019

– A retrospective analysis was carried out to assess the prognostic significance of microvascular invasion (mV) in 48 patients with pT3aN0M0 renal cell cancer. mV is defined in this study as the definite presence of neoplastic thrombosis, more or less adhering to and/or infiltrating the walls of the small venous vessels. Taking into consideration just neoplasms with a nuclear grading of 2 and 3 (according to Fuhrman), at the time of the study 65% of deceased patients were mV+, while 74% of living patients were in mV-. The probabilities of survival, according to Kaplan Mayer, in the two groups of patients appear to be significantly influenced by the mV+ and mV- factor. It can be concluded that this factor, histologically easy to determine, is useful for selecting a sub-group of patients with a more unfavourable prognosis.
Heterotopic continent urinary diversions: Statistic evaluation in Northern Italy
Authors: Spatafora S. , Cesolari R. Rossi , Muto G. , Leoni S.
Published: July 2019

– A questionnaire was sent to all Urological Centres in Northern Italy in order to assess their opinion about continent cutaneous urinary diversions. Results were somewhat surprising and brought out many controversial aspects. Although good results of the heterotopic pouches were reported by 12 (31.6%) Units, the ileal conduit is still considered the “gold standard” for more than 50% of Urological Departments, while ureterosigmoidostomy is still widely performed (31.6%). Some new concepts about uretero-intestinal anastomosis and the criteria of exclusion are emerging.
Continent urinary pouches in pediatric age
Authors: Caione P. , Capozza N. , Matarazzo E. , Lais A. , Mosiello G. , Nappo S. , Di Palma E. , Ferro F.
Published: July 2019

– To make a new urinary reservoir which can be catheterised either through an external stoma or transurethrally, is the only way to achieve continence in quite a large number of irreversible structural and functional disorders of the bladder wall, also in pediatric age. Orthotopic are usually preferred to heterotopic pouches in pediatric patients, indications for the latter being few. Bladder exstrophy, neurogenic bladder from spina bifida, severe fibrosis of the bladder walls as a consequence of congenital outlet obstruction in prenatal age, such as posterior urethral valves and bilateral ectopic ureterocele, are the most frequent clinical indications, while bladder tumours are uncommon. Over the last 10 years we have perfomed 31 partial or total bladder substitutions in pediatric patients, 7 of which were continent urinary pouches with 2 in an ectopic position in the iliac fossa (Indiana pouch and Kock pouch). The 7 pouches were made in 4 bladder exstrophies (Indiana Pouch), 1 neurogenic bladder (gastric pouch with continent appendico-vesicostomy), 2 bladder tumours (Kock pouch). Results, in terms of continence and major or minor complications, are presented and discussed with particular reference to pediatric patients.
Strictures and fistulas of the anterior urethra
Authors: Ranno S. , Leonardi R. , Stracuzzi G. , Minaldi G. , Miria P.
Published: July 2019

– The first documents of urethral surgery for urethral strictures date back to the 4th century BC. In the past, endoscopic surgery was the best solution for most urologists. Nowadays, literature shows that the approach to urethral strictures depends on the degree of involvement of the spongy body. The choice of surgical reconstruction technique depends on the anatomical differences in the anterior portion of the urethra, which is divided anatomically into navicular, penile and bulbar. The gold standard for urethroplasty of the navicular urethra is the free graft which can take root due to the presence of glandular tissue. Techniques using a preputial pedunculated graft are good for penile urethra, while a free graft of preputial origin, that has first been perforated and then tubularised, is suggested for very long strictures (> 5 cm). Epidermal or mucosal free grafts can be used for bulbous urethral strictures, due to the presence of thick spongy tissue. The urethra should be completely substituted with a neo-urethra formed by preputial pedunculated and tubularised graft only for wide strictures with associated fibrosis of the spongy portion. Recurrent strictures can be treated twice with surgery.
A randomized study comparing mitomycin C, mitomycin C plus epirubicin and mitomycin C plus interferon-alpha-2 in the intravesical prophylaxis of superficial bladder tumour recurrences
Authors: Serretta V. , Falletta V. , Vasile P. , Pomara S. , Piazza B.
Published: July 2019

– After TUR of superficial bladder tumours (G1-G3, Ta-T1), 121 patients were randomized in three groups of intravesical treatment: mitomycin C alone, mitomycin C plus epirubicin, mitomycin C plus interferon-alpha-2. At a mean follow-up of 53 months, 64 patients (52.8%) showed a recurrence. A trend (p < 0.02) in favour of the combination of mitomycin C and epirubicin was evident. The higher efficacy of this association was particularly evident when patients with primary tumours were excluded from the statistical analysis.
Urothelioma of the upper urinary tract: Case description and literature review
Authors: Barbera M. , Panarisi S. , Paola Q. , Cammarata C. , Solazzo G. , Curto G. , Albano G.
Published: July 2019

– Transitional cell carcinoma of the upper urinary tract is relatively uncommon and the fewer the symptoms the more difficult the diagnosis. Choice of therapeutic approach is also difficult because the exams do not always enable the disease to be accurately staged and being a fundamental organ the use of conservative or radical surgery is controversial. The authors report the case of an 80-year-old man with a urothelioma in hydrocalyx of the left kidney due to lithiasis of the collar of the upper calyceal groups. The case was unusual for the concomitance of lithiasis with consequent urostasis and chronic inflammation of the sequestered calyces and the onset of neoplasia in the same. The diagnostic routine was arduous and only the CT scan removed the doubts raised by previous exams. Although precise data regarding the stage could not be obtained, radical surgery was performed. The subsequent histological exam proved the authors’ choice of procedure correct since the neoplasm was infiltrating.
The wall stent in strictures of the lower urinary tract in inoperable patients
Authors: Zumbo G.
Published: July 2019

– A new therapeutic procedure originally used in angiological surgery has been used in the treatment of urethral strictures. A permanent stent (tubular in shape), called the “wall stent” is placed in the stricture by means of a specially designed urethroscope. The authors report their experience using the “wall stent” in 2 patients with recurrent urethral stenosis and in 1 patient with BPH. There was no recurrence at follow-up.
Percutaneous nephrolithotripsy
Authors: Rotondo S. , La Rosa P. , Aragona C.
Published: July 2019

– Percutaneous nephrolithotripsy is an excellent method for treating staghorn or coralliform stones rather than by extracorporeal lithotripsy or surgery. The method features relatively easy execution, low morbility, reduced hospital stay, rare and mostly modest complications. Greatly improved advanced lithotripsy techniques, easy identification of the approach route by echo-guided puncture and if necessary the combination with extracorporeal lithotripsy make the method today even more effective and safe. This study reviews the indications, advantages and complications of the technique.
Enterovesical fistula: Case report
Authors: Savoca F. , Nisticò C. , Morana C. , Caizzone F. , Di Marco G. , Amuso G. , Nicolosi D.
Published: July 2019

– Since last century cases of abnormal communication between bowel and bladder have been reported. The authors describe a case of enterovesical fistula with unclear symptoms secondary to adenocarcinoma of the colon, which had fully infiltrated the bladder wall and a segment of ileal loop. Surgical management consisted of removing the sigma, bladder and ileal segment.
Latrogenous vesico-vaginal fistulas: Technique
Authors: Angileri N. , De Marco M. , Di Natale G. , Ferrera M. , Galfano G.
Published: July 2019

- The authors describe a new technique for the delayed repair of iatrogenic WF using the fibrous tissue around the fistula as a support for the suture of the bladder muscular wall. The results obtained on five patients are reported.
Detrusorial areflexia secondary to nodous periarteritis. Case report
Authors: Nisticò C. , Lopes M. , Savoca F. , Bartolotta S. , Politi A. , Ventimiglia B.
Published: July 2019

– A boy with periarteritis nodosa (PAN) came to our department for urodynamic evaluation. The various cystomanometric tests gave alternating areflexic and hyperreflexic pictures. It is advisable in such cases for the neurourologist to follow a clinical screening protocol combined with a “self-oversee” supervision by members of the patient's family.
Raro caso di adenocarcinoma dell'uraco
Authors: Incarbone G.P. , Monica B. , Barbieri A. , Ziveri M. , Di Stefano C.
Published: July 2019

Urachal carcinoma represents less than 1% of all bladder neoplasms. A case is reported of a 66-year-old man who presented with episodes of macroscopic hematuria. Cystoscopy revealed the presence of a papillar neoplasm between the dome and the right bladder wall. The histological examination showed a “mucinous adenocarcinoma morphologically similar to intestinal neoplasms”. Heteroplasia of the urach was diagnosed following urography, CT and NMR.
Nefrectomia laparoscopica: Nostra esperienza
Authors: Porpiglia F. , Morino M. , Garrone C. , Morra I. , Rocca A. , Fontana D.
Published: July 2019

In this work we report our experience in the use of laparoscopie nephrectomy for benign renal disease. From September 1995 to April 1997, 10 patients, with age range from 36 to 67 years, underwent laparoscopie nephrectomy (4 for hydronephrosis, 4 contracted kidneys, 1 staghorn stone with excluded kidney, 1 tubercular contracted kidney). The average operating time was 150’. Average blood loss was about 200 cc. The patients resumed oral intake and started walking within 1 day, while just 1 patient required 500 ml of autologous blood. The average post-operative hospital stay was 4 days. Although laparoscopie operating times (average: 150’) are longer than those for traditional surgery, we achieved a considerable reduction in pain, post-operative hospital stay and in the time taken to resume normal activities. We therefore consider that laparoscopie nephrectomy may be a good alternative to traditional surgery for selected patients.
Uretroplastica a lembo libero dorsale
Authors: Bondavalli C. , Pegoraro C. , Schiavon L. , Dall'Oglio B. , Luciano M. , Canclini L. , Parma A.
Published: July 2019

The Authors report their experience in the new urethroplasty technique by Barbagli for penile and bulbar urethral strictures. This procedure involves a free skin graft sutured to the corpora cavernosa. With this dorsal approach mechanical weakening is virtually impossible, so pseudo-diverticulum or urethrocele cannot develop. We adopted this technique in 5 patients during the last 12 months. The strictures of the urethra were 2.5 to 8 cm long. The follow-up, even thought short, show that this technique is safe and quite simple.
Perineal rehabilitation and its indications in non-neurogenous urinary incontinence in adults
Authors: Ninfa C.
Published: July 2019

Rehabilitation plays an important role among the conservative forms of treatment of urinary incontinence. The techniques employed are: physiokinesitherapy, biofeedback, electric functional stimulation and behavioural therapy, aimed at preventing and curing urinary incontinence and at micturitional, anorectal and sexual rehabilitation. Applied singly or in different combinations, they tend to improve functionality of the perineal muscles. Some basic principles are outlined on which their rational use in practical therapy is based.
An uncommon case of cutaneous facial metastasis as the first manifestation of renal carcinoma
Authors: Lapira G. , Rizza G. , De Grande G.
Published: July 2019

The authors report an unusual case of a 67-year-old man without urinary symptoms, with facial neoplasm. After biopsy, histological findings revealed a clear cell metastasis from renal carcinoma. Intravenous pyelography plus abdominal and brain CT scan were therefore performed, revealing renal cancer with widespread metastasis, making surgery impossible. Given the peculiarity of this case, the authors also give data from international literature which show that this type of first manifestation of renal carcinoma is very uncommon.
Pre-aortic lymphadenopathy after nephroureterectomy for transitional cell carcinoma of the renal pelvis: Unexpected histological results
Authors: Rizzo M. , Bohlen D. , Studer U.E.
Published: July 2019

A patient underwent nephroureterectomy for transitional cell carcinoma of the renal pelvis (pT3 G3 N0 M0). After 5 years a CT scan showed a retroperitoneal lymphadenopathy, suspected of being a metastasis. Histological examination of the surgically-removed lymph node showed seminoma. Palpation of the testes was negative. Testicular ultrasonography showed three hypoechoic areas in the right testis. Orchiectomy was subsequently performed and the histological examination of the testis confirmed the presence of seminoma (pT1).
TUIP in the treatment of BPH: Personal experience
Authors: Pirritano D. , Martino L.F. , Falvo F. , Spasari A. , Gemelli R. , Talarico B. , Sicuro O.L. , Zagordi A.A. , Apollini L. , Scalfari A.
Published: July 2019

The authors describe their experience with 40 patients subjected to TUIP for BPH from May ‘92 to November ‘96. The criteria used for including patients in the study were based on the prostatic weight calculated ultrasonically by means of the ellipsoid rule. Results were similar to those reported in world literature. The authors conclude that although TURP is the best endoscopic technique for BPH, TUIP is also important since both catheterisation and hospitalisation times are shorter with resulting cost savings.
Advances in bacteriological diagnosis
Authors: Porpiglia F. , Chirillo M.G. , Galietti F. , Morra I. , Destefanis P. , Fontana D.
Published: July 2019

Microbiological diagnosis of urogenital tuberculosis, traditionally based on the results from bacterioscopy and cultures, may sometimes be insufficient apart from requiring a particularly long time (4–8 weeks). In an attempt to reduce the times of response and to improve sensitivity, new methods have been put forward using DNA probes in culture media (fast methods) and nucleic acid amplification systems (ultra-fast methods). The authors describe the various methods and report their experience using the fast (AccuProbe) and the ultra-fast methods (MTBDA). They still consider the culture examination as the gold standard, but times of response may be reduced (10–15 days) using the AccuProbe test. The ultra-fast methods MTBDA may be put to good use when there is a clinical and/or radiological suspicion of tuberculosis with a negative culture or in cases where a rapid differential diagnosis is necessary.
Ternary Trends in Nursing Home Information Technology and Quality Measures in the United States
Authors: Alexander Gregory L. , Madsen Richard , Deroche Chelsea B. , Alexander Rachel , Miller Erin
Published: July 2019

Nursing home information technology (NH IT) adoption trends are not measured regularly. Evidence indicates digital footprints are growing, but gaps about NH IT adoption and quality impacts remain. We hypothesize as NH IT adoption grows, quality improves. This research assessed ternary (2014-2017) trends in IT and quality measures using a primary survey of U.S. NHs. Survey measures included nine dimensions/domains and total IT sophistication. Administrators completed 815 Year 1 surveys. Each year mean total IT sophistication scores in nine dimensions/domains consistently increased. Eighteen significant correlations ( r > .13, absolute value) between IT sophistication and quality measures existed. Regression shows that for every 10 units increase in administrative activity extent of IT use, a decrease of 1.3% occurs in the percentage of low-risk long-stay residents with bowel or bladder incontinence. Increases in NH IT sophistication positively impact quality. Estimating ongoing trends in NH IT sophistication provides new information that should be consistently available.
Social values and civic behaviour among youth in Ireland: The influence of social contexts
Authors: Silke Charlotte , Brady Bernadine , Dolan Pat , Boylan Ciara
Published: July 2019

As youth civic engagement is widely considered important for social cohesion and democracy, concerns have been expressed regarding a perceived decline in civic and political engagement among young people throughout the western world. While research has shown that the social environment is influential in terms of the development of civic values, knowledge and behaviours among youth, limited research has been conducted on these issues in an Irish context. Drawing on survey research conducted with 167 young people aged 12–15 years in Irish secondary schools, this paper examines young people's civic attitudes and behaviours and how they are linked to their social contexts. Findings indicate that youth report high levels of social responsibility values but low engagement in both online and offline civic engagement. Furthermore, while parent, peer, school and/or community contexts were found to have a significant influence on youths' social responsibility values and offline civic behaviours, youth's online civic behaviours were not connected to these social environments. This study provides insights into the socialisation of civic values and behaviours among young people in Ireland and highlights the importance of investigating the link between the social context and different forms of youth civic involvement.
A review of aerodynamic studies on dragonfly flight
Authors: Salami Erfan , Ward Thomas A , Montazer Elham , Ghazali Nik Nazri Nik
Published: July 2019

In the recent decades, the design and development of biomimetic micro air vehicles have gained increased interest by the global scientific and engineering communities. This has given greater motivation to study and understand the aerodynamics involved with winged insects. Dragonflies demonstrate unique and superior flight performance than most of the other insect species and birds. They are capable of sustained gliding flight as well as hovering and able to change direction very rapidly. Pairs of independently controlled forewings and hindwings give them an agile flying ability. This article presents a review of all published journal articles, listed in the Thomson-Reuters Web-of-Science database (1985–2018), that are related to the flight aerodynamics of dragonflies or micro air vehicles that biomimic them. The effects of dragonfly wing motions and interactions (between forewing and hindwing) that are necessary to generate the appropriate aerodynamic forces in different flight modes are described. The associated power requirements of these modes are also addressed. This article aims to provide a valuable reference to the aerodynamic design and control of dragonfly-inspired biomimetic micro air vehicles.
Dynamic analysis of an open-loop proportional valve controlled hydrostatic drive
Authors: Dasgupta K , Ghoshal Sanjoy K , Kumar Sujit , Das J
Published: July 2019

This article highlights the dynamic analysis of a proportional valve controlled hydrostatic drive. Such drives are used widely in construction and mining applications. In the drive considered for the analysis, the speed of a bent-axis hydro-motor is controlled by varying flow supplied through a proportional direction controlled valve. A non-linear mathematical model using bond graph simulation technique is developed, where detailed model of the drive system including its loading arrangement is incorporated. From the test results of the pressure-flow characteristics of the valves, its port resistances are identified. Using them and taking into account various losses of the hydro-motor, the drive model is validated through experiments. The verified model is used to study the effects of the perturbations of some critical parameters on the transient responses of the hydrostatic drive through simulation. The proposed model may be useful for initial design of such drive and the development of control systems where these drives are used as actuators.
Analysis of contact and bending stiffness for Curvic couplings considering contact angle and surface roughness
Authors: Yu Younghun , Lee Bora , Cho Yongjoo
Published: July 2019

This paper develops a method for calculating the contact and bending stiffness of a Curvic coupling, and investigates stiffness changes according to the coupling shape and surface roughness characteristics. The surface of the on-site Curvic coupling is chosen as reference for a most accurate simulation. The three parameters representing the surface roughness characteristics—the standard deviation of the asperity height distribution, the average radius of asperities, and the density of asperity on the nominal contact area—are calculated with a profile of the coupling surface through a random process: the contact problem between rough surfaces is tackled using the Greenwood-Williamson model, the Curvic coupling is modeled assuming that it has as many teeth as possible within the machining limits depending on the contact angle, and the tangential stiffness resulting from the contact angle is calculated by dividing into the stick and slip regions, and is taken into account in terms of total stiffness. With this, results showed that using Curvic couplings reduces stiffness than using flat disc couplings because of the contact angle, and that the standard deviation of rough surface height is the most crucial surface parameter affecting stiffness.