Objective To prospectively review our experience with extravesical robotic-assisted laparoscopic ureteral reimplantation to determine whether postoperative voiding dysfunction can be avoided with ...pelvic plexus visualization and to assess the efficacy of this approach for the treatment of vesicoureteral reflux (VUR). Methods We prospectively followed 150 patients who underwent bilateral extravesical robotic-assisted laparoscopic ureteral reimplantation by a single surgeon at an academic institution. Each patient was followed for a 2-year period. All 150 patients had primary VUR of grade 3 or greater bilaterally, with 127 having parenchymal defects found on renal scans. All patients were toilet trained before surgical intervention. The operation was performed with an extravesical transperitoneal approach with robotic assistance using the daVinci Surgical System. All patients underwent voiding cystourethrography at 3 months postoperatively to document the resolution of VUR. Voiding dysfunction was assessed in each patient by uroflow, postvoid residual urine volume, and a validated questionnaire. Results The operative success rate was 99.3% for VUR resolution on voiding cystourethrography. One patient with bilateral grade 5 VUR that was downgraded to unilateral grade 2 VUR was considered to have treatment failure. This patient ultimately underwent subsequent subureteral injection therapy after an episode of pyelonephritis. No patient experienced de novo voiding dysfunction. Conclusion Bilateral nerve-sparing robotic-assisted extravesical reimplantation has the same success rate as the traditional open approaches, with minimal morbidity and no voiding complications in our series.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
The purpose of this study was to report on outcomes of a cohort of patients who were treated with reirradiation with stereotactic body radiation therapy (SBRT) for locally recurrent pancreatic ...adenocarcinoma.
Patients treated with SBRT reirradiation for locally recurrent pancreatic adenocarcinoma from December 2009 to April 2020 were included in the study. Descriptive statistics were used to record patient demographics, tumour and treatment characteristics. Kaplan–Meier analysis was used to evaluate overall survival, local progression-free survival (LPFS), distant metastasis-free survival and progression-free survival (PFS).
In total, 27 patients were included in the study. The median follow-up time from local recurrence was 19.7 months (range 4.2–43.1 months). Most patients received five-fraction SBRT (26/27, 96%). The median overall survival after local recurrence treatment was 18.3 months (range 3.0–42.6 months), with 6-month, 1-year and 2-year overall survival rates of 88.5%, 73.1% and 33.6%. The median LPFS after local recurrence treatment was 16.2 months (range 2.3–33.6 months), with 6-month, 1-year and 2-year LPFS rates of 95.8%, 62.9% and 27.2%. Peri-SBRT chemotherapy improved LPFS (median 17.5 versus 8.5 months; P = 0.010) and overall survival (median 19.3 versus 5.5 months; P = 0.049). Tumours ≤ 3 cm in the greatest dimension showed better local control (median LPFS 19.2 versus 10.2 months; P = 0.130). There was one case (4%) of acute grade 3 pain and one case (4%) of late grade 3 gastrointestinal toxicity.
Reirradiation with five-fraction SBRT is safe, but local control remains suboptimal. Patients with smaller tumours experienced improved outcomes, as did patients whose treatment plan included the administration of peri-SBRT chemotherapy.
•Locoregional failure alone is common after treatment of localised pancreatic cancer.•Reirradiation with SBRT is safe and feasible but local control can be suboptimal.•Peri-SBRT chemotherapy improved both survival and local control.•Smaller recurrences (≤3 cm) were associated with improved local control.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Summary
Objectives
Anaemia and thyrotoxicosis are both relatively common. It is unclear whether thyrotoxicosis results in anaemia in the absence of other causes. The aim of this study was to ...determine the prevalence and characteristics of anaemia in patients with thyrotoxicosis.
Design
A prospective cohort study of patients with thyrotoxicosis.
Patients: 353 patients referred to a regional endocrinology centre in New Zealand from March 2013 to November 2014 for new‐onset thyrotoxicosis.
Measurements
Detailed assessment including thyroid function tests, full blood count, inflammatory markers, haematological parameters and coeliac serology. Anaemia was defined as a haemoglobin value <115 g/L (woman) or <130 g/L (men).
Results
Anaemia was present in 31 (8.7%) patients at diagnosis. Of these, pre‐existing anaemia was present in 10, and a further 11 had one or more identifiable underlying cause(s) for the anaemia. Only 10 patients (2.8% of the entire cohort) had anaemia not clearly attributable to another cause. Median free thyroid hormone levels were higher in those with anaemia of unknown cause compared to patients with thyrotoxicosis alone. The median duration of anaemia was shorter in patients with thyrotoxicosis‐associated anaemia compared to those with anaemia due to an underlying cause (1 vs 6 months, P = .001). In all patients with thyrotoxicosis‐associated anaemia, the anaemia resolved, either prior to, or on becoming euthyroid.
Conclusion
Anaemia coexisting with thyrotoxicosis is less common than previously reported and is mild and transient. Patients with thyrotoxicosis and significant anaemia should be investigated for other potential causes, particularly when anaemia persists.
Full text
Available for:
BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Rice is the most important food crop of India. Majority of Rice is sown in kharif season in the country. This is monsoon season for the country where cloud cover poses a major problem for optical ...remote sensing. Therefore, for these states rice acreage estimation is being done using Synthetic Aperture Radar (SAR) data operationally in India since 1998. A case study is presented in this paper for analysis of past 6 years’ (2012–13 to 2017–18) estimations. Multi temporal Radarsat-2 (HH), RISAT-1 ScanSAR (HH) and Sentinel-1 (VV) data was used in years 2012, 2013–2016, and 2017, respectively for paddy identification. Hierarchal Decision Rule based classification (HDRC) approach was used to identify rice areas under sample segments. Extensive ground truth collected by state remote sensing departments and agriculture departments was utilized in setting the limits of HDRC models and accuracy assessment. Yield was estimated using weather based and remote sensing-based models. Area, production and yield estimates were made and compared with those given by DES. RMSE and R2 were used as statistical measures to assess the accuracy of results. The RMSE % ranged from 2.3 to 4.3; 0.84 to 1.35; 0.24 to 0.27 for area, production and yield respectively. The coefficient of determination (R2) ranged from 0.62 to 0.92; 0.75 to 0.91; 0.5 to 0.83 for area, production and yield respectively. The study showed that use of multi temporal SAR data (both HH and VV) is quite useful for paddy acreage estimation, especially during monsoon.
An experimental study is carried out to investigate the effect of entrance and exit conditions that prevail due to different flow arrangements on the thermal performance of a copper micro-channel ...heat sink. Three flow arrangements-U-type, S-type, and P-type-were considered for the analysis with a test piece having inlet and outlet plenum dimensions of 10 mm × 30 mm × 2.5 mm with an array of parallel micro-channels having an individual width of 330 μm and a uniform channel depth of 2.5 mm. Performance evaluations for different flow conditions at inlet and outlet plenums were made by maintaining constant heat supply at 125 W, 225 W, and 375 W with varying Reynolds number ranging from 224 to 1,121. Nusselt number and pressure drop were computed by measuring temperature difference and pressure drop across the inlet and outlet plenum for various test combinations. Maximum heat transfer was observed for the U-type flow arrangement, followed by the P-type and S-type; maximum pressure drop was noted for the S-type flow arrangement, followed by the U-type and P-type arrangements for a constant Reynolds number. A detailed analysis of the experimental results indicate that from a pressure drop point of view, the P-type flow arrangement is preferred, whereas from the heat transfer point of view, the U-type is found to be a better option.
Full text
Available for:
BFBNIB, DOBA, GIS, IJS, IZUM, KILJ, KISLJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Bacterial wilt disease (pathogen: Pseudomonas solancearum) is a major problem affecting brinjal crop. Infected leaves show yellowing, loss in turgidity, drying and ultimately the entire plant ...collapses. The study aims to examine the potential of hyperspectral remote sensing for detection of biotic stress caused due to bacterial wilt disease and identify best spectral band widths and hyperspectral indices indicative of disease infestation. This study was conducted in a farmer’s plot at Alampur in Baruipur block, South 24 Pargana district, West Bengal. Canopy spectra (using ASD Fieldspec 2 Spectroradiometer), chlorophyll content (by Chlorophyll meter) and Leaf Area Index (LAI) (by plant canopy imager) were collected. The healthy plants had green and fully turgid leaves whereas diseased plants had lower chlorophyll content and LAI. The reduction in chlorophyll content lowered reflectance in green region and internal leaf damage in near-infrared region. A correlation analysis was carried out between reflectance at specific bandwidths and hyperspectral indices with chlorophyll content and LAI of healthy and stressed plants. Bandwidths of 528–531 nm, 550–570 nm, 710–760 nm, and single bands such as 800 nm and 920 nm and indices viz. Greenness index, Modified Chlorophyll Absorption in Reflectance Index (MCARI), Transformed Chlorophyll Absorption in Reflectance Index (TCARI), Triangular Vegetation Index (TVI), Simple Ratio Pigment Index (SRPI), Photochemical Reflectance Index (PRI 2), Lichtenthaler Indices (LIC1, LIC2), Structure Intensive Pigment Index (SIPI) etc. were found to have strong positive correlation (R2 > 0.9) with plant parameters. These specific bandwidths and indices can be helpful in biophysical parameter estimation and early detection of crop stress, crop growth and disease monitoring.
PDF
