Objetivos: La termoterapia bipolar por radiofrecuencia es uno de los métodos adoptados en pacientes con alto riesgo quirúrgico. El objetivo de este estudio es comparar el efecto de la termoterapia de ...radiofrecuencia bipolar y los métodos de RTUP en los síntomas de vaciado y en las tasas de complicaciones posoperatorias, especialmente en pacientes con alto riesgo quirúrgico. Métodos: Se compararon el IPSS, el Qmax, la calidad de vida, los volúmenes de próstata y las complicaciones posoperatorias de los pacientes sometidos a RTUP y RF para la HBP preoperatorios, posoperatorios al primer y sexto mes. Resultados: En el grupo de RF, la mediana preoperatoria del IPSS fue de 30, el volumen prostático de 41.5 cc, el PVR de 80 ml y el Qmax de 5.85 ml/seg.; En el grupo RTUP estos fueron 29, 40 cc, 85 ml y 5.3 ml/seg, respectivamente. En el grupo de RF bipolar, los valores medianos postoperatorios del primer y sexto mes fueron IPSS 18, 21; volumen de próstata 40, 40; PVR 40, 35; Qmax 10.9, 9.15 y en el grupo TURP IPSS 9, 8; volumen de próstata 20, 20; PVR 30, 10; Qmax 17.25, 19.1, respectivamente. Conclusión: La termoterapia de RF bipolar es un método de tratamiento aplicable para pacientes con HPB con alto riesgo quirúrgico.
Lower urinary tract symptoms due to benign prostatic hyperplasia in men increase with aging. Risks related to anesthesia and surgery have led a search for alternative treatments. Bipolar ...radiofrequency (RF) thermotherapy is one of the methods adopted in patients with high surgical risks. The aim of this study is to compare the effect of bipolar RF thermotherapy and transurethral resection of the prostate (TURP) methods on voiding symptoms and on post-operative complication rates especially in patients carrying high surgical risks.
Pre-operative, post-operative 1
and 6
month International Prostate Symptom Score (IPSS), Qmax, quality of life, prostate volumes, and postoperative complications of the patients underwent TURP and RF for benign prostatic hyperplasia (BPH) were compared.
In the RF group, the pre-operative median IPSS was 30, prostate volume 41.5 cc, post-void residual (PVR) 80 ml, and Qmax is 5.85 ml/s.; In the TURP group, these were 29, 40 cc, 85 ml, and 5.3 ml/sec, respectively. In the Bipolar RF group, post-operative 1
- and 6
-month median values were IPSS 18, 21; prostate volume 40, 40; PVR 40, 35; Qmax 10.9, 9.15 and in the TURP group IPSS 9, 8; prostate volume 20, 20; PVR 30, 10; Qmax 17.25, 19.1, respectively.
Bipolar RF thermotherapy is an applicable treatment method for BPH patients with high surgical risks.
Objective: We aimed to investigate the significance of time to re-staging transurethral resection (re-TUR) on recurrence and progression rates in patients with high-risk non-muscle-invasive bladder ...cancer as a prospective randomized study. Methods: The patients were randomly separated into three groups according to Re-TUR timing. In Groups 1, 2, and 3, the time interval between initial and re-TUR was 14-28 days, 29-42 days, and 43-56 days, respectively. Cox regression analysis was used to assess the effect of time from initial TUR to re-TUR on oncological outcomes. Results: Twenty patients in Group 1 (14-28 days), 22 patients in Group 2 (29-42 days), and 29 patients in Group 3 (43-56 days) completed the study. Kaplan–Meier plots showed no differences in recurrence-free survival (RFS) and progression-free survival (PFS) rates between the three groups. Cox regression analysis demonstrated that only tumor number was found to be a prognostic factor on RFS rates. Conclusion: Our prospective study demonstrated that time laps from initial TUR to re-TUR did not significantly affect on RFS and PFS rates.
Propósito: El objetivo de este estudio fue investigar los efectos de la pandemia COVID-19 en la derivación, el diagnóstico, el tratamiento y el seguimiento de los TCG. Métodos: Se realizó un análisis ...retrospectivo unicéntrico de todos los pacientes que se sometieron a procedimientos diagnósticos y quirúrgicos debido a TCG entre septiembre de 2018 y septiembre de 2021. Resultados: Se inscribieron 65 pacientes en el estudio dividiéndolos en dos grupos como antes de la pandemia (Pre- CovGCT) y durante la pandemia (CovGCT). Se evaluaron y compararon 33 pacientes en el grupo Pre-CovGCT y 32 pacientes en el grupo CovGCT. Se observó un aumento significativo de la duración de los síntomas (p = 0.018), la duración entre el diagnóstico y el procedimiento quirúrgico (p = 0.028) y el riesgo de metástasis oculta de los tumores en estadio 1 (p = 0.05) durante el período pandémico. Conclusiones: Nuestro estudio mostró que la duración de los síntomas y la duración entre el diagnóstico y el procedimiento quirúrgico se prolongaron en los pacientes con TCG diagnosticados durante el período pandémico. Además, se ha observado un mayor riesgo de metástasis oculta en pacientes con TCG en estadio 1. Subrayamos la importancia de concienciar a los pacientes sobre el ingreso hospitalario sin demora en presencia de síntomas de cáncer de testículo y recomendamos tener cuidado de no retrasar el proceso de tratamiento.
Antecedentes. Los efectos inducidos por la COVID-19 en pacientes con cáncer de vejiga primario no están aclarados actualmente. Objetivo. Investigar los efectos de la pandemia en el diagnóstico, el ...tratamiento y el seguimiento del cáncer de vejiga primario. Método. Se realizó un análisis retrospectivo unicéntrico de todos los pacientes que se sometieron a procedimientos diagnósticos y quirúrgicos por cáncer primario de vejiga durante noviembre de 2018 y julio de 2021. Se incluyeron 275 pacientes en el estudio. Los pacientes fueron asignados a uno de dos grupos: pre-COVIDBC (antes de la pandemia) o COVIDBC (durante la pandemia). Resultados. Los pacientes con cáncer de vejiga diagnosticados durante la pandemia se encontraban en su mayoría en estadios más altos (T2) (p = 0.04), el grupo de riesgo era más alto en el cáncer de vejiga no invasivo del músculo (p = 0.02), y la recurrencia y las puntuaciones de progresión aumentaron (p = 0.001) en comparación con antes del período pandémico. Además, el tiempo hasta la cirugía desde el diagnóstico (p = 0.001) y la duración de los síntomas (p = 0.04) aumentaron considerablemente durante la pandemia, y la tasa de seguimiento disminuyó significativamente (p = 0.03). Conclusiones. Destaca el aumento significativo del cáncer de vejiga invasivo del músculo y del cáncer de vejiga no invasivo del músculo de muy alto riesgo durante la pandemia.
The COVID-19-induced effects of primary bladder cancer (BC) patients have not yet been clarified. The aim of this study was to investigate the effects of the pandemic on the diagnosis, treatment, and ...follow-up of primary BC patients.
A retrospective single-center analysis was made of all patients who underwent diagnostic and surgical procedures due to primary BC between November 2018 and July 2021. A total of 275 patients were identified and allocated to one of the groups: Pre-COVIDBC (BC diagnosed before the COVID-19 pandemic) or COVIDBC (during the pandemic).
The BC patients diagnosed during the pandemic were mostly at higher stages (T2) (p = 0.04), the risk of non-muscle invasive BC (NMIBC) was higher (p = 0.02), and recurrence and progression scores were increased (p = 0.001) compared to patients diagnosed before the pandemic. The time to surgery from diagnosis (p = 0.001) and symptom duration (p = 0.04) were significantly prolonged during the pandemic and the rate of follow-up significantly decreased (p = 0.03).
The study results highlight the significant increase in muscle invasive BC and the very high risk of NMIBC in patients presenting during the COVID-19 pandemic.
Future detection of extensive air showers (EAS) produced by ultra high energy cosmic particles by means of space-based fluorescence telescopes will open a new window on the universe and allow cosmic ...ray and neutrino astronomy at a level that is virtually impossible for ground based detectors. In the context of the extreme universe space observatory (EUSO) project, an end-to-end simulation of EAS observation with a spatial detector has been designed (EUSO simulation and analysis framework, ESAF). This paper describes the detailed Monte-Carlo developed to simulate all the physical processes involved in the fluorescence detection technique, from the EAS development to the instrument response. Particular emphasis is given to modeling the light propagation in the atmosphere and the effect of clouds. The simulation is used to assess the performances of EAS spatial detection. Main results on energy threshold and resolution, direction resolution and
X
max determination are reported. Results are based on EUSO telescope design, but are also extended to larger and more sensitive detectors.
The new setup of the CODALEMA experiment installed at the Radio Observatory in Nançay, France, is described. It includes broadband active dipole antennas and an extended and upgraded particle ...detector array. The latter gives access to the air shower energy, allowing us to compute the efficiency of the radio array as a function of energy. We also observe a large asymmetry in counting rates between showers coming from the North and the South in spite of the symmetry of the detector. The observed asymmetry can be interpreted as a signature of the geomagnetic origin of the air shower radio emission. A simple linear dependence of the electric field with respect to
v
∧
B is used which reproduces the angular dependencies of the number of radio events and their electric polarity.
Being able to ignite or reignite a gas turbine engine in a cold and rarefied atmosphere is a critical issue for many manufacturers. From a fundamental point of view, the ignition of the first burner ...and the flame propagation from one burner to another are phenomena that are usually not studied. The present work is a large eddy simulation (LES) of these phenomena. To simulate a complete ignition sequence in an annular chamber, LES has been applied to the full 360° geometry, including 18 burners. This geometry corresponds to a real gas turbine chamber. Massively parallel computing (700 processors on a Cray XT3 machine) was essential to perform such a large calculation. Results show that liquid fuel injection has a strong influence on the ignition times. Moreover, the rate of flame progress from burner to burner is much higher than the turbulent flame speed due to a major effect of thermal expansion. This flame speed is also strongly modified by the main burner aerodynamics due to the swirled injection. Finally, the variability of the combustor sectors and quadrant ignition times is highlighted.
Male anterior urethral strictures can be treated successfully with the help of optical internal urethrotomy (OIU) and is usually performed under general or regional anesthesia. In this study, we ...determined the efficacy of intraurethral lidocaine in OIU for anterior urethral stricture in an outpatient setting.
A total 157 patients with anterior urethral strictures underwent OIU under local urethral anesthesia with lidocaine. Optical urethrotomy was performed with a cold-cutting knife. Visual analogue scale (VAS) was used to evaluate patient discomfort and pain levels.
Using local anesthesia with lidocaine 2%, internal urethrotomy under vision was successfully completed in 151 of 157 patients. The overall success rate 96.1%. A total of 125 patients experienced mild, 26 patients moderate and 6 patients severe pain. The procedure was not completed in six patients because of severe pain. These patients went on OIU under general anesthesia. 18 (11.4%) recurrent strictures were seen during at least 6 months of follow-up.
Topical intraurethral lidocaine is a simple and efficacious anesthesia technique for surgical procedures on the anterior urethra. It is a safe, cost-effective and a well tolerated procedure. OIU under topical anesthesia can be easily performed and satisfactorily completed in an outpatient setting. It is anesthetic efficacy and reasonable success rate when compared with the other anesthetic techniques may provide an alternative approach in the management of urethral strictures.
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