Introduction and Objectives
Our goals were to study prostatic volume as a limiting factor after HoLEP surgery with short‐circuit outpatient care (4 h) and to define other factors that affect the ...success of the proposed circuit.
Materials and Methods
An observational analysis and review was performed using a prospective database. Preoperative, intraoperative, and postoperative variables were included for patients who were scheduled for short‐circuit outpatient care (SCOC) and who underwent HoLEP between 2020 and 2023. We defined SCOC as a postoperative hospital stay of 4 h. Subjects who required more than 4 h in hospital were categorized as conventional hospital admission (CHA). A descriptive populational study was conducted, expressing the mean using a 95% confidence interval and percentages for the continuous variables. In order to analyze them, we used the Student's t‐test for the continuous variables and the chi‐squared test for the categorical variables.
Results
Sixty‐eight patients were included, 54 of which completed SCOC, which represented a success ratio of 79.5%. The mean age and prostatic volume of the whole cohort were 68.9 (±6.8) years and 79.5 (±29.1) mL, respectively. We found no significant differences in age, prostatic volume, antiplatelet drug use, indwelling bladder catheter, or applied energy among the subjects who completed SCOC and those who required CHA. No patient was presented with a complication of Grade 3 (or higher) in the modified Clavien–Dindo classification. At the six‐month follow‐up, no differences were observed in the uroflowmetry or International Prostate Symptoms Score variables.
Conclusions
Prostatic volume does not seem to be a limiting factor after undergoing HoLEP with short‐circuit outpatient care.
The Cancer of the Bladder Risk Assessment (COBRA) score is a predictive tool for estimating Cancer Specific Survival (CSS) after Radical Cystectomy (RC) for urothelial carcinoma. COBRA score ...variables are: age at RC, Tumor stage and Lymph Node Density (LND). We sought to externally validate the COBRA score and to improve its performance in estimating CSS adding Lymphovascular Invasion (LVI) as a further variable (Modified COBRA score). Clinicopathological and survival data from 789 patients who underwent RC and Pelvic Lymph Node Dissection (PLND) between January 2007 and December 2020 in two European referral centers (Paris, France and Badalona, Spain) were analyzed. COBRA score was applied to our cohort and CSS Kaplan-Meier curves were performed. Univariable and Multivariable analysis was performed in order to identify risk factors for Cancer Specific Mortality (CSM) and a score was assigned for any statistically significant risk factor; afterward, c-index calculation was performed and CCS curves have been plotted for the model after having integrated LVI variable to the COBRA score. Finally, we compared both COBRA score and Modified COBRA score models with the established AJCC model. A total of 789 patients underwent RC during the observation period. Complete data were available for 731 patients with a median follow-up of 32 months (8-47). CSM was 27.6% (no. 218 patients) at follow-up. When COBRA score was applied to our cohort, c-index was 0.76. Regression COX analysis has shown HR 0.36, CI 95% (0.16-0.83), P = .016 for patients with COBRA score 1; HR 0, CI 95% (0-1.77), P =.94 for score 2; HR 0.51, CI 95% (0.39 -0.67), P =.001 for score 3; HR 1.67, CI 95% (1.23-2.27), P =.001 for score 4; HR 2.45, CI 95% (1.51-3.99), P =.001 for score 5; HR 2.01, CI 95% (1.42-2.85), P =.001 for score 6 and HR 0.66, CI 95% (0.09-4.73), P =.682 for score 7. When the LVI variable was added to the CSS predictive model the discriminatory power increased to a c-index of 0.78. COBRA score adequately identifies those patients with a higher risk of CSM, with a c-index of 0.76. Moreover, LVI variable further improves its predictive accuracy from c-index of 0.76 to c-index of 0.78. LVI variable could be integrated in the COBRA score to optimizing prognosis stratification for patients who undergo RC.
Se presentan los resultados de la excavación y estudio de la necrópolis ibérica de Les Esquarterades (Ulldecona, Tarragona) y la reconstrucción del ritual funerario del período Ibérico Antiguo a ...partir de los mismos. Este yacimiento se sitúa en una zona donde existen datos relativamente abundantes sobre el mundo funerario, incluyendo varias necrópolis excavadas entre los ríos Ebro y Mijares. Sin embargo, la mayoría de estas investigaciones se realizó entre las décadas de 1960 y 1970, con importantes carencias metodológicas, entre las que destaca la total ausencia de estudios antropológicos. Esta necrópolis se ha estudiado mediante una metodología renovada, con elevado carácter interdisciplinar. Esto ha permitido recuperar información de calidad sobre aspectos hasta ahora poco conocidos para el período y la zona, como la caracterización antropológica de la población enterrada, los ustrina o la identificación de banquetes funerarios o libaciones en el momento de realizar los depósitos funerarios.
Geophysical survey methods are broadly used to delimit and characterize archaeological sites, but the archaeological interpretation of geophysical data remains one of the challenges. Indeed, many ...scenarios can generate a similar geophysical response, and often interpretations can not be validated without access to the subsoil. In large geophysical surveys many anomalies are detected and validation through archaeological trenches can not be afforded. This paper analyses the validity of geoarchaeological core survey to check the archaeological interpretations based on geophysical results. The Roman site located at Auritz/Burguete and Aurizberri/Espinal (Navarre), provides a great case of study as many investigations have been carried out. After the gradiometer survey performed in 2013 a sediment core survey was designed. 132 cores were drilled using a hand-held coring machine and the sediments were analysed in situ. Site delimitation and archaeological interpretations based on magnetic data could be improved or corrected. In this regard, the core survey proved to be an useful methodology as many anomalies could be checked within reasonable time and resources. However, further geophysical investigations trough GPR revealed unexpected remains in areas where no archaeological deposits were identified through coring. Excavations showed poor conservation level in some of those areas, leading to thin archaeological deposits hard to identify at the cores. The sediment core survey, therefore, was proved to be inconclusive to delimit the archaeological site.
Se presentan los resultados históricos derivados de la primera fase de la investigación sobre este importante yacimiento, realizada exclusivamente a partir de métodos no invasivos. Los datos ...recuperados a partir de la prospección pedestre y geofísica han permitido verificar la condición urbana del asentamiento, atestiguada tanto por sus dimensiones como por su complejidad estructural y la naturaleza de los materiales muebles recuperados, que sugieren actividades económicas especializadas y la coexistencia de distintos sectores sociales. La desaparición del asentamiento en torno a 200 a. C. confirma el profundo impacto de la conquista romana en los patrones de poblamiento del mundo ibérico septentrional.
Introduction
The analysis of post-HoLEP urinary incontinence (UI) has traditionally focused on stress UI. Our aim is to evaluate the factors associated with stress and urgency UI in the first month ...after the surgery.
Methods
Data were obtained from patients who underwent HoLEP by the same experienced surgeon. UI was evaluated at one month and at 6 months after the surgery. Three groups were defined: continent patients, patients with pure urgency UI and patients with stress or mixed UI. Preoperative, intraoperative, urodynamic and clinical variables were analyzed and compared between the three groups.
Results
In total, 235 subjects were included. One month after the surgery, 156 (66.5%) were continent (group 1), 49 (20.8%) reported pure urgency UI (group 2), and 30 (12.7%) reported some level of stress UI (group 3). In Group 2, the factors associated with urgency UI in the univariate analysis were age, presurgical urgency UI, having diabetes or hypertension. In Group 3, age, prostatic volume, preoperative PSA, time of enucleation, weight of the resection in grams, having an IDC or being diabetic were significant in the univariate analysis. In the multivariate analysis, age predicts both types of UI, while prostatic volume and having an IDC predict stress or mixed UI.
Conclusion
In the first month post-HoLEP, age is a predictive factor of urgency UI and stress UI. In addition, prostatic volume and the presence of an indwelling urinary catheter are predictive factors of stress UI.
Landscape plays a vital role in the development of military campaigns through the definition of geostrategic landmarks that structure the control of the territory, the imposition of constraints to ...the movement of armies and the identification of features that facilitate defence against attackers. These factors are linked to the study of past spatial mobility which is typically done by finding optimal pathways between pairs of points using Least-Cost Path analysis. This emphasis on optimality may not be ideal for case studies that need a general approach to spatial connectivity such as the study of conflict-related dynamics. Connectivity modelling based on Circuit Theory (CT) is an alternative approach to spatial mobility that captures the connectivity of an entire region identifying not only optimal paths but also bottlenecks, dead-ends and any other spatial feature that may impact movement. We present here a framework to study landscapes of conflict using connectivity modelling; the framework combines CT, visibility analysis and statistical hypothesis testing to understand the reasons behind the assault and destruction of Puig Ciutat (NE Iberian Peninsula) during Julius Caesar’s civil war. Results suggest that the site exerted decisive control over a highly connected area linking two possible logistical bases (Emporion and Massalia) to the armies fighting at Ilerda (49 BC).
An integrated geophysical survey has been conducted at the Tarragona’s Cathedral (Catalonia, NE Spain) with the aim to confirm the potential occurrence of archaeological remains of the Roman Temple ...dedicated to the Emperor Augustus. Many hypotheses have been proposed about its possible location, the last ones regarding the inner part of the Cathedral, which is one of the most renowned temples of Spain (twelfth century) evolving from Romanesque to Gothic styles. A geophysical project including electrical resistivity tomography (ERT) and ground probing radar (GPR) was planned over 1 year considering the administrative and logistic difficulties of such a project inside a cathedral of religious veneration. Finally, both ERT and GPR have been conducted during a week of intensive overnight surveys that provided detailed information on subsurface existing structures. The ERT method has been applied using different techniques and arrays, ranging from standard Wenner–Schlumberger 2D sections to full 3D electrical imaging with the advanced Maximum Yield Grid array. Electrical resistivity data were recorded extensively, making available many thousands of apparent resistivity data to obtain a complete 3D image after a full inversion. In conclusion, some significant buried structures have been revealed providing conclusive information for archaeologists. GPR results provided additional information about shallowest structures. The geophysical results were clear enough to persuade religious authorities and archaeologists to conduct selected excavations in the most promising areas that confirmed the interpretation of geophysical data. In conclusion, the significant buried structures revealed by geophysical methods under the cathedral were confirmed by archaeological digging as the basement of the impressive Roman Temple that headed the Provincial Forum of Tarraco, seat of the Concilium of Hispania Citerior Province.
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