Collecting system percutaneous access using real-time tracking sensors: first pig model in vivo experience

Purpose: Precise needle puncture of the renal collecting system is an essential but challenging step for successful percutaneous nephrolithotomy. We evaluated the efficiency of a new real-time electromagnetic tracking system for in vivo kidney puncture. Materials and Methods: Six anesthetized female pigs underwent ureterorenoscopy to place a catheter with an electromagnetic tracking sensor into the desired puncture site and ascertain puncture success. A tracked needle with a similar electromagnetic tracking sensor was subsequently navigated into the sensor in the catheter. Four punctures were performed by each of 2 surgeons in each pig, including 1 each in the kidney, middle ureter, and right and left sides. Outcome measurements were the number of attempts and the time needed to evaluate the virtual trajectory and perform percutaneous puncture. Results: A total of 24 punctures were easily performed without complication. Surgeons required more time to evaluate the trajectory during ureteral than kidney puncture (median 15 seconds, range 14 to 18 vs 13, range 11 to 16, p ¼ 0.1). Median renal and ureteral puncture time was 19 (range 14 to 45) and 51 seconds (range 45 to 67), respectively (p ¼ 0.003). Two attempts were needed to achieve a successful ureteral puncture. The technique requires the presence of a renal stone for testing. Conclusions: The proposed electromagnetic tracking solution for renal collecting system puncture proved to be highly accurate, simple and quick. This method might represent a paradigm shift in percutaneous kidney access techniques

Papa Bento XVI e Papa Francisco na grande final!

A chamada Lei do Branqueamento de Capitais - Lei 25/2008, de 5/6 e alterações -, considera que estão sujeitas a especiais obrigações os “Notários, conservadores de registos, advogados, solicitadores e outros profissionais independentes, constituídos em sociedade ou em prática individual, que intervenham ou assistam, por conta de um cliente ou noutras circunstâncias, em operações: § vi) De alienação e aquisição de direitos sobre praticantes de actividades desportivas profissionais;”. Estamos a pensar, como é óbvio, nas transferências de jogadores de futebol, nomeadamente na Europa, as quais atingem somas astronómicas e muitas vezes ocultas. São por demais evidentes as notícias da comunicação social que dão conta que, em muitos dos casos, os verdadeiros valores envolvidos não são os declarados. Quer para fugir aos impostos, quer para esconder o pagamento de avultadas comissões extraordinárias; Abstract: The Call of the Money Laundering Law - Law 25/2008, of 5/6 and change - considers that are subject to the special obligations "notaries, registrars, lawyers, solicitors and other independent professionals, made in society or in practice individual, that participating or assisting, on behalf of a client or other circumstances in operations: § vi) sale and acquisition of rights to practitioners of professional sports activities; ". We are thinking, of course, transfers of football players, particularly in Europe, which reach astronomical sums and often hidden. Are all too apparent the news media that realize that in many cases the true values involved are not declared. Want to evade taxes or to hide the payment of large exceptional fees.