Outcomes of minimally invasive simple prostatectomy for benign prostatic hyperplasia: a systematic review and meta-analysis.

PURPOSE: (1) To assess the outcomes of minimally invasive simple prostatectomy (MISP) for the treatment of symptomatic benign prostatic hyperplasia in men with large prostates and (2) to compare them with open simple prostatectomy (OSP). METHODS: A systematic review of outcomes of MISP for benign prostatic hyperplasia with meta-analysis was conducted. The article selection process was conducted according to the PRISMA guidelines. RESULTS: Twenty-seven observational studies with 764 patients were analyzed. The mean prostate volume was 113.5 ml (95 % CI 106-121). The mean increase in Qmax was 14.3 ml/s (95 % CI 13.1-15.6), and the mean improvement in IPSS was 17.2 (95 % CI 15.2-19.2). Mean duration of operation was 141 min (95 % CI 124-159), and the mean intraoperative blood loss was 284 ml (95 % CI 243-325). One hundred and four patients (13.6 %) developed a surgical complication. In comparative studies, length of hospital stay (WMD -1.6 days, p = 0.02), length of catheter use (WMD -1.3 days, p = 0.04) and estimated blood loss (WMD -187 ml, p = 0.015) were significantly lower in the MISP group, while the duration of operation was longer than in OSP (WMD 37.8 min, p < 0.0001). There were no differences in improvements in Qmax, IPSS and perioperative complications between both procedures. The small study sizes, publication bias, lack of systematic complication reporting and short follow-up are limitations. CONCLUSIONS: MISP seems an effective and safe treatment option. It provides similar improvements in Qmax and IPSS as OSP. Despite taking longer, it results in less blood loss and shorter hospital stay. Prospective randomized studies comparing OSP, MISP and laser enucleation are needed to define the standard surgical treatment for large prostates.

European cancer mortality predictions for the year 2015 : does lung cancer have the highest death rate in EU women?

BACKGROUND: Cancer mortality statistics for 2015 were projected from the most recent available data for the European Union (EU) and its six more populous countries. Prostate cancer was analysed in detail. PATIENTS AND METHODS: Population and death certification data from stomach, colorectum, pancreas, lung, breast, uterus, prostate, leukaemias and total cancers were obtained from the World Health Organisation database and Eurostat. Figures were derived for the EU, France, Germany, Italy, Poland, Spain and the UK. Projected 2015 numbers of deaths by age group were obtained by linear regression on estimated numbers of deaths over the most recent time period identified by a joinpoint regression model. RESULTS: A total of 1 359 100 cancer deaths are predicted in the EU in 2015 (766 200 men and 592 900 women), corresponding to standardised death rates of 138.4/100 000 men and 83.9/100 000 women, falling 7.5% and 6%, respectively, since 2009. In men, predicted rates for the three major cancers (lung, colorectum and prostate) are lower than in 2009, falling 9%, 5% and 12%. Prostate cancer showed predicted falls of 14%, 17% and 9% in the 35-64, 65-74 and 75+ age groups. In women, breast and colorectal cancers had favourable trends (-10% and -8%), but predicted lung cancer rates rise 9% to 14.24/100 000 becoming the cancer with the highest rate, reaching and possibly overtaking breast cancer rates-though the total number of deaths remain higher for breast (90 800) than lung (87 500). Pancreatic cancer has a negative outlook in both sexes, rising 4% in men and 5% in women between 2009 and 2015. CONCLUSIONS: Cancer mortality predictions for 2015 confirm the overall favourable cancer mortality trend in the EU, translating to an overall 26% fall in men since its peak in 1988, and 21% in women, and the avoidance of over 325 000 deaths in 2015 compared with the peak rate.

Seleção de genótipos de aceroleira assistida por marcadores isoenzimáticos visando à resistência a Meloidogyne incognita raça 2

A cultura da aceroleira despertou um grande interesse do mercado consumidor, tendo em vista o alto teor de vitamina C (ácido ascórbico), que varia entre 1.325 a 2.250 mg por 100 mL de suco. Com a expansão da cultura, surgiram problemas fitossanitários, entre os quais a infecção das raízes da aceroleira por nematóides. Os produtos químicos utilizados no controle dos nematóides são agressivos ao meio ambiente, e a seleção de genótipos resistentes e tolerantes constitui-se na melhor alternativa para a solução do problema. O trabalho foi desenvolvido em casa de vegetação com 18 genótipos de aceroleira, com o objetivo de encontrar genótipos resistentes e tolerantes a Meloidogyne incognita raça 2 assistida por marcadores isoenzimáticos, para indicar plantas destinadas a porta-enxerto. A avaliação foi realizada 60 dias após a inoculação mediante análise das variáveis: número de ovos por planta e por grama de raiz, índice de galhas e massa de ovos, biomassa fresca relativa do sistema radicular e biomassa fresca relativa da parte aérea. Os resultados permitiram identificar o genótipo 023-CMF como menos suscetível, e os genótipos 027-CMF e 035-CMF, como mais suscetíveis. Estudos realizados através da eletroforese isoenzimática com os sistemas α esterase, fosfatase ácida e peroxidase, 20; 40 e 60 dias após a inoculação com ovos de M. incognita raça 2, possibilitaram relacionar a expressão de proteínas com a suscetibilidade. Os genótipos mais próximos geneticamente, com índice de similaridade 0,941, foram 027-CMF e 026-CMF, 046-CMF e 026-CMF, e 041-CMF e 026-CMF. O menor índice de similaridade genética (0,115) foi observado entre os genótipos 002-SPE e 036-CMF.

Estado actual de fruticultura colombiana y perspectivas para su desarrollo

La horticultura en Colombia comprende las áreas de floricultura, fruticultura, olerícultura, producción de plantas aromáticas y medicinales y la horticultura urbana. La promoción y desarrollo del sector frutícola representa para Colombia una importante fuente de crecimiento de la agricultura, de generación de empleo rural y de desarrollo con equidad para las distintas regiones puesto que las frutas pueden asentarse en los diversos pisos térmicos de que dispone el país, a la vez que conforma una producción administrada con criterios de eficiencia y sostenibilidad en escalas que van desde micro, pequeños y medianos productores hasta grandes productores y empresas. Durante las últimas cuatro décadas el área sembrada en frutas expresa una dinámica de constante crecimiento, consiguiendo así aumentar su participación tanto en el área dedicada a cultivos no transables, como en el total del área de la agricultura sin café. Así, mientras en 1970 la participación del área frutícola en los no transables era del 1,6%, en el 2005 ésta era del 12,6%. Las áreas plantadas en frutas en Colombia pasaron de 191.035 ha en 2003 a 225.325 ha en 2007 lo que representa un crecimiento de 17,9 %, mientras que los volúmenes de producción pasaron de 2.675.736 t a 3.279.264 t en el mismo período en 47 especies frutícolas. El Plan Frutícola Nacional - PFN, constituye una propuesta estratégica conformada por conjunto coherente de objetivos, estrategias y programas que, con base en una visión de futuro, buscan la meta inicial de duplicar el área de la producción frutícola nacional, asegurar las condiciones tecnológicas y de innovación para una producción sostenible y de calidad, agregar valor en la cadena frutícola, y lograr una vinculación plena en los mercados internacionales. Se busca que los participantes conozcan los principales desarrollos de la fruticultura Colombiana, sus retos y oportunidades para la próxima década.

Le scellement de sillon est-il efficace dans la prévention de la carie des dents permanentes? : revue cochrane pour le praticien

Scénario: Un enfant de 8 ans, que vous connaissez depuis plusieurs années, se présente à votre consultation pour un contrôle de santé. Il a eu une carie en denture temporaire, qui a été soignée; depuis lors, l'enfant maintient une bonne hygiène buccale et alimentaire. Les parents vous demandent s'il serait indiqué d'appliquer un scellement de sillon pour éviter le développement de nouvelles caries chez leur enfant. Question: Le scellement de sillon (sealant) prévient-il la survenue de caries en denture permanente? Si oui, quel produit utiliser? Contexte: Depuis leur introduction dans les années 60, les programmes de fluoration ont permis un déclin considérable de l'incidence de la carie. Les scellements de sillon semblent également jouer un rôle protecteur en limitant la croissance bactérienne dans les puits et fissures des dents postérieures, zones les plus vulnérables au développement de la maladie carieuse. Néanmoins, il existe un doute sur leur efficacité en cas de risque carieux faible. D'autre part, la diversité des produits (verres ionomères, résine composite, compomères hybrides) proposés sur le marché laisse le praticien dans l'embarras du choix.

Geometric stopping of a random walk and its applications to valuing equity-linked death benefits

We study discrete-time models in which death benefits can depend on a stock price index, the logarithm of which is modeled as a random walk. Examples of such benefit payments include put and call options, barrier options, and lookback options. Because the distribution of the curtate-future-lifetime can be approximated by a linear combination of geometric distributions, it suffices to consider curtate-future-lifetimes with a geometric distribution. In binomial and trinomial tree models, closed-form expressions for the expectations of the discounted benefit payment are obtained for a series of options. They are based on results concerning geometric stopping of a random walk, in particular also on a version of the Wiener-Hopf factorization.

Metabolic gene expression changes in astrocytes in Multiple Sclerosis cerebral cortex are indicative of immune-mediated signaling.

Emerging as an important correlate of neurological dysfunction in Multiple Sclerosis (MS), extended focal and diffuse gray matter abnormalities have been found and linked to clinical manifestations such as seizures, fatigue and cognitive dysfunction. To investigate possible underlying mechanisms we analyzed the molecular alterations in histopathological normal appearing cortical gray matter (NAGM) in MS. By performing a differential gene expression analysis of NAGM of control and MS cases we identified reduced transcription of astrocyte specific genes involved in the astrocyte-neuron lactate shuttle (ANLS) and the glutamate-glutamine cycle (GGC). Additional quantitative immunohistochemical analysis demonstrating a CX43 loss in MS NAGM confirmed a crucial involvement of astrocytes and emphasizes their importance in MS pathogenesis. Concurrently, a Toll-like/IL-1β signaling expression signature was detected in MS NAGM, indicating that immune-related signaling might be responsible for the downregulation of ANLS and GGC gene expression in MS NAGM. Indeed, challenging astrocytes with immune stimuli such as IL-1β and LPS reduced their ANLS and GGC gene expression in vitro. The detected upregulation of IL1B in MS NAGM suggests inflammasome priming. For this reason, astrocyte cultures were treated with ATP and ATP/LPS as for inflammasome activation. This treatment led to a reduction of ANLS and GGC gene expression in a comparable manner. To investigate potential sources for ANLS and GGC downregulation in MS NAGM, we first performed an adjuvant-driven stimulation of the peripheral immune system in C57Bl/6 mice in vivo. This led to similar gene expression changes in spinal cord demonstrating that peripheral immune signals might be one source for astrocytic gene expression changes in the brain. IL1B upregulation in MS NAGM itself points to a possible endogenous signaling process leading to ANLS and GGC downregulation. This is supported by our findings that, among others, MS NAGM astrocytes express inflammasome components and that astrocytes are capable to release Il-1β in-vitro. Altogether, our data suggests that immune signaling of immune- and/or central nervous system origin drives alterations in astrocytic ANLS and GGC gene regulation in the MS NAGM. Such a mechanism might underlie cortical brain dysfunctions frequently encountered in MS patients.

SOIL ATTRIBUTES THREE YEARS AFTER MAKING RIDGES AND OR DRAINS FOR PLANTING GRAPEVINE ROOTSTOCK

RESUMO Os atributos do solo estão relacionados com o desenvolvimento e a produção das culturas, tanto anuais como perenes. O presente trabalho teve como objetivo determinar os atributos químicos e físicos do solo três anos após a aplicação de sistemas de manejo para implantação de porta-enxertos de videira, em um Nitossolo Vermelho com textura muito argilosa. Os sistemas de manejo consistiram na confecção ou não de camalhões e/ou de drenos antes da implantação das mudas de porta-enxertos Dog Ridge. Os atributos químicos (pH em água e teores de matéria orgânica e de macronutrientes) foram determinados em amostras coletadas na linha da cultura, nas camadas de 0-0,1; 0,1-0,2; 0,2-0,3 e 0,3-0,4 m de profundidade. Os atributos físicos do solo (teor de argila, densidade, porosidade, resistência à penetração e estabilidade dos agregados) foram determinados em amostras coletadas com estrutura preservada nas camadas de 0,025-0,075; 0,125-0,175; 0,225-0,275 e 0,325-0,375 m de profundidade. Também foram determinadas a massa seca de raízes do portaenxerto nas camadas de 0-0,2 e 0,2-0,4 m de profundidade e suas correlações com os atributos do solo. A confecção de camalhões alterou significativamente a maioria dos atributos químicos do solo e proporcionou maior uniformidade nos valores em profundidade, criando condições mais favoráveis ao crescimento radicular nas camadas mais profundas. Os atributos físicos foram menos afetados do que os químicos pela confecção de camalhões ou drenos, e não foram observados valores restritivos ao crescimento radicular nas camadas amostradas após quatro anos da aplicação dos sistemas de manejo do solo. A confecção de drenos alterou menos os atributos químicos e físicos do solo do que a confecção de camalhões.

Enhancement of human adipose-derived stem cell expansion and stability for clinical use

Co-culture techniques associating both dermal fibroblasts and epidermal keratinocytes have shown to have better clinical outcome than keratinocyte culture alone for the treatment of severe burns. Since fat grafting has been shown to improve scar remodelling, new techniques such as cell-therapy-assisted surgical reconstruction with isolated and expanded autologous adipose-derived stem cells (ASCs) would be of benefit to increase graft acceptation. Therefore, integrating ASCs into standardized procedures for cultured skin grafting could be of benefit for the patient if cell quality and quantity could be maintained. The purpose of this study was to evaluate ASC processing from adult tissue with simple isolation (without enzymatic steps), expansion (low density of 325-3,000 cells/cm2) and storage conditions to assure methods to enhance the cellular resistance when transferred back to the patient. Co-culture with cell-banked skin progenitor cells (FE002-SK2) showed an increase of 40-50% ASCs yield at high passages alongside with a better preservation of morphology, proper adipogenic and osteogenic differentiation and efficient biocompatibility with 3D collagen scaffolds. ASCs can be considered as a valuable additional cell source to be delivered in biological bandages to the patient in a need of tissue reconstruction such as burn patients.

Sonat

Soitinnus: piano.

Historia Regiae Academiae Aboensis

Invocatio: I.N.J.C.

Utilitates, qvae ex commerciis & coloniis in calidioribus mundi partibus patriae adfluerent

Painovuosi nimekkeestä.

Le Constitutionnel : journal politique et littéraire

1816/11/20 (Numéro 325).