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L'utilizzo della P.E.M.F. in pazienti affetti da ipertrofia prostatica benigna. Effetti su volume ghiandolare e sintomatologia urinaria in uno studio pilota
Get PDFBACKGROUND. L'eziopatogenesi dell'ipertrofia prostatica benigna (IPB) resta ad oggi in parte sconosciuta. Sempre maggior attenzione è rivolta al ruolo dell'infiammazione cronica intraghiandolare. Tale condizione determina la comparsa di LUTS (Lower Urinary Tract Symtoms) in grado di consizionare la qualità di vita (QoL) del paziente. La PEMF (Pulsed Electromagnetic ield therapy) è una metodica efficace dotata di azione antinfiammatoria. SCOPO DEL LAVORO. Valutare l'efficacia della PEMF nel ridurre il volume prostatico (PV) e la sintomatologia del minzionale. MATERIALI E METODI. Ventisette pazienti affetti da IPB sintomatica sono stati arruolati in uno studio longitudinale, prospettico e di intervento. La numerosità campionaria è stata calcolata con il modello dell'optimal-two-stage di Simon. Al baseline (V0) i pazienti si sono sottoposti ad stadiazione ematochimica, ecografica prostatica transrettale e compilazione del questionario validato IPSS (International Prostate Symptoms Score). E' stato loro consegnato il dispositivo Magcell®Microcirc (Physiomed Elektromedizin) per l'esecuzione della terapia con PEMF. Il protocollo ha previsto l'applicazione del dispositivo in sede perineale per 5 minuti a cadenza bi-giornaliera per 28 giorni. Al termine del ciclo (V1) i pazienti sono stati nuovamente ristadiati per valutare gli effetti ottenuti. La numerosità campionaria è staa dunque suddivisa in due bracci: il primo (PT - patients treatment) ha protratto la terapia con PEMF ulteriori 90 giorni, il secondo (FU - Follow-Up patients) ha interrotto la terapia sottoponendosi esclusivamente a controlli. L'intero campione è stato rivalutato a 90 giorni (V2). RISULTATI. E' stata osservata una riduzione del PV sia al V1 sia al V2: PVV0 44.5 mL (38.0;61.6) vs PVV1 42.1 mL (33.7;61.5, P = .039) vs PVV2 41.7mL (32.7;62.8, P = .045). Una riduzione anche dell'IPSS è stata osservata sia al V1 sia al V2: IPSSV0 11 (5.7;23.2) vs IPSSV1 10 (6;16, P = .045) vs IPSSV2 9 (6;14, P = .015). Non sono emerse differenze statisticamente significative tra i due bracci in termini di PV ed IPSS al V2. Una migliore risposta in termini di riduzione del PV è stata osservata in pazienti non affetti da sindrome metabolica (ΔPVV1nMetS −4.7 mL, 95%CI −7.3;‐2.0) rispetto ai pazienti affetti da tale condizione (ΔPVV1MetS 1.7 mL, 95%CI −2.69;6.1)(P = .017, Relative RiskMetS = 6). DISCUSSIONE. Una riduzione statisticamente significativa del PV e l'IPSS è stata evidenziata dopo soli 28 giorni di terapia con PEMF. Non si sono registrati eventi avversi. I pazienti hanno mostrato buona compliance al trattamento. CONCLUSIONE. La PEMF può costituire una metodica di trattamento efficace e non invasiva in pazienti affetti da IPB sintomatica unfit per terapie convenzionali e preferibilmente indenni da sindome metabolica
Large primary leiomyosarcoma of the seminal vesicle: A case report and literature revision
No full textPrimary Leiomyosarcoma of the seminal vesicle is a very rare condition. We report a case of a 74-year-old man with a tumour detected by rectal symptoms with pelvic pain and dysuria at ultrasonography. Computed tomography and magnetic resonance imaging suggest an origin in the left seminal vesicle and did not show a clear cleavage plan with the rectum and a right hydroureteronephrosis was also present. A radical vesiculo-cystoprostatectomy with ileal conduit and bilateral pelvic lymphadenectomy was performed, a sigmoidectomy with end colostomy was performed also. Pathological examination showed a high grade (G3) leiomyosarcoma of the seminal vesicle
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Fatal infections in andrology. Atypical clinical presentation of a Fournier's disease
No full textBackground: Fournier disease (FD) is a worrisome infection of genital area caused by a polimicrobial infection and characterized by a rapid progression to necrosis. Scrotum, perineum and lower abdomen represent the primary sites of origin. Clinical presentation and laboratory strongly suggest FD, but if not precociously diagnosed, it may quickly evolve into septic syndrome and patient's death. Case report: A 62 years old Caucasian male presented for fever and penile gross oedema recently occurred. No history of previous urinary tract infection, hematuria or genital trauma was referred. He did not complain any storage or voiding low urinary tract symptom (LUTS); no foci of infection in genitoperineal area was observed nor urethral discharge. The ultrasound (US) revealed a disomogeneous broad thickening of subcutaneous tissues with increased vascularity on Color-Doppler. When the penis was manipulated in order to reduce oedema, retract foreskin and evaluate the glans, clinical parametres rapidly worsened and the patient developed a septic shock with blood pressure falling down, dyspnoea and tachyarrhythmia, and he was fastly sent to Intensive Care Unit where it has been hemodynamically stabilized and subjected to antibiotic therapy. Considering the clinical absence of gangrene's foci, we opted for a conservative treatment by maintaining bladder catheter and drug therapy
Epidermoid cyst of the adult testis. Case report and literature review
No full textBACKGROUND: Testicular epidermoid cysts (TEC) are rare lesions often incidentally discovered and radically treated. They present as testicular firm palpable mass. Ultrasound and MR may be useful in characterizing the lesion. Diagnosis depends on histology. The real understanding of biological behaviour and clinical management is unresolved. We report the case of a young male who underwent to surgical keratocyst enucleation.
CASE REPORT: A 16 y.o. male presented for a firm mass in the testis. The right testis presented with a palpable painless mass in the middle portion. Inguinal and supraclavicular lymph nodes were negative. Serum markers (AFP, bHCG, PLAP and LDH) were normal. Scrotal sonography (US) reported a well circumscribed 2 centimetres mass with intervening septa and coexisting solid areas: intralesional calcifications were not described. Magnetic Resonance (MR) ruled out secundarisms and intralesional contrast enhancement. Biopsy with was offered.
RESULTS: Frozen section was suggestive for mature keratocyst and surgical enucleation of the mass was offered.
DISCUSSION: TEC are benign tumors which arise from ectoderm, endoderm or mesoderm tissues. They account for around 1-2% of all testicular masses and tipically present in mid-adulthood. The etiology is still debated and whether these should be classed as a variant of mature teratoma is still under discussion. Simple TEC correspond to the prepubertal-type teratoma of the 2018 WHO classification and are unrelated to germ cell neoplasm in situ (GCNIS). Post-pubertal variant may be more frequently associated with invasive GCT and should be radically treated especially when bad prognostic features coexist: due to this reason the are identifyed as complex TEC. Clinically keratocysts are highly indistinguishable to all testicular neoplasms. Serum markers are negative too. Sonographic study (US) may guide diagnosis: they present as non-vascular, well marginated intratesticular masses with a lamellar ‘onion skin’ or ‘bull-eye’ image and avascular centre. Contrast enhanced ultrasound (CEUS) and Magnetic Resonance (MR) also provide with more informations since the absence of contrast enhancement highly suggest the benign nature of the lesions. Diagnosis only depends on histology: differentiation from coexisting enthities such as teratomas, germ cell tumors (GCT) and granulomatous disease is mandatory also in pre-pubertal forms. Microscopically, cellular atypia, mitotic activity, necrosis, hemorrhage and epythelial hyperplasia are usually missing in pre-pubertal ones totally suggesting a benign behaviour. Moreover, no case of recurrence or metastases have been to date reported in literature: partial orchiectomy or testis-sparing excision with frozen section is becoming day by day the standard treatment.
CONCLUSION: Testicular keratocysts are rare lesions commonly presenting in young male and indistinguishable from other testicular lesions. Pre- and post-pubertal form represent the main variants. Biologic behaviour and clinical management is still unresolved. Pre-pubertal form are not related to IGCNIS and no cases of spreading have been reported to date: differently from post-pubertal ones they are considered benign tumors to date. Serum markers, sonographic features and MR may be helpful in making diagnosis and surgical planning. Only histology confirms the nature of the lesion and ruling out coexisting histotype. The importance of accurate diagnosis is crucial for preventing unncessary orchiectomy since testicular sparing surgery shoudl be offered
Post-pubertal testicular epidermoid cyst: surgical options and literature review
No full textPOST-PUBERTAL TESTICULAR EPIDERMOID CYST: SURGICAL OPTIONS AND LITERATURE REVIEW
Olivieri Valerio1, Fortunati Valentina2, Corongiu Emanuele3, Forte Flavio3, De Luca Francesco4, Ruggiero Gabriele1 and Griffa Daniele1
1 Division of Urology, Ivrea Hospital – ASL TO4, Ivrea (Turin), Italy
2 Division of Pathology, Hospital “Policlinico of Tor Vergata”, Rome, Italy
3 Division of Urology, Hospital “Madre Giuseppina Vannini”, Rome, Italy
4 Department of Gynecological, Obstetrics and Urological Sciences, Hospital, Policlinico Umberto I, Rome, Italy
INTRODUCTION AND OBJECTIVES: Epidermoid cysts (TEC) are uncommon benign tumors accounting for around 1-2% of all testicular lesions. Incidence is higher in people between the ages of 10 and 40 years. Caucasian males are frequently involved and righ testis more than left one. Etiology is not completely understood. Clinically they present with a firm, painless palpable mass highly indistinguishable to all testicular neoplasms. Preoperative serum markers are always negative. Radiology and biopsy are important criteria for surgical planning. Scrotal sonography (US) confirm its typical “onion-ring” appearance. Magnetic resonance (MR) add more informations on vascularity and borders. Diagnosis depends on histology: frozen section may be useful in preventing unnecessary orchiectomy. Two forms of TEC have been described. Prepubertal ones are considered as a benign tumors since they’re not associated with germ cell tumor (GCT) and no cases of metastatic spread have been reported: unfavorable prognostic features are usually missing. Post-pubertal TEC or “complex” may act differently. Association with GCT has been rarely described totally representing an unfavorable prognostic features: cellular atypia, high mitotic activity, necrosis are rare but may be present. MATERIALS AND METHODS: We present the case of an adult male affected by TEC.and reviewed the literature. A 40 y.o. caucasian male presented for a mass in the left testis discovered on self-examination. No familiarity for testicular cancer was reported. Inguinal lymph nodes were negative. Serum markers (AFP, bHCG and LDH) were normal too. The testis presented with a painless firm lesion at the upper pole. US revealed a 15 mm heterogeneous well-circumscribed mass being chraracterized by an echogenic rim: MR ruled out intralesional vascularity. Testicular biopsy was offered. RESULTS: Frozen section was suggestive for mature TEC and a testing sparing surgery was offered. Macroscopically the lesion presented as indishinguable from any malignant neoplasm. On microscopic evaluation, the cyst was lined by a fibrous membrane (Fig. 1) filled with layers of cornifying squamous epithelium composing the wall. Coexisting teratomatous element were ruled out. Association with GCT and atypical features were also excluded. It was classed as post-pubertal mature TEC. Surgical enucleation was offered. CONCLUSIONS: TEC are rare benign tumors incidentally discovered during self examination or scrotal ultrasound frequently affecting young males. Sonography and testicular MR helps in characterizing the lesion. Diagnosis depends on histology. The biological behaviour of these neoplasms in the adult testis still remains unknown leading to different surgical approaches. Testis sparing surgery represent the gold standard. Radical orchiectomy is mandatory as unfavorable features coexist.
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Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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