Evaluation and management of male lower urinary tract symptoms : treatment patterns and guidelines in a correlation study among Polish urology consultants

Introduction: In March 2013, the European Association of Urology (EAU) released a new edition of the guidelines on management of male lower urinary tract symptoms (LUTS), including benign prostatic obstruction. The objective of this study was to evaluate how well the EAU guidelines have been implemented in day-to-day practice by Polish urologists. Material and methods: A structured questionnaire, which explored how urologists diagnose and manage male lower urinary tract symptoms, was emailed to all certified, actively practicing urologists from a list provided by the Polish Urological Association. Results: The questionnaire return rate was 33.7% (135/400). Overall, the median (quartile 1; quartile 3) frequency of correct answers was 65.0% (58.0%; 69.0%). Analysis of the association of availability and acceptance of the EAU guidelines with question answers showed no pattern. A multivariate regression model showed a positive correlation with regards to correct answers given in the survey and doctors’ participation in international congresses (p = 0.018, r = 0.181). Basket analysis showed the strongest association for those who failed to correctly answer the questions regarding diagnosis of LUTS and overactive bladder (OAB) (support = 27.41%, confidence = 86.05%). Conclusions: Although there is a significant degree of adherence to the 2013 EAU guidelines, some discrepancies between urologists’ practice and the recommendations regarding diagnosis and treatment of male LUTS do exist. The data obtained provide valuable benchmarks and also identify possible interventions that may improve the standard of care in this population of patient

Evolution in the approach to overlooked ureteral injuries after gynecological surgery

Objectives: To analyzed the therapeutic results for patients with overlooked iatrogenic ureteral injuries after gynecological surgery, treated at the department since 1990. Before the era of endourology, ureteral injuries were operated on immediately after making a diagnosis. This approach was changed after the popularization of percutaneous nephrostomy (PN) and ureteral stenting using a JJ stent. Material and methods: 27 patients who were diagnosed with a ureteral injury between the first and sixty-fourth day after injury were included. Only PN was performed in 21 patients (group A). In 6 patients, a JJ stent was introduced either immediately after making a diagnosis or after PN (group B). Results: In group A, a good therapeutic result was obtained in only 6 patients (28.6%). Of the 12 patients subjected to PN up to two weeks after injury, 5 had a good result without a need for repair surgery. Of the 9 patients with an injury diagnosed after 3 weeks, only one had a good therapeutic outcome. In Group B, a good result was achieved in 5 out of 6 patients. In 2 patients, a JJ stent was introduced immediately after making the diagnosis, and, in 3 patients, after PN. A successful attempt to „tunnelize” a complete and long obstruction in the sixth patient failed. Conclusions: Attempting to introduce a JJ stent should be the treatment of choice in patients with an overlooked iatrogenic ureteral injury. If an attempt to introduce the JJ stent fails, PN should be performed as a first step to manage the injury

Love of enemies in Matthew and Luke-Acts

Thesis advisor: Daniel J. HarringtonThesis advisor: Christopher R. MatthewsThesis (STL) — Boston College, 2013.Submitted to: Boston College. School of Theology and Ministry.Discipline: Sacred Theology

Prototype set for higher efficiency of energetic potential exploitation in SHP

Full efficiency of energy conversion in small hydropower plants (SHP) can be achieved for power technology with generators working at a variable speed. This paper presents a concept of a energy conversion system dedicated for application in a prototype SHP which is based on a permanent magnet (PM) generators with a propeller turbine integrated with the generator rotors. These PM generators can work at a variable speed and therefore energy produced by the PM generators have to be converted by means of a power electronic unit to fit to the three-phase power grid parameters. The elements of such SHP like PM generator and power electronic unit are described in details

Management of energy conversion in small hydropower plant with variable speed generators

This paper presents the rules of management of an energy conversion system in a small hydropower plant (SHP). The SHP contains two permanent magnet (PM) generators which can work at a variable speed. In the article the way of obtaining the optimal work characteristic curve is described. To achieve the best efficiency the special methodology of units cooperation is also presented. The theoretic analysis is algorithmizated, implemented and tested in the real object of 150 kW electrical power. The measurement results of this object are presented

Złośliwy nowotwór osłonek nerwów obwodowych o umiejscowieniu w sterczu

The diagnostic and therapeutic approach to prostatic neurosarcoma, currently known as a malignant peripheral nerve sheath tumor (MPNst) of the prostate, due to its rarity, is not well established. Our presenting case was a 73 year old patient, admitted to the Hospital with suspicion of a prostatic tumor. The patient underwent surgical resection of the described pathological mass. Gross appearance of the pathological examination revealed a yellow-gray colored tumor, 12 × 6 × 7 cm in size. On cross-section: tumor heterogeneity, fatty, yellow-gray, with no foci of necrosis, but with a few cysts of 1–3 cm in size, with a gelatinous substance. Microscopic examination — showed neurosarcoma of the prostate. The patient died at six months follow-up, due to cardiovascular insufficiency.Postępowanie diagnostyczne i terapeutyczne u pacjentów z nerwiakomięsakami prostaty (aktualnie klasyfikowanymi jako złośliwe nowotwory osłonek nerwów obwodowych) pozostaje nieokreślone z powodu rzadkiej na nie zapadalności. Przedstawiamy przypadek 73-letniego chorego, przyjętego do szpitala z powodu nowotworu stercza, który został poddany wycięciu zmiany. Makroskopowo stwierdzono żółto-szarawy guz o wymiarach 12 × 6 × 7 cm, na przekroju o niejednorodnej budowie z zawartością tkanki tłuszczowej, bez ognisk martwicy, ale z obecnością kilku torbieli o wymiarach 1–3 cm, wypełnionych treścią galaretowatą. Badanie mikroskopowe ujawniło cechy nerwiakomięsaka. Pacjent zmarł sześć miesięcy po operacji w następstwie niewydolności krążenia

Rozrusznik serca a zabiegi przezcewkowe. Doświadczenia Kliniki Urologii Ogólnej, Onkologicznej i Czynnościowej Warszawskiego Uniwersytetu Medycznego

We have the analyzed the course of surgery in 146 patients with pacemakers who underwent transurethral resection op prostate (TURP) or bladder tumor (TURBT) at The Depatrment or Urology in 2014-2018. In the study group, spinal anesthesia was performed in 48 patients (32.9%) and general in 98 patients (67.1%). The average time of surgery was 71.8 minutes. Bipolar electroresections were performed in 6 patients and monopolar in 140 patients. ECG monitoring and pulse oximetry evaluation were used continuously and up to 4 hours after the procedure, resting 12-lead ECG was performed before and immediately after surgery. Pacemaker control was performed before and after the procedure in the pacemaker control office. There was no case of significant cardiac pacemaker disturbances observed. Transurethral electroresection of bladder and prostate tumors in patients with implanted pacemakers while following guidelines and recommendations were not associated with the occurrence of pacemaker complications.Dokonano analizy przebiegu operacji u 146 pacjentów ze stymulatorami serca, którzy przebyli operacje przezcewkowe TURP, TURBT w Klinice Urologii w latach 2014-2018. W grupie badanej znieczulenie podpajęczynówkowe wykonano u 48 pacjentów (32,9%) a ogólne u 98 pacjentów (67,1%). Średni czas trwania zabiegu wynosił 71,8 minut. Zabiegi elektroresekcji bipolarnej wykonano u 6 pacjentów a elektresekcji monopolarnej u 140 pacjentów. W czasie zabiegów stosowano monitorowanie EKG oraz ocenę pulsoksymetryczną w sposób ciągły oraz do 4 godzin po zabiegu, EKG spoczynkowe 12-odprowadzeniowe wykonywano przed zabiegiem oraz bezpośrednio po. U każdego pacjenta kontrolowano pracę stymulatora przed zabiegiem oraz po zabiegu w pracowni kontroli stymulatorów. W żadnym przypadku nie obserwowano istotnych zaburzeń pracy rozrusznika serca. Zabiegi przezcewkowej elektroresekcji guzów pęcherza moczowego i prostaty u pacjentów z wszczepionymi stymulatorami serca przy zachowaniu zasad postępowania nie wiązały się z wystąpieniem powikłań pracy stymulatora

Synthesis and Self-Assembly Behavior of Double Ullazine-Based Polycyclic Aromatic Hydrocarbons

Polycyclic aromatic azomethine ylides (PAMY, 1) are versatile building blocks for the bottom-up synthesis of nitrogen-containing polycyclic aromatic hydrocarbons (N-PAHs). Although the chemistry of PAMY was already established few years ago, the cycloaddition of a double PAMY building block has not been reported so far. In this work, we demonstrate the first cycloaddition of a PAMY-dimer (6), which opens the access to three different alkyl ester-substituted N-PAHs with a laterally extended double ullazine scaffold (DU-1, DU-2 and DU-3). Interestingly, the cyclic voltammetry of DU-1-3 exhibited three reversible oxidation waves, which confirmed the electron-rich nature of the double ullazine scaffold. Furthermore, in-situ spectroelectrochemistry study of ethylhexyl ester-substituted DU-3 revealed the formation of different cationic species with new absorption bands up to 1689 nm. Additionally, the influence of the attached substituents on the film formation and supramolecular organization in the thin films were investigated by polarized optical microscopy and grazing incidence wide-angle X-ray scattering