Using Artificial Intelligence for the Diagnosis of Prostate Cancer: The Paper of Yuichiro Oishi et al. Is a Step Forward on the Way of Precision Medicine

Yuichiro Oishi et al. presented an interesting study reporting the ability of Artifi- cial Intelligence (AI) to diagnose and locate prostate cancer from multiparametric MRI (mpMRI) [1]. The authors evaluated the diagnostic performance of their AI with a ROC analysis; interestingly the area under the ROC curve was 0.985, while the sensitivity and the specificity were 0.875 and 0.961 (p < 0.01), respectively. Figure 1 of the paper shows that the regions of the prostate labeled by AI as prostate cancer correspond strictly to the cancer areas identified at pathological examination of the gland. These good results justified the strong conclusions of the paper: “diagnostic partition using the superpixel method and SVM-computed likelihood maps enables automated diagnosis of prostate cancer location and shape in mpMRI” [1]. Many aspects of this paper deserve to be emphasized. During the last two decades, numerous attempts to use radiomics for the diagnosis of cancer have been made [2]. So far, the dimensions of the dataset have always been a major limiting factor for the AI training and consequently for its diagnostic performance. The AI-based computer-aided diagnosis used in this study interestingly reached a good result with only a small number of patients, apparently overcoming the need for a large dataset. The authors achieved this result by sampling all the peripheral zone pixels for training the Support Vector Machine. Using this strategy, the dataset which resulted was very large despite the small number of patients included in the study. Because of the previous consideration, the strategy proposed by Yuichiro Oishi et al. will probably be crucial in the development of future diagnostic tools

222Rn daughters influence on scaler mode of the ARGO-YBJ detector

The ARGO-YBJ experiment is a full coverage air shower array; its lowest energy threshold is reached using the "scaler mode technique". Working in this mode, the signals generated by any particle hitting each cluster are put in coincidence every 150 ns and read by four independent scaler channels, giving the counting rates of multiplicity \geq1, \geq2, \geq3 and \geq4 (C1, C2, C3 and C4, respectively). The study of these counting rates pointed out a different behaviour of C1 respect to C2, C3 and C4, suggesting that C1 is detecting not only cosmic rays. This work shows that the radon (222Rn) gamma emitter daughters present in the ARGO-YBJ building air are contributing to C1 counts at the level of 1 Hz each Bq/m3 of radon. The uncertainty about this contribution is great, because of the high variability of 222Rn concentration and the building ventilation. The radon monitoring will allow the C1 correction improving the sensitivity of the ARGO-YBJ experiment at its lowest energy threshold.Comment: 4 pages, 3 figures, Proceedings of the 32nd International Cosmic Ray Conference (ICRC

Pulmonary recurrence from prostate cancer and biochemical remission after metastasis directed therapy. A case report.

We report a case of a 69-years-old man who presented with a solitary 1 cm nodule in the lower lobe of the left lung almost 3 years after radical prostatectomy for pT3aN0M0, Gleason score 4+3 disease, without evidence of osseous or lymphatic spread. Surgical resection of the pulmonary lobe confirmed the metastatic nature of the lesion, with subsequent reduction of serum PSA to undetectable levels. After 2 years from the metastasis resection, serum PSA is still undetectable, without the necessity of additional treatments. Solitary pulmonary metastases from prostate cancer (Pca) are rare in clinical practice, with only 29 previous cases described besides the one that we present

Selective arterial embolization for a high-flow priapism following perineal trauma in a young gymnast

Introduction. High-flow priapism is a rare condition in children, usually due to a perineal trauma. Materials and methods. We present a case of traumatic highflow priapism investigated by Doppler ultrasound and managed by angiography and selective embolization of a branch of the internal pudendal artery. Results. A 13-year-old gymnast underwent perineal trauma during training and developed a high-flow priapism. The first ultrasound (immediately after the trauma) showed the presence of an inhomogeneous area of 3 x 2 cm associated with an anechoic vascularized area (pseudoaneurysm) in the right corpus cavernosum. On the left side there was a similar finding, but of smaller size. After 3 weeks the pseudoaneurysm on the left was completely obliterated while the right one was still present. Angiography and superselective catheterization of a branch of the left pudendal artery and its embolization with microspheres and with metal microcoils were performed. After the procedure, ultrasound showed that the right pseudoaneurysm was completely obliterated and there were no more branches reaching it. The cavernous arteries were both pervious. Conclusions. Selective arterial embolization is a safe treatment that can also be used in pediatric patients

It's not always varicocele: A strange case of Zinner syndrome

A 42-year-old man presented with a huge varicocele. The patient was completely asymptomatic and he did not complain of dysuria, perineal discomfort, or ejaculatory pain. During the visit, the mass mimicked a varicocele and during the Valsalva maneuver a reflux was documented by colour Doppler ultrasound and an abdominal ultrasound revealed an agenesis of the right kidney and a 4.5-cm diameter intra-prostatic cyst. An abdominal and pelvis magnetic resonance imaging was then performed, which confirmed the right renal agenesis, with an epididymal enlargement in the body and tail. This is a unique case of Zinner syndrome in which the patient presented with a paratesticular mass mimicking a varicocele. \ua9 2015 Canadian Urological Association

Inguinal recurrence of malignant mesothelioma of the tunica vaginalis: one case report with delayed recurrence and review of the literature

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Mixed Reality Environment and High-Dimensional Continuification Control for Swarm Robotics

A significant challenge in control theory and technology is to devise agile and less resource-intensive experiments for evaluating the performance and feasibility of control algorithms for the collective coordination of large-scale complex systems. Many new methodologies are based on macroscopic representations of the emerging system behavior, and can be easily validated only through numerical simulations, because of the inherent hurdle of developing full scale experimental platforms. In this paper, we introduce a novel hybrid mixed reality set-up for testing swarm robotics techniques, focusing on the collective motion of robotic swarms. This hybrid apparatus combines both real differential drive robots and virtual agents to create a heterogeneous swarm of tunable size. We validate the methodology by extending to higher dimensions, and investigating experimentally, continuification-based control methods for swarms. Our study demonstrates the versatility and effectiveness of the platform for conducting large-scale swarm robotics experiments. Also, it contributes new theoretical insights into control algorithms exploiting continuification approaches

Clinical management of severe active ulcerative colitis in the TNF-a inhibitors era

Ulcerative colitis (UC) is a chronic inflammation of the coli mucosa clinically characterized by bloody diarrhea, abdominal pain and other systemic symptoms. The onset, as well as subsequent relapses, may occur with varying degrees of clinical and endoscopic activity and extent of disease. The clinical and endoscopic activity varies from mild to severe, while the extent of disease, without interruption, may involve from the rectum up to the entire colon. The severe form, when not properly and promptly treated, can be life-threatening and may determine various complications requiring urgent surgical treatment. Early recognition of severe forms, their treatment and patient monitoring can reduce morbidity and mortality, and improve surgical outcome. Since the 1950s, systemic corticosteroids have been the first-line treatment in severe active UC. Today, appropriate patient monitoring, and recognition of clinical, radiological and laboratory findings indicative of steroid failure guide the clinician in the use of immunomodulatory drugs or suggest indications for surgery. The aim of our study is to review the more recent data and guidelines that could be useful in clinical practice for the management of severe UC. © Copyright A. Calafiore et al., 2013

Cohort study of electronic cigarette use: effectiveness and safety at 24 months

OBJECTIVE: To evaluate the safety and effectiveness of e-cigarettes, by comparing users of only e-cigarettes, smokers of only tobacco cigarettes and dual users. DESIGN: Prospective cohort study. We update previous 12-month findings and report the results of the 24-month follow-up. DATA SOURCES: Direct contact and questionnaires by phone or via internet. METHODS: Adults (30-75 years) were classified as: (1) tobacco smokers, if they smoked ≥1 tobacco cigarette/day, (2) e-cigarette users, if they inhaled ≥50 puffs/week of any type of e-cigarette and (3) dual users, if they smoked tobacco cigarettes and also used e-cigarettes. Carbon monoxide levels were tested in 50% of those declaring tobacco smoking abstinence. Hospital discharge data were used to validate possibly related serious adverse events in 46.0% of the sample. MAIN OUTCOME MEASURES: Sustained abstinence from tobacco cigarettes and/or e-cigarettes after 24 months, the difference in the number of tobacco cigarettes smoked daily between baseline and 24 months, possibly related serious adverse events. RESULTS: Data at 24 months were available for 229 e-cigarette users, 480 tobacco smokers and 223 dual users (overall response rate 68.8%). Of the e-cigarette users, 61.1% remained abstinent from tobacco (while 23.1% and 26.0% of tobacco-only smokers and dual users achieved tobacco abstinence). The rate (18.8%) of stopping use of either product (tobacco and/or e-cigarettes) was not higher for e-cigarette users compared with tobacco smokers or dual users. Self-rated health and adverse events were similar between all groups. Among those continuing to smoke, there were no differences in the proportion of participants reducing tobacco cigarette consumption by 50% or more, the average daily number of cigarettes and the average self-rated health by baseline group. Most dual users at baseline abandoned e-cigarettes and continued to smoke tobacco. Those who continued dual using or converted from tobacco smoking to dual use during follow-up experienced significant improvements in the 3 outcomes compared with those who continued or switched to only smoking tobacco (p<0.001). CONCLUSIONS: E-cigarette use alone might support tobacco quitters remaining abstinent from smoking. However, dual use did not improve the likelihood of quitting tobacco or e-cigarette use, but may be helpful to reduce tobacco consumption. Adverse event data were scarce and must be considered preliminary. TRIAL REGISTRATION NUMBER: NCT01785537

Prevention and treatment of infectious complications after urogenital prosthesis surgery

Prostheses are widely used in urogenital surgery for many decades and have gained a fundamental role in the management of multiple diseases with good results in terms of functionality, aesthetic outcomes and patients\u2019 satisfaction. It is remarkable that prosthetic device vary in term of mechanical sophistication, costs and surgical implantation techniques ranging from simple device widely used in urological practice like testicular prosthesis to highly sophisticated devices as Inflatable Penile Prosthesis (IPP) and Artificial Urinary Sphincter (AUS). Despite continuous implementations of the devices and improvements of surgical implantation techniques infective complications are still fearful and not uncommon events. Risk of infection depends on patients\u2019 individual features, perioperative strategies, implantation techniques and prosthetic devices. Prevent these complications is imperative because the management of prosthesis infection requires removal of the device in most cases. Centres that plan prosthetic implantations should based on these strategies protocols in order to prevent as far as possible infective complications