Titan's atmosphere as observed by Cassini/VIMS solar occultations: CH4_4, CO and evidence for C2_2H6_6 absorption

We present an analysis of the VIMS solar occultations dataset, which allows us to extract vertically resolved information on the characteristics of Titan's atmosphere between 100-700 km with a characteristic vertical resolution of 10 km. After a series of data treatment procedures, 4 occultations out of 10 are retained. This sample covers different seasons and latitudes of Titan. The transmittances show clearly the evolution of the haze and detect the detached layer at 310 km in Sept. 2011 at mid-northern latitudes. Through the inversion of the transmission spectra with a line-by-line radiative transfer code we retrieve the vertical distribution of CH$_4$ and CO mixing ratio. The two methane bands at 1.4 and 1.7 {\mu}m are always in good agreement and yield an average stratospheric abundance of $1.28\pm0.08$%. This is significantly less than the value of 1.48% obtained by the GCMS/Huygens instrument. The analysis of the residual spectra after the inversion shows that there are additional absorptions which affect a great part of the VIMS wavelength range. We attribute many of these additional bands to gaseous ethane, whose near-infrared spectrum is not well modeled yet. Ethane contributes significantly to the strong absorption between 3.2-3.5 {\mu}m that was previously attributed only to C-H stretching bands from aerosols. Ethane bands may affect the surface windows too, especially at 2.7 {\mu}m. Other residual bands are generated by stretching modes of C-H, C-C and C-N bonds. In addition to the C-H stretch from aliphatic hydrocarbons at 3.4 {\mu}m, we detect a strong and narrow absorption at 3.28 {\mu}m which we tentatively attribute to the presence of PAHs in the stratosphere. C-C and C-N stretching bands are possibly present between 4.3-4.5 {\mu}m. Finally, we obtain the CO mixing ratio between 70-170 km. The average result of $46\pm16$ ppm is in good agreement with previous studies.Comment: 51 pages, 28 figure

Shock wave lithotripsy for a renal stone in a tetraplegic patient as a trigger for life-threatening posterior reversible encephalopathy syndrome

Shock wave lithotripsy (SWL) is considered a non-invasive treatment for urinary stones and usually advocated for frail patients with spinal cord injury (SCI). We report a life-threatening complication, called posterior reversible encephalopathy syndrome (PRES), in a tetraplegic person who underwent SWL for a small renal stone. Based on our experience, we recommend performing SWL with caution in SCI patients and in tertiary referral hospitals that can promptly manage similar severe complications

Second-look turbt: Evaluation of anatomopatological and oncologic results in a single center

Introduction: T1 bladder cancer is associated with a high risk of recurrence and progression; concomitant carcinoma in situ and/or multifocality are negative prognostic factors. Persistent disease after resection of T1 tumours has been observed in 33-55% of patients, and after resection of High-grade (HG) Ta tumour in 41,4%. It has been demonstrated that a second TURB can increase recurrence-free survival and it can make a restaging of the cancer. Patients and methods: From January 2011 to December 2016, 87 patients with superficial bladder tumor (Ta-T1), undergoing TURB and routine repeat TURB (Re-TURB) 4-6 weeks after the initial resection, were included in the study. Re-TURB was applied to the scar of the first resection and other suspicious lesions in the bladder. After the second-look, we studied the follow-up of each patient. Results: Specimens obtained during the second TURBT showed no tumor in 47 (54,02%) patients; 40 (45,98%) patients had residual cancer: 34 of them had cancer of the same stage, 6 patients of pT1 had a lower stage, and 3 had a higher stage. 5 patient underwent radical cistectomy immediatly after re-TURBT. During the first year of follow up, 15 patients had a recurrent bladder cancer; 2 of them underwent radical cistectomy. Conclusions: T1 bladder cancer is an high risk tumor, so that second-look TURBT is a valuable procedure for accurate staging of nonmuscle-invasive bladder cancer and it can guarantee a better eradicationof the neoplasm

Experience of a tertiary referral center in managing bladder cancer in conjunction with neurogenic bladder

Study design: Case series. Objectives: The aim of this study was to present our experience with the management of bladder cancer (BCa) in individuals followed for neurogenic bladder (NB). Setting: An Italian tertiary referral center for NB. Methods: We retrospectively collected all pre-operative, intra-operative, and post-operative data of our NB cases with BCa, diagnosed from 2004 to 2019. Results: We included ten cases: eight with acquired spinal cord injury (SCI) and two with myelomeningocele (MMC). Considering individuals with acquired SCI, the median age at BCa diagnosis and time since SCI were 53 and 34 years, respectively. One out of seven cases had positive urine cytology. All cases underwent a radical cystectomy, diagnosing squamous cell carcinoma (SCC) and transitional cell carcinoma in 60 and 40% cases, respectively. Surgical-related complications occurred after 90% procedures. Three out of eight individuals with acquired SCI died 2, 12, and 80 months after the diagnosis. Both individuals with MMC presented no evidence of disease after 24 and 27 months. Conclusions: BCa in individuals with NB proved to be associated with a diagnosis at an advanced stage and a high rate of surgical complications. In this population we advocate annual genitourinary ultrasound exam and urine cytology, and cystoscopy in all cases of macrohematuria. Considering the low accuracy of urine cytology and the difficult-to-interpret inflamed bladder walls at cystoscopy in NB, a patient-tailored follow-up schedule based on specific risk factors (e.g., smoking status, indwelling urinary catheter) is mandatory to diagnose and treat BCa at an early stage

Effectiveness of D-mannose, Hibiscus sabdariffa and Lactobacillus plantarum therapy in prevention of infectious events following urodynamic study

The urodynamic study is an invasive examination that allows a thorough evaluation of the functional activity of the lower urinary tract (bladder, urethra). The execution of urodynamic study exposes the patient to the risk of contracting infections of the lower urinary tract. Prevention of urinary tract infections consists in the avoidance of risk factors and prophylaxis with antimicrobial and non-antimicrobial measures. In this article, we aimed to evaluate the effectiveness of a phytotherapeutic product composed of D-mannose, Hibiscus sabdariffa, and Lactobacillus plantarum in the prevention of infectious events following invasive urodynamic examination.Introduction and aim: The urodynamic study is an invasive examination that allows a thorough evaluation of the functional activity of the lower urinary tract (bladder, urethra). The execution of urodynamic study exposes the patient to the risk of contracting infections of the lower urinary tract. Prevention of urinary tract infections consists in the avoidance of risk factors and prophylaxis with antimicrobial and non-antimicrobial measures. In this article, we aimed to evaluate the effectiveness of a phytotherapeutic product composed of D-mannose, Hibiscus sabdariffa, and Lactobacillus plantarum in the prevention of infectious events following invasive urodynamic examination. Materials and methods: We selected 100 female consecutive patients (age 19-87 years) that underwent urodynamic invasive procedure. We prescribed 14-day therapy with D-mannose, H. sabdariffa, and L. plantarum to these 100 patients after urodynamic invasive test. After that, we have examined urine cultures and urinary symptoms through telephone interviews and hospital outpatient visits to evaluate the possible presence of urinary tract infections. Results: Urinary tract infections were observed through urine culture in 13% of the selected patients; of the 13 urinary tract infections, 9 were observed in patients with urinary tract recurrent infections in the last year and the other 4 cases were associated with patients with no urinary infection in the last year. Three women reported some urinary symptoms and underwent antibiotic therapy. The other 10 cases were classified as asymptomatic bacteriuria. Three cases were related to patients presenting with pelvic organ prolapse. Eight cases were instead related to significant post-voiding residue (>100). Six patients with urinary tract infection reported constipation in the last year. All patients completed the prescribed therapy due to the affordable price of the product and no side effects have been reported. Conclusion: Our study about the administration of D-mannose, H. sabdariffa, and L. plantarum after invasive urodynamic examination underlined how this phytotherapeutic product can reduce the risk of bacteriuria and urinary tract infection in women

RHESSI images and spectra of two small flares

We studied the evolution of two small flares (GOES class C2 and C1) that developed in the same active region with different morphological characteristics: one is extended and the other is compact. We analyzed the accuracy and the consistency of different algorithms implemented in RHESSI software to reconstruct the image of the emitting sources, for energies between 3 and 12 keV. We found that all tested algorithms give consistent results for the peak position whil the other parameters can differ at most by a factor 2. Pixon and Forward-fit generally converge to similar results but Pixon is more reliable for reconstructing a complex source. We investigated the spectral characteristics of the two flares during their evolution in the 3--25 keV energy band. We found that a single thermal model of the photon spectrum is inadequate to fit the observations and we needed to add either a non-thermal model or a hot thermal one.The non-thermal and the double thermal fits are comparable. If we assume a non-thermal model, the non-thermal energy is always higher than the thermal one.Only during the very final decay phase a single thermal model fits fairly well the observed spectrum.Comment: 26 pages, 11 figures, accepted by Solar Physic

Ejaculation-sparing thulium laser enucleation of the prostate (ES-ThuLEP): outcomes on a large cohort

Purpose: To assess the effects of a new ejaculation-sparing thulium laser enucleation of the prostate (ES-ThuLEP) technique on sexual functions and micturition, in patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH) and to evaluate how the surgical technique of ES-ThuLEP can lead to ejaculation preservation. Methods: A prospective study was carried out between January 2015 and January 2018 on patients with surgical indication for BPH, who wished to preserve ejaculation. The patients were treated with ES-ThuLEP and were evaluated before and 3 and 6 months after surgery. Three validated questionnaires (ICIQ-MLUTSsex, IIEF-5 and IPSS) were used to assess changes in ejaculation, erectile function and urinary symptoms. Uroflowmetry (Qmax and Qavg), post-void residual volume and voided volume were also evaluated, to assess micturition improvement. Patients with moderate to severe erectile dysfunction were excluded. Statistical analysis was performed with the Student\u2019s t test, Chi-square test and logistic regression analysis. Results: Two hundred and eighty three patients were enrolled. Ejaculation was spared in 203 and 219 patients at 3 and 6 months after surgery. No significant differences were observed between erectile function before and after surgery: baseline IIEF-5 = 16.2 \ub1 4.47 vs 16.7 \ub1 2.9 (p = 0.419) and 17.7 \ub1 3.2 (p = 0.410) at 3 and 6 months. Significant improvement in urinary symptoms was achieved: baseline IPSS = 19.4 \ub1 7.24 vs 5.8 \ub1 4.3 (p = 0.032) and 3.9 \ub1 4.1 (p = 0.029) at 3 and 6 months. Conclusion: ES-ThuLEP effectively preserved ejaculation in over two thirds of the patients without compromising micturition improvement or erectile function. ES-ThuLEP could be a valid treatment option for BPH in young and sexually active men