Organ harvesting as a mandatory training step of all PGY1 and PGY2 surgical residents

To the Editor, Good surgical training is essential for the formation of excellent surgeons, consequently providing the best possible care for our patients in the future. Considering the increase in surgeon shortage over the last two decades (estimated between 14,300 and 23,400 by the year 2032 only in the US), it is important for filling the national health system's needs as well [...]

Urology apps: overview of current types and use

CITATION:Mantica G, Malinaric R, Dotta F, et al. Urology apps: overview of current types and use. Cent European J Urol. 2020; 73: 369-372.Introduction In recent years numerous applications have been developed with different purposes, aimed both at simplifying the lives of doctors and patients also within the urological field. Material and methods In January 2020 we conducted a search in the Apple App Store and Google Play Store. Results A total of 521 apps were reviewed, an increase of 8 times as compared to the last complete available review of eight years ago. Most of the urological apps are geared towards the patient and provide information and services to improve the understanding and treatment of different diseases. Some of these apps also get the patient directly in touch with healthcare staff allowing for an improvement in doctor-patient communication. Conclusions Although the usefulness of many of these tools is undoubted, the problem of scientific validation, content control and privacy are not yet solved

Extraperitoneal cystectomy with ureterocutaneostomy derivation in fragile patients - should it be performed more often?

Introduction and objectives: Radical cystectomy (RC) continues to be standard of care for muscle-invasive bladder cancer and recurrent or refractory nonmuscle invasive bladder cancer. Unfortunately, it has high rates of perioperative morbidity and mortality. One of the most important predictors of postoperative outcomes is frailty, while the majority of complications are diversion related. The aim of our study was to evaluate safety of extraperitoneal cystectomy with ureterocutaneostomy in patients considered as frail. Materials and methods: We retrospectively collected data of frail patients who underwent extraperitoneal cystectomy with ureterocutaneostomy from October 2018 to August 2020 in a single center. We evaluated frailty by assessing patients' age, body mass index (BMI), nutritional status by Malnutrition Universal Screening Tool, overall health by RAI (Risk Analysis Index) and ASA (American Society of Anaesthesiologists) score, and laboratory analyses. We observed intraoperative outcomes and rates of perioperative (within 30 days) and early postoperative (within 90 days) complications (Clavien-Dindo classification). We defined extraperitoneal cystectomy with ureterocutaneostomy as safe if patients did not develop Clavien Dindo IIIb, or worse, complication. Results: A total of 34 patients, 3 female and 31 male, were analyzed. The median age was 77, BMI 26, RAI 28, ASA 3 and the majority had preexisting renal insufficiency. Blood analyses revealed presence of severe preoperative hypoalbuminemia and anemia in half of our cohort. Intraoperative median blood loss was 250 cc, whilst operative time 245 min. During perioperative period 60% of our cohort developed Clavien Dindo II complication and during early postoperative period 32% of patients required readmission. One death occurred during early postoperative period (2.9%). After 12 months of follow-up, we observed stability of the renal function for most patients. Conclusions: We believe that extraperitoneal cystectomy with ureterocutaneostomy could be considered as a treatment option for elderly and/or frail patients

How long should we follow patients managed for muscle-invasive bladder cancer? Lesson learned from a recent clinical practice

To the Editor, The exact time to stop bladder cancer patient's follow-up is not well known and there is not a clear recommendation on if and when stop to follow a patient managed for muscle invasive bladder cancer (MIBC). Major urological guidelines do not provide a precise indication on the timing of follow-up, and there is currently no real consensus on optimal time schedule [...]

Intravesical Therapy for Non-Muscle-Invasive Bladder Cancer: What Is the Real Impact of Squamous Cell Carcinoma Variant on Oncological Outcomes?

Background and Objectives: To evaluate the oncological impact of squamous cell carcinoma (SCC) variant in patients submitted to intravesical therapy for non-muscle-invasive bladder cancer (NMIBC). Materials and Methods: Between January 2015 and January 2020, patients with conventional urothelial NMIBC (TCC) or urothelial NMIBC with SCC variant (TCC + SCC) and submitted to adjuvant intravesical therapies were collected. Kaplan\u2013Meier analyses targeted disease recurrence and progression. Uni-and multivariable Cox regression analyses were used to test the role of SCC on disease recurrence and/or progression. Results: A total of 32 patients out of 353 had SCC at diagnosis. Recurrence was observed in 42% of TCC and 44% of TCC + SCC patients (p = 0.88), while progression was observed in 12% of both TCC and TCC + SCC patients (p = 0.78). At multivariable Cox regression analyses, the presence of SCC variant was not associated with higher rates of neither recurrence (p = 0.663) nor progression (p = 0.582). Conclusions: We presented data from the largest series on patients with TCC and concomitant SCC histological variant managed with intravesical therapy (BCG or MMC). No significant differences were found in term of recurrence and progression between TCC and TCC + SCC. Despite the limited sample size, this study paves the way for a possible implementation of the use of intravesical BCG and MMC in NMIBC with histological variants

GAME FEEL IN 2D-PLATFORMERS : A study of game feel techniques used in 2D-platformers

I detta arbete studerades hur olika tekniker för att förstärka game feel av realtidskontroll inom spel, delvis generellt men också specifikt kopplat till 2D-platformers, användes inom spel av den genren. Bakgrundskapitlet beskriver vad game feel är och hur det upplevs. Det nämns även aspekter kopplat till game feel och realtidskontroll som är viktiga att diskutera, exempelvis flow. Problemformuleringen tar upp processen för hur studien utfördes och presenterar även frågeställningen som lyder: Vilka tekniker används inom 2D platformers för att förbättra game feel inom realtidskontroll av spelar-karaktären och hur påverkar de spelupplevelsen? Analysen utfördes på åtta spel. Dessa spel var Super Mario Bros 3 (1988), Sonic The Hedgehog 2 (1992), Rayman (1995), New Super Mario Bros (2006), Rayman Legends (2013), Shovel Knight (2014), Donkey Kong Country: Tropical Freeze (2014) och Celeste (2018). Resultatet visade att de flesta tekniker som analyserades användes i majoriteten av spelen och på ett liknande sätt med några få undantag

Fragile! | Tena Štivičić

Un'approfondimento sulla scrittura della drammaturga croata naturalizzata britannica Tena Stivici

GAME FEEL IN 2D-PLATFORMERS : A study of game feel techniques used in 2D-platformers

I detta arbete studerades hur olika tekniker för att förstärka game feel av realtidskontroll inom spel, delvis generellt men också specifikt kopplat till 2D-platformers, användes inom spel av den genren. Bakgrundskapitlet beskriver vad game feel är och hur det upplevs. Det nämns även aspekter kopplat till game feel och realtidskontroll som är viktiga att diskutera, exempelvis flow. Problemformuleringen tar upp processen för hur studien utfördes och presenterar även frågeställningen som lyder: Vilka tekniker används inom 2D platformers för att förbättra game feel inom realtidskontroll av spelar-karaktären och hur påverkar de spelupplevelsen? Analysen utfördes på åtta spel. Dessa spel var Super Mario Bros 3 (1988), Sonic The Hedgehog 2 (1992), Rayman (1995), New Super Mario Bros (2006), Rayman Legends (2013), Shovel Knight (2014), Donkey Kong Country: Tropical Freeze (2014) och Celeste (2018). Resultatet visade att de flesta tekniker som analyserades användes i majoriteten av spelen och på ett liknande sätt med några få undantag

Verso il dramaturg: rivelarsi nell'officina di Simona Gonella

L’articolo tratta il divenire della figura polivalente e sofisticata del dramaturg all’interno della prassi teatrale italiana. In particolare, prendendo in esame l’esempio di Simona Gonella, cerca di delineare i tratti peculiari del suo mestiere interrogandosi sui modi in cui il suo lavora influenza la creazione artistica. Attraverso l’analisi dei due ultimi lavori, Book is a Book is a Book e Macbeth, le cose nascoste, si evince quello che potrebbe essere definito come “lo sguardo del dramaturg” quale connettore delle diverse parti del lavoro del gruppo. Il lavoro è stato fatto in collaborazione con Simona Gonella, che ha concesso all’autrice dell’articolo l’intervista e i materiali utilizzati

Les besoins et les connaissances des jeunes de moins de 25 ans concernant les consultations en santé sexuelle : une étude quantitative auprès de collégiens et d’étudiants dans les Bouches du Rhône

Contexte : la santé sexuelle fait partie intégrante de la santé, du bien-être et de la qualité de vie dans son ensemble. La promotion de la santé sexuelle chez les jeunes est un des axes de la stratégie nationale pour l’agenda 2017-2030. En effet ils sont particulièrement concernés par les échecs de contraception et le recours à l’IVG. Ils sont également dans la tranche d’âge ou la prévalence des IST (Infections Sexuellement Transmissibles) est la plus importante. Méthodologie : nous avons réalisé une étude quantitative descriptive. Nous avons réalisé un questionnaire de 17 questions de type multi dichotomique à choix unique ou multiples. Nous avons interrogé des étudiants de l’université Aix Marseille et des collégiens du 11ème et du 16ème arrondissement de Marseille entre février et juin 2021.Nous avons également réalisé un état des lieux des consultations ayant eu lieu dans les CPEF (Centre de Planification et d’Éducation Familiale), CeGIDD (Centres Gratuits d’Information de Dépistage et de Diagnostic) et sites du Planning Familial dans les Bouches du Rhône durant l’année 2019.Résultats : nous avons analysé 604 réponses. 76,7 % des participants ont assisté à des cours d’éducation sexuelle durant leur cursus. 71% ne connaissent pas les CPEF et 62% ne connaissent pas les CeGIDD. Les principales ressources en matière de santé sexuelle sont internet et les amis. Les critères de choix principaux sont la discrétion/l’anonymat et la rapidité de prise en charge. Le frein principal est la peur du jugement. Les horaires privilégiés pour consulter étaient « entre 17h et 19h » et « le matin ».Conclusion : Les recommandations gouvernementales concernant le nombre de séances d’éducation sexuelle ne sont pas suivies par les établissements. Les jeunes ne sont pas correctement informés sur les structures de soins existantes. Il pourrait être intéressant de favoriser des rencontres entre les jeunes et les professionnels de santé. Cela permettrait de les faire connaître. Cela favoriserait également le début d’une relation de confiance, qui semble nécessaire pour motiver les jeunes à consulter