Correlation of Likert scores III–V with increasingly worse pathology in radical prostatectomy specimens significant only for men aged <60 or PSAD >0.15, with age <60 as good as PSAD <0.15 at discriminating lower risk in Likert III

Objectives: This study aimed to compare Likert scores with radical prostatectomy specimens. Methods: This study examined 443 men with validated pre-biopsy magnetic resonance imaging results and used cross-tabulation and chi-square significance testing with National Comprehensive Cancer Network risk categories. Results: The mean prostate-specific antigen (PSA) was 10, and the mean age was 64 years. Comparing Likert III to Likert V and Likert IV to Likert V, both (each p=0.02) were significantly associated with higher prostate cancer risk groups, but Likert III versus Likert IV was not ( p=0.1). Within the subgroup PSA density (PSAD) &lt;0.15 ( n=140), the correlation of Likert score and final pathological risk group was lost ( p=0.5), but it was not lost within the subgroup PSAD &gt;0.15 ( n=281; p=0.045 III vs. IV only and p=0.055 overall). Within the subgroup age &lt;60 ( n=104), the correlation of Likert score and final pathological risk group was significant ( p=0.006 for III vs. IV and p=0.04 overall), whereas within the subgroup age &gt;60 ( n=339) this significant difference was lost ( p=0.34). Further subgroup analysis within Likert III ( n=86) found that men &lt;60 ( n=22) had neither high-grade (G3 or G4 or G5) nor very high-risk disease. There were only two high-risk cases, both of which were G2T3a (2/22; 10%). In men with Likert III and PSAD &lt;0.15 ( n=31), there were seven high-risk and two very high-risk cases (9/31; 25%). This difference was not significant ( p=0.31) Conclusion: With these two findings, we recommend that men &lt;60 with Likert III can be counselled like men with Likert III and PSAD &lt;0.15, that they are unlikely to have unfavourable or high-risk disease and that they may wish to avoid biopsy or treatment. Level of evidence: Level 1b. </jats:sec

Diviseurs sur les courbes réelles

Dans un article sur les sommes de carrés, Scheiderer a prouvé que pour toute courbe algébrique, réelle, projective, irréductible, lisse, ayant des points réels, il existait un entier N tel que tout diviseur de degré plus grand que N soit linéairement équivalent à un diviseur dont le support est totalement réel. Ensuite Huisman et Monnier ont montré que dans le cas des courbes avec beaucoup de composantes connexes, ie. celle en ayant au moins autant que le genre g, ici supposé strictement positif, de la courbe, on pouvait prendre N égal à 2g 1. Monnier a également abordé la question pour les cas des courbes singulières : il en a exhibé pour lesquelles un tel entier n'existait pas et d'autres pour lesquelles il existait. Dans cette thèse on étend la classe des courbes singulières pour lesquelles un tel entier existe, essentiellement des courbes avec des noeuds ou des cusps, et on arrive dans certains cas a contrôlé explicitement cet entier en fonction du genre de la courbe et du nombre de ces singularités. Pour y parvenir on utilise d'une part une " singularisation successive " et d'autre part une variante de l'invariant où l'on demande qu'en plus les points du support soient deux-à-deux distincts. Pour ce nouvel invariant, on étend tel quel les résultats sur les courbes ayant beaucoup de composantes et on traite celui des courbes de genre 2 ayant une seule composante, le " premier " cas jusqu'alors inconnu : dans ce cas la borne 3 est impossible en général, mais par contre 5 convient.In an article about sums of squares, Scheiderer proved that for every real, algebraic, projective, irreducible, smooth curve with some real points, their exists an integer N such that every divisor of degre not lower than N is linearly equivalent to a divisor whose support is totally real. Then Huisman and Monnier proved that for real curves with many components, ie. those with at least as many components as the genus g, assumed here to be positive, of the curve, one can choose N equal to 2g 1. Monnier also dealed with singular curves: he showed that for some of them such an integer does not exist and gave some others where it does exist. In this thesis we extend the classe of singular curves for wich such an integer exists, essentially those with nodes and cusps, and we sometimes manage to bound such an integer in terms of the genus. To do so, an "iterative singularisation" is used and also a slightly different invariant where we ask the real points of the support to be distinct from each-other. We extend the results about curves with many components to that new invariant and deal with curves of genus 2 having only one component, which is the "very first" unknown case so far: in that case, 3 cannot bound the invariant, but 5 does.ANGERS-BU Lettres et Sciences (490072106) / SudocSudocFranceF