A randomised trial of robotic and open prostatectomy in men with localised prostate cancer

Background: Prostate cancer is the most common male cancer in the Western world however there is ongoing debate about the optimal treatment strategy for localised disease. While surgery remains the most commonly received treatment for localised disease in Australia more recently a robotic approach has emerged as an alternative to open and laparoscopic surgery. However, high level data is not yet available to support this as a superior approach or to guide treatment decision making between the alternatives. This paper presents the design of a randomised trial of Robotic and Open Prostatectomy for men newly diagnosed with localised prostate cancer that seeks to answer this question.Methods/design: 200 men per treatment arm (400 men in total) are being recruited after diagnosis and before treatment through a major public hospital outpatient clinic and randomised to 1) Robotic Prostatectomy or 2) Open Prostatectomy. All robotic prostatectomies are being performed by one surgeon and all open prostatectomies are being performed by one other surgeon. Outcomes are being measured pre-operatively and at 6 weeks and 3, 6, 12 and 24 months post-surgery. Oncological outcomes are being related to positive surgical margins, biochemical recurrence +/- the need for further treatment. Non-oncological outcome measures include: pain, physical and mental functioning, fatigue, summary (preference-based utility scores) and domain-specific QoL (urinary incontinence, bowel function and erectile function), cancer specific distress, psychological distress, decision-related distress and time to return to usual activities. Cost modelling of each approach, as well as full economic appraisal, is also being undertaken.Discussion: The study will provide recommendations about the relative benefits of Robotic and Open Prostatectomy to support informed patient decision making about treatment for localised prostate cancer; and to assist in treatment services planning for this patient group.Trial registration: ACTRN12611000661976

TNF-α and TNF-β Gene Polymorphism in Saudi Rheumatoid Arthritis Patients

Background Tumor necrosis factor (TNF)-α and -β are cytokines with a wide range of inflammatory, apoptotic and immunomodulatory activities. TNF-α promoter –308 G < A polymorphism has been reported to be associated with rheumatoid arthritis (RA) with inconsistent results. Objective The aim of this study is to elucidate a possible association of TNF-α (G–308A) and TNF-β (A+252G) polymorphisms with the susceptibility of RA in Saudi patients. Patients and Methods This case control study consisted of 232 Saudi subjects including 106 RA patients and 126 matched controls. Genomic DNA was extracted using QIAamp R DNA mini kit (Qiagen CA, USA). TNF-α and TNF-β genes were amplified using Arms primers. Results The frequencies of TNF-α (–308) allele G and genotype GG were significantly higher in RA patients as compared to controls while allele A and genotype AA were predominant in control group. On the other hand the frequency of TNF-β (+252) GG and AA genotypes were significantly higher in RA patients as compared to controls while GA genotype was predominant in controls. It was inferred that genotype GG positive individuals at position –308 of TNF-α were susceptible to RA while genotype AA might has a protective effect on RA susceptibility in Saudis. Whereas GG and AA genotype of TNF-β at +252 position might exert additive susceptibility to RA and GA might be refractory. However, there was no significant association between duration of morning stiffness, RF positivity and number of joints involved and distribution of alleles/genotypes of TNF-α (–308) or TNF-β (+252) polymorphism. It may be concluded that the TNF-α (–308) and TNF-β (+252) polymorphisms might influence the susceptibility to RA in Saudi population. These results might have prognostic value for future clinical observations

The Rotational Spectrum of Propynal in the 250-700 GHz range using Coherent Synchrotron Radiation Fourier Transform Spectrometry

International audienceThe Coherent Synchrotron radiation obtained at SOLEIL has allowed, for the first time, measurement of broad band absorption, Fourier Transform spectra in the sub-THz range at 0.001 cm -1 resolution, with a signal-to-noise ratio of 100 attained in a few hours. The technique has been applied to the observation of the pure rotational spectrum of propynal (HC≡CCHO) in the 250 -700 GHz range. The new data have allowed the determination of more precise values for rotational constants and for higher order rotational constants. The potential of the technique for rapid recording of rotational spectra in this energy range is outlined

On the separability of subproblems in Benders decompositions

Benders decomposition is a well-known procedure for solving a combinatorial optimization problem by defining it in terms of a master problem and a subproblem. Its effectiveness relies on the possibility of synthethising Benders cuts (or nogoods) that rule out not only one, but a large class of trial values for the master problem. In turns, this depends on the possibility of separating the subproblem into several subproblems, i.e., problems exhibiting strong intra-relationships and weak inter-relationships. The notion of separation is typically given informally, or relying on syntactical aspects. This paper formally addresses the notion of separability of the subproblem by giving a semantical definition and exploring it from the computational point of view. Several examples of separable problems are provided, including some proving that a semantical notion of separability is much more helpful than a syntactic one. We show that separability can be formally characterized as equivalence of logical formulae, and prove the undecidability of the problem of checking separability. © Springer-Verlag Berlin Heidelberg 2006

Use of modified resistogram to type Candida albicans isolated from cases of vaginitis and from faeces in the same geographical area.

Ninety strains of Candida albicans were isolated from vaginal swabs taken by general practitioners from cases of vaginal candidosis. One hundred and nine strains were also isolated from 300 specimens of faeces received from outpatients living in the same geographical area. These strains were typed using a modification of the resistotyping method. We were unable to find any significant differences between the two populations of strains. This suggests that no particular resistotype has an increased ability to cause vaginitis