Vaginal cuff recurrence after radical cystectomy: an under - studied site of bladder cancer relapse

Vaginal cuff recurrence of tumor following radical cystectomy is a rare site of disease recurrence, however it has never been specifically studied. The aim of the study is to evaluate incidence, risk factors, and long-term oncologic outcomes of vaginal cuff recurrence in a cohort of female patients treated with radical cystectomy for invasive urothelial carcinoma of the bladder

Cross-Layer Design in Dynamic Spectrum Sharing Systems

We consider a dynamic spectrum sharing system consisting of a primary user, whose licensed spectrum is allowed to be accessed by a secondary user as long as it does not violate the prescribed interference limit inflicted on the primary user. Assuming the Nakagami-m block-fading environment, we aim at maximizing the performance of secondary user's link in terms of average spectral efficiency (ASE) and error performance under the specified packet error rate (PER) and average interference limit constraints. To this end, we employ a cross-layer design policy which combines adaptive power and coded discrete M-QAM modulation scheme at the physical layer with a truncated automatic repeat request (ARQ) protocol at the data link layer, and simultaneously satisfies the aforementioned constraints. Numerical results affirm that the secondary link of spectrum sharing system combining ARQ with adaptive modulation and coding (AMC) achieves significant gain in ASE depending on the maximum number of retransmissions initiated by the ARQ protocol. The results further indicate that the ARQ protocol essentially improves the packet loss rate performance of the secondary link

Death, dying and informatics: misrepresenting religion on MedLine

BACKGROUND: The globalization of medical science carries for doctors worldwide a correlative duty to deepen their understanding of patients' cultural contexts and religious backgrounds, in order to satisfy each as a unique individual. To become better informed, practitioners may turn to MedLine, but it is unclear whether the information found there is an accurate representation of culture and religion. To test MedLine's representation of this field, we chose the topic of death and dying in the three major monotheistic religions. METHODS: We searched MedLine using PubMed in order to retrieve and thematically analyze full-length scholarly journal papers or case reports dealing with religious traditions and end-of-life care. Our search consisted of a string of words that included the most common denominations of the three religions, the standard heading terms used by the National Reference Center for Bioethics Literature (NRCBL), and the Medical Subject Headings (MeSH) used by the National Library of Medicine. Eligible articles were limited to English-language papers with an abstract. RESULTS: We found that while a bibliographic search in MedLine on this topic produced instant results and some valuable literature, the aggregate reflected a selection bias. American writers were over-represented given the global prevalence of these religious traditions. Denominationally affiliated authors predominated in representing the Christian traditions. The Islamic tradition was under-represented. CONCLUSION: MedLine's capability to identify the most current, reliable and accurate information about purely scientific topics should not be assumed to be the same case when considering the interface of religion, culture and end-of-life care

Prostate cancer in renal transplant recipients

As patients with end-stage renal disease are receiving renal allografts at older ages, the number of male renal transplant recipients (RTRs) being diagnosed with prostate cancer (CaP) is increasing. Historically, the literature regarding the management of CaP in RTR's is limited to case reports and small case series. To date, there are no standardized guidelines for screening or management of CaP in these complex patients. To better understand the unique characteristics of CaP in the renal transplant population, we performed a literature review of PubMed, without date limitations, using a combination of search terms including prostate cancer, end stage renal disease, renal transplantation, prostate cancer screening, prostate specific antigen kinetics, immuno-suppression, prostatectomy, and radiation therapy. Of special note, teams facilitating the care of these complex patients must carefully and meticulously consider the altered anatomy for surgical and radiotherapeutic planning. Active surveillance, though gaining popularity in the general low risk prostate cancer population, needs further study in this group, as does the management of advance disease. This review provides a comprehensive and contemporary understanding of the incidence, screening measures, risk stratification, and treatment options for CaP in RTRs

Development and characterization of physical modified pearl millet starch-based films

Pearl millet is an underutilized and drought-resistant crop that is mainly used for animal feed and fodder. Starch (70%) is the main constituent of the pearl millet grain; this starch may be a good substitute for major sources of starch such as corn, rice, potatoes, etc. Starch was isolated from pearl millet grains and modified with different physical treatments (heat-moisture (HMT), microwave (MT), and sonication treatment (ST)). The amylose content and swelling capacity of the starches decreased after HMT and MT, while the reverse was observed for ST. Transition temperatures (onset (To), peak of gelatinization (Tp), and conclusion (Tc)) of the starches ranged from 62.92–76.16◦C, 67.95–81.05◦C, and 73.78–84.50◦C, respectively. After modification (HMT, MT, and ST), an increase in the transition temperatures was observed. Peak-viscosity of the native starch was observed to be 995 mPa.s., which was higher than the starch modified with HMT and MT. Rheological characteristics (storage modulus (G′) and loss modulus (G′′)) of the native and modified starches differed from 1039 to 1730 Pa and 83 to 94 Pa; the largest value was found for starch treated with ST and HMT. SEM showed cracks and holes on granule surfaces after HMT as well as MT starch granules. Films were prepared using both native and modified starches. The modification of the starches with different treatments had a significant impact on the moisture, transmittance, and solubility of films. The findings of this study will provide a better understanding of the functional properties of pearl millet starch for its possible utilization in film formation

Male infertility in spinal cord trauma

Every year there are 10 thousand new cases of patients victimized by spinal cord trauma (SCT) in the United States and it is estimated that there are 7 thousand new cases in Brazil. Eighty percent of patients are fertile males. Infertility in this patient group is due to 3 main factors resulting from spinal cord lesions: erectile dysfunction, ejaculatory disorder and low sperm counts. Erectile dysfunction has been successfully treated with oral and injectable medications, use of vacuum devices and penile prosthesis implants. The technological improvement in penile vibratory stimulation devices (PVS) and rectal probe electro-ejaculation (RPE) has made such procedures safer and accessible to patients with ejaculatory dysfunction. Despite the normal number of spermatozoa found in semen of spinal cord-injured patients, their motility is abnormal. This change does not seem to be related to changes in scrotal thermal regulation, frequency of ejaculation or duration of spinal cord damage but to factors related to the seminal plasma. Despite the poor seminal quality, increasingly more men with SCT have become fathers through techniques ranging from simple homologous insemination to sophisticated assisted reproduction techniques such as intracytoplasmic sperm injection (ICSI).Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM) Department of UrologySan Francisco Home School Section of UrologyUNIFESP, EPM, Department of UrologySciEL

Evaluation of improved pigeon pea (Cajanus cajan) varieties for organoleptic dal quality in India

Pigeon pea (Cajanus cajanL.) is an important pulse crop in the Indian diet and one of the most important sources of dietary protein for the population. Organoleptic qualities of pigeon pea dal were tested to draw conclusions on the preferred varieties. Organoleptic qualities such as taste, texture, aroma, tenderness, sweetness and overall acceptance were tested by a trained sensory panel. Available and commercially viable improved varieties were selected for the analysis. All samples were milled and cooked under the same conditions. Results indicated that PUSA ARHAR 16, one of the improved varieties, presents a good potential in terms of agronomic characteristics for farmers and is also well accepted by the sensory panel during the organoleptic evaluation. Generating sound scientific evidence on organoleptic characteristics of pigeon pea is important for the breeders, as they will evaluate which varieties have a commercial potential and are accepted by the consumers

The hypoactive corpora cavernosa with degenerative erectile dysfunction: a new syndrome

BACKGROUND: In a group of 22 patients with erectile dysfunction, vasculogenic, neurogenic, endocrinologic or psychogenic investigations failed to find a cause for their erectile dysfunction. The electro-cavernosograms of these patients recorded a diminished activity. We investigated the hypothesis that diminished corpus cavernosum electromyography activity was the cause of erectile dysfunction in these patients. METHODS: The study comprised the above mentioned 22 patients (study group, 43.8 ± 5.9 SD years) and 15 healthy volunteers (control group, 41.8 ± 5.1 SD years). The electro-cavernosograms were recorded in the flaccid, erectile and detumescent phases by 2 electrodes inserted into the corpus cavernosum. RESULTS: The electro-cavernosogram of the healthy volunteers registered in the flaccid phase regular slow waves and random action potentials. The wave variables declined significantly in the erectile phase (p < 0.01). In the study group, the slow wave variables in the flaccid phase exhibited a significant decrease (p < 0.05) compared to the healthy volunteers, and the rhythm was irregular. Erection did not occur with sildenafil administration or intracavernosal papaverine injection, and penile implant was performed. Biopsy examination showed degenerated muscle fibers, and fragmented collagen and elastic fibers with areas of fibrosis. CONCLUSION: A novel concept of the cause of erectile dysfunction was presented. Corpora cavernosa showed degenerative changes on histopathologic examination and exhibited diminished electromyography activity. They did not respond to sildenafil administration or intracavernosal papaverine injection. Penile implants were the only treatment. The condition is given the name 'hypoactive corpus cavernosum'. The cause of corpus cavernosum degenerative changes needs further study