Tunical plication in the management of penile curvature due La Peyronie’s disease. Our experience on 47 cases.

BACKGROUND: Peyronie’s disease is an acquired connective tissue disorder of the penile tunica albuginea with fibrosis and inflammation. The disease produces palpable plaques, penile curvature and pain during erections. Patients report negative effects in four major domains: physical appearance and self-image, sexual function and performance. These changes damage sexual life and compromise the quality of life. Our objective is to review the patient's sexual life after penile tunical plicature using the International Index of Erectile Function (IIEF) and the Sexual Encounter Profile (SEP) questionnaires. METHODS: A total of 47 patients with Peyronie's disease (PD) were enrolled at our urology department and they underwent correction of penile deviation between February 2009 and March 2010. Mean patient age was 56 years and mean follow-up was 24 months. Patients with painless PD plaque with no progression in angulation for at least 12 months were chosen for surgery. They underwent a penile tunical plication. IIEF and SEP questionnaire were administered to all patients. RESULTS: Of all treated patients, 94% were able to insert their penis in the partner's vagina (p<0.01; SEP question 2), compared with 62% preoperatively and 90% of them was satisfied overall with the sexual intercourse (p<0.01; SEP question 5) .Patients had a significantly higher endpoint and a greater change from baseline for the remaining SEP questions related to achievement of an erection, satisfaction of erection hardness (SEP questions 1 and 4; p < 0:001). We reported a significant improvement in the IIEF scores (from a baseline total score of 25.2 +/- 3.2 to a final score of 38.3 +/- 5.2; P<0.01). It resulted in significantly higher endpoint IIEF scores across all five IIEF domains: Erectile Function, Intercourse Satisfaction, Orgasmic Function, Sexual Desire and Overall Satisfaction. The main complaint was penile shortening (28 patients, 60%), feeling of the suture during flaccidity and tumescence (37 patients, 80%). CONCLUSION: Patient quality of life improved after surgery thanks to the improvement of their sexual life. The complications are unimportant and few bother symptoms are reported. The significant improvement in erectile function was also supported by IIEF and SEP questionnaire data. Nowadays tunical plication is a safe, advantageous and useful technique to treat patients suffering of Peyronie’s disease

The Non--Ergodicity Threshold: Time Scale for Magnetic Reversal

We prove the existence of a non-ergodicity threshold for an anisotropic classical Heisenberg model with all-to-all couplings. Below the threshold, the energy surface is disconnected in two components with positive and negative magnetizations respectively. Above, in a fully chaotic regime, magnetization changes sign in a stochastic way and its behavior can be fully characterized by an average magnetization reversal time. We show that statistical mechanics predicts a phase--transition at an energy higher than the non-ergodicity threshold. We assess the dynamical relevance of the latter for finite systems through numerical simulations and analytical calculations. In particular, the time scale for magnetic reversal diverges as a power law at the ergodicity threshold with a size-dependent exponent, which could be a signature of the phenomenon.Comment: 4 pages 4 figure

Out-of-equilibrium states as statistical equilibria of an effective dynamics

We study the formation of coherent structures in a system with long-range interactions where particles moving on a circle interact through a repulsive cosine potential. Non equilibrium structures are shown to correspond to statistical equilibria of an effective dynamics, which is derived using averaging techniques. This simple behavior might be a prototype of others observed in more complicated systems with long-range interactions, like two-dimensional incompressible fluids or self-gravitating systems.Comment: 4 figure

Asymptotic Statistics of Poincar\'e Recurrences in Hamiltonian Systems with Divided Phase Space

By different methods we show that for dynamical chaos in the standard map with critical golden curve the Poincar\'e recurrences P(\tau) and correlations C(\tau) asymptotically decay in time as P ~ C/\tau ~ 1/\tau^3. It is also explained why this asymptotic behavior starts only at very large times. We argue that the same exponent p=3 should be also valid for a general chaos border.Comment: revtex, 4 pages, 3 ps-figure

Quantum Poincar\'e Recurrences

We show that quantum effects modify the decay rate of Poincar\'e recurrences P(t) in classical chaotic systems with hierarchical structure of phase space. The exponent p of the algebraic decay P(t) ~ 1/t^p is shown to have the universal value p=1 due to tunneling and localization effects. Experimental evidence of such decay should be observable in mesoscopic systems and cold atoms.Comment: revtex, 4 pages, 4 figure

El agua subterránea para consumo humano en Bahía Blanca y el suroeste de la provincia de Buenos Aires

El agua subterránea es un recurso estratégico que reúne cerca del 97% del agua dulce de la tierra, disponible para consumo humano. Su estudio y utilización adquieren fundamental relevancia, en condiciones de clima árido o semiárido, como en la región del suroeste bonaerense y debido a la escasez de agua superficial. La investigación hidrogeológica ha demostrado la factibilidad del aprovechamiento racional y sustentable del recurso subterráneo para suplementar el abastecimiento a la ciudad de Bahía Blanca y su región de influencia. Siguiendo la tendencia actual de procurar una utilización conjunta del agua superficial y subterránea, los responsables de la gestión y planificación hidrológicas, deberían contemplar el uso del agua del subsuelo, como alternativa prioritaria para el suministro. En la región de Bahía Blanca, pueden identificarse, en términos generales, tres ambientes hidrogeológicos portadores de agua subterránea apta para uso humano: el sector periserrano de las Sierras Australes, los sedimentos pampeanos distribuidos en la llanura aledaña y la cadena de médanos costeros que se extiende entre Monte Hermoso y Punta Alta. Los estudios que se están desarrollando tienen como objetivos definir modelos conceptuales de funcionamiento de los acuíferos, cuantificar reservas y recursos y analizar la factibilidad de explotación, también para uso industrial u otros, lo que constituiría un ahorro de agua de red. La transferencia a terceros se realiza a través de la Fundación de la Universidad y se traducen en apoyo técnico-científico a gestores y usuarios del agua, en núcleos urbanos del distrito de Bahía Blanca y aledaños del suroeste bonaerense

The cavity method for large deviations

A method is introduced for studying large deviations in the context of statistical physics of disordered systems. The approach, based on an extension of the cavity method to atypical realizations of the quenched disorder, allows us to compute exponentially small probabilities (rate functions) over different classes of random graphs. It is illustrated with two combinatorial optimization problems, the vertex-cover and coloring problems, for which the presence of replica symmetry breaking phases is taken into account. Applications include the analysis of models on adaptive graph structures.Comment: 18 pages, 7 figure

Current challenges in the management of patients with sickle cell disease - A report of the Italian experience

Sickle cell disease (SCD) is an inherited red blood cell disorder caused by a structural abnormality of hemoglobin called sickle hemoglobin (HbS). Clinical manifestations of SCD are mainly characterized by chronic hemolysis and acute vaso-occlusive crisis, which are responsible for severe acute and chronic organ damage. SCD is widespread in sub-Saharan Africa, in the Middle East, Indian subcontinent, and some Mediterranean regions. With voluntary population migrations, people harboring the HbS gene have spread globally. In 2006, the World Health Organization recognized hemoglobinopathies, including SCD, as a global public health problem and urged national health systems worldwide to design and establish programs for the prevention and management of SCD. Herein we describe the historical experience of the network of hemoglobinopathy centers and their approach to SCD in Italy, a country where hemoglobinopathies have a high prevalence and where SCD, associated with different genotypes including f-thalassemia, is present in the native population

Extended gaussian ensemble solution and tricritical points of a system with long-range interactions

The gaussian ensemble and its extended version theoretically play the important role of interpolating ensembles between the microcanonical and the canonical ensembles. Here, the thermodynamic properties yielded by the extended gaussian ensemble (EGE) for the Blume-Capel (BC) model with infinite-range interactions are analyzed. This model presents different predictions for the first-order phase transition line according to the microcanonical and canonical ensembles. From the EGE approach, we explicitly work out the analytical microcanonical solution. Moreover, the general EGE solution allows one to illustrate in details how the stable microcanonical states are continuously recovered as the gaussian parameter $\gamma$ is increased. We found out that it is not necessary to take the theoretically expected limit $\gamma \to \infty$ to recover the microcanonical states in the region between the canonical and microcanonical tricritical points of the phase diagram. By analyzing the entropy as a function of the magnetization we realize the existence of unaccessible magnetic states as the energy is lowered, leading to a treaking of ergodicity.Comment: 8 pages, 5 eps figures. Title modified, sections rewritten, tricritical point calculations added. To appear in EPJ

Expression levels of circulating miRNAs as biomarkers during multimodal treatment of rectal cancer - TiMiSNAR-mirna: a substudy of the TiMiSNAR Trial (NCT03962088)

Background: Neoadjuvant chemoradiotherapy followed by surgery is the mainstay treatment for locally advanced rectal cancer, leading to significant decrease in tumor size (downsizing) and a shift towards earlier disease stage (downstaging). Extensive histopathological work-up of the tumor specimen after surgery including tumor regression grading and lymph node status helped to visualize individual tumor sensitivity to chemoradiotherapy, retrospectively. As the response to neoadjuvant chemoradiotherapy is heterogeneous, however, valid biomarkers are needed to monitor tumor response. A relevant number of studies aimed to identify molecular markers retrieved from tumor tissue while the relevance of blood-based biomarkers is less stringent assessed. MicroRNAs are currently under investigation to serve as blood-based biomarkers. To date, no screening approach to identify relevant miRNAs as biomarkers in blood of patients with rectal cancer was undertaken. The aim of the study is to investigate the role of circulating miRNAs as biomarkers in those patients included in the TiMiSNAR Trial (NCT03465982). This is a biomolecular substudy of TiMiSNAR Trial (NCT03962088). Methods: All included patients in the TiMiSNAR Trial are supposed to undergo blood collection at the time of diagnosis, after neoadjuvant treatment, after 1 month from surgery, and after adjuvant chemotherapy whenever indicated. Discussion: TiMiSNAR-MIRNA will evaluate the association of variation between preneoadjuvant and postneoadjuvant expression levels of miRNA with pathological complete response. Moreover, the study will evaluate the role of liquid biopsies in the monitoring of treatment, correlate changes in expression levels of miRNA following complete surgical resection with disease-free survival, and evaluate the relation between changes in miRNA during surveillance and tumor relapse. Trial registration: Clinicaltrials.gov NCT03962088 . Registered on 23 May 2019