Positive surgical margins in nephron-sparing surgery; the great unknown

There is a currently a general trend towards organ-preserving surgery, and urology is no exception. Specifically, nephron-sparing surgery (NSS) has gained general acceptance for T1a renal cell carcinoma (guidelines recommendations). Moreover T1b, T2 and even T3 stage tumors have been included on the nephron sparing list at some centers. An unresolved issue is that of positive surgical margins (PSM), not only their detection but also the implications for follow up and treatment. This paper highlights data available on risk factors for PSM, their clinical relevance, and possible therapeutic consequences. From the surgeon’s viewpoint, NSS is a daring and risky surgical procedure. Urological guidelines stress the importance of NSS, and thus the trend is moving in that direction. Unresolved, however, is the problem of PSM. Trifecta, MIC, and pentafecta are applicable concepts which attempt to define the optimal endpoint of NSS, but further elaboration is necessary. Specifically, research needs to focus less on the concept of definitive margins and more on their identification and avoidance. Although some studies suggest that PSMs do not influence overall survival rate, the basic idea of preserving tissue that is not cancerous leads to further medical, social, and psychological considerations

Pelvic floor disorders in gynecological malignancies. An overlooked problem?

Cervical, endometrial, ovarian, vulvar, and vaginal cancers affect women of a broad age spectrum. Many of these women are still sexually active when their cancer is diagnosed. Treatment options for gynecological malignancies, such as gynecological surgery, radiation, and chemotherapy, are proven risk factors for pelvic floor dysfunction. The prevalence of urinary incontinence, fecal incontinence, and sexual dysfunction before cancer treatment is still unclear. Hypotheses have been raised in the literature that these manifestations could represent early symptoms of pelvic cancers, but most remain overlooked even in cancer surviving patients. The primary focus of therapy is always cancer eradication, but as oncological and surgical treatment options become more successful, the number of cancer survivors increases. The quality of life of patients with gynecological cancers often remains an underrated subject. Pelvic floor disorders are not consistently reported by patients and are frequently overlooked by many clinicians. In this brief review we discuss the importance of pelvic floor dysfunction in patients with gynecological malignant tumors

Evolution of epidemical process of acute viral hepatitis B, C and D in the context of realization of National Programs for viral hepatitis B, C and D prevention

This scientific article discusses particularities of modern evolution of epidemic process of viral hepatitis B, C and D in the Republic of Moldova. Three national programs for viral hepatitis B, C and D prevention have been implemented in the Republic of Moldova. As a result of the introduction of these programs the morbidity of parenteral viral hepatitis has decreased significantly, but the implementation of all preventive measures is necessary for viral hepatitis diminution. In order to further reduce the incidence of acute viral hepatitis to the indicators registered in most European countries and the incidence of chronic hepatitis, cirrhosis and primary liver cancer, as well as to improve the epidemiological situation and the health status of the population of the Republic of Moldova and to reduce the economic impact the Ministry of Health together with the National Centre of Health has developed a National Program on the fight against viral hepatitis B, C and D for 2012-2016. The materials and results of the research on the epidemiology of viral hepatitis, conducted over a period of many years by the staff of the laboratory of the National Centre of Public Health, have been used. The epidemiological, analytical and statistical methods have been applied in the study

Size Dependence of Static and Dynamic Magnetic Properties in Nanoscale Square Permalloy Antidot Arrays

Permalloy antidot arrays with different square hole sizes ( , , and ) have been fabricated by means of electron-beam lithography and lift-off techniques. The smaller square hole size results in enhanced remanence and reduced coercivity in the antidot array. Multiple resonance modes were clearly observed for the magnetic field applied normal to the array plane, and double uniform resonance modes occurred when the field deviated more than 30° from the normal to the plane. Two distinct dipolar field patterns with different orientations and magnitudes split the uniform resonance into double resonance modes. The double resonance modes show uniaxial in-plane anisotropy and the easy axes are orthogonal. The magnitude of the induced dipolar anisotropy remains almost constant with changes in the square hole size. The double resonance peaks move to low field with reduction of the square hole size

Tuning the Thermal Relaxation of Transition-Metal Ferrite Nanoparticles Through Their Intrinsic Magnetocrystalline Anisotropy

Monodispersed ferrite nanoparticles of Fe3O4, MnFe2O4, and CoFe2O4 (near to 10 nm), were synthesized by organometallic synthesis, showing the same homogeneous chemical, morphological, and crystalline characteristics. The study and correlation of the thermal relaxation processes were analyzed through static and dynamic measurements. Due to the intrinsic chemical characteristics and magnetocrystalline anisotropy of the ferrite nanoparticles, the energy barrier can be tuned to a range between 1100 K EB 7300 K, showing an alternative approach for tuning the magnetic dynamic properties, in contrast to the well-known mechanism through particle-size-effects. Specific loss power efficiencies were evaluated for the three ferrite samples. Comparing the three samples at the maximum ac frequency of ¼10 kHz, MnFe2O4 exhibits the single-peak maximum of loss with the value of 273 erg/s g at T¼65 K, whereas for the CoFe2O4 , a maximum of 132 erg/s g (T¼ 217 K) was determined. A considerable drop in the efficiency was determined for the Fe 3O4 nanoparticles, with the value of 20 erg/s g at T¼ 43.5 K

Positive surgical margins in nephron-sparing surgery; the great unknown

There is a currently a general trend towards organ-preserving surgery, and urology is no exception. Specifically, nephron-sparing surgery (NSS) has gained general acceptance for T1a renal cell carcinoma (guidelines recommendations). Moreover T1b, T2 and even T3 stage tumors have been included on the nephron sparing list at some centers. An unresolved issue is that of positive surgical margins (PSM), not only their detection but also the implications for follow up and treatment. This paper highlights data available on risk factors for PSM, their clinical relevance, and possible therapeutic consequences. From the surgeon’s viewpoint, NSS is a daring and risky surgical procedure. Urological guidelines stress the importance of NSS, and thus the trend is moving in that direction. Unresolved, however, is the problem of PSM. Trifecta, MIC, and pentafecta are applicable concepts which attempt to define the optimal endpoint of NSS, but further elaboration is necessary. Specifically, research needs to focus less on the concept of definitive margins and more on their identification and avoidance. Although some studies suggest that PSMs do not influence overall survival rate, the basic idea of preserving tissue that is not cancerous leads to further medical, social, and psychological considerations