[Urologic malignancies in renal transplant candidates and recipients].

International audienceOBJECTIVE:To review epidemiology and management of urologic neoplasms in renal transplant candidates and recipients.MATERIAL AND METHODS:Relevant publications were identified through Medline (http://www.ncbi.nlm.nih.gov) and Embase (http://www.embase.com) database using the following keywords, alone or in association, "neoplasms"; "prostate cancer"; "renal carcinoma"; "renal transplantation"; "transitional carcinoma"; "waiting list". Articles were selected according to methods, language of publication and relevance. A total of 7730 articles were identified including 781 for solid tumors, 1565 for renal cell carcinoma (RCC), 2674 for prostate cancer (Pca), 385 for transitional carcinoma (TC) and 56 for testicular cancer; after careful selection, 221 publications were eligible for our review.RESULTS:Renal transplant candidates and recipients are at higher risk of urologic neoplasms than general population, but prostate cancer has similar features. Thus, all therapeutic options are valid. Conversely to radiation therapy, radical prostatectomy provides precise staging and immediate affirmation of therapeutic success. Lymph nodes dissection needs to be discussed; systematic screening using PSA level and digital rectal examination should be offered in this specific population. RCC arising in native kidneys are usually low grade and stage and require total nephrectomy. In transplant candidates, there is no need to delay transplantation after treatment of low risk RCC according to published predictive nomograms. RCC of the allograft are rare, with a prevalence of 0.2 to 05% with a dialysis free survival ranging from 40 to 75% at 21.5 to 43 months. Treatment options are nephron sparing surgery, percutaneous ablation and immediate or deferred transplantectomy. Conversely to RCC or PCa, TC present with more unfavorable features as general population. Their management faces specific difficulties such as lower efficacy of BCG instillation or the technical challenge of urinary diversion.CONCLUSION:Application of appropriate indication for transplantectomy relies on benefit-risk balance between the interruption of immunosuppressive agents versus survival and quality of life impairment after returning to dialysis. No robust recommendation exists regarding switch of immunosuppressive drugs. Cancer predictive factors and access to a subsequent transplantation are key decisive elements

Épidémiologie des calculs urinaires dans le Sud de la France : étude rétrospective monocentrique

International audienceINTRODUCTION:Incidence of urolithiasis is increasing in industrialized countries. Amendments can be explained among others by dietary changes. More and more young patients have urolithiasis. The objective of this study was to analyze and update the epidemiology of stones in south of France about age and gender.MATERIAL AND METHODS:A retrospective single-center study from 2009 to June 2015 included all urolithiasis analyzed by infrared spectroscopy. Groups were composed according to the mineral content (oxalocalcic with whewellite and weddelite, calcium phosphate stones, uric acid stones…).RESULTS:A total of 749 stones were analyzed. The sex ratio was 1.96 all aged confused. The most common stones were oxalocalcic (51.3 %), followed mixed stones (21.2 %) and calcium phosphate stones (11.9 %). The calcium oxalate stones are mainly composed of whewellite (42 %) and calcium phosphate stones of carbapatite (18.6 %). The stones of whewellite were more frequent in men (P=0.0009), as well as uric acid stones (P=0.01) and mixed stones in women (P=0.00003), as well as calcium phosphate (P=0.0005).CONCLUSIONS:Epidemiology of stones has changed with an increased incidence in women, and nephrolithiasis patients getting older. A change in the type of stones is observed with increasing the proportion of mixed stones especially among women. Nutritional and metabolic studies are needed to find the etiology of the change in the epidemiology of urolithiasis.LEVEL OF EVIDENCE:4

Manifestations auto-immunes inaugurales d’une mycobactériose disséminée à Mycobacterium bovis , à 17 mois d’un traitement endovésical par BCG-thérapie

International audienc

Depth and Image Restoration from Light Field in a Scattering Medium

Traditional imaging methods and computer vision algorithms are often ineffective when images are acquired in scattering media, such as underwater, fog, and biological tissue. Here, we explore the use of light field imaging and algorithms for image restoration and depth estimation that address the image degradation from the medium. Towards this end, we make the following three contributions. First, we present a new single image restoration algorithm which removes backscatter and attenuation from images better than existing methods do, and apply it to each view in the light field. Second, we combine a novel transmission based depth cue with existing correspondence and defocus cues to improve light field depth estimation. In densely scattering media, our transmission depth cue is critical for depth estimation since the images have low signal to noise ratios which significantly degrades the performance of the correspondence and defocus cues. Finally, we propose shearing and refocusing multiple views of the light field to recover a single image of higher quality than what is possible from a single view. We demonstrate the benefits of our method through extensive experimental results in a water tank

Tumeurs testiculaires dans le département de l’Hérault : résultats de 30 ans d’enregistrement (1987–2016)

International audienceObjectifsLe registre des tumeurs de l’Hérault est un registre général qualifié par le comité national des registres depuis 1987. L’objectif de cette étude est de présenter l’évolution de l’épidémiologie des cancers testiculaires dans le département de l’Hérault à partir des données collectées par le registre des tumeurs de l’Hérault (RTH) sur une période de 30 ans.MéthodesÀ partir de la base de données du RTH, nous avons étudié l’évolution des tumeurs de la vessie de 1987 à 2016. Nous avons analysé les données concernant l’incidence, la mortalité, l’anatomopathologie des tumeurs et leur stade au diagnostic. Nous avons comparé ces résultats aux données nationales et internationales.RésultatsNous avons recensé 729 nouveaux cas de tumeur du testicule. Le taux standardisé sur la population mondiale (TSM) de l’incidence est passé de 4,6 en 1987 à 9 en 2016 pour 100 000, la mortalité de 0,6 à 0,2 pour 100 000 pour la même période. Le pic d’incidence se situe entre 30 et 35 ans.ConclusionEn 30 ans, l’incidence des tumeurs testiculaire à fortement augmenter dans l’Hérault, on observe une faible diminution de sa mortalité sur cette même période. Ces données analytiques seront améliorées par le développement du Registre de l’Hérault Spécialisé en onco-urologie (RHESOU)

Recommandations en onco-urologie 2013 du CCAFU : Tumeurs germinales du testicule CCAFU Recomm ndations 2013: Testicular germ cell cancer

Résumé Introduction.-L'objectif de cet article a été d'établir par le groupe organes génitaux externes du CCAFU des recommandations pour le diagnostic, le traitement et le suivi des tumeurs germinales du testicule. Matériel et méthodes.-Le groupe de travail multidisciplinaire a étudié les recommandations précédentes, revue de manière exhaustive la littérature, évalué les références, leur niveau de preuve a n d'attribuer des grades de recommandation. Résultats.-Le bilan initial d'un cancer du testicule repose sur un bilan clinique, biologique (AFP, hCG totale, LDH) et d'imagerie (échographie scrotale et tomodensitométrie thoracoabdomino-pelvienne). L'orchidectomie par voie inguinale est la première étape thérapeutique permettant de préciser le type histologique, de dé nir le stade local et les facteurs de risque de micrométastases. La prise en charge des tumeurs de stade I repose sur une attitude thérapeutique adaptée au risque en exposant au patient le béné ce/inconvénient d'un traitement actif ou d'une surveillance en fonction du risque de rechute. Pour les TGS de stade I, le choix se fait entre une surveillance, une chimiothéraoie (1 cycle de carboplatine) ou une radiothérapie lombo-aortique. Pour les TGNS de stade I, le choix se fait entre une surveillance, une chimiothérapie (2 cycles de BEP) ou une lymphadénectomie rétro-péritonéale de stadi cation. La prise en charge des tumeurs métastatiques est dominée par une chimiothérapie par 3 ou 4 cycles de BEP en fonction du groupe pronostique. Dans les cas de TGS avec une atteinte métastatique ganglionnaire < 3 cm, une radiothérapie peut se discuter. MOTS CLÉS Summary Introduction.-The objective of this article is to establish guidelines proposed by the external genital organ group of the CCAFU for the diagnosis, treatment and follow-up of the germ cell tumours of the testis. Material and Methods.-The multidisciplinary working party studied previous guidelines, exhaustively reviewed the literature, and evaluated references and their level of proof in order to attribute grades of recommendation. Results.-The initial work-up of testicular cancer is based on clinical, laboratory (AFP, total hCG, LDH) and imaging assessment (scrotal ultrasound and chest, abdomen and pelvis computed tomography). Inguinal orchidectomy is the rst-line treatment allowing characterization of the histological type, local staging and identi cation of risk factors for micrometastases. The management of stage I tumours must be adapted to the risk by explaining to the patient the bene ts/disadvantages of active treatment or watchful waiting as a function of the risk of relapse. Treatment options for stage 1 seminomas comprise : watchful waiting, chemotherapy (1 cycle of carboplatin) or para-aortic radiotherapy. Treatment options for stage 1 nonseminomatous germ cell tumours comprise : watchful waiting, chemotherapy (2 cycles of BEP) or staging retroperitoneal lymphadenectomy. The management of metastatic tumours essentially comprises chemotherapy with 3 or 4 cycles of BEP according to the prognostic group. Radiotherapy may be indicated in seminomas with lymph node metastasis < 3 cm. Review 3 to 4 weeks post-chemotherapy is essentially based on tumour marker assays and chest, abdomen and pelvis computed tomography. Surgical retroperitoneal lymph node dissection is indicated for all residual NSGCT masses > 1 cm and for persistent residual seminoma masses > 3 cm with 18 F-FDG PET-CT uptake. Conclusions.-Germ cell tumours have an excellent survival rate based on precise initial staging, adapted and strictly de ned treatment and close surveillance