Is simulation the only keystone of surgical training?

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Optical response of strongly absorbing inhomogeneous materials: Application to paper degradation

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Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes

Background: Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage 653 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage 653 CKD in a large cohort of patients affected by T1DM. Methods: A total of 4284 patients affected by T1DM followed-up at 76 diabetes centers participating to the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD) initiative constitutes the study population. Urinary albumin excretion (ACR) and estimated GFR (eGFR) were retrieved and analyzed. The incidence of stage 653 CKD (eGFR < 60 mL/min/1.73 m2) or eGFR reduction > 30% from baseline was evaluated. Results: The mean estimated GFR was 98 \ub1 17 mL/min/1.73m2 and the proportion of patients with albuminuria was 15.3% (n = 654) at baseline. About 8% (n = 337) of patients developed one of the two renal endpoints during the 4-year follow-up period. Age, albuminuria (micro or macro) and baseline eGFR < 90 ml/min/m2 were independent risk factors for stage 653 CKD and renal function worsening. When compared to patients with eGFR > 90 ml/min/1.73m2 and normoalbuminuria, those with albuminuria at baseline had a 1.69 greater risk of reaching stage 3 CKD, while patients with mild eGFR reduction (i.e. eGFR between 90 and 60 mL/min/1.73 m2) show a 3.81 greater risk that rose to 8.24 for those patients with albuminuria and mild eGFR reduction at baseline. Conclusions: Albuminuria and eGFR reduction represent independent risk factors for incident stage 653 CKD in T1DM patients. The simultaneous occurrence of reduced eGFR and albuminuria have a synergistic effect on renal function worsening

Premio ASTELLAS

The aim of our study was to evaluate the real utility of the TRIMprob test before TRUS-guided biopsy approach, putting in relation the number of positive tests of the TRIMprob with the number of positive prostate biopsies that were performed successfully. Sensitivity, Specificity, PPV (Positive predicted value), NPV (Negative predicted value) of the TRIMprob test were analyzed with statistical software package for Social Sciences (SPSS Inc, Chicago, Illinois US

Advantages on urinary continence using the capio rp suturing device for vesico-urethral anastomosis after radical retropubic prostatectomy

Synopsis of Video Showing the use of the Caprio RP Suturing device for vesico-urethral anastomosis on patients who have had radical retropubic prostatectomy. Hypothesis / aims of study A well performed vesico-urethral anastomosis should provide watertight closure, with appropriate mucosal to mucosal coaptation, and a proper tension free urethral realignment, in order to avoid complications, and improve functional results on early continence rate. Aim of the study is to evaluate the urinary continence rate in patients undergone radical retropubic prostatectomy and Capio RP assisted vesico-urethral anastomosis. Study design, materials and methods 150 patients age ranged from 51 to 73 suffering from localized prostate cancer, underwent radical retropubic prostatectomy, and vesico-urethral anastomosis using the Capio RP suturing device. After the prostate gland and seminal vesicles had been removed, bladder neck was tailored, and the mucosal everted ,to obtain a caliber compatible with urethral size, for a better and safe Capio Rp assisted anastomosis by means of six stitches. The 20F. Foley catheter was removed on postoperative day 7,during cystography, which showed a perfec anastomosis in all cases, with a small leakage in 4 patients. Urinary continence was evaluated on the basis of the daily count of pads used , as reported by the patients. Results 130 patients (86,6%) showed an immediate complete urinary continence, when the catheter has been removed. 18 patients(12%) had a mild urinary dribbling (2 to 3 pads/day), which disappeared within 4 to 6 weeks from surgery.1 patient is completely incontinent,1 patient has a stress incontinence. Interpretation of results Complete urinary continence after radical prostatectomy depends mostly on a well –healed vesico-urethral anastomosis. The results obtained with our surgical technique on continence rate are very encouraging when compared with those reported in Literature (from 6% to 20%). Concluding message In our experience, the use of Capio RP made every vesico-urethral anastomosis extremely easy and safe, allowing the needle to rotate perfectly deep inside the urethral stump,so that the suture can pass through the mucosal, the smooth fibers of the urethra, and the peri- urethral muscular aponeurotic fibers ,thus preserving in most cases an immediate and complete urinary continence. Specify source of funding or grant NONE Is this a clinical trial? No What were the subjects in the study? HUMAN Was this study approved by an ethics committee? No This study did not require eithics committee approval because IT'S A

9. The accuracy of tissue resonance interaction method prob (Trimprob TM) in non-invasive diagnosis of prostatic cancer.Analysis of the result of 782 patients

The aim of our study was to evaluate the real utility of the TRIMprob test before TRUS-guided biopsy approach, putting in relation the number of positive tests of the TRIMprob with the number of positive prostate biopsies that were performed successfully. Sensitivity, Specificity, PPV (Positive predicted value), NPV (Negative predicted value) of the TRIMprob test were analyzed with statistical software package for Social Sciences (SPSS Inc, Chicago, Illinois USA

Theoretical optical spectroscopy of complex systems

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