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Transperineal laser ablation of the prostate as a treatment for benign prostatic hyperplasia and prostate cancer: The results of a Delphi consensus project

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Asian Journal of Urology 2024年第2期11卷 271-279页

作者： Andrea Cocci Marta Pezzoli Fernando Bianco Franco Blefari Pierluigi Bove Francois Cornud Gaetano De Rienzo Paolo Destefanis Danilo Di Trapani Alessandro Giacobbe Luca Giovanessi Antonino Laganà Giovanni Lughezzani Guglielmo Manenti Gianluca Muto Gianluigi Patelli Novello Pinzi Stefano Regusci Giorgio I.Russo Juan I.M.Salamanca Matteo Salvi Luigi Silvestri Fabrizio Verweij Eric Walser Riccardo GBertolo Valerio Iacovelli Alessandro Bertaccini Debora Marchiori hugo davila Pasquale Ditonno Paolo Gontero Gennaro Iapicca Theo M De Reijke Vito Ricapito Pierluca Pellegrini Andrea Minervini Sergio Serni Francesco Sessa Department of Urology Careggi HospitalUniversity of FlorenceFlorenceItaly Urology Section University of FlorenceFlorenceItaly Urological Research Network MiamiFLUSA Urology Section Prato HospitalPratoItaly Torvergata Oncoscience Research Centre of Excellence TORDepartment of Experimental MedicineUniversity of Rome Tor VergataRomeItaly Department of Urology San Carlo di Nancy HospitalRomeItaly Department of Radiology Hôpital CochinParis Descartes UniversityParisFrance Urology and Andrology Unit II Department of Emergency and Organ TransplantationUniversity of BariBariItaly Unit of Urology Cittàdella Salute e della Scienza HospitalUniversity of TurinTurinItaly Urology Unit Buccheri La Ferla Fatebenefratelli HospitalPalermoItaly Department of Urology Humanitas Gradenigo HospitalTurinItaly Urology Unit Surgical DepartmentFondazione Poliambulanza Istituto OspedalieroBresciaItaly Departement of Urology “S.Giovanni Evangelista”HospitalTivoliItaly Humanitas Clinical and Research CentereIRCCS Department of UrologyRozzanoItaly Department of Biomedical Sciences Humanitas UniversityPieve EmanueleItaly Department of Biomedicine and Prevention University of Rome“Tor Vergata”RomeItaly Department of Diagnostic Imaging and Interventional Radiology University of Rome“Tor Vergata”RomeItaly Department of Interventional Radiology Pesenti-Fenaroli Hospital-ASST Bergamo EstAlzano LombardoItaly Department of Urology University of SienaSienaItaly Swiss International Prostate Center GenevaSwitzerland Clinique Générale Beaulieu GenevaSwitzerland Department of Urology University of CataniaItaly Department of Urology Puerta de Hierro-Majadahonda University HospitalMadridSpain Lyx Institute of Urology Universidad Francisco de VitoriaMadridSpain Department of Medico-Surgical Sciences and Biotechnologies Sapienza University of RomeFaculty of Pharmacy and MedicineUrology Unit ICOTLatinaItaly Department of Urology European Institute of Oncology(IEO)IRCCSMilanItaly Department of Radiology D

Objective: To evaluate transperineal laser ablation (TPLA) with Echolaser® (Echolaser® TPLA, Elesta S.p.A., Calenzano, Italy) as a treatment for benign prostatic hyperplasia (BPH) and prostate cancer (PCa) using the Delphi consensus ***: Italian and international experts on BPH and PCa participated in a collaborative consensus project. During two rounds, they expressed their opinions on Echolaser® TPLA for the treatment of BPH and PCa answering online questionnaires on indications, methodology, and potential complications of this technology. Level of agreement or disagreement to reach consensus was set at 75%. If the consensus was not achieved, questions were modified after each round. A final round was performed during an online meeting, in which results were discussed and ***: Thirty-two out of forty invited experts participated and consensus was reached on all topics. Agreement was achieved on recommending Echolaser® TPLA as a treatment of BPH in patients with ample range of prostate volume, from 80 mL (80%), comorbidities (100%), antiplatelet or anticoagulant treatment (96%), indwelling catheter (77%), and strong will of preserving ejaculatory function (100%). Majority of respondents agreed that Echolaser® TPLA is a potential option for the treatment of localized PCa (78%) and recommended it for low-risk PCa (90%). During the final round, experts concluded that it can be used for intermediate-risk PCa and it should be proposed as an effective alternative to radical prostatectomy for patients with strong will of avoiding urinary incontinence and sexual dysfunction. Almost all participants agreed that the transperineal approach of this organ-sparing technique is safer than transrectal and transurethral approaches typical of other techniques (97% of agreement among experts). Pre-procedural assessment, technical aspects, post-procedural catheterization, pharmacological therapy, and expected outcomes were discussed, leading t

关键词： Transperineal laser ablation Prostatecancer Benignprostatic hyperplasia Delphi consensus

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Robotic Assisted Laparoscopic Apical Suspension. Description of a 4 Points Technique (RALAS-4): First Case Reported

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Open Journal of Obstetrics and Gynecology 2017年第9期7卷 944-950页

作者： hugo H davila Lindsey Bruce Lindsey Goodman Taryn Gallo Florida Healthcare Specialist Urology and Minimally Invasive Surgery Florida Cancer Specialist & Research Institute Sebastian and Vero Beach USA Department of Surgery Division of Urology and Gynecology Sebastian River Medical Center Sebastian USA Florida State University College of Medicine Fort Pierce Campus Fort Pierce USA

The uterosacral ligaments (UTSL), together with the cardinal ligament (CL), hold the upper vagina and cervix over the levator plate. These 2 ligaments provided 4 points support at the apex. Here we describe our surgical technique of robotic assisted laparoscopic apical suspension (RALAS) using non-absorbable sutures and describe a new 4 points technique (RALAS-4). 73-year-old Caucasian woman, gravida 5, para 4 had symptomatic pelvic organ prolapse (POP) apical/anterior stage III. At pelvic ultrasound evaluation the uterus was small and normal appearing of adnexa bilaterally. She failed pessaries and was sexually active. The most relevant complaints were vaginal bulging, pressure and urinary incontinence, mainly stress urinary incontinence;she is using 5 - 7 pads/day. Robotic assisted laparoscopic hysterectomy, mid-urthral sling and apical suspension was successfully performed in 125 min. Once we finished with hysterectomy, we proceed with RALAS-4, we used V-Loc 3-0, CV-23 (Covidien) sutures (absorbable) on the right and left uterosacral ligaments (2 points) and theses were reinforced with Gore-Tex 2-0, CV-2 (non-absorbable, Gore Medical). On the right/left anterior apical support we used Gore-Tex 2-0 and these provided the 2 point suspension (UTLS = 2 and anterior vagina = 2). The 2 anterior apical support sutures are taken from the vagina to the transversalis fascia and the obliterated umbilical artery on the anterior abdominal wall. The tension of these anterior sutures was maintained with Hem-o-lock (TeleFlex) and LAPRA-TY (Ethicon). In our opinion RALAS-4 may represents an alternative to robotic or laparoscopic sacrocolpopexy. This new approach simulate the natural 4 points support given by uterosacral ligaments and cardinal ligament, with the additional benefit of no mesh and no dissection on the sacrum promontory. With this technique we are chasing the Trifecta: no mesh, no complications and good anatomic support.

关键词： Apical Prolapse Vaginal Prolapse Pelvic Anatomy Robotic Surgery Uterosacral Ligament Cardinal Ligament

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Anatomic Evaluation of Uterosacral and Cardinal Ligament during Robotic and Laparoscopic Surgery for Pelvic Organ Prolapse

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Open Journal of Obstetrics and Gynecology 2017年第12期7卷 1216-1227页

作者： hugo H davila Renzo Di Natale Lindsey Bruce Lindsey Goodman Taryn Gallo Florida Healthcare Specialist Urology and Minimally Invasive Surgery Florida Cancer Specialist & Research Institute Sebastian and Vero Beach FL USA Department of Surgery Division of Urology and Gynecology Sebastian River Medical Center Sebastian FL USA Florida State University College of Medicine Fort Pierce Campus FL USA

Introduction: It is widely accepted that the uterosacral ligaments (UTSL), together with the cardinal ligament (CL), hold the upper vagina and cervix over the levator plate. The aim of this study is to evaluate the anatomical relationship between the right vs. left CL and UTSL during robotic and laparoscopic utero-sacral ligament suspension (UTSLS) and its implication with the surgical technique during UTSL suspension. Material and Methods: We evaluated 25 women with apical pelvic organ prolapses of stages 2 - 4 and we analyzed 100 uterosacral and cardinal ligaments. They were assigned (non-randomly) to: a) robotic-assisted laparoscopic uterosacral ligament suspension (RAL-UTSLS), b) robotic-assisted single-site utero-sacral ligament suspension (RASS-UTSLS) or laparo-endoscopic single site utero-sacral ligament suspension (LESS-UTSLS). We evaluated the length (distance between origins and insertions) of the aforementioned ligaments using the Da Vinci Si and other laparoscopic instruments like calipers. Results: The mean length of the UTSL in their caudal-cranial extent was 3.5 ± 0.5 cm (right side) and 2.58 ± 0.3 cm (left side). Measurements were performed on the same way for the CL, resulting in 5.1 ± 0.3 cm (both side). The only significant difference was observed when comparing the right vs. left UTSL. This anatomic difference translates to 5 ± 1 suture stitches on the right UTSL vs. 2 ± 1 on the left UTSL. Conclusion: In our evaluation on cardinal and uterosacral ligament, the right UTSL was significantly longer as compared to the left and this allowed us to take 3 additional stitches on the right UTSL vs. left during RAL-UTSLS. Future studies are necessary to compare females with/without POP.

关键词： Apical Prolapse Vaginal Prolapse Pelvic Anatomy Robotic Surgery Pelvic Floor Pelvic Ligaments

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Removal of saxitoxin and anatoxin-a by PAC in the presence and absence of microcystin-LR and/or cyanobacterial cells

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Journal of Environmental Sciences 2023年第6期128卷 161-170页

作者： Justin Rorar Laura davila Garcia Teresa Cutright Department of Civil Engineering The University of AkronOH 44325-3905USA

Cyanobacteria can produce cyanotoxins such as microcystin-LR(MC),saxitoxin(STX),and anatoxin-a(ANTX-a)which are harmful to humans and other *** removal efficiencies of STX and ANTX-a by powdered activated carbon(PAC)was investigated,aswell as when MC-LR and cyanobacteriawere *** conductedwith distilled water and then source water,using the PAC dosages,rapid mix/flocculation mixing intensities and contact times of two drinking water treatment plants in northeast *** pH 8 and 9,STX removal was 47%-81%in distilled water and 46%-79%in source water,whereas it was 0-28%for pH 6 in distilled water and 31%-52%in source *** 1.6μg/L or 20μg/L MC-LR was present with STX,STX removal was increased with PAC simultaneously removing 45%-65%of the 1.6μg/L MC-LR and 25%-95%of the 20μg/L MC-LR depending on the ***-a removal at pH 6 was 29%-37%for distilled water and 80%for source water,whereas it was 10%-26%for pH 8 in distilled water and 28%for pH 9 in source *** presence of cyanobacteria cells decreased ANTX-a removal by at least 18%.When 20μg/L MC-LR was present with ANTX-a in source water,59%-73%ANTX-a and 48%-77%of MCLR was removed at pH 9 depending on the PAC *** general,a higher PAC dose led to higher cyanotoxin *** study also documented that multiple cyanotoxins can be effectively removed by PAC for water at pH’s between 6 and 9.

关键词： pH Cyanotoxins Cyanobacteria PAC Microcystin Saxitoxin Anatoxin-a

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Urethroplasty in a post irradiation urethral stricture-a review

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Plastic and Aesthetic Research 2022年第1期9卷 133-139页

作者： Carlos Guerra Sergio davila Slavica Pusica Predrag Aleksic Department of Urology Belgrade Center for Genitourinary Reconstructive SurgeryBelgrade 11000Serbia Department of Urology Hospital Universitario“Dr.JoséEleuterio González”MonterreyNuevo Leon 64460Mexico Department of Urology Medical Military AcademyBelgrade 11000Serbia

Radiotherapy-induced urethral strictures(RIUS)decrease quality of life and present a great challenge for surgical reconstruction,especially due to proximal location,compromised vascular supply,and poor wound *** is unclear whether urethroplasty is an option in cases with stricture resulting from exposure to pelvic *** review the pathophysiology,diagnostic workup,and disease-specific aspects of ***,we discuss several management alternatives such as excision and primary anastomosis,as well as techniques for open reconstruction with *** most extensive techniques in the treatment of strictures include,for example,those using gracilis muscle flaps,as they can involve periurethral tissue to provide sufficient vascularity for excellent post-surgery urethral *** brief,RIUS represent a significant *** carefully chosen patients,urethroplasty should be considered as a feasible and durable ***,medical practitioners should always take into consideration that the results of urethroplasty in RIUS are not comparable to urethroplasties without a radiation background.

关键词： Urethra stricture radiotherapy urethroplasty buccal mucosa graft gracilis muscle flap stricture

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Adaptive Thermoforming and Structural Design of Millimeter-Wave Antenna Panels

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Nanomanufacturing and Metrology 2022年第4期5卷 327-335页

作者： Zack Hatfield Alex St.Peter Christian davila-Peralta Joel Berkson Daewook Kim Justin Hyatt James C.Wyant College of Optical Sciences University of Arizona1630 E.University BlvdTucsonAZ85721USA Department of Astronomy and Steward Observatory University of Arizona933 N.Cherry AveTucsonAZ85721USA

Future large-scale radio telescope observatories,such as the next-generation Very Large Array,involve extremely large collection *** collection areas are divided into smaller shaped panels,which typically require their own unique molds to *** these projects to be cost-effective,an efficient fabrication method for the shaped panels is *** paper outlines the development and success of a novel adaptive freeform panel molding technology that greatly improves manufacturing efficiency due to its repeatable and reusable ***,it presents an analysis of a proposed panel structural design for the shaped panels,which incorporates a study on surface deformation due to gravity and wind loading under realistic operational conditions.

关键词： Radio telescope Millimeter-wave Thermoform Adaptable mold

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UNCONDITIONAL CAUCHY SERIES AND UNIFORM CONVERGENCE ON MATRICES

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Chinese Annals of Mathematics,Series B 2004年第3期25卷 335-346页

作者： A.AIZPURU A.GUTIERREZ-davila DepartarnentodeMatematicas UniversidaddeCadizApdo.4011510-PuertoReal（Cadiz）Spain DepartamentodeMatematicas UniversidaddeCadizApdo.4011510-PuertoReal（Cadiz）Spain

The authors obtain new characterizations of unconditional Cauchy series in terms of separation properties of subfamilies of p(N), and a generalization of the Orlicz-Pettis Theorem is also obtained. New results on the uniform convergence on matrices and a new version of the Hahn-Schur summation theorem are proved. For matrices whose rows define unconditional Cauchy series, a better sufficient condition for the basic Matrix Theorem of Antosik and Swartz, new necessary conditions and a new proof of that theorem are given.

关键词：绝对柯西级数收敛矩阵定理必要条件

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New considerations regarding pelvic organ prolapse treatment in China

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Chinese Medical Journal 2012年第7期125卷 1209-1211页

作者： ZHU Lan G.Willy davila Department of Obstetrics and Gynecology Peking Union Medical College HospitalBeijing 100730China Department of Gynecology Cleveland Clinic Florida2950 Cleveland Clinic BoulevardWestonFL 33331USA Department of Gynecology Cleveland Clinic Florida2950 Cleveland Clinic BoulevardWestonFL 33331USA Department of Gynecology Cleveland Clinic Florida2950 Cleveland Clinic BoulevardWestonFL 33331USA

Pelvic organ prolapse （POP） is non-fatal conditions which can markedly affect a patient’s quality of life. Multiple recently developed pelvic reconstructive surgeries have led to a recent expansion in China. In this study, we would like to discuss various aspects of the evaluation and management of POP and raise the question of what is sufficient evidence for the adoption of innovative treatments for POP.

关键词： pelvic organ prolapse urogynecology reconstructive surgery pelvic surgery mesh

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Baseline moderate-range albuminuria is associated with protection against severe COVID-19 pneumonia

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World Journal of Diabetes 2022年第12期13卷 1154-1167页

作者： Amir Bashkin Mona Shehadeh Lina Shbita Kamil Namoura Ronza Haiek Elena Kuyantseva Yousef Boulos Orly Yakir Etty Kruzel-davila Department of Diabetes Endocrinologyand MetabolismGalilee Medical CenterNahariya 2210001Israel Azrieli Faculty of Medicine Bar-Ilan UniversityZefat 1311502Israel Clinical Laboratories Division Clinical Biochemistry and Endocrinology LaboratoryGalilee Medical CenterNahariya 2210001Israel Internal Medicine A Galilee Medical CenterNahariya 2210001Israel Statistical Analysis Division Galilee Medical CenterNahariya 2210001Israel Department of Nephrology Galilee Medical CenterNahariya 2210001Israel

BACKGROUND Diabetes mellitus is considered a leading contributor to severe coronavirus disease 2019(COVID-19).AIM To characterize differences between hospitalized diabetic patients with vs without COVID-19,and parameters associated with COVID-19 severity for *** This case-control study included 209 patients with type 2 diabetic mellitus hospitalized at the Galilee Medical Center(Nahariya,Israel)and recruited between September 2020 and May 2021,65 patients with COVID-19 infection in dedicated wards and 144 COVID-19-negative patients in internal medicine wards hospitalized due to other *** parameters-including age,type of antiglycemic medications,presence of retinopathy,smoking history,body mass index(BMI),glycosylated hemoglobin,maximum neutrophil:lymphocyte ratio(NLR_(max)),C-reactive protein(CRP),estimated glomerular filtration rate(eGFR),and albumin(blood and urine)-were compared between the two primary patient groups,and then between COVID-19-negative patients hospitalized due to infectious vs non-infectious ***,we explored which parameters were associated with severe COVID-19 *** COVID-19-negative patients were older(63.9±9.9 vs 59.8±9.2,P=0.005),and had longer duration of diabetes(P=0.031),lower eGFR(P=0.033),higher albumin(P=0.026),lower CRP(P<0.001),greater smoking prevalence(P<0.001),and more baseline albuminuria(54.9%vs 30.8%,P=0.005)at admission;70%of COVID-19 patients with albuminuria had moderate-range albuminuria(albumin:creatinine 30-300 mg/g).Most of the patients with albuminuria had chronic kidney disease stage II(CKD II).Oral antiglycemic therapies were not significantly different between the two *** logistic regression showed that higher BMI was significantly associated with severe COVID-19(OR 1.24,95%CI:1.01-1.53,P=0.04),as was higher NLR_(max)(OR 1.2,95%CI:1.06-1.37,P=0.005).Surprisingly,pre-hospitalization albuminuria,mostly moderate-range,was associated with reduced risk(OR

关键词： Diabetes mellitus COVID-19 Albuminuria Severity Chronic kidney disease Immunomodulation

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Ethyl Methanesulfonate as Inductor of Somaclonal Variants in Different Crops

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Phyton-International Journal of Experimental Botany 2020年第4期89卷 835-850页

作者： Jose Gregorio Joya-davila F.A.Gutierrez-Miceli Plant Biotechnology Laboratory Tecnologico Nacional de MexicoInstituto Tecnologico de Tuxtla GutierrezTuxtla Gutierrez29050Mexico

Ethyl methanesulfonate is a chemical mutagen,which is currently being used in plant breeding,to increase genetic variability in genes of agronomic interest,of species useful in *** primarily causes single base point mutations by inducing guanine alkylation,resulting in GC to AT *** effect is different between clones of a genotype and between genotypes of the same *** review presents the results obtained in recent research,where its effect on plant tissues,callus,and cells in suspension has been *** in the phenotypic expression of somaclonal variants were reported,involving morphology,production of secondary metabolites,changes in metabolic routes of resistance,tolerance to stress,increased seed yield,among *** addition,this review compiles the doses and guidelines to consider before using this mutagen,which can serve as a guide for future trials in deciding the response variables,the type of plant explants and the selection of the study *** lines have allowed plant breeders to have a collection of plants with different characteristics,in places where the cultivar does not have its center of *** is important to note that it is still necessary to continue evaluating the heritability of mutations and their behaviour in the environment where they will be established,in order to obtain new varieties of plants that can be cultivated with uniformity in their genetic response.

关键词： Geneticvariability plantbreeding pointmutation guaninealkylation chemical mutagen

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