RESUMEN
Post-prostatectomy urinary incontinence (PPUI) is an important issue in the urological practice and imposes a negative effect on quality of life (QoL). Despite recent technological advances, PPUI remains a common complication and the artificial urinary sphincter (AUS) is regarded as the most effective long-term surgical treatment for moderate-to-severe stress urinary incontinence. Success rates for AUS as defined by a continence status of zero to one pad per day range from 59% to 90%. One potential downside of the AUS is the need for periodic revisions in a number of patients. Revision and explantation rates due to mechanical failure, urethral atrophy, infection and erosion vary considerably among studies with reports of 8-45% and 7-17%, respectively. These complications can be classified into different categories, including recurrent or refractory incontinence, erosion and/or infection, and other complications. This review article aims to describe the main AUS-related complications and their management strategies. Diagnostic work-up strategies are explored to facilitate timely identification and management of these complications. Additionally, emerging technologies and future directions in AUS development are discussed, highlighting potential advancements to mitigate complications and enhance device performance. This review consolidates current knowledge and provides insights for clinicians to manage the complexities associated with AUS therapy effectively.
RESUMEN
Weedy rice, a pervasive and troublesome weed found across the globe, has often evolved through fertilization of rice cultivars with little importance of crop-weed gene flow. In Argentina, weedy rice has been reported as an important constraint since the early 1970s, and, in the last few years, strains with herbicide-resistance are suspected to evolve. Despite their importance, the origin and genetic composition of Argentinian weedy rice as well its adaptation to agricultural environments has not been explored so far. To study this, we conducted genotyping-by-sequencing on samples of Argentinian weedy and cultivated rice and compared them with published data from weedy, cultivated and wild rice accessions distributed worldwide. In addition, we conducted a phenotypic characterization for weedy-related traits, a herbicide resistance screening and genotyped accessions for known mutations in the acetolactate synthase (ALS) gene, which confers herbicide resistance. Our results revealed large phenotypic variability in Argentinian weedy rice. Most strains were resistant to ALS-inhibiting herbicides with a high frequency of the ALS mutation (A122T) present in Argentinian rice cultivars. Argentinian cultivars belonged to the three major genetic groups of rice: japonica, indica and aus while weeds were mostly aus or aus-indica admixed, resembling weedy rice strains from the Southern Cone region. Phylogenetic analysis supports a single origin for aus-like South American weeds, likely as seed contaminants from the United States, and then admixture with local indica cultivars. Our findings demonstrate that crop to weed introgression can facilitate rapid adaptation to agriculture environments.
Asunto(s)
Acetolactato Sintasa , Resistencia a los Herbicidas , Herbicidas , Oryza , Oryza/genética , Resistencia a los Herbicidas/genética , Argentina , Acetolactato Sintasa/genética , Malezas/genética , Fenotipo , Genotipo , Adaptación Fisiológica/genética , Productos Agrícolas/genética , Flujo Génico , Agricultura , MutaciónRESUMEN
BACKGROUND: The objective of this study was to compare two cytological subcategories of thyroid nodules with Bethesda category III initial cytology. METHODS: This was a prospective study. All patients with thyroid nodules > 1 cm were eligible and 98 patients with category III cytology were selected. Cytology was subcategorized into architectural atypia only (AA, n = 45) and nuclear atypia (NA, n = 53). All patients underwent a second fine-needle aspiration (FNA). Only patients whose second cytology was benign and ultrasonography was non-suspicious were not referred for surgery. In these patients, the nodules were considered benign. RESULTS: The second FNA more frequently revealed "benign cytology" in the AA subcategory (44.4% vs. 24.5% in the NA subcategory). The second cytology suggested "follicular neoplasm" or was "suspicious for follicular neoplasm" (category IV) in 5 patients (11.1%) of subcategory AA and was "suspicious for malignancy" (category V) in 13 (24.5%) of subcategory NA. Finally, malignancy was diagnosed in 15.5% of cases of subcategory AA and in 41.5% of subcategory NA. Follicular carcinoma was more frequent in subcategory AA, while classical papillary carcinoma was more frequent in subcategory NA. Excluding cases of the noninvasive encapsulated follicular variant of papillary carcinoma, malignancy was diagnosed in 11.1% of patients of subcategory AA and in 35.8% of subcategory NA. CONCLUSIONS: The results showed that subclassification of the Bethesda category III improves cancer risk prediction, with potential repercussions for clinical practice. Diagn. Cytopathol. 2017;45:604-607. © 2017 Wiley Periodicals, Inc.
Asunto(s)
Adenocarcinoma Folicular/diagnóstico por imagen , Carcinoma Papilar/diagnóstico por imagen , Neoplasias de la Tiroides/diagnóstico por imagen , Nódulo Tiroideo/clasificación , Nódulo Tiroideo/diagnóstico por imagen , Adenocarcinoma Folicular/patología , Biopsia con Aguja Fina , Carcinoma Papilar/patología , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Guías de Práctica Clínica como Asunto , Estudios Prospectivos , Riesgo , Glándula Tiroides/diagnóstico por imagen , Glándula Tiroides/patología , Neoplasias de la Tiroides/patología , Nódulo Tiroideo/patología , UltrasonografíaRESUMEN
A personagem enlouquecida amarrada ao pé do castanheiro de "Cem anos de solidão" serve-nos de metáfora para as amarras que a institucionalização pode propiciar. Como fazer para que uma Residência Terapêutica (RT), por não oferecer as mesmas amarras das instituições psiquiátricas, possa ter a função de um espaço transitório para outro lugar? Para tentar responder esta questão construímos uma aproximação entre o ambiente facilitador e o meio que a RT representa a partir dos conceitos de Winnicott.
The mad man tied to the chestnut tree in One Hundred Years of Solitude can be seen as a metaphor of the ties that institutionalization can engender. What can be done to make a therapeutic residence perform the role of a transitory space for patients, since there they are not tied down as they would be in a psychiatric institution? Based on Winnicott's concepts we tried to answer this question by making a connection between the facilitating environment and the therapeutic residence environment.
Le personnage fou attaché au pied d'un châtaignier dans Cent ans de solitude nous sert de métaphore pour les chaines invisibles que l'institutionnalisation peut représenter. Étant donné que la résidence thérapeutique (RT) ne produit pas les mêmes rapports de dépendance que les institutions psychiatriques, comment la configurer pour qu'elle puisse jouer un rôle d'espace transitionnel? Pour essayer de répondre à cette question, nous avons construit une approximation entre l'environnement facilitateur et celui de la RT à partir des concepts de Winnicott.
El personaje loco atado al castañero del libro Cien años de soledad nos sirve como una metáfora de las amarras que la institucionalización puede propiciar. ¿Como hacer para que una Residencia Terapéutica (RT), por no ofrecer las mismas amarras de las instituciones psiquiátricas, tenga la función de un espacio de transición para otro lugar? Para intentar responder a esta pregunta hemos construído una aproximación entre el ambiente facilitador y el ambiente que la RT representa basado en los conceptos de Winnicott.
Asunto(s)
Humanos , Desinstitucionalización , PsicoanálisisRESUMEN
O tema da transitoriedade era lugar-comum da medicina da alma da primeira modernidade. Este artigo analisa algumas dessas fontes para mostrar como a dor do tempo e os males da alma atinentes eram relacionados a um modo de encarar a fugacidade do tempo e a fragilidade da vida. Dá-se destaque, sobretudo, às construções em torno da condição humana enquanto desterro da certeza.
The theme of transitoriness was commonplace in medicine of the soul of early modernity. This article examines some of these sources to show how the pain of time and similar ailments of the soul were related to a way of dealing with the fleetingness of time and the fragility of life. The author underlines constructions of the human condition as exile from certainty.
Le thème de la fugacité était un lieu commun de la médecine de l'âme de la première modernité. Cet article examine quelques-unes de ces sources pour montrer comment la douleur du temps et le maux de l'âme étaient liés à une façon d'envisager la nature éphémère du temps et la fragilité de la vie. Cet article met en relief les constructions liées à la condition humaine comprise comme exil de la certitude.
El tema de la transitoriedad era un lugar común en la medicina del alma durante la primera modernidad. Este artículo analiza algunas de esas fuentes para mostrar como el dolor del tiempo y los males del alma estaban relacionados a un modo de encarar la fugacidad del tiempo y la fragilidad de la vida. Se destaca sobretodo las construcciones en torno de la condición humana como destierro de la certeza.