Search

The PROpel trial assessed the combination of olaparib+abiraterone acetate (AA) plus prednisone and androgen deprivation therapy (ADT) versus AA plus prednisone and ADT alone as first-line treatment for metastatic castration-resistant prostate cancer (mCPRP). To contextualize the progression free survival (PFS) benefit in PROpel, we performed a systematic review and quasi-individual patient data network meta-analysis on randomized controlled trials of first-line hormonal treatments for mCPRC. Meta-analysis was performed for the PROpel control arm and PREVAIL (enzalutamide) and COU-AA-302 (AA) treatment arms. Kaplan-Meier PFS curves were digitally reconstructed and differences in restricted mean survival time (ΔRMST) were computed. Combination therapy yielded longer PFS (24-mo ΔRMST 1.5 mo, 95% confidence interval 0.6-2.4) in comparison to novel hormonal treatments alone. However, the lack of mature overall survival data, higher complication rates, and higher health care costs are limitations of combination therapy. Ultimately, combining treatments, rather than molecularly targeted sequencing in cases of failure, might not be justified in unselected patients with mCRPC.Patient summaryA recent trial showed that for metastatic prostate cancer that does not respond to hormone treatment, combined therapy with two drugs (olaparib and abiraterone) may prolong survival free from cancer progression. We included these data in an analysis of three trials that confirmed a small benefit. This combination approach has higher complication rates and is more expensive, and longer-term results for overall survival are needed.

BACKGROUND: Head-to-head comparisons between ileal conduit (IC) and orthotopic neobladder (ONB) in terms of peri- and postoperative outcomes and complications, in the specific setting of robot-assisted radical cystectomy (RARC), are not available. OBJECTIVE: To address the impact of the type of urinary diversion (UD, IC vs ONB) on RARC morbidity, as well as operative time (OT), length of stay (LOS), and readmissions. DESIGN, SETTING, AND PARTICIPANTS: Urothelial bladder cancer patients treated with RARC at nine high-volume European institutions between 2008 and 2020 were identified. INTERVENTION: RARC with either IC or ONB. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Intra- and postoperative complications were collected and reported according to the Intraoperative Complications Assessment and Reporting with Universal Standards recommendations and European Association of Urology guidelines, respectively. Multivariable logistic regression models tested the impact of UD on outcomes, after adjustment for clustering at single hospital level. RESULTS AND LIMITATIONS: Overall, 555 nonmetastatic RARC patients were identified. In 280 (51%) and 275 (49%) patients, an IC and an ONB were performed, respectively. Eighteen intraoperative complications were recorded. The rates of intraoperative complications were 4% in IC patients and 3% in ONB patients (p = 0.4). The median LOS and readmission rates were 10 versus 12 d (p

To determine the oncological impact and adverse events of performing simultaneous transurethral resection of bladder tumour (TURB) and transurethral resection of the prostate (TURP), as evidence on the outcomes of simultaneous TURB for bladder cancer and TURP for obstructive benign prostatic hyperplasia is limited and contradictory.Patients from 12 European hospitals treated with either TURB alone or simultaneous TURB and TURP (TURB+TURP) were retrospectively analysed. A propensity score matching (PSM) 1:1 was performed with patients from the TURB+TURP group matched to TURB-alone patients. Associations between surgery approach with recurrence-free (RFS) and progression-free (PFS) survivals were assessed in Cox regression models before and after PSM. We performed a subgroup analysis in patients with risk factors for recurrence (multifocality and/or tumour size3 cm).A total of 762 men were included, among whom, 76% (581) underwent a TURB alone and 24% (181) a TURB+TURP. There was no difference in terms of tumour characteristics between the groups. We observed comparable length of stay as well as complication rates including major complications (Clavien-Dindo Grade ≥III) for the TURB-alone vs TURB+TURP groups, while the latest led to longer operative time (P 0.001). During a median follow-up of 44 months, there were more recurrences in the TURB-alone (47%) compared to the TURB+TURP group (28%; P 0.001). Interestingly, there were more recurrences at the bladder neck/prostatic fossa in the TURB-alone group (55% vs 3%, P 0.001). TURB+TURP procedures were associated with improved RFS (hazard ratio [HR] 0.39, 95% confidence interval [CI] 0.29-0.53; P 0.001), but not PFS (HR 1.63, 95% CI 0.90-2.98; P = 0.11). Within the PSM cohort of 254 patients, the simultaneous TURB+TURP was still associated with improved RFS (HR 0.33, 95% CI 0.22-0.49; P 0.001). This was also true in the subgroup of 380 patients with recurrence risk factors (HR 0.41, 95% CI 0.28-0.62; P 0.001).In our contemporary cohort, simultaneous TURB and TURP seems to be an oncologically safe option that may, even, improve RFS by potentially preventing disease recurrence at the bladder neck and in the prostatic fossa.

Agata Sobczyk et Herman Braet nous livrent la première édition de Florimont, texte jusqu’à ce jour inédit. Ce Florimont écrit par un auteur anonyme du xve siècle n’a rien à voir avec le célèbre roman homonyme, écrit en vers par Aimon de Varennes en 1188 et mis en prose à trois reprises à la fin du Moyen Age. En effet, le roman édité raconte l’histoire d’un couple de jeunes gens, le fils des ducs d’Orléans et la fille du sultan (chrétien), qui réussit à réaliser un amour auquel ils sont destin...

Ce n’est que rarement qu’il arrive de rendre compte de l’édition d’une œuvre médiévale majeure qui ne bénéficiait pas encore d’un travail critique et qu’on était par conséquent obligé de lire dans les éditions partielles disponibles ou dans les manuscrits. La circonstance vient pourtant de se produire. Les Edizioni del Galluzzo de Florence ont fait paraître, dans la collection Archivio Romanzo, ce Guiron le Courtois qu’on voyait autrefois comme un seul roman et qu’il est convenu désormais de ...

« A tant m’en vois ». Figures du départ au Moyen Âge, éd. Nelly Labère, Luca Pierdominici, Arras, Fano, 2020. « Ad consolationem legentium ». Il Marco Polo dei Domenicani, éd. Maria Conte, Antonio Montefusco, Samuela Simion, Venise, Edizioni Ca’ Foscari, 2020 « Intavulare ». Tavole di canzonieri romanzi. Firenze, Biblioteca Riccardiana a aII (2814) Modena, Biblioteca Estense Universitaria a1 (Campori γ.N.8.4 : 11-13). (Canzoniere di Bernart Amoros), éd. Luciana Borghi Cedrini, Walter Meliga, ...

INTRODUCTION: Data about the role of chemotherapy in sarcomatoid bladder cancer (SBC) are limited. We addressed the effect of chemotherapy in non-metastatic SBC patients treated with radical cystectomy (RC). METHODS: Using the Surveillance, Epidemiology, and End Results database (2001–2018), we identified 331 patients with non-metastatic muscle-invasive or higher SBC (T(2–4)N(0–3)M(0)). Kaplan-Meier plots and Cox regression models tested cancer-specific mortality (CSM ). Sample size and power analyses tested for power limitations. RESULTS: Of 331 SBC patients, 129 (38.9%) were exposed to chemotherapy. The rate of organ-confined stage (T(2)N(0)M(0)) was 33% in both chemotherapy-exposed and chemotherapy-naive patients. In the overall cohort, median CSM-free survival was 84 months (interquartile range [IQR] 21–NA) vs. 26 months (IQR 17–84) in chemotherapy exposed vs. chemotherapy-naive patients, respectively. In multivariable Cox regression models, chemotherapy was associated with lower CSM, without reaching statistical significance (hazard ratio [HR ] 0.72, confidence interval [CI] 0.51–1.01, p=0.054). In subgroup analyses, chemotherapy exposure in organ-confined (n=110) vs. non-organ-confined (n=221) patients resulted in a HR of 0.51 (p=0.12) vs. 0.77 (p=0.17), respectively. Power analyses, based on two-sided α=0.05, revealed values of 52%, 14%, and 43% in the entire population, organ-confined, and nonorgan-confined subgroups, respectively. CONCLUSIONS: In non-metastatic SBC treated with RC, the association between chemotherapy and lower CSM is particularly strong in organ-confined stage. A substantially larger cohort would be required to confirm the statistical significance of the recorded protective effect of chemotherapy.

Einf��hrung und Zielsetzung: Die STAMPEDE Studie hat f��r die Kombination der lokalen RT mit begleitender Systemtherapie einen ��berlebensbenefit f��r das oligometastasierte PCA bei geringer Metastasenlast gezeigt. Ziel unserer Studie war der Vergleich der RP bei identischem Patientencharakteristika [zum vollst��ndigen Text gelangen Sie ��ber die oben angegebene URL]

La Renaissance est une époque où se côtoient des formes concurrentes d’appropriation des textes (lecture privée, lecture collective, lecture oralisée, lecture silencieuse). En en offrant un échantillon d’exemples, cette contribution propose de mettre en place un répertoire des indices, littéraires et historiques, aptes à approfondir notre connaissance de ces pratiques de lecture.

L’article étudie trois éditions de Claude Nourry (1470-1533) inconnues de la bibliographie. Ces éditions - La Vie de Jhesucrist, LaDestruction de Hierusalem, Robert le Diable – sont transmises par un recueil d’époque conservé à Sion (CH). La contribution étudie la constitution du recueil et analyse le matériel typographique. Une enquête philologique est portée sur Robert le diable identifiant par ailleurs une possible participation de Pierre de Vingle, associé de Nourry, dans cette publication., The contribution presents three editions by Claude Nourry (1470-1533) unknown to bibliographers. These editions – La Vie de Jhesucrist, La Destruction de Hierusalem, Robert le Diable – are gathered in a contemporary Sammelband held in Sion (CH). The article deals with the composition of the book and examines the typographical material. A philological analysis of Robert le Diable allows us to speculate on the participation of Pierre de Vingle, associate of Nourry’s, in this edition.

Background Bladder cancer is the ninth most common type of cancer worldwide. In the past, radical cystectomy via open surgery has been considered the gold-standard treatment for muscle invasive bladder cancer. However, in recent years there has been a progressive increase in the use of robot-assisted laparoscopic radical cystectomy. The aim of the current project is to investigate the surgical, oncological, and functional outcomes of patients with bladder cancer who undergo radical cystectomy comparing three different surgical techniques (robotic-assisted, laparoscopic, and open surgery). Pre-, peri- and post-operative factors will be examined, and participants will be followed for a period of up to 24 months to identify risks of mortality, oncological outcomes, hospital readmission, sexual performance, and continence. Methods We describe a protocol for an observational, prospective, multicenter, cohort study to assess patients affected by bladder neoplasms undergoing radical cystectomy and urinary diversion. The Italian Radical Cystectomy Registry is an electronic registry to prospectively collect the data of patients undergoing radical cystectomy conducted with any technique (open, laparoscopic, robotic-assisted). Twenty-eight urology departments across Italy will provide data for the study, with the recruitment phase between 1st January 2017-31st October 2020. Information is collected from the patients at the moment of surgical intervention and during follow-up (3, 6, 12, and 24 months after radical cystectomy). Peri-operative variables include surgery time, type of urinary diversion, conversion to open surgery, bleeding, nerve sparing and lymphadenectomy. Follow-up data collection includes histological information (e.g., post-op staging, grading, and tumor histology), short- and long-term outcomes (e.g., mortality, post-op complications, hospital readmission, sexual potency, continence etc). Discussion The current protocol aims to contribute additional data to the field concerning the short- and long-term outcomes of three different radical cystectomy surgical techniques for patients with bladder cancer, including open, laparoscopic, and robot-assisted. This is a comparative-effectiveness trial that takes into account a complex range of factors and decision making by both physicians and patients that affect their choice of surgical technique. Trial registration ClinicalTrials.gov , NCT04228198 . Registered 14th January 2020- Retrospectively registered.

Due to the involvement of the endocannabinoid system (ECS) in cancer onset and progression and the less studied connection between ECS and bladder cancer, here an evaluation of the ECS modifications associated with bladder cancer is reported. Urine samples were collected from healthy volunteers and patients with bladder cancer at different grades. Endocannabinoids (ECs) and N-acylethanolamides (NAEs) were quantified by HPLC-MS/MS and results normalized for creatinine content. An increase in the urine concentrations of four ECs and NAEs analyzed was observed with a statistically significant increase in the arachidonoylethanolamide (AEA) and stearoylethanoamide (SEA) associated with bladder cancer. Receiver operating characteristic curves built with AEA and SEA data allowed the selection of 160 pg/mL for SEA (area under the curve (AUC) = 0.91, Selectivity (SE) 94%, Specificity (SP) 45%) and 8 pg/mL for AEA (AUC = 0.85, SE 94%, SP 61%) as the best cut-off values. Moreover, data from bladder cancer samples at different grades were derived from The Cancer Genome Atlas, and the expressions of thirteen different components of the &ldquo, endocannabinoidome&rdquo, were analyzed. Statistical analysis highlights significant variations in the expression of three enzymes involved in EC and NAE turnover in bladder cancer.

Dernier ouvrage de Herberay des Essarts, Dom Flores (1552) se présente comme le remaniement d’un manuscrit en ancien français bien qu’il constitue l’adaptation d’un libro de caballerías. Cette étude s’attache à élucider la préface, qui réinvestit en le détournant le motif du manuscrit trouvé. Peu connu, ce prologue contient une réponse implicite aux critiques de Jacques Amyot ainsi qu’une défense originelle d’un genre médiéval, ici légitimé par le recours au concept de patrimoine national.

Apr��s avoir pass�� en revue les origines chr��tiennes et classiques du genre, la contribution identifie quelques d��fis majeurs qui attendent les chercheurs qui explorent le champ, encore �� d��fricher, des chroniques universelles en langue vernaculaire.

Si le XVIe siècle français n’élabore pas de théorie sur le roman de chevalerie, il produit des réflexions ponctuelles sur le genre. Alors que les préfaces des récits imprimés entre 1480 et 1530 évoquent le topos de l’instruction et du plaisir, certains textes publiés au milieu du siècle formulent une conceptualisation plus précise. C’est le cas des réflexions proposées par Jean Maugin pour sa traduction du Palmerin d’Olive de 1546 et pour le remaniement du Nouveau Tristan de 1554., The French sixteenth century did not develop a theory about the chivalric romance, elaborating only some sparse reflections. While the prefaces of novels printed between 1480 and 1530 evoke the traditional topos of utility and pleasure, some texts published in the mid-sixteenth century propose a more precise conceptualization. This is true for the reflections put forward by Jean Maugin in his Palmerin d’Olive of 1546 and Nouveau Tristan of 1554.

It has been brought to our attention that for the secondary outcome of tumour response, we reported an incorrect p value of 0.04 for a χ2 test comparing the groups. A careful reanalysis of all our results revealed that the p value is in fact 0.054 for this secondary outcome. However, we believe that given the low number of patients included in the study, a p value 0.054 instead of 0.04, which demonstrates borderline significance, does not invalidate the main study results. Conflicts of interest The authors have nothing to disclose.

To evaluate whether the position of the working channel affects the effectiveness of flexible ureteroscopy.

Pelvic lymph node dissection (PLND) represents the gold standard of lymph node staging in prostate cancer (PCa) patients.

Background The effect of local treatment on survival in advanced-stage patients has gained interest in several malignancies; however, limited data exist regarding urothelial carcinoma (UC). Objective To test the impact of surgery of the primary tumor site on cancer-specific mortality (CSM) and overall mortality (OM) in patients affected by metastatic UC. Design, setting, and participants Individual patient-level data from a multicenter collaboration, including metastatic UC patients treated with first-line cisplatin- or carboplatin-based chemotherapy administered between January 2006 and January 2011 from hospitals in the USA, Europe, Israel, and Canada. Outcome measurements and statistical analysis Univariable and multivariable Cox regression analyses were used to assess the effect of surgery on CSM and OM in patients affected by metastatic UC using 3-mo landmark analyses. Subgroup analyses were performed on the basis of the number of metastasis sites involved and including only patients treated with surgery before the start of chemotherapy. Results and limitations Of the 326 patients included in the study, 47 (14%) were treated with surgery of the primary tumor site. Median (interquartile range) follow-up was 43 (33–45) mo. Of the patients treated with surgery, 28 (60%) were affected by a primary bladder cancer and 19 (40%) by a primary upper urinary tract tumor. On multivariable analyses, surgery was associated with a protective effect on CSM (hazard ratio [HR]: 0.59, confidence interval [CI]: 0.35–0.98, p = 0.04) and OM (HR: 0.45, CI: 0.37–0.99, p = 0.04) compared with patients treated with chemotherapy only. Similar results were found considering patients only surgically treated before the start of chemotherapy. After stratifying according to the number of metastatic sites, surgery has an effect on survival in patients with only one metastatic site, while no survival benefit was observed in patients with two or more metastatic sites. The study is limited by its retrospective nature. Conclusions We found that surgery of the primary tumor site is associated with improved survival in patients with metastatic UC who received standard chemotherapy. This effect disappears in patients affected by two or more metastatic sites. Our results need to be validated in a high-quality prospective trial. Patient summary In our multicenter, retrospective series, surgery in metastatic urothelial cancer patients improve survival compared with patients treated with chemotherapy only. This effect was evident in patients with limited disease extent, identified as one metastatic site.

C’est par le plus grand des hasards que, en 2011, dans le grenier d’une villa de Savone (IT), huit cahiers décousus d’un manuscrit ont été redécouverts. Ces cinquante-sept feuillets réchappés de l’oubli ont livré un fragment d’un volgarizzamento inédit du Lancelot. Cette heureuse découverte a comblé une lacune dans la réception de la légende arthurienne en Italie, où les récits les plus importants de la saga ont bénéficié de traductions (Tristan, Estoire del Saint Graal, Merlin, Queste, Mort ...

PURPOSE: We compared the use of 11C-choline and 68Ga-prostate specific membrane antigen in men undergoing salvage lymph node dissection for nodal recurrent prostate cancer. MATERIALS AND METHODS: The study included 641 patients who experienced prostate specific antigen rise and nodal recurrence after radical prostatectomy and underwent salvage lymph node dissection. Lymph node recurrence was documented by positron emission tomography/computerized tomography using 11C-choline (407, 63%) or 68Ga-PSMA ligand (234, 37%). The outcome was underestimation of tumor burden (difference between number of positive nodes on final pathology and number of positive spots at positron emission tomography/computerized tomography). Multivariable analysis tested the association between positron emission tomography/computerized tomography tracer (11C-choline vs 68Ga-PSMA) and tumor burden underestimation. RESULTS: Overall the extent of tumor burden underestimation was significantly higher in the 11C-choline group compared to the 68Ga-PSMA group (p

Aiol. Chanson de geste (XIIe-XIIIe siècles). Traduite par Jean-Marie Ardouin d’après l’édition du manuscrit unique BnF fr. 25516, Paris, Champion, 2019. Allegranzi, Viola, Aux sources de la poésie ghaznavide (en 2 volumes). Les inscriptions persanes de Ghazni (Afghanistan, XIe-XIIe siècles), Presses Sorbonne nouvelle, 2019, 536 p. Amadas et Ydoine, édition bilingue, publication, traduction, présentation et notes par Christine Acher et Denis Hüe, Paris, Champion, 2020, 608 p. Andreose, Alvise,...

Personne ou presque n’a jamais entendu parler du _De Ovide arte amandi_. C’est pourtant ce recueil, imprimé au XVIe siècle, qui a garanti la diffusion tout au long de la Renaissance de l’_Ars amatoria_ en français. S’il atteste de la lecture du texte ovidien à cette époque, il témoigne aussi de sa relecture au fil d’une tradition qui remonte en réalité deux ou trois siècles auparavant: héritière des différentes versions déclinées au Moyen Âge sous forme de traductions libres, l’imprimerie a ainsi sélectionné et adapté au contexte éditorial les arts d’aimer en français, dont celui attribué à Jacques d’Amiens et l’anonyme _Clef d’amors_. Situé entre Moyen Âge et Renaissance, le livre ici examiné a subi le sort d’autres ouvrages publiés en cette période de transition, objets perdus dans un _no man’s land_ disciplinaire. Il était donc souhaitable de mener une enquête sur cet ouvrage négligé et par certains aspects mystérieux. Si elle n’a pas résolu toutes ses énigmes, l’étude ici menée et le catalogue dont elle est assortie contribuent à mettre en lumière une tradition complexe – jalonnée d’éditions avec fausses adresses, d’éditions sans indications typographiques, ou encore d’éditions «quasi-identiques» – et la fortune exceptionnelle d’un recueil méconnu qui représente, en l’état actuel de nos connaissances, le premier ouvrage parisien publié sous une fausse adresse.

Acte de congrès issu de : "La littérature arthurienne tardive en Europe (1270-1530), approches comparatives", Rennes 2, 1-2 février 2018; International audience

Pour savoir quel traitement l’auteur de l’Ovide moralisé a réservé aux rites religieux si souvent décrits dans les Métamorphoses et afin d’évaluer l’intérêt antiquaire de l’auteur français, cet article étudie la traduction médiévale des passages latins pertinents et analyse en même temps l’attitude adoptée dans l’une de ses sources principales, le Commentaire vulgate.

Purpose To prospectively identify clinical/dosimetric predictors of acute/late hematologic toxicity (HT) in chemo-naÏve patients treated with whole-pelvis radiotherapy (WPRT) for prostate cancer. Material and methods Data of 121 patients treated with adjuvant/salvage WPRT were analyzed (static-field IMRT n = 19; VMAT/Rapidarc n = 57; Tomotherapy n = 45). Pelvic bone marrow (BM) was delineated as ilium (IL), lumbosacral, lower and whole pelvis (WP), and the relative DVHs were calculated. HT was graded both according to CTCAE v4.03 and as variation in percentage relative to baseline. Logistic regression was used to analyze association between HT and clinical/DVHs factors. Results Significant differences (p < 0.005) in the DVH of BM volumes between different techniques were found: Tomotherapy was associated with larger volumes receiving low doses (3-20 Gy) and smaller receiving 40-50 Gy. Lower baseline absolute values of WBC, neutrophils and lymphocytes (ALC) predicted acute/late HT (p ≤ 0.001). Higher BM V40 was associated with higher risk of acute Grade3 (OR = 1.018) or late Grade2 lymphopenia (OR = 1.005). Two models predicting lymphopenia were developed, both including baseline ALC, and BM WP-V40 (AUC = 0.73) and IL-V40+smoking (AUC = 0.904) for acute/late respectively. Conclusions Specific regions of pelvic BM predicting acute/late lymphopenia, a risk factor for viral infections, were identified. The 2-variable models including specific constraints to BM may help reduce HT.

L’étude porte sur Gli egregi fatti del gran re Meliadus, traduction de l’imprimé Meliadus (Paris, 1528 et 1532), qui paraît à Venise par les soins de Torresani d’Asola vers 1558-1560. Cette version se distingue par une fidélité souvent littérale à sa source. Néanmoins, il est possible de déceler l’interpolation d’un assez long épisode. Favorisée par la structure du roman, elle témoigne d’une réception renaissante du cycle de Guiron. Elle peut être mise en parallèle avec d’autres lectures, dont celles de Boiardo et de L’Arioste.

OBJECTIVES: To assess the use of post radical prostatectomy (RP) urinary incontinence (PPI) surgery and to investigate factors related to its use. METHODS: Cohort study in Prostate Cancer database Sweden (PCBaSe) of men who underwent primary RP between 1998 and 2012. PPI correction procedures were identified in the Patient Registry. Hazard ratios (HR) and 95% confidence intervals (CIs) of PPI surgeries were estimated. RESULTS: Seven hundred eighty-two out of 26 280 (3%) men underwent PPI surgery at a median time of 3 years after RP. There was an eightfold increase in the absolute number of PPI surgeries during 2000-2014 and a threefold increase in the number per 1000 RPs performed. Factors associated with high use PPI surgery were age >70, HR 1.96 (1.54-2.50), and high hospital RP volume (>100 RPs/year), HR 0.81 (0.66-0.99). There was a 10-fold difference in use of PPI surgery per 1000 RPs between the county with the highest versus lowest use. In a subgroup of men with Patient-Reported Outcome Measures (PROM); severe PPI was reported by 7% of men and 24% of them underwent PPI surgery. CONCLUSIONS: Three percent of all men received PPI surgery, with a 10-fold variation among health care providers. Only a quarter of men with severe PPI underwent PPI surgery, suggesting that PPI surgery remains underutilized.

Introduction: Previous studies have shown that the injection of adipose tissue–derived stem cells (ADSCs) into the tunica albuginea (TA) during the active phase of Peyronie's disease (PD) prevents the development of fibrosis. Aim: To investigate, using an animal model, whether local injection of human ADSCs (hADSCs) can alter the degree of fibrosis in the chronic phase of PD. Methods: 27 male, 12-week-old rats were divided into 3 equal groups: sham, PD without treatment, and PD treated with hADSCs 1 month after disease induction. Sham rats underwent 2 injections of vehicle into the TA 1 month apart. PD rats underwent transforming growth factor β1 (TGFβ1) injection and injection of vehicle 1 month later. PD-hADSC rats underwent TGFβ1 injection followed by 1 million hADSCs 1 month later. 1 week after treatment, n = 3 animals/group were euthanized, and the penises were harvested for quantitative polymerase chain reaction. 1 month after treatment, the other animals, n = 6 per group, underwent measurement of intracavernous pressure (ICP) and mean arterial pressure (MAP) during electrostimulation of the cavernous nerve. After euthanasia, penises were again harvested for histology and Western blot. Main Outcome Measure: The primary outcome measures included (a) gene expression at one week post-injection; (b) measurement of ICP/MAP upon cavernous nerve stimulation as a measure of erectile function; (c) elastin, collagen I and III protein expression; and (d) Histomorphometric analysis of the penis. Means where compared by analysis of variance (ANOVA) followed by a Student-Newman-Keuls test for post hoc comparisons or Mann-Whitney test when applicable. Results: No significant difference was noted in ICP or ICP/MAP in response to cavernous nerve electrostimulation between the 3 groups at 2.5, 5, and 7.5 V (P > .05 for all voltages). PD animals developed tunical and subtunical areas of fibrosis with a significant upregulation of collagen III protein. The collagen III/I ratio was higher in the PD (4.6 ± 0.92) group compared with sham (0.66 ± 0.18) and PD-hADSC (0.86 ± 0.06) groups (P < .05) These fibrotic changes were prevented when treated with hADSCs. Compared with PD rats, PD-hADSC rats demonstrated a decreased expression of several fibrosis-related genes. Conclusion: Injection of hADSCs reduces collagen III expression in a rat model of chronic PD. Castiglione F, Hedlund P, Weyne E, et al. Intratunical Injection of Human Adipose Tissue–Derived Stem Cells Restores Collagen III/I Ratio in a Rat Model of Chronic Peyronie's Disease. Sex Med 2018;XX:XX–XX.

Cette étude examine la manière dont l’instance narratoriale est traduite dans l’Ovide moralisé : les apostrophes aux personnages et les adresses aux lecteurs, qui engagent la voix narrative, ont été effacées régulièrement, ainsi que les passages qui mettent en scène un « narrateur incertain ». En effet l’Ovide moralisé, qui prétend porter le message de la Vérité, ne pouvait traduire fidèlement ces procédés qui, sous la plume d’Ovide, exhibaient le statut d’artefact littéraire de l’œuvre.

Après avoir décelé des traces ténues de diffusion de l’Historia regum Britannie en Italie du nord à la fin du Moyen Âge, l’article envisage sa réception indirecte, plus importante, sous la forme des traductions du Merlin de Robert de Boron qui ont circulé dans la même région aux XVe et XVIe siècles. À l’issue d’analyses philologiques minutieuses, l’étude littéraire de l’une des versions, la plus éloignée de sa source, est conduite., This work will focus on the translations of Merlin that circulated in Italy in the 15th and 16th centuries. After a philological analysis based on our collation of the texts, the translations are approached from a literary point of view.

In men with node-positive prostate cancer after radical prostatectomy there are limited data on the value of adding androgen deprivation therapy (ADT) to postoperative radiotherapy.To determine whether there is a clear oncologic benefit to ADT in the setting of node-positive prostate cancer treated with postoperative radiotherapy.We analyzed data for 372 prostate cancer patients treated at San Raffaele Hospital with postoperative radiotherapy for node-positive disease after radical prostatectomy, 272 received both ADT and radiotherapy. Eighty-six men were followed without an event for more than 10 years.Patients who received postoperative radiotherapy + ADT had more aggressive disease, with higher preoperative PSA level, higher rate of ISUP grade 5, pT3b-T4 tumors and ≥3 positive nodes. At multivariable Cox regression, the comparison between men treated by postoperative radiotherapy + ADT vs. radiotherapy alone did not show a significant difference for overall (hazards ratio: 0.91; 95% confidence interval: 0.45, 1.84; P = 0.8) and cancer-specific survival (hazards ratio: 5.39; 95% confidence intervalI: 0.70, 41.39; P = 0.11). These results remained consistent in a number of sensitivity analyses, including propensity score matching. Consideration of 95% CIs suggests that a clinically significant benefit of ADT in node-positive patients receiving radiotherapy after surgery is unlikely.We can exclude the sort of large survival benefit that would be required to justify the risks and toxicities of ADT in men with node-positive disease receiving postoperative radiotherapy. Awaiting larger and more powered studies on this topic, men with pN+ prostate cancer treated with postoperative radiotherapy should not receive ADT outside well-controlled clinical trials.

INTRODUCTION: Very few population-based assessments of delirium have been performed to date. These have not assessed the implications of delirium after major surgical oncology procedures (MSOPs). We examined the temporal trends of delirium following 10 MSOPs, as well as patient and hospital delirium risk factors. Finally, we examined the effect of delirium on length of stay, inhospital mortality, and hospital charges. METHODS: We retrospectively identified patients who underwent prostatectomy, colectomy, cystectomy, mastectomy, gastrectomy, hysterectomy, nephrectomy, oophorectomy, lung resection, or pancreatectomy within the Nationwide Inpatient Sample (2003–2013). We yielded a weighted estimate of 3 431 632 patients. Multivariable logistic regression (MLR) analyses identified the determinants of postoperative delirium, as well as the effect of delirium on length of stay, in-hospital mortality, and hospital charges. RESULTS: Between 2003 and 2013, annual delirium rate increased from 0.7 to 1.2% (+6.0%; p

L’histoire de la matière de Bretagne dans la Renaissance italienne est en général abordée par les spécialistes à travers les chefs-d’œuvre de l’Arioste et Boiardo. Mais le Cinquecento n’a pas conservé le souvenir d’Arthur uniquement par le biais oblique du Roland Amoureux et du Roland Furieux. Entre 1558 et 1559 trois traductions imprimées à Venise ont essayé, sans succès il est vrai, de faire redécouvrir aux Italiens les histoires originales de la Table Ronde. Une traduction du Parsaforesto ...

Le Roman de Perceforest est l'un des derniers récits arthuriens du Moyen Âge et certainement le plus long roman de la langue française. On y trouve aussi bien l'une des plus anciennes versions de la Belle au Bois dormant, que des tournois, des joutes, des vols diaboliques et un sabbat, ainsi que des histoires d'amours tumultueuses et des merveilles étonnantes comme le luiton Zéphir. En cours d'édition par Gilles Roussineau, ce roman-fleuve est actuellement l'objet d'une réévaluation. Le présent volume dresse à la fois le bilan des recherches contemporaines, propose des avancées et de nouvelles perspectives et ouvre des champs d'investigation prometteurs. La première partie aborde le problème des sources (écrites, folkloriques, romanesques, encyclopédiques…) et celui de la datation et de la tradition manuscrite de l'œuvre. La seconde met en évidence la cohérence thématique du roman, autour de l'amour et des pratiques chevaleresques (fêtes, héraldique), l'habileté de son écriture, dont témoignent l'art des discours et la mise en scène des paysages, et sa construction savante, qu'organisent la généalogie, les enjeux herméneutiques et l'usage de l'entrelacement. Loin d'être un « fatras à quoi l'enfance s'amuse » (pour reprendre l'expression de Montaigne), Perceforest est une œuvre concertée, complexe, foisonnante. On comprend dès lors la richesse de sa réception, étudiée dans la troisième partie, autour des diverses copies qui en ont été faites, des imprimés du XVIe siècle, ou de sa reprise dans la Bibliothèque universelle des romans, sans oublier son influence sur la littérature renaissante, et sa traduction, aussi bien dans le Parsaforesto italien du XVIe siècle, qu'en français moderne.

INTRODUCTION: Previous studies have shown that the injection of adipose tissue-derived stem cells (ADSCs) into the tunica albuginea (TA) during the active phase of Peyronie's disease (PD) prevents the development of fibrosis. AIM: To investigate, using an animal model, whether local injection of human ADSCs (hADSCs) can alter the degree of fibrosis in the chronic phase of PD. METHODS: 27 male, 12-week-old rats were divided into 3 equal groups: sham, PD without treatment, and PD treated with hADSCs 1 month after disease induction. Sham rats underwent 2 injections of vehicle into the TA 1 month apart. PD rats underwent transforming growth factor β1 (TGFβ1) injection and injection of vehicle 1 month later. PD-hADSC rats underwent TGFβ1 injection followed by 1 million hADSCs 1 month later. 1 week after treatment, n = 3 animals/group were euthanized, and the penises were harvested for quantitative polymerase chain reaction. 1 month after treatment, the other animals, n = 6 per group, underwent measurement of intracavernous pressure (ICP) and mean arterial pressure (MAP) during electrostimulation of the cavernous nerve. After euthanasia, penises were again harvested for histology and Western blot. MAIN OUTCOME MEASURE: The primary outcome measures included (a) gene expression at one week post-injection; (b) measurement of ICP/MAP upon cavernous nerve stimulation as a measure of erectile function; (c) elastin, collagen I and III protein expression; and (d) Histomorphometric analysis of the penis. Means where compared by analysis of variance (ANOVA) followed by a Student-Newman-Keuls test for post hoc comparisons or Mann-Whitney test when applicable. RESULTS: No significant difference was noted in ICP or ICP/MAP in response to cavernous nerve electrostimulation between the 3 groups at 2.5, 5, and 7.5 V (P > .05 for all voltages). PD animals developed tunical and subtunical areas of fibrosis with a significant upregulation of collagen III protein. The collagen III/I ratio was higher in the PD (4.6 ± 0.92) group compared with sham (0.66 ± 0.18) and PD-hADSC (0.86 ± 0.06) groups (P < .05) These fibrotic changes were prevented when treated with hADSCs. Compared with PD rats, PD-hADSC rats demonstrated a decreased expression of several fibrosis-related genes. CONCLUSION: Injection of hADSCs reduces collagen III expression in a rat model of chronic PD. Castiglione F, Hedlund P, Weyne E, et al. Intratunical Injection of Human Adipose Tissue-Derived Stem Cells Restores Collagen III/I Ratio in a Rat Model of Chronic Peyronie's Disease. Sex Med 2019;7:94-103. ispartof: SEXUAL MEDICINE vol:7 issue:1 pages:94-103 ispartof: location:England status: published