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Background: Myoid gonadal stromal tumors (MGST) of the testis represent a very rare finding. They are an emerging clinicopathological entity with specific features and identity. Nowadays, pathological recognition and diagnosis of MGSTs still represents a difficult challenge in most cases and there are no data of specific radiological features of these tumors expect for what seen by ultrasound; besides a conservative surgical approach was never performed to treat these lesions.Case Description: We present the case of a 20-year-old young man patient with symptoms suspicious for left varicocele, who was incidentally diagnosed with right testicular nodule via scrotal doppler ultrasound powered with contrast enhancement infusion and subsequent multiparametric magnetic resonance imaging. Then, lesion was treated through a testis sparing surgical approach. Histopathology, which included an external revision by an experienced Center, revealed a MGST with benign features, so that no further treatment was considered. 3 and 12 months after surgery a contrast enhancement ultrasound was performed with no evidence of recurrence.Conclusions: Previous reported cases of MGST were all difficult to characterize as a specific pathological entity; treatment usually applied was radical orchiectomy and a subsequent total Body CT was performed for staging purpose. No metastatic spreading nor recurrence were ever reported. Considering the favorable behavior of this pathologic entity, testis-sparing surgery with no radiation exposure during follow-up is a safe and effective strategy.

38th International Symposium on Lattice Field Theory, Lattice 2021, Online, United States, 26 Jul 2021 - 30 Jul 2021; Proceedings of Science / International School for Advanced Studies (LATTICE2021), 171 (2022). doi:10.22323/1.396.0171, We present results for the light, strange and charm quark masses using $N_f=2+1+1$ twisted mass fermion ensembles at three values of the lattice spacing, including two ensembles simulated with the physical value of the pion mass. The analysis is done both in the meson and baryon sectors. The difference in the mean values found in the two sectors is included as part of the systematic error. The presentation is based on the work of Ref. [1], where more details can be found., Published by SISSA, Trieste

We investigate numerically different techniques to extract scattering amplitudes from the Euclidean Lattice {\phi}4 theory with two fields, having different masses. We present an exploratory study of the recently proposed method by Bruno and Hansen for extracting the scattering length from a four-point function (cf 10.1007/JHEP06(2021)043), and a study of the two- and three-particle quantization condition., Comment: Contribution to the 38th International Symposium on Lattice Field Theory (LATTICE21), 26-30 July 2021, Zoom/Gather@Massachusetts Institute of Technology. This contribution overlap with arXiv:2107.04853

We present a lattice QCD computation and preliminary results for the leptonic decay constants of the pseudoscalar mesons $K$, $D$ and $D_{s}$ in the isosymmetric QCD limit. The computation is based on simulations of $N_f = 2+1+1$ dynamical quarks performed by the Extended Twisted Mass Collaboration (ETMC), where the light, strange and charm quark masses are all tuned at their physical values. We also present preliminary unitarity checks for the first and second rows of the Cabibbo-Kobayashi-Maskawa matrix., Comment: 9 pages, 3 figures, 38th International Symposium on Lattice Field Theory, LATTICE2021 26th-30th July, 2021 Zoom/Gather@MIT

BACKGROUND: We aimed to assess the detection rate of overall PCa and csPCa, and the clinical impact of MRI/TRUS fusion targeted biopsy (FUSION-TB) compared to TRUS guided systematic biopsy (SB) in patients with different biopsy settings. METHODS: Three hundred and five patients were submitted to FUSION-TB, divided into three groups: biopsy naïve patients, previous negative biopsies and patients under active surveillance (AS). All patients had a single suspicious index lesion at mpMRI. Within these groups, we enrolled men underwent both to FUSION-TB and SB in the same session. Overall detection rate of PCa and csPCa for the two biopsy methods were compared separately between the three groups of patients. RESULTS: No differences were observed between the three groups concerning clinical and radiological characteristics. We found no differences in terms of overall PCa detection (66% vs. 63.8%, P=0.617) and csPCa detection (56.4% vs. 51.1%; P=0.225) concerning biopsy naïve patients. In patients previously submitted to a negative biopsy, FUSION-TB showed higher detection rate of csPCa compared to SB alone (41,3% vs. 27% respectively, P=0.038). In patients under AS, no differences were observed between FUSION-TB and SB in terms of overall PCa (50% vs. 73.1%) and csPCa (30.8% vs. 26.9%, respectively; P=0.705) detection. CONCLUSIONS: Our results suggest that in men with previously negative biopsy, FUSION-TB showed significantly higher diagnostic performance for clinically significant PCa as compared to SB. Combination of FUSION-TB and SB should be recommended in AS population to offer higher chance of csPCa diagnosis.

We present a non-perturbative calculation of the form factors which contribute to the amplitudes for the radiative decays $P\to \ell \bar \nu_\ell \gamma$, where $P$ is a pseudoscalar meson and $\ell$ is a charged lepton. Together with the non-perturbative determination of the virtual photon corrections to the processes $P\to \ell \bar \nu_\ell$, this will allow accurate predictions to be made at $O(\alpha_{em})$ for leptonic decay rates for pseudoscalar mesons ranging from the pion to the $B$ meson. We are able to separate unambiguously the point-like contribution, the square of which leads to the infrared divergence in the decay rate, from the structure dependent, infrared-safe, terms in the amplitude. The fully non-perturbative, $O(a)$ improved calculation of the inclusive leptonic decay rates will lead to significantly improved precision in the determination of the corresponding Cabibbo-Kobayashi-Maskawa (CKM) matrix elements. Precise predictions for the emission of a hard photon are also very interesting, especially for the decays of heavy $D$ and $B$ mesons for which currently only model-dependent predictions are available to compare with existing experimental data.

The natural history of urinary kidney stone disease includes the risk of relapses and can be associated with the risk of chronic kidney disease, bone and cardiovascular disease. For this reason, a wide clinical-metabolic assessment of the kidney stone patient is of great importance since the first presentation of the stone, to set an appropriate preventive treatment. The proposed diagnostic-therapeutic pathway includes a careful medical history, in order to highlight a secondary kidney stone disease and the main risk factors for kidney stones, chronic renal disease, or cardiovascular and bone disease; a metabolic evaluation on multiple levels, according to the severity of the disease, and the presence or absence of risk factors, and appropriate instrumental investigations. Thus, the information collected makes it possible to set a preventive treatment consisting of general rules and, if necessary, specific pharmacological or nutritional interventions. This paper has been prepared by the Italian Multidisciplinary Study Group for Kidney Stone Disease, and it is addressed to the several professional figures involved in the management of patients suffering from nephrolithiasis, from the emergency doctor to the general practitioner, urologist, nephrologist, radiologist, and dietician. A diagnostic-therapeutic pathway for patients with kidney stone disease was first published on this Journal in 2010. The present contribution aims at amending and updating the article published exactly ten years ago, to serve as an easy-to-use reference and to guide good clinical practice in this field.

We agree that the ideal strategy in patients withan SMT would be to follow them with periodic USand perform surgery only in those who show sig-nificant growth during followup. This is our actualpolicy in masses less than 5 mm in diameter. Inthis group few patients required surgical explora-tion during followup. It is likely that in cases ofsuch small lesions strict surveillance may notchange the progression of germinal tumors, as re-ported by Bieniek et al, who noted a mean lesiondiameter of 4.142.0 mm (reference 1 in EditorialComment).However, sparse data are available in the litera-ture on the natural history of larger masses whenleft untreated. Our study shows that even largerlesions up to 20 mm in diameter may be benign, indicating that strict surveillance might be justifiedeven for masses larger than 5 mm. Our experiencealso demonstrates that with increasing lesion sizethe risk of cancer significantly increases 7 times permm. This information could be used to bettercounsel patients about the risk of harboring TC andeventually better support a followup strategy inpatients with an STM.We believe that 2 research lines which might helpus in the near future are 1) study of the individuallesion growth rate, which could differentiate benignfrom malignant lesions, and 2) new imaging diag-nostic tests such as contrast enhanced US1ortesticular magnetic resonance imaging, whichmight improve the diagnostic performance of scrotalUS.

Using lattice simulations we demonstrate from first principles the existence of a non-perturbative mechanism for elementary particle mass generation in models with gauge fields, fermions and scalars, if an exact invariance forbids power divergent fermion masses and fermionic chiral symmetries broken at UV scale are maximally restored. We show that in the Nambu-Goldstone phase a fermion mass term, unrelated to the Yukawa operator, is dynamically generated. In models with electro-weak interactions weak boson masses are also generated opening new scenarios for beyond the Standard Model physics., Comment: 24 pages, 17 figures

PURPOSE: Nonpalpable tumors of the testis are generally incidental findings on ultrasound examination. Most of these tumors are benign but some turn out to be germinal tumors at histology. Therefore, intraoperative histopathologic analysis of nonpalpable testicular lesions is pivotal for guiding a testis-sparing surgical approach. METHODS: We report clinical and pathologic characteristics of 3 small nodules of the testis with challenging histologic features at intraoperative frozen section examination and peculiar histology. One was a known testicular mass, undertreated for 5 years, whose enlargement worried the patient, while the other 2 were incidental findings during clinical testicular examination for non-neoplastic diseases. CONCLUSIONS: The 3 cases reported are characterized by small size, which limited the accuracy of preoperative ultrasound diagnosis. Intraoperative frozen section examination was able to rule out a diagnosis of germ cell malignancy in all cases, but diagnosis was conclusive only at histology. Knowledge of unexpected rare testicular lesions is of great relevance at the time of frozen section examination in view of conservative surgical strategy.v Nonpalpable tumors of the testis are generally incidental findings on ultrasound examination. Most of these tumors are benign but some turn out to be germinal tumors at histology. Therefore, intraoperative histopathologic analysis of nonpalpable testicular lesions is pivotal for guiding a testis-sparing surgical approach. METHODS: We report clinical and pathologic characteristics of 3 small nodules of the testis with challenging histologic features at intraoperative frozen section examination and peculiar histology. One was a known testicular mass, undertreated for 5 years, whose enlargement worried the patient, while the other 2 were incidental findings during clinical testicular examination for non-neoplastic diseases. CONCLUSIONS: The 3 cases reported are characterized by small size, which limited the accuracy of preoperative ultrasound diagnosis. Intraoperative frozen section examination was able to rule out a diagnosis of germ cell malignancy in all cases, but diagnosis was conclusive only at histology. Knowledge of unexpected rare testicular lesions is of great relevance at the time of frozen section examination in view of conservative surgical strategy.

Introduction: Self-inflicted orchidectomy and auto-castration, also known as “Eshmun complex” is a rare phenomenon. The aim of our study it to present the management of a patient who performed a self orchiectomy and propose a non-systematic review of literature about self-orchiectomy. Material and method: A 27-years old male Patient with psychiatric disorder was admitted to our ward to have been cutted his scrotum with scissors and cut away his left testicle causing active bleeding from the left spermatic artery. The patient underwent emergency surgery with clamping of the spermatic cord and hemostasis of the wound. Results: After surgery the clinical condition of the patient remained good during whole hospitalization. Urgent psychiatric evaluation was performed in order to administer proper therapy for acute management. To best of our knowledge, only 11 cases of self-orchidectomy are reported in literature and all of them except 1 case, underwent surgical exploration. Conclusions: Self-orchidectomy is an extremely rare phenomenon, often associated with psychiatric disorders, compounded by the use of drugs. In our opinion, emergency surgery should be the first choice of treatment, offering diagnostic and hemostatic purpose in a single act, aimed to prevent acute and postacute complications.

In this contribution we lay down a lattice setup that allows for the non-perturbative study of a field theoretical model where a SU(2) fermion doublet, subjected to non-Abelian gauge interactions, is also coupled to a complex scalar field doublet via a Yukawa and an "irrelevant" Wilson-like term. Using naive fermions in quenched approximation and based on the renormalized Ward identities induced by purely fermionic chiral transformations, lattice observables are discussed that enable: a) in the Wigner phase, the determinations of the critical Yukawa coupling value where the purely fermionic chiral transformation become a symmetry up to lattice artifacts; b) in the Nambu-Goldstone phase of the resulting critical theory, a stringent test of the actual generation of a fermion mass term of non-perturbative origin. A soft twisted fermion mass term is introduced to circumvent the problem of exceptional configurations, and observables are then calculated in the limit of vanishing twisted mass., Comment: 8 pages, 2 figures; Proceedings of the 35th International Symposium on Lattice Field Theory, 18-24 June 2017, Granada, Spain. arXiv admin note: text overlap with arXiv:1611.03997

Based on a recent proposal according to which elementary particle masses could be generated by a non-perturbative dynamical phenomenon, alternative to the Higgs mechanism, we carry out lattice simulations of a model where a non-abelian strongly interacting fermion doublet is also coupled to a doublet of complex scalar fields via a Yukawa and an "irrelevant" Wilson-like term. In this pioneering study we use naive fermions and work in the quenched approximation. We present preliminary numerical results both in the Wigner and in the Nambu-Goldstone phase, focusing on the observables relevant to check the occurrence of the conjectured dynamical fermion mass generation effect in the continuum limit of the critical theory in its spontaneously broken phase., Comment: 8 pages, 4 figures; Proceedings of the 35th International Symposium on Lattice Field Theory, 18-24 June 2017, Granada, Spain

The case report present the case of a young men with bladder cancer that previously underwent radical cistectomy with orthotopic neobladder (ON), converted to ileal conduct due to early surgical complications, who demanded a further ON conversion because of a perceived strong altered self-body image to affect QoL hugely.

Aim of the Study: Radical Orchiectomy (RO) represents the standard treatment for patients (pts) with suspicious testicular masses and normal contralateral testis. Because a considerable amount of small testicular masses (STM) are benign lesions, this practice exposes to a substantial risk of overtreatment with possible medical-legal consequences. The aim of this study is to report results of testis sparing surgery (TSS) in the treatment of STM (

ntroduction & Objectives: Radical Orchiectomy (RO) represents the standard treatment for patients (pts) with suspicious testicular masses and normal contralateral testis. Because a considerable amount of small testicular masses (STM) are benign lesions, this practice expose to a high risk of overtreatment. The aim of this study is to report results of testis sparing surgery (TSS) in the treatment of STM(< 2cm) and to identify an updated treatment strategy. Materials & Methods: We retrospectively reviewed clinical history of pts treated with TSS for STM

PURPOSE: To evaluate, by using a standardized reporting methodology, the perioperative complications and mortality in patients who underwent radical cystectomy. MATERIALS AND METHODS: We retrospectively reviewed all data of 404 consecutive patients who underwent radical cystectomy from 1995 to 2009 for nonmetastatic bladder cancer at the same academic center. Perioperative complications and perioperative mortality were defined as any adverse event or death from any cause within 90 days of surgery. All perioperative complications were reported according to the Martin criteria and were graded according to the Clavien system (grade 1-5). Univariate and multivariate analyses for the clinical and pathologic characteristics were used to evaluate predictors of complications. RESULTS: A total of 296 complications occurred in 209 (51.7%) patients. Among them, 139 (34.4% of the entire population) had only a '"minor"' (grade 1-2) complication, whereas 70 (17.3%) had a "major" (grade 3-5) complication. Eighteen (4.5%) patients died within 90 days after surgery. At univariate analysis, age ≥75 years (2P = .018), serum creatinine level ≥1.4 mg/dL (2P = .025), American Society of Anesthesiologists (ASA) score of 3 to 4 (2P < .001) were significant predictors of complications after 30 days from surgery; conversely, the ASA score was the only significant predictor of complications after 90 days. At multivariate analysis, only the ASA score was independently correlated with the development of complications at 30 and 90 days of follow-up (2P < .001). CONCLUSIONS: Radical cystectomy is one of the most complex procedures in urology, with a high rate of complications and mortality. The use of a standardized methodology is the only way to estimate the actual rate and the severity of complications.

Numerical stochastic perturbation theory is a powerful tool for estimating high-order perturbative expansions in lattice field theory. The standard algorithms based on the Langevin equation, however, suffer from several limitations which in practice restrict the potential of this technique. In this work we investigate some alternative methods which could in principle improve on the standard approach. In particular, we present a study of the recently proposed instantaneous stochastic perturbation theory, as well as a formulation of numerical stochastic perturbation theory based on generalized hybrid molecular dynamics algorithms. The viability of these methods is investigated in ${\ensuremath{\varphi}}^{4}$ theory.

In this note we present an example of an extension of the Standard Model where unification of strong and electroweak interactions occurs at a level comparable to that occurring in the minimal supersymmetric standard model., 15 pages, 6 figures

What's known on the subject? and What does the study add? Without age being a limiting risk factor, recent reports have shown that almost any version of percutaneous nephrolithotomy (PCNL) can be safely applied in children. As there has been no standardisation in the age categorisation of children, there are inconsistencies among the age subgroups in the current literature. To achieve a standard terminology and thus a common language, the World Health Organization age classification criterion was used in the present study. Based on the findings, we can suggest that PCNL can be applied safely and effectively in children in different age groups. Objectives To present the overall results of paediatric percutaneous nephrolithotomy (PCNL) compared with adults. To present the indications, complications and outcomes of patients treated in the participating centres in the PCNL Global Study, as categorised in different age groups. Patients and Methods The Clinical Research Office of the Endourological Society (CROES) Study was conducted from November 2007 to December 2009, and included 96 centres and >5800 patients. All children aged ≤14 years in the PCNL Global Study database were the focus of the study. Results In all, 107 children aged ≤14 years were included in the analysis. The PCNL procedure was conducted in 13 patients (12.1%) in the supine position; tubeless PCNL was performed in 15 patients (14%); and balloon dilatation was preferred in 22 patients (20.5%). The overall mean operative duration was 97.02 min; blood transfusion rate, fever and stone-free rates were 9%, 14% and 70.1%, respectively. A comparison of the paediatric PCNL cases according to age groups showed no statistically significant differences between the subgroups for patient characteristics, co-morbidities, renal anomalies, or previous surgical history. In the evaluation of the operative details, the mean sheath size and nephrostomy tube size were larger in school-age children than the preschool children (P = 0.01 and 0.002, respectively). There was a difference in the preferred methods for confirming stone-free status, with ultrasonography preferred more in preschool children (P < 0.001). The PCNL procedure position, puncture site, dilatation method, postoperative tube application, and surgical outcomes were comparable in school- and preschool-age children. While operative details showed some differences between children and adults, the surgical outcomes were comparable. Conclusions A considerable number (45.7%) of the paediatric patients had a previous history of stone intervention. Based on the findings of the present study, we can suggest that PCNL can be applied safely and effectively in children in different age groups. Outcomes appear comparable with those in adults for the success and complication rates, in the presence of substantial indications, appropriate equipment and adequate experience.

OBJECTIVE: • To assess the impact of pelvic lymph node dissection (PLND) and of the number of lymph nodes (LNs) retrieved during radical prostatectomy (RP) on biochemical relapse (BCR) in pNX/0/1 patients with prostate cancer according to the clinical risk of lymph node invasion (LNI). PATIENTS AND METHODS: • We evaluated 872 pT2-4 NX/0/1 consecutive patients submitted to RP between October 1995 and June 2009, with the following inclusion criteria: (i) a follow-up period ≥12 months; (ii) the avoidance of neoadjuvant hormonal therapy or adjuvant hormonal and/or adjuvant radiotherapy; (iii) the availability of complete follow-up data; (iv) no pathological T0 disease; (v) complete data regarding the clinical stage and Gleason score (Gs), the preoperative prostate-specific antigen (PSA) level and the pathological stage. • The patients were stratified as having low risk (cT1a-T2a and cGs ≤6 and PSA level < 10 ng/mL), intermediate risk (cT2b-T2c or cGs = 7 or PSA level = 10-19.9) or high risk of LNI (cT3 or cGs = 8-10 or PSA level ≥ 20). • The 872 patients were divided into two LN groups according to the number of LNs retrieved: group 1 had no LN or one to nine LNs removed; group 2 had 10 or more LNs. • The variables analysed were LN group, age, PSA level, clinical and pathological stage and Gs, surgical margin status, LN status and number of LN metastases; the primary endpoint was the BCR-free survival. RESULTS: • The mean follow-up was 55.8 months. • Of all the patients, 305 (35%) were pNx and 567 (65.0%) were pN0/1. • Of the 567 patients submitted to PLND, the mean number of LNs obtained was 10.9, and 49 (8.6%) were pN1. • In the 402 patients at low risk of LNI, LN group was not a significant predictor of BCR at univariate analysis, while in the 470 patients at intermediate and high risk of LNI, patients with ≥ 10 LNs removed had a significantly lower BCR-free survival at univariate and multivariate analysis. CONCLUSION: • In our study population, a more extensive PLND positively affects the BCR-free survival regardless of the nodal status in intermediate- and high-risk prostate cancer.

The optimal management of prostate cancer (PCa) patients with clinical positive lymph nodes (cN+) is still matter of debate. Historically, cN+ as well as metastatic PCa men were scheduled for androgen deprivation therapy (ADT). However, despite the lack of prospective randomized controlled trials, some authors recently reported improved survival outcomes in PCa patients who underwent local therapies (LT) for cN+ disease as compared to long-term ADT alone (1). As consequence, current guidelines include radical prostatectomy (RP) with extended pelvic lymph node dissection as a part of a multi-modal therapy for cN+ PCa patients (2). As previously stated, PCa with nodal metastases doesn’t necessarily translate in a poor prognosis (3), since node positive PCa men represent a highly heterogeneous group and each man should be counseled accordingly to choose the most suitable management on individualized level (4-7).

This chapter for a forthcoming text on investment promotion explains the concept of “luring with tax”. It first lays out in broad strokes how nation states compete with each other for direct and portfolio investment using their tax systems. It then analyzes whether using the tax system as an investment promotion tool should be considered fundamentally competitive (following market/economic principles) or anti-competitive (deliberately distorting a market with subsidies). It considers these questions from the perspective of the EU’s “fiscal state aid” framework and in light of WTO prohibitions against subsidies. It concludes that the distinction drawn between “fair but fierce” tax competition among free-market economies and “harmful” tax practices has been hotly contested ground in international tax policy for many decades, and it is likely to remain so despite international efforts to coordinate tax policy among nations for mutual benefit.

Objective: To present the management of a patient with partial disruption of both cavernosal bodies and complete urethral rupture and to propose a non-systematic review of literature about complete urethral rupture. Material and method - Case report: A 46 years old man presented to our emergency department after a blunt injury of the penis during sexual intercourse. On physical examination there was subcutaneous hematoma extending over the proximal penile shaft with a dorsal-left sided deviation of the penis and urethral bleeding. Ultrasound investigation showed an hematoma in the ventral shaft of the penis with a discontinuity of the tunica albuginea of the right cavernosal corporum. The patient underwent immediate emergency surgery consisted on evacuation of the hematoma, reparation the partial defect of both two cavernosal bodies and end to end suture of the urethra that resulted completely disrupted. Results: The urethral catheter was removed at the 12-th postoperative day without voiding symptoms after a retrograde urethrography. 6 months postoperatively the patients was evaluated with uroflowmetry demonstrating a max flow rate of 22 ml/s and optimal functional outcomes evaluated with validated questionnaires. 8 months after surgery the patients was evaluated by dynamic magnetic resonance (MRI) of the penis showing only a little curvature on the left side of the penile shaft. Conclusion: Penile fracture is an extremely uncommon urologic injury with approximately 1331 reported cases in the literature till the years 2001. To best of our knowledge from 2001 up today, 1839 more cases have been reported, only in 159 of them anterior urethral rupture was associated and in only 22 cases a complete urethral rupture was described. In our opinion, in order to prevent long term complications, in case of clinical suspicion of penile fracture, especially if it is associated to urethral disruption, emergency surgery should be the first choice of treatment.

The objective of the study was to assess the efficacy and safety of tubeless percutaneous nephrolithot- omy (t-PCNL) in comparison with standard PCNL (s-PCNL). We retrospectively evaluated 317 consecutive PCNL and compared perioperative results, time of hospi- talization and analgesic requirement of t-PCNL (114; 36.0 %) to s-PCNL (203; 64.0 %). The decision to perform a tubeless PCNL was made at the end of the procedures depending on the surgeon’s preference and according to the following inclusion criteria: (a) no serious bleeding or perforation in the collecting system during the procedure; (b) patients with no more than one access; and (c) residual stone burden needing a second-stage nephroscopy. Stag- horn stones and anatomic anomalies were not considered as exclusion criteria for t-PCNL. Univariate analyses were conducted with one-way ANOVA, Fisher’s exact test, Pearson’s Chi-square and linear-by-linear association test as appropriate. Stepwise multivariable regression analyses were used to assess the independent correlation between demographics and clinical variables and the clinical out- comes. There were no significant differences between the two groups in terms of stone-free rate, hemoglobin decrease, blood transfusion and complication rate. Mean hospital stay was significantly shorter in the t-PCNL group (3.3 vs. 4.6 days; P \ 0.001). Tubeless PCNL was asso- ciated with less analgesia requirement (68.4 vs. 86.7 %; P \ 0.001) and with lower analgesic dose requirement (1.6 vs. 2.1 mean doses; P = 0.010). Multivariable analyses showed that t-PCNL ( P \ 0.001), postoperative fever ( P \ 0.001), transfusions ( P \ 0.001), operative time ( P = 0.002), postoperative hydronephrosis ( P = 0.005) and residual fragment dimension ( P = 0.024) were inde- pendently correlated with duration of hospitalization, while analgesic dose requirement was independently influenced by hemoglobin decrease ( P \ 0.001), t-PCNL ( P = 0.005) and stone number ( P = 0.044). Our study confirmed that t-PCNL has similar outcomes to s-PCNL in terms of stone- free rate without increasing complications in selected cases. t-PCNL is a factor independently associated with shorter hospitalization and lower analgesic requirement.

In this paper, the authors propose a techno-economic comparative analysis between different lighting solutions, using, respectively, floodlight with metal halide lamps, luminaires with fluorescent lamps and LED floodlights. The comparison is aimed to identify general criteria for assessing the techno-economic sustainability of the use of LED lighting for indoor sports facilities, since this solution is very often proposed to achieve a reduction of the electrical power for lighting. From a technical standpoint, the analysis takes into particular consideration the aspects related to the satisfaction of lighting requirements, safety and energy efficiency. From an economic standpoint the investment, the operating and the maintenance costs are evaluated. To make comparisons on an economic basis, specific indicators are used. From the obtained results it is possible to highlight as the solution that uses the LED floodlights is characterized by highest energy efficiency. This solution requires a smaller number of luminaires and it has limited maintenance costs compared to the other solutions, but it has high investment costs, which involve reasonable payback times only when the sports facility is used intensively and for competitions of high level.

OBJECTIVE: • To assess the impact of pelvic lymph node dissection (PLND) and of the number of lymph nodes (LNs) retrieved during radical prostatectomy (RP) on biochemical relapse (BCR) in pNX/0/1 patients with prostate cancer according to the clinical risk of lymph node invasion (LNI). PATIENTS AND METHODS: • We evaluated 872 pT2-4 NX/0/1 consecutive patients submitted to RP between October 1995 and June 2009, with the following inclusion criteria: (i) a follow-up period ≥12 months; (ii) the avoidance of neoadjuvant hormonal therapy or adjuvant hormonal and/or adjuvant radiotherapy; (iii) the availability of complete follow-up data; (iv) no pathological T0 disease; (v) complete data regarding the clinical stage and Gleason score (Gs), the preoperative prostate-specific antigen (PSA) level and the pathological stage. • The patients were stratified as having low risk (cT1a-T2a and cGs ≤6 and PSA level < 10 ng/mL), intermediate risk (cT2b-T2c or cGs = 7 or PSA level = 10-19.9) or high risk of LNI (cT3 or cGs = 8-10 or PSA level ≥ 20). • The 872 patients were divided into two LN groups according to the number of LNs retrieved: group 1 had no LN or one to nine LNs removed; group 2 had 10 or more LNs. • The variables analysed were LN group, age, PSA level, clinical and pathological stage and Gs, surgical margin status, LN status and number of LN metastases; the primary endpoint was the BCR-free survival. RESULTS: • The mean follow-up was 55.8 months. • Of all the patients, 305 (35%) were pNx and 567 (65.0%) were pN0/1. • Of the 567 patients submitted to PLND, the mean number of LNs obtained was 10.9, and 49 (8.6%) were pN1. • In the 402 patients at low risk of LNI, LN group was not a significant predictor of BCR at univariate analysis, while in the 470 patients at intermediate and high risk of LNI, patients with ≥ 10 LNs removed had a significantly lower BCR-free survival at univariate and multivariate analysis. CONCLUSION: • In our study population, a more extensive PLND positively affects the BCR-free survival regardless of the nodal status in intermediate- and high-risk prostate cancer.

With increasing application of positron-emission tomography (PET) imaging, familiarity with the applications of PET in genitourinary oncology, especially prostate-cancer (PCa) imaging, becomes important. PET studies provide functional information using radiolabeled tracers, with fluoro-dexoxy-glucose (FDG) being the most commonly used. Nevertheless FDG has limitations for evaluation of PCa patients and therefore alternative tracers are being investigated. To date, the best results have been obtained with 11C-choline and 11C-acetate PET, which seem to demonstrate similar values in this field. We review the current role of PET in PCa patients based on data published in the literature as well as our own experience. Most studies of PET imaging of PCa address three goals: a) detecting primary PCa; b) staging PCa; and c) assessing PCa recurrence. From available results, routine clinical use of 11C-choline PET cannot be recommended for detecting and staging primary PCa. At present, the only clinical indication for imaging PCa with 11C-choline-PET is evaluation of suspected recurrence after treatment.