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BACKGROUND ‘Splenosis’ is defined as the autotransplantation of splenic tissue following trauma or surgery, usually in the form of intraperitoneal nodules. The proliferation of imaging techniques has resulted in increased unexpected discoveries of splenosis nodules, and achieving a differential diagnosis can be challenging. Nuclear medicine studies have been playing an increasingly important role in this process, but the clinical significance of asymptomatic nodules remains uncertain. CASE SUMMARY We present a case of pelvic splenosis in a 73-year-old man diagnosed 56 years after a splenectomy during a computed tomography (CT) follow-up for B-cell lymphoma, presenting intense contrast enhancement of an 18 mm nodule in the right recto-vesical space. 18F-fluorodeoxyglucose demonstrated weak metabolic activity. Since histological diagnosis was deemed necessary, the nodule was easily removed with robotically assisted laparoscopy, together with another 6 mm left a paracolic lesion. The latter was previously undiagnosed but retrospectively visible on the CT scan. CONCLUSION In a patient requiring differential diagnosis of splenosis nodules from lymphoma recurrence, the robotic approach provided a safe en bloc removal with short hospitalization. The Da Vinci Xi robot was particularly helpful because its optics can be introduced from all ports, facilitating visualization and lysis of multiple intra-abdominal adhesions.

Prognosis of canine oral malignant melanoma encompasses clinical, histological and immunohistochemical parameters. The aim of this study was to evaluate the prognostic impact of bone invasion in oral canine melanoma. Sixty-eight dogs bearing oral melanoma staged II and III that underwent surgery and anti-CSPG4 electrovaccination, with available histological data and a minimum follow up of minimum 1 year, were retrospectively selected. Bone invasion was detected on imaging and/or histology. Median survival time of dogs with evidence of bone invasion (group 1) was 397 days and significantly shorter compared with dogs with oral melanomas not invading the bone (group 2, 1063 days). Dogs with tumours localized at the level of the cheek, lip, tongue and soft palate (soft tissue - group 3) lived significantly longer compared with dogs having tumours within the gingiva of the maxilla or mandible (hard tissue - group 4) with a median survival time of 1063 and 470 days, respectively. Within group 4, the subgroup of dogs with tumours not invading the bone (group 5) showed a significant prolonged survival time (972 days) in comparison with dogs of group 1 (bone invasion group). Similar results were obtained for the disease-free intervals among the different groups. Statistical analysis showed that Ki67 and mitotic count were correlated with shorter survival in patients of group 1 (with bone invasion). Bone invasion should always be assessed since it appears to be a negative prognostic factor. This article is protected by copyright. All rights reserved.

OBJECTIVES Acquired oesophageal strictures remain challenging to manage in canine and feline patients. The aims of this study were to describe the treatment, complications, short-term outcome and long-term follow-up of benign oesophageal strictures treated by balloon dilatation or stenting in dogs and cats and to describe adjunctive techniques to minimise the complication rate of stent placement. MATERIALS AND METHODS Retrospective analysis of medical records of dogs and cats with benign oesophageal stricture diagnosed under endoscopy between 2002 and 2019. RESULTS Eighteen dogs and nine cats were included, representing 39 strictures. Balloon dilatation was used as first-line therapy, with a good outcome in 59% of cases. Stents were placed in eight cases due to stricture recurrence; 88% had a long-term satisfactory outcome. Short-term complications occurred in six of eight cases; migration and aberrant mucosal reaction were uncommon. In three cases, progressive mesh cutting during follow-up reduced discomfort and trichobezoars formation and improved long-term stent tolerance. Overall median survival time was 730 days. CLINICAL SIGNIFICANCE Long-term prognosis of balloon dilatation as a first-line therapy for esophageal strictures and of stenting as a rescue therapy was considered satisfactory. Although discomfort associated with stenting was frequent, tolerability might be improved by per-endoscopic adjunctive techniques.

INTRODUCTION The present case describes the treatment of a mucoepidermoid carcinoma in a 13-year-old female sterilized European domestic cat, using lung lobectomy and -accompanying mitoxantrone chemotherapy. Six, 14, 19 and 27 months after the initial treatment tomodensitometric and radiographic examinations showed no abnormalities. However, the cat had to be euthanized 27 months after the lung lobectomy due to a soft tissue sarcoma in the interscapular area.

The continuous improvement of energy storage and distributed generation technologies, in conjunction with demand-side pricing policies set by governments worldwide, modify electricity customers’ behavior, with potentially adverse effects on the quality of power delivered to the end-users. A major technical challenge is the optimization of power dispatch to minimize customer operating costs under constraints from the supply side. Therefore, this research proposes a multi-source distributed energy resources management system capable of delivering a compromise solution for power supply, storage, and demand-side in different electric pricing policies, using non-linear operating restrictions such as cable loading, transformer loading, power factor, maximum contract demand, and voltage level, calculated using a power flow algorithm. To test the proposed management system, the authors evaluated two different scenarios in an existing microgrid: a time-of-use electricity tariff, and a real-time tariff. The results show that the proposed system can lead to savings of up to 40% of the total operating costs for consumers when applied to time-of-use electricity tariff and up to 20% when applied to real-time electricity tariff, considerably reducing the violation probabilities of power quality indicators set by local utility company regulations.

Purpose Thoracic epidural analgesia (TEA) has been shown to reduce postsurgical morbidity and mortality; nevertheless, major and minor complications can occur. We report our 10-year experience with TEA and incidence of complications. Patients and methods Patients received continuous infusion TEA (0.2% ropivacaine and 2 µg ml-1 fentanyl) to control postoperative pain. Every 8 hours, the acute pain service recorded the analgesia regimen and occurrence of side effects. The initial infusion rate was tapered daily in response to improvement in pain symptoms or occurrence of side effects. Results A total of 3126 patients received TEA. The median age was 65 years (range, 18-94) and the duration of catheter placement was 3.5 days (range, 2-8). Three major complications were identified (1:1042): two subarachnoid blocks and one epidural abscess which led to permanent sequela (1:3126). Minor complications were hypotension (4.8%), pruritus (4.4%), accidental catheter removal (3.7%), insertion site inflammation (2.5%), motor weakness (2.0%), postoperative nausea and vomiting (1.8%), catheter disconnection (1.9%), catheter occlusion (0.3%), post-dural puncture headache (0.5%), and catheter fragment retention (0.06%), which were the reasons for a 7.4% rate of early discontinuation of epidural analgesia. No occurrence of epidural hematoma, local anesthetic systemic toxicity, and cardiovascular/respiratory depression was recorded. Conclusion Postoperative TEA is an advanced technique that poses certain difficulties that can subvert its great potential. While serious complications were rare, minor complications occurred more often and affected the postoperative course negatively. A risk/benefit evaluation of each patient should be done before employing the technique.

A 2-year-old spayed female Maine Coon presented with urinary incontinence and recurrent urinary tract infection since 2 months of age. Clinical examination was unremarkable. Ultrasonography, CT and cystourethroscopy revealed urogenital abnormalities consistent with genitourinary dysplasia. Urethral pressure profilometry suggested urethral sphincter mechanism incompetence. Surgical placement of an artificial urethral sphincter occluder was performed. Mild decrease of urinary incontinence was observed 6 weeks postoperatively. Inflation of the occluder under urethral pressure profilometry was subsequently performed and resolved the incontinence. This is the first report to describe the use of urodynamic testing at the time of inflation of an artificial urethral sphincter occluder to adjust the degree of urethral occlusion.

AIM To evaluate efficacy and safety of ATOMS implant in neurogenic patients with stress incontinence performing clean intermittent catheterization (CIC). METHODS We included all patients with neurogenic sacral/subsacral lesion and stress urinary incontinence, treated with ATOMS implant between January 2018 and March 2019. All patients received anamnesis, 24-hour pad test and pad count, physical examination, video urodynamic evaluation, Qualiveen questionnaire. All patients were followed up at 12 months after implantation. Patients were considered "continent" when dry or when wearing a security pad (social continence). RESULTS We treated eight male patients with a median age of 25 years, four affected by myelomeningocele, and four by cauda equine syndrome. The median preoperative 24-hour pad test was 225 g (interquartile range [IQR]: 180-275). During the surgical procedure, we did not fill the cushion to prevent postoperative urethral injuries when performing CIC in the early postoperative time. At a 12-month follow-up, we had a significant reduction in postoperative 24-hour pad test (median value: 7.5 g; IQR: 0-16.25; P

Background The FreeStyle Libre (Abbott Laboratories) is a flash glucose monitoring system (FGMS) that measures interstitial glucose concentration (IG). The system is factory-calibrated, easy to use, inexpensive, and could be useful for monitoring diabetic cats. Objectives To evaluate the analytical and clinical accuracy of the FGMS in cats and establish the lag-time between IG and blood glucose concentration (BG). Animals Twenty client-owned diabetic cats and 7 purpose-bred healthy cats. Methods Prospective study. Blood glucose concentration was measured using a portable glucose meter validated for use in cats that served as a reference method for IG, as measured by FGMS. In diabetic cats, data were collected for sensor wearing time with different methods of application and accuracy across glycemic ranges. Accuracy was determined by fulfillment of ISO15197:2013 criteria. In healthy cats, lag-time between IG and BG was established after IV administration of exogenous glucose. Results Good agreement between IG and BG was obtained (r = .93). Analytical accuracy was not achieved, whereas clinical accuracy was demonstrated with 100% of the results in zones A + B of the Parkes consensus error grid analysis. In the immediate 30 minutes after an IV bolus of glucose, when BG was increasing rapidly (approximately 2%/min), IG increased slowly, resulting in a difference of as much as 579 mg/dL, and no positive correlation between BG and IG was found. Conclusions and clinical importance The FGMS did not fulfill ISO requirements but is sufficiently accurate for glucose monitoring in cats, while considering the lag between IG and BG during periods of rapid changes in BG.

Canine oral malignant melanoma is locally invasive and highly metastatic. At present, the best option for local control is en bloc excision followed by radiation if excision margins are incomplete. Adjuvantly, the role of chemotherapy is dubious while immunotherapy appears encouraging. This retrospective study evaluated 155 dogs with oral malignant melanomas (24 stage I, 54 stage II, 66 stage III and 11 stage IV) managed in a single institution. The aim was to evaluate the differences in median survival time (MST) and disease-free interval (DFI) between dogs which, at presentation, were treated surgically with a curative intent (group 1) vs those marginally excised only (group 2). MST in group 1 was longer than in group 2 (594 vs 458 days), but no significant difference was found (P = .57); a statistical difference was, however, found for DFI (232 vs 183 days, P = .008). In the subpopulation of vaccinated dogs, the impact of adjuvant anti-CSPG4 DNA electrovaccination was then evaluated (curative intent, group 3, vs marginal, group 4); a significant difference for both MST (1333 vs 470 days, respectively, P = .03) and DFI (324 vs 184 days, respectively, P = .008) was found. Progressive disease was significantly more common in dogs undergoing marginal excision than curative intent excision for both the overall population (P = .03) and the vaccinated dogs (P = .02). This study pointed out that, after staging, wide excision together with adjuvant immunotherapy was an effective approach for canine oral malignant melanoma.

The aim of the present study was to evaluate whether prostate cancer (PC) patients can be accurately classified on the bases of tissue expression of gastrin-releasing peptide receptor (GRPR) and prostate-specific membrane antigen (PSMA). This retrospective study included 28 patients with PC. Formalin-fixed paraffin-embedded samples were used for diagnosis. Immunohistochemistry staining techniques were used to evaluate PSMA and GRPR expression (both number of cells expressed and % of area stained). To assess the independent associations among selected variables, a multi-dimensional scaling (MDS) analysis was used. It was found that the PSMA expression was inversely correlated with GRPR expression. Only the number of cells expressing GRPR was significantly related to the Gleason score. Both the percentage of area expressing GRPR and the number of cells expressing PSMA were close to reaching significance at the 0.05 level. MDS provided a map of the overall, independent association confirming that GRPR and PSMA represent inversely correlated measures of the same dimension. In conclusion, our data showed that GRPR expression should be evaluated in prostate biopsy specimens to improve our ability to detect PC with low grades at the earliest phases of development. Considering that GRPRs appear to be directly involved in the mechanisms of tumor proliferation, advancements in nuclear medicine radiotherapy can focus on this receptor to improve the therapeutic approach to PC. Further studies in our laboratory will investigate the molecular mechanisms of activation based on GRPR.

Introducción: La neoplasia primaria del apéndice es una entidad rara y de difícil diagnóstico preoperatorio. La histología más frecuente es la neuroendócrina representando un 50 % de los casos, mientras que el adenocarcinoma representa tan solo el 10%, dándose mayormente es pacientes de 62 a 65 años de edad. Caso clínico: Paciente femenina de 73 años que consulta por dolor en fosa iliaca derecha de 5 meses de evolución asociado a masa palpable de 6 x 6 cm aproximadamente, parcialmente móvil. Tomografía abdominopélvica, engrosamiento parietal circunferencial e irregular del ciego. Marcadores tumorales elevados. Se realiza hemicolectomía derecha con criterio oncológico. Anatomía patológica, adenocarcinoma de apéndice variante intestinal con 2 ganglios positivos de 12. Buena evolución clínica. Actualmente en tratamiento adyuvante. Conclusión: Se presenta un caso poco frecuente de adenocarcinoma apendicular de tipo colónico. En esta ocasión, se presentó como una masa palpable, dolorosa, de tiempo de evolución, sumado a ello, la evidencia imagenológica y humoral, permitieron sospechar la presencia de una patología neoplásica, por lo que se decidió realizar una hemicolectomía derecha de forma electiva y con criterio oncológico, obteniendo así una pieza adecuada para la estadificación postoperatoria y posterior tratamiento oncológico. Palabras Claves: adenocarcinoma apendicular-masa palpable-hemicolectomia

The multi-award-winning Toledo station on Metro line 1 in the Spanish quarter of Naples, Italy, has been described as one of the most impressive and beautiful in the world. Designed by architect Oscar Tusquets Blanca and completed in 2012, the station also uniquely serves as an underground museum, blending iconic architecture, contemporary artworks and 500-year-old archaeological remains. In the 5 years since its opening the station has won many awards and helped Naples win the 2019 World Tunnelling Congress. This paper first describes the excavation of the station’s unusually large platform access tunnel in unstable water-bearing soft rock and loose sand, which required a complex combination of cement–chemical grouting, ground freezing and extensive monitoring. It then explains how archaeology, architecture and art were successfully integrated into the resulting underground spaces.

BACKGROUND: Recent studies in literature, have raised some doubts on the routine use of urodynamic testing. Many physicians and articles recommend a selective use of this tool, considering carefully risks and benefits. These recommendations are intended to guide clinicians in the right selection of the male and neurological patients to submit to an urodynamic evaluation. This is the second part of a previous article regarding the urodynamic recommendations in the female population. METHODS: We reviewed the literature, regarding the use of UDS in male and neurological population with lower urinary tract symptoms (LUTS). Specifically, we analyzed and compared the guidelines and recommendations of the most important urology and uro-gynaecology international scientific societies. These publications were used to create the evidence basis for characterizing the recommendations to perform urodynamic testing. A panel of 10 experts was composed and Delphi process was followed to obtain the panelist consensus. The final recommendations were approved by the unanimous consensus of the panel and compared with the best practice recommendations available in the literature. RESULTS: The recommendations are provided for diagnosis and management of common LUTS in male and neurological population. CONCLUSIONS: This review provides a summary of the most effective utilization of urodynamic studies for the global evaluation of patients with lower urinary tract symptoms, and how to use them when really needed, avoiding unnecessary costs and patient inconveniences.

Introduction Neurogenic bowel dysfunction (NBD) is an impairment of defecation control due to any nervous system lesion negatively affecting physical health status and quality of life. We aimed at systematically assessing all available evidence on NBD treatment in adults and providing clinical management guidance and recommendations. Evidence acquisition PICOs and questions (N.=7) were identified by an expert panel. We searched for and retrieved evidence from the PUBMED and EMBASE databases, limited to the English language and the Western countries context, related to any type of setting and published from 2009 to 2019. Health effects, patient values, preferences and resource use were assessed. Of all, only RCTs, observational studies and systematic reviews on adult population (≥18 years) were analyzed. The study was conducted according to PRISMA guidelines and Cochrane recommendations. The effect size, if possible, was calculated for the interpretation of the outcomes, and evidence was assessed through the GRADE method. Evidence synthesis Thirty-one studies were included in our qualitative synthesis. Evidence is generally scarce. Most of the outcomes are narratively described and therefore defined by imprecision. Besides, most of the included studies are affected by risk of bias. Digital stimulation was found to be effective in short term follow-up. The pharmacological treatment choice, combined or alone, needs to be balanced case by case considering clinical history, setting of use and bowel management protocol. According to only one RCT supporting evidence mainly in persons affected by spinal cord injury (SCI), trans-anal irrigation (TAI) improves QoL and patient independency with a significant reduction of time spent for defecation and daily bowel program. History of urinary infections predicts the choice of using TAI. Patient-reported efficacy of colostomy alone or in combination with other surgeries appears evident in terms of patient's satisfaction and QoL over time. Nonetheless, perioperative and late complications can occur and may result in reduced acceptability over time. Conclusions Evidence is somehow weak and mainly reported in SCI. The systematic use of assistive interventions does not reduce the need of conservative or invasive approaches. Studies are needed on the role of bowel management in protecting patients from complications secondary to NBD in long term follow-ups.

Aims: The objective of the study was to analyze short-term outcomes and safety profile of the newly designed artificial urinary sphincters (AUSs) VICTO® and VICTOplus®. Methods: Data from the implant of VICTO® or VICTOplus® AUSs on a series of consecutive male patients with stress urinary incontinence (SUI) following radical prostatectomy (RP) were retrospectively collected in 3 tertiary referral centers between May 2017 and December 2019. Patients were affected by moderate-severe genuine SUI (200–400 or >400 g urine leakage in 24-h pad test) refractory to conservative treatment. Outcomes were evaluated through the 24-h pad test and the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF). Follow-up was scheduled after 3, 6, and 12 months and then when clinically needed. Nonparametric tests were applied in subgroup analyses. Results: Seventeen patients were enrolled: 8 were implanted with the VICTO® device and 9 with VICTOplus®. The median age at surgery was 69 (interquartile range (IQR) 60–75) years. The median follow-up was 15 (IQR 12–18) months. At 12 months, the dry rate was 76.4% and the social continence rate was 94%. The postoperative complication rate was 17.6%. All complications were classified as Clavien-Dindo I. No difference in terms of outcomes was observed between the VICTO® and the VICTOplus® subgroups. Conclusions: Preliminary outcomes of the VICTO® and VICTOplus® implantation are satisfactory. These devices may represent a safe and realistic solution for patients with moderate-severe SUI following RP.

Although physical exercise has unquestionable benefits on bone health, its effects on bone healing have been poorly investigated. This study evaluated the effects of preemptive moderate continuous running on the healing of non-critical sized bone defects in rats by &micro, CT. We hypothesized that a preemptive running exercise would quicken bone healing. Twenty 5-week-old, male, Wistar rats were randomly allocated to one of the following groups (n = 10): sedentary control (SED) or continuous running (EX, 45 min/d, 5 d/week at moderate speed, for 8 consecutive weeks). A 2 mm diameter bone defect was then performed in the right tibia and femur. No exercise was performed during a 4 week-convalescence. Healing-tissue trabecular microarchitectural parameters were assessed once a week for 4 weeks using &micro, CT and plasma bone turnover markers measured at the end of the study protocol (time point T12). At T12, bone volume fraction (BV/TV, BV: bone volume, TV: tissue volume) of the healing tissue in tibiae and femurs from EX rats was higher compared to that in SED rats (p = 0.001). BV/TV in EX rats was also higher in tibiae than in femurs (p &lt, 0.01). The bone mineral density of the healing tissue in femurs from EX rats was higher compared to that in femurs from SED rats (p &lt, 0.03). N-terminal telopeptide of collagen type I in EX rats was decreased compared to SED rats (p &lt, 0.05), while no differences were observed for alkaline phosphatase and parathyroid hormone. The study provides evidence that preemptive moderate continuous running improves the healing of non-critical sized bone defects in male Wistar rats.

Background Autologous fascial slings (AFS) have been used for a very long time in the treatment of female stress urinary incontinence, but the introduction of synthetic mesh slings placed either retropubicallyor trans-obturator has decreased the need to harvest the autologous rectus muscle fascia, thus reducing invasiveness and operative time. However AFS are still indicated in complicated cases and re-interventions, and the FDA has underlined safety concerns over the use of surgical meshes for the transvaginal repair of prolapsed pelvic organs. Case presentation A 76-year-old woman with muscle-invasivebladder cancer underwent radical cystectomy 16 years after retropubic positioning of an autologous rectus muscle fascial sling for SUI, with complete symptom resolution. The sling was easily identified and removed en bloc with the bladder and urethra, providing an opportunity to histologicallyevaluate the autologous fascial graft after its long permanence in the new position. Histopathological examination demonstrated increased fibroblastic proliferation and formation of capillaries. A slight separation and an increased waviness of the connective fibers were both evident. An increased vascularity was also apparent, including transverse vessels, with clusters of vessels. A relative inflammatory reaction was present in over 300 cells/10 HPF. All these characteristics indicated viable connective tissue. Conclusions AFS remain a valuable surgical option for both primary and recurrent SUI in women, showing high cure rates and low complications in the long-term. The present case, to the best of our knowledge, presents the longest follow-up period of an autologous rectus muscle fascia placed retropubically and its histological evaluation documents characteristics which support its mechanical strength and viability.

Objectives The main purpose of this study was to determine the reproducibility and accuracy of a three-dimensional (3D) bone model printed on a desktop 3D-printer based on fused deposition modelling (FDM) technology with polylactic acid (PLA) and the effect of autoclave sterilization on the printed models. Methods Computed tomographic images of the tibia were obtained from 10 feline cadavers, used to create a bone surface-rendering file and sent to the 3D printing software. Right and left tibias were each printed five times with the FDM desktop 3D printer using PLA plastic material. Plastic models and cadaveric bones were measured with a profile projector device at six predetermined landmarks. Plastic bones were then sterilized using an autoclave before being re-measured applying the same method. Analyses of printed model size reliability were conducted using intra-class correlation coefficients (ICC) and Bland–Altman plots. Results The ICC always showed an almost perfect agreement when comparing 3D-printed models issued from the same cadaveric bone. The ICC showed moderate agreement for one measurement and strong/perfect agreement for others when comparing a cadaveric bone with the corresponding 3D model. Concerning the comparison of the same 3D-printed model, before and after sterilization, ICC showed either strong or perfect agreement. Clinical Significance Rapid-prototyping with our FDM desktop 3D-printer using PLA was an accurate, a reproducible and a sterilization-compliant way to obtain 3D plastic models.

CASE DESCRIPTION 7 privately owned female African lions (Panthera leo) that had been bred for public exhibition and were housed in outdoor pens were evaluated prior to undergoing elective ovariectomy. CLINICAL FINDINGS All animals were healthy. Median age was 15 months (range, 9 to 34 months), and median body weight was 71 kg (156 lb; range, 48 to 145 kg [106 to 319 lb]). TREATMENT AND OUTCOME Surgical sterilization by means of single-incision laparoscopic ovariectomy was elected. A 2- to 3-cm-long skin incision was made just caudal to the umbilicus, and a single-port multiple-access device was bluntly inserted through the incision. Traction was maintained with stay sutures to provide counterpressure, and three 5-mm-diameter cannulae were introduced through the device's access channels with a blunt trocar. The abdomen was insufflated to a pressure of 12 mm Hg with CO2. Each ovary was grasped and suspended with a standard 36-cm-long laparoscopic grasper, and ovariectomy was performed with a 5-mm vessel sealer and divider device. Because of the depth of subcutaneous fat, extensive subcutaneous dissection was necessary to insert the single-port device. In contrast, fat content of the mesovarium was minimal and did not vary markedly among animals. Subjectively, single-incision laparoscopic ovariectomy was easily performed, but all surgeons had experience in laparoscopic surgery. Median duration of the surgical procedure was 29 minutes (range, 21 to 49 minutes). No perioperative complications were encountered. CLINICAL RELEVANCE Findings suggested that the single-incision laparoscopic technique may be an acceptable, minimally invasive option for ovariectomy of large felids.

The diffusion of minimally invasive techniques for renal surgery has prompted a renewed interest in nephropexy which is indicated to prevent nephroptosis in symptomatic patients and to mobilize the upper ureter downward in order to bridge a ureteral defect. Recent publications have been reviewed to present the state of the art of the diagnosis and management of these two challenging conditions and to try to foresee the next steps. The evaluation of patients with mobile kidney can be made relying on diagnostic criteria such as ultrasound with color Doppler and measurement of resistive index, conventional upright X-ray frames after a supine uro-computerized tomography scan and both static and dynamic nuclear medicine scans, always with evaluation in the sitting or erect position. Laparoscopic nephropexy emerges as the current treatment option combining both objectively controlled repositioning of the kidney and resolution of symptoms with minimal invasiveness, low morbidity, and short hospital stay. The use of robotics is presently limited by its higher cost, but may increase in the future. Downward renal mobilization and nephropexy is a safe and versatile technique which has been adopted as a unique strategy or more often in combination with other surgical maneuvers in order to cope with complex ureteral reconstruction.

Pregnancy in women with spinal-cord injury (SCI) poses a clinical challenge. We hypothesized that changes in the management of neurogenic bladder during pregnancy are commonly required and should receive more attention. Data were collected by retrospective analysis of medical records and via cross-sectional survey of 52 women with SCI, representing 67 pregnancies, at ten Italian neurourological clinics. All participants provided informed consent. Between 1976 and 2013, 39 participants had one child, 11 had two children, and two had three children. Mean age at the time of SCI was 18 years and at the time of first pregnancy was 30 years. Delivery occurred from weeks 32 to 40 in 98% of first and second pregnancies, and 94% of neonates were healthy. Oxybutynin was used by four women during five pregnancies, which resulted in delivery of healthy babies. Intermittent catheterization was used before 54% of first pregnancies and 39% of second pregnancies. Bladder management was altered during 45% of these pregnancies, and the most common changes were increased use or frequency of intermittent catheterization or use of an indwelling catheter. Urinary tract infections occurred in 48% of pregnancies, and an irregular course was reported in 13% of pregnancies mainly related to tetraplegia and urological complications. Pregnancy in women with SCI generally has good outcomes and limited risks but frequently necessitates changes in the management of neurogenic bladder. High levels of awareness and focused monitoring of bladder issues are recommended.

A 7-year-old, 34-kg, neutered male Labrador retriever was presented with a 1-year history of intermittent sneezing with occasional left-sided epistaxis. CT revealed a mass in the left nasal cavity. Histopathological analysis of rhinoscopy-guided tissue biopsies was consistent with chronic necrotic and ulcerative rhinitis. Surgical debridement by ventral rhinotomy was subsequently performed and histopathological diagnosis was leiomyoma. Complete resolution of the nasal discharge and reduced sneezing frequency were observed after surgery. Fourteen months postoperatively, CT detected no regrowth of the mass.

Prilocaine is a local anesthetic characterized by intermediate potency and duration and fast onset of action. As hyperbaric formulation of 5% solution, it was introduced and has been successfully used for spinal anesthesia since 1960. A new formulation of 2% plain and hyperbaric solution is currently available in Europe. Because of its lower incidence of transient neurological symptoms, prilocaine is suggested as substitute to lidocaine and mepivacaine in spinal anesthesia for ambulatory surgery, as well as a suitable alternative to low doses of long-acting local anesthetics. The National Library of Medicine database, the Excerpta Medica database, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials database, were searched for the period 1970 to September 2016, with the aim to identify studies evaluating the intrathecal use of 2% prilocaine. A total of 13 randomized clinical trials (RCTs), 1 observational study, 2 dose finding, and 4 systematic reviews has been used for this review. The studies evaluated showed that 2% hyperbaric prilocaine due to a favorable anesthetic and safety profile is an alternative drug to lidocaine and mepivacaine for spinal anesthesia of intermediate or short duration. In comparison with plain solutions, hyperbaricity remarkably accelerates the onset and offset times of intrathecal 2% prilocaine. Literature suggests a dose ranging between 40 and 60 mg of prilocaine for lower extremities and lower abdominal procedures lasting up to 90 min, whereas a dose ranging from 10 to 30 mg is appropriate for perineal surgery. Readiness for discharge occurs in ~4 h from spinal administration.

The first cases of AIDS occurred about 1981. There are not fully appropriate therapeutic interventions for treating this medical condition. People who are diagnosed HIV-positive or with AIDS suffer a poor quality of life and receive medication that produces severe adverse reactions. We have analyzed a significant number of papers published in several countries on these topics, and we have found various inconsistencies: - HIV risk behaviors: According to the Centers for Disease Control and Prevention, in the United States, the Estimated Per-Act Probability of Acquiring HIV from an Infected Source, by Exposure Act (heterosexual) is about one in one thousand for women and about one in two thousand for men. Nevertheless, in an investigation conducted through the University of San Francisco, California, on 442 discordant heterosexual couples no seroconversions were observed throughout the ten years the research lasted. (1985-1995). No other study of similar characteristics has been conducted ever since. - Diagnostics methods: In Argentina, we employ the ELISA screening method, subsequently confirmed by a Western Blot test, but in the United Stated this last is discouraged since 2014. - Medication: Many of the drugs that are used to treat HIV are DNA chain terminators which interfere with the normal functioning and replication of normal cells. As a result, damage in the immune system and the mitochondrial DNA are reported very frequently. We ask the scientific community what we should inform the patients about all these. We urge the experts´ opinion on the ethical management aspects. Since the diagnostic tests employed may result in false positives and the fact that the medication is highly toxic, we recommend that patients with HIV positive diagnosis fully re-test their condition at least once a year to minimize eventual diagnostic errors, suspending specific medications in case of discrepancies on the testing results.

Background: The pancreas can be the site of neoplasms of several histogenetic origins; in most cases, tumors derive from the exocrine component, and ductal adenocarcinoma certainly prevails over the others. This tumor displays remarkably aggressive behavior, and it is often diagnosed at a late stage of disease. Case presentation: We discuss the rare case of a 76-year-old male with locally advanced pancreatic head adenocarcinoma who developed uncommon metastatic disease. The bladder constitutes a very rare site of metastases, mostly deriving from melanoma, gastric, lung and breast cancers. The bladder’s secondary involvement in pancreatic malignancies represents an extremely unusual occurrence, and there are very few cases described in the literature to date. Conclusions: The finding of pancreatic adenocarcinoma metastases leads to a poor prognosis, and patients who are diagnosed at this stage constitute 53% of cases, with a 5-year survival of 3%. Although rare, therefore, the diagnostic hypothesis of pancreatic ductal adenocarcinoma (DAC) metastases to the bladder must, in some cases, be considered, especially if accompanied by a clinical picture that may suggest it.

Since the early 1990s, minimally invasive surgery, specifically laparoscopy, has been widely adopted as an alternative to laparotomy in human surgery and has become a standard of care for the treatment of many conditions. The advantages of laparoscopy are now obvious for people. Numerous studies have demonstrated that laparoscopic procedures result in shorter hospital stays and improved surgical outcomes when compared with open abdominal surgery. In veterinary medicine, there is a similar paradigm shift from open surgery to minimally invasive surgery, except that the widespread use of the technique has lagged the human field by 10 to 15 years. Over the past decade, the development and implementation of laparoscopy in veterinary surgery has accelerated, particularly for one of the most common procedures performed in veterinary practice, and for which owners are seeking a less invasive option: elective canine ovariectomy.1,2 The first canine laparoscopic sterilisation procedure was reported by Wildt and Lawler in 1985.3 Since then, laparoscopic ovariectomy techniques have been extensively developed and different methods have been described. Laparoscopic ovariectomies are now routinely performed and have become the most popular, if not the most commonly performed, minimally invasive soft tissue procedure in veterinary medicine in several countries.4,5 To date, despite the lack of comparative blinded trials, the advantages of laparoscopy are indisputable.6 Indeed, many reports describe fewer perioperative complications, reduced postoperative pain, less surgical stress and an increase in postoperative activity levels in dogs undergoing laparoscopic ovariectomy compared with open procedures.7-10 Additional advantages of laparoscopic ovariectomy include excellent visibility of the genitourinary tract, including the ovarian vessels and other viscera. …

Background The angiogenesis inhibitor monoclonal antibody Bevacizumab is presently the standard treatment for numerous neoplasms but particular toxicities are emerging, such as hypertension, haemorrhage, thromboembolism, gastrointestinal perforation, fistulae, and delayed wound healing. The addition of Bevacizumab to radio and chemotherapy has improved the overall survival rate in patients with metastatic, persistent or recurrent cervical carcinoma. However an increased risk of enteric or urinary fistula formation has been documented, related to hypoxia which is induced by the inhibition of angiogenesis. Moreover, previous pelvic surgery, repeated ureteral stenting and radiation are additional risk factors. Case presentation We describe the remarkable case of a right ureteral stent displacement inside the rectum lumen in a patient treated with Bevacizumab for pelvic recurrence of cervical cancer. The patient was referred to our Urology Department with urinary sepsis and bilateral hydronephrosis. Right ureteral stent substitution was planned; at cystoscopy the distal loop of the stent was not visualized inside the bladder. The presence of the distal loop of the right ureteral inside the rectum was clearly demonstrated with a CT scan. Conclusions Since Bevacizumab is increasingly used in the treatment of gynaecological neoplasms and indwelling ureteral stents are often required to treat or prevent ureteral compressions, similar cases are likely to be diagnosed and this complication should be considered in the management of advanced pelvic cancers.

Central retinal vein occlusion (CRVO) is a common retinal disease. Recent works mentioned spontaneous retinal arterial pulsations (SRAPs) as a feature of some CRVOs. This is a retrospective study on patients presenting with CRVO who were followed up for at least 6 months. The objective was to identify SRAP in the acute phase of the disease and determine their relationship with patients’ characteristics and visual prognosis. A 10-second infrared film centered on the optic disc was recorded within a month of the onset of symptoms, and SRAPs were detected in two-thirds of the cases. Patients with SRAP were significantly younger than those without SRAP. Mean central macular thickness was significantly higher in the absence of SRAP, which was translated into a more severe macular edema; however, this difference faded with time. BCVA tended to be higher in the presence of SRAP at the 6-month follow-up when adjusted to baseline. This study demonstrates that SRAPs are a frequent finding, easily detected by infrared fundus video recording, and associated with a younger age and lesser macular edema.

Highlights • Ranitidine (RT) is an antagonist against H2 histamine receptors (H2R) that weakly suppress acid secretion in patients. Despite that a clinical effect is often achieved. • H2 antagonists (H2RA) also called H2 blockers, are a group of medications that block the action of histamine at the H2R of parietal cells in the stomach. • Preliminary analysis indicates that the levels of H2 receptors in the serum and gastric walls are the same. • Evidence suggests that the level of H2 receptors in dogs with acute vomiting is greater than in healthy dogs, thus probably contributing to a greater efficiency of ranitidine treatment., Despite the lack of evidence of the ability to suppress gastric acid secretion in dogs, ranitidine (RT) is often used to control clinical signs in dogs with acute vomiting even if the way it happens it is still largely unknown. The aim of this study was thus to evaluate the therapeutic effect of ranitidine on H2 receptors in dogs with acute vomiting. To investigate the RT activity a preliminary study was performed in dogs which underwent gastroscopy analyses, demonstrating that the level of H2R observed in the serum and gastric wall tissue was the same [1.473(1.30; 1.79) ng/ml and 1.498 (1.33; 1.85) ng/ml, respectively]. After that H2R levels in the serum of 22 healthy dogs (Group 1) and in a group of 22 dogs with acute vomiting (Group 2) were compared both before (T0), after 7–10 days (T1) of 2 mg/kg twice a day ranitidine administration and after 11 days since the drug was discontinued (T2). Significant differences (p

Resumen En los últimos años, la penetrante influencia social de los medios digitales populariza metodologías, propuestas y recetas de enseñanza, que, en muchos casos, carecen de credenciales académicas para justificar su validez, o incluso, han sido refutadas ya por la comunidad científica, convirtiéndose en meros bulos educativos. Ante esta realidad actual, este artículo de investigación revisa y reflexiona sobre la formación del profesorado, general y de ciencias, proponiendo que debe basarse en resultados acreditados de la investigación, para lograr altos estándares educativos. La propuesta se articula en torno a varios elementos educativos: unos, aportados por la didáctica de la ciencia, tales como alfabetización científica y tecnológica, educación en contexto y modelo de formación del profesorado de ciencias, y otros, aportados por la investigación educativa general, tales como conocimiento profesional docente, investigación basada en pruebas, cogniciones y neurociencia educativa y pensamiento crítico. La reflexión enfatiza los temas y necesidades compartidos entre esos elementos, proponiendo el concepto de alfabetización crítica, que se desarrolla en una taxonomía de destrezas de pensamiento crítico, considerada esencial para la formación del profesorado en el espacio digital de información, común a toda la educación actual. Finalmente, se sugiere un modelo empírico y algunos rasgos generales, como la integración de conocimientos y el desarrollo de destrezas de pensamiento crítico de la formación del profesorado, para atender los requerimientos de enseñanza y aprendizaje actuales en relación con la alfabetización crítica en ciencia y tecnología. Abstract In recent years, the penetrating social influence of digital media popularizes teaching methodologies, proposals and recipes, which, in many cases, lack academic credentials to justify its validity, or even, have already been refuted by the scientific community, becoming in mere educational hoaxes. Given this current reality, this research article reviews and reflects on the training of teachers (general and of science) proposing that it should be based on accredited research results, to achieve high educational standards. The proposal is articulated around several educational elements: some, contributed by the didactics of science, such as scientific and technological literacy, education in context and training model of science teachers, and others, contributed by general educational research, such as professional teaching knowledge, test-based research, cognitions, educational neuroscience and critical thinking. The reflection emphasizes the themes and needs shared between these elements, proposing the concept of critical literacy, which is developed in a taxonomy of critical thinking skills, considered essential for teacher training in the digital information space, common to all current education. Finally, an empirical model and some general features are suggested, such as the integration of knowledge and the development of critical thinking skills during teacher training, to meet current teaching and learning requirements in relation to critical literacy in science and technology. Resumo Nos últimos anos, a penetrante influencia social da mídia digital populariza metodologias, propostas e receitas de ensino, que, em muitos casos, carecem de credenciais académicas para justificar sua validade, ou mesmo já foram refutadas pela comunidade científica, tornando-se em meras fraudes educacionais. Diante dessa realidade atual, este artigo de pesquisa revisa e reflete sobre a formacào de professores, geral e de ciências, propondo que se baseie em resultados de pesquisa credenciados, para atingir altos padròes educacionais. A proposta articula-se em torno de vários elementos educacionais: alguns, contribuídos pela didática da ciência, como alfabetizacào científica e tecnológica, educacào em contexto e modelo de formacào de professores de ciências, e outros, aportados por pesquisas gerais em educacào, tais como conhecimento profissional de ensino, pesquisa baseada em testes, cognicòes e neurociência educacional, e pensamento crítico. A reflexào enfatiza os temas e necessidades compartilhadas entre esses elementos, propondo o conceito de alfabetizacào crítica, desenvolvido em uma taxonomia de habilidades de pensamento crítico, consideradas essenciais para a formacào de professores no espaço da informacào digital, comum a toda a educacào atual. Finalmente, sugere-se um modelo empírico e algumas características gerais, como a integracào do conhecimento e o desenvolvimento de habilidades de pensamento crítico da formacào de professores, para atender aos requisitos atuais de ensino e aprendizagem em relacào à alfabetizacào crítica em ciências e tecnologia .

This paper presents some results from the application of examination papers for engineering courses developed through Matlab/Octave scripts and the AMC (Auto Multiple Choice) package. A large set of exam versions is generated; each student receives a particular version with specific numerical data, and even specific questions. Exams are composed through LaTeX text processing instructions. As this process can be very tedious, Matlab/Octave scripts are included so as to automate the generation of input data and the corresponding answers for all versions. AMC then scans all returned exams, computes the scores and sends the marked exams back to the students through e-mail. Benefits arising from this methodology are as follows: (i) the students receive fast, detailed feedback from which they can self-evaluate their own learning process, and (ii) executing statistical analyses regarding the students' overall performance with respect to a particular question or topic is straightforward.

A two-level energy management model that integrates energy procurement contract, operation scheduling under uncertainty, and demand response for connected microgrids is presented in this paper. It provides a framework for managing microgrid operations efficiently by prioritizing renewable over non-renewable generation. In this way, it is possible to size/measure both battery system and diesel generators reserves for overcoming forecast errors of both renewable generation and non-deferrable load demand; and this also enables deferrable load managing. A flexible chance-constraints-based mathematical programming model is also proposed, which can be used as an optimization model at both levels of the energy management model for defining an optimal energy procurement contract based on energy market trade policies and for generating an optimal daily operation schedule based on the energy contract. Furthermore, a new criterion for chance-constraints modeling based on historical minimum/maximum values is proposed. This modeling is intended to consider a high percentage of potential scenarios that may take place during execution. The percentage of presumed cases is estimated from simulation results.

Resume Une ureterocele correspond a une dilatation kystique de la portion distale, intravesicale et sous-muqueux, de l’uretere. Cet article presente un cas d’ureteroceles ectopiques bilaterales chez une jeune chienne atteinte d’incontinence urinaire, traitee par ureterocelectomie partielle bilaterale. S’il s’agit d’un cas rare, la presentation clinique est classique. Pour differencier cette affection d’une ectopie ureterale intramurale, le recours a l’imagerie, et notamment a l’echographie, est necessaire. La technique chirurgicale, simple, utilisee pour ce cas est peu rapportee dans la litterature. Elle decoule d’autres techniques decrites et de la presence ou non d’anomalie observee lors de la chirurgie, et a permis une resolution parfaite de l’incontinence urinaire de la chienne.

This paper presents an algorithm for fault-location for series-compensated transmission lines based on phase components and on an heuristic method. The proposed algorithm uses voltages and currents measurements provided by intelligent electronic devices installed at both line ends to calculate the voltages at the fault point and to determine the exact fault location. The paper also presents a detailed mathematical model of the series compensation, which is capable of representing its behavior accurately, improving the algorithm's response. The authors implemented a series-compensated double-circuit transmission line using the Alternative Transients Program, in order to evaluate the performance of the proposed algorithm. The results indicate that it presents a high level of accuracy.

ResumenLa bacteriemia por Enterococcus adquirió un papel relevante en los últimos años, debido al incremento de casos intrahospitalarios. Nuestro objetivo fue describir los episodios ocurridos en pacientes adultos de nuestro hospital. Entre enero del 2000 y diciembre del 2013 se registraron 117 episodios. El 61% eran varones y el 39% mujeres. La edad promedio fue 68 años. El 91% presentaba condiciones predisponentes. El principal foco fue intraabdominal. Enterococcus faecalis fue responsable del 65% de los casos, Enterococcus faecium del 28% y otras especies del 7%. El 34% fueron bacteriemias polimicrobianas. Todas las cepas de E. faecalis fueron sensibles a ampicilina y vancomicina. El 88% de los aislamientos de E. faecium fue resistente a ampicilina y el 54% a vancomicina y teicoplanina. En nuestro hospital, el enterococo es el sexto patógeno causante de bacteriemia intrahospitalaria y predomina E. faecium resistente a ampicilina y vancomicina.AbstractEnterococcal bacteremia has acquired considerable importance in recent years, mainly due to an increased number of cases that occur during hospital admission. We describe the episodes of enterococcal bacteremia in adult patients recorded at our hospital. Between January 2000 and December 2013, 117 episodes were analyzed. Sixty one percent (61%) of the patients were male and 39% female. The mean age was 68. Predisposing factors were present in 91% of patients. The primary source of infection was intraabdominal. Enterococcus faecalis was responsible for 65% of the cases; E. faecium for 28%; and other species for 7%. Thirty four percent (34%) of cases were polymicrobial bacteremia. All E. faecalis isolates were susceptible to ampicillin and vancomycin. Eighty eight percent (88%) of E. faecium were resistant to ampicillin and 54% to vancomycin and teicoplanin. In our hospital, Enterococcus is the sixth pathogen causing nosocomial bacteremia, with high incidence of ampicillin and vancomycin-resistant E. faecium.

This study examines the effectiveness of a teaching–learning sequence (TLS) to improve the understanding of the influences and interactions between a technology (mining) and society. The aim of the study is also to show the possibility of both teaching and assessing the most innovative issues and aspects of scientific competence and their impact on the understanding of the nature of science. The methodology used a quasi-experimental, pre–post-test design with a control group, with pre–post-test differences as the empirical indicators of improved understanding. Improvements were modest, as the empirical differences (pre–post and experimental–control group) were not large, but the experimental group scored more highly than the control group. The areas that showed improvement were identified. The paper includes the TLS itself and the standardized assessment tools that are functional and transferable to other researchers and teachers.

Tissue constructs containing mesenchymal stem cells (MSCs) are appealing strategies for repairing large segmental bone defects, but they do not allow consistent bone healing and early cell death was identified as a cause of failure. However, little is known about cell survival in the clinical microenvironment encountered during bone healing process. Osteoconductive coral scaffold with or without luciferase-labeled human MSCs were implanted either in a critical segmental femoral bone defect stabilized by plate or subcutaneously in 44 mice. Cell survival was evaluated by serial bioluminescence imaging (BLI) and osteogenic capabilities by histology and microcomputed tomography. Comparisons between groups were performed with two-way analysis of variance test. Twenty mice were sacrificed 2 weeks after surgery for short-term evaluation and 24 mice at 10 weeks for long-term evaluation. BLI provided evidence of fast and continuous cell death: 85% decrease of the BLI signal over the first 2 weeks in both locations; in fact, less than 2% of the initial cell number was present in all constructs analyzed 4 weeks postimplantation and less than 1% of the initial cell number by 8 weeks postimplantation. By 2 weeks postimplantation, the amount of newly formed bone was self-limited and was similar to ectopic and orthotopic groups. By 10 weeks postimplantation, bone formation was significantly enhanced in the presence of MSCs in orthotopic site and the amount of newly formed bone in cell-containing constructs implanted in orthotopic locations was significantly higher than that observed in the ectopic group. Our results indicated that hMSCs promote bone formation despite early and massive cell death when loaded on coral scaffolds. Interestingly, bone formation was higher in orthotopic than ectopic site despite the same survival pattern. Ectopic implantation of cell-containing constructs is suitable to evaluate cell survival, but assessment of bone formation ability requires orthotopic implantation.

Nucleoside reverse transcriptase inhibitors (NRTIs) are associated with the development of painful neuropathies and may further aggravate sensory neuropathy produced by HIV-1 infection, leading to discontinuation of NRTI therapy by HIV patients. Following antiretroviral-induced peripheral neuropathy, c-Jun N-terminal kinase (JNK) is activated in the dorsal root ganglia (DRG) and spinal cord. However, the contribution of individual JNK genes remains unknown. Here, we have tested the behavioural mechanical sensitivity of JNK1, JNK2 and JNK3 knockout (KO) mice in the von Frey test after treatment with 2',3'-dideoxycytidine (ddC). Protein expression was investigated in the spinal cord of wild type (wt) and KO mice by western blotting. The onset of neuropathic pain was prevented by the deletion of JNK3, leading us to hypothesize that JNK3 protein plays a major role in the regulation of pain threshold in antiretroviral neuropathy. The growth-associated protein 43 (GAP-43) and the transcription factor c-Jun are involved in regeneration processes. This study revealed an up-regulation of GAP-43 and c-Jun protein, 14 days after ddC administration. JNK1 deletion induced a significant reduction in c-Jun phosphorylation and GAP-43 protein contents. In contrast, there was no difference in ddC-induced reduction of hind paw intraepidermal nerve fibre density in all JNK KO mice. Overall, these findings indicate that JNK3 plays a critical role in regulating ddC neurotoxicity-induced mechanical pain hypersensitivity, while JNK1 is important for activation of c-Jun and GAP-43 as a critical pathway of a regeneration program. These data highlight the impact of individual JNK isoforms on antiretroviral neurotoxicity and neuro-regeneration processes.

Purpose: The aim of our study is to evaluate the efficacy and safety of ATOMS® system for the treatment of postoperative male stress urinary incontinence (SUI). Materials and methods: We retrospectively evaluated all patients treated at our institution for postoperative male SUI with ATOMS® implant. We excluded patients with low bladder compliance (< 20 mL / cmH2O), uncontrolled detrusor overactivity, detrusor underactivity (BCI < 100), urethral or bladder neck stricture and low cystometric capacity (< 200 mL). Results: From October 2014 to July 2017 we treated 52 patients, mean age 73.6 years. Most of them (92.3%) had undergone radical prostatectomy, 3.85% simple open prostatectomy, 3.85% TURP; 28.8% of patients had undergone urethral surgery, 11.5% adjuvant radiotherapy; 57.7% had already undergone surgical treatment for urinary incontinence. The average24 hours pad test was 411.6 g (180 – 1100). The mean follow-up was 20.1 months (8.1 – 41.5) 30.8% of patients were dry, 59.6% improved ≥ 50%, 7.7% improved < 50% and 1.9% unchanged. In total 73.1% reached social continence. There was a significant reduction of the 24 hours pad test and ICIQ - UI SF scores (p < 0.01). In the postoperative follow-up we detected complications in 8 patients (19%): 5 cases of displacement of the scrotal port, in 2 cases catheterization difficulties, one case of epididimitis and concomitant superficial wound infection; no prosthesis infection, nor explants. Radiotherapy, previous urethral surgery,previous incontinence surgery were not statistically related to social continence rates (p 0.65;p 0.11;p 0.11). Conclusions: The ATOMS® system is an effective and safe surgical treatment of mild and moderate male postoperative SUI with durable results in the short term.