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Mobile EEG allows the investigation of brain activity in increasingly complex environments. In this study, EEG equipment was adapted for use and transportation in a backpack while cycling. Participants performed an auditory oddball task while cycling outside and sitting in an isolated chamber inside the lab. Cycling increased EEG noise and marginally diminished alpha amplitude. However, this increased noise did not influence the ability to measure reliable event related potentials (ERP). The P3 was similar in topography, and morphology when outside on the bike, with a lower amplitude in the outside cycling condition. There was only a minor decrease in the statistical power to measure reliable ERP effects. Unexpectedly, when biking outside significantly decreased P2 and increased N1 amplitude were observed when evoked by both standards and targets compared with sitting in the lab. This may be due to attentional processes filtering the overlapping sounds between the tones used and similar environmental frequencies. This study established methods for mobile recording of ERP signals. Future directions include investigating auditory P2 filtering inside the laboratory.HighlightsA backpack containing all the equipment necessary to record ERP and EEG was worn by participants as they rode a bicycle outside along a streetEEG and ERP data from an auditory oddball task is compared with data acquired within subject inside the labReliable MMN/N2b and P3 responses were measured during bicycle riding outside equal in magnitude to those obtained inside the labA surprising decrease in the P2 component of the ERP evoked by targets and standards was observed when doing the task outside on a bicycle, which we attribute to increased auditory filtering

Since 2014, OnabotulinumtoxinA BotoxAll urogynecology centers of the country were asked in order to list all patients who were treated since marketing autorisation. Patient symptoms, previous treatments, paraclinic evaluations, data of surgery and the characteristics of the follow up were collected and analyzed.Six centers used BoNTA and five have accepted to participate. Ninety-seven patients have been identified. Sixty-eight first injections (70 %) were carried out with the strict frameworf of the marketing autorisation (urinary frequency, urinary urgency, urinary incontinence). All patients had at least two symptoms. In 69 %, Botulinum toxin was a second-line treatment after the failure of tibial neuromodulation or sacral neuromodulation. Urodynamic evaluation was carried out for 91 % of patients. The search for a post-void residual volume was observed for 59 % of patients during the follow up.In our country, BoNTA injections for idiopathic overactive bladder are mainly effected after tibial neuromodulation or sacral neuromodulation failure. Diagnostic, operating and outcome evaluation practices are still very heterogeneous pleading for a greater standardization of this new therapy in this indication.3.

Prostate cancer brachytherapy can be used as an alternative to the radical prostatectomy and radiotherapy. In the low-risk group, specific survivals are up to 95% after 10years. The aim of the study is to describe the practices in brachytherapy in France.A survey made by AFU (French Urologic Association) and SFRO (French Society Of Oncological Radiotherapy) assessing the practices in brachytherapy in France was sent to all the urologists and radiotherapists even if they did not practice it.In total, 1417 surveys were sent, 285 were received coming from 211 urologists (74%) and 74 radiotherapists (26%). Sixty (21%) practiced brachytherapy (31 urologists, 29 radiotherapists). Low dose rate with permanent implants was used in 83,3%. Brachytherapy was advised for low-risk group by 90% who responded the survey, 73% used it in intermediate risk and only 13% in high risk.Brachytherapy is hardly used in low risk prostate cancer. It probably needs a reconsideration of recommendations due to the good results in association with a good picking. The urologist-radiotherapist couple is essential in the overall care of the patient.4.

Objective To devise and validate a system to categorize GreenLight photoselective vaporization of prostate (PVP) complications according to Clavien score (CS), to report complications of PVP using this categorization, and to determine risk factors. Materials and Methods A survey questionnaire was distributed to all participants of the second meeting of the Group of GreenLight Users. They were asked to grade PVP complications according to CS. We calculated the mode CS for each complication from the survey data to propose a categorization system for complications of PVP. Complications encountered in a large single-center cohort of 370 patients were reported according to this system. We assessed the reproducibility of CS by estimating inter-rater agreement by the Fleiss kappa. We performed univariate and multivariate analyses to determine risk factors for complications. Results Of the 67 meeting participants, 42 (62.7%) completed the survey. Overall agreement between urologists was fair (Fleiss kappa = 0.356). Among the 370 patients, 21 (5.7%) had intraoperative complications, 147 (39.7%) had postoperative complications, and 70 (18.9%) had long-term complications. Among the postoperative complications, 125 patients (33.8%) were classified as Clavien grade I, 58 (15.7%) as Clavien grade II, 4 (1.1%) as Clavien grade IIIb, 5 (1.3%) as Clavien grade IVa, 1 (0.3%) as Clavien grade IVb, and 1 (0.3%) as Clavien grade V. In multivariate analysis, the only predictor of overall complications was a polymicrobial preoperative urine culture. Conclusion The grading of PVP complications by CS is fairly reproducible. We are the first to propose a system for the categorization of PVP complications. PVP complications are frequent but most often minor.

Studies have shown different clinical outcomes of noninvasive positive pressure ventilation (NPPV) from those of continuous positive airway pressure (CPAP).We evaluated whether bilevel positive airway pressure (BPAP) more rapidly improves dyspnea, ventilation, and acidemia without increasing the myocardial infarction (MI) rate compared to continuous positive pressure ventilation (CPAP) in patients with acute cardiogenic pulmonary edema (APE).Patients with APE were randomized to either BPAP or CPAP. Vital signs and dyspnea scores were recorded at baseline, 30 min, 1 h, and 3 h. Blood gases were obtained at baseline, 30 min, and 1 h. Patients were monitored for MI, endotracheal intubation (ETI), lengths of stay (LOS), and hospital mortality.Fourteen patients received CPAP and 13 received BPAP. The two groups were similar at baseline (ejection fraction, dyspnea, vital signs, acidemia/oxygenation) and received similar medical treatment. At 30 min, PaO2:FIO2 was improved in the BPAP group compared to baseline (283 vs. 132, p0.05) and the CPAP group (283 vs. 189, p0.05). Thirty-minute dyspnea scores were lower in the BPAP group compared to the CPAP group (p = 0.05). Fewer BPAP patients required intensive care unit (ICU) admission (38% vs. 92%, p0.05). There were no differences between groups in MI or ETI rate, LOS, or mortality.Compared to CPAP to treat APE, BPAP more rapidly improves oxygenation and dyspnea scores, and reduces the need for ICU admission. Further, BPAP does not increase MI rate compared to CPAP.

The purpose of the guidelines national committee CCAFU was to propose updated french guidelines for localized and metastatic prostate cancer (PCa).A Medline search was achieved between 2013 and 2016, as regards diagnosis, options of treatment and follow-up of PCa, to evaluate different references with levels of evidence.Epidemiology, classification, staging systems, diagnostic evaluation are reported. Disease management options are detailed. Recommandations are reported according to the different clinical situations. Active surveillance is a major option in low risk PCa. Radical prostatectomy remains a standard of care of localized PCa. The three-dimensional conformal radiotherapy is the technical standard. A dose of74Gy is recommended. Moderate hypofractionation provides short-term biochemical control comparable to conventional fractionation. In case of intermediate risk PCa, radiotherapy can be combined with short-term androgen deprivation therapy (ADT). In case of high risk disease, long-term ADT remains the standard of care. ADT is the backbone therapy of metastatic disease. In men with metastases at first presentation, upfront chemotherapy combined with ADT should be considered as a new standard. In case of metastatic castration-resistant PCa (mCRPC), new hormonal treatments and chemotherapy provide a better control of tumor progression and increase survival.These updated french guidelines will contribute to increase the level of urological care for the diagnosis and treatment for prostate cancer. © 2016 Elsevier Masson SAS. All rights reserved.

Las anomalias de la arteria y de la vena renales son numerosas, de causas multiples y muy a menudo desconocidas. Aparte de las lesiones frecuentes como las estenosis ateromatosas, el aneurisma, la diseccion de la arteria renal y la trombosis de la vena renal, las demas alteraciones de los vasos renales, ya sean congenitas o adquiridas, son infrecuentes y, por tanto, dificiles de manejar, hecho que implica un considerable retraso diagnostico y terapeutico. Se han producido avances en el diagnostico y el tratamiento desde hace varios anos, en especial con el desarrollo de nuevas tecnicas de revascularizacion arterial endovascular, como la angioplastia transluminal percutanea, mas o menos completada con la implantacion de una endoprotesis. Esta tecnica se ha convertido en el tratamiento de eleccion de la estenosis de la arteria renal, de una obstruccion aguda e incluso de un aneurisma o de una fistula arteriovenosa. Estas lesiones pueden excluirse directamente o de forma complementaria, con la liberacion in situ de espirales metalicos (coils) que hacen posible la embolizacion de la lesion arterial. El beneficio principal de estos tratamientos es una menor morbilidad, respecto al empleo de la via percutanea, en pacientes afectados por lesiones multivasculares y, por tanto, fragiles y poco aptos para soportar una cirugia vascular mas invasiva. Sin embargo, en caso de complicacion o de fracaso de las intervenciones endovasculares o desde el principio si se trata de lesiones arteriales complejas, que se detallaran mas adelante, la cirugia vascular esta indicada. En funcion de la gravedad de las lesiones y la duracion de su reparacion, la revascularizacion puede ser anatomica, extraanatomica o por cirugia ex situ con enfriamiento del parenquima renal, cuyo objetivo es evitar al maximo la cirugia de exeresis definitiva.

Measuring site quality for birds at migration stopover grounds and identifying critical stopover habitats are both important components of gauging the full life cycle conservation of migratory birds. We evaluated riparian stopover habitat quality on the San Joaquin and Mokelumne rivers in California's Central Valley for migrant Willow Flycatchers (Empidonax traillii), Orange-crowned Warblers (Oreothlypis celata), Yellow Warblers (Setophaga petechia), and Wilson's Warblers (Cardellina pusilla). For each species, we used 3 approaches to assess habitat quality: (1) we examined change in mass of individuals that were recaptured at least once; (2) we tracked body condition over the time of day and over the course of the migratory season; and (3) we compared the rates of hourly mass change for Wilson's Warbler to similar studies in Canada and the United States. On average, individuals of all species recaptured at stopover sites increased mass from initial capture to final capture (0.49 g to 0.88 g). ...

We used light-level geolocators to describe the migratory geography of Swainson's Thrushes (Catharus ustulatus) from a breeding population in central coastal California. Between 11 June and 20 July 2010, we attached geolocator tags to 35 Swainson's Thrushes at three sites in Marin County, California, and recovered 12 in the following two breeding seasons. All 12 birds spent the winter in Mexico, north of the Isthmus of Tehuantepec. Eleven of the birds went to the Jalisco region in western Mexico, but two of those birds (18% of total) moved east in midwinter to either the Sierra Madre Oriental or Sierra Madre del Sur; the 12th bird went directly to one of the latter regions. The return rate over the next 2 years for tagged birds (34%) was not statistically lower than that for control birds (45%). We combined our results with the results of an earlier study that used geolocators on Swainson's Thrushes from British Columbia to quantify the strength of migratory connectivity using Mantel's correlati...

Resume But Comparer les consequences a long terme sur la capacite erectile des patients operes d’une prostatectomie totale par voie cœlioscopique robot-assistee (PTCR) et par voie cœlioscopique manuelle (PTC) et comparer les modifications de la sexualite des partenaires. Patients et methodes Un autoquestionnaire etait envoye aux 412 patients operes par le meme operateur entre mars 2004 et juillet 2009. Quatre-vingt-seize patients avaient les criteres de bonne fonction erectile preoperatoire et de suivi superieur ou egal a 24 mois. La fonction erectile etait evaluee par l’IIEF-5 et les QLQ-C30 PR25. Les modifications de la sexualite des partenaires etaient evaluees par un questionnaire base sur le FSFI. Resultats En preoperatoire, il n’a pas ete observe de difference significative entre les deux groupes PTCR et PTC. En postoperatoire, l’IIEF-5 sans traitement etait meilleur dans le groupe PTCR que dans le groupe PTC ( p = 0,025). En cas de preservation bilaterale des bandelettes (BNV2), l’IIEF-5 maximal etait meilleur dans le groupe PTCR ( p = 0,002). Pour la sexualite des partenaires, nous n’avons pas mis en evidence de difference entres les techniques et il est apparu que la communication dans le couple semble l’item le moins altere apres cette chirurgie. Conclusion En cas de preservation bilaterale des bandelettes neurovasculaires (BNV), un operateur entraine a la chirurgie laparoscopique devrait observer des resultats a long terme sur la fonction erectile meilleurs avec la technique robot-assistee. Les modifications de la sexualite des partenaires necessitent une evaluation prospective.

Currently, the French High Authority for Health does not recommend mass screening for prostate cancer (PCa), due to the risk of over-treatment, notably of low risk patients. Our study is intended to reflect the therapeutic attitudes for the management of patients classified as low risk of progression in French clinical centers.For all positive prostate biopsies performed during 2012 and 2013 in five French departments of urology, clinicopathological characteristics required to calculate the d'Amico risk group and the Cancer of the Prostate Risk Assessment (CAPRA) score were filled. Information on the first treatment of "low risk" patients was collected.A total of 1035 patients were included, with a median age at diagnosis of 66 years old. According to d'Amico and CAPRA classifications, 30.4% and 35.0% of patients were at low, 34.5% and 33.2% at intermediate, 35.1% and 31.8% at high risk. The diagnosis severity increased with age (P0.0001). The main treatment for low risk patients was radical prostatectomy (41.6% and 42.0% for d'Amico and CAPRA, respectively), but active surveillance was the most frequent treatment if diagnosed after 75 years old. The management of low risk patients varied significantly between centers (P0.0001), according to the therapeutic platforms available within the hospital.In absence of strong progression predictor, the management of low risk PCa remains based on center habits and local therapeutic platforms. New predictive markers, such as multiparametric MRI or molecular tests, are needed to guide rational management of low risk PCa.4.

Monitoring responses by birds to restoration of riparian vegetation is relatively cost-effective, but in most assessments species-specific abundances, not demography, are monitored. Data on birds collected during the nonbreeding season are particularly lacking. We captured birds in mist nets and resighted banded birds to estimate species richness and diversity, abundance, demographic indexes, and site-level persistence of permanent-resident and overwintering migrants in remnant and restored riparian sites in California. Species richness in riparian remnants was significantly higher than in restored sites because abundances of uncommon permanent residents were greater in remnants. Species richness of overwintering migrants did not differ between remnants and restored sites. Responses among overwintering migrants (but not permanent residents) to remnant and restored riparian sites differed. Capture rates were higher in remnant or restored riparian sites for 7 of 10 overwintering migratory species. For Lincoln's Sparrows (Melospiza lincolnii )a nd White-crowned Sparrows (Zonotrichia leucophrys) proportions of older birds were significantly higher in remnants, even though capture rates of these species were higher in restored sites. Overwinter persistence of 4 migrant species was significantly higher in remnant than in restored sites. A higher proportion of Hermit Thrushes (Catharus guttatus, 56.3%), older Fox Sparrows (Passerella iliaca, 57.1%), Lincoln's Sparrows (59.7%), and White-crowned Sparrows (67.8%) persisted in remnants than restored sites. Our results suggest restored riparian sites provide habitat for a wide variety of species in comparable abundances and diversity as occurs in remnant riparian sites. Our demographic and persistence data showed that remnants supported some species and age classes to a greater extent than restored sites.

Since short polymer chains have a higher mobility than long molecules, conventional expectations are that the growth rate, G, of polymer crystals should decrease as the concentration of large chains increases in a binary blend. Here we present results on G as the blend concentration, ϕ, is varied from short chains of poly(ethylene oxide) (PEO), which are well above the entanglement molecular weight, to long PEO chains. Contrary to the simple mobility argument, G(ϕ) is nonmonotonic—clear evidence that another mechanism can dominate. We propose a tentative model based on the simple idea that chain ends retard the crystal growth. Thus, increasing the chain end concentration with the addition of short chain molecules can reduce the crystal growth rate.

In some passerines, the extent of preformative molt varies among individuals. Wrentits (Chamaea fasciata) undergo either a complete preformative molt or an eccentric (i.e., incomplete) preformative molt where some juvenile remiges are retained through the first cycle. Factors that influence the incidence and extent of molt are largely unknown. Using a 10-yr data set from the Palomarin Field Station in central coastal California, we quantified the incidence of eccentric molt and the degree to which variation in the incidence was associated with fledging date and weather. From 1999 to 2009, 159 Wrentits were banded as nestlings and subsequently recaptured. Of these, 21% of first-year Wrentits underwent eccentric molt. We used logistic regression and an information theoretic approach to compare models with fledging date, weather (annual precipitation and breeding-season temperature), and a random effect of year as predictors of the incidence of eccentric molt. Our top model included a random intercept term for year and a fixed effect for the effect of fledging date; birds that fledged later in the season were more likely to undergo eccentric molt. Although the proportion of individuals that underwent eccentric molt varied among years, models with breeding-season temperature and annual rainfall showed little to no support. Our results suggest that the incidence of eccentric molt is more strongly associated with fledging date than with annual variation in weather. The absence of a correlation with weather suggests that weather does not impose an energetic constraint on molt or, if it does, that birds are constrained in their ability to respond to changes in weather by adjusting the extent of their preformative molt. Other factors, such as nestling condition, may provide alternative explanations for year-to-year variability in the incidence of eccentric molt. RESUMEN En algunos paserinos, la cantidad de muda despues de la etapa juvenil varia entre individuos. C. fasciata sufre una muda despues de la etapa juvenil completa o una muda excentrica (i.e., incompleta) en donde las rectrices de algunos juveniles son retenidas a lo largo del primer ciclo. Los factores que influyen y extienden la muda son en su mayoria desconocidos. Usando una base de datos de 10 anos de la estacion de campo Palolmarin en la costa central de California, cuantificamos la incidencia de la muda excentrica y el grado en el cual la variacion en la incidencia estaba asociada con el dia de abandono del nido y el clima. Desde 1999 hasta 2009, 159 polluelos de C. fasciata fueron anillados y subsecuentemente recapturados. De estos, el 21% de las recapturas de C. fasciata del primer ano sufrieron una muda excentrica. Usamos una regresion logistica y una aproximacion con informacion teorica para comparar modelos con fechas de abandono del nido, clima (precipitacion anual y temperatura durante la temporada reproductiva), y ano como efecto aleatorio para vaticinar la incidencia de la muda excentrica. Nuestro modelo incluyo un termino de intercepto aleatorio para ano y un efecto fijo para el efecto de la fecha de abandono del nido; las aves que abandonaron el nido tarde en la temporada aumentaron la probabilidad de experimentar muda excentrica. Aunque la proporcion de individuos que experimentaron muda excentrica vario entre anos, modelos con temperatura durante la temporada reproductiva y precipitacion anual mostraron poco o ningun soporte. Nuestros resultados sugieren que la incidencia de la muda excentrica esta mas fuertemente asociada con la fecha de abandono del nido que con la variacion climatica anual. La falta de correlacion con el clima sugiere que el clima no impone una restriccion energetica en la muda o, si lo hace, estas aves estan limitadas en sus habilidades de responder a cambios en el clima a traves del ajuste en la extension de su muda despues de la etapa juvenil. Otros factores, como la condicion de los polluelos, pueden brindar explicacion alternativas para la variacion ano tras ano en la incidencia de la muda excentrica.

Summary 1. The capture of birds using mist nets is a widely utilized technique for monitoring avian populations. While the method is assumed to be safe, very few studies have addressed how frequently injuries and mortalities occur and the associated risks have not been formally evaluated. 2. We quantified the rates of mortality and injury at 22 banding organizations in the United States and Canada and used capture data from five organizations to determine what kinds of incidents occur most frequently. Analyses focused on passerines and near-passerines, but other groups were included. We evaluated whether body mass, age, sex, mist net mesh size, month and time of day or frequency of capture are related to the risk or type of incident. We also compared the recapture histories over time between birds that were injured and those that were never injured for 16 species. 3. The average rate of injury was 0AE59%, while mortality was 0AE23%. Birds captured frequently were less at risk to incident. Body mass was positively correlated with incident and larger birds were at greater risk to predation, leg injuries, broken legs, internal bleeding and cuts, while smaller birds were more prone to stress, tangling-related injuries and wing strain. Rates of incident varied among species, with some at greater risk than others. We found no evidence for increased mortality over time of injured birds compared with uninjured birds. 4. We provide the first comprehensive evaluation of the risks associated with mist netting. Our results indicate that (1) injury and mortality rates below one percent can be achieved during mist netting and (2) injured birds are likely to survive in comparable numbers to uninjured birds after release. While overall risks are low, this study identified vulnerable species and traits that may increase a bird’s susceptibility to incident that should be considered in banding protocols aimed at minimizing injury and mortality. Projects using mist nets should monitor their performance and compare their results to those of other organizations.

Objectifs La detorsion manuelle du cordon spermatique est un geste non invasif qui peut etre realise avant toute detorsion chirurgicale. La surete, l’efficacite et la fiabilite de la manœuvre de detorsion ont ete etudiees en analysant des criteres cliniques et operatoires. Methodes Entre mai 2004 et septembre 2015, 144 torsions du cordon spermatique etaient repertoriees chez des enfants âges de 4 a 17 ans. L’âge, l’examen physique a l’admission, la realisation ou non d’une detorsion, les caracteristiques de cette manœuvre, le delai entre la consultation et l’heure de la chirurgie, ainsi que toutes les donnees du compte rendu operatoire etaient recueillies et analysees. La presence d’une detorsion complete a l’incision chirurgicale etait notre critere principal pour juger de l’efficacite de la detorsion manuelle. La sensibilite et la specificite d’une detorsion manuelle consideree complete etaient analysees pour predire une detorsion complete a l’incision. Resultats Des donnees exhaustives etaient disponibles pour 65 patients. L’âge moyen etait de 13 ans [4,17; σ=8.1], sans difference entre les groupes avec et sans detorsion (14 vs 13; p = 0,2). Trente-huit manœuvres de detorsion etaient realisees. Lorsqu’une detorsion etait effectuee, on observait une detorsion complete du testicule lors de l’incision dans 71% des cas contre 7%, sans manœuvre realisee (p Conclusion La realisation d’une detorsion manuelle du cordon spermatique permet une detorsion effective a l’incision de 71% vs 7% sans manœuvre. Elle est associee a un delai d’intervention chirurgicale significativement plus long, sans augmentation du nombre d’orchidectomies. Dans notre serie, cette procedure est donc majoritairement efficace, plaidant pour un recours plus systematique dans la pratique courante au sein d’une population pediatrique.

Resume La prostatectomie est le traitement de reference du cancer localise de la prostate. Depuis 2004 le Robot Da Vinci ® est utilise par notre centre dans le cadre de la prostatectomie totale laparoscopique. Objectif Evaluer l’interet de la laparoscopie robot-assistee (PTLR) dans la prostatectomie totale en la comparant a la laparoscopie standard (PTL) sur les resultats fonctionnels urinaires et carcinologiques a trois ans de recul. Materiel Deux cent quarante-sept patients ont ete operes de mars 2004 a avril 2007, dont 125 en PTL et 122 en PTLR, de facon consecutive et de maniere sequentielle, par un seul chirurgien senior au debut de son experience. Resultats L’ensemble des donnees pre-, peri- et postoperatoire a ete analyse. Il n’y avait pas de difference statistique entre les deux groupes en preoperatoire. A un an, 17 % des patients portaient une ou plusieurs protections dans le groupe PTL et 19 % dans le groupe PTRL. De facon detaillee, parmi les patients portant au moins une protection, 71 % dans le groupe PTL portaient une seule protection contre 87 % dans le groupe PTLR. L’analyse multivariee sur la continence faisait apparaitre une tendance en faveur de la PTLR ( Odd Ratio en faveur du Robot 2,1 [IC : 0,86–5,48]). Conclusion L’incontinence paraissait moins frequente et moins severe au robot tout en conservant des caracteristiques carcinologiques acceptables. L’impression par le chirurgien de l’interet de la PTLR est evidente, mais un nombre de patient plus eleve est necessaire pour vraisemblablement verifier cette hypothese.

INTRODUCTION: Walking is a preferred and recommended physical activity for middle-aged and older adults, but many barriers exist, including concerns about safety (ie, personal security), falling, and inclement weather. Mall walking programs may overcome these barriers. The purpose of this study was to summarize the evidence on the health-related value of mall walking and mall walking programs. METHODS: We conducted a scoping review of the literature to determine the features, environments, and benefits of mall walking programs using the RE-AIM framework (reach, effectiveness, adoption, implementation, and maintenance). The inclusion criteria were articles that involved adults aged 45 years or older who walked in indoor or outdoor shopping malls. Exclusion criteria were articles that used malls as laboratory settings or focused on the mechanics of walking. We included published research studies, dissertations, theses, conference abstracts, syntheses, nonresearch articles, theoretical papers, editorials, reports, policy briefs, standards and guidelines, and nonresearch conference abstracts and proposals. Websites and articles written in a language other than English were excluded. RESULTS: We located 254 articles on mall walking; 32 articles met our inclusion criteria. We found that malls provided safe, accessible, and affordable exercise environments for middle-aged and older adults. Programmatic features such as program leaders, blood pressure checks, and warm-up exercises facilitated participation. Individual benefits of mall walking programs included improvements in physical, social, and emotional well-being. Limited transportation to the mall was a barrier to participation. CONCLUSION: We found the potential for mall walking programs to be implemented in various communities as a health promotion measure. However, the research on mall walking programs is limited and has weak study designs. More rigorous research is needed to define best practices for mall walking programs' reach, effectiveness, adoption, implementation, and maintenance. Language: en

Robotics and ambulatory are modern applications of surgery. This case study proves the feasibility of robot-assisted radical prostatectomy as an outpatient procedure.This report highlights the first, half-day, robotic prostatectomy performed on a 57-year-old man with localized prostate cancer. This operation was proposed to the subject because of his excellent physical condition and favorable environmental factors. He chose to undergo the surgery voluntarily. He underwent a nerve sparing radical prostatectomy. Target-controlled infusion propofol was used in perioperative sedation and analgesia. Postoperative evaluation criteria was made with the Visual Analog Scale of Pain Intensity (VASPI), Chung score and a patient satisfaction survey.No perioperative or postoperative complications were reported. Blood loss was low (75 mL). The patient stayed less than 12 hours in the ambulatory unit thanks to a rapid recovery. The patient returned home after reporting a Chung score of 10. No hospital readmission was necessary. Functional results were: a bowel movement on day 1, back to work on day 2, normal urinary continence on day 8, a correct erectile function on day 9. Oncological results revealed negative surgical margins for cancer and PSA postoperative0.03 ng/mL.Ambulatory robotic radical prostatectomies can be performed on voluntarily-selected patients without affecting the high quality of urological surgery outcomes.

Background: Sleep complaints are common in patients with major depressive disorder (MDD). Both MDD and antidepressant drugs characteristically alter objective sleep measures. This study compares the effects of mirtazapine and fluoxetine on sleep continuity measures in DSM-IV MDD patients with insomnia. Method: Patients (N = 19) received initial baseline polysomnography evaluations over 2 consecutive nights. Subjects were randomly assigned to either fluoxetine (20-40 mg/day) or mirtazapine (15-45 mg/day) treatment for an 8-week, double-blind, double-dummy treatment trial. Single-night polysomnograms were conducted at weeks 1, 2, and 8, with depression ratings assessed at baseline and weeks 1, 2, 3, 4, 6, and 8. Statistical analysis was performed by repeated-measures analysis of variance followed by Dunnet's post hoc analyses. Results: Patients receiving mirtazapine (N = 8) had significant improvement in objective sleep physiology measures at 8 weeks. Improvements in sleep latency, sleep efficiency, and wake after sleep onset were significant after only 2 weeks of mirtazapine treatment. No significant changes in sleep continuity measures were observed in the fluoxetine group (N = 11). Both groups improved clinically in mood and subjective sleep measures from baseline, with no differences between groups. Conclusion: These data demonstrate the differential effects of mirtazapine and fluoxetine, with significant improvement in favor of mirtazapine, on objective sleep parameters in MDD patients with insomnia.

Resume But de l’etude. – Le but de cette etude etait de rapporter l’experience preliminaire de la surrenalectomie robotique utilisant le systeme Da Vinci ® et de comparer les resultats obtenus avec ceux de l’abord conventionnel laparoscopique. Materiel et methode. – Etude prospective concernant tous les patients consecutifs operes d’une surrenalectomie unilaterale par voie laparoscopique ou robotique realisee entre le 1 er novembre 2000 et le 1 er novembre 2002. Resultats. – Vingt-huit patients ont ete operes soit par laparoscopie (14 patients) soit par chirurgie robotique (14 patients). La duree moyenne de la surrenalectomie robotique avait tendance a etre plus longue que celle des approches laparoscopiques (111 vs 83 min ; p = 0,057). Cette tendance diminuait au fur et a mesure de l’experience des operateurs. La duree d’occupation de la salle operatoire etait equivalente pour les deux types de chirurgie. La frequence des incidents peroperatoires sans necessite de conversion en laparotomie, le taux de conversion (7 %), le saignement postoperatoire, la reprise du transit, la morbidite (21 %), la duree d’hospitalisation et d’arret de travail etaient similaires pour les deux types de chirurgie. A l’inverse du systeme robotique, la duree operatoire avait tendance a etre d’autant plus longue que l’index de masse corporel etait eleve chez les patients operes par laparoscopie. Conclusion. – Cette etude preliminaire n’a retrouve aucun argument objectif en faveur de l’utilisation du systeme robotique Da Vinci ® pour realiser une surrenalectomie unilaterale. Nous pensons cependant que le confort operatoire du robot est tel que la poursuite de son utilisation et de son evaluation devraient confirmer sa validite dans de futures etudes.

Resume But de l’etude : La taille tumorale est consideree comme une limitation de la surrenalectomie laparoscopique. Le but de cette etude etait d’evaluer en fonction de la taille du pheochromocytome (PH), les particularites diagnostiques, les variations hemodynamiques operatoires ainsi que les resultats de la surrenalectomie laparoscopique transperitoneale. Materiel et methode : Etude retrospective du 1 er janvier 1997 au 31 decembre 2000. Les comparaisons ont ete faites en fonction de la taille de la tumeur mesuree en anatomopathologie ( Resultats : Quarante-deux patients ont ete operes d’une surrenalectomie laparoscopique dont 11 (26 %) pour pheochromocytome (6 patients p = 0,01). Le rapport moyen du dosage urinaire de metanephrines/normetanephrines etait de 1,259 et de 0,268 ( p = 0,08). La tumeur a ete fragmentee chez 27 % des patients. Le scanner sous-estimait la taille du PH de respectivement 24 et 52 %. La duree d’hospitalisation etait respectivement de huit et dix jours. La morbidite et la mortalite etaient respectivement de 18 et 0 %. Ces criteres etaient equivalents entre les deux groupes de patients. Conclusion : La taille tumorale ≥ 5 cm ne parait pas modifier radicalement les resultats de cette exerese. Elle semble cependant responsable d’une secretion preferentielle de noradrenaline induisant des modifications tensionnelles plus importantes. Le taux de fragmentation et la sous-estimation scanographique de la taille reelle de la tumeur paraissent importants. Ces caracteristiques doivent etre integrees par l’equipe anesthesiste-chirurgien pour encore ameliorer les resultats de l’exerese laparoscopique des pheochromocytomes.

Resumen En el adulto la vejiga normal no puede explorarse ni por palpacion ni por percusion si no contiene al menos 150 ml. La palpacion bimanual permite apreciar la movilidad de la vejiga y la extension de un tumor vesical. Se deben respetar procedimientos de esterilizacion estrictos. La exploracion directa de la uretra y de la vejiga se efectua por cistouretroscopia una vez comprobada la ausencia de infeccion urinaria. Las ventajas de la cistoscopia rigida son la mejor visibilidad (en particular en caso de hematuria), un conducto de operacion mas amplio y un mayor flujo de llenado. La fibroendoscopia es menos agresiva para el paciente, el paso del aparato es mas facil y posibilita el examen del cuello vesical por retrovision.

To evaluate the feasibility of robot-assisted radical prostatectomy (RARP) in high risk prostate cancer (HR). The rate of positive surgical margins (PSM) was compared between anticipated HR cancer according to D'Amico risk classification and discovered postoperative HR cancer.A retrospective study was conducted between 2006 and 2013 on patients who underwent RARP. Before surgery, patients were divided according to the D'Amico risk classification. After surgery, HR was defined as pT3a or pT3b, or Gleason score≥8 or positive lymph nodes. The rate of PSM was compared according to the D'Amico risk classification and postoperative HR.During the study, 485 patients were reviewed. Before surgery, 10 % of cancers were classified as D'Amico 3 (49/485). After surgery, 27.6 % (134/485) were classified as HR. There was a significant difference between the rate of PSM in HR/D'Amico 3 and HR/non D'Amico 3 cancer, respectively 22.9 % and 34.3 % (P0.001).The RARP is feasible in HR with an average of 30 % of PSM as in open surgery. However, the accurate assessment of preoperative HR will allow a more adapted dissection and a decrease of rate of PSM. So it is necessary to improve the detection of HR and so to select the most suitable cancer for surgery.Level 5.

Diagnosis, localization of recurrence in the management of prostate cancer patients with increasing concentrations of tumor serum markers is crucial for treatment planning of the patients. The present review describes the role of prostate MRI and (18) Fcholine PET/computed tomography (CT) in tumor detection and extent, when there is a suspicion of residual or recurrent disease after treatment of prostate cancer.A systematic review of the literature was performed by searching in the PUB MED/MEDLINE database searching for articles in French or English published between the last 12years.In patient with a clinical suspicion of recurrence after treatment for prostate cancer, imaging can be used to distinguish between local recurrence and metastatic disease. (11)C-choline PET/CT and pelvic multiparametric MR imaging (mp MRI) are complementary in this indication. In this paper, the current status of imaging techniques used for the staging of patients with suspected locally recurrent or metastatic disease in patients treated for prostate cancer were reviewed.Mp MRI of the prostate may be valuable imaging modality for the detection and localization of local recurrence. C-choline PET/CT offers an advantage in detecting metastatic disease to lymph node and bone.

Major improvements in the field of radiotherapy planning such as stereotactic radiation therapy, have recently been performed, aiming to the development of personalized therapeutic strategies in patients with biochemical failure of prostate cancer. However, this needs an early and accurate location of sites of recurrence. Development of multimodality magnetic resonance imaging (MRI) and positron emission tomography (PET) permits to consider this objective. Thus, it is worthwhile to apprehend the respective performance of these imaging techniques in order to rationalize their use. We propose a review of the recent literature organized by technique and by location, regarding the performance of multimodality MRI and PET for restaging of patients with biochemical failure of prostate cancer initially treated with curative intent.

The widespread use of prostate cancer screening has led to a stage migration resulting in an increase in the diagnosis of low-risk disease, which currently accounts for 40-50% of diagnosed forms. New therapeutic strategies have been developed in order to minimize the risk of overtreatment.A systematic review of the literature over the past 20 years was performed using the Medline database. The literature selection was based on evidence and practical considerations.Low-risk tumors are conventionally defined by the d'Amico classification. The use of multiparametric MRI helps to better characterize these tumors. The contribution of molecular biology remains to be determined in clinical practice. Novel therapeutic options for low-risk disease are currently being evaluated.The new therapeutic strategies are evolving. They seek to reduce overtreatment without compromising oncological success.

The sub Comittee prostate of the CCAFU established guidelines for diagnostic, treatment, evaluation and standart of care of prostate cancer.Guidelines 2010 were updated based on systematic literature search performed by the sub-Comittee in Medline and PubMed databases to evaluate references, levels of evidence and grade of recommandation.Pathological examination of the tissue specimens was defined specifically for Gleason score according to ISP 2005 recommandations. Prostate and pelvis RMN became the reference in terms of radiological exam. Individual and early diagnosis of prostate cancer was defined and role of PSA was precised. Active surveillance became one of the standart of care of low-risk tumors, radical prostatectomy remained one of the options for all risk group tumors, length of hormonotherapy in association with radiotherapy was precised according to the risk group. Side effects of hormonotherapy treament needed specific supervision ; hormonotherapy had no indication in case of non metastatic tumors and intermittent hormonotherapy in metastatic tumors. New hormonal drugs in pre and post chemotherapy and bone target drugs opened new therapeutics pathways.From 2010 to 2013, standarts of care of prostate cancer were modified because of results of prospective studies and new therapeutics. They allowed precise treatments for each specific clinical situation. In the future, multidisciplinary treatments for high risk tumors, time of adjuvant treatment and sequencies of new hormonal treatment had to be defined.

Resume Quatre cas d’hyperlactatemie apres transplantation renale sont rapportes. Dans les premiers jours postoperatoires, trois transplantes avaient une hemorragie occulte dans la loge du greffon. L’exteriorisation de l’hemorragie et le retentissement sur la pression arterielle, la frequence cardiaque et la pression veineuse centrale etaient faibles. Au plan biologique, il existait de facon precoce, une hyperlactatemie ou une acidose a trou anionique augmente. Le syndrome compartimental abdominal constitue par ces hematomes retroperitoneaux compressifs provoquait des troubles de la perfusion du transplant et necessitait une intervention chirurgicale. Dans le quatrieme cas, il n’y avait pas d’hematome mais une thrombose partielle de la veine du greffon et de la veine iliaque externe et une hyperlactatemie. Lors de la reintervention, les prelevements sanguins au niveau de la veine et de l’artere du greffon objectivaient une production de lactate sur le rein ischemie. Le role particulier du rein dans le metabolisme des lactates permet d’evoquer l’hypothese d’une production de lactates par le greffon renal hypoperfuse. En l’absence de signe de choc, dans les circonstances a risque d’hematome perirenal, ou en cas d’oligurie, le dosage des lactates pourrait se reveler utile au diagnostic d’hypoperfusion severe du greffon.

Le nombre de transplants renaux reste insuffisant Deux observations de prelevements renaux sur donneurs en arret cardiocirculatoire, ou l'utilisation de la perfusion et refroidissement in situ permit de reduire au minimum la duree d'ischemie chaude et d'obtenir quatre greffons de qualite, sont rapportees. Les indications, les limites medico-legal et la technique de refroidissement in situ sont rappelees, car cette procedure peut mermettre d'augmenter les prelevements chez les patients en arret cardiaque.

Literature showed the impact of surgical margin status on prognosis after radical prostatectomy (mostly on biochemical survival). Margin status is an easy self-evaluation of surgical practice to assess. The aim of this paper was to define what a positive surgical margin (PSM) is and how to prevent the occurrence, to precise the impact on survival and how to treat.A literature analysis with Pubmed has been performed to 2012, furthermore conclusions of the main congresses with selection committee and review publication have also been studied.PSM is defined as "tumor cells touching the ink on the specimen edge". The most frequent reported incidence is between 15 to 20%. Margin status remains one of the major criteria to determine the need of adjuvant radiotherapy after surgery. Quality of life is not or only lightly modified by radiotherapy with the current techniques. Adjuvant radiotherapy improves biological survival but is synonymous with overtreatment in many times. Salvage radiotherapy has to be quickly performed after Prostate Specific Antigen (PSA) relapse (PSA1 ng/mL even0.5 ng/mL).This literature review did not allow to suggest superiority of one surgical technique over another. In the same way, the kind of dissection i.e. bladder neck or neurovascular bundle preservation does no clearly modify PSM rate. However, it seems logical to "customize" dissection according to prostate cancer characteristics (D'Amico criteria for instance) guided with multiparametric MRI. Intrafascial dissection has to be applied only to low risk. Lastly, the debate between adjuvant or salvage radiotherapy is always ongoing.

which corresponds to the limit of eq. (28) when R → 0. Note that the 4/3 factor between the two expressions applies on a single point of the grid, the others being described by the full eq. (33). We have verified that this error is insignificant up to a typical 10−4 relative error on the output profiles, with the chosen spatial increment (ΔR = 0.01) reported in table 2. The results and figures of the article are thus unchanged. However, the missing 4/3 factor may lead to larger discrepancies for a coarser grid. We take advantage of this Erratum to mention also that the conditions of eqs. (36a), (36d) and (36e) are not needed in the algorithm.

To summarize the indications and outcomes of low dose-rate prostate brachytherapy with permanent implants.Bibliographic database PubMed was searched with prostate cancer and brachytherapy as keywords from 1995 to 2012.The main indication of prostate brachytherapy is the favorable group, but it could be proposed to patients with an intermediate prognostic group if the PSA is ≤ 15 ng/mL or if the Gleason score is 7 (3+4), under cover of a prostate MRI without any extra-capsular extension. Oncologic results are similar to those of surgery or external beam irradiation (EBRT), with a 10-yr biochemical control rate approaching 90%. Urinary toxicity is common during the year following the implant, mainly irritative symptoms; 5 to 15% of patients experienced acute urinary retention. A prostate volume higher than 50 cc or an initial high international prostatic symptom score (IPSS) are predictive of toxicity and are recognized as relative contraindications of the technique. Sexual activity is maintained in 60% of patients.Brachytherapy must be proposed as a validated option beside active surveillance, surgery and EBRT.

To compare the long-term sexual outcome of laparoscopic radical prostatectomy (LRP) vs robot-assisted laparoscopic prostatectomy (RALP).A questionnaire was sent to the 412 patients treated by the same surgeon by LRP or RALP from March 2004 to July 2009. Ninety-six patients were evaluated preoperatively with a good erectile function before surgery and a follow-up more than 24 months. Erectile function was evaluated by the IIEF-5, the QLQ-C30 PR25 questionnaires. Partner's sexuality was evaluated with a FSFI's based questionnaire.There was no significant difference before surgery between two groups LRP and RALP. After surgery, the IIEF-5 without any treatment was better in RALP group than in LRP group (P=0.025). When a bilateral nerve sparing was performed, the IIEF-5 maximum was better in RALP group (P=0.002). For the partners, there was no difference between the two techniques and it appeared that communication about sexuality is the less altered, long time after a radical prostatectomy.In case of bilateral nerve sparing prostatectomy, an experimented operator in laparoscopic surgery should have better long-term erectile function results with RALP than LRP. Partner's sexuality modifications need more prospective studies to know its influence on erectile rehabilitation.

Monitoring responses by birds to restoration of riparian vegetation is relatively cost-effective, but in most assessments species-specific abundances, not demography, are monitored. Data on birds collected during the nonbreeding season are particularly lacking. We captured birds in mist nets and resighted banded birds to estimate species richness and diversity, abundance, demographic indexes, and site-level persistence of permanent-resident and overwintering migrants in remnant and restored riparian sites in California. Species richness in riparian remnants was significantly higher than in restored sites because abundances of uncommon permanent residents were greater in remnants. Species richness of overwintering migrants did not differ between remnants and restored sites. Responses among overwintering migrants (but not permanent residents) to remnant and restored riparian sites differed. Capture rates were higher in remnant or restored riparian sites for 7 of 10 overwintering migratory species. For Lincoln's Sparrows (Melospiza lincolnii) and White-crowned Sparrows (Zonotrichia leucophrys) proportions of older birds were significantly higher in remnants, even though capture rates of these species were higher in restored sites. Overwinter persistence of 4 migrant species was significantly higher in remnant than in restored sites. A higher proportion of Hermit Thrushes (Catharus guttatus, 56.3%), older Fox Sparrows (Passerella iliaca, 57.1%), Lincoln's Sparrows (59.7%), and White-crowned Sparrows (67.8%) persisted in remnants than restored sites. Our results suggest restored riparian sites provide habitat for a wide variety of species in comparable abundances and diversity as occurs in remnant riparian sites. Our demographic and persistence data showed that remnants supported some species and age classes to a greater extent than restored sites.

Lymph node invasion is the first step of metastatic evolution of prostate cancer. In this case, today, no local treatment should be proposed. Detection of lymph node invasion is performed by CT-scan and RMI, which show hypertrophied nodes. No difference in term of sensibility and specificity is observed between CT-scan and RMI. Invaded nodes are defined by modifications of size, form, and aspect of the architecture of nodes. Sentinel node belongs to expert centers. Surgical lymphadenectomy remains the best way to evaluate lymph node status. Limited to ilio-obturator land, it underestimates the risk of lymph node invasion: Extended lymph node excision defined by the association of bilateral ilio-obturator, internal iliaca and external iliaca lymphadenectomy should be systematically proposed to intermediate and high risk prostate cancer. A "well done" lymphadenectomy is represented by more than 10 nodes removed. Lymph node invasion represents bad prognosis. However, therapeutic value and influence of prognosis of lymphadenectomy in prostate cancer is still not established. Therefore, one or two invade lymph nodes represented a population of patients with better prognosis, specially if no capsular effraction is observed. After radical prostatectomy, in case of lymph node invasion, immediate hormonotherapy is the standard; however, this treatment is discussed in case of low number of invaded nodes (one or two) and if postoperative PSA is equal to zero. In this case, radiotherapy is still in evaluation and chemotherapy has no indication.

Two randomised trials and negative conclusion of the FDA about inhibitors of 5 alpha-reductase in prevention of prostate cancer need a revision of the indications of these drugs.After description of fundamentals data, review of the literature in PubMed library was performed to analyse the indications of these drugs according to the different stages of prostate cancer.Even if PCPT and REDUCE studies showed a decrease of cancers with the use of 5 alpha-reductase (5ARI) but with side effects, there is no indication for prostate cancer prevention by these drugs. In the same way, despite the results of REEDEM study, there is no indication of these drugs in active surveillance.Despite the large interest of these drugs, no recommendation can be given for indications of 5ARI in prevention or treatment of prostate cancer.

We present results on the leveling of polymer microdroplets on thin films prepared from the same material. In particular, we explore the crossover from a droplet spreading on an infinitesimally thin film (Tanner's law regime) to that of a droplet leveling on a film thicker than the droplet itself. In both regimes, the droplet's excess surface area decreases towards the equilibrium configuration of a flat liquid film, but with a different power law in time. Additionally, the characteristic leveling time depends on molecular properties, the size of the droplet, and the thickness of the underlying film. Flow within the film makes this system fundamentally different from a droplet spreading on a solid surface. We thus develop a theoretical model based on thin film hydrodynamics that quantitatively describes the observed crossover between the two leveling regimes., Comment: accepted for publication in Physical Review Letters

Resume La detection peroperatoire a la MIBG a ete proposee pour ameliorer le reperage de tissus pathologiques et augmenter l’efficacite du geste d’exerese chirurgicale des tumeurs derivees de la crete neurale. Cette detection peroperatoire a ete rapportee dans moins d’une dizaine de cas lors de reintervention pour pheochromocytome. Nous rapportons un exemple d’utilisation de detection peroperatoire 123 I-MIBG ayant permis d’augmenter l’efficacite du geste d’exerese chirurgicale lors d’une reintervention pour pheochromocytome. L’utilisation de la detection peroperatoire parait donc particulierement utile lors d’une reintervention pour pheochromocytome.