Robotic simple prostatectomy vs HOLEP, a 'multi single-center' experiences comparison.

Introduction: The aim of this study was to compare peri-operative and mid-term outcomes of patients who underwent robot-assisted simple prostatectomy (RASP) vs holmium laser enucleation of the prostate (HOLEP). RASP and HOLEP are the treatments of choice for men with symptomatic benign prostatic obstruction (BPO) and a prostate ≥80 g, achieving comparable short and mid-term efficacy. No randomized controlled studies have proved the superiority of one technique over the other. Material and methods: The prospectively maintained databases of the participating institutions were queried for patients with a prostate volume (PV) ≥80 g, who underwent surgery for BPO between 2011 and 2021. The study population was divided into two subgroups based on surgical approach. Demographics, baseline characteristics, and 12 months outcomes were compared between groups: χ2 and Student t-tests were used for categorical and continuous variables, respectively. The Trifecta composite outcome (post-operative Q-max >15 ml/sec, International Prostate Symptom Score (IPSS) <8 and absence of complications) was used to define surgical quality and the two groups were compared accordingly. Logistic regression analyses investigated predictors of Trifecta achievement. Results: We included 97 patients with comparable pre-operative features (all p >0.30): 43 underwent RASP, 54 HOLEP. Median PV was 102 g (IQR 89-120) and Q-max was 7.2 ml/s (IQR 5.4-9.0). The Trifecta rate was 43% overall, higher in the RASP subgroup (56% vs 33%; p = 0.02). The endoscopic approach was its only independent predictor (OR 0.5; 95% CI 0.28-0.88; p = 0.016). Conclusions: At univariable regression analysis, surgical approach was the only independent predictor of Trifecta achievement, which was significantly higher in the RASP group compared to HOLEP.

The Impact of Metastasectomy on Survival Outcomes of Renal Cell Carcinoma: A 10-Year Single Center Experience.

OBJECTIVES: The role of surgical metastasectomy (MST) in solitary or oligometastasis from renal cell carcinoma (RCC) and its impact on survival outcomes remains poorly addressed. We evaluated the impact of MST on overall survival (OS) in patients with oligometastatic (m)RCC. MATERIALS AND METHODS: The institutional renal cancer prospective database was examined for cases treated with partial or radical nephrectomy who developed metastatic disease during follow-up. Patients with evidence of clinical metastasis at first diagnosis were excluded. Patients considered unfit for MST received systemic treatment (ST); all others received MST. The impact of MST vs. the ST only cohort was assessed with the Kaplan-Meier method. Age, gender, bilaterality, histology, AJCC stage of primary tumor, surgical margins, local vs. distant metastasis and MST were included in univariable and multivariable regression analyses to assess the predictors of OS. RESULTS: Overall, at a median follow-up of 16 months after primary treatment, 168 patients with RCC developed asynchronous metastasis at the adrenal gland, lung, liver, spleen, peritoneal, renal fossa, bone, nodes, brain and thyroid gland. Nine patients unfit for any treatment were excluded. The site of metastasis was treated with surgical MST (77/159, 48.4%), with or without previous or subsequent ST, while 82/159 cases (51.2%) received ST only. The 2-year, 5-year and 10-year OS probabilities were 93.8%, 82.8% and 79.5%, respectively. After multivariable analysis, MST and the primary tumor AJCC stage were independent predictors of OS probabilities (p = 0.019 and p = 0.035, respectively). After Kaplan-Meier analysis, MST significantly improved OS probabilities versus patients receiving ST (p < 0.001). LIMITATIONS: The main drawbacks of our research were the small sample size from a single-tertiary referral institution, as well as the absent or different ST lines in the cohort of patients receiving MST. CONCLUSIONS: When an NED status is achievable, surgical MST of mRCC significantly impacts OS, delaying and not precluding further subsequent ST.

Polarisation-independent ultrafast laser selective etching processing in fused silica.

In fused silica, ultrafast laser assisted etching enables high chemical etching rates (>300 µm h-1) by setting a light polarisation linear and perpendicular to the beam writing direction. However, for many non-planar surfaces and 3D structures, dynamic polarisation control is difficult or not yet possible to implement. In this contribution, we identify a laser inscription regime in which high etching rates are accomplished independently of the light polarisation. In this regime (<15 pulses per µm), we measure etching rates ∼300 µm h-1 (4 hours in NaOH) including femtosecond-pulse energies corresponding to type II modifications. Few pulse inscriptions show a low degree of anisotropy as compared to higher number of pulses, thus enabling the polarisation insensitivity whose mechanisms are discussed. To demonstrate the capabilities of the processing, we fabricate curved and square-wave microchannels together with a complex 3D geometrical structure (stellated octahedron) containing an inter-plane arrangement with challenging angles (45°), which are difficult to achieve even employing dynamic polarisation control.

Recent Advances in Biomedical Photonic Sensors: A Focus on Optical-Fibre-Based Sensing.

In this invited review, we provide an overview of the recent advances in biomedical photonic sensors within the last five years. This review is focused on works using optical-fibre technology, employing diverse optical fibres, sensing techniques, and configurations applied in several medical fields. We identified technical innovations and advancements with increased implementations of optical-fibre sensors, multiparameter sensors, and control systems in real applications. Examples of outstanding optical-fibre sensor performances for physical and biochemical parameters are covered, including diverse sensing strategies and fibre-optical probes for integration into medical instruments such as catheters, needles, or endoscopes.

Photodynamic Therapy: A Compendium of Latest Reviews.

Photodynamic therapy (PDT) is a promising therapy against cancer. Even though it has been investigated for more than 100 years, scientific publications have grown exponentially in the last two decades. For this reason, we present a brief compendium of reviews of the last two decades classified under different topics, namely, overviews, reviews about specific cancers, and meta-analyses of photosensitisers, PDT mechanisms, dosimetry, and light sources. The key issues and main conclusions are summarized, including ways and means to improve therapy and outcomes. Due to the broad scope of this work and it being the first time that a compendium of the latest reviews has been performed for PDT, it may be of interest to a wide audience.

Light Technology for Efficient and Effective Photodynamic Therapy: A Critical Review.

Photodynamic therapy (PDT) is a cancer treatment with strong potential over well-established standard therapies in certain cases. Non-ionising radiation, localisation, possible repeated treatments, and stimulation of immunological response are some of the main beneficial features of PDT. Despite the great potential, its application remains challenging. Limited light penetration depth, non-ideal photosensitisers, complex dosimetry, and complicated implementations in the clinic are some limiting factors hindering the extended use of PDT. To surpass actual technological paradigms, radically new sources, light-based devices, advanced photosensitisers, measurement devices, and innovative application strategies are under extensive investigation. The main aim of this review is to highlight the advantages/pitfalls, technical challenges and opportunities of PDT, with a focus on technologies for light activation of photosensitisers, such as light sources, delivery devices, and systems. In this vein, a broad overview of the current status of superficial, interstitial, and deep PDT modalities-and a critical review of light sources and their effects on the PDT process-are presented. Insight into the technical advancements and remaining challenges of optical sources and light devices is provided from a physical and bioengineering perspective.

Shaping Perovskites: In Situ Crystallization Mechanism of Rapid Thermally Annealed, Prepatterned Perovskite Films.

Understanding and controlling the crystallization of organic-inorganic perovskite materials is important for their function in optoelectronic applications. This control is particularly delicate in scalable single-step thermal annealing methods. In this work, the crystallization mechanisms of flash infrared-annealed perovskite films, grown on substrates with lithographically patterned Au nucleation seeds, are investigated. The patterning enables the in situ observation to study the crystallization kinetics and the precise control of the perovskite nucleation and domain growth, while retaining the characteristic polycrystalline micromorphology with larger crystallites at the boundaries of the crystal domains, as shown by electron backscattering diffraction. Time-resolved photoluminescence measurements reveal longer charge carrier lifetimes in regions with large crystallites on the domain boundaries, relative to the domain interior. By increasing the nucleation site density, the proportion of larger crystallites is increased. This study shows that the combination of rapid thermal annealing with nucleation control is a promising approach to improve perovskite crystallinity and thereby ultimately the performance of optoelectronic devices.

High-Mobility In2O3:H Electrodes for Four-Terminal Perovskite/CuInSe2 Tandem Solar Cells.

Four-terminal (4-T) tandem solar cells (e.g., perovskite/CuInSe2 (CIS)) rely on three transparent conductive oxide electrodes with high mobility and low free carrier absorption in the near-infrared (NIR) region. In this work, a reproducible In2O3:H (IO:H) film deposition process is developed by independently controlling H2 and O2 gas flows during magnetron sputtering, yielding a high mobility value up to 129 cm2 V-1 s-1 in highly crystallized IO:H films annealed at 230 °C. Optimization of H2 and O2 partial pressures further decreases the crystallization temperature to 130 °C. By using a highly crystallized IO:H film as the front electrode in NIR-transparent perovskite solar cell (PSC), a 17.3% steady-state power conversion efficiency and an 82% average transmittance between 820 and 1300 nm are achieved. In combination with an 18.1% CIS solar cell, a 24.6% perovskite/CIS tandem device in 4-T configuration is demonstrated. Optical analysis suggests that an amorphous IO:H film (without postannealing) and a partially crystallized IO:H film (postannealed at 150 °C), when used as a rear electrode in a NIR-transparent PSC and a front electrode in a CIS solar cell, respectively, can outperform the widely used indium-doped zinc oxide (IZO) electrodes, leading to a 1.38 mA/cm2 short-circuit current (Jsc) gain in the bottom CIS cell of 4-T tandems.

Adenocarcinoma de la vesícula seminal. Presentación de un caso y revisión de la literatura / Adenocarcinoma of seminal vesicle. Report of a case and review of the literature

Se presenta un caso de adenocarcinoma de vesicula seminal tratado en los servicios de Urología y Anatomía patológica del Hospital de Especialidades de Puebla, Pue., que se considera uno de los primeros que se informa con corroboración histológica en la República Mexicana y se agrega a los existentes en la literatura mundial, con la característica de mostrar histológicamente las zonas de transición del epitelio normal hacia la neoplasia, como base para fundamentar el diagnóstico de un origen primario de la vesícula seminal. Se exponen los criterios existentes en relación con esta alteración patológica, y más que llegar a una conclusión, debe insistirse que se requiere tener en mente la existencia de esta entidad para poder sospechar su diagnóstico y corroborarlo con los medios al alcance. Además del sitio bien establecido de la resección radical, los estudios recientes acerca de la presencia de receptores específicos de estrògenos en las vesículas seminales podrían abrir una nueva senda para la institución temprana de la terapeútica hormonal antiandrógena que modifique el comportamiento que ha mostrado este carcinoma hasta la actualidad