The impact of robotic-assisted transperineal biopsy of the prostate on erectile function.

BACKGROUND: Prostate biopsy represents one of the most frequently performed urologic procedures worldwide and therefore presupposes knowledge on potential effects like on the erectile function, especially in extensive or repeated biopsies. The robotic-assisted biopsy system (Mona Lisa) offers a minimal invasive approach via only two incision points ensuring maximal accuracy combined with protection of the neurovascular bundle of the prostate. OBJECTIVE: Our purpose was to analyse the impact of robotic-assisted transperineal biopsy of the prostate on the erectile function. METHODS: Our prospective study analyses the outcomes of 210 patients, who had undergone minimal-invasive, transperineal robotic-assisted biopsy of the prostate at the University Hospital Basel from January 2020 to March 2022 and provided sufficient data. Of these, 157 (74.8%) were included in final analysis. RESULTS: Mean (range) age, prostate volume, PSA and IIEF-5 score at baseline were 63.8 years (46.1-83.6), 46.4 ml (9-310), 13.2 ng/ml (0.2-561), and 18.8 points (6-25), respectively. EF before and 1 month after intervention was assessed with the IIEF-5 questionnaire for the whole cohort. No significant change of IIEF-5 was observed for the whole cohort with a mean (± SD) decrease of 0.4 (± 3.1) points. Except for patients > 69 years, subgroup analysis revealed no change of IIEF-5 in statistically significant manner for all subgroups. Number of biopsy cores (< 20 and ≥ 20), previous biopsies and active surveillance showed no significant influence. CONCLUSION: Our results suggest that the minimally invasive and highly precise robotic technique can spare the erectile function without limiting the extent of biopsy and without compromising diagnostic accuracy.

Safety profile of robotic-assisted transperineal MRI-US-fusion guided biopsy of the prostate.

Introduction: Robotic-assisted transperineal MRI-US-fusion guided biopsy of the prostate is a novel and highly accurate procedure. The aim of this study was to evaluate the MonaLisa prostate biopsy system in terms of safety, tolerability, and patient-related outcomes. Methods: This prospective study included 228 patients, who had undergone Robotic-assisted transperineal MRI-US-fusion guided biopsy of the prostate at the University Hospital Basel between January 2020 and June 2022. Peri-operative side effects, functional outcomes and patient satisfaction were assessed. Results: Mean pain score on the day of biopsy was 1.3 points on VAS, which remained constant on the day after biopsy. Overall, 32 of 228 patients (14%) developed grade I complications according to Clavien-Dindo classification. No higher-grade complications occurred. Gross haematuria, hematospermia and acute urinary retention occurred in 145/228 (63.6%), 98/228 (43%) and 32/228 (14%) patients, respectively. One patient (0.4%) developed urinary tract infection. Conclusions: Robotic-assisted transperineal MRI-US-fusion guided biopsy of the prostate performed under general anesthesia is a safe and well tolerated procedure. This technique allows to omit perioperative prophylaxis and at the same time minimizes the risk of infectious complications. We attribute the favorable risk profile and tolerability to the minimal invasive approach via two entry points.

Imaginarios sociales sobre lo juvenil en el Chile contemporáneo / Social imaginaries of youth in contemporary Chile / Imaginários sociais sobre o juvenil no Chile contemporâneo

En este artículo, se presentan los resultados de una investigación cuyo objetivo fue identificar imaginarios sociales emergentes sobre lo juvenil en el Chile contemporáneo. Es un estudio cualitativo basado en el análisis de trece grupos de discusión realizados en cinco regiones del país. La selección de los participantes en el estudio consideró a estudiantes que cursan su último año de educación secundaria en Chile. Entre los resultados más relevantes se encuentra la identificación de un imaginario social sobre lo juvenil como un desafío de escolarización, que se estructura conflictivamente con énfasis en varias dimensiones y procesos claves en la configuración de la condición social de las juventudes chilenas contemporáneas.

This paper presents the finding/results of an investigation that had theobjective of identifying emerging social imaginaries related to youth in contemporary Chile. Thisis a qualitative study based on the analysis of thirteen discussion groups, conducted in five regionsacross the country. Participants in the study were studying their last year of secondary education/high school in Chile. Among the most relevant results is the identification of a social imaginary ofyouth as a permanent challenge to be controlled by the education system, which is structured as aconflict into the foundation of emphasizing different dimensions and processes that are consideredessential in the configuration of the social condition of contemporary Chilean youth.

Neste artigo apresentam-se os resultados de uma pesquisa cujo objetivofoi identificar imaginários sociais emergentes sobre o juvenil no Chile contemporâneo. É um estudoqualitativo baseado na análise de treze grupos de discussão realizados em cinco regiões do país. Aseleção dos participantes no estudo considerou a estudantes que cursam seu último ano de educaçãosecundária em Chile. Entre os resultados mais relevantes se encontram a identificação de umimaginário social sobre o juvenil como um desafio permanente de escolarização, o qual se estruturaconflituosamente sobre a base de enfatizar diversas dimensões e processos chaves na configuraçãoda condição social das juventudes chilenas contemporâneas.

Effects of sustained release dexamethasone hydrogels in hearing preservation cochlear implantation.

It has been shown that glucocorticoids reduce the hearing threshold shifts associated with cochlear implantation. Previous studies evaluated the administration of glucocorticoids immediately before surgery or the repeated pre- or perioperative systemic application of glucocorticoids. The aim of this study was to evaluate the effects of a sustained release dexamethasone hydrogel in hearing preservation cochlear implantation. To address this issue, a guinea pig model of cochlear implantation was used. 30 normal hearing pigmented guinea pigs were randomized into a group receiving a single dose of a dexamethasone/poloxamer407 hydrogel one day prior to surgery, a second group receiving the hydrogel seven days prior to surgery and a control group. A silicone cochlear implant electrode designed for the use in guinea pigs was inserted to a depth of 5 mm through a cochleostomy. Compound action potentials of the auditory nerve (frequency range 0.5-32 kHz) were measured preoperatively, directly postoperatively and on postoperative days 3, 7, 14, 21 and 28. Following the last audiometry, temporal bones were harvested and histologically evaluated. Dexamethasone hydrogel application one day prior to surgery resulted in significantly reduced hearing threshold shifts at low, middle and high frequencies measured at postoperative day 28 (p < 0.05). Application of the hydrogel seven days prior to surgery did not show such an effect. Dexamethasone application one day prior to surgery resulted in increased outer hair cell counts in the cochlear apex and in reduced spiral ganglion cell counts in the basal and middle turn of the cochlea, a finding that was associated with a higher rate of electrode translocation in this group. In this study, we were able to demonstrate functional benefits of a single preoperative intratympanic application of a sustained release dexamethasone hydrogel in a guinea pig model of cochlear implantation.

Interfaces complejas en políticas educativas y de juventud: sentidos e identidades / Complex interfaces in educational and juvenile politics: meaning and identities in Chile’s secondary school system

En el artículo damos cuenta de las transformaciones e inflexiones socioeconómicas, sociopolíticas y socioculturales -a escala global- de las sociedades contemporáneas, en correlato con los procesos situados de configuración de sentidos educativos e identidad de las jóvenes y los jóvenes escolares secundarios de Chile. Este estudio lo realizamos en cuatro escuelas secundarias públicas en Santiago de Chile. La metodología es de tipo cualitativa y está basada en 32 entrevistas en profundidad. Los resultados evidencian que en la escuela secundaria se configura una pluralidad de sentidos educativos y emergen nuevas identidades entre las personas jóvenes que la habitan cotidianamente. Concluimos que las actuales transformaciones estructurales y subjetivas en curso, tienen profundas implicancias para el diseño de políticas públicas educativas y de juventud en un contexto de fragmentación social y segregación de las instituciones educativas...

Meningoencefalitis tuberculosa en el Hospital Dos de Mayo de Lima / Tuberculous meningo-encephalitis in Hospital Dos de Mayo of Lima 1985 - 1989

Se realizó un estudio retrospectivo-prospectivo para conocer las características clínicas y la morbimortalidad de la meningoencefalitis tuberculosa (MEC TBC) del adulto. De 124 historias clínicas con ese diagnóstico en el Hospital Dos de mayo de Lima entre 1985 - 1989, 97 cumplieron los criterios de inclusión. Se halló que la población más afectada fue de jóvenes, solteros, migrantes, de bajas escolaridades y renumeraciones. La forma de presentación más frecuente fue de inicio insidioso (91.1 por ciento) y curso subagudo (59.4 por ciento); con contactos TBC, (29.1 por ciento); con antecedentes de TBC, (42.5 por ciento); hipoglucorraquia (53.6 por ciento), hiperproteinorraquia (95.2 por ciento), pleocitosis (98.9 por ciento); BK directo, 0 por ciento; con TBC pulmonar, 70.5 por ciento; PPD positivo, 36.0 por ciento ; estadío moderado de enfermedad, 67.0 por ciento; tratamiento adecuado, 94.8 por ciento ; corticoterapia, 79.4 por ciento; hospitalización mayor de 30 días, 42.2 por ciento; fallecidos, 30.,9 por ciento; seguimiento ambulatorio, 59.7 por ciento; recaídas, 11.9 por ciento. Después del alta fueron ubicados 41 pacientes (61.2 por ciento), de los cuales 22 (53.7 por ciento), 9 (21.9 por ciento), y 2 (4.8 por ciento) con categorías 1, 2 y 3 respectivamente, más 8 (19.5 por ciento) fallecidos. Se concluye que la MEC TBC afecta a la población joven, de bajo nivel socioeconómico, que la mortalidad es alta, que la morbimortalidad al alta correlaciono con la edad y la condición clínica al ingreso, no correlacionó con otros factores. La morbimortalidad al seguimiento correlacionó con la edad y el tratamiento ambulatorio irregular