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О существенных значениях показателей колеблемости решений линейной однородной двумерной дифференциальной системы 线性均匀二维微分系统决策的波动值
IF 0.5 Q4 MATHEMATICS, APPLIED Pub Date : 2023-06-01 DOI: 10.21538/0134-4889-2023-29-2-157-171
А. Х. Сташ
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引用次数: 0
From the Triangulation Technique to the Use of the Donor Aorta and Vena Cava for Kidney Transplantation: Lessons from the Past and Path to the Future of Xenotransplantation 从三角测量技术到使用供体主动脉和腔静脉进行肾移植:异种移植的过去和未来的经验教训
IF 0.5 Q4 MATHEMATICS, APPLIED Pub Date : 2023-05-26 DOI: 10.3390/uro3020016
D. Nghiem
Revascularization of the kidney transplant is classically performed by anastomosing the renal vessels to the recipient iliac vessels. This technique is not applicable when the renal vessels are very small, numerous or anomalous and aberrant. In these instances, the donor aorta and the vena cava have to be used for vascular anastomosis. It would be useful to briefly review the development and the use of the donor aorta and cava in renal transplantation during the last century and discuss the potential clinical application of this technique in xenotransplantation of the porcine kidneys in humans at the dawn of the 21st century.
肾移植的血运重建通常是通过将肾血管与受体髂血管吻合来实现的。当肾血管非常小、多或异常异常时,该技术不适用。在这些情况下,必须使用供体主动脉和腔静脉进行血管吻合。简要回顾上个世纪供体主动脉和腔体在肾移植中的发展和应用,并讨论21世纪初该技术在猪肾异种移植中的潜在临床应用,是有益的。
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引用次数: 0
A Decade of Pancreas Transplantation—A Registry Report 十年胰腺移植——一份登记报告
IF 0.5 Q4 MATHEMATICS, APPLIED Pub Date : 2023-05-25 DOI: 10.3390/uro3020015
A. Gruessner
Since the first pancreas transplant in 1966, over 67,000 pancreas transplants have been performed worldwide and the number is growing. While the number of transplants in the US has changed only slightly over the past decade, many countries outside the US have shown strong growth in transplant numbers. The worldwide growth in numbers is due to the increasing number of patients with type 2 diabetes mellitus receiving a pancreas transplant. Only during the COVID-19 pandemic in 2020 and 2021 did transplant numbers decline, but they started to recover in 2022. The decline was especially noted for solitary transplants. This development over time was due to excellent patient and graft survival after simultaneous pancreas and kidney transplant (SPK). Patient survival at three years was >90% in SPK as well as in solitary transplants. At 3 years post-transplant, SPK pancreas graft survival was over 86% and SPK kidney graft survival over 90%. In pancreas transplants alone (PTA) and in pancreas after kidney transplants, the 3-year graft function reached 75%. The main reasons for advancement in outcome were reductions in technical failures and immunological graft losses. These improvements were due to better patient and donor selection, standardization of surgical techniques, and superior immunosuppressive protocols.
自1966年首例胰腺移植手术以来,全世界已经进行了超过67000例胰腺移植手术,而且这个数字还在不断增长。虽然美国的器官移植数量在过去十年中变化不大,但美国以外的许多国家的移植数量都出现了强劲增长。世界范围内数量的增长是由于越来越多的2型糖尿病患者接受胰腺移植。只有在2020年和2021年的COVID-19大流行期间,移植数量才有所下降,但在2022年开始恢复。这种下降在单独移植中尤为明显。随着时间的推移,这种发展是由于同时进行胰腺和肾脏移植(SPK)后患者和移植物的良好生存。SPK和单独移植患者的3年生存率均为约90%。移植后3年,SPK胰腺移植存活率超过86%,SPK肾脏移植存活率超过90%。单独胰腺移植(PTA)和肾移植后胰腺3年移植功能达到75%。结果进步的主要原因是技术失败和免疫移植损失的减少。这些改善是由于更好的患者和供体选择,标准化的手术技术,和优越的免疫抑制方案。
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引用次数: 3
Evolving Treatment Options for Metastatic Renal Cell Carcinoma (mRCC) 转移性肾细胞癌(mRCC)治疗方案的演变
IF 0.5 Q4 MATHEMATICS, APPLIED Pub Date : 2023-04-01 DOI: 10.3390/uro3020014
Eun-mi Yu, M. Mudireddy, Ishan Patel, J. Aragon-Ching
Approximately a third of patients diagnosed with kidney cancer in the United States present with advanced disease and those who present with distant metastases historically had dismal 5-year relative survival. However, over the last several years, advancements have led to improved life expectancy and patient outcomes in those who develop advanced renal cell carcinoma. Metastatic clear cell renal cell carcinoma (mccRCC) treatment has rapidly evolved with multiple drug approvals since 2006. Moreover, multiple combination regimens including a vascular endothelial growth factor tyrosine kinase inhibitor (VEGF-TKI) plus immune checkpoint inhibitor (ICI) and the combination of ipilimumab plus nivolumab have supplanted first-line VEGF-TKI monotherapy. Thus, the insights we gained from prospective randomized controlled trials focusing on systemic therapy beyond first-line therapy in mRCC patients treated in the TKI monotherapy era quickly became less relevant with the adoption of contemporary first-line combination regimens. Herein, we will review contemporary first- and second-line therapies for mccRCC, as well as highly anticipated clinical trials looking into novel regimens beyond first-line therapy in patients who have received combination therapy.
在美国,大约三分之一被诊断为肾癌的患者表现为晚期疾病,而那些历史上表现为远处转移的患者的5年相对生存率很低。然而,在过去的几年里,技术的进步已经改善了晚期肾细胞癌患者的预期寿命和预后。自2006年以来,转移性透明细胞肾细胞癌(mccRCC)的治疗迅速发展,有多种药物获批。此外,包括血管内皮生长因子酪氨酸激酶抑制剂(VEGF-TKI)加免疫检查点抑制剂(ICI)和易普利姆单抗加纳沃单抗在内的多种联合治疗方案已经取代了一线VEGF-TKI单药治疗。因此,我们从前瞻性随机对照试验中获得的见解侧重于TKI单药治疗时代mRCC患者在一线治疗之外的全身治疗,很快与采用当代一线联合治疗方案变得不那么相关。在此,我们将回顾当代mccRCC的一线和二线治疗方法,以及在接受联合治疗的患者中寻找一线治疗之外的新方案的备受期待的临床试验。
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引用次数: 1
Current Knowledge on Radiation-Therapy-Induced Erectile Dysfunction in Prostate-Cancer Patients: A Narrative Review 前列腺癌患者放射治疗引起的勃起功能障碍的现状:一个叙述性的回顾
IF 0.5 Q4 MATHEMATICS, APPLIED Pub Date : 2023-04-01 DOI: 10.3390/uro3020013
Connie Labate, A. Panunzio, Francesco De Carlo, F. Zacheo, Sara De Matteis, M. Barba, U. Carbonara, F. Rizzo, S. Leo, S. Forte, P. Ditonno, A. Tafuri, V. Pagliarulo
Prostate cancer is the most frequently diagnosed cancer in men in the United States. Among the different available treatment options, radiation therapy is recommended for localized or even advanced disease. Erectile dysfunction (ED) often occurs after radiation therapy due to neurological, vascular, and endocrine mechanisms resulting in arterial tone alteration, pudendal-nerve neuropraxia, and lastly fibrosis. Considering the influence of quality of life on patients’ treatment choice, radiation-therapy-induced ED prevention and treatment are major issues. In this narrative review, we briefly summarize and discuss the current state of the art on radiation-therapy-induced ED in PCa patients in terms of pathophysiology and available treatment options.
前列腺癌是美国男性中最常见的癌症。在不同的可用治疗方案中,建议对局部甚至晚期疾病进行放射治疗。放射治疗后,由于神经、血管和内分泌机制导致动脉张力改变,阴部神经失用,最后发生纤维化,常发生勃起功能障碍。考虑到生活质量对患者治疗选择的影响,放射治疗性ED的预防和治疗是主要问题。在这篇叙述性的综述中,我们从病理生理学和可用的治疗方案方面简要地总结和讨论了前列腺癌患者放射治疗诱导ED的现状。
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引用次数: 0
Prostate Cancer: Advances in Genetic Testing and Clinical Implications 前列腺癌:基因检测和临床意义的进展
IF 0.5 Q4 MATHEMATICS, APPLIED Pub Date : 2023-03-24 DOI: 10.3390/uro3020012
A. Abdelrazek, K. Ghoniem, Mohamed E. Ahmed, Vidhu B. Joshi, Ahmed M. Mahmoud, Nader Saeed, N. Khater, M. Elsharkawy, A. Gamal, E. Kwon, A. Kendi
The demand for genetic testing (GT) for prostate cancer (PCa) is expanding, but there is limited knowledge about the genetic counseling (GC) needs of men. A strong-to-moderate inherited genetic predisposition causes approximately 5–20% of prostate cancer (PCa). In men with prostate cancer, germline testing may benefit the patient by informing treatment options, and if a mutation is noticed, it may also guide screening for other cancers and have family implications for cascade genetic testing (testing of close relatives for the same germline mutation). Relatives with the same germline mutations may be eligible for early cancer detection strategies and preventive measures. Cascade family testing can be favorable for family members, but it is currently unutilized, and strategies to overcome obstacles like knowledge deficiency, family communication, lack of access to genetic services, and testing expenses are needed. In this review, we will look at the genetic factors that have been linked to prostate cancer, as well as the role of genetic counseling and testing in the early detection of advanced prostate cancer.
前列腺癌(PCa)基因检测(GT)的需求正在扩大,但对男性遗传咨询(GC)需求的了解有限。强至中度遗传易感性导致约5-20%的前列腺癌(PCa)。对于患有前列腺癌的男性,生殖系检测可以通过告知治疗方案使患者受益,如果发现突变,它也可以指导其他癌症的筛查,并具有级联基因检测的家庭意义(对近亲进行相同生殖系突变的检测)。具有相同种系突变的亲属可能有资格获得早期癌症检测策略和预防措施。级联家庭检测可能对家庭成员有利,但目前尚未得到利用,需要采取策略克服知识缺乏、家庭沟通、缺乏获得遗传服务的机会和检测费用等障碍。在这篇综述中,我们将探讨与前列腺癌有关的遗传因素,以及遗传咨询和检测在早期发现晚期前列腺癌中的作用。
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引用次数: 1
Importance of Urodynamic Dysfunctions as Risk Factors for Recurrent Urinary Tract Infections in Patients with Multiple Sclerosis 尿动力功能障碍是多发性硬化症患者复发性尿路感染的危险因素
IF 0.5 Q4 MATHEMATICS, APPLIED Pub Date : 2023-03-14 DOI: 10.3390/uro3010011
M. Vírseda-Chamorro, J. Salinas‐Casado, J. Matías‐Guiu
Objective: To analyze the role of urodynamic dysfunctions as risk factors for recurrent urinary tract infections (rUTIs) in patients with multiple sclerosis (MS). Material and methods: We conducted a prospective cohort study of 170 patients with MS who underwent a urodynamic study due to lower urinary tract symptoms. Patients were followed for one year, and 114 (84 women [74%] and 30 men [26%]; mean age 49 years) completed the study. Clinical variables and urodynamic findings (free uroflowmetry, cystometry, and pressure-flow study results) were recorded. Results indicated rUTIs was present in 37 patients (32%). Statistical analysis was performed using Fisher’s exact test, chi-square test, Student’s t-test, and multivariate regression analysis. Results: In univariate analysis, significant differences were observed between patients with and without rUTIs for the following clinical variables: symptom progression time, MS duration, Expanded Disability Status Scale score, and MS type. Regarding urodynamic findings, significant differences were observed in maximum flow rate (Qmax) (lower in patients with rUTIs), voided volume, bladder voiding efficiency, stress urinary incontinence (SUI) (greater rUTI frequency in affected patients), detrusor pressure at maximum flow, and bladder contractility index score. Multivariate analysis identified the urodynamic factors: low Qmax [Odds Ratio (OR) = 0.90 and SUI (OR = 2.95) as the independent predictors of rUTs. Conclusions: Two urodynamic variables: Qmax and SUI, are independent risk factors for rUTIs in MS patients. These two variables might be associated with Pelvic floor dysfunctions.
目的:分析尿动力功能障碍在多发性硬化症(MS)患者复发性尿路感染(rUTIs)中的危险因素作用。材料和方法:我们对170例因下尿路症状而接受尿动力学研究的MS患者进行了一项前瞻性队列研究。随访1年,114例患者(女性84例[74%],男性30例[26%]);平均年龄49岁)完成研究。记录临床变量和尿动力学结果(自由尿流仪、膀胱术和压力-血流研究结果)。结果显示,37例(32%)患者存在ruti。统计学分析采用Fisher精确检验、卡方检验、Student’s t检验和多元回归分析。结果:在单因素分析中,ruti患者与非ruti患者在以下临床变量上存在显著差异:症状进展时间、MS持续时间、扩展残疾状态量表评分和MS类型。尿动力学方面,两组患者在最大流量(Qmax) (rUTI患者较低)、排尿量、膀胱排尿效率、应激性尿失禁(SUI) (rUTI患者频率较高)、最大流量时逼尿肌压力和膀胱收缩指数评分方面存在显著差异。多因素分析确定尿动力学因素:低Qmax[比值比(OR) = 0.90]和SUI (OR = 2.95)是rUTs的独立预测因素。结论:两个尿动力学变量:Qmax和SUI是MS患者rUTIs的独立危险因素。这两个变量可能与盆底功能障碍有关。
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引用次数: 0
Hospitalist Co-Management of Urethroplasty Patients in an Academic Center: Implementation of a Standardized Postoperative Care Model 学术中心泌尿道成形术患者的住院医师共同管理:标准化术后护理模式的实施
IF 0.5 Q4 MATHEMATICS, APPLIED Pub Date : 2023-03-02 DOI: 10.3390/uro3010010
Pegah Taheri, A. Tijerina, Sofia Gereta, Safiya-Hana Belbina, E. Osterberg
Objectives: to evaluate whether hospitalist co-management would lead to improved outcomes and value in patients undergoing urethroplasty (UPL) with a single surgeon for urethral stricture disease (USD). Material: A co-management model with hospitalists was introduced in August 2019 for all patients undergoing UPL for USD with a single surgeon in a United States teaching center. The hospitalist worked closely with the urologic surgeon and the support staff. The hospitalist managed post-operative concerns, such as pain and comorbidities, as well as conducted rounds with the urological team for disposition planning and addressing interdisciplinary needs. Retrospective analysis compared a 42-month period before initiation of co-management (Jan 2016–July 2019) with a 32-month period after initiation (Aug 2019–March 2022). Outcomes assessed were recurrence of stricture, complications, length of stay, readmission, and emergency room visits. Results: A total of 135 patients (71 surgeon-managed, 64 co-managed) underwent urethroplasty from January 2016 to March 2022. Hospitalist co-management did not affect complications, length of stay, readmission, and emergency room visits. Accounting for confounding variables using multivariable analysis, no factors were independently associated with recurrence. There were no demographic, comorbidity, or American Society of Anesthesiologists (ASA) score differences between the two groups. Conclusions: This study suggests that hospitalist care for patients undergoing urethroplasty may be non-inferior to surgeon care, based on similar outcomes between the two groups. There were no significant differences in the total length of stay or blood pressure readings, and the complication rates and hospital readmission rates were also similar.
目的:评价与一名外科医生共同治疗尿道狭窄疾病(USD)的患者行尿道成形术(UPL)是否会改善预后和价值。材料:2019年8月,在美国的一个教学中心,一名外科医生对所有接受UPL的患者引入了与医院的共同管理模式。住院医生与泌尿外科医生和辅助人员密切合作。住院医生处理术后问题,如疼痛和合并症,并与泌尿科团队进行查房,以制定处置计划和解决跨学科需求。回顾性分析比较了联合管理开始前的42个月(2016年1月- 2019年7月)和开始后的32个月(2019年8月- 2022年3月)。评估的结果是狭窄复发、并发症、住院时间、再入院和急诊室就诊。结果:2016年1月至2022年3月,共有135例患者(71例由外科医生管理,64例由共同管理)接受了尿道成形术。住院医师共同管理对并发症、住院时间、再入院和急诊室就诊没有影响。使用多变量分析计算混杂变量,没有因素与复发独立相关。两组之间没有人口统计学、合并症或美国麻醉医师协会(ASA)评分差异。结论:本研究表明,基于两组患者相似的结果,住院医生对接受尿道成形术患者的护理可能不逊于外科医生的护理。两组的总住院时间和血压读数没有显著差异,并发症发生率和再入院率也相似。
{"title":"Hospitalist Co-Management of Urethroplasty Patients in an Academic Center: Implementation of a Standardized Postoperative Care Model","authors":"Pegah Taheri, A. Tijerina, Sofia Gereta, Safiya-Hana Belbina, E. Osterberg","doi":"10.3390/uro3010010","DOIUrl":"https://doi.org/10.3390/uro3010010","url":null,"abstract":"Objectives: to evaluate whether hospitalist co-management would lead to improved outcomes and value in patients undergoing urethroplasty (UPL) with a single surgeon for urethral stricture disease (USD). Material: A co-management model with hospitalists was introduced in August 2019 for all patients undergoing UPL for USD with a single surgeon in a United States teaching center. The hospitalist worked closely with the urologic surgeon and the support staff. The hospitalist managed post-operative concerns, such as pain and comorbidities, as well as conducted rounds with the urological team for disposition planning and addressing interdisciplinary needs. Retrospective analysis compared a 42-month period before initiation of co-management (Jan 2016–July 2019) with a 32-month period after initiation (Aug 2019–March 2022). Outcomes assessed were recurrence of stricture, complications, length of stay, readmission, and emergency room visits. Results: A total of 135 patients (71 surgeon-managed, 64 co-managed) underwent urethroplasty from January 2016 to March 2022. Hospitalist co-management did not affect complications, length of stay, readmission, and emergency room visits. Accounting for confounding variables using multivariable analysis, no factors were independently associated with recurrence. There were no demographic, comorbidity, or American Society of Anesthesiologists (ASA) score differences between the two groups. Conclusions: This study suggests that hospitalist care for patients undergoing urethroplasty may be non-inferior to surgeon care, based on similar outcomes between the two groups. There were no significant differences in the total length of stay or blood pressure readings, and the complication rates and hospital readmission rates were also similar.","PeriodicalId":44555,"journal":{"name":"Trudy Instituta Matematiki i Mekhaniki UrO RAN","volume":"16 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77863737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Асимптотика решения задачи оптимального управления с интегральным выпуклым критерием качества, дешевым управлением и возмущением начальных данных 最佳管理问题的渐近线,具有集成质量标准、廉价管理和原始数据扰动。
Q4 MATHEMATICS, APPLIED Pub Date : 2023-03-01 DOI: 10.21538/0134-4889-2023-29-1-67-76
А. Р. Данилин, А. А. Шабуров
УДК 517.977 MSC: 49N05, 93C70 DOI: 10.21538/0134-4889-2023-29-1-67-76 Рассматривается задача оптимального управления для линейной системы с постоянными коэффициентами с интегральным выпуклым критерием качества, содержащим два малых параметра (один — при интегральном слагаемом, другой — в начальных условиях), в классе кусочно–непрерывных управлений с гладкими геометрическими
udk 517977 MSC: 49N05, 9370 DOI: 1021538 / 0189 / 20889 / 20889 / 20889 / 20889 / 20889 / 20889 / 20889 / 20889 / 2889 / 20889 / 2889 / 2029 -67-76考虑了线性系数的最佳管理任务,其中包括两个小参数(一是积分值,一是初始条件)
{"title":"Асимптотика решения задачи оптимального управления с интегральным выпуклым критерием качества, дешевым управлением и возмущением начальных данных","authors":"А. Р. Данилин, А. А. Шабуров","doi":"10.21538/0134-4889-2023-29-1-67-76","DOIUrl":"https://doi.org/10.21538/0134-4889-2023-29-1-67-76","url":null,"abstract":"УДК 517.977 MSC: 49N05, 93C70 DOI: 10.21538/0134-4889-2023-29-1-67-76 Рассматривается задача оптимального управления для линейной системы с постоянными коэффициентами с интегральным выпуклым критерием качества, содержащим два малых параметра (один — при интегральном слагаемом, другой — в начальных условиях), в классе кусочно–непрерывных управлений с гладкими геометрическими","PeriodicalId":44555,"journal":{"name":"Trudy Instituta Matematiki i Mekhaniki UrO RAN","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136390336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
О cинтезе управлений в задаче усиленного уклонения для линейных многошаговых систем 论线性多步系统强化偏差问题中的控制集成
IF 0.5 Q4 MATHEMATICS, APPLIED Pub Date : 2023-03-01 DOI: 10.21538/0134-4889-2023-29-1-111-126
Е. К. Костоусова
{"title":"О cинтезе управлений в задаче усиленного уклонения для линейных многошаговых систем","authors":"Е. К. Костоусова","doi":"10.21538/0134-4889-2023-29-1-111-126","DOIUrl":"https://doi.org/10.21538/0134-4889-2023-29-1-111-126","url":null,"abstract":"","PeriodicalId":44555,"journal":{"name":"Trudy Instituta Matematiki i Mekhaniki UrO RAN","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44229233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Trudy Instituta Matematiki i Mekhaniki UrO RAN
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