A study was conducted to compare results of transrectal ultrasound with pathologic findings on 116 patients who underwent radical prostatectomy for treatment of prostate cancer. In 96% (111 of 116), transrectal ultrasound guided biopsies of a hypoechoic lesion proved cancer; seven patients had known Stage A cancer; one patient had cancer detected by palpation and not detected by ultrasound. Cancers in the outer gland (peripheral and central zones) were compared with cancers in the inner gland (transition zone) by both ultrasound and pathology. Forty-eight percent (52 of 108) of cancers originating in the outer gland showed extraprostatic extension (Stage C disease). The primary sites of tumor escape from the outer gland were the prostatic capsule (38%), anterior fibromuscular stroma (5%), seminal vesicle (18%), the base of the gland at the neurovascular bundle (21%), and the apex (31%). Twenty-two percent (17 of 54) of cancers originating in the inner gland (transition zone) showed extraprostatic extension (Stage C disease). The primary sites of tumor escape from the inner gland were the anterior fibromuscular stroma (6%) and apex (11%). Both histologic and biologic differences between outer and inner gland cancers were found when tumor size was controlled. Gleason scores were significantly different for inner and outer gland cancers, with mean scores of 6.2 +/- 1.6 and 7.4 +/- 0.9, respectively. An odds ratio of 8.6 confirmed the increased risk of extraprostatic extension for outer gland cancer. Outer gland cancers showed increased aggressive behavior of both histologic and biologic nature. The difference in biologic aggressiveness of outer and inner gland cancers has definite implications for treatment options. Use of other diagnostic parameters, such as DNA ploidy, may help to determine which cancers to treat and when to treat them; this may have more relevance for cancers originating in the inner gland. Strategic transrectal ultrasound guided biopsy affords accurate tumor mapping and staging when modes of internal spread and escape of cancer from both outer and inner gland are known. Thus, transrectal ultrasound may be our "window of observation" through which additional research may explain the histologic and biologic discrepancies between outer and inner gland cancers.
The aim of this paper is to present evidence on the effects on wellbeing of providing a basic dwelling on-site to households living in situations of extreme poverty in urban slums. In particular, the paper evaluates the impact of the NGO TECHO's emergency housing programme in informal settlements of Buenos Aires, Argentina. Using a quasi-experimental pipeline approach, the paper shows that the programme has a large effect on privacy, security, interpersonal relations, psychological wellbeing and perception of quality of life. In health the program only produces a reduction in the prevalence of cough and congestion. While indicators of sleep quality improve, the effects are not statistically significant after adjusting for multiple hypothesis testing. Additionally, the programme increases the likelihood that households with school age children have a tranquil place to study, evidence that the programme could broaden children's long-term opportunities.
The objective of this paper is to analyze the historical roots and contribution to human development of civil society organizations in marginalized communities based on fieldwork undertaken in seven informal settlements of the City of Buenos Aires, Argentina. The paper provides evidence of a dense network of organizations whose principal function is the provision of social services, especially food assistance, through a complementary relationship with the state. The current effectiveness of the settlements' representative organizations-the principal vehicles through which community members voice their collective demands-is limited by a mix of factors intimately related to civil society-state relations, including irregularities in election processes, conflicts between organizations and lack of transparency in the allocation of public resources. The paper concludes that true empowerment of these communities to act as a unified force for change requires the strengthening of neighborhood organizations and greater government openness to civil society participation in public decision-making processes.
She specializes in the analysis of diverse social topics, including multidimensional poverty, education, civil society and the evaluation of social programmes.Jimena Macció has a doctorate in Economics from the Universidad de Buenos Aires and is Professor of Econometrics in the Department of Economics of the Pontificia Universidad Católica Argentina. She also holds a position in the Unit for Evaluation of Educational Quality and Equity of the Government of the City of Buenos Aires. She specializes in quantitative analysis of social topics, with a focus on multidimensional poverty and education.
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