previous negative biopsy, and continued suspicion of prostate cancer, we are seeing an increased utilization on mpMRI in biopsy naive men. We performed a systematic review and meta-analysis of prospective studies looking at the performance of mpMRI on prostate cancer detection in men who had never undergone a previous biopsy of the prostate.METHODS: We searched the Pubmed, Embase and Cochrane databases for studies assessing the performance of mpMRI on prostate cancer detection at biopsy. Studies were included if they were prospective, included only patients with no previous prostate biopsy, and reported biopsy outcomes for all patients including those with a negative mpMRI. Each mpMRI was classified as either positive or negative for suspicion of prostate cancer. We used standard methods recommended for meta-analyses of diagnostic test evaluation and reported the pooled sensitivity, specificity, and positive and negative likelihood ratios for mpMRI on the detection of any and clinically significant prostate cancer (csPCa). csPCa was defined according to the definition used in each paper, which was usually any Gleason 7 or a minimum length of Gleason 6. Summary receiver operating characteristic (SROC) curves were used to assess the performance of mpMRI on prostate cancer detection.RESULTS: Ten studies met the inclusion criteria comprising 2,194 patients. If a biopsy was only to be performed in men with a positive mpMRI, then 7.4 to 58.5% of biopsies could have been avoided, with only 2.3-36% of cancers and 6.3-30.8% of csPCa being missed. Of the ten studies we found, nine had data available for a metaanalysis of any prostate cancer and five had data available for a metaanalysis of csPCa. For any prostate cancer, the pooled sensitivity and specificity were 0.83 (95% CI, 0.75-0.88), and 0.71 (0.46-87), while the positive and negative likelihood ratio were 2.9 (1.3-6.0) and 0.23 (0.15-0.35), respectively. The AUC for any prostate cancer detection was 0.87 and the diagnostic odds ratio (DOR) was 12.3 (4.3-34.7). For csPCa, the pooled sensitivity and specificity was 0.83 (0.75-0.88) and 0.58 (0.46e0.69), while, the positive and negative likelihood ratio was 2 (CI, 1.5-2.5), and 0.28 (0.19-0.39), respectively. The AUC for csPCa detection was 0.66 and the DOR was 7.1 (4.5-11.1).CONCLUSIONS: A meta-analysis of prospective studies in men with no previous biopsy of the prostate confirms that mpMRI of the prostate accurately detects prostate cancer and can help avoid unnecessary biopsies.

A low-cost smart sensor GNSS system has been developed to provide accurate real-time position and orientation measurements on a floating offshore wind platform. The approach chosen to offer a viable and reliable solution for this application is based on the use of the well-known advantages of the GNSS system as the main driver for enhancing the accuracy of positioning. For this purpose, the data reported in this work are captured through a GNSS receiver operating over multiple frequency bands (L1, L2, L5) and combining signals from different constellations of navigation satellites (GPS, Galileo, and GLONASS), and they are processed through the precise point positioning (PPP) and real-time kinematic (RTK) techniques. Furthermore, aiming to improve global positioning, the processing unit fuses the results obtained with the data acquired through an inertial measurement unit (IMU), reaching final accuracy of a few centimeters. To validate the system designed and developed in this proposal, three different sets of tests were carried out in a (i) rotary table at the laboratory, (ii) GNSS simulator, and (iii) real conditions in an oceanic buoy at sea. The real-time positioning solution was compared to solutions obtained by post-processing techniques in these three scenarios and similar results were satisfactorily achieved.

No abstract

El cáncer de próstata es el tipo de cáncer más frecuente diagnosticado en los hombres. Específicamente en Estados Unidos, corresponde a la segunda causa de muerte por cáncer. El uso generalizado de antígeno prostático específico desde principios de la década de 1990 ha aumentado significativamente su incidencia. Sin embargo, el cribado del cáncer de próstata sigue siendo uno de los temas más controvertidos en la literatura urológica. La evidencia científica más reciente sugiere que el cribado no afecta la mortalidad por todas las causas y solo un pequeño efecto en la mortalidad específica de la próstata. Al mismo tiempo, existen riesgos asociados con la biopsia y el tratamiento del cáncer de próstata, como incontinencia urinaria, infección y disfunción eréctil. Las recomendaciones actuales proponen la toma de decisiones compartida con los hombres, aunque existen diferencias notables, especialmente en lo que respecta a las edades adecuadas de detección y los intervalos de seguimiento.

ureterolysis/omental wrap procedure for presumed retroperitoneal fibrosis after failed medical management. Fibrosis was isolated to the region of a tortuous left iliac artery, which was likely due to trauma from a prior femoral artery catheterization during a cardiac procedure. The ureter was freed of fibrotic attachments and covered with an omental wrap. The patient did well for 1 year, but eventually developed recurrent ureteral obstruction with a 6cm mid/upper ureteral stricture requiring nephrostomy drainage and stent. He elected to undergo BMG ureteroplasty. For both robotic procedures, the patient was positioned in modified lateral decubitus lithotomy position with ports similar to a pyeloplasty. For the ureteroplasty, the mouth was prepped separately for BMG harvest. Ureteroscopy and near-infrared fluorescence were used to define the proximal and distal extent of the stricture. The stricture was measured and the BMG was harvested accordingly. A ureterotomy was made along the length of the stricture over the ureteroscopy. The BMG was sewn to the ureteral edges as an onlay patch. Ureteroscopy was used to confirm patency and a stent was placed. An omental wrap was sutured over the ureter and BMG for blood supply.RESULTS: The patient underwent an uncomplicated ureterolysis procedure with an EBL of 75cc, OR time of 280 minutes, and a hospital stay of 3 days. He is doing well with followup <1 year with no complications or evidence of obstruction.CONCLUSIONS: We describe a case of robotic ureterolysis followed by robotic BMG ureteroplasty in the same patient. Robotic BMG ureteroplasty is an option for patients with long ureteral strictures with proximal extent, and is an alternative to autotransplantation or ileal ureter.