Disaster recovery after Hurricane Maria in Puerto Rico: Assessment using Endsley's three-level model of situational awareness.

This paper uses Endsley's three-level model of situational awareness to analyse the challenges faced by the Federal Emergency Management Agency (FEMA) when coordinating the relief efforts in Puerto Rico after Hurricane Maria made landfall. Most obviously, obtaining data about the impacted area was highly challenging, making it much harder to comprehend the magnitude of the event. In turn, this made it difficult to know where to focus recovery efforts as the event unfolded.

Reversal of resistance to pyriproxyfen in the Q biotype of Bemisia tabaci (Hemiptera: Aleyrodidae).

Pyriproxyfen, a juvenile hormone (JH) mimic, is a biorational insecticide that disrupts insect development. It is one of the principal insecticides being used to control Bemisia tabaci (Gennadius) on cotton, and has many environmentally positive attributes that make it compatible with integrated pest management (IPM) programs. In Israel, a high level of resistance to pyriproxyfen has been observed in several isolated regions.

Safety and efficacy of sildenafil in postmenopausal women with sexual dysfunction.

Objectives: Sildenafil has been demonstrated to be safe and effective in the treatment of men with erectile dysfunction. The role of sildenafil in treating women with sexual dysfunction has heretofore not been reported. The purpose of this preliminary study was to ascertain the response of postmenopausal women with self-described sexual dysfunction treated with sildenafil for 3 months.

Transurethral resection of the prostate versus transurethral electrovaporization of the prostate: a blinded, prospective comparative study with 1-year followup.

Purpose: Transurethral electrovaporization of the prostate has been increasingly used as a surgical adjunct in the management of men with lower urinary tract symptoms. In this prospective study we compare the safety and efficacy of transurethral resection of the prostate and electrovaporization.

Materials And Methods: We compared 32 consecutive men (mean age 68.

The limited impact of involved surface area and surgical débridement on survival in Fournier's gangrene.

Objective: To evaluate the influence of involved surface area (extent of disease) and the number and timing of surgical débridements on survival in patients with Fournier's gangrene.

Patients And Methods: The medical records of 30 patients with Fournier's gangrene treated over a 15-year period were reviewed. The extent of disease was quantified and expressed as a percentage of the body surface area by applying a modified diagram used to assess burn injuries.

Outcome prediction in patients with Fournier's gangrene.

We treated 30 patients with Fournier's gangrene during a 15-year period. Data were collected on demographics, medical history, admission signs and symptoms, physical examination, admission laboratory studies and bacteriology. The timing and degree of surgical débridement as well as antibiotic therapy were also reviewed.

Prostate cancer screening using fine-needle aspiration cytology prior to open prostatectomy.

We performed a prospective study to evaluate fine-needle aspiration (FNA) cytology as a screening tool of carcinoma of the prostate in 159 men with normal digital rectal examinations and acid phosphatase prior to open prostatectomy for voiding symptoms. The incidence of carcinoma of the prostate was 5.6%.

Distribution and variability of resistive index values in undilated kidneys in children.

Objectives: To assess better the utility of duplex Doppler sonography in the diagnosis of obstructive hydronephrosis in children, we specifically studied undilated urinary tracts with the intention of establishing a nomogram of resistive index (RI) values and determining if the RI value of 0.7 reliably precludes an undilated collecting system.

Methods: Renal duplex Doppler ultrasound was performed in a standard fashion on 47 children more than 12 months of age (93 renal units) where there was no suspicion of upper urinary tract dilation.

Unusual case of renal Candida fungus balls.

Renal fungus balls are rare in the adult population. A case of asymptomatic renal pelvic fungus balls is presented, and several approaches to treatment are discussed.

Simplified gonadotropin-releasing hormone (GnRH) stimulation test.

Provocative gonadotropin-releasing hormone (GnRH) stimulation testing indirectly assesses testicular function with more sensitivity than determination of basal gonadotropin levels alone. Unfortunately, the drawbacks of multiple blood sampling and high cost have limited the clinical usefulness of this test. We herein present a simplified, two-point, thirty-minute GnRH stimulation test.

Unilateral testicular torsion: abnormal histological findings in the contralateral testis--cause or effect?

A histological review of testicular biopsies of the contralateral testis, obtained at the time of surgical intervention for testicular torsion, was performed in 20 post-pubertal men. Contralateral histological abnormalities were found in 12 specimens. The duration of torsion correlated well with the viability of the involved testis but not with the presence of contralateral abnormalities.

Paravesical granulomas masquerading as bladder neoplasms: late complications of inguinal hernia repair.

Paravesical granuloma formation after inguinal herniorrhaphy is a rare complication due to infected suture material. We present 8 cases of large paravesical granulomas masquerading as bladder tumors. Irritable symptoms predominate the symptom complex and accurate diagnosis can be obtained with multiple, sonographically guided, needle biopsies of the mass.

Detection of testicular endocrine abnormalities and their correlation with serum antisperm antibodies in men following vasectomy.

We measured the serum gonadotropin response to gonadotropin-releasing hormone in 25 men who underwent vasectomy 2 to 64 months before the study. Ten age-matched fertile men were used as controls. Baseline serum follicle-stimulating hormone, luteinizing hormone and testosterone levels were not significantly different between vasectomized men and controls.

Gonadal dysfunction after testicular torsion: luteinizing hormone and follicle-stimulating hormone response to gonadotropin releasing hormone.

We studied 14 postpubertal patients at an average of 33 months after treatment for testicular torsion. Of these patients 11 had been treated by detorsion and 3 by orchiectomy. Five normal male volunteers of the approximate age of the study group served as controls.

Continence mechanisms following transphincteric urethroplasty.

Urinary continence mechanisms were studied in 6 patients, 5 of whom had undergone end-to-end urethroplasty for membranous urethral strictures. All patients were able to interrupt the urinary stream on command by contracting the distal intrinsic sphincteric mechanism, despite an absent extrinsic sphincter. In 2 patients with prostatectomy and transphincteric urethroplasty, the intrinsic sphincteric mechanism was the sole remaining sphincter.

Urachal remnants in adults.

Urachal disorders are uncommon and present with varied appearances. Three cases of urachal disease, one congenital and two acquired, are reported. Each case is representative of the symptoms and findings of its respective category.

Unstable bladder: urodynamic diagnosis and observations in evaluating urinary incontinence in the female.

Unstable bladder in the female has been the subject of controversy with regard to its etiology, identification, and treatment. One hundred thirty consecutive female patients referred with incontinence were evaluated as to their symptoms and urodynamic findings. A stress cystometrogram, systematically done, was introduced and observations were made regarding certain findings on the urodynamic examination.

Role of urodynamics in management of urethral diverticulum in females.

This report deals with 10 female patients with urethral diverticula, 8 of whom were also found to have findings of stress incontinence. This association was proved by urodynamic studies. Three patients were seen with incontinence postdiverticulectomy.

On percutaneous drainage of retroperitoneal collections: when is primary surgical drainage preferable?

Percutaneous drainage of retroperitoneal collections is a method employed with an ever-increasing frequency. The indication for primary surgical drainage of these collections is rapidly decreasing. Herein we describe what we consider to be the indications for primary surgical drainage of retroperitoneal collections illustrated by the recurrence of the abscess in 3 of our patients following adequate primary percutaneous drainage.

Influence of indwelling urinary tract stones on twenty-four-hour urine chemistries.

Twenty-two patients with ureteral stones underwent twenty-four-hour urinary excretion studies of calcium, phosphorus, and uric acid before and after stone elimination from the urinary tract. Comparison of pre- and post-stone elimination studies showed no significant differences suggesting that the presence of stones in the urinary tract has little influence on the twenty-four-hour urinary excretion of calcium, phosphorus, and uric acid.

Intraoperative profilometry.

Intraoperative profilometry measurements were done on 28 patients during various types of urethropexy to determine whether useful information could be provided to the operating surgeon. Successful Burch, Marshall-Marchetti and Stamey-Pereyra procedures resulted in a 50 per cent increase in urethral length. Closure pressure increases were noted only with the Stamey-Pereyra procedure (plus 49 per cent).

Androgen receptors in bladder tumors.

Cytosol androgen receptor content of transitional cell bladder cancer tissue was found to be substantially higher than its content in normal bladder mucosa and lower than in control benign prostatic hypertrophy tissue. Tumors arising in female patients had a lower androgen receptor content than those arising in male patients. High-grade tumors had a lower androgen receptor content than low-grade tumors.