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1.
Introduction
Tamsulosin is an α-1A-specific blocker inducing selective relaxation of ureteral smooth muscle and inhibition of ureteral spasms leading to ureteral dilatation that can facilitates retrograde ureterorenoscopy (URS).Objective
To assess the efficacy of tamsulosin in improving the outcome of URS management of lower ureteral stones.Patients and methods
This prospective, randomised, controlled, clinical trial was carried out between June 2011 and December 2014. It included 98 patients with lower ureteral stones scheduled for treatment with URS. Before URS, patients were randomly divided into 2 groups; study group including 51 patients, in which pre-URS daily oral dose of tamsulosin 0.4 mg tab, for 1 week, was given and control group including 47 patients who received no additional therapy rather than standard analgesic on demand. The URS outcomes were evaluated and compared between both groups.Results
The demographic and stone characteristics were comparable between both groups. The mean URS time was significantly shorter in study group than in control group (52.0 ± 14.9 min vs. 71.0 ± 17.3 min; p = 0.039). Of the 98 patients, 89 (90.81%) had a successful URS procedures. The success rate was 94.1% (98/51) in study group compared 89.2% (58/65) in the control group, with statistically significant difference (p = 0.045). The major complications occurred in 4.25% of patients in control group but in only 1.96% of those received tamsulosin (p = 0.034).Conclusion
Post-tamsulosin ureteroscopy was easier and safer; leading to significantly increased stone-free rates and fewer complications. 相似文献2.
D.E. Orakwe K.H. Tijani E.A. Jeje M.A. Ogunjimi R.W. Ojewola 《The African Journal of Urology》2017,23(2):105-108
Objectives
To compare serum testosterone and prostate specific antigen (PSA) levels of patients diagnosed of prostate cancer to those with benign prostatic hyperplasia (BPH).Subjects and methods
One hundred and thirteen male patients with or without LUTS who had indication(s) for prostate biopsies were recruited. Blood samples were analysed for serum testosterone and serum PSA. Prostate sizes were measured and PSA densities calculated before trans-rectal prostate biopsies were performed.Results
On histology of prostate biopsy specimens, 54 patients (47.8%) had prostate adenocarcinoma while 59 patients (52.2%) had BPH. Serum testosterone levels were lower in the prostate cancer group (23.09 ± 2.31 nmol/L versus 24.37 ± 1.94 nmol/L in the BPH group) but this difference was not statistically significant (p = 0.671). Serum testosterone also did not differ significantly with Gleason grade and Gleason score in patients with prostate cancer.Serum PSA and PSA density (PSAD) values were significantly higher in men with prostate cancer, and also in prostate cancer patients with high grade disease.Conclusion
Serum testosterone levels of patients with prostate cancer did not significantly differ from those of patients with BPH and were not related to grade in prostate cancer patients. 相似文献3.
Boris Gershman Holly K. Van Houten Jeph Herrin Daniel M. Moreira Simon P. Kim Nilay D. Shah R. Jeffrey Karnes 《European urology》2017,71(1):55-65
Background
Prostate biopsy and postbiopsy complications represent important risks of prostate-specific antigen (PSA) screening. Although landmark randomized trials and updated guidelines have challenged routine PSA screening, it is unclear whether these publications have affected rates of biopsy or postbiopsy complications.Objective
To evaluate whether publication of the 2008 and 2012 US Preventive Services Task Force (USPSTF) recommendations, the 2009 European Randomized Study of Screening for Prostate Cancer and the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, or the 2013 American Urological Association (AUA) guidelines was associated with changes in rates of biopsy or postbiopsy complications, and to identify predictors of postbiopsy complications.Design, setting, and participants
This quasiexperimental study used administrative claims of 5 279 315 commercially insured US men aged ≥40 yr from 2005 to 2014, of whom 104 584 underwent biopsy.Interventions
Publications on PSA screening.Outcome measurements and statistical analysis
Interrupted time-series analysis was used to evaluate the association of publications with rates of biopsy and 30-d complications. Logistic regression was performed to identify predictors of complications.Results and limitations
From 2005 to 2014, biopsy rates fell 33% from 64.1 to 42.8 per 100 000 person-months, with immediate reductions following the 2008 USPSTF recommendations (?10.1; 95% confidence interval [CI], ?17.1 to ?3.0; p < 0.001), 2012 USPSTF recommendations (?13.8; 95% CI, ?21.0 to ?6.7; p < 0 .001), and 2013 AUA guidelines (?8.8; 95% CI, ?16.7 to ?0.92; p = 0.03). Concurrently, complication rates decreased 10% from 8.7 to 7.8 per 100 000 person-months, with a reduction following the 2012 USPSTF recommendations (?2.5; 95% CI, ?4.5 to ?0.45; p = 0.02). However, the proportion of men undergoing biopsy who experienced complications increased from 14% to 18%, driven by nonsepsis infectious complications (p < 0.001). Predictors of complications included prior fluoroquinolone use (odds ratio [OR]: 1.27; 95% CI, 1.22–1.32; p < 0.001), anticoagulant use (OR: 1.14; 95% CI, 1.04–1.25; p = 0.004), and age ≥70 yr (OR: 1.25; 95% CI, 1.15–1.36; p < 0.001). Limitations included the retrospective design.Conclusions
Although there has been an absolute reduction in rates of biopsy and 30-d complications, the relative morbidity of biopsy continues to increase. These observations suggest a need to reduce the morbidity of biopsy.Patient summary
Absolute rates of biopsy and postbiopsy complications have decreased following landmark publications about prostate-specific antigen screening; however, the relative morbidity of biopsy continues to increase. 相似文献4.
A. Nayman I. Yildiz N. Koca S. Deniz M. Koplay L. Oguzkurt 《Diagnostic and interventional imaging》2017,98(1):29-36
Purpose
The purpose of this study was to determine the occlusion rate of incompetent great saphenous veins (GSVs) and small saphenous veins (SSVs) treated with radiofrequency ablation (RFA) and individualize variables associated with recanalization.Materials and methods
A retrospective review of 311 veins (256 GSVs and 55 SSVs) in 211 patients [177 women, 34 men; mean age, 45 years ± 12 (SD) (range: 18–75 years)] with incompetent GSVs and/or SSVs who were treated using new-generation RFA catheters was performed. The clinical results, occlusion rates, and variables associated with recanalization for the incompetent GSVs and SSVs were analyzed.Results
No major complications were observed in the study population. Ten months after RFA, the occlusion rate was 89% (227/256) for GSVs and 91% (50/55) for SSVs. An increased pre-procedure diameter of the incompetent GSVs was associated with a higher rate of recanalization (OR: 0.825; 95% CI: 0.715–0.952) (P < 0.05). No significant differences in age, gender, and side of treated veins were found between patients with recanalization of treated veins and those without recanalization.Conclusion
Our results show that pre-procedure diameter of the GSV is the single risk factor for recanalization after RFA. 相似文献5.
Barbara Bosch Diana Bilton Patrick Sosnay Karen S. Raraigh Denise Y.F. Mak Hiroshi Ishiguro Vincent Gulmans Muriel Thomas Harry Cuppens Margarida Amaral Kris De Boeck 《Journal of cystic fibrosis》2017,16(4):488-491
Background
The diagnosis of Cystic Fibrosis (CF) is by consensus based on the same parameters in all patients, yet the influence of ethnicity has only scarcely been studied. We aimed at elucidating the impact of Asian descent on the diagnosis of CF.Methods
We performed a retrospective analysis of the CFTR2 and UK CF databases for clinical phenotype, sweat chloride values and CFTR mutations and compared the diagnostic characteristics of Asian to non-Asian patients with CF.Results
Asian patients with CF do not have a worse clinical phenotype. The repeatedly reported lower FEV1 of Asian patients with CF is attributable to the influence of ethnicity on lung function in general. However, pancreatic sufficiency is more common in Asian patients with CF. The diagnosis of CF in people with Asian ancestry is heterogeneous as mean sweat chloride values are lower (92 ± 26 versus 99 ± 22 mmol/L in controls) and 14% have sweat chloride values below 60 mmol/L (versus 6% in non-Asians). Also, CFTR mutations differ from those in Caucasians: 55% of British Asian patients with CF do not have one mutation included in the routine newborn screening panel.Conclusions
Bringing together the largest cohort of patients with CF and Asian ethnicity, we demonstrate that Asian roots impact on all three CF diagnostic pillars. These findings have implications for clinical practice in the increasingly ethnically diverse Western population. 相似文献6.
Dominique Hubert Raphaël Chiron Boubou Camara Dominique Grenet Anne Prévotat Laurence Bassinet Stéphane Dominique Gilles Rault Julie Macey Isabelle Honoré Reem Kanaan Sylvie Leroy Nadine Desmazes Dufeu Pierre-Régis Burgel 《Journal of cystic fibrosis》2017,16(3):388-391
Objective
To investigate the short-term adverse events and effectiveness of lumacaftor/ivacaftor combination treatment in adults with cystic fibrosis (CF) and severe lung disease in a real life setting.Methods
A multicentre observational study investigated adverse events, treatment discontinuation, FEV1 and body mass index (BMI) one month and three months after lumacaftor/ivacaftor initiation in adults with CF and FEV1 below 40% predicted.Results
Respiratory adverse events (AEs) were reported by 27 of 53 subjects (51%) and 16 (30%) discontinued treatment. The mean absolute change in FEV1 was + 2.06% after one month of treatment (P = 0.086) and + 3.19% after 3 months (P = 0.009). BMI was unchanged.Conclusions
Treatment with lumacaftor/ivacaftor in patients with CF and severe lung disease was discontinued more frequently than reported in clinical trials, due to respiratory AEs. Nevertheless, the patients who continued treatment had an increase in lung function comparable to what was observed in pivotal trials. 相似文献7.
Zhao-Kai Low Wai-Yee Ng Stephanie Fook-Chong Bien-Keem Tan Si-Jack Chong Jolie Hwee Sook-Muay Tay 《Burns : journal of the International Society for Burn Injuries》2017,43(2):436-444
Objective
Diabetic burns patients may be at risk of worse clinical outcomes. This study aims to further investigate the impact of diabetes mellitus on clinical outcomes in burns patients in Singapore.Methods
A 3-year retrospective review was performed at the Singapore General Hospital Burns Centre (2011–2013). Pure inhalational burns were excluded. Diabetic (N = 53) and non-diabetic (N = 533) patients were compared, and the impact of diabetes on clinical outcomes, adjusting for confounders, was investigated using multivariate logistic regression.Results
The diabetic group had a significantly higher incidence of wound infection and severe renal impairment, as well as a longer length of stay, higher number of operations and higher rate of unplanned readmission. ICU admission was significantly associated with hyperglycaemia (OR 5.44 [2.61–11.35], p < 0.001) and a higher total body surface area of burn (OR per 1% TBSA 1.07 [1.05–1.09], p < 0.001). Unplanned readmission was significantly associated with wound infection (OR 4.29 [1.70–10.83], p = 0.002), and mortality associated with a higher TBSA (OR per 1% TBSA 1.1 [1.07–1.14], p < 0.001). After adjusting for confounders, diabetes mellitus was not significantly associated with unplanned readmission or mortality.Conclusions
Diabetic burns patients have an increased risk of worse clinical outcomes, including wound infections, renal impairment and longer length of stay. 相似文献8.
O. Abdelkader K. Mohyelden M.H. Sherif A.H. Metwaly H. Aldaqadossi A. Shelbaya H. Khairy A. Elnashar 《The African Journal of Urology》2017,23(1):28-32
Objectives
To compare the role of alpha-blocker (Tamsulosin) monotherapy, anticholinergic (Tolterodine) monotherapy or combination of both drugs versus analgesics in improving post-ureteroscopy (URS) lower urinary tract symptoms related to double-J ureteral stent.Patients and methods
Between January 2009 and June 2013, 160 consecutive patients with ureteric stones were included in this study at 2 tertiary care centers’. Patients were randomized into 4 groups; group A (n = 40) received 0.4 mg Tamsulosin once a day, group B (n = 40) received 4 mg Tolterodine once a day, group C (n = 40) received Tamsulosin 0.4 mg and Tolterodine 4 mg once a day and group D (n = 40) as a control group, received placebo once a day. All patients received analgesics on demand. Pre-treatment evaluation was done followed by among-groups comparison after 14 days including ureteral stent symptom questionnaire (USSQ) [Urinary symptom index (USI), pain symptom index (PSI), general health index (GHI), work perform index (WPI), need for pain killer (PK), need for analgesia, visual analogue scale (VAS) for pain and quality of life (QOL)]. Side effects were recorded and compared.Results
Out of 160 patients, 153 patients (40, 38, 37 and 38 patients in groups A, B, C and D, respectively) completed the study with a mean age of 34.3 ± 7.6 (20–50) years. All groups were comparable in terms of age, gender, stone size and stone location, USSQ items and QOL. After 14 days, the USSQ and QOL were significantly lower in group A, B and C in comparison with group D (p < 0.05). Patients in group C had significantly much improvement than those of groups A and B (p < 0.05).Conclusion
Combination of alpha blockers (Tamsulosin) and Anticholinergics (Tolterodine) seems to significantly improve post-URS lower urinary tract symptoms secondary to ureteral stents with lower need for analgesia and better quality of life. Adverse effect of used drugs mentioned as transient and tolerated by the patients without need for auxiliary medication. 相似文献9.
K.H. Tijani C.C. Anunobi A.O. Adeyomoye T.O. Alabi A.O. Lawal N.O. Akanmu R.W. Ojewola O.O. Soriyan 《The African Journal of Urology》2017,23(1):14-19
Introduction
In Western and Asian literature, the measurement of percentage free prostate specific antigen (%fPSA) has been known to enhance the predictive role of total prostate specific antigen (tPSA) in early prostate cancer (Ca-P) detection. Relationship between the tPSA and Ca-P are known to be influenced by race. To the best of our knowledge, the relationship between %fPSA and Ca-P has not been studied in sub-Saharan Africa using current established biopsy protocol.Objective
To evaluate the usefulness of %fPSA in indigenous West African men and determine the appropriate cut-off values that may be used as indication for prostate biopsy in men with tPSA of 4–10 ng/ml.Subjects and methods
A total 169 consecutive patients with tPSA of 4–10 ng/ml with non-suspicious findings on digital rectal examination (DRE) had a transrectal ultrasound (TRUS) guided 10-core prostate biopsy. The technique of PSA analysis was the Access hybritech assay technique using the Beckman's Access autoimmuno analyser. The rates of prostate cancer in different %fPSA ranges were evaluated. Receiver operating characteristic curve (ROC) was used to evaluate the efficiency of %fPSA in the diagnosis of prostate cancer.Results
A reduction %fPSA was associated with a higher detection rate of Ca-P. There was a 62% prevalence of Ca-P with %fPSA ≤ 10% while there was a zero prevalence in patients with fPSA above 20%. At a %fPSA cut off of 20% the sensitivity and specificity were 100% and 45%, respectively. Using the ROC curve, the area under the curve (AUC) was 0.76 while the ROC decision plot showed that a %fPSA cut off 15% was associated with the highest ability to discriminate between benign and malignant diseases.Conclusion
The %fPSA is an effective discriminating tool in determining the need for prostate biopsy in indigenous West African men with PSA 4–10 ng/ml. A cut off of 15% was associated with the highest performance. 相似文献10.
George M. Solomon Bo Liu Isabelle Sermet-Gaudelus Isabelle Fajac Michael Wilschanski Francois Vermeulen Steven M. Rowe 《Journal of cystic fibrosis》2017,16(5):573-578
Background
Nasal Potential Difference (NPD) is a biomarker of CFTR activity used to diagnose CF and monitor experimental therapies. Limited studies have been performed to assess agreement between expert readers of NPD interpretation using a scoring algorithm.Methods
We developed a standardized scoring algorithm for “interpretability” and “confidence” for PD (potential difference) measures, and sought to determine the degree of agreement on NPD parameters between trained readers.Results
There was excellent agreement for interpretability between NPD readers for CF and fair agreement for normal tracings but slight agreement of interpretability in indeterminate tracings. Amongst interpretable tracings, excellent correlation of mean scores for Ringer's Baseline PD, Δamiloride, and ΔCl-free + Isoproterenol was observed. There was slight agreement regarding confidence of the interpretable PD tracings, resulting in divergence of the Ringers and Δamiloride, and ΔCl-free + Isoproterenol PDs between “high” and “low” confidence CF tracings.Conclusion
A multi-reader process with adjudication is important for scoring NPDs for diagnosis and in monitoring of CF clinical trials. 相似文献11.
Alexander M. Helfand Rebekah Beach Miriam Hadj-Moussa Naveen Krishnan Chang He Jeffrey S. Montgomery Todd M. Morgan Alon Z. Weizer Khaled Hafez Cheryl T. Lee John T. Stoffel Ted A. Skolarus 《Urologic oncology》2017,35(1):33.e1-33.e9
Objective
To examine whether long-term renal function and overall survival outcomes vary according to management approach for ureteral anastomotic stricture (UAS) after cystectomy and urinary diversion.Methods
We conducted a retrospective cohort study of patients with benign UAS following cystectomy and urinary diversion using our institutional database. We compared time to stricture, renal function, rates of renal loss, and overall survival between patients undergoing ureteral reimplantation vs. those undergoing nonoperative management (nephrostomy tube or ureteral stent). A multivariable Cox proportional hazard model was used to determine whether reimplantation was independently associated with overall survival.Results
We identified 87 UAS in 69 patients. Reimplantation was performed in 26 patients (37.7%), and 43 patients (62.3%) were managed nonoperatively. The interval between cystectomy and stricture diagnosis was similar in the reimplanted and nonoperative groups (3.06 vs. 4.34 mo, P = 0.42). The differences between baseline and follow-up creatinine levels (+0.40 vs.+0.40 mg/dl, P = 0.72) and estimated glomerular filtration rate (?25.0 vs.?18.9 ml/min/1.73 m2, P = 0.66) were similar between groups, as were rates of renal loss (34.6% vs. 39.5%, P = 0.68); however, mortality was significantly higher in the nonoperative group. After multivariable adjustment, overall survival remained significantly higher among UAS patients who underwent reimplantation (adjusted hazard ratio [aHR] for risk of death = 0.32, 95% CI: 0.13–0.80).Conclusion
Reimplantation was associated with improved overall survival but not with improved long-term renal functional outcomes compared with nonoperative management. Nonrenal complications of nonoperative UAS management may play an important role in reducing longevity. 相似文献12.
Michael Thomas LeCompte Lisa Rae Steven Alexander Kahn 《Burns : journal of the International Society for Burn Injuries》2017,43(1):121-126
Introduction
Many burn centers utilize propranolol in both adult and pediatric burn patients to attenuate the hypermetabolic response related to thermal injury despite the relative paucity of data in adults compared to children. The purpose of this study was to identify practice patterns related to propranolol, for which groups it is being used, length of use, and the intended benefit.Methods
A 17 question survey regarding the use of propranolol was distributed to burn centers listed in the ABA website with a link to provide anonymous responses.Results
A 31% response rate was achieved. Results demonstrated 60.5% use propranolol while 39.5% do not. Use in both adult and pediatric patients was reported in 82% of centers. The majority of centers (60.8%) initiate propranolol in patients with >20% TBSA burns. The drug is continued while inpatient for most adults (43%) with only 10% continuing treatment up to 6 months vs. rates of 17.6% long term outpatient use in pediatric patients. Drug dosing ranged from 10 to 40 mg in adults and 0.1 mg/kg to 5 mg/kg in pediatric patients dosed twice daily to four times daily with 25% and 40% titrating the dose to a reduced heart rate respectively. Propranolol was felt to improve outcomes in 56% of responses while 39% were “unsure”.Conclusion
The majority of centers use propranolol for both adult and pediatric patients despise the lack of randomized studies in adult populations. A wide variation of practice patterns highlights the need for further study in regard to patient outcomes, duration of therapy, and dosing to drive consensus guidelines. 相似文献13.
Ian D. Davis Wanling Xie Carmel Pezaro Frede Donskov J. Connor Wells Neeraj Agarwal Sandy Srinivas Takeshi Yuasa Benoit Beuselinck Lori A. Wood D. Scott Ernst Ravindran Kanesvaran Jennifer J. Knox Allan Pantuck Sadia Saleem Ajjai Alva Brian I. Rini Jae-Lyun Lee Daniel Y.C. Heng 《European urology》2017,71(6):970-978
Background
We hypothesized that changes in International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) prognostic category at start of second-line therapy (2L) for metastatic renal cell carcinoma (mRCC) might predict response.Objective
To assess outcomes of 2L according to type of therapy and change in IMDC prognostic category.Design, setting, and participants
We performed a retrospective review of the IMDC database for mRCC patients who received first-line (1L) VEGF inhibitors (VEGFi) and then 2L with VEGFi or mTOR inhibitors (mTORi). IMDC prognostic categories were defined before each line of therapy (favorable, F; intermediate, I; poor, P). Data were analyzed for 1516 patients, of whom 89% had clear cell histology.Intervention
All included patients received targeted therapy for mRCC.Outcome measurements and statistical analysis
Overall survival (OS), time to treatment failure, and response to 2L were analyzed using Cox or logistic regression.Results and limitations
At start of 2L, 60% of patients remained in the same prognostic category; 9.0% improved (3% I → F; 6% P → I); 31% deteriorated (15% F → I or P; 16% I → P). Patients with the same or better IMDC prognostic category had a longer time to treatment failure if they remained on VEGFi compared to those who switched to mTORi (adjusted hazard ratio [AHR] ranging from 0.33 to 0.78, adjusted p < 0.05). Patients who deteriorated from F to I appeared more likely to benefit from switching to mTORi (median OS 16.5 mo, 95% confidence interval [CI] 12.0–19.0 for VEGFi; 20.2 mo, 95% CI 14.3–26.1 for mTORi; AHR 1.53, 95% CI 1.04–2.24; adjusted p = 0.03).Conclusions
Changes in IMDC prognostic category predict the subsequent clinical course for patients with mRCC and provide a rational basis for selection of subsequent therapy.Patient summary
The pattern of treatment failure might help to predict what the next treatment should be for patients with metastatic renal cell carcinoma. 相似文献14.
Nicco Krezdorn Sören Könneker Felix Julian Paprottka Christian Tapking Tobias R. Mett G. Felix Brölsch Maria Boyce Ramin Ipaktchi Peter M. Vogt 《Burns : journal of the International Society for Burn Injuries》2017,43(1):195-199
Background
Limited data is available for treatment of scald lesions in adults. The use of the biosynthetic matrix Biobrane® has been suggested as treatment option with more benefits over topical dressings. Application of Biobrane® in scalds in our center led to a perceived increase of infection, secondary deepening, surgery and length of stay. We therefore assessed the effect of different treatment options in adult scalds in our center.Methods
We performed a retrospective cohort study of adult patients that have been admitted with scalds in our center between 2011 and 2014. We assessed two groups, group 1 with Biobrane® as initial treatment and group 2 with topical treatment using polyhexanid hydrogel and fatty gauze. Primary outcome variables were rate of secondary deepening, surgery, infection (defined as positive microbiological swabs and antibiotic treatment) and length of stay. Total body surface area (TBSA) as well as diabetes mellitus (DM), hypertension, smoking and alcohol consumption as potential confounders were included.Results
A total of 52 patients were included in this study. 36 patients received treatment with Biobrane® and 16 with ointment and fatty gauze. No significant differences were found for age and TBSA whereas gender ratio was different (25/11 male/female in group 1 vs 4/12 in group 2, p = 0.003). Rate of secondary deepening, surgery, infection as well as days of hospital stay (DOHS) were comparable. Logistic and multilinear regression showed TBSA to be a predictive factor for infection (p = 0.041), and TBSA and age for length of stay (age p = 0.036; TBSA p = 0.042) in group 1.Conclusion
The use of Biobrane® in adult scald lesions is safe and non-inferior to topical treatment options. In elder patients and larger TBSA Biobrane® may increase the risk of infection or a prolonged stay in hospital.Level of evidence
Level 3 – retrospective cohort study. 相似文献15.
16.
A. Abhishek V. Singh R.J. Sinha N.G. Ansari M.K.J. Siddiqe M. Verma M. Kumar 《The African Journal of Urology》2017,23(2):126-132
Objective
To examine the variation of cadmium (Cd), zinc (Zn) and mitochondrial DNA (mtDNA) copy number in prostate cancer (PCa) patients and their age match controls and correlations with clinicopathological parameters.Subjects and methods
This study was conducted between January 2012 and January 2015. Blood Cd and Zn level was measured by inductively coupled plasma spectrophotometer. The variation of mitochondrial copy number in blood was measured by real-time PCR. We scrutinized the correlation of Cd, Zn and mtDNA with clinicopathological parameters like prostate specific antigen (PSA) and [Gleason] score.Results
Mean Cd level (μg/L ± SD) was significantly higher (3.89 ± 1.49) while Zn level was low (85 ± 10.4) in PCa patients comparison to control patients (2.92 ± 1.23; 116 ± 19.1). A wide distribution of variance and higher mtDNA copy numbers were found in PCa patients [Range (fold difference) 1968–39,245 (17.4)] as compared to controls [10,178–332,243.9], (p value: 0.036). Clinicopathological analysis showed that Cd, Zn and mtDNA DNA copy numbers were significantly associated with increased [Gleason] score but not with serum PSA level (Zn: r = ?0.68; Cd: r = 0.64; mtDNA: r = 0.84) (p < 0.05).Conclusion
Cd, Zn and mtDNA copy number significantly correlate with [Gleason] score which suggests that the former may serve as marker for therapeutic guidance. 相似文献17.
Erin M. Lowery William Adams Shellee A. Grim Nina M. Clark Leah Edwards Jennifer E. Layden 《Journal of cystic fibrosis》2017,16(6):727-734
Background
Post-transplant lymphoproliferative disease (PTLD) is an important cause of morbidity and mortality following lung transplantation. Recipients with cystic fibrosis (CF) may have an increased risk of PTLD although the literature is limited to single center cohorts. Our primary aim is to examine PTLD in an adult lung transplant population by utilizing the International Society for Heart and Lung Transplantation Registry.Methods
We studied 30,598 adult recipients of lung transplants performed between 1999 and 2011. The primary outcome was development of and time to PTLD. In addition to indication for transplant, other predictors examined included Epstein–Barr virus (EBV) and cytomegalovirus (CMV) serostatus, gender, and age. Outcomes were assessed with univariable and multivariable Cox proportional hazard models to obtain hazard ratios (HR).Results
17% of the cohort had a diagnosis of CF. PTLD developed in 2% of CF recipients compared to 1% for non-CF recipients (p < 0.001). Compared to non-CF recipients, CF recipients had higher prevalence of EBV and CMV seronegativity and higher prevalences of high risk EBV and CMV mismatch (D +/R ?). There is a significant association between CF and the development of PTLD [HR 1.66 (95% CI 1.30–2.12)]. Stratified multivariable analysis controlling for age revealed EBV negative non-CF recipients have an almost 2 fold increased risk of developing PTLD, whereas EBV negative CF recipients had an almost 6.5 fold increased risk.Conclusions
CF recipients have a higher risk for PTLD compared to non-CF recipients. Further studies are needed to account for additional risk factors and management in this population post-transplant. 相似文献18.
Ji Shizhao Zheng Yongjun Zhang Lisen Luo pengfei Zheng Xiaopeng Wang Guangyi Zhu Shihui Hu Xiaoyan Xiao Shichu Xia Zhaofan 《Burns : journal of the International Society for Burn Injuries》2017,43(1):206-214
Background
The shortage of autologous skin sources not only adds difficulty to the repair of extremely large-area deep burn wounds but affects the healing quality. The aim of the present study is to explore an ideal method for repairing large-areas burn wounds with low scar formation.Methods
Between 2002 and 2014, we used grafting of small auto- and cryopreserved allo-skin to repair large-area residual burn wounds in wounds after 21 days 21 patients, and after early excision in 17 patients. The wound healing rate and quality were observed.Results
The skin expansion rate was 1:9–1:16, and the mean area of wounds repaired after three weeks was 64.8 ± 7.3%TBSA, the wound healing rate was 91.8 ± 3.7%. The mean area of the early excision group was 65.9 ± 9.8 TBSA, where the healing rate was 94.5 ± 5.6%. After small auto- and cryopreserved allograft skin grafting, the epidermis of the auto-skin gradually replaced the allo-epidermis, and the allo-dermis persisted for a prolonged period. The dermal collagen fibers at the allo-skin grafting sites were well arranged. At 1–2-year follow-up, observation showed that the Vancouver Scar Scale total score was 4·304 ± 2·363, and we did not discern significant contracture and dysfunction in the large joints of the four extremities.Conclusions
Small auto- and cryopreserved allograft skin grafting of small auto- and allo-skin not only raised the graft expansion rate but offers a stable wound healing rate. This new technique may provide an option for repair of large-area deep burn wounds. 相似文献19.
Martijn G. Schouten Marloes van der Leest Morgan Pokorny Martijn Hoogenboom Jelle O. Barentsz Les C. Thompson Jurgen J. Fütterer 《European urology》2017,71(6):896-903
Background
Knowledge of significant prostate (sPCa) locations being missed with magnetic resonance (MR)- and transrectal ultrasound (TRUS)-guided biopsy (Bx) may help to improve these techniques.Objective
To identify the location of sPCa lesions being missed with MR- and TRUS-Bx.Design, setting, and participants
In a referral center, 223 consecutive Bx-naive men with elevated prostate specific antigen level and/or abnormal digital rectal examination were included. Histopathologically-proven cancer locations, Gleason score, and tumor length were determined.Intervention
All patients underwent multi-parametric MRI and 12-core systematic TRUS-Bx. MR-Bx was performed in all patients with suspicion of PCa on multi-parametric MRI (n = 142).Outcome measurements and statistical analysis
Cancer locations were compared between MR- and TRUS-Bx. Proportions were expressed as percentages, and the corresponding 95% confidence intervals were calculated.Results and limitations
In total, 191 lesions were found in 108 patients with sPCa. From these lesion 74% (141/191) were defined as sPCa on either MR- or TRUS-Bx. MR-Bx detected 74% (105/141) of these lesions and 61% (86/141) with TRUS-Bx. TRUS-Bx detected more lesions compared with MR-Bx (140 vs 109). However, these lesions were often low risk (39%). Significant lesions missed with MR-Bx most often had involvement of dorsolateral (58%) and apical (37%) segments and missed segments with TRUS-Bx were located anteriorly (79%), anterior midprostate (50%), and anterior apex (23%).Conclusions
Both techniques have difficulties in detecting apical lesions. MR-Bx most often missed cancer with involvement of the dorsolateral part (58%) and TRUS-Bx with involvement of the anterior part (79%).Patient summary
Both biopsy techniques miss cancer in specific locations within the prostate. Identification of these lesions may help to improve these techniques. 相似文献20.
Matthew A. Tucker Reva Crandall Nichole Seigler Paula Rodriguez-Miguelez Kathleen T. McKie Caralee Forseen Jeffrey Thomas Ryan A. Harris 《Journal of cystic fibrosis》2017,16(6):752-758