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Identification of pathologically favorable disease in intermediate‐risk prostate cancer patients: Implications for active surveillance candidates selection
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Giorgio Gandaglia Nazareno Suardi Vito Cucchiara Marco Bianchi Shahrokh F. Shariat Morgan Roupret Andrea Salonia Francesco Montorsi Alberto Briganti 《Translational andrology and urology》2015,4(2):110-123
Context
Erectile dysfunction (ED) represents one of the most common long-term side effects in patients with clinically localized prostate cancer (PCa) undergoing nerve-sparing radical prostatectomy (RP).Objective
To analyze the role of penile rehabilitation in the recovery of erectile function (EF) after nerve-sparing RP.Evidence synthesis
Penile rehabilitation is defined as the use of any intervention or combination with the goal not only to achieve erections sufficient for satisfactory sexual intercourses, but also to return EF to preoperative levels. The concept of rehabilitation is based on the implementation of protocols aimed at improving oxygenation, preserving endothelial structure, and preventing smooth muscle structural alterations. Nowadays, the most commonly adopted approaches for penile rehabilitation after nerve-sparing RP are represented by the administration of phosphodiesterase type-5 inhibitors (PDE5-Is), intracorporeal injection therapy, vacuum erection devices (VED), and the combination of these therapies. Several basic science studies support the rational for the adoption of penile rehabilitation protocols. Particularly, rehabilitation, set as early as possible, seems to be better than leaving the erectile tissues unassisted. On the other hand, results from solid prospective randomized trials finally assessing the long-term beneficial effects of PDE5-Is, intracavernosal injections, or VED on EF recovery after surgery are still lacking.Conclusions
Although preclinical evidences support the rationale for penile rehabilitation after nerve-sparing RP, clinical studies reported conflicting results regarding its efficacy on long-term EF recovery. Nowadays, which is the optimal rehabilitation program still represents a matter of debate. 相似文献7.
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Guang‐Shing Cheng Katherine E. Selwa Charles Hatt Sundaresh Ram Aleksa B. Fortuna Margaret Guerriero Ben Himelhoch Daniel McAree Timothy C. Hoffman Joseph Brisson Ryan Nazareno Kiernan Bloye Timothy D. Johnson Mats Remberger Jonas Mattsson Dharshan Vummidi Ella E. Kazerooni Vibha N. Lama Stefanie Galban Michael Boeckh Gregory A. Yanik Craig J. Galban 《American journal of transplantation》2020,20(8):2198-2205
Parametric response mapping (PRM) is a novel computed tomography (CT) technology that has shown potential for assessment of bronchiolitis obliterans syndrome (BOS) after hematopoietic stem cell transplantation (HCT). The primary aim of this study was to evaluate whether variations in image acquisition under real‐world conditions affect the PRM measurements of clinically diagnosed BOS. CT scans were obtained retrospectively from 72 HCT recipients with BOS and graft‐versus‐host disease from Fred Hutchinson Cancer Research Center, Karolinska Institute, and the University of Michigan. Whole lung volumetric scans were performed at inspiration and expiration using site‐specific acquisition and reconstruction protocols. PRM and pulmonary function measurements were assessed. Patients with moderately severe BOS at diagnosis (median forced expiratory volume at 1 second [FEV1] 53.5% predicted) had similar characteristics between sites. Variations in site‐specific CT acquisition protocols had a negligible effect on the PRM‐derived small airways disease (SAD), that is, BOS measurements. PRM‐derived SAD was found to correlate with FEV1% predicted and FEV1/ forced vital capacity (R = ?0.236, P = .046; and R = ?0.689, P < .0001, respectively), which suggests that elevated levels in the PRM measurements are primarily affected by BOS airflow obstruction and not CT scan acquisition parameters. Based on these results, PRM may be applied broadly for post‐HCT diagnosis and monitoring of BOS. 相似文献
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Firas Abdollah R. Jeffrey Karnes Nazareno Suardi Cesare Cozzarini Giorgio Gandaglia Nicola Fossati Marco Bianchi Stephen A. Boorjian Maxine Sun Pierre I. Karakiewicz Francesco Montorsi Alberto Briganti 《European urology》2014