bluuebunny/crossref_metadata_2025 huggingface dataset:
Power, command and violence in von Trier’s Manderlay. A political and philosophical analysis of pseudo-democracies.
Authors: Marino Sara
Published: October 2016

Alabama, 1933. A caravan of limousines carrying gangsters arrives in Manderlay, a small village where slavery still exists as an institution. Mam (Lauren Bacall) rules the plantation assisted by her foreman Wilhelm (Danny Glover), a slave who believes his people are not ready for the responsibilities of freedom. Driving up to the gates of the plantation, Grace (Bryce Dallas Howard) declares that the slaves must be informed how to enjoy freedom and thus becoming good citizens. Drawing on a textual and visual analysis of Manderlay, the article explores how democracy arises from the exercise of violence and power, as well as the inability of Western societies to deal with the dogma of difference.
House of Affection: On the Way to the School
Authors: Yücel Volkan
Published: October 2016

This paper focuses on the school as a house of affection. The debate is based on the movie, “On the Way to the School” (2008) and traces the difficulties of education in the second language. How the students’ daily life is being transformed to a unified educational synthesis in the east part of Turkey? Emre (the protagonist) requires the students speak only in Turkish and tries to teach them which creates two different feeling spaces and isolated schooling with no real affection.
Labyrinths and Illusions in David Lynch’s Mulholland Drive and Inland Empire
Authors: Barzegar Ebrahim
Published: October 2016

David Lynch is known for its surrealistic and bizarre spectacles in his films in and out of America which puzzle and disturb the viewers and yet force them to ponder on the underlying mystery and meaning of them. Multilayered and disjointed narratives of his films strike most of the viewers to get lost in his magical world or Lynchland. In order to fully apprehend his convoluted cinematic narrative, this article aims at unfolding the different layers of his postmodern award-winning film, Mulholland Drive (2001) and INLAND EMPIRE (2006). To achieve this goal, Brian McHale’s thoughts and notions associated with postmodern fiction’s characteristic dealing with foregrounding ontological narratives are chosen and used in this research. It is conclude that Mulholland Drive’s and INLAND EMPIRE's embedded narratives function as a reflection of the primary narrative or diegetic leading to the construction of abysmal worlds.
Zakharov v. Russia (Eur. Ct. H.R.)
Authors: Woods Lorna
Published: October 2016

The European Court of Human Rights (ECtHR) in Zakharov v. Russia held that the Russian system of surveillance constituted a violation of Article 8 of the European Convention on Human Rights (ECHR). This decision is not the first judgment concerning surveillance, but it is of note because it is a Grand Chamber judgment in which the ECtHR drew together strands of its existing case law. It comes at a time when national systems of surveillance are the subject of much scrutiny: further cases are pending before the ECtHR.
Opinion 2/13 of the Court (C.J.E.U.)
Authors: Halberstam Daniel
Published: October 2016

Opinion 2/13 of the Court of Justice of the European Union (CJEU) declared the draft agreement on European Union accession to the European Convention on Human Rights (ECHR) incompatible with the Treaty on European Union. The Opinion comes toward the end of a long and gradual process of incorporating human and fundamental rights principles into the legal system of the European Community and its successor, the European Union. Opinion 2/13 sends the Commission back to the drawing board on what has long been seen as the capstone of that process—EU accession to the Strasbourg human rights regime as an external check on human rights protection within the European Union.
Agreement on Compensation for Certain Victims of Holocaust-Related Deportation From France who are not Covered by French Programs & Exchange of Notes (U.S.-FR.)
Authors: Bettauer Ronald J.
Published: October 2016

Under the Agreement, which entered into force on November 1, 2015, France provided $60 million for payment by the United States to Americans and others for Holocaust-related claims for deportation from France. In return, the United States undertook to ensure legal peace for France with respect to such claims.
United Nations Basic Principles and Guidelines on the Right of Anyone Deprived of their Liberty to Bring Proceedings Before a Court
Authors: Lazarus Liora
Published: October 2016

On April 29, 2015, the United Nations Working Group on Arbitrary Detention (WGAD) adopted the United Nations Basic Principles and Guidelines on the Right of Anyone Deprived of Their Liberty to Bring Proceedings Before a Court (BPGs). This comprehensive and practical document is based on an extensive range of international law sources, standards, and good practice. It provides states with specific and specialized guidance on how to fulfill their international obligations to protect against the arbitrary deprivation of liberty.
OAO Neftyanaya Kompaniya Yukos v. Russia (Eur. Ct. H.R.)
Authors: De Brabandere Eric
Published: October 2016

On July 31, 2014, the European Court of Human Rights (ECtHR) rendered its final decision on a claim brought by the liquidated Russian company OAO Neftyanaya Kompaniya Yukos (Yukos) against the Russian Federation (Russia), a decision that is the last in a series of three decisions in this case relating respectively to the admissibility of the application, the merits, and just satisfaction.

A couple weeks prior to the ECtHR’s decision, three arbitral tribunals established under the auspices of the Permanent Court of Arbitration (PCA) and functioning under the UNCITRAL Arbitration Rules had issued their final awards based on claims brought by three former shareholders of Yukos under the Energy Charter Treaty. The dispute, while brought by the shareholders of Yukos, in essence is the same as the one brought by Yukos against Russia before the European Court of Human Rights.
Keyu v. Secretary of State for Foreign and Commonwealth Affairs (U.K. Sup. Ct.)
Authors: Cerna Christina M.
Published: October 2016

On November 25, 2015, the U.K. Supreme Court dismissed a case in which the British Secretaries of State for Foreign Affairs and Defense failed to hold a public inquiry into an atrocity committed in 1948 by British troops in the British protectorate of Malaya, today Malaysia. The case is of particular interest because it concerns the obligations of states for atrocities committed in the past, before their obligations under the European Convention on Human Rights (European Convention) or a comparable treaty, entered into force. Whereas the principle of the nonretroactivity of treaties protects a state from responsibility for acts committed before the human rights treaty entered into force for that state, the issue in this case was whether the state nonetheless had an obligation to investigate the crimes of the past.
Analyzes of health profiles of patients receiving home health care services over last five years in Diyarbakir, Turkey
Authors: Gumus Rojan , Sarıbaş Seyfettin
Published: October 2016

Objective: To determine the health profiles of patients who have been delivered home health care services by public hospitals in over the last five years.Methods: Data which were recorded by the Ministry of Health and the Diyarbakır Directorate of Health Services had been provided from 1,826 patients from three city center and five district hospitals located in Diyarbakir, Turkey.Results: Of 1,826 patients, 989 (54%) were female and 837 (46%) were male. The patients were divided into three age groups: 0-18 years 467 (25%), 19-64 years 511 (28%) and +65 years 848 (47%). There were more female patients in +65 age group and male in 0-18 age group (χ2 = 89.923, p < .001). In 2015, there was an increase in the number of people who received services in all age groups (χ2 = 164.344, p < .001). It was found that neurodegenerative diseases were more widespread in +65 age group (χ2 = 44.823, p < .001). Neurogenetic dieases were more seen in the 0-18 age group (χ2 = 97.800, p < .001). In the +65 age group, musculoskeletal (χ2 = 16.037, p < .001) and respiratory diseases (χ2 = 6.054, p < .05) were detected to be more widespread. There were no significant sex-based differences between the years involved (χ2 = 2.246, p > .05). Neurodegenerative diseases (χ2 = 4.07, p < .05), neurogenetic diseases (χ2 = 6.043, p < .05) and respiratory diseases (χ2 = 5.254, p < .05) were determined to be more widespread in male patients. Musculoskeletal (χ2 = 17.943, p < .001)and cardiovascular diseases (χ2 = 11.994, p < .001) were seen more in female groups.Conclusions: Over the last five years, there has been an increase in the utilization of home health care services. Policy legislation for health care services to be provided at home is generating succesful results.
Case report and review of the literature: Rectal linitis plastica secondary to the lipoid cell variant of transitional cell carcinoma of the urinary bladder
Authors: McPherson Victor A. , Ott Michael , Tweedie Edward J. , Izawa Jonathan
Published: October 2016

The overall 5-year survival of patients with urothelial carcinoma of the bladder (UC) is about 78%; however, there are some rare subtypes. One of these is the lipoid cell subtype, which bears a very poor prognosis. Another rare disease entity with a poor prognosis is metastasis to the lower gastrointestinal tract in the form of secondary linitis plastica of the rectum. We describe an extremely rare and unique case of rectal linitis plastica secondary to the rare lipoid cell variant of UC.
Diagnosis and management of benign prostatic hyperplasia in primary care
Authors: Tanguay Simon , Awde Murray , Brock Gerald , Casey Richard , Kozak Joseph , Lee Jay , Nickel J. Curtis , Saad Fred
Published: October 2016

Benign prostatic hyperplasia (BPH), and its clinical manifestation as lower urinarytract symptoms (LUTS), is a major health concern for aging men. There havebeen significant advances in the diagnosis and treatment of BPH in recentyears. There has been a renewed interest in medical therapies and less invasivesurgical techniques. As a consequence, the treatment needs of men withmild to moderate LUTS without evidence of prostate cancer can now be accomplishedin a primary care setting. There are differences in the way urologistsand primary care physicians approach the evaluation and management of LUTSdue to BPH, which is not reflected in Canadian Urological Association (CUA)and American Urological Association (AUA) guidelines. A “shared care” approachinvolving urologists and primary care physicians represents a reasonable andviable model for the care of men suffering from LUTS. The essence of the modelcentres around educating and communicating effectively with the patient onBPH. This article provides primary care physicians with an overview of the diagnosticand management strategies outlined in recent CUA and AUA guidelinesso that they may be better positioned to effectively deal with this patient population.It is now apparent that we must move away from the urologist as thefirst-line physician, and allow primary care physicians to accept a new role inthe diagnosis and management of BPH.
Optical coherence tomography: a novel modality for scrotal imaging
Authors: Davis Cole , Kuang Wayne
Published: October 2016

Background: For patients with nonobstructive azoospermia,sperm retrieval rates remain modest. We describe the use ofoptical coherence tomography to improve retrieval rates and todecrease tissue destruction.Methods: Four patients underwent diagnostic testicular biopsyand imaging with the Niris optical coherence tomography de -vice. We performed a descriptive comparison between optic alcoherence tomographic images and conventional histology.Results: The measured seminiferous tubule diameter differed by16 μm between comparative imaging from optical coherencetomography and conventional histology using hematoxylin andeosin staining.Conclusion: We illustrate the usefulness of optical coherencetomography in the setting of testicular biopsy and the managementof nonobstructive azoospermia.Contexte : Chez les patients atteints d'azoospermie non obstructive,les taux de collecte de spermatozoïdes demeurent modestes.Nous décrivons le recours à une tomographie optiquecohérente pour améliorer les taux de collecte et réduire ladestruction tissulaire.Méthodes : Quatre patients ont subi une biopsie testiculaire diagnostiqueet une épreuve d'imagerie à l'aide d'un appareil Nirisde tomographie optique cohérente. Une comparaison descriptivea été effectuée entre les images obtenues par tomographieoptique cohérente et les résultats des épreuves histologiquesstandard.Résultats : La différence dans le diamètre des tubules séminifèresmesuré par tomographie optique cohérente et par coloration histologiqueà l'hématoxyline-éosine n'était que de 16 μm.Conclusion : Nous présentons une étude descriptive illustrant l’uti -lité de la tomographie optique cohérente pendant une biopsietesticulaire en vue de la prise en charge d'une azoospermie nonobstructive.
Robot-assisted laparoscopic prostatectomy performed in a patient with severe thrombocytopenia due to primary myelofibrosis
Authors: Khavari Rose , Stamatakis Lambros , Miles Brian
Published: October 2016

Robot-assisted laparoscopic prostatectomy (RALP) has emergedas a minimally invasive alternative to open radical prostatectomy(ORP) for the treatment of clinically localized prostate cancer. Incomparison to the open procedure, there is significantly less intraoperativeblood loss during RALP. This benefit has allowed RALPto become a feasible option for patients who would be poor candidatesfor ORP, including those patients with intrinsic hematologicaldisorders. In this case study, we report a successfully performedRALP in a patient with severe thrombocytopenia in thepresence of primary myelofibrosis.
Dermoid cyst of the spermatic cord: a rare cause of benign inguinal lump
Authors: Aslam Muhammad Z. , Kheradmund Ferhad , Patel Nilay S. , Turner Gareth , Cranston David
Published: October 2016

Dermoid cyst of the spermatic cord is an extremely rarepathology seen at the urological clinic. We present the caseof a 26-year-old man who presented with a groin lump,thought to be a lipoma or a hydrocoele of the cord. Thefinal histopathological analysis established the diagnosis ofa dermoid cyst.
Perfusion CT evaluation in experimentally induced testicular torsion
Authors: Yilmaz Ovali Gulgun , Yilmaz Omer , Tarhan Serdar , Genc Abdulkadir , Demireli Peyker , Tunçyurek Ozum , Unden Cansu , Taneli Can , Pabuscu Yüksel
Published: October 2016

Introduction: In this study, we define the characteristics of perfusioncomputed tomography (CT) in an experimental model of testiculartorsion.Methods: Twenty male Sprague-Dawley rats were included forthe study. Torsion was applied to 10 rats and perfusion CT wasperformed in the first hour to evaluate the following perfusionparameters: blood flow (BF), blood volume (BV) and time to peak(TTP) values. Detorsion was done for the same rats, and perfusionCT was repeated 2 hours later to evaluate reperfusion. Tenrats were left as part of the control group.Results: There is significant statistical correlation between the BFand BV values in the torsion and control groups (p = 0.001 andp = 0.001, respectively). There is no statistical correlation of theTTP parameters between the groups. No correlation was foundbetween torsion and detorsion perfusion parameters.Conclusion: Perfusion CT can demonstrate the testicular perfusioninsult in an experimental model of torsion. Perfusion CT may bean alternative method for diagnosis of torsion in indeterminatecases. Following detorsion an interval of 2 hours is not sufficientfor demonstrating luxury perfusion of the testis.Introduction : Dans cette étude, nous définissons les caractéristiquesd’une tomodensitométrie (TDM) de perfusion dans un mo -dèle expérimental de torsion testiculaire.Méthodologie : Vingt rats Sprague-Dawley mâles ont été utiliséspour l’étude. Une torsion a été appliquée chez 10 rats et uneTDM de perfusion a été effectuée dans l’heure suivante pour éva -luer les paramètres suivants : débit sanguin (DS), volume sanguin(VS) et temps nécessaire pour arriver aux valeurs maximales (TVM).On a procédé à une détorsion chez les mêmes rats avant de répéterla TDM de perfusion 2 heures plus tard. Les 10 autres rats formaientle groupe témoin.Résultats : Il existe une corrélation significative sur le plan statistiqueentre les valeurs de DS et de VS dans le groupe ayant subila torsion et le groupe témoin (p = 0,001 et p = 0,001, respectivement).Par contre, aucune corrélation statistique n’a été observéedans les deux groupes concernant les valeurs de TVM, ni entreles paramètres de perfusion liés à la torsion et la détorsion.Conclusion : Une TDM de perfusion peut permettre de démontrerune anomalie de perfusion testiculaire selon un modèle expérimentalde torsion. La TDM de perfusion peut constituer une mé -thode diagnostique de rechange dans les cas indéterminés. Aprèsla détorsion, un intervalle de 2 heures ne suffit pas pour démontrerune perfusion excessive des testicules.
Syndrome de levée d’obstacle : physiopathologie et prise en charge
Authors: Ziouziou Imad , Daoudi Anass , Nouri Anass , Karmouni Tarik , Khalid El Khader Khalid , Koutani Abdellatif , Andaloussi Ahmed Iben Attya
Published: October 2016

Le syndrome de levée d’obstacle est une polyurie massive faisant suite au traitement d’une insuffisance rénale obstructive. Les mécanismes physiopathologiques sont multiples : un état de surcharge hydrique qui dépend du caractère complet ou incomplet de l’obstacle, des anomalies tubulaires (atteinte de la capacité de dilutionet de concentration des urines, diminution de la réabsorption dusodium, fuites de potassium, troubles de l’acidification des urines, insensibilité des cellules tubulaires à l’hormone antidiurétique), ainsi que des facteurs biochimiques et immunologiques sont mis en jeu. La levée d’un obstacle nécessite une surveillance clinique et biologique stricte (diurèse horaire, état hémodynamique, état d’hydratation, créatininémie, urémie, ionogramme sanguin). Letraitement a pour but d’éviter les troubles hémodynamiques etmétaboliques graves, et repose sur le principe de la compensation des pertes hydroélectrolytiques.
Ureteral stent-related aortoureteric fistula: case report and literature review
Authors: Dangle Pankaj P , Bahnson Robert , Patel Ashay
Published: October 2016

We describe a case of early postoperative aortoureteric fistula followingexenterative surgery treated with wet ostomy with bilateralureterosigmoidostomies and ureteric stent placement. A high indexof clinical suspicion is required, as diagnosis is often difficult.
Dose escalation of second-line sunitinib results in rapid partial remission of multiple hepatic metastases
Authors: Guevremont Catherine , Mija Florin I. , Isbarn Hendrik , Jeldres Claudio , Lughezzani Giovanni , Sun Maxine , Audet Pascale , Perrotte Paul , Karakiewicz Pierre I.
Published: October 2016

A 58-year-old man with metastatic clear cell renal cell carcinomaon sunitinib therapy, who previously failed on sorafenib, wasfound to have progression of multiple hepatic metastases; he wason a standard sunitinib dose of 50 mg/day (4 weeks on, 2 weeksoff). Due to the unavailability of alternative therapies, a sunitinibdose escalation of 50 mg/day was attempted. After one 6-weekcycle of continuously dosed sunitinib 50 mg, the hepatic lesionsregressed. After the second cycle, virtual disappearance of thelesions was recorded. There was no added toxicity. These findingssuggest that sunitinib dose escalation to 50 mg/day usingcontinuous daily administration dosing might represent a valid,effective and well-tolerated therapeutic option in patients whoprogress on standard sunitinib therapy.
Screening for bladder cancer: the best opportunity to reduce mortality
Authors: Fradet Yves
Published: October 2016

Bladder cancer kills more women than cervical cancer and is alsoa significant cause of mortality in men. Little progress has beenmade in improving survival in patients with advanced bladdercancer. Two pilot studies using microhematuria screening haveshown that screening for bladder cancer results in close to 80%downstaging, with high-grade cancers being detected before theyhave invaded the bladder wall. Results of long-term follow-upeven suggest a striking reduction in bladder cancer mortality. Themain obstacles to screening for bladder cancer may be overcomeif a higher-risk population is identified by designing a risk scalefor exposure to cigarette smoke and occupational carcinogens,and through genetic testing for susceptibility to cancer and homehematuria screening, which in itself identifies a population withapproximately 3% to 4% risk of bladder cancer. The feasibilityand cost effectiveness of screening for bladder cancer can besignificantly improved by incorporating a secondary screeningstrategy using a more sensitive and specific bladder cancer markerthat is currently available, and by limiting urological evaluationsto patients who show positive results on one or more of thesetests. Bladder cancer is the most costly cancer to treat in theUnited States and pharmacoeconomic studies suggest that screeningfor bladder cancer could not only save lives but also reducecosts per year-life saved. A pilot study is underway and the urologycommunity should be very supportive of studies to validatethis opportunity.
The management of BCG failure in non-muscle-invasive bladder cancer: an update
Authors: Zlotta Alexandre R. , Fleshner Neil E. , Jewett Michael A.
Published: October 2016

Up to 40% of patients with non-muscle-invasive bladder cancer(NMIBC) will fail intravesical bacillus Calmette-Guérin (BCG)therapy. There is unfortunately no current gold standard for salvageintravesical therapy after appropriate BCG treatment. Indeed,outcomes are at best suboptimal. The vast majority of low-gradeNMIBC are prone to recur but very rarely progress. Failure afterintravesical BCG in these patients is usually superficial and lowgrade.At the other end of the spectrum, failure to respond to BCGin high-risk T1 bladder cancer and/or carcinoma in situ (CIS orTIS) is more problematic, since those tumours often have the potentialto progress to muscle invasion. In these cases, radical cystectomyremains the mainstay after BCG failure. With appropriateselection, certain patients who “fail” BCG (but with favourablerisk factors) can be managed with intravesical regimens, includingrepeated BCG, BCG plus cytokines, intravesical chemotherapy,thermochemotherapy or new immunotherapeutic modalities. Inthis review, reasons explaining BCG failure, how to define BCGfailure, optimal risk stratification and prediction of response andmanagement of BCG failures are discussed.
Challenging the 10-year rule: The accuracy of patient life expectancy predictions by physicians in relation to prostate cancer management
Authors: Leung Kevin M.Y.B. , Hopman Wilma M. , Kawakami Jun
Published: October 2016

Introduction: We assess physicians’ ability to accurately predictlife expectancies. In prostate cancer this prediction is especiallyimportant as it affects screening decisions. No previous studieshave examined accuracy in the context of real cases and concreteend points.Methods: Seven clinical scenarios were summarized from chartsof deceased patients. We recruited 100 medical professionals toreview these scenarios and estimate each patient’s life expectancy.Responses were analyzed with respect to the patients’ actual survivalend points, then stratified based on the demographic informationprovided.Results: Respondent factors, such as sex, level of training, locationof work or specialty, made no significant difference on predictionaccuracy. Furthermore, respondents were typically pessimistic intheir estimations with a negative linear trend between estimated lifeexpectancy and actual survival. Overall, respondents were within 1year of actual life expectancy only 15.9% of the time; on average,respondents were 67.4% inaccurate in relation to actual survival. Ifframed in terms of correctly identifying which patients would livemore than or less than 10 years (dichotomous accuracy), physicianswere correct 68.3% of the time.Conclusions: Physicians do poorly at predicting life expectancyand tend to underestimate how long patients have left to live.This overall inaccuracy raises the question of whether physiciansshould refine screening and treatment criteria, find a better proxyor dispose of the criteria altogether.
Personalized medicine in advanced urothelial cancer: when to treat, how to treat and who to treat
Authors: Ehdaie Behfar , Smith Steven C. , Theodorescu Dan
Published: October 2016

The past decade has provided an improved understanding of themolecular mechanism of bladder cancer by defining distinct pathwaysin tumorigenesis and progression. Advances in technologies,such as high-throughput transcript profiling, microarrays andproteomics, offer a systematic approach to identifying targets forbladder cancer diagnostics and drug discovery. This review presentsa select outline of the advances in the development of biomarkersand targets for patient prognosis and therapy selection.This paper describes a representative cohort of recent studies thathave the potential to significantly impact the management of muscleinvasive and metastatic urothelial carcinoma of the bladder.Space constraints do not permit this review to be comprehensiveand we apologize to the authors whose work we do not cite.
Reproductibilité des classifications OMS 1973 et OMS 2004 des tumeurs urothéliales papillaires de la vessie
Authors: Ben Abdelkrim Soumaya , Rammeh Soumaya , Trabelsi Amel , Ben Yacoub-Abid Lilia , Ben Sorba Nabil , Jaïdane Lilia , Mokni Moncef
Published: October 2016

Objectif : Déterminer les taux d’accord et la reproductibilité intra et inter-observateurs des classifications OMS 1973 et OMS 2004 des tumeurs urothéliales papillaires de la vessie.Matériel et méthodes : Cent deux cas de tumeurs urothéliales papillaires de stade pTa/pT1 ont été étudiés. Deux pathologistes ont revu les lames et ont établi le grade tumoral selon les deux classifications OMS 1973 et OMS 2004. En cas de désaccord, les deux évaluateurs ont procédé à une lecture commune au microscope en double tête afin d’aboutir à un grade consensuel selon les deux classifications. La variabilité intra-observateur a été étudiée chez l’un des deux évaluateurs qui a procédé à la relecture des lames un mois après sa première lecture. Les taux d’accord entre les deux pathologistes pour chaque catégorie de grade ont été déterminés et la reproductibilité des deux classifications a été évaluée à l’aide du coefficient kappa. Une valeur de 0 à 0,2 était interprétée comme un désaccord absolu, de 0,21 à 0,4, un accord faible, de 0,41 à 0,6, un accord modéré, de 0,61 à 0,8, un accord considérable, et de 0,8 à 1, un accord absolu.Résultats : Selon la classification OMS 1973, les proportions desgrades G1, G2 et G3 étaient respectivement de 40,2 %, 50 % et 9,8 %. Selon la classification OMS 2004, les proportions respectives des tumeurs de faible potentiel de malignité, des carcinomes de bas grade et des carcinomes de haut grade de malignité étaientde 23,5 %, 60,8 % et 15,7 %. La reproductibilité intra-observateur était excellente pour les deux classifications (accord absolu). Les taux d’accord entre les deux pathologistes étaient meilleurs pour la classification OMS 2004 (kappa = 0,7) que pour la classification OMS 1973 (kappa = 0,51).Conclusions : La reproductibilité entre observateurs de la classification OMS 2004 est supérieure à celle de 1973. La reproductibilité intra-observateur est excellente pour les deux classifications.
Fistule artério-urétérale après une pelvectomie antérieure : Complication rare et grave
Authors: Zine el abidine Mohamed Hosni , Hmida Wissem , Slama Adel , Hidoussi Adnene , Jaidane Mehdi , Ben Sorba Nabil , Mosbah Ali Fawzi
Published: October 2016

La fistule artério-urétérale (FAU), qui survient immédiatement après une cystectomie, est une complication exceptionnelle et grave. De nos jours, seulement quelques cas sporadiques ont été signalés dans la littérature. Elle se manifeste presque exclusivement par une hématurie brutale, massive et intermittente pouvant être à l’origine d’une instabilité hémodynamique menaçant le pronostic vital du patient à court terme. Son diagnostic doit être fait sans retard. Les explorations radiologiques restent peu spécifiques et peu sensibles et se basent essentiellement sur l’artériographie. Le traitement est non codifié selon l’état général du patient et surtout de la nature de la fistule. Nous décrivons un cas de FAU faisant suite à une pelvectomie antérieure et nous discuterons à l’aide d’une revue de la littérature les aspects diagnostiques, thérapeutiques et pronostiques de cette complication.
Inverted papilloma of the ureter: study of a rare case with emphasis on clinicopathologic implications
Authors: Mertziotis Nikolaos , Kozyrakis Diomidis , Petrolekas Andreas , Terzi Maria , Kapranos Nikiforos
Published: October 2016

A 62-year old male patient presented complaining of intermittent macroscopic hematuria. The ultrasonographic investigation revealed a hydronephrosis of remarkable degree with indiscreterenal parenchyma. The abdominal computed tomography scan identified a ureteral lesion with proximal dilatation, hydronephrosis and a functionless ipsilateral renal unit. The retrograde urography showed a 4-cm lesion with multiple filling defects and a smooth contour. The endoscopic examination showed an exophytic lesion, highly suspicious for malignancy. Urine cytology revealed atypia. Right nephroureterectomy was performed and the pathology revealed a ureteral inverted papilloma (UIP). Polymerase chain reaction examination for the presence of human papilloma virus, using GP5+/6+ consensus primers, was negative. The presence UIP should be considered in patients with urotheleal lesions in the ureter when the diagnostic workup for malignancy is inconclusive. The clinical course of the disease seems to be favorable.
Canadian Urology Resident Scholarly Performance
Authors: Andrews J. Matthew , Abdolell Mohamed , Norman Richard W.
Published: October 2016

Introduction:Scholarly research is a key component of Canadian urology residency. Through comparison of scholarly performance of urology residents before residency with that achieved during residency, we aimed to elicit predictive factors for completion of research activities.Methods: Electronic surveys were sent to 152 urology residents of 11 accredited Canadian programs. Survey questions pertained to post-graduate training year (PGY), formal education, scholarly activity completed before and after the start of residency, protected/dedicated research time, structured research curriculum and pursuit of fellowship training. Results:Surveys were completed by 42 residents from 10 programs. Only 26% of residents had a structured research curriculum, 38% a dedicated research rotation and 43% protected research time. Forty-five percent of residents published at least one manuscript so far during residency (mean 1.14 ± 0.32), and 43% submitted at least one manuscript (mean 0.86 ± 0.25). During residency, 62% of residents completed ≥1 formal research presentation (median number 1.5; range 0 – ≥ 10). Only the level of PGY significantly impacted the number of manuscripts published (p < 0.001) and number of formal research presentations (p < 0.001) completed during residency. Eighty-six percent of residents intent on pursuing fellowship training had a mean number of publications and presentations during residency of 1.25 ± 0.37 and 2.25 ± 0.54, respectively. Interpretation: Level of PGY significantly impacted quantitative scholarly activity but the numbers and types of presentations performed prior to residency, completion of an honours or graduate degree and plans to pursue fellowship training did not.
Study comparing the applicability of dorsal lumbotomy in older children
Authors: Cloutier Jonathan , Haidar Nadim , Rompre-Deschenes Marie-Pier , Grimard Maryse , Bolduc Stéphane
Published: October 2016

Objective: Dismembered pyeloplasty through dorsal lumbotomy to correct ureteropelvic junction obstruction is mainly successfully performed in children under 5 years old for technical reasons. We compared children who underwent dorsal lumbotomy by age group (<5 vs. ≥5 years old) to determine if the surgical success and long-term results were comparable.Materials and Methods: We retrospectively reviewed the charts of 134 children undergoing a pyeloplasty. Group 1 consisted of children <5 years old (n = 90) and Group 2 consisted of children ≥5 years old. Patients’ characteristics, as well as hospital stay, narcotic use, radiologic follow-up and success rate, were compared. Success was defined by absence of symptoms and ≥50% reduction in renal pelvis anteroposterior diameter and/or scintigraphic normalization of the drainage T1/2 when obtained. Univariate analysis was performed to compare the groups.Results: Mean age (years) and weight (kg) at surgery for Groups 1 and 2 were 1/8 kg and 11/35 kg, respectively. Mean operative time was 98 minutes versus 120 minutes, respectively; mean hospital stay was 2.5 days for both groups and analgesia requirement was 50% higher in Group 2. A Pippi-Salle stent was used in 90% (n = 120) of cases. Mean follow-up was 26 months and the success rate was 89% and 90% for Groups 1 and 2, respectively.Conclusion: Our study showed comparable success rates. We can infer that, as a technique, dismembered pyeloplasty is effective and safe in the younger and older children.
What is an evidence-based appropriate workup?
Authors: Zimmern Philippe E.
Published: October 2016

At the present time, there is no evidence-based guidance available for workup of stress urinary incontinence (SUI). In the absence of such evidence, we must rely on expert consensus, which dictates that a workup should typically include documentation of SUI, assessment of impact on the patient, and information on voiding function. Typical assessment may need to be adjusted for more complicated populations (e.g., those with mixed incontinence, those who have failed previous treatment).
Surgical management of stress urinary incontinence: A rational approach to treatment selection
Authors: Winters J. Christian
Published: October 2016

There are a number of operative approaches to correct stress urinary incontinence (SUI). There is clearly not one procedure that “fits all.” This review provides a summary of key available data comparing the various interventions. These findings are then incorporated into an algorithm, which attempts to outline a rational approach to select the most appropriate procedures in women seeking surgical treatment of SUI.
Male lower urinary tract symptoms associated with overactive bladder
Authors: Drake Marcus J.
Published: October 2016

Lower urinary tract symptoms (LUTS) associated with overactive bladder (OAB) are more likely to respond to antimuscarinic therapy than to alpha blockade. As such, initial treatment of men with storage symptoms should incorporate an antimuscarinic agent. For men who are truly refractory to current pharmacotherapies, there is emerging evidence to support the use of botulinum toxin A.
Appropriate workup for lower urinary tract symptoms in men
Authors: Nitti Victor W.
Published: October 2016

For most men with lower urinary tract symptoms (LUTS), the initial workup should consist of a careful history and physical examination, with or without simple adjunctive tests (e.g., uroflowometry, post-void residual, and frequency volume charts). Based on this basic workup, one is usually able to make an informed selection of initial treatment or watchful waiting. Urodynamics, cystoscopy and imaging are most useful in select cases when a specific reason is identified, the diagnosis is uncertain or when patients have failed simple initial treatments and seek further therapy.
Lower urinary tract symptoms in men: A case-based discussion
Authors: Bailly Greg , Nickel J. Curtis
Published: October 2016

At the conclusion of the sessions on lower urinary tract symptoms (LUTS) in men, participants at the 2012 Canadian Urology Forum (academic and clinical urologists from across Canada) engaged in a discussion of optimal LUTS evaluation and management. The discussion was led by Dr. J. Curtis Nickel and was based on a patient case. This review provides a summary of the case and the discussion it generated.
A smoking cessation program as a resource for bladder cancer patients
Authors: Vilensky Daniel , Lawrentschuk Nathan , Hersey Karen , Fleshner Neil E.
Published: October 2016

Background: Continued tobacco use following a bladder cancer(CaB) diagnosis puts patients at risk for other tobacco-associateddiseases and has also been associated with heightened risks oftreatment-related complications, tumour recurrence, morbidity andmortality. Our aim was to determine if patients with CaB who continueto smoke warrant a smoking cessation program as a resourcefor improving their prognosis and long-term health.Methods: A cross-sectional quantitative questionnaire-based studywas performed between January and April 2009. We surveyedpatients with a pathologically confirmed diagnosis of CaB duringtheir cystoscopy appointments at a single cancer centre.Results: One hundred patients completed the survey with 72% ofthem admitting to smoking in their lifetime. A third of respondentssmoked at the time of their diagnosis; 76% of patients who hadbeen active smokers at the time of their diagnosis (n = 33) reportedsmoking at some point thereafter and 58% continued to smoke. Among continued smokers, they were classified in the following categories: 26% were in “precontemplation,” 5% in “contemplation,”16% in “preparation,” and 53% in “action;” 37% of patientswho continued to smoke were interested in a hospital-based smokingcessation program. Overall, 70% reported smoking as a risk factor for a poor CaB prognosis. The two most common barriersto quitting were “trouble managing stress and mood” and “fear ofgaining weight.”Conclusion: Based on the data from our centre, patients with CaBwho continue to smoke after their diagnosis warrant a smoking cessationprogram as a resource for improving prognosis and long-term health. Further research should focus on establishing an efficacious and cost-effective program that provides these patients with theresources they need to quit smoking.
Recurrent transitional cell carcinoma of the bladder: A mixed nested variant case report and literature review
Authors: De Berardinis Ettore , Busetto Gian Maria , Giovannone Riccardo , Antonini Gabriele , Di Placido, Mariarosaria , Gentile Vincenzo
Published: October 2016

Nested variant of urothelial cell carcinoma (NVUC) is a rare histological entity, with about 80 reported cases. It has a deceptively benign appearance with an aspect characterized by confluent small nest or urothelial’s cell tubules. This tumour often resembles inverted papilloma, von Brunn’s nests (VBNs), cystitis cystica, nephrogenic metaplasia and sometimes usual transitional cell cancer. It is very important to be able to distinguish between benign lesions and nested variant bladder cancer because, in spite of its bland morphology, there is evidence that it behaves aggressively.
Renal cell carcinoma with secondary hemophagocytic syndrome:A case report
Authors: Chao Chia-Ter , Kao Chih-Chin , Lee Szu-Ying , Ho Shu-Jung , Jhuang Ying-Jheng , Li Lars Hung-Yuan , Kao Tze-Wah
Published: October 2016

A patient with a suspected malignancy and pancytopenia warrants much consideration. Most clinicians would consider bone marrow infiltrative process, heralding a grave prognosis. However, rare occurrence of hemophagocytic lymphohistiocytosis is another diagnostic possibility we should keep in mind. The treatment choices and overall prognosis may differ from patients without hemophagocytosis. We present a case of incidentally found advanced renal cell carcinoma (RCC) concurrent with hemophagocytosis process in the bone marrow. We also discuss the importance of this finding.
Genitourinary malignancy presenting as an ocular metastasis: A case report and review of the literature
Authors: Lefresne Shilo , Fairchild Alysa , Johnson Royce , Deschenes Jean , Russell Laurie , Pederson John
Published: October 2016

Metastases to the eye or orbit as the initial presentation of genitourinary malignancy are unusual and can be a diagnostic challenge. We report an 81-year-old man who presented with pain and proptosis in an eye that had been blind for 50 years. Radiologic investigations identified a mass involving the left globe and orbit. Histology of the enucleation specimen was consistent with a metastatic poorly differentiated carcinoma suggestive of a prostate primary. With the constellation of obstructive urinary symptoms, an abnormal digital rectal examination, elevated prostate-specific antigen and a positive bone scan, androgen deprivation therapy was initiated for metastatic prostate cancer. After an initial response to treatment, the patient’s disease progressed in a manner atypical for prostate cancer. After describing our case, we review the literature on ocular and orbital metastases and their relation to genitourinary malignancies.
A rare case of recurrent urinary obstruction and acute renal failure from cystitis cystica et glandularis
Authors: Zhu Justin X.G. , Gabril Manal Y. , Sener Alp
Published: October 2016

The use of lasers to perform photoselective vaporization of the prostate (PVP) has been widely accepted as a safe and effectivetreatment for benign prostatic hyperplasia with very few reported complications. To date, most of the published data report outcomesfor the 80-W potassium-titanyl-phosphate laser. A more potent laser, the 120-W GreenLight HPS, was introduced in 2006 and provides more efficient vaporization of prostatic tissue anddecreased operating times. Despite these benefits, the increased energy applied to the prostate evokes concerns of potential serious complications, including capsular perforation and injury to adjacent structures. A more powerful laser system, the 180-WGreenLight XPS laser (American Medical Systems, Minnetonka, MN) has recently become available. We report a rare but serious complication of GreenLight HPS PVP resulting in prostatic capsularperforation with urinary extravasation, presenting with bilateral thigh urinomas and osteitis pubis.
Chilaiditi syndrome in a patient with urological problems: Incidental diagnosis on computed tomography
Authors: Özer Cevahir , Zenger Seda
Published: October 2016

A rare syndrome, Chilaiditi’s syndrome is interposition of the colon only or with the small intestine in hepatodiaphragmatic area. It may be asymptomatic, but it may also present with symptoms, such as abdominal pain, nausea, vomiting, constipation and respiratory distress. We present a patient who was admitted with urological problems; he was incidentally diagnosed with Chilaiditi’s syndrome
Evolving therapeutic strategies for premature ejaculation: The search for on-demand treatment – topical versus systemic
Authors: Morales Alvaro
Published: October 2016

Premature ejaculation (PE) is a common sexual dysfunction affecting20% to 30% of men worldwide. Definitions of PE vary, but itis typically characterized by short intravaginal ejaculatory latencytime (IELT) with concomitant sexual dissatisfaction and distress.PE may be lifelong or acquired, but its etiology remains unclear.Treatment of PE typically involves pharmacotherapy, particularlywhen lifelong. Although there are numerous reports on the offlabeluse of selective serotonin reuptake inhibitors (SSRIs) andother compounds, only 2 treatments have been evaluated in randomizedcontrolled phase 3 clinical trials: PSD502 and dapoxetine(SSRI). Both significantly improved IELT and patient-reportedoutcome domains of ejaculatory control, sexual satisfaction, anddistress as measured by the index of premature ejaculation (IPE),compared with placebo. They constitute the focus of this review.Evidence demonstrated that PSD502, dapoxetine and other SSRIsall significantly improve the symptoms of PE. Systemic use of SSRIspresents risks associated with the known pharmacology of thisclass. PSD502 allows for topical on-demand treatment appliedapplied immediately before intercourse, and is not associated withsystemic adverse events.
Éléphantiasis pénoscrotal idiopathique : une nouvelle observation et revue de la littérature
Authors: Dekou Angoran , Konan Paul-Gérard , Yao Blaise , Vodi Clément , Fofana Abroulaye , Manzan Konan
Published: October 2016

Nous rapportons un nouveau cas d’éléphantiasis pénoscrotal idiopathique chez un adulte de 31 ans. La masse scrotale atteignait les genoux, avec lésions de grattage traitées et guéries à l’éosine aqueuse associée à une antibiothérapie par voie parentérale. Une exérèse de la masse scrotale a été effectuée, suivie d’une plastie de peau scrotale postérosupérieure associée à une circoncision partielle. Le résultat esthétique et fonctionnel à long terme fut excellent, avec une peau pénienne assouplie et élastique.
Spontaneous fracture of indwelling polyurethane ureteral stents: A case series and review of literature
Authors: Chua Michael E. , Morales Marcelino L
Published: October 2016

Polyurethane, due to its low cost, high versatility and availability, it commonly used for ureteral stents. Spontaneous fracture of these stents is rare, and the most dreaded complication. We present four cases of spontaneous fracture of indwelling polyurethane ureteral stents and review the literature to identify potential factors and preventive strategies.
A unique case of an alpha-fetoprotein-producing lung cancer with testicular metastasis
Authors: Willder Jennifer M , Thomson Andrew M , Grigor Kenneth M , Howard Grahame , Stewart Grant D
Published: October 2016

Alpha-fetoprotein (AFP)-producing primary lung tumours are rare; we present the first case of an AFP-producing lung tumour with metastasis to testes. The patient, a 72-year-old man, presented with a history of flu-like symptoms and abdominal pain. On examination he had a hard, tender left scrotal mass. Imaging showed a 4.4-cm right lower lobe lung mass and the serum-AFP was raised (1189 ng/mL). Left orchidectomy excised a necrotic tumour. Microscopy showed complete hemorrhagic infarction and immunohistochemistry showed a lack of staining for AFP. Serum-AFP rose 3 days post-orchidectomy to 1466 ng/mL. The patient subsequently developed melaena and died. Autopsy revealed a 9 × 5-cm necrotic right lower lobe lung tumour. Immunohistochemistry showed the tumour cells reacted with a pan-cytokeratin antibody and less than 5% expressed AFP. Bilateral adrenal tumour deposits were also identified in addition to those in the bowel and spleen. The expression of AFP solely in the lung lesion and lack of expression in both testes, together with a rise in serum-AFP post-orchidectomy and the bilateral adrenal metastases, is overwhelming evidence for the reversal of the usual situation: a poorly differentiated AFP-secreting metastatic lung adenocarcinoma
COSMiC details
Authors: Editorial CUAJ
Published: October 2016

A Canadian Observational Study in Metastatic Cancer of the Prostate: A Study of ZYTIGA Use in the Community Urology Setting. The COSMiC Prospective Prostate Cancer Registry.The purpose of this non-interventional, prospective, observational study is to temporally evaluate the impact of abiraterone acetate (ZYTIGA) therapy on Patient Reported Outcomes (PROs) and on clinical outcomes in the chemotherapy-naive metastatic castrate-resistant prostate cancer (mCRPC) population.Study participants must have a confirmed diagnosis of mCRPC according to medical history and have rising PSA levels or radiographic progression (documented by previous positive bone scan or metastatic lesions identified on CT or MRI) despite ongoing conventional ADT.Study participants will complete Quality of Life and Patient Satisfaction questionnaires longitudinally at defined time points. Safety and efficacy data, as well as levels of health care resource utilization associated with ZYTIGA therapy, will also be prospectively collected and analyzed.Once enrolled, study participants will be followed for a maximum of 72 weeks from the time of initiation of ZYTIGA treatment, or up to the time of early study withdrawal/termination.For additional information please contact Richard K. Plante at rplante@its.jnj.com