bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is there any relationship between serum levels of total bilirubin and the severity of erectile dysfunction?
Authors: Keskin Ercüment , Karabakan Mehmet , Bozkurt Aliseydi , Hirik Erkan , Karabulut İbrahim , Gunay Murat , Çakan Murat 
Published: June 2018

Objective: Recent studies have shown that atherosclerosis is associated with erectile dysfunction and the serum bilirubin level. In this study, the serum total bilirubin levels of patients with erectile dysfunction were measured to investigate the relationship between the levels of erectile dysfunction and total bilirubin. Methods: A total of 94 patients with erectile dysfunction were divided into three groups; severe erectile dysfunction (33 patients), moderate erectile dysfunction (31 patients), and mild erectile dysfunction (30 patients). In addition, a control group was formed with 31 healthy men. The International Index of Erectile Function-5 Questionnaire was used to measure the quality of erection in all the groups. The body mass index was calculated for all the participants. The serum glucose, low-density lipoprotein and high-density lipoprotein, cholesterol, triglyceride, total bilirubin, and total testosterone levels were also determined. Results: No statistically significant difference was observed between the groups in terms of the mean age, hypertension, smoking status, alcohol use, cardiovascular diseases, hepatobiliary disease, diabetes mellitus, and levels of total testosterone, low-density lipoprotein–cholesterol, and triglyceride. However, high-density lipoprotein, body mass index, and total bilirubin were significantly lower compared to the control group (p < 0.001). The serum total bilirubin level was found to be 0.41 ± 0.21 ng/dL in the severe erectile dysfunction, 0.43 ± 0.19 ng/dL in the moderate erectile dysfunction, and 0.48 ± 0.11 ng/dL in the mild erectile dysfunction groups (p < 0.001). Conclusion: Considering the significant differences between the erectile dysfunction and control groups in terms of serum total bilirubin levels, a low level of bilirubin may have a role in the etiology of erectile dysfunction.
Comparative results of cryoablation and laparoscopic radical prostatectomy in the treatment of localized prostate cancer
Authors: Chinenov Denis Vladimirovich , Rapoport Leonid Mikhailovich , Shpot Evgeniy Valerievich , Enikeev Dmitry Victorovich , Chernov Yaroslav Nikolaevich , Taratkin Mark Sergeevich , Korolev Dmitry Olegovich 
Published: June 2018

Aim: To evaluate early prostate cancer cryoablation functional and oncological results in comparison with results of extraperitoneoscopic radical prostatectomy. Materials and methods: We analyzed early results of surgical treatment of 285 patients with prostate cancer: 42 of them had undergone total cryoablation (Group 1) while the rest of them had been treated by radical laparo- and extraperitoneoscopic prostatectomy. For comparative assessment of prostate cryoablation results, 42 patients from Group 2 randomized in accordance with their age, stage of disease, Gleason, prostate-specific antigen, and prostate volume were selected. In compliance with the results of pre-surgical examination, all the patients had low oncological risk and were not concerned in sexual function. Volume of prostate was from 22 to 65 cm3, prostate-specific antigen level was from 4.1 to 10 ng/mL, and level of neoplastic process differentiation using Gleason grading system was from 6 to 7a (3 + 4) scores. Results: Patients after prostate cryoablation in early post-surgical period felt lower intensity of postoperative pain compared with those who had undergone prostatectomy. Follow-up period up to 12 months manifested significant true reduction of prostate-specific antigen level in both groups of patients. Frequency of stress-induced enuresis in Group 1 was not observed. Conclusion: Radical prostatectomy is still the traditional treatment of choice in the case of localized prostate cancer. But we can draw the conclusion that cryoablation is an effective low-invasive method for treatment of low oncological risk patients, which gives the opportunity both to achieve good oncological results and to preserve high life quality.
Postoperative complications and 90-day mortality in radical cystectomy in high-risk patients: A monocentric retrospective observational study
Authors: Pavone Carlo , Candela Luigi , Fontana Dario , Simonato Alchiede 
Published: June 2018

Aim: Assessing the incidence of immediate postoperative complications and 90-day mortality in high-risk patients who have undergone radical cystectomy; evaluating the correlation between preoperative conditions and surgery outcomes. Materials and methods: This is a monocentric retrospective observational study in which data of 65 patients have been analyzed. High-risk criteria: (a) Age ≥75 years, (b) obesity, (c) age-adjusted Charlson Comorbidity Index ≥8, (d) anemic status, and (e) pT ≥3. More than 50% of patients had two or more “high-risk” indicators. Postoperative complications were assessed through Clavien–Dindo classification. Results: Average age of patients was 70.4 years, average age-adjusted Charlson Comorbidity Index was 5.8, and average body mass index was 27.5. In 28% of patients, no complications arose, while in 46% grades I–II complications according to Clavien–Dindo occurred, in 23% grades III–IV complications occurred, and in 3% of the patients, death arose in the immediate postoperative period (grade V). Overall, 90-day mortality rate after surgery was 12.3%. The age ≥75 years and an age-adjusted Charlson Comorbidity Index score ≥8 have shown to be risk factors for the onset of severe complications (odds ratio = 3.54, p = 0.028 and odds ratio = 4.7, p = 0.026), while preoperative anemic status was a risk factor for complications in general (odds ratio = 4.1, p = 0.015). No analyzed parameter was a predictor of 90-day mortality ( p > 0.05). Conclusion: Immediate postoperative complications and 90-day mortality in radical cystectomy in high-risk patients remain significant, but still in line with the data in the literature on comparable populations. Some of the preoperative parameters were able to predict the outcomes of the intervention with regard to the onset of complications but not to the 90-day mortality.
Evaluation of the success rate and complications of conventional varicocelectomy: Do we need microscopic surgery really?
Authors: Ameli Mojtaba , Ahmadzadeh Milad , Khajavi Abdoljavad , Nabizadeh Mostafa 
Published: June 2018

Objective: Varicocele is the most commonly curable cause of infertility in men. Varicocele is found in 15% of the total male population, 35% of men with primary infertility, and 75%–81% of men with secondary infertility. Generally, patients seek microscopic surgery via surfing the Internet, which is not an available option in all medical centers. The purpose of this study was to determine the success rate and complications of conventional varicocelectomy and to compare it with that of the microscopic method. Methods: In this descriptive cross-sectional study, 88 patients with varicocele who underwent non-microscopic varicocele surgery in the 15th Khordad Hospital during 2013–2015 were evaluated by the census method. Results: The mean age of patients with varicocele was 27.30 years; 52 patients underwent bilateral varicocelectomy and 36 left varicocelectomy. Surgical complications of non-microscopic varicocelectomy in the studied patients included bleeding and hydrocele formation both in 0.7% and recurrence in 2.8%. Testicular atrophy was not observed in any case. Conclusion: The incidence of recurrence, hydrocele formation, atrophy, and bleeding in non-microscopic varicocelectomy, if done in accordance with its principles, is not more than the microscopic approach and therefore it could be recommended as a safe surgical treatment in centers where microscopic surgery is not available.
Entero-neovesical fistula after radical cystectomy and orthotopic ileal neobladder: A report of two cases requiring surgical management
Authors: Palumbo Vito , Giannarini Gianluca , Subba Enrica , Inferrera Antonino , Ficarra Vincenzo 
Published: June 2018

Introduction: Entero-neovesical fistula is a rare complication after radical cystectomy and orthotopic ileal bladder substitution. Typical presenting symptoms are faecaluria, pneumaturia, recurrent urinary tract infections and abdominal pain. Risk factors include history of pelvic radiation, chemotherapy and abdominal surgery, as well as diverticular colonic disease, inflammatory bowel disease and traumatic pelvic injury. The paucity of cases reported in the literature makes the management of this threatening complication very challenging. Conservative treatment has only anecdotally been reported. Case description: We describe two cases of entero-neovesical fistula with different presentation, which both required an immediate surgical treatment. The former patient was admitted to the emergency room with faecaluria, complete urinary incontinence and fever 2 years after radical cystectomy, and a fistula between the Y-shaped neobladder and the bowel anastomosis was detected. He had previously undergone chemotherapy because of tumour progression. Undiversion into an ileal conduit was required. The latter patient presented with faecaluria 20 days after an uneventful radical cystectomy, and a fistula between the Vescica Ileale Padovana neobladder and the sigmoid was documented. Treatment included resection of the sigmoid with several small diverticula, temporary ileostomy and closure of the neobladder fistula. Conclusion: Conservative treatment of entero-neovesical fistula can be attempted only in patients with small openings in the small bowel and no systemic symptoms. In all other cases, surgical treatment with bowel resection and either closure of the neobladder opening or undiversion should be the preferred option.
Onabotulinumtoxin-A improves health status and urinary symptoms in subjects with refractory overactive bladder: Real-life experience
Authors: Tamburro Fabiola R , Castellan Pietro , Neri Fabio , Berardinelli Francesco , Bada Maida , Sountoulides Petros , Giuliani Nicola , Finazzi Agrò Enrico , Schips Luigi , Cindolo Luca 
Published: June 2018

Objective: Onabotulinumtoxin-A has been approved for wet overactive bladder refractory to anticholinergics in randomised controlled trials; however, data from real-life practice are scarce. This study was designed to assess the efficacy of intravesical onabotulinumtoxin-A injections, focusing on health status, urinary symptoms and subjective satisfaction. Methods: Data from consecutive patients with overactive bladder-refractory to anticholinergics treated with onabotulinumtoxin-A were prospectively collected and analysed. Standard doses (100–150 U) were used, followed by repeat sessions when clinical benefits diminished. Efficacy and safety of repeat onabotulinumtoxin-A administrations were assessed at 12-week post-injection. Clinical parameters evaluated were: change in the magnitude and frequency of incontinence, urgency and nocturia episodes, change in the number of pads used and procedural complications. Quality of life was evaluated using the 36-Item Short-Form Health Survey, Overactive Bladder Screener and Treatment Benefit Scale questionnaires. Results: Consecutive overactive bladder-refractory to anticholinergics patients ( n = 22) (median duration of oral therapy: 10 months) were enrolled. No intraoperative complications occurred, but two urinary retention cases were recorded. Forty-five percent of patients (10/22) were re-treated (median duration of perceived benefits: 18 months, range: 8–55 months). The number of urinary incontinence, frequency and nocturia episodes, and pads used went from 3.6, 11.3, 2.7 and 2.4 preoperatively to 1.0, 5.8, 0.7 and 0.7 postoperatively ( p < 0.005). Quality of life (36-Item Short-Form Health Survey) was significantly improved and symptom scores (Overactive Bladder Screener) were reduced, from 34.5 to 17.1 at week 12 ( p < 0.05). Eighty-seven percent of patients indicated improvement/great improvement in their condition (Treatment Benefit Scale). Conclusion: Intradetrusor injections of onabotulinumtoxin-A in patients with overactive bladder-refractory to anticholinergics significantly improved health status and urinary symptoms, with high subjective satisfaction.
Ischemia of the glans 24 hours after circumcision: A case report and therapeutic solution
Authors: Mittino Irene , Sangalli Mattia , Fabbri Fabio , Sozzi Francesco , Ghezzi Massimo , Zanni Giuseppe , Cestari Andrea 
Published: June 2018

Introduction: Circumcision is a common surgical procedure, typically performed under local anesthesia and somehow also as outpatient clinic. Although complications are rare and most frequently related to the procedure itself, ischemia of the glans may occur as a major complication and can be related to local ischemia following dorsal penile nerve block. Case description: We describe the case of a 33-year-old patient who underwent circumcision at our institution and, 24 h after the procedure, developed an acute ischemia of the glans; a re-intervention was performed in emergency setting to ensure a large, not-tightened circular suture under the glans, and low-molecular-weight heparin and antiplatelet therapy was introduced to achieve anti-coagulative/antiaggregant effects. After 48 h, the skin returned to its normal color and in 7 days the penile glans achieved complete remission of the ischemic aspect. A 6-month follow-up confirmed regular outcomes with normal erectile functions. Conclusion: The treatment we proposed to treat acute post-circumcision ischemia of the glans is a simple and effective one, with a perfect aesthetic and functional outcome observed within 4 weeks and confirmed at 6-month follow-up.
15 years’ survey of safety and efficacy of Serenoa repens extract in benign prostatic hyperplasia patients with risk of progression
Authors: Vinarov Andrey Zinovievich , Spivak Leonid Grigorievich , Platonova Darina Vladimirovna , Rapoport Leonid Mikhailovich , Korolev Dmitry Olegovich 
Published: June 2018

Aim: The aim of this study is to investigate the efficacy and safety of long-term therapy with Serenoa repens extract with regard to halting benign prostatic hyperplasia progression. Material and methods: An open non-comparative observational study of the continuous use of S. repens plant extract at a dosage of 320 mg once a day for 15 years was performed in 30 patients at risk for benign prostatic hyperplasia progression. Changes in IPSS (International Prostatic Symptoms Scale) and QoL (Quality of life) scores and changes in Qmax, voided volume, residual urine volume, and prostate volume were evaluated during the study. Results: The study showed an absence of progression based on both subjective (the sum of scores on the IPSS and QoL scales) and objective (prostate volume, urination rate, residual urine volume) criteria. Furthermore, the patients had no adverse events related to the study drug, including prostate cancer. Conclusions: The 15 years’ study results suggest that taking S. repens plant extract continuously at a daily dose of 320 mg is an effective and safe way to prevent the progression of benign prostatic hyperplasia.
Comparison Between Two Types of Educational Computer Games
Authors: Dedeaux Timothy , Hartsell Taralynn 
Published: June 2018

Background. Educational computer games can enhance learner engagement and content knowledge gain. Video games based on Malone’s theory of game design that involve challenge, fantasy, and curiosity can help improve learning. Aim. The purpose of the study is to compare differences between two drill-and-skill games to learn French phrases. Variables examined were student engagement, content knowledge gain, and demographical implications (e.g., gender, minority status, and socio-economic status). One of the games in the study meets Malone’s theory of game design. Method. This quasi-experimental study divides participants into two groups, each playing a different type of drill-and-skill game. Instruments to collect data include a pre- and post-test on French phrases and a digital game engagement questionnaire. Participants receive a short instructional session, game play time, and instruments to complete. Results. No significant results have been found in content knowledge gain and engagement between participants in the pre- and post-tests. A slight difference in relation to minority status has been discovered. Feedback from the participants show a positive response toward the games, except that some distraction and technicality have interfered with their learning. Conclusion. Although results are inconclusive, drill-and-skill computer games can be a tool to enhance learning and provide student engagement.
Frequency and Impact of Adverse Events in Patients Undergoing Surgery for End-Stage Ankle Arthritis
Authors: Norvell Daniel C. , Shofer Jane B. , Hansen Sigvard T. , Davitt James , Anderson John G. , Bohay Donald , Coetzee J. Chris , Maskill John , Brage Michael , Houghton Michael , Ledoux William R. , Sangeorzan Bruce J. 
Published: June 2018

Background: This study summarized the frequency and functional impact of adverse events (AEs) that occur after surgery for end-stage ankle arthritis (ESAA) to inform decision making. Methods: This was a multisite prospective cohort study to compare ankle arthroplasty to ankle arthrodesis in the treatment of ESAA among 6 participating sites. We compared the risk and impact of nonankle AEs and ankle-specific AEs versus no AEs controlling for potential confounding factors, including operative procedure using multinomial logistic regression. We estimated differences in postoperative functional outcomes by AE occurrence using linear mixed effects regression. Among 517 patients who had surgery for ankle arthritis and completed the full baseline assessment, follow-up scores were available in 494 (95%) patients. Results: There were a total of 628 reported AEs (477 in the arthroplasty group and 151 in the arthrodesis group). These occurred in 261 (63%) arthroplasty patients and 67 (65%) arthrodesis patients. There were 50 (8%) ankle-specific AEs. The risk of an ankle-specific AE was slightly higher in the arthrodesis group versus the arthroplasty group, odds ratio (OR) 1.84, 95% confidence interval (CI, 0.85, 3.98). The OR for the risk of non–ankle-specific AE versus no AE was 0.96, 95% CI (0.57, 1.61) for those receiving arthrodesis compared to arthroplasty. Compared to patients with no AEs, those experiencing ankle-specific AEs had significantly less improvement in Foot and Ankle Ability Measure Sports and activities of daily living (ADL) subscores and worst pain outcomes; however, both groups improved significantly in all measures except mental health. Conclusions: Ankle-specific AEs were infrequent and only weakly associated with operative procedure. Although patients improved in all functional outcomes except mental health, regardless of AE occurrence, ankle-specific AEs negatively impacted patient improvement compared to those with no AEs or a nonankle AE. The logistical effort and cost of tracking nonankle AEs does not seem to be justified. Level of Evidence: Level II, prospective comparative study.
An unusual complication after placement of an inferior vena cava filter via right internal jugular vein access
Authors: Nas Hala , Bowe Dedrick , Soubani Ayman O 
Published: June 2018

Introduction: Totally implantable venous access devices are used extensively worldwide in cancer patients for administration of venotoxic agents, blood sampling, and nutrition. Their tip is usually positioned at the junction of superior vena cava and right atrium. Inferior vena cava filters are usually used for deep venous thrombosis in cases where anticoagulation is contraindicated; they can be inserted either via internal jugular or femoral access depending on patient conditions and preference. Case description: We are describing here a case of totally implantable venous access device fracture following a right internal jugular approach for inferior vena cava filter placement as the patient had inferior vena cava thrombus below the renal veins, extending into the right common iliac vein prohibiting femoral approach. Conclusion: Iatrogenic fracture of totally implantable venous access device is a potential complication of accessing the internal jugular vein for other procedures such as insertion of inferior vena cava filter.
Impact of Tibial Runoff on Outcomes of Endovascular Treatment for Femoropopliteal Atherosclerotic Lesions
Authors: Park Ui Jun , Kim Hyoung Tae , Roh Young-Nam 
Published: June 2018

Objectives: The aim of this study is to investigate the impact of tibial runoff on outcomes of femoropopliteal interventions for atherosclerotic lesions. Methods: A retrospective review of 243 endovascular procedures for femoropopliteal atherosclerotic lesions on 243 limbs of 197 patients was performed. Results: The distribution rates of good tibial runoff (runoff score <7) and poor tibial runoff (runoff score ≥7) were 37.0% and 63.0%, respectively. In the poor tibial runoff group, the patients were older ( P = .019), and the proportion of male was lower ( P = .014). There was a significantly higher proportion of rest pain or tissue loss ( P < .001), and the prevalence of stroke ( P = .031) and renal insufficiency ( P = .005) was significantly higher in the poor runoff group. After femoropopliteal intervention, the amputation-free survival ( P = .03) and freedom from ischemia ( P = .003) were significantly lower in the poor runoff group. The interventions targeting below-the-knee (BTK) lesions performed concomitantly for critical limb ischemia or tissue loss with poor tibial runoff did not show a significant advantage in terms of freedom from ischemia; however, minor trends of longer lasting freedom from ischemia were observed when BTK intervention was combined. Conclusion: The patients with poor runoff showed significantly lower amputation-free survival and freedom from ischemia. In poor tibial runoff limbs with critical limb ischemia or tissue loss, BTK intervention did not demonstrate additional significant beneficial outcomes; however, there was a minor trend of longer lasting freedom from ischemia after concomitant BTK intervention.
Lipohypertrophic Skin Changes in Patients With Diabetes: Visualization by Infrared Images
Authors: Kaltheuner Lars , Kaltheuner Matthias , Heinemann Lutz 
Published: June 2018

Background: Many patients with diabetes on insulin therapy develop lipohypertrophies (LHTs). So far, LHTs are diagnosed by conventional methods (CM; visual inspection, palpation and/or ultrasound). In everyday life, it would be advantageous to have a quick, simple and inexpensive alternative, for example, diagnosing them by obtaining infrared (IR) images. Methods: We obtained IR images from 43 subjects (21 patients with type 1 diabetes, conventional subcutaneous insulin therapy and known LHTs, 8 patients with CSII and LHTs, 7 patients without LHTs, and 7 healthy people), all from one specialized diabetes practice. The IR images were taken under standardized conditions with a high-resolution infrared camera (VarioCam® HDx Jenoptic, IR pixel 640 × 480, thermal resolution 0.003K) and compared with LHT diagnoses with CM. Results: In 14 of the 29 (48%) patients, CM diagnosed LHTs were “cold spots” in the IR images. The temperature difference to “healthy” skin (without LHTs) was up to 6°C. Of the 14 patients, 11 also showed such spots, without findings with CM. Four patients did not show clearly identifiable cold spots as LHT and 2 patients showed no changes in the IR images. The remaining 9 patients did not show clearly identifiable cold spots as LHT, but the diagnosis with CM was also ambiguous. Conclusions: The results of this small (pilot) study do not clearly support the value of IR images for the diagnosis of LHTs, but they do not refute this approach. Diagnosis of LHT might be hampered due to the existence of different types of LHTs. Usage of IR images can apparently detect LHTs before they can be diagnosed with CM. Further targeted investigations are required to make statements about the usability of this method.