bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinician-reported changes in octreotide prescribing for malignant bowel obstruction as a result of an adequately powered phase III study: A transnational, online survey
Authors: Campbell Rachel , McCaffrey Nikki , Brown Linda , Agar Meera R , Clark Katherine , Currow David C 
Published: June 2018

Background: Translating research evidence into clinical practice often has a long lag time. Aim: To determine the impact of a phase III randomised controlled trial on palliative care clinicians’ self-reported practice change. Design: Online survey about use of octreotide in managing inoperable malignant bowel obstruction due to cancer or its treatments distributed in November 2016, 2 years after the first publication of the study in a peer-reviewed journal. Demographic, self-reported practice and the reasons underpinning this were collected. Responses were aggregated to ‘practice modified’ or ‘practice not modified’. A multinomial regression model explored predictors of practice change. Setting: Members of the Australian New Zealand Society of Palliative Medicine. Results: Response rate was 20.8% (106/509): 55.6% were aged >50 years, 56.5% were female and 77% had previously prescribed octreotide for this clinical indication. Out of 106 respondents, 52 (49.1%) indicated modified practice (60.9% of those who had previously prescribed octreotide in this setting). In those who reported practice change, most frequently octreotide was now used when other therapies failed; for not changing practice, ‘more confirmatory evidence was needed’ was most often cited. In the regression model, older age (clinician age = 50–59 years; relative risk = 0.147; 95% confidence interval = 0.024–0.918; p = 0.04) and having practices with lower proportions of people treated with octreotide (0%–20%; relative risk = 0.039; 95% confidence interval = 0.002–0.768; p = 0.033) predicted greater self-reported practice change. Conclusion: Clinician-reported change in practice in the survey is seen in the majority of respondents. This suggests that there is a cohort of ‘early adopters’ within palliative care practice as new evidence becomes available.
Occidental Encounters and Impressions
Authors: Singh Sohini 
Published: June 2018

The visual and literary chronicles of British Residents and Surveyors comprise a reservoir of information on the historical, social and economic milieus of various territorial regions within the Indian subcontinent. Further, they contain copious documentation on the art and architectural heritage of these regions. Straddling the realms of antiquarianism and archaeology, the concomitant processes of survey and documentation evolved during the seventeenth century and acquired a panoptic character by the nineteenth century. They were essentially products of the interface between the diametrically opposed occidental and oriental cultures and were furthered by the expedients of colonialism. This article is divided into three parts. The first part delves into the relationship between antiquarianism and archaeology. The second part elucidates upon the practices of surveying and documentation in India. The third part elaborates upon the career of Lt. Frederick Charles Maisey and his explorations in central India with special reference to his mid-nineteenth century illustrations of Chanderi’s architectural edifices and structural members. Chanderi, a town of historical importance in Madhya Pradesh, is interspersed with tombs, step-wells, mosques and free-standing gateways of Indo-Islamic affiliation, ascribable largely to the fifteenth century. Some of these edifices are in a bad state of preservation and Maisey’s illustrations have been instrumental in reconstructing their effaced architectonic and decorative details. The illustrations under purview have also contributed towards a holistic understanding of the architectural style at Chanderi, an area which is fairly uncharted.
Ureteropelvic Junction Obstruction: Some new Acquisitions about Etiology, Pathophysiology and Diagnostics
Authors: Alberti C. , Tizzani A. 
Published: June 2018

The etiopathogenesis of uretero-pelvic junction obstruction (UPJO) has been the subject of many speculations and it remains, in some ways, a debatable matter. Some recently reported thorough research refer to neuro-mediated pathogenetic mechanisms rather than (or together with) myogenic ones. Advances in US, radioisotopic functional imaging, CT and RM contribute to differentiate the obstructive conditions from the non-obstructive ones and to afford today a better assessment of renal functional damage. Particularly, diuretic renography is a non-invasive test for characterization of the renal functional abnormalities resulting from UPJO. Helical CT with angiography is a useful technique for identification of crossing vessels (pyelo-vascular tangle) which can be used for the pre-surgical planning of endopyelotomy. Endoluminal ultrasonography can be used to guide the position of the incision for endopyelotomy (US-guided endopyelotomy). Laboratory examinations are important to determine the overall renal function (serum creatinine, acid-base balance, serum electrolytes, etc.), urinary MCP-1 and NAG (markers of tubular damage), and to rule out urinary tract infections. The management of UPJO (watchful waiting; either open or laparoscopic dismembered pyeloplasty; endoluminal procedures) is greatly influenced by the diagnostic evaluation. The paper aims to outline the advances in both physiopathology and diagnostics of UPJO on the basis of a review of the literature.
Perioperative Complications of Laparoscopic Radical Prostatectomy: Initial Experience
Authors: Gregori A. , Simonato A. , Lissiani A. , Bozzola A. , Galli S. , Rossi P. , Gaboardi F. 
Published: June 2018

We retrospectively evaluated the intraoperative and early postoperative complications of the initial experience with the first 80 laparoscopic radical prostatectomies performed at our institution. Between January 17, 2001 and July 24, 2002, 80 patients with clinically localized prostate cancer underwent transperitoneal laparoscopic radical prostatectomy. The pathological tumor stage revealed 18 pT2a (22.5%), 29 pT2b (36.25%), 21 pT3a (26.25%), 10 pT3b (12.5%), 1 pT4 (1.25%), 1 pT4 N1 (1.25%). No conversion was necessary in all cases. Injury to the epigastric vessels was detected intraoperatively in 5 cases (6.25%) with immediate hemostatis achieved. There was 1 death (1.25%) 35 days after a cerebrovascular accident occurred on postoperative day 3. We observed 1 (1.25%) postoperative ileus, hemoperitoneum in 5 cases (6.25%), 2 (2.5%) acute urinary retentions, 6 (7.5%) anastomotic leakages, 1 (1.25%) anastomotic stricture, 1 (1.25%) hydrocele and 2 (2.5%) urinary tract infections. In our initial experience laparoscopic radical prostatectomy was performed with no complications in 77.5% of patients. We observed major and minor complications respectively in 16.25% and 6.25% of the patients. Our series provides evidence that the laparoscopic approach during a learning curve is feasible and associated with acceptable morbidity.
Extensive Neurophisyological Evaluation in Primary Premature Ejaculation Patients
Authors: Imbimbo C. , Granata A.M. , Buonopane R. , Barba C. , Ranavolo R. , Cicalese A.R. , Mirone V. 
Published: June 2018

Pudendal nerve somatosensory evoked potentials (PN-SEPs), bulbo-cavernosus reflex (BC reflex) and perineal motor evoked potentials (BC MEPs) following transcranial magnetic cortical stimulation (TMS) were performed in patients with primary premature ejaculation (PPE), to investigate the somatic sensory and motor function of the genital area. Methods Fourteen patients with PPE underwent psychological counseling, urologic physical and trasnrectal ultrasound examination, laboratory data and Stamey test. Spinal and cortical PN-SEPs were recorded by dorsal nerve stimulaiton at penile shaft (DN-SEPs) in all patients, and at glans penis (GP-SEPs) in 3 of them. BC reflex was obtained by stimulating the basis of penis. Results Mean sensory thresold did not significantly differ between patients and normal subjects. Cortical DN-SEPs were normal in alla patients. Sensory central conduction was significantly smaller in patients than controls. In 3 patients and in 3 controls undergone both DN-SEPs and GP-SEPs, glans penis sensory threshold was lower than dorsal nerve one, and cortical GP-SEP latency longer than cortical DN-SEP latency. BC reflex was normal in most patients. BC MEPs were normal in all patients, but one. Conclusions We did not confirm either a faster conduction along the pudendal sensory pathway, or a greater cortical representation of the sensory stimuli from the genital area in oue patients. Moreover, we did not confirm an hyperexcitability of BC reflex in them. Our results suggest that the electrophysiological approach is probably not sufficient to clariphy the causes of PPE and more integrated investigation are requested.
A Case of Renal Pseudoaneurysm Incidentally Discovered
Authors: Mazzariol C. , Ca'Bianca E. , DI Tonno F. , Risica G. , Malossini G. 
Published: June 2018

Intrarenal pseudoaneurysms generally derive by renal trauma. They usually present with hematuria after a few time. Angiography combined with embolization represent the best diagnostic and therapeuthic procedure, with a success rate of about 100%. We report a case of voluminous renal pseudoaneurysm, incidentally discovered and treated with angio-embolization.
Renal Tumours, Epidemiology and Diagnostic Profile
Authors: Ricciotti G. , Bozzo W. 
Published: June 2018

Our understanding of the natural history of renal cell carcinoma and the possibilities of new technologies are evolving and being integrated with advances in classification and staging. In this article we reviewed the literature in order to provide an analysis of the changing epidemiology of renal cell carcinoma. Radiological evaluation of renal masses has rapidly progressed from conventional angiography and intravenous urography to ultrasounds, CT and MRI. As more patients are imaged for many opportunities, the incidental detection has increased. This article reviews the imaging and not techniques in order to characterize these lesions accurately.
Laparoscopic Lymphadnectomy in the Prostate Cancer
Authors: Fasolis G. , Fasolo P. P. , Conti E. , Sebastiani G. , Mandras R. , Puccetti L. , Lacquaniti S. 
Published: June 2018

Treating prostate cancer, pelvic lymphadenectomy is still a debating topic in current international licterature. Surgical removal of both internal iliac vessels and obturatory fossa lymphonodes is usefull in order to stage lymphatic spreading of prostate cancer. We evaluated possible indications to laparoscopic limphadenectomy according to present know-ledges. Methods From october 2001 to june 2003, at our instituction 18 consecutive patients with clinically advanced prostate carcinoma diagnosed at transrectal ultrasonography guided needle biopsy and >20% preoperative risk of lymphonode metatstasis, underwent laparoscopic pelvic lymphadenectomy. Patients’ surgical postion in the theatre room was according to classic reported transperitoneal approach. Five disposable trocars were used for optical and instruments access. Results Mean surgical intervention time, blood loss and number of removed lymphonodes was 163 ± 32.8 minutes, 180 mL ± 25 and 28.7 ± 8.6 respectively. Ten patients (55%) were diagnosed to have lymphonode metastasis. Mean number of metastatic lymphonodes was 3. Conversion to open surgical procedure was not recorded. In 17 out of 18 cases, analgesic therapy was not necessary during hospital stay; in those patients intestinal canalisation, mobilisation and oral food intake restarted in first postoperative day. We had only one major complication. Laparoscopic pelvic lymphadenectomy costs were € 4.244. Regional diagnosis relata groups fee was € 4.463. Conclusion Laparoscopic lymphadenectomy, when indicated, was in our experience safe and effective but still expensive procedure with high patient’ satisfaction.
Nodal Involvement in Bladder Cancer
Authors: Bassi PF. , DE Marco V. , Tavolini IM. , Dal Moro F. , Battaglia D. , Aragona M. , Longo F. 
Published: June 2018

There are many controversies about the actual meaning of nodal involvement in bladder cancer and, subsequently, about the real benefit of pelvic lymph node dissection (PLND) in patients with positive nodes at the time of cystectomy. In this article we reviewed the literature about the role of nodal involvement and the impact of positive nodes on the prognosis. The finding of positive nodes after radical cystectomy and PLND makes generally consider bladder cancer as a systemic disease and it is associated with poor prognosis. Therefore many urologists don't perform radical surgery in patients with positive nodes at time of cystectomy. P category, N category, and distant metastases are the most important factors in determining the outcome of patients with bladder cancer with nodal involvment. PLND is necessary for accurate staging in bladder cancer and appears to benefit patients with limited nodal involvement. PLND should be considered as a standard procedure that should be performed in every patient with indication of surgical treatment for TCC of the bladder.
An Evaluation of Quality of Life in Patients who Underwent Urinary Diversion after Radical Cistectomy: Comparison of Different Urinary Diversions, our Experience
Authors: Mariani L. , Milanese G. , Piergallina M. , Minardi D. , Polito M. , Muzzonigro G. 
Published: June 2018

The aim of the study was to compare health-related quality of life (HRQOL) in 3 groups of patients with different urinary diversions using the “36 Item Short-Form Healt Survey” questionnaire; metabolic changes related to urinary diversion were also evaluated. The study included 22 patients who underwent radical cystectomy for bladder cancer: 10 pts had an an ileal-conduit (Group I), 9 had a retto-sigmoid pouch sec. Mainz II (Group II), and 3 had an ileal orthotopic neobladder (Group III). There were no significant differences among the 3 groups regarding the metabolic status. The SF -36 survey showed that patients with ileal-conduit (Group I) had a significant decrease of general health (GH) and of physical functioning (AF) scores compared to patients with continent urinary diversion (Groups II and III). This appeared to be related to a decreased emotional drive (RE) rather than to a loss of vitality (VT). There were no significant differences in any scale score between Group II and III.
Long-Term Results of Nephron Sparing Surgery for Localized Renal Cell Carcinoma
Authors: Autorino R. , De Sio M. , Damiano R. , Schiavo M. , Cosentino L. , Pane U. , Di Giacomo F. , Giordano D.R. , Quarto G. , Mordente S. , Domenico R. , D'Armiento M. 
Published: June 2018

Several unrandomized studies from the current literature confirm that in selected patients with localized renal cell carcinoma (RCC), nephron sparing surgery (NSS) shows to be as effective as radical surgery. In this regard, we evaluated the data from patients treated by using such a conservative approach with a long-term follow-up. Materials and Methods. We considered 28 patients (19 M, 9 F; median age 54 years) with unilateral, localized, small (< 4 cm) RCC, submitted to NSS from 1988 to 1994. Only 3 of them (10%) were symptomatic at presentation. Oncological follow-up had been conducted with visits every 4 months for the first two years, every six for another three years and then annually. Results. All the patients were clinical stage T1aN0M0 (UICC TNM 2002). Grading was: 10 G1, 10 G2, 8 G3. Mean tumor diameter was 3.2 cm. After a long-term follow-up (mean 10 years, range 8–14), none present local relapse, disease specific survival is 93% and overall survival is 86%. Based on biochemistry, 82% of the remaining patients still have a normal renal function. Conclusions. Given the excellent long-term results and the recognized benefits of elective NSS, this approach should be preferentially adopted in a selected population of patients with small (<4 cm), unilateral, RCC.
Transitional Cell Carcinoma of the Posterior Urethra in Men: Our Experience
Authors: Parma P. , Dall'Oglio B. , Schiavon L. , Luciano M. , Guatelli S. , Galletta V. , Bondavalli C. 
Published: June 2018

We present the experience of the Division of Urology of Mantova Hospital about the primitive carcinoma of the posterior male urethra. This kind of tumor is very rare and there are't great experiences that permit to define a standardize therapy. Material and Methods. Three cases of primary posterior urethral carcinoma who had been treated at our institution between 1999 and 2001 were retrospectively analyzed. The location of the tumor was in 2 cases in the prostatic urethra and in 1 case in the membranosus urethra. The treatment was cistoprostatectomy in 1 case, cistoprostcatectomy associated with penectomy in the case of carcinoma of the membranosus urethra and a prostatectomy in one case of the carcinoma of the prostatic urethra. In 2 cases an adiuvant chemotherapy with cispaltinum was performed while in the third patient a chemiotherapy with gemcitabina was performed at the presentation of a local relapse of tumor. Results. In the case of carcinoma of the prostatic urethra treated with cistoprostatectomy and uretrhectomy and adiuvant chemotherapy there was a good local and distand controll of the cancer with a follow up of 24 months. The patients with carcinoma of the membranosus urethra treated with cistoprostcatectomy associated with penectomy and adiuvant chemiotherapy had a local relapse at 24 months and was treated with radiotherapy. The patient treated with only prostatectomy presented a local relapse at 2 months and distant metastasis at 15 months. After 2 years this patient is still alive but in clinical progression. Conclusions. The most adequate treatment in the cases of posterior urethral cancer seems the major surgical treatment with urethrectomy associated with radical cistectomy. In advanced stages chemotherapy which by necessity must follow the guidelines established for the treatment of other urothelial cell malignancies seems to give good results. The follow-up of these patients has to be very close.
Osservational Study on Early Diagnosis of Prostate Carcinoma in Sicily and Calabria
Authors: Allegro R. , Serretta V. , Aragona F. , Motta M. , Orestano L. , Cammarata C. , Melloni D. , Magno C. , Aragona C. , Pirritano D. , Paola Q. , Cosentino V. , Capizzi G. , Saita A. , Spampinato A. , Nicolosi D. , Raciti G. , Salvia G. , Rinella M. , Macaluso M. Pavone ,   E MEMBRI DELLA SOCIETÀ SICULO-CALABRA DI UROLOGIA (SSCU) E DEL GRUPPO STUDIO TUMORI UROLOGICI (GSTU), Orestano F. , Vacirca F. , Caramia M. , Cozzupoli P. , De Grande G. , Lapira G. , Ventrici F. , Falvo F. , Galfano G. , Armenio A , Gange E. , Rizzo I. , Massarelli M , Saita A. , Bartolotta S. , Pepe P. , Pavone C. , Ingargiola G.B. , Taschetti S. , Vaccarella G. , Contino G. , De Leo F. 
Published: June 2018

The diagnosis of prostate carcinoma has been monitored in Sicily and Calabria for one year. Material e Methods Twenty-seven urological centres of Sicily and Calabria joined the study. Detailed informations about age, familiarity, PSA, Gleason score and TNM stage at diagnosis were centralized between november 2001 and november 2002. Results 721 patients have been recruited. The median age was 73 years. More than 80% of the patients were older than 65 years. Median PSA was 14 ng/ml. The clinical stage at diagnosis was T1c in 33% of patients and 67% had an organ confined prostate cancer (T1-T2). Familiarity was detected in 8% of cases. Age and PSA at diagnosis in these patients were similar to those of the remaining population. However, only 18% of them had a T1 tumor, emphasizing the delay in diagnosis in these patients. Although only 10% of the patients shows at diagnosis a metastatic tumor, 29% only are fit for radical prostatectomy in according to age, PSA and stage.
Predictive Factors of Prostate Cancer in Patients Subjected a Prostatic Re-Biopsy, with Psa in the Grey Zone
Authors: Zaramella S. , Monesi G. , Sala M. , Favro M. , Marchioro G. , Gontero P. , Kocjancic E. , Ceratti G. , Maso G. , Frea B. 
Published: June 2018

In this study we have tried to define which are the most useful predictive factors in the diagnosis of the prostate cancer in patients with first negative biopsy and with PSA in the grey zone. We have therefore analysed 123 patients subjected at re-biopsy: in 25 patients (20%) it is been diagnosed a prostate cancer at the second biopsy, while in 98% (80%) also the second biopsy was negative. The PSA ratio and the PSA density of the transitional zone have demonstrated having the highest sensitiveness in finding patients with cancer at the re-biopsy (92% and 88%) in comparison with the ER and the TRUS (20% and 32%). Moreover the PSA DTZ let spare the 41% of the re-biopsy that will result negatives.
Alpha1 Adrenoceptor Subtypes in Human Urinary Bladder: Sex and Regional Comparison
Authors: Peroni A. , Mirabella G. , Sigala S. , Fornari S. , Palazzolo F. , Faccoli S. , Simeone C. , Pezzotti G. , Spano P.F. , Cunico S. Cosciani 
Published: June 2018

The aim of this work is to report a detailed study of the presence of α1 AR subtypes in human urinary bladder areas involved in the micturition (i.e. detrusor, trigone and neck), investigating whether or not there are differences between sexes. Methods Urinary bladder specimens were obtained as discarded tissue after cystectomy for vesical carcinoma (17 men and 14 women). Molecular characterization of α1 AR subtypes was done by semi-quantitative RT-PCR. The α1 AR protein expression was studied by saturation binding curves using the α1 AR antagonist 125I-HEAT and by western blot. Analysis of data was performed using the GraphPad PRISM 4 software. Results Results obtained indicated that α1 AR proteins were detectable in each bladder area. In both sexes, the detrusor and the neck expressed similar levels of α1 ARs: respectively, detrusor: 14.6 ± 1.2 in men and 13.1 ± 1.1 fmol/mg prot in women; neck: 16.9±3.2 in men and 17.5 ± 4.1 fmol/mg prot in women. In the trigone, significantly higher α1 ARs were found in women compared to men (20.6 ± 1.1 vs 11.7 ± 0.7 fmol/mg prot). Subtype analysis indicated that in women, each area was endowed with mRNA and protein encoding for each α1 AR subtype. The men detrusor expressed α1A and α1D ARs, while in the trigone and the neck, each subtype was present. Conclusions A selective distribution of α1 ARs did exist between sexes and between the different areas involved in micturition, supporting evidence which indicates a role of different α1 AR subtypes in the pathophysiology of the lower urinary tract symptoms.