bluuebunny/crossref_metadata_2025_split huggingface dataset:
Are prophylactic antibiotics necessary in patients with preoperative sterile urine undergoing ureterorenoscopic lithotripsy?
Authors: Hsieh Cheng‐Hsing , Yang Stephen Shei‐Dei , Lin Chia‐Da , Chang Shang‐Jen 
Published: October 2013

Objective
To compare the efficacy of prophylactic antibiotics in reducing post‐surgical infections in patients undergoing ureterorenoscopic lithotripsy (URSL).
Patients and Methods
The study was a double‐blind, prospective, randomized controlled trial.
Between 2009 and 2012, 212 patients with preoperative sterile urine undergoing URSL were randomly allocated, in a ratio of 1:1:1:1, to receive prophylactic antibiotics with single‐dose i.v. cefazolin (1 g), ceftriaxone (1 g) or oral levofloxacin (500 mg), or no treatment (control group), respectively.
Urine analysis and urine cultures were obtained between postoperative days 5 and 7.
Pyuria was defined as ≥10 white blood cells/high power field. Significant bacteriuria was defined as ≥100,000 colony‐forming units uropathogens/mL. Febrile urinary tract infection (fUTI) was defined as a body temperature of 38.5 °C with pyuria or significant bacteriuria ≤7 days after surgery.
Results
In total, 206 patients were eligible for analysis. The rates of postoperative pyuria were significantly lower in patients with prophylaxis than in the control group (48.4 vs 64.7%, P = 0.04).
Patients receiving prophylaxis with levofloxacin and ceftriaxone had a significantly lower risk of pyuria compared with the control group (52.0 and 36.5 vs 64.7%, respectively; P < 0.05).
The rates of bacteriuria and fUTI tended to be lower in patients with prophylaxis, although the difference was not significant (4.5 vs 11.8%, P = 0.09, 1.3 vs 5.9%, P = 0.09).
There was no significant difference in rates of bacteriuria and fUTI between the four groups. Patients with proximal stones had a higher risk of developing postoperative fUTI (odds ratio 9.35; P = 0.03).
Conclusion
Antibiotic prophylaxis significantly reduces the incidence of pyuria after URSL and tends to diminish the risk of bacteriuria and fUTI.
Cyclooxygenase‐2 inhibitor suppresses tumour progression of prostate cancer bone metastases in nude mice
Authors: Garcia Marta , Velez Roberto , Romagosa Cleofé , Majem Blanca , Pedrola Núria , Olivan Mireia , Rigau Marina , Guiu Marc , Gomis Roger R. , Morote Juan , Reventós Jaume , Doll Andreas 
Published: October 2013

Objective
To assess whether celecoxib, a selective cyclooxygenase‐2 (COX‐2) inhibitor with anti‐cancer properties, has an inhibitory effect on tumour establishment and progression of prostate cancer (PCa) bone metastases.
Materials and Methods
PC‐3 stable luciferase‐expressing cells were injected into male nude mice by intracardiac (i.c.) and intratibial (i.t.) injections, and the effect of celecoxib on bone metastases was then recorded using bioluminescence image analysis.
In cases of chemoprevention, mice received 3 mg/kg celecoxib from 1 week before cell implantation until the end of the study, and to test the therapeutic effect, mice received celecoxib 1 week after cell implantation until the end of the study.
Tumour tissue samples were histologically examined and COX‐2 expression was quantified at the protein level.
Results
Celecoxib significantly decreased cell viability and the proliferation of human PCa cells in vitro in a dose‐dependent manner.
Bone metastases were detected after i.c. injection in nude mice.
Celecoxib (15 ppm) administered before i.c. injection did not inhibit the cellular metastatic potential, as the numbers of bone metastases were similar in both groups. However, celecoxib did decrease metastatic progression in the osseous environment when cells were injected directly into the tibia (P < 0.05).
At the protein level, COX‐2 expression was significantly decreased in the celecoxib treatment group (P < 0.01).
Conclusion
In a preclinical mice model, celecoxib administered orally at the standard human dose inhibits the progression of established PCa bone metastases.
Open and robot‐assisted radical retropubic prostatectomy in men receiving ongoing low‐dose aspirin medication: revisiting an old paradigm?
Authors: Leyh‐Bannurah Sami‐Ramzi , Hansen Jens , Isbarn Hendrik , Steuber Thomas , Tennstedt Pierre , Michl Uwe , Schlomm Thorsten , Haese Alexander , Heinzer Hans , Huland Hartwig , Graefen Markus , Budäus Lars 
Published: October 2013

Objective
To assess blood loss, transfusion rates and 90‐day complication rates in patients receiving ongoing 100 mg/day aspirin medication and undergoing open radical prostatectomy (RP) or robot‐assisted RP (RARP).
Patients and Methods
Between February 2010 and August 2011, 2061 open RPs and 400 RARPs were performed. All patients received low‐molecular‐weight heparin for thrombembolism prophylaxis. Aspirin intake during surgery was recorded in 137 patients (5.5%).
Descriptive statistics and multivariable analyses after propensity‐score matching for balancing potential differences in patients with and without aspirin medication were used to assess the risk of blood loss above the median in patients undergoing open RP or RARP.
Results
The median blood loss in the open RP cohort with and without aspirin medication was 750 and 700 mL, respectively, and in the RARP cohort it was 200 and 150 mL, respectively. Within the same cohorts, transfusions were administered in 21 and 8% and 0 and 1% of patients, respectively. The 90‐day complication rates in patients with ongoing aspirin medication were 5.8, 4.4, 7.3 and 0% for Clavien grades I, II, III and IV complications, respectively.
In multivariable analyses and after propensity‐score matching, prostate volume (odds ratio 1.03; 95% CI 1.02–1.04; P < 0.01) but not ongoing aspirin medication achieved independent predictor status for the risk of blood loss above the median.
Conclusions
Major surgery such as open RP and RARP can be safely performed in patients with ongoing aspirin medication without greater blood loss.
Higher 90‐day complication rates were not detected in such patients.
Differences in transfusion rates between the groups receiving and not receiving ongoing aspirin medication may be explained by a higher proportion of patients with coronary artery disease in the group receiving ongoing aspirin mediciation. This comorbidity may result in a higher peri‐operative threshold for allogenic blood transfusion.
A critical appraisal of complications of percutaneous nephrolithotomy in paediatric patients using adult instruments
Authors: Goyal Neeraj Kumar , Goel Apul , Sankhwar Satya Narayan , Singh Vishwajeet , Singh Bhupendra Pal , Sinha Rahul Janak , Dalela Divakar , Yadav Rahul 
Published: October 2013

Objective
To evaluate the complications (using the CROES Clavien scoring system) and various factors affecting them in children undergoing percutaneous nephrolithotomy (PCNL).
Patients and Methods
We analysed prospectively maintained data of paediatric PCNL (patients ≤17 years) from January 2008 to December 2012.
Stone complexity was defined according to validated Guy's stone score (GSS). Procedures were performed in the prone position by experienced urologists. The tract was dilated (24–30F) under fluoroscopic guidance, and an adult rigid nephroscope complemented with a cystoscope/ureteroscope were used.
Complications were recorded according to the CROES‐Clavien score, recently defined by the Clinical Research Office of the Endourological Society (CROES) Study Group.
Results
The study group comprised 158 procedures performed in 153 children (98 boys and 55 girls), with a mean (range) age 10.03 ± 4.51 (2–17) years.
The mean (range) stone burden was 376.68 ± 265.23 (150–2400) mm2. The distribution of cases according to the GSS was 31% grade I, 35.4% grade II, 19% grade III, and 14.6% grade IV.
The stone‐free rate of PCNL monotherapy was 85.4%, which increased to 93.7% after relook PCNL/extracorporeal shock wave lithotripsy. In all, 62 children (39.2%) had operative complications; 84% were minor, i.e. Clavien grade 1/2, and managed conservatively.
Stone size, GSS, tract size, number of punctures and operation duration were significantly associated with complications on univariate analysis (P < 0.05). However, on multivariate logistic regression analysis, operation duration was the only independent risk factor associated with complications (95% confidence interval: 1.013–1.065, odds ratio = 1.04; P = 0.038).
Conclusions
Percutaneous nephrolithotomy in children using adult instruments is an effective and safe procedure for managing simple as well as complex renal calculi.
Assignment of specific Clavien scores to all possible PCNL complications by the CROES PCNL Study Group have improved precision in reporting complications in a standard objective format, including the minor ones. Such models are very useful for making inter‐observer comparisons to obtain clinically relevant inferences.
Mean operation duration is the only independent factor affecting complications of the procedure.
Comparison of high‐dose (86.4 Gy) IMRT vs combined brachytherapy plus IMRT for intermediate‐risk prostate cancer
Authors: Spratt Daniel E. , Zumsteg Zachary S. , Ghadjar Pirus , Kollmeier Marisa A. , Pei Xin , Cohen Gilad , Polkinghorn William , Yamada Yoshiya , Zelefsky Michael J. 
Published: October 2013

Objective
To compare tumour control and toxicity outcomes with the use of high‐dose intensity‐modulated radiation therapy (IMRT) alone or brachytherapy combined with IMRT (combo‐RT) for patients with intermediate‐risk prostate cancer.
Patients and Methods
Between 1997 and 2010, 870 consecutive patients with intermediate‐risk prostate cancer were treated at our institution with either 86.4 Gy of IMRT alone (n = 470) or combo‐RT consisting of brachytherapy combined with 50.4 Gy of IMRT (n = 400).
Brachytherapy consisted of low‐dose‐rate permanent interstitial implantation in 260 patients and high‐dose‐rate temporary implantation in 140 patients.
The median (range) follow‐up for the entire cohort was 5.3 (1–14) years.
Results
For IMRT alone vs combo‐RT, 7‐year actuarial prostate‐specific antigen (PSA)‐relapse‐free survival (PSA‐RFS) rates were 81.4 vs 92.0% (P < 0.001), and distant metastases‐free survival (DMFS) rates were 93.0 vs 97.2% (P = 0.04), respectively.
Multivariate analysis showed that combo‐RT was associated with better PSA‐RFS (hazard ratio [HR], 0.40 [95% confidence interval, 0.24–0.66], P < 0.001), and better DMFS (HR, 0.41 [0.18–0.92], P = 0.03).
A higher incidence of acute genitourinary (GU) grade 2 (35.8 vs 18.9%; P < 0.01) and acute GU grade 3 (2.3 vs 0.4%; P = 0.03) toxicities occurred in the combo‐RT group than in the IMRT‐alone group. Most acute toxicity resolved. Late toxicity outcomes were similar between the treatment groups. The 7‐year actuarial late toxicity rates for grade 2 gastrointestinal (GI) toxicity were 4.6 vs 4.1% (P = 0.89), for grade 3 GI toxicity 0.4 vs 1.4% (P = 0.36), for grade 2 GU toxicity 19.4 vs 21.2% (P = 0.14), and grade 3 GU toxicity 3.1 vs 1.4% (P = 0.74) for the IMRT vs the combo‐RT group, respectively.
Conclusions
Enhanced dose escalation using combo‐RT was associated with superior PSA‐RFS and DMFS outcomes for patients with intermediate‐risk prostate cancer compared with high‐dose IMRT alone at a dose of 86.4 Gy.
While acute GU toxicities were more prevalent in the combo‐RT group, the incidence of late GI and GU toxicities was similar between the treatment groups.
Positive vascular wall margins have minimal impact on cancer outcomes in patients with non‐metastatic renal cell carcinoma (RCC) with tumour thrombus
Authors: Abel E. Jason , Carrasco Alonso , Karam Jose , Tamboli Pheroze , Delacroix Scott , Vaporciyan Ara A. , Wood Christopher G. 
Published: October 2013

Objective
To evaluate the impact of microscopically positive vascular margins on recurrence and cancer‐specific survival (CSS) in patients with renal cell carcinoma (RCC) with venous thrombus
Patients and Methods
We reviewed the records from the period 1993 to 2009 of consecutive patients treated surgically for RCC with venous tumour thrombus at the University of Texas MD Anderson Cancer Center.
Patients with metastatic disease, positive soft tissue margins or gross residual disease at time of thrombectomy were excluded.
The primary outcome measures were local or systemic disease recurrence, and CSS.
Univariate and multivariate analysis were used to evaluate whether microscopically positive vascular margins were associated with RCC recurrence or CSS after nephrectomy with thrombectomy.
Results
A total of 256 patients with RCC were identified with a median (interquartile range) follow‐up of 36.7 (18.4–63.5) months. Microscopic tumour was present at the margin of resection in 47 patients (18.4%).
The median recurrence‐free interval was significantly shorter in patients with positive vascular margins: 22.1 vs 70.2 months (P = 0.009).
The rate of local recurrence was higher in patients with positive vein margins: 12.8 vs 4.3% (P < 0.01). Local recurrence without concomitant systemic recurrence was identified in only two of 256 (0.8%) patients.
Patients with positive vascular margins had significantly worse CSS times compared with patients with negative vascular margins: 37.7 vs 93.0 months (P = 0.004).
In multivariable analysis, positive vascular margins were found to be independently predictive of local recurrence but not of systemic recurrence or CSS.
Conclusions
Complete surgical excision should always be attempted because positive vascular wall margins increase local recurrence rates.
Invasion of RCC into the vein wall at the resection margin is associated with aggressive tumour biology, and the majority of patients with positive vascular wall margins experience systemic recurrence.
Reflex fluorescence in situ hybridization assay for suspicious urinary cytology in patients with bladder cancer with negative surveillance cystoscopy
Authors: Kim Philip H. , Sukhu Ranjit , Cordon Billy H. , Sfakianos John P. , Sjoberg Daniel D. , Hakimi A. Ari , Dalbagni Guido , Lin Oscar , Herr Harry W. 
Published: October 2013

Objective
To assess the ability of reflex UroVysion fluorescence in situ hybridization (FISH) testing to predict recurrence and progression in patients with non‐muscle‐invasive bladder cancer (NMIBC) with suspicious cytology but negative cystoscopy.
Patients and Methods
Patients under NMIBC surveillance were followed with office cystoscopy and urinary cytology every 3–6 months.
Between March 2007 and February 2012, 500 consecutive patients with suspicious cytology underwent reflex FISH analysis.
Clinical and pathological data were reviewed retrospectively.
Predictors for recurrence, progression and findings on subsequent cystoscopy (within 2–6 months after FISH) were evaluated using univariate and multivariate Cox regression.
Results
In all, 243 patients with suspicious cytology also had negative surveillance cystoscopy.
Positive FISH was a significant predictor of recurrence (hazard ratio [HR] = 2.35, 95% confidence interval [CI]: 1.42–3.90, P = 0.001) in multivariate analysis and for progression (HR = 3.01, 95% CI: 1.10–8.21, P = 0.03) in univariate analysis, compared with negative FISH.
However, positive FISH was not significantly associated with evidence of tumour on subsequent surveillance cystoscopy compared with negative FISH (odds ratio = 0.8, 95% CI: 0.26–2.74, P = 1).
Conclusions
Positive FISH predicts recurrence and progression in patients under NMIBC surveillance with suspicious cytology but negative cystoscopy.
However, there was no association between the FISH result and tumour recurrence in the immediate follow‐up period.
Reflex FISH testing for suspicious cytology might have limited ability to modify surveillance strategies in NMIBC.
Incremental detection rate of prostate cancer by real‐time elastography targeted biopsies in combination with a conventional 10‐core biopsy in 1024 consecutive patients
Authors: Salomon Georg , Drews Nils , Autier Philippe , Beckmann Ann , Heinzer Hans , Hansen Jens , Michl Uwe , Schlomm Thorsten , Haese Alex , Steuber Thomas , Graefen Markus , Becker Andreas 
Published: October 2013

Objective
To quantify the incremental detection rate (DR) of a targeted biopsy in addition to a randomized 10‐core biopsy.
Patients and Methods
This retrospective study analysed 1024 patients who consecutively underwent a four‐core real‐time elastography (RTE) targeted biopsies in addition to a randomized 10‐core transrectal ultrasonography (TRUS)‐guided biopsy in a primary or rebiopsy setting.
The overall DR, the DR of a 10‐core randomized, RTE targeted biopsy and the incremental DR were calculated.
Results
Overall, randomized and RTE targeted biopsy DRs (for the combination, the 10‐core and the four‐core RTE biopsy scheme) were 46.2% (n = 473), 39.1% (n = 400) and 29.0% (n = 297), respectively.
Four‐core RTE targeted biopsies detected an additional 73 patients not detected by the 10‐core randomized biopsies (increase in the overall DR of 7.1%). This represented a relative increase in DR of 18.3%. The incremental DR was better in rebiopsy patients (24.8%) than in patients having their first biopsy (14.7%).
Within all patients diagnosed by RTE targeted biopsy only, 34 patients harboured significant Gleason 4 or 5 prostate cancer (PCa), diagnosed by four‐core RTE biopsy only. Moreover, PCa with a Gleason grade of 4 or 5 was detected by four‐core RTE biopsies in 30 patients, who showed low‐grade PCa ≤ Gleason 3 only in the systematic 10‐core biopsy.
Conclusions
Real‐time elastography targeted biopsy seems to be an appropriate method for increasing the DR of PCa.
Nevertheless, RTE targeted biopsies missed a high proportion of patients with PCa and should therefore be considered as an addition to randomized biopsies.
Japanese Adolescents' Disclosure and Information Management With Parents
Authors: Nucci Larry , Smetana Judith , Araki Noriyuki , Nakaue Masataka , Comer Jessamy 
Published: October 2013

Adolescents' obligation to disclose and their actual disclosure about their activities to parents, justifications for nondisclosure, and strategies for information management were examined in different domains in 460 middle adolescents (Mage = 16.6 years) from working and middle‐class families in Japan. Adolescents felt most obligated to disclose prudential issues, but disclosed most about personal issues. Adolescents primarily justified nondisclosure with claims to personal choice and for prudential issues, concerns with parental disapproval. They rarely lied and mostly told parents if asked or avoided the issue. Findings revealed consistencies with prior work on disclosure with European and U.S. adolescents, as well as patterns specific to the Japanese cultural setting.
Prophylactic and therapeutic vaccination with carrier‐bound Bet v 1 peptides lacking allergen‐specific T cell epitopes reduces Bet v 1‐specific T cell responses via blocking antibodies in a murine model for birch pollen allergy
Authors: Linhart B. , Narayanan M. , Focke‐Tejkl M. , Wrba F. , Vrtala S. , Valenta R. 
Published: October 2013

SummaryBackgroundVaccines consisting of allergen‐derived peptides lacking IgE reactivity and allergen‐specific T cell epitopes bound to allergen‐unrelated carrier molecules have been suggested as candidates for allergen‐specific immunotherapy.ObjectiveTo study whether prophylactic and therapeutic vaccination with carrier‐bound peptides from the major birch pollen allergen Bet v 1 lacking allergen‐specific T cell epitopes has influence on Bet v 1‐specific T cell responses.MethodsThree Bet v 1‐derived peptides, devoid of Bet v 1‐specific T cell epitopes, were coupled to KLH and adsorbed to aluminium hydroxide to obtain a Bet v 1‐specific allergy vaccine. Groups of BALB/c mice were immunized with the peptide vaccine before or after sensitization to Bet v 1. Bet v 1‐ and peptide‐specific antibody responses were analysed by ELISA. T cell and cytokine responses to Bet v 1, KLH, and the peptides were studied in proliferation assays. The effects of peptide‐specific and allergen‐specific antibodies on T cell responses and allergic lung inflammation were studied using specific antibodies.ResultsProphylactic and therapeutic vaccination with carrier‐bound Bet v 1 peptides induced a Bet v 1‐specific IgG antibody response without priming/boosting of Bet v 1‐specific T cells. Prophylactic and therapeutic vaccination of mice with the peptide vaccine induced Bet v 1‐specific antibodies which suppressed Bet v 1‐specific T cell responses and allergic lung inflammation.Conclusion and Clinical RelevanceVaccination with carrier‐bound allergen‐derived peptides lacking allergen‐specific T cell epitopes induces allergen‐specific IgG antibodies which suppress allergen‐specific T cell responses and allergic lung inflammation.
Managing generalized interferon‐induced eruptions and the effectiveness of desensitization
Authors: Poreaux C. , Bronowicki J.‐P. , Debouverie M. , Schmutz J.‐L. , Waton J. , Barbaud A. 
Published: October 2013

SummaryBackgroundWe evaluated the value of skin tests and the efficacy of a 12‐step desensitization protocol to pegylated interferon (IFN) in patients with generalized drug eruptions due toIFNs.MethodsA retrospective study (1998–2009) was followed by a cross‐sectional clinical study conducted prospectively (2009–2011). All patients received a dermatological clinical examination and skin tests. Twelve‐stepIFNdesensitization was proposed for patient with active hepatitis C and no alternative therapy.ResultsTwenty‐six patients (13 males, mean age, 53.5 years) had generalized reactions toIFNs; 21 were treated withIFN‐α and 5 withIFN‐β. Moreover, 21 patients had skin tests. Intradermal tests (IDTs) were positive after an average of 72 h. Cross‐reactivity between peg‐IFN‐α2a and peg‐IFN‐α2b was observed in 5/10 cases in the prospective study. In 16 of 26 cases,IFNtreatment was stopped. In 8 of 16 cases of diffuse eczematous drug eruption, treatment was continued. The corticosteroid and antihistamine were sufficient in 4/8 cases. In three other cases, topical tacrolimus was highly effective. In 3 of 16 cases in which treatment were stopped, patients underwent the early resumption of peg‐IFN‐α. These three patients had positive tests with peg‐IFN‐α2a and peg‐IFN‐α2b and successfully completed the tolerance induction protocol for peg‐IFN‐α2b. Tolerance induction involved a weekly dose of peg‐IFNand a gradual increase in the recovery of an antiviral C. Clinical tolerance was excellent, and the patients' viral load C became negative.ConclusionsOur study demonstrates the benefit of allergy testing in cases of generalized drug reactions toIFN, cross‐reactivities in a single class ofIFNs and the importance of delayedIDTreading. We report for the first time the effectiveness of 12‐step desensitization with peg‐IFN.
Intravascular immunity as a key to systemic vasculitis: a work in progress, gaining momentum
Authors: Ramirez G A , Maugeri N , Sabbadini M G , Rovere-Querini P , Manfredi A A 
Published: October 2013

Summary
Vascular inflammation contributes to the defence against invading microbes and to the repair of injured tissues. In most cases it resolves before becoming apparent. Vasculitis comprises heterogeneous clinical entities that are characterized by the persistence of vascular inflammation after it has served its homeostatic function. Most underlying mechanisms have so far remained elusive. Intravascular immunity refers to the surveillance of the vasculature by leucocytes that sense microbial or sterile threats to vessel integrity and initiate protective responses that entail most events that determine the clinical manifestations of vasculitis, such as end-organ ischaemia, neutrophil extracellular traps generation and thrombosis, leucocyte extravasation and degranulation. Understanding how the resolution of vascular inflammation goes awry in patients with systemic vasculitis will facilitate the identification of novel pharmacological targets and bring us a step closer in each patient to the selection of more effective and less toxic treatments.