bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long‐needle bladder neck suspension for genuine stress incontinence—does endoscopy influence results? A structured overview
Authors: JARVIS G.J. 
Published: November 2008

Objective To assess the hypothesis that the use of an endoscope to aid suture placement in long‐needle suspension procedures is more likely to be lead to improved results.Materials and methods A literature survey of 15 journals yielded 77 evaluable publications which provided data to compare the subjective and objective outcomes following a Pereyra procedure (2259 and 301 patients, respectively) or a Stamey procedure (2029 and 456 patients, respectively).Results There was no statistically significant difference in the mean percentage continence rates, based on subjective assessment of continence, following either the Pereyra or the Stamey procedure. Approximately 7% of patients subjectively claimed to be continent yet were not so upon some form of objective measurement.Conclusion The analysis detected no improvement in the likelihood of continence after long‐needle suspension procedures whether or not they were performed under endoscopic control to aid suture placement. This conclusion applied to primary procedures whether outcome was judged subjectively or objectively, and to subjective outcome after previously failed surgery. This study suggests that those surgeons who report their results are sufficiently skilled in judging suture placement as accurately as is needed without the benefit of a cystoscope.
The role of urodynamic studies in the evaluation of patients with augmentation cystoplasties
Authors: McINERNEY P.D. , DeSOUZA N. , THOMAS P.J. , MUNDYM A.R. 
Published: November 2008

Objective To assess the role and value of videouro‐dynamic studies (VUD) in the post‐operative evaluation of 100 patients who were continent following augmentation (clam) enterocystoplasty.Patients and methods Fifty patients had non‐neuropathic detrusor instability and 50 had neuropathic bladder dysfunction. All underwent standard dual channel medium fill cystometry and synchronous video screening before and at 6 months and 2 years after a clam ileocystoplasty.Results Pre‐operative capacity was variable in non‐neuropathic patients but post‐operative capacity in this group, and both pre‐and post‐operative capacity in the neuropathic group, were more reproducible. Of non‐neuropathic patients, 88% became stable and 83% became normally compliant, compared with only 38 and 50% respectively of neuropathic patients. More surprisingly, two of eight neuropathic patients previously stable became unstable and four of 12 of those previously normally compliant became poorly compliant. In all patients voiding spontaneously there was a tendency for capacity to increase and voiding efficiency to decrease with time.Conclusions From these results, standard VUD studies contributed little to the post‐operative assessment of patients with clam cystoplasties beyond that which could be obtained by ultrasonography of the bladder before and after voiding. The effect or lack of effect of augmentation cystoplasty on compliance in the neuropathic bladder suggests a neuropathic effect on bowel contractility and warrants further investigation. The meaning and significance of ‘urodynamic’ observations when bowel is incorporated into the bladder also needs careful investigation.
Neomycin‐induced perception deafness following bladder irrigation in patients with end‐stage renal disease
Authors: GERHARZ E.W. , WEINGÄRTNER K. , MELEKOS M.D. , VARGA S. , FEIBER H. , RIEDMILLER H. 
Published: November 2008

Objective To report a serious side‐effect of intravesical instillations of neomycin in patients with end‐stage renal disease.Patients and methods Three patients (two men and a woman, aged 51,71 and 54 respectively) with end‐stage renal disease who had undergone bladder irrigation with neomycin sulphate solution suffered complete irreversible deafness, which was assessed by audiogram.Results All three patients developed complete perception deafness after 3, 4 and 10 months, with characteristic changes in the audiogram. The severe progressive hearing loss was maximal in the high‐frequency range. A high‐pitched tinnitus was the first sign of impending hearing difficulty and two patients developed a spontaneous nystagmus.Conclusion In view of the doubtful efficacy and, most importantly, the risk of severe disabling side‐effects such as ototoxicity, we recommend the avoidance of intravesical instillation with neomycin whenever possible.
Serum granulocyte colony‐stimulating factor levels in patients with urinary bladder tumour and various urological malignancies
Authors: MIZUTANI Y. , OKADA Y. , TERACHI T. , KAKEHI Y. , YOSHIDA O. 
Published: November 2008

Objectives To measure the serum levels of granulocyte colony‐stimulating factor (G‐CSF) in patients with urinary bladder tumour (UBT) or various urological malignant tumours, and to assess G‐CSF production by tumour cells.Patients and methods Peripheral blood was obtained, before operation or anti‐cancer therapy, from 141 patients with UBT, 37 patients with other urological malignant tumours (21 with renal cell carcinoma, nine with renal pelvic or ureteric tumours, five with prostatic cancer, and two with testicular cancer), 38 patients with benign urological diseases (21 with benign prostatic hypertrophy, 11 with urolithiasis and six with a varicocele), and from 15 healthy donors. The serum G‐CSF levels were quantified using an enzyme immunoassay.Results Of 141 patients with UBT, 13 showed elevated serum G‐CSF levels above the sensitivity of the assay (30 pg/mL) with a mean value of 328 pg/mL. The serum levels in normal healthy donors and in patients with prostatic cancer, testicular cancer or varicocele were < 30 pg/mL, while the levels were > 30 pg/mL in two of nine patients with renal pelvic or ureteric tumour (mean 754 pg/mL) and in one of 21 patients with renal cell carcinoma (40 pg/mL). The levels of serum G‐CSF in several patients with benign prostatic hypertrophy or urolithiasis were also elevated, but the mean levels were low. The serum G‐CSF levels in patients with UBT correlated with the increase of grade and the progression of the stage of UBT. Furthermore, patients with UBT and an undetectable level of serum G‐CSF had higher disease‐specific survival rates at the 5‐year follow‐up when compared with those with an elevated level of serum G‐CSF. There was a positive correlation between serum G‐CSF levels and white blood cell counts. T24 and J82 UBT cell lines and freshly separated tumour cells derived from the patient whose serum G‐CSF level was high produced G‐CSF.Conclusion These results suggest that elevated serum G‐CSF level might be associated with a poor prognosis in patients with UBT and be due to the production of G‐CSF by UBT cells
The burden of prostate cancer from diagnosis until death
Authors: OTNES B. , HARVEI S. , FOSSÅ S.D. 
Published: November 2008

Objective To quantify the need for treatment and care in patients with conservatively treated prostate cancer.Patients and methods All men who had been diagnosed with prostate cancer in a defined geographical area and who died within the period 1987–91 were identified. Patients treated with curative intent were excluded. Medical records from hospitals, nursing homes and community nurses for the period from diagnosis until death were scrutinized for the remaining 174 patients.Results Of the 174 patients, 95% were symptomatic at diagnosis and 62% died from prostate cancer. All but two patients were hospitalized for prostate cancer, for a mean of 1 month. Thirty‐six per cent needed regular nursing in nursing homes or by community nurses at home. Complications requiring hospitalization or long‐term catheterization occurred in 49%. Prostatic surgery was performed in 66% and androgen ablation in 76% of the patients; palliative irradiation was given to 16% and 50% received analgesics regularly, including opiates or equivalents in 37%. Prednisone was given to 29%, after the failure of androgen ablation.Conclusion Our findings demonstrate the considerable burden imposed both on patients and health‐care resources by symptomatic prostate cancer, conservatively treated. There are few data available for comparison.
Is day‐case prostatectomy feasible?
Authors: KEOGHANE S.R. , MILLAR J.M. , CRANSTON D.W. 
Published: November 2008

Objective To assess the possibility of discharging patients, catheter‐free, on the same day that they undergo contact‐laser prostatectomy.Patients and methods Ten patients underwent contact vaporization of the prostate using the SLT (Surgical Laser Technologies, Oaks, PA, USA) Nd:YAG laser with an MTRL10 6 mm tip. Patients were selected in the out‐patient clinic for day‐case surgery on the basis of their good general health and clinically small glands. All patients had pre‐operative urodynamic assessment and were proven obstructed and stable. Contact vaporization was carried out under general anaesthesia. Both intra‐operative blood loss and irrigant absorption were assessed. The follow‐up at 3 and 6 months included American Urological Association (AUA‐7) symptom scores and the measurement of urinary flow rates.Results The mean operating time was 25.2 min, with a mean application of 43.05 kJ of laser energy. The mean absorption of irrigant fluid was 30 mL and the mean intra‐operative blood loss was 31 mL. Nine patients were discharged on the day of treatment. Two patients went into clot retention following discharge and had a suprapubic catheter sited, and two failed to void once discharged, necessitating catheterization for 2 weeks. At 3 and 6 months, there was a substantial decrease in the AUA symptom score and an improvement in urinary flow rate.Conclusion Day‐case laser prostatectomy is possible, but the patients must be selected carefully and, perhaps more importantly, a specialist day‐case anaesthetist must be available.
Targeting of bladder cancer with monoclonal antibody NCRC48—a possible approach for intravesical therapy
Authors: KUNKLER R.B. , BISHOP M.C. , GREEN D.J. , PIMM M.V. , PRICE M.R. , FRIER M. 
Published: November 2008

Objective To determine the localization of the anti‐MUCl mucin monoclonal antibody (mAb) NCRC48 to bladder cancer following intravesical administration.Patients and methods mAb NCRC48 (330–500 μg) radiolabeled with 111indium (11–17 MBq) was administered intravesically to 12 unselected patients with radiological evidence of bladder cancer. Tumour localization was assessed by gamma‐camera imaging and by tissue biodistribution studies on biopsies obtained at cystoscopy at about 2 or 24 h after the procedure. After 24 h, whole blood radioactivity was measured and 3 weeks after the procedure the serum level of human anti‐mouse antibodies was estimated using an ELISA method.Results Eleven patients had tumours confirmed at cystoscopy (grades 1–3, stages pTa‐pT2). The mean uptake of NCRC48 by tumour and by normal uro‐thelium (expressed as the percentage of the instilled dose/g × 103± SD) at 2h was 3.42 ± 3.68 and 0.41 ± 0.77 (P < 0.05). After 24 h, the values for tumour and normal urothelium were 1.17 ± 1.18 and 0.17 ± 0.11, respectively. Areas of increased activity on the scintigrams were consistent with the position of the tumours at cystoscopy. No radioactivity was detected in blood at 24 h and there was no evidence of a human anti‐mouse antibody response.Conclusion The MUC1 mucin may be a suitable antigen to study the potential of therapeutic strategies based on monoclonal antibody targeting of superficial bladder cancer and may allow the development of more effective agents in the treatment of this condition.
Hydration monitoring in the prevention of recurrent idiopathic urinary tract infections in pre‐menopausal women
Authors: ECKFORD S.D. , KEANE D.P. , LAMOND E. , JACKSON S.R. , ABRAMS P. 
Published: November 2008

Objective To assess whether the use of simple hydration monitoring can encourage adequate hydration and reduce urinary osmolality and the incidence of urinary tract infections (UTIs) in a population of susceptible pre‐menopausal women with recurrent idiopathic urinary infections.Subjects and methods The study included 28 premenopausal women who had at least two idiopathic UTIs in the previous 6 months. Urinary osmolality was assessed by the patients at each void by a simple hand‐held probe, and the readings over 4 months compared. Monthly urine culture was compared between successive 4‐month periods in which the probe was or was not used.Results The study was completed by 17 women. There was a significant shift towards urine of lower osmolality over the 4‐month period using the probe (Pearson's χ2 < 0.001). Significantly fewer urinary tract infections developed during the 4 months using the probe (McNemar's χ2= 0.046).Conclusions The use of the osmolality probe encouraged the subject to maintain adequate hydration. The resulting augmentation of the natural urethral washout mechanism led to lower osmolality urine and a reduction in the incidence of UTIs.
Alfuzosin attenuates erectile dysfunction in rats with partial bladder outlet obstruction
Authors: Gur Serap , Sikka Suresh C. , Chandra Surabhi , Koka Padma Sandeep , Agrawal Krishna C. , Kadowitz Philip J. , Hellstrom Wayne J.G. 
Published: November 2008

OBJECTIVETo determine how partial bladder outlet obstruction (PBOO) in a rat model affects erectile function, and whether an uroselective α1‐adrenoceptor antagonist, alfuzosin (Sanofi‐Aventis, Paris, France) attenuates any erectile dysfunction (ED).MATERIALS AND METHODSAdult male Sprague‐Dawley rats (120) were randomized into four groups: 1, sham‐operated; 2, alfuzosin‐treated; 3, PBOO; and 4, alfuzosin‐treated with PBOO. Groups 3 and 4 were subjected to PBOO for 6 weeks by ligation of the urethra, while groups 2 and 4 rats received daily oral alfuzosin (10 mg/day) for 6 weeks. In vivo erectile responses were monitored by evaluating ratios of intracavernosal pressure (ICP)/mean arterial pressure, and total ICP (area under the curve). Organ‐bath studies were performed on corpus cavernosum smooth muscle (CCSM) strips. Nitric oxide synthase (NOS) expression was determined immunohistochemically (IHC) for neuronal (n)NOS and by Western blot analysis for endothelial (e) and inducible (i) NOS protein.RESULTSRats with PBOO showed lower erectile responses than controls. Maximumelectrical field stimulation‐mediated and endothelium‐dependent acetylcholine‐induced relaxations and contractile responses to phenylephrine were significantly reduced in CCSM strips from the PBOO group. The NO donor sodium nitroprusside completely relaxed CCSM from rats in all groups. IHC analyses showed decreased expression of nNOS in PBOO groups compared with controls; by contrast, protein expression of eNOS and iNOS was increased. Alfuzosin‐treatment partially attenuated functional and molecular changes in penises of PBOO rats.CONCLUSIONRats with PBOO show ED, most likely due to altered NOS expression and NO bioavailability. The α‐adrenoreceptor antagonist alfuzosin reversed this ED by altering sympathetic tone, increasing NO‐induced relaxation and augmenting blood flow in the penis. This study suggests a rationale for further clinical trials using combinations of α‐adrenoceptor antagonists and phosphodiesterase‐5 inhibitors in patients with ED and lower urinary tract symptoms.
Promoting patient–practitioner partnership in clinical training: a critical evaluation
Authors: Gale Nicola Kay 
Published: November 2008

AbstractThis study provides a critical assessment of the application of the ‘partnership’ model of clinical interaction in an educational context, in the light of ethnographic research on education in complementary and alternative medicine (CAM). The concept of ‘partnership’ in healthcare practice is central to current health policy developments in the UK and the sense of patient empowerment in a more equitable practitioner–patient relationship is often cited as a reason why people are turning to CAM in ever greater numbers. After locating the concept of partnership in its policy and theoretical context (comparing it with traditional and consumer models), the study draws on ethnographic research with student osteopaths and homeopaths to explore the extent to which partnership can be achieved in clinical training situations. The implications for a working concept of professional expertise are subsequently discussed. I argue that the partnership model of clinical interaction is a useful point of departure for critically exploring issues in the patient–practitioner relationship in an educational context.
Just deserts? Developing practice in youth justice
Authors: Kubiak Chris , Hester Richard 
Published: November 2008

AbstractThis paper considers the issues involved in developing a programme for youth justice practitioners. Contemporary youth justice practice occurs in an increasingly managerialist and punitive context raising questions about how best to develop effective practitioners. It is argued that youth justice practice involves a recurring challenge of meeting situations of high complexity that must be dealt with on a case‐by‐case basis, guided by a clear understanding of how offending behaviour is constituted. The Professional Certificate in Effective Practice is reviewed and it is argued that education must emphasize reflective understanding. A critique of competency‐based education in relation to the Diploma in Probation Studies is also presented arguing that such an approach renders invisible important aspects of practice. Recommendations are made for a curriculum for a youth justice programme which stresses humanism, reflective understanding of context and history, criminology, sociology and psychology, social exclusion, social control, risk, victimology and comparative youth justice.
Evaluation of two soil conditioners for limiting post‐fire erosion as part of a soil conservation strategy
Authors: Darboux F. , Robin J.‐G. , Fox D. 
Published: November 2008

AbstractSoil conservation is a major concern for catchments affected by forest fires. The lack of vegetation cover and the development of soil water repellency increase the risk of topsoil erosion. This paper evaluates two soil conditioners (a wetting agent and a polyvinyl acetate) for limiting overland flow and erosion in inter‐rill areas. Unburned and burned soil samples were treated with one or both soil conditioners. The effects of these treatments on run‐off, water retention, erosion and plant growth were assessed using laboratory rainfall simulations. Polyvinyl acetate had little impact on water retention but was effective in reducing soil loss. The surfactant had little impact on water run‐off or soil loss but substantially improved water retention and plant biomass production. Application of soil conditioners on post‐fire areas could be a valuable technique in a soil conservation strategy. To maximize their benefits, soil conditioners could be applied with seeding using hydroseeding techniques and be limited to particular areas, such as paths and roadsides. Laboratory results indicate that field testing should also be carried out.
Effect of Left Ventricular Lead Concordance to the Delayed Contraction Segment on Echocardiographic and Clinical Outcomes after Cardiac Resynchronization Therapy
Authors: FUNG JEFFREY W.H. , LAM YAT‐YIN , ZHANG QING , YIP GABRIEL W.K. , CHAN WINNIE W.L. , CHAN GARY C.P. , CHAN JOSEPH Y.S. , YU CHEUK‐MAN 
Published: November 2008

Introduction: The optimal left ventricular (LV) pacing site for cardiac resynchronization therapy (CRT) is unclear. The current study aims to explore the clinical significance of LV lead concordance to delayed contraction segment in CRT. Methods and Results: Concordant LV lead position was defined as the lead tip located by fluoroscopy at or immediately adjacent to the LV segment with latest contraction determined by tissue Doppler imaging. Echocardiographic and clinical outcomes among 101 consecutive patients with or without concordant LV lead positions were compared. There was no significant difference in changes in LV volumes and clinical parameters between patients with concordant (n = 46) or nonconcordant (n = 55) LV lead positions at 3 and 6 months. In multivariate analysis, the baseline asynchrony index (β= 1.092, 95% CI: 1.050–1.114; P < 0.001), but not LV lead concordance, was the only independent predictor of LV reverse remodeling. By Cox regression analysis, ischemic etiology, and LV reverse remodeling, but not LV lead concordance, were independent predictors of mortality (β= 2.475, 95% CI: 1.183–5.178; P = 0.016, and β= 0.272, 95% CI: 0.130–0.567; P < 0.001, respectively), cardiovascular hospitalization (β= 1.551, 95% CI: 1.032–2.333; P = 0.035, and β= 0.460, 95% CI: 0.298–0.708; P < 0.001, respectively), and heart failure hospitalization (β= 0.486, 95% CI: 0.320–0.738; P = 0.001 for LV reverse remodeling). Conclusion: LV lead concordance to the delayed contraction segment may not be a major determining factor for favorable echocardiographic and clinical outcomes after CRT.
Radiofrequency Catheter Selection Based on Cavotricuspid Angiography Compared with a Control Group with an Externally Cooled‐Tip Catheter: A Randomized Pilot Study
Authors: DA COSTA ANTOINE , ROMEYER‐BOUCHARD CÉCILE , JAMON YANN , BISCH LAURENCE , ISAAZ KARL 
Published: November 2008

Background: Radiofrequency ablation (RFA) of cavotricuspid isthmus (CTI)‐dependent atrial flutter (AFL) can be performed using either externally cooled‐tip RFA catheters or large‐tip (8 mm) catheters. However, experimental and clinical studies suggest that the efficacy of both catheters may vary with CTI anatomy and catheters orientation. Objectives: The aim of this prospective study was to evaluate: a RFA catheter selection based on CTI angiography compared with a control group with an externally cooled‐tip catheter together with the risk of an expensive crossover catheter in both groups. Method: Over a period of 16 months, 119 patients were included and randomized. Results: When comparing the angiographic group (n = 56) and the externally cooled‐tip RFA catheter group (n = 63), the duration of application time with a median of 7 min (interquartile range 4.5–11) versus a median of 10 min (interquartile range 6–20; P = 0.008) and the duration of X‐ray exposure with a median of 7 min (interquartile range 4–10) versus a median of 10 min (interquartile range 5–15; P = 0.025) were significantly lower in the angiographic group versus externally cooled‐tip catheter group. Furthermore, the number of catheters crossover was significantly higher in the angiographic group versus externally cooled‐tip catheter group I (27% vs 7%; P = 0.007). Conclusions: This study shows that a strategy with a catheter selection based on a CTI angiographic evaluation is superior to an empirical use of an externally cooled‐tip catheter during CTI RFA. Thus, angiographic isthmus evaluation predicts the effectiveness of a RFA catheter and the risk of an expensive catheter crossover.