bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of tumour location on the histological subtype of renal cortical tumours
Authors: SCHACHTER LEE R. , BACH ARIADNE M. , SNYDER MARK E. , KATTAN MICHAEL W. , RUSSO PAUL 
Published: June 2006

OBJECTIVETo determine whether the location of renal cortical tumours (RCTs) is a possible factor affecting tumour behaviour, by investigating whether exophytic vs a central location is associated with a difference in histological subtype distribution, as recognized prognostic factors for RCTs include size, stage, grade, and histological subtype.PATIENTS AND METHODSBetween 1 January 1996 and 1 June 2003, we evaluated 485 consecutive RCTs in 469 patients who had renal imaging studies and underwent either partial or radical nephrectomy at our institution. A radiologist and a urologist independently reviewed the imaging studies of all patients to determine exophytic vs central location. An exophytic lesion was defined as one that clearly both pushed out the renal contour and did not extend into the collecting system, hilum, or renal sinus. A lesion that did not meet these criteria was defined as a central lesion. Logistic regression analysis was used to determine if either type of lesion had a greater representation of any histological subtype. A two‐tailed P ≤ 0.05 was considered to indicate significance.RESULTSOf the 485 RCTs, 171 (35%) were exophytic and 314 (65%) were central, while 308 (64%) were clear cell and 177 (36%) were non‐clear cell tumour histology. Of the exophytic lesions, 52.0% were clear cell, while 69.7% of central lesions were clear cell (P < 0.001). Conversely, 71.1% of clear cell tumours were central, while 53.7% of non‐clear cell tumours were central (P = 0.003). After controlling for size and stage, tumour location remained associated with histological subtype (P = 0.003).CONCLUSIONSExophytic lesions are significantly more likely than central lesions to be non‐clear cell tumours, and clear cell tumours are significantly more likely than non‐clear cell tumours to be central. As studies indicate that the clear cell histological subtype portends a worse prognosis than the non‐clear cell subtype, our results imply that tumour location affects the prognosis in RCTs, with exophytic lesions having a better prognosis than central lesions. This result may have important implications for physicians and patients when planning partial vs radical nephrectomy by either open or minimally invasive techniques.
Diagnostic difficulties in children with coexisting pelvi‐ureteric and vesico‐ureteric junction obstruction
Authors: ÇAY ALI , IMAMOGLU MUSTAFA , BAHAT ELIF , SARIHAN HALUK 
Published: June 2006

OBJECTIVETo assess the diagnosis of children with coexisting pelvi‐ureteric junction (PUJ) and vesico‐ureteric junction (VUJ) obstruction, and the management of such patients, as having these two anomalies in the same ureter creates serious diagnostic difficulties, but any delay in diagnosis might cause a deterioration of renal function and affect the success of surgery to correct either anomaly.PATIENTS AND METHODSWe assessed the diagnostic difficulties and approach to 14 patients with coexistent PUJ and VUJ obstruction, who were treated surgically in our clinic between 1994 and 2005; we also review related published reports in English.RESULTSSurgery was used in all 14 patients over the 11‐year period; only five patients had an accurate diagnosis before surgery. Six patients were diagnosed with uroradiological techniques immediately after pyeloplasty; three were diagnosed on investigating an associated anomaly later.CONCLUSIONIn children with coexisting PUJ and VUJ obstruction there are serious diagnostic problems; to prevent any deterioration in renal function due to obstruction, these anomalies require early diagnosis and treatment. For an early and accurate diagnosis, the coexistence of these two anomalies in the same ureter should be considered.
A new bulking agent (polyacrylamide hydrogel) for treating stress urinary incontinence in women
Authors: LOSE GUNNAR , MOURITSEN LONE , NIELSEN JOHN BUGGE 
Published: June 2006

OBJECTIVETo evaluate the efficacy and safety of a transurethral injection with polyacrylamide hydrogel (PAHG) for treating stress urinary incontinence (SUI) in women.PATIENTS AND METHODSThe study comprised 17 women with pure SUI and eight with mixed incontinence (age range 35–84 years). Between November 2001 and November 2003, the women were injected into the urethral wall with a PAHG (Aquamid®, Contura International A/S, Denmark), a homogenous, highly biocompatible, atoxic, nonresorbable sterile watery gel consisting of ≈2.5% cross‐linked polyacrylamide and 97.5% nonpyrogenic water. The women were followed prospectively (assessed at 1, 3 and 12 months after treatment) and their clinical outcome documented.RESULTSFour women did not complete the study, and of the remainder, eight (38%) were subjectively dry and a further nine (43%) improved. Objectively, urine leakage/24 h was decreased by 93% and the number of incontinence episodes by 87%. Quality‐of‐life measures improved significantly in all domains other than general health perception. There were no significant changes of urodynamic variables. Treatment‐related adverse events were recorded in 16 women. Urinary tract infection (10 cases) and urinary retention (five cases) were most common. There were no injection site reactions.CONCLUSIONPAGH seems to be a promising new bulking agent for the treatment of SUI.
Urethral stricture assessment: a prospective study evaluating urethral ultrasonography and conventional radiological studies
Authors: GUPTA NITIN , DUBEY DEEPAK , MANDHANI ANIL , SRIVASTAVA ANEESH , KAPOOR RAKESH , KUMAR ANANT 
Published: June 2006

Authors from India have found that sono‐urethrography is an accurate method of evaluating the length of anterior urethral strictures, being more accurate than retrograde urethrography, and that it gives additional information about spongiofibrosis.OBJECTIVETo evaluate the accuracy of urethral ultrasonography (sono‐urethrography, SUG) in determining the length of anterior urethral strictures, and for predicting the degree of spongiofibrosis.PATIENTS AND METHODSIn all, 52 patients with anterior urethral strictures detected on retrograde urethrography (RUG) were also examined using SUG, to assess the stricture location, length and degree of spongiofibrosis. The findings of both procedures were then compared with the operative findings.RESULTSThe mean (sd) stricture length on RUG, SUG and at surgery was 2 (0.8), 3.8 (1.4) and 3.5 (1.6) cm, respectively. The mean length on SUG was closer to that at surgery. Spongiofibrosis was detected by SUG with an overall accuracy of 42%, 56% and 83% for mild, moderate and severe degrees of fibrosis, respectively. There were no significant complications during the procedure.CONCLUSIONSUG is more accurate for evaluating the length of anterior urethral strictures than RUG, and gives additional information about spongiofibrosis.
Comparison of the International Index of Erectile Function erectile domain scores and nocturnal penile tumescence and rigidity measurements: does one predict the other?
Authors: YANG CLAIRE C. , PORTER MICHAEL P. , PENSON DAVID F. 
Published: June 2006

Associate EditorMichael G. WyllieEditorial BoardIan Eardley, UKJean Fourcroy, USASidney Glina, BrazilJulia Heiman, USAChris McMahon, AustraliaBob Millar, UKAlvaro Morales, CanadaMichael Perelman, USAMarcel Waldinger, NetherlandsOBJECTIVETo describe the relationship between the International Index of Erectile Function (IIEF) erectile domain score, and nocturnal penile tumescence and rigidity values measured by RigiScan (Timm Medical Technologies, Eden Prairie, MN).PATIENTS AND METHODSIn all, 73 men were evaluated with the IIEF and 2 nights of continuous penile monitoring with the RigiScan. Twenty‐six men were evaluated before and after prostatectomy, for a total of 99 pairs of data points. We dichotomized the RigiScan results as ‘adequate’ (no erectile dysfunction, ED), or ‘inadequate’ (having ED), based on the ‘best erectile event’ over the 2 nights of monitoring. Two separate criteria for adequate erectile function were used, one of >70% rigidity for ≥10 min, and the other >60% rigidity for ≥10 min. The erectile domain score of the IIEF was calculated in the standard fashion.RESULTSUsing both the 70% and the 60% rigidity criteria, there was a statistically significant association between the IIEF erectile domain scores and the RigiScan data (r = 0.27, P = 0.008 and r = 0.29, P = 0.003, respectively). However, the sensitivity of the IIEF to predict ED based on RigiScan results using the 70% rigidity criteria was 68.9%, and the specificity was 57.1%. When the IIEF was used as a continuous predictor of RigiScan results, the area under the receiver‐operating characteristic (ROC) curve was 0.66. Using the 60% criteria, the sensitivity was 55.8% and the specificity was 73.2%; the area under the ROC curve was 0.72.CONCLUSIONSIIEF erectile domain scores and nocturnal penile tumescence and rigidity measurements are weakly associated, and the clinical utility of one test to predict the other is limited. However, because of the differences in the measured outcomes (perception of erectile function vs physiological capacity), a weak association does not disqualify either test’s individual utility.
Examination of the safety and use of apomorphine prescribed in general practice in England as a treatment for erectile dysfunction
Authors: MACLENNAN KARYN M. , BOSHIER ANDREW , WILTON LYNDA V. , SHAKIR SAAD A.W. 
Published: June 2006

OBJECTIVESTo examine the safety and use of apomorphine as prescribed in general medical practice in England as a treatment for erectile dysfunction (ED).PATIENTS AND METHODSApomorphine hydrochloride (marketed as Uprima®, Abbott Laboratories Ltd, UK) is licensed in the UK as a sublingual therapy for ED. It is the first treatment for ED with a central mode of action. This postmarketing observational cohort study was conducted using prescription‐event monitoring (PEM) methods. Exposure information was obtained from dispensed prescription data for patients first prescribed apomorphine between October 2001 and December 2002. Outcome data were derived from Green‐Form questionnaires posted to prescribing physicians ≥6 months after the date of the first apomorphine prescription for each patient. The study cohort comprised 11 185 patients, 99.3% (11 111) of whom were men, with a median (interquartile range) age of 61 (54–68) years.RESULTSThe most frequently reported prescribing indication was ED and the most frequently reported reason for stopping apomorphine was that it was ‘not effective’. In addition, the percentage of patients for whom apomorphine was reported to have been effective was relatively low. Headache was the most commonly reported adverse drug reaction, and the most frequently reported clinical condition occurring in the first month of observation. A small number of events (24) were reported that were not listed in the current Summary of Product Characteristics (SPC) and were considered by the prescribing general practitioner (GP) to be associated with apomorphine use.CONCLUSIONThe proportion of patients for whom apomorphine was reported to be effective was low. Also, ‘not effective’ was the most frequently reported event and a high percentage of patients stopped apomorphine because it was ‘not effective’. The most frequently reported clinical adverse events (headache and nausea) were those listed in the SPC. A small number of reports for unlabelled events were thought by prescribers to be related to apomorphine use. The confounding factors of patient age and coexisting disease should be considered when assessing data from this study.
A prospective study of 100 cases of penile cancer managed according to European Association of Urology guidelines
Authors: HEGARTY PAUL K. , KAYES OLIVER , FREEMAN ALEX , CHRISTOPHER NIM , RALPH DAVID J. , MINHAS SUKS 
Published: June 2006

OBJECTIVETo prospectively assess the outcome of patients treated according to the European Association of Urology (EAU) guidelines on the management of penile cancer, a system originally based on retrospective series.PATIENTS AND METHODSBetween 2002 and 2005, 100 consecutive patients (median age 62 years) with penile cancer were treated at one institution; all were categorized and treated according to EAU guidelines. Data were analysed using the z‐test, with significance defined as P < 0.05.RESULTSSurvival curves were limited to those with >12 months of follow‐up (mean 29); the survival of the whole group was 92%. Of men with palpable nodes, 72% had lymph node involvement, whereas 18% of those with impalpable nodes who had lymphadenectomy according to the guidelines had lymph node disease. The grade of the primary tumour was more predictive than T stage for lymph node involvement and survival. The 3‐year disease‐specific survival for N0, N1 and N2 disease was 100%, 100% and 73%, respectively, and survival at 12 months for N3 disease was 67%. The median survival for those with metastases was 3 months.CONCLUSIONThe overall survival of men with penile cancer is high, with a clear benefit for early lymphadenectomy in men with positive nodal disease. However, the current EAU guidelines are limited in predicting those patients with micrometastatic disease, with the result that 82% of patients undergo unnecessary prophylactic lymphadenectomy. There is a need to identify more accurate molecular markers for predicting lymph node disease, or the role of novel staging techniques must be assessed.
To what extent does the prostate‐specific antigen nadir predict subsequent treatment failure after transrectal high‐intensity focused ultrasound therapy for presumed localized adenocarcinoma of the prostate?
Authors: UCHIDA TOYOAKI , ILLING ROWLAND O. , CATHCART PAUL J. , EMBERTON MARK 
Published: June 2006

OBJECTIVETo explore the association between the prostate‐specific antigen (PSA) nadir after transrectal high‐intensity focused ultrasound (HIFU) therapy for organ‐confined prostate cancer and subsequent treatment failure, as defined by the presence of residual disease at biopsy 6 months after treatment.PATIENTS AND METHODSBetween January 1999 and January 2005, 115 patients in a Japanese hospital were treated using a transrectal HIFU system (SonablateTM, Focus Surgery, IN, USA) for presumed localized adenocarcinoma of the prostate. All treatments were primary and none of the patients had received hormone therapy. The PSA level was measured at 2‐monthly intervals and all patients had a transrectal prostate biopsy taken at 6 months. Multiple logistic regression was used to examine the relationship between PSA nadir and treatment failure, as defined by the presence of disease at biopsy.RESULTSThe PSA nadir was strongly associated with treatment failure (P < 0.001). Patients with a PSA nadir of 0.0–0.2 ng/mL had a treatment failure rate of only 11% (four of 36), compared to 46% (17 of 37) in patients with a PSA nadir of 0.21–1.00 ng/mL and 48% (20 of 42) with a PSA nadir of >1.0 ng/mL. In addition, the PSA nadir was strongly associated with both preoperative PSA level and residual prostate volume.CONCLUSIONThere is a clear and intuitive association between the PSA nadir and the risk of treatment failure after HIFU. These data can be used to predict the risk of residual disease in patients with prostate cancer undergoing HIFU therapy. They can also be used to inform where the target PSA nadir should be set for this novel therapy.
The MTHFR C677T polymorphism confers a high risk for stroke in both homozygous and heterozygous T allele carriers with Type 2 diabetes
Authors: Hermans M. P. , Gala J.‐L. , Buysschaert M. 
Published: June 2006

AbstractObjective  Individuals with Type 2 diabetes are at increased risk of stroke. Plasma homocysteine (tHcy) is an independent risk factor for cardiovascular (CV) disease. The methylene–tetrahydrofolate reductase (MTHFR) gene polymorphism (thermolabile variant C677T) is associated with CV risk, partly as a result of increased Hcy, especially in homozygous subjects.Aim  To relate the occurrence of the MTHFR polymorphism with stroke prevalence by examining allelic frequency and genotype distribution in 165 subjects with Type 2 diabetes studied for the presence of thermolabile C677T MTHFR mutation.Results  Mean age was 67.7 years, and tHcy 18.2 µmol/l. T allele frequency was 38.5%. MTHFR genotypes were: normal (CC) 40%; heterozygous (CT) 43%; homozygous (TT) 17%. Serum levels of folic acid and B12 vitamin were within normal limits. Stroke prevalence was 14%. Sixty‐four per cent of stroke‐free subjects had the normal C allele vs. 46% in stroke subjects. The frequencies of genotypes (CC‐CT‐TT) were (%): 44‐41‐15 in stroke‐free vs. 17‐57‐26 in stroke patients. Coronary (CAD) and peripheral artery disease (PAD) were common in all groups, with no differences according to genotypes. Stroke prevalence was markedly higher in genotypes CT and TT (18 and 21%) compared with CC (6%). Mean tHcy levels were higher in TT subjects.Conclusion  The allelic frequency of C677T MTHFR mutation in Type 2 diabetes subjects with stroke is markedly different from that of subjects without stroke. Genotypic characteristics suggest that C677T MTHFR mutation confers a higher risk for stroke to both homozygous and heterozygous T allele carriers that cannot be ascribed solely to raised tHcy and/or lower folate status in CT subjects, nor to phenotypic expression of conventional risk factors for stroke. The impact of the MTHFR polymorphism on stroke may result from T allele‐linked deleterious effects, or C allele‐linked protection. Confirmatory studies are warranted, as this cohort was not randomly selected, and a type 1 error cannot be ruled out.
Weight gain is associated with improved glycaemic control but with adverse changes in plasma lipids and blood pressure isn Type 1 diabetes
Authors: Ferriss J. B. , Webb D. , Chaturvedi N. , Fuller J. H. , Idzior‐Walus B. ,   The EURODIAB Prospective Complications Group
Published: June 2006

AbstractAims  To assess the effects of weight gain on metabolic control, plasma lipids and blood pressure in patients with Type 1 diabetes.Methods  Patients in the EURODIAB Prospective Complications Study (n = 3250) were examined at baseline and 1800 (55%) were re‐examined a mean of 7.3 years later. Patients had Type 1 diabetes, defined as a diagnosis made before age 36 years and with a need for continuous insulin therapy within a year of diagnosis. Patients were aged 15–60 years at baseline and were stratified for age, sex and duration of diabetes.Results  The change in HbA1c from baseline to follow‐up examination was significantly more favourable in those who gained 5 kg or more during follow‐up (‘marked weight gain’) than in patients who gained less or no weight or lost weight (‘less or no weight gain’). In those with marked weight gain, there was a significantly greater rise in plasma triglycerides and total cholesterol and significantly less favourable changes in low‐density lipoprotein and high‐density lipoprotein cholesterol compared with those with less or no weight gain, with or without adjustment for HbA1c. Systolic and diastolic blood pressure also rose significantly more in the group with marked weight gain.Conclusion  Weight gain in patients with Type 1 diabetes has adverse effects on plasma lipids and blood pressure, despite a small improvement in glycaemic control.
Metabolic syndrome—a new world‐wide definition. A Consensus Statement from the International Diabetes Federation
Authors: Alberti K. G. M. M. , Zimmet P. , Shaw J. 
Published: June 2006

AbstractAims  To establish a unified working diagnostic tool for the metabolic syndrome (MetS) that is convenient to use in clinical practice and that can be used world‐wide so that data from different countries can be compared. An additional aim was to highlight areas where more research into the MetS is needed.Participants  The International Diabetes Federation (IDF) convened a workshop held 12–14 May 2004 in London, UK. The 21 participants included experts in the fields of diabetes, public health, epidemiology, lipidology, genetics, metabolism, nutrition and cardiology. There were participants from each of the five continents as well as from the World Health Organization (WHO) and the National Cholesterol Education Program—Third Adult Treatment Panel (ATP III). The workshop was sponsored by an educational grant from AstraZeneca Pharmaceuticals.Consensus process  The consensus statement emerged following detailed discussions at the IDF workshop. After the workshop, a writing group produced a consensus statement which was reviewed and approved by all participants.Conclusions  The IDF has produced a new set of criteria for use both epidemiologically and in clinical practice world‐wide with the aim of identifying people with the MetS to clarify the nature of the syndrome and to focus therapeutic strategies to reduce the long‐term risk of cardiovascular disease. Guidance is included on how to compensate for differences in waist circumference and in regional adipose tissue distribution between different populations. The IDF has also produced recommendations for additional criteria that should be included when studying the MetS for research purposes. Finally, the IDF has identified areas where more studies are currently needed; these include research into the aetiology of the syndrome.
The establishment and dynamics of a recently established urban camp of flying foxes (Pteropus poliocephalus) outside their geographic range
Authors: Van Der Ree R. , McDonnell M. J. , Temby I. , Nelson J. , Whittingham E. 
Published: June 2006

AbstractGrey‐headed flying foxes Pteropus poliocephalus (Megachiroptera: Pteropodidae), listed nationally in Australia as vulnerable, have been recorded infrequently in low numbers in Melbourne from the first record of the species in 1884 till the early 1980s. The number of individuals and duration of their visit to Melbourne increased dramatically in the early 1980s, with the first year‐round presence occurring in 1986 within the Royal Botanic Gardens, Melbourne. Anecdotal information suggests that the Melbourne colony has been continuously present since 1986; however, counts of roosting animals were sporadic between 1987 and 1993. Regular monthly counts that began in December 1993 confirm the continuous presence of the species in Melbourne from that date onwards. The growth of the size of the colony from 1994 onwards was exponential, with a peak in March 2003 (when counting ceased) at between 20 000 (static count) and 30 000 (flyout count) individuals. The number of P. poliocephalus within the colony fluctuated across the year, with a peak in summer/autumn (December–May) and a trough in winter/spring (July–October). The exact timing of the influx of animals varied slightly from year to year. The establishment of the permanent camp in urban Melbourne is a range expansion for the species.