bluuebunny/crossref_metadata_2025_split huggingface dataset:
Alfuzosin 10 mg once daily for treating benign prostatic hyperplasia: a 3‐year experience in real‐life practice
Authors: Vallancien Guy , Emberton Mark , Alcaraz Antonio , Matzkin Haim , Van Moorselaar R. Jeroen A. , Hartung Rudolf , Harving Niels , Elhilali Mostafa ,   ALF‐ONE Study Group
Published: March 2008

OBJECTIVESTo assess the 3‐year efficacy and safety of the selective α1‐blocker alfuzosin at 10 mg once daily in men with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) in ‘real‐life practice’. The influence of treatment response on the risk of acute urinary retention (AUR) and BPH‐related surgery was also analysed.PATIENTS AND METHODSIn all, 689 European men (mean age 67.6 years) were enrolled by general practitioners in a 3‐year open‐label study with alfuzosin at 10 mg once daily. They were asked to complete the International Prostate Symptom Score (IPSS), its eighth question (bother score), and the Danish Prostatic Symptom Score for sexual function (DAN‐PSSsex). Efficacy was analysed at the endpoint in the intent‐to‐treat population. The impact of baseline variables (age, PSA level, IPSS and bother severity) and dynamic variables (IPSS worsening of ≥4 points and bother at the last available assessment under treatment) on the risk of AUR and BPH‐related surgery was evaluated.RESULTSWith alfuzosin, IPSS improved by 6.4 points (−33.4%) from baseline (P < 0.001), reaching ≥3 points and >6 points in 71.3% and 47.2% of men, respectively. There were also significant (P < 0.001) improvements from baseline in nocturia (−0.8, −25.5%), bother score (−1.7, −40.7%) and DAN‐PSSsex weighted scores with treatment. Symptom relief was rapid and maintained over 3 years. Overall, 78 men (12.4%) had an IPSS worsening of ≥4 points, 16 (2.6%) had AUR, and 36 (5.7%) required BPH‐related surgery. Symptom deterioration during treatment and high baseline PSA values were the best predictors of AUR and BPH‐related surgery. Alfuzosin was well tolerated, dizziness being the most frequent adverse event (4.5%) possibly related to vasodilatation. Ejaculatory disorders were uncommon (0.4%). Changes in blood pressure remained marginal, including in men aged ≥65 years and those receiving antihypertensive agents.CONCLUSIONAlfuzosin administered for 3 years at 10 mg once daily in real‐life practice is effective and well tolerated. High PSA values and symptom worsening under treatment appear the best predictors of AUR and BPH‐related surgery in the long term. Treatment with alfuzosin might thus help to identify patients at risk of LUTS/BPH progression in order to optimize their management.
Is the utility of prostate‐specific antigen velocity for prostate cancer detection affected by age?
Authors: Loeb Stacy , Roehl Kimberly A. , Catalona William J. , Nadler Robert B. 
Published: March 2008

OBJECTIVETo determine whether prostate‐specific antigen velocity (PSAV) is useful for prostate cancer detection in men from different age groups, and whether the same PSAV thresholds can reasonably be applied to all men aged ≥40 years.PATIENTS AND METHODSFrom a large prostate cancer screening study, 13 615 men had data on age and a calculable PSAV. We used statistical analysis to examine the ability of PSAV to predict prostate cancer risk in each age decade.RESULTSFor men of all ages, the median PSAV was 0.6–0.7 ng/mL/year in men with prostate cancer, and 0–0.1 ng/mL/year in men with no prostate cancer (P < 0.005 for all). On receiver operating characteristic (ROC) analysis, the area under the curve was 0.800, 0.697, 0.693, and 0.668 for predicting prostate cancer risk using PSAV for men aged 40–49, 50–59, 60–69 and ≥70 years, respectively. In the multivariate model controlling for race, family history, and the total PSA level, both PSA and PSAV were significant independent predictors of prostate cancer risk in men of all ages.CONCLUSIONSThe PSAV is significantly higher in men of all ages with prostate cancer compared with men with no prostate cancer; although on ROC analysis it performed the best in young men. Interestingly, the median PSAV in men with prostate cancer was <0.75 ng/mL/year regardless of age, suggesting that this threshold may be too high. Overall, this data confirms that PSAV is a useful tool for prostate cancer detection for men aged ≥40 years.
Clinical relevance of health‐related quality of life outcomes with darifenacin
Authors: Abrams Paul , Kelleher Con , Huels Jasper , Quebe‐Fehling Erhard , Omar Mohamed A. , Steel Michael 
Published: March 2008

OBJECTIVETo determine the clinical relevance of changes in health‐related quality of life (HRQoL) in patients with overactive bladder (OAB) treated with darifenacin.PATIENTS AND METHODSData were pooled from three randomized, placebo‐controlled, parallel‐group, fixed‐dose, 12‐week studies. After 2‐week washout, treatment‐free or placebo run‐in periods, patients with OAB (n = 1059; 85% women; age 19–88 years) were randomized to 12 weeks’ treatment with darifenacin controlled‐release 7.5 mg (n = 337) or 15 mg once daily (n = 334) or placebo (n = 388). The King’s Health Questionnaire (KHQ) was used to assess HRQoL at baseline and Week 12. The clinical significance of changes in KHQ domain scores was assessed using the concept of minimum important difference (MID), using two different methods.RESULTSDarifenacin treatment was associated with significantly greater improvements than placebo in six primary KHQ domain scores known to be of importance to patients with OAB. In addition, a significantly greater proportion of darifenacin‐treated patients met or exceeded reference MID vs placebo in these domains (Incontinence Impact, Severity Measures, Role Limitations, Social Limitations, Emotions and Physical Limitations; P = 0.01). In darifenacin‐treated patients, there were significant correlations between the reductions in incontinence episodes per week and improvements in KHQ scores (P < 0.001). The strongest correlations were in the Incontinence Impact, Social Limitations, Role Limitations, Severity Measures and Emotions domains.CONCLUSIONSDarifenacin treatment was associated with significant, clinically relevant improvements in HRQoL in patients with OAB, shown using the concept of MID to interpret change in KHQ scores.
The lymph node yield during robot‐assisted radical cystectomy
Authors: Guru Khurshid A. , Sternberg Kevan , Wilding Gregory E. , Tan Wei , Butt Zubair M. , Mohler James L. , Kim Hyung L. 
Published: March 2008

OBJECTIVETo evaluate the lymph node yield (LNY) during robot‐assisted radical cystectomy (RC), as it has been questioned as to whether robot assistance allows adequate pelvic LN dissection (LND), especially during the initial experience.PATIENTS AND METHODSIn all, 67 consecutive patients were selected for robot‐assisted RC and LND with open urinary diversion from October 2005 to November 2007. Data was collected prospectively in a standard fashion as part of a quality assurance programme. Nine patients were excluded (three had unresectable disease and six underwent palliative cystectomy) and the remainder were divided into five groups. Data included demographics, operative variables, complications and pathological outcomes. Evidence of the LNY curve was examined using nonlinear regression to compare the number of LNs obtained.RESULTSThe mean (range) patient age was 67 (36–90) years and the mean body mass index (BMI) was 27 (17–45) kg/m2. The mean operative duration for the robot‐assisted pelvic LND was 44 (19–85) min. There was one postoperative complication that required exploration for vascular injury. The mean number of LNs retrieved was 18 (6–43). The mean LNY for each of the five groups was 13, 16, 21, 19 and 23, respectively, and neither BMI nor previous major abdominal surgery affected LNY.CONCLUSIONRobot‐assisted RC with pelvic LND was performed safely. LNY was oncologically acceptable and increased with experience.
A comparison of the performance of microsatellite and methylation urine analysis for predicting the recurrence of urothelial cell carcinoma, and definition of a set of markers by Bayesian network analysis
Authors: Rouprêt Morgan , Hupertan Vincent , Yates David R. , Comperat Eva , Catto James W.F. , Meuth Mark , Lackmichi Amine , Ricci Sylvie , Lacave Roger , Gattegno Bernard , Richard François , Hamdy Freddie C. , Cussenot Olivier 
Published: March 2008

OBJECTIVETo compare the potential of two diagnostic methods for detecting recurrence of urothelial cell carcinoma (UCC) of the bladder, by (i) detecting alterations in microsatellite DNA markers and loss of heterozygosity (LOH), and (ii) detecting aberrant gene hypermethylation, as UCC has a high recurrence rate in the urinary tract and the disease can invade muscle if new tumours are overlooked.PATIENTS AND METHODSOver 1 year, urine samples were retrieved from 40 patients already diagnosed with bladder UCC (30 pTa, two pTis, eight pT1). Samples were collected 6 months after bladder tumour resection, during the follow‐up schedule. We used samples to analyse nine microsatellite markers and the methylation status of 11 gene promoters. Receiver operating characteristic curves were generated and Bayesian statistics used to create an interaction network between recurrence and the biomarkers.RESULTSDuring the study, 15 of the 40 patients (38%) had a tumour recurrence and 14 were identified by cystoscopy (reference method). Overall, microsatellite markers (area under curve, AUC 0.819, 95% confidence interval, CI, 0.677–0.961) had better performance characteristics than promoter hypermethylation (AUC 0.448, 0.259–0.637) for detecting recurrence. A marker panel of IFNA, MBP, ACTBP2, D9S162 and of RASSF1A, and WIF1 generated a higher diagnostic accuracy of 86% (AUC 0.92, 0.772–0.981).CONCLUSIONMicrosatellite markers have better performance characteristics than promoter hypermethylation for detecting UCC recurrence. These data support the further development of a combination of only six markers from both methods in urinary DNA. Once validated, it could be used routinely during the follow‐up for the early detection and surveillance of UCC from the lower and upper urinary tract.
Pulmonary gas exchange in the morbidly obese
Authors: Zavorsky G. S. , Hoffman S. L. 
Published: March 2008

SummaryThe literature on pulmonary gas exchange at rest, during exercise, and with weight loss in the morbidly obese (body mass index or BMI ≥ 40 kg m−2) is reviewed. Forty‐one studies were found (768 subjects weighted mean = 40 years old, BMI = 48 kg m−2). The alveolar‐to‐arterial oxygen partial pressure difference (AaDO2) was large at rest in upright subjects at sea level (23, range 5–38 mmHg) while the arterial pressure of oxygen (PaO2) was low (81, range 50–95 mmHg). Arterial pressure of carbon dioxide (PaCO2) was normal. At peak exercise (162 W), gas exchange improves. Weight loss of 45 kg (BMI = −13 kg m−2) over 18 months is associated with an improvement in PaO2 (by 10 mmHg, range 1–23 mmHg), a reduction in AaDO2 (by 8 mmHg, range −3 to −16 mmHg), and PaCO2 (by −3 mmHg, range 3 to −14 mmHg) at rest. Every 5–6 kg reduction in weight increases PaO2 by 1 and reduces AaDO2 by 1 mmHg, respectively. Morbidly obese women have better gas exchange at rest compared with morbidly obese men which is likely due to lower waist‐to‐hip ratios in women than from differences in weight or BMI.
Indirect costs of obesity: a review of the current literature
Authors: Trogdon J. G. , Finkelstein E. A. , Hylands T. , Dellea P. S. , Kamal‐Bahl S. J. 
Published: March 2008

SummaryThis study reviews the recent literature on the relationship between obesity and indirect (non‐medical) costs. Medline and Web of Science searches were conducted to identify published studies from 1992 to present that report indirect costs by obesity status; 31 studies were included. The indirect costs were grouped into six categories: costs associated with absenteeism, disability, premature mortality, presenteeism, workers’ compensation, and total indirect costs. Compared with non‐obese workers, obese workers miss more workdays due to illness, injury, or disability. Costs of premature mortality vary substantially across countries. The results for presenteeism and workers’ compensation were mixed. More research is needed to determine obesity's causal role in increasing indirect costs, especially for workers’ compensation and presenteeism. Cohort and longitudinal study designs should be a priority.
Tracking of childhood overweight into adulthood: a systematic review of the literature
Authors: Singh A. S. , Mulder C. , Twisk J. W. R. , Van Mechelen W. , Chinapaw M. J. M. 
Published: March 2008

SummaryOverweight and obesity in youth are important public health concerns and are of particular interest because of possible long‐term associations with adult weight status and morbidity. The aim of this study was to systematically review the literature and update evidence concerning persistence of childhood overweight. A computerized bibliographical search – restricted to studies with a prospective or retrospective longitudinal design – was conducted. Two authors independently extracted data and assessed the methodological quality of the included studies in four dimensions (i) study population and participation rate; (ii) study attrition; (iii) data collection and (iv) data analysis. Conclusions were based on a rating system of three levels of evidence. A total of 25 publications were selected for inclusion in this review. According to a methodological quality assessment, 13 studies were considered to be of high quality. The majority of these high‐quality studies were published after 2001, indicating that recently published data, in particular, provide us with reliable information. All included studies consistently report an increased risk of overweight and obese youth becoming overweight adults, suggesting that the likelihood of persistence of overweight into adulthood is moderate for overweight and obese youth. However, predictive values varied considerably. Limiting aspects with respect to generalizability and methodological issues are discussed.
RESEARCH INVOLVING PRISONERS: CONSENSUS AND CONTROVERSIES IN INTERNATIONAL AND EUROPEAN REGULATIONS
Authors: ELGER BERNICE S. 
Published: March 2008

ABSTRACTThis article examines international and European regulations on research involving prisoners for consensus, differences, and their consequences, and offers a critical evaluation of the various approaches. Agreement exists that prisoners are at risk of coercion, which might interfere with their ability to provide voluntary informed consent to research. Controversy exists about the magnitude of this risk and the consequences that should follow from this risk. Two strategies are proposed for a method of protecting prisoners that does not lead to discrimination: first, more caution to assure non‐coerced consent and second, restrictions on the type of research. Most regulations stress the importance of the principle of equivalence of healthcare in places of detention as part of an efficient protection against research risks and discrimination.All the presented approaches have shortcomings. While ‘over‐use’ of prisoners for research as compared to the general population is ethically unjustified, not granting prisoners access to studies beneficial to their own health because of over‐strict regulations is equally unjustified. A middle solution should be preferred, one that grants a minimum of protection together with the lowest possible barriers. Research that does not entail a direct benefit for the individual detainee should be restricted to types of research that have a benefit for detainees as a group and that are of low risk. What will ultimately protect prisoners best, while producing the greatest benefit for them, is access to the same healthcare available to members of the community including research as a true option.
NEUROSTIMULATION AND THE MINIMALLY CONSCIOUS STATE
Authors: GLANNON WALTER 
Published: March 2008

ABSTRACTNeurostimulation to restore cognitive and physical functions is an innovative and promising technique for treating patients with severe brain injury that has resulted in a minimally conscious state (MCS). The technique may involve electrical stimulation of the central thalamus, which has extensive projections to the cerebral cortex. Yet it is unclear whether an improvement in neurological functions would result in a net benefit for these patients. Quality‐of‐life measurements would be necessary to determine whether any benefit of neurostimulation outweighed any harm in their response to different degrees of cognitive and physical disability. These measures could also indicate whether the technique could be ethically justified and whether surrogates could give proxy consent to its use on brain‐injured patients.
CLARIFYING APPEALS TO DIGNITY IN MEDICAL ETHICS FROM AN HISTORICAL PERSPECTIVE
Authors: VAN DER GRAAF RIEKE , VAN DELDEN JOHANNES JM 
Published: March 2008

ABSTRACTOver the past few decades the concept of (human) dignity has deeply pervaded medical ethics. Appeals to dignity, however, are often unclear. As a result some prefer to eliminate the concept from medical ethics, whereas others try to render it useful in this context. We think that appeals to dignity in medical ethics can be clarified by considering the concept from an historical perspective. Firstly, on the basis of historical texts we propose a framework for defining the concept in medical debates. The framework shows that dignity can occur in a relational, an unconditional, a subjective and a Kantian form. Interestingly, all forms relate to one concept since they have four features in common: dignity refers, in a restricted sense, to the ‘special status of human beings’; it is based on essential human characteristics; the subject of dignity should live up to it; and it is a vulnerable concept, it can be lost or violated. We argue that being explicit about the meaning of dignity will prevent dignity from becoming a conversation‐stopper in moral debate. Secondly, an historical perspective on dignity shows that it is not yet time to dispose of dignity in medical ethics. At least Kantian and relational dignity can be made useful in medical ethics.
Social Competence with Peers in Third Grade: Associations with Earlier Peer Experiences in Childcare1
Authors:   National Institute of Child Health and Human Development Early Child Care Research Network
Published: March 2008

AbstractThe early developmental antecedents of individual differences in children's social functioning with peers in third grade were examined using longitudinal data from the large‐scale National Institute of Child Health and Human Development (NICHD) study of early child care. In a sample of 1,364 children, with family and child factors controlled, the frequency of positive and negative peer interactions in childcare between 24 and 54 months and the number of hours spent in childcare peer groups of different sizes (alone, dyad, small, medium, large) predicted third graders' peer competence at three levels of analysis: individual social skills, dyadic friendships, and peer‐group acceptance. Children who had more positive experiences with peers in childcare had better social and communicative skills with peers in third grade, were more sociable and co‐operative and less aggressive, had more close friends, and were more accepted and popular. Children with more frequent negative experiences with peers in childcare were more aggressive in third grade, had lower social and communicative skills, and reported having fewer friends. When children spent more time in small‐sized peer groups in childcare (four or fewer children at 24 months of age up to seven or fewer at 54 months), they were more sociable and co‐operative in third grade, but their teachers rated them as more aggressive, suggesting that such children may be more socially outgoing and active both positively and negatively. Like those who spent more time in small peer groups, children who spent more hours in medium‐sized groups received higher ratings for peer aggression by their third‐grade teachers. Children who spent more time with one other child in childcare or in small peer groups had fewer classroom friends in third grade as reported by the teacher but not according to maternal report or self‐report. There were no significant associations between the amount of time children spent in large childcare‐based peer groups and third‐grade peer social competence.
Social‐cognitive Competence, Peer Rejection and Neglect, and Behavioral and Emotional Problems in Middle Childhood
Authors: Hoglund Wendy L. G. , Lalonde Christopher E. , Leadbeater Bonnie J. 
Published: March 2008

AbstractThis prospective, longitudinal study examines individual differences in two conceptually related but empirically distinct domains of social‐cognitive competence (cognitive interpretive understanding and interpersonal perspective co‐ordination) as moderators of the relation between peer rejection and neglect and behavioral and emotional problems in grades 2 and 3. As expected, peer rejection and neglect increased risks for behavioral and emotional problems whereas interpretive understanding (understanding of mental states) and perspective co‐ordination (awareness of others' emotions and motives) reduced risks for aggressive, disruptive, inattentive, and anxious, sad, withdrawn behaviors. Assumptions that awareness of others' perspectives bestows consistent benefits for children experiencing peer problems were challenged. Unexpectedly, rejection and neglect increased risks for behavioral and emotional problems for children who demonstrated average and high levels of perspective co‐ordination. More advanced perspective co‐ordination may heighten children's sensitivity to peer relationship problems and result in general maladjustment, both concurrently and over time. Less advanced perspective co‐ordination may also be responsible for the ‘optimistic bias’ that has been noted in aggressive children.
The Parent's Capacity to Treat the Child as a Psychological Agent: Constructs, Measures and Implications for Developmental Psychopathology
Authors: Sharp Carla , Fonagy Peter 
Published: March 2008

AbstractRecent studies of the relationship between parenting and child development have included a focus on the parent's capacity to treat the child as a psychological agent. Several constructs have been developed to refer to this capacity, for example maternal mind‐mindedness, reflective functioning, and parental mentalizing. In this review article, we compare and contrast different constructs from diverse theoretical backgrounds that have been developed to operationalize parental mentalizing. We examine the empirical evidence to date in support of each of the constructs and review the relevant measures associated with each construct. Next, we discuss the possibility that these apparently diverse constructs may tap into the same underlying neurobiological socio‐cognitive system. We conclude by proposing a testable model for describing the links between parental mentalization, the development of mentalizing in children, and child psychopathology.