bluuebunny/crossref_metadata_2025_split huggingface dataset:
A comparison of intramuscular ketorolac and pethidine in the alleviation of renal colic
Authors: SANDHU D.P.S. , IACOVOU0 J.W. , FLETCHER M.S. , KAISARY A.V. , PHILIP N.H. , ARKELL D.G. 
Published: November 2008

Objective To compare the analgesic efficacy of a single 30 mg intramuscular dose of ketorolac with that of intramuscular pethidine 100 mg. in a double‐blind, parallel‐group investigation of patients presenting with pain suggestive of renal colic. Patients and methods Seventy‐six patients (17 women, 15 men; mean age 45.2 years, range 20–80) were allocated by means of a pre‐determined randomization schedule to receive ketorolac and 78 patients (20 women, 58 men; mean age 42.1, years range 18–70) to receive pethidine. Data from eight patients in the ketorolac group and six in the pethidine group were excluded from the efficacy analyses because of protocol violations. The severity of each patient's pain was assessed on a four‐point verbal rating scale (VRS) and a 10 cm visual analogue scale at pre‐dose and at 15 min intervals for the first hour post dosing. The time to first administration of rescue analgesic, up to 24 h following dosing with the study medication, was recorded. Adverse events were elicited by general questioning. Results Eighty‐eight per cent of patients in each treatment group had improved according to the VRS of pain severity 1 h after dosing; the summed pain intensity differences up to 1 h were statistically significantly different in favour of ketorolac (P<0.05). Fifty‐six per cent of patients who were receiving ketorolac required rescue analgesia during the study period compared with 74% receiving pethidine. The incidences of adverse events were lower in the ketorolac group (28%) than the pethidine group (51%). Conclusion Ketorolac can be considered a viable alternative to pethidine for the treatment of renal colic.
Ultrasonography of ureteric abnormalities induced by Schistosoma haematobium infection before and after praziquantel treatment
Authors: KARDORFF R. , TRAORÉ M. , DOEHRING‐SCHWERDTFERGER E. , VESTER U. , EHRICH J.H.H. 
Published: November 2008

Objective To describe the ultrasonographic appearance of ureteric lesions due to Schistosoma haematobium infection and to report prevalence rates of such lesions in endemic communities in Mali before and after praziquantel treatment. Subjects and methods The total population (n = 961) of three S. haematobium‐endemic villages in Mali was examined ultrasonographically to detect urinary tract morbidity. Urine was tested for S. haematobium ova and for haematuria. An identical follow‐up study was performed 1 year after mass treatment with praziquantel. Results Prevalence rates of S. haematobium infection in the three villages were 53%, 72% and 73%. Ultrasonography revealed dilatation of the ureters in 143 subjects (15%). In 20 of these, mainly children and adolescents, thickening and irregularities of the ureteric wall with distal ureter obstruction were directly visualized on ultrasonography. Within the bladder of two others, an intraluminal structure of ureterocele‐like appearance was seen. None of these alterations has been previously described as an ultrasonographic feature of schistosomal uropathy. Active S. haematobium infection and microhaematuria were found in 21 and 20 of these 22 subjects respectively. Significant renal obstruction was present in 10 of them. One year after treatment, an entirely normal urinary tract was found in 85% of 104 re‐examined individuals who had had ureter dilatation. Ureteric wall thickening or ureterocele‐like lesions had disappeared in 95% of subjects. Conclusions The role of ultrasound in the evaluation of schistosomal uropathy is confirmed. Ureteric wall abnormalities causing strictures and ureterocele‐like lesions of the ostium must be regarded as further ultrasonographic features of this condition. The study documents the excellent reversibility of ureteric abnormalities after antischistosomal treatment in children and adolescents, thus emphasizing the need for early and efficient medical treatment of the infection.
An assessment of the contribution of visco‐elastic factors in the aetiology of poor compliance in the human neurophathic bladder
Authors: GERMAN K. , BEDWANI J. , DAVIES J. , BRADING A.F. , STEPHENSON T.P. 
Published: November 2008

ObjectiveTo compare the mechanical properties of full‐thickness bladder strips from poorly complaint neuropathic bladders with controls and to determine the overall contribution that mechanical factors might have in the actiology of the poor compliance of medium‐fill cyctomerty. Patients and methods The visco‐elastic properties of full‐thickness bladder strips from 11 neuropathic patients (with poorly complaint during medium‐fill cystomerty) were compared with strips from 11 control bladders. A Strip (measuring 2 cm long and 0.5 cm wide) was mounted in an organ bath and streched by 1 cm at a slow and at a fast rate. The streches were repeated in modified Krebs solution containing Zero calcium and 12mM magnesium. The final experiment involoved stretching the strip by 1 cm in <1 s (instantaneous strech) Result only modest differences in the peak tensions of both tissues were uncovered by the slow and fast streches (fast stretch: 14.6 ± 5.5 in neuropaths vs 10.1 ± 4.1 g in controls. P = NS; slow stretch: 9.6 ± 3.5 in neuropaths vs 6.7 ± 2.5 g in controls. P <0.05). Straches carries out in modified Krebs solution resulted in lower tensions. Fast, intermediate and slow components of viscous decay (derived from the rate of tension decay following the instantaneous stretch) were not significantly different in neuropaths compared to controls (P = NS). Conclusion The differences in the mechanical properties between neuropathic and control bladder strips were small and could not alone have accounted for the large differnces in bladder compliance that was observed between neuropathic and normal patients during medium‐fill cystometry. This implied that neurogenic rather than mechanical factors were more important in the aetiology of the observed poor compliance in these patients.
Ureteric retrieval net: comparison with stone extraction by Dormia baskets in an in vitro porcine model
Authors: PHAN C. N. , STOLLER M. L. 
Published: November 2008

Objective To develop a ureteric retrieval net with advantages over existing stone retrieval methods.Materials and methods In vitro experimental trials comparing the ureteric retrieval net with Dormia baskets were performed with porcine ureters and artificial calculi placed in a proximal or distal position.Results For removing a single, large stone (9 times 6 × 5 mm) the net was slightly better than baskets (100% versus 90%) and it was significantly (P < 0.001) more effective for removing multiple small stones (2 times 2 × 3 mm to 5 times 4 × 3 mm) in one pass (76% versus 40% with three distal stones; 73% versus 13% with three proximal stones; and 53% versus 3% with six proximal stones).Conclusion This newly developed ureteric retrieval net has a compact design, resulting in minimal resistance during retraction. Its smooth hydrophilic outer surface enhances scooping properties against the luminal wall. The mesh is similar to that in nylon stockings — porous enough to allow flow, yet small enough to capture fragments. It can capture numerous small fragments with one scoop, but can easily disengage them if extraction is not possible. The loop encompasses the entire lumen with the ‘pusher’ offset to a side wall, allowing maximal space and visualization, and the device can dilate the ureter to facilitate extraction. Clinical studies are in progress to evaluate the full potential of this new device.
The effect of transrectal ultrasonography (TRUS) including digital rectal examination (DRE) of the prostate on the level of prostate specific antigen (PSA)
Authors: KLOMP M. L. F. , HENDRIKX A. J. M. , KEYZER J. J. 
Published: November 2008

Objective To study the effect of transrectal ultrasonography (TRUS) including digital rectal examination (DRE) of the prostate on serum prostate specific antigen (PSA).Patients and methods In a diagnostic centre for general practitioners serum PSA was determined in patients before, immediately after, and one week after TRUS including DRE. In a small group of patients PSA was determined at various times after DRE and TRUS.Results The PSA levels showed a statistically significant rise of 20% immediately after DRE and TRUS. After 7 days the PSA levels had returned to their initial levels. This decrease appeared to occur within the first 24 h.Conclusion When applying the diagnostic triad PSA, DRE and TRUS blood samples for PSA should preferably be taken before DRE and TRUS. If blood samples are taken afterwards, it is safe to do so after seven days.
The diagnostic yield of intravenous urography: a demographic study
Authors: COLLIE D. A. , PAUL A. B. , WILD S. R. 
Published: November 2008

Objective To examine the impact of intravenous urography (IVU) on patient management in unselected patients in an effort to identify groups in which the use of urography could be reduced.Patients and methods The results of IVU in 235 consecutive unselected patients were assessed prospectively to establish the value of IVU in patient management. Patients were divided into subgroups on the basis of age, sex, presenting symptoms and source of referral. The percentage of examinations with findings affecting patient management was taken as the ‘positive diagnostic yield.’ Differences between the positive diagnostic yields of IVU in the various groups were examined using the ξ2 test.Results For all patients the diagnostic yield was 37.4%. In patients over 50 years of age the yield was 46% while below that age the yield fell to 20%. This difference was significant (ξ2= 13.88, P < 0.001). There were no significant differences between the other defined groups. Specifically, patients referred by general practitioners were as likely to have an IVU abnormality as were patients referred by a hospital practitioner. Patients with painless microscopic hae‐maturia had a lower diagnostic yield (20%) than the other groups examined but this was not significant.Conclusion IVU has a high diagnostic yield in an unselected population. Although the yield is lower in younger patients IVU offers advantages over other techniques in the investigation of urolithiasis — the commonest positive diagnosis in this study. We argue that it should retain its position as the primary investigation for the majority of patients with urological disease, particularly those suffering loin pain or haematuria.
Controlled trial evaluation of a General Practitioner education package on incontinence: use of a mailed questionnaire
Authors: SZONYI G. , MILLARD R.J. 
Published: November 2008

Objective To evaluate whether an education package will significantly improve General Practitioners' knowledge of the aetiology, diagnosis and treatment of incontinence.Subjects and methods Of the 510 General Practitioners contacted 124 returned a 27 item questionnaire (q1). The doctors were randomized into a test group (n= 80) who received an education package and a control group (n= 44) who did not. Follow‐up questionnaires (q2) were sent to those in the test group at 6 weeks and to those in the control group at 4 weeks post‐randomization. The answers to 18 of the 27 questions were found in the education package and the remaining nine were not. The test group was asked to rate the usefulness of the package.Results There was a mean increase in scores for the two questionnaires of 5.2 in the test group compared with 0.4 in the control group. The average increase in scores in the test group was highly significant compared with that in the control group (P< 0.001). The results remained significant when the non‐responders were included. The change inscoresin the test group was significant only for those 18 questions with answers contained in the education package. There was no significant improvement between the two groups for the change in scores for the nine questions not answered in the education package (P= 0.74). General Practitioners gave the package a mean rating of 4.2/5 and it was still being used more than 6 weeks after delivery by at least 31 of 49 General Practitioners.Conclusions For the General Practitioners who expressed an interest in receiving an education package on incontinence, and who answered the questionnaires, there was an improvement in the knowledge of incontinence directly attributable to the package
Marker tumour response to Evans and Pasteur bacilie Calmette‐Guérin in multiple recurrent pTa/pT1 bladder tumours: report from the Medical Research Council Subgroup on Superficial Bladder Cancer (Urological Cancer Working Party)
Authors: FELLOWS G.J. , PARMAR M.K.B. , GRIGOR K.M. , HALL R.R. , HEAL M.R. , WALLACE D.M.A. 
Published: November 2008

Objective To compare the efficacy of Evans bacilie Calmette‐Guérin (BCG) and Pasteur BCG in eradicating marker bladder tumours and to compare the toxicity of the two strains.Patients and methods Ninety‐nine patients with multiple recurrent pTa or pT1 bladder tumours were allocated at random to six instillations at weekly intervals of either Evans BCG or Pasteur BCG. All tumours were resected except one marker tumour. At cystoscopy 3 months after randomization all tumours including the marker tumour, if still present, were resected.Results The incidence of adverse events was similar in the two groups but numbers were small and only large differences would have been detected. No statistically significant difference in efficacy regarding the response of the marker tumour or the appearance of other tumours at 3 months was noted in the two groups. There was no evidence of stage progression of the marker tumours.Conclusions In multiple recurrent pTa or pT1 bladder tumours clearing the bladder of all except one marker tumour provides a safe and convenient way of measuring the response to intravesical therapy. No significant difference in efficacy or toxicity was detected between Evans BCG and Pasteur BCG.
Immunotherapy with bacille Calmette‐Guérin in patients with superficial transitional cell carcinoma of the bladder associated with bilharziasis
Authors: WISHAHI M.M. , ISMAIL I.M.H. , EL‐SHERBINI M. 
Published: November 2008

Objective To test the effectiveness and possible side‐effects that may result from intravesical immunotherapy with bacillus Calmette‐Guérin (BCG) for superficial bladder cancer associated with bilharziasis.Patients and methods Intravesical instillation of the Pasteur strain of BCG was carried out in 13 patients after transurethral resection of superficial transitional cell carcinoma (TCC) associated with bilharziasis. The recurrence rate in these patients was compared retrospectively with that of 17 patients with superficial TCC associated with bilharziasis in whom a recurrence had occurred previously and who had not received immunotherapy.Results There was a statistically significant decrease in the recurrence of tumours after intravesical BCG therapy. The tumour‐free period after BCG treatment was 15.7 months compared with 6.7 months in the control group.Conclusion The presence of bilharziasis does not appear to influence the effectiveness of immunotherapy with BCG for superficial bladder cancer.
Transrectal prostatic sonography as a useful diagnostic means for patients with chronic prostatitis or prostatodynia
Authors: LUDWIG M. , WEIDNER W. , SCHROEDER‐PRINTZEN I. , ZIMMERMANN O. , RINGERT R. H. 
Published: November 2008

Objective To evaluate the sonographic changes that occur in patients with chronic prostatitis and compare them with those of non‐inflammatory prostatodynia using transrectal prostatic sonography (TPS).Patients and methods In a prospective study, TPS findings were analysed in 88 men with chronic prostatitis and 53 patients with prostatodynia, all of whom had undergone a standardized diagnostic procedure to detect inflammation.Results A statistically significant accumulation of prostatic calcifications and unilateral seminal gland alterations was demonstrated in patients with chronic inflammation. Nevertheless, both findings were also present in patients with prostatodynia (22% and 11%, respectively).Conclusion TPS is widely recommended for differential diagnosis in cases of chronic prostatitis and prostatodynia. Prostatic calcifications and seminal vesical abnormalities are regarded as typical signs of inflammation. The results of this study show that these sonographic abnormalities are indicative but do not prove the presence of chronic prostatitis.
Prognosis of testicular teratoma differentiated
Authors: STEVENS M.J. , NORMAN A.R. , FISHER C. , HENDRY W.F. , DEARNALEY D.P. , HORWICH A. 
Published: November 2008

Objective To determine whether the clinical course of patients with testicular teratoma differentiated (TD) and those with testicular teratoma undifferentiated justify a different follow‐up protocol.Patients and methods Between 1979 and 1989, 16 adult patients with testicular TD were treated at the Royal Marsden Hospital. These represented 2.7% of the 592 testicular teratoma patients seen during this period. With the exception of a propensity to involve the right testis (76%), there were no differences in clinical presentation between TD and non‐TD histological subtypes.Results The mean follow‐up was 55 months (range 7–137). Seven of the 16 patients had Stage I disease and were entered into surveillance programmes; one relapsed at 7 months. Ten men were treated with cisplatin or carboplatin‐based chemotherapy for metastases, of whom three had had prior chemotherapy at other hospitals and were referred after relapse. In the seven previously‐untreated chemotherapy group two patients failed. In the concurrent era, 375 patients with other subtypes of metastatic testicular nonseminoma were treated with chemotherapy and 47 (12.5%) failed (Progress Free Survival chi square (ξ2) = 2.73, P= 0.01). Although no difference in progression‐free survival was demonstrated between TD and non‐TD patients, the former had a worse overall survival probability (ξ2= 9.02, P= 0.003); this may be an artefact due to the small number of events.Conclusion Despite the apparently more benign histology, it is recommended that the management of adult TD should not deviate from the general principles established for other histological subtypes of testicular teratoma.
Efficacy of the combination of nilutamide plus orchidectomy in patients with metastatic prostatic cancer. A meta‐analysis of seven randomized double‐blind trials (1056 patients)
Authors: BERTAGNA C. , GÉRY A. DE , HUCHER M. , FRANÇOIS J. P. , ZANIRATO J. 
Published: November 2008

Objective To review the efficacy of the combination of the anti‐androgen nilutamide (Anandron®) plus orchidectomy in patients with stage D prostate cancer who had received no previous treatment. Patients and methods The results of seven randomized double‐blind trials were analysed. In these studies patients were followed up until progression of disease or withdrawal for other reasons. Bone pain, urinary symptoms, performance status, levels of prostatic acid phosphatase (PAP) and alkaline phosphatase (AP) were evaluated before treatment and after 1, 3, 6, 12 and 18 months of treatment. Bone scans and X‐rays were taken every 6 months. The best objective response, the time of progression and the time of death were recorded. The changes from baseline in symptoms and levels of tumour markers at month six and the percentages of objective regressions in the two treatment groups were compared using the Cochran‐Mantel‐Haenszel test stratified by study. Peto's method was used for the analysis of time to progression and of survival. Results Of the 1191 patients enrolled in all the original trials, 1056 were eligible. In the group of patients treated with nilutamide 50% had complete or partial regression of disease compared with 33% of those who were given a placebo (P<0.001); bone pain and levels of PAP and AP were improved or returned to normal significantly more frequently (P< 0.01); the odds of disease progression were significantly reduced (odds ratio 0.84, P=0.05); the odds of death from cancer and from other causes were reduced but the difference was not statistically significant. Conclusions The combination of nilutamide and orchidectomy has a beneficial effect on pain of metastatic origin, levels of tumour markers, the objective response of disease and the time to disease progression. This treatment combination might also improve survival.
Correction of recurrent stress urinary incontinence by needle urethropexy with a vaginal wall sling
Authors: PIDUTTI R. W. , GEORGE S. W. , MORALES A. 
Published: November 2008

Objective To review the results of a modification of the transvaginal needle urethropexy as a treatment for patients developing recurrence after surgical correction of stress urinary incontinence (SUI). Subjects and methods Twelve women who had undergone previous surgery for SUI and had developed recurrence of the symptoms were treated by a needle urethropexy technique which employed an island of in situ vaginal skin as a sling to support the bladder neck and urethra. Results After a mean follow‐up of 17.3 months, eight of the patients obtained excellent results, three experienced improvement and one was a failure. Conclusions The vaginal wall sling needle urethropexy was a simple technique to perform and carries a low morbidity. The results are similar to those of the more elaborate traditional sling procedures reported in the literature.
Ejaculation in men: a dynamic endorectal ultrasonographical study
Authors: GIL‐VERNET J. M. , ALVAREZ‐VIJANDE R. , GIL‐VERNET A. , GIL‐VERNET J. M. 
Published: November 2008

ObjectiveTo study the ejaculatory mechanisms in men using a dynamic endorectal ultrasonographical approach.Subjects and methodsSeven recordings were made of a young healthy volunteer during ejaculation, scanning the longitudinal plane from the bladder neck to the bulbous urethra.ResultsThe study demonstrated the existence of a preejaculatory phase characterized by a notable decrease in echogenicity of the inner prostate gland, due to the contraction of the pre‐prostatic sphincter 13‐2 5 s before ejaculation. Several stages were recorded including an ejaculatory stage with an initial prostatic emission phase lasting 2–20 s and a posterior emission phase through the ejaculatory ducts lasting 3–14 s, with a seminal stoppage of 3–8 s. and finally a urethro‐vesical reflux of a minimal fraction of the ejaculate over 5–9 s. The bladder neck and inner gland returned to their resting configuration between 10 and 90 s after ejaculation.ConclusionsEndorectal ultrasonographical imaging during ejaculation, a recently developed diagnostic procedure, may provide a new approach to ejaculation‐related problems.