bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cognitive coping intervention for acutely ill HIV‐positive men
Authors: Côté José K , Pepler Carolyn 
Published: February 2005

Aim. A nursing intervention was designed that is intended to develop, maintain and strengthen the patient's cognitive coping skills to regulate emotional response to severe physical symptoms. It was tested in a randomized trial reported elsewhere and this article describes the intervention and discusses its application.Background. Research shows that psychological distress and depressive symptoms are likely to increase with the development of human immunodeficiency virus (HIV)‐related physical symptoms. Nurses who work with HIV‐positive individuals have an opportunity to influence their patients’ health experiences substantially.Clinical application. The intervention was carried out with hospitalized HIV patients who had to cope with an acute period of stress due to an exacerbation of HIV‐related symptoms. The intervention was administered on three consecutive days, in 20–30‐minute sessions. The features of the intervention in relation to two examples of patient profiles are described: patients needing to develop their cognitive skills to regulate severe emotional distress and patients with effective cognitive coping skills.Relevance to clinical practice. The intervention empowers nurses by offering an effective approach to deal with individuals who are facing severe illness. It has also the potential to empower patients both to take advantage of their own personal resources and to take control over their situation.
The development of a screening tool to identify carers in a general practice by a large‐scale mailed survey: the experience in one Scottish general practice
Authors: Jarvis Alison , Worth Allison 
Published: February 2005

Aims and objectives.  To determine the feasibility of a screening tool to identify carers in a general practice.Background.  The need to support informal carers is well established in policy and practice, but many carers continue to lack the support they need. Identifying carers is a fundamental precondition to providing them with support. Studies often recruit carers who are members of carers’ organizations or via the care recipient in receipt of services. However, as nearly 60% of carers receive no support from the statutory services, this group of carers may not be representative of the majority of carers. This paper describes the results of a study undertaken to identify a broader group of carers in a general practice in a large Scottish city.Design and methods.  A quantitative research design was employed using a mailed screening survey to identify carers within a general practice. Carers were systematically identified, independent of the care recipient, using a screening tool developed by the researcher which was sent to all adult patients registered with the practice.Results.  The response rate was 69%. Overall, 11% of the surgery population identified themselves as carers with a mean age of 55 years. The carers were involved in a range of caring activities of varying levels and duration.Conclusion.  The screening exercise was time consuming and costly. However, it would be feasible and useful to identify carers in smaller groups.Relevance to practice.  This study tackles issues that are pertinent to health policy and practice. Carers were systematically identified from a general practice population and included those at an early stage of the caring role, prior to being involved with service providers, as well as those established in their role. If carers are identified early in their caring career the primary health care team is more able to support them proactively.
Ultrasonography‐guided fine‐needle aspiration cytology before sentinel node biopsy in patients with penile carcinoma
Authors: Kroon Bin K. , Horenblas Simon , Deurloo Eline E. , Nieweg Omgo E. , Teertstra Hendrik J. 
Published: February 2005

OBJECTIVETo assess the accuracy of ultrasonography (US)‐guided fine‐needle aspiration cytology (FNAC) for detecting occult lymph node metastases in patients with squamous cell carcinoma of the penis.PATIENTS AND METHODSForty‐three patients with 83 clinically node‐negative inguinal regions were assessed with US and FNAC. The results were compared with histology from subsequent dynamic sentinel‐node biopsy (DSNB) or inguinal lymph node dissection.RESULTSThirty‐four groins in 27 patients were considered to be suspicious by US and the lymph nodes were aspirated. Nine nodes contained tumour cells and this was confirmed by subsequent lymph node dissection. The sensitivity and specificity of US‐guided FNAC were 39% (nine of 23) and 100% (60 of 60), respectively. The number of groins requiring DSNB was reduced by 11% (nine of 83).CONCLUSIONUS‐guided FNAC can be used as the initial investigation in clinically node‐negative groins. If tumour is confirmed then therapeutic inguinal lymph node dissection can be earlier and fewer DSNBs are required.
Surgical excision of isolated renal‐bed recurrence after radical nephrectomy for renal cell carcinoma
Authors: Sandhu Sarbjinder S. , Symes Andrew , A’hern Roger , Sohaib S.A. Aslam , Eisen Tim , Gore Martin , Christmas Timothy J. 
Published: February 2005

OBJECTIVETo present our results on managing loco‐regional recurrence of renal cell carcinoma (RCC) with surgical excision, as local recurrence at the site of a previous nephrectomy is resistant to both systemic therapy and radiotherapy.PATIENTS AND METHODSIn all, 16 patients were operated on between 1994 and 2003 for local recurrence of RCC. The median (mean, range) age at the time of local recurrence was 57.9 (57.4, 28.9–71.7) years, and the median interval from primary surgery 2.22 (3.88, 0.27–14.46) years. Before surgery eight patients had been given systemic immunotherapy, with no response of their local recurrence.RESULTSTwo patients were deemed inoperable because of direct invasion of the great vessels and the liver by tumour. The remaining 14 patients had recurrence in residual adrenal tissue (two), para‐aortic nodes (three), para‐caval nodes (two), retrocaval nodes (one), renal bed (six), liver, spleen and stomach (one each), and diaphragm (two). Although complete macroscopic en‐bloc clearance was achieved in these patients, only eight had tumour‐free margins on histological examination. The histology was consistent with RCC recurrence in all cases. All of the patients were followed with computed tomography at regular intervals. At a median follow‐up of 1.0 (1.65, 0.25–6.5) years, five patients remain disease‐free, four have local and distant relapse, and five developed distant metastasis only. The presence of tumour at the resection margin was a significant factor in predicting local and distant disease‐free survival (P < 0.05).CONCLUSIONSEn bloc excision of isolated locally recurrent RCC is possible, and complete surgical extirpation can lead to prolonged disease‐free survival.
An evaluation of urinary function after radical prostatectomy in Japanese men: concordance with definitions of urinary continence
Authors: Namiki Shunichi , Kuwahara Masaaki , Ioritani Naomasa , Akito Terai , Arai Yoichi 
Published: February 2005

OBJECTIVETo determine how well various definitions of continence outcome after radical retropubic prostatectomy (RP) corresponded with each other, using published health‐related quality‐of‐life (HRQoL) questionnaires.PATIENTS AND METHODSIn all, 198 patients undergoing RP alone were enrolled in a study between November 2000 and June 2003. The baseline interview was conducted before RP and 3, 6 and 12 months afterward. The disease‐specific HRQoL was assessed using the University of California‐Los Angeles Prostate Cancer Index; the correspondence among definitions of incontinence was investigated.RESULTSThe urinary function score substantially declined at 3 months, continued to recover at 6 and 12 months, but remained lower than at baseline (P < 0.001). The correspondence among definitions of continence varied widely; 97% of men who did not have urine leakage at all claimed to use no pads, but only 63% of those claiming no use of pads had no urine leakage at all. Interestingly, this concordance rate progressively changed from 46% at 3 months to 60% at 12 months, whereas it was 82% at baseline.CONCLUSIONSBased on self‐reported questionnaire data, different definitions of continence gave different results when applied to the same patients at the same time. The correspondence among definitions may vary with time after RP. No single question adequately assesses the urinary HRQoL outcome after treatment for prostate cancer.
A retrospective study of the treatment of locally advanced prostate cancer by six institutions in eastern and north‐eastern Japan
Authors: Hachiya Takahiko , Akakura Koichiro , Saito Shiro , Shinohara Nobuo , Sato Kazunari , Harada Masaoki , Kato Tetsuro , Okada Kiyoki 
Published: February 2005

OBJECTIVETo investigate patients with locally advanced prostate cancer treated at six academic institutions in eastern and north‐eastern Japan from 1988 to 2000, to facilitate the establishment of Japanese guidelines for the diagnosis and treatment of locally advanced prostate cancer.PATIENTS AND METHODSThe study included 391 eligible patients with locally advanced prostate cancer who were treated by radical prostatectomy (RP), radiotherapy and/or primary hormone therapy. Disease‐specific survival rates for these patients were assessed in relation to their clinicopathological characteristics and the types of treatment they received. The Mann–Whitney U‐test, Kruskal–Wallis, chi‐square and log‐rank test were used for statistical analysis, as appropriate.RESULTSIn all, 128 patient with lower prostate‐specific antigen levels (P = 0.023) and/or better performance status (P = 0.001) had RP. Neoadjuvant hormone therapy before RP was the treatment in 68 (53%) of these 128 patients; 66 (52%) received immediate adjuvant hormone therapy. Of 87 patients treated with radiotherapy, 75 (86%) had external beam radiotherapy (EBRT) as the primary treatment with no brachytherapy, and 12 (14%) had brachytherapy as the primary method. Neoadjuvant hormone therapy was given to 56 of the 87 patients (64%); 48 (55%) received immediate adjuvant hormone therapy. Of the 176 patients treated with primary hormone therapy alone, combined androgen blockade and surgical or medical castration was the treatment in 76 (43%) and 85 (48%), respectively. Disease‐specific survival rates at 5 years for patients treated with RP, EBRT and primary hormone therapy were 90%, 98%, and 89%, respectively.CONCLUSIONThe treatments provided by the participating institutions did not differ significantly from those set out in European and American guidelines, and short‐term disease‐specific survival rates for each treatment did not differ significantly from those of historical controls. Further investigation may facilitate the establishment of Japanese guidelines for the diagnosis and treatment of locally advanced prostate cancer.
Examining the location and cause of death within 30 days of radical prostatectomy
Authors: Alibhai Shabbir M.H. , Leach Marc , Tomlinson George 
Published: February 2005

OBJECTIVESTo better characterize the cause and location of death after radical prostatectomy (RP), as early mortality is relatively uncommon after RP, with little known about the cause of death among men who die within 30 days of RP, and the trend toward earlier discharge after surgery means that a greater proportion of early mortality after RP may occur out of hospital.PATIENTS AND METHODSUsing the Ontario Cancer Registry, we identified 11 010 men (mean age 68 years) who had a RP in the province of Ontario between 1990 and 1999. We identified the occurrence and location of all deaths within 30 days of RP. The cause of death was obtained from death certificate information. Logistic regression was used to examine factors (age, comorbidity, year of surgery) associated with the location of death.RESULTSOf the 11 010 men, 53 died within 30 days of RP (0.5%); of these 53 men, 28 (53%) died in hospital. Neither age, comorbidity nor year of surgery were significantly associated with location of death (P > 0.05). Major causes of death included cardiovascular disease (38%) and pulmonary embolism (13%). More than half of the patients who died out of hospital had an unknown cause of death.CONCLUSIONSAlmost half of all deaths within 30 days of RP occur out of hospital; the two most common causes of death are potentially preventable. More detailed cause‐of‐death information may help to identify opportunities for prevention.
Effects of a shared protocol between urologists and general practitioners on referral patterns and initial diagnostic management of men with lower urinary tract symptoms in Italy: the Prostate Destination study
Authors: Spatafora Sebastiano , Canepa Giorgio , Migliari Roberto , Rotondo Salvatore , Mandressi Alberto , Puppo Paolo ,   the AURO.it Cooperative Group
Published: February 2005

OBJECTIVETo assess whether adopting a shared protocol between urologists and general practitioners (GPs) might change diagnostic procedures and referral patterns in the management of men with lower urinary tract symptoms (LUTS).SUBJECTS AND METHODSForty‐five urological centres and 263 GPs in Italy participated in this prospective study. Procedures adopted by GPs for evaluating five consecutive patients (aged ≥ 50 years) were compared before (phase 1) and after (phase 2) implementation of the shared protocol. An evidence‐based diagnostic algorithm was developed and approved by participating urologists and presented to local GPs at a training session. Protocol modifications were allowed after discussion with GPs. Direct costs of diagnostic procedures carried out before and after implementing the protocol were calculated from the perspective of the national health service.RESULTSIn all, 903 patients were evaluable in phase 1 and 856 in phase 2. Implementation of the protocol did not change referral patterns, with about half the patients being managed entirely by GPs. The use of a digital rectal examination by GPs increased from 32% to 41%, use of transrectal and suprapubic ultrasonography decreased from 33% to 23% and 53% to 44%, respectively, (all P < 0.001) and use of the International Prostate Symptom Score increased from 4.5% to 23.1% (P < 0.001). Overall, protocol‐recommended tests were used more frequently, while those not recommended decreased after implementing the protocol. However, overuse of the tests not recommended (i.e. urine culture and free/total prostate specific antigen ratio) remained high. The mean cost per patient of diagnostic procedures ordered by GPs decreased from €71.82 to €61.93, with €9.9 saved for each patient.CONCLUSIONOur intervention failed to decrease the percentage of cases of LUTS being referred to specialists, but was moderately effective in inducing changes in the diagnostic management by GPs that were indicative of increased compliance with best‐practice principles, and produced cost savings of 13.8%.
Variability of detrusor overactivity on repeated filling cystometry in men with urge symptoms: comparison with spinal cord injury patients
Authors: Ockrim Jeremy , Laniado Marc E. , Khoubehi Bijan , Renzetti Roberto , Finazzi Agrò Enrico , Carter Simon S. , Tubaro Andrea 
Published: February 2005

OBJECTIVETo investigate the variation in urodynamic variables during repeated filling cystometry and the impact that the variability had on the observed incidence of detrusor overactivity, to evaluate the correlation of detrusor overactivity with the symptoms of urge in men with lower urinary tract symptoms (LUTS), and to compare the variability of detrusor overactivity in men with LUTS to that in men with spinal cord injury (SCI).PATIENTS AND METHODSSixty men with LUTS and 35 with neurogenic bladders after SCI were assessed. Investigations included the International Prostate Symptom Score (IPSS), Madsen–Iversen Symptom Score (MSS), uroflowmetry, filling cystometry and pressure‐flow, in three successive studies.RESULTSIn men with LUTS, a significant decrease in the number and pressure of involuntary detrusor contractions (IDCs) in consecutive cystometries resulted in a reduction of observed detrusor overactivity from 72% to 63% and 48%, in the three studies. Urgency scores were significantly lower in men who became ‘stable’ than in those who remained ‘unstable’ throughout the three studies. In men with SCI, cystometric variables and detrusor overactivity remained consistent over sequential studies.CONCLUSIONUrodynamic detrusor overactivity is affected by repeated cystometry. In men with LUTS, two populations with detrusor overactivity were identified; one group adapted to repeated filling while another had persistent IDCs and greater urgency scores. The latter group had bladder behaviour similar to that of men with neurogenic bladders secondary to SCI. These findings might be important in explaining the cause of symptoms, initiating further investigation, and predicting the outcome of therapy.
Glycosylated haemoglobin levels and the severity of erectile function in diabetic men
Authors: Rhoden Ernani L. , Ribeiro Eduardo P. , Riedner Charles E. , Teloken Claudio , Souto Carlos A.V. 
Published: February 2005

OBJECTIVETo evaluate the association between the levels of glycosylated haemoglobin (HbA1c) and the severity of erectile dysfunction (ED) in men with diabetes mellitus (DM).PATIENTS AND METHODSThis cross‐sectional study included sexually active men with a diagnosis of DM attending a urological medical centre from January 2000 to December 2001. The 115 men with ED (95%) completed the International Index of Erectile Function questionnaire, and fasting serum glucose and HbA1c serum levels were measured. The relationship between the severity of ED and serum HbA1c levels was assessed.RESULTSOf men with HbA1c levels of < 8%, half had mild, and 18% and 32% had moderate and severe ED, respectively (P = 0.038); of men with HbA1c levels of ≥ 8%, 25%, 29%, and 46% had mild, moderate and severe ED, respectively (P = 0.008). In addition, men with HbA1c levels of ≥ 11% had a statistically higher prevalence of severe ED (P = 0.002). There was no difference in severity of ED in the HbA1c subgroups when the duration of DM was ≤ 5 years (P = 0.87), but most men with HbA1c levels of ≥ 8% and a history of DM of 6–10 or > 10 years had severe ED (P < 0.03).CONCLUSIONThis study suggests that the severity of ED is associated with increasing HbA1c levels in diabetic men.
Percutaneous nephrolithotomy for treating renal calculi in children
Authors: Boormans Joost L. , Scheepe Jeroen R. , Verkoelen Carl F. , Verhagen Paul C.M.S. 
Published: February 2005

There are various topics covered in the paediatric section this month. Another series of percutaneous nephrolithotomy is reported, as is the necessity or not to use the GFR in the follow‐up of children who have had a unilateral nephrectomy.In addition, authors from the USA present a new classification for genital ambiguity and urogenital sinus anomalies. They entitle it the PVE classification, and conclude that it is very helpful in surgical planning and in surgical outcomes research.OBJECTIVETo report our experience with the percutaneous management of renal stone disease in children.PATIENTS AND METHODSThe medical and radiological records of children up to 18 years old who were treated for renal calculi by percutaneous nephrolithotomy (PCNL) at our institution between March 1995 and April 2003 were reviewed. For stone removal a special paediatric 18 F access sheath was used.RESULTSIn all, 26 PCNLs were used in 23 patients (10 boys and 13 girls, aged 1.7–16.8 years). The presenting symptoms were urinary tract infection, abdominal pain and/or haematuria. Of the 23 patients, 17 (75%) had associated metabolic disease or underlying urological anatomical abnormalities. Urinary tract infections were found in 15 patients (65%). The mean (range) stone burden was 6.0 (0.5–18.2) cm2, and the operative duration 127 (50–260) min. The primary stone‐free rate was 58%, which increased to 81% after treating residual fragments. One blood transfusion was required and one patient developed urosepsis after PCNL, which was treated with antibiotics.CONCLUSIONPCNL is an effective alternative for treating renal stones in children, and is the treatment of choice for stones refractory to extracorporeal shock wave lithotripsy.
Over- and Underbidding in Central Bank Open Market Operations Conducted as Fixed Rate Tender
Authors: Bindseil Ulrich 
Published: February 2005

AbstractOpen market operations play a key role in allocating central bank funds to the banking system and thereby in steering short-term interest rates in line with the stance of monetary policy. Many central banks apply so-called ‘fixed rate tender’ auctions in their open market operations. This paper presents, on the basis of a survey of central bank experience, a model of bidding in such tenders. In their conduct of fixed rate tenders, many central banks faced specifically an ‘under-’ and an ‘overbidding’ problem. These phenomena are revisited in the light of the proposed model, and the more general question of the optimal tender procedure and allotment policy of central banks is addressed.
Choosing between Impossible Alternatives: Creating a New Constituency Map for Wales, 2004
Authors: JOHNSTON RON , McLEAN IAIN 
Published: February 2005

The allocation of at least 35 parliamentary constituencies to Wales in the 1944 House of Commons (Redistribution of Seats) Act meant that Wales was over‐represented in the House of Commons. Subsequent decisions by the Boundary Commission for Wales, operating within a set of mutually contradictory rules, increased the number of Welsh seats to 40 and exacerbated the country's over‐representation in the House, relative to the situation for England.In its Fifth Periodic Review, the Boundary Commission has determined not to recommend any further growth in the number of Welsh constituencies, but its method of doing this has created substantial inequalities within the country, with the area around Cardiff significantly under‐represented relative to the situation in North Wales. These inequalities will also apply to the Welsh Assembly. The political parties did not challenge these recommendations, presumably because they felt that their interests were best served by the inequalities. Analysis shows that alternative sets of recommendations would have been somewhat more egalitarian, but within an overall structure of unfairness guaranteed by the unworkable rules under which the Commissions must operate.