bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health care seeking behavior of Korean women with lymphedema
Authors: Cho Myoung Ok 
Published: May 2004

AbstractThe present biocultural study aimed to describe the health care use patterns of women with lymphedema. Data came from interviews and participant observations with eight key informants between February 2000 and February 2002. Analyzing the process of seeking health care, this paper explored how Korean women with lymphedema make use of all the available resources in the three sectors of the health care system: professional, folk and popular health. In these three sectors of the health care system, informants showed different patterns of behavior. In the professional health care sector, they behave based on scientific Western medicine and holistic herbal medical frameworks. Informants want scientific technological treatment from a Westernized doctor and perfect humanistic and holistic treatment from a herbal doctor. In the folk sector, informants’ behavior is ruled by a pragmatic and supernatural framework. Informants seek religious healers who have strong spirituality and non‐religious healers who have experience and skills. Informants complied with these healer's remedies based on efficacy and empirical healing evidence. In the popular sector of the health care system, informants behave based on their concept of illness and rules of daily life. They believe lymphedema comes from poor blood circulation and they want to be regarded as members of society, not as patients with lymphedema. Therefore, informants practised popular remedies that they believed were good for promoting blood circulation and keeping their social network active. This description about health care seeking behaviors being embedded in Korean socio‐medical culture can serve to understand patients with other chronic health problems. With these results, we can put a bridge over the river of cultural conflict between health professionals and patients.
Spousal relationship changes in Alzheimer's disease
Authors: Holland Christi 
Published: May 2004

Over 4 million Americans are affected by Alzheimer's disease (AD). Research suggests that caregivers are at risk for developing serious health problems due to the demands of the role. The purposes of this grounded theory study were to explore the changes experienced by spouse caregivers in their marital relationships because of AD, describe the challenges they faced, and to discover the process used by the caregivers to explain what was happening to them, their spouses, and their relationships over time.Guided by the conceptual perspectives of Modeling‐Role Modeling and Attachment‐Loss‐Reattachment, the process of imposed detachment emerged as the grounded theory that captured the participants’ descriptions of what happened within the marital relationship over time while caring for a partner with AD. Findings of this study provide direction to future research and suggest to clinical practitioners that healing interventions can be developed to support the needs of this special group of caregivers.
Evaluation and management of renal injuries: consensus statement of the renal trauma subcommittee
Authors: Santucci R.A. , Wessells H. , Bartsch G. , Descotes J. , Heyns C.F. , McAninch J.W. , Nash P. , Schmidlin F. 
Published: May 2004

The first in this series of five papers concerns the evaluation and management of renal injuries. The authors of this paper come from four continents and seven countries, and they reviewed all papers on renal injury published between 1966 and April 2002. The results of the authors’ deliberations are present here as a consensus document.OBJECTIVETo determine the optimal evaluation and management of renal injuries by review of the world's English‐language literature on the subject.METHODSA consensus conference convened by the World Health Organization and the Societé Internationale d’Urologie met to critically review reports of the diagnosis and treatment of renal trauma. The English‐language literature about renal trauma was identified using Medline, and additional cited works not detected in the initial search obtained. Evidence‐based recommendations for the diagnosis and management of renal trauma were made with reference to a five‐point scale.RESULTSThere were many Level 3 and 4 citations, few Level 2, and one Level 1 which supported clinical practice patterns. Findings of nearly 200 reviewed citations are summarized.CONCLUSIONSPublished reports on renal trauma still rely heavily on expert opinion and single‐institution retrospective case series. Prospective trials of the most significant issues, when possible, might improve the quality of evidence that dictates the behaviour of practitioners.
An analysis of risk factors for biochemical progression in patients with seminal vesicle invasion: validation of Kattan's nomogram in a pathological subgroup
Authors: Ramsden A.R. , Chodak G. 
Published: May 2004

OBJECTIVETo assess the ability of a recently published nomogram to predict failure after radical retropubic prostatectomy (RRP) in a cohort of patients with seminal vesicle invasion (SVI) of the resected specimen, widely regarded as a very poor prognostic factor in patients with prostate cancer.PATIENTS AND METHODSMen with SVI after RRP were analysed retrospectively; patients with positive lymph nodes, adjuvant radiotherapy or hormone therapy were excluded. Age, race, baseline prostate specific antigen (PSA) level, clinical stage, Gleason score, margin status, perineural invasion, capsular invasion, laterality and route of invasion were recorded. Biochemical recurrence was defined as one PSA measurement of 0.4 ng/mL. Biochemical disease‐free survival probability was plotted using the Kaplan‐Meier method. Kattan's nomogram was applied to each patient and a receiver‐operator characteristic (ROC) curve produced to assess the test's reliability.RESULTSIn all, 67 patients with SVI were identified (mean age 64.6 years, sd 5.9; median follow‐up 30.5 months). Biochemical disease‐free survival was significantly better for men with negative margins, unilateral SVI and perineural invasion. No other significant factors were detected. The median (95% confidence limit) area under the ROC curve was 0.739 (0.604–0.847).CONCLUSIONThere were significant prognostic differences for three of the factors assessed. Although components of the Kattan nomogram were not significant in this group its predictive value approached that found originally, suggesting that it can be applied to patients with SVI in helping to direct adjuvant therapy and guide postoperative counselling.
Preferences for sexual information resources in patients treated for early‐stage prostate cancer with either radical prostatectomy or brachytherapy
Authors: Davison B.J. , Keyes M. , Elliott S. , Berkowitz J. , Goldenberg S.L. 
Published: May 2004

OBJECTIVETo identify the preferences for sexual information resources of patients before and after definitive treatment for early‐stage prostate cancer with either radical prostatectomy (RP) or brachytherapy.PATIENTS AND METHODSTwo hundred patients (mean age 64 years) treated with either RP or brachytherapy were recruited from radiation oncology (100) and urology (100) outpatient clinics. Patients completed a survey questionnaire to identify the types of information used, preferred sources of information, knowledge of treatments for erectile dysfunction (ED), effect of sexual function on the treatment decision, and the International Index of Erectile Function (IIEF) to assess their current level of sexual function.RESULTSUrologists were identified as the main source of sexual information. Written information, Internet access and videos were identified as preferred sources of information before and after treatment. The effects of treatment on sexual function had no apparent significant influence on the men's definitive treatment choice. Compared with patients in the brachytherapy group, patients in the RP group reported having significantly higher levels of sexual desire (P < 0.001) after treatment, but otherwise the erectile domains of the groups were remarkably similar. Two‐thirds of patients wanted more information on the effects of treatment on sexual function, and on available treatments for ED.CONCLUSIONSThese results support the need for physicians to offer patients access to information on the effect of treatment for early‐stage prostate cancer on erectile function before and after treatment.
Comparative evaluation of various prostate specific antigen ratios for the early detection of prostate cancer
Authors: Ozdal O.L. , Aprikian A.G. , Bégin L.R. , Behlouli H. , Tanguay S. 
Published: May 2004

OBJECTIVETo compare the performance of various ratios using total prostate specific antigen (PSA), complexed PSA (cPSA) and free PSA (fPSA) in the early detection of prostate cancer.PATIENTS AND METHODSThe study included 535 consecutive patients evaluated at a prostate cancer detection clinic between January 1998 and October 1999. Patients had blood samples drawn before transrectal ultrasonography and prostate biopsy to measure PSA, cPSA and fPSA. Receiver operating characteristic (ROC) curves (sensitivity vs 1 − specificity) were used to evaluate the performance of PSA, cPSA, f/tPSA, cPSA/tPSA, fPSA/cPSA, tPSA/prostate volume (PV), fPSA/PV, and cPSA/PV. The areas under the curve (AUC) were calculated for each ratio. The performance of each ratio over all patients or in those with a tPSA of 4–6 or 4–10 ng/mL were evaluated.RESULTSOf the 535 patients, 204 (38%) had biopsy‐confirmed prostate cancer. The AUC obtained with tPSA alone was 0.64; when measured for all patients the cPSA/PV (0.78), PSA/PV (0.77), f/tPSA (0.76) and fPSA/cPSA (0.75) performed better than tPSA alone. Furthermore, in patients with a tPSA of 4–10 ng/mL, tPSA/PV (0.72), cPSA/PV (0.71), f/tPSA (0.69), fPSA/cPSA (0.69) and cPSA/tPSA (0.62) performed better than tPSA alone (0.52). Finally, in patients with a tPSA of 4–6 ng/mL, PSA/PV and cPSA/PV performed better than the other ratios.CONCLUSIONSThe use of PSA ratios gives a higher sensitivity and specificity for detecting prostate cancer than the use of tPSA alone.
Bacillus Calmette‐Guérin therapy in stage Ta/T1 bladder cancer: prognostic factors for time to recurrence and progression
Authors: Andius P. , Holmäng S. 
Published: May 2004

OBJECTIVETo report prognostic factors for time to recurrence and progression after bacillus Calmette‐Guérin (BCG) prophylaxis in patients with stage Ta/T1 papillary bladder cancer.PATIENTS AND METHODSThe clinical records were assessed retrospectively for 236 patients with papillary stage Ta/T1 bladder cancer treated with BCG between 1986 and 2000. Patients with known carcinoma in situ were excluded. The median (range) follow‐up was 44 (4–155) months. The effect of 13 variables on the time to recurrence and progression was evaluated using multivariate Cox proportional hazard regression and Kaplan‐Meier analyses.RESULTSThe recurrence rate was markedly reduced for all grades and stages. Patients with a negative first cystoscopy and maintenance BCG had a significantly longer time to recurrence than those treated with an induction course alone (P < 0.001). Thirty‐seven patients (16%) progressed in stage. The result of the first cystoscopy (P < 0.001), tumour grade (P = 0.003) and six or fewer initial instillations (P = 0.002) had prognostic importance for the time to progression. Twenty‐eight patients (12%) had a history of an upper tract tumour, which was 3–10 times the expected rate. Age, number of tumours, number of positive cystoscopies, length of tumour history before BCG, BCG strain and treatment year had no influence on time to recurrence and progression.CONCLUSIONSMaintenance treatment does not seem to be necessary among patients with TaG1‐G2 disease after a negative first cystoscopy, as the progression rate was very low. One new finding was that BCG seemed to be equally effective among patients with or with no history of an upper tract tumour. Another new and surprising finding was that patients treated with fewer than six induction instillations, because of very bothersome side‐effects, had an increased risk of tumour progression and of local failure.
A randomized placebo‐controlled multicentre study to evaluate the safety and efficacy of finasteride for male chronic pelvic pain syndrome (category IIIA chronic nonbacterial prostatitis)
Authors: Nickel J.C. , Downey J. , Pontari M.A. , Shoskes D.A. , Zeitlin S.I. 
Published: May 2004

OBJECTIVETo determine if finasteride can reduce symptoms in men with a clinical diagnosis of chronic nonbacterial prostatitis (National Institutes of Health, NIH, category IIIA chronic pelvic pain syndrome, CPPS) compared with placebo.PATIENTS AND METHODSMen (76) with category IIIA CPPS enrolled in four North American prostatitis research centres were randomized after a 2‐week placebo run‐in to finasteride or placebo for 6 months. The primary efficacy variable was a subjective overall assessment (SOA); the secondary efficacy variables included the NIH chronic prostatitis symptom index (NIH‐CPSI) and safety data. Patients were assessed at screening, baseline (after the 2‐week placebo run‐in), 3 and 6 months.RESULTSSixty‐four patients had at least one assessment on medication (31 placebo, 33 finasteride); 75% of the finasteride and 54% of the placebo group had at least a mild improvement (defined as > 25% improvement in SOA), and 44% and 27%, respectively, a moderate or marked improvement (>50% improvement in SOA). The trend was similar in the NIH‐CPSI scores. Five patients in the finasteride and seven in the placebo group reported medication‐related adverse events.CONCLUSIONThis randomized placebo‐controlled pilot study suggests that finasteride was of benefit for some men with category IIIA CPPS, but the results do not justify recommending finasteride as monotherapy, except for men who also have benign prostatic hyperplasia. A larger, properly powered study, possibly evaluating combination with other therapies or specifically in men with prostatitis and benign prostatic hyperplasia, is required to confirm any clinical benefit.
Use of the short form of King's Health Questionnaire to measure quality of life in patients with an overactive bladder
Authors: Homma Y. , Uemura S. 
Published: May 2004

OBJECTIVETo develop a short version of the King's Health Questionnaire (KHQ), as there is a practical need to have a shorter version to summarize the eight domain scores into fewer domains.PATIENTS AND METHODSData from 293 patients were obtained from a randomized, double‐blind, placebo‐controlled clinical trial in Japan of oxybutynin and tolterodine in patients with symptoms of an overactive bladder. The KHQ has two single‐item and six multiple‐item domains. To construct the short form of the KHQ one item was selected from the each of multiple‐item domains, based on standardized structural coefficients estimated by confirmatory factor analysis (CFA) in a previous study. These six items include the domains: ‘daily activities from role limitation’, ‘travel from physical limitation’, ‘social life from social limitation’, ‘family life from personal relationship’, ‘depressed from emotion’ and ‘tired from sleep and energy’. Based on the six selected items a series of psychometric analyses were conducted.RESULTSExploratory factor analysis (EFA) with promax rotation identified two factors ‘limitation of daily life’ (LDL) and mental health. LDL consisted of ‘daily activities’, ‘travel’ and ‘social life’, and mental health included ‘family life’, ‘depressed’ and ‘tired’. Based on the results from the EFA, the second‐order factor structure was tested by CFA. The model fitted the data well for both the male and female model. The KHQ short form showed excellent reliability with Cronbach's α coefficients for LDL and mental health for both genders. The domains in the short form were responsive to clinical efficacy variables, and had statistically significant sensitivity to change in the patients’ perception of bladder condition in all domains.CONCLUSIONThese analyses confirm the psychometric properties and clinical validity of the short‐form KHQ, which appears to offer a practical, valid and reliable health‐related quality‐of‐life instrument.
Correlation of ultrasonographic and orchidometer measurements of testis volume in adults
Authors: Schiff J.D. , Li P.S. , Goldstein M. 
Published: May 2004

A study from New York was aimed at determining the correlation between testicular volume measurements made with an orchidometer and with high‐resolution scrotal ultrasonography; the authors found that measurements made with the former strongly correlate with those from the latter.Premature ejaculation remains a significant problem, and authors from Brazil reports a placebo‐controlled study into the use of topical anaesthetic in this condition.OBJECTIVETo determine the correlation between testicular volume measured with an orchidometer or high‐resolution scrotal ultrasonography (US) with colour‐flow Doppler analysis.PATIENTS AND METHODSIn all, 159 men (mean age 36.6 years) presenting for infertility evaluation underwent both a physical examination by a one experienced examiner and high‐resolution US with colour‐flow Doppler analysis. An orchidometer was also used to measure testicular volume after stretching the scrotal skin tightly over the testis and after warming with a heating pad. The US was interpreted by a radiologist who had no knowledge of the orchidometer estimates. The volume was calculated as 0.71 × length × width × height.RESULTSFor the right testes the mean orchidometer and US estimates were 18.4 and 18.3 mL, yielding a correlation coefficient of 0.72 (r 2 = 0.52, P < 0.01). On the left the respective values were 17.1 and 16.9 mL, with a correlation coefficient of 0.69 (r 2 = 0.48, P < 0.01).CONCLUSIONOrchidometer estimates of testicular volume correlate closely and very significantly with US estimates in adults. In the hands of an experienced examiner orchidometer measurements provide an accurate, rapid and inexpensive assessment of testicular volume.
Topical anaesthetic use for treating premature ejaculation: a double‐blind, randomized, placebo‐controlled study
Authors: Busato W. , Galindo C.C. 
Published: May 2004

OBJECTIVETo assess the use of a topical anaesthetic mixture to improve premature ejaculation (PE), for which penile hypersensitivity might be a cause.PATIENTS AND METHODSThe study included 42 men divided in two groups; group A used a lidocaine‐prilocaine solution and group B used an inert cream. The tubes of cream were distributed randomly and participants asked to note any unpleasant symptoms, difficulties and the results of each attempt at intercourse, assessed by the intravaginal ejaculatory latency time (IELT).RESULTSThere was a significant increase in the mean (sd) IELT, from 1.49 (0.9) to 8.45 (0.9) min (P < 0.001) in group A but not in group B, at 1.67 (0.7) to 1.95 (0.12) min (P > 0.05).CONCLUSIONWe suggest that anaesthetic cream might be effective for treating PE.
Cost analysis of flexible ureterorenoscopy
Authors: Collins J.W. , Keeley F.X. , Timoney A. 
Published: May 2004

The development of ureteroscopy, in the first instance with rigid ureteroscopes, and subsequently with flexible ureteroscopes, has been a huge contribution to the non‐operative removal of urinary tract calculi. Access can be gained to stones in the ureter and to many in the kidney. Two reports presented in this section examined aspects of ureteroscopy; the cost of the procedure, and whether stenting of the ureter is required after removing ureteric stones by this means.OBJECTIVETo assess the costs of flexible ureterorenoscopy.MATERIALS AND METHODSData were collected prospectively for 100 cases using a new flexible ureteroscope (DUR8, Circon ACMI, Stamford, USA), including the indications for flexible ureterorenoscopy, use of laser probes, disposable instrumentation, and the cost and timing of ureteroscope repair.RESULTSOf the 100 procedures 68 were for stone disease, 21 for known or suspected transitional cell carcinoma (TCC), six were diagnostic only and five were for pelvi‐ureteric junction obstruction. The ureteroscope was repaired after the 29th and 88th cases. The ability of the ureteroscope to deflect was maintained throughout. At the time of purchase the ureteroscope was listed at £15 000 and each repair/exchange currently costs £4200, thus the total expenditure on the ureteroscope was £23 400. Total expenditure on ancillary equipment was £28 727, of which £22 927 was on disposables and £5800 on 10 laser probes.CONCLUSIONIn this series the costs of the ancillary equipment exceeded the purchase and maintenance of the ureteroscope, and we expect this trend to continue in the long term. The advent of more durable ureteroscopes may ultimately reduce the frequency of costly repairs. The cost of disposables should be considered in planning the budget.
An audit over 2 years’ practice of open and laparoscopic live‐donor nephrectomy at renal transplant centres in the UK and Ireland
Authors: Brook N.R. , Nicholson M.L. 
Published: May 2004

OBJECTIVETo collate information on the practice of live‐donor nephrectomy and compare this with the published British Transplantation Society (BTS) guidelines for best practice, using two questionnaires sent to all renal transplant centres in the UK and Ireland to cover practice for the years 2000 and 2002.METHODSA postal questionnaire was sent to all surgical kidney transplant consultants in the UK and Ireland, including questions on the practice of live‐donor nephrectomy in the year 2000 (the questionnaire was sent in 2001) and 2002 (questionnaire sent in 2003).RESULTSAll 28 centres responded fully for both years; 27 centres used live kidney donation in 2000, decreasing to 24 in 2002. Consultants reported 356 operations in 2000, representing 19% of all kidney transplants, and 403 in 2002, representing 23% of all kidney transplants. Three centres offered laparoscopic donor nephrectomy in 2000, and five did so in 2002. Most centres organize donor and recipient operations synchronously, and most have a consultant anaesthetist present for the donor procedure. There were variations in the use of analgesia and thromboprophylaxis, and in donor follow‐up.CONCLUSIONSThere is widespread application of live‐donor nephrectomy in the UK but BTS guidelines are not closely followed. Minimal access donor nephrectomy is offered at a few centres but many have plans to introduce this into their practice.