bluuebunny/crossref_metadata_2025_split huggingface dataset:
Information needs and prostate cancer: the development of a systematic means of identification
Authors: Dale Jeremy , Jatsch Wolfram , Hughes Nathan , Pearce Alison , Meystre Chantal 
Published: June 2004

OBJECTIVETo design, from first principles, a valid and reliable scale for assessing the importance of specific items of information needed by patients with prostate cancer that would be straightforward to use in clinical settings, as despite its prevalence, there is little research focusing specifically on the information needs associated with prostate cancer.PATIENTS AND METHODSSeveral stages of consultation and modification were used to inform the development of a scale which was then piloted on 96 patients with prostate cancer. Respondents were asked to rate the importance they placed on a range of prostate cancer‐related topics of information, and the extent to which they felt these information needs had been met. The construct and content validity of the instrument were established and an exploratory factor analysis used to guide restructuring of the tool. Internal consistency/reliability was calculated using Cronbach's α.RESULTSUsing the scale showed that men with prostate cancer placed considerable importance on a broad range of information needs, most of which had been inadequately met. Age had a significant influence on the overall importance attributed to information, with younger patients having more need for information. The construct and content validity of the instrument were established. The factor analysis revealed four discrete factors which together explained > 68% of the variance, termed ‘basics of prostate cancer care’, ‘disease management’, ‘physical well‐being’ and ‘self‐help’. Internal consistency/reliability was satisfactory (α = 0.91).CONCLUSIONSThe basis of a tool capable of ascertaining the information needs of patients with prostate cancer was developed; it may offer clinicians a valid means of ascertaining information preferences and hence potentially enhance the quality of service provided. Further research is now required to refine the tool and test the effect of its longitudinal use in clinical practice on patient satisfaction and outcome.
Surgery for adrenal tumours with thrombus in the supra‐diaphragmatic infra‐atrial inferior vena cava, with no cardiopulmonary bypass
Authors: Lucon Antonio M. , Machado Marcel C.C. , Pereira Maria A.A. , Mendonça Berenice B. , Praxedes Jose N. , Arap Sami 
Published: June 2004

OBJECTIVESTo assess the result of surgery for adrenal neoplasia with thrombus in the supra‐diaphragmatic infra‐atrial inferior vena cava.PATIENTS AND METHODSFive patients with adrenal cortex carcinoma and three with phaeochromocytoma were reviewed. All the thrombi were removed through a right thoracophrenolaparotomy in the fifth intercostal space, with clamping of the intrathoracic portion of the inferior vena cava, with no cardiopulmonary bypass. In the first two cases the thrombi were removed in a second surgical procedure after resecting the tumours. In the other six the complete procedure was done in one surgical stage.RESULTSThere were no surgery‐related deaths. The major complications after surgery were pulmonary atelectasis, acute renal failure, a large retroperitoneal collection, deep vein thrombosis and pulmonary embolism, each in one patient. Of the five patients with adrenal cortex carcinoma one is still alive after 15 years with no evidence of disease, one is alive with pulmonary metastases 15 months after surgery and the other three died from widespread disease after 5, 12 and 15 months. Of the three patients with phaeochromocytoma, two show no evidence of the disease 2.5 and 11 years later and one died from myocardial infarction, with no evidence of the disease, 9 years later.CONCLUSIONThrombi from adrenal neoplasia in the supra‐diaphragmatic infra‐atrial inferior vena cava may be removed with no need for cardiopulmonary bypass and cardiac arrest, thus avoiding the associated morbidity and high cost.
‘Burned‐out’ primary testicular cancer
Authors: Fabre Elodie , Jira Hassan , Izard Vincent , Ferlicot Sophie , Hammoudi Yacine , Theodore Christine , Di Palma Mario , Benoit Gerard , Droupy Stephane 
Published: June 2004

OBJECTIVETo report the natural history of ‘burned‐out’ testicular tumour (a testicular tumour that has regressed spontaneously with no treatment and that generally presents at the stage of metastases).PATIENTS AND METHODSWe report five cases of burned‐out testicular tumours to illustrate the clinical, radiological and histopathological features, and discuss the hypothesis of natural history of these neoplasms.RESULTSThe findings in the five patients tended to indicate that metastatic progression appears to induce spontaneous regression of the previous tumour site. Patients explored for extragonadal germ cell tumour present with various clinical features depending on the site of the metastases.CONCLUSIONDespite the controversial hypotheses of the origin of these tumours, extragonadal germ cell tumours should be considered to be metastases of a ‘burned‐out’ primary testicular tumour that must be investigated. When a primary testicular tumour is detected, the testis must be removed, and standard chemotherapy yields good long‐term results. The hypothesis of an immunological reaction against the tumour inducing the spontaneous necrosis of the primary tumour and possibly the metastases should be considered. Immunological screening should be proposed in patients to investigate this interesting model of spontaneous tumour regression.
A meta‐analysis of trials of transurethral needle ablation for treating symptomatic benign prostatic hyperplasia
Authors: Boyle Peter , Robertson Christopher , Vaughan E. Darracott , Fitzpatrick John M. 
Published: June 2004

This section opens with two meta‐analyses, the first into the use of transurethral needle ablation (TUNA) for treating symptomatic BPH and the second into comparative trials between transurethral electrovaporization and TURP.The first of these meta‐analyses showed that despite a variety of trial methods, not all were satisfactory. TUNA was effective in improving symptoms and flow rates. The place of this therapy in the treatment of symptomatic BPH is suggested.In the second meta‐analysis, methodological shortcomings of the various trials are again discussed. The possible advantages of both of these treatments are described, but the authors suggest that there is a need for future well‐designed trials with extended follow‐up. This seems to be the ultimate conclusion of a significant number of the meta‐analysis into technological treatments for symptomatic BPH.OBJECTIVESTo investigate the short‐ and long‐term effectiveness of transurethral needle ablation (TUNA) of the prostate for clinical benign prostatic hyperplasia (BPH), using a meta‐analysis of all clinical studies involving TUNA.METHODSData were extracted from two randomized trials, two non‐randomized observational protocols and 10 single‐arm studies conducted on TUNA, according to a determined protocol. The meta‐analysis was based on the change in the mean score at the end of study from that at baseline. The estimation of the effects from the meta‐analysis used a multilevel model including random effects for the studies.RESULTSIn all studies the patients recruited had severe lower urinary tract symptoms and a mean International Prostate Symptom Score (IPSS) of > 20 before treatment. The effect of TUNA was to halve the mean IPSS at 1 year after treatment and, although there was a slight tendency for the IPSS to increase in all arms from year 1 to year 5, this decrease by half was maintained at 5 years. The maximum urinary flow rate (Qmax) also increased by ≈ 70% from baseline to 1 year and in virtually all studies the mean Qmax approached or exceeded 15 mL/s. Although there was a tendency for Qmax to decline slightly over time, the mean Qmax 5 years after treatment was > 50% over baseline.CONCLUSIONSThis meta‐analysis shows that TUNA is an effective and minimally invasive treatment for men with clinical BPH, even when the symptoms are severe. There is a significant improvement in symptoms and flow rate after 1 year which persists for at least 5 years. TUNA therapy would appear to be an alternative to surgery and an attractive option for men who do not wish to undergo long‐term medical therapy, are poor candidates for surgery or are concerned about the side‐effects of TURP.
Transurethral electrovaporization vs transurethral resection for symptomatic prostatic obstruction: a meta‐analysis
Authors: Poulakis Vassilis , Dahm Philipp , Witzsch Ulrich , Sutton Alex J. , Becht Eduard 
Published: June 2004

OBJECTIVETo compare the effectiveness and safety of transurethral electrovaporization (TUEVP) and transurethral resection of the prostate (TURP) for symptomatic bladder outlet obstruction secondary to benign prostatic hyperplasia (BPH).METHODSPublications comparing TUEVP and TURP were identified systematically using Medline, the Cochrane Controlled Trial Register and other database search engines. From a total of 25 randomized controlled trials, 20 studies met the predefined inclusion criteria and were subjected to a formal meta‐analysis. Primary endpoints were symptom scores and peak urinary flow rates. Secondary endpoints included transfusion requirements, operative time, duration of catheterization, incidence of adverse events, hospital stay, re‐operation rates and sexual dysfunction.RESULTSAfter 1 year of follow‐up there was no significant difference between TUEVP and TURP in urinary symptom scores and peak urinary flow rates. There was heterogeneity at baseline for both primary outcome measures. TUEVP was associated with significantly lower transfusion requirements, a shorter catheterization time, and a shorter length of stay. TURP was associated with a lower risk of urinary retention afterward and re‐operation than was TUEVP.CONCLUSIONThis formal meta‐analysis suggests that both TUEVP and TURP in patients with symptomatic bladder outlet obstruction provide comparable improvements in maximum urinary flow rates and symptom scores. While comparative analysis is limited by the methodological shortcomings of the underlying studies and the short follow‐up, both TURP and TUEVP may offer distinct advantages in terms of secondary outcomes. A future, well‐designed, multicentre randomized clinical trial with extended follow‐up may be needed to better define the role of vaporization techniques in treating patients with symptomatic BPH.
Differences in prostate disease symptoms and visits to the general practitioner among three ethnic groups in New Zealand
Authors: Gray Marion A. , Crampton Peter , Weinstein Philip , Nacey John N. 
Published: June 2004

OBJECTIVETo define lower urinary tract symptoms (LUTS) and their relationship to general practitioner (GP) visits and ethnicity among men in the New Zealand (NZ) population‐based Wellington Region Community Prostate Study.SUBJECTS AND METHODSIn 2001–2002 NZ European, Maori and Pacific Island participants were selected from the Wellington region of NZ. Demographic questions, the International Prostate Symptom Score and yearly GP attendance questions were completed by 862 subjects with no history of prostate cancer.RESULTSThere were no significant differences in LUTS among the ethnic groups (P = 0.80) but symptom scores were positively correlated with age only for NZ Europeans (P < 0.001, r = 0.179). Overall, NZ populations have a lower prevalence of LUTS than is evident for ethnic groups in other countries. Pacific Islanders attended the GP more often than both NZ Europeans and Maori.CONCLUSIONEthnic differences in age‐related urinary symptoms and visits to the GP are important for informing culturally appropriate clinical practice and prostate health promotion with minority groups.
Posterior tibial nerve stimulation in patients with intractable interstitial cystitis
Authors: Zhao Jimao , Nordling Jørgen 
Published: June 2004

OBJECTIVETo evaluate the efficacy of intermittent percutaneous posterior tibial nerve stimulation (PPTNS) in patients with refractory interstitial cystitis.PATIENTS AND METHODSOne man and 13 women (mean age 58.3 years) with suprapubic or perineal pain were enrolled in a prospective open study, in which they had 10 weekly sessions of PPTNS. Their mean duration of symptoms was 8.3 years. All patients were previously diagnosed as having interstitial cystitis according to the National Institute of Diabetes and Digestive and Kidney Diseases criteria. The response to the treatment were assessed using voiding diary, visual analogue scale diary for a pain index, and the Interstitial Cystitis Problem Index (ICPI), O’Leary/Sant Interstitial Cystitis Symptom Index (ICSI) and the 36‐item short‐form health survey (SF‐36) quality‐of‐life questionnaire.RESULTSOf the 14 patients, 13 completed the 10 weeks of treatment with no complications; 12 continued treatment for a short period after the study. There were no statistically significant changes in pain scores, voiding frequency and volumes, or in the ICPI, ICSI and SF‐36 scores. However, there was an improvement in some patients, with one having complete resolution of the pain.CONCLUSIONIntermittent PPTNS in patients with refractory interstitial cystitis has no significant clinical effect over 10 weeks of treatment.
Complications of tension‐free vaginal tape surgery: a multi‐institutional review
Authors: Abouassaly Robert , Steinberg Jordan R. , Lemieux Marguerite , Marois Carlos , Gilchrist Lawrence I. , Bourque Jean‐Louis , Tu Le Mai , Corcos Jacques 
Published: June 2004

OBJECTIVETo analyse the complications of tension‐free vaginal tape (TVT) surgery, a minimally invasive alternative for treating patients with stress urinary incontinence (SUI), at six institutions, and to review the management of these complications and their effect on patient outcome.PATIENTS AND METHODSIn all, 241 patients who had a TVT procedure by six urologists at six hospitals (two university and four community) were reviewed retrospectively by the same urologist. Complications during and after surgery, and their management, were analysed.RESULTSComplications during surgery included bladder perforation in 48 patients (5.8%) and blood loss > 500 mL in 16 (2.5%). Immediate complications after surgery were urinary retention (>24 h after) in 47 patients (19.7%), pelvic haematoma in four (1.9%) and suprapubic wound infection in one (0.4%). Of the 47 patients in retention, 32 were in retention for <48 h and treated with an indwelling catheter. The 15 remaining patients were treated with an indwelling catheter (one) or clean intermittent catheterization for a mean of 22 days. To correct the retention the TVT was released in seven patients and the tape sectioned in three. Late complications were de novo urgency, persistent suprapubic discomfort and intravaginal tape erosion in 36 (15%), 18 (7.5%) and one (0.4%) patient, respectively. Most of these complications resolved with observation and medical management, but intravaginal tape erosion required partial resection of the tape with closure and repair of the vaginal mucosa.CONCLUSIONSThe present TVT complication rates were slightly higher than reported previously. This multi‐institutional review in both academic and community hospitals may better reflect the morbidity of TVT insertion in clinical practice. TVT is a highly effective, minimally invasive method for treating SUI. A stricter definition of each complication and a better understanding of the mechanism of these complications may further improve the surgical outcome and decrease patient morbidity.
The use of neural networks for predicting the result of endoscopic treatment for vesico‐ureteric reflux
Authors: Serrano‐Durbá Agustín , Serrano Antonio J. , Magdalena José R. , Martín José D. , Soria Emilio , Domínguez Carlos , Estornell Francisco , García‐Ibarra Fernando 
Published: June 2004

OBJECTIVETo create an artificial neural network (ANN) to aid in predicting the results of endoscopic treatment for vesico‐ureteric reflux (VUR).MATERIALS AND METHODSDuring 1999–2001 we used endoscopic treatment in 261 ureteric units with VUR of all grades and causes. An ANN based on multilayer perceptron architecture was created using an 11 × 6 × 1 structure, taking the following as variables: the cause and grade of VUR, the patient's age and sex, the type of implanted substance and its volume, the number of treatments, the affected ureter, the endoscopic findings, and the type of cystography used. In all, 174 cases were used as training samples for the ANN and 87 to validate it. We calculated the sensitivity, specificity, positive (PPV) and negative predictive values (NPV), and the success rate (%) of the system.RESULTSIn the training group the ANN gave a sensitivity of 86.4%, a specificity of 89.5%, a PPV of 76% and NPV of 94%, with a success rate of 88.6%. In the same training group logistic regression (LR) gave respective values of 68.2%, 58.8%, 39%, 82.7% and 61.4%. In the validation group the respective values for the ANN were 71.4%, 81.6%, 58.8%, 88.6% and 78.9%, and in the same validation group the LR gave 64.4%, 50%, 32.1%, 79.2% and 53.9%. The Wilcoxon test confirmed the independence of both methods (P < 0.001).CONCLUSIONThe ANN is an effective tool for assisting the urologist in indicating and applying endoscopic treatments for VUR.
Interstitial cells of Cajal in the human normal urinary bladder and in the bladder of patients with megacystis‐microcolon intestinal hypoperistalsis syndrome
Authors: Piaseczna Piotrowska Anna , Rolle Udo , Solari Valeria , Puri Prem 
Published: June 2004

OBJECTIVETo investigate the distribution of c‐kit‐positive interstitial cells of Cajal (ICCs) in normal bladder and bladders from patients with megacystis‐microcolon‐intestinal peristalsis syndrome (MMIHS, a rare congenital and generally fatal cause of functional intestinal obstruction in the newborn), the most characteristic feature of which is abdominal distension caused by a distended unobstructed urinary bladder.PATIENTS AND METHODSFull‐thickness bladder specimens were obtained from four infants with MMIHS and four controls, and processed as paraffin‐wax and frozen sections. Sections were assessed using single immunohistochemistry with monoclonal and polyclonal anti‐c‐kit antibodies. Anti‐α‐smooth muscle actin (SMA) antibody was used to investigate the contractile apparatus in smooth muscle cells of the urinary bladder. Specimens were examined using light and confocal scanning microscopy.RESULTSThere were many c‐kit positive ICCs in the normal urinary bladder, appearing as small, long, bipolar cells with only two long and several short processes. In contrast, ICCs were absent in the MMIHS bladder. α‐SMA immunoreactivity was lower in MMIHS urinary bladder than in control sections.CONCLUSIONThis study shows for the first time the presence of c‐kit‐positive ICCs in the normal human urinary bladder. The lack of ICCs in the MMIHS bladder may contribute to the voiding dysfunction in this disease.
A rat model for studying effects of sacral neuromodulation on the contractile activity of a chronically inflamed bladder
Authors: Riazimand Seyed‐Hossein , Mense Siegfried 
Published: June 2004

OBJECTIVETo develop an animal model in which the effects of electrical stimulation of the sacral nerves (sacral neuromodulation) on a chronic hyperactive urinary bladder can be studied.MATERIALS AND METHODSIn female rats the urinary bladder was instilled with mustard oil (0.4%); after 10 days the animals were anaesthetized with intraperitoneal urethane, the bladder catheterized and connected to a pressure transducer. Stimulating electrodes were placed into the sacral foramina bilaterally. The intensity and duration of sacral electrical stimulation was varied systematically to determine the effects of the sacral neuromodulation on bladder contractions.RESULTSThe main effect of the neuromodulation was an increase in the interval between contractions, i.e. during and for some time after the stimulation the contractions were completely abolished. The duration of the pause increased with the intensity and duration of stimulation. After the contractions had reappeared the frequency of contractions was reduced for a long period. In animals with chronic cystitis the effects of neuromodulation tended to be stronger (the pauses were longer) than in control animals with an intact bladder, but only in one test (increase of pause length with stimulus duration) was the difference statistically significant.CONCLUSIONSThe results show that this animal model is suitable for studying the effects and mechanisms of sacral neuromodulation on a chronic hyperactive urinary bladder.
Patriotism, Universalism and the Scottish Conventions, 1792–1794
Authors: PENTLAND GORDON 
Published: June 2004

AbstractScottish radicalism in the 1790s was informed by indigenous ideologies and traditions and by the more universalist ideology associated with the American and French revolutions and with the writings of Thomas Paine. Scottish, English and Irish radicals also operated in a British context, and throughout the decade they contested the language of British patriotism with the state and loyalists who sought to represent all radicals as essentially foreign. This article investigates the radical conventions held in Edinburgh between 1792 and 1794, which culminated in the British Convention. The majority of delegates who attended were from Scottish societies, but English radicals played prominent roles in its proceedings. The British Convention sat in the context of war with revolutionary France, when patriotism was at a premium, and was broken up by the government, who tried its leaders for sedition. At the convention, delegates appealed to a British ‘constitutional idiom’ to justify and legitimize their actions. This language was not only flexible enough to incorporate aspects of other ideological justifications for political reform, both secular and religious, but also allowed radicals to articulate an alternative British patriotism to that espoused by loyalists.
Globalism, Hegemonism and British Power: J. A. Hobson and Alfred Zimmern Reconsidered
Authors: PEATLING G. K. 
Published: June 2004

AbstractInterpretations of British imperial history which highlight the role played in the decline of the British empire by misguided gestures of appeasement, and particularly by supercilious internal anti‐imperial critics, have recent been influentially restated within and outside of historical scholarship. Such analysis however is characterized by inadequate assessment of the nature of debate within Britain about the empire during key phases of history. This article considers the ideas of the leading intellectuals Alfred Eckhard Zimmern and John Atkinson Hobson as exemplars of opposed positions taken in that debate in the context of imperial Britain's global strength in the years before and at the start of the First World War. Within this debate, however, Zimmern and Hobson agreed on many fundamentals, not least on the significant potential for good possessed by British imperial power. This case study demonstrates that it is usually desirable for students of history to avoid analogical modes of argument in foreign policy by demonstrating the complexity of decision‐making therein. It also suggests, however, that internal dissent and weakness is likely to be less of a source of difficulty in the world's predominant power – even in one that frequently underpins international order – than is commonly assumed.
Changing patterns of human resource management in contemporary China: WTO accession and enterprise responses
Authors: Zhu Ying , Warner Malcolm 
Published: June 2004

ABSTRACTThis study examines the increasingly complex challenges facing human resource management (HRM) in China following the country's accession to the WTO and, consequently, the implications for further reform of government policy and enterprise‐level HRM practices. The article concludes that current HR practices among enterprises vary depending on ownership, industrial sector, location and history. The direction of future changes may depend on the level of involvement from external forces as well as internal strategies adopted by Chinese enterprises to survive.