bluuebunny/crossref_metadata_2025_split huggingface dataset:
Depression in Older Chinese Migrants to Auckland
Authors: Abbott Max W. , Abbott Max W. , Wong Sai , Giles Lynne C. , Wong Sue , Young Wilson , Au Ming 
Published: July 2003

Objective: This study was conducted to identify risk factors for depressive symptomatology among older Chinese migrants. Method: One hundred and sixty-two Chinese migrants aged 55 years or older, living in the community and recruited via Chinese community organizations and general practitioners, were interviewed using a Chinese version of the Geriatric Depression Scale and measures of stressful life events, morbid conditions, self-rated health, acculturation, social support and service utilization. Result: Twenty-six percent of participants met the criteria for depressive symptomatology. No recent migrants showed symptoms of depression. Multiple logistic regression analysis showed that lower emotional support, greater number of visits to a doctor, difficulties in accessing health services and low New Zealand cultural orientation increased the risk of showing symptoms of depression. Conclusion: Significant numbers of older Chinese migrants appear to be depressed or at risk for depression and, while participants with depressive symptoms consulted general practitioners more than their counterparts without such symptoms, they reported greater difficulty in accessing health services. The findings point to the need for further epidemiological study of this growing sector of the population and investigation of the nature of its engagement with health services. Social support and aspects of acculturation may play a significant role in preventing depression. This also requires further investigation.
Diagnostic Concordance of ICD-10 Personality and Comorbid Disorders: A Comparison of Standard Clinical Assessment and Structured Interviews in a Clinical Setting
Authors: Egan Sarah , Nathan Paula , Lumley Margaret 
Published: July 2003

Objective: The diagnosis of personality disorders is one of the most problematic areas in psychiatric diagnosis. Diagnoses are usually made by standard clinical interview, but they have poor reliability. The aim of this study was to compare the concordance in diagnosis between structured assessment tools and assessment as usual in a clinical setting. Method: Diagnosis of 33 patients on the International Personality Disorder Examination (IPDE) and the Mini International Neuropsychiatric Interview (MINI) was compared to diagnosis made by standard assessment through clinical interview. Results: There was poor concordance between structured measures and standard assessment by clinical interview, and poor levels of diagnostic sensitivity and specificity on standard assessment. Conclusion: Structured measures were more comprehensive, sensitive and specific in diagnosis than standard clinical assessment. Increased diagnostic accuracy is needed for effective understanding and treatment planning for personality disorders.
Screening for prostate cancer: have you had your cholesterol measured?
Authors: Boyle P. 
Published: July 2003

Screening for prostate cancer has become one of the most common topics of conversation at urological oncology meetings. Most people have a bias as to whether there should or should not be a national screening programme. Unfortunately there are many unanswered questions, which may or may not be possible to answer definitively. In a balanced and scholarly review of the subject, Professor Peter Boyle indicates several flaws in the agreement for screening, but feels that PSA testing will continue unabated.The authors from the University of Stellenbosch review the plentiful literature relating to testicular torsion and functional recovery. They also review the mechanism of injury and the effect on the contralateral testis.
Comparative efficacy of triptorelin pamoate and leuprolide acetate in men with advanced prostate cancer
Authors: Heyns C.F. , Simonin M.‐P. , Grosgurin P. , Schall R. , Porchet H.C. ,   for the South African Triptorelin Study Group
Published: July 2003

OBJECTIVETo compare the efficacy of monthly administrations of the luteinizing hormone‐releasing hormone agonists triptorelin pamoate and leuprolide acetate to induce and maintain castrate levels of serum testosterone in men with advanced prostate cancer.PATIENTS AND METHODSMen with advanced prostate cancer were randomly assigned to receive triptorelin 3.75 mg or leuprolide 7.5 mg. The agent was injected intramuscularly every 28 days for nine injections. Primary endpoints were the percentages of men whose serum testosterone concentrations declined to and were maintained at or below castrate levels (≤ 1.735 nmol/L or ≤ 500 ng/L) during 9 months (253 days) of treatment. Secondary endpoints were luteinizing hormone levels, bone pain, prostate specific antigen levels, quality of life, testosterone pharmacodynamics, survival, and safety variables.RESULTSIn all, 284 men received either triptorelin (140) or leuprolide (144). The percentage of men with castrate levels of serum testosterone was lower at 29 days for triptorelin than for leuprolide (91.2% vs 99.3%; point estimate − 8.0, 95% confidence interval − 16.9% to − 1.4%), but equivalent at 57 days (97.7% vs 97.1%). The mean (98.8% vs 97.3%) and cumulative (96.2% vs 91.2%) castration maintenance rates between 29 and 253 days were equivalent between the treatment groups. Secondary endpoints were equivalent between treatment groups except for the 9‐month survival rate, which was significantly higher for triptorelin than for leuprolide (97.0% vs 90.5%; P = 0.033). Both treatments were well tolerated.CONCLUSIONTriptorelin reduced testosterone concentrations less rapidly, but maintained castration as effectively as leuprolide. There was no evidence that the slower onset of castration caused deleterious effects.
Safety and efficacy of alfuzosin 10 mg once‐daily in the treatment of lower urinary tract symptoms and clinical benign prostatic hyperplasia: a pooled analysis of three double‐blind, placebo‐controlled studies
Authors: Roehrborn C.G. , Van Kerrebroeck P. , Nordling J. 
Published: July 2003

OBJECTIVESTo examine the efficacy and safety of a once‐daily formulation of alfuzosin in a pooled analysis of three parallel, randomized, double‐blind, placebo‐controlled 3‐month studies of patients with lower urinary tract symptoms (LUTS) consistent with clinical benign prostatic hyperplasia.PATIENTS AND METHODSPatients were randomized to receive alfuzosin, 10 mg once‐daily (473) or placebo (482) for 12 weeks. Primary efficacy criteria were improvements in the International Prostate Symptom Score (IPSS) and peak urinary flow rate (PFR).RESULTSAlfuzosin significantly improved the mean (sd) IPSS, by − 6.0 (5.1) vs − 4.2 (5.7) with placebo (P < 0.005) and the PFR, by + 2.3 (3.8) vs + 1.1 (3.1) ml/s with placebo (P < 0.001), irrespective of prostate size. The significant improvement in LUTS included the irritative and the obstructive subscore of the IPSS and the nocturia criterion; the PFR increased rapidly and significantly, from the first visit (14 days). The quality‐of‐life score also improved significantly in alfuzosin‐treated patients. Alfuzosin was well tolerated; the number of withdrawals for adverse events was comparable in both treatment groups. The most frequently reported adverse event was dizziness (placebo 2.9%, alfuzosin 6.1%). There were no significant changes in blood pressure with alfuzosin compared with placebo, including in elderly and hypertensive patients. Sexual adverse events were rare (abnormal ejaculation, 0.6%).CONCLUSIONSThe once‐daily formulation of alfuzosin, administered at 10 mg with no dose titration is effective, with a good safety profile, especially in elderly and hypertensive patients.
Improvements in benign prostatic hyperplasia‐specific quality of life with dutasteride, the novel dual 5α‐reductase inhibitor
Authors: O'Leary M.P. , Roehrborn C. , Andriole G. , Nickel C. , Boyle P. , Höfner K. 
Published: July 2003

OBJECTIVESTo examine the effect of the dual‐action 5α−reductase inhibitor dutasteride on benign prostatic hyperplasia (BPH)‐specific health status, as measured by the BPH Impact Index (BII), and to identify baseline and treatment risk factors for those most bothered by their BPH symptoms at the end of the protocol.PATIENTS AND METHODSData were derived from three randomized, double‐blind, placebo‐controlled, 2‐year studies conducted in 4325 men with lower urinary tract symptoms caused by benign prostatic enlargement. Each study comprised a 1‐month single‐blind placebo run‐in period, followed by randomization to oral dutasteride 0.5 mg once daily or placebo for 2 years. Patients eligible for inclusion were consenting men aged ≥ 50 years with moderate to severe symptoms (American Urological Symptom Index, AUA‐SI, score ≥ 12), a prostate volume of ≥ 30 mL, a serum prostate‐specific antigen (PSA) level of ≥ 1.5 or < 10 ng/mL, and a maximum urinary flow rate (Qmax) of ≤ 15 mL/s. BII scores were recorded at baseline and each study visit. Clinically and statistically significant changes in BII scores from baseline were investigated for each study visit. Logistical regression analysis was used to assess the significance of baseline prostate volume, symptoms, BII item 3, baseline Qmax, serum dihydrotestosterone, testosterone, PSA, age and weight in predicting the BII score at 2 years.RESULTSDutasteride, but not placebo, resulted in clinically and statistically significant improvements in mean BII score from 6 months. Of patients with a baseline BII score of ≥ 5 (greatest symptomatic burden) treatment with dutasteride improved the scores by 2.41, while the scores in placebo‐treated patients only improved by 1.64. Dutasteride‐treated patients with a baseline BII score of < 5 (least symptom burden) had a clinically significant improvement in health status, while placebo‐treated patients deteriorated. Regression analysis showed that men with a combination of a baseline BII item‐3 score of 3 (bothered a lot) and a high symptom score (AUA‐SI ≥ 20) were more likely to be bothered by their symptoms at the end of the study. Men receiving placebo were also more likely to be bothered at the end of the study than were those receiving dutasteride.CONCLUSIONSDutasteride treatment is associated with clinically significant improvements in BII score, reflecting improvements in the quality of life of men with BPH. Taken together with previously reported improvements in prostate volume, lower urinary tract symptoms and urinary flow, and diminution of the risk of acute urinary retention and the need for BPH‐related surgery, dutasteride offers demonstrable efficacy in the management of BPH.
A prospective comparison of radical retropubic and robot‐assisted prostatectomy: experience in one institution
Authors: Tewari A. , Srivasatava A. , Menon M. ,   members of the VIP Team
Published: July 2003

The authors from the Vattikuti Institute in the USA report a prospective comparison of radical prostatectomy and robot‐assisted prostatectomy. They found that the robot‐assisted procedure was safer, and yielded favourable oncological and functional results. They also present work in association with the Department of Urology in Mansoura into robot‐assisted radical cystoprostatectomy and urinary diversion, and point out the advantages and disadvantages associated with performing the most complex types of urinary diversion.There is also an interesting paper relating to the association between sexual factors and prostate cancer, from authors in institutions in Australia, New Zealand and Italy. They found that in a case‐control study of men aged <70 years, ejaculatory frequency was negatively associated with the risk of prostate cancer.Technology has made many contributions to the management of urological patients. The classic example is that of urinary stone management. Authors from the USA evaluated cyroablation of renal carcinoma in patients with solitary kidneys. They are encouraged by their results and suggest that there is merit in this treatment, but indicate the need for a longer follow‐up.OBJECTIVETo prospectively compare standard radical retropubic prostatectomy (RRP) and the robotically assisted Vattikuti Institute prostatectomy (VIP) in the management of localized prostate cancer.PATIENTS AND METHODSThe study was a single‐institution, prospective, unrandomized comparison of histopathological, and functional outcomes, at baseline and during and after surgery, in 100 patients undergoing RRP and 200 undergoing VIP.RESULTSWhile the variables before surgery, the operative duration (163 vs 160 min) and pathological stages were comparable, there were significant differences in the measured outcomes. The blood loss was 910 and 150 mL for RRP and VIP, respectively, and transfusion was greater after RRP (67% vs none; both P < 0.001). There were four times as many complications after RRP (20% vs 5%, P < 0.05), the haemoglobin level at discharge was lower (100 vs 130 g/L, P < 0.005) and the hospital stay longer (3.5 vs 1.2 days; P < 0.05). Most (93%) of VIP and none of the RRP patients were discharged within 24 h (P < 0.001); the duration of catheterization was twice as long after RRP (15.8 vs 7 days; P < 0.05). Positive margin was more frequent after RRP (23% vs 9%, P < 0.05). After VIP, patients achieved continence and return of erections more quickly than after RRP (160 vs 44, and 180 vs 440 days, both P < 0.5). The median return to intercourse was 340 days after VIP but after RRP half the patients have as yet not resumed intercourse at 700 days (P < 0.05).CONCLUSIONSThe VIP procedure appears to be safer, less bloody and requires shorter hospitalization and catheterization. The oncological and functional results were favourable in patients undergoing VIP.
The Finnish version of The National Institutes Of Health Chronic Prostatitis Symptom Index correlates well with the visual pain scale: translation and results of a modified linguistic validation study
Authors: Leskinen M.J. , Mehik A. , Sarpola A. , Tammela T.L.J. , Järvelin M.‐R. 
Published: July 2003

Authors from Finland have assessed a version in their language of the National Institutes of Health‐Chronic Prostatitis Symptom Index; they found that their translated version was valid and easily understandable in the management of the symptoms of chronic pelvic pain syndrome. They felt it should be used as a primary outcome measure in studies with these patients.There are three papers in this issue relating to the effect of drugs on LUTS; the first of these is a pooled analysis of three double‐blind placebo‐controlled studies into the safety and efficacy of the 10 mg dose of alfuzosin. The second evaluates the effect on quality‐of‐life issues of treatment with dutasteride. Finally, authors from Australia compare the effect of a Serenoa repens extract with placebo for LUTS.OBJECTIVESTo provide a fluent and easily comprehensible Finnish version of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH‐CPSI) and to study its linguistic validity and correlation with a visual pain scale (VAS).PATIENTS AND METHODSThe double‐back translation method with two interim modifications was used to produce the Finnish version of the NIH‐CPSI. The validity was tested by presenting the questionnaire to 155 men with clinically confirmed chronic pelvic pain syndrome (CPPS) and 12 controls with no previous urological symptoms. Convergent validity of the NIH‐CPSI was tested by determining the correlation between the Finnish NIH‐CPSI and VAS. Patients’ and urologists’ opinions about the utility of the Finnish NIH‐CPSI were also reviewed.RESULTSThe total Finnish NIH‐CPSI scores and the pain domain and voiding symptom domain scores differed significantly (P < 0.001) between the groups, suggesting good discriminant validity of the symptom index. The NIH‐CPSI scores correlated well with the VAS (Pearson's correlation 0.76). The preciseness and comprehensibility of the questionnaire were consistently evaluated to be ‘good’ or ‘excellent’ both by patients and urologists.CONCLUSIONSThe Finnish version of the NIH‐CPSI is valid and easily comprehensible for measuring CPPS symptoms. In addition, it provides good discriminant and convergent validity in distinguishing CPPS symptoms and should be used as primary outcome measure in CPPS studies.
The role of transarterial embolization in the treatment of renal cell carcinoma
Authors: Munro N.P. , Woodhams S. , Nawrocki J.D. , Fletcher M.S. , Thomas P.J. 
Published: July 2003

OBJECTIVETo review the role of transarterial renal embolization in our unit, assessing the indications, tolerability and efficacy of this technique for treating renal cell carcinoma (RCC).PATIENTS AND METHODSThirty patients undergoing transarterial embolization between 1991 and 1999 were identified and 25 case notes analysed retrospectively.RESULTSMost patients (14 of 25) presented with less advanced (stage I–III) RCC who were unable or unwilling to undergo radical surgery; the remainder (11) presented with advanced (stage IV) disease. The embolizing agent was ethanol, usually combined with stainless steel coils (85% of cases). Procedural pain and fever was controlled successfully. The median hospital stay associated with the procedure was 4 days. At the time of analysis six of 11 stage IV and 11 of 14 stage I–III patients were alive (median follow‐up 27 and 39 months, respectively). Symptoms from the primary tumour were well controlled. Overall, 17 of 25 (68%) of patients reported no problems while three (12%) required brief hospital admission for treatment of persistent haematuria. Fourteen patients were subsequently re‐staged; the primary tumour in two had increased, in seven remained unchanged and in five it decreased. No patients without metastases developed them and metastases in two patients regressed.CONCLUSIONTransarterial embolization is associated with minimal morbidity and complications, and subsequent symptom control is good. The effect of palliative embolization on RCC progression is unknown and requires prospective investigation. Presently, there is no role for cytoreductive embolization; it should be included as a treatment option in clinical trials evaluating such options in patients with metastatic RCC.
Squamous cell carcinoma antigen: a role in the early identification of nodal metastases in men with squamous cell carcinoma of the penis
Authors: Laniado M.E. , Lowdell C. , Mitchell H. , Christmas T.J. 
Published: July 2003

OBJECTIVETo evaluate whether serum squamous cell carcinoma antigen (SCCAg) measurements may be of use in identifying nodal metastases in patients with SCC of the penis after treating the primary tumour.PATIENTS AND METHODSThe levels of SCCAg were analysed in 11 men with penile SCC between 1994 and 2001.RESULTSAn elevated SCCAg level had a sensitivity of 57% (95% confidence interval, CI, 18–90%) and a specificity of 100% (CI 40–100%) for nodal metastases. Levels of SCCAg increased exponentially in patients who developed nodal metastases after treatment of the primary tumour, and were elevated before clinical or radiological evidence of nodal disease.CONCLUSIONEither the absolute level or the rate of rise of SCCAg may be a useful tool with which to follow patients after excision of the primary tumour. It may be more sensitive than computed tomography and magnetic resonance imaging in detecting recurrence, but further evaluation is needed.
Serenoa repens extract for benign prostate hyperplasia: a randomized controlled trial
Authors: Willetts K.E. , Clements M.S. , Champion S. , Ehsman S. , Eden J.A. 
Published: July 2003

OBJECTIVETo compare the effect of a Serenoa repens extract with placebo for symptoms of benign prostatic hyperplasia (BPH).PATIENTS AND METHODSIn a double‐blind placebo‐controlled randomized trial between January 1999 and March 2000, 100 men with symptoms of BPH, aged < 80 years, with a maximum urinary flow rate of 5–15 mL/s for a voiding volume of 150 mL, were randomly and equally allocated to 320 mg S. repens extract or placebo (paraffin oil). The main outcome measures were the International Prostate Symptom Score (IPSS), peak urinary flow rate, and the Rosen International Index of Erectile Function (IIEF) questionnaire.RESULTSThere was no significant difference between the treatments over the 12 weeks of the study in the IPSS, peak urinary flow rate or for the IIEF questionnaire.CONCLUSIONSDuring the trial all participants had some improvement in their symptoms of BPH but there was no significant beneficial effect of this S. repens extract over placebo in this 12‐week trial.
Previous testicular position in boys referred for an undescended testis: further explanation of the late orchidopexy enigma?
Authors: Hack W.W.M. , Meijer R.W. , Van Der Voort‐Doedens L.M. , Bos S.D. , De Kok M.E. 
Published: July 2003

OBJECTIVETo investigate the significance of the acquired undescended testis (UDT), which is differentiated into congenital and acquired forms, by assessing the previous testicular position in affected boys.PATIENTS AND METHODSThe study comprised 261 boys who had been referred for a non‐scrotal testis to the outpatient clinic during an 8‐year period (1993–2000). There was a bimodal distribution of age, with peaks at 2.0 and 10.0 years. In each boy with UDT the previous testicular position was ascertained.RESULTSOn referral, 340 testes were not in the scrotum (182 uni‐ and 79 bilateral). Of the 340 testes, 82 (24%) in 61 boys were diagnosed as retractile, whereas the remaining 258 in 221 boys were undescended. The previous testicular position was known in 208 of 221 boys (94%), with 244 UDTs. In 65 of these 244 (26.6%) the testis had never been scrotal (congenital UDT); in 179 (73.4%) a previous intrascrotal position was recorded in early childhood (acquired UDT) at least once, in 149 (61%) at least twice and in 117 (48%) at least three times. The mean age at referral for congenital UDT was 2.1 years and for acquired UDT was 8.4 years.CONCLUSIONSThese results show that acquired UDT is frequent, and occurs at about three times the rate of congenital UDT. Because these boys are referred for treatment later in childhood, the acquired UDT probably accounts for the high rate of (late) orchidopexy.
The growth inhibitory effect of p21 adenovirus on androgen‐dependent and ‐independent human prostate cancer cells
Authors: Gotoh A. , Shirakawa T. , Wada Y. , Fujisawa M. , Okada H. , Kamidono S. , Hamada K. 
Published: July 2003

OBJECTIVETo assess the potential of p21 as a gene therapy treatment for prostate cancer, by introducing p21 into both androgen‐dependent (AD) and ‐independent (AI) human prostate cancer cell lines via a recombinant adenoviral vector, Ad5CMV‐p21, carrying human p21 cDNA.MATERIALS AND METHODSThe LNCaP, DU145 and PC‐3 human prostate cancer cell lines were cultured and infected with Ad5CMV‐p21. Cell growth, cell‐cycle progression and tumorigenicity were then assessed by thymidine incorporation into cellular DNA, and cell number, flow cytometry, and tumour growth after inoculating the cells into nude mice.RESULTSGrowth was inhibited in Ad5CMV‐p21 viral‐infected AD and AI prostate cancer cells. The effects were dose‐dependent, regardless of the androgen status of the cell lines. Flow cytometric analysis showed that Ad5CMV‐p21 arrested cell‐cycle progression at G1/S with no appreciable effect on the levels of apoptotic cells. The tumorigenicity of cancer cells infected with Ad5CMV‐p21 was greatly reduced in athymic mice.CONCLUSIONSThese results suggest that Ad5CMV‐p21 may be a new therapeutic agent for human prostate cancer gene therapy.