bluuebunny/crossref_metadata_2025_split huggingface dataset:
Beneficial effects of continuous overnight catheter drainage in children with polyuric renal failure
Authors: Montané B. , Abitbol C. , Seeherunvong W. , Chandar J. , Strauss J. , González R. , Zilleruelo G. 
Published: August 2003

The authors from Miami discuss the problems affecting children with dysfunctional bladder syndrome. If there is progressive renal disease polyuria may overwhelm bladder capacity. They set out to determine whether overnight catheter drainage in such patients might have a beneficial effect. They found that this technique in patients with progressive polyuric renal failure may have the potential to preserve renal function in selected patients. They also state that it should not be seen as a replacement for surgical augmentation of the bladder or intermittent catheterization.OBJECTIVETo determine the possible beneficial effect of providing decompression of the collecting system by continuous overnight catheter drainage (COCD) in children with progressive renal disease and dysfunctional bladder syndrome, commonly associated with polyuria which may overwhelm bladder capacity.PATIENTS AND METHODSCOCD was used in seven patients (four boys) with progressive polyuric kidney failure associated with dysfunctional bladders (current age 18.7 years, sd 5; age at COCD 12 years, sd 6). Five children had surgical bladder augmentation and all were prescribed daytime intermittent catheterization (IC) for a mean (sd) of 4.7 (3.4) years before COCD. All had significant polyuria, with a mean (sd) urine output of 2370 (971) mL/m2 per day.RESULTSThe mean (sd) glomerular filtration rate at the start of COCD was 48 (21) mL/min/1.73 m2, which is currently stable in the five patients continuing treatment. The mean (sd) duration of COCD was 4.9 (2) years. One patient showed no improvement and had a pre‐emptive transplant within 1.2 years; another was transplanted after 5.5 years. Six patients showed evidence of benefit from COCD, with significant attenuation in the slope of renal functional decay (P = 0.02) and a mean (sd) prolongation of the predicted time to end‐stage renal disease of 12.2 (5.6) years (P < 0.002). Hospitalization for febrile urinary tract infections was decreased from a mean (sd) of 1.7 (1.4) to 0.4 (0.7) times (P = 0.03) in the first year of COCD and eliminated by the second year (P < 0.01).CONCLUSIONCOCD of the dysfunctional bladder in patients with progressive polyuric renal failure appears to offer the potential for preserving kidney function in selected patients. It does not replace surgical bladder augmentation or daytime IC in the core management.
Triple incision to treat phimosis in children: an alternative to circumcision?
Authors: Fischer‐Klein Ch. , Rauchenwald M. 
Published: August 2003

OBJECTIVETo evaluate the functional and cosmetic results and patient satisfaction after triple incision plasty for phimosis in children.PATIENTS AND METHODSThe study included 197 boys who had a triple incision for phimosis (mean age 5.8 years, range 0.25–18). The indications for preputial surgery were recurrent balanoposthitis, ballooning during micturition and severe phimotic stenosis. The results after surgery were assessed using a questionnaire about the child’s/parent's satisfaction, and an outpatient follow‐up examination for functional and cosmetic preputial appearance.RESULTSOf 128 parents/children responding, 108 (84%) were satisfied with the function and 102 (80%) reported a good cosmetic outcome. Triple incision as preputioplasty would be recommended to other parents by 119 (93%) respondents. Ninety‐one (71%) of the parents feared disadvantages in their son's later life if the child had been circumcised. The outpatient examination showed an excellent functional and cosmetic outcome in 71 (77%) of the children.CONCLUSIONTriple incision is a simple, fast and safe technique for preputial relief, with good functional and cosmetic results, and was well accepted by the patients.
Partner's influence on patient preference for treatment in early prostate cancer
Authors: Srirangam S.J. , Pearson E. , Grose C. , Brown S.C.W. , Collins G.N. , O'Reilly P.H. 
Published: August 2003

OBJECTIVETo determine the partner's influence on the patient's choice of treatment for early prostate cancer, and whether partner characteristics and biases predict the preference.PATIENTS, SUBJECTS AND METHODSQuestionnaires for partners to complete retrospectively were sent to consecutive patients recruited in a study comparing treatment options for early prostate cancer. The partners’ perceptions about prostate cancer were explored and the partners asked to comment on the suitability of each treatment option. Partners recorded their influence on the patient's choice using a 10‐point visual linear analogue scale.RESULTSQuestionnaires were sent to 116 eligible patients and 82 were returned for analysis (mean partner age 63 years). When asked to recall the treatment options initially discussed, all partners recalled radiotherapy (EBRT), all but one radical prostatectomy (RP), 51% brachytherapy, but only 29% watchful waiting (WW); 41% of partners stated RP as their chosen option, 37% EBRT, 12% brachytherapy and 10% no clear favourite. None preferred WW. Employment and education status were not significant predictors of partners’ preference but retired partners and those aged > 65 years were 3 times more likely to prefer EBRT than were their employed and younger counterparts, respectively. The partners’ mean (median, sd) self‐assessed influence factor was 4.8 (5, 3.4). Of the partners, 88% reported active involvement throughout the process, identifying information‐gathering and emotional support as their primary roles. Most deliberately chose not to influence the patient's final decision.CONCLUSIONPartner preference is influenced by pre‐existing conceptions about cancer and its treatment. While undoubtedly influential throughout the decision‐making process, partners deliberately left the final decision to the patient.
Trazodone for erectile dysfunction: a systematic review and meta‐analysis
Authors: Fink H.A. , MacDonald R. , Rutks I.R. , Wilt T.J. 
Published: August 2003

Evidence‐based medicine is an important way of allowing the reader to judge clearly whether a treatment has a place in a particular condition, and to see what faults were present in the various trials of its efficacy. It is often rather unsettling to read in a meta‐analysis or in a systematic literature review how poorly constructed many trials are. The authors from Minneapolis have carried out such a study into the use of trazodone in male erectile dysfunction. They draw attention to the poor quality of many of the trials and give their reasons for this observation. They suggest that trazodone may be helpful in men with this condition, possibly at higher doses and in men with psychogenic erectile dysfunction.OBJECTIVETo determine the efficacy and safety of trazodone in the treatment of erectile dysfunction (ED) in a meta‐analysis.METHODSThe data sources used were Medline and the Cochrane Library databases (January 1966 to May 2002), bibliographies of retrieved articles and review articles, and conference proceedings and abstracts. Trials were eligible for inclusion in the review if they included men with ED, compared trazodone with a control, were randomized, of ≥ 7 days’ duration and assessed clinically relevant outcomes. Two reviewers independently evaluated study quality and extracted data in a standardized fashion.RESULTSSix trials (comprising 396 men) met the inclusion criteria; they consisted of heterogeneous populations, were small, brief and in some cases methodologically weak. Three of the six trials showed an apparently clinically meaningful benefit of trazodone for ED compared with placebo, the differences being statistically significant in two. In pooled results, trazodone monotherapy appeared more likely than placebo to lead to a ‘positive treatment response’, although this difference was not statistically significant (37% vs 20%; relative benefit increase, 1.6; 95% confidence interval, CI, 0.8–3.3). Subgroup analyses suggested that men with psychogenic ED might be more likely to benefit from trazodone than those with mixed or physiological ED. The efficacy of trazodone also appeared greater at higher doses (150–200 vs 50 mg/day). Men randomized to trazodone were not significantly more likely than those receiving placebo to withdraw for any reason or for an adverse event, or to have specific adverse events, but wide CIs could not exclude a greater risk of these adverse outcomes with trazodone. Specific adverse events with trazodone included dry mouth (19%), sedation (16%), dizziness (16%) and fatigue (15%).CONCLUSIONTrazodone may be helpful in men with ED, possibly more so at higher doses, and in men with psychogenic ED. Future high‐quality trials should compare trazodone with placebo and other therapies in men with depression and psychogenic ED.
Quantitative evaluation of bone metastases in patients with advanced prostate cancer during systemic treatment
Authors: Yahara J. , Noguchi M. , Noda S. 
Published: August 2003

OBJECTIVETo assess the clinical usefulness of quantifying the extent of disease on bone scans in monitoring treatment response in patients with advanced prostate cancer, using computer‐assisted image analysis.PATIENTS AND METHODSThe percentage of the positive area on the bone scan (%PABS) was quantified automatically using a personal computer with an image‐analysis program. Serial measurements of %PABS in 42 patients with bone metastasis from prostate cancer followed for a mean (range) of 33 (4–72) months with hormonal therapy were compared with those of the extent of disease (EOD) grades in bone lesions and serum prostate specific antigen (PSA) levels according to treatment response.RESULTSSerial values of EOD grades and %PABS decreased during treatment in 11 patients with a partial response and in 12 with progressive disease who had no bone metastasis progression. However, EOD grades and %PABS increased in the remaining 19 patients with progressive disease who had bone metastatic progression. Estimated survival curves showed that %PABS was a useful prognostic indicator, in that patients with a > 25% decline in %PABS survived longer than those with a < 25% decline after treatment (P = 0.0207).CONCLUSIONSThe %PABS is a simple and reproducible estimate of the proportion of the skeleton involving tumours in patients with advanced prostate cancer, and serial measurements of %PABS can assist in monitoring the treatment response in patients with bone metastatic prostate cancer.
Tolterodine is equally effective in patients with mixed incontinence and those with urge incontinence alone
Authors: Kreder K.J. , Brubaker L. , Mainprize T. 
Published: August 2003

OBJECTIVETo examine the efficacy of tolterodine, an antimuscarinic agent with a bladder‐selective profile, in patients with mixed incontinence (MI, stress and urge) compared with patients with urge incontinence (UI) alone.PATIENTS AND METHODSThe study included 239 patients with MI (urge predominating) and 755 with urge incontinence alone from a single‐blind, multicentre trial of 1380 patients (80% female) with an overactive bladder. Those completing the trial were analysed ‘per‐protocol’. After a 7‐day washout and a 3‐day run‐in to collect baseline information, patients were treated with tolterodine twice daily for 16 weeks. The two groups were compared for incontinence episodes/24 h, voiding frequency, nocturia episodes and pad usage after 16 weeks of treatment.RESULTSAfter 16 weeks the median changes from baseline for all voiding variables were statistically significant for the MI and the UI groups (P < 0.001), with no apparent significant between‐group differences. The median percentage reduction in incontinence episodes from baseline was 67% for the MI and 75% for the UI groups (P = 0.39). ‘Dry’ rates for the MI and UI groups at the end of the study were 39% (66/171) and 44% (243/552), respectively, whilst 24% of patients in each group (MI 40/170; UI 130/551) achieved a voiding pattern of < 8 voids/24 h. ‘Cure’ rates for nocturia and the reduction in the number of patients not using pads used were also similar between the groups.CONCLUSIONTolterodine is as effective in reducing leakage and other symptoms of an overactive bladder in patients with MI as it is in patients with UI alone.
A comparison of lycopene and orchidectomy vs orchidectomy alone in the management of advanced prostate cancer
Authors: Ansari M.S. , Gupta N.P. 
Published: August 2003

OBJECTIVETo compare the efficacy of lycopene plus orchidectomy with orchidectomy alone in the management of advanced prostate cancer.PATIENTS AND METHODSFifty‐four patients with histologically confirmed metastatic prostatic cancer (M1b or D2) and a performance status of 0–2 (World Health Organization) were entered into the trial between March 2000 and June 2002. The trial comprised two treatment arms, i.e. patients were randomized to orchidectomy alone or orchidectomy plus lycopene (OL), each of 27 patients. Lycopene was started on the day of orchidectomy at 2 mg twice daily. Patients were evaluated clinically before and every 3 months after the intervention, with measurements of prostate‐specific antigen (PSA), a bone scan and uroflowmetry, with the clinical response assessed as the change in these variables.RESULTSAt 6 months there was a significant reduction in PSA level in both treatments, but more marked in the OL group (mean 9.1 and 26.4 ng/mL, P = 0.9). After 2 years these changes were more consistent in the OL group (mean 3.01 and 9.02 ng/mL; P < 0.001). Eleven (40%) patients in orchidectomy and 21 (78%) in the OL group had a complete PSA response (P < 0.05), with a partial response in nine (33%) and four (15%), and progression in seven (25%) and two (7%), respectively (P < 0.05). Bone scans showed that in the orchidectomy arm only four (15%) patients had a complete response, vs eight (30%) in the OL group (P < 0.02), with a partial response in 19 (70%) and 17 (63%), and progression in four (15%) and two (7%), respectively (P < 0.02). There was a significant improvement in peak flow rate in the OL group, with a mean difference of +1.17 mL/s (P < 0.04). Of the 54 patients who entered the trial, 19 (35%) died, 12 (22%) in orchidectomy and seven (13%) in OL group (P < 0.001).CONCLUSIONAdding lycopene to orchidectomy produced a more reliable and consistent decrease in serum PSA level; it not only shrinks the primary tumour but also diminishes the secondary tumours, providing better relief from bone pain and lower urinary tract symptoms, and improving survival compared with orchidectomy alone.
Predicting the impacts of climate change on the distribution of species: are bioclimate envelope models useful?
Authors: Pearson Richard G. , Dawson Terence P. 
Published: August 2003

ABSTRACTModelling strategies for predicting the potential impacts of climate change on the natural distribution of species have often focused on the characterization of a species’ bioclimate envelope. A number of recent critiques have questioned the validity of this approach by pointing to the many factors other than climate that play an important part in determining species distributions and the dynamics of distribution changes. Such factors include biotic interactions, evolutionary change and dispersal ability. This paper reviews and evaluates criticisms of bioclimate envelope models and discusses the implications of these criticisms for the different modelling strategies employed. It is proposed that, although the complexity of the natural system presents fundamental limits to predictive modelling, the bioclimate envelope approach can provide a useful first approximation as to the potentially dramatic impact of climate change on biodiversity. However, it is stressed that the spatial scale at which these models are applied is of fundamental importance, and that model results should not be interpreted without due consideration of the limitations involved. A hierarchical modelling framework is proposed through which some of these limitations can be addressed within a broader, scale‐dependent context.
Passive internal transport of aquatic organisms by waterfowl in Doñana, south‐west Spain
Authors: Figuerola Jordi , Green Andy J. , Santamaría Luis 
Published: August 2003

ABSTRACTAim Waterbirds may play an important role in the maintenance of aquatic ecosystem biodiversity by transporting plants and invertebrate propagules between different wetlands. The aim of this study is to provide the first quantitative analysis of the transport of plant and animal propagules by a community of waterbirds.Location Doñana marshes in south‐west Spain.Methods We quantified the number of intact seeds and invertebrate eggs in 386 faecal samples from 11 migratory waterfowl species (10 ducks and coot), collected from 3 November to 3 December 1998 (when birds were arriving from further north), and 22–25 February 1999 (when birds were leaving Doñana).Results Intact seeds of at least 7 plant genera, and invertebrate eggs (ephippia of at least 2 crustacea, statoblasts of at least 2 bryozoans and eggs of Corixidae) occurred in 65.6% of the faecal samples in early winter and 67.8% in late winter.Main conclusions The abundance of different propagule types varied between waterfowl species in a seasonal and species specific manner, probably owing to differences in foraging strategies, bill and gut morphology, and seasonal shifts in propagule availability or distribution. Lamellar density was positively correlated with the abundance of intact propagules. Our results confirm that waterfowl play an important role in the dispersal of organisms in aquatic environments by internal transport. Wherever there is a propagule bank accessible to waterbirds, transport can occur even when propagule production and waterfowl movements do not overlap in time.
Latitudinal and altitudinal body size variation among north‐west European land snail species
Authors: Hausdorf Bernhard 
Published: August 2003

ABSTRACTAim To investigate latitudinal and altitudinal patterns in body size variation among north‐west European land snail species, as well as factors influencing such patterns.Location Latitudinal patterns were investigated in north‐west Europe from the British Isles and France in the west to Finland, Poland, Slovakia and Hungary in the east and from Norway in the north to France (with the exception of the Mediterranean part of the country), Switzerland, Austria and Hungary in the south. Altitudinal patterns were examined in the Alps in Austria and Switzerland.Methods Data on latitudinal ranges of 366 north‐west European land snail species, on altitudinal ranges of 175 species from Austria and 150 species from Switzerland, and on their body sizes were used to test for the presence of interspecific latitudinal or altitudinal body size patterns. Four methods, Stevens’ method, the midpoint method, the across‐species method, and a phylogenetically controlled analysis (CAIC) were applied.Results As a result of the predominance of some small bodied clades at higher latitudes and some large bodied clades at lower latitudes, body size of north‐west European land snails decreases significantly with increasing latitude. However, little of the body size variation across species is explained by latitude and the phylogenetically controlled analysis showed that the decrease of body size with increasing latitude is not a result of repeated and independent evolution of an association between body size and latitude in many clades. There is no significant correlation between body size of land snail species and altitude in the Alps although a negative correlation of body size and altitude is frequent within species.Main conclusion If phylogenetic effects are controlled for, neither latitudinal nor altitudinal patterns in body size could be found. Bergmann's rule, which predicts a positive correlation between body size of species and latitude, could not be confirmed for north‐west European land snails.
Uphill shifts in distribution of butterflies in the Czech Republic: effects of changing climate detected on a regional scale
Authors: Konvicka Martin , Maradova Monika , Benes Jiri , Fric Zdenek , Kepka Pavel 
Published: August 2003

ABSTRACTAim To assess whether altitude changes in the distribution of butterflies during the second half of the 20th century are consistent with climate warming scenarios.Location The Czech Republic.Methods Distributional data were taken from a recent butterfly distribution atlas, which maps all Czech butterflies using a grid of 10′ longitude to 6′ latitude, equivalent to about 11.1 × 12 km. Cell altitude was used as an independent variable, and altitudinal ranges of individual species (less migrants, extinct species, recent arrivals and extremely rare species) in 1950–80 vs. 1995–2001 and in 1950–80, 1981–94, 1995–2001 were compared using U‐tests and linear regressions.Results Of 117 (U‐tests) and 119 (regressions) species, we found significant uphill increases in 15 and 12 species, respectively. The two groups were nested; none (U‐test) and one (regression) species showed a significant altitudinal decrease. Binomial tests of frequencies of signs of the U‐tests and regression coefficients, including nonsignificant ones, also showed that the increases prevailed. The mean and median of the significant shifts were 60 and 90 m, respectively, and the maximum shift per species was 148 m. The recording effort in individual time periods was not biased with respect to altitude.Main conclusion Altitude shifts in the distribution of Czech butterflies are already detectable on the coarse scales of standard distribution maps. The increasing species do not show any consistent pattern in habitat affiliations, conservation status and mountain vs. nonmountain distribution, which renders climatic explanation as the most likely cause of the distributional shifts.
The Early Holocene treeline in the southern French Alps: new evidence from travertine formations
Authors: Ali Adam A. , Carcaillet Christopher , Guendon Jean‐Louis , Quinif Yves , Roiron Paul , Terral Jean‐Frédéric 
Published: August 2003

ABSTRACTAims The present paper concerns the analysis of macro‐remains (plant imprints) from high altitude travertine deposits dating back to the early Holocene (9800 BP). Our results allow us to discuss treeline location and ecology, and to supplement previous data based on pollen from natural sediments and charcoal from natural soil.Location The travertine under study is located in the Queyras massif, in the southern French Alps, along the Italian border. The site is situated on a south‐facing slope.Methods The travertine deposit has been dated by 230Th/234U. Taxonomic identification of plant imprints was achieved by comparison of the morphology of fossil specimens with extant material.Results Imprints of Pinus uncinata (cones and needles), broad‐leaved trees (Betula cf. pubescens, Populus tremula and Salix spp.), and unidentified trunks have been found. The plant assemblage records the existence at a high altitude (2200 m) of shade‐intolerant vegetation at around 9800 BP. Our data indicate that the treeline limit was at least 100 m higher than previously thought. The morphological features of the travertine, the plant assemblage and trunk diameters indicate that during the travertinization process, vegetation around the site was probably dense with tall upright trees.Main conclusions Our data show that Pinus uncinata and broad‐leaved trees developed at 2200 m, while regional pollen analyses locate the treeline at lower altitudes. Different research methods appear to provide different results. Around 9800 BP tree regeneration and growth were made possible up to at least 2200 m a.s.l., probably as a result of warmer and wetter summers. Warmer conditions are inferred from the predicted increase in incoming solar radiation based on calculated orbital variations, and wetter conditions are inferred from the build‐up of the travertine.