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https://www.readbyqxmd.com/read/28426464/comparative-effectiveness-in-urology-a-state-of-the-art-review-utilizing-a-systematic-approach
#1
Jathin Bandari, Charles B Wessel, Bruce L Jacobs
PURPOSE OF REVIEW: Comparative effectiveness research plays a vital role in healthcare delivery by guiding evidence-based practices. We performed a state-of-the-art review of comparative effectiveness research in the urology literature for 2016, utilizing a systematic approach. Seven high-impact papers are reviewed in detail. RECENT FINDINGS: Across the breadth of urology, there were several important studies in comparative effectiveness research, of which we will highlight two randomized controlled trials and five observational trials: radiotherapy, prostatectomy, and active monitoring have equivalent mortality outcomes in patients with localized prostate cancer; the ideal modality of patient education is yet to be determined, and written education has minimal effect on patient perception of prostate specific antigen screening; robotic prostatectomy is associated with higher perioperative complication rates on a population basis; racial disparities exist in incontinence rates after treatment for localized prostate cancer, but not in irritative, bowel, or sexual function; androgen deprivation therapy is associated with higher fracture, peripheral artery disease, and cardiac-related complications than bilateral orchiectomy; robotic and open cystectomy offer comparable cancer-specific mortality and perioperative outcomes; and bonuses for low-cost hospitals can inadvertently reward low-quality hospitals...
April 19, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28416195/pitavastatin-versus-pravastatin-in-adults-with-hiv-1-infection-and-dyslipidaemia-intrepid-12-week-and-52-week-results-of-a-phase-4-multicentre-randomised-double-blind-superiority-trial
#2
Judith A Aberg, Craig A Sponseller, Douglas J Ward, Vladimir A Kryzhanovski, Stuart E Campbell, Melanie A Thompson
BACKGROUND: People living with HIV-1 infection are at greater risk for cardiovascular disease than seronegative adults. Treatment of dyslipidaemia with statins has been challenging in people with HIV because of an increased potential for drug interactions due to competing cytochrome P450 metabolism between statins and commonly used antiretroviral agents. Neither pitavastatin nor pravastatin depend on cytochrome P450 for primary metabolism. We aimed to assess the safety and efficacy of pitavastatin versus pravastatin in adults with HIV and dyslipidaemia...
April 13, 2017: Lancet HIV
https://www.readbyqxmd.com/read/28396191/prostate-artery-embolization-via-transradial-or-transulnar-versus-transfemoral-arterial-access-technical%C3%A2-results
#3
Shivank Bhatia, Sardis H Harward, Vishal K Sinha, Govindarajan Narayanan
PURPOSE: To compare safety and feasibility of prostate artery embolization (PAE) via transradial/transulnar access (TR/UA) and transfemoral access (TFA). MATERIALS AND METHODS: A retrospective analysis was conducted for 3 cohorts: the first 32 consecutive PAE procedures performed via TFA (initial TFA, January 2014 to August 2015), the following 32 procedures performed via TFA (advanced TFA, August 2015 to February 2016), and the first 32 procedures performed via TR/UA (February 2016 to July 2016)...
April 7, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28394524/-x-ray-guided-endovascular-surgery-in-patients-with-benign-prostatic-hyperplasia-and-prostate-cancer
#4
A I Neimark, M A Tachalov, B A Neimark, D V Torbik, D D Arzamastsev
AIM: To evaluate the efficacy and safety of superselective embolization and chemoembolization of the prostatic artery as an independent method of treating prostate cancer and BPH. MATERIALS AND METHODS: From 2004 to 2015, 116 patients with BPH (mean age 73.2+/-5.2 years) underwent prostatic artery embolization. Mean prostate volume ranged from 55 to 296 cc3. From 2011 to 2015, 37 patients with prostate cancer (mean age 72.3+/-2.06 years) were treated with X-ray-guided endovascular chemoembolization...
April 2017: Urologii︠a︡
https://www.readbyqxmd.com/read/28382905/hematospermia-a-symptom-with-many-possible-causes
#5
Michael J Mathers, Stefan Degener, Herbert Sperling, Stephan Roth
BACKGROUND: Hematospermia, or blood in the ejaculate, is a symptom with many possible causes that often gives rise to worry. Precise figures on its prevalence are unavailable. It is most common in men under 40, and its cause is usually benign; nonetheless, even a single episode of hematospermia calls for a basic diagnostic evaluation. METHODS: This review is based on pertinent articles re trieved by a search in PubMed with the key words "hemato spermia," "hemospermia," "ejaculation," "male semen," and "transrectal ultrasound...
March 17, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28356203/variation-in-patients-travel-times-among-imaging-examination-types-at-a-large-academic-health-system
#6
Andrew B Rosenkrantz, Yu Liang, Richard Duszak, Michael P Recht
RATIONALE AND OBJECTIVES: Patients' willingness to travel farther distances for certain imaging services may reflect their perceptions of the degree of differentiation of such services. We compare patients' travel times for a range of imaging examinations performed across a large academic health system. MATERIALS AND METHODS: We searched the NYU Langone Medical Center Enterprise Data Warehouse to identify 442,990 adult outpatient imaging examinations performed over a recent 3...
March 27, 2017: Academic Radiology
https://www.readbyqxmd.com/read/28335793/thrombus-leukocytes-exhibit-more-endothelial-cell-specific-angiogenic-markers-than-peripheral-blood-leukocytes-do-in-acute-coronary-syndrome-patients-suggesting-a-possibility-of-trans-differentiation-a-comprehensive-database-mining-study
#7
Hangfei Fu, Nish Vadalia, Eric R Xue, Candice Johnson, Luqiao Wang, William Y Yang, Claudette Sanchez, Jun Nelson, Qian Chen, Eric T Choi, Jian-Xing Ma, Jun Yu, Hong Wang, Xiaofeng Yang
BACKGROUND: Current angiogenic therapies for cancers and cardiovascular diseases have not yet achieved expected benefits, which reflects the need for improved understanding of angiogenesis. In this study, we focused on solving the problem of whether tissues have different angiogenic potentials (APs) in physiological conditions and how angiogenesis is regulated in various disease conditions. METHODS: In healthy and diseased human and mouse tissues, we profiled the expression of 163 angiogenic genes, including transcription regulators (TRs), growth factors and receptors (GF/Rs), cytokines and chemokines (C/Cs), and proteases and inhibitors (P/Is)...
March 23, 2017: Journal of Hematology & Oncology
https://www.readbyqxmd.com/read/28324340/quantitative-18-f-fluorocholine-positron-emission-tomography-for-prostate-cancer-correlation-between-kinetic-parameters-and-gleason-scoring
#8
Joshua J D Schaefferkoetter, Ziting Wang, Mary C Stephenson, Sharmili Roy, Maurizio Conti, Lars Eriksson, David W Townsend, Thomas Thamboo, Edmund Chiong
BACKGROUND: The use of radiolabeled choline as a positron emission tomography (PET) agent for imaging primary tumors in the prostate has been evaluated extensively over the past two decades. There are, however, conflicting reports of its sensitivity and the relationship between choline PET imaging and disease staging is not fully understood. Moreover, relatively few studies have investigated the correlation between tracer uptake and histological tumor grade. This work quantified (18)F-fluorocholine in tumor and healthy prostate tissue using pharmacokinetic modeling and stratified uptake parameters by histology grade...
December 2017: EJNMMI Research
https://www.readbyqxmd.com/read/28284886/role-of-coil-embolization-during-prostatic-artery-embolization-incidence-indications-and-safety-profile-%C3%A2
#9
Shivank Bhatia, Vishal Sinha, Matthew Bordegaray, Issam Kably, Sardis Harward, Govindarajan Narayanan
PURPOSE: To determine if coil embolization is a safe adjunctive measure to prevent nontarget embolization during prostatic artery embolization (PAE). MATERIALS AND METHODS: A retrospective analysis of patients who underwent PAE with coil embolization (cPAE) or without coil embolization (nPAE) between January 2014 and June 2016 was conducted. Adverse events, identified in accordance with SIR guidelines, and procedural variables were compared between the 2 cohorts...
March 8, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28259503/radiation-exposure-of-patients-and-interventional-radiologists-during-prostatic-artery-embolization-a-prospective-single-operator-study
#10
Gustavo Andrade, Helen J Khoury, William J Garzón, Felipe Dubourcq, Michel F Bredow, Lucas M Monsignore, Daniel G Abud
PURPOSE: To prospectively analyze the radiation exposure of patients and interventional radiologists during prostatic artery embolization (PAE). MATERIALS AND METHODS: Twenty-five consecutive PAE procedures performed with an Artis zee system in a single center by an interventional radiologist were prospectively monitored. The mean age, weight, and prostate volume of the patients were 65.7 year (range, 43-85 y), 71.4 kg (range, 54-88 kg), and 79 cm(3) (range, 36-157 cm(3)), respectively...
March 2, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28248038/-alterations-in-blood-circulation-of-vesicourethral-segment-in-men-with-neurogenic-and-non-neurogenic-lower-urinary-tract-symptoms
#11
Yu G Alayev, Yu M Esilevskiy, T E Shmidt, Yu L Demidko, D N Fiev, K Yu Kazantsev
AIM: To specify the pathogenetic link between blood supply of the bladder neck and lower urinary tract symptoms (LUTS). MATERIAL AND METHODS: The study involved 78 men aged 26 to 50 years, including 19 patients with multiple sclerosis (MS) and LUTS, 29 patients with chronic prostatitis category IIIB with LUTS and 30 patients with chronic prostatitis category IIIB without LUTS (control group). All the patients underwent Doppler ultrasonography of prostatic arteries and selective study of blood flow in the neck of the bladder...
December 2016: Urologii︠a︡
https://www.readbyqxmd.com/read/28228874/embolization-of-prostatic-brachytherapy-seeds-to-pulmonary-arteries-a-case-study
#12
Alexander D Calvert, Andrew W Dyer, Van A Montgomery
Pulmonary seed embolization is a complication of prostatic brachytherapy with varying incidence rates. Key factors that reportedly influence the incidence of seed embolization include planning volume, quantity of seeds, seed placement, and type of seeds (stranded vs free). The clinical implications of seed migration are unclear because sequelae were not demonstrated in multiple short-term studies yet there have been several reports of long-term complications. We report a case of a 56-year-old patient who presented with dyspnea approximately 6 years after brachytherapy treatment for a very low-risk prostate cancer...
March 2017: Radiology case reports
https://www.readbyqxmd.com/read/28208186/comparison-of-patient-report-and-medical-records-of-comorbidities-results-from-a-population-based-cohort-of-patients-with-prostate-cancer
#13
Fan Ye, Dominic H Moon, William R Carpenter, Bryce B Reeve, Deborah S Usinger, Rebecca L Green, Kiayni Spearman, Nathan C Sheets, Kevin A Pearlstein, Angela R Lucero, Mark R Waddle, Paul A Godley, Ronald C Chen
Importance: The comorbid conditions of patients with cancer affect treatment decisions, which in turn affect survival and health-related quality-of-life outcomes. Comparative effectiveness research studies must account for these conditions via medical record abstraction or patient report. Objective: To examine the agreement between medical records and patient reports in assessing comorbidities. Design, Setting, and Participants: Patient-reported information and medical records were prospectively collected as part of the North Carolina Prostate Cancer Comparative Effectiveness & Survivorship Study, a population-based cohort of 881 patients with newly diagnosed localized prostate cancer enrolled in the North Carolina Central Cancer Registry from January 1, 2011, through June 30, 2013...
February 16, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28194505/adenomatous-dominant-benign-prostatic-hyperplasia-adbph-as-a-predictor-for-clinical-success-following-prostate-artery-embolization-an-age-matched-case-control-study
#14
M W Little, P Boardman, A C Macdonald, N Taylor, R Macpherson, J Crew, C R Tapping
PURPOSE: To investigate the clinical impact of performing prostate artery embolization (PAE) on patients with adenomatous-dominant benign prostatic hyperplasia (AdBPH). MATERIALS AND METHODS: Twelve patients from the ongoing proSTatic aRtery EmbolizAtion for the treatMent of benign prostatic hyperplasia (STREAM) trial were identified as having AdBPH; defined as two or more adenomas within the central gland of ≥1 cm diameter on multi-parametric MRI (MP-MRI). These patients were age-matched with patients from the STREAM cohort, without AdBPH...
February 13, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28182304/benign-prostatic-hyperplasia-after-prostatic-arterial-embolization-in-a-canine-model-a-3t-multiparametric-mri-and-whole-mount-step-section-pathology-correlated-longitudinal-study
#15
Basen Li, Anhui Xu, Nan Wang, Xiangde Min, Zhaoyan Feng, Ming Deng, Liang Li, Jie Cai, Zhen Kang, Kehua Jiang, Dong Kuang, Liang Wang
PURPOSE: To explore the morphological and functional characteristics of prostatic arterial embolization (PAE) in a canine model of benign prostatic hyperplasia (BPH) with 3T multiparametric magnetic resonance imaging (mp-MRI) and whole-mount step-section pathology correlation. MATERIALS AND METHODS: Eight adult male beagle dogs with hormone-induced BPH underwent 3T mp-MRI before and 1, 3, and 6 months after PAE, with subsequent whole-mount step-section pathologic assessment...
February 9, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28175975/prostatic-tissue-elimination-after-prostatic-artery-embolization-pae-a-report-of-three-cases
#16
Leandro Cardarelli Leite, Andre Moreira de Assis, Airton Mota Moreira, Sardis Honoria Harward, Alberto Azoubel Antunes, Francisco Cesar Carnevale
PURPOSE: We report three cases of spontaneous prostatic tissue elimination through the urethra while voiding following technically successful prostatic artery embolization (PAE) as a treatment for lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH). METHODS: All patients were embolized with 100- to 300-μm microspheres alone or in combination with 300- to 500-μm microspheres. RESULTS: During follow-up prior to eliminating the tissue fragments, the three patients all presented with intermittent periods of LUTS improvement and aggravation...
February 7, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28133345/-introduction-of-hyperthermia-therapy-with-low-dose-systemic-chemotherapy-and-hepatic-transarterial-chemo-embolization-for-a-case-of-advanced-prostatic-cancer
#17
Atsushi Hori, Takeo Yuki, Keita Yamashiro, Ryosuke Ohira, Shinichi Hori
The case of a 78-year-old man with hormone-independent locally advanced prostatic cancer with liver metastases is reported. Standard systemic chemotherapy was not administered due to his poor general condition. At the initial consultation, rapidly growing liver metastases, multiple lymph node metastases, and extensive locally advanced prostatic lesions were found. Transcatheter arterial chemoembolization, low dose systemic chemotherapy, and thermotherapy were administered. After introduction of this combination therapy, marked regression of all of the lesions, including the liver metastases, lymph node metastases, and pelvic extension was observed...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28130568/prostatic-artery-embolization-as-an-alternative-to-indwelling-bladder-catheterization-to-manage-benign-prostatic-hyperplasia-in-poor-surgical-candidates
#18
Antonio Rampoldi, Fabiane Barbosa, Silvia Secco, Carmelo Migliorisi, Antonio Galfano, Giovanni Prestini, Sardis Honoria Harward, Dario Di Trapani, Pietro Maria Brambillasca, Vercelli Ruggero, Marco Solcia, Francisco Cesar Carnevale, Aldo Massimo Bocciardi
PURPOSE: To prospectively assess discontinuation of indwelling bladder catheterization (IBC) and relief of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) following prostate artery embolization (PAE) in poor surgical candidates. METHODS: Patients ineligible for surgical intervention were offered PAE after at least 1 month of IBC for management of urinary retention secondary to BPH; exclusion criteria for PAE included eligibility for surgery, active bladder cancer or known prostate cancer...
January 27, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28110760/prostatic-arterial-embolization-for-control-of-hematuria-in-patients-with-advanced-prostate-cancer
#19
Jhih-Wei Chen, Ji Hoon Shin, Teng-Fu Tsao, Heung-Gyu Ko, Hyun-Ki Yoon, Ki-Chang Han, Somrach Thamtorawat, Bumsik Hong
Nine patients with advanced prostate cancer (stage T4) underwent prostatic arterial embolization (PAE) for refractory prostatic hematuria. Angiograms showed prostatic neovascularity in all cases, and complete PAE was achieved in 8 cases (89% technical success rate). Gross hematuria ceased after PAE in 6 cases, translating to a 67% clinical success rate. There were no PAE-related complications. At 3-month follow-up, 2 cases showed recurrent hematuria, 4 patients had died from PAE-unrelated etiologies, and only 3 patients survived and were without gross hematuria...
February 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28074310/recurrence-of-lower-urinary-tract-symptoms-following-prostate-artery-embolization-for-benign-hyperplasia-single-center-experience-comparing-two-techniques
#20
Francisco Cesar Carnevale, Airton Mota Moreira, Sardis Honoria Harward, Shivank Bhatia, Andre Moreira de Assis, Miguel Srougi, Giovanni Guido Cerri, Alberto Azoubel Antunes
PURPOSE: To compare recurrence of lower urinary tract symptoms (LUTS) recurrence at 12 months following original prostate artery embolization (oPAE) or "proximal embolization first, then embolize distal" (PErFecTED) PAE for benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: 105 consecutive patients older than 45 years, with prostate size greater than 30 cm(3), International Prostate Symptom Score (IPSS) ≥ 8, quality of life (QoL) index ≥ 3, and refractory status or intolerance of medical management were prospectively enrolled between June 2008 and August 2013...
March 2017: Cardiovascular and Interventional Radiology
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