Tag: pubmed

Arch Esp Urol. 2022 Sep;75(7):655-662. doi: 10.56434/j.arch.esp.urol.20227507.95.

ABSTRACT

INTRODUCTION: Radiotherapeutic treatment of prostate cancer has been validated in terms of efficacy, but its relationship with the occurrence of second pelvic primary malignancy and the relevance of radio-induced toxicity is still under debate. This study analyses the occurrence of second pelvic primary malignancy as well as morbidity secondary to radiotherapy treatment in patients treated for prostate cancer.

MATERIAL AND METHODS: Retrospective consecutive descriptive study of 317 patients who received radiotherapy treatment for prostate cancer between 2007 and 2017. Predictor variables, side effects and the appearance of second pelvic primary malignancy during a maximum follow-up of 10 years were collected. We analyse whether there is a significant relationship in the appearance of second pelvic primary malignancy and describe the clinical toxicity presented by the patients.

RESULTS: The median age was 62.27 years and the most commonly employed treatment modality was brachytherapy with IMRT (60%). 17 patients (5.4%) developed a second pelvic primary malignancy, with a median time to onset of 58 and 25 months for bladder and colon tumours, respectively. Local recurrence and mortality rates are 8% and 7%, respectively. Statistically significant association is demonstrated for the occurrence of second pelvic primary malignancy and for chronic radioinduced toxicity according to type of radiotherapy χ² (4) = 16.34; p = 0.003 and χ² (1) = 6.47; p = 0.011 respectively.

CONCLUSIONS: In our series, the occurrence of a second pelvic primary malignancy is statistically associated with the modality of radiotherapy administered and occurrence of chronic adverse effects.

PMID:36214149 | DOI:10.56434/j.arch.esp.urol.20227507.95

Arch Esp Urol. 2022 Sep;75(7):630-637. doi: 10.56434/j.arch.esp.urol.20227507.91.

ABSTRACT

OBJECTIVES: Knowing the incidence of prostate cancer in Salamanca and its evolution, as well as the age at diagnosis and its evolution. In addition, analyzing the mortality from prostate cancer in the province of Salamanca.

METHODS: Descriptive and analytical, longitudinal and retrospective observational study. From the collection of data from the Pathological Anatomy service and the Clinical Documentation service of the Hospital Complex of Salamanca a database was developed for the calculation of incidence rates. The information collected on mortality was obtained through the National Institute of Statistics. For regression analysis, segmented “jointpoint” models were developed.

RESULTS: 2676 males diagnosed with prostate cancer were recorded in the province of Salamanca (period 2006-2015). The risk of prostate cancer up to age 74 in 2006 was 6.23%, almost double in 2010. The evolution of mortality rates adjusted to the European population in the province of Salamanca during the period 2006-2015 showed a slight decrease.

CONCLUSIONS: In general, Prostate cancer incidence rates increased progressively over the years studied, similar to Spain’s overall rates. These rates increased as age progressed. In general, our incidence rates were lower than those reported by the provinces of northern Spain (except Vizcaya) and higher than those recorded by the provinces of southern Spain. In Europe, our rate was surpassed by countries in northern and western Europe and lower than countries in southern and eastern Europe, and part of central Europe. Countries like U.S.A had rates higher than ours, while Canada accounted for a similar rate. On the other hand, mortality rates remained stable during the middle of the study period, suffering from then on a non-statistically significant anual decrease.

PMID:36214145 | DOI:10.56434/j.arch.esp.urol.20227507.91

Arch Esp Urol. 2022 Sep;75(7):624-629. doi: 10.56434/j.arch.esp.urol.20227507.90.

ABSTRACT

OBJECTIVES: To compare the efficacy of 4 different analgesic regimens that include music and nitrous oxide during the treatment of renal lithiasis with ambulatory extracorporeal shock wave lithotripsy (ESWL).

MATERIALS AND METHODS: A single-centre, longitudinal, prospective, randomized, open and parallel group study was conducted. Patients with renal lithiasis were included and were randomized to Group A (basal analgesia: midazolam (1 mg), fentanyl (0.05 mg) and dexketoprofen (50 mg)), Group B (basal analgesia and nitrous oxide), Group C (basal analgesia and music) and Group D (basal analgesia, nitrous oxide and music). For the measurement of pain, a visual analogue scale ranging from 0 (no pain) to 100 (maximum pain imaginable) was used. Patient satisfaction was assessed using a Likert questionnaire. The epidemiological data of the patients in terms of lithiasis, previous clinical and ESWL sessions, and pain measured with the VAS before, during (maximum) at the end of the session and at discharge were recorded. Data on complications were also collected, as was the patients’ subjective evaluation of the treatment and their satisfaction. The ESWL procedure was performed with a Storz Modulith SLX-F2® lithotripter. A maximum of 4000 waves were applied at a frequency of 1.5 Hz.

RESULTS: Eighty patients were included (20 per group). None of the analgesia guidelines proved to be superior to the others for pain control during the ESWL session. Patients younger than 50 years had significantly higher values for the maximum VAS. Only 13.75% of patients required rescue analgesia. A total of 77.5% described their experience as good, very good or excellent, regardless of the assigned group.

CONCLUSIONS: The addition of nitrous oxide and/or music did not result in a statistically significant improvement over the basal analgesia regimen of midazolam, fentanyl and dexketoprofen; however, the degree of patient satisfaction was very high.

PMID:36214144 | DOI:10.56434/j.arch.esp.urol.20227507.90

Arch Esp Urol. 2022 Sep;75(7):618-623. doi: 10.56434/j.arch.esp.urol.20227507.89.

ABSTRACT

OBJECTIVES: Flexible ureteroscopic lithotripsy (FURL), as a common method for treating upper urinary tract calculi, has the risks of complications such as infection and bleeding. Especially, systemic inflammatory response syndrome (SIRS) after FURL may induce multiple organ dysfunction threatening the lives of patients. We aimed to investigate the clinical characteristics and risk factors of SIRS after FURL.

METHODS: A total of 157 upper urinary tract calculus patients treated with FURL from January 2018 to December 2019 were enrolled, and clinical outcomes and complications were analyzed. Patients were divided into SIRS group (n = 31) and non-SIRS group (n = 126) according to the presence or absence of SIRS after FURL. Their clinical data were compared by univariate analysis, and the factors with statistically significant difference were incorporated into LASSO logistic regression analysis. The model was visualized using a nomogram, and model discrimination and accuracy were verified.

RESULTS: The results of univariate analysis indicated that there were significant differences in gender, average stone size, preoperative urinary white blood cell count, surgery time and postoperative stone bacterial culture between the two groups. The results of LASSO logistic regression analysis showed that the above factors were independent risk factors for patients with SIRS. The C-index of the SIRS risk prediction model was 0.992. The area under the ROC curve of this model was 0.944 (95% CI: 0.913-0.997), the sensitivity was 97.9%, and the specificity was 95.8%. The average absolute error between actual and predicted risk probabilities was 0.028. The model for predicting the risk of SIRS had good discrimination and high consistency with the actual observed value.

CONCLUSIONS: Females, larger stones, higher preoperative urinary white blood cell count, longer surgery time and postoperative positive stone bacterial culture are independent risk factors of SIRS after FURL for upper urinary tract calculi.

PMID:36214143 | DOI:10.56434/j.arch.esp.urol.20227507.89

Eur J Ophthalmol. 2022 Oct 9:11206721221131129. doi: 10.1177/11206721221131129. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate retinal and choriocapillary vessel density (VD) changes in patients with chronic central serous chorioretinopathy (CSC) treated with half-fluence verteporfin photodynamic therapy (vPDT) or eplerenone, using optical coherence tomography angiography (OCTA).

METHODS: Patients affected by CSC and treated with vPDT and eplerenone were retrospectively studied. At baseline and 3 months after each treatment, all patients underwent a complete ophthalmological examination, including an evaluation of best-corrected visual acuity (BCVA), slit-lamp biomicroscopy, fundus examination, fluorescein angiography (FA), indocyanine green angiography (ICGA), spectral-domain optical coherence tomography (SD-OCT) and OCTA.

RESULTS: Forty-eight eyes of patients with CSC were analysed. Twenty-four eyes were placed in the vPDT group, and 24 eyes formed the eplerenone group. In both groups, OCTA showed a significant improvement in the VD of deep capillary plexus (DCP) and choriocapillaris (CC) after treatments with respect to baseline (p < 0.001), whereas the VD of superficial capillary plexus (SCP) did not show significant differences (p > 0.05). The PDT group demonstrated a statistically significant increase in the VD of DCP and CC with respect to the eplerenone group (DCP p = 0.012; CC p = 0.004). A statistically significant reduction with respect to baseline in subfoveal choroidal thickness (SFCT) (p = 0.001 for vPDT group; p = 0.001 for eplerenone group) and in central foveal thickness (CFT) (p = 0.001 for vPDT group; p = 0.001 for eplerenone group) was also found. The SFCT was significantly thinnest in the PDT group with respect to the eplerenone group (p = 0.021).

CONCLUSION: OCTA allowed us to study retinal and choriocapillary vascular changes in patients with CSC treated with vPDT and eplerenone.

PMID:36214140 | DOI:10.1177/11206721221131129

Arch Esp Urol. 2022 Sep;75(7):584-611. doi: 10.56434/j.arch.esp.urol.20227507.87.

ABSTRACT

INTRODUCTION AND OBJECTIVES: Multiple chemical sensitivity (MCS) is a complex disease with multiorgan manifestations, some of which are still poorly understood, such as genitourinary manifestations. The objective of this article is to review these genitourinary manifestations.

MATERIAL AND METHODS: A retrospective descriptive study on the genitourinary manifestations described in patients with multiple chemical sensitivity is performed, based on a systematic review of the literature between February 1956 and December 2020, consulting the Medline/PubMed database and the Google search engine. Descriptive statistics of the variables studied were performed with frequency and percentage for qualitative variables and median and range (minimum-maximum value) for quantitative variables.

RESULTS: We reviewed the originals or abstracts of 3450 articles on MCS, including 461 on symptoms (13.3%) and selecting 40 (1.1%) that referred to genitourinary pathologies or symptoms and corresponded to 19 reviews, 14 articles on case reports (11 clinical cases and 3 series), 5 books with case reports, 1 consensus document and 1 update. The number of patients with MCS studied in these 40 articles was 4556 of whom 303 presented genitourinary symptoms (6.6%), and corresponded to 277 women (91.4%) and 27 men (8.6%) with a mean age of 39.4 years, range (7-82 years). There were 119 different genitourinary symptoms or pathologies with 170 citations which in frequency were 77 for gynecological symptoms (45.3%) in 28 publications (70%), 62 for urological symptoms (36.5%) in 29 publications (72.5%), 18 for sexological symptoms (10.6%) in 8 publications (20%) and 13 for andrological symptoms (7.6%) in 5 publications (12.5%).

CONCLUSIONS: Genitourinary manifestations of MCS are rare and predominantly in women. They constitute a genitourinary syndrome including gynecological, urological, sexological and andrological symptoms. Until today there has been no study of these symptoms in the medical literature.

PMID:36214141 | DOI:10.56434/j.arch.esp.urol.20227507.87

Lupus. 2022 Oct 8:9612033221132484. doi: 10.1177/09612033221132484. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study was to evaluate the effects of the high mobility group box protein 1 (HMGB1) serum and urinary levels and gene polymorphisms on systemic lupus erythematosus (SLE) development and investigate their link to lupus nephritis (LN).

METHODS: We enrolled 120 Egyptian SLE patients and 120 healthy controls. Thorough medical and clinical evaluation were carried out, and SLE disease activity index (SLEDAI) was assessed. Lupus patients were divided into two groups according to the presence of LN. Measurement of HMGB1 serum and urinary levels was done using ELISA and genotyping for HMGB1 (rs1045411) was performed.

RESULTS: There were statistically significantly higher HMGB1 serum and urinary levels in SLE patients (p < 0.001). There was a marginally significant association between lupus and alleles (p = 0.059, φ = -0.086). ‘C’ allele was marginally significant risk allele for SLE. After classifying SLE patients based on the presence or absence of LN, there was no significant difference as regard sex (p = 0.387), age (p = 0.208) and disease duration (p = 0.094).However, there was a significant difference between the 2 groups in regard to the frequency of musculoskeletal manifestations (p = 0.035), SLEDAI score (p < 0.001), both serum (p < 0.001) and urinary HMGB1 levels (p < 0.001) in addition to the frequency of HMGB1 genotypes (p = 0.003). Lupus patients with C/T-T/T HMGB1 genotypes had 3.5-times higher odds to exhibit LN.

CONCLUSIONS: Serum and urine HMGB1 measurements are helpful in the diagnosis of SLE and the prediction of LN. There is a link between HMGB1 gene variations and the risk of SLE, with evidence that the C/T-T/T HMGB1 genotype is linked to a significantly greater risk of LN in the Egyptian population.

PMID:36214106 | DOI:10.1177/09612033221132484

Epilepsia Open. 2022 Oct 10. doi: 10.1002/epi4.12657. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate and analyze the etiology and prognosis of patients with new-onset status epilepticus (NOSE).

METHODS: We conducted a retrospective analysis of all adult patients (≧16 years old) who were admitted to Sichuan Provincial People’s Hospital between January 2018 and December 2020 with status epilepticus and no prior epilepsy history.

RESULTS: We collected data from 85 patients, aged from 16 to 90 years, of whom 49 were male and 36 were female. 55 of these cases (64.7%) were younger than 60 years of age. Acute symptomatic SE was mostly seen in the NOSE (53.9%), followed by unknown SE(25.9%), progressive SE (11.8%), and remote SE(9.4%). The differences in the etiology of NOSE between age groups were statistically significant (P<0.05). For the young, the main etiology remained unknown (36.3%), followed by autoimmune-related SE (16.4%); in the elderly, the primary etiology was central nervous system infection (23.3%), followed by cerebrovascular disease (20%), and intracranial tumors ( 20%). Normal imaging was mostly seen in young people with NOSE (P<0.001). Regarding outcome parameters and risk factors in patients with NOSE, adverse outcome was associated with age (OR=3.5, 95%CI=0.108-0.758, P=0.012) , co-infection (OR=4.5, 95%CI=0.083-0.599, P=0.003 ), and tracheal intubation (OR=6.318, 95%CI=0.060-0.204, P=0.011).

SIGNIFICANCE: In our cohort, intracranial tumors, central nervous system infections, and cerebrovascular disease were the predominant causes of NOSE in the elderly, while autoimmune encephalitis was the largest recognized cause of NOSE in young patients. In addition, imaging varies with age. According to the data, preventing infections may enhance patient prognosis because greater infection rates are connected with less favorable results. Meanwhile, age and mechanical ventilation are related to the prognosis of NOSE.

PMID:36214088 | DOI:10.1002/epi4.12657

Child Maltreat. 2022 Oct 10:10775595221125454. doi: 10.1177/10775595221125454. Online ahead of print.

ABSTRACT

This study investigated whether statewide delivery of the wraparound service model (WSM) improved child and caregiver outcomes and reduced subsequent child protective service (CPS) contact among families referred to services following a CPS report. Caregivers (n = 247) completed baseline and 6-month interviews to document self-reported engagement in WSM and non-WSM conditions and assess changes in outcomes. Kernel-weighted difference-in-difference (K-DID) models were used to assess program effects, based on reported condition. Child behavior outcomes improved among WSM-engaged families, but differences by condition were non-significant except for internalizing behaviors. Caregiver receipt of WSM was associated with greater retention of behavioral health services, but did not produce statistically significant improvements in their wellbeing. Households in the WSM condition were more likely to be reported to CPS at 6-month follow-up, but this difference was not significant at 12 months and differences in substantiation were not statistically significant. Supplemental analyses compared alternative means of contrasting group effects, highlighting some differences based on method. The WSM produced few significant differential improvements in child or caregiver outcomes and failed to prevent future CPS involvement. Inadequate program fidelity appeared to be a factor in implementation of the WSM, which may have hampered program effectiveness under real-world conditions.

PMID:36214073 | DOI:10.1177/10775595221125454

Mol Nutr Food Res. 2022 Oct 10:e2200145. doi: 10.1002/mnfr.202200145. Online ahead of print.

ABSTRACT

SCOPE: Consumption of meat has been associated with a higher risk of type 2 diabetes (T2D), but if plasma metabolite profiles associated with these foods reflect this relationship is unknown. The objective was to identify a plasma metabolite signature of consumption of total meat (TM), red meat (RM), processed red meat (PRM), and fish, and to examine if they are associated with the risk of T2D.

METHODS AND RESULTS: The discovery population includes 1833 participants from the PREDIMED trial. The internal validation sample included 1522 of these participants with available 1-year follow-up metabolomic data. Cross-sectional associations between metabolites and TM, RM, PRM, and fish were evaluated with continuous elastic net regression. Prospective associations between the identified profiles and incident T2D were estimated using Cox regressions. The metabolite profiles included 72 metabolites for TM, 69 metabolites for RM, 74 metabolites for PRM, and 66 metabolites for fish. After adjusting for T2D risk factors, only the metabolite profiles of TM (HR: 1.25, 95%CI:1.06,1.49), RM (HR: 1.27, 95%CI:1.07,1.52) and PRM (HR: 1.27, 95%CI:1.07,1.51) were associated with T2D.

CONCLUSIONS: The consumption of total meat, its subtypes, and fish was associated with different metabolites, some of which have been previously associated with T2D. Scores based on the identified metabolites for TM, RM, and PRM showed a significant association with the risk of T2D in a Mediterranean population at high cardiovascular risk. This article is protected by copyright. All rights reserved.

PMID:36214069 | DOI:10.1002/mnfr.202200145