Tag: pubmed

Arch Ital Urol Androl. 2021 Jun 28;93(2):178-183. doi: 10.4081/aiua.2021.2.178.

ABSTRACT

OBJECTIVES: To assess the course of functional and morphological recovery of the kidney following the relief of obstruction with ureteral JJ stent in cases with unilateral impacted stones.

MATERIALS AND METHODS: A total of 42 adult patients who were admitted to our clinic with unilateral obstructing impacted ureteral stones requiring JJ stent placement were included in the study. The course of functional recovery was assessed by evaluating the serum creatinine levels, renal resistive index (RRI) values and urinary levels of kidney injury molecule-1, neutrophil gelatinaseassociated lipocalin as well as microalbumin before at 1 day, 1 week and 4 weeks after JJ stent placement. Course of morphologic recovery was evaluated by evaluating the degree of hydronephrosis, kidney size, perirenal straining and ureteral diameter.

RESULTS: Our results showed that all relevant parameters began to decrease after 24 hours and continue to normalize during 1 week evaluation; majority of these variables indicating the functional and morphological recovery were in normal range after 4 weeks. Decompression of the obstructed kidneys with JJ stent placement in patients with impacted ureteral stones was found to be effective enough with recovery of normal renal functional and morphological status after a minimum time period of 4 weeks. Morphological recovery of affected kidneys following JJ stenting was obtained with a significant difference between baseline and 1-month evaluation findings (p = 0.001, p < 001, p < 001, respectively). KIM-1 excretion began to decline to normal levels after 4 weeks (3.52 ± 0.99 ng/ml versus 2.84 ± 0.66 ng/ml, p < 0.001). The same findings were observed for the urinary excretion levels of NGAL, which normalized at the 1-month evaluation (604.55 ± 140.28 ng/ml versus 596.87 ± 80.17 ng/ml p = 0.895). Urinary microalbumin excretion levels however remained high even until 1-month follow-up with a statistically significant difference when compared with the normal excretion values (p < 0.001). There was a statistically significant difference in RRI values between baseline and 1-month follow-up findings in obstructed kidney (p < 0.001).

CONCLUSIONS: Elective management of the obstructing impacted ureteral stone(s) will be safer with limited risk of infective complications after functional and morphological normalization in such kidneys following 4 weeks of JJ stent placement.

PMID:34286552 | DOI:10.4081/aiua.2021.2.178

Arch Ital Urol Androl. 2021 Jun 28;93(2):211-214. doi: 10.4081/aiua.2021.2.211.

ABSTRACT

INTRODUCTION: The aim of the study is to evaluate the effectiveness of a Multi-disciplinary team (MDT) and multi-disciplinary approach in the treatment of Chronic Pelvic Pain (CPP).

METHODS: The data of all consecutive patients referred for a CPP from 11/2016 to 2/2019 has been prospectively collected. The sample was divided in two groups: Group A, made by patients managed after the institution of our MDT, and Group B, made of patients managed before this date. The MDT is composed by three urogynecologists, a psychologist and a physiotherapist. All Group A patients underwent a weekly bladder instillation with dimethyl sulfoxide (DMSO), kinesiotherapy for trigger points and Percutaneous Tibial Nerve Stimulation for 10 consecutive weeks. Patients were asked to perform a self-treatment following the Stanford Protocol and to adhere to a specific diet. All Group B patients were managed only with DMSO instillations and a strict diet.

RESULTS: The Group A was made of 41 females and 6 males while the Group B was made of 38 females and 5 males. The Group A patients showed a statistically significant improvement in the Pelvic Pain Urgency Frequency, in the frequency times reported at the 6 months voiding diary, and a better Patient Global Impression of Improvement.

CONCLUSIONS: Our data support the efficacy of the MDT in the management of CPP. The multimodal approach might represent an effective and reproducible non-invasive option to manage successfully CPP.

PMID:34286558 | DOI:10.4081/aiua.2021.2.211

Arch Ital Urol Androl. 2021 Jun 28;93(2):173-177. doi: 10.4081/aiua.2021.2.173.

ABSTRACT

BACKGROUND: Miniaturization of endoscopic instruments in percutaneous nephrolithotomy (PCNL) allowed less invasive procedures with low complication rates, especially in children. This study was conducted to evaluate the safety and efficacy of ultrasonography-guided (USG) versus fluoroscopy-guided (FG) mini-PCNL in children.

MATERIALS AND METHODS: This is a retrospective comparative study conducted from June 2015 to June 2020. The sample included 70 children (35 pateints underwent USG mini-PCNL and 35 pateints underwent FG mini-PCNL). They were compared mainly by the patients’ demographic characteristics, procedural information, and post-treatment outcomes. In the USG mini-PCNL group, puncturing was performed using a 3.5 MHz US probe, whereas fluoroscopy was utilized in the FG mini- PCNL group.

RESULTS: Both groups were comparable in terms of gender, previous history of failed ESWL, and hydronephrosis grade. The mean stone burden was 15.94 ± 3.69 mm and 19.20 ± 7.41 mm in USG and FG groups, respectively (p = 0.024). The stonefree rate (SFR) was 97.1% in the USG group and 94.3% in the FG group, which was not statistically significant (p = 0.16). Mean operative time in the USG group and FG group was 69.00 ± 13.33 minutes and 63.48 ± 16.90 minutes, respectively. Four (11.4%) patients in the FG group required blood transfusions to restore the hemodynamic state (p = 0.039). Fever was detected in 4 (11.4%) patients in the USG group and 15 (31.4%) patients in the FG group (p = 0.041).

CONCLUSIONS: In children, mini PCNL under USG is safe and as effective as fluoroscopy.

PMID:34286551 | DOI:10.4081/aiua.2021.2.173

J Endocr Soc. 2021 Jun 19;5(9):bvab114. doi: 10.1210/jendso/bvab114. eCollection 2021 Sep 1.

ABSTRACT

CONTEXT: Women with polycystic ovary syndrome (PCOS) have increased incidence of atherogenic dyslipidemia and cardiovascular disease (CVD). Interventions targeting atherogenic dyslipidemia to reduce CVD risk are limited in women with PCOS.

OBJECTIVE: This pilot study was conducted to determine the effect of 12 weeks of high dose fish oil (FO), metformin, and FO as an adjunct to metformin (FO-metformin) therapy on fasting and nonfasting plasma lipids and ApoB-remnants in young women with the metabolic syndrome (MetS) and PCOS.

METHODS: In this open-label parallel pilot trial, women with MetS and PCOS (18-30 years of age) were randomized into 1 of 3 interventions: (1) FO; (2) metformin; and (3) FO-metformin. Plasma lipids and ApoB (48 and 100)-lipoproteins and triglycerides (TG) were measured in the fasted and postprandial state following a high-fat meal at baseline and postintervention.

RESULTS: FO-metformin significantly lowered fasting plasma TG by >40% compared with FO and metformin treatments. Fasting plasma apoB48 was lowered 40% in FO-metformin and 15% in the FO groups from baseline to postintervention. ApoB48 area under the curve (ApoB48_AUC), ApoB48 incremental AUC (ApoB48_iAUC), ApoB100_AUC, and ApoB100_iAUC decreased in all groups from baseline to postintervention; however, these findings did not reach statistical significance.

CONCLUSION: The findings of this pilot trial show that high dose FO and FO-metformin combination therapy tend to lower fasting and postprandial plasma TG and ApoB-lipoprotein remnants compared with metformin; however, the study is limited by small sample size. These results may be clinically significant in individuals with PCOS for management of atherogenic dyslipidemia.

PMID:34286169 | PMC:PMC8282216 | DOI:10.1210/jendso/bvab114

Contemp Clin Trials Commun. 2021 Jul 2;23:100815. doi: 10.1016/j.conctc.2021.100815. eCollection 2021 Sep.

ABSTRACT

INTRODUCTION: The German Commission for Hospital Hygiene and Infection Prevention recommends nominating one authorized medical specialist in every medical department as an infection prevention link physician (PLP). It has been roughly described that a PLP serves as a link between the infection prevention team and the respective clinical departments. No detailed evidence about the contribution made by PLPs to the decrease of infection rates is available in Germany. The “HygArzt” project aims to demonstrate the medical and economic benefits of the implementation of hygiene measures by PLP in trauma surgery/orthopedics.

METHODS: A multicenter interventional pre/post cohort study design was chosen. The study will run for a three-year period, including a pre-, post-, and an intervention phase, in four different hospitals, one of which will serve as pilot. A complex intervention containing evidence-based infection control measures will be developed and implemented by a PLP to proof efficacy. After the successful implementation of the preventive measures in the pilot hospital, the concept will be transposed to the three remaining trauma and orthopedic departments to confirm the transferability and generalizability. To enable the PLPs of the non-pilot departments, a subject-specific training program will be developed based on the study results of the pilot hospital and offered to the PLPs.

DISCUSSION: Data are intended to provide evidence that and, if so, to which extent the implementation of specific preventive measures by a medical department-specific PLP is possible and results in a reduction of nosocomial infections in orthopedic surgery and traumatology.

CONTRIBUTION TO THE LITERATURE: The present study describes a novel complex study design to prove the effectiveness of intervention measures for infection prevention. The study design and newly developed methodological approach could serve as a model for similar studies on infection prevention in the future. For the first time, the presented research project “HygArzt” focuses on the implementation of hygiene measures by an infection prevention link physician (PLP) and investigates whether nosocomial infections, especially surgical site infections, can be reduced by the measures implemented.

TRIAL REGISTRATION: German clinical Trials register DRKS-ID:00013,296. Registered on March 5, 2018, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00013296.

PMID:34286158 | PMC:PMC8274293 | DOI:10.1016/j.conctc.2021.100815

Heliyon. 2021 Jul 5;7(7):e07486. doi: 10.1016/j.heliyon.2021.e07486. eCollection 2021 Jul.

ABSTRACT

In this study, the age-dependent variations in haematological and serum biochemical parameters of domestic pigeons were evaluated. Sixty apparently healthy domestic pigeons comprising 30 young (2-7 weeks of age) and 30 adult (>7 weeks of age) were sampled from local breeders. Blood was collected from each bird via brachial venipuncture and divided into 2 parts; one part dispensed into labeled tubes containing ethylenediaminetetraacetic acid as anticoagulant was processed for haematological analyses. The other part was dispensed into labeled plain tubes, serum harvested and processed for serum biochemical analyses. Results revealed overall packed cells volume (PCV), haemoglobin concentration (HGB) and red blood cells (RBC) of 42.97 ± 4.53%, 13.15 ± 1.82 g/dL and 3.63 ± 0.50 × 10¹²/L respectively. All haematological parameters except mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC) and lymphocyte count showed statistical (p < 0.05) differences between young and adult pigeons. Values recorded for serum total protein, albumin, globulin, serum/albumin ratio, urea, creatinine and urea/creatinine ratio were 4.32 ± 0.74 g/dL, 2.07 ± 0.30 g/dL, 2.25 ± 0.74 g/dL, 1.04 ± 0.43, 0.48 ± 0.33 mg/dL, 0.75 ± 0.52 mg/dL and 0.73 ± 0.51 respectively. Serum urea and creatinine concentrations were significantly (p < 0.05) higher in adult (0.62 ± 0.40; 1.04 ± 0.60 mg/dL) compared to young (0.34 ± 0.13; 0.47 ± 0.15 mg/dL) pigeons. This study therefore demonstrated age-dependent variations in haematological and serum biochemical parameters of domestic pigeons.

PMID:34286143 | PMC:PMC8273409 | DOI:10.1016/j.heliyon.2021.e07486

Clin Transl Radiat Oncol. 2021 Jul 4;30:26-30. doi: 10.1016/j.ctro.2021.06.010. eCollection 2021 Sep.

ABSTRACT

BACKGROUND: Radiotherapy plays an important role for symptom control in advanced stage cancer patients. Yet patients need to be carefully selected, and its use and benefits must be weighed against time spent under treatment and patient priorities in the last phase of life. In this study, we assess prevalence, indications and outcomes of radiotherapy close to death.

METHODS: We screened all radiotherapy treatments performed at the Department of Radiation Oncology of the University Hospital Zurich between January 2010 and December 2019 to identify those which occurred near patients’ end-of-life. Analyzed data was extracted from the database of the Comprehensive Cancer Center Zurich, the treatment planning system Aria® and the electronical medical records system KISIM®.

RESULTS: Within 60 days of death, 377 radiotherapy courses were prescribed to 280 patients, which constitutes 3.4% of all radiotherapy courses administered over the last decade at our department. Within 60-31, 30-8, and 7-0 days to death 164, 159, and 54 radiotherapy courses were prescribed, respectively. The most frequent treatment sites were brain (N = 122, 32%) and bone (N = 119, 32%), and there was no statistically significant difference in treatment site between the three sub-groups. The most common regimen was 10x3Gy (N = 130, 35%) in all three sub-groups (p = 0.23). Radiotherapy finished more than one week before death was associated with high completion rates (>80%) and treatment benefit (>55%).

CONCLUSION: Patient selection and survival prognostication remains challenging for radiation oncologists. While radiotherapy achieved high completion and success rates until one week before death, treatment within one week of death should be restricted to carefully selected patients or avoided altogether.

PMID:34286114 | PMC:PMC8273096 | DOI:10.1016/j.ctro.2021.06.010

Heliyon. 2021 Jul 3;7(7):e07476. doi: 10.1016/j.heliyon.2021.e07476. eCollection 2021 Jul.

ABSTRACT

This study aimed to examine the strategy use of Brazilian students learning Chinese as a foreign language (CFL) and the factors that might affect the variations in strategy use. The Strategy Inventory for Language Learning was employed as the research instrument, and altogether 120 students in a Confucius Institute in Brazil participated in the questionnaire survey. Statistical analyses of the data revealed that metacognitive and social strategies were the most frequently employed strategies by the participants. No significant differences were observed in the use of either overall or individual strategies by gender, age, or education level. Chinese proficiency level was found to impose main effects on the learners’ overall strategy use as well as on the use of memory and cognitive strategies. This study has pedagogical implications for CFL teachers, as findings related to the learners’ strategy use and the influencing factors can help CFL teachers tailor their instructions to the learner groups.

PMID:34286137 | PMC:PMC8273203 | DOI:10.1016/j.heliyon.2021.e07476

Heliyon. 2021 Jul 3;7(7):e07479. doi: 10.1016/j.heliyon.2021.e07479. eCollection 2021 Jul.

ABSTRACT

BACKGROUND: Erectile dysfunction is one of the common complications of testicular cancer with a prevalence of 11.3%-84%. It has devastating effects on men and their partner’s quality of life, sexual satisfaction, and sexual experience. The findings of the previous studies on this matter were uneven and inconsistent. Therefore, this systematic review and meta-analysis is conducted to acquire a more recent and comprehensive result.

METHODS AND MATERIALS: PubMed, Scopus, Goggle scholar, Science Direct, African Index Medicus, African Journal online, EMBASE, and Cochrane Library databases were searched. All necessary data were extracted using a standardized data extraction format. Data were analyzed using STATA 14 statistical software. A heterogeneity of studies was assessed using the I² statistics. Publication bias was checked by using a funnel plot and Egger’s regression test. A random-effects model was computed to estimate the pooled prevalence of erectile dysfunction.

RESULT: Fourteen full-text studies were included in this systematic review and meta-analysis. The pooled prevalence of erectile dysfunction among testicular cancer survivors was found to be 34.60% (95% CI: 25.89, 43.30 [I² = 95.9% p = 0.000]). Study design subgroup analysis indicated that the pooled prevalence of erectile dysfunction was 50.02% (95% CI: 22.78, 77.28% [I² = 96.1 p = 0.000]), and 27.36% (95% CI: 19.23, 34.48% [I² = 91.6, P = 0.000]) in the case-control and cohort studies, respectively. Likewise, the level of erectile dysfunction was varied based on ED erectile dysfunction measuring tools and testicular cancer treatment modalities.

CONCLUSION: In this study erectile dysfunction was found to be a highly prevalent complication in testicular cancer survivors. It had also causes of heterogeneity in terms of treatment modalities, study designs, and measuring tools. Therefore prevention of this complication should be the concern of the responsible bodies.

PMID:34286139 | PMC:PMC8278428 | DOI:10.1016/j.heliyon.2021.e07479

GMS J Med Educ. 2021 Jun 15;38(5):Doc92. doi: 10.3205/zma001488. eCollection 2021.

ABSTRACT

Introduction: The successful treatment of a multitude of chronic diseases is largely dependent on effective interprofessional collaboration. In Germany, many healthcare employees feel unprepared for the challenges of interprofessional teamwork. Can a seminar designed by an interprofessional team for an interprofessional target group improve mutual understanding and provide the basis for successful interprofessional collaboration? Methodological approach: For the development of the seminar, Kern’s model for curriculum development was used, which includes the following six steps: problem identification, needs analysis, goal definition (learning objectives and learning content), educational strategies, implementation and evaluation. The all-day event brought together physiotherapists, pharmacists, medical assistants and doctors undergoing specialist training in family medicine. Representatives of the various professions were recruited through multiple channels (associations, pharmacist societies, alumni-networks, etc.). Practical examples and role-play were used to develop a better understanding of each other’s professions and to support goal-oriented and appreciative communication among them. The seminar belongs to the curriculum provided by the Hesse Competence Center for Specialist Training in General Practice and has so far taken place three times. The evaluation was carried out by means of a detailed, self-designed questionnaire with five open and 20 closed questions. The statistical analysis was mainly descriptive (mean value, minimum, maximum and SD). Results: Overall, 29 persons have participated in the workshops (eleven doctors undergoing specialist training, six physiotherapists, six pharmacists, six medical assistants). Overall, the seminar was rated very highly. Individual aspects of the seminar’s design, such as relevance and practice-orientation, as well as an assessment of whether the seminar contributed towards increasing participants’ ability to collaborate with other professionals, were rated positively. In addition, a pre-post comparison of self-assessed ability to collaborate interprofessionally showed significant improvement. Discussion: This highly interactive one-day seminar design contributed towards improving understanding for other professions and communication skills. In order to achieve a broad-based improvement in interprofessional collaboration over the long term, this or similar concepts should be employed more extensively. Conclusions: The results suggest that participants in interprofessional seminars consider them to improve interprofessional collaboration.

PMID:34286072 | PMC:PMC8256127 | DOI:10.3205/zma001488