Current Issue : April - June Volume : 2018 Issue Number : 2 Articles : 5 Articles
Background. Immunosuppressive therapy for antineutrophil cytoplasmic antibody-associated vasculitis has been associated with\nincreased malignancy risk. Objectives. To quantify the cancer risk associated with contemporary cyclophosphamide-sparing\nprotocols. Methods. Patients from the Norwegian Kidney Biopsy Registry between 1988 and 2012 who had biopsy-verified pauciimmune\nglomerulonephritis and positive antineutrophil cytoplasmic antibody (ANCA) serology were included. Standardised\nincidence ratios (SIRs) were calculated to compare the study cohort with the general population. Results.The study cohort included\n419 patients. During 3010 person-years, cancer developed in 41 patients (9.79%); the expected number of cancer cases was 37.5\n(8.95%). The cohort had SIRs as follows: 1.09, all cancer types (95% CI, 0.81 to 1.49); 0.96, all types except nonmelanoma skin\ncancer (95% CI, 0.69 to 1.34); 3.40, nonmelanoma skin cancer (95% CI, 1.62 to 7.14); 3.52, hematologic cancer (95% CI, 1.32 to\n9.37); 2.12, posttransplant cancer (95% CI, 1.01 to 4.44); and 1.53, during the 1ââ?¬â??5-year follow-up after diagnosis (95% CI, 1.01 to\n2.32). Conclusions. Cancer risk did not increase significantly in this cohort with ANCA-associated glomerulonephritis. However,\nincreased risk of nonmelanoma skin cancer, posttransplant cancer, and hematologic cancer indicates an association between\nimmunosuppression and malignancy....
Purpose: To clarify which patients need careful neurourological management\nafter abdominal radical hysterectomy (RH) by investigating the effects of adjuvant\nradiotherapy and reversibility of neurogenic bladder (NB) on the storage\nfunction as well as the effects of urethral resistance on the emptying\nfunction. Methods: Data from sixty-two patients referred to our NB clinic after\nRH were retrospectively reviewed. Findings of urodynamic studies performed\nat 3 (UDS-1) and 12 (UDS-2) months after treatment were compared,\nand logistic analysis was used to calculate the odds ratio (OR) of the effects of\nradiotherapy and irreversible NB on decreased bladder capacity and decreased\ncompliance. Irreversible NB was defined as the need for clean intermittent\ncatheterization at the last follow-up. Results: At the median follow-up period\nof 41 months, 60% of the patients continued to require clean intermittent catheterization.\nOf patients with irreversible NB and radiotherapy, 80% had decreased\nbladder capacity and decreased compliance at UDS-2. For decreased\nbladder capacity and decreased compliance, ORs of adjuvant radiotherapy at\nUDS-2 were 38.42 (p < 0.001) and 7.46 (p = 0.001), respectively, while ORs of\nirreversible NB were 1.64 (p = 0.527) and 3.42 (p = 0.062), respectively. Detrusor\ncontraction could be demonstrated in only 15% and 45% at UDS-1 and\nUDS-2, respectively. However, regardless of improvement in detrusor con-tractility, urodynamic studies revealed a high urethral resistance. Conclusions:\nCareful neurourological follow-up after RH is mandatory for patients\nwho undergo adjuvant radiotherapy and have irreversible NB with impaired\nurethral relaxation....
OBJECTIVE:\nThe aim of this study is to evaluate the response to low-intensity extracorporeal shock wave therapy in a group of patients with organic vascular erectile dysfunction.\n\nMATERIALS AND METHODS:\nThis is an observational retrospective study. The researchers reviewed 710 patients with a clinical diagnosis of organic vascular erectile dysfunction (ED) of more than 3-month duration from male sexual health clinics of the Boston Medical Group from 12 cities in Spain and 4 in Mexico. Patients received 5 outpatient shock wave therapy sessions. They were evaluated with the erection hardness score (EHS) before the first session (n�=�710), at the end of the last session (n�=�710), and one month after the last session (n�=�412).\n\nRESULTS:\nIn the first examination, the EHS improved in 43.1% (306/710) of subjects compared to the baseline measurement and ability to penetrate increased from 26.8% to 44% (p < 0.0001). In the second examination, the ability to penetrate was 37.9%, lower than in the first (p=0.042) but higher than the baseline (p=0.0001).\n\nCONCLUSIONS:\nThe results suggest that the shock wave therapy with or without concomitant treatments improved the quality of erections in patients with erectile dysfunction treated in specialised male sexual health clinics. This trial is registered with NCT03237143....
Background. Acute kidney injury (AKI) is common in hospitalised patients. The relationship between body mass index (BMI) and\nthe risk of having AKI for patients in the acute hospital setting is not known, particularly in the Asian population. Methods.Thiswas\na retrospective, single-centre, observational study conducted in Singapore, a multiethnic population. All patients aged ââ?°Â¥21 years\nand hospitalised from January to December 2013 were recruited. Results. A total of 12,555 patients were eligible for the analysis.\nA BMI of <18.5 kg/m2 was independently associated with the development of AKI in hospitalised patients (odds ratio (OR): 1.23\n[95% confidence interval [CI]: 1.04ââ?¬â??1.44, ...
Background. Fractalkine is produced in seminal plasma in small amounts and correlates with sperm motility. Purpose. To investigate\nthe possible effect of low-level leucospermia on spermatozoa oxidative stress and sDNA fragmentation in patients with subclinical\nvaricocele and apparently normal seminogram, and also to study the role of spermatozoal fractalkine and its receptor (CX3CR1) gene\nexpression as a marker of spermatozoa inflammatory response. Methods. This study included 80 patients with subclinical varicocele\n(45 fertile and 35 infertile) and 45 age-matched fertile volunteers. In semen samples, fractalkine and CX3CR1 gene expression were\ninvestigated by qRT-PCR. Moreover, seminal plasma malondialdehyde (MDA) and total antioxidant capacity (TAC) were measured.\nResults. There are significant decrease in semen quality and significant increase in seminal leucocytes count in subclinical varicocele.\nOur results show a significant increase in MDA and TAC levels, DNA fragmentation, and expression levels of fractalkine and its\nreceptor (CX3CR1) in subclinical varicocele groups. Conclusion. Subclinical varicocele induces seminal and spermatozoal subclinical\ninflammatory response in the form of low-level leucospermia and increased mRNA expression of the fractalkine signaling pathway,\nleading to increased spermatozoal ROS production, oxidative stress, and DNA fragmentation. These could cooperate in the\npathogenesis of delayed fertility in males with subclinical varicocele....
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