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Studio di validazione dell’IxipPlus, un nuovo marker per la neoplasia prostatica e sua valutazione comparativa con gli altri marker attualmente disponibili
No full textStudio di validazione dell’IxipPlus, un nuovo marker per la neoplasia prostatica e sua valutazione comparativa con gli altri marker attualmente disponibili
Arancio Marcello
Introduzione: non esiste attualmente un marcatore in grado di permettere di fare una diagnosi di certezza del tumore della prostata (PCa), tantomeno di distinguere, al momento della diagnosi, tra tumori indolenti e tumori aggressivi.
Materiali e metodi: abbiamo raccolto 365 campioni ematici di soggetti con indicazione a biopsia prostatica e abbiamo dosato un nuovo marcatore prostatico, il PSAIgM. Di 114 di questi pazienti abbiamo ottenuto anche un campione di urine e abbiamo dosato anche i seguenti marcatori prostatici tPSA, fPSA, f/tPSA, p2PSA, Phy, PCA3 score, PSA IgM e iXip Plus. Abbiamo sottoposto i pazienti ad ecografia prostatica transrettale e a biopsia.
Risultati: dal valore di PSAIgM, correlato con età e volume prostatico abbiamo calcolato iXip, un indice di probabilità di PCa. Correlando iXip con il tPSA abbiamo ottenuto iXip Plus, che permette di divedere la popolazione in due classi, una a basso rischio di PCa ed in una ad alto rischio, riducendo così il numero di biopsie non necessarie.
Abbiamo analizzato i vari marcatori prostatici nelle diverse associazioni possibili e abbiamo dimostrato come, in analisi univariata, utilizzando contemporaneamente f/tPSA, iXip Plus, PCA3 score, Phi si potrebbe classificare correttamente il 70% dei pazienti prima di sottoporli a biopsia.
Con solo f/tPSA e l’indice iXip Plus si classifica correttamente il 68% dei casi. In analisi multivariata, analizzando insieme il tPSA, l’età del paziente e il reperto rettale è possibile classificare correttamente il 76% dei pazienti, mentre il PCA3score e l’iXip Plus perdono valore.
Conclusioni: I risultati dello studio supportano le attuali indicazioni proposte dalle linee guida per la diagnosi del PCa secondo cui la determinazione del valore di tPSA, f/tPSA ed esecuzione di esplorazione rettale rappresentano gli esami di primo livello da proporre ai pazienti per definire se candidarli o meno a biopsia prostatica, nel sospetto che possano essere affetti da PCa. Il PCA3 score non sembra un indice accurato nel predire la presenza di PCa nei pazienti sottoposti a primo set bioptico.
Non esiste un marcatore in grado di predire l’aggressività di un PCa al momento della diagnosi.Study on the validity of iXip Plus, a new prostate neoplasm marker and its comparative assessment in relation to the other cancer markers currently available.
Arancio Marcello
Introduction: at the present time, no cancer marker allows to arrive at a definite diagnosis of prostate cancer (PCa) or to determine the aggressiveness of cancer in the diagnostic phase.
Materials and methods: 365 blood samples of patients who were candidates for prostate biopsy were collected and a new prostate cancer marker, PSA IgM, was measured.
Of those patients, 114 also provided urine samples, from which the following prostate cancer marker levels were measured: tPSA, fPSA, f/t PSA, p2PSA, Phy, PCA3 score, PSA IgM and iXip Plus. These patients were also evaluated by means of transrectal ultrasound and biopsy.
Results: PSA IgM level was correlated with the patient age and prostate volume and iXip, a PCa prediction rate, was calculated. iXip was subsequently correlated with PSA in order to obtain iXip Plus, which makes it possible to subdivide the population in two groups: the first one being that of patients at high risk and the other of those at low risk for PCa. This leads to a reduction in the number of unnecessary biopsies.
The various prostate cancer markers were analyzed in several possible combinations and through univariate analysis and simultaneous analysis of f/t PSA, iXip Plus, PCA3 score and Phi, which demonstrated that 70% of the patients could be correctly classified prior to performing biopsy.
By only using f/t PSA and iXip Plus prediction rate, 68% of the cases can be correctly classified.
Through multivariate analysis, by considering tPSA, patient age and rectal exam together, 76% of the patients can be correctly classified, while PCA3 score and iXip Plus lose their relevance.
Conclusions: the results of this study support the current guidelines on PCa diagnosis, which recommend tPSA, f/t PSA and rectal exam as first level screening tests to determine if patients are candidates for prostate biopsy in the presence of a clinical suspicion of PCa.
PCA3 score does not seem to be an accurate indicator of PCa in patients who already had a first set of biopsies taken.
No marker can predict the degree of PCa aggressiveness in the diagnostic phase
365 POSTOPERATIVE TRANSPERINEAL ULTRASOUND PARAMETERS IN WOMEN WITH INTRISIC SPHINTERIC DEFICIENCY UNDERWENT MIDURETHRAL SLING FOR STRESS URINARY INCONTINENCE
No full textWe evaluated the postoperative transperineal ultrasound parameters in women with intrinsic sphincteric deficiency, underwent midurethral sling for stress urinary incontinenc
RETROGRADE INTRA RENAL SURGERY FOR RENAL STONES
No full textIntroduction and Objectives: Urolithiasis affects 5–15% of the population during their lives. Stone recurrence rate can be as high as 50% during life. The improvement of mininvasive techniques led to an important decrease of the open surgery, nowadays unnecessary in most cases. Extracorporeal shock wave lithotripsy (ESWL) was introduced in the 1980s as a revolutionary technique to fragment renal and ureteral calculi. Due to ESWL limits, other mininvasive techniques were performed to treat renal calculi such as percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS). Today the boundary between the indications of this three procedures is not well defined, especially considering patients with multiple stone relapses who undergo many sessions of treatment during their lives.
The purposes of this study are to evaluate effectiveness and safety of RIRS; to assess its potential use as first line treatment of renal medium-sized stones (10–20mm); to set RIRS in the management of people prone to multi stone recurrences. Material and Methods: This prospective study considered 35 renal stone patients who underwent RIRS in our department. In this study we analysed location, number and diameter of renal calculi using the conventional imaging methods and their composition. We evaluated the different surgical instrumentation necessary to obtain successful result, type and length of the ureteral stenting, number of hospitalization days, intra and post-operative complications of the treatment. RIRS results were evaluated after three months with abdominal ultrasound and plain abdominal x-ray.
Results: Stone free rate was achieved in 63% and 80% after single procedure and retreatment respectively. Single calculus were treated more successfully (83%) than multiple stones (41%) (p = 0.002). RIRS results and stone dimension are related with statistic significance (p = 0.004): retrograde intrarenal surgery is able to dissolve with higher success renal calculi smaller than 20 mm. 7% of treatments had post-operative complications. We did not find statistically significant differences in efficacy and safety between patients with renal stone relapse and patients with their first episode of calculi disease.
Conclusions: RIRS is an effective and safe procedure to treat renal calculi. It may be considered as the first-line therapy to treat renal stones smaller than 20mm. It may be the first option to manage patients with multiple stone relapses. They are suggested to take an intensive follow up in order to diagnose and treat renal stones when they are still smaller than 20 mm
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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