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Factors predictive of shockwave lithotripsy failure for ureteral stones: Why we need to hurry
No full textBackground: The Aims of This Study Are to Evaluate The Prognostic Factors of Extracorporeal Shockwave Lithotripsy In Patients With Ureteric Stones, and to Identify Which Patients Might Directly Benefit of An Endoscopic Treatment. Methods: We Performed a Prospective Study From January 2013 and July 2016 On Patients With Single Ureteric Stone and Undergoing Extracorporeal Shockwave Lithotripsy (Swl). We Divided Patients Into Two Groups: First Group (Success Group) Included Cases Resolved With Swl Only, and a Second Group (Failure Group) Including Patients With Stone Not Resolved By Swl and Requiring An Endoscopic Treatment. We Evaluated Age, Weight, Height, Body Mass Index, Stone Size, Hydronephrosis, Laterality, Location, Days Elapsed From Onset of Symptoms to Swl and Stone Density When Computed Tomography Was Performed. In Case of Stone Fragments >4 Mm, The Procedure Was Repeated Up to a Maximum of Three Times. Swl Was Considered As Failed If Patients Had a Residual Stone of Any Size After a Follow-Up of 3 Months or If a Complication Occurred. Results: 274 Patients Completed Follow-Up and Were Enrolled In The Study. Mean Age Was 53.22 Years (Standard Deviation: 13.98). Swl Overall Success Rate Was 84.3% (231 Patients Successfully Treated With Shockwaves) and Failure Rate Was 15.7% (43 Patients Underwent Auxiliary Endoscopic Procedure). At The Univariate Analysis, We Observed a Statistically Significant Difference for Hydronephrosis (P=0.006), Time Elapsed From Symptoms Onset (P=0.013), Patients’ Age (P=0.06) and Mean Stone Density (0.023). In The Multivariate Logistic Regression, Patients’ Age (or: 1.517), and Time Elapsed From Obstruction to Swl (or: 3.005) Were Independent Predictive Factors for Swl Failure. Furthermore, Moderate and Severe Hydronephrosis Seemed to Be Independent Predictive Factors for Swl Failure, Presenting An or of 2.451 and 4.207 Respectively. High Stone Density Resulted to Be a Predictive Factor for Swl Failure (or: 2.293 If Density Was Higher Than 1100 Hounsfield Units). Conclusions: We Report a Large Series of Patients Undergone Primary Swl for Ureteric Stones. Our Data Demonstrated The Role of Hydronephrosis, Time Elapsed From Obstruction Onset to Treatment and Stone Density As Independent Predictive Factors of Swl Failure
Comparison of Sexual Function in Transsexual Women Who Underwent Sex Reassignment Surgery by Two Different Techniques
No full textN/
BIOMARKERS OF UROTHELIAL DAMAGE IN PATIENTS TREATED BY ADJUVANT INTRAVESICAL THERAPY
No full textIntroduction/Aim: Chemotherapy or BCG given intravesically
to prevent recurrence after transurethral resection (TUR) of
non-muscle invasive bladder cancer (NMI-BC) cause
frequent, sometime severe, local toxicity. As a consequence,
many patients do not complete the planned treatment (1). A
major challenge for the urologists is to identify an early biomarker of urothelial damage to recognize and prevent local
toxicity improving patient’s compliance. The purpose of our
research was to investigate the relation between urothelial
injury by intravesical treatment and the expression of
potential biomarkers in urine and/or in barbotage solution.
The urinary HB-EGF expression in interstitial cystitis has
been analyzed by a few studies (2, 3). As a preliminary step,
the variations of Fibronectin (FN), Epidermal Growth Factor-
Receptor (EGF-R) and Heparin-binding Epidermal Growth
Factor-like Growth Factor (HB-EGF) during intravesical
therapy and after the administration of a solution with the
potential role of urothelial repairing (hyaluronic acid and
chondroitin sulphate) were investigated. Patients and
Methods: the toxicity of intravesical therapy with mitomycin,
epirubicin or BCG was classified in 3 grades (absent,
moderate, severe). Urine and bladder washing solution during
intravesical therapy in 55 patients after NMI-BC TUR and in
10 healthy controls for a total of 200 samples were collected.
Total cellular RNA was isolated from the cell pellet using
miRNeasy Mini Kit (Qiagen®). FN and EGF-R gene
expression by Real Time quantitative PCR were analyzed.
The expression of HB-EGF was measured in urine samples
by ELISA (Abcam®). Results: In barbotage samples the FN
gene expression and the EGF-R levels in our patients were
respectively increased a median of 4.7 fold and decreased of
0.9 fold compared to controls. Before intravesical therapy and
in absence of local toxicity, gene expression increased 1.9
fold for FN and 1.1 fold for EGF-R. In contrast, in patients
with local toxicity due to intravesical therapy, the FN gene
expression levels increased to a median of 5.82 fold, while
EGF-R remained unchanged. The administration of
hyaluronic acid and chondroitin sulphate solution decreased
the mean FN gene expression from 3 to 0.6 fold, with
concomitant symptomatic relief. HB-EGF protein median
urine levels were 25.7 pg/ml in 13 patients before intravesical
therapy and 18.9 pg/ml in 5 healthy controls. No significant
variations in relation to the local toxicity. During therapy
median HB-EGF protein levels in urine varied from 21.6
pg/ml in absence of toxicity to 25.7 pg/ml in case of severe
toxicity to 18.5 pg/ml after hyaluronic acid and chondroitin
sulphate solution. Preliminarily, the observed variations of
HB-EGF, increasing no more than 1.2 fold compared to
healthy controls, do not seem possible marker of urothelial
damage. Discussion and Conclusion: EGF-R gene and HBEGF
expressions do not seem to vary significantly in relation
to local toxicity due to intravesical therapy. FN gene is
overexpressed in presence of urothelial damage significantly
reduced by intravesical hyaluronic acid and chondroitin
sulphate solution administration, according with symptoms
relief
S9-Fibronectin, EGF-R, HB-EGF:biomarkers of urothelial damage during intravesical adjuvant therapy?
No full textIntravesical chemotherapy and immunotherapy with BCG represent the standard therapy to
prevent recurrence after transurethral resection (TUR) of non-muscle invasive bladder cancer (NMI-BC).
Maintenance for at least one year is considered the best regimen. Noteworthy, a relevant number of
patients do not complete the planned treatment due to local toxicity of the drug given intravesically1, 2. A
major challenge for the urologists is to identify an early urothelial damage biomarker to prevent severe
local toxicity requiring treatment interruption and to improve patient's compliance. The preliminary
purpose of our research was to verify the possible correlation between urothelial damage induced by
intravesical treatment and the expression of potential biomarkers in urine or bladder washing solution.
Fibronectin (FN), Epidermal Growth Factor-Receptor (EGF-R) and Heparin-binding Epidermal Growth
Factor-like Growth Factor (HB-EGF) have been preliminary investigated. The urinary HB-EGF expression in
patients with interstitial cystitis has been already analyzed by some studies3, 4, 5 The biomarkers trend
during therapy with hyaluronic acid and chondroitin sulphate solution will be investigated.
Materials and Methods: we collected 50 ml urine and bladder washing solution during intravesical
therapy in 55 patients after NMI-BC TUR and in 10 healty controls for a total of 200 samples. After
centrifugation, total cellular RNA was isolated from the cell pellett using miRNeasy Mini Kit (Qiagen®)
according to the manufacturer's instructions. We investigated FN and EGF-R gene expression by Real Time
quantitative PCR. Finally, the abundance of HB-EGF in urine samples was measured using Enzyme-linked
immunosorbent assay (ELISA) (Abcam®) following manufacturer's instructions.
Results: The FN gene expression levels in NMI-BC compared with controls were increased 4.7 fold while
EGF-R levels were decreased 0.9 fold. In the patients in whom local toxicity due to intravesical therapy was
clinically relevant, the FN gene expression levels were increased 5.82 fold, and the EGF-R one was
decreased 0.88 fold. In contrast patients before starting therapy or with a good tolerance showed gene
expression levels increased 1.9 fold for FN and 1.1 fold for EGF-R. In patients receiving hyaluronic acid and
chondroitin sulphate solution to treat the severe vesical toxicity the average FN gene expression levels
were decreased from 3 to 0.6 fold, with concomitant symptomatic improvement. HB-EGF protein levels in
urine in patients receiving intravesical chemo or immunotherapy were increased 1.2 fold compared to
controls and remained unchanged during therapy. No fold change was detected in patients treated with
hyaluronic acid and chondroitin sulphate solution. Our preliminary data will be updated in the final
presentation. Statistical analysis is ongoing.
Conclusion: EGF-R gene expression in the bladder washing solution and HB-EGF levels in urine did not
show significant fold change in relation to urothelial damage compared to controls. Preliminarly, FN gene
expression in bladder washing solution showed an overexpression during urothelial damage and decrease
after therapy with hyaluronic acid and chondroitin sulphate solution in correlation to symptoms relief
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe 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
Get PDF“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
Get PDFWe 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
Get PDFWe 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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