1,720,957 research outputs found
Clinical significance of intravesical prostatic protrusion in the management of benign prostatic enlargement: A systematic review and critical analysis of current evidence
No full textINTRODUCTION: Filling cystometry and pressure flow studies (PFS) are the most widespread used invasive urodynamic techniques in the assessment of male LUTS. However, these techniques are time- and cost-intensive. Intravesical prostatic protrusion (IPP) has been proposed as non-invasive method used to diagnose bladder outlet obstruction (BOO) in men with male lower urinary tract symptoms (LUTS). The purpose of the present review is to analyze the diagnostic and therapeutic relevance of IPP. EVIDENCE ACQUISITION: A comprehensive systematic MEDLINE search was performed for English language reports published before June 2016 using the term "intravesical prostatic protrusion." EVIDENCE SYNTHESIS: We identified 28 eligible original articles. Determination of IPP seems as useful method to predict BOO. The area under the curve of IPP for the prediction of BOO was found to range from 0.708 (95% CI: 0.615- 0.791) to 0.858 (95% CI : 0.809-0.908). IPP seems to have a predictive role in a successful trial without catheter following acute urinary retention. The percentage of successful TWOC in patients with IPP>10 mm was reported at 13% and 18%, respectively, compared to a approximately 80% chance of successful trial in patients with IPP10 mm should be counseled regarding the high chance of need for surgical treatment following acute urinary retention
New treatment strategies for benign prostatic hyperplasia in the frail elderly population: A systematic review
No full textINTRODUCTION: Life expectancy is constantly increasing and as a consequence older men, frequently with multiple comorbidities, are seeking treatment for benign prostatic hyperplasia. Given their frail health, these men need extreme attention in their management, as efficacious and safe treatment strategies in the general population may not be adequate for them. EVIDENCE ACQUISITION: The National Library of Medicine Database was searched for relevant articles published between 2006 and 2015. Each article's title, abstract and text were reviewed for their appropriateness and their relevance. 57 articles were eligible for the review. EVIDENCE SYNTHESIS: In the elderly and frail, α1-antagonists should be used with caution given the risk of orthostatic hypotension and consequent falls, cause of significant morbidity in the elderly. 5ARIs present a good safety profile. Anticholinergics must also be prescribed with caution, given the risk of aggravating symptoms of dementia due to a central blockage of cholinergic neuronal pathways. Prostatic urethral lift is a medical device with low morbidity and valid functional results, which appear to endure over time. Prostatic artery embolization is demonstrating good results with minimal complication rates. Laser prostate vaporization or enucleation is also safe in elderly men and in those receiving anticoagulation therapy, due to its excellent hemostatic effect on prostatic tissue. CONCLUSIONS: Urologists should be familiar with the safety and efficacy profile of medical and surgical therapy in the elderly population, given the inevitable increase in older patients which we will observe in the near future.SCOPUS: re.jinfo:eu-repo/semantics/publishe
The influence of the medical treatment of LUTS on benign prostatic hyperplasia surgery: Do we operate too late?
No full textAbstract
INTRODUCTION:
The aim of this article is to systematically collect the available evidence on the influence of lower urinary tract symptoms (LUTS) medical treatment on benign prostatic hyperplasia (BPH) surgery.
EVIDENCE ACQUISITION:
A systematic literature search January 1990 until June 2016 was performed by combining the following MeSH terms: "lower urinary tract symptoms", "benign prostatic hyperplasia", "male", "medical treatment", "surgical treatment", "deferred/postponed treatment/intervention", "early intervention/treatment". Each article title and abstract was reviewed for relevance and appropriateness with regards to the topic of this review.
EVIDENCE SYNTHESIS:
The pharmacological treatment of LUTS is undoubtedly a successful story in the field of urology. Over the last two decades, the introduction of novel pharmaceutical agents has dramatically reduced the rate of BPH surgery interventions all over the world. Thus, nowadays, patients who undergo surgery are generally older, with more severe comorbidities and with larger prostates, theoretically requiring more challenging interventions. Nevertheless, the recent advances in surgical techniques and instruments have counterbalanced this unfavorable scenario and, overall, a non-pejorative trend has been observed in peri-/postoperative complications. On the other hand, evidence from the "pre-pharmacological-treatment era" suggested that immediate BPH surgery might be the best option for patients at risk of severe BPH progression. Still, no clear-cut, shared criteria have yet been established to effectively identify these patients.
CONCLUSIONS:
Several questions remain unanswered regarding the role of medical treatment in BPH, and good-quality studies available on this topic are surprisingly rare. The evidence presented in this review supports the need for prospective comparative studies evaluating long-term LUTS/BPH pharmacological treatment versus an early surgical intervention, particularly using the emerging laser technologies
Bladder stone management: An update
No full textAbstract
INTRODUCTION:
Bladder stone (BS) is a rare disease curable with several options. Herein, we reviewed the specific literature in order to update the current BS management.
EVIDENCE ACQUISITION:
A comprehensive systematic MEDLINE search was performed for English language reports published before April 2017 using the BS related terms, i.e. bladder-vesical calculi, lithotripsy. Then manuscripts references were screened to identify unfounded studies. Studies regarding BS in children were excluded.
EVIDENCE SYNTHESIS:
Retrieved studies were classified according to their main item as: etiology, diagnosis, treatment, treatment in specific illnesses and advances in BS management. Treatment option was mainly related to stone size and number as well as concomitant causative disease. However, stone nature was not analyzed in all the retrieved studies. Both trans-urethral and percutaneous lithotripsy were efficacy for stone fragmentation although the last one was suggested to avoid urethral injuries. Holmiun:Yag laser lithotripsy has made stone fragmentation feasible by using local anesthesia however in selected patients only. The urological dogma to perform concomitant prostate surgery in men with BS has been recently questioned by some observational case-series studies however, the lack of randomization and long follow up preserve that knowledge.
CONCLUSIONS:
Bladder stone is a rare and ancient disease. Nowadays new technologies have been developed in the effort to make less invasive stone treatment. The retrieved studies show that stone fragmentation can be archived by using several surgical approaches and devices whereas comparative randomized studies are still unavailable to identify the best option
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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