128 research outputs found
A systematic review and meta-analysis of the placebo effect on both semen quality and male infertility
No full textINTRODUCTION: Placebo influence on such objective indicators, as sperm quality and infertility, has not been studied previously, but some studies report that placebo may distort even objective outcomes. The aim of current study is to assess the placebo effect on fertility in patients suffering from sperm abnormalities and/or infertility. EVIDENCE ACQUISITION: We conducted a search of two databases (Scopus and MEDLINE) and identified placebo-controlled clinical trials which focused on sperm abnormalities and/or male infertility treatment. Primary outcomes included changes in semen parameters (volume, total count, sperm concentration in semen, progressive motility, morphology (normal cells)). Secondary outcomes included DNA fragmentation and change in pregnancy rate. EVIDENCE SYNTHESIS: Seventy-seven articles published from 1983 to 2022 were included. Statistically significant changes were observed for the following values: total sperm count, mean change 0.16 (95% CI 0.05, 0.26); P=0.004, I2=75.1%; and progressive motility, mean change 0.13 (95% CI 0.02, 0.24); P=0.026, I2=84.9%. In contrast, placebo did not affect sperm concentration, sperm volume, sperm morphology or DNA fragmentation index. The publication bias for all the values measured with Egger's test and funnel plots was low. CONCLUSIONS: The current meta-analysis indicated a statistically significant increase of total sperm count and progressive motility in the placebo group. In contrast, placebo did not affect sperm concentration, sperm volume, sperm morphology and DNA fragmentation index. These findings should be considered while planning or analyzing placebo-controlled clinical trials
Does concordance between preoperatively measured prostate volume and enucleated weight predict outcomes in endoscopic enucleation of the prostate? Results from the REAP database
No full textBackground: We aimed to determine if preoperative prostate volume-enucleated weight concordance predicts short-term anatomical endoscopic enucleation of the prostate (AEEP) outcomes using the REAP international database. Methods: 649 patients with data on both preoperative ultrasound-derived prostate volume and enucleated specimen weight were analyzed. Linear regression was used to investigate the effect of volume-weight concordance on postoperative outcomes. Model residuals were used to divide the cohort into 3 centiles: (1) less-than-expected enucleated specimen weight; (2) appropriate concordance between prostate volume and specimen weight; (3) more-than-expected specimen weight. Outcomes were also analyzed with only enucleated weight as a predictor (comparing ≤ 80 g and > 80 g). Results: There was a trend towards more-than-expected enucleated specimen weight with increased age (p = 0.006). There was an increasing trend of operation time (p = 0.012) and enucleation time (p = 0.015) as specimen weight increased, and a decreasing trend of postoperative acute urinary retention (p = 0.005). Laser type, enucleation method, and early apical release were similar. In correlation analysis, greater-than-expected prostate weight was associated with greater Qmax improvement at 3 months. Prostate weight alone did not appear to be a significant predictor of outcomes. Conclusions: If enucleated specimen weight is more than expected according to preoperative ultrasound volume measurement, greater Qmax improvement and less postoperative acute urinary retention is expected. Although precision may be limited by ultrasound approximation and inexact specimen weight measurements, these shortcomings are similar in real-world clinical practice. Overall, preoperative prostate volume and actual enucleated specimen weight should be interpreted in the context of each other to predict clinical outcomes
A Novel and Less Traumatic Needle for Kidney Puncture: Development and Preclinical Study Results
No full text20.500.12530/87855Introduction: A considerable proportion of percutaneous nephrolithotomy complications occurs during renal puncture. An option to decrease the complications rate is needle modification to make the procedure less traumatic. We aimed to evaluate the effectiveness of the novel MG needle in a preclinical study.Materials and Methods: We developed an original MG needle based on the Veress needle concept containing an atraumatic (blunt) mandrin connected through a spring to the cannula. The MG needle's properties were compared with those of the conventional Chiba and Trocar needles in two experiments. In the first experiment, we assessed the force required to puncture the model. In the second experiment, we punctured a porcine kidney and analyzed histology report after the puncture.Results: We performed a series of 30 punctures of polypropylene block by each needle. The force required to make a puncture with the Chiba needle (6.53 +/- 0.87 N) was significantly lower compared with the MG needle (7.1 +/- 1.07 N), p = 0.027. However, the MG needle turned out to be superior to the Trocar needle (8.71 +/- 1.08 N), p = 0.001. A total of 15 specimens were obtained after three renal punctures were made with each needle. A microscopy of the specimen after puncture with the Chiba and Trocar needles showed small fragments of epithelium and erythrocytes inside the canal with uneven margins where the needle passed. A microscopy of the specimen after puncture with a novel MG needle showed a canal with even margins. No tissue fragments inside the canal were observed.Conclusion: The force required to puncture with the novel MG needle is comparable with conventional needles. According to preclinical experiments, histology report of porcine kidney indicates that renal puncture with an MG needle is less traumatic. It may reduce the risk of bleeding, and this should be proved during clinical trials
A novel less-traumatic needle for kidney puncture: first clinical experience
No full text20.500.12530/87855IntroductionTo decrease complication rate, we developed a novel MG needle for kidney puncture consisting of a pointed cannula, an atraumatic mandrin-bulb and a spring mechanism pushing the mandrin-bulb forward.Aim of the studyTo assess efficacy and safety of kidney puncture during percutaneous nephrolithotomy (PCNL) using a novel less-traumatic MG needle within a clinical trial.Materials and methodsWe conducted a prospective randomized single-center study. In the experimental group, kidney puncture was performed with a novel MG needle while in the control group, standard Trocar or Chiba puncture needles were used. Primary endpoint: hemoglobin drop.ResultsA total of 67 patients were enrolled. Patients who underwent standard puncture (n = 33) had higher hemoglobin drop in the early postoperative period (p = 0.024). Although there was no statistical difference in overall complication rate between the two groups (p = 0.351), two severe Clavien-Dindo IIIa complications with urinoma occurred in patients from the control group.ConclusionLess-traumatic needle for kidney puncture may reduce hemoglobin drop and prevent the development of severe complications. At the same time, in terms of stone-free rate (SFR), the efficacy of PCNL remains the same regardless of the needle used for renal access
A systematic review of nerve-sparing surgery for high-risk prostate cancer
No full textWe provide a systematic analysis of nerve-sparing surgery (NSS) to assess and summarize the risks and benefits of NSS in high-risk prostate cancer (PCa)
Transfer Pricing in Russia, analyzing an international company during internship – Case Liebherr
No full textTransfer pricing mechanisms have been actively used by foreign companies for more than a half of century. The necessity to optimize financial flows between related parties by establishing transfer prices on the one hand, and the existence of proper economic assessment of pricing data in order to minimize negative financial flows related to possible fines and additional charging by tax authorities on the other hand, have both made transfer pricing issues relevant to foreign organizations.
Since the beginning of the Russian transition to the market economy, Russian companies faced this problem. Underdevelopment of a given market and market institutions in Russian regions, a high degree of monopolization of individual economic sectors, the lack of consolidated information about market transactions and market prices, as well as taxation differences in each of the Russian region, all these aspects exacerbated the problem of transfer pricing between Russian enterprises. Despite the fact that efficiency of transfer pricing in companies is highly influencing the economic situation in the country, extremely insufficient attention has been given for learning the topic of transfer pricing.
Since 1 January 2012, the situation has changed significantly, transfer pricing legislation entered into force, which aims to address the previous shortcomings, to bring into line with international practice.
The main goal of this thesis is to learn deeper the topic of transfer pricing in Russia. The aim of the research is to get to know how companies use transfer pricing for minimizing tax risks and how they select an appropriate transfer pricing method. Fortunately, the author has an opportunity to have professional internship during thesis writing. It helps to understand the topic from the company point of view
MP62-10 MONOPOLAR VERSUS LASER (THUFLEP, HOLEP) ENDOSCOPIC ENUCLEATION OF THE PROSTATE: A SINGLE-CENTER EXPERIENCE
No full textRetrospective Analysis of Short-Term Outcomes After Monopolar Versus Laser Endoscopic Enucleation of the Prostate: A Single Center Experience
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