169,884 research outputs found

    Neoadjuvant sutent induction therapy may effectively down-stage renal cell carcinoma atrial thrombi

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    A 75-yr-old previously healthy woman presented with gross hematuria, European Cooperative Oncology Group 0, and an 11-cm renal mass with right atrial thrombus. The patient refused the sternotomy. She was offered two cycles of sunitinib maleate (Sutent) induction therapy to down-stage the thrombus and to reduce the extent of the surgery. (C) 2007 European Association of Urology. Published by Elsevier B.V. All rights reserved

    Going Beyond Counting First Authors in Author Co-citation Analysis

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    The 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

    Mitomycin C in highly myopic eyes - Author reply

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    Ophthalmology. 2005 Feb;112(2):208-18; discussion 219. Mitomycin C modulation of corneal wound healing after photorefractive keratectomy in highly myopic eyes. Gambato C, Ghirlando A, Moretto E, Busato F, Midena E. SourceRefractive Surgery Service and Antimetabolite Therapy Research Unit, Department of Ophthalmology, University of Padova, Padova, Italy. Abstract PURPOSE: To evaluate the role of topical mitomycin C in corneal wound healing (CWH) after photorefractive keratectomy (PRK) in highly myopic eyes. DESIGN: Prospective, double-masked, randomized clinical trial. PARTICIPANTS: Seventy-two eyes of 36 patients affected by high (>7 diopters) myopia. METHODS: In each patient, one eye was randomly assigned to PRK with intraoperative topical 0.02% mitomycin C application, and the fellow eye was treated with a placebo. Postoperatively, mitomycin C-treated eyes received artificial tears (3 times daily, tapered in 3 months), whereas the fellow eye was treated with fluorometholone sodium 2% and artificial tears (3 times daily, tapered in 3 months). MAIN OUTCOME MEASURES: Uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA), contrast sensitivity, manifest refraction, and biomicroscopy. Contrast sensitivity was determined using the Pelli-Robson chart. Corneal confocal microscopy documented CWH. RESULTS: Mean follow-up was 18 months (range, 12-36). No side effects or toxic effects were documented. At 12-month follow-up examination, UCVAs (logarithm of the minimum angle of resolution) were 0.4+/-0.48 and 0.5+/-0.53 (P = .03) in mitomycin C-treated eyes and corticosteroid-treated eyes, respectively. At 1 year, corneal haze developed in 20% of corticosteroid-treated eyes, versus 0% of mitomycin C-treated eyes. At 12, 24, and 36 months, corneal confocal microscopy showed activated keratocytes and extracellular matrix significantly more evident in untreated eyes (Ps = 0.004, 0.024, and 0.046, respectively). CONCLUSION: Topical intraoperative application of 0.02% mitomycin C can reduce haze formation in highly myopic eyes undergoing PRK. Comment in Ophthalmology. 2006 Feb;113(2):357; author reply 357-8

    Dispelling the Myths Behind First-author Citation Counts

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    We 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

    Impact of chronic prostatitis-like symptoms on the quality of life in a large group of men

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    Objective To assess the prevalence of chronic prostatitis (CP) and chronic pelvic pain syndrome (CPPS) symptoms in a large group of men, using the National Institute of Health-Chronic Prostatitis Symptom Index (NIH-CPSI), and to evaluate which of the NIH-CPSI symptoms had the most detrimental effect on quality of life (QoL). Subjects and methods The NIH-CPSI was completed by 1273 men during a male-health promotion event. The presence of CP/CPPS-like symptoms was defined according to the NIH-CPSI criteria (perineal pain or ejaculatory pain and NIH-CPSI-pain score >= 4). Finally, using linear regression analyses we evaluated the effect of each questionnaire symptom on the NIH-CPSI-QoL domain. Results The mean (range) age of the men was 57.6 (40-89) years; 133 (10.5%) reported CP/CPPS-like symptoms, with 62 (4.9%) reporting mild and 71 (5.6%) reporting moderate to severe CP/CPPS-like symptoms. Men with CP/CPPS-like symptoms had higher NIH-CPSI-QoL scores, showing a greater detriment of QoL (4.9 vs 2.5; P < 0.001). Of all NIH-CPSI symptoms, urinary frequency was associated with the least favourable QoL, followed by incomplete bladder emptying, pain frequency and pain intensity. The individual pain location had no significant impact on the QoL. Conclusion In a large healthy population CP/CPPS-like symptoms are common and have an important impact on QoL. Functional CP/CPPS-like symptoms have a greater detrimental effect on QoL than pain symptoms. Therefore, these symptoms should represent the main therapeutic targets in affected patients

    The effect of comorbidities and socioeconomic status on sexual and urinary function in men undergoing prostate cancer screening

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    Introduction. Comorbidities and socioeconomic status (SES) represent known confounders of baseline health-related quality of life. Aim. To assess the effect of comorbidities and of SES variables on urinary function (UF) and sexual function (SF) and on associated bother items. Methods. A cohort of 1,162 men without an established diagnosis of prostate cancer (PCa) completed questionnaires addressing SES characteristics, the lifetime prevalence of 12 comorbid conditions, SF and UF as well as their associated bother. Main Outcome Measures. Crude and adjusted logistic regression models tested the association between the predictors, SES and comorbidity, and four separate outcomes, namely SF and UF and their associated bother. Results. Of all men, aged 40-79 years, 172 (14.8%) reported poor or very poor ability to have an erection, and for 165 (14.2%), erectile function (EF) was a big or moderate problem. Daily or weekly urinary incontinence was reported by 98 (8.4%) men, and for 94 (8.1%) men, UF was a big or moderate problem. One or more comorbidities were present in 437 (37.6%) men. In age- and SES-adjusted analyses, major depression and diabetes had the most detrimental effect on EF (5.8 [P < 0.001] and 4.8 [P < 0.001], respectively) and on sexual bother (4.3 [P < 0.001] and 7.2 [P < 0.001], respectively). Stroke (4.7 [P = 0.004]) and drug problems (4.8 [P = 0.002]) had the most detrimental effect on urinary incontinence. Alcoholism and alcohol-related problems (3.1 [P = 0.004]) had the most detrimental effect on the urinary bother scale. Finally, SES only affected urinary incontinence, which was poorer in men who lived with a spouse or partner (2.1 [P = 0.03]). Conclusion. Select comorbidities have very strong effects on UF and EF. Conversely, for most SES variables, the effect was weak and insignificant. In consequence, when patients are assessed for definitive PCa therapy, comorbidities require an adjustment, whereas SES assessment may potentially be omitted, especially if questionnaire brevity is a consideration

    Prediction of delayed graft function after renal transplantation

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    Introduction: Delayed graft function (DGF), defined as the need for dialysis during the first week after renal transplantation, is an important adverse clinical outcome. A previous model relied on 16 variables to quantify the risk of DGF, thereby undermining its clinical usefulness. We explored the possibility of developing a simpler, equally accurate and more user-friendly paradigm for renal transplant recipients from deceased donors. Methods: Logistic regression analyses addressed the occurrence of DGF in 532 renal transplant recipients from deceased donors. Predictors consisted of recipient age, gender, race, weight, number of HLA-A, HLA-B and HLA-DR mismatches, maximum and last titre of panel reactive antibodies, donor age and cold ischemia time. Accuracy was quantified with the area under the curve. Two hundred bootstrap resamples were used for internal validation. Results: Delayed graft function occurred in 103 patients (19.4%). Recipient weight (p < 0.001), panel of reactive antibodies (p < 0.001), donor age (p < 0.001), cold ischemia time (p = 0.005) and HLA-DR mismatches (p = 0.05) represented independent predictors. The multivariable nomogram relying on 6 predictors was 74.3% accurate in predicting the probability of DGF. Conclusion: Our simple and user-friendly model requires 6 variables and is at least equally accurate (74%) to the previous nomogram (71 %). We demonstrate that DGF can be accurately predicted in different populations with this new model

    Toxicities associated with the administration of sorafenib, sunitinib, and temsirolimus and their management in patients with metastatic renal cell carcinoma

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    Objective: To provide a systematic review of the side effects associated with sorafenib, sunitinib, and temsirolimus and to provide an outline of possible preventive or therapeutic measures. Methods: We performed a PubMed-based systematic review of side effects associated with the three agents and relied on product monographs and prescribing information to provide an outline of treatments aimed at reducing these toxicities. Results: Side effects range from < 1% to 72%. Grade 3/4 side effects are less common and range from < 1% to 13% for sorafenib, < 1% to 16% for sunitinib, and 1% to 20% for temsirolimus. Overall, sunitinib causes the most grade 3/4 side effects and sorafenib causes the fewest grade 3/4 side effects, although head-to-head trials are required to compare safety profiles of all three kinase inhibitors. Virtually all side effects can be managed effectively. Conclusion: Prevention, recognition, and prompt management of side effects are of key importance and avoid unnecessary dose reductions, which may undermine treatment efficacy. (c) 2007 European Association of Urology. Published by Elsevier B.V. All rights reserved
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