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| 2. |
- Grabe, Magnus, et al.
(författare)
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Controlled trial of a short and a prolonged course with ciprofloxacin in patients undergoing transurethral prostatic surgery
- 1987
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Ingår i: European Journal of Clinical Microbiology and Infectious Diseases. - 0722-2211. ; 6:1, s. 11-17
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Tidskriftsartikel (refereegranskat)abstract
- The efficacy of a short (Group I) and a prolonged (Group II) course with ciprofloxacin was assessed in patients undergoing transurethral prostatic resection for benign hyperplasia or cancer of the prostate and compared with that of controls without antibiotic (Group III). Both regiments significantly reduced the frequency of postoperative bacteriuria (p less than 0.01) and of severe infectious complications (p = 0.004) as compared to the controls. Both regimens were equally effective in preventing perioperative and postoperative acquisition of bacteriuria in patients without bacteriuria at surgery. In patients with bacteriuria before surgery, bacteriuria was found postoperatively in 35% in Group I and 10% in Group II (p = 0.012), but in 82% of the patients in Group III. Ciprofloxacin inhibited all but 7 of 176 bacterial strains at an MIC of less than or equal to 1 microgram/ml. Given orally ciprofloxacin is a valuable alternative antimicrobial for use in conjunction with transurethral prostatic resection. A short course is sufficient for prophylaxis, and adequate therapy is achieved with a prolonged regimen.
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| 3. |
- Hellsten, Sverker, et al.
(författare)
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Use of ciprofloxacin in patients undergoing transurethral prostatic surgery
- 1989
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Ingår i: Scandinavian Journal of Infectious Diseases. Supplementum. - 0300-8878. ; 60, s. 104-107
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Tidskriftsartikel (refereegranskat)abstract
- The efficacy of a short (Group I) and a prolonged (Group II) course with ciprofloxacin was assessed in patients undergoing transurethral prostatic resection and compared with that of controls without antibiotic (Group III). Both regimens significantly reduced the frequency of post-operative bacteriuria (p less than 0.01) and of severe infectious complications (p = 0.004) compared to the controls. Both regimens were equally effective in preventing peri-operative and post-operative acquisition of bacteriuria in patients without bacteriuria at surgery. In patients with bacteriuria before surgery, bacteriuria was found post-operatively in 35% in Group I and in 9% in Group II (p = 0.012), but in 82% of the patients in Group III. Ciprofloxacin inhibited all but 7 of 176 bacterial strains at an MIC of less than or equal to 1 microgram/ml. Given orally, ciprofloxacin is a valuable alternative antimicrobial for use in conjunction with transurethral prostatic resection. A short course is sufficient for prophylaxis, and adequate therapy is achieved with a prolonged regimen.
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| 5. |
- Malmström, Per-Uno, et al.
(författare)
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Role of hexaminolevulinate-guided fluorescence cystoscopy in bladder cancer: critical analysis of the latest data and European guidance
- 2012
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Ingår i: Scandinavian Journal of Urology and Nephrology. - : Informa UK Limited. - 0036-5599 .- 1651-2065. ; 46:2, s. 108-116
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Tidskriftsartikel (refereegranskat)abstract
- Objective. Hexaminolevulinate (HAL) is an optical imaging agent used with fluorescence cystoscopy (FC) for the detection of non-muscle-invasive bladder cancer (NMIBC). Guidelines from the European Association of Urology (EAU) and a recent, more detailed European expert consensus statement agree that HAL-FC has a role in improving detection of NMIBC and provide recommendations on situations for its use. Since the publication of the EAU guidelines and the European consensus statement, new evidence on the efficacy of HAL-FC in reducing recurrence of NMIBC, compared with white light cystoscopy (WLC), have been published. Material and methods. To consider whether these new trials have an impact on the expert guidelines and on clinical practice (e. g. supporting existing recommendations or providing evidence for a change or expansion of practice), a group of bladder cancer experts from Denmark, Finland, Norway and Sweden met to address the following questions: What is the relevance of the new data on HAL-FC for clinical practice in managing NMIBC? What impact do the new data have on European guidelines? How could HAL-FC be used in clinical practice? and What further information on HAL-FC is required to optimize the management of NMIBC? Results and conclusions. This article reports the outcomes of the discussion at the Nordic expert panel meeting, concluding that, in line with European guidance, HAL-FC has an important role in the initial detection of NMIBC and for follow-up of patients to assess tumour recurrence after WLC. It provides practical advice, with an algorithm on the use of this diagnostic procedure for urologists managing NMIBC.
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| 6. |
- Egevad, Lars, et al.
(författare)
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Urachal signet-cell adenocarcinoma
- 2009
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Ingår i: Scandinavian Journal of Urology and Nephrology. - : Informa UK Limited. - 0036-5599 .- 1651-2065. ; 43:1, s. 88-91
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Tidskriftsartikel (refereegranskat)abstract
- This report presents two cases of urachal signet-cell adenocarcinoma (USCA). Two men, aged 53 and 51 years, presented with haematuria. Cystoscopy showed tumours in the dome of the bladder and transurethral resection revealed signet ring cell carcinoma. They both underwent cystoprostatectomy but died of metastatic disease after 14 and 26 months. USCA is a very rare tumour with poor prognosis. Only 25 cases have been reported. The tumours have a specific gross and microscopic morphology but must be distinguished from metastases of signet ring cell originating from other sites. Immunohistochemistry is helpful for the determination of the primary site.
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| 7. |
- Chabot, Sophie, et al.
(författare)
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Impact of Cernitin™ on induced chronic prostatitis in animal model for understanding management of lower urinary tract symptoms
- 2021
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Ingår i: Phytomedicine Plus. - : Elsevier BV. - 2667-0313. ; 1:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cernitin™ pollen extracts (brand name Cernilton®) alleviates symptoms related to common lower uro-genital tract disorders in men. The underlying mechanisms are ill-defined but the inflammatory pathway could be one of them. In a previous in vitro study it was shown that Cernitin™ induce a regulatory effect on inflammatory parameters. Methods: In this study, male Sprague Dawley rats were used to validate the effects of Cernitin™ in chronic prostatitis and benign prostatic hyperplasia. Pain was assessed by von Frey assay. Results: Cernitin™ exhibited significant pain relief in the induced prostatitis rat model and was associated with a significant decrease in the intraprostatic level of COX-2 and MCP-1 in the prostatic tissue homogenates. In a parallel study, Cernitin™ treatment led to a significant decrease in prostate weight in rats with testosterone induced BPH. Concurrently, a significant decrease in the percentage of proliferation marker, Ki-67, and androgen receptor expressing cells was observed. Similarly, a low level of cytoplasmic 5α-reductase expression was observed in Cernitin™- and finasteride-treated animals. Conclusion: The current in vivo experiments support the use of Cernitin™ as an anti-inflammatory and symptom reducing agent that could, in part, explain the impact of Cernitin™ on the management of chronic pelvic pain in men.
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| 9. |
- Zare, Reza, et al.
(författare)
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Can routine outpatient follow-up of patients with bladder cancer be improved? A multicenter prospective observational assessment of blue light flexible cystoscopy and fulguration
- 2018
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Ingår i: Research and Reports in Urology. - : DOVE MEDICAL PRESS LTD. - 2253-2447. ; 10, s. 151-157
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this prospective cohort study was to determine the feasibility of incorporating blue light flexible cystoscopy (BLFC) and biopsy/fulguration into routine outpatient follow-up of non-muscle invasive bladder cancer patients. Methods: The study included patients with non-muscle-invasive bladder cancer (NMIBC) who were scheduled for routine follow-up. Hexaminolevulinate was instilled in the outpatient department, and the bladder was examined under white light and then with BLFC. Biopsies were taken from all suspicious lesions. Small tumors and suspicious lesions were fulgurated on site; patients with larger lesions were referred to the operating room for resection. Results: The study included 69 patients, with a mean age of 70 years (range 33–89 years) and a mean duration since NMIBC diagnosis of 8 years. Most patients had high-grade cancer at initial diagnosis (52/69) and were at high risk of recurrence (48/69). Two patients per hour could be assessed using outpatient BLFC. Preparation and instillation of hexaminolevulinate took less than 10 minutes per patient, and patients had an additional waiting time of 45–60 minutes following instillation, while the hexaminolevulinate solution was retained in the bladder before examination. Eleven patients had histologically confirmed tumors that were identified using both white light flexible cystoscopy and BLFC. An additional three patients had tumors that were identified by BLFC only: two with Ta tumors and one with carcinoma in situ. Of the 14 patients with confirmed tumors, 11 could be managed on site with fulguration, whereas three were referred to the operating room. No adverse events attributable to BLFC were reported. Conclusion: Routine outpatient management of patients with NMIBC using BLFC and onsite biopsy/fulguration is feasible, despite the additional time required for hexaminolevulinate instillation, and appears to allow early detection of recurrent lesions, which can be fulgurated without the need for hospitalization.
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| 10. |
- Holmbom, Martin, et al.
(författare)
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Community-onset urosepsis: incidence and risk factors for 30-day mortality - a retrospective cohort study
- 2022
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Ingår i: Scandinavian Journal of Urology. - : Medical Journals Sweden AB. - 2168-1805 .- 2168-1813. ; 56:5-6, s. 414-420
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Tidskriftsartikel (refereegranskat)abstract
- Background Urosepsis is a life-threatening condition that needs to be addressed without delay. Two critical issues in its management are: (1) Appropriate empirical antibiotic therapy, considering the patients general condition, comorbidity, and the pathogen expected; and (2) Timing of imaging to identify obstruction requiring decompression. Objectives To identify risk factors associated with 30-day mortality in patients with urosepsis. Methods From a cohort of 1,605 community-onset bloodstream infections (CO-BSI), 282 patients with urosepsis were identified in a Swedish county 2019-2020. Risk factors for mortality with crude and adjusted odds ratios were analysed using logistic regression. Results Urosepsis was found in 18% (n = 282) of all CO-BSIs. The 30-day all-cause mortality was 14% (n = 38). After multivariable analysis, radiologically detected urinary tract disorder was the predominant risk factor for mortality (OR = 4.63, 95% CI = 1.47-14.56), followed by microbiologically inappropriate empirical antibiotic therapy (OR = 4.19, 95% CI = 1.41-12.48). Time to radiological diagnosis and decompression of obstruction for source control were also important prognostic factors for survival. Interestingly, 15% of blood cultures showed gram-positive species associated with a high 30-day mortality rate of 33%. Conclusion The 30-day all-cause mortality from urosepsis was 14%. The two main risk factors for mortality were hydronephrosis caused by obstructive stone in the ureter and inappropriate empirical antibiotic therapy. Therefore, early detection of any urinary tract disorder by imaging followed by source control as required, and antibiotic coverage of both gram-negative pathogens and gram-positive species such as E. faecalis to optimise management, is likely to improve survival in patients with urosepsis.
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