| 1. |
- Burgu, Berk, et al.
(författare)
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When is it necessary to perform nuclear renogram in patients with a unilateral neonatal hydronephrosis?
- 2012
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Ingår i: World journal of urology. - : Springer Science and Business Media LLC. - 1433-8726 .- 0724-4983. ; 30:3, s. 347-52
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Tidskriftsartikel (refereegranskat)abstract
- To examine whether anteroposterior(AP) pelvic diameter on postnatal renal ultrasound scan (US) can predict both initial differential renal function (DRF) and deterioration in DRF in patients with prenatally diagnosed hydronephrosis.One hundred and thirty-three patients diagnosed with a unilateral prenatal hydronephrosis, confirmed postnatally, were evaluated. We tried to find the cutoff values for initial AP diameter and change in AP diameter based on initial DRF and renal outcome. Reduction of 5% or more was considered as deterioration in function. All patients had an initial US scan at a mean age of 1.62weeks (1-4) and nuclear renogram at 13.24weeks (7-21). All patients had a second US at a mean age of 10.58weeks (6-19). 119 patients had a second renogram.Initial mean pelvic diameter was 20.86 (11-49)mm. When AP pelvic diameter was less than 20mm, 98.6% of all renal units had a function of ≥40%. The cutoff point for AP pelvic diameter was 19.05 when DRF was ≥45% (P<0.001). When the reduction in hydronephrosis in pelvic diameter was analyzed to predict the initial renal function, a cutoff point of 1.3mm decrease was found when initial renal function was ≥40% (P<0.001). The reduction in AP pelvic diameter was 2.1mm when initial DRF was ≥45% (P=0.009). For all patients except 3 individuals, if there was a reduction in AP diameter or the AP diameter was stable, then no reduction in function was observed.When the AP pelvic diameter is less than 20mm at presentation, DRF is normal. If the AP diameter is stable or decreases, there is unlikely to be a significant deterioration in renal function. Consequently, in selected patients, congenital unilateral hydronephrosis can be followed with serial ultrasounds.
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| 2. |
- Hagman, A., et al.
(författare)
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Urinary continence recovery and oncological outcomes after surgery for prostate cancer analysed by risk category: results from the LAParoscopic prostatectomy robot and open trial
- 2021
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Ingår i: World Journal of Urology. - : Springer Science and Business Media LLC. - 0724-4983 .- 1433-8726. ; 39:9, s. 3239-3249
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Tidskriftsartikel (refereegranskat)abstract
- Purpose To evaluate urinary continence (UC) recovery and oncological outcomes in different risk-groups after robot-assisted radical prostatectomy (RALP) and open retropubic radical prostatectomy (RRP). Patients and methods We analysed 2650 men with prostate cancer from seven open (n = 805) and seven robotic (n = 1845) Swedish centres between 2008 and 2011 in a prospective non-randomised trial, LAPPRO. UC recovery was defined as change of pads less than once in 24 h. Information was collected through validated questionnaires. Rate of positive surgical margins (PSM) and biochemical recurrence (BCR), defined as prostate-specific antigen (PSA) > 0.25 mg/ml, were recorded. We stratified patients into two risk groups (low-intermediate and high risk) based on the D'Amico risk classification system. Result Among men with high-risk prostate cancer, we found significantly higher rates of UC recovery up to 24 months after RRP compared to RALP (66.1% vs 60.5%) RR 0.85 (CI 95% 0.73-0.99) while PSM was more frequent after RRP compared to RALP (46.8% vs 23.5%) RR 1.56 (CI 95% 1.10-2.21). In the same group no significant difference was seen in BCR. Overall, however, BCR was significantly more common after RRP compared to RALP at 24 months (9.8% vs 6.6%) RR 1.43 (Cl 95% 1.08-1.89). The limitations of this study are its non-randomized design and the relatively short time of follow-up. Conclusions Our study indicates that men with high-risk tumour operated with open surgery had better urinary continence recovery but with a higher risk of PSM than after robotic-assisted laparoscopic surgery. No significant difference was seen in biochemical recurrence.
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| 3. |
- Jerlström, Tomas, 1969-, et al.
(författare)
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No increased risk of short-term complications after radical cystectomy for muscle-invasive bladder cancer among patients treated with preoperative chemotherapy : a nation-wide register-based study
- 2020
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Ingår i: World journal of urology. - : Springer. - 0724-4983 .- 1433-8726. ; 38:2, s. 381-388
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Preoperative chemotherapy is underused in conjunction with radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC) due to concerns for complications and delay of surgery. Prospective data on short-term complications from population-based settings with frequent use of preoperative chemotherapy and standardised reporting of complications is lacking.METHODS: We identified 1,340 patients who underwent RC between 2011 and 2015 in Sweden due to MIBC according to the Swedish Cystectomy Register. These individuals were followed through linkages to several national registers. Propensity score adjusted logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for complications and death within 90 days of surgery, comparing patients receiving preoperative chemotherapy or not.RESULTS: Minimum two cycles of preoperative chemotherapy were given to 519 (39%) of the patients, who on average tended to be younger, have higher education, better physical status, and more advanced bladder cancer than patients not receiving chemotherapy. After adjusting for these and other parameters, there was no association between treatment with preoperative chemotherapy and short-term complications (OR 1.06 95% CI 0.82-1.39) or mortality (OR 0.75 95% CI 0.36-1.55). We observed a risk reduction for gastrointestinal complications among patients who received preoperative chemotherapy compared with those who did not (OR 0.49 95% CI 0.30-0.81).CONCLUSION: This nation-wide population-based observational study does not suggest that preoperative chemotherapy, in a setting with high utilisation of such treatment, is associated with an increased risk of short-term complications in MIBC patients treated with radical cystectomy.
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| 4. |
- Nordling, Jørgen, et al.
(författare)
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Global concepts of bladder pain syndrome (interstitial cystitis).
- 2012
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Ingår i: World Journal of Urology. - : Springer Science and Business Media LLC. - 1433-8726 .- 0724-4983. ; 30:4, s. 457-464
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Bladder pain syndrome (BPS), commonly referred to as "interstitial cystitis", is no longer considered a rare disorder. It may affect up to 2.7% of the adult female population (Ueda et al. in Int J Urol 10:1-70, 2003) with up to 20% of cases occurring in men. METHODS: The last two decades have seen a worldwide effort to try to standardize its nomenclature, definition, diagnosis, and treatment algorithm. The literature has been reviewed. RESULTS: In this article, we will detail current terminology, diagnostic approaches and treatment. Standard therapies will be discussed, and a section that concentrates on the management of the subset of patients with a Hunner's lesion will be highlighted. CONCLUSIONS: BPS is today viewed through a new paradigm. It is no longer considered primarily a bladder disease, but rather one of a number of chronic pain syndromes that is distinguished by being manifest through bladder-related symptoms. A distinct subgroup of patients with Hunner's lesion has specific characteristics, and successful treatment of this subgroup is available.
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| 5. |
- Stranne, Johan, 1970, et al.
(författare)
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Single institution followed by national implementation of systematic surgical quality control and feedback for radical prostatectomy: a 20-year journey
- 2020
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Ingår i: World Journal of Urology. - : Springer Science and Business Media LLC. - 0724-4983 .- 1433-8726. ; 38, s. 1397-1411
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The demand for objective and outcome-based facts about surgical results after radical prostatectomy (RP) is increasing. Systematic feedback is also essential for each surgeon to improve his/her performance. Methods: RP outcome data (e.g., pT-stage and margin status) have been registered at Sahlgrenska University Hospital (SUH) since 1988 and patient-related outcome measures (PROM) have been registered since 2001. The National Prostate Cancer Registry (NPCR) has covered all Regions in Sweden since 1998 and includes PROM-data from 2008. Initially PROM was on-paper questionnaires but due since 2018 all PROMs are collected electronically. In 2014 an on-line “dashboard” panel was introduced, showing the results for ten quality-control variables in real-time. Since 2017 all RP data on hospital, regional, and national levels are publicly accessible on-line on “www.npcr.se/RATTEN”. Results: The early PROM-data from SUH have been used for internal quality control. As national clinical and PROM-data from the NPCR have been made accessible on-line and in real-time we have incorporated this into our pre-existing protocol. Our data are now internally available as real-time NPCR reports on the individual surgeons’ results, as well as ePROM data. We can compare the results of each surgeon internally and to other departments’ aggregated data. The public can access data and compare hospital level data on “RATTEN”. Conclusions: The process of quality control of RP locally at SUH, and nationally through the NPCR, has been long but fruitful. The online design, with direct real-time feedback to the institutions that report the data, is essential.
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| 6. |
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| 7. |
- Murta-Nascimento, C., et al.
(författare)
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Epidemiology of urinary bladder cancer: from tumor development to patient's death
- 2007
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Ingår i: World J Urol. - 0724-4983. ; 25:3, s. 285-295
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Tidskriftsartikel (refereegranskat)abstract
- Urinary bladder cancer (UBC) ranks ninth in worldwide cancer incidence. It is more frequent in men than in women. We review the main established/proposed factors, both environmental and genetic, associated with bladder cancer etiology and prognosis. Data were extracted from previous reviews and original articles identified from PubMed searches, reference lists, and book chapters dealing with the reviewed topics. Evaluation and consensus of both the contribution of each factor in bladder cancer burden and the appropriateness of the available evidences was done during an ad hoc meeting held during the 18th Congress of the European Society for Urological Research. Cigarette smoking and specific occupational exposures are the main known causes of UBC. Phenacetin, chlornaphazine and cyclophosphamide also increase the risk of bladder cancer. Chronic infection by Schistosoma haematobium is a cause of squamous cell carcinoma of the bladder. NAT2 slow acetylator and GSTM1 null genotypes are associated with an increased risk of this cancer. Vegetables and fresh fruits protect against this tumor. Regarding prognosis, there is little knowledge on the predictive role of environmental exposures and genetic polymorphisms on tumor recurrence and progression and patient's death. Although active tobacco smoking is the most commonly studied factor, no definitive conclusion can be drawn from the literature. More research is needed regarding the effect of complex etiological factors in bladder carcinogenesis. Subgroup analysis according to stage, grade, and molecular features may help in identifying specific etiological and prognostic factors involved in different bladder cancer progression pathways.
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| 8. |
- Bersani, M. M., et al.
(författare)
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PuRSUE -from specification of robotic environments to synthesis of controllers
- 2020
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Ingår i: Formal Aspects of Computing. - : Association for Computing Machinery (ACM). - 0934-5043 .- 1433-299X. ; 32, s. 187-227
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Tidskriftsartikel (refereegranskat)abstract
- Developing robotic applications is a complex task, which requires skills that are usually only possessed by highly-qualified robotic developers. While formal methods that help developers in the creation and design of robotic applications exist, they must be explicitly customized to be impactful in the robotics domain and to support effectively the growth of the robotic market. Specifically, the robotic market is asking for techniques that: (i) enable a systematic and rigorous design of robotic applications though high-level languages; and (ii) enable the automatic synthesis of low-level controllers, which allow robots to achieve their missions. To address these problems we present the PuRSUE (Planner for RobotS in Uncontrollable Environments) approach, which aims to support developers in the rigorous and systematic design of high-level run-time control strategies for robotic applications. The approach includes PuRSUE-ML a high-level language that allows for modeling the environment, the agents deployed therein, and their missions. PuRSUE is able to check automatically whether a controller that allows robots to achieve their missions might exist and, then, it synthesizes a controller. We evaluated how PuRSUE helps designers in modeling robotic applications, the effectiveness of its automatic computation of controllers, and how the approach supports the deployment of controllers on actual robots. The evaluation is based on 13 scenarios derived from 3 different robotic applications presented in the literature. The results show that: (i) PuRSUE-ML is effective in supporting designers in the formal modeling of robotic applications compared to a direct encoding of robotic applications in low-level modeling formalisms; (ii) PuRSUE enables the automatic generation of controllers that are difficult to create manually; and (iii) the plans generated with PuRSUE are indeed effective when deployed on actual robots.
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