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1.
Actas urol. esp ; 46(5): 293-300, jun. 2022. ilus, tab
Artículo en Español | IBECS | ID: ibc-208677

RESUMEN

Introducción y objetivos Nuestro objetivo fue comparar los resultados oncológicos y funcionales del primer año tras la prostatectomía radical asistida por robot con preservación del espacio de Retzius (PRAR-PR) y la prostatectomía radical estándar asistida por robot (PRAR). Materiales y métodos Se incluyeron 88 pacientes sometidos a prostatectomía radical robótica entre 2018-2019. Se compararon los resultados oncológicos y funcionales de los pacientes que recibieron PRAR-PR o PRAR durante un periodo mínimo de seguimiento de un año. La potencia se evaluó con la puntuación del cuestionario de salud sexual del varón (Sexual Health Inventory for Men) y se definió como una erección con rigidez suficiente para la penetración. La continencia se definió como la ausencia de incontinencia urinaria sin compresa de seguridad. Los pacientes fueron evaluados en el primer mes y trimestralmente durante el resto del seguimiento. Resultados Se incluyeron 46 pacientes en el grupo PRAR-PR y 42 en el grupo PRAR. El tiempo de retirada del catéter fue menor en el grupo PRAR-PR (12 vs. 14 días, p=0,001). En la consulta del primer mes 41 pacientes (89%) eran continentes (no utilizaban compresas) en el grupo PRAR-PR, mientras que 25 pacientes (59%) eran continentes en el grupo PRAR (p=0,001). Los pacientes sometidos a PRAR-PR lograron una recuperación más rápida de la continencia urinaria (Log-rank, p=0,001). Tras un año de seguimiento 43 pacientes (93%) del grupo PRAR-PR y 38 (90%) del grupo PRAR eran continentes (p=0,6). Las tasas de potencia fueron del 38,7% en el grupo PRAR-PR y del 34,4% en el grupo PRAR (p=0,28). No se observaron recurrencias bioquímicas en ningún grupo. Conclusiones La PRAR-PR es una técnica factible, que proporciona un retorno temprano de la continencia. Sin embargo, las tasas globales de continencia fueron similares al final del periodo de un año de seguimiento (AU)


Introduction and objectives We aim to compare the first year oncological and functional outcomes of Retzius-sparing robot-assisted radical prostatectomy (Rs-RARP) and standard robot-assisted radical prostatectomy (RARP). Materials and methods Eighty-eight patients who underwent robotic radical prostatectomy between 2018-2019 were included. We compared the minimum one-year follow-up results of patients who underwent Rs-RARP or RARP in terms of oncological and functional outcomes. Potency was assessed with the Sexual Health Inventory for Men (SHIM) score and was defined as an erection sufficient for penetration. Continence was defined as the absence of urinary incontinence with no safety pad. Patients were evaluated in the first month of follow-up and subsequently, every three months. Results Forty-six patients in Rs-RARP and 42 patients in the RARP group were enrolled. Catheter removal time was shorter in the Rs-RARP group (12 vs. 14 days, P=.001). At the 1st month visit, 41 patients (%89) were continent (no pads) in the Rs-RARP group while 25 patients (%59) were continent in the RARP group (P=.001). Patients who underwent Rs-RARP achieved faster recovery of urinary continence (Log-rank, P=.001). After one year of follow-up, 43 patients (93%) in Rs-RARP group and 38 patients (90%) in RARP group were continent (P=.6). Potency rates were 38.7% in Rs-RARP and 34.4% in RARP group (P=.28). There were no cases of biochemical recurrence in any group. Conclusions Rs-RARP is a feasible technique, providing early return of continence. However, overall continence rates were similar at the end of the one-year follow-up (AU)


Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Anciano , Procedimientos Quirúrgicos Robotizados/métodos , Prostatectomía/métodos , Neoplasias de la Próstata/cirugía , Resultado del Tratamiento , Estudios de Seguimiento , Estudios Prospectivos
2.
Actas Urol Esp (Engl Ed) ; 46(5): 293-300, 2022 06.
Artículo en Inglés, Español | MEDLINE | ID: mdl-35221232

RESUMEN

INTRODUCTION AND OBJECTIVES: We aim to compare the first year oncological and functional outcomes of Retzius-sparing robot-assisted radical prostatectomy (Rs-RARP) and standard robot-assisted radical prostatectomy (RARP). MATERIALS AND METHODS: Eighty-eight patients who underwent robotic radical prostatectomy between 2018-2019 were included. We compared the minimum one-year follow-up results of patients who underwent Rs-RARP or RARP in terms of oncological and functional outcomes. Potency was assessed with the Sexual Health Inventory for Men (SHIM) score and was defined as an erection sufficient for penetration. Continence was defined as the absence of urinary incontinence with no safety pad. Patients were evaluated in the first month of follow-up and subsequently, every three months. RESULTS: Forty-six patients in Rs-RARP and 42 patients in the RARP group were enrolled. Catheter removal time was shorter in the Rs-RARP group (12 vs. 14 days, p = 0.001). At the 1st month visit, 41 patients (%89) were continent (no pads) in the Rs-RARP group while 25 patients (%59) were continent in the RARP group (p = 0.001). Patients who underwent Rs-RARP achieved faster recovery of urinary continence (Log-rank, p = 0.001). After one year of follow-up, 43 patients (93%) in Rs-RARP group and 38 patients (90%) in RARP group were continent (p = 0.6). Potency rates were 38.7% in Rs-RARP and 34.4% in RARP group (p = 0.28). There were no cases of biochemical recurrence in any group. CONCLUSIONS: Rs-RARP is a feasible technique, providing early return of continence. However, overall continence rates were similar at the end of the one-year follow-up.


Asunto(s)
Neoplasias de la Próstata , Procedimientos Quirúrgicos Robotizados , Robótica , Humanos , Masculino , Prostatectomía/métodos , Neoplasias de la Próstata/cirugía , Procedimientos Quirúrgicos Robotizados/métodos , Resultado del Tratamiento
3.
Int J Clin Pharm ; 40(2): 386-393, 2018 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-29353396

RESUMEN

Background There is a growing interest in the use of targeted and immunotherapies in oncology. However, the assessment of side effects can be different due to interpretation of patients' health status by healthcare professionals in oncology outpatient clinics. Objective To demonstrate the differences in the assessments of side effects conducted independently by a clinical pharmacist and nurses in patients who receive targeted therapies at an oncology outpatient clinic. Setting The study was conducted at the University Oncology Hospital in an outpatient clinic from October 2015 to March 2016. Method Patients receiving ipilimumab, nivolumab, pembrolizumab, bevacizumab, panitumumab or cetuximab during study period were included. The assessment of side effects was conducted by a pharmacist and nurse independently using the NCI-CTCAE version-2. Main outcome measure To compare the severity assessments of side effects between a clinical pharmacist and nurses in an outpatient clinic. Results During the study, 204 visits for 43 patients with a total of 5508 side effect assessments were recorded where 1137 (20.64%) assessments were graded differently. Out of 1137 assessments, 473 of them were graded higher by a clinical pharmacist whereas 664 were graded higher by nurses. Statistically significant differences were detected in the assessment of vomiting, taste changes, sense changes, alopecia, fatigue, mood changes, anxiety, hearing impairment, and allergic reactions. Conclusion An assessment of side effects by healthcare providers in patients with cancer may be challenging due to an increased workload in clinics and undistinguishable symptoms of side effects and cancer itself. Therefore, a new care model which increases an interprofessional communication may improve pharmaceutical care in oncology outpatient clinics.


Asunto(s)
Antineoplásicos/efectos adversos , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/diagnóstico , Enfermeras y Enfermeros/normas , Servicio Ambulatorio en Hospital/normas , Farmacéuticos/normas , Rol Profesional , Antineoplásicos/uso terapéutico , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/epidemiología , Femenino , Humanos , Masculino , Neoplasias/tratamiento farmacológico , Neoplasias/epidemiología , Estudios Prospectivos
4.
Andrology ; 4(5): 952-6, 2016 09.
Artículo en Inglés | MEDLINE | ID: mdl-27368423

RESUMEN

There are various treatment modalities for erectile dysfunction with different success and satisfaction rates. We aim to compare patient satisfaction with tadalafil, intracavernosal injection, and penile prosthesis implantation in patients with erectile dysfunction. The records of 3448 men with erectile dysfunction were evaluated retrospectively. A total of 356 men with organic erectile dysfunction were enrolled into this study. Of these patients, 132 (37%) received tadalafil 20 mg twice a week for 12 weeks, 106 (30%) patients received tadalafil 5 mg once-daily for 12 weeks, 96 (27%) patients used intracavernosal injection therapy (Bi-mix; papaverine and phentolamine). Moreover, 22 patients underwent penile prosthesis implantation. Patient and partner satisfaction were assessed with International Index of Erectile Function (IIEF) and Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire. Patients' mean age was 52.4 ± 25.76 (32-71). The etiology of erectile dysfunction was chronic systemic diseases in 133 (44%) and radical prostatectomy in 121 patients (40%). The mean IIEF-5 scores improvement after the treatment was higher in penile prosthesis implantation group (12.4 ± 1.3) compared with tadalafil 5 mg (6.7 ± 1.5) (p < 0.01), tadalafil 20 mg (6.2 ± 1.5) (p < 0.01), and intracavernosal injection group (8.4 ± 3.2) (p < 0.05). The EDITS score was significantly higher in penile prosthesis implantation group (78.2 ± 11.3) compared with intracavernosal injection (60.3 ± 6.3), tadalafil 5 mg (72.5 ± 4.5), and tadalafil 20 mg 70.7 ± 3.4 groups (p < 0.05). Partners' EDITS scores were 70.1 ± 10 in penile prosthesis implantation group, 50.2 ± 1.5 in intracavernosal injection group, 62.9 ± 7.8 in tadalafil 5 mg, and 61.3 ± 5.3 in tadalafil 20 mg group (p < 0.05). Erectile dysfunction patients who underwent penile prosthesis implantation seem to be more satisfied compared with tadalafil treatment and intracavernosal injection. Future clinical trials are warranted to confirm our results.


Asunto(s)
Disfunción Eréctil/terapia , Satisfacción del Paciente , Implantación de Pene , Tadalafilo/uso terapéutico , Vasodilatadores/uso terapéutico , Adulto , Anciano , Disfunción Eréctil/tratamiento farmacológico , Disfunción Eréctil/cirugía , Humanos , Masculino , Persona de Mediana Edad , Parejas Sexuales , Encuestas y Cuestionarios , Resultado del Tratamiento
5.
Andrologia ; 48(10): 1080-1085, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26791438

RESUMEN

The aim of the study was to evaluate the effect of the acupuncture treatment on sperm parameters and pregnancy rates in patients with primary infertility. Between January 2008 and May 2010, 30 men with the primary infertility (one year of unprotected intercourse, healthy wife) and varicocele with normal hormone levels and abnormal semen analysis were randomised into two groups. Group 1 underwent subinguinal microscopic varicocelectomy, and Group 2 underwent acupuncture treatment twice a week for 2 months. Both groups were evaluated with semen analysis at 6 months after the treatment. Patients in both groups evaluated with telephone calls and e-mail in terms of pregnancy. The mean age of the patients was 27.2, and groups were comparable regarding the age (P = 0.542). The pre-treatment sperm concentration, motility and morphological characteristics were similar in both groups. Sperm concentration and motility improved significantly in both groups after the treatment. Increase in sperm concentration was higher in the acupuncture group compared to the varicocelectomy group (P = 0.039). The average follow-up was 42 months, and pregnancy rates were emphasised 33% in both groups. Acupuncture treatment in primary infertile varicocele patients with semen abnormalities seems to be effective and has comparable results with the varicocelectomy treatment.


Asunto(s)
Infertilidad Masculina/terapia , Microcirugia/métodos , Motilidad Espermática/fisiología , Espermatozoides/citología , Procedimientos Quirúrgicos Urogenitales/métodos , Varicocele/terapia , Terapia por Acupuntura , Adulto , Humanos , Infertilidad Masculina/fisiopatología , Infertilidad Masculina/cirugía , Masculino , Análisis de Semen , Recuento de Espermatozoides , Resultado del Tratamiento , Varicocele/fisiopatología , Varicocele/cirugía , Adulto Joven
6.
Hum Exp Toxicol ; 35(8): 833-8, 2016 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-26429931

RESUMEN

INTRODUCTION: The aim of this study was to evaluate the cytotoxic effects of three different light-cured orthodontic composites. MATERIAL AND METHODS: Light Bond (Reliance orthodontic products), Grengloo (Ormco corporation), and Kurasper F (Kuraray Europe GmbH) were selected for the experiment. Specimens were prepared according to the manufacturers' instructions, measuring 5 mm in diameter and 2 mm in thickness. Fibroblast cells were obtained from healthy gingival connective tissues. The composite cylinders were incubated in Dulbecco's modified Eagle's culture medium for 72 h according to ISO 10993-5 standards. The xCELLigence method was used to evaluate fibroblast cell vitality. After seeding 200 mL of the cell suspensions into the wells (20,000 cells/well) of the E-plate 96, gingival fibroblasts were treated with bioactive components released by the orthodontic composite materials and monitored every 15 min for 121 h. RESULTS: There were no significant differences between the human gingival fibroblast (HGF) cell indexes of the control and all testing groups (p > 0.05) at 24 and 48 h. Light Bond demonstrated statistically significant decrease in HGF index (p < 0.05) at 72 h, but there was no significant difference among the Kurasper F, Grengloo, and untreated control groups (p > 0.05). Light Bond (p < 0.001) and Grengloo (p < 0.05) groups had lower HGF cell index values when compared to untreated control group, but Kurasper F demonstrated no significant differences between the control groups at 96 h (p > 0.05). CONCLUSION: Orthodontic composite materials include biologically active components and may change oral tissue. So, biocompatible orthodontic bonding composites should be used.


Asunto(s)
Resinas Acrílicas/toxicidad , Materiales Biocompatibles/toxicidad , Resinas Compuestas/toxicidad , Fibroblastos/efectos de los fármacos , Encía/efectos de los fármacos , Ácidos Fosfóricos/toxicidad , Cementos de Resina/toxicidad , Proliferación Celular/efectos de los fármacos , Supervivencia Celular/efectos de los fármacos , Células Cultivadas , Encía/citología , Humanos , Ensayo de Materiales
7.
Bratisl Lek Listy ; 117(12): 691-696, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-28127964

RESUMEN

OBJECTIVE: The aim of this study was to evaluate the frequency of anatomical variation in nasal cavity and paranasal sinuses by comparing a unilateral cleft lip and palate (UCLP) group with a non-syndromic control group using cone beam computed tomography (CBCT). SUBJECTS AND METHODS: This study included 24 UCLP patients in the UCLP group and 24 non-syndromic patients in the control group. Coronal CBCT images were taken in all patients and were evaluated for anatomical variation. The measurements obtained in this study were analysed using chi-square and Fisher's exact tests to compare the two groups statistically. RESULTS: In the UCLP group, there were statistically lower frequencies of pterygoid process pneumatisation (p<0.05), higher wing pneumatisation (p<0.05), and sphenoid sinus over pneumatisation (p<0.05), and statistically higher frequencies of anterior nasal septal deviation (p<0.05) compared to the control group. CONCLUSION: A higher incidence of anterior nasal septal deviation was found in UCLP patients compared to the patients in the control group. It is likely that for this reason, UCLP patients might be predisposed to sinusitis. In UCLP patients, the incidence of neurovascular structures in the sphenoid sinus was lower than that in non-syndromic control patients (Tab. 1, Fig. 6, Ref. 33).


Asunto(s)
Labio Leporino/diagnóstico por imagen , Fisura del Paladar/diagnóstico por imagen , Tomografía Computarizada de Haz Cónico/métodos , Cavidad Nasal/diagnóstico por imagen , Senos Paranasales/diagnóstico por imagen , Adolescente , Adulto , Femenino , Humanos , Masculino
8.
Herz ; 39(1): 142-8, 2014 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-23575980

RESUMEN

BACKGROUND: Saphenous vein graft disease (SVGD) after by-pass surgery is an important cause of morbidity and mortality for patients with coronary artery disease. Comprehensive evaluation of biochemical and hematological parameters associated with this problem is limited. Plateletcrit (PCT) provides complete information on total platelet mass, but it has not been previously studied. In this study, we examined the relationship between SVGD and platelet parameters such as PCT, mean platelet volume, platelet count, and platelet distribution. METHODS: We retrospectively analyzed 14,398 patients who underwent coronary angiography between February 2006 and August 2012. Records from 893 patients with previous coronary artery by-pass graft operation were re-evaluated. A total of 251 cases were divided into two groups (127 patients receiving a saphenous vein graft; 124 patients diagnosed with SVGD) and hematological and biochemical parameters were compared. RESULTS: There were no significant differences in clinical characteristics between the two groups except that the SVGD group had a higher median time from surgery to coronary angiography than the patent saphenous vein graft group [7 years (2-16) vs. 5 years (2-15), p < 0.001]. The SVGD groups also had significantly higher median PCT, mean platelet volume, platelet count, uric acid level, and red blood cell distribution width. The cut-off value for PCT was found to be 0.188 for predicting SVGD, with an 80.65 % sensitivity and 81.1 % specificity. CONCLUSION: Plateletcrit has an important predictive value for SVGD, and it could be used as a marker for anti-platelet therapy to prevent graft atherosclerosis in patients undergoing by-pass surgery.


Asunto(s)
Puente de Arteria Coronaria/efectos adversos , Enfermedad de la Arteria Coronaria/sangre , Enfermedad de la Arteria Coronaria/cirugía , Oclusión de Injerto Vascular/sangre , Oclusión de Injerto Vascular/etiología , Volúmen Plaquetario Medio , Vena Safena/trasplante , Anciano , Biomarcadores/sangre , Enfermedad de la Arteria Coronaria/diagnóstico , Femenino , Oclusión de Injerto Vascular/diagnóstico , Humanos , Masculino , Persona de Mediana Edad , Recuento de Plaquetas , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Resultado del Tratamiento
10.
Int J Impot Res ; 19(6): 610-4, 2007.
Artículo en Inglés | MEDLINE | ID: mdl-17673931

RESUMEN

The aim of the present study was to investigate degree of erectile dysfunction (ED) in males with slow coronary flow (SCF). Endothelial dysfunction was proposed to be the underlying mechanism in both diseases. A total of 29 male patients with slow coronary flow (mean age 45+/-7 years) and 23 male patients with normal coronary arteries (mean age 48+/-12 years) were included in the study. The severity of ED was determined according to the International Index of Erectile Function (IIEF) questionnaire. Mean IIEF scores in patients with SCF and control group were determined as 20.97+/-7.26 and 25.26+/-5.17, P=0.016. ED was detected in 45% (n=13) of SCF patients and 35% (n=8) of the control group (P=0.035). There was a negative correlation between the mean TIMI frame count and IIEF score between patients with SCF and controls (r=-0.31, P=0.029). These data suggest that ED is observed more frequently in patients with SCF phenomenon compared to patients with otherwise normal coronary angiograms.


Asunto(s)
Circulación Coronaria , Células Endoteliales , Disfunción Eréctil/sangre , Humanos , Masculino , Persona de Mediana Edad
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