Technologies to Treat Benign Prostatic Hyperplasia - #UCLAMDChat Webinar
Abstract PURPOSE: Although the European Association of Urology, First International Consultation on Bladder Tumors, National Comprehensive Cancer Network and American Urological Association guidelines all provide an excellent evidence-based framework for the management of nonmuscle invasive bladder cancer, these guidelines vary with respect to important issues such as risk level definitions and management strategies for these risk categories.
Therefore, we built on the existing framework provided by current guidelines, and provide consensus on the definitions of low, intermediate and high risk nonmuscle invasive bladder cancer, as well as practical recommendations for the treatment of patients in each of these risk categories.
For low risk disease a single, immediate chemotherapeutic instillation after transurethral bladder tumor resection is recommended. For intermediate or high risk disease there is no significant benefit from an immediate, postoperative chemotherapeutic instillation. For intermediate risk disease intravesical bacillus Calmette-Guérin with maintenance or intravesical chemotherapy is recommended. For high risk disease bacillus Calmette-Guérin induction plus maintenance is recommended.
The appropriate management of recurrence depends on the patient level of risk as well as previous treatment, while the management of treatment failure depends on the type of failure as well as the level of risk for recurrence and disease progression. Transapical aortic valve implantation in high-risk patients with severe aortic valve stenosis. Ann Thorac Surg. Epub Oct The aim of this prospective BPH e Chirurgia endovascolare observational study was to assess early and 2-year clinical and hemodynamic outcomes after TA-TAVI.
Patients underwent clinical and echocardiographic follow-up visits at hospital discharge, 3 and 6 months after TA-TAVI, and every 6 months thereafter. The impact of the learning curve for the centers and of intraoperative complications on patient outcomes was also evaluated. Transapical delivery was successful in all patients. Seventeen severe intraoperative complications occurred in 13 7.
Thirty-day mortality was 3. Mean follow-up was 9. Late mortality occurred in 9 patients. An intraoperative severe complication was identified as the only significant independent predictor of 1-year mortality. A significant reduction of both mean and peak gradients from the preoperative to the postoperative period, which remained stable during follow-up, was found.
Survival after TA-TAVI is affected by the center learning curve and by the occurrence of an intraoperative complication. Breve commento a cura di N. Il follow up clinico-funzionale è stato fatto alla dimissione e poi ogni 6 mesi.
Nel 7. Gli autori sottolineano il successo ed i benefici di questa tecnica dedicata a pazienti ad alto rischio, anche se nuove evidenze sono necessarie per valutare i risultati nel lungo termine. Previous experiences support the usefulness of combined chemotherapy and radiotherapy. The impact on relapse-free survival of clinical and pathological variables and adjuvant treatment received was analyzed by univariate and multivariate analysis. Median age was 62 years range Four patients were excluded from analysis because they were not treated with any adjuvant therapy.
At univariate analysis, tumor grade G3 vs. Relapse-free survival at 3 years BPH e Chirurgia endovascolare At multivariable analysis, age and grading were independently BPH e Chirurgia endovascolare with recurrence-free survival. Hazard ratio for relapse-free survival was 0.
A combined approach with radiotherapy and chemotherapy may induce an advantage in relapse-free survival compared to radiotherapy or chemotherapy alone. Prospective clinical trials are needed to verify this clinical hypothesis.
Comparison of long-term clinical and angiographic outcomes following implantation of bare metal stents and drug-eluting stents in aorto-ostial lesions. Am J Cardiol. Epub Jul Abstract Percutaneous coronary intervention PCI to aorto-ostial AO lesions is technically demanding and associated with high revascularization rates. A retrospective cohort analysis was conducted of all consecutive patients who underwent PCI to AO lesions at 2 centers. Angiographic and clinical outcomes in patients with DES from September to December were compared to a historical control group of patients with BMS.
Cox regression analysis with propensity score adjustment for baseline differences suggested that DES were associated with a reduction in target lesion revascularization hazard ratios 0. In conclusion, despite differences in baseline characteristics favoring the BMS group, PCI with DES in AO lesions was associated with improved outcomes, with lower restenosis, revascularization, and major adverse cardiac event rates.
Abstract The influence of age on the clinical results after rescue angioplasty percutaneous coronary intervention [PCI] has been poorly investigated. The primary end point of the study was the incidence of death at 1 year of follow-up. The secondary end point was the 1-year incidence of major cardiac adverse events MACE defined as a composite BPH e Chirurgia endovascolare death, recurrent acute myocardial infarction, and target vessel revascularization.
The predictors of death and MACE at 1 year were also investigated. The Cox proportional hazards model identified age adjusted hazard ratio 0. Treatment of abdominal aortic aneurysm in nine countries a vascunet report. Eur J Vasc Endovasc Surg. Primary outcome was in-hospital or day mortality. Multivariate logistic regression was used to assess case-mix.
EVAR varied between countries from Overall perioperative mortality after intact AAA repair was 2. The perioperative mortality BPH e Chirurgia endovascolare varied from 1. Increasing age, open repair and presence of comorbidities were associated with outcome. The overall perioperative mortality was Perioperative outcome after intact AAA repair was stable over time, BPH e Chirurgia endovascolare improved after ruptured repair.
Geographical differences in treatment of AAA remain. Sono stati studiati oltre La mortalità periopeartoria overall è 2. Per tale esito BPH e Chirurgia endovascolare osserva una significativa riduzione nel tempo. However, previous reports have been limited by small sample size and single-institution design. Patients were similar respect to age, gender, rates BPH e Chirurgia endovascolare cirrhosis, hepatitis C infection, tumour size, and American Society of BPH e Chirurgia endovascolare classification.
The MIH group had lower rates of hepatitis B infection. There were no differences in type of resection anatomic or non-anatomicuse of Pringle's maneuver, and operative time. Survival outcomes were similar in the two groups.
Curr Hematol Malig Rep. Istituto di Ematologia "L. Seràgnoli", Bologna, Italy. Several studies have confirmed that 2-[fluorine]fluorodeoxy-D-glucose 18FDG uptake varies among different subtypes of lymphoma, a disparity that can be explained by the differences in histology, proliferation of tumor cells, and the ratio of viable tumor and reactive cells in the environment.
These observations are based on investigation of B-cell lymphomas. Several meta-analyses have confirmed the role of PET in evaluating the viability of the residual tumor mass after treatment.
Outcome and quality of life of elderly critically ill patients: An Italian prospective observational study. Arch Gerontol Geriatr.
Abstract The demand of critical care admissions to intensive care unit ICU is projected to rise in the next decade. The aim of this study was to evaluate short and long-term mortality and quality of life QoL of elderly patients 80 years and older admitted to two ICUs for medical conditions, abdominal surgery planned and unplanned and orthopedic surgery for hip fractures, over a 6-year period. Three months and one year after ICU discharge, patients or family members were contacted by telephone to obtain follow-up information using the EuroQoL questionnaire.
The data were compared with an age-matched of the Italian population. Two hundred eighty-eight patients were included in the study. ICU mortality of medical Three months and 12 months mortality rates after ICU discharge were QoL measures revealed that, one year BPH e Chirurgia endovascolare ICU discharge, medical and orthopedic patients had significantly more severe problems vis-à-vis mobility, self-care BPH e Chirurgia endovascolare activity than abdominal surgical patients and control population.
Type of admission was the independent risk factor associated with ICU and long-term mortality, whereas age 90 year and older was associated with long-term mortality.
Orthopedic surgery for hip fractures seems to influence QoL similar to medical diseases. Laparoscopically guided minilaparotomy: a minimally invasive approach for the treatment of gynaecologic diseases in morbidly obese patients. Laparotomy is generally performed, even though this approach is regarded as highly invasive, whereas laparoscopy, though minimally invasive, is relatively contraindicated because of the high conversion rates to laparotomy.
In light of this, we propose laparoscopically guided transverse minilaparotomy LGTM as a minimally invasive alternative technique. The rationale of diagnostic laparoscopy is to BPH e Chirurgia endovascolare the feasibility of a minimally invasive approach. We have evaluated the feasibility and compared the outcomes with a historical group treated with laparotomy LPTMin morbidly obese patients MOP subjected to gynaecologic surgery. Patients with a uterine BPH e Chirurgia endovascolare greater than the umbilical transverse BPH e Chirurgia endovascolare and with indication for vaginal surgery were excluded operative data and outcome were prospectively recorded.
In two women, the procedure was aborted due to intraperitoneal and ovarian malignant disease spread diagnosed at laparoscopy. In three cases, BPH e Chirurgia endovascolare was necessary due to severe adhesions in one case; laparoscopically unrecognized disease spread in the parametria in the second, and in the remaining case a right common iliac vein injury during lymphadenectomy. Complications were higher in the control group: due to a significantly higher incidence of wound dehiscence OR 0.
Crit Care. Using data BPH e Chirurgia endovascolare the European registry for Studying the Treatment of Acute hyperTension Euro-STATwe sought to evaluate 'real-life' management practices and outcomes in patients who received intravenous antihypertensive therapy to treat an episode of acute hypertension. Subarachnoid hemorrhage in elderly: advantages of the endovascular treatment. Geriatr Gerontol Int. A significant improvement in surgery and endovascular procedures has reduced mortality and morbidity.