Pub Date : 2021-02-01DOI: 10.1093/MED/9780190655341.003.0001
P. Dahm
This chapter describes the design, main findings, relevance, and limitations of the European Randomized Study of Screening for Prostate Cancer (ERSPC), which compared screening based on prostate-specific antigen (PSA) to no screening. ERSPC indicated that screened patients may derive a small survival benefit in terms of prostate cancer–specific mortality but not all-cause mortality. Such a benefit is most likely realized in men with an extended life expectancy of 15 years or greater. The potential harms of PSA-based prostate cancer screening include a high rate of false-positive tests, biopsy-related complications, the unnecessary diagnosis of low-risk prostate cancer unlikely to affect a man during his lifetime (overdiagnosis) in some, and treatment sequelae both in men who may benefit from treatment and those who will not (overtreatment).
{"title":"Early Detection of Prostate Cancer","authors":"P. Dahm","doi":"10.1093/MED/9780190655341.003.0001","DOIUrl":"https://doi.org/10.1093/MED/9780190655341.003.0001","url":null,"abstract":"This chapter describes the design, main findings, relevance, and limitations of the European Randomized Study of Screening for Prostate Cancer (ERSPC), which compared screening based on prostate-specific antigen (PSA) to no screening. ERSPC indicated that screened patients may derive a small survival benefit in terms of prostate cancer–specific mortality but not all-cause mortality. Such a benefit is most likely realized in men with an extended life expectancy of 15 years or greater. The potential harms of PSA-based prostate cancer screening include a high rate of false-positive tests, biopsy-related complications, the unnecessary diagnosis of low-risk prostate cancer unlikely to affect a man during his lifetime (overdiagnosis) in some, and treatment sequelae both in men who may benefit from treatment and those who will not (overtreatment).","PeriodicalId":435097,"journal":{"name":"50 Studies Every Urologist Should Know","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127762952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-01DOI: 10.1093/MED/9780190655341.003.0034
Michael Borofsky, V. Bird
This chapter reviews the findings of the initial case series of patients with renal stones treated with extracorporeal shock wave lithotripsy (ESWL) with 12 months of follow-up. In the majority of patients, the renal stones were broken up into fragments that could pass spontaneously, and only a few patients required surgical interventions. Renal function did not appear adversely impacted by the procedure.
{"title":"First Clinical Experience With Extracorporeally Induced Destruction of Kidney Stones by Shock Waves","authors":"Michael Borofsky, V. Bird","doi":"10.1093/MED/9780190655341.003.0034","DOIUrl":"https://doi.org/10.1093/MED/9780190655341.003.0034","url":null,"abstract":"This chapter reviews the findings of the initial case series of patients with renal stones treated with extracorporeal shock wave lithotripsy (ESWL) with 12 months of follow-up. In the majority of patients, the renal stones were broken up into fragments that could pass spontaneously, and only a few patients required surgical interventions. Renal function did not appear adversely impacted by the procedure.","PeriodicalId":435097,"journal":{"name":"50 Studies Every Urologist Should Know","volume":"369 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122343695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-01DOI: 10.1093/MED/9780190655341.003.0043
J. Bodie
This chapter summarizes the results of a landmark trial comparing different doses of oral sildenafil versus placebo to treat erectile dysfunction. Patients received either an identical placebo or 25- mg, 50-mg, or 100-mg tablets of sildenafil to be taken approximately one hour before planned sexual activity (but not more than once daily) for 24 weeks. Higher doses of sildenafil resulted in higher mean score for frequency of penetration and maintenance of erection, which were also consistently better than placebo. The most common side effects were headaches, flushing, dyspepsia, rhinitis, and visual disturbances. This study established sildenafil as an effective, reasonably well-tolerated treatment for men with erectile dysfunction of varying etiologies.
{"title":"Oral Sildenafil in the Treatment of Erectile Dysfunction","authors":"J. Bodie","doi":"10.1093/MED/9780190655341.003.0043","DOIUrl":"https://doi.org/10.1093/MED/9780190655341.003.0043","url":null,"abstract":"This chapter summarizes the results of a landmark trial comparing different doses of oral sildenafil versus placebo to treat erectile dysfunction. Patients received either an identical placebo or 25- mg, 50-mg, or 100-mg tablets of sildenafil to be taken approximately one hour before planned sexual activity (but not more than once daily) for 24 weeks. Higher doses of sildenafil resulted in higher mean score for frequency of penetration and maintenance of erection, which were also consistently better than placebo. The most common side effects were headaches, flushing, dyspepsia, rhinitis, and visual disturbances. This study established sildenafil as an effective, reasonably well-tolerated treatment for men with erectile dysfunction of varying etiologies.","PeriodicalId":435097,"journal":{"name":"50 Studies Every Urologist Should Know","volume":"138 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132436344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-01DOI: 10.1093/MED/9780190655341.003.0022
C. Weight
This chapter summarizes the findings of the landmark CheckMate 025 trial for the new class of drugs of immune checkpoint blockade in advanced renal cell cancer. The trial randomized patients with metastatic renal cell carcinoma who had failed antiangiogenic therapy to systemic therapy with nivolumab versus everolimus and found improved overall survival and fewer treatment-related adverse events in the nivolumab arm.
{"title":"Nivolumab Versus Everolimus in Advanced Renal Cell Carcinoma","authors":"C. Weight","doi":"10.1093/MED/9780190655341.003.0022","DOIUrl":"https://doi.org/10.1093/MED/9780190655341.003.0022","url":null,"abstract":"This chapter summarizes the findings of the landmark CheckMate 025 trial for the new class of drugs of immune checkpoint blockade in advanced renal cell cancer. The trial randomized patients with metastatic renal cell carcinoma who had failed antiangiogenic therapy to systemic therapy with nivolumab versus everolimus and found improved overall survival and fewer treatment-related adverse events in the nivolumab arm.","PeriodicalId":435097,"journal":{"name":"50 Studies Every Urologist Should Know","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114617567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-01DOI: 10.1093/MED/9780190655341.003.0033
Michael Borofsky, V. Bird
This chapter reviews the results of an important observational study seeking to establish how, in individuals without a history of nephrolithiasis, dietary calcium intake is associated with the risk of symptomatic stone disease. The study found that the mean daily dietary calcium intake was lower in the group who formed stones compared to those who did not and that, after adjusting for covariates, high daily dietary calcium intake was strongly associated with decreased risk of stones.
{"title":"A Prospective Study of Dietary Calcium and Other Nutrients and the Risk of Symptomatic Kidney Stones","authors":"Michael Borofsky, V. Bird","doi":"10.1093/MED/9780190655341.003.0033","DOIUrl":"https://doi.org/10.1093/MED/9780190655341.003.0033","url":null,"abstract":"This chapter reviews the results of an important observational study seeking to establish how, in individuals without a history of nephrolithiasis, dietary calcium intake is associated with the risk of symptomatic stone disease. The study found that the mean daily dietary calcium intake was lower in the group who formed stones compared to those who did not and that, after adjusting for covariates, high daily dietary calcium intake was strongly associated with decreased risk of stones.","PeriodicalId":435097,"journal":{"name":"50 Studies Every Urologist Should Know","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122822851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-01DOI: 10.1093/MED/9780190655341.003.0005
N. Sathianathen
This chapter provides a summary of an important observational study of men with clinically localized, mostly favorable-risk prostate cancer who were followed with active surveillance, which consisted of periodic prostate-specific antigen testing and repeat biopsies. It found that local treatment with curative intent can be safely deferred long term in many patients as long as they are carefully monitored.
{"title":"Clinical Results of Long-Term Follow-Up of a Large, Active Surveillance Cohort With Localized Prostate Cancer","authors":"N. Sathianathen","doi":"10.1093/MED/9780190655341.003.0005","DOIUrl":"https://doi.org/10.1093/MED/9780190655341.003.0005","url":null,"abstract":"This chapter provides a summary of an important observational study of men with clinically localized, mostly favorable-risk prostate cancer who were followed with active surveillance, which consisted of periodic prostate-specific antigen testing and repeat biopsies. It found that local treatment with curative intent can be safely deferred long term in many patients as long as they are carefully monitored.","PeriodicalId":435097,"journal":{"name":"50 Studies Every Urologist Should Know","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127210408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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