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Furthering the capacity of urologists to shape the field of dissemination and implementation science and enhance clinical practice. 提高泌尿科医生在传播和实施科学领域的能力,加强临床实践。
Pub Date : 2024-10-14 DOI: 10.1097/ju.0000000000004293
Shellie D Ellis,Ted A Skolarus
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引用次数: 0
A Patient-Prioritized Research Agenda for Clinical Trials in Kidney Stone Disease. 肾结石病临床试验的患者优先研究议程。
Pub Date : 2024-09-20 DOI: 10.1097/ju.0000000000004242
Jonathan S Ellison,Kathryn E Flynn,Katherine Sheridan,Samantha Siodlarz,Jodi Antonelli,Christopher E Bayne,Hunter Beck,Christina Ching,Pankaj P Dangle,Casey Dauw,Carley Davis,Kim Hollander,Dirk Lange,Kristi Ouimet,Carswell Ouimet,Amy Y Pan,Kristina Penniston,Charles D Scales,Nayan Shah,Ryan Spiardi,Necole Streeper,Kristin Whitmore,Mike Witt,Liyun Zhang,Gregory E Tasian
PURPOSETo ensure that research on kidney stones provides meaningful impact for the kidney stone community, patients and caregivers should be engaged as stakeholders in clinical trial design, starting at study inception. This project aimed to elicit, refine, and prioritize research ideas from kidney stone stakeholders to develop a patient-centered research agenda for clinical trials.MATERIALS AND METHODSThe Kidney Stone Engagement Core, a group of patients, caregivers, advocates, clinicians, and researchers, executed an iterative process of surveys and focus groups to elicit and refine research themes, which were then translated into research questions. A separate group of patients, caregivers, and clinicians prioritized these questions through parallel modified Delphi and crowd-sourced digital platforms. A research agenda was developed by the Kidney Stone Engagement Core based on the highest rated questions during a hybrid virtual/in-person capstone session.RESULTSA total of 70 individuals (57 patients and caregivers, 13 researchers and clinicians) participated in the elicitation, 20 individuals (15 patients and caregivers, 5 researchers and clinicians) participated in refinement, and an additional 80 individuals (81 patients and caregivers, 9 researchers and clinicians) participated in prioritization. Key novel themes emerged from elicitation and refinement: ureteral stents, genetic evaluation, shared surgical decision-making, key subgroups, cumulative disease burden, genetic evaluation, and psychosocial support. Stakeholders generated 6 proposed trials from these themes focused on surveillance, surgical intervention, and medical prevention.CONCLUSIONSPatients and caregivers valued comparative effectiveness kidney stone research that focused on individualized care, shared decision-making, and improvement of patient-reported experiences. This process provided actionable recommendations for future patient-centered clinical trials within kidney stone disease.
目的为确保肾结石研究对肾结石群体产生有意义的影响,患者和护理人员应作为利益相关者参与临床试验设计,从研究开始时就应如此。由患者、护理人员、倡导者、临床医生和研究人员组成的 "肾结石参与核心"(Kidney Stone Engagement Core)小组通过反复进行调查和焦点小组讨论,提出并完善研究主题,然后将其转化为研究问题。由患者、护理人员和临床医生组成的另一个小组通过平行修改的德尔菲和众包数字平台对这些问题进行了优先排序。结果共有 70 人(57 名患者和护理人员、13 名研究人员和临床医生)参与了征集,20 人(15 名患者和护理人员、5 名研究人员和临床医生)参与了完善,另有 80 人(81 名患者和护理人员、9 名研究人员和临床医生)参与了优先排序。在征询和完善过程中出现了一些关键的新主题:输尿管支架、遗传评估、共同手术决策、关键亚组、累积性疾病负担、遗传评估和社会心理支持。利益相关者从这些主题中提出了 6 项试验建议,主要集中在监测、手术干预和医疗预防方面。结论患者和护理人员非常重视注重个性化护理、共同决策和改善患者报告经验的肾结石比较效益研究。这一过程为今后在肾结石疾病领域开展以患者为中心的临床试验提供了可行的建议。
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引用次数: 0
Letter: miR-371a-3p Predicting Viable Tumor in Patients Undergoing Retroperitoneal Lymph Node Dissection for Metastatic Testicular Cancer: The SWENOTECA-MIR Study. 信:miR-371a-3p 预测因转移性睾丸癌接受腹膜后淋巴结清扫术患者的存活肿瘤:SWENOTECA-MIR研究。
Pub Date : 2024-09-17 DOI: 10.1097/ju.0000000000004241
Klaus-Peter Dieckmann,Gazanfer Belge
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引用次数: 0
Reevaluating the Definition of "Clinically Significant" Prostate Cancer as Grade Groups 2-5: An Imperative for Improved Risk Stratification. 重新评估 2-5 级前列腺癌 "临床意义重大 "的定义:改进风险分层势在必行。
Pub Date : 2024-09-17 DOI: 10.1097/ju.0000000000004253
Sigrid V Carlsson,Peter R Carroll,Freddie C Hamdy
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引用次数: 0
11-Year Experience With Midline Extraperitoneal Retroperitoneal Lymph Node Dissection for Germ Cell Tumors. 中线腹膜外腹膜后淋巴结清扫术治疗生殖细胞瘤的11年经验
Pub Date : 2024-09-13 DOI: 10.1097/ju.0000000000004246
Muhannad Alsyouf,Alireza Ghoreifi,Arman Ashrafi,Seyedeh-Sanam Ladi-Seyedian,Hamed Ahmadi,Madeleine Burg,Antoin Douglawi,Qi Nie,Ming Li,Sumeet Bhanvadia,Anne Schuckman,Hooman Djaladat,Siamak Daneshmand
PURPOSEA midline extraperitoneal approach for retroperitoneal lymph node dissection (EP-RPLND) has been associated with decreased morbidity compared to transperitoneal approach. We aimed to review our 11-year experience in patients with germ cell tumors (GCT) who underwent EP-RPLND at a single institution.METHODSAll patients with GCT who underwent EP-RPLND between 2010 to 2021 were reviewed. Surgical, peri-operative, and oncologic outcomes were reported. A logistic regression model was developed to evaluate variables predictive of early discharge. Oncologic outcomes included recurrence free survival (2-year RFS) and recurrence patterns, which were analyzed according to pathology.RESULTSOverall, 237 patients underwent EP-RPLND, of which 72% were in the post-chemotherapy (PC) setting. Median follow-up was 16.7(IQR 3.9-39.6) months. Median size of retroperitoneal disease was 2.8 (1.8-5.4)cm, of which 16 cases were > 10 cm. There were no cases of postoperative ileus or readmission due to small bowel obstruction. Median hospital stay was 2(IQR 1-3) days. From 2020 to 2021, 73% of patients were discharged on POD1 and 89% by POD2. Thirty-one complications occurred, including 4% grade III-IV. In the primary setting, 2-year RFS for seminoma and NSGCT were 0.93 (95% CI 0.84-1.00) and 0.85 (95% CI 0.72-1.00); respectively. In the PC setting, 2-year RFS for seminoma and NSGCT were 0.88 (95% CI 0.74-1.00) and 0.88 (95% CI 0.81-0.95); respectively. Overall, only 7 patients had in-field recurrence.CONCLUSIONSMidline EP-RPLND is safe, associated with rapid gastrointestinal recovery, short hospital stay, and low complication rates. It also demonstrates acceptable oncologic outcomes in the primary and post-chemotherapy settings, with low rates of in-field relapse.
目的腹膜后淋巴结清扫术(EP-RPLND)采用中线腹膜外方法,与经腹膜方法相比,发病率较低。我们旨在回顾一家医疗机构11年来对生殖细胞瘤(GCT)患者进行EP-RPLND的经验。方法回顾2010年至2021年期间接受EP-RPLND的所有GCT患者。报告了手术、围手术期和肿瘤学结果。建立了一个逻辑回归模型来评估早期出院的预测变量。肿瘤学结果包括无复发生存期(2 年 RFS)和复发模式,根据病理学进行分析。结果总计有 237 名患者接受了 EP-RPLND,其中 72% 为化疗后(PC)患者。中位随访时间为16.7(IQR 3.9-39.6)个月。腹膜后疾病的中位尺寸为2.8(1.8-5.4)厘米,其中16例大于10厘米。没有出现术后回肠梗阻或因小肠梗阻再次入院的病例。住院时间中位数为 2 天(IQR 1-3)。从2020年到2021年,73%的患者在POD1出院,89%在POD2出院。共发生 31 例并发症,其中 4% 为 III-IV 级。在初级治疗中,精原细胞瘤和NSGCT的2年RFS分别为0.93(95% CI 0.84-1.00)和0.85(95% CI 0.72-1.00)。在 PC 环境中,精原细胞瘤和 NSGCT 的 2 年 RFS 分别为 0.88(95% CI 0.74-1.00)和 0.88(95% CI 0.81-0.95)。结论中线 EP-RPLND 是安全的,胃肠道恢复快,住院时间短,并发症发生率低。此外,它在初治和化疗后的肿瘤治疗效果也是可以接受的,场内复发率较低。
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引用次数: 0
Break Wave Lithotripsy for Urolithiasis: Results of the First-in-Human International Multi-Institutional Clinical Trial. 破波碎石术治疗泌尿系结石:首次人体国际多机构临床试验结果。
Pub Date : 2024-09-10 DOI: 10.1097/ju.0000000000004091
Ben H Chew,Jonathan D Harper,Roger L Sur,Thomas Chi,Shubha De,Anne R Buckley,Ryan F Paterson,Victor K F Wong,Connor M Forbes,M Kennedy Hall,Ross Kessler,Seth K Bechis,Jason R Woo,Ralph C Wang,David B Bayne,Derek Bochinski,Trevor D Schuler,Tim A Wollin,Rahim Samji,Mathew D Sorensen
PURPOSEThis study reports on a prospective, multicenter, single-arm, clinical trial utilizing the SonoMotion (San Mateo, California) Break Wave lithotripsy (BWL) device to fragment urinary stones.MATERIALS AND METHODSPatients with a urinary stone underwent a single treatment of 30 minutes and peak negative pressure of 4.5 to 8 MPa. Subjects were contacted and outcomes assessed at 7, 14, and 35 days after treatment, with clinical follow-up and CT imaging 70 ± 14 days postprocedure. The primary objectives were to assess the safety (hematomas, complications, etc) and effectiveness of BWL (any fragmentation, residual fragments ≤4 mm or ≤2 mm, and completely stone-free rate) as assessed via noncontrast CT-kidneys, ureters, and bladder.RESULTSForty-four patients with a ureteral (43%) or renal (57%) stone were treated across 5 centers. Stone fragmentation occurred in 88% of cases; 70% had fragments ≤ 4 and 51% ≤ 2 mm, while 49% were completely stone free on CT; no serious adverse events were reported. Eighty-six percent of patients received either no analgesic medication at all (50%) or minor analgesia (36%). After determining optimal therapy settings, 36 patients were treated and the effectiveness improved exhibiting fragmentation in 92% (33/36), residual fragments ≤ 4 mm in 75% and 58% with fragments ≤ 2 mm with 58% completely stone free. Effectiveness was less in subjects with lower pole stones with 81% fragmentation, 71% having fragments ≤ 4 mm, 29% with fragments ≤ 2 mm, and 29% completely stone free; of distal ureteral stone patients, 89% were completely stone free.CONCLUSIONSBWL offered safe and effective noninvasive stone therapy requiring little to no anesthesia and was carried out successfully in nonoperative environments.TRIAL REGISTRATIONClinicalTrials.gov identifier: NCT03811171.
本研究报告了一项前瞻性、多中心、单臂临床试验,利用 SonoMotion 公司(加利福尼亚州圣马特奥市)的碎石波碎石(BWL)设备碎除尿路结石。与受试者取得联系,并在治疗后 7、14 和 35 天进行结果评估,术后 70 ± 14 天进行临床随访和 CT 成像检查。主要目的是评估 BWL 的安全性(血肿、并发症等)和有效性(任何碎石、残留碎石≤4 毫米或≤2 毫米、完全无石率),通过肾脏、输尿管和膀胱的非对比 CT 进行评估。88%的病例出现结石碎裂;70%的病例碎石小于4毫米,51%的病例碎石小于2毫米,49%的病例在CT检查中完全无结石;无严重不良事件报告。86%的患者完全没有接受镇痛药物治疗(50%)或接受轻微镇痛(36%)。在确定了最佳治疗方案后,36 名患者接受了治疗,治疗效果有所改善,92% 的患者(33/36)碎石,75% 的患者残留碎石小于 4 毫米,58% 的患者碎石小于 2 毫米,58% 的患者完全无结石。结论BWL提供了安全有效的无创结石治疗,几乎不需要麻醉,并能在非手术环境中成功实施:NCT03811171。
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引用次数: 0
Letter: Mayo Clinic Validation of the AUA Risk Groups for Localized Renal Cell Carcinoma. 信:梅奥诊所对 AUA 局部肾细胞癌风险分组的验证。
Pub Date : 2024-09-10 DOI: 10.1097/ju.0000000000004123
Mattia Longoni,Giuseppe Rosiello,Alessandro Larcher,Francesco Montorsi,Umberto Capitanio
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引用次数: 0
Pediatric Urologists' Views on the US News and World Report. 儿科泌尿科医生对《美国新闻与世界报道》的看法。
Pub Date : 2024-06-17 DOI: 10.1097/ju.0000000000004105
N Valeska Halstead, Ilina Rosoklija, David I Chu, Emilie K Johnson, Earl Y Cheng
To understand the general attitudes of pediatric urologists regarding the United States News and World Report rankings for Best Children's Hospitals in Urology.
了解儿科泌尿科医生对《美国新闻与世界报道》泌尿科最佳儿童医院排名的普遍态度。
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引用次数: 0
Radical Prostatectomy Without Prior Biopsy in Selected Patients Evaluated by 18F-Labeled Prostate-Specific Membrane Antigen-Ligand Positron Emission Tomography/Computed Tomography and Multiparameter Magnetic Resonance Imaging: A Single-Center, Prospective, Single-Arm Trial. 通过 18F 标记的前列腺特异性膜抗原配体正电子发射断层扫描/计算机断层扫描和多参数磁共振成像评估部分患者未进行活检的根治性前列腺切除术:单中心、前瞻性、单臂试验。
Pub Date : 2024-06-17 DOI: 10.1097/ju.0000000000004025
Shaoxi Niu, Xiaohui Ding, Baichuan Liu, Liyan Ao, Haiyi Wang, Wei Chen, Baixuan Xu, Alberto Olivero, Jiajin Liu, Jiangping Gao, Yu Gao, Weijun Fu, Xin Ma, Hongzhao Li, Baojun Wang, Yachao Liu, Xu Zhang
This study aimed to verify the feasibility and short-term prognosis of prostatectomy without biopsy.
本研究旨在验证不进行活检的前列腺切除术的可行性和短期预后。
{"title":"Radical Prostatectomy Without Prior Biopsy in Selected Patients Evaluated by 18F-Labeled Prostate-Specific Membrane Antigen-Ligand Positron Emission Tomography/Computed Tomography and Multiparameter Magnetic Resonance Imaging: A Single-Center, Prospective, Single-Arm Trial.","authors":"Shaoxi Niu, Xiaohui Ding, Baichuan Liu, Liyan Ao, Haiyi Wang, Wei Chen, Baixuan Xu, Alberto Olivero, Jiajin Liu, Jiangping Gao, Yu Gao, Weijun Fu, Xin Ma, Hongzhao Li, Baojun Wang, Yachao Liu, Xu Zhang","doi":"10.1097/ju.0000000000004025","DOIUrl":"https://doi.org/10.1097/ju.0000000000004025","url":null,"abstract":"This study aimed to verify the feasibility and short-term prognosis of prostatectomy without biopsy.","PeriodicalId":501636,"journal":{"name":"The Journal of Urology","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141334296","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}
引用次数: 0
Beyond PI-RADS: Combining MRI PI-RADS and PSMA-PET/CT PRIMARY Score in a Composite (P) Score for More Accurate Diagnosis of Clinically Significant Prostate Cancer. 超越 PI-RADS:将磁共振成像 PI-RADS 和 PSMA-PET/CT PRIMARY 评分合并为综合 (P) 评分,更准确地诊断有临床症状的前列腺癌。
Pub Date : 2024-05-17 DOI: 10.1097/ju.0000000000004010
Louise Emmett, Nathan Papa, Thomas A Hope, Wolfgang Fendler, Jeremie Calais, Irene Burger, Matthias Eiber, Francesco Barbato, Daniel Moon, William Counter, Nikeith John, Alan Xue, Anthony Franklin, James Thompson, Kris Rasiah, Mark Frydenberg, John Yaxley, James Buteau, Shikha Agrawal, Bao Ho, Andrew Nguyen, Victor Liu, Jonathan Lee, Henry Woo, Edward Hsiao, Thomas Sutherland, Elyse Perry, Phillip Stricker, Michael S Hofman, Veeru Kasivisvanathan, Matthew Roberts, Declan Murphy
The PI-RADS score is standard of care for clinically significant prostate cancer (csPCa) diagnosis. The PRIMARY-score (PSMA-PET/CT) also has high diagnostic accuracy for csPCa. This study aimed to develop an easily calculated combined (P) score for csPCa detection (ISUP ≥ 2) incorporating separately read PI-RADS and PRIMARY scores, with external validation.
PI-RADS 评分是诊断有临床意义的前列腺癌(csPCa)的标准。PRIMARY 评分(PSMA-PET/CT)对 csPCa 的诊断准确率也很高。本研究旨在开发一种易于计算的综合 (P) 评分,用于 csPCa 检测(ISUP ≥ 2),将分别读取的 PI-RADS 和 PRIMARY 评分结合起来,并进行外部验证。
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引用次数: 0
期刊
The Journal of Urology
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