Pub Date : 2025-01-01Epub Date: 2024-08-01DOI: 10.1111/bju.16492
John Pfail, Jasmin Capellan, Rachel Passarelli, Alain Kaldany, Kevin Chua, Benjamin Lichtbroun, Arnav Srivastava, David Golombos, Thomas L Jang, Henry A Pitt, Vignesh T Packiam, Saum Ghodoussipour
Objective: To examine the impact of increased compliance to contemporary perioperative care measures, as outlined by enhanced recover after surgery (ERAS) guidelines, among patients undergoing radical cystectomy (RC).
Patients and methods: From the National Surgical Quality Improvement Program database we captured patients undergoing RC between 2019 and 2021. We identified five perioperative care measures: regional anaesthesia block, thromboembolism prophylaxis, ≤24 h perioperative antibiotic administration, absence of bowel preparation, and early oral diet. We stratified patients by the number of measures utilised (one to five). Statistical endpoints included 30-day complications, hospital length of stay (LOS), readmissions, and optimal RC outcome. Optimal RC outcome was defined as absence of any postoperative complication, re-operation, prolonged LOS (75th percentile, 8 days) with no readmission. Multivariable regressions with Bonferroni correction were performed to assess the association between use of contemporary perioperative care measures and outcomes.
Results: Of the 3702 patients who underwent RC, 73 (2%), 417 (11%), 1010 (27%), 1454 (39%), and 748 (20%) received one, two, three, four, and five interventions, respectively. On multivariable analysis, increased perioperative care measures were associated with lower odds of any complication (odds ratio [OR] 0.66, 99% confidence interval [CI] 0.6-0.73), and shorter LOS (β -0.82, 99% CI -0.99 to -0.65). Furthermore, patients with increased compliance to contemporary care measures had increased odds of an optimal outcome (OR 1.38, 99% CI 1.26-1.51).
Conclusions: Among the measures we assessed, greater adherence yielded improved postoperative outcomes among patients undergoing RC. Our work supports the efficacy of ERAS protocols in reducing the morbidity associated with RC.
{"title":"National Surgical Quality Improvement Program audit of contemporary perioperative care for radical cystectomy.","authors":"John Pfail, Jasmin Capellan, Rachel Passarelli, Alain Kaldany, Kevin Chua, Benjamin Lichtbroun, Arnav Srivastava, David Golombos, Thomas L Jang, Henry A Pitt, Vignesh T Packiam, Saum Ghodoussipour","doi":"10.1111/bju.16492","DOIUrl":"10.1111/bju.16492","url":null,"abstract":"<p><strong>Objective: </strong>To examine the impact of increased compliance to contemporary perioperative care measures, as outlined by enhanced recover after surgery (ERAS) guidelines, among patients undergoing radical cystectomy (RC).</p><p><strong>Patients and methods: </strong>From the National Surgical Quality Improvement Program database we captured patients undergoing RC between 2019 and 2021. We identified five perioperative care measures: regional anaesthesia block, thromboembolism prophylaxis, ≤24 h perioperative antibiotic administration, absence of bowel preparation, and early oral diet. We stratified patients by the number of measures utilised (one to five). Statistical endpoints included 30-day complications, hospital length of stay (LOS), readmissions, and optimal RC outcome. Optimal RC outcome was defined as absence of any postoperative complication, re-operation, prolonged LOS (75th percentile, 8 days) with no readmission. Multivariable regressions with Bonferroni correction were performed to assess the association between use of contemporary perioperative care measures and outcomes.</p><p><strong>Results: </strong>Of the 3702 patients who underwent RC, 73 (2%), 417 (11%), 1010 (27%), 1454 (39%), and 748 (20%) received one, two, three, four, and five interventions, respectively. On multivariable analysis, increased perioperative care measures were associated with lower odds of any complication (odds ratio [OR] 0.66, 99% confidence interval [CI] 0.6-0.73), and shorter LOS (β -0.82, 99% CI -0.99 to -0.65). Furthermore, patients with increased compliance to contemporary care measures had increased odds of an optimal outcome (OR 1.38, 99% CI 1.26-1.51).</p><p><strong>Conclusions: </strong>Among the measures we assessed, greater adherence yielded improved postoperative outcomes among patients undergoing RC. Our work supports the efficacy of ERAS protocols in reducing the morbidity associated with RC.</p>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":"140-147"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11628928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141858970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daniele Amparore, Sabrina De Cillis, Marco Colombo, Valentina Garzena, Michele Sica, Enrico Checcucci, Alberto Piana, Federico Piramide, Alberto Quarà, Matteo Manfredi, Cristian Fiori, Francesco Porpiglia
ObjectivesTo evaluate the role of the TYTOCARE™ telemedicine programme for home telemonitoring during the early postoperative period following radical cystectomy (RC) in a prospective single‐centre study.Materials and MethodsThe study included patients aged <80 years with internet access who underwent RC at our institution between March 2021 and August 2023. Upon discharge, patients were monitored at home using the TYTOCARE™ telemedicine system. Daily, patients completed a symptom questionnaire and recorded heart rate, body temperature, intestinal sounds, and urine output, and wound/ostomy evaluations via photos. Weekly televisits via the TYTOCARETM platform and app were scheduled, with additional controls as needed. After 30 days, patients assessed their satisfaction using a visual analogue scale (VAS; 0–100) and a Telemedicine Satisfaction Questionnaire (TSQ; 1–5) and any technical issues were documented. A control group of patients, who underwent RC in the same study period but who did not take part in a postoperative telemonitoring programme, was chosen for comparison, with analysis of demographics, peri‐operative data, postoperative complications and hospital readmissions within 30 days after discharge.ResultsA total of 16 patients were included in the TYTOCARETM group, and 88 in the control group. The mean VAS satisfaction scores were 86.4 (patients) and 92.3 (healthcare providers). The mean TSQ score was 4.3, indicating high satisfaction. All TYTOCARETM patients reported they would use and recommend the device. Two patients encountered minor technical issues, which were easily resolved. The TYTOCARETM group had a shorter hospital stay (11 vs 14 days; P = 0.04) and fewer medical complications ( 2/16 vs 21/88; P = 0.02). No TYTOCARETM patients were readmitted within 30 days, compared to 20.4% in the control group.ConclusionThe TYTOCARETM telemonitoring programme seems to be feasible and highly adhered to by patients and caregivers, with reductions in length of hospital stay, medical complications and hospital readmissions within the first 30 days post‐discharge.
目的：在一项前瞻性单中心研究中，评估TYTOCARE™远程医疗项目在根治性膀胱切除术（RC）术后早期家庭远程监测中的作用。材料和方法该研究纳入了2021年3月至2023年8月期间在我们机构接受RC的80岁可上网患者。出院后，患者在家中使用TYTOCARE™远程医疗系统进行监测。患者每天完成一份症状问卷，记录心率、体温、肠音、尿量，并通过照片对伤口/造口进行评估。通过TYTOCARETM平台和应用程序安排每周的电视节目，并根据需要进行额外的控制。30天后，患者使用视觉模拟量表(VAS；0-100)和远程医疗满意度问卷(TSQ；1-5)和任何技术问题都被记录下来。选择在同一研究期间接受RC但未参加术后远程监测计划的对照组进行比较，分析人口统计学、围手术期数据、术后并发症和出院后30天内的再入院情况。结果TYTOCARETM治疗组16例，对照组88例。VAS满意度平均分为86.4分（患者）和92.3分（医护人员）。TSQ平均得分为4.3分，满意度较高。所有TYTOCARETM患者都表示他们会使用并推荐该设备。两名患者遇到了一些小的技术问题，这些问题很容易解决。TYTOCARETM组住院时间较短(11天vs 14天；P = 0.04)和更少的医疗并发症(2/16 vs 21/88；P = 0.02)。30天内没有TYTOCARETM患者再次入院，而对照组为20.4%。结论TYTOCARETM远程监护方案似乎是可行的，并且患者和护理人员高度遵守，减少了住院时间、医疗并发症和出院后30天内的再入院率。
{"title":"TYTOCARE™ home telemonitoring device after radical cystectomy to optimise postoperative outcomes","authors":"Daniele Amparore, Sabrina De Cillis, Marco Colombo, Valentina Garzena, Michele Sica, Enrico Checcucci, Alberto Piana, Federico Piramide, Alberto Quarà, Matteo Manfredi, Cristian Fiori, Francesco Porpiglia","doi":"10.1111/bju.16637","DOIUrl":"https://doi.org/10.1111/bju.16637","url":null,"abstract":"ObjectivesTo evaluate the role of the TYTOCARE™ telemedicine programme for home telemonitoring during the early postoperative period following radical cystectomy (RC) in a prospective single‐centre study.Materials and MethodsThe study included patients aged <80 years with internet access who underwent RC at our institution between March 2021 and August 2023. Upon discharge, patients were monitored at home using the TYTOCARE™ telemedicine system. Daily, patients completed a symptom questionnaire and recorded heart rate, body temperature, intestinal sounds, and urine output, and wound/ostomy evaluations via photos. Weekly televisits via the TYTOCARE<jats:sup>TM</jats:sup> platform and app were scheduled, with additional controls as needed. After 30 days, patients assessed their satisfaction using a visual analogue scale (VAS; 0–100) and a Telemedicine Satisfaction Questionnaire (TSQ; 1–5) and any technical issues were documented. A control group of patients, who underwent RC in the same study period but who did not take part in a postoperative telemonitoring programme, was chosen for comparison, with analysis of demographics, peri‐operative data, postoperative complications and hospital readmissions within 30 days after discharge.ResultsA total of 16 patients were included in the TYTOCARE<jats:sup>TM</jats:sup> group, and 88 in the control group. The mean VAS satisfaction scores were 86.4 (patients) and 92.3 (healthcare providers). The mean TSQ score was 4.3, indicating high satisfaction. All TYTOCARE<jats:sup>TM</jats:sup> patients reported they would use and recommend the device. Two patients encountered minor technical issues, which were easily resolved. The TYTOCARE<jats:sup>TM</jats:sup> group had a shorter hospital stay (11 vs 14 days; <jats:italic>P</jats:italic> = 0.04) and fewer medical complications ( 2/16 vs 21/88; <jats:italic>P</jats:italic> = 0.02). No TYTOCARE<jats:sup>TM</jats:sup> patients were readmitted within 30 days, compared to 20.4% in the control group.ConclusionThe TYTOCARE<jats:sup>TM</jats:sup> telemonitoring programme seems to be feasible and highly adhered to by patients and caregivers, with reductions in length of hospital stay, medical complications and hospital readmissions within the first 30 days post‐discharge.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"48 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142888104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>Pellegrino F., Martini A., Falagario U.G. et al. How can we reduce morbidity after robot-assisted radical cystectomy with intracorporeal neobladder? A report on postoperative complications by the European Association of Urology Robotic Urology Section Scientific Working Group, BJU Int. 2024 Jun;133(6):673–677. doi: 10.1111/bju.16283</p> <p>The author affiliations published in the June 2024 issue were incorrect. Additionally, the surname of one coauthor was misspelled. The correct author affiliations and surnames appear below:</p> <p>Francesco Pellegrino<sup>1,3,7</sup>, Alberto Martini<sup>9</sup>, Ugo Giovanni Falagario<sup>4,8</sup>, Juhana Rautiola<sup>7</sup>, Antonio Russo<sup>2,10</sup>, Laura S Mertens<sup>11</sup>, Luca Di Gianfrancesco<sup>6</sup>, Carlo Andrea Bravi <sup>14,15,18</sup>, Jonathan Vollemaere<sup>20</sup>, Muhammad Abdeen<sup>20</sup>, Marco Moschini<sup>1,3</sup>, Mikolaj Mendrek<sup>21</sup>, Eirik Kjøbli<sup>24</sup>, Stephan Buse<sup>22</sup>, Carl Wijburg<sup>13</sup>, Alae Touzani<sup>9,25</sup>, Guillaume Ploussard<sup>9</sup>, Alessandro Antonelli<sup>5</sup>, Laura Schwenk<sup>26</sup>, Jan Ebbing<sup>26</sup>, Nikhil Vasdev<sup>19</sup>, Gabriel Froelicher<sup>27</sup>, Hubert John<sup>27</sup>, Abdullah Erdem Canda<sup>28,29</sup>, Mevlana Derya Balbay<sup>28,30</sup>, Marcel Stoll<sup>23</sup>, Sebastian Edeling<sup>23</sup>, Camille Berquin<sup>16</sup>, Charles Van Praet<sup>16</sup>, Sami-Ramzi Leyh-Bannurah<sup>21</sup>, Stefan Siemer<sup>20</sup>, Michael Stoeckle<sup>20</sup>, Alexander Mottrie<sup>14,15</sup>, Frederiek D'Hondt<sup>14,15</sup>, Alessandro Crestani<sup>6</sup>, Angelo Porreca<sup>6</sup>, Alberto Briganti<sup>1,3</sup>, Francesco Montorsi<sup>1,3</sup>, Hendrik van der Poel<sup>11,12</sup>, Karel Decaestecker<sup>17,16,32</sup>, Richard Gaston<sup>10</sup>, Abolfazl Hosseini<sup>7</sup>, N Peter Wiklund<sup>8,31</sup></p> <p><sup>1</sup>Division of Oncology/Unit of Urology, URI, IRCCS San Raffaele Scientific Institute, Milan, Italy; <sup>2</sup>Department of Urology, IRCCS Ospedale San Raffaele, Milan, Italy; <sup>3</sup>Vita-Salute San Raffaele University, Milan, Italy; <sup>4</sup>Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy; <sup>5</sup>Department of Urology, University of Verona, Verona, Italy; <sup>6</sup>Oncological Urology, IRCCS Veneto Institute of Oncology, Padua, Italy; <sup>7</sup>Department of Urology, Karolinska University Hospital, Solna, Sweden; <sup>8</sup>Department of Molecular Medicine and Surgery, Karolinska institute, Stockholm, Sweden; <sup>9</sup>Department of Urology, La Croix du Sud Hospital, Quint Fonsegrives, France; <sup>10</sup>Department of Urology, Clinique Saint Augustin, Bordeaux, France; <sup>11</sup>Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands; <sup>12</sup>Department of Urology, Amsterdam University Medical Centers, Amsterdam, The Netherlands; <sup>13</sup>Department of Urolog
佩莱格里诺F，马提尼A，法拉格里奥U.G.等。如何降低机器人辅助根治性膀胱切除术伴体内新膀胱的发病率？欧洲泌尿外科协会机器人泌尿外科科学工作组关于术后并发症的报告，BJU国际医学杂志，2024年6月；133(6):673-677。doi: 10.1111 /北大。16283 2024年6月刊上发表的作者归属不正确。此外，一位合著者的姓氏也拼错了。正确的作者关系和姓氏如下：Francesco pellegrino 1,3,7、Alberto Martini9、Ugo Giovanni falagario4,8、Juhana Rautiola7、Antonio russo2,10、Laura S Mertens11、Luca Di Gianfrancesco6、Carlo Andrea Bravi 14,15,18、Jonathan Vollemaere20、Muhammad Abdeen20、Marco moschini1,3、Mikolaj Mendrek21、Eirik kj约bli24、Stephan Buse22、Carl Wijburg13、Alae touzani9,25、Guillaume Ploussard9、Alessandro Antonelli5、Laura Schwenk26、Jan Ebbing26、Nikhil Vasdev19、Gabriel Froelicher27、Hubert John27, Abdullah Erdem canda28,29, Mevlana Derya balbay28,30, Marcel Stoll23, Sebastian Edeling23, Camille Berquin16, Charles Van Praet16, Sami-Ramzi Leyh-Bannurah21, Stefan Siemer20, Michael Stoeckle20, Alexander mottrie14,15, Frederiek D' hondt14,15, Alessandro Crestani6, Angelo Porreca6, Alberto briganti1,3, Francesco montorsi1,3, Hendrik Van der poel11,12, Karel decaestecker17,16,32, Richard Gaston10, Abolfazl Hosseini7, N Peter wiklund8,31意大利米兰圣拉斐尔科学研究所；2意大利米兰圣拉斐尔医院泌尿外科；3意大利米兰圣拉斐尔大学vita - salute；4意大利福贾大学泌尿外科与器官移植科，福贾；5意大利维罗纳大学泌尿外科；6意大利帕多瓦，IRCCS威尼托肿瘤研究所泌尿肿瘤科；7瑞典索尔纳，卡罗林斯卡大学附属医院泌尿外科；8瑞典斯德哥尔摩卡罗林斯卡医学院分子医学与外科学系；9法国Quint Fonsegrives La Croix du Sud医院泌尿科；10法国波尔多圣奥古斯丁诊所泌尿科；11荷兰癌症研究所泌尿外科，荷兰阿姆斯特丹；12阿姆斯特丹大学医学中心泌尿外科，荷兰阿姆斯特丹；13荷兰阿纳姆Rijnstate医院泌尿科；14比利时阿尔斯特OLV医院泌尿外科；15奥尔西学院，根特，比利时；16根特大学医院泌尿外科，比利时根特；17比利时根特Maria Middelares医院泌尿外科；18英国伦敦皇家马斯登NHS基金会泌尿科；19英国斯蒂夫尼奇利斯特医院赫特福德郡和贝德福德郡泌尿肿瘤中心泌尿科；20萨尔大学泌尿外科和儿科泌尿外科，德国洪堡/萨尔；21德国格罗瑙圣安东尼奥医院泌尿外科、泌尿肿瘤与机器人辅助外科；22德国埃森Alfried Krupp Krankenhaus泌尿外科；23德国汉诺威Vinzenz医院泌尿外科；24特隆赫姆大学附属医院St. Olavs医院泌尿科，挪威特隆赫姆；25摩洛哥卡萨布兰卡国际肿瘤中心泌尿外科；26瑞士巴塞尔大学医院泌尿外科；27瑞士温特图尔温特图尔州立医院泌尿科；28土耳其伊斯坦布尔科ßc大学医学院泌尿外科；29RMK AIMES （Rahmi M. Koßc介入医学、教育和模拟学院），土耳其伊斯坦布尔；30土耳其伊斯坦布尔美国医院泌尿外科；31西奈山伊坎医学院泌尿外科，纽约，美国；32根特大学医学院人体结构与修复系，比利时根特我们为这个错误道歉。
{"title":"Correction to “How can we reduce morbidity after robot-assisted radical cystectomy with intracorporeal neobladder? A report on postoperative complications by the European Association of Urology Robotic Urology Section Scientific Working Group”","authors":"","doi":"10.1111/bju.16619","DOIUrl":"https://doi.org/10.1111/bju.16619","url":null,"abstract":"<p>Pellegrino F., Martini A., Falagario U.G. et al. How can we reduce morbidity after robot-assisted radical cystectomy with intracorporeal neobladder? A report on postoperative complications by the European Association of Urology Robotic Urology Section Scientific Working Group, BJU Int. 2024 Jun;133(6):673–677. doi: 10.1111/bju.16283</p>\u0000<p>The author affiliations published in the June 2024 issue were incorrect. Additionally, the surname of one coauthor was misspelled. The correct author affiliations and surnames appear below:</p>\u0000<p>Francesco Pellegrino<sup>1,3,7</sup>, Alberto Martini<sup>9</sup>, Ugo Giovanni Falagario<sup>4,8</sup>, Juhana Rautiola<sup>7</sup>, Antonio Russo<sup>2,10</sup>, Laura S Mertens<sup>11</sup>, Luca Di Gianfrancesco<sup>6</sup>, Carlo Andrea Bravi <sup>14,15,18</sup>, Jonathan Vollemaere<sup>20</sup>, Muhammad Abdeen<sup>20</sup>, Marco Moschini<sup>1,3</sup>, Mikolaj Mendrek<sup>21</sup>, Eirik Kjøbli<sup>24</sup>, Stephan Buse<sup>22</sup>, Carl Wijburg<sup>13</sup>, Alae Touzani<sup>9,25</sup>, Guillaume Ploussard<sup>9</sup>, Alessandro Antonelli<sup>5</sup>, Laura Schwenk<sup>26</sup>, Jan Ebbing<sup>26</sup>, Nikhil Vasdev<sup>19</sup>, Gabriel Froelicher<sup>27</sup>, Hubert John<sup>27</sup>, Abdullah Erdem Canda<sup>28,29</sup>, Mevlana Derya Balbay<sup>28,30</sup>, Marcel Stoll<sup>23</sup>, Sebastian Edeling<sup>23</sup>, Camille Berquin<sup>16</sup>, Charles Van Praet<sup>16</sup>, Sami-Ramzi Leyh-Bannurah<sup>21</sup>, Stefan Siemer<sup>20</sup>, Michael Stoeckle<sup>20</sup>, Alexander Mottrie<sup>14,15</sup>, Frederiek D'Hondt<sup>14,15</sup>, Alessandro Crestani<sup>6</sup>, Angelo Porreca<sup>6</sup>, Alberto Briganti<sup>1,3</sup>, Francesco Montorsi<sup>1,3</sup>, Hendrik van der Poel<sup>11,12</sup>, Karel Decaestecker<sup>17,16,32</sup>, Richard Gaston<sup>10</sup>, Abolfazl Hosseini<sup>7</sup>, N Peter Wiklund<sup>8,31</sup></p>\u0000<p><sup>1</sup>Division of Oncology/Unit of Urology, URI, IRCCS San Raffaele Scientific Institute, Milan, Italy; <sup>2</sup>Department of Urology, IRCCS Ospedale San Raffaele, Milan, Italy; <sup>3</sup>Vita-Salute San Raffaele University, Milan, Italy; <sup>4</sup>Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy; <sup>5</sup>Department of Urology, University of Verona, Verona, Italy; <sup>6</sup>Oncological Urology, IRCCS Veneto Institute of Oncology, Padua, Italy; <sup>7</sup>Department of Urology, Karolinska University Hospital, Solna, Sweden; <sup>8</sup>Department of Molecular Medicine and Surgery, Karolinska institute, Stockholm, Sweden; <sup>9</sup>Department of Urology, La Croix du Sud Hospital, Quint Fonsegrives, France; <sup>10</sup>Department of Urology, Clinique Saint Augustin, Bordeaux, France; <sup>11</sup>Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands; <sup>12</sup>Department of Urology, Amsterdam University Medical Centers, Amsterdam, The Netherlands; <sup>13</sup>Department of Urolog","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"5 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142887228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sophie L. Harding, Marcus M. Ilg, Stephen A. Bustin, David J. Ralph, Selim Cellek
To investigate which phosphodiesterase (PDE) isoforms are expressed in fibroblasts isolated from the tunica albuginea (TA) of patients with Peyronie's disease (PD), and to measure the potency of PDE inhibitors in preventing transformation of these fibroblasts to profibrotic myofibroblasts.
{"title":"Inhibition of phosphodiesterases 1 and 4 prevents myofibroblast transformation in Peyronie's disease","authors":"Sophie L. Harding, Marcus M. Ilg, Stephen A. Bustin, David J. Ralph, Selim Cellek","doi":"10.1111/bju.16631","DOIUrl":"https://doi.org/10.1111/bju.16631","url":null,"abstract":"To investigate which phosphodiesterase (PDE) isoforms are expressed in fibroblasts isolated from the tunica albuginea (TA) of patients with Peyronie's disease (PD), and to measure the potency of PDE inhibitors in preventing transformation of these fibroblasts to profibrotic myofibroblasts.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"36 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142880150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Glenn T. Werneburg, Daniel D. Rhoads, Alex Milinovich, Sean McSweeney, Jacob Knorr, Lyla Mourany, Alex Zajichek, Howard B. Goldman, Georges‐Pascal Haber, Sandip P. Vasavada
ObjectiveTo develop, externally validate, and test a series of computer algorithms to accurately predict antibiotic susceptibility test (AST) results at the time of clinical diagnosis, up to 3 days before standard urine culture results become available, with the goal of improving antibiotic stewardship and patient outcomes.Patients and MethodsMachine learning algorithms were developed and trained to predict susceptibility or resistance using over 4.7 million discrete AST classifications from urine cultures in a cohort of adult patients from outpatient and inpatient settings from 2012 to 2022. The algorithms were validated on a cohort from a geographically‐distant hospital system, ~1931 km (~1200 miles) from the training cohort facilities, from the same time period. Finally, algorithms were clinically validated in a contemporary cohort and compared to the empiric therapy prescribed by clinicians. Appropriateness of the antibiotics selected by clinicians and the algorithm during the clinical validation was compared.ResultsAlgorithms were accurate during clinical validation (area under the receiver operating characteristic curve [AUC] 0.71–0.94) for all 11 tested antibiotics. The algorithms’ accuracy improved as the organism was identified (AUC 0.79–0.97). In external validation in a geographically‐distant cohort, the algorithms remained accurate even without additional training on this group (AUC 0.69–0.87). When the algorithms were trained on the antibiogram from the geographically‐distant hospital, the accuracy improved (AUC 0.70–0.93). When algorithms’ performances were tested against clinicians in a contemporary cohort for the empiric prescription of oral antibiotics, the drug agent suggested by the algorithms more frequently resulted in adequate empiric coverage.ConclusionsMachine learning algorithms trained on a large dataset are accurate in prediction of urine culture susceptibility vs resistance up to 3 days prior to urine AST availability. Clinical implementation of such an algorithm could improve both clinical care and antimicrobial stewardship.
{"title":"External validation of predictive models for antibiotic susceptibility of urine culture","authors":"Glenn T. Werneburg, Daniel D. Rhoads, Alex Milinovich, Sean McSweeney, Jacob Knorr, Lyla Mourany, Alex Zajichek, Howard B. Goldman, Georges‐Pascal Haber, Sandip P. Vasavada","doi":"10.1111/bju.16626","DOIUrl":"https://doi.org/10.1111/bju.16626","url":null,"abstract":"ObjectiveTo develop, externally validate, and test a series of computer algorithms to accurately predict antibiotic susceptibility test (AST) results at the time of clinical diagnosis, up to 3 days before standard urine culture results become available, with the goal of improving antibiotic stewardship and patient outcomes.Patients and MethodsMachine learning algorithms were developed and trained to predict susceptibility or resistance using over 4.7 million discrete AST classifications from urine cultures in a cohort of adult patients from outpatient and inpatient settings from 2012 to 2022. The algorithms were validated on a cohort from a geographically‐distant hospital system, ~1931 km (~1200 miles) from the training cohort facilities, from the same time period. Finally, algorithms were clinically validated in a contemporary cohort and compared to the empiric therapy prescribed by clinicians. Appropriateness of the antibiotics selected by clinicians and the algorithm during the clinical validation was compared.ResultsAlgorithms were accurate during clinical validation (area under the receiver operating characteristic curve [AUC] 0.71–0.94) for all 11 tested antibiotics. The algorithms’ accuracy improved as the organism was identified (AUC 0.79–0.97). In external validation in a geographically‐distant cohort, the algorithms remained accurate even without additional training on this group (AUC 0.69–0.87). When the algorithms were trained on the antibiogram from the geographically‐distant hospital, the accuracy improved (AUC 0.70–0.93). When algorithms’ performances were tested against clinicians in a contemporary cohort for the empiric prescription of oral antibiotics, the drug agent suggested by the algorithms more frequently resulted in adequate empiric coverage.ConclusionsMachine learning algorithms trained on a large dataset are accurate in prediction of urine culture susceptibility vs resistance up to 3 days prior to urine AST availability. Clinical implementation of such an algorithm could improve both clinical care and antimicrobial stewardship.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"24 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Frederik F. Thomsen, Marcus Westerberg, Rasmus D. Petersson, Rasmine Bak, Julie Bak Lindholst, Hayder Al-Husseinawi, Emma Heeno, Nessn H. Azawi
To identify predictors of metastases, estimate the proportion of metastatic clear cell renal cell carcinoma (ccRCC) cases according to these predictors, and subsequently create a risk table showing the absolute difference in metastasis proportion for each 10 mm increase in tumour size.
{"title":"Metastatic risk in clear cell renal cell carcinoma: a tool incorporating sex, size, and grade","authors":"Frederik F. Thomsen, Marcus Westerberg, Rasmus D. Petersson, Rasmine Bak, Julie Bak Lindholst, Hayder Al-Husseinawi, Emma Heeno, Nessn H. Azawi","doi":"10.1111/bju.16624","DOIUrl":"https://doi.org/10.1111/bju.16624","url":null,"abstract":"To identify predictors of metastases, estimate the proportion of metastatic clear cell renal cell carcinoma (ccRCC) cases according to these predictors, and subsequently create a risk table showing the absolute difference in metastasis proportion for each 10 mm increase in tumour size.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"14 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Patrick Juliebø-Jones, Vineet Gauhar, Ali Talyshinskii, Christian Arvei Moen, Ingunn Roth, Lazaros Tzelves, Christian Beisland, Bhaskar K Somani
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点击文章标题阅读更多内容。
{"title":"Sharing surgical images on social media: a snapshot of practices and some reflections for improvement","authors":"Patrick Juliebø-Jones, Vineet Gauhar, Ali Talyshinskii, Christian Arvei Moen, Ingunn Roth, Lazaros Tzelves, Christian Beisland, Bhaskar K Somani","doi":"10.1111/bju.16625","DOIUrl":"https://doi.org/10.1111/bju.16625","url":null,"abstract":"Click on the article title to read more.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"51 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142825539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nico Christian Grossmann, Fabian Joel Aschwanden, Julian Cornelius, Christian Malkmus, Leutrim Zahiti, Pascal Viktorin, Lea Fierley, Einar Wilder‐Smith, Philipp Baumeister, Agostino Mattei, Christian Daniel Fankhauser
ObjectiveTo investigate whether ankle braces or shoulder support used for fixation during robot‐assisted radical prostatectomy (RARP), where patients are commonly positioned in the head‐down Trendelenburg position, differ in their potential to cause peripheral nerve injury.Patients and MethodsA prospective, double‐blind, randomised controlled trial was conducted on patients undergoing RARP for prostate cancer between May 2020 and September 2021 using the da Vinci® Si system (Intuitive Surgical Inc., Sunnyvale, CA, USA). Patients were randomly assigned to either the shoulder or ankle brace fixation group and were positioned in a modified lithotomy position. Neurological examinations were performed pre‐ and postoperatively. The primary endpoint was the prevalence of any peripheral neuropathy on the first postoperative day.ResultsA total of 98 patients were treated using the da Vinci Si system: 46 in the lithotomy lower fixation group and 52 in the lithotomy upper fixation group. Both groups mainly recorded neuropathies in the lower extremity, with a total incidence of 6.9% for lower neuropathies and 3.9% for upper neuropathies. All neuropathies were sensory, with one exception in the upper fixation group presenting a motor deficit. Over a median follow‐up of 12 months, no neuropathies persisted. Neuropathy on the first postoperative day was observed in 15% of patients in the upper fixation group and 6.5% in the lower fixation group (P = 0.2).ConclusionWe observed neuropathies in a clinically relevant proportion of men undergoing RARP. We were not able to demonstrate a significant difference regarding postoperative neuropathies between ankle braces or shoulder support during RARP.
{"title":"Impact of patient positioning during surgery on neuropathies after robot‐assisted laparoscopic radical prostatectomy: a randomised controlled trial","authors":"Nico Christian Grossmann, Fabian Joel Aschwanden, Julian Cornelius, Christian Malkmus, Leutrim Zahiti, Pascal Viktorin, Lea Fierley, Einar Wilder‐Smith, Philipp Baumeister, Agostino Mattei, Christian Daniel Fankhauser","doi":"10.1111/bju.16623","DOIUrl":"https://doi.org/10.1111/bju.16623","url":null,"abstract":"ObjectiveTo investigate whether ankle braces or shoulder support used for fixation during robot‐assisted radical prostatectomy (RARP), where patients are commonly positioned in the head‐down Trendelenburg position, differ in their potential to cause peripheral nerve injury.Patients and MethodsA prospective, double‐blind, randomised controlled trial was conducted on patients undergoing RARP for prostate cancer between May 2020 and September 2021 using the da Vinci<jats:sup>®</jats:sup> Si system (Intuitive Surgical Inc., Sunnyvale, CA, USA). Patients were randomly assigned to either the shoulder or ankle brace fixation group and were positioned in a modified lithotomy position. Neurological examinations were performed pre‐ and postoperatively. The primary endpoint was the prevalence of any peripheral neuropathy on the first postoperative day.ResultsA total of 98 patients were treated using the da Vinci Si system: 46 in the lithotomy lower fixation group and 52 in the lithotomy upper fixation group. Both groups mainly recorded neuropathies in the lower extremity, with a total incidence of 6.9% for lower neuropathies and 3.9% for upper neuropathies. All neuropathies were sensory, with one exception in the upper fixation group presenting a motor deficit. Over a median follow‐up of 12 months, no neuropathies persisted. Neuropathy on the first postoperative day was observed in 15% of patients in the upper fixation group and 6.5% in the lower fixation group (<jats:italic>P</jats:italic> = 0.2).ConclusionWe observed neuropathies in a clinically relevant proportion of men undergoing RARP. We were not able to demonstrate a significant difference regarding postoperative neuropathies between ankle braces or shoulder support during RARP.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"29 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The role of social media in education: how to maximise learning","authors":"Thomas Hughes, Bhaskar K Somani","doi":"10.1111/bju.16621","DOIUrl":"https://doi.org/10.1111/bju.16621","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"21 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142809733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mattia Longoni, Francesco Di Bello, Natali Rodriguez Peñaranda, Fabian Falkenbach, Andrea Marmiroli, Quynh Chi Le, Zhe Tian, Jordan A. Goyal, Nicola Longo, Salvatore Micali, Markus Graefen, Gennaro Musi, Felix K. H. Chun, Fred Saad, Shahrokh F. Shariat, Marco Moschini, Giorgio Gandaglia, Francesco Montorsi, Alberto Briganti, Pierre I. Karakiewicz
ObjectivesIt is not known whether cancer‐specific mortality (CSM) differences distinguish radical cystectomy (RC) from trimodal therapy (TMT) in octogenarians harbouring organ‐confined (T2N0M0) urothelial cancer of the urinary bladder (UCUB).MethodsWithin the Surveillance, Epidemiology, and End Results database (2004–2021), CSM and other‐cause mortality (OCM) rates were computed in octogenarian patients with organ‐confined UCUB undergoing either TMT or RC. Smoothed cumulative incidence plots depicted 5‐year CSM and OCM rates according to RC vs TMT. Competing risks regression (CRR) models were fitted, adjusting for age, gender, and race/ethnicity. Nearest‐neighbour 1:1 propensity‐score matching (PSM) for age and gender was also applied. Sensitivity analyses were additionally performed, focusing on White patients.ResultsOf 2335 octogenarian patients with T2N0M0 UCUB, 1562 (66.3%) received TMT and 793 (33.7%) received RC. Of those, 2082 (88.4%) were White. TMT rates increased from 53.5% in 2004 to 82.2% in 2021 (P < 0.001). The 5‐year CSM rate was 50.1% for TMT vs 31.1% for RC. After multivariable CRR, TMT independently predicted 1.7‐fold higher CSM (P < 0.001). After additional PSM, TMT also independently predicted 1.7‐fold higher CSM (P < 0.001). In sensitivity analyses exclusively focusing on White patients, almost identical results were recorded.ConclusionRates of TMT have nearly doubled in octogenarian patients with organ‐confined UCUB in recent years; however, CSM rates after TMT are also nearly twice as high as those observed after RC. It is crucial to communicate these observations.
{"title":"Survival after trimodal therapy in octogenarians with organ‐confined urothelial bladder cancer","authors":"Mattia Longoni, Francesco Di Bello, Natali Rodriguez Peñaranda, Fabian Falkenbach, Andrea Marmiroli, Quynh Chi Le, Zhe Tian, Jordan A. Goyal, Nicola Longo, Salvatore Micali, Markus Graefen, Gennaro Musi, Felix K. H. Chun, Fred Saad, Shahrokh F. Shariat, Marco Moschini, Giorgio Gandaglia, Francesco Montorsi, Alberto Briganti, Pierre I. Karakiewicz","doi":"10.1111/bju.16622","DOIUrl":"https://doi.org/10.1111/bju.16622","url":null,"abstract":"ObjectivesIt is not known whether cancer‐specific mortality (CSM) differences distinguish radical cystectomy (RC) from trimodal therapy (TMT) in octogenarians harbouring organ‐confined (T2N0M0) urothelial cancer of the urinary bladder (UCUB).MethodsWithin the Surveillance, Epidemiology, and End Results database (2004–2021), CSM and other‐cause mortality (OCM) rates were computed in octogenarian patients with organ‐confined UCUB undergoing either TMT or RC. Smoothed cumulative incidence plots depicted 5‐year CSM and OCM rates according to RC vs TMT. Competing risks regression (CRR) models were fitted, adjusting for age, gender, and race/ethnicity. Nearest‐neighbour 1:1 propensity‐score matching (PSM) for age and gender was also applied. Sensitivity analyses were additionally performed, focusing on White patients.ResultsOf 2335 octogenarian patients with T2N0M0 UCUB, 1562 (66.3%) received TMT and 793 (33.7%) received RC. Of those, 2082 (88.4%) were White. TMT rates increased from 53.5% in 2004 to 82.2% in 2021 (<jats:italic>P</jats:italic> < 0.001). The 5‐year CSM rate was 50.1% for TMT vs 31.1% for RC. After multivariable CRR, TMT independently predicted 1.7‐fold higher CSM (<jats:italic>P</jats:italic> < 0.001). After additional PSM, TMT also independently predicted 1.7‐fold higher CSM (<jats:italic>P</jats:italic> < 0.001). In sensitivity analyses exclusively focusing on White patients, almost identical results were recorded.ConclusionRates of TMT have nearly doubled in octogenarian patients with organ‐confined UCUB in recent years; however, CSM rates after TMT are also nearly twice as high as those observed after RC. It is crucial to communicate these observations.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"20 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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