The Journal of urology
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The Journal of urology · Jun 2007
Clinical TrialDetermining dosing intervals for luteinizing hormone releasing hormone agonists based on serum testosterone levels: a prospective study.
Long acting luteinizing hormone releasing hormone agonists are the predominant form of androgen suppression in the treatment of prostate cancer with the goal of maintaining castrate levels of testosterone. Current dosing of luteinizing hormone releasing hormone agonists does not include monitoring the end organ response of serum testosterone. Recent evidence suggests standard dosing regimens fail to achieve castrate levels of testosterone in some patients while in other patients testosterone can remain at castrate levels longer than the manufacturer recommended dosing interval. We prospectively evaluated patients with prostate cancer receiving luteinizing hormone releasing hormone agonist hormonal therapy to determine the length of time that serum testosterone remains at or below castrate levels. ⋯ Testosterone based luteinizing hormone releasing hormone agonist therapy makes empirical sense. It represents continuous androgen ablation based on the patient physiological end point, namely testosterone. Early data suggest that using serum testosterone to guide luteinizing hormone releasing hormone dosing is safe, efficacious and cost-effective. By following end organ response, patients receive individualized care and more accurate androgen suppression therapy.
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The Journal of urology · Jun 2007
Genitourinary trauma at a combat support hospital during Operation Iraqi Freedom: the impact of body armor.
This report details the occurrences of genitourinary trauma experienced during Operation Iraqi Freedom at a United States Army Combat Support Hospital, and determines if wearing body armor decreases the frequency of genitourinary and specifically kidney trauma. ⋯ The percentage of casualties with genitourinary injuries and the distribution of these injuries appear similar to previous conflicts. The percentage of casualties undergoing nephrectomy appears to be greater than that observed in other recent conflicts. There was a significant reduction in overall genitourinary injuries and specifically kidney injuries in those casualties wearing body armor.
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The Journal of urology · Jun 2007
An assessment of quality of life following radical prostatectomy, high dose external beam radiation therapy and brachytherapy iodine implantation as monotherapies for localized prostate cancer.
Monotherapy with radical prostatectomy, high dose external beam radiotherapy or a (125)I implant is reported to produce equivalent outcomes. We assessed the health related quality of life associated with these 3 treatment approaches. ⋯ Of patients with prostate cancer treated with a monotherapy approach we noted better urinary continence in those who underwent radiation based therapies, and better bowel function and less urinary irritation in those who underwent surgery. Sexual function was impaired across all monotherapies but higher scores were seen in men who selected brachytherapy.
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The Journal of urology · Jun 2007
Randomized Controlled TrialReduction of renal stone risk by potassium-magnesium citrate during 5 weeks of bed rest.
Exposure to the microgravity environment of space increases the risk of kidney stone formation, particularly for calcium oxalate and uric acid stones. This study was performed to evaluate the efficacy of potassium alkali as potassium-magnesium citrate in reducing renal stone risk and bone turnover. ⋯ Provision of alkali as potassium-magnesium citrate is an effective countermeasure for the increased risk of renal stone disease associated with immobilization. Despite an increase in urine calcium concentration, the relative saturation of calcium oxalate decreased due to citrate chelation of calcium and the concentration of undissociated uric acid decreased due to the significant increase in urine pH.
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The Journal of urology · Jun 2007
Randomized Controlled TrialEfficacy of botulinum toxin-A for treating idiopathic detrusor overactivity: results from a single center, randomized, double-blind, placebo controlled trial.
We evaluated the use of botulinum toxin-A in treating patients with idiopathic detrusor overactivity refractory to anticholinergics. ⋯ Botulinum toxin-A at 200 U is safe and effective for idiopathic detrusor overactivity and the beneficial effects persist for at least 24 weeks.