The Journal of urology
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The Journal of urology · Aug 2005
Multicenter StudyA need for reevaluation of sports participation recommendations for children with a solitary kidney.
We sought to evaluate the incidence and outcome of blunt renal injury in children by mechanism of injury. These data could then be used to provide the basis for more rational recommendations to parents and physicians regarding participation in sporting activities. ⋯ The majority of renal injuries in children associated with kidney loss (21 of 28) occurred as a result of motor vehicle accidents, pedestrians being struck by a vehicle or other object, and falls. There were no kidneys lost in any contact sport. Sledding, skiing and rollerblading resulted in kidney loss. Current recommendations of the American Academy of Pediatrics Committee on Sports Medicine and Fitness prohibiting children with a solitary kidney from participating in contact sports appear to be overly protective and need to be reevaluated. In some instances activities listed as limited contact sports resulted in renal loss, showing that the risk associated with these activities has been underestimated.
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The Journal of urology · Mar 2005
Multicenter StudyDefinitions of biochemical failure that best predict clinical failure in patients with prostate cancer treated with external beam radiation alone: a multi-institutional pooled analysis.
Pooled data on 4,839 patients with T1-2 prostate cancer treated with external beam radiation therapy (RT) alone at 9 institutions have previously provided long-term biochemical failure (BF) and clinical outcomes using the American Society for Therapeutic Radiology and Oncology (ASTRO) definition. In this report we determined the sensitivity and specificity of several BF definitions using distant failure (DF) alone or clinical failure (CF), defined as local failure (LF) and/or DF. ⋯ Using what is to our knowledge the largest data set of patients with prostate cancer treated with RT alone we correlated multiple definitions of BF with the strict clinical end points of DF alone and CF (DF or local failure). Defining BF as PSA greater than absolute nadir plus 2 ng/ml, dated at the call, PSA greater than current nadir plus 3 ng/ml, dated at the call, or 2 consecutive increases of at least 0.5 ng/ml, back dated, had higher sensitivity and specificity for DF alone or CF compared with the ASTRO definition. This information should contribute to the discussion regarding suggested modifications to the ASTRO definition of biochemical failure.
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The Journal of urology · Mar 2005
Multicenter StudyProstate biopsy following a positive screen in the prostate, lung, colorectal and ovarian cancer screening trial.
The benefit of prostate specific antigen (PSA) and digital rectal examination (DRE) screening for prostate cancer is under evaluation in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial. Followup of positive screens in PLCO is done by subject personal physicians and it is outside of trial control. We describe the pattern of prostate biopsy in men with positive screens in PLCO. ⋯ : These biopsy rates following positive PSA and DRE screens are likely to be representative of national rates. These results suggest that PLCO is evaluating the effects of screening in a contemporary and robust manner.
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The Journal of urology · Sep 2004
Multicenter Study Clinical TrialInterim results from a national multicenter phase II trial of combination bacillus Calmette-Guerin plus interferon alfa-2b for superficial bladder cancer.
Interim results are provided from a large multicenter trial of combination bacillus Calmette-Guerin (BCG) plus interferon (IFN) alfa-2b for BCG naive (BCG-N) and previous BCG failure (BCG-F) cases of superficial bladder cancer. ⋯ This multicenter trial provides a benchmark for the efficacy and safety of combination BCG and IFN as up front and salvage therapy. The incremental value of IFN cannot be determined from this study.
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The Journal of urology · Apr 2004
Randomized Controlled Trial Multicenter Study Clinical TrialCost-effectiveness of zoledronic acid for the prevention of skeletal complications in patients with prostate cancer.
We estimated the cost-effectiveness of zoledronic acid vs placebo for decreasing skeletal complications in men with prostate cancer. ⋯ The nominal base case estimate of the cost per quality adjusted life-year for zoledronic acid in the prevention of skeletal complications of prostate cancer is consistent with that of bisphosphonates in breast cancer. However, the cost-effectiveness ratios for bisphosphonates are higher than commonly cited thresholds for conferring cost-effectiveness.