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Rozsypalova A, Rosova B, Filipova A, Nikolov DH, Chloupkova R, Richter I, Zachoval R, Matej R, Melichar B, Buchler T, Dvorak J. Association of the combined parameters including the frequency of primary cilia, PD-L1, Smoothened protein, membranous β-catenin and cytoplasmic β-catenin expression with the outcome of patients with clear cell renal cell carcinoma. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2024. [PMID: 38420990 DOI: 10.5507/bp.2024.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024] Open
Abstract
AIMS The objective of this study was to investigate the association and combined prognostic significance of the PD-L1, Smoothened protein and β-catenin expressions in patients with clear cell renal cell carcinoma (ccRCC). METHODS The PD-L1, Smoothened protein and β-catenin expression were evaluated in 104 ccRCC patients. All studied tumor samples were acquired from nephrectomy specimens of primary tumors and not from biopsies or metastases. An indirect immunohistochemistry using polyclonal rabbit anti-Smoothened antibody, monoclonal mouse anti-human β-catenin-1 antibody, immunohistochemical assay PD-L1 28-8 pharmDx using monoclonal rabbit anti-PD-L1 antibody and anti-VHL (C- terminal) rabbit antibody was used. Immunohistochemistry was scored semiquantitavely. RESULTS Median overall survival (OS) was significantly better in patients with lower PD-L1 expression (≤5%), Smoothened protein (SMO) expression (<5%) or cytoplasmic β-catenin expression (≤75%) than in patients with higher expressions of these biomarkers (P<0.001, P=0.047, and P<0.001, respectively). Membranous β-catenin showed an opposite effect with its lower expression (≤75%) being associated with longer OS (P=0.020). There was significant association between PD-1 and PD-L1 expression (P=0.007) and significant association of tumor grade (WHO 2016) with membranous β-catenin (P<0.001), cytoplasmic β-catenin (P=0.005), pVHL (P=0.042), PD-L1 (P=0.049) and PD-1 (P=0.028) expression. CONCLUSION The present study provides the first data on the potential association and combined prognostic significance of frequency of primary cilia, PD-L1, Smoothened protein and β-catenin expression with the outcome in clear cell renal cell carcinoma.
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Affiliation(s)
- Aneta Rozsypalova
- Department of Oncology, First Faculty of Medicine, Charles University and Thomayer University Hospital, Prague, Czech Republic
| | - Blanka Rosova
- Department of Pathology and Molecular Medicine, Third Medical Faculty, Charles University and Thomayer University Hospital, Prague, Czech Republic
| | - Alzbeta Filipova
- Department of Radiobiology, Faculty of Military Health Sciences, University of Defense, Hradec Kralove, Czech Republic
| | | | - Renata Chloupkova
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Igor Richter
- Department of Oncology, First Faculty of Medicine, Charles University and Thomayer University Hospital, Prague, Czech Republic
- Department of Oncology, Regional Hospital, Liberec, Czech Republic
| | - Roman Zachoval
- Department of Urology, Third Medical Faculty, Charles University and Thomayer University Hospital, Prague, Czech Republic
| | - Radoslav Matej
- Department of Pathology and Molecular Medicine, Third Medical Faculty, Charles University and Thomayer University Hospital, Prague, Czech Republic
| | - Bohuslav Melichar
- Department of Oncology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
| | - Tomas Buchler
- Department of Oncology, First Faculty of Medicine, Charles University and Thomayer University Hospital, Prague, Czech Republic
| | - Josef Dvorak
- Department of Oncology, First Faculty of Medicine, Charles University and Thomayer University Hospital, Prague, Czech Republic
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Krhut J, Tintěra J, Rejchrt M, Skugarevska B, Grepl M, Zachoval R, Zvara P, Blok BFM. Brain Response Induced by Peroneal Electrical Transcutaneous Neuromodulation Invented for Overactive Bladder Treatment, as Detected by Functional Magnetic Resonance Imaging. Neuromodulation 2024; 27:353-359. [PMID: 36599767 DOI: 10.1016/j.neurom.2022.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 10/27/2022] [Accepted: 11/28/2022] [Indexed: 01/03/2023]
Abstract
OBJECTIVES In this study, we aimed to investigate whether peroneal electrical Transcutaneous Neuromodulation invented for overactive bladder (OAB) treatment elicits activation in brain regions involved in neural regulation of the lower urinary tract. MATERIALS AND METHODS Among 22 enrolled healthy female volunteers, 13 were eligible for the final analysis. Functional magnetic resonance imaging (fMRI) (Siemens VIDA 3T; Erlangen, Germany) was used to compare the brain region activation elicited by peroneal electrical Transcutaneous Neuromodulation with the activation elicited by sham stimulation. Each subject underwent brain fMRI recording during eight 30-second periods of rest, alternating with 30-second periods of passive feet movement using the sham device, mimicking the motor response to peroneal nerve stimulation. Subsequently, fMRI recording was performed during the analogic "off-on" stimulation paradigm using peroneal electrical transcutaneous neuromodulation. Magnetic resonance imaging data acquired during both paradigms were compared using individual and group statistics. RESULTS During both peroneal electrical Transcutaneous Neuromodulation and sham feet movements, we observed activation of the primary motor cortex and supplementary motor area, corresponding to the cortical projection of lower limb movement. During peroneal electrical Transcutaneous Neuromodulation, we observed significant activations in the brain stem, cerebellum, cingulate gyrus, putamen, operculum, and anterior insula, which were not observed during the sham feet movement. CONCLUSIONS Our study provides evidence that peroneal electrical Transcutaneous Neuromodulation elicits activation of brain structures that have been previously implicated in the perception of bladder fullness and that play a role in the ability to cope with urinary urgency. Our data suggest that neuromodulation at the level of supraspinal control of the lower urinary tract may contribute to the treatment effect of peroneal electrical Transcutaneous Neuromodulation in patients with OAB.
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Affiliation(s)
- Jan Krhut
- Department of Urology, University Hospital, Ostrava, Czech Republic; Department of Surgical Studies, Ostrava University, Ostrava, Czech Republic.
| | - Jaroslav Tintěra
- Department of Radiodiagnostics and Interventional Radiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Michal Rejchrt
- Department of Urology, Second Faculty of Medicine of Charles University and Motol University Hospital, Prague, Czech Republic
| | - Barbora Skugarevska
- Department of Urology, University Hospital, Ostrava, Czech Republic; Department of Surgical Studies, Ostrava University, Ostrava, Czech Republic
| | - Michal Grepl
- Department of Urology, University Hospital, Ostrava, Czech Republic; Department of Surgical Studies, Ostrava University, Ostrava, Czech Republic
| | - Roman Zachoval
- Department of Urology, First Faculty of Medicine of Charles University and Thomayer Hospital, Prague, Czech Republic
| | - Peter Zvara
- Biomedical Laboratory and Research Unit of Urology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Urology, Odense University Hospital, Odense, Denmark
| | - Bertil F M Blok
- Department of Urology, Erasmus Medical Center, Rotterdam, the Netherlands
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Májek O, Babjuk M, Roobol MJ, Bratt O, Van Poppel H, Zachoval R, Ferda J, Koudelková M, Ngo O, Gregor J, Collen S, Hejduk K, Dušek L, Válek V. How to follow the new EU Council recommendation and improve prostate cancer early detection: the Prostaforum 2022 declaration. EUR UROL SUPPL 2023; 53:106-108. [PMID: 37441346 PMCID: PMC10334243 DOI: 10.1016/j.euros.2023.05.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2023] [Indexed: 07/15/2023] Open
Abstract
An updated Council of the EU recommendation on cancer screening was adopted in December 2022 during the Czech EU presidency. The recommendation included prostate cancer as a suitable target disease for organised screening, and invited countries to proceed with piloting and further research. To support further discussions and actions to promote early detection of prostate cancer, an international conference in November 2022 (Prostaforum 2022) resulted in a joint declaration. Here we describe the EU policy background, summarise the preparation of the declaration and the key underlying evidence and expert recommendations, and report the text of the declaration. The declaration summarises the striking inequalities in prostate cancer burden in Europe and calls on all stakeholders to consider and support concrete steps for advancement of organised early detection of prostate cancer. Our aim is to request endorsement of the text and potential initiation of practical actions by all stakeholders to support the aims of the declaration. Patient summary Prostate cancer is among the most frequent cancers and is one of the most common causes of cancer death among men. The European Union has recommended new pilot programmes for prostate cancer screening. The Prostaforum 2022 declaration invites all stakeholders to support this new recommendation with specific steps.
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Affiliation(s)
- Ondřej Májek
- National Screening Centre, Institute of Health Information and Statistics of the Czech Republic, Prague, Czechia
- Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Marek Babjuk
- Department of Urology, 2nd Faculty of Medicine, Charles University, Motol University Hospital, Prague, Czechia
| | - Monique J. Roobol
- Department of Urology, Erasmus University Medical Centre, Cancer Institute, Rotterdam, The Netherlands
| | - Ola Bratt
- Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Urology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Hendrik Van Poppel
- European Association of Urology Policy Office, Arnhem, The Netherlands
- Department of Urology, KU Leuven, Leuven, Belgium
| | - Roman Zachoval
- Department of Urology, 3rd Faculty of Medicine of Charles University and Faculty Thomayer Hospital, Prague, Czechia
| | - Jiří Ferda
- Department of Imaging Methods, Medical Faculty Pilsen, Charles University, University Hospital Pilsen, Pilsen, Czechia
| | - Marcela Koudelková
- National Screening Centre, Institute of Health Information and Statistics of the Czech Republic, Prague, Czechia
- Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Ondřej Ngo
- National Screening Centre, Institute of Health Information and Statistics of the Czech Republic, Prague, Czechia
- Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Jakub Gregor
- National Screening Centre, Institute of Health Information and Statistics of the Czech Republic, Prague, Czechia
- Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Sarah Collen
- European Association of Urology Policy Office, Arnhem, The Netherlands
| | - Karel Hejduk
- National Screening Centre, Institute of Health Information and Statistics of the Czech Republic, Prague, Czechia
- Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Ladislav Dušek
- National Screening Centre, Institute of Health Information and Statistics of the Czech Republic, Prague, Czechia
- Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Vlastimil Válek
- Faculty of Medicine, Masaryk University, Brno, Czechia
- Ministry of Health of the Czech Republic, Prague, Czechia
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Krhut J, Tintěra J, Rejchrt M, Skugarevská B, Zachoval R, Zvara P, Blok BFM. Differences between brain responses to peroneal electrical transcutaneous neuromodulation and transcutaneous tibial nerve stimulation, two treatments for overactive bladder. Neurourol Urodyn 2023. [PMID: 37144657 DOI: 10.1002/nau.25197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/27/2023] [Accepted: 04/20/2023] [Indexed: 05/06/2023]
Abstract
OBJECTIVES To compare brain responses to peroneal electrical transcutaneous neuromodulation (peroneal eTNM®) and transcutaneous tibial nerve stimulation (TTNS), two methods for treating overactive bladder (OAB), using functional magnetic resonance imaging (fMRI). The present study was not designed to compare their clinical efficacy. MATERIALS AND METHODS This study included 32 healthy adult female volunteers (average age 38.3 years (range 22-73)). Brain MRI using 3 T scanner was performed during three 8-min blocks of alternating sequences. During each 8-min block, the protocol alternated between sham stimulation (30 s) and rest (30 s) for 8 repeats; then peroneal eTNM® stimulation (30 s) and rest (30 s) for 8 repeats; then, TTNS stimulation (30 s) and rest (30 s) for 8 repeats. Statistical analysis was performed at the individual level with a threshold of p = 0.05, family-wise error (FWE)-corrected. The resulting individual statistical maps were analyzed in group statistics using a one-sample t-test, p = 0.05 threshold, false discovery rate (FDR)-corrected. RESULTS During peroneal eTNM®, TTNS, and sham stimulations, we recorded activation in the brainstem, bilateral posterior insula, bilateral precentral gyrus, bilateral postcentral gyrus, left transverse temporal gyrus, and right supramarginal gyrus. During both peroneal eTNM® and TTNS stimulations, but not sham stimulations, we recorded activation in the left cerebellum, right transverse temporal gyrus, right middle frontal gyrus, and right inferior frontal gyrus. Exclusively during peroneal eTNM® stimulation, we observed activation in the right cerebellum, right thalamus, bilateral basal ganglia, bilateral cingulate gyrus, right anterior insula, right central operculum, bilateral supplementary motor cortex, bilateral superior temporal gyrus, and left inferior frontal gyrus. CONCLUSIONS Peroneal eTNM®, but not TTNS, induces the activation of brain structures that were previously implicated in neural control of the of bladder filling and play an important role in the ability to cope with urgency. The therapeutic effect of peroneal eTNM® could be exerted, at least in part, at the supraspinal level of neural control.
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Affiliation(s)
- Jan Krhut
- Department of Urology, University Hospital, Ostrava, Czech Republic
- Department of Surgical Studies, Ostrava University, Ostrava, Czech Republic
| | - Jaroslav Tintěra
- Department of Radiodiagnostics and Interventional Radiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Michal Rejchrt
- Department of Urology, 2nd Faculty of Medicine of Charles University and Motol University Hospital, Prague, Czech Republic
| | - Barbora Skugarevská
- Department of Urology, University Hospital, Ostrava, Czech Republic
- Department of Surgical Studies, Ostrava University, Ostrava, Czech Republic
| | - Roman Zachoval
- Department of Urology, 1st Faculty of Medicine of Charles University and Thomayer Hospital, Prague, Czech Republic
| | - Peter Zvara
- Department of Clinical Research, Biomedical Laboratory and Research Unit of Urology, University of Southern Denmark, Odense, Denmark
- Department of Urology, Odense University Hospital, Odense, Denmark
| | - Bertil F M Blok
- Department of Urology, Erasmus Medical Center, Rotterdam, The Netherlands
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Hrbáček J, Hanáček V, Kadlečková D, Cirbusová A, Čermák P, Tachezy R, Zachoval R, Saláková M. Urinary shedding of common DNA viruses and their possible association with bladder cancer: a qPCR-based study. Neoplasma 2023; 70:311-318. [PMID: 37226931 DOI: 10.4149/neo_2023_220703n681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 03/22/2023] [Indexed: 05/26/2023]
Abstract
After a decade of human urinary microbiota research, little is known about the composition of the urinary virome and its association with health and disease. This study aimed to investigate the presence of 10 common DNA viruses in human urine and their putative association with bladder cancer (BC). Catheterized urine samples were collected from patients undergoing endoscopic urological procedures under anesthesia. After DNA extraction from the samples, viral DNA sequences were detected using real-time PCR. Viruria rates were compared between BC patients and controls. A total of 106 patients (89 males and 17 females) were included in the study. Fifty-seven (53.8%) were BC patients and 49 (46.2%) had upper urinary tract stones or bladder outlet obstruction. The viruses detected in the urine were human cytomegalovirus (2.0%), Epstein-Barr virus (6.0%), human herpesvirus-6 (12.5%), human papillomavirus (15.2%), BK polyomavirus (15.5%), torque teno virus (44.2%), and JC polyomavirus (47.6%), while no adenoviruses, herpes simplex virus 1 and 2, or parvoviruses were found. There were statistically significant differences in HPV viruria rates between cancer patients and controls (24.5% vs. 4.3%, p=0.032 after adjustment for age and gender). Viruria rates increased from benign to non-muscle-invasive and muscle-invasive tumors. Patients with a history of BC have higher HPV viruria rates than controls. Whether this relationship is a causal one remains to be established by further research.
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Affiliation(s)
- Jan Hrbáček
- Department of Urology, 3rd Faculty of Medicine, Charles University, Prague and Thomayer University Hospital, Prague, Czech Republic
| | - Vítězslav Hanáček
- Department of Urology, 3rd Faculty of Medicine, Charles University, Prague and Thomayer University Hospital, Prague, Czech Republic
| | - Dominika Kadlečková
- Department of Genetics and Microbiology, Faculty of Science, Charles University, BIOCEV, Vestec, Czech Republic
| | - Adéla Cirbusová
- Department of Genetics and Microbiology, Faculty of Science, Charles University, BIOCEV, Vestec, Czech Republic
| | - Pavel Čermák
- Department of Clinical Microbiology, Thomayer Hospital, Prague, Czech Republic
| | - Ruth Tachezy
- Department of Genetics and Microbiology, Faculty of Science, Charles University, BIOCEV, Vestec, Czech Republic
| | - Roman Zachoval
- Department of Urology, 3rd Faculty of Medicine, Charles University, Prague and Thomayer University Hospital, Prague, Czech Republic
| | - Martina Saláková
- Department of Genetics and Microbiology, Faculty of Science, Charles University, BIOCEV, Vestec, Czech Republic
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Hrbáček J, Tláskal V, Čermák P, Hanáček V, Zachoval R. Bladder cancer is associated with decreased urinary microbiota diversity and alterations in microbial community composition. Urol Oncol 2023; 41:107.e15-107.e22. [PMID: 36402713 DOI: 10.1016/j.urolonc.2022.09.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 08/21/2022] [Accepted: 09/22/2022] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Human urine microbiota (UM) research has uncovered associations between composition of microbial communities of the lower urinary tract and various disease states including several reports on the putative link between UM and bladder cancer (BC). The aim of this study was to investigate male UM in patients with BC and controls using catheterised urine specimens unlike in previous studies. METHODS Urine samples were obtained in theatre after surgical prepping and draping using aseptic catheterisation. DNA was extracted and hypervariable region V4 of the 16S rRNA gene was amplified using 515F and 806R primers. Sequencing was performed on Illumina MiSeq platform. Sequencing data were processed using appropriate software tools. Alpha diversity measures were calculated and compared between groups. Prevalence Interval for Microbiome Evaluation was used to test differences in beta diversity. RESULTS A total of 63 samples were included in the analysis. Mean age of study subjects was 65.1 years (SD 12.5). Thirty-four men had bladder cancer and 29 participants were undergoing interventions for benign conditions (benign prostate hyperplasia or upper urinary tract stone disease). BC patients had lower UM richness and diversity than controls (83 vs. 139 operational taxonomic units, P = 0.015; Shannon index: 2.46 vs. 2.94, P = 0.049). There were specific taxa enriched in cancer (Veillonella, Varibaculum, Methylobacterium-Methylorubrum) and control groups (Pasteurella, Corynebacterium, Acinetobacter), respectively. CONCLUSION BC patients had lower bladder microbiota richness and diversity than controls. Specific genera were enriched in cancer and control groups, respectively. These results corroborate some of previous reports while contradicting others. Future microbiota research would benefit from parallel transcriptomic/metabolomic analysis.
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Affiliation(s)
- Jan Hrbáček
- Department of Urology, 3rd Faculty of Medicine, Charles University, Prague and Thomayer University Hospital, Prague, Czech Republic.
| | - Vojtěch Tláskal
- Laboratory of Environmental Microbiology, Institute of Microbiology of the Czech Academy of Sciences, Prague, Czech Republic; Institute of Soil Biology and Biogeochemistry, Biology Centre of the Czech Academy of Sciences, Ceske Budejovice
| | - Pavel Čermák
- Department of Clinical Microbiology, Thomayer University Hospital, Prague, Czech Republic
| | - Vítězslav Hanáček
- Department of Urology, 3rd Faculty of Medicine, Charles University, Prague and Thomayer University Hospital, Prague, Czech Republic
| | - Roman Zachoval
- Department of Urology, 3rd Faculty of Medicine, Charles University, Prague and Thomayer University Hospital, Prague, Czech Republic
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Šámal V, Krhut J, Zachoval R, Matoušková M, Ák MB. Permanent urethral catheter - a good servant, but bad master: Guidelines for prevention, diagnosis, and treatment of catheter-associated urinary tract infections. Cas Lek Cesk 2023; 161:303-308. [PMID: 36868839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Catheter-associated urinary tract infections (CAUTI) are among the most common healthcare-associated infections, which increase morbidity, mortality, prolong the length of hospitalization and have a significant impact on the cost of treatment. The most efficient preventive method is removing catheters as soon as possible and avoid unnecessary catheterizations. Treatment of asymptomatic bacteriuria is not recommended. In cases of serious CAUTI, vigorous antibiotic therapy covering multidrug-resistant uropathogens should be initiated. These recommendations are intended for all medical specialties to improve the care of patients with indwelling catheters in the prevention, diagnosis, and treatment of CAUTI in primary care and subsequent long-term care.
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Nagdyman N, Kalies J, Hager A, Meierhofer C, Clevert D, Zachoval R, Ewert P. How Common Is Liver Fibrosis in Adult Patients with Ebstein's Anomaly and Can It Serve as an Additional Criterion for Surgical Indication? Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- N. Nagdyman
- Deutsches Herzzentrum München, München, Deutschland
| | - J. Kalies
- Deutsches Herzzentrum München, München, Deutschland
| | - A. Hager
- Deutsches Herzzentrum München, München, Deutschland
| | | | - D. Clevert
- Clinic of Radiology, Großhadern, München, Deutschland
| | - R. Zachoval
- Medizinische Klinik I, Großhadern, München, Deutschland
| | - P. Ewert
- Deutsches Herzzentrum München, München, Deutschland
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Hrbacek J, Morais D, Cermak P, Hanacek V, Zachoval R. Alpha-diversity and microbial community structure of the male urinary microbiota depend on urine sampling method. Sci Rep 2021; 11:23758. [PMID: 34887510 PMCID: PMC8660768 DOI: 10.1038/s41598-021-03292-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 11/30/2021] [Indexed: 02/06/2023] Open
Abstract
Considerable variation exists in the methodology of urinary microbiota studies published so far including the cornerstone of any biomedical analysis: sample collection. The aim of this study was to compare the urinary microbiota of first-catch voided urine (FCU), mid-stream voided urine (MSU) and aseptically catheterised urine in men and define the most suitable urine sampling method. Forty-nine men (mean age 71.3 years) undergoing endoscopic urological procedures were enrolled in the study. Each of them contributed three samples: first-catch urine (FCU), mid-stream urine (MSU) and a catheterised urine sample. The samples were subjected to next-generation sequencing (NGS, n = 35) and expanded quantitative urine culture (EQUC, n = 31). Using NGS, Bacteroidetes, Firmicutes, and Proteobacteria were the most abundant phyla in our population. The most abundant genera (in order of relative abundance) included: Prevotella, Veillonella, Streptococcus, Porphyromonas, Campylobacter, Pseudomonas, Staphylococcus, Ezakiella, Escherichia and Dialister. Eighty-two of 105 samples were dominated by a single genus. FCU, MSU and catheterised urine samples differed significantly in three of five alpha-diversity measures (ANOVA, p < 0.05): estimated number of operational taxonomic units, Chao1 and abundance-based coverage estimators. Beta-diversity comparisons using the PIME method (Prevalence Interval for Microbiome Evaluation) resulted in clustering of urine samples according to the mode of sampling. EQUC detected cultivable bacteria in 30/31 (97%) FCU and 27/31 (87%) MSU samples. Only 4/31 (13%) of catheterised urine samples showed bacterial growth. Urine samples obtained by transurethral catheterisation under aseptic conditions seem to differ from spontaneously voided urine samples. Whether the added value of a more exact reflection of the bladder microbiota free from urethral contamination outweighs the invasiveness of urethral catheterisation remains to be determined.
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Affiliation(s)
- Jan Hrbacek
- Department of Urology, 3rd Faculty of Medicine, Charles University, Thomayer University Hospital, Videnska 800, 14059, Prague, Czech Republic.
| | - Daniel Morais
- Laboratory of Environmental Microbiology, Institute of Microbiology, Czech Academy of Sciences, Videnska 1083, 14200, Prague, Czech Republic
| | - Pavel Cermak
- Department of Clinical Microbiology, Thomayer University Hospital, Videnska 800, 14059, Prague, Czech Republic
| | - Vitezslav Hanacek
- Department of Urology, 3rd Faculty of Medicine, Charles University, Thomayer University Hospital, Videnska 800, 14059, Prague, Czech Republic
| | - Roman Zachoval
- Department of Urology, 3rd Faculty of Medicine, Charles University, Thomayer University Hospital, Videnska 800, 14059, Prague, Czech Republic
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Hrbacek J, Hanacek V, Morais D, Cermak P, Zachoval R. Catheterised urine is not superior to mid-stream samples in the study of male urinary microbiota. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00523-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Zachoval R, Krhut J, Slatinska J, Viklicky O, Janousek L. The relationship between lower urinary tract dysfunctions and urinary leakage from ureterocystoneoanastomosis in male patients after kidney transplantation. ACTA ACUST UNITED AC 2021; 122:336-340. [PMID: 33848184 DOI: 10.4149/bll_2021_057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the association of lower urinary tract dysfunctions with urinary leakage from ureterocystoneoanastomosis (UCNA) after kidney transplantation. BACKGROUND The UCNA leakage after kidney transplantation can be associated with various conditions while severe lower urinary tract dysfunctions could be one of them. METHODS The analysis included all men who underwent kidney transplantation between January 2009 and December 2014. The parameters of storage and voiding functions were evaluated. All patients were monitored during their post-transplantation period for the incidence of urinary leakage from UCNA. Urodynamic parameters were compared between men with and without a documented leakage. RESULTS The study cohort included 127 male patients, while UCNA leakage was observed in 11 (8.7 %) patients. Significant differences between both groups of patients were found for storage parameters (patients with leakage had smaller volume at first and a normal desire to void, smaller maximal cystometric capacity, and lower detrusor compliance) and voiding parameters (patients with leakage had a lower maximal flow rate, higher detrusor pressure at maximal flow rate and higher bladder outlet obstruction index). CONCLUSION This study shows an association between lower urinary tract dysfunction and UCNA leakage in men without previous urological history (Tab. 2, Fig. 2, Ref. 24). Text in PDF www.elis.sk Keywords: urinary leakage, ureterocystoneoanastomosis, lower urinary tract dysfunctions, kidney transplantation.
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Krhut J, Wohlfahrt P, Pudich J, Kufová E, Borovička V, Bílková K, Sýkora R, Mokriš J, Cífková R, Zachoval R, Zvara P. Cardiovascular safety of mirabegron in individuals treated for spinal cord injury- or multiple sclerosis-induced neurogenic detrusor overactivity. Int Urol Nephrol 2021; 53:1089-1095. [PMID: 33417146 DOI: 10.1007/s11255-020-02774-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 12/22/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE To analyze cardiovascular safety of mirabegron in patients with spinal cord injury (SCI)- and multiple sclerosis (MS)-induced neurogenic detrusor overactivity (NDO) in a prospective, randomized, double-blind, placebo-controlled study. METHODS Seventy-eight patients were enrolled into the study, and 66 of them were included into the final analysis. In 49 (74.2%), NDO developed due to suprasacral SCI, 17 (25.8%) suffered from NDO due to MS. Eleven patients were previously treated for hypertension and one for arrhythmia. All study participants received placebo for 2 weeks run-in period. Subsequently, eligible subjects were randomized for 4 weeks of active treatment with mirabegron 50 mg once daily (Group A; n = 32) or placebo (Group B; n = 34). Data from resting electrocardiography (ECG), 24-h ECG and blood pressure monitoring, and echocardiographic examination, were used for cardiovascular safety assessment. All reported variables were evaluated at time of randomization and at the end of the study. Longitudinal changes of variables within the groups and differences between the groups were assessed using nonparametric Kruskal-Wallis test, and p ≤ 0.05 was considered statistically significant. RESULTS No statistically significant longitudinal changes were found in safety variables, except for prolongation of QT interval in placebo group (p = 0.0328) recorded by resting ECG. No significant difference between the Groups A and B, in any of the variables, was observed. A single cardiovascular study drug-related adverse event was recorded in a patient with cervical SCI (3.13%). CONCLUSIONS Our results suggest that mirabegron can be safely used in the treatment of patients with SCI- and MS-induced NDO.
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Affiliation(s)
- Jan Krhut
- Department of Urology, University Hospital, Tř. 17. listopadu 1790, 708 52, Ostrava, Czech Republic. .,Department of Surgical Studies, Medical Faculty, Ostrava University, Ostrava, Czech Republic.
| | - Peter Wohlfahrt
- Center for Cardiovascular Prevention, 1st Faculty of Medicine of Charles University and Thomayer Hospital, Prague, Czech Republic
| | - Jiří Pudich
- Department of Cardiology, University Hospital, Ostrava, Czech Republic
| | - Eliška Kufová
- Department of Cardiology, University Hospital, Ostrava, Czech Republic
| | - Vladimír Borovička
- Department of Urology, 3rd Faculty of Medicine of Charles University and Thomayer Hospital, Prague, Czech Republic
| | - Karolína Bílková
- Spinal Cord Rehabilitation Unit, Rehabilitation Center, Kladruby, Czech Republic
| | - Radek Sýkora
- Department of Urology, University Hospital, Tř. 17. listopadu 1790, 708 52, Ostrava, Czech Republic.,Department of Surgical Studies, Medical Faculty, Ostrava University, Ostrava, Czech Republic
| | - Jan Mokriš
- Department of Urology, 3rd Faculty of Medicine of Charles University and Thomayer Hospital, Prague, Czech Republic
| | - Renata Cífková
- Center for Cardiovascular Prevention, 1st Faculty of Medicine of Charles University and Thomayer Hospital, Prague, Czech Republic
| | - Roman Zachoval
- Department of Urology, 3rd Faculty of Medicine of Charles University and Thomayer Hospital, Prague, Czech Republic
| | - Peter Zvara
- Department of Clinical Research, Biomedical Laboratory and Research Unit of Urology, University of Southern Denmark, Odense, Denmark.,Department of Urology, Odense University Hospital, Odense, Denmark
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13
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Dietz J, Spengler U, Müllhaupt B, Schulze Zur Wiesch J, Piecha F, Mauss S, Seegers B, Hinrichsen H, Antoni C, Wietzke-Braun P, Peiffer KH, Berger A, Matschenz K, Buggisch P, Backhus J, Zizer E, Boettler T, Neumann-Haefelin C, Semela D, Stauber R, Berg T, Berg C, Zeuzem S, Vermehren J, Sarrazin C, Giostra E, Berning M, Hampe J, De Gottardi A, Rauch A, Semmo N, Discher T, Trauth J, Fischer J, Gress M, Günther R, Heinzow H, Schmidt J, Herrmann A, Stallmach A, Hilgard G, Deterding K, Lange C, Ciesek S, Wedemeyer H, Hoffmann D, Klinker H, Schulze P, Kocheise F, Müller-Schilling M, Kodal A, Kremer A, Ganslmayer M, Siebler J, Lammert F, Rissland J, Löbermann M, Götze T, Canbay A, Lohse A, von Felden J, Jordan S, Maieron A, Moradpour D, Chave JP, Moreno C, Müller T, Muche M, Epple HJ, Port K, von Hahn T, Cornberg M, Manns M, Reinhardt L, Ellenrieder V, Rockstroh J, Schattenberg J, Sprinzl M, Galle P, Roeb E, Steckstor M, Schmiegel W, Brockmeyer N, Seufferlein T, Stremmel W, Strey B, Thimme R, Teufel A, Vogelmann R, Ebert M, Tomasiewicz K, Trautwein C, Tacke F, Koenen T, Weber T, Zachoval R, Mayerle J, Raziorrouh B, Angeli W, Beckebaum S, Doberauer C, Durmashkina E, Hackelsberger A, Erhardt A, Garrido-Lüneburg A, Gattringer H, Genné D, Gschwantler M, Gundling F, Hametner S, Schöfl R, Hartmann C, Heyer T, Hirschi C, Jussios A, Kanzler S, Kordecki N, Kraus M, Kullig U, Wollschläger S, Magenta L, Beretta-Piccoli BT, Menges M, Mohr L, Muehlenberg K, Niederau C, Paulweber B, Petrides A, Pinkernell M, Piso R, Rambach W, Reiser M, Riecken B, Rieke A, Roth J, Schelling M, Schlee P, Schneider A, Scholz D, Schott E, Schuchmann M, Schulten-Baumer U, Seelhoff A, Stich A, Stickel F, Ungemach J, Walter E, Weber A, Winzer T, Abels W, Adler M, Audebert F, Baermann C, Bästlein E, Barth R, Barthel K, Becker W, Behrends J, Benninger J, Berger F, Berzow D, Beyer T, Bierbaum M, Blaukat O, Bodtländer A, Böhm G, Börner N, Bohr U, Bokemeyer B, Bruch H, Bucholz D, Burkhard O, Busch N, Chirca C, Delker R, Diedrich J, Frank M, Diehl M, Dienethal A, Dietel P, Dikopoulos N, Dreck M, Dreher F, Drude L, Ende K, Ehrle U, Baumgartl K, Emke F, Glosemeyer R, Felten G, Hüppe D, Fischer J, Fischer U, Frederking D, Frick B, Friese G, Gantke B, Geyer P, Schwind H, Glas M, Glaunsinger T, Goebel F, Göbel U, Görlitz B, Graf R, Gruber H, Härter G, Herder M, Heuchel T, Heuer S, Höffl KH, Hörster H, Sonne JU, Hofmann W, Holst F, Hunstiger M, Hurst A, Jägel-Guedes E, John C, Jung M, Kallinowski B, Kapzan B, Kerzel W, Khaykin P, Klarhof M, Klüppelberg U, Klugewitz K, Knapp B, Knevels U, Kochsiek T, Körfer A, Köster A, Kuhn M, Langekamp A, Künzig B, Link R, Littman M, Löhr H, Lutz T, Knecht G, Lutz U, Mainz D, Mahle I, Maurer P, Mayer C, Meister V, Möller H, Heyne R, Moritzen D, Mroß M, Mundlos M, Naumann U, Nehls O, Ningel K, Oelmann A, Olejnik H, Gadow K, Pascher E, Petersen J, Philipp A, Pichler M, Polzien F, Raddant R, Riedel M, Rietzler S, Rössle M, Rufle W, Rump A, Schewe C, Hoffmann C, Schleehauf D, Schmidt K, Schmidt W, Schmidt-Heinevetter G, Schmidtler-von Fabris J, Schnaitmann E, Schneider L, Schober A, Niehaus-Hahn S, Schwenzer J, Seidel T, Seitel G, Sick C, Simon K, Stähler D, Stenschke F, Steffens H, Stein K, Steinmüller M, Sternfeld T, Strey B, Svensson K, Tacke W, Teuber G, Teubner K, Thieringer J, Tomesch A, Trappe U, Ullrich J, Urban G, Usadel S, von Lucadou A, Weinberger F, Werheid-Dobers M, Werner P, Winter T, Zehnter E, Zipf A. Efficacy of Retreatment After Failed Direct-acting Antiviral Therapy in Patients With HCV Genotype 1-3 Infections. Clin Gastroenterol Hepatol 2021; 19:195-198.e2. [PMID: 31706062 DOI: 10.1016/j.cgh.2019.10.051] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/19/2019] [Accepted: 10/25/2019] [Indexed: 02/07/2023]
Abstract
Hepatitis C virus infection is causing chronic liver disease, cirrhosis, and hepatocellular carcinoma. By combining direct-acting antivirals (DAAs), high sustained virologic response rates (SVRs) can be achieved. Resistance-associated substitutions (RASs) are commonly observed after DAA failure, and especially nonstructural protein 5A (NS5A) RASs may impact retreatment options.1-3 Data on retreatment of DAA failure patients using first-generation DAAs are limited.4-7 Recently, a second-generation protease- and NS5A-inhibitor plus sofosbuvir (voxilaprevir/velpatasvir/sofosbuvir [VOX/VEL/SOF]) was approved for retreatment after DAA failure.8 However, this and other second-generation regimens are not available in many resource-limited countries or are not reimbursed by regular insurance, and recommendations regarding the selection of retreatment regimens using first-generation DAAs are very important. This study aimed to analyze patients who were re-treated with first-generation DAAs after failure of a DAA combination therapy.
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Affiliation(s)
- Julia Dietz
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Ulrich Spengler
- Department of Internal Medicine I, University of Bonn, Bonn, and German Center for Infection Research (DZIF), Partner Site, Cologne-Bonn, Germany
| | - Beat Müllhaupt
- Swiss Hepato-Pancreato-Biliary Center and Department of Gastroenterology and Hepatology, University Hospital Zürich, Zürich, Switzerland
| | - Julian Schulze Zur Wiesch
- I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, and German Center for Infection Research (DZIF), Partner Site, Hamburg-Lübeck-Borstel-Riems, Germany
| | - Felix Piecha
- I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, and German Center for Infection Research (DZIF), Partner Site, Hamburg-Lübeck-Borstel-Riems, Germany
| | - Stefan Mauss
- Center for HIV and Hepatogastroenterology, Düsseldorf, Germany
| | - Barbara Seegers
- Gastroenterologisch-Hepatologisches Zentrum Kiel, Kiel, Germany
| | | | - Christoph Antoni
- Department of Internal Medicine II, University Hospital Mannheim, Mannheim, Germany
| | | | - Kai-Henrik Peiffer
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Annemarie Berger
- Institute for Medical Virology, University Hospital Frankfurt, Frankfurt, Germany
| | | | - Peter Buggisch
- Institute for Interdisciplinary Medicine IFI, Hamburg, Germany
| | - Johanna Backhus
- Department of Internal Medicine I, Ulm University, Ulm, Germany
| | - Eugen Zizer
- Department of Internal Medicine I, Ulm University, Ulm, Germany
| | - Tobias Boettler
- Department of Medicine II, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christoph Neumann-Haefelin
- Department of Medicine II, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - David Semela
- Division of Gastroenterology and Hepatology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - Rudolf Stauber
- Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Thomas Berg
- Department of Gastroenterology and Rheumatology, University Hospital Leipzig, Leipzig, Germany
| | - Christoph Berg
- Department of Internal Medicine I, University of Tübingen, Tübingen, Germany
| | - Stefan Zeuzem
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Johannes Vermehren
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Christoph Sarrazin
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany; Medizinische Klinik 2, St Josefs-Hospital, Wiesbaden, Germany.
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Stejskal J, Adamcová V, Záleský M, Novák V, Čapoun O, Fiala V, Dolejšová O, Sedláčková H, Veselý Š, Zachoval R. The predictive value of the prostate health index vs. multiparametric magnetic resonance imaging for prostate cancer diagnosis in prostate biopsy. World J Urol 2020; 39:1889-1895. [PMID: 32761380 DOI: 10.1007/s00345-020-03397-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 07/25/2020] [Indexed: 02/03/2023] Open
Abstract
PURPOSE To compare the ability of Prostate Health Index (PHI) to diagnose csPCa, with that of total PSA, PSA density (PSAD) and the multiparametric magnetic resonance (mpMRI) of the prostate. METHODS We analysed a group of 395 men planned for a prostate biopsy who underwent a mpMRI of the prostate evaluated using the PIRADS v1 criteria. All patients had their PHI measured before prostate biopsy. In patients with an mpMRI suspicious lesions, an mpMRI/ultrasound software fusion-guided biopsy was performed first, with 12 core systematic biopsy performed in all patients. A ROC analysis was performed for PCa detection for total PSA, PSAD, PIRADS score and PHI; with an AUC curve calculated for all criteria and a combination of PIRADS score and PHI. Subsequent sub-analyses included patients undergoing first and repeat biopsy. RESULTS The AUC for predicting the presence of csPCa in all patients was 59.5 for total PSA, 69.7 for PHI, 64.9 for PSAD and 62.5 for PIRADS. In biopsy naive patients it was 61.6 for total PSA, 68.9 for PHI, 64.6 for PSAD and 63.1 for PIRADS. In patients with previous negative biopsy the AUC for total PSA, PHI, PSAD and PIRADS was 55.4, 71.2, 64.4 and 69.3, respectively. Adding of PHI to PIRADS increased significantly (p = 0.007) the accuracy for prediction of csPCa. CONCLUSION Prostate Health Index could serve as a tool in predicting csPCa. When compared to the mpMRI, it shows comparable results. The PHI cannot, however, help us guide prostate biopsies in any way, and its main use may, therefore, be in pre-MRI or pre-biopsy triage.
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Affiliation(s)
- Jiří Stejskal
- Department of Urology, 3rd Faculty of Medicine of Charles University and Thomayer Hospital, Vídeňská 800, Prague, 14059, Czech Republic.
| | - Vanda Adamcová
- Department of Urology, 3rd Faculty of Medicine of Charles University and Thomayer Hospital, Vídeňská 800, Prague, 14059, Czech Republic
| | - Miroslav Záleský
- 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Vojtěch Novák
- Department of Urology, 2nd Faculty of Medicine of Charles University, University Hospital Motol, Prague, Czech Republic
| | - Otakar Čapoun
- Department of Urology, 1st Faculty of Medicine of Charles university, General Universtity Hospital, Prague, Czech Republic
| | - Vojtěch Fiala
- Department of Urology, 1st Faculty of Medicine of Charles university, General Universtity Hospital, Prague, Czech Republic
| | - Olga Dolejšová
- Department of Urology, Faculty of Medicine in Pilsen, Charles University, University Hospital in Pilsen, Pilsen, Czech Republic
| | - Hana Sedláčková
- Department of Urology, Faculty of Medicine in Pilsen, Charles University, University Hospital in Pilsen, Pilsen, Czech Republic
| | - Štěpán Veselý
- Department of Urology, 2nd Faculty of Medicine of Charles University, University Hospital Motol, Prague, Czech Republic
| | - Roman Zachoval
- Department of Urology, 3rd Faculty of Medicine of Charles University and Thomayer Hospital, Vídeňská 800, Prague, 14059, Czech Republic
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15
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Zalesky M, Stejskal J, Minarik I, Adamcova V, Babjuk M, Zachoval R. Cancer detection rates and inter-examiner variability of MRI/TRUS fusion targeted biopsy and systematic transrectal biopsy. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2019; 164:314-319. [PMID: 31602045 DOI: 10.5507/bp.2019.050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 09/25/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Software-based MRI/TRUS fusion biopsy depends on the coordination of several steps, and inter-examiner differences could influence the results. The aim of this bicentric prospective study was to compare the detection rates of MRI/TRUS fusion targeted biopsy (TG) and systematic biopsy (SB), and the detection rates of examiners with different levels of previous experience in prostate biopsy. METHODS A total of 419 patients underwent MRI based on a suspicion of prostate cancer with elevated PSA levels. MRI was positive in 395 patients (221 in the first biopsy group [FB] and 174 in the repeated biopsy group [RB]). A subsequent TG, followed by a SB, was performed on these patients by four different examiners. RESULTS In the detection of clinically significant prostate cancer, a significant difference was found for TG+SB against SB in the RB group (35.1% vs. 25.3%, P=0.047). In the detection of clinically insignificant prostate cancer, the SB had a significantly higher detection rate than TG in both subgroups (FB: 11.9% vs. 4.7%, P=0.008; RB: 13.8% vs. 6.9%, P=0.034). A significant difference was found between the four examiners in the FB for TG (P=0.028), SB (P=0.036), and TG+SB (P=0.017). CONCLUSION MRI/TRUS TG in combination with SB had significantly higher detection rates than SB in the RB group only. Differences in detection rates between examiners were dependent on the level of previous experience with TRUS guided biopsy.
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Affiliation(s)
- Miroslav Zalesky
- Department of Urology, Thomayer Hospital and 3rd Faculty of Medicine, Charles University, Prague, Czech Republic.,Department of Urology, 1
| | - Jiri Stejskal
- Department of Urology, Thomayer Hospital and 3rd Faculty of Medicine, Charles University, Prague, Czech Republic
| | | | - Vanda Adamcova
- Department of Urology, Thomayer Hospital and 3rd Faculty of Medicine, Charles University, Prague, Czech Republic
| | | | - Roman Zachoval
- Department of Urology, Thomayer Hospital and 3rd Faculty of Medicine, Charles University, Prague, Czech Republic.,Department of Urology, 1
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Rozsypalova A, Rosova B, Filipova A, Nikolov DH, Chloupkova R, Richter I, Proks J, Zachoval R, Matej R, Melichar B, Buchler T, Dvorak J. Negative prognostic significance of primary cilia, CD8+ tumor infiltrating lymphocytes and PD1+ cells expression in clear cell renal cancer. J BUON 2019; 24:1644-1651. [PMID: 31646820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
PURPOSE The aim of this study was to investigate the potential association and combined prognostic significance of the frequency of primary cilia (PC), programmed cell death protein-1 receptor (PD1) and CD8+ tumor infiltrating lymphocytes (TIL) in patients with clear cell renal cancer (ccRCC). METHODS The frequency of PC, PD1 expression and the frequency of intratumoral CD8+ TIL were evaluated in 104 ccRCC patients. RESULTS The median frequency of PC was 0.003. The expression of PD1+ cells were <5% in 52 patients, 5-25% in 34 patients and 26-50% in 13 patients and >50% in 5 patients. Intratumoral CD8+ TIL were evaluable in all patients: negative in 1 patient, <25% in 63, 26-50% in 29 and >50% in 11 patients. Overall survival (OS) according to the frequency of PC was significantly shorter in patients with higher frequency (≥0.002) than in patients with lower frequency (<0.002) (p<0.001). Median OS was significantly shorter in patients with higher (25%) CD8+ TIL and higher (>25%) PD1+ expression than in patients with lower (<25%) expression (4.6 vs. 97. years, p=0.006 and 2.9 vs. 8.9 years, p=0.006, respectively). CONCLUSIONS The present study provides the first data on the potential association and combined prognostic significance of frequency of PC, PD1+ cells and CD8+ TIL in patients with clear cell renal cancer.
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Affiliation(s)
- Aneta Rozsypalova
- 1Department of Oncology, First Medical Faculty, Charles University and Thomayer Hospital, Prague, Czech Republic
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Záleský M, Stejskal J, Adamcova V, Hrbáček J, Minarik I, Pavlicko A, Votrubova J, Babjuk M, Zachoval R. Use of Prostate Specific Antigen Density Combined with Multiparametric Magnetic Resonance Imaging Improves Triage for Prostate Biopsy. Urol Int 2019; 103:33-40. [DOI: 10.1159/000500350] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 04/12/2019] [Indexed: 11/19/2022]
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18
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Ryznarová Z, Keller J, Záleský M, Zachoval R, Čapek V, Malikova H. Comparison of Prostate Imaging Reporting and Data System (PI-RADS) version 1 and version 2 and combination with apparent diffusion coefficient as a predictor of biopsy outcome. Neuro Endocrinol Lett 2019; 40:41-50. [PMID: 31184822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 03/03/2019] [Indexed: 06/09/2023]
Abstract
PURPOSE The main aim of the study was to compare the diagnostic performance of Prostate Imaging Reporting and Data System (PI-RADS) versions 1 and 2 for detection of prostate carcinoma (PCa) and clinically significant prostate carcinoma (CSPCa). The second aim was to evaluate the potential benefit of adding the apparent diffusion coefficient (ADC) and prostate specific antigen (PSA) density to the standard evaluation protocol. METHODS A total of 167 consecutive patients with elevated PSA underwent magnetic resonance imaging. The images were evaluated prospectively using both versions of the PI-RADS and the results compared with 12-core template biopsy and magnetic resonance/transrectal ultrasound fusion biopsy. Receiver-operating characteristic (ROC) curves were compared for each scoring system using DeLong\'s test. The area under the curve (AUC) was calculated for ADC and PSA density for lesions scored 4. RESULTS PI-RADS V2 had high discriminative ability for PCa prediction with an AUC of 0.824 (95% CI 0.763 to 0.885), compared to an AUC of 0.724 (95% CI 0.654 to 0.794) for PI-RADS V1 (p = 0.0335). ADC demonstrated a higher discriminative ability with an AUC of 0.702 (95% CI 0.548 to 0.856) in CSPCa prediction. Using the obtained ADC threshold of 828x10^-6 mm^2/s improved specificity to 86.73% with a sensitivity of 60.38%. CONCLUSION PI-RADS version 2 exhibited significantly higher discriminative ability for PCa and CSPCa detection compared to PI-RADS version 1. Using the ADC can improve the tumor predictability of PI-RADS version 2 in lesions scored 4.
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Affiliation(s)
- Zuzana Ryznarová
- Department of Radiology, Na Homolce Hospital, Prague, Czech Republic
| | - Jiri Keller
- Department of Radiology, Na Homolce Hospital, Prague, Czech Republic
| | - Miroslav Záleský
- Department of Urology, Thomayer Hospital, Prague, Czech Republic
| | - Roman Zachoval
- Department of Urology, Thomayer Hospital, Prague, Czech Republic
| | - Václav Čapek
- National Institute of Public Health, Prague, Czech Republic
| | - Hana Malikova
- Radiology Department, Third Faculty of Medicine, Charles University, Faculty Hospital Kralovske Vinohrady, Prague, Czech Republic
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Mühlstädt S, Friedl A, Zachoval R, Mohammed N, Schumann A, Theil G, Fornara P. An overview of the ATOMS generations: port types, functionality and risk factors. World J Urol 2018; 37:1679-1686. [DOI: 10.1007/s00345-018-2548-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 10/25/2018] [Indexed: 11/29/2022] Open
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20
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Dvorak J, Rosova B, Filipova A, Hadzi Nikolov D, Dusek L, Rozsypalova A, Proks J, Richter I, Melichar B, Buchler T, Zachoval R, Matej R. The frequency of primary cilia, CD8+ tumor infiltrating lymphocytes and PD-1 expression in renal cell carcinoma of clear-cell type. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy269.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Krhut J, Borovička V, Bílková K, Sýkora R, Míka D, Mokriš J, Zachoval R. Efficacy and safety of mirabegron for the treatment of neurogenic detrusor overactivity-Prospective, randomized, double-blind, placebo-controlled study. Neurourol Urodyn 2018; 37:2226-2233. [PMID: 29603781 DOI: 10.1002/nau.23566] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 02/05/2018] [Indexed: 11/11/2022]
Abstract
AIMS To assess the efficacy and safety of mirabegron in the treatment of neurogenic detrusor overactivity. METHODS This prospective, multicenter, randomized, double-blind, placebo-controlled study was conducted in three tertiary centers, and included 78 patients suffering from spinal cord injury or multiple sclerosis. Patients were randomized for Mirabegron 50 mg (Group A) or placebo (Group B). Urodynamic parameters, the 24 h pad-weight test, and patient-reported outcomes were assessed. Safety assessments included monitoring the incidence and severity of adverse events. Changes in time and differences between groups were assessed with nonparametric Kruskal-Wallis one-way analysis of variance; P ≤ 0.05 was considered statistically significant. RESULTS In total, 66 patients were eligible for inclusion in the final analysis. There was a significant increase of volume at the first detrusor contraction (P = 0.00047) and an improvement in bladder compliance (P = 0.0041) in the mirabegron group compared with the placebo-treated group, whereas the increase in cystometric capacity did not reach statistical significance (P = 0.061). There was a clear tendency to reduced urine leakage (P = 0.056) in Group A. There were significant changes in all the patient-reported outcomes, favoring the mirabegron group. The incidence of drug-related adverse events was 3.13%. CONCLUSIONS Mirabegron (50 mg) improved both urodynamic variables and patient-reported outcomes in patients with NDO. The treatment was tolerated well.
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Affiliation(s)
- Jan Krhut
- Department of Urology, University Hospital, Ostrava, Czech Republic
| | | | - Karolína Bílková
- Spinal Cord Rehabilitation Unit, Rehabilitation Center, Kladruby, Czech Republic
| | - Radek Sýkora
- Department of Urology, University Hospital, Ostrava, Czech Republic
| | - David Míka
- Department of Urology, University Hospital, Ostrava, Czech Republic
| | - Jan Mokriš
- Department of Urology, Thomayer Hospital, Prague, Czech Republic
| | - Roman Zachoval
- Department of Urology, Thomayer Hospital, Prague, Czech Republic
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Krhut J, Gärtner M, Mokris J, Horcicka L, Svabik K, Zachoval R, Martan A, Zvara P. Effect of severity of urinary incontinence on quality of life in women. Neurourol Urodyn 2018; 37:1925-1930. [PMID: 29603780 DOI: 10.1002/nau.23568] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 12/25/2017] [Indexed: 11/09/2022]
Abstract
AIMS While the effect of different types of incontinence on the quality of life (QoL) has been clearly documented, the information about the impact of incontinence severity on QoL in women is lacking. Therefore, we investigated whether increasingly severe degrees of incontinence were linearly correlated with poorer QoL. METHODS We included 391 incontinent women and 81 continent volunteers in the study and assessed them in accordance with routine clinical practice. A 24 h pad-weight test was used to objectively quantify the incontinence severity. We then stratified participants according to incontinence type and severity and assessed correlations between incontinence severity and Patient Perception of Bladder Condition (PPBC), International Consultation on Incontinence short-form questionnaire (ICIQ-SF), and King's Health Questionnaire (KHQ) quality of life scores in the entire study population and in individual groups according to incontinence type. RESULTS Minimal incontinence was associated with significant negative impact on QoL, as measured by all quality of life assement tools. There were nonlinear correlations between scores on individual questionnaires and daily leakage volumes. Stress urinary incontinence had a weaker impact on quality of life than urge or mixed incontinence, as measured by PPBC (P < 0.0001), KHQ part 1 (P < 0.0001), and KHQ part 2 (P < 0.001). Stress urinary incontinence also had a weaker impact on QoL than mixed incontinence as measured by ICI-Q (P = 0.007). CONCLUSIONS This study demonstrated that even mild urinary leakage significantly reduces the QoL, while subsequent increase in the degree of incontinence has only minimal additional effect. There was no linear correlation between incontinence severity and QoL.
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Affiliation(s)
- Jan Krhut
- Faculty of Medicine, Department of Urology, University Hospital, Ostrava, Czech Republic
| | - Marcel Gärtner
- Faculty of Medicine, Department of Gynecology and Obstetrics, University Hospital, Ostrava, Czech Republic
| | - Jan Mokris
- Department of Urology, Thomayer Hospital, Prague, Czech Republic
| | | | - Kamil Svabik
- 1-st Faculty of Medicine, Department of Obstetrics and Gynecology, Charles University and General Faculty Hospital, Prague, Czech Republic
| | - Roman Zachoval
- Department of Urology, Thomayer Hospital, Prague, Czech Republic
| | - Alois Martan
- 1-st Faculty of Medicine, Department of Obstetrics and Gynecology, Charles University and General Faculty Hospital, Prague, Czech Republic
| | - Peter Zvara
- Department of Urology and Biomedical Laboratory, University of Southern Denmark, Odense, Denmark
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Zachoval R, Borovicka V, Marada T, Viklicky O, Fronek J, Krhut J, Janousek L, Slatinska J, Nencka P. The Effects of Diuresis, Duration of Dialysis and Age on Lower Urinary Tract Function in Urologically Healthy Male Patients on the Waiting List for Kidney Transplant. Urol J 2018; 15:49-54. [PMID: 29290083 DOI: 10.22037/uj.v0i0.3888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PURPOSE This work investigated the effects of diuresis, duration of dialysis and age on lower urinary tract function in urologically healthy males on the waiting list for kidney transplant. MATERIALS AND METHODS The study included all men who had kidney transplants at our centre between January 2009 and December 2014 who had normal urological findings prior to inclusion on the list. Diuresis, the duration of haemodialysis, age, and parameters of function of the lower urinary tract as determined by filling and voiding cystometry were evaluated. RESULTS The study included 127 men (median age, 59 years; median diuresis, 250 mL; median duration of dialysis, 469.5 days). We found that greater diuresis was accompanied by significantly higher FDV, FDV/Cmax, NDV,Cmax and compliance and by significantly lower Pdet.max, PdetQmax and BOOI. Longer duration of dialysis was accompanied by significantly lower FDV, NDV and Cmax, compliance and Qmax.p and with significantlyhigher Pdet.max, PdetQmax and BOOI. Older age was associated with significantly higher Pdet.max and with significantly lower compliance. Worsening of the basic parameters of the storage function of the lower urinary tract occurred when diuresis decreased to 500-750 mL, when the duration of dialysis was one year and when patients were older than 54 years. CONCLUSION In healthy male patients on the waiting list for kidney transplant, there were connections between the occurrence of dysfunctions of the lower urinary tract and diuresis, duration of dialysis and age. Patients should be monitored for dysfunctions of the lower urinary tract before and after transplantation.
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Affiliation(s)
- Roman Zachoval
- Department o Urology, Thomayer Hospital, Prague, Czech Republic.
| | | | - Tomas Marada
- Department of Transplantation Surgery, Institute of Clinical and Experimental Medicine, Prague, Czech Republic
| | - Ondrej Viklicky
- Department of Nephrology, Institute of Clinical and Experimental Medicine, Prague, Czech Republic
| | - Jiri Fronek
- Department of Transplantation Surgery, Institute of Clinical and Experimental Medicine, Prague, Czech Republic
| | - Jan Krhut
- Department of Urology, University Hospital in Ostrava
| | - Libor Janousek
- Department of Transplantation Surgery, Institute of Clinical and Experimental Medicine, Prague, Czech Republic
| | - Janka Slatinska
- Department of Nephrology, Institute of Clinical and Experimental Medicine, Prague, Czech Republic
| | - Petr Nencka
- Department of Urology, Kralovske Vinohrady Faculty Hospital and 3rd Faculty of Medicine of Charles University in Prague
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Abstract
Zusammenfassung
Ziel: Ziel dieser Studie war, die diagnostische Aussagekraft der 111In-Oc-treotide- und der 123I-MIBG-Szintigraphie an einem größeren Patientengut in der Diagnostik von Karzinoiden zu vergleichen und mit computertomographischen Befunden zu korrelieren. Methoden: Bei 28 Patienten wurden in engem zeitlichen Intervall eine Octreotide-, MIBG-Szintigraphie und Computertomographie durchgeführt. Ergebnisse: Bei 13/15 präoperativ untersuchten Patienten konnte eine Rezeptorexpression des Primärtumors mit Octreotide nachgewiesen werden, eine MIBG-Speicherung lediglich bei 8/15 Fällen. Lebermetastasen waren im Octreotide-Szintigramm in 26 Fällen nachweisbar, mit MIBG in 19 Fällen, computertomographisch bei 22 Patienten. Die Zahl der gefundenen Herde war mit MIBG und CT geringer als mit Octreotide. Drei Patienten wiesen bisher unbekannte, extrahepatische Octreotide-Mehrspeiche-rungen auf, 2 davon zeigten keine MIBG-Speicherung. Fünf nichthormonaktive Tumoren waren im MIBG-Szintigramm negativ, wurden aber im Octreotide-Szintigramm nachgewiesen. Schlußfolgerung: Hinsichtlich der diagnostischen Möglichkeiten ist die Octreotide-Rezeptor-szintigraphie der MIBG-Szintigraphie deutlich überlegen. Somit bringt die Durchführung der MIBG-Szintigraphie nach der vorliegenden Studie keinen diagnostischen Zugewinn und erscheint nur im Hinblick auf eine eventuelle 131I-MIBG-Therapie sinnvoll.
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Švabík K, Mašata J, Krhut J, Zachoval R, Hanuš T, Halaška M, Martan A. How durable is the effect of mirabegron in successfully-treated overactive bladder patients? Analysis of a multicentre study. Ceska Gynekol 2018; 83:164-168. [PMID: 30764614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Many clinical studies indicate that pharmacologic treatment of overactive bladder (OAB) is considered effective and safe, but in real clinical practice a substantial proportion of patients discontinues the treatment. The reason for discontinuing the treatment most frequently reported is lack of efficacy and/or side effects. A further significant proportion of patients reports that they stopped the treatment because the symptoms disappeared or were resolved. This β3 agonist seems to be crucial in providing comparable efficacy in the OAB treatment and better tolerance in comparison with anticholinergics. Our aim was to investigate the durability of the mirabegron effect in successfully treated OAB patients and to understand more fully what prompts patients to return to the medication. Is this merely a subjective decision, or is it based on objective worsening of the symptoms? DESIGN Analysis of multicentre prospective study. SETTINGS Gynaecology and Obstetric Department First Faculty of Medicine, Charles University and General University Hospital, Prague. METHODS This is an analysis of longitudinal multicentre study of OAB mirabegron treatment persistence. After continuing mirabegron treatment for more than 18 months patients were assessed by bladder diary and specific questionnaires. Patients with a UB-VAS score (Urgency Bother Visual Analogue Scale) of 50 or less were asked to stop the mirabegron treatment and restart the treatment any time later if they felt the need. Patients recorded the date of return to medication; they kept a daily bladder diary and filled in the same questionnaires as at the time of medication discontinuation. We provide a comparison of symptoms at the time of mirabegron discontinuation and at the time of mirabegron medication restart. RESULTS 206 patients entered the study. 176 females (85%) and 30 males (15%) with mean age 62.9 ± 12.43, BMI ranging from 16.6 to 48.0 (mean 27.2 ± 4.96). After 18 months 126 patients were persisting with mirabegron treatment. 89 patients had UB-VAS score 50 (89 of 126 patients, i.e. 71%). Those patients were asked to stop the treatment. From the eligible group of 89 patients, 19 patients (21%) were unwilling to stop the treatment and were therefore excluded. There were no significant differences in bladder diary and QoL characteristics between patients who were unwilling to discontinue the treatment and patients who did stop taking the medication. The group who stopping treatment comprised 70 patients. At the time of last follow-up 22 patients (31%) had not restarted the medication, with mean follow-up of 122.6 days. Therapy was restarted by 48 patients (i.e. 69% of 70). The mean time without treatment was 48 days (± 32.0 days), median 53 days. There was significant worsening of OAB symptoms and subjective bother at the time of restarting the medication. CONCLUSION Subjective bother based on increase number of frequency, urgency, and nycturia causes patients with positive experience to return to mirabegron treatment. Most patients with successfully-treated symptoms of OAB who discontinue treatment can only do so temporarily. A worsening of the symptoms occurs rather rapidly, because 69% of patients with OAB symptoms successfully treated with mirabegron (UB-VAS 50) are unable to discontinue taking the medication for more than two months.
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Nencka P, Zachoval R, Vašáková M, Kopecká E, Wallenfels J, Čermák P. Immune status in patients with subclinical forms of genitourinary tuberculosis. Epidemiol Mikrobiol Imunol 2018; 67:55-57. [PMID: 30126281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The study aim was to determine whether there is a correlation between subclinical forms of genitourinary tuberculosis (GUTB) and immune status. All patients admitted to the Pneumology Clinic of the Thomayer Hospital, Prague with lung tuberculosis (LTB) were enrolled in the study. The study group consisted of 102 patients, 75 males and 27 females, median age of 46.8 years. In a previously published part of the study, 6.9 % of LTB patients were diagnosed with subclinical forms of GUTB. In the present part of the study, immune status was determined in patients with subclinical forms of GUTB by measuring circulating immunoglobulin G and CD4 T cell levels. The comparison of the immunological results did not show a statistically significant difference between the patients diagnosed with GUTB and other LTB patients..
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Tycová I, Hrubá P, Maixnerová D, Girmanová E, Mrázová P, Straňavová L, Zachoval R, Merta M, Slatinská J, Kollár M, Honsová E, Tesař V, Viklický O. Molecular profiling in IgA nephropathy and focal and segmental glomerulosclerosis. Physiol Res 2017; 67:93-105. [PMID: 29137483 DOI: 10.33549/physiolres.933670] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
The aim of the study was to characterize by molecular profiling two glomerular diseases: IgA nephropathy (IgAN) and focal segmental glomerulosclerosis (FSGS) and to identify potential molecular markers of IgAN and FSGS progression. The expressions of 90 immune-related genes were compared in biopsies of patients with IgAN (n=33), FSGS (n=17) and in controls (n=11) using RT-qPCR. To identify markers of disease progression, gene expression was compared between progressors and non-progressors in 1 year follow-up. The results were verified on validation cohort of patients with IgAN (n=8) and in controls (n=6) using laser-capture microdissection, that enables to analyze gene expression separately for glomeruli and interstitium. In comparison to controls, patients with both IgAN and FSGS, had lower expression of BAX (apoptotic molecule BCL2-associated protein) and HMOX-1 (heme oxygenase 1) and higher expression of SELP (selectin P). Furthermore, in IgAN higher expression of PTPRC (protein-tyrosine phosphatase, receptor-type C) and in FSGS higher expression of BCL2L1 (regulator of apoptosis BCL2-like 1) and IL18 compared to control was observed. Validation of differentially expressed genes between IgAN and controls on another cohort using laser-capture microdissection confirmed higher expression of PTPRC in glomeruli of patients with IgAN. The risk of progression in IgAN was associated with higher expression EDN1 (endothelin 1) (AUC=0.77) and FASLG (Fas ligand) (AUC=0.82) and lower expression of VEGF (vascular endothelial growth factor) (AUC=0.8) and in FSGS with lower expression of CCL19 (chemokine (C-C motif) ligand 19) (AUC=0.86). Higher expression of EDN1 and FASLG along with lower expression of VEGF in IgAN and lower expression of CCL19 in FSGS at the time of biopsy can help to identify patients at risk of future disease progression.
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Affiliation(s)
- I Tycová
- Transplant Laboratory, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
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Adamcová V, Záleský M, Stejskal J, Minárik I, Koldová M, Pavličko A, Votrubová J, Matěj R, Babjuk M, Zachoval R. MRI as a triage test in prostate cancer diagnostic algorithm: Prospective study. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/s1569-9056(17)32017-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Friedl A, Schneeweiss J, Stangl K, Mühlstädt S, Zachoval R, Hruby S, Gründler T, Kivaranovic D, Fornara P, Lusuardi L, Brössner C. The Adjustable Transobturator Male System in Stress Urinary Incontinence After Transurethral Resection of the Prostate. Urology 2017; 109:184-189. [PMID: 28712889 DOI: 10.1016/j.urology.2017.07.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 06/30/2017] [Accepted: 07/05/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate the efficacy and safety of the Adjustable Transobturator Male System (ATOMS) in men with stress urinary incontinence after transurethral resection of the prostate (TURP). MATERIALS AND METHODS From a large international prospectively administrated ATOMS register, we identified 49 patients with an ATOMS device as a result of persistent stress urinary incontinence after TURP. For evaluation, the men were divided into standard transurethral resection of the prostate (sTURP) and palliative transurethral resection of the prostate (pTURP) in radiated patients. Baseline and follow-up measurements included continence parameters, urodynamics, quality-of-life surveys (Patient Global Impression-Improvement and International Consultation on Incontinence Questionnaire-Short Form), and pain ratings. The dry rate (0-1 security pad/<10 mL urine loss), the success rate (overall improvement), removals, complications, and treatment failures were recorded. A P value of <.05 was considered statistically significant. RESULTS After a median of 34 and 22 months' follow-up and 2-3 adjustments, the sTURP and pTURP cohorts had 58% and 50% dry rates and 90% and 87% success rates. Hence, no improvement was seen in 10% and 13%. The removal rate was higher in pTURP (50% vs 10%, P = .0171) and infection was the most common side effect (50%) observed. Neither intraoperative nor Clavien-Dindo 4 and 5 adverse events were recorded. In sTURP and pTURP, the median daily pad count and the pad test improved significantly (all P <.001), and quality-of-life parameters shifted to a high satisfaction level (P <.001 and P = .001). Urodynamics remained unchanged and postoperative pain was not an issue. CONCLUSION The ATOMS device shows promising treatment outcomes in patients after TURP and a similar efficacy as in postprostatectomy incontinence. There is no difference in continence outcome between sTURP and pTURP; however, a higher removal rate was found after pTURP, which may be important for patient counseling.
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Affiliation(s)
- Alexander Friedl
- Department of Urology, Barmherzige Schwestern Krankenhaus, Vienna, Austria.
| | | | - Kathrin Stangl
- Department of Urology, Barmherzige Schwestern Krankenhaus, Vienna, Austria
| | - Sandra Mühlstädt
- Klinik and Poliklinik of Urology and Kidney Transplantation, University Hospital, Martin Luther University, Halle (Saale), Germany
| | - Roman Zachoval
- Thomayer Hospital, Department of Urology and 1st and 3rd Medical Faculty, Charles University, Prague, Czech Republic
| | - Stephan Hruby
- Department of Urology, Landeskrankenhaus Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Therese Gründler
- Department of Urology, Landeskrankenhaus Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Danijel Kivaranovic
- Department of Statistics and Operations Research, University of Vienna, Vienna, Austria
| | - Paolo Fornara
- Klinik and Poliklinik of Urology and Kidney Transplantation, University Hospital, Martin Luther University, Halle (Saale), Germany
| | - Lukas Lusuardi
- Department of Urology, Landeskrankenhaus Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Clemens Brössner
- Department of Urology, Barmherzige Schwestern Krankenhaus, Vienna, Austria
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Krhut J, Zachoval R, Rosier PFWM, Shelly B, Zvara P. ICS Educational Module: Electromyography in the assessment and therapy of lower urinary tract dysfunction in adults. Neurourol Urodyn 2017; 37:27-32. [PMID: 28419532 DOI: 10.1002/nau.23278] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 03/10/2017] [Indexed: 12/15/2022]
Abstract
AIM To present the teaching module "Electromyography in the assessment and therapy of lower urinary tract dysfunction in adults." This teaching module embodies a presentation, in combination with this manuscript. This manuscript serves as a scientific background review; the evidence base made available on ICS website to summarize current knowledge and recommendations. METHODS This review has been prepared by a Working Group of The ICS Urodynamics Committee. The methodology used included comprehensive literature review, consensus formation by the members of the Working Group, and review by members of the ICS Urodynamics Committee core panel. RESULTS Electromyography (EMG) is a method to record spontaneous or artificially induced electrical activity of the nerve-muscle unit or to test nerve conductivity. EMG of the anal sphincter using surface electrode is most widely used screening technique to detect detrusor-sphincter dyssynergia in urology. It is non-invasive and easy to perform. EMG methods using needle electrodes are reserved for diagnostics in well selected group of mainly neurogenic patients. These methods require expertise in the field of general EMG and are usually performed by neurologist and neuro-physiologist. The evidence in many aspects of use of EMG in urology remains sparse. CONCLUSIONS Currently EMG methods rarely play a decision making role in selecting proper treatment of lower urinary tract dysfunction. With the current efforts to improve phenotyping of these patients in order to provide individualized treatment, the role of EMG could increase.
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Affiliation(s)
- Jan Krhut
- Department of Urology, Ostrava University, University Hospital, Ostrava, Czech Republic
| | - Roman Zachoval
- Department of Urology, Thomayer Hospital and 1st and 3rd Faculty of Medicine of Charles University, Prague, Czech Republic
| | - Peter F W M Rosier
- Department of Urology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Beth Shelly
- Beth Shelly Physical Therapy, Moline, Illinois
| | - Peter Zvara
- Department of Urology and Biomedical Laboratory, University of Southern Denmark, Odense, Denmark
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Svihra J, Krhut J, Zachoval R, Svihrova V, Luptak J. Impact of clean intermittent catheterization on quality adjusted life years (QALYs) in spinal cord injury patients with neurogenic urinary incontinence. Neurourol Urodyn 2017; 37:250-256. [PMID: 28407301 DOI: 10.1002/nau.23283] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 02/19/2017] [Indexed: 11/11/2022]
Abstract
AIMS The impact of clean intermittent catheterization (CIC) on quality adjusted life years (QALYs) gained in adults' spinal cord injury population with neurogenic urinary incontinence (UI). METHODS Patients were recruited from the national registry January-June 2014. The inclusion criteria were adults, neurogenic UI due to spinal cord injury (SCI), use of collection devices and CIC for more than 6 months. The exclusion criteria were inability to perform CIC, cancer of the lower urinary tract and fistulas formation. Measurement tools were the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) and an estimation of life expectancy by the national registry. The calculation of the weighting factor (WF) was obtained by linear transformation of the ICIQ-UI SF total score. A score was transformed to the range from 0 (worst impact) to 1 (no impact). The QALYs was calculated as the weighting factor × life expectancy in years. RESULTS A total of 229/365 patients were involved in this study (63%). Patients before CIC reached an ICIQ mean score of 14.83, WF of 0.29, and QALYs of 9.02 during life expectancy. After 6 months of follow-up using CIC, ICIQ reached 9.12, WF 0.57 and QALYs 17.45. The number of QALYs increased by 93.5% and UI evaluated with the ICIQ-UI SF decreased by 38.5% (P < 0.01). CONCLUSIONS The CIC of the urinary bladder statistically significantly increased the number of QALYs and reduced the degree of UI in SCI patients.
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Affiliation(s)
- Jan Svihra
- Department of Urology, Jessenius Faculty of Medicine, Comenius University Bratislava, Martin, Slovak Republic
| | - Jan Krhut
- Department of Urology, University Hospital, Ostrava, Czech Republic
| | - Roman Zachoval
- Department of Urology, Thomayer Hospital and Department of Urology, 1st and 3rd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Viera Svihrova
- Department of Public Health, Jessenius Faculty of Medicine, Comenius University Bratislava, Martin, Slovak Republic
| | - Jan Luptak
- Department of Urology, Jessenius Faculty of Medicine, Comenius University Bratislava, Martin, Slovak Republic
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Martan A, Masata J, Krhut J, Zachoval R, Hanus T, Svabik K. Persistence in the treatment of overactive bladder syndrome (OAB) with mirabegron in a multicenter clinical study. Eur J Obstet Gynecol Reprod Biol 2017; 210:247-250. [DOI: 10.1016/j.ejogrb.2016.12.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 11/11/2016] [Accepted: 12/22/2016] [Indexed: 11/29/2022]
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Martan A, Mašata J, Švabík K, Hanuš T, Krhut J, Zachoval R. [Cure effect and persistence of treatment with Mirabegron in patients with symptoms of overactive bladder: a multicentre clinical study]. Ceska Gynekol 2017; 82:424-429. [PMID: 29302974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The objective of this study was to monitor and evaluate the persistence and cure effect of Mirabegron in patients with overactive bladder syndrome after 18 months of treatment. DESIGN Prospective clinical study. SETTINGS 10 gynecological and urological departments in CZE. MATERIALS AND METHODS This is an analysis of a prospective, multicenter monitoring study from May to September 2014. The patients were 18 years old and had symptoms of OAB for a minimum of three months. Patient check-ups were performed 18 months after the first visit. The dosage of Mirabegron was 50 mg per day in 162 patients, though for 44 of the patients the treatment was changed. During the final check-ups it was ascertained how many patients had discontinued treatment with Mirabegron, at first as a proportion of the whole group of patients and then in relation to gender, age, previous treatment with anticholinergic drugs and changes in the treatment during the study. To evaluate treatment efficacy we employed the TS-VAS and PPBC. During the check-up it was ascertained how many patients had discontinued treatment with Mirabegron, and reasons for this were established. The statistics were calculated using the softwares STATISTICA 12 (Statsoft, USA) and SPSS 20.0 (IBM, v.20.0). RESULTS Prospective monitoring was performed on 206 patients. Their mean age was 62.8 years; mean body mass index for the whole group of patients was 27.3. At the check-up 18 months post-initiation of treatment it emerged that 79 (38.3%) patients had discontinued the treatment. The reasons for discontinuation of treatment were insufficient treatment efficacy (35.4% of patients), while 49.4% cited other reasons (hospitalisation, surgery, gravidity) and 15.2% of patients discontinued therapy because of side effects. The evaluation of treatment persistence with Mirabegron in groups with relation to gender, age and previous treatment with anticholinergic drugs did not establish statistically significant differences. However, there was a statistically significant difference between groups in relation to changes of treatment during study. At the evaluation of the efficacy of the treatment during the check-up 18 months after initiation of treatment the mean TS-VAS was 73.4, a decrease of the scale of bothers evaluated by PPBC before treatment from a mean value of 4.6 to a value of 2.7. CONCLUSIONS In our clinical study 18 months treatment persistence with Mirabegron was 61.7%. The reasons were reduced side effects and good cure effect of the drug.
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Švabík K, Mašata J, Krhut J, Zachoval R, Hanuš T, Halaška M, Horčička L, Krofta L, Hanáková M, Martan A. [Degree of satisfaction of patients continuing overactive bladder treatment with mirabegron]. Ceska Gynekol 2017; 82:48-52. [PMID: 28252310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Overactive bladder syndrome is chronic disease with high prevalence rate (9-42%). This syndrome requires long term therapy, but the treatment persistence is after 3 months over all 26% with further decline in one-year period as low as 18.5%. Main reasons for stopping the treatment are low efficacy, the medication didnt work as expected and side effects. How much satisfied are patients with mirabegron persisting on its treatment? To answer this question, we provided secondary analysis of multicentre follow-up study of patients on mirabegron. We compared subjective and objective parameters between patients continuing mirabegron treatment and those who discontinued the medication. DESIGN Secondary analysis multicentre prospective follow-up. SETTINGS Ob/Gyn department First Faculty of Medicine, Charles University and General University Hospital, Prague. METHODS It is secondary analysis of multicentre prospective study following patients with mirabegron 50 mg treatment. We have analysed objective data from micturition diary and subjective data using visual analogue scales (UB-VAS - urgency bother visual analogue scale, and TS-VAS - treatment satisfaction visual analogue scale) and compared data between the group of patients continuing mirabegron treatment and patients who stopped the medication during the study. RESULTS We included 206 patients (176 women, 30 men) with diagnosis of overactive bladder. Patients continuing the treatment (group n1) had baseline UB-VAS 70.1 vs. 75.0 (p = n.s.) in patients who stopped the medication during the follow-up period (group n2). Baseline episodes of severe urgency and urge incontinence where n1 - 5.1 vs. n2 - 6.2 (p = n.s.). Six months urgency bother score UB-VAS was n1 - 32.4 vs. n2 - 58.9 (p < 0,001). Treatment satisfaction TS-VAS was n1 - 80.3 vs. n2 - 57.7 (p < 0,001). Number of severe urgencies with or without urge incontinence was after 6 months n1 - 2.1 vs. n2 - 3.3 (p = n.s.), lower in group continuing the treatment. When comparing the data between patients stopping the medication for reason of low efficacy (group s1) with patients stopping for other reasons (group s2) UB-VAS bas: s1 - 68.5 vs. s2 - 43.9 (p = 0.001); TS VAS s1 - 45.1 vs. s2 - 58.4 (p = n.s.) and number of severe urgency with or without incontinence s1 - 5.9 vs. s2 - 3.2 (p = 0.009). CONCLUSION Our data shows that patients expectation on treatment with mirabegron is not low. Patients accept treatment either without side effects or with decrease of severe urgency with or without urge incontinence around 50%. Regardless the reason the patients continuing the treatment scale treatment satisfaction - TS-VAS over 70 points.
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Šimša J, Visokai V, Lipská L, Levý M, Zachoval R. [Total pelvic exenteration - strategy and extent of surgery]. Rozhl Chir 2017; 96:242-246. [PMID: 28931289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Pelvic exenteration is an essential part of complex treatment of advanced tumours of the small pelvis. The strategy of surgery is well known and consensual. However, the optimal extent of lymphadenectomy is still under discussion. The aim of this paper is to summarize the strategy of surgery and the extent of lymphadenectomy. METHODS Review of the literature and retrospective analysis of 63 patients of our cohort, operated on at the Department of Surgery of the First Faculty of Medicine, Charles University and Thomayer Hospital between 1999-2015. CONCLUSION The paper describes indications for pelvic exenteration, the strategy of surgery and the necessary extent of lymphadenectomy.
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Friedl A, Mühlstädt S, Zachoval R, Giammò A, Kivaranovic D, Rom M, Fornara P, Brössner C. Long-term outcome of the adjustable transobturator male system (ATOMS): results of a European multicentre study. BJU Int 2016; 119:785-792. [PMID: 27868328 DOI: 10.1111/bju.13684] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate the long-term effectiveness and safety of the adjustable transobturator male system (ATOMS® , Agency for Medical Innovations A.M.I., Feldkirch, Austria) in a European-wide multicentre setting. PATIENTS AND METHODS In all, 287 men with stress urinary incontinence (SUI) were treated with the ATOMS device between June 2009 and March 2016. Continence parameters (daily pad test/pad use), urodynamics (maximum urinary flow rate, voiding volume, residual urine), and pain/quality of life (QoL) ratings (visual analogue scale/Leeds Assessment of Neuropathic Symptoms and Signs, International Consultation on Incontinence Questionnaire-Short Form [ICIQ-SF]/Patient Global Impression of Improvement [PGI-I]) were compared preoperatively and after intermediate (12 months) as well as after individual maximum follow-up. Overall success rate, dry rate (<10 mL/day and 0-1 pad/day), device durability, treatment failure, and device complications were recorded. Nonparametric tests were used for statistical analyses. RESULTS After a median (interquartile range [IQR]) follow-up of 31 (10-54) months and a median (IQR) of 3 (2-4) adjustments, the overall success rate was 90% (258 men) and the dry rate was 64% (184). Daily pad test and pad use decreased from a median of 400 mL/day and 4 pads/day to a median of 18 mL/day and 1 pad/day (both P < 0.001), concomitantly QoL ratings significantly improved and changed to a high level of satisfaction (PGI-I 4 to 2, ICIQ-SF 17 to 5; both P < 0.001). The UI results at 12 months were comparable to those at final follow-up. Chronic pain and intraoperative complications did not occur. Most of the postoperative complications were Clavien-Dindo grade I-III (no grade IV or V). At present, 231 (80%) of all the ATOMS devices are still functioning; 56 (20%) were removed, the most common reason being local titanium intolerance (41%) and leak/dysfunction (30%). The operating time and continence outcome varied between port generations. In this regard the latest port generation (silicone-covered scrotal port) was superior to its predecessors. Primary implantation (P = 0.002), good physical health (P = 0.001), and no history of radiotherapy (P < 0.001) were prognostic factors for beneficial treatment outcome. CONCLUSION The ATOMS device is safe and shows high treatment efficacy and patient satisfaction in the largest cohort study to date. The latest generation, with its pre-attached silicone-covered scrotal port, is superior to its predecessors. Significantly better results were achieved with primary implantation and in those without a history of radiotherapy.
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Affiliation(s)
- Alexander Friedl
- Department of Urology, Hospital Göttlicher Heiland, Vienna, Austria
| | - Sandra Mühlstädt
- Klinik and Poliklinik of Urology and Kidney Transplantation, University Hospital, Martin-Luther-University, Halle-Wittenberg, Halle/Saale, Germany
| | - Roman Zachoval
- Thomayer Hospital, Department of Urology and 1st and 3rd Medical Faculty, Charles University, Prague, Czech Republic
| | | | - Danijel Kivaranovic
- Center for Medical Statistics, Informatics, and Intelligent Systems, Vienna, Austria
| | - Maximilian Rom
- Department of Urology, Medical University Vienna, Vienna, Austria
| | - Paolo Fornara
- Klinik and Poliklinik of Urology and Kidney Transplantation, University Hospital, Martin-Luther-University, Halle-Wittenberg, Halle/Saale, Germany
| | - Clemens Brössner
- Department of Urology, Hospital Göttlicher Heiland, Vienna, Austria
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Deppe C, Zachoval R, Denk G, Delius M, Blume C, Hilgendorff A, Flemmer A, Mahner S, Hasbargen U. Schwangerschaften mit Child-B-Leberzirrhose aufgrund einer Gallengangsatresie, Fallbericht. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Novak J, Vik V, Zachoval R, Bjerklund Johansen TE. Renal Abscess Caused by Extended-Spectrum Beta-Lactamase-Producing Bacteria and Complicated by the Perforation to a Cyst and to the Renal Pelvis. J Endourol Case Rep 2016; 2:123-6. [PMID: 27579439 PMCID: PMC4996593 DOI: 10.1089/cren.2016.0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We report a 50-year-old female patient with a left-sided renal abscess caused by extended-spectrum β-lactamase-producing bacteria. According to the ORENUC classification she had phenotype N. The course was complicated by a perforation to an adjacent cyst and later to the renal pelvis. A primarily conservative approach of intravenous antibiotics had to be changed to an ultrasonography-guided percutaneous drainage of the lesion and insertion of a ureteral stent to stem a high volume of urine leakage. Drainage of a renal abscess is indicated if the size is larger than 3 cm according to EAU guidelines (relative size) or when the resolution does not occur after antibiotics. One-year follow-up showed the patient made a full recovery with no recurrence of a urinary tract infection or of any abscess.
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Affiliation(s)
- Jan Novak
- Department of Urology, Thomayer Hospital , Prague, Czech Republic
| | - Viktor Vik
- Department of Urology, Thomayer Hospital , Prague, Czech Republic
| | - Roman Zachoval
- Department of Urology, Thomayer Hospital , Prague, Czech Republic
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Zimmermann T, Beckebaum S, Berg C, Berg T, Braun F, Eurich D, Herzer K, Neumann U, Rupp C, Sterneck M, Strassburg C, Welker MW, Zachoval R, Gotthardt DN, Weigand K, Schmidt H, Wedemeyer H, Galle PR, Zeuzem S, Sarrazin C. [Expert recommendations: Hepatitis C and transplantation]. Z Gastroenterol 2016; 54:665-84. [PMID: 27429106 DOI: 10.1055/s-0042-107360] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
With the approval of new direct acting antiviral agents (DAA), therapeutic options for patients with chronic hepatitis C virus (HCV) infection are now generally available before and after liver transplantation (LT). Interferon-free DAA regimens are highly effective therapies and provide a good safety profile. However, the body of clinical evidence in this patient population is limited and the best treatment strategies for patients on the waiting list with (de)compensated cirrhosis and after LT are not well defined. The following recommendations for antiviral therapy in the context of LT are based on the currently available literature and clinical experience of experts in the field, and have been discussed in an expert meeting. The aim of this article is to guide clinicians in the decision making when treating patients before and after LT with DAAs.
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Affiliation(s)
- T Zimmermann
- I. Med. Klinik und Poliklinik, Universitätsmedizin Mainz
| | - S Beckebaum
- Klinik für Transplantationsmedizin, Universitätsklinikum Münster
| | - C Berg
- Abteilung Innere Medizin I, Universitätsklinikum Tübingen
| | - T Berg
- Klinik für Gastroenterologie und Hepatologie, Universitätsklinikum Leipzig
| | - F Braun
- Transplantationszentrum, Universitätsklinikum Schleswig-Holstein, Kiel
| | - D Eurich
- Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Charité-Universitätsmedizin Berlin
| | - K Herzer
- Klinik für Gastroenterologie und Hepatologie/Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Essen
| | - U Neumann
- Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Medizinische Fakultät, RWTH Aachen
| | - C Rupp
- Abteilung Innere Medizin IV, Universitätsklinikum Heidelberg
| | - M Sterneck
- Klinik und Poliklinik für Hepatobiliäre Chirurgie und Transplantationschirurgie, Universitätsklinikum Hamburg-Eppendorf
| | - C Strassburg
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Bonn
| | - M-W Welker
- Med. Klinik 1, Universitätsklinikum Frankfurt, Frankfurt am Main
| | - R Zachoval
- Transplantationszentrum München der LMU, München
| | - D N Gotthardt
- Abteilung Innere Medizin IV, Universitätsklinikum Heidelberg
| | - K Weigand
- Innere Medizin I, Universitätsklinikum Regensburg
| | - H Schmidt
- Klinik für Transplantationsmedizin, Universitätsklinikum Münster
| | - H Wedemeyer
- Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover
| | - P R Galle
- I. Med. Klinik und Poliklinik, Universitätsmedizin Mainz
| | - S Zeuzem
- Med. Klinik 1, Universitätsklinikum Frankfurt, Frankfurt am Main
| | - C Sarrazin
- Med. Klinik 1, Universitätsklinikum Frankfurt, Frankfurt am Main
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Boublikova L, Bakardjieva-Mihaylova V, Skvarova Kramarzova K, Kuzilkova D, Dobiasova A, Fiser K, Stuchly J, Kotrova M, Buchler T, Dusek P, Grega M, Rosova B, Vernerova Z, Klezl P, Pesl M, Zachoval R, Krolupper M, Kubecova M, Stahalova V, Abrahamova J, Babjuk M, Kodet R, Trka J. Wilms tumor gene 1 (WT1), TP53, RAS/BRAF and KIT aberrations in testicular germ cell tumors. Cancer Lett 2016; 376:367-76. [PMID: 27085458 DOI: 10.1016/j.canlet.2016.04.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 04/04/2016] [Accepted: 04/08/2016] [Indexed: 12/17/2022]
Abstract
PURPOSE Wilms tumor gene 1 (WT1), a zinc-finger transcription factor essential for testis development and function, along with other genes, was investigated for their role in the pathogenesis of testicular germ cell tumors (TGCT). METHODS In total, 284 TGCT and 100 control samples were investigated, including qPCR for WT1 expression and BRAF mutation, p53 immunohistochemistry detection, and massively parallel amplicon sequencing. RESULTS WT1 was significantly (p < 0.0001) under-expressed in TGCT, with an increased ratio of exon 5-lacking isoforms, reaching low levels in chemo-naïve relapsed TGCT patients vs. high levels in chemotherapy-pretreated relapsed patients. BRAF V600E mutation was identified in 1% of patients only. p53 protein was lowly expressed in TGCT metastases compared to the matched primary tumors. Of 9 selected TGCT-linked genes, RAS/BRAF and WT1 mutations were frequent while significant TP53 and KIT variants were not detected (p = 0.0003). CONCLUSIONS WT1 has been identified as a novel factor involved in TGCT pathogenesis, with a potential prognostic impact. Distinct biologic nature of the two types of relapses occurring in TGCT has been demonstrated. Differential mutation rate of the key TGCT-related genes has been documented.
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Affiliation(s)
- L Boublikova
- Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.
| | - V Bakardjieva-Mihaylova
- Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - K Skvarova Kramarzova
- Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - D Kuzilkova
- Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - A Dobiasova
- Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - K Fiser
- Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - J Stuchly
- Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - M Kotrova
- Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - T Buchler
- Department of Oncology, 1st Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic
| | - P Dusek
- Department of Urology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - M Grega
- Department of Pathology and Molecular Medicine, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - B Rosova
- Department of Pathology and Molecular Medicine, Thomayer Hospital, Prague, Czech Republic
| | - Z Vernerova
- Department of Pathology, 3rd Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - P Klezl
- Department of Urology, 3rd Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - M Pesl
- Department of Urology, 1st Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - R Zachoval
- Department of Urology, Thomayer Hospital, Prague, Czech Republic
| | - M Krolupper
- Department of Urology, Na Bulovce Hospital, Prague, Czech Republic
| | - M Kubecova
- Department of Oncology and Radiotherapy, 3rd Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - V Stahalova
- Institute of Radiotherapy and Oncology, 1st Faculty of Medicine, Charles University and Na Bulovce Hospital, Prague, Czech Republic
| | - J Abrahamova
- Department of Oncology, 1st Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic
| | - M Babjuk
- Department of Urology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - R Kodet
- Department of Pathology and Molecular Medicine, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - J Trka
- Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
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Amarenco G, Sutory M, Zachoval R, Agarwal M, Del Popolo G, Tretter R, Compion G, De Ridder D. Solifenacin is effective and well tolerated in patients with neurogenic detrusor overactivity: Results from the double-blind, randomized, active- and placebo-controlled SONIC urodynamic study. Neurourol Urodyn 2015; 36:414-421. [PMID: 26714009 DOI: 10.1002/nau.22945] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 11/24/2015] [Indexed: 11/08/2022]
Abstract
AIMS To investigate the effect on urodynamics of 4 weeks treatment with solifenacin succinate in patients with neurogenic detrusor overactivity (NDO) due to multiple sclerosis (MS) or spinal cord injury (SCI). METHODS SONIC was a prospective, multicenter, double-blind, phase 3b/4 study investigating the efficacy and safety of solifenacin 10 mg in patients with NDO due to MS or SCI. Patients (n = 189) were randomized to placebo or active treatment (solifenacin 5 mg, 10 mg or oxybutynin hydrochloride 15 mg) for 4 weeks, after a 2-week, single-blind, placebo run-in period. The primary endpoint was change in maximum cystometric capacity (MCC) from baseline to end of treatment. The primary analysis compared solifenacin 10 mg versus placebo; all other comparisons were considered secondary. Secondary endpoints included changes in urodynamic parameters, patient-reported outcomes, and safety assessments. RESULTS In the primary analysis, solifenacin 10 mg significantly improved mean change from baseline MCC versus placebo (P < 0.001) and was associated with improvements in bladder volume at first contraction and at first leak as well as detrusor pressure at first leak. Similar results were obtained for oxybutynin versus placebo. Patient perception of bladder condition significantly improved with solifenacin 10 mg versus placebo (P = 0.041). There was a clear improvement in quality of life (QoL) in the solifenacin arms versus placebo. The overall incidence of adverse events was low. CONCLUSIONS In patients with NDO due to MS and SCI, 4 weeks of treatment with solifenacin 10 mg improved urodynamic variables and QoL versus placebo and was well tolerated. Neurourol. Urodynam. 36:414-421, 2017. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- G Amarenco
- Hôpital Tenon, Service De Neuro-Urologie Et D'Explorations Perineales, Paris, France
| | - M Sutory
- Urological Department of Traumatological Clinic, Traumatological Hospital, School of Medicine, Masaryk University, Brno, Czech Republic
| | - R Zachoval
- Thomayer Hospital and 1st and 3rd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - M Agarwal
- Cardiff University and University Hospital of Wales, Cardiff, United Kingdom
| | - G Del Popolo
- Department of Neuro-Urology, Careggi University Hospital, Florence, Italy
| | - R Tretter
- Astellas Pharma Europe, Global Data Science, Leiden, The Netherlands
| | - G Compion
- Department of Medical Affairs, Formerly at Astellas Pharma Europe, Chertsey, United Kingdom
| | - D De Ridder
- Department of Urology, KU Leuven, University Hospitals Leuven, Leuven, Belgium
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Krhut J, Tintera J, Bilkova K, Holy P, Zachoval R, Zvara P, Blok B. Brain activity on fMRI associated with urinary bladder filling in patients with a complete spinal cord injury. Neurourol Urodyn 2015; 36:155-159. [PMID: 26445209 DOI: 10.1002/nau.22901] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 09/16/2015] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Patients with complete spinal cord injury (SCI) may maintain some perception of bladder fullness. The aim of the study was to evaluate brain activation arising from anticipated extraspinal sensory pathways. METHODS Fourteen patients ages 24-54 years were enrolled, all having experienced a complete SCI (ASIA A) at C7 to T5 an average of 17 months before study entry. Urodynamic equipment was used for repeated bladder filling and detrusor activity evaluation. All functional magnetic resonance imaging measurements were performed using a Siemens Trio 3T scanner with the GRE-EPI sequence (field of view = 192 × 192 mm, voxel 3 × 3 × 3 mm, TR/TE = 3000/30 ms, 45 slices). Nine hundred dynamic scans were acquired over 45 min. Statistical analysis was done in SPM8 using a general linear model. Statistics using t-tests were thresholded at P = 0.001. RESULTS We excluded results from two patients because of activation artifacts. In 8 of 12 patients, significant brain activity was observed during urinary bladder filling. We found significant activation clusters at the nucleus of the solitary tract (NTS) (3/8), parabrachial nucleus (PBN) (4/8), hypothalamus (4/8), thalamus (6/8), amygdala (7/8), insular lobe (5/8), anterior cingulate gyrus (5/8), and prefrontal cortex (8/8). Activations in nuclei involved in afferents likely from the vagal nerve (NTS and PBN) correlated significantly with reported bladder sensations. CONCLUSIONS These data suggest that extraspinal sensory pathways may develop following SCI and that vagal nerve may play a role in re-innervation of the urinary bladder. Neurourol. Urodynam. 36:155-159, 2017. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Jan Krhut
- Department of Urology, University Hospital, Ostrava, Czech Republic.,Department of Surgical Studies, Ostrava University, Ostrava, Czech Republic
| | - Jaroslav Tintera
- Radiodiagnostis and Interventional Radiology Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Karolina Bilkova
- Spinal Cord Rehabilitation Unit, Rehabilitation Center, Kladruby, Czech Republic
| | - Petr Holy
- Department of Urology, Thomayer Hospital and 1st and 3rd Faculty of Medicine of Charles University, Prague, Czech Republic
| | - Roman Zachoval
- Department of Urology, Thomayer Hospital and 1st and 3rd Faculty of Medicine of Charles University, Prague, Czech Republic
| | - Peter Zvara
- Department of Surgical Studies, Ostrava University, Ostrava, Czech Republic.,Division of Urology, University of Vermont, Burlington, Vermont
| | - B Blok
- Department of Urology, Erasmus Medical Center, Rotterdam, the Netherlands
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Krhut J, Tintera J, Zachoval R, Holy P, Bilkova K, Zvara P, Blok B. Detection of the extraspinal sensory pathways from the urinary bladder in patients with a complete spinal cord injury – FMRI study. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Friedrich-Rust M, Lupsor M, de Knegt R, Dries V, Buggisch P, Gebel M, Maier B, Herrmann E, Sagir A, Zachoval R, Shi Y, Schneider MD, Badea R, Rifai K, Poynard T, Zeuzem S, Sarrazin C. Point Shear Wave Elastography by Acoustic Radiation Force Impulse Quantification in Comparison to Transient Elastography for the Noninvasive Assessment of Liver Fibrosis in Chronic Hepatitis C: A Prospective International Multicenter Study. Ultraschall Med 2015; 36:239-247. [PMID: 25970201 DOI: 10.1055/s-0034-1398987] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
PURPOSE The aim of the present prospective European multicenter study was to demonstrate the non-inferiority of point shear wave elastography (pSWE) compared to transient elastography (TE) for the assessment of liver fibrosis in patients with chronic hepatitis C. MATERIALS AND METHODS 241 patients with chronic hepatitis C were prospectively enrolled at 7 European study sites and received pSWE, TE and blood tests. Liver biopsy was performed with histological staging by a central pathologist. In addition, for inclusion of cirrhotic patients, a maximum of 10 % of patients with overt liver cirrhosis confirmed by imaging methods were allowed by protocol (n = 24). RESULTS Owing to slower than expected recruitment due to a reduction of liver biopsies, the study was closed after 4 years before the target enrollment of 433 patients with 235 patients in the 'intention to diagnose' analysis and 182 patients in the 'per protocol' analysis. Therefore, the non-inferiority margin was enhanced to 0.075 but non-inferiority of pSWE could not be proven. However, Paired comparison of the diagnostic accuracy of pSWE and TE revealed no significant difference between the two methods in the 'intention to diagnose' and 'per protocol' analysis (0.81 vs. 0.85 for F ≥ 2, p = 0.15; 0.88 vs. 0.92 for F ≥ 3, p = 0.11; 0.89 vs. 0.94 for F = 4, p = 0.19). Measurement failure was significantly higher for TE than for pSWE (p = 0.030). CONCLUSION Non-inferiority of pSWE compared to TE could not be shown. However, the diagnostic accuracy of pSWE and TE was comparable for the noninvasive staging of liver fibrosis in patients with chronic hepatitis C.
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Affiliation(s)
- M Friedrich-Rust
- Department of Internal Medicine 1, J. W. Goethe-University Hospital, Frankfurt, Germany
| | - M Lupsor
- Department of Ultrasound, University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - R de Knegt
- Gastroenterology and Hepatology, Erasmus Medical Center, Rotterdam, Netherlands
| | - V Dries
- Institute of Pathology, Institute of Pathology, Mannheim, Germany
| | - P Buggisch
- Hepatology, Institute for Interdisciplinary Medicine, Hamburg, Germany
| | - M Gebel
- Department of Internal Medicine, Medical School Hannover, Germany
| | - B Maier
- Department of Internal Medicine 1, J. W. Goethe-University Hospital, Frankfurt, Germany
| | - E Herrmann
- Institute of Biostatistics and Mathematical Modelling, Faculty of Medicine, J. W. Goethe-University, Frankfurt, Germany
| | - A Sagir
- Department of Gastroenterology and Infectious Disease, University Hospital Düsseldorf, Germany
| | - R Zachoval
- Department of Medicine II, Campus Grosshadern, University Hospital Munich, Germany
| | - Y Shi
- Institute of Biostatistics and Mathematical Modelling, Faculty of Medicine, J. W. Goethe-University, Frankfurt, Germany
| | - M D Schneider
- Department of Internal Medicine 1, J. W. Goethe-University Hospital, Frankfurt, Germany
| | - R Badea
- Imaging, University Iuliu Hatieganu, Cluj, Romania
| | - K Rifai
- Gastroenterology and Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - T Poynard
- Hôpital Pitié-Salpêtrière, Université Pierre et Marie Curie, Paris, France
| | - S Zeuzem
- Department of Internal Medicine 1, J. W. Goethe-University Hospital, Frankfurt, Germany
| | - C Sarrazin
- Department of Internal Medicine 1, J. W. Goethe-University Hospital, Frankfurt, Germany
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Boublikova L, Bakardjieva-Mihaylova V, Skvarova Kramarzova K, Kuzilkova D, Buchler T, Dusek P, Grega M, Rosova B, Vernerova Z, Klezl P, Zachoval R, Pesl M, Krolupper M, Kubecova M, Stahalova V, Babjuk M, Abrahamova J, Kodet R, Trka J. Wilms’ tumor gene 1 (WT1) aberrations in testicular germ cell tumors (TGCTs). J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.4534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Ludmila Boublikova
- Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Violeta Bakardjieva-Mihaylova
- Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Karolina Skvarova Kramarzova
- Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Daniela Kuzilkova
- Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Tomas Buchler
- Department of Oncology, 1st Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic
| | - Pavel Dusek
- Department of Urology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Marek Grega
- Department of Pathology and Molecular Medicine, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Blanka Rosova
- Department of Pathology and Molecular Medicine, Thomayer Hospital, Prague, Czech Republic
| | - Zdenka Vernerova
- Department of Pathology, 3rd Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - Petr Klezl
- Department of Urology, 3rd Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - Roman Zachoval
- Department of Urology, Thomayer Hospital, Prague, Czech Republic
| | - Michal Pesl
- Department of Urology, 1st Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Marek Krolupper
- Department of Urology, Na Bulovce Hospital, Prague, Czech Republic
| | - Martina Kubecova
- Department of Oncology and Radiotherapy, 3rd Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - Vladimira Stahalova
- Institute of Radiotherapy and Oncology, 1st Faculty of Medicine, Charles University and Na Bulovce Hospital, Prague, Czech Republic
| | - Marek Babjuk
- Department of Urology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Jitka Abrahamova
- Department of Oncology, 1st Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic
| | - Roman Kodet
- Department of Pathology and Molecular Medicine, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Jan Trka
- Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
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Kogan MI, Zachoval R, Ozyurt C, Schäfer T, Christensen N. Epidemiology and impact of urinary incontinence, overactive bladder, and other lower urinary tract symptoms: results of the EPIC survey in Russia, Czech Republic, and Turkey. Curr Med Res Opin 2014; 30:2119-30. [PMID: 24932562 DOI: 10.1185/03007995.2014.934794] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To estimate the prevalence of urinary incontinence (UI), overactive bladder (OAB), and other lower urinary tract symptoms (LUTS) in the Czech Republic, Russia, and Turkey. METHODS Stage one of this population-based survey consisted of computer-assisted telephone interviews to obtain prevalence estimates of storage, voiding, and post-micturition LUTS. Stage two face-to-face interviews evaluated subjects with mixed urinary incontinence (MUI), stress urinary incontinence (SUI) or OAB (case group) and a control group (subjects with other incontinence or LUTS complaints, or no symptoms). OUTCOME MEASURE Prevalence of LUTS categories were determined for each country based on International Continence Society (ICS) criteria. RESULTS AND LIMITATIONS A total of 3130 individuals agreed to participate in the survey, which found high rates of LUTS (men 80%; women 84%) and OAB (men 18%; women 28%). Duration of urinary symptoms was relatively brief (approximately 60% ≤ 3 years) and was associated with relatively modest effects on quality of life and work performance in the majority of individuals. Forty percent had consulted with a healthcare provider about their urinary symptoms, of whom 37% had consulted with a physician and 34% with an urologist, and 12% had been treated with a prescription medication. Drug therapy, while uncommon, was associated with a high degree of self-reported improvement (96%). Because of between-country population differences, aggregate results may not always be representative of results for each of the three countries individually. Study limitations include reliance on patient self-report, and potential bias introduced by patients who declined to participate in the survey. CONCLUSIONS The results of this epidemiologic survey found high rates of LUTS and OAB, but low levels of medical consultation and very low use of medication treatment, despite high levels of improvement when medications were used.
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Mebus S, Kügel J, Zachoval R, Braun S, Haverkämper G, Opgen-Rhein B, Berger F, Horster S, Salvador C, Kappler S, Bauer U, Hess J, Ewert P, Kaemmerer H. Noninvasive assessment of liver function in adults with congenital heart disease (ACHD) by transient elastography (Fibroscan), Acoustic Radiation Force Impulse Imaging (ARFI) and biochemical markers. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1394042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Berthelot L, Robert T, Tabary T, Vuiblet V, Drame M, Toupance O, Rieu P, Monteiro RC, Toure F, Ferrario S, Cantaluppi V, De Lena M, Dellepiane S, Beltramo S, Rossetti M, Manzione AM, Messina M, Gai M, Dolla C, Biancone L, Camussi G, Pontrelli P, Oranger AR, Accetturo M, Rascio F, Gigante M, Castellano G, Schena A, Fiorentino M, Zito A, Zaza G, Stallone G, Gesualdo L, Grandaliano G, Pattonieri EF, Gregorini M, Corradetti V, Rocca C, Milanesi S, Peloso A, Ferrario J, Cannone M, Bosio F, Maggi N, Avanzini MA, Minutillo P, Paulli M, Maestri M, Rampino T, Dal Canton A, Wu KST, Coxall O, Luque Y, Candon S, Rabant M, Noel LH, Thervet E, Chatenoud L, Snanoudj R, Anglicheau D, Legendre C, Zuber J, Hruba P, Brabcova I, Krepsova E, Slatinska J, Sekerkova A, Striz I, Zachoval R, Viklicky O, Scholbach TM, Wang HK, Loong CC, Yang AH, Wu TH, Hruba P, Brabcova I, Krepsova E, Slatinska J, Sekerkova A, Striz I, Zachoval R, Viklicky O, Guberina H, Rebmann V, Dziallas P, Dolff S, Wohlschlaeger J, Heinemann FM, Witzke O, Zoet YM, Claas FHJ, Horn PA, Kribben A, Doxiadis IIN, Prasad N, Yadav B, Agarwal V, Jaiswal A, Rai M, Hope CM, Coates PT, Heeger PS, Carroll R, Zaza G, Masola V, Secchi MF, Onisto M, Gambaro G, Lupo A, Matsuyama M, Kobayashi T, Yoneda Y, Chargui J, Touraine JL, Yoshimura R, Vizza D, Perri A, Lupinacci S, Toteda G, Lofaro D, Leone F, Gigliotti P, La Russa A, Papalia T, Bonofilgio R, Sentis Fuster A, Kers J, Yapici U, Claessen N, Bemelman FJ, Ten Berge IJM, Florquin S, Glotz D, Rostaing L, Squifflet JP, Merville P, Belmokhtar C, Le Ny G, Lebranchu Y, Papazova DA, Friederich-Persson M, Koeners MP, Joles JA, Verhaar MC, Trivedi HL, Vanikar AV, Dave SD, Suarez Alvarez B, Garcia Melendreras S, Carvajal Palao R, Diaz Corte C, Ruiz Ortega M, Lopez-Larrea C, Yadav AK, Bansal D, Kumar V, Kumar V, Minz M, Jha V, Kaminska D, Koscielska-Kasprzak K, Chudoba P, Mazanowska O, Banasik M, Zabinska M, Boratynska M, Lepiesza A, Korta K, Klinger M, Csohany R, Prokai A, Pap D, Balicza-Himer N, Vannay A, Fekete A, Kis-Petik K, Peti-Peterdi J, Szabo A, Masajtis-Zagajewska A, Muras K, Niewodniczy M, Nowicki M, Pascual J, Srinivas TR, Chadban S, Citterio F, Henry M, Legendre C, Oppenheimer F, Lee PC, Tedesco-Silva H, Zeier M, Watarai Y, Dong G, Hexham M, Bernhardt P, Vincenti F, Rocchetti MT, Pontrelli P, Rascio F, Fiorentino M, Zito A, Stallone G, Gesualdo L, Grandaliano G, Su owicz J, Wojas-Pelc A, Ignacak E, Janda K, Krzanowski M, Su owicz W, Dellepiane S, Cantaluppi V, Mitsuhashi M, Murakami T, Benso A, Biancone L, Camussi G, Scholbach TM, Wang HK, Loong CC, Wu TH, Leuning D, Reinders M, Lievers E, Duijs J, Van Zonneveld AJ, Van Kooten C, Engelse M, Rabelink T, Assounga A, Omarjee S, Ngema Z, Ersoy A, Gultepe A, Isiktas Sayilar E, Akalin H, Coskun F, Oner Torlak M, Ayar Y, Riegersperger M, Plischke M, Steinhauser C, Jallitsch-Halper A, Sengoelge G, Winkelmayer WC, Sunder-Plassmann G, Foedinger M, Kaziuk M, Kuz'Niewski M, Ignacak E, B Tkowska- Prokop A, Pa Ka K, Dumnicka P, Kolber W, Su Owicz W. TRANSPLANTATION BASIC SCIENCE, ALLOGENIC AND XENOGENIC TOLERANCE. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Zachoval R, Jarabak J, Slatinska J, Burgelova M, Sobotka V, Vranova J, Krhut J. Dynamics of fertility in patients on waiting list for kidney transplantation. ACTA ACUST UNITED AC 2014; 114:711-5. [PMID: 24329510 DOI: 10.4149/bll_2013_150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES To evaluate the presence of hormonal abnormalities and fertility disorders in patients with chronic kidney disease (CKD) awaiting renal transplantation. METHODS From September 2009 to April 2011 all male patients with CKD awaiting kidney transplantation were investigated. The following tests were performed: semen analysis, serum concentration of testosterone, SHBG, LH, FSH and prolactin. Differences in hormone levels and sperm count parameters were statistically evaluated between the control group and the patient group. RESULTS The group of patients consisted of 74 and the control group of 41 men. Average testosterone levels were lower in patients compared to control group. In patients significantly higher levels of SHBG, LH, FSH and PRL were found, and statistically significantly lower ejaculate volume, total sperm count, sperm concentration, total and progressive sperm motility and sperm morphology than in the control group. Within the group of patients a negative correlation between testosterone and PRL was found and a positive correlation between testosterone and total sperm motility and morphology. A negative correlation was detected between the duration of haemodialysis and testosterone, sperm concentration, total and progressive motility and sperm morphology. CONCLUSION Significant changes in hormone levels and impaired fertility are found in haemodialyzed patients on a waiting list for kidney transplantation. The dynamics of these changes are dependent on the duration of haemodialysis (Tab. 4, Fig. 2, Ref. 15). Text in PDF www.elis.sk.
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Lummert E, Hauser M, Vigl M, Pujol C, Braun S, Zachoval R, Fischereder M, Engelhardt A, Mebus S, Eicken A, Ewert P, Kaemmerer H. PP-371 Noncardiac Comorbidities of Congenital Heart Disease in Adults. Am J Cardiol 2014. [DOI: 10.1016/j.amjcard.2014.01.283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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