Lifestyle Coaching May Be an Effective Treatment for Schizophrenia.

This commentary critiques the Danish CHANGE trial, which evaluated 3 levels of outpatient intervention intensity, in a group of outpatients with obesity and schizophrenia. Neither adding care coordination with weekly nurse contacts alone nor combining this treatment with assertive community lifestyle coaching as compared to treatment as usual improved outcomes, which included cardiovascular disease risk calculation, cardiorespiratory fitness, weight, and self-reported behaviors such as smoking, physical activity, and diet. The CHANGE trial investigators appear strongly averse to recommending the development and implementation of lifestyle medicine programs as a major component when treating outpatients with severe mental disorders.

The New PGY-1 Year: Lessons Learned.

Purpose Of Review: Describe the ACGME's changes to the PGY-1 year in urology and discuss the benefits and challenges faced by training programs.

Recent Findings: There are no publications detailing the integration of the PGY-1 year in urology; however, response of other surgical subspecialties to their own integration has been studied. Benefits of integration include earlier exposure to techniques and knowledge specific to urology, potentially leading to increased preparedness for next steps in training and exams.

Rare Encounters: Medical Students Give Assertive Community Treatment Team Visits Rave Reviews.

Objective: For 8 years, Albert Einstein College of Medicine students have worked with the Bronx Psychiatric Center Assertive Community Treatment (ACT) team. We relate the medical student ACT team experience using the ratings and words of the students themselves. We describe the history, evolution, and structure of this novel program.

The assertive community treatment team: an appropriate treatment for medical disorders that present with prominent psychiatric symptoms.

Physical diseases are difficult to treat in psychiatric patients, whether they are comorbid disorders or mental disorders due to a general medical condition. The psychiatric symptoms are difficult to treat in a medical ward or clinic, and the physical symptoms are difficult to treat in a psychiatric ward or clinic. For this reason, medical-psychiatric units have been developed but remain uncommon.

Cystic mucinous tumors of the urachus: carcinoma in situ or adenoma of unknown malignant potential?

Mucinous cystadenocarcinomas of the urachus are rare. Mucinous benign or premalignant tumors are even rarer, yet pose a challenge in diagnosis and management. We report a case of a 66-year-old man with lower abdominal pain who had a large cystic tumor at the dome of the bladder.

A case of acute renal failure in a patient recently treated with clozapine and a review of previously reported cases.

Clozapine has been reported to cause acute renal failure due to acute interstitial nephritis. We discuss a case of clozapine-induced acute renal failure and compare it to 7 other cases reported in the literature. We review the signs and symptoms of the hypersensitivity response, such as fever and eosinophilia, caused by clozapine and make recommendations for early detection.

Measurement of singlet-oxygen in vivo: progress and pitfalls.

This article is a highlight of the paper by Jarvi et al. in this issue of Photochemistry and Photobiology as well as a brief overview of the state of the field of singlet-oxygen ((1) O(2) ) detection in vivo. The in vivo detection of (1) O(2) using its characteristic 1270 nm phosphorescence is technically challenging.

MRI of the urethra in women with lower urinary tract symptoms: spectrum of findings at static and dynamic imaging.

Objective: The purpose of our study was to determine the findings at both static and dynamic MRI in women with a clinically suspected urethral abnormality.

Materials And Methods: MRI of the urethra was performed in 84 women with lower urinary tract symptoms using multiplanar T2-weighted turbo spin-echo and unenhanced and contrast-enhanced gradient-echo sequences. A dynamic true fast imaging with steady-state free precession sequence was performed during straining in the sagittal plane.

Effect of warm ischemia time during laparoscopic partial nephrectomy on early postoperative glomerular filtration rate.

Purpose: We evaluated the effect of warm ischemia time on early postoperative renal function following laparoscopic partial nephrectomy.

Materials And Methods: Of 453 patients who were surgically treated for renal tumors between May 2001 and September 2007, and who were identified in our database 128 underwent laparoscopic partial nephrectomy. Of these 128 patients 101 who were evaluable had complete demographic, operative, preoperative and early postoperative data available.

The necessity of adrenalectomy at the time of radical nephrectomy: a systematic review.

Purpose: We describe the literature base pertaining to adrenalectomy at radical nephrectomy and present a pragmatic approach based on primary tumor and disease characteristics.

Materials And Methods: Literature searches were performed via the National Center for Biotechnology Information databases using various keywords. Articles that pertained to the concomitant use of adrenalectomy with radical nephrectomy were surveyed.

Quenching of singlet oxygen by a carotenoid-cyclodextrin complex: the importance of aggregate formation.

The Girard's reagent P derivative of canthaxanthin ((GRP)(2)-canthaxanthin), a dicationic carotenoid, forms a highly water-dispersible complex with (2-hydroxypropyl)-gamma-cyclodextrin. The UV-visible light spectrum of the complex is consistent with some degree of aggregation, but the spectrum is independent of concentration from 7.5 to 750 mum.

MRI of pelvic floor dysfunction: dynamic true fast imaging with steady-state precession versus HASTE.

Objective: The objective of our study was to retrospectively compare the degree of pelvic organ prolapse shown on dynamic true fast imaging with steady-state precession (FISP) versus HASTE sequences in symptomatic patients.

Materials And Methods: Fifty-nine women (mean age, 57 years) with suspected pelvic floor dysfunction underwent MRI using both a sagittal true FISP sequence, acquired continuously during rest alternating with the Valsalva maneuver, and a sagittal HASTE sequence, acquired sequentially at rest and at maximal strain. Data sets were evaluated in random order by two radiologists in consensus using the pubococcygeal line (PCL) as a reference.

Laparoscopic Doppler technology: applications in laparoscopic pyeloplasty and radical and partial nephrectomy.

Introduction: The identification and isolation of vascular structures are crucial and technically demanding aspects of laparoscopic renal surgery. Doppler technology has been used for this purpose in laparoscopic varicocele repair, renal cryoablation, and adrenalectomy. However, it has not been formally described for use in laparoscopic radical nephrectomy, partial nephrectomy, or pyeloplasty.

Transperitoneal laparoscopic radical nephrectomy for large (more than 7 cm) renal masses.

Objectives: To evaluate our laparoscopic radical nephrectomy (LRN) series to determine whether any significant increases have occurred in operative morbidity when resecting large (7 cm or greater) renal masses. LRN is becoming the reference standard for treating suspicious renal masses not amenable to nephron-sparing surgery.

Methods: We retrospectively reviewed the charts of 164 consecutive patients who had undergone laparoscopic radical nephrectomy performed for suspicious renal masses by two surgeons from February 2000 and December 2006.

Spontaneous renal artery dissection.

Spontaneous renal artery dissection (SRAD) is a rare event, and thus may be a challenge for physicians to diagnose and treat. We report a case of SRAD in a healthy 56-year-old male who presented with flank pain, fever, and elevated white blood cell count. The patient was initially diagnosed with nephrolithiasis versus pyelonephritis and was admitted for observation.

Effect of tension-free vaginal tape and TVT-obturator on lower urinary tract symptoms other than stress urinary incontinence.

Variable effects on lower urinary tract symptoms (LUTS) other than stress urinary incontinence (SUI) have been reported after tension-free vaginal tape (TVT). We measured the effect of TVT on LUTS using the American Urological Association Symptom Index (AUASI). Patients undergoing TVT completed the AUASI pre- and post-operatively.

Activity of a cationic carotenoid derivative in a mouse model of protoporphyria.

Prior work using cell culture has shown that certain synthetic carotenoid derivatives are more effective than natural carotenoids in preventing photosensitized cell killing. These carotenoid derivatives are either cationic or are weak bases. We have now found that of one of these derivatives, the Girard's reagent T derivative of beta-apo-8'-carotenal (GRT-carotenal) decreases acute photosensitivity in a mouse model of protoporphyria.

A matched-cohort comparison of laparoscopic cryoablation and laparoscopic partial nephrectomy for treating renal masses.

Objective: To compare the surgical outcomes of elderly patients with renal masses treated with laparoscopic partial nephrectomy (LPN) or laparoscopic cryoablation (LCA).

Patients And Methods: All 15 patients who had LCA at the authors' institution between May 2003 and July 2005 were included, and compared with a matched cohort of 15 patients selected by patient age and tumour size, from a pre-existing database of 104 patients who had LPN from July 2002 to July 2005. The two groups were compared for gender, number of comorbidities, American Society of Anesthesiologists status (ASA), body mass index (BMI), baseline renal function and haematocrit, location and size of lesion, length of stay, operative time, estimated blood loss (EBL), transfusion rate, number and type of complications, conversion rate, and postoperative renal function and haematocrit.

Impact of discordant radiologic and pathologic tumor size on renal cancer staging.

Objectives: To determine whether the discrepancy in the radiologic and pathologic size of renal cell carcinoma influences the final cancer stage.

Methods: Renal masses resected from December 1999 to September 2004 were identified using a pathologic database and compared by surgical accession number to an existing clinical renal tumor database to identify those T1 and T2 tumors for which radiologic and pathologic data were available. The tumor histologic features, maximal pathologic diameter, and maximal radiologic diameter were recorded.

Tolterodine for treatment of overactive bladder.

Tolterodine was developed as an antimuscarinic agent specifically for the treatment of overactive bladder. Initial in vivo studies demonstrated a functional selectivity for the muscarinic receptors in the urinary bladder over the salivary glands, and subsequent clinical trials showed an overall superior tolerability profile compared with other drugs in the same class (ie, oxybutynin). With immediate- and extended-release formulations and sustained clinical efficacy during long-term treatment, tolterodine gas become an important treatment option for the symptoms of overactive bladder.

Synthetic carotenoid derivatives prevent photosensitised killing of retinal pigment epithelial cells more effectively than lutein.

We studied the photosensitised killing of retinal pigment epithelial (RPE) cells using two photosensitisers that localise in lysosomes. The ARPE-19 cell line was photosensitised using either acridine orange or cis-di(4-sulfonatophenyl)diphenylporphine. We then measured the amount of photoprotection provided to RPE cells by five synthetic carotenoid derivatives and by lutein.