Stability of time trade-off utilities for health states associated with the treatment of prostate cancer.

Background: Patients diagnosed with localized prostate cancer face several treatment options. Patient preferences for treatment side effects often dominate the decision making process. We proposed to learn more about the nature of patient preferences, or utilities, for these side effects.

Comparing the costs of radiation therapy and radical prostatectomy for the initial treatment of early-stage prostate cancer.

Purpose: Radical prostatectomy and external-beam radiation are the most common treatments for localized prostate cancer. Given the absence of clinical consensus in favor of one treatment or the other, relative costs may be a significant factor. This study compares the direct medical costs during the month before and 9 months after diagnosis for patients treated primarily with external-beam radiation or radical prostatectomy for early-stage prostate cancer.

Impact of prostate cancer screening on health-related quality of life in at-risk families.

Objectives: To describe the impact of prostate-specific antigen (PSA) screening on the health-related quality of life (HRQOL) and anxiety of men with a family history of prostate cancer.

Methods: We asked 334 brothers or sons of men with prostate cancer who agreed to undergo PSA testing to fill out HRQOL questionnaires. The questionnaires were the RAND SF-36 (generic HRQOL) and State-Trait Anxiety Inventory (anxiety-specific).

Knowledge and beliefs among brothers and sons of men with prostate cancer.

Objectives: To describe prostate cancer knowledge and beliefs, important predictors of screening behavior, in first-degree relatives of men with prostate cancer and to compare the knowledge with beliefs about familial risk.

Methods: We sent a letter to 837 men with prostate cancer to invite their brothers and/or sons aged 40 to 70 years to participate in the study. Their first-degree relatives who responded received a survey to explore their prostate cancer family history, prostate cancer knowledge, self-efficacy, barriers to screening, perceived benefits, perceived vulnerability, social support, and sociodemographic and medical characteristics.

Design of a multicenter randomized clinical trial for chronic prostatitis/chronic pelvic pain syndrome.

Objectives: To describe the study design and rationale for the first placebo-controlled, randomized clinical trial to be conducted by the Chronic Prostatitis Collaborative Research Network sponsored by the National Institutes of Health.

Methods: The clinical trial will use a 2 by 2 factorial design to evaluate four treatments: placebo, tamsulosin hydrochloride alone, ciprofloxacin alone, and tamsulosin hydrochloride and ciprofloxacin combined. The primary objectives are to compare the efficacy and safety endpoints in patients with chronic prostatitis/chronic pelvic pain syndrome.

Ketorolac-based analgesia improves outcomes for living kidney donors.

Background: To reduce the morbidity of living kidney donors we introduced ketorolac-based analgesia for patients undergoing open donor nephrectomy in August 1999. There are no prior reports on the use of ketorolac for patients undergoing donor nephrectomy.

Methods: We conducted a retrospective review of all 198 consecutive patients who underwent open living donor nephrectomy between January 1998 and July 2000 at our institution.

Variations in use of imaging in a national sample of men with early-stage prostate cancer.

Objectives: To measure the national practice variations in imaging studies performed for men newly diagnosed with clinically localized prostate cancer.

Methods: We created an analytic file from 1991 to 1996 Medicare claims data using files for a random sample of 5% of all Medicare beneficiaries. Among men with newly diagnosed clinically localized prostate cancer, we identified those undergoing staging bone scans, staging computed tomography (CT), or staging magnetic resonance imaging (MRI) at the time of diagnosis.

Quality of life at the end of life: trends in patients with metastatic prostate cancer.

Objectives: To identify the rates of decline in health-related quality of life during the year before death in men with prostate cancer.

Methods: We studied men in a subset analysis within a longitudinal, observational cohort of patients with metastatic prostate cancer at the University of California, Los Angeles, Center for Health Sciences. The analysis included 23 patients who died and had submitted at least two health-related quality-of-life surveys in the final months before death.

Patient survival and causes of death on hemodialysis and peritoneal dialysis--single-center study.

Survival and causes of death in children dialyzed in a single center were analyzed. During the last 12 years a chronic dialysis program was introduced in 146 children in our center and 125 of them, eligible for observation, were included in this analysis; 58 patients were on hemodialysis (HD) and 67 on peritoneal dialysis [continuous ambulatory peritoneal dialysis/automated peritoneal dialysis (CAPD/APD)]. Mean age at the start of dialysis was 13.

Comprehensive comparison of health-related quality of life after contemporary therapies for localized prostate cancer.

Purpose: Health-related quality-of-life (HRQOL) concerns are pivotal in choosing prostate cancer therapy. However, concurrent HRQOL comparison between brachytherapy, external radiation, radical prostatectomy, and controls is hitherto lacking. HRQOL effects of hormonal adjuvants and of cancer control after therapy also lack prior characterization.

[Tubulointerstitial nephritis related to immunotherapy and immunostimulation: a report of two cases].

Two cases of tubulointerstitial nephritis (TIN) with renal failure related to immunotherapy (case 1) and immunostimulation (case 2) have been described. Case 1: 18 years old male patient with hay fever was admitted because of rapid increase of serum creatinine from 1.1 mg/dl to 5.

Quality of life is impaired in men with chronic prostatitis: the Chronic Prostatitis Collaborative Research Network.

Objective: Health-related quality of life (HRQOL) impairment may be a central component of chronic prostatitis for men afflicted with this condition. Our objective was to examine HRQOL, and factors associated with HRQOL, using both general and condition-specific instruments.

Design: Chronic Prostatitis Cohort (CPC) study.

The Spanish National Institutes of Health-Chronic Prostatitis Symptom Index: translation and linguistic validation.

Purpose: The prominence of health related quality of life end points in international clinical research underscores the importance of well validated and translated measures to enable cross-cultural comparison. The National Institutes of Health (NIH)-Chronic Prostatitis Symptom Index (CPSI) assesses symptoms and health related quality of life in men with chronic nonbacterial, NIH type III prostatitis. To expand its use to Spanish speaking patients we performed a translation and linguistic validation.

Improvement in emotional well-being and relationships of users of sildenafil.

Purpose: We estimated the association of sildenafil use with erectile function, relationship with sexual partner, functional status and emotional well-being in men with erectile dysfunction.

Materials And Methods: Letters were mailed to eligible patients at a university hospital urology and internal medicine clinic, and university affiliated community primary care clinics by the primary care provider or urologist inviting them to participate in the study. Of the eligible sample 124 men (53%) completed and returned a survey, including 85 who reported current sildenafil use.

Predictors of utilities for health states in early stage prostate cancer.

Purpose: When faced with treatment choices for early stage prostate cancer, patients must balance the survival benefit of a treatment with its morbidity. Little is known about how patients balance these trade-offs. To further our understanding of patient decision making we assessed patient utilities for prostate cancer treatment related morbidities.

Life after radical prostatectomy: a longitudinal study.

Purpose: We investigate the longitudinal recovery of quality of life after radical prostatectomy in men with localized prostate cancer.

Materials And Methods: We assessed the self-reported health related quality of life in 247 men undergoing radical prostatectomy for prostate cancer. Patients were assessed at baseline before surgery and postoperatively every 3 months for 1 year and then every 6 months for up to 48 months (median 30).

Racial differences in the cost of treating men with early-stage prostate cancer.

Objective: To compare the cost and resource utilization in the evaluation, treatment, and 6-month follow-up of African-American and White men undergoing either external beam radiation therapy (XRT) or radical prostatectomy (RP) for early-stage prostate cancer.

Design: Retrospective analysis of cost and resource utilization data from encrypted patient-specific hospital inpatient, hospital outpatient, and physician/supplier data files.

Setting: National Medicare claims data from 1993 through 1996.

The association between socioeconomic status, health insurance coverage, and quality of life in men with prostate cancer.

The objective of this study was to examine the effect of socioeconomic status and insurance status on health-related quality of life (HRQOL) outcomes in men with prostate cancer. The design was a retrospective cohort study using multiple sites, including both academic and private practice settings. A cohort of 860 men with newly diagnosed, biopsy-proven prostate cancer of any stage was identified within CaPSURE, a longitudinal disease registry of prostate cancer patients.

Folate, vitamin B12, and sulfur amino acid levels in patients with renal failure.

We examined the plasma profile of sulfur amino acids (SAA) in patients with chronic renal failure (CRF) and looked for any correlation with serum folate (FA) and/or vitamin B12. Group 1 comprised 9 patients with CRF and glomerular filtration rate (GFR) >20 ml/min per 1.73 m2, 9 patients with GFR<20 ml/min per 1.

Relationship of first-year costs of treating localized prostate cancer to initial choice of therapy and stage at diagnosis: results from the CAPSURE database.

Objectives: To determine the relationship among the initial choice of therapy, stage at presentation, and first-year treatment costs in men with newly diagnosed localized prostate cancer.

Methods: First-year resource use and clinical data were collected for 235 subjects with newly diagnosed localized prostate cancer. The costs were estimated from the standard Medicare payment schedules.

Quality of life before death for men with prostate cancer: results from the CaPSURE database.

Purpose: We examined changes in health related quality of life during the 12 months before death in men with prostate cancer.

Materials And Methods: We studied patients from CapSure, which is a longitudinal observational cohort of men with biopsy proved prostate cancer treated in community and academic urology practices across the United States. Of all men in the cohort who died while being followed for prostate cancer 131 who had submitted health related quality of life surveys during the 6 months before death were included in this analysis.

Urinary function and bother after radical prostatectomy or radiation for prostate cancer: a longitudinal, multivariate quality of life analysis from the Cancer of the Prostate Strategic Urologic Research Endeavor.

Purpose: We measure the effect of time on urinary function and bother during the first 2 years following treatment for early stage prostate cancer.

Materials And Methods: We studied urinary function and bother in 564 men recently diagnosed with early stage prostate cancer and treated with radiotherapy or radical prostatectomy with or without nerve sparing. Outcomes were assessed with the UCLA Prostate Cancer Index, which is a validated, health related quality of life instrument that includes these 2 domains.