Artificial intelligence-generated targets and inter-observer variation in online adaptive radiotherapy of bladder cancer.

Background And Purpose: Daily target re-delineation in online adaptive radiotherapy (oART) introduces uncertainty. The aim of this study was to evaluate artificial intelligence (AI) generated contours and inter-observer target variation among radiotherapy technicians in cone-beam CT (CBCT) guided oART of bladder cancer.

Materials And Methods: For each of 10 consecutive patients treated with oART for bladder cancer, one CBCT was randomly selected and retrospectively included.

AXL Inhibition Improves the Antitumor Activity of Chimeric Antigen Receptor T Cells.

The receptor tyrosine kinase AXL is a member of the TYRO3, AXL, and proto-oncogene tyrosine-protein kinase MER family and plays pleiotropic roles in cancer progression. AXL is expressed in immunosuppressive cells, which contributes to decreased efficacy of immunotherapy. Therefore, we hypothesized that AXL inhibition could serve as a strategy to overcome resistance to chimeric antigen receptor T (CAR T)-cell therapy.

Online adaptive radiotherapy of urinary bladder cancer with full re-optimization to the anatomy of the day: Initial experience and dosimetric benefits.

Background And Purpose: Online adaptive radiotherapy (oART) potentially reduces the dose to organs at risk (OARs) as the planning target volume (PTV) margins are reduced compared to a non-adaptive approach (non-ART). This study evaluates the feasibility and dosimetric impact of cone-beam computed tomography (CBCT)-guided oART of urinary bladder cancer for the first patients treated, using patient-specific margins.

Materials And Methods: Sixteen consecutive patients with muscle-invasive bladder cancer received two or more (median = 23) fractions as oART, and remaining fractions as non-ART.

Single-Cell Proteomic Profiling Identifies Combined AXL and JAK1 Inhibition as a Novel Therapeutic Strategy for Lung Cancer.

Cytometry by time-of-flight (CyTOF) simultaneously measures multiple cellular proteins at the single-cell level and is used to assess intertumor and intratumor heterogeneity. This approach may be used to investigate the variability of individual tumor responses to treatments. Herein, we stratified lung tumor subpopulations based on AXL signaling as a potential targeting strategy.

Vinflunine/gemcitabine versus carboplatin/gemcitabine as first-line treatment in cisplatin-ineligible patients with advanced urothelial carcinoma: A randomised phase II trial (VINGEM).

Background: The present study (VINGEM) is the first randomised trial comparing vinflunine/gemcitabine (VG) to standard carboplatin/gemcitabine (CG) in patients with advanced urothelial carcinoma (aUC) ineligible for treatment with cisplatin.

Patients And Methods: Patients with aUC, creatinine clearance 30-60 ml/min, performance status ≤1 and no prior chemotherapy for metastatic disease were randomised to the experimental arm (vinflunine 280 or 250 mg/m day 1, gemcitabine 1000 mg/m days 1 and 8, q21 days) or the control arm (carboplatin AUC 4.5 day 1, gemcitabine 1000 mg/m days 1 and 8, q21 days).

[Fatal neutropenic enterocolitis in a patient with castration-resistant prostate cancer treated with first-line chemotherapy].

Neutropenic enterocolitis (NE) is a possible life-threatening complication to chemotherapy. The pathogenesis is multi-factorial with mucosal injury and impaired mucosal defence as contributing factors. Histopathological findings are heterogeneous.

The Danish experience with trabectedin treatment for metastatic sarcoma: Importance of hyponatremia.

Background: Trabectedin was in Europe approved for treatment of metastatic soft tissue sarcoma (STS) in 2007 based on results of a phase II study with relatively few patients. The purpose of this nationwide retrospective study was to assess efficacy and safety of using trabectedin in the entire unselected cohort of patients with metastatic sarcoma and to test known, as well as new prognostic factors that may affect overall survival (OS).

Patients And Methods: Between January 2008 and April 2013, 117 patients were treated with trabectedin for metastatic sarcoma in the three specialized sarcoma centers in Denmark.

Long-term follow-up after urethral injection with polyacrylamide hydrogel for female stress incontinence.

Urethral injection therapy for treatment of stress urinary incontinence has been in use for years, but only a few long-term follow-up studies have been published. Twenty-five women, injected with polyacrylamide hydrogel 8 years earlier, were invited for follow-up. Twenty-four could be contacted; 15 had had no further treatment, seven had been re-operated with placement of mid-urethral slings, and two had been re-injected with polyacrylamide hydrogel.

Interobserver delineation variation in lung tumour stereotactic body radiotherapy.

Objectives: In radiotherapy, delineation uncertainties are important as they contribute to systematic errors and can lead to geographical miss of the target. For margin computation, standard deviations (SDs) of all uncertainties must be included as SDs. The aim of this study was to quantify the interobserver delineation variation for stereotactic body radiotherapy (SBRT) of peripheral lung tumours using a cross-sectional study design.

The inter-system association between the simplified pelvic organ prolapse quantification system (S-POP) and the standard pelvic organ prolapse quantification system (POPQ) in describing pelvic organ prolapse.

Introduction And Hypothesis: The objective of this study is to determine the association between the POPQ and a simplified version of the POPQ.

Methods: This was an observational study. The subjects with pelvic floor disorder symptoms underwent two exams: a POPQ exam and a simplified POPQ.

Long-term results of vaginal repairs with and without xenograft reinforcement.

Introduction And Hypothesis: The aim of this paper is to study if xenograft reinforcement of vaginal repair reduces recurrence of prolapse.

Methods: Results 1-5 years after vaginal repair were studied in 41 cases with xenograft and in 82 matched controls without. Symptoms were evaluated by a validated questionnaire and anatomy by pelvic organ prolapse quantification (POPQ).

Pathophysiology of sexual dysfunction as related to pelvic floor disorders.

Female sexual dysfunction must be evaluated in the context of age, marital status, and general health status of the woman. Questionnaires evaluating the four domains of female sexual dysfunction can be used as a screening tool to evaluate the effect of pelvic floor disorders and coital leakage, as well as the effect of surgical methods and medical treatment on sexual function. Sexual problems are seldom volunteered symptoms, and only recording whether the woman has dyspareunia and frequency of sexual activity must be considered end-point parameters of a complex function.

Tissue integration of polyacrylamide hydrogel: an experimental study of periurethral, perivesical, and mammary gland tissue in the pig.

BACKGROUND Polyacrylamide hydrogel (PAAG) is a nondegradable water-based polymer with high viscoelasticity. The gel is used as a tissue filler, the only risk being prolonged infection with anaerobic, contaminating microorganisms if not treated early with broad-spectrum antibiotics. OBJECTIVE With silicone gel as reference, PAAG tissue integration and migration was studied in a longitudinal study of the pig.

Vaginal pressure during daily activities before and after vaginal repair.

The objective of the study was to measure vaginal pressure during various daily activities in patients before and after vaginal surgery for pelvic organ prolapse, searching data for evidence-based activity guidelines. Vaginal pressure (VP) was studied in 23 patients during activities such as rest, pelvic floor contraction (PFC), coughing, Valsalva, rising from sitting to standing and lifting 2 and 5 kg with four different lifting techniques. VP was measured before, 1-5 days and 4-6 weeks after vaginal repair.

A new bulking agent (polyacrylamide hydrogel) for treating stress urinary incontinence in women.

Objective: To evaluate the efficacy and safety of a transurethral injection with polyacrylamide hydrogel (PAHG) for treating stress urinary incontinence (SUI) in women.

Patients And Methods: The study comprised 17 women with pure SUI and eight with mixed incontinence (age range 35-84 years). Between November 2001 and November 2003, the women were injected into the urethral wall with a PAHG (Aquamid, Contura International A/S, Denmark), a homogenous, highly biocompatible, atoxic, nonresorbable sterile watery gel consisting of approximately 2.

Classification and evaluation of prolapse.

Pelvic organ prolapse is prevalent among older women. Milder stages of prolapse, cranial to the hymen, are common and usually symptomless. A specific symptom is a bulge outside the vagina.

How important is TVT location?

Background: The tension-free vaginal tape (TVT) is claimed to be a midurethral procedure, but data on sling placement are scarce to date. The aim of this study was to investigate tape position and mobility and correlate this with postoperative symptoms of bladder dysfunction.

Methods: One hundred and forty-one women 5 weeks to 2.

Symptoms, bother and POPQ in women referred with pelvic organ prolapse.

The aim of this study was to evaluate symptoms and bother in patients with pelvic organ prolapse (POP) and to compare symptoms with POP-Q grading and measurements. One hundred and ten women with POP filled in a symptom-bother questionnaire concerning frequency of mechanical, bladder, bowel and sexual problems, and a 4-point bother score. The POP was grouped grade 0-1 versus grade >or=2 in each compartment.

Does the tension-free vaginal tape stay where you put it?

Objective: The tension-free vaginal tape (TVT) is a widely used procedure for the surgical treatment of urodynamic stress incontinence. Long-term follow-up data remain scarce. It has been speculated that scar formation leads to tape shortening and stiffening.

Should measurement of maximum urinary flow rate and residual urine volume be a part of a "minimal care" assessment programme in female incontinence?

Objective: The aim of this study was to evaluate the value of routine measurements of urinary flow rate and residual urine volume as a part of a "minimal care" assessment programme for women with urinary incontinence in detecting clinical significant bladder emptying problems.

Material And Methods: Four hundred and eight women were examined and treated in an open-access, interdisciplinary incontinence clinic. A standardized programme for investigation and primarily non-surgical treatment of incontinence was applied.

Acute endogenous endophthalmitis due to Bartonella henselae.

A 45-year-old man presented with progressively worsening vitreitis of 1 week's duration. Treatment for cat-scratch disease 3 years prior to presentation and persistent vitreitis led to vitrectomy, and analysis of the vitrectomy specimen revealed inflammatory cells and necrotic debris; polymerase-chain-reaction analysis of the vitreous fluid sample, done by use of a novel heminested protocol, demonstrated the presence of Bartonella henselae DNA. Treatment with doxycycline led to improvement in the intraocular inflammation but resulted in a poor visual outcome.

Effect of vaginal devices on bladder neck mobility in stress incontinent women.

Objective: To evaluate how vaginal continence products affect the bladder neck mobility and ability to contract the pelvic floor muscles.

Material And Methods: Fifteen stress incontinent women with leakage >8 g/24 hours were assessed by a questionnaire, 24 hours pad test and vaginal ultrasonography of bladder neck position and mobility. The patients were examined without any device, with a commercially available device (Conveen Continence Guard, CCG, Coloplast A/S) and two new shaped test models (TM I/II).

Pro et contra pelvic floor exercises for female stress urinary incontinence.

Pelvic floor exercises are now established as a first line treatment for female urinary stress incontinence. This treatment modality can give substantial improvement in many patients. However, the incontinence is often not completely cured and the treatment requires a long term effort by the patient, which many are unable or unwilling to make.