N-terminal pro-B-type Natriuretic Peptides' Prognostic Utility Is Overestimated in Meta-analyses Using Study-specific Optimal Diagnostic Thresholds.

Background: N-terminal fragment B-type natriuretic peptide (NT-proBNP) prognostic utility is commonly determined post hoc by identifying a single optimal discrimination threshold tailored to the individual study population. The authors aimed to determine how using these study-specific post hoc thresholds impacts meta-analysis results.

Methods: The authors conducted a systematic review of studies reporting the ability of preoperative NT-proBNP measurements to predict the composite outcome of all-cause mortality and nonfatal myocardial infarction at 30 days after noncardiac surgery.

A newer technique to program a semi adjustable articulator.

Introduction: The difficulty in reproducing accurate angle of condylar guidance in semi-adjustable articulators.

Purpose: The purpose of this study was to determine the correlation between the angle of horizontal condylar inclination obtained on a semi-adjustable articulator and the corresponding angle traced on a temporomandibular joint (TMJ) radiograph in completely edentulous subject.

Materials And Methods: The horizontal condylar inclination angle was obtained in a semi-adjustable articulator by means of height tracer (extra oral tracing device) and interocclusal records to program the articulator in 21 subjects.

Xanthoma of the urinary bladder: a rare benign condition which may be mistaken for malignancy.

A 77-year-old man was referred with a history of recurrent urinary tract infections and a raised prostate-specific antigen. He was found to have an atypical lesion of the urinary bladder on cystoscopic examination. A preoperative MRI study suggested no evidence of malignancy and histology was consistent with urinary bladder xanthoma.

The prognostic value of pre-operative and post-operative B-type natriuretic peptides in patients undergoing noncardiac surgery: B-type natriuretic peptide and N-terminal fragment of pro-B-type natriuretic peptide: a systematic review and individual patient data meta-analysis.

Objectives: The objective of this study was to determine whether measuring post-operative B-type natriuretic peptides (NPs) (i.e., B-type natriuretic peptide [BNP] and N-terminal fragment of proBNP [NT-proBNP]) enhances risk stratification in adult patients undergoing noncardiac surgery, in whom a pre-operative NP has been measured.

Postoperative B-type natriuretic peptide for prediction of major cardiac events in patients undergoing noncardiac surgery: systematic review and individual patient meta-analysis.

Background: It is unclear whether postoperative B-type natriuretic peptides (i.e., BNP and N-terminal proBNP) can predict cardiovascular complications in noncardiac surgery.

Hemostasis in laparoscopic renal surgery.

Hemorrhage is a potential risk at any step of laparoscopic nephrectomies (LNs). The advances in surgical equipment and tissue sealants have increased the safety and efficiency of performing LN and laparoscopic partial nephrectomy (LPN). However, hemostasis remains a major issue and there is still scope for further development to improve haemostatic techniques and devices.

Implications of pacemakers and implantable cardioverter defibrillators in urological practice.

Purpose: Pacemakers and implantable cardioverter defibrillators are widely used and often encountered in urology practices worldwide. Safety and performance during electrosurgery, extracorporeal shock wave lithotripsy, magnetic resonance imaging, positron emission tomography and radiotherapy are not clearly defined. We reviewed the literature on their use and implications in urological practice.

Laparoscopic orchidopexy in boys with prune belly syndrome--outcome and technical considerations.

Background And Purpose: Cryptorchidism is an ubiquitous feature in prune belly syndrome (PBS). Laparoscopic orchidopexy allows dissection of the spermatic cord with minimal morbidity. We discuss the technical difficulties and outcome of three boys with PBS who underwent two-stage laparoscopic Fowler-Stephens orchidopexy (F-SO).

Medical management of overactive bladder.

Overactive bladder (OAB), as defined by the International Continence Society, is characterized by a symptom complex including urinary urgency with or without urge incontinence, usually associated with frequency and nocturia. OAB syndrome has an incidence reported from six European countries ranging between 12-17%, while in the United States; a study conducted by the National Overactive Bladder Evaluation program found the incidence at 17%. In Asia, the prevalence of OAB is reported at 53.

Cost benefits of intraoperative cell salvage in radical cystectomy.

Objective: We have looked into the clinical and financial benefits of using intra-operative cell salvage (ICS) as a method to reduce the amount of autologous blood transfusion (ABT) requirement for our radical cystectomy (RC) patients.

Materials And Methods: Fifteen consecutive patients undergoing radical cystectomy received cell salvaged blood (ICS), while 15 did not (NCS). The cost of using the cell saver, number of homologous transfusions, survival, and recurrences were recorded and compared using paired t-test and chi-square test between the two groups.

Orthotopic neobladder versus ileal conduit urinary diversion after cystectomy--a quality-of-life based comparison.

Introduction: Radical cystectomy remains the gold standard in treatment of muscle invasive bladder cancer. Evolution of pathological guidelines has empowered centres to offer orthotopic substitution (OBS) to patients undergoing radical cystectomy. We compared health-related quality of life (HRQoL) between patients who underwent OBS or ileal conduit urinary diversion (ICD) following radical cystectomy.

Prostate cancer diagnosis: should patients with prostate specific antigen >10ng/mL have stratified prostate biopsy protocols?

Background: Trans-rectal ultrasound (TRUS) guided systematic prostate biopsy is a standard tool in prostate cancer (CaP) diagnosis. Extended biopsy techniques using 10-12 cores are the norm. Controversy exists on extended TRUS biopsy in men with PSA>10ng/mL.

Implications of computer tomography measurement in the management of renal tumours.

Background: To compare radiographic measurement and pathological measurement of renal tumours to see if there was a significant difference between the two as this may have implications in the management.

Methods: We retrospectively analyzed CT measurements of 106 consecutive patients who underwent either radical or nephron sparing surgery in our institution and compared this to the actual measurement of the surgical specimen. The largest axial measurement was compared as this is the primary consideration before offering either treatment modality.

Symplastic scrotal leiomyoma: a case report.

Introduction: Scrotal leiomyomas are rare tumours which are essentially benign. Recurrence and malignant transformation to leiomyosarcoma have been reported. However, a specific subgroup with increased bizarre nuclei showing increased mitosis raises the need for a closer follow-up.

Primitive neuroectodermal tumour of the kidney with vena caval and atrial tumour thrombus: a case report.

Introduction: Renal primitive neuroectodermal tumour is an extremely rare malignancy.

Case Presentation: A 21-year-old woman presented with microscopic haematuria, a palpable right loin mass, dyspnoea, dizziness and fatigue. Initial ultrasound scan of the kidneys revealed an 11 cm right renal mass with venous extension into the inferior vena cava.

Routine use of magnetic resonance imaging in the management of T(1c) carcinoma of the prostate: is it necessary?

Purpose: To assess the role and implications of MRI in the management of patients with stage T(1c) prostate cancer.

Patients And Methods: Data were collected from our oncology database, where all new prostate cancers are recorded, for a period of 3 years ending December 2005. A total of 915 patients were found to have prostate cancer.

Inflammatory pseudotumor of the Kidney.

Background: Inflammatory pseudotumor of the kidney or inflammatory myofibroblastic tumor (IMT) is composed of spindle cells admixed with variable amount of proliferating myofibroblasts, fibroblasts, extracellular collagen, lymphocytes and plasma cells. This mainly affects the urinary bladder or prostate. Renal involvement is rare.

Do anatomic factors pose a significant risk in the formation of lower pole stones?

Objectives: To determine whether various anatomic factors predispose to a lower pole stone on one side compared with the other.

Methods: We analyzed the intravenous urography pictures of 40 consecutive patients presenting with a single lower pole stone. Measurements were taken of the infundibulopelvic angle (IPA), ureteroinfundibular angle, infundibular width, pelvicaliceal height, infundibular length, and pelvicaliceal angle of the affected and normal kidney.

Ejaculatory-duct calculus causing secondary obstruction and infertility.

Objective: To report on a patient with ejaculatory-duct calculi that caused secondary obstruction and infertility.

Design: Case report.

Setting: Clinical.

Long-term results of extracorporeal shockwave therapy for Peyronie's disease.

Purpose: To analyze the long-term results in patients undergoing extracorporeal shockwave therapy (ESWT) for Peyronie's disease.

Patients And Methods: Patients treated with ESWT (3000 shockwaves on a Storz Minilith SL lithotripter) for Peyronie's disease were included. The mean disease duration prior to treatment was 23.

Testicular metastasis from gastric carcinoma.

Secondary neoplasms of the testis have been reported with an incidence of 0.02% to 2.5% on autopsy.

Stuttering priapism after ingestion of alfuzosin.

A patient who presented with priapism after ingestion of alfuzosin is described. He presented with recurrent priapism, which was relieved temporarily after physical exercise. It did not subside with pharmacologic management and was managed surgically using Winter's procedure.