Publications by authors named "Thomas Kessler"

Purpose: Optimal follow-up strategies following trimodal treatment for muscle invasive bladder cancer play a crucial role in detecting and managing relapse and side-effects. This article provides a comprehensive summary of the patterns and risk factors of relapse, functional outcomes, and follow-up protocols.

Methods: A systematic literature search on PubMed and review of current guidelines and institutional follow-up protocols after trimodal therapy were conducted.

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Witnesses of moral violations stand up for their moral principles, despite facing substantial costs for intervening. Notwithstanding its importance, little is known whether responsibility attributions and the relation between the victim and a witness (i.e.

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Urinary tract infections (UTIs) are among the most common infections. Increasing rates of multidrug-resistant bacteria are complicating treatment, necessitating alternative strategies. Bacteriophages (phages) are viruses that only target and kill bacteria, and this specific lytic activity can be harnessed therapeutically.

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Liquid biopsy for minimally invasive diagnosis and monitoring of cancer patients is progressing toward routine clinical practice. With the implementation of highly sensitive next-generation sequencing (NGS) based assays for the analysis of cfDNA, however, consideration of the utility of liquid biopsy for clinical genetic testing is critical. While the focus of liquid biopsy for cancer diagnosis is the detection of circulating tumor DNA (ctDNA) as a fraction of total cell-free DNA (cfDNA), cfDNA analysis reveals both somatic mosaic tumor and germline variants and clonal hematopoiesis.

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In-between groups encompass individuals who simultaneously belong to social categories that are often seen as mutually exclusive in addition to maintaining their distinct group identity. The current paper sheds light on how members of in-between groups manage their relations within intergroup conflicts. Three studies were conducted among the Druze minority in Israel, a group that is ethnically Arab and shares the Arab identity with the Arab-Palestinian minority in Israel and simultaneously identifies as Israeli.

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Introduction: Magnetic resonance imaging (MRI) enables the investigation of pathological changes in gray and white matter at the lumbosacral enlargement (LSE) and conus medullaris (CM). However, conducting group-level analyses of MRI metrics in the lumbosacral spinal cord is challenging due to variability in CM length, lack of established image-based landmarks, and unknown scan-rescan reliability. This study aimed to improve inter-subject alignment of the lumbosacral cord to facilitate group-level analyses of MRI metrics.

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Detrusor sphincter dyssynergia (DSD) is defined as a detrusor contraction concurrent with an involuntary contraction of the urethral and/or periurethral striated muscles typically occurring in a patient with a spinal cord lesion above the sacral cord. Consequently, high urethral closure pressures during the detrusor contraction leads to high intravesical voiding pressure and large postvoid residuals, which can lead to significant complications in up to 50% of patients if DSD is not treated and followed-up regularly. DSD treatment options are centered around symptomatic management rather that addressing the underlying causative mechanisms.

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Article Synopsis
  • The 2024 EAU guidelines for neurourology emphasize the importance of lifelong management for patients with neurological conditions affecting urinary, sexual, and bowel functions.
  • The guidelines were updated based on a literature review from 2021-2023, with evidence and strength ratings assigned to each recommendation to ensure a comprehensive approach to diagnosis and treatment.
  • Key recommendations include early diagnosis, customized management plans involving multidisciplinary care, and continuous follow-up to maintain patients' quality of life.
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Background: Liquid biopsy enables the non-invasive analysis of genetic tumor variants in circulating free DNA (cfDNA) in plasma. Accurate analytical validation of liquid biopsy NGS assays is required to detect variants with low variant allele frequencies (VAFs).

Methods: Six types of commercial cfDNA reference materials and 42 patient samples were analyzed using a duplex-sequencing-based liquid biopsy NGS assay.

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Understanding the molecular mechanisms underlying neuro-urological disorders is crucial for the development of targeted therapeutic interventions. Through the establishment of comprehensive biobanks, researchers can collect and store various biological specimens, including urine, blood, tissue, and DNA samples, to study these mechanisms. In the context of neuro-urology, biobanking facilitates the identification of genetic variations, epigenetic modifications, and gene expression patterns associated with neurogenic lower urinary tract dysfunction.

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Article Synopsis
  • The study wanted to find evidence on how useful urodynamic studies (UDS) are for women with pee problems.
  • A group of experts talked about how to create strong research designs, including who to study and how to measure results.
  • They concluded that while no perfect research method exists, following their suggestions can help improve future studies.
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Background: Patients with neurogenic lower urinary tract dysfunction (NLUTD) often rely on some type of catheterization for bladder emptying. Intermittent catheterization (IC) is considered the gold standard and is preferred over continuous catheterization, since it is considered to cause fewer urinary tract infections (UTIs) than indwelling catheterization. The main objective of our study was to describe UTI prevalence (at visit) and incidence (within the last 12 months) and urine culture characteristics between patients using an indwelling catheter versus (vs) those performing IC.

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Transcutaneous tibial nerve stimulation (TTNS) is a promising treatment for neurogenic lower urinary tract symptoms. However, the evidence is limited due to a general lack of randomised controlled trials (RCTs) and, also, inconsistency in the sham and blinding conditions. In the context of much-needed RCTs, we aimed to develop a suitable sham-control protocol for a clinical setting to maintain blinding but avoid meaningful stimulation of the tibial nerve.

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The rapid detection and species-level differentiation of bacterial pathogens facilitates antibiotic stewardship and improves disease management. Here, we develop a rapid bacteriophage-based diagnostic assay to detect the most prevalent pathogens causing urinary tract infections: Escherichia coli, Enterococcus spp., and Klebsiella spp.

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Bacteriophages operate via pathogen-specific mechanisms of action distinct from conventional, broad-spectrum antibiotics and are emerging as promising alternative antimicrobials. However, phage-mediated killing is often limited by bacterial resistance development. Here, we engineer phages for target-specific effector gene delivery and host-dependent production of colicin-like bacteriocins and cell wall hydrolases.

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Article Synopsis
  • * The study involved 97 patients who underwent urodynamic assessments at various intervals post-SCI, focusing on factors such as demographic details and neurological status one month after injury.
  • * Two models were identified that show fair predictive value for risk factors like high bladder pressure, but further validation is needed; overall, urodynamic testing is crucial for accurately pinpointing patients at risk for UUT damage.
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Spinal cord injury (SCI) produces damage to the somatic and autonomic pathways that regulate lower urinary tract, sexual, and bowel function, and increases the risk of autonomic dysreflexia. The recovery of these functions has a high impact on health, functioning, and quality of life and is set as the utmost priority by patients. The application of reliable models to predict lower urinary tract, sexual, and bowel function, and autonomic dysreflexia is important for guiding counseling, rehabilitation, and social reintegration.

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Overactive bladder (OAB) is a global problem reducing the quality of life of patients and increasing the costs of any healthcare system. The etiology of OAB is understudied but likely involves supraspinal network alterations. Here, we characterized supraspinal resting-state functional connectivity in 12 OAB patients and 12 healthy controls (HC) who were younger than 60 years.

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Background: Given the high frequency of patients presenting with urinary tract infections (UTIs) and the ensuing high degree of antibiotic prescription, UTI is a critical point of intervention for non-antibiotic treatments to curb the further development of antimicrobial resistance and provide risk-appropriate care for patients.

Objectives: To highlight several select non-antibiotic therapies for the treatment of uncomplicated UTI and relevant indications (prevention and complicated UTI) from recent literature.

Sources: PubMed, Google Scholar, and clinicaltrials.

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Objective: To present the protocol for a randomized controlled trial (RCT) evaluating the efficacy and safety of transcutaneous tibial nerve stimulation (TTNS) for refractory neurogenic lower urinary tract dysfunction (NLUTD).

Study Design And Results: bTUNED (bladder and TranscUtaneous tibial Nerve stimulation for nEurogenic lower urinary tract Dysfunction) is an international multicentre, sham-controlled, double-blind RCT investigating the efficacy and safety of TTNS. The primary outcome is success of TTNS, defined as improvements in key bladder diary variables at study end compared to baseline values.

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Objective: To investigate clinically relevant microbiological characteristics of uropathogens and to compare patients with catheter-associated urinary tract infections (CAUTIs) to those with non-CAUTIs.

Methods: All urine cultures from the calendar year 2019 of the Swiss Centre for Antibiotic Resistance database were analyzed. Group differences in the proportions of bacterial species and antibiotic-resistant isolates from CAUTI and non-CAUTI samples were investigated.

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Article Synopsis
  • * Key gaps in research include understanding the impacts of NLUTD on sexual and bowel function, assessing renal function in those with limited mobility, and establishing effective guidelines for low-resource settings.
  • * The authors advocate for a global, unified approach to develop comprehensive, resource-independent guidelines for NLUTD and related issues, highlighting the need for targeted research to address existing evidence gaps.
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Article Synopsis
  • Spinal cord injuries disrupt autonomic control, leading to issues with cardiovascular health, bowel function, and urinary tract function, which negatively impact overall quality of life.
  • Spinal cord stimulation shows potential for aiding recovery of these autonomic functions, although the exact mechanisms behind this effect are still not fully understood.
  • This review highlights key mechanisms like the activation of the somatoautonomic reflex and neuroplastic changes in the spinal cord, while also pointing out areas needing more research to improve the clinical application of spinal cord stimulation for recovery.
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What positive effects do victims gain by punishing their offenders? Previous research suggests that punishment increases victims' justice-related satisfaction only when the offender indicates that they changed their moral attitude and behaviour. However, offender change may increase justice-related satisfaction independently of punishment. So far, it is empirically unclear whether punishment affects satisfaction beyond offender change (e.

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BACKGROUND: Neurogenic lower urinary tract dysfunction (NLUTD) is a highly prevalent and disabling condition; nevertheless, standard treatments often remain unsatisfactory. Sacral neuromodulation (SNM) is a well-established therapy for non-NLUTD, but there is a lack of randomized controlled trials to show benefit in patients with NLUTD. METHODS: For this sham-controlled, double-blind, multicenter trial, patients with refractory NLUTD (and intended SNM) were recruited at four Swiss SNM referral centers.

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