Introduction: Patients upstaged to pT3 after partial nephrectomy (PN) may be at an increased risk of disease progression compared to those patients submitted to radical nephrectomy (RN). We sought to identify preoperative factors predicting pT3 upstaging in localized renal cell carcinoma.
Material And Methods: Patients submitted to nephrectomy for clinically localized (cT1-cT2) renal cell carcinoma between 2011 and 2016 were identified from a prospective registry, those presenting with locally advanced or metastatic disease were excluded. Clinical factors, laboratory, and imaging using RENAL score, were analyzed. A multivariate analysis was performed looking for stage pT3a predictors.
Results: Two hundred and nine patients were included, 66% were men, with a mean age of 57 years. Mean tumor size was 49 ±31 mm. 19% were staged as pT3a. Of this group, 10% underwent a PN. Age, hypertension, presence of hematuria, creatinine levels, size and RENAL score were statistically associated with locally advanced stage. The variables of the RENAL score that were associated to pT3a stage were size, nearness to renal sinus/collector system and contact with main renal vessels. On the multivariate analysis, only age, size, and contact with renal vessels were found to predict upstaging. A model was developed which was able to predict stage pT3a with an area under the curve (AUC) of 0.864 in the ROC curve.
Conclusions: Upstaging to pT3a is fairly common in clinically localized tumors. A formula that includes tumor size, age and contact with the main vessels on imaging, can help predict it. This should be considered when deciding if the patient is a candidate for nephron sparing surgery.
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http://dx.doi.org/10.5173/ceju.2020.0005 | DOI Listing |
J Int AIDS Soc
February 2025
Centre for Integrated Data and Epidemiological Research, School of Public Health, University of Cape Town, Cape Town, South Africa.
Introduction: Sexually transmitted infections (STIs) in pregnancy are associated with an increased risk of vertical HIV transmission and adverse pregnancy and birth outcomes. In South Africa, syndromic management is the standard of care for STI management. We assessed the potential impact of point-of-care (POC) screening for curable STIs (Chlamydia trachomatis [CT], Trichomonas vaginalis [TV] and Neisseria gonorrhoeae [NG]) during pregnancy on vertical HIV transmission and adverse pregnancy and birth outcomes.
View Article and Find Full Text PDFAim: To discuss inter-organisational collaboration in the context of the successful COVID-19 vaccination programme in North Central London (NCL).
Design: An action research study in 2023-2024.
Methods: Six action research cycles used mixed qualitative methods.
Cancer
February 2025
General Medicine Service, VA Puget Sound Health Care System, Seattle, Washington, USA.
Background: Breast cancer screening (BCS) inequities are evident at national and local levels, and many health systems want to address these inequities, but may lack data about contributing factors. The objective of this study was to inform health system interventions through an exploratory analysis of potential multilevel contributors to BCS inequities using health system data.
Methods: The authors conducted a cross-sectional analysis within a large academic health system including 19,774 individuals who identified as Black (n = 1445) or White (n = 18,329) race and were eligible for BCS.
Lipids
January 2025
Department of Laboratory Medicine, Peoples Hospital of Deyang City, Deyang, China.
Lipid-lowering drugs have been used in clinics widely. It is unclear whether the drugs have an effect on renal failure. We chose high-density lipoprotein cholesterol (ieu-b-109), low-density lipoprotein cholesterol (ieu-a-300), triglyceride (ieu-b-111), and total cholesterol (ebi-a-GCST90038690) as exposures.
View Article and Find Full Text PDFProtein Sci
February 2025
IRR Chemistry Hub, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK.
Super-resolution microscopy has revolutionized biological imaging, enabling the visualization of structures at the nanometer length scale. Its application in live cells, however, has remained challenging. To address this, we adapted LIVE-PAINT, an approach we established in yeast, for application in live mammalian cells.
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