Introducing the patient's perspective in hospital health technology assessment (HTA): the views of HTA producers, hospital managers and patients.

Background: The recent establishment of health technology assessment (HTA) units in University hospitals in the Province of Quebec (Canada) provides a unique opportunity to foster increased participation of patients in decisions regarding health technologies and interventions at the local level. However, little is known about factors that influence whether the patient's perspective is taken into consideration when such decisions are made.

Objective: To explore the practices, perceptions and views of the various HTA stakeholders concerning patient involvement in HTA at the local level.

Erythropoietin and its antagonist regulate hypoxic fictive breathing in newborn mice.

Clinical use of erythropoietin in adult and newborn patients has revealed its involvement in neuroprotection, neurogenesis, and angiogenesis. More recently, we showed in adult mouse, that brain erythropoietin interacts with the major brainstem centers associated with respiration to enhance the ventilatory response to acute and chronic conditions of physiological hypoxia (e.g.

A rare testicular solid mass in children: Juvenile granulosa cell tumour of testis.

Juvenile granulosa cell tumour (JGCT) of the testis is a benign neoplasm rarely seen in children. It usually presents as a unilateral scrotal mass and can be associated with genital ambiguity and chromosomal anomalies. Radical orchiectomy is the treatment of choice.

Bilateral renal cell carcinoma in a child.

Renal cell carcinoma is a rare renal tumor in the pediatric population with an incidence of 0.1-0.3%.

A liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for monitoring drug exposure in hematopoietic stem cell transplant recipients.

A liquid chromatography-tandem mass spectrometry method was developed for the quantification of circulating levels of multiple immunosuppressant drugs including cyclosporine (CsA), tacrolimus, methotrexate (Mtx), prednisone, prednisolone, methylprednisone, total and free mycophenolic acid (MPA), as well as MPA phenolic (MPAG) and acyl (AcMPAG) glucuronide metabolites. Linearity, precision and accuracy were validated within the typical therapeutic range of concentrations for each compound. The assay was linear over 0.

The impact of germline genetic variations in hydroxysteroid (17-beta) dehydrogenases on prostate cancer outcomes after prostatectomy.

Background: The relationship between polymorphisms in the hydroxysteroid (17-beta) dehydrogenase (HSD17B) family of genes, which are involved in steroid hormone biotransformation, and the risk of prostate cancer (PCa) progression remains unexplored.

Objective: Determine whether inherited variations in HSD17B genes are associated with PCa progression.

Design, Setting, And Participants: We studied two independent Caucasian cohorts composed of 526 men with organ-confined PCa and 213 men with advanced disease who had a median follow-up of 7.

Macroglossia due to Systemic Amyloidosis: Is There a Role for Radiotherapy?

Background: Macroglossia due to amyloid depositions can cause cosmetic problems and functional disability, and can lead to life-threatening airway obstruction. Management of macroglossia in systemic amyloidosis is controversial, and the role of surgery is unclear.

Case Description: We present a case of a 66-year-old woman affected by macroglossia due to light chain amyloidosis who presented with eating and breathing difficulties.

Inverse-planned gynecologic high-dose-rate interstitial brachytherapy: clinical outcomes and dose--volume histogram analysis.

Purpose: To present clinical outcomes and dose-volume histogram parameters of three-dimensional image-based high-dose-rate interstitial brachytherapy (HDR-ISBT) in patients with primary or recurrent gynecologic cancer unsuitable for intracavitary brachytherapy (ICB).

Methods And Materials: Records of 43 women treated between 2001 and 2009 with iridium-192 gynecologic HDR-ISBT boost, using a Syed-Neblett template and inverse planning simulated annealing dose optimization, were reviewed. Median HDR-ISBT dose was 30Gy, delivered in 4-6Gy/fraction.

Enhanced erythropoietin expression in the brainstem of newborn rats at high altitude.

In addition to its role in elevating red blood cell number, erythropoietin (Epo) exerts protective functions against acute and delayed degenerative diseases of the brain. Moreover, we have recently demonstrated that endogenously synthesized Epo and soluble Epo receptor (a negative regulator of Epo binding to the Epo receptor) in the central nervous system play a crucial role in facilitating the ventilatory response and acclimatization to hypoxia. Here we hypothesized that cerebral Epo in the brainstem is implicated in the process that allows cardiorespiratory acclimatization to high altitude hypoxia during the postnatal period.

SRD5A polymorphisms and biochemical failure after radical prostatectomy.

Background: The relationship between inherited germ-line variations in the 5α-reductase pathways of androgen biosynthesis and the risk of biochemical recurrence (BCR) after radical prostatectomy (RP) remains an unexplored area.

Objective: To determine the link between germ-line variations in the steroid-5α-reductase, α-polypeptide 1 (SRD5A1) and steroid-5α-reductase, α-polypeptide 2 (SRD5A2) genes and BCR.

Design, Settings, And Participants: We studied retrospectively two independent cohorts composed of 526 white (25% BCR) and 320 Asian men (36% BCR) with pathologically organ-confined prostate cancer who had a median follow-up of 88.

Allantoic cysts and posterior urethral valves: a case report.

Allantoic cysts are a somewhat rare entity. They are identifiable on antenatal ultrasound examination but are not easily distinguishable from pseudocysts, which are often associated with a poor prognosis. Their etiology remains obscure and obstructive uropathies have been proposed to be one of the underlying mechanisms.

Study comparing the applicability of dorsal lumbotomy in older children.

Objective: : Dismembered pyeloplasty through dorsal lumbotomy to correct ureteropelvic junction obstruction is mainly successfully performed in children under 5 years old for technical reasons. We compared children who underwent dorsal lumbotomy by age group (<5 vs. ≥5 years old) to determine if the surgical success and long-term results were comparable.

Value of sentinel node mapping in cancer of the cervix.

Objectives: To compare the relative value of two methods of detection for the sentinel lymphatic nodes (SLNs): colorimetric with Isosulfan blue (ISB) and radio-isotopic with Technetium-99 (Tc99), and to evaluate the concept of the SLN mapping applied to cervical cancer.

Methods: From October 2000 to December 2006, radical surgery was planned in 211 patients who presented early-stage cancer of the cervix. Both ISB and Tc99 were used to detect the SLNs.

The vaginal radical trachelectomy: an update of a series of 125 cases and 106 pregnancies.

Objective: To review our first consecutive 125 vaginal radical trachelectomies (VRT) to assess the oncologic, fertility and obstetrical outcomes.

Methods: Data from our prospective database was used to identify all VRT planned between October 1991 to March 2010 in patients with early-stage cervical cancer (stages IA, IB and IIA). Chi-square test, Fisher's exact test and Student t-test were used to compare baseline characteristics and Kaplan-Meier survival curves were constructed and compared with the use of the log-rank test.

Place of Schauta's radical vaginal hysterectomy.

Women affected by early stage invasive cancer of the cervix are usually treated by surgery. Radical abdominal hysterectomy with pelvic lymphadenectomy is the most widely used technique. Because the morbidity of the abdominal approach can be important, the radical vaginal hysterectomy has gained acceptance in gynaecologic oncology.

Matrix metalloproteinase 9 is associated with Gleason score in prostate cancer but not with prognosis.

Prostate cancer is the most common cancer in North American men. Among men diagnosed with prostate cancer in more than three cores or with high grade prostate cancer, many experience long disease-free survival. However, these patients still undergo radical treatment while they could benefit from active surveillance with complementary therapy.

Interventions for improving the adoption of shared decision making by healthcare professionals.

Background: Shared decision making (SDM) is a process by which a healthcare choice is made jointly by the practitioner and the patient and is said to be the crux of patient-centred care. Policy makers perceive SDM as desirable because of its potential to a) reduce overuse of options not clearly associated with benefits for all (e.g.

Changes of AMPA receptors in MPTP monkeys with levodopa-induced dyskinesias.

Overactivity of glutamate neurotransmission is suspected to be implicated in Parkinson's disease and levodopa-induced dyskinesia. The fast glutamatergic transmission in the striatum from the cortex is mediated mainly by non-n-methyl-d-aspartate (non-NMDA) receptors. Animal models of Parkinson's disease reveal conflicting data concerning striatal glutamate AMPA receptors.

Extensive splicing of transcripts encoding the bile acid-conjugating enzyme UGT2B4 modulates glucuronidation.

Background And Aims: UGT2B4 is a member of the UDP-glucuronosyltransferase (UGT) superfamily, a major detoxifying system in humans. UGT2B4 is involved in bile acids metabolism and highly expressed in liver and extrahepatic tissues. The aim of this study was to uncover new molecular mechanisms underlying interindividual variability in the UGT2B4 pathway.

Type 2 and 5 17beta-hydroxysteroid dehydrogenases and androgen receptor in human fetal lungs.

Androgens delay fetal lung maturation through an androgen receptor (AR)-dependent mechanism. Type 2 and 5 17beta-hydroxysteroid dehydrogenases (17betaHSD) are involved in androgen inactivation and synthesis, respectively. We aimed to further characterize the human fetal lung potential for androgen metabolism and response.

Epithelial cells are the major site of hydroxysteroid (17beta) dehydrogenase 2 and androgen receptor expression in fetal mouse lungs during the period overlapping the surge of surfactant.

Many genes involved in the peripheral metabolism of androgens, including hydroxysteroid (17beta) dehydrogenases (HSD17B) 2 and 5, steroid 5alpha reductase 1, and 3alpha-HSD, are expressed in the developing lung. Because lung development is delayed by androgens and pathologies related to lung immaturity are major concerns for preterm neonates, we are interested in the elucidation of the androgen metabolism in developing lung. In the present report we have identified the cell types expressing HSD17B2 (testosterone into androstenedione) and androgen receptor in normal male and female mouse developing lung between the gestation days 15.

Androgen receptor and 17beta-HSD type 2 regulation in neonatal mouse lung development.

A QPCR analysis of androgen receptor and several androgen metabolizing genes was performed during the saccular and alveolar stages of mouse lung development. Androgen receptor expression showed a statistically significant increase during the alveolar stage while levels of 17beta-hydroxysteroid dehydrogenase type 2 (17beta-HSD 2) expression significantly decreased at the end of the saccular stage and remained low throughout the alveolar period. 17beta-HSD 1, 17beta-HSD 5, 5alpha-reductase type 1, and mouse 3alpha-HSD did not present such a regulation.

Copy-number variations (CNVs) of the human sex steroid metabolizing genes UGT2B17 and UGT2B28 and their associations with a UGT2B15 functional polymorphism.

UGT2B17 and UGT2B28 are among the most commonly deleted genes in humans and encode members of the uridine diphosphate (UDP)-glucuronosyltransferase 2B (UGT2B) subfamily. They are involved, along with UGT2B15, in the catabolism of sex-steroid hormones. Despite the recent biomedical interest in UGT2B17 and UGT2B28 copy-number variations (CNVs) within human populations, the impact of their gene dosage has been hampered by the lack of precise molecular identification of the common deletion breakpoints within high homology sequence regions on chromosome 4.

Early detection of prostate cancer local recurrence by urinary prostate-specific antigen.

Purpose: We assessed the role of urinary prostate-specific antigen (uPSA) in the follow-up of prostate cancer after retropubic radical prostatectomy (RRP) for the early detection of local recurrences.

Methods: We recruited 50 patients previously treated for prostate cancer with RRP and who had not experienced a prostate-specific antigen (PSA) recurrence within their first postoperative year into a cross-sectional laboratory assessment and prospective 6-year longitudinal follow-up study. We defined biochemical failure as a serum PSA (sPSA) of 0.

Insights into endometriosis-associated endometrial dysfunctions: a review.

Endometriosis is defined as the presence of ectopic endometrial-like tissue outside the uterus cavity. This disease, afflicting women during their reproductive age, is mainly associated with pelvic pain and infertility. Sampson's theory which supports the ability of endometrial fragments from retrograde menstruations to slough through fallopian tubes and reach peritoneal environment has been recognized as the most plausible explanation for endometriosis during many years.