Mcculloughstanton1902

1%). The 24-month OS was 96.4 ± 3.5% and the 24-month RFS was 31.7 ± 9.4%. Lower RFS rates were found in high grade tumor patients (22.2 ± 13.9%) compared to low grade tumor patients (35.6 ± 12.3%) (p=0.237). There was statistical difference in creatinine and eGFR values when comparing baseline to last follow-up (p=0.018 and p=0.005, respectively). CONCLUSIONS Endoscopic management of UTUC in patients with imperative indications appears to be a reasonable alternative to nephroureterectomy. However, stringent endoscopic follow- up is necessary due to the high risk of disease recurrence.INTRODUCTION To systematically review the effect of additional drug therapy as metaphylaxis in patients with cystinuria. EVIDENCE ACQUISITION A literature search of three databases (MEDLINE, Embase and the Cochrane Library) was performed according to the PRISMA-guidelines enclosing articles published up to May 2019. A total of 1117 articles were screened. Thirty-four publications met the inclusion criteria for this review. EVIDENCE SYNTHESIS Male-female ratio in the studied cohorts was 49,9% - 50.1%. The majority of studies showed a positive effect in reducing stone events and/or urinary cystine excretion. D-Penicillamine showed success in 13/14 (92%) studies, whereas Tiopronin-treatment showed a reduction in all (8/8; 100%) studies. All studies on Captopril (4/4) showed a decrease, however not all significant. The same is true for studies on Thiols in combination with Captopril (2/2). Furthermore, Tiopronin showed less side effects compared to D-penicillamine, respectively 30% and 37%. Captopril showed the least adverse events, with one event in nine patients. CONCLUSIONS The evidence on benefit of additional drug therapy in patients with cystinuria is scarce. All studied medications showed an effect on stone event and urinary cystine excretion, when used in addition to hyperhydration, alkalization and a diet low on methionine. Based on this systematic review, no drug can be preferred over another. An important aspect in the choice of drug is the risk of side effects. Therefore, the choice of additional drug should be personalized for every patient where the risk of side effects should be taken into consideration.BACKGROUND Evidence about the clinical benefits of Hyperbaric Oxygen Therapy (HBOT) in patients with Fournier's Gangrene (FG) is controversial and inconclusive. We aimed to compare the mortality related to FG between patients undergoing surgical debridement and/or standard antibiotic therapy alone or in combination with HBOT. METHODS We performed a retrospective multi-institutional observational case-control study. All patients admitted with diagnosis of FG from June 2009 to June 2019 were included into the study. Patients received surgical debridement and/or standard antibiotic therapy alone or in combination with HBOT. Factors associated with FG related mortality were assessed with uni- and multivariate analyses. The main outcome measure was FG related mortality. RESULTS A total of 161 patients with diagnosis of FG were identified. Mean FG Severity Index was 8.6 ± 4.5. All patients had broad-spectrum parenteral antibiotic therapy. An aggressive debridement was performed in 139 (86.3%) patients. A total of 72 patients (44.7%) underwent HBOT. Mortality due to FG was observed in 32 (36.0%) of patients who do not underwent HBOT and in 14 (19.4%) of patients who underwent HBOT (p=0.01). At the multivariate analysis, surgical debridement and HBOT were independent predictors of lower mortality while higher FG Severity Index was independent predictor of higher mortality. CONCLUSIONS HBOT and surgical debridement are independent predictors of reduced FG related mortality.BACKGROUND Aim of our study was to analyze adverse events (AEs) associated with Radium 223 using real life data from Eudra-Vigilance (EV) database. METHODS EV database is the system for managing and analyzing information on suspected adverse reactions to medicines which have been authorized or being studied in clinical trials in the European Economic Area (EEA). We recorded number of AEs for Radium 223 per category and severity from 2013 to May 2019. We recorded AEs per age group (85 years) treated with Radium 223 were at increased risk of cardiac, infectious, and metabolism disorders when compared to younger patients ( less then 65). However, we have no information on the number of patients under treatment in the EV database. CONCLUSIONS EV database highlights several AEs which are not reported in registry studies as well as different AEs profiles according to age. Clinicians should consider these data when treating patients with Radium 223.INTRODUCTION Our aim is to compare feasibility and safety of open radical cystectomy (ORC), laparoscopic radical cystectomy (LRC) and robot-assisted radical cystectomy (RARC) for the treatment of bladder cancer through network meta-analysis. EVIDENCE ACQUISITION Eligible articles were identified from electronic databases including PubMed/Medline, Embase, the Cochrane Library and Web of Science up to August 2019 with no language limitations. Studies selection, quality assessment, data extraction and analysis were accomplished by two independent reviewers (DCF and AL) using Cochrane Collaboration's tools. EVIDENCE SYNTHESIS After screening 2528 articles, 27 studies were included in the final meta-analysis. In the network meta-analysis, both RARC (MD83.09, 95%CI 61.06 to 105.11) and LRC (MD 49.68, 95%CI 21.75 to 77.62) showed a longer operative time compared with ORC. Besides, RARC had a longer operative time than LRC (MD 33.40, 95%CI 1.35 to 65.45). RARC (MD-591.86, 95%CI -879.46 to - 304.27) and LRC (MD -435.2med by experienced surgeons in selected patients. Notably, RARC may be more suitable for RC with extracorporeal urinary diversion. Larger well-designed trials are still needed to confirm these findings due to the observational nature of most studies.INTRODUCTION Metastasis directed therapy (MDT) is increasingly being implemented in recurring prostate cancer (PCa), although its role in PCa management has yet been fully defined. Aim of the current systematic review is to analyze current knowledge of MDT in the setting of recurrent PCa and highlight future trials which will continue to shed a light on a controversial aspect of current PCa management. EVIDENCE ACQUISITION The National Library of Medicine Database was searched for relevant articles published between January 2014 and August 2019. A wide search was performed including the combination of following words ((metastasis AND directed AND therapy) AND prostate AND cancer). GSK 3 inhibitor The selection procedure followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) principles. EVIDENCE SYNTHESIS Biologic studies support the use of MDT in oligometastatic PCa. Modern imaging techniques as PSMA PET/CT, Fuciclovine PET/CT and whole body MRI are fundamental to implement such an approach given the high diagnostic yield at low PSA values.