Commentaries: New analysis recommends against using digital rectal exam in primary care – American Academy of Family Physicians, vie EurekAlert (free) AND Little Evidence Supports Use of Digital Rectal Exam – Medscape (free registration required) AND Digital Rectal Exams for Routine Prostate Screening Discouraged – NEJM Physician’s First Watch (free)
Effect of a Low-Intensity PSA-Based Screening Intervention on Prostate Cancer Mortality: The CAP Randomized Clinical Trial – JAMA (link to abstract – $ for full-text)
Commentary: One-off PSA screening for prostate cancer does not save lives – eCancer News (free)
Related: Infographic: ATLS Trauma Update 2018
Robot-assisted radical prostatectomy vs laparoscopic and open retropubic radical prostatectomy: functional outcomes 18 months after diagnosis from a national cohort study in England – British Journal of Cancer (free)
Related Cochrane Review with similar results: Laparoscopic and robotic-assisted versus open radical prostatectomy for the treatment of localised prostate cancer – Cochrane Library (free)
Potential Yield of Imminent Death Kidney Donation – American Journal of Transplantation, via Medscape (free registration required)
Mid- and Long-Term Health Risks in Living Kidney Donors: A Systematic Review and Meta-analysis – Annals of Internal Medicine (link to abstract – $ for full-text)
Commentaries: Analysis looks at long-term risks of living kidney donation – American College of Physicians, via EurekAlert (free) AND What Are The Health Risks To Living Kidney Donors? – MedicalResearch.com (free) AND Living kidney donors have low but elevated risk of renal failure – Reuters (free)
Treatment of Non-neurogenic Male LUTS – European Urology Association (free, but not accessible via mobile devices) (via @KariTikkinen)
Commentary: Lymphadenectomy in Renal Cell Carcinoma: No Benefit? – Medscape (free registration required)
Author Interview: Work-Related Musculoskeletal Disorders Among Surgeons and Interventionalists (free)
Commentary: Work-Related Musculoskeletal Injury Common in Surgeons, Interventionalists – Medscape (free registration required)
Investigation and Management of Renal Stone Disease – Nephrology Dialysis Transplantation, via Medscape (free registration required)
Electrical stimulation with non-implanted devices for stress urinary incontinence in women – Cochrane Library (link to abstract – $ for full-text) (via @CochraneUK see Tweet with Infographic)
Commentary: Trunk Imaging Tied to Higher Nephrectomy Risk – MedPage Today (free registration required)
Comparative Analysis of Biopsy Upgrading in Four Prostate Cancer Active Surveillance Cohorts – Annals of Internal Medicine (link to abstract – $ for full-text)
Commentaries: Low-Risk Prostate Cancer May Merit Less Frequent Biopsies – Reuters (free) AND Less Frequent Biopsy May Be Option in Prostate Cancer Care – Physician’s Weekly (free) AND Biennial biopsies may be adequate for men under active surveillance for prostate cancer – 2 Minute Medicine (free)
Systematic Review and Meta-analysis Comparing the Efficacy of Nonsteroidal Anti-inflammatory Drugs, Opioids, and Paracetamol in the Treatment of Acute Renal Colic – European Urology (free) (via @KariTikkinen and @EUplatinum)
“In kidney stone–related acute pain episodes in patients with adequate renal function, treatment with nonsteroidal anti-inflammatory drugs offers effective and most sustained pain relief, with fewer side effects, when compared with opioids or paracetamol”.
News release: KDIGO Guidelines on Living Kidney Donors: A Call for A Paradigm Shift (free)
Effect of Robotic-Assisted vs Conventional Laparoscopic Surgery on Risk of Conversion to Open Laparotomy Among Patients Undergoing Resection for Rectal Cancer: The ROLARR Randomized Clinical Trial – JAMA (link to abstract – $ for full-text)
Commentaries: Comparison of Outcomes for Robotic-Assisted vs Laparoscopic Surgical Procedures – The JAMA Network (free) AND Robotic docs can boost surgery time and cost – Science News (free) AND Robot-assisted surgery for kidney removal associated with longer operating times, higher cost – Stanford Medicine (free) AND Robotic-assisted surgery: more expensive, but not always more effective – Reuters (free)
Association Between Use of Antithrombotic Medication and Hematuria-Related Complications – JAMA (link to abstract – $ for full-text)
Original article: Laparoscopic and robotic-assisted versus open radical prostatectomy for the treatment of localised prostate cancer – Cochrane Library (link to abstract – $ for full-text)
“Urinary and sexual quality of life-related outcomes appear similar”.
Commentaries: Prostate cancer treatment associated with higher risk of heart failure – Cardiovascular Business (free) AND Hormone Treatment for Prostate Cancer Tied to Heart Risks – New York Times (10 articles per month are free)
Commentaries: A new study claims prostate cancer screenings significantly reduce deaths. Not everyone agrees – STAT (free) AND New Study Offers Support for Prostate Testing – The New York Times (10 articles per month are free)
A National Implementation Project to Prevent Catheter-Associated Urinary Tract Infection in Nursing Home Residents – JAMA Internal Medicine (link to abstract – $ for full-text)
Commentaries: Study Shows 54 Percent Drop in CAUTIs Among Nursing Home Residents – Infection Control Today (free) AND AHRQ safety program helps cut catheter infections by more than 50% among nursing home patients, JAMA study shows – Healthcare Finance (free) AND Implementing technical and socioadaptive bundles may decrease catheter-associated urinary tract infections in nursing homes – 2 Minute Medicine (free) AND Nursing homes cut urinary tract infections in half through focused effort on catheter care – Michigan University, via EurekAlert (free)
Comparative safety of pioglitazone versus clinically meaningful treatment alternatives concerning the risk of bladder cancer in older US adults with type 2 diabetes – Diabetes, Obesity and Metabolism (link to abstract – $ for full-text)
Commentaries: Another Study Ties Pioglitazone to Bladder Cancer Risk – MedPage Today (free registration required) AND Diabetes Treatments Compared for Bladder Cancer Risk – MPR (free)
Commentaries: Gout Patients Run Higher Risk of Kidney Stones – MedPage Today (free registration required) AND Gout associated with elevated risk for kidney stones – MedWire News (free)
“60% increased risk of first-time nephrolithiasis versus general population, with little protection from allopurinol” (from MedPage Today)
“For most people, treatment was not beneficial and may be harmful. Antibiotic treatment did appear to benefit women in pregnancy and those about to undergo urological surgery”.
Commentaries: Sperm counts among western men have halved in last 40 years: study – The Guardian (free) AND Sperm Concentrations Have Fallen 50% in Western World – Medscape (free registration required)
High prevalence of erectile dysfunction in diabetes: a systematic review and meta-analysis of 145 studies – Diabetic Medicine (link to abstract – $ for full-text)
Commentary: Screening for Erectile Dysfunction Should Be Routine in Diabetes – Medscape (free registration required)
Commentary: 3 steps to restore patient trust in overlapping surgeries – FierceHealthcare (free)
This interesting viewpoint discusses the practice of scheduling overlapping surgeries, in which a qualified practitioner finishes noncritical parts of the first operation while the primary surgeon moves to the next surgery.
Effect of Electroacupuncture on Urinary Leakage Among Women With Stress Urinary Incontinence: A Randomized Clinical Trial – JAMA (link to abstract – $ for full-text)
Commentaries: Electroacupuncture linked to improvements for stress urinary incontinence – 2 Minute Medicine (free) AND Electroacupuncture May Decrease Stress Urinary Incontinence – Medscape (free registration required) AND Mixed Results on Effectiveness of Acupuncture to Treat Stress Urinary Incontinence, Infertility – The JAMA Network (free)
The Association Between Vasectomy and Prostate Cancer: A Systematic Review and Meta-analysis – JAMA Internal Medicine (link to abstract – $ for full-text)
Commentary: Meta-Analysis: Vasectomy Likely Does Not Cause Prostate Cancer – Physician’s First Watch (free) AND Weak Link Between Vasectomy, Prostate Cancer – MedPage Today (free registration required)
Follow-up of Prostatectomy versus Observation for Early Prostate Cancer – New England Journal of Medicine (link to abstract – $ for full-text)
Long-term, surgery for localized prostate cancer offers little extra benefit – Reuters (free) AND No Benefit with Surgery for Low-Risk Prostate Cancer – MedPage Today (free registration required) AND Prostatectomy for Localized Prostate Cancer Doesn’t Improve Long-Term Survival – Physician’s First Watch (free) AND Surgery for Early Prostate Cancer May Not Save Lives – Washington University in St. Louis, via NewsWise (free)
“Most men just as likely to survive with limited or no treatment” (from NewsWise)
Commentaries: Tall men at higher risk of aggressive prostate cancer – OnMedica (free) AND Tall men at bigger risk of aggressive prostate cancer, study suggests – The Guardian (free) AND Height, Weight Linked with High-Grade Prostate Cancer – MedPage Today (free registration required)
The ABCs and Ds of Whether to Get Prostate Cancer Screening – The New York Times (10 articles per month are free)
See also the new USPSTF guidelines on prostate cancer screening and related commentaries in our April 12 issue (see #1) and in our April 13 issue (see #4)
Balanced point of view regarding prostate cancer screening.
Source: EvidenceAlerts (free resource to find articles of interest)
“Antiplatelet therapy at the time of noncardiac surgery confers minimal bleeding risk with no difference in thrombotic complications. In many cases, it is safe to continue antiplatelet therapy in patients with important indications for their use”
Original article: Alpha blockers for treatment of ureteric stones: systematic review and meta-analysis – The BMJ (free)
#ASCO2017 – Abiraterone for Prostate Cancer
Abiraterone plus Prednisone in Metastatic, Castration-Sensitive Prostate Cancer – New England Journal of Medicine (free) AND Abiraterone for Prostate Cancer Not Previously Treated with Hormone Therapy – New England Journal of Medicine (free)
Invited commentary: Surgical Site Infection Prevention – What We Know and What We Do Not Know – JAMA Surgery (free)
Commentary: ‘Long-Awaited’ CDC Guidelines on SSI Prevention Released – Medscape (free registration required)
Transplantation of HCV-infected-kidneys into uninfected recipients seems feasible in this era of direct-acting antiviral agents, maybe shortening waiting times for those willing to take the risk.
“How frequently should indwelling urinary catheters be changed? Are catheter washouts effective? Which type of catheter reduces rates of urinary tract infection?”. This post look at the evidence regarding urinary catheter care.
Mortality Trends After a Voluntary Checklist-based Surgical Safety Collaborative – Annals of Surgery (link to abstract – free PDF available)
Sources: Global Health NOW Newsletter (free) AND South Carolina Hospitals Saw Surgery Deaths Drop After Implementing WHO Checklist – AJMC News (free) AND A simple checklist prevents deaths after surgery, a large new study suggests – The Washington Post (a few articles per month are free)
See also: WHO Surgical Safety Checklist – World Health Organization (free) AND A Surgical Safety Checklist to Reduce Morbidity and Mortality in a Global Population – New England Journal of Medicine (free)
Invited commentary: Asymptomatic Microscopic Hematuria – Rethinking the Diagnostic Algorithm (free)
Routine urinalysis for screening is not presently recommended by any major health organization, but asymptomatic microscopic hematuria is a common incidental finding. This study suggests that the combination of renal ultrasound and cystoscopy is the most cost-effective approach for the evaluation of these patients.
“Extended thromboprophylaxis is warranted in some procedures (eg, open and robotic cystectomy) but not others (eg, robotic prostatectomy without pelvic lymph node dissection in low-risk patients)”
“Extended prophylaxis is warranted for some procedures (eg, kidney transplantation procedures in high-risk patients) but not others (transurethral resection of the prostate and reconstructive female pelvic surgery in low-risk patients)”
Prostate Cancer Screening – Conflicting views on the new USPSTF draft recommendations
In favor of screening: New Official Prostate Cancer Screening Guidelines Announced: Too Little, Too Late? – Forbes (free) AND Federal Task Force Softens Opposition To Routine Prostate Cancer Screening – NPR
Against screening: The new recommendations for prostate cancer screenings are a bad deal – STAT News (free)
For those aged 55 to 69 it recommends “informed, individualized decision making based on a man’s values and preferences”. According to a useful infographic from the draft recommendations, the benefits are likely small. For every 1000 men offered PSA based screening over a period of 10-15 years, the test would avoid cancer spreading in 3 men and death from prostate cancer in 1-2 men, with the undesired consequences of false positives and subsequent procedures in many patients.
Browse Appropriateness Criteria Topics (free)
This comprehensive guide from American College of Radiology (ACR) covers 230 topics with more than 1,100 clinical indications and has just been updated. It is a very useful resource for doctors in all specialties to guide which exam is most appropriate in each clinical situation.
Observational data suggests there might be a link.
Going Under the Knife, With Eyes and Ears Wide Open – New York Times (free access to 10 articles per month)
“More and more surgeries are being performed with the patient awake and looking on, for financial and medical reasons”.
Adverse Effects of Prostate Cancer Treatments Vary – MedPage Today (free registration required)
Study 1 – Link to abstract ($ required for full-text): Association Between Radiation Therapy, Surgery, or Observation for Localized Prostate Cancer and Patient-Reported Outcomes After 3 Years – JAMA
Study 2 – Link to abstract ($ required for full-text): Association Between Choice of Radical Prostatectomy, External Beam Radiotherapy, Brachytherapy, or Active Surveillance and Patient-Reported Quality of Life Among Men With Localized Prostate Cancer – JAMA