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Biomedical subjects

Eduard Bercovich

Publications and source records attributed to Eduard Bercovich.

7 recordsLinked to original sources
PubMed2006

Impact of preoperative biofeedback on incontinence in cancer patients undergoing radical prostatectomy.

OBJECTIVE: Post-radical prostatectomy incontinence is mainly attributable to iatrogenic verify the importance of preoperative biofeedback (BFB) in an attempt to identify a strategy to improve postoperative urinary incontinence. MATERIALS AND METHODS: Ninety candidates (median age 68 years: range 49-75) for radical retropubic prostatectomy were evaluated. Forty-five patients underwent preoperative pelvic floor training (PFT) and BFB, whereas the remaining 45 (control group) had preoperative PFT only. Patients started PFT exercises two weeks before surgery and continued during the immediate postoperative period, after catheter removal (6-7 days after surgery), and thereafter at home. No adjuvant therapy was administered and all 90 patients were assessed at follow up visits timed 1, 3 and 6 months post surgery. RESULTS: Patients who were completely dry and without use of pads were defined as continent. At the 1-month follow-up, 6.6% (3/45) of both the PFT+BFB group and the PFT only arm were continent. After 3 months, the continence rate had increased to 33.3% (15/45) and 26.6% (12/45), respectively, and at 6-month follow-up, this percentage had further risen to 71.1% (32/45) in the former group and 66.6% (30/45) in the latter group. No significant differences were observed between the two arms during follow-up, but there was a statistically significant correlation between follow-up time and continence improvement in each group. CONCLUSIONS: Preoperative BFB associated with PFT does not significantly influence urinary continence recovery after radical prostatectomy.

Aged↗
PubMed2005

Relevance of urine telomerase in the diagnosis of bladder cancer.

CONTEXT: The identification of new molecular markers is one of the most challenging goals for the early detection of bladder cancer because available noninvasive methods have neither sufficient sensitivity nor specificity to be acceptable for routine use. OBJECTIVE: To develop a relatively simple, inexpensive, and accurate test that measures telomerase activity in voided urine to apply to large-scale screening programs for bladder cancer detection. DESIGN, SETTING, AND PARTICIPANTS: Case-control study conducted in 218 men (84 healthy individuals and 134 patients at first diagnosis of histologically confirmed bladder cancer), frequency matched by age and recruited between March 2003 and November 2004 in Italy. Urine telomerase activity was determined using a highly sensitive telomeric repeat amplification protocol (TRAP) assay. Urine samples were processed for cytological diagnosis and TRAP assay. The diagnosis of bladder cancer was based on bioptic and cystoscopic examinations. The performance of the TRAP assay to detect urine telomerase activity was compared with urine cytology as an aid to early cancer detection. Quantification of urine telomerase activity was conducted in a blinded manner. MAIN OUTCOME MEASURE: Sensitivity and specificity of TRAP to detect bladder cancer. RESULTS: Using a 50 arbitrary enzymatic unit cutoff value, we validated the results obtained in the pilot study. In the overall series, sensitivity was 90% (95% confidence interval [CI], 83%-94%) and specificity was 88% (95% CI, 79%-93%). Specificity increased to 94% (95% CI, 85%-98%) for individuals aged 75 years or younger. The same predictive capacity of telomerase activity levels was observed for patients with low-grade tumors or with negative cytology results. CONCLUSIONS: The present validation study demonstrated the ability of urine telomerase activity levels to accurately detect the presence of bladder tumors in men. This test represents a potentially useful noninvasive diagnostic innovation for bladder cancer detection in high-risk groups such as habitual smokers or in symptomatic patients.

Adult↗
PubMed2002

[Echo-dynamic study of female urinary incontinence: our experience with the use of tridimensional ultrasonography].

Traditional 2-D ultrasound is a fast, inexpensive, non-invasive procedure and may be used routinely for the pre and post-operative evaluation of patients with various grade of cystocele, but a new tool in ultrasound investigation is recently available: the 3D scan. Our aim is to assess the real usefulness of 3D scan in the evaluation of cystocele grade. 15 women with clinical and urodynamic findings of genuine stress incontinence and grade 2-3 cystocele (in accord to Baden-Walker grading) underwent both ultrasonographic 3D imaging and traditional 2D trans labial scan with Convex probe (3.5 Mh). Correct evaluation of the relationships between the bladder, urethrovesical junction, urethra and pubic bones at rest and when straining was correctly evaluated by 2D scan in all the women underwent the examination, whereas 3D scan did not let us exactly quantify the same anatomical defect. 3D ultrasound did not prove to be as useful as traditional trans-labial 2D ultrasound procedure to provide an objective demonstration of the mobility of the urethrovesical junction. A possible explanation is that the lack of reliability of 3D investigation is due to the impossibility of real-time scanning that make approximate the choice of the image to evaluate. In conclusion traditional ultrasound is up to now an important complementary evaluation for the study of female urinary incontinence which allows not only morphological documentation but can also improve our knowledge of function and anatomy of lower urinary tract. Finally it is basic to stress that a worldwide standardisation will be the starting point for the real success of this technique and, especially for the new 3D scan, it will be important to achieve this goal together a large amount of data to compare for defining the real importance of this investigation.

Female↗
PubMed2002

[Imaging of the prostate: traditional methods].

Transrectal prostatic ultrasonography is an inexpensive, non-invasive procedure which permits an accurate evaluation of the dimensions and echostructure of the prostate and seminal vesicles. Prostatic tumors may present as hypoechogenic (60-80%) or isoechogenic nodules (30%), the latter requiring the use of specific techniques, which increase the sensitivity and specificity of the procedure (contrast-enhanced color-power Doppler), to identify and characterize focal lesions. The color Doppler increases the predictive value of TRUS (62-75%) but has a low sensitivity, while the power Doppler enables us to study vessels with slow blood flow. The recent introduction of contrast medium could lead to an enhancement of the Doppler signal, thus increasing sensitivity of the exam; it is also, however, an expensive, invasive and time-consuming method. Improved test sensitivity has also increased the problems relating to the identification of very small prostatic lesions which are probably of low clinical significance.

Biopsy↗
PubMed2002

[Morbidity, tolerability, and number of samples in prostatic biopsy: our experience].

Transrectal prostatic ultrasonography with biopsy is a fundamental step in the diagnosis of prostate cancer. The number of bioptic samples taken has a direct influence on the sensitivity of the diagnostic procedure. We compared the degree of acceptance of the biopsy, using visual analogue scale, with the appearance of complications in two groups of 250 patients: group A (sextant biopsy) and group B (traditional transrectal prostatic biopsy + 2 additional lateral samples from each lobe). 21% of group A patients reported slight pain, 63% tolerable pain and 16% severe pain, while pain intensity of group B patients was 18%, 65% e 17%, respectively. The appearance and degree of painful symptomatology, and the frequency of serious complications were not significantly different in either group. The extensive prostatic biopsy is well tolerated by patients and is associated with modest local complications.

Aged↗
PubMedDate not supplied

Urine telomerase: an important marker in the diagnosis of bladder cancer.

Telomerase activity is present in most human malignant tumors, whereas it is generally not detectable, with some exceptions, in normal cells. Therefore, it represents a potential tool for tumor detection. In the present study, telomerase activity was determined in urine from 79 healthy individuals and 121 previously untreated bladder cancer patients using a highly sensitive telomeric repeat amplification protocol (TRAP) assay and the results were expressed as arbitrary enzymatic units (AEU). This approach enabled us to identify cutoff values characterized by high sensitivity (from 75% to 93%) and specificity (from 72% to 92%). Moreover, analysis as a function of gender showed a higher accuracy of TRAP assay in males (93% sensitivity and 90% specificity at the cutoff of 50 AEU) than in females. This sensitivity was confirmed in patients with nonassessable or negative cytology. In women, morphological and immunocytochemical determinations using a monoclonal antibody (anti-hTERT) recently developed in our laboratory showed a large fraction of immunoreactive inflammatory or nonbladder cells, which may justify the false-positive TRAP results. In conclusion, this assay represents an important noninvasive diagnostic tool to detect bladder cancer also in patients with negative or nonassessable urine cytology and with low-grade and early-stage lesions.

Biomarkers, Tumor↗