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Biomedical subjects

Edward M Schaeffer

Publications and source records attributed to Edward M Schaeffer.

10 recordsLinked to original sources
PubMed2026

The 'Prostate Cancer Screening for People at Genetic Risk of Aggressive Disease' (PATROL) study.

BACKGROUND: Inherited (germline) pathogenic and likely pathogenic variants (gPVs) in key genes associated with increased risk of prostate cancer (PCa) now warrant more attentive PCa screening per National Comprehensive Cancer Network (NCCN) guidelines-e.g., BRCA2, HOXB13, ATM, BRCA1, MSH2, MSH6, CHEK2 and TP53. However, the optimal early detection strategy for gPV carriers, including use of age-adjusted PSA thresholds and prostate imaging may be refined. and as a means to investigate novel biomarkers. STUDY DESIGN: 'Prostate Cancer Screening for People at Genetic Risk of Aggressive Disease' (PATROL) is a multicentre, prospective early detection study for individuals at increased risk for PCa due to carrying a gPV in a PCa risk gene. ENDPOINTS: The primary endpoint is to determine the positive predictive value of pre-defined age-directed prostate-specific antigen (PSA) level thresholds and prostate-specific imaging, e.g., multiparametric magnetic resonance imaging (MRI) for clinically significant PCa on biopsy for individuals at risk of PCa due to a gPV. Exploratory endpoints include characterising clinicopathological characteristics of PCa and patient-reported outcomes. Biospecimens will be collected to evaluate emerging clinical and research biomarkers. PATIENTS AND METHODS: Key eligibility includes: individuals aged &#x2265;40&#x2009;years who carry a gPV in an eligible gene, who have no prior diagnosis of PCa, do not have another active malignancy, and provide informed consent. Study procedures include annual physical examination and PSA. Imaging with MRI is optional at baseline and recommended if the PSA level is above the protocol-recommended PSA level threshold. Participants will be offered prostate biopsy for any clinical concern, PSA level >1.0&#x2009;ng/mL if aged <50&#x2009;years; PSA level >1.5&#x2009;ng/mL if aged 50-59&#x2009;years; PSA level >2.0&#x2009;ng/mL if aged &#x2265;60&#x2009;years. If PCa is diagnosed, clinical care is determined by the participant and treating physician. If opting for active surveillance, study procedures will be collected annually for 10&#x2009;years or until definitive treatment. If definitive treatment, study procedures will be collected for an additional 1&#x2009;year. Long-term clinical outcomes will be collected annually until the study closes.

Humans↗
PubMed2006

Duplex ultrasonography detects clinically significant anomalies of penile arterial vasculature affecting surgical approach to penile straightening.

OBJECTIVES: To determine the frequency of aberrant penile arterial anatomy in men with Peyronie's disease (PD) and the potential impact on the surgical approach to penile straightening. METHODS: A retrospective analysis of 63 consecutive men undergoing penile duplex ultrasonography in preparation for penile straightening surgery was performed. They were compared with a group of 61 men with erectile dysfunction (ED) undergoing penile duplex ultrasonography during the same period. RESULTS: Arterial anomalies distal to the pubic symphysis were noted in 44% of men with PD and 46% of men with ED. The most common anomaly observed was crossing cavernosal arteries seen in 37% of the men with PD and 39% of the men with ED. Distal perforators of the dorsal artery supplying the cavernosal bodies were observed in 10% and 8% of the men with PD and ED, respectively. No difference was found in the overall frequency or type of arterial anomalies between the two groups. CONCLUSIONS: Men with PD have a high prevalence of arterial anomalies, including distal perforating arteries. Their preoperative evaluation should include duplex ultrasonography with delineation of the penile arterial anatomy. This will aid in surgical planning and potentially prevent maneuvers that may adversely affect the cavernosal blood supply and place the patient at risk of postoperative ED.

Humans↗
PubMed2006

Clinical sequelae of radiographic iceball involvement of collecting system during computed tomography-guided percutaneous renal tumor cryoablation.

OBJECTIVES: Percutaneous renal tumor cryoablation is being evaluated as a treatment option for small renal tumors. However, when tumors are located centrally, involvement of the collecting system by the radiographic iceball can occur. We reviewed our series of computed tomography (CT)-guided percutaneous renal tumor cryoablation to identify those cases in which there appeared to be involvement of the collecting system by the radiographic iceball and to determine any clinical sequelae of such involvement. METHODS: Retrospective review of the medical records identified 6 patients who had undergone CT-guided percutaneous renal tumor cryoablation with evidence of collecting system involvement. Measurements of the tumor size, size of the radiographic iceball, and the size of the immediate postprocedure "cryozone" (region of apparent treatment on contrast-enhanced CT) were obtained from the preprocedure, intraprocedure, and immediate postprocedure CT scans. Follow-up imaging was obtained beginning at 3 to 6 months. RESULTS: Six patients were identified who met the inclusion criteria and had at least 3 months of documented follow-up. Despite the apparent involvement of the collecting system during the cryoablation procedure, no patient developed clinical signs or symptoms or radiographic evidence of a urine leak or fistula formation. Furthermore, no evidence of ureteral narrowing or stricture formation has been found to date, with a mean follow-up of 167.7 days (range 90 to 288). CONCLUSIONS: We observed no clinically appreciable urine leaks despite what appeared to be obvious involvement of the collecting system by the radiographic iceball. However, care should be exercised to avoid this insult when possible until additional research has confirmed its safety.

Adult↗
PubMed2006

Prophylactic use of antimicrobials in commonly performed outpatient urologic procedures.

An antimicrobial is an agent capable of killing or inhibiting the growth of a micro-organism. Antimicrobial prophylaxis encompasses efforts to prevent postprocedure infections through the use of an antimicrobial agent before, and, in some cases, for a limited time after a procedure. A thorough history and physical examination are essential to identify host factors that increase a patient's risk for postprocedural infection. Risk-modifying factors include age, anatomy, geographical area of residence, immune and nutritional status, cardiac valve integrity, prosthetic joints, the presence of indwelling hardware and distant infectious wounds. Prophylaxis for the most common urologic outpatient procedures can be attained with oral trimethoprim-sulfamethoxazole or fluoroquinolone administered between 2 h and 30 min before a procedure. Special consideration for the type and duration of prophylaxis should be given to patients with moderate to severe cardiac valvular conditions and recently inserted prosthetic joints.

Ambulatory Surgical Procedures↗
PubMed2006

Urinary markers in the detection of bladder cancer: what's new?

PURPOSE OF REVIEW: Bladder cancer is one of the most common genitourinary malignancies and is a potentially life-threatening diagnosis. For many patients, however, the diagnosis of bladder cancer entails a lifetime of vigilant, costly, and invasive surveillance for recurrent and/or progressive disease. In the context of relative limitations of the current standard of cystoscopy and cytology, there has been burgeoning activity in the development of novel molecular urine-based markers for bladder cancer detection. RECENT FINDINGS: A large number of candidate bladder cancer biomarkers have emerged as our understanding of the molecular pathogenesis of the disease has evolved. Many of these are in the relatively earlier phases of development but several have received the approval of the United States Food and Drug Administration for clinical use and are already being applied to patients in clinical practice. SUMMARY: Urine-based markers for bladder cancer detection represent an area of substantial innovation and discovery with potentially profound scientific, clinical, and economic implications. As more of these tests become standardized and undergo evaluation in large multicenter trials, it is conceivable that a novel marker or panel of markers will emerge as a major enhancement to the current standard of care.

Biomarkers, Tumor↗
PubMed2005

Laparoscopic retroperitoneal lymph node dissection: duplication of open technique.

Laparoscopic retroperitoneal lymph node dissection has been used to stage germ cell testicular cancer. Since its initial description, this minimally invasive procedure has evolved into a therapeutic operation that adheres to established strict oncologic principles. A modified template dissection that fully duplicates the open technique is now routinely performed at our institution. We describe and show in the accompanying video segments a laparoscopic modified template dissection.

Humans↗
PubMed2005

Adrenal myelolipoma.

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Adrenal Gland Neoplasms↗