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Riccardo Autorino

Publications and source records attributed to Riccardo Autorino.

At least 19 recordsLinked to original sources
PubMed2006

NeuroD1 expression in human prostate cancer: can it contribute to neuroendocrine differentiation comprehension?

OBJECTIVES: Neuroendocrine differentiation is a common feature of prostate cancer (pCA). NeuroD1 is a neuronal transcription factor able to convert epithelial cells into neurons. The aim of the study is to investigate NeuroD1 expression and compare it with chromogranin-A, synaptophysin, and CD56 staining in human prostate cell lines and surgical specimens. METHODS: We detected NeuroD1 gene expression, by duplex reverse transcriptase-polymerase chain reaction, in primary human prostate fibroblasts, in EPN, LNCaP, DU145, and PC3 cell lines before and after cAMP exposure, in 6 BPH and 11 pCA samples. Thereafter 166 paraffin sections from normal and neoplastic prostates were stained with NeuroD1, chromogranin-A, synaptophysin, and CD56 antibodies. The relationships between chromogranin-A and NeuroD1 and clinicopathologic parameters were evaluated by multivariate logistic regression analysis. RESULTS: NeuroD1 is inactive in baseline prostate cell lines and BPHs, whereas it is actively expressed in cAMP-treated EPN, PC3, and DU145 cells. In our surgical series, positive chromogranin-A, synaptophysin, CD56, and NeuroD1 staining was detected in 26.5%, 4.3%, 3.1%, and 35.5%, respectively (difference between chromogranin-A and NeuroD1: p<0.05). The multivariate analysis showed a strong association between chromogranin-A and microscopic perineural invasion (OR: 2.49; 95%CI, 0.85-7.32; p=0.097) and a high primary Gleason score (OR: 1.96; 95%CI, 1.14-3.39; p=0.015), whereas NeuroD1 expression strictly correlated to microscopic perineural invasion (OR: 2.97; 95%CI, 1.05-8.41; p=0.04). CONCLUSIONS: Expression of NeuroD1 versus chromogranin-A is more frequent in pCA, and correlates to increased indicators of malignancy in moderately to poorly differentiated pCA, and could be involved in the pathophysiology of the neuroendocrine differentiation of pCA.

Adenocarcinoma↗
PubMed2006

Are abstracts presented at the EAU meeting followed by publication in peer-reviewed journals? A critical analysis.

PURPOSE: Our goal was to assess the rate and time-course of peer-reviewed publication of abstracts presented at the European Association of Urology (EAU) Annual Meeting and to identify factors predictive of publication. METHODS: All abstracts accepted for presentation at the 2000 and 2001 EAU annual meetings were identified from the related published supplements in European Urology. The subsequent publication rate was estimated for the corresponding studies based on a scan of Medline covering a 5-year period following the meetings. We examined whether the following factors were associated with publication rate: research type, study subject, and country of origin. The analysis was performed using logistic regression of the dichotomous variable of publication versus non-publication and the candidate factors. RESULTS: Overall, 47.3% of 1406 abstracts presented at the EAU meetings were followed by publication in peer-reviewed journals. Pre-clinical research studies were more likely to be published than clinical studies (53.3% vs 45%, p<0.05). Prospective series were more likely to be published than retrospective ones (46.5% vs 32.2%, p<0.05). Studies presented at the meetings were mostly from Europe (74.2%). Mean time to publication was 8.6 months, and in most cases, the reports were published in The Journal of Urology and European Urology. The mean IF of journals where papers were published was 1.95. CONCLUSIONS: Almost half of the abstracts presented at the EAU are ultimately published in peer-reviewed journals, usually within 2 years after presentation. The publication rate differs significantly according to country of origin, study subject, and research type.

Abstracting and Indexing↗
PubMed2006

Quality of life in women with multiple sclerosis and overactive bladder syndrome.

The aim of this study was to evaluate the impact of symptoms of overactive bladder syndrome (OAB) on the quality of life (QoL) in female patients with or without multiple sclerosis (MS) and their correlation with findings from urodynamics (UDS). We enrolled 107 female patients with clinically definite MS and urinary symptoms of OAB. One-hundred female patients with similar OAB symptoms were used as a control group. Data on OAB symptoms, onset and progression, and results of any previous investigation were obtained, and any urinary complications were documented. A complete UDS investigation was performed. Health status assessment was obtained using the Kings Health Questionnaire. Results showed that urinary symptoms had a greater impact on the QoL in patients with MS. Nevertheless, the perception of the severity of these symptoms was minor in the MS group compared to the control group. No significant correlations were found between the dysfunctions as detected by UDS and the OAB symptoms in both groups. Recurrent urinary tract infections represented the main complication in the study population. In conclusion, OAB symptoms have a major impact on the QoL in patients with MS, even if their perception of QoL impairment remains limited. Optimal management in these subjects should include a complete UDS assessment.

Disability Evaluation↗
PubMed2006

Gyrus bipolar versus standard monopolar transurethral resection of the prostate: a randomized prospective trial.

OBJECTIVES: To compare bipolar plasmakinetic (PK) with standard monopolar transurethral resection of the prostate (TURP). METHODS: A total of 70 patients were prospectively randomized into two groups: 35 patients underwent PK TURP with the Gyrus device, and 35 patients underwent standard monopolar TURP. We evaluated the time to catheter removal and hospital discharge, operating time, blood loss, postoperative irrigation, complications, urinary flow rates, symptom relief, and postvoid residual volumes. RESULTS: At baseline, the study groups were comparable in age, prostate volume, mean prostate-specific antigen value, International Prostate Symptom Score, quality-of-life score, flow rate, and postvoid residual volume. The mean catheterization time was 72 and 100 hours in the PK and standard groups, respectively. This difference was statistically significant (P <0.05), as was the difference in the time to hospital discharge. No difference was found in the mean resection time, amount of resected tissue, or variations in hemoglobin and sodium levels. The improvement in flow rate, postvoid residual volume, International Prostate Symptom Score, and quality-of-life score was comparable between the two groups at 12 months of follow-up. CONCLUSIONS: In our experience, PK TURP showed comparable perioperative results to those obtained with standard TURP, but with more favorable postoperative outcomes. The resection time and blood loss were similar between the two groups, but the need for continuous bladder irrigation after surgery and time to catheter removal and hospital discharge were significantly shorter in the PK group.

Humans↗
PubMed2006

Medical expulsive treatment of distal-ureteral stones using tamsulosin: a single-center experience.

PURPOSE: To evaluate the efficacy of the addition of tamsulosin to our standard expulsive pharmacologic therapy for the treatment of distal-ureteral stones. PATIENTS AND METHODS: A series of 96 patients referred to our department for the management of symptomatic distal-ureteral calculi were randomly divided into group 1 (N = 46) who received diclofenac (100 mg/daily) plus aescin (80 mg/daily) and group 2 (N = 50) who received the same therapy plus tamsulosin (0.4 mg/daily) for a maximum of 2 weeks. There were no differences between the groups with respect to age, sex, or stone size. The primary endpoint was the expulsion rate. Expulsion time, need for analgesics, need for hospitalization, and drug side effects were the secondary endpoints. RESULTS: The expulsion rate was significantly higher in group 2 (90%) than in group 1 (58.7%; P = 0.01), and group 2 achieved stone passage in a shorter time (mean 4.4 v 7.5 days, respectively; P = 0.005). Lower analgesic use was found in group 2 (P = 0.003), as well as significantly fewer hospitalizations for recurrent colic (P = 0.01). Both groups experienced few side effects associated with expulsive therapy. CONCLUSIONS: A conservative approach should be considered as an option in the management of uncomplicated distal-ureteral stones. Even if the best pharmacologic expulsive regimen remains to be established, the use of the selective alpha-blocker tamsulosin is recommended in this setting.

Adrenergic alpha-1 Receptor Antagonists↗
PubMed2006

Fate of abstracts presented at the World Congress of Endourology: are they followed by publication in peer-reviewed journals?

PURPOSE: To estimate the acceptance rate of peer-reviewed journals, to describe the time course of subsequent full publication, and to identify those with characteristics associated with publication of the abstracts presented at the World Congress of Endourology (WCE). METHODS: All abstracts accepted for presentation at the 2001 and 2002 WCE meetings were identified from the published supplements to the Journal of Endourology. The subsequent publication rate for the corresponding studies was evaluated by scanning MEDLINE for the 5-year period after the meetings. RESULTS: Overall, 20.5% of the abstracts were followed by publication in peer-reviewed journals. Abstracts on transurethral, laparoscopic, and percutaneous procedures had the highest publication rates (25.5%, 25%, and 24.3%, respectively). Studies from North America had the highest publication rate (29.2%). The mean time to publication was 14.6 months. There was an 80% chance that an eventually published abstract was in print 2 years after presentation. The largest number of the reports were published in the Journal of Endourology (75 of 234; 32%), the official publication of the society that sponsors the WCE. CONCLUSIONS: Only one fifth of the abstracts presented at the WCE are ultimately published in peer-reviewed journals. Attendees should be aware of this limitation, and scientific committees should be encouraged to be more selective. Although presentation at major urological congresses constitutes an invaluable method for rapid scientific dissemination, abstracts contain data that usually are difficult to access and of questionable validity. In this respect, investigators are encouraged to publish their data.

Bibliometrics↗
PubMed2005

The use of tamsulosin in the medical treatment of ureteral calculi: where do we stand?

It has recently been demonstrated that specific adrenoceptors subtypes (alpha(1A)/alpha(1D)) are prevalent in the distal part of the ureter, a finding supporting the interesting results obtained by different groups with the use of tamsulosin in the treatment of distal ureteral calculi. We performed a prospective randomized study to evaluate the effects of the addition of tamsulosin on our standard pharmacological therapy for the treatment of selected ureteral stones. A total of 64 patients referred to our department for the management of symptomatic ureteral calculi were considered. Patients were randomly divided into two treatment groups: group A (n=32) who received diclofenac (100 mg/daily) plus aescin (80 mg/daily) and group B (n=32) who received the same therapy plus tamsulosin (0.4 mg/daily) for a maximum of 2 weeks. No significant differences were found between the groups for age, gender distribution and mean stone size measured in the single largest dimension at presentation. The stone expulsion rate was 60% (19/32 patients) for group A and 88% for (28/32) for group B with a mean expulsion time of 7.4+/-2.2 (range 3.5-12) and 4.8+/-2.7 days (range 1.8-10.5), respectively. Group B showed a significant advantage in terms of both expulsion rate (P=0.01) and expulsion time (P=0.005). Different analgesics from those used in the standard treatment regimen were required in ten patients in group A (31%) but only three patients in group B (9%). This difference was significant (P=0.003). Hospitalization for recurrent colic was needed in 21% of patients in group A (7/32) and in 9% in group B (3/32) (P=0.01). Only two patients in each group (6%) experienced minor side effects associated with the expulsive therapy. Our data confirm the efficacy of tamsulosin in the treatment of distal ureteral stones up to 1 cm. This selective alpha-blocker should therefore be included in the pharmacological regimen of patients when a conservative approach is considered in the treatment of ureteral lithiasis.

Adrenergic alpha-Antagonists↗
PubMed2005

Does the size of ureteral stent impact urinary symptoms and quality of life? A prospective randomized study.

OBJECTIVE: To evaluate the effect of stent diameter on patients' symptoms and quality of life (QoL) by using dedicated questionnaires. METHODS: We prospectively enrolled 34 patients with unilateral ureteral obstruction due to urinary stone undergoing to ureteral stenting (17 pts with 4.8 F and 17 pts with 6 F) before treatment of stone disease. Twenty-one patients with lower urinary symptoms from other causes were used as a control group. Two questionnaires, one on QoL and another on stent specific symptoms, were administered to patients one week after stent positioning and 4 week after removal. RESULTS: There was a significant association between stent state and answers on pain and discomfort on QoL questionnaire. A high percentage of patients reported anxiety and depression associated with the stent. Similar significant association was found between stent state and urinary symptoms and pain. No differences in QoL and urinary symptoms and pain were detected using stents with different size. CONCLUSIONS: Ureteral stents are invariably associated with urinary symptoms and impaired QoL. We did not find any difference between stent with different size, whereas there was a tendency for stent with smaller diameter to dislodge more often.

Adult↗
PubMed2005

Dynamic sentinel node biopsy in clinically node-negative penile cancer versus radical inguinal lymphadenectomy: a comparative study.

OBJECTIVES: To evaluate the reliability and morbidity of dynamic sentinel node biopsy compared with radical inguinal lymphadenectomy (RIL) in the treatment of selected patients with squamous cell penile carcinoma. METHODS: We retrospectively considered patients with clinically node-negative Stage pT2-pT3 penile cancer. From 1994 to 2000, 48 patients (group 1, mean age 63 years) underwent penectomy and, after 4 weeks, prophylactic bilateral RIL. From 2001 to 2004, 22 patients (group 2, mean age 67 years) underwent penectomy and dynamic sentinel node biopsy. After 4 weeks, bilateral RIL was performed. RESULTS: In group 1, nodal disease was found in 39.6% of the patients. Early complications occurred in 21 patients (47.5%), with the most common being seroma formation. Late complications occurred in 18 patients (37.5%), with the most common being leg edema. In group 2, preoperative lymphoscintigraphy revealed no sentinel nodes in 1 patient, unilateral sentinel nodes in 7, and bilateral nodes in 14. A total of 35 sentinel nodes were seen in 42 inguinal regions (mean 0.83), including 27 (77.2%) identified with the probe and blue dye and 8 (22.8%) located with the probe only. Metastases were noted in 8 (36.4%) of 22 patients, bilaterally in 4 of them. Early minor complications occurred in 3 patients (13.6%). The technique had an 89% negative predictive value and 90% sensitivity. CONCLUSIONS: The results of this study have shown that dynamic sentinel node biopsy is a minimally invasive technique that is easy to perform, with similar results to those of RIL, but lower morbidity. This procedure offers the possibility of less-extensive surgery for clinically node-negative penile carcinoma.

Carcinoma, Squamous Cell↗
PubMed2005

Efficacy of tamoxifen and radiotherapy for prevention and treatment of gynaecomastia and breast pain caused by bicalutamide in prostate cancer: a randomised controlled trial.

BACKGROUND: Gynaecomastia and breast pain are frequent adverse events with bicalutamide monotherapy, and might cause some patients to withdraw from treatment. We aimed to compare tamoxifen with radiotherapy for prevention and treatment of gynaecomastia, breast pain, or both during bicalutamide monotherapy for prostate cancer. METHODS: 51 patients were randomly assigned to 150 mg bicalutamide per day, 50 patients to 150 mg bicalutamide per day and to 10 mg tamoxifen per day for 24 weeks, and 50 patients to 150 mg bicalutamide per day and radiotherapy (one 12-Gy fraction on the day of starting bicalutamide). 35 of the 51 patients allocated bicalutamide alone developed gynaecomastia or breast pain and were subsequently randomly allocated to tamoxifen (n=17) or radiotherapy (n=18) soon after symptoms started (median 180 days, range 160-195). Gynaecomastia and breast pain were assessed once a month. Severity of gynaecomastia was scored on the basis of the largest diameter. Breast pain was scored as none, mild, moderate, or severe. The primary outcome was frequency of gynaecomastia or breast pain; secondary outcomes were safety and tolerability, relapse-free survival, as assessed by concentration of prostate specific antigen, and quality of life. Analyses were by intention to treat. RESULTS: 35 of 51 patients assigned bicalutamide alone developed gynaecomastia, compared with four of 50 assigned bicalutamide and tamoxifen (odds ratio [OR] 0.1 [95% CI 0.08-0.12], p=0.0009), and with 17 of 50 assigned bicalutamide and radiotherapy (0.51 [0.47-0.54], p=0.008). Breast pain was seen in 29 of 51 patients allocated bicalutamide alone, compared with three allocated bicalutamide and tamoxifen (0.1 [0.07-0.11], p=0.009), and with 15 allocated bicalutamide and radiotherapy (0.43 [0.40-0.45], p=0.02) In 35 patients assigned bicalutamide alone who subsequently developed gynaecomastia, breast pain, or both, tamoxifen significantly reduced the frequency of gynaecomastia (0.2 [0.18-0.22], p=0.02). INTERPRETATION: Antioestrogen treatment with tamoxifen could help patients with prostate cancer to tolerate the hypergonadotropic effects of bicalutamide monotherapy.

Aged↗
PubMed2005

Management of gynaecomastia in patients with prostate cancer: a systematic review.

Patients with prostate cancer are increasingly being offered treatment with non-steroidal antiandrogen monotherapy, which offers potential quality-of-life benefits compared with other treatment. Non-steroidal antiandrogens directly antagonise androgen action in breast tissue, and indirectly increase the oestrogen concentration. Thus, the most troublesome side-effects of monotherapy with these drugs are gynaecomastia and breast pain. Patients younger than 60 years of age, who might not have symptoms of prostate cancer, are probably more concerned about their body image and the development of enlarged breasts than are those older than 60 years. Clinicians who seek a treatment for prostate cancer need information on simple and well-tolerated options for the management of gynaecomastia and breast pain. In this review, management options for gynaecomastia caused by hormonal manipulation in patients with prostate cancer are discussed.

Androgen Antagonists↗
PubMed2005

How to decrease pain during transrectal ultrasound guided prostate biopsy: a look at the literature.

PURPOSE: There is growing interest among urologists on the need for decreasing pain during transrectal ultrasound (TRUS) guided prostate biopsy. MATERIALS AND METHODS: We performed a systematic MEDLINE search of clinical trials of any kind of anesthesia, analgesia or sedation during TRUS guided prostate biopsy published since 2000. We critically analyzed the impact of pain and discomfort associated with the procedure, the described methods for evaluating it and the different techniques that have been described. RESULTS: There is strong evidence in the current literature that patient tolerance and comfort during TRUS guided prostate biopsy can be improved by anesthesia/analgesia. What remains is the need to urge all urologists to introduce it in clinical practice as a routine part of the procedure, whatever the biopsy scheme. CONCLUSIONS: Of the various options periprostatic anesthetic infiltration has been shown to be safe, easy to perform and highly effective. It should be considered the gold standard at the moment, even if the optimal technique remains to be established. Further studies addressing this issue are warranted.

Anesthetics↗
PubMed2005

Gynecomastia and breast pain induced by adjuvant therapy with bicalutamide after radical prostatectomy in patients with prostate cancer: the role of tamoxifen and radiotherapy.

PURPOSE: We investigated the role of tamoxifen and radiotherapy (RT) for the prevention and treatment of gynecomastia and breast pain during adjuvant bicalutamide monotherapy after radical prostatectomy (RP) in patients with prostate cancer. Also, we evaluated their effects on patient hormonal status, quality of life (QOL), sexual function and prostate specific antigen relapse-free survival. MATERIALS AND METHODS: This was a multicenter prospective trial. From January 2002 to February 2004, 102 patients who had undergone RP for localized or locally advanced prostate cancer were recruited and randomized into 3 groups, namely group 1-those receiving only 150 mg bicalutamide as adjuvant hormonal therapy, group 2-those receiving bicalutamide and 10 mg tamoxifen, and group 3-those receiving bicalutamide and RT. Patients in group 1 in whom gynecomastia or breast pain developed were subsequently randomized to receive tamoxifen or RT soon after symptoms started. Gynecomastia, breast pain, prostate specific antigen, QOL, sexual function and hormonal levels were assessed. Minimum followup was 12 months. RESULTS: Of group 1 patients 67% had gynecomastia compared with 8% in group 2 and 34% in group 3. Breast pain was more frequent in group 1 than in groups 2 and 3 (58% vs 7% and 30%, respectively). Differences were significant between groups 1 and 2 (OR 0.12 p <0.001), and groups 1 and 3 (OR 0.52 p < 0.01). In patients in group 1 who had gynecomastia or breast pain a significant decrease in symptoms was achieved in those receiving tamoxifen (p <0.05). Treatments were well tolerated in the 3 groups. No differences in QOL between groups 2 and 3 were found. At a median followup of 26 months we observed 12 biochemical relapses. CONCLUSIONS: Gynecomastia and breast pain induced by bicalutamide monotherapy after RP can be prevented and treated. Tamoxifen has been shown to be more effective and safe than RT in this setting. QOL and sexual function are not negatively influenced by these 2 treatment options.

Aged↗
PubMed2005

Renal cell carcinoma with solitary toe metastasis.

Solitary metastases to the small bones and/or to the soft tissue of the hands and feet (acrometastases) are rare. We report a case of renal cell carcinoma (RCC) with big toe metastasis revealed before the primary tumor became apparent. The best treatment for a single metastasis is always surgical excision, regardless of the lesion being synchronous or metachronous. The biological behavior of metastatic RCC is unpredictable and only early diagnosis and treatment may favorably affect patient survival. Thus, metastatic RCC should be included in the differential diagnosis of all enlarging cutaneous nodules, wherever they develop.

Aged↗
PubMed2005

Orbital metastasis as a first indication of prostate cancer: a case report.

Prostatic carcinoma accounts for only 3.6% of orbital metastases encountered in clinical practice. We report the clinical presentation and response to treatment of a patient with metastatic prostatic carcinoma to the sella turcica. A 73-year-old man presented with a three-months history of progressive right proptosis associated with increasing diplopia in down-gaze and slightly decreased visual acuity. Gadolinium-MRI scans of the head revealed a left osteoblastic intrasellar mass, displacing the pituitary gland. Laboratory testing revealed a serum PSA level of 22 ng/ml. Transrectal ultrasound-guided biopsy revealed prostatic adenocarcinoma (Gleason score 4+3) in both lobes of the prostate. A bone scan was performed showing that the patient had multiple secondary bony lesions. Total androgen blockade was initiated. Moreover, he was referred for radiotherapy of this metastatic lesion to the sella turcica. The visual complaints regressed dramatically within the first month of the treatment. A follow-up MRI scan at 6 months showed almost complete involution of the orbital metastatic process. However the disease subsequently progressed and the patient died 22 months after diagnosis.

Adenocarcinoma↗
PubMed2004

Stent positioning after ureteroscopy for urinary calculi: the question is still open.

OBJECTIVES: We conducted a study to assess the need for routine ureteral stenting after ureteroscopic stone removal using Lithoclast pneumatic intracorporeal lithotripsy. MATERIALS AND METHODS: A total of 104 patients, prospectively divided in two groups to receive (group A, 52 patients) or not (group B, 52 patients) a stent after stone removal, underwent ureteroscopy for the treatment of ureteral lithiasis. The procedure was performed with the patient under either general or epidural anesthesia. A semirigid ureteroscope (Wolf 8.9 Fr) was used in all cases and intracorporeal lithotripsy with ballistic energy was performed. In group A a double pigtail ureteral 4.8 or 6 Fr polyurethane stent was placed following ureteroscopy. All patients were closely evaluated on follow-up examinations. The outcomes measured were postoperative patient pain, lower urinary tract symptoms, the need for hospital care as a result of the postoperative pain and late postoperative complications. RESULTS: The two patient groups were comparable with respect to the baseline variables of patient gender and age, stone location and mean stone size. Mean operative time plus or minus standard deviation (S.D.) in group A was 42 +/- 15 minutes (range 20-65) compared to 37 +/- 20 (range 15-60) in group B. Operative time was not significantly longer when a stent was placed (p = 0.17). At day 3 the mean visual analog pain score in group B was much higher than in group A (p = 0.01). Dysuria, hematuria and frequency/urgency were more prevalent in the stented group, although without statistically significant difference. Readmission to the hospital for unremitting pain was necessary in 12 of 104 patients (11.5%) all being in unstented group (p < 0.05). The incidence of anatomical ureteral narrowing on IVP at 6 months follow-up was not statistically different between the two groups. CONCLUSIONS: In our experience, using Swiss Lithoclast ballistic energy to fragment stones, routine stent placement is advisable also after uncomplicated ureteroscopic lithotripsy without ureteral dilation. Further prospective randomized studies are needed to assess the role of stenting after ureteroscopic lithotripsy, considering different energies sources, scopes, diameter and site of the stones in the ureter.

Adult↗