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How to reduce bacillus Calmette-Guerin discontinuation in patients with severe functional impairment

Current Urology 2022年第3期16卷 160-167页

作者： Luca Di Gianfrancesco Mauro Ragonese Massimiliano Foti Giuseppe Palermo Emilio Sacco pierfrancesco bassi Marco Racioppi Clinica Urologica Fondazione Policlinico Universitario"Agostino Gemelli"IRCCS-Università Cattolica del Sacro Cuore di RomaRome800168Italy

Background:Severe functional impairment is often considered a contraindication to intravesical therapy for nonmuscle-invasive bladder cancer(NMIBC).A tailored intravesical bacillus Calmette-Guérin(BCG)procedure was evaluated in high-risk(HR)-NMIBC patients with severe functional *** and methods:Patients with a Katz Index score of 2 or less and an initial diagnosis of HR-NMIBC with atraumatic insertion of a Foley-type indwelling catheter,bladder emptying,and BCG instillation were prospectively treated;after 2 hours,the bladder was emptied and the catheter was removed(group A).After propensity score matching,52 patients in group A were compared with that of 52 consecutive patients in group B using a retrospective database,with similar baseline/oncological characteristics and treated with standard intermittent ***,groups A and B were compared with that of 130 consecutive patients(group C)retrospectively evaluated,with similar oncological characteristics but with a Katz Index score of 3 or greater and treated with standard intermittent ***:The discontinuation rates were 11.5%,35%,and 9%in groups A,B,and C,respectively(A vs.B,log-rank score 42.52[po0.05]).The overall adverse event rates were 38.5%,57.7%,and 39.2%,respectively(A vs.B,p=0.04;B vs.C,0.03;A vs.C,0.92).The rates of severe adverse events were 1.9%,1.9%,and 1.5%,respectively,without statistically significant *** cumulative HR disease-free survival rates were 63.4%,48%,and 69.2%,respectively(A vs.B,log-rank score 154.9[p<0.05];B vs.C,415[p<0.05];A vs.C,244[p<0.05]).Conclusions:A tailored intravesical instillation procedure may reduce BCG discontinuation and adverse effects.

关键词： Intravesical bacillus Calmette-Guérin Discontinuation rate Adverse event Tailored procedure Severe functional impairment

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The indispensable role of urinalysis for patients undergoing treatment for nonmuscle invasive bladder cancer

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Current Urology 2022年第3期16卷 172-174页

作者： Luca Di Gianfrancesco Mauro Ragonese Giuseppe Palermo Emilio Sacco Foschi Nazario pierfrancesco bassi Marco Racioppi Clinica Urologica Fondazione Policlinico Universitario"Agostino Gemelli"IRCCS-UniversitàCattolica del Sacro Cuore di RomaRome800168Italy

Despite several efforts in the search for noninvasive biomarkers to provide prognostic information for noninvasive muscle bladder cancer,none have shown significant *** this context,standard urinalysis is still necessary to provide many *** method is an inexpensive,simple,and easy-to-repeat tool to follow-up patients over *** does not fall within study protocols and allows evaluation of the immune activation/response(even if indirectly).As such,this method can certainly provide useful information for prognosis.

关键词： Urinalysis Immune system Bacteriuria Prognosis Inflammatory response Microbiome

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Pioneering drugs for overactive bladder and detrusor overactivity: Ongoing research and future directions

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World Journal of Obstetrics and Gynecology 2015年第2期4卷 24-39页

作者： Emilio Sacco Salvatore Recupero Riccardo Bientinesi Giuseppe Palermo Daniele D'Agostino Diego Currò pierfrancesco bassi Urologic Clinic Department of Surgical Sciences "Agostino Gemelli" Hospital Catholic University Medical School 00168 Rome Italy Institute of Pharmacology Catholic University Medical School 00168 Rome Italy

The ongoing research on pioneering drug candidates for the overactive bladder （OAB） aimed to overcome the limitations of currently licensed pharmacotherapies, such as antimuscarinics, β3-adrenergic agents, and botulinum neurotoxin, has been reviewed performing a systematic literature review and web search. The review covers the exploratory agents alternative to available medications for OAB and that may ultimately prove to be therapeutically useful in the future mana-gement of OAB patients based on preclinical and early clinical data. It emerges that many alternative pharmacological strategies have been discovered or are under investigation in disease-oriented studies. Several potential therapeutics are known for years but still fnd obstacles to pass the clinical stages of development, while other completely novel compounds, targeting new pharmacological targets, have been recently discovered and show potential to translate into clinical therapeutic agents for idiopathic and neurogenic OAB syndrome. The global scenario of investigational drugs for OAB gives promise for the development of innovative thera-peutics that may ultimately prove effective as first, combined or second-line treatments within a realistic timescale of ten years.

关键词： Detrusor overactivity Drug therapy Lower urinary tract symptoms Overactive bladder Urinary incontinence

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