How to conduct a successful workshop: The trainees' perspective

Objectives To define the success of a medical workshop from the trainees' perspective, where a medical workshop is a scientific event with the aim of presenting updated knowledge and to teach medical skills to the participants. In surgical specialties, it contributes to the development and maintenance of surgical skills. Methods Medline was searched for the previous 4 months to identify articles with combinations of the keywords 'workshops', 'training', 'simulators', and 'virtual reality'. Further articles were obtained by manually searching the reference lists of identified papers. We also obtained information and critical aspects of view from other trainees. Results Based on 30 articles from the Medline search, and mostly from the trainees' perspective, we present the basic characteristics of a successful workshop. The objective of the workshop, appropriate faculty members and presenters, highly motivated participants, the use of simulators and evaluation sheets, the venue and the registration fees all have a major role in the success of a workshop. Conclusions A successful workshop is that from which trainees have grasped most of the knowledge and skills imparted to them, with a positive progression reflected on their learning curve. Workshops are a current necessity and all efforts should be made to achieve the desired result from the trainees' perspective. © 2013 Production and hosting by Elsevier B.V. on behalf of Arab Association of Urology

Measurement of PSA density by 3 imaging modalities and its correlation with the PSA density of radical prostatectomy specimen

Objective: To evaluate the difference between the PSA density (PSAD) calculated with 3 imaging modalities and the PSAD of the radical prostatectomy specimen. Materials and methods: The PSAD of 60 men with clinically localized prostate cancer was calculated with transabdominal ultrasound (TAUS), transrectal ultrasound (TRUS), and computed tomography (CT) before radical retropubic prostatectomy, and was compared with the PSAD of the surgical specimen using the paired t-test. The relationship of the real prostate volume and the difference between the PSAD calculated with the 3 imaging modalities and that of the PSAD of the specimen was analyzed using Pearson's correlation coefficient. Finally, the sensitivity of PSAD calculated with the examined imaging modalities and the specimen was also studied. Results: The mean difference between the PSAD calculated by each one of the 3 imaging modalities and the PSAD of the specimen was -0.01 ng/ml/cm3 (P = 0.28) for TAUS, 0.01 ng/ml/cm3 (P = 0.37) for TRUS, and -0.03 ng/ml/cm3 (P = 0.001) for CT. This difference has not been shown to depend on the real prostate volume according to Pearson's correlation coefficient, which was 0.056 (P = 0.673) for TAUS, -0.014 (P = 0.917) for TRUS, and 0.184 (P = 0.159) for CT. The sensitivity of PSAD calculated with TAUS, TRUS, and CT was 58.3%, 65%, and 45%, respectively, while that of the specimen was 70%. Conclusions: Although PSAD showed a moderate sensitivity, TRUS and TAUS are the imaging modalities that calculate it closer to the real PSAD of the specimen. © 2013 Elsevier Inc

Thromboprophylaxis and bleeding diathesis in minimally invasive stone surgery

With populations ageing and active treatment of urinary stones increasingly in demand, more patients with stones are presenting with an underlying bleeding disorder or need for regular thromboprophylaxis, by means of antiplatelet and other medication. A practical guide to thromboprophylaxis in the treatment of urinary tract lithiasis has not yet been established. Patients can be stratified according to levels of risk of arterial and venous thromboembolism, which influence the requirements for antiplatelet and anticoagulant medications, respectively. Patients should also be stratified according to their risk of bleeding. Consideration of the combined risks of bleeding and thromboembolism should determine the perioperative thromboprophylactic strategy. The choice of shockwave lithotripsy, percutaneous nephrolithotomy or ureteroscopy with laser lithotripsy for treatment of lithiasis should be determined with regard to these risks. Although ureteroscopy is the preferred method in high-risk patients, shockwave lithotripsy and percutaneous nephrolithotomy can be chosen when indicated, if appropriate guidelines are strictly followed. © 2014 Macmillan Publishers Limited. All rights reserved

The Role of PCA 3 as a Prognostic Factor in Patients with Castration-resistant Prostate Cancer (CRPC) Treated with Docetaxel

AIM: To investigate potential fluctuations in prostate cancer antigen 3 (PCA 3) scores in castration-resistant prostate cancer (CRPC) patients treated with docetaxel and investigate the assay as a potential prognostic factor. PATIENTS AND METHODS: This was a prospective observational cohort study. Inclusion criteria included patients on hormonal treatment who were recently diagnosed with CRPC. Exclusion criteria included patients previously having radical treatment (surgery or radiotherapy) and patients who have completed the first cycle of chemotherapy. All urine samples were collected and analyzed using the Progensa(R) assay. Samples were collected before starting chemotherapy and at 12 months. A prospective database was created including routine blood tests, prostate staging and prostate-specific antigen (PSA) levels throughout the study period. The effects of chemotherapy were also recorded. RESULTS: Between January 2010 and February 2013, 12 patients were included in the study out of an initial cohort of 23 patients with CRPC. Mean follow-up was 14.8 months. Mean age at CRPC diagnosis was 73.8 years (+/-3.6 SD). Mean Gleason score was 8, with PSA 84.23 ng/ml (+/-158 SD). Mean duration of androgen deprivation treatment (ADT) was 45.16 months (+/-34.9 SD). Mean time to castrate-resistant state was 46.58 months (+/-35.3 SD). All twelve (n=12, 100%) patients had non-assessable PCA 3 scores at baseline and at 12 months follow-up. As a direct consequence, statistical analysis was not performed as the anticipated change in PCA 3 scores was not identified and correlation between measurable differences was not possible. All patients tolerated chemotherapy and completed the scheduled cycles with no serious adverse effects. CONCLUSION: To our knowledge, this is the first prospective study to demonstrate lack of expression of PCA3 in CRPC, with the result apparently not influenced by chemotherapy. There appears to be a strong association between hormonal treatment and lack of PCA 3 expression. It is still unknown whether disease progression per se affects PCA 3 scores. The gradual reduction and eventual complete non-expression of PCA 3 with ongoing treatment and disease progression provide an insight towards molecular pathways that may be connected to castration-resistant state