Laparoscopic versus open radical prostatectomy in high prostate volume cases: impact on oncological and functional results

To prospectively compare the laparoscopic versus open approach to RP in cases with high prostate volume and to evaluate a possible diferente impact of prostate volume

A meta-analysis and systematic review of randomized controlled trials with degarelix versus gonadotropin-releasing hormone agonists for advanced prostate cancer

Our aim was to systematically evaluate the benefits of degarelix as antagonist versus agonists of gonadotropin-releasing hormones (GnRH) for the treatment of advanced prostate cancer (PC). This comparison was performed either in terms of biochemical or oncological or safety profiles. To this end we, carried out a systematic review and meta-analysis of the literature.We selected only studies directly and prospectively analyzing the two treatments in the same population (randomized phase III studies). We followed the Preferred Reporting Items for Systematic Reviews and meta-analyses process for reporting studies.After we eliminated studies according to the exclusion criteria, 9 publications were considered relevant to this review. These articles described 5 clinical trials that were eligible for inclusion. The follow-up duration in all trials did not exceed 364 days. This meta-analysis and review comprised a total of 1719 men, 1061 randomized to degarelix versus 658 to GnRH agonists treatment for advanced PC. Oncological results were evaluated only in 1 trial (CS21:408 cases) and they were not the primary endpoints of the study. Treatment emerging adverse events were reported in 61.4% and 58.8% of patients in the degarelix and GnRH agonists group, respectively (odds ratio, OR = 1.17; 95% confidence interval, 95% CI: 0.78-1.77, P > 0.1). Treatment related severe cardiovascular side effects were reported (trial CS21-30-35) in 1.6% and 3.6% of patients in the degarelix and GnRH agonists group, respectively (OR = 0.55, 95% CI: 0.26-1.14, P > 0.1).Our analysis evidences relevant limitations in particular for the comparative evaluation of the efficacy and the oncological results related to degarelix

Nowcasting the Italian unemployment rate with Google Trends

The Italian National Institute of Statistics, as well as most of the National Statistical Institutes in the world, produces forecasts of socio-economic indicators by means of statistical models that make no use of information from external sources and rely only the data provided by its own sample survey. In the field of Official Statistics, some studies have recently been conducted to assess whether online search data can be used to facilitate the estimation of phenomena of interest or to produce additional information, starting from data such as internet search data, whose main features are easy availability and low cost. Several studies have used the Google Trends (GT) time series for the nowcast of important short-term economic indicators. One of the most studied is the unemployment rate and specifically many studies have focused on the prediction of the youth unemployment rate because it is assumed that these use more than the others the online job search channel. The paper tries to verify the consistency of the time series available from GT and compare different models for the nowcast of the quarterly unemployment rate for different age categories, specifically 15-24, 25-34 and 35-49. Some analysis aimed at studying the volatility of the time series provided by GT are provided in the paper. The results show critical issues in terms of high variability for the GT time series, questioning the use of them for the production of Official Statistics. Furthermore, the nowcast results show that for each age category analyzed the best predictions are always those provided by the ARIMA model in which the exogenous variable is the GT query share. The results obtained also showed that the age category that has the greatest prediction improvements is the 25-34

GOOGLE TRENDS FOR NOWCASTING QUARTERLY HOUSEHOLD CONSUMPTION EXPENDITURE

During last years, several studies focused on the predictive capability of web data to forecast statistical indicators. Google Trends is a free web tool that quantify search-term volume on the search engine. The aim of this work is to forecast the household expenditures for consumption in Italy, using Google Trends related to particular expenditure keywords. Several prediction models have been tested, also including relevant leading indicators correlated to the household expenditures behavior, on a time series survey data from 2004 to 2016. The ARIMA model has been chosen and models with different lag structures have been tested. The model comparison shows that the results including Google data outperform those of both benchmark and augmented models

Recovery of urinary continence after radical prostatectomy using early vs late pelvic floor electrical stimulation and biofeedback-associated treatment

OBJECTIVE To compare the early vs late use of pelvic floor electrical stimulation (FES) plus biofeedback (BF) in terms of time to recovery and rate of continence after radical prostatectomy (RP). MATERIALS AND METHODS Between April 2007 and April 2012, a total of 120 patients who underwent RP were prospectively included in the study. In group 1 (60 cases), we included patients who presented a urinary leakage weight 50 g for 24 hours, 14 days after catheter removal. In group 2 (60 cases), we included patients who continued to present a urinary leakage weight 50 g for 24 hours, 12 months after surgery. In both groups, patients were prospectively submitted to the same program of BFþFES. RESULTS Mean leakage weight became significantly lower (P <.002) in group 1 than in group 2 starting from visit 1 (2 weeks) through visit 7 (24 weeks). However, a significant difference (P <.05) between the 2 groups in terms of percentage of continent patients was achieved only at 2 weeks (group 1 ¼ 20%; group 2 ¼ 0%) and 4 weeks (group 1 ¼ 66.7%; group 2 ¼ 46.7%). The objective continence rate 6 months after the beginning of treatment was 96.7% in group 1 and 91.7% in group 2. CONCLUSION In our experience, the treatment with BF and FES has a significant positive effect on the recovery of urinary continence independently to the time in which it is used (early vs delayed). This protocol might represent a noninvasive method for all patients undergoing RP, also in a 12- month interval from surgery

Prostate-specific antigen increase during dutasteride to indicate the need for prostate biopsy: influence of prostatic inflammation

The aim of this study was to analyze the significance of an increase in total prostate-specific antigen (PSA) serum levels despite dutasteride treatment as a predictor of prostate cancer (PC) at biopsy. We focused our attention on the rate of the first PSA increase and on the influence of prostatic inflammation

La FR.E.M.S. (FRequency modulated ElectroMagnetic neural Stimulation): una nuova prospettiva terapeutica per la neuropatia diabetica dolorosa degli arti inferiori

The FR.E.M.S. therapy represents an useful therapeutic remedy for the symptomatic management of the diabetic patients with a painful sensitive neuropathy

Efficacy and Safety of Etelcalcetide in Hemodialysis Patients with Moderate to Severe Secondary Hyperparathyroidism

Background. Secondary hyperparathyroidism (SHPT) is a major risk factor for cardiovascular events and all-cause mortality in hemodialysis (HD) patients. The purpose of our study was to evaluate the effects and tolerability of etelcalcetide in HD patients with SHPT. Methods. An observational study was conducted on 16 hemodialysis patients with SHPT treated with etelcalcetide. All patients were followed up for a duration of 6 months. The primary endpoints were the reduction in mean PTH ≥ 30% and ≥40% from baseline after 6 months of etelcalcetide. All patients were divided into two groups (group A versus group B) based on baseline serum PTH level prior to etelcalcetide: above and below the median serum PTH (1300 pg/mL), respectively. Results. After 6 months, a significant decrease in PTH levels was achieved by all patients receiving etelcalcetide (p = 0.015). Both primary endpoint of reduction in PTH ≥ 40% at 6 months (p = 0.01), and the secondary endpoint of reduction in median PTH values (p = 0.0001) and median percentage reduction in PTH values (p = 0.009) were significantly achieved in group A. In contrast, a greater decline of calcium (p = 0.028) and phosphorus was reached in group B than group A. Dialysis vintage ≥ 36 months, arteriovenous fistula (AVF)-based hemodialysis, post-diluition hemodiafiltration (HDF) method, and baseline values of PTH p = 0.015). The history of cinacalcet use negatively correlated with the possibility to reach therapeutic targets with etelcalcetide (OR 0.47, 95% CI 0.26–0.85, p = 0.031). Treatment with etelcalcetide was well tolerated and no adverse effects were observed. Conclusions. In our study, patients with low baseline PTH levels showed a better response to etelcalcetide than patients with higher PTH levels. Consequently, the possibility to reach desirable therapeutic targets could depend on SHPT severity at the time of initiation of therapy

Efficacy and Safety of Etelcalcetide in Hemodialysis Patients with Moderate to Severe Secondary Hyperparathyroidism

Background. Secondary hyperparathyroidism (SHPT) is a major risk factor for cardiovascular events and all-cause mortality in hemodialysis (HD) patients. The purpose of our study was to evaluate the effects and tolerability of etelcalcetide in HD patients with SHPT. Methods. An observational study was conducted on 16 hemodialysis patients with SHPT treated with etelcalcetide. All patients were followed up for a duration of 6 months. The primary endpoints were the reduction in mean PTH ≥ 30% and ≥40% from baseline after 6 months of etelcalcetide. All patients were divided into two groups (group A versus group B) based on baseline serum PTH level prior to etelcalcetide: above and below the median serum PTH (1300 pg/mL), respectively. Results. After 6 months, a significant decrease in PTH levels was achieved by all patients receiving etelcalcetide (p = 0.015). Both primary endpoint of reduction in PTH ≥ 40% at 6 months (p = 0.01), and the secondary endpoint of reduction in median PTH values (p = 0.0001) and median percentage reduction in PTH values (p = 0.009) were significantly achieved in group A. In contrast, a greater decline of calcium (p = 0.028) and phosphorus was reached in group B than group A. Dialysis vintage ≥ 36 months, arteriovenous fistula (AVF)-based hemodialysis, post-diluition hemodiafiltration (HDF) method, and baseline values of PTH < 1300 pg/mL can positively influence the achievement of the endpoints. Furthermore, the baseline PTH < 1300 pg/mL, among these variables, was the only one showing statistically significant relevance (OR 2.28, 95% CI 1.32–3.96, p = 0.015). The history of cinacalcet use negatively correlated with the possibility to reach therapeutic targets with etelcalcetide (OR 0.47, 95% CI 0.26–0.85, p = 0.031). Treatment with etelcalcetide was well tolerated and no adverse effects were observed. Conclusions. In our study, patients with low baseline PTH levels showed a better response to etelcalcetide than patients with higher PTH levels. Consequently, the possibility to reach desirable therapeutic targets could depend on SHPT severity at the time of initiation of therapy