Operative mortality after nephrectomy for renal cell carcinoma

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldOBJECTIVE: To study the rate and causes of operative and treatment-related mortality after nephrectomy for renal cell carcinoma (RCC) in Iceland. MATERIAL AND METHODS: This retrospective population-based study included all patients who underwent nephrectomy for RCC in Iceland between 1971 and 2000. Patients who died <30 days after the operation were analyzed and compared to those who survived surgery. Disease stage, tumor size, patient age and preoperative American Society of Anesthesiologists classification were compared between the two groups. Autopsy records were examined to determine the causes of death. RESULTS: During the study period 880 patients were diagnosed with RCC and 575 (65%) of them underwent a nephrectomy, 116 (20%) with palliative intent. Operative mortality (OM) was 2.8% and did not change during the 30-year period. Patients with OM were significantly older than those without (73 vs 64 years, respectively) but disease stage, tumor size, ASA classification and gender were comparable between the groups. OM was comparable for patients operated on with palliative (3.4%) vs. curative (2.6%) intent (ns). Median time of death was 10 days postoperatively but no patient died intraoperatively. Causes of death were peri- and postoperative bleeding in five patients, infection/sepsis in four, arrhythmia in three, acute renal failure in two, pulmonary embolism in one and multiorgan failure in one. CONCLUSIONS: OM after nephrectomy for RCC has remained low during the past three decades in Iceland. It is most often caused by perioperative bleeding and infections. We find that the low OM in patients with metastases gives support to the use of palliative nephrectomy as a treatment option when other forms of treatment have failed

To Alfred Deakin

OBJECTIVE: One prerequisite for performing multicentre studies is that the clinical handling of the patients must be uniform. We therefore evaluated possible differences in pretreatment evaluation, surgical treatment and follow-up regimes between the Nordic countries and between the different departments that performed nephrectomy due to renal cell carcinoma. MATERIAL AND METHODS: A questionnaire comprising 21 different questions was sent to all hospitals in the five Nordic countries performing nephrectomy. The questionnaires were returned by 195/226 (86%) departments. RESULTS: In total, 24% of the departments performed fewer than five tumour nephrectomies per year. The main differences were as follows. I.v. pyelography was never used in Finland in clinics with urologists while preoperative CT scans were performed by most departments and in most countries. Cytology/biopsy examinations were never used in urological clinics in Finland and Iceland in contrast to 31% of urological clinics in Denmark. In Finland, 69% of the departments performed nephrectomy in patients with multiple distant metastases, compared to only 15% in the other Nordic countries. Follow-up after nephrectomy was done in 38% of Danish departments and in 96% of departments in the other Nordic countries. CONCLUSION: There were evident differences between the urological/surgical departments in the five Nordic countries, especially concerning radiological evaluation, treatment of patients with metastases and postoperative follow-up

Changes in attitudes, practices and barriers among oncology health care professionals regarding sexual health care: Outcomes from a 2-year educational intervention at a University Hospital

To access publisher's full text version of this article click on the hyperlink at the bottom of the pagePurpose: To examine the attitudes, practices and perceived barriers in relation to a sexual health care educational intervention among oncology health care professionals at the Landspitali-National University Hospital of Iceland. Methods: The design was quasi experimental, pre- post test time series. A comprehensive educational intervention project, including two workshops, was implemented over a two year time period. A questionnaire was mailed electronically to all nurses and physicians within oncology at baseline (T1, N = 206), after 10 months (T2, N = 216) and 16 months (T3, N = 210). Results: The response rate was 66% at T1, 45% at T2 and 38% at T3. At all time points, the majority of participants (90%) regarded communication about sexuality part of their responsibilities. Mean scores on having enough knowledge and training, and in six of eight practice issues increased significantly over time. Overall, 10-16% reported discussing sexuality-related issues with more than 50% of patients and the frequency was significantly higher among workshop attendants (31%) than non-attendants (11%). Overall, the most common barriers for discussing sexuality were "lack of training" (38%) and "difficult issue to discuss" (27%), but the former barrier decreased significantly by 22% over time. Conclusions: The intervention was successful in improving perception of having enough knowledge and training in providing sexual health care. Still, the issue remains sensitive and difficult to address for the majority of oncology health care professionals. Specific training in sexual health care, including workshops, should be available to health care professionals within oncology. (C) 2015 Elsevier Ltd. All rights reserved.Novartis Sanof

Carved tree at Molong, New South Wales, 2001, 8 [picture] /

Title devised by cataloguer based on acquisition documentation.; On panel: Most useful native, Wiradjuri, Molong, New South Wales, 2001.; Part of the collection: Cage of ghosts, 1994-2006.; Inscriptions: "A most useful native, Wiradjuri, Molong, NSW, 2001, Grave and Carved trees"--Exhibition caption.; Also available in electronic version via the Internet at: http://nla.gov.au/nla.pic-vn4268350-s9; Donated through the Australian Government's Cultural Gifts Program by Jon Rhodes, 2007.; Exhibited: Cage of Ghosts, National Library of Australia, Canberra, 27 September to 25 November 2007

Australian Inland Mission Old Timers Homes, Birdsville, with the roof damaged, Queensland, ca. 1969 [transparency] /

Location identified from sign in image.; Mould spots.; Part of The Reverend Andrew Leslie McKay collection of photographs relating to Inland Australia, 1950-1976.; This location also appears in PIC/9193/624, 637, 638 and 639.; Also available in an electronic version via the internet at: http://nla.gov.au/nla.pic-vn4181545; Collection donated by Mrs Lyn McKay, widow of Reverend Les McKay, through their daughter Dr. Judith McKay

Protein expression within the human renal cortex and renal cell carcinoma: The implication of cold ischemia

To access Publisher full text version of this article. Please click on the hyperlink in Additional LinkCold ischemia of tissue during tissue treatment may influence protein expression, but has not been well studied. Better understanding of this is fundamental prior to using stored fresh-frozen tissue where the time from organ harvest until tissue collection and storage is most often not documented. We collected samples from normal renal cortex and cancerous tissues at serial time points for up to 60 min from three nephrectomized individuals with newly diagnosed clear cell renal cell carcinoma (RCC). Samples were processed onto protein chips and identified using surface-enhanced laser desorption/ionization- time of flight mass spectrometry (SELDI). The number and size of proteins expressed at separate sites within homogenous tissue sections were comparable. Cold ischemia time neither affected the number nor the size of proteins expressed. While the quantity of most proteins was similar between separate sites and unaffected by cold ischemia time, we noted variation in the quantity of some proteins compared to duplicate measurements. Such variation was noted between separate samples collected at same cold ischemia time points. Taken together, these data indicate that cold ischemia time for up to 60 min does not influence the number or size of proteins expressed within renal tissue. © Mary Ann Liebert, Inc

Four little johnnycakes [music] /

B.7932 (Publisher number). Also available online http://nla.gov.au/nla.mus-vn2928194; MUS: N, MUS/339/118

A genome-wide study of allelic imbalance in human testicular germ cell tumors using microsatellite markers

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldTesticular germ cell tumors (TGCT) arise by multistep carcinogenesis pathways involving selective losses and gains of chromosome material. To locate cancer genes underlying this selection, we performed a genome-wide study of allelic imbalance (AI) in 32 tumors, using 710 microsatellite markers. The highest prevalence of AI was found at 12p, in line with previous studies finding consistent gain of the region in TGCTs. High frequency of AI was also observed at chromosome arms 4p, 9q, 10p, 11q, 11p, 13q, 16q, 18p, and 22q. Within 39 candidate regions identified by mapping of smallest regions of overlap (SROs), the highest frequency of AI was at 12p11.21 approximately p11.22 (62%), 12p12.1 approximately p13.1 (53%), 12p13.1 approximately p13.2 (53%), 11q14.1 approximately q14.2 (53%), 11p13 approximately p14.3 (47%), 9q21.13 approximately q21.32 (47%), and 4p15.1 approximately p15.2 (44%). Two genes known to be involved in cancer reside in these regions, ETV6 at 12p13.2 (TEL oncogene) and WT1 at 11p13. We also found a significant association (P = 0.02) between AI at 10q21.1 approximately q22.2 and higher clinical stage. This study contributes to the ongoing search for genes involved in transformation of germ cells and provides a useful reference point to previous studies using cytogenetic techniques to map chromosome changes in TGCTs