Urology
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Randomized Controlled Trial Comparative Study Clinical Trial
Intraoperative blood loss during radical retropubic prostatectomy: epidural versus general anesthesia.
There are conflicting reports on the influence of different anesthetic techniques, such as regional versus general anesthesia, on intraoperative blood loss. The purpose of this study was to elucidate the effects of anesthetic technique on intraoperative blood loss in men undergoing radical retropubic prostatectomy (RRP). ⋯ Similar blood loss in patients receiving general anesthesia, either alone or when combined with epidural anesthesia, implies that epidural anesthesia did not reduce bleeding, but, rather, that general anesthesia increased blood loss.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
A controlled trial of bicalutamide versus flutamide, each in combination with luteinizing hormone-releasing hormone analogue therapy, in patients with advanced prostate cancer. Casodex Combination Study Group.
To compare the efficacy and safety of bicalutamide and flutamide, each used in combination with luteinizing hormone-releasing analogue (LHRH-A) therapy, in patients with untreated metastatic (Stage D2) prostate cancer. ⋯ In patients with metastatic prostate cancer, bicalutamide plus LHRH-A is well tolerated and provides superior efficacy to flutamide plus LHRH-A with respect to time to treatment failure. Assessment of the effects of these regimens on longer term survival requires additional time for follow-up.
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Comparative Study
Incidence of negative hematuria in patients with acute urinary lithiasis presenting to the emergency room with flank pain.
To determine the incidence of negative hematuria in patients with acute urinary lithiasis presenting to the emergency room with flank pain. ⋯ This is the first report in the literature documenting the incidence of negative hematuria in patients with AUL to be 14.5%. With the addition of the combination of urinalysis and urine dipstick test for hematuria, the incidence is only 5.5% and, therefore, represents a low yield when evaluated by IVU.
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Randomized Controlled Trial Comparative Study Clinical Trial
Androgen deprivation with radiation therapy compared with radiation therapy alone for locally advanced prostatic carcinoma: a randomized comparative trial of the Radiation Therapy Oncology Group.
Androgen deprivation therapy before and during radiation therapy could, by reducing tumor volume, increase local tumor control, disease-free survival, and overall survival in patients with locally advanced adenocarcinomas of the prostate. ⋯ Short-term androgen deprivation with radiation therapy results in a marked increase in local control and disease-free survival compared with pelvic irradiation alone in patients with locally advanced carcinoma of the prostate. Long-term surveillance is required to assess effects on overall survival.
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Although combined androgen blockade with flutamide plus medical or surgical castration is effective in metastatic prostate cancer, debate exists over whether it is cost effective. ⋯ Flutamide has an incremental cost effectiveness more favorable than most accepted therapies. If drug costs are covered under health care reform, flutamide should be initiated and covered for all good performance status patients.