78 results on '"Andrzej Paradysz"'
Search Results
2. Correction to: Awareness of testicular cancer among adult Polish men and their tendency for prophylactic self-examination: conclusions from Movember 2020 event
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Jakub Ryszawy, Maksymilian Kowalik, Jakub Wojnarowicz, Grzegorz Rempega, Michał Kępiński, Bartłomiej Burzyński, Paweł Rajwa, Andrzej Paradysz, and Piotr Bryniarski
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Reproductive Medicine ,Urology ,General Medicine - Published
- 2023
3. Not as black as it is painted? The impact of the first wave of COVID-19 pandemic on surgical treatment of urological cancer patients in Poland a cross-country experience
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Mieszko Kozikowski, Piotr Zapała, Bartosz Małkiewicz, Marcin Jarzemski, Łukasz Zapała, Andrzej Paradysz, Dominik Chorągwicki, Aleksander Ślusarczyk, Piotr Petrasz, Piotr Radziszewski, Remigiusz Stamirowski, Jakub Dobruch, Jacek Zostawa, Joanna Zajączkowska, Piotr Chlosta, Romuald Zdrojowy, Tomasz Drewa, Mikolaj Przydacz, Blazej Kuffel, Bartosz Dybowski, Magdalena Szymańska, Bartosz Brzoszczyk, Maciej Przudzik, Marek Roslan, Wojciech Krajewski, Piotr Jarzemski, Przemysław Kubik, Rafał Osiecki, Paweł Kiełb, and Pawel Rajwa
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medicine.medical_specialty ,Cross country ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Family medicine ,Pandemic ,medicine ,Urological cancer ,General Medicine ,medicine.disease_cause ,business ,Coronavirus - Abstract
IntroductionIn the majority of Western European countries, the coronavirus disease (COVID-19) pandemic has led to a dramatic reduction in urooncological surgeries. Our objective was to evaluate the impact of the pandemic on volume and patterns of urooncological surgery in Poland.Material and methodsThis is a retrospective analysis of 10 urologic centres in Poland. Data regarding major oncological procedures performed after the COVID-19 pandemic outbreak (March 15, 2020 – May 31, 2020) were evaluated and compared with data from the respective period in 2019.ResultsBetween March 15, 2020 and May 31, 2020, a total of 968 oncological procedures were performed in participating centres. When compared to the respective period in 2019 (1063 procedures) the overall number of surgeries declined by 8.9%. The reduction was observed for transurethral resection of bladder tumour (TURBT) (20.1%) and partial nephrectomies (PN) (16.5%). Surgical activity considering radical nephrectomy (RN), nephroureterectomy (NU), and radical prostatectomy (RP) remained relatively unchanged, whereas radical cystectomy (RC) burden showed a significant increase (90.9%). Characteristics of patients treated with TURBT, RC, NU, PN, and RN did not differ significantly between the compared periods, whereas RP in the COVID-19 period was performed more frequently in patients with a higher grade group (p = 0.028) and positive digital rectal examination (p = 0.007).ConclusionsSurgical activity for urological cancers in Poland has been maintained during the first wave of the COVID-19 pandemic. The Polish strategy in the initial period of the COVID-19 crisis mirrors the scenario of hard initial lockdown followed by adaptive lockdown, during which oncological care remained undisrupted and did not require particular priority triage.
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- 2023
4. Prostate cancer risk, screening and management in patients with germline BRCA1/2 mutations
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Pawel, Rajwa, Fahad, Quhal, Benjamin, Pradere, Giorgio, Gandaglia, Guillaume, Ploussard, Michael S, Leapman, John L, Gore, Andrzej, Paradysz, Derya, Tilki, Axel S, Merseburger, Todd M, Morgan, Alberto, Briganti, Ganesh S, Palapattu, and Shahrokh F, Shariat
- Abstract
Mutations in the BRCA1 and BRCA2 tumour suppressor genes are associated with prostate cancer risk; however, optimal screening protocols for individuals with these mutations have been a subject of debate. Several prospective studies of prostate cancer incidence and screening among BRCA1/2 mutation carriers have indicated at least a twofold to fourfold increase in prostate cancer risk among carriers of BRCA2 mutations compared with the general population. Moreover, BRCA2 mutations are associated with more aggressive, high-grade disease characteristics at diagnosis, more aggressive clinical behaviour and greater prostate cancer-specific mortality. The risk for BRCA1 mutations seems to be attenuated compared with BRCA2. Prostate-specific antigen (PSA) measurement or prostate magnetic resonance imaging (MRI) alone is an imperfect indicator of clinically significant prostate cancer; therefore, BRCA1/2 mutation carriers might benefit from refined risk stratification strategies. However, the long-term impact of prostate cancer screening is unknown, and the optimal management of BRCA1/2 carriers with prostate cancer has not been defined. Whether timely localized therapy can improve overall survival in the screened population is uncertain. Long-term results of prospective studies are awaited to confirm the optimal screening strategies and benefits of prostate cancer screening among BRCA1/2 mutation carriers, and whether these approaches ultimately have a positive impact on survival and quality of life in these patients.
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- 2022
5. Online Crowdfunding for Urologic Cancer Care
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Pawel Rajwa, Philip Hopen, Jakub Wojnarowicz, Julia Kaletka, Iga Paszkiewicz, Olga Lach-Wojnarowicz, Hadi Mostafaei, Wojciech Krajewski, David D’Andrea, Bartosz Małkiewicz, Andrzej Paradysz, Guillaume Ploussard, Marco Moschini, Benjamin N. Breyer, Benjamin Pradere, Shahrokh F. Shariat, and Michael S. Leapman
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Urologic Diseases ,Cancer Research ,Oncology ,crowdfunding ,Oncology and Carcinogenesis ,bladder cancer ,kidney cancer ,urology ,prostate cancer ,testicular cancer ,Cancer - Abstract
Background: we aimed to characterize the financial needs expressed through online crowdfunding for urologic cancers. Methods: the data used in this study came from the online crowdfunding platform GoFundMe.com. Using an automated software method, we extracted data for campaigns related to urologic cancers. Subsequently, four independent investigators reviewed all extracted data on prostate, bladder, kidney and testicular cancer. We analyzed campaigns’ basic characteristics, goals, fundraising, type of treatment and factors associated with successful campaigns. Results: in total, we identified 2126 individual campaigns, which were related to direct treatment costs (34%), living expenses (17%) or both (48%). Median fundraising amounts were greatest for testicular cancer. Campaigns for both complementary and alternative medicine (CAM) (median $11,000) or CAM alone (median $8527) achieved higher fundraising totals compared with those for conventional treatments alone (median $5362) (p < 0.01). The number of social media shares was independently associated with campaign success and highest quartile of fundraising. Conclusions: using an automated web-based approach, we identified and characterized online crowdfunding for urologic cancer care. These findings indicated a diverse range of patient needs related to urologic care and factors related to campaigns’ success.
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- 2022
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6. Post-Radical Prostatectomy Erectile Dysfunction Assessed Using the IIEF-5 Questionnaire – A Systematic Literature Review
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Tomasz Jurys, Andrzej Paradysz, Anna Potyka, and Bartlomiej Burzynski
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medicine.medical_specialty ,education.field_of_study ,Social Psychology ,Prostatectomy ,business.industry ,medicine.medical_treatment ,Population ,Public Health, Environmental and Occupational Health ,Urology ,Postoperative complication ,Dermatology ,medicine.disease ,Gender Studies ,Prostate cancer ,Systematic review ,Erectile dysfunction ,Reproductive Medicine ,medicine ,education ,business - Abstract
Erectile dysfunction is common postoperative complication after radical prostatectomy. The aim of this study is to evaluate erectile dysfunction among the population of men who have undergone radic...
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- 2021
7. Role of systemic immune-inflammation index in patients treated with salvage radical prostatectomy
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Hadi Mostafaei, Andrzej Paradysz, Satoshi Katayama, Victor M. Schuettfort, Harun Fajkovic, K. Mori, Shahrokh F. Shariat, Pierre I. Karakiewicz, Reza Sari Motlagh, Kristin Zimmermann, Pawel Rajwa, Andreas Aulitzky, B. Pradere, Fahad Quhal, Paolo Gontero, Nico C. Grossmann, Axel Heidenreich, and E. Laukhtina
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Male ,Nephrology ,Index (economics) ,Survival ,Neutrophils ,medicine.medical_treatment ,Brachytherapy ,030232 urology & nephrology ,Logistic regression ,Gastroenterology ,Leukocyte Count ,Prostate cancer ,0302 clinical medicine ,Salvage radical prostatectomy ,Lymphocytes ,Prostatectomy ,Multimodal therapy ,Middle Aged ,Prognosis ,SII ,Survival Rate ,030220 oncology & carcinogenesis ,Preoperative Period ,Biomarker (medicine) ,Original Article ,Immune inflammation ,Blood Platelets ,medicine.medical_specialty ,Urology ,03 medical and health sciences ,Internal medicine ,medicine ,Humans ,In patient ,Lymphocyte Count ,Aged ,Neoplasm Staging ,Proportional Hazards Models ,Retrospective Studies ,Inflammation ,Salvage Therapy ,Platelet Count ,Proportional hazards model ,business.industry ,Prostatic Neoplasms ,Retrospective cohort study ,medicine.disease ,Biomarkers ,Multivariate Analysis ,Lymph Nodes ,Radiotherapy, Intensity-Modulated ,Neoplasm Recurrence, Local ,business - Abstract
Purpose To examine the predictive and prognostic value of preoperative Systemic Immune-inflammation Index (SII) in patients with radio-recurrent prostate cancer (PCa) treated with salvage radical prostatectomy (SRP). Materials and methods This multicenter retrospective study included 214 patients with radio-recurrent PCa, treated with SRP between 2007 and 2015. SII was measured preoperatively (neutrophils × platelets/lymphocytes) and the cohort was stratified using optimal cut-off. Uni- and multivariable logistic and Cox regression analyses were performed to evaluate the predictive and prognostic value of SII as a preoperative biomarker. Results A total of 81 patients had high preoperative SII (≥ 730). On multivariable logistic regression modeling, high SII was predictive for lymph node metastases (OR 3.32, 95% CI 1.45–7.90, p = 0.005), and non-organ confined disease (OR 2.55, 95% CI 1.33–4.97, p = 0.005). In preoperative regression analysis, high preoperative SII was an independent prognostic factor for cancer-specific survival (CSS; HR 10.7, 95% CI 1.12–103, p = 0.039) and overall survival (OS; HR 8.57, 95% CI 2.70–27.2, p p = 0.036) and OS (HR 5.98, 95% CI 1.67–21.44, p = 0.006). Notably, the addition of SII to preoperative reference models improved the C-index for the prognosis of CSS (89.5 vs. 80.5) and OS (85.1 vs 77.1). Conclusions In radio-recurrent PCa patients, high SII was associated with adverse pathological features at SRP and survival after SRP. Preoperative SII could help identify patients who might benefit from novel imaging modalities, multimodal therapy or a closer posttreatment surveillance.
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- 2021
8. The Severity of Pain in Prostate Biopsy Depends on the Biopsy Sector
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Grzegorz Rempega, Paweł Rajwa, Michał Kępiński, Jakub Ryszawy, Jakub Wojnarowicz, Maksymilian Kowalik, Marcela Krzempek, Aleksandra Krzywon, Michał Dobrakowski, Andrzej Paradysz, and Piotr Bryniarski
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prostate biopsy ,pain ,prostate cancer ,Medicine (miscellaneous) - Abstract
BACKGROUND: The pain experienced by a patient during a prostate fusion biopsy is cumulative and can also be modulated by many factors. The aim of the study was to assess the association between the degree of pain intensity during prostate biopsy and the region of the biopted organ. MATERIALS AND METHODS: The study included a group of 143 patients who underwent prostate fusion biopsy under local analgesia followed by blockage of the periprostatic nerve. After a biopsy, the patients completed the original questionnaire about the pain experienced during the procedure. RESULTS: There was a statistically significant difference in pain score between cores taken in the apex (median 5 (IQR 2–5)), medium level (median 1 (IQR 1–2)), and prostate base (median 1 (IQR 1–3)) (p < 0.001). The malignancy scale ISUP ≥ 2 (p = 0.038) and lower PSA value (r = −0.17; p = 0.046) are associated with higher pain during procedure. Biopsy time was correlated with discomfort (r = 0.19; p = 0.04). Age (p = 0.65), lesion size (p = 0.29), PI-RADS score (p = 0.86), prostate volume (p = 0.22), and the number of cores (p = 0.56) did not correspond to the pain scale. CONCLUSIONS: The apex is the most sensitive sector of the prostate. ISUP ≥ 2 and patients with low PSA levels more often indicated higher values on the pain rating scale.
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- 2023
9. En-bloc resection of urinary bladder tumour – a prospective controlled multicentre observational study
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Andrzej Paradysz, Piotr Zapała, Tomasz Drewa, Romuald Zdrojowy, Piotr Radziszewski, Łukasz Nowak, Sławomir Poletajew, Paweł Stelmach, Piotr Kryst, Marco Moschini, Jan Adamowicz, and Wojciech Krajewski
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medicine.medical_specialty ,Urology ,Resection ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,transurethral resection ,en-bloc ,Original Paper ,Bladder cancer ,Urinary bladder ,business.industry ,transurethral resection of bladder tumour ,Significant difference ,Gastroenterology ,Obstetrics and Gynecology ,En bloc resection ,medicine.disease ,Surgery ,surgical procedures, operative ,medicine.anatomical_structure ,Residual Tumours ,030220 oncology & carcinogenesis ,Propensity score matching ,bladder cancer ,Observational study ,business ,030217 neurology & neurosurgery - Abstract
Introduction Transurethral resection of bladder tumour (TURBT) is one of the most commonly performed urologic procedures. Because of the shortcomings of conventional TURBT, the en-bloc resection concept was created. Aim To analyse the influence of en-bloc technique on surgical and oncological outcomes of TURBT performed with electric current. Material and methods This non-randomized, prospective controlled multicentre study enrolled 427 consecutive patients undergoing TURBT performed by five experienced endourologists in five academic institutions. Choice of procedure was at the discretion of the surgeon. The vast majority of patients underwent monopolar resection. The en-bloc procedure was performed with Collin’s knife or the classic resection loop. Study end-points were surgery, catheterization and hospitalization time, presence of muscularis propria (MP) in the specimen and 3-month recurrence-free survival (RFS). Results The study included 427 (274 conventional TURBT vs. 153 en-bloc) patients with mean age of 69 years (range: 18–99). There were more cases with MP present in the specimen in the en-bloc group (91.3% vs. 75.5%; p < 0.001). Surgery and hospitalization times were statistically shorter in the en-bloc group (both p < 0.05). A borderline significant difference was noted when the number of residual tumours in reTURBTs was analysed, with fewer cases of residual tumour in the en-bloc group (p = 0.051). RFS at 3 months was higher in the en-bloc group (88.4% vs. 80.1%; p = 0.027). After propensity score matching, differences in MP presence, hospitalization time and 3-month RFS status remained statistically significant. Conclusions When compared to conventional TURBT, en-bloc resection of bladder tumour is associated with higher percentage of MP presence in histopathological specimen, higher 3-month RFS and shorter hospitalization time.
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- 2020
10. Physiotherapeutic assessment and management of overactive bladder syndrome: a case report
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Bartlomiej Burzynski, Tomasz Jurys, Karolina Kwiatkowska, Katarzyna Cempa, and Andrzej Paradysz
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Physical Therapy, Sports Therapy and Rehabilitation - Abstract
Overactive Bladder Syndrome (OAB) has multiple treatment methods including pharmacotherapy, pelvic floor muscle training, electrostimulation, or surgery. One of the nonpharmacological treatment options is physiotherapy including pelvic floor muscle training.The patient was a 25 year-old woman who attended the urogynecological physiotherapy consulting room due to frequent sensations of bladder pressure. Manual inspection and ultrasound imaging was used by the physiotherapist in order to assess the function of pelvic and abominal structures. The patient reported pain symptoms during examination of several pelvic floor and abdominal muscles. The patient was judged eligible for urogynecological physiotherapeutic treatment. Manual therapy of the lumbopelvic hip complex, manual therapy per vaginum, manual therapy of theTreatment of OAB is often a multistage process involving application of different therapies by a multidisciplinary team. For this patient, physiotherapy assessment and intervention were an integral part of the conservative management of OAB.
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- 2022
11. Awareness of testicular cancer among adult Polish men and their tendency for prophylactic self-examination: conclusions from Movember 2020 event
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Jakub Ryszawy, Maksymilian Kowalik, Jakub Wojnarowicz, Grzegorz Rempega, Michał Kępiński, Bartłomiej Burzyński, Paweł Rajwa, Andrzej Paradysz, and Piotr Bryniarski
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Adult ,Male ,Health Knowledge, Attitudes, Practice ,Reproductive Medicine ,Testicular Neoplasms ,Urology ,Humans ,General Medicine ,Poland ,Neoplasms, Germ Cell and Embryonal - Abstract
Background Testicular cancer (TC), due to its non-specific symptoms and occurrence in young men, is particularly dangerous. A critical point for early diagnosis is awareness of the disease and the willingness to perform a testicular self-examination (TSE). The main aim of the study was to assess the knowledge of 771 adult men about testicular cancer. Additionally, the sources of information on TC and TSE were analyzed and the influence of demographic factors on the willingness to join preventative programs was examined. Materials and methods The study was carried out during the Movember2020 campaign, where a testicular ultrasound was performed on participants. They were asked to complete a questionnaire with 26 questions to assess their knowledge. Results The results obtained in the study indicate a low level of knowledge (average 3.5 points out of 18) about TC. Living in a large city (OR = 1.467; p = 0.03), as well as an earlier conversation about TC (OR = 1.639; p = 0.002), increased the awareness about the disease. Additionally it showed that many participants do not perform TSE at all (52.4%) and that only few perform TSE frequently (18.4%). Relationship status (OR = 2.832; p p = 0.02) was reported to be the main contributing factors in males deciding to have TSE. Conclusions Our research indicates large educational neglect in terms of knowledge about TC and reluctance in performing TSE. It is worth carrying out preventative actions periodically on an increasing scale, not only for the screening of testicular cancer, but also to expand knowledge on this subject.
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- 2021
12. MP67-24 ASSESSING ONLINE CROWDFUNDING FOR UROLOGIC CANCER CARE USING AUTOMATED DATA EXTRACTION
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Michael S. Leapman, Julia Kaletka, Shahrokh F. Shariat, Pawel Rajwa, Benjamin Pradere, Jakub Wojnarowicz, Iga Paszkiewicz, Andrzej Paradysz, Philip Hopen, and Olga Lach-Wojnarowicz
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Automated data ,medicine.medical_specialty ,business.industry ,Urology ,Urologic cancer ,Medicine ,Cancer ,Medical physics ,business ,medicine.disease - Abstract
INTRODUCTION AND OBJECTIVE:Medical crowdfunding through online platforms has rapidly expanded as a means to defray the financial toxicity associated with cancer care. We aimed to understand the fin...
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- 2021
13. Online Crowdfunding Response to Coronavirus Disease 2019
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Andrzej Paradysz, Michael S. Leapman, Cary P. Gross, Jakub Wojnarowicz, Lin Mu, Pawel Rajwa, and Philip Hopen
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2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,biology ,SARS-CoV-2 ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Pneumonia, Viral ,COVID-19 ,Fund Raising ,biology.organism_classification ,Virology ,Betacoronavirus ,Internal Medicine ,Crowdsourcing ,Humans ,Medicine ,Coronavirus Infections ,business ,Pandemics ,Concise Research Report - Published
- 2020
14. 55th EASD Annual Meeting of the European Association for the Study of Diabetes
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Rudi Vennekens, Dorte Møller Jensen, Simranjeet Kaur, David Lui, Johan Røikjer, Daniela Marques, Katharina Grupe, Kamilla Miskowiak, Morten Hasselstrøm Jensen, Jens Christian Laursen, David Álvarez-Cilleros, Aase Handberg, Stig Molsted, Flemming Pociot, Knud Yderstraede, Alessandro Di Toro, Annette Bauer-Brandl, Yeray Brito Casillas, Jens Ahm Sørensen, Janusz Gumprecht, Jaco Botha, Dorota Pawełka, Per Trolle Jørgensen, Namson Lau, Jesper Wengel, Muhammad Khan, Hindrik Mulder, Tine Hansen, Hanna Kwiendacz, Andrzej Paradysz, Michal Tendera, Tine Dalsgaard Clausen, Anna Zheleznyakova, Katarzyna Nabrdalik, Peter Rossing, Stefan Mutter, Marija Petkovic, and Rula Bany Bakar
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medicine.medical_specialty ,Screen detected ,business.industry ,Endocrinology, Diabetes and Metabolism ,Disease ,Type 2 diabetes ,medicine.disease ,Internal medicine ,Internal Medicine ,Cardiology ,medicine ,business ,Autonomic neuropathy ,All cause mortality ,Subclinical infection - Published
- 2019
15. Neutrophil-to-mean platelet volume ratio as a new predictor for overall and cancer-specific survival in patients with localized clear cell renal cell carcinoma
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Pawel Rajwa, Andrzej Paradysz, Maciej Gaździk, Monika Slabon-Turska, Iga Florczyk, Bartłomiej Burzyński, and Marcin Życzkowski
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medicine.medical_specialty ,renal cell carcinoma ,Proportional hazards model ,business.industry ,neutrophil-to-mean platelet volume ratio ,medicine.medical_treatment ,Urology ,neutrophil ,General Medicine ,medicine.disease ,Nephrectomy ,03 medical and health sciences ,Clear cell renal cell carcinoma ,0302 clinical medicine ,Renal cell carcinoma ,Clinical Research ,platelets ,medicine ,Biomarker (medicine) ,Population study ,biomarker ,030212 general & internal medicine ,Mean platelet volume ,business ,Survival analysis - Abstract
Introduction The present study investigated the prognostic value of neutrophil-to-mean platelet volume ratio (NMPVR) for overall (OS) and cancer-specific survival (CSS) in patients treated with nephrectomy for localized clear cell renal cell carcinoma (ccRCC). Material and methods Medical records of 344 consecutive patients who underwent partial or radical nephrectomy for M0 ccRCC were retrospectively analyzed. Based on the median NMPVR, the study population was divided into two groups: the high NMPVR group with NMPVR higher than or equal to the median, and the low NMPVR group with NMPVR lower than the median. Comparisons of baseline characteristics and laboratory and pathological findings were performed. Kaplan-Meier survival curves and Cox regression model analysis were used to assess the prognostic value of the NMPVR. Results Patients with higher NMPVR values were more frequently diagnosed with advanced disease, tumor necrosis and higher tumor grade. The OS and CSS were significantly shorter in patients with NMPVR ≥ 0.41 compared to patients with NMPVR < 0.41. Inclusion of NMPVR in multivariable models of OS and CSS with other confounding variables determined categorized NMPVR as an independent prognostic factor for both endpoints. Conclusions Pretreatment NMPVR ≥ 0.41 was associated with lower OS and CSS. NMPVR might be applied as a cheap and uncomplicated prognostic indicator in localized ccRCC patients treated with a primary surgical approach.
- Published
- 2019
16. Erector Spinae Plane Block for Perioperative Analgesia after Percutaneous Nephrolithotomy
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Michal Kepinski, Piotr Bryniarski, Anna Szelka-Urbanczyk, Szymon Bialka, Andrzej Paradysz, and Hanna Misiołek
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Mean arterial pressure ,Visual analogue scale ,Nausea ,Health, Toxicology and Mutagenesis ,medicine.medical_treatment ,030232 urology & nephrology ,Paraspinal Muscles ,lcsh:Medicine ,Nephrolithotomy, Percutaneous ,Article ,03 medical and health sciences ,0302 clinical medicine ,030202 anesthesiology ,Clinical endpoint ,medicine ,Humans ,percutaneous nephrolithotomy ,Percutaneous nephrolithotomy ,Pain, Postoperative ,business.industry ,urolithiasis ,lcsh:R ,Public Health, Environmental and Occupational Health ,Nerve Block ,Nalbuphine ,Blood pressure ,erector spinae plane block ,Anesthesia ,Vomiting ,medicine.symptom ,Analgesia ,business ,medicine.drug - Abstract
Erector spinae plane block was recently introduced as an alternative to postoperative analgesia in surgical procedures including thoracoscopies and mastectomies. There are no clinical trials regarding erector spinae plane block in percutaneous nephrolithotomy. The aim of our study was to test the efficacy and safety of erector spinae plane block after percutaneous nephrolithotomy. We analyzed 68 patients, 34 of whom received erector spinae plane block. The average visual analogue scale score 24 h postoperatively was the primary endpoint. The secondary endpoints were nalbuphine consumption and the need for rescue analgesia. Safety measures included the mean arterial pressure, Ramsey scale score, and rate of nausea and vomiting. The visual analogue scale, blood pressure, and Ramsey scale were assessed simultaneously at 1, 2, 4, 6, 12, and 24 h postoperatively. The average visual analogue scale was 2.9 and 3 (p = 0.65) in groups 1 (experimental) and 2 (control), respectively. The visual analogue scale after 1 h postoperatively was significantly lower in the erector spinae plane block group (2.3 vs. 3.3, p = 0.01). The average nalbuphine consumption was the same in both groups (46 mL vs. 47.2 mL, p = 0.69). The need for rescue analgesia was insignificantly different in both groups (group 1, 29.4, group 2, 26.4%, p = 1). The mean arterial pressure was similar in both groups postoperatively (91.8 vs. 92.5 mmHg, p = 0.63). The rate of nausea and vomiting was insignificantly different between the groups (group 1, 17.6%, group 2, 14.7%, p = 1). The median Ramsey scale in all the measurements was two. Erector spinae plane block is an effective pain treatment after percutaneous nephrolithotomy but only for a very short postoperative period.
- Published
- 2021
17. Lymphocyte-to-Monocyte Ratio Is the Independent Prognostic Marker of Progression in Patients Undergoing BCG-Immunotherapy for Bladder Cancer
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Andrzej Paradysz, Bartłomiej Burzyński, Piotr Bryniarski, Maksymilian Kowalik, Mateusz Adamkiewicz, and Pawel Rajwa
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Oncology ,Cancer Research ,medicine.medical_specialty ,lymphocyte-to-monocyte ratio ,030232 urology & nephrology ,Disease ,lcsh:RC254-282 ,transurethral resection of bladder tumor ,03 medical and health sciences ,Bacillus Calmet-Guiren immunotherapy ,0302 clinical medicine ,neutrophil-to-lymphocyte ratio ,Internal medicine ,medicine ,Stage (cooking) ,Neutrophil to lymphocyte ratio ,Original Research ,Bladder cancer ,Receiver operating characteristic ,business.industry ,Gold standard (test) ,medicine.disease ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,platelet-to-lymphocyte ratio ,030220 oncology & carcinogenesis ,Ambulatory ,Biomarker (medicine) ,bladder cancer ,business - Abstract
IntroductionTransurethral resection of bladder tumor with subsequent BCG immunotherapy is the current gold standard in the treatment of high risk and some medium-risk non-muscle invasive bladder cancer. Clinical factors like stage, grade, age and gender are well-know predictors of progression to muscle-invasive bladder cancer. In recent years novel hematological biomarkers were shown to be independent predictors of progression. This study aimed to evaluate which of these novel markers has the highest prognostic value of progression in patients with bladder cancer receiving BCG immunotherapy.Materials and methodsWe retrospectively analyzed the data of 125 patients with non-muscle invasive bladder cancer who received BCG immunotherapy. Of these, 61 progressed to muscle-invasive disease or had high-grade recurrence. These patients were compared with the group who did not progress (n = 64). Clinical data including stage, grade, age, gender, smoking status and observational time was collected. Besides, information on blood count analysis was obtained from ambulatory digital charts. On this basis neutrophil-to-lymphocyte ratio (NLR), platelet-to lymphocyte ratio (PLR) and lymphocyte-to-monocyte ratio (LMR) was counted and compared between groups.ResultsNLR, PLR and LMR were shown to be independent prognostic markers of progression in multivariable analysis. The model with stage, grade, age, gender, smoking status and LMR had the highest prognostic values of all models (area under curve [AUC] = 0.756). The cut-off point according to ROC curves for LMR was 3.25. Adding LMR to the baseline model including clinical variables significantly increased area under curve by 0.08 (p = 0.001). NLR and PLR did not increase areas under curve significantly to baseline model.ConclusionsLMR outperformed NLR and PLR for prediction of progression in patients with non-muscle-invasive bladder cancer receiving BCG immunotherapy. LMR, as an easily obtainable biomarker, should be incorporated to the present risk stratification models.
- Published
- 2021
18. Use of the International Index of Erectile Function to assess sexual dysfunction in the male population with prostate cancer treated by radical prostatectomy – a systematic review
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Andrzej Paradysz, Tomasz Jurys, Piotr Bryniarski, and Bartlomiej Burzynski
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medicine.medical_specialty ,Index (economics) ,Prostatectomy ,business.industry ,medicine.medical_treatment ,Urology ,General Medicine ,Erectile function ,medicine.disease ,Prostate cancer ,Erectile dysfunction ,Sexual dysfunction ,medicine ,Male population ,medicine.symptom ,business - Abstract
Introduction: Prostate carcinoma is the second most commonly diagnosed cancer among men, accounting for 14.1% of diagnoses and with a 6.8% mortality rate. Among current treatment options, radical prostatectomy is strongly indicated for localized prostate cancer. Although surgical techniques for radical prostatectomy are constantly being improved in terms of effectiveness and safety, postoperative disorders such as stress urinary incontinence and sexual dysfunction, including erectile dysfunction, remain quite common. Aim: The aim of our systematic review is to discuss the prevalence and severity of sexual dysfunction in the population of men suffering from prostate cancer who have been treated by means of radical prostatectomy. Material and methods: For the purposes of this systematic review we undertook a search of the literature in five databases using the English and Polish languages. We have focused on studies which assess sexual dysfunction using the International Index of Erectile Function (IIEF) questionnaire. Results and discussion: A total of 145 potentially relevant studies was retrieved. After selection, it was determined that 5 studies fulfilled the eligibility criteria and these were selected for qualitative synthesis. Our systematic review supports the finding that impairment of sexual function continues during the first 12 months after radical prostatectomy. Conclusions: Sexual dysfunction is a common complication after radical prostatectomy, and recovery takes at least 12 months. The male population with prostate cancer is at risk of sexual dysfunction even before radical prostatectomy due to age, comorbidities and mental factors related to the course of the disease.
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- 2021
19. Influence of SGLT2 Inhibitor Treatment on Urine Antioxidant Status in Type 2 Diabetic Patients: A Pilot Study
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Piotr Adamczyk, Tomasz Stompór, Mirela Hendel, Katarzyna Sedlaczek, Krzysztof Irlik, Hanna Kwiendacz, Diana Nabrdalik-Leśniak, Andrzej Paradysz, Tomasz Sawczyn, Patryk Główczyński, Karolina Drożdż, Katarzyna Nabrdalik, Paweł Stelmach, Janusz Gumprecht, Sławomir Kasperczyk, and Weronika Hajzler
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0301 basic medicine ,Aging ,Antioxidant ,Article Subject ,medicine.medical_treatment ,education ,Pilot Projects ,Urine ,030204 cardiovascular system & hematology ,Pharmacology ,medicine.disease_cause ,behavioral disciplines and activities ,Biochemistry ,Antioxidants ,Superoxide dismutase ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Sodium-Glucose Transporter 2 Inhibitors ,QH573-671 ,biology ,business.industry ,Healthy subjects ,Type 2 Diabetes Mellitus ,Cell Biology ,General Medicine ,Middle Aged ,030104 developmental biology ,Diabetes Mellitus, Type 2 ,Catalase ,biology.protein ,SGLT2 Inhibitor ,Cytology ,business ,psychological phenomena and processes ,Oxidative stress ,Research Article - Abstract
Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have been recognized as potent antioxidant agents. Since SGLT2i are nephroprotective drugs, we aimed to examine the urine antioxidant status in patients with type 2 diabetes mellitus (T2DM). One hundred and one subjects participated in this study, including 37 T2DM patients treated with SGLT2i, 31 T2DM patients not using SGLT2i, and 33 healthy individuals serving as a control group. Total antioxidant capacity (TAC), superoxide dismutase (SOD), manganese superoxide dismutase (MnSOD), free thiol groups (R-SH, sulfhydryl groups), and catalase (CAT) activity, as well as glucose concentration, were assessed in the urine of all participants. Urine SOD and MnSOD activity were significantly higher among T2DM patients treated with SGLT2i than T2DM patients without SGLT2i treatment ( p = 0.009 and p = 0.003 , respectively) and to the healthy controls ( p = 0.002 and p = 0.001 , respectively). TAC was significantly lower in patients with T2DM treated with SGLT2i when compared to those not treated and healthy subjects ( p = 0.036 and p = 0.019 , respectively). It could be hypothesized that the mechanism by which SGLT2i provides nephroprotective effects involves improvement of the SOD antioxidant activity. However, lower TAC might impose higher OS (oxidative stress), and elevation of SOD activity might be a compensatory mechanism.
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- 2021
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20. Prognostic factors in postoperative radiotherapy for prostate cancer - tertiary center experience
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Pawel Rajwa, Leszek Miszczyk, Wojciech Majewski, Iwona Jabłońska, Łukasz Magrowski, Oliwia Masri, Konrad Rasławski, Marcin Miszczyk, Andrzej Paradysz, and Konrad Stawiski
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Oncology ,Male ,genetic structures ,medicine.medical_treatment ,R895-920 ,Kaplan-Meier Estimate ,urologic and male genital diseases ,Tertiary Care Centers ,Prostate cancer ,Medical physics. Medical radiology. Nuclear medicine ,0302 clinical medicine ,Interquartile range ,030212 general & internal medicine ,Treatment Failure ,Aged, 80 and over ,Prostatectomy ,postoperative radiotherapy ,Middle Aged ,Prognosis ,prostate cancer ,030220 oncology & carcinogenesis ,Disease Progression ,Research Article ,Adult ,medicine.medical_specialty ,disease-free survival ,Recursive partitioning ,nomogram ,03 medical and health sciences ,Median follow-up ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Aged ,Retrospective Studies ,Postoperative Care ,Analysis of Variance ,business.industry ,Prostatic Neoplasms ,prognostic factors ,Retrospective cohort study ,Nomogram ,Prostate-Specific Antigen ,medicine.disease ,Radiation therapy ,Nomograms ,Neoplasm Grading ,Neoplasm Recurrence, Local ,business - Abstract
Background The aim of the study was to analyse the prognostic factors in postoperative prostate cancer irradiation and develop a nomogram for disease-free survival (DFS). Patients and methods This retrospective study included 236 consecutive prostate cancer patients who had radical prostatectomy followed by radiotherapy (RT) at a single tertiary institution between 2009 and 2014. The main outcome was DFS analysed through uni- and multivariable analysis, Kaplan-Meier curves, log-rank testing, recursive partitioning analysis, and nomogram development. Results The median follow up was 62.3 (interquartile range [IQR] 38.1–79) months. The independent clinical factors associated with increased risk of recurrence or progression in the multivariate analysis (MVA) were prostate-specific antigen (PSA) level before RT, pT3 characteristic, and local failure as salvage indication. The value of PSA nadir had a significant impact on the risk of biochemical failure. Biochemical control and DFS were significantly different depending on treatment indication (p < 0.0001). The recursive partitioning analysis highlighted the importance of the PSA level before RT, Gleason Grade Group, PSA nadir, and local failure as a treatment indication. Finally, the nomogram for DFS was developed and is available online at https://apps.konsta.com.pl/app/prostate-salvage-dfs/. Conclusions The Pre-RT PSA level, pT3 characteristic and local failure as salvage indication are pivotal prognostic factors associated with increased risk of recurrence or progression. The Gleason grade group of 4–5 and PSA nadir value allow for further risk stratification. The treatment outcomes in postoperative prostate cancer irradiation are significantly different depending on treatment indication. An online nomogram comprising of both pre-treatment and current data was developed allowing for visualization of changes in prognosis depending on clinical data.
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- 2020
21. Restaging Transurethral Resection of Bladder Tumours after BCG Immunotherapy Induction in Patients with T1 Non-Muscle-Invasive Bladder Cancer Might not Be Associated with Oncologic Benefit
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Giuseppe Simone, Evanguelos Xylinas, Maria Cristina Marconi, Romuald Zdrojowy, Mario Alvarez-Maestro, Joanna Krajewska, Ettore Di Trapani, Karl H. Tully, Andrea Mari, Sławomir Poletajew, Alessandro Antonelli, Radosław Piszczek, Tim Muilwijk, Stefania Zamboni, Riccardo Mastroianni, Wojciech Krajewski, Andrzej Tukiendorf, Ekaterina Laukhtina, Anna Kołodziej, Andrea Rodriguez Serrano, Jeremy Yuen-Chun Teoh, Claudio Simeone, Alessandro Tafuri, Kees Hendricksen, Marco Moschini, Aleksandra Zdrojowy-Wełna, Łukasz Nowak, Andrzej Paradysz, Steven Joniau, Alessandra Gozzo, Luca Afferi, Guillaume Ploussard, and Pawel Rajwa
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medicine.medical_specialty ,CARCINOMA ,medicine.medical_treatment ,030232 urology & nephrology ,Urology ,lcsh:Medicine ,PROGRESSION ,1ST ,Tertiary care ,Article ,Resection ,03 medical and health sciences ,Medicine, General & Internal ,0302 clinical medicine ,General & Internal Medicine ,medicine ,In patient ,BCG ,RECURRENCE ,Science & Technology ,Bladder cancer ,business.industry ,lcsh:R ,Bcg immunotherapy ,General Medicine ,Immunotherapy ,medicine.disease ,bladder cancer ,reTURB ,Clinical Practice ,030220 oncology & carcinogenesis ,Non muscle invasive ,business ,Life Sciences & Biomedicine - Abstract
Background and Purpose: The European Association of Urology guidelines recommend restaging transurethral resection of bladder tumours (reTURB) 2&ndash, 6 weeks after primary TURB. However, in clinical practice some patients undergo a second TURB procedure after Bacillus Calmette-Gué, rin immunotherapy (BCG)induction. To date, there are no studies comparing post-BCG reTURB with the classic pre-BCG approach. The aim of this study was to assess whether the performance of reTURB after BCG induction in T1HG bladder cancer is related to potential oncological benefits. Materials and Methods: Data from 645 patients with primary T1HG bladder cancer treated between 2001 and 2019 in 12 tertiary care centres were retrospectively reviewed. The study included patients who underwent reTURB before BCG induction (Pre-BCG group: 397 patients, 61.6%) and those who had reTURB performed after BCG induction (Post-BCG group: 248 patients, 38.4%). The decision to perform reTURB before or after BCG induction was according to the surgeon&rsquo, s discretion, as well as a consideration of local proceedings and protocols. Due to variation in patients&rsquo, characteristics, both propensity-score-matched analysis (PSM) and inverse-probability weighting (IPW) were implemented. Results: The five-year recurrence-free survival (RFS) was 64.7% and 69.1% for the Pre- and Post-BCG groups, respectively, and progression-free survival (PFS) was 82.7% and 83.3% for the Pre- and Post-BCG groups, respectively (both: p >, 0.05). Similarly, neither RFS nor PFS differed significantly for a five-year period or in the whole time of observation after the PSM and IPW matching methods were used. Conclusions: Our results suggest that there might be no difference in recurrence-free survival and progression-free survival rates, regardless of whether patients have reTURB performed before or after BCG induction.
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- 2020
22. How has the COVID-19 pandemic impacted Polish urologists? Results from a national survey
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Dominik Chorągwicki, Piotr Radziszewski, Piotr Chlosta, Pawel Rajwa, Rafał B. Drobot, Mikolaj Przydacz, Jakub Ryszawy, Piotr Zapała, Andrzej Paradysz, and Gniewko Więckiewicz
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medicine.medical_specialty ,Original Paper ,business.industry ,Incidence (epidemiology) ,Respiratory infection ,COVID-19 ,General Medicine ,Mental health ,Family life ,030227 psychiatry ,03 medical and health sciences ,0302 clinical medicine ,Family medicine ,Health care ,Pandemic ,Medicine ,Outpatient clinic ,resident ,survey ,030212 general & internal medicine ,Poland ,business ,Adverse effect ,urology - Abstract
Sept 15, 2020 Introduction Poland was initially less affected by the coronavirus disease 2019 (COVID-19) pandemic, however, severe restrictions, and health care restructuration have impacted all areas of medicine, including urology [ ]we aimed, via an online survey, to examine the impact of the COVID-19 pandemic on Polish urologists and urology residents [ ]despite initial success with flattening the COVID-19 incidence curve, escalating restrictions, further health care restructuration (including the opening of COVID-19-dedicated hospitals), and unexplored COVID-19 fear likely led to indirect adverse effects of the pandemic also impacting Polish physicians and their work [ ]COVID-19, a droplets-transmitted respiratory infection, despite not being in the initial scope of treatment of urologists, has impacted all areas of urology including emergencies, outpatient clinics, elective surgeries, as well as physicians' everyday lives [6, 7] Most of the responders felt that their main worksite provided PPE (definitely yes: 20 09%;rather yes: 49 78%), with 78 60% believing that the availability of PPE has improved since the outbreak in March, 2020 [ ]86 92% of doctors reported over 25% declines in outpatient consultations and 55 90% claimed that their income dropped over 25% There were also other borderline significant results, such as more urologists and residents working in the COVID-19 centers indicating >50% earnings decreases as compared to those not in COVID-19 dedicated centers (36 1% vs 21 2%) DISCUSSION Our study indicates that the COVID-19 pandemic has deeply and negatively influenced Polish urologists and urology residents, in terms of clinical practice, financial situation, mental health, and family life
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- 2020
23. The comparison of oxidative stress effect in classic and tubeless percutaneous nephrolithotomy
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Małgorzata Cisowska-Babraj, Andrzej Paradysz, Piotr Bryniarski, Pawel Rajwa, Sławomir Kasperczyk, and Paweł Stelmach
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Male ,Nephrology ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Urine ,medicine.disease_cause ,Antioxidants ,Superoxide dismutase ,Kidney Calculi ,03 medical and health sciences ,Kidney stone disease ,0302 clinical medicine ,Urolithiasis ,Internal medicine ,medicine ,Humans ,Percutaneous nephrolithotomy ,Postoperative Period ,Sulfhydryl Compounds ,Nephrostomy, Percutaneous ,Kidney ,Urology - Original Paper ,biology ,Superoxide Dismutase ,business.industry ,Middle Aged ,Catalase ,medicine.disease ,Oxidative Stress ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Preoperative Period ,biology.protein ,Female ,Kidney stones ,business ,Oxidative stress - Abstract
Purpose Surgical stone treatment induces oxidative stress in kidney tissue. We hypothesized that tubeless percutaneous nephrolithotomy (tPCNL) may induce less oxidative stress than classic percutaneous nephrolithotomy (cPCNL) with nephrostomy tube. Methods Seventy-two consecutive patients with kidney stones qualified for PCNL were enrolled in the study. Patients were assigned to one of two groups (first group 33 patients—cPCNL and second group 39 patients—tPCNL). Four urine samples were collected in four consecutive days, starting the day before operation. Four oxidative stress markers were analyzed in each sample: catalase (CAT), protein sulfhydryl group (SH), total antioxidant capacity (TAC) and superoxide dismutase (SOD). Results Baseline mean levels of CAT (IU/l), SH (μmol/l), TAC (mmol/l) and SOD (NU/ml) were 19.4 versus 11.7; 18 versus 58.7; 2.02 versus 1.99; 20.5 versus 22.6 in cPCNL and tPCNL group, respectively. On day two, the levels were 89 versus 104.9; 334.7 versus 518.9; 1.87 versus 1.79; 33.7 versus 41.4, respectively. On the third day, the levels were: 67.4 versus 28.3; 206.8 versus 306.9; 2.01 versus 2.06; 38.2 versus 36.6, respectively. On the fourth day, the concentrations were 47.4 versus 18.5; 129.3 versus 208.7; 2 versus 2.06; 35 versus 45.2, respectively. Significant differences were observed only for CAT and TAC concentrations in days 3 (p = 0.04 and 0.04) and 4 (p = 0.02 and
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- 2018
24. Basic Parameters of Blood Count, Serum Sodium, and Creatinine as Prognostic Factors for Renal Cell Carcinoma at Five-Year Follow-Up
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Marcin Życzkowski, Grzegorz Prokopowicz, Andrzej Paradysz, Paweł Stelmach, Pawel Rajwa, Piotr Taborowski, and Krzysztof Nowakowski
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Male ,medicine.medical_specialty ,Sodium ,030232 urology & nephrology ,chemistry.chemical_element ,Gastroenterology ,Metastasis ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Clinical Research ,Risk Factors ,Renal cell carcinoma ,Internal medicine ,Carcinoma ,Humans ,Medicine ,Platelet ,Carcinoma, Renal Cell ,Creatinine ,Platelet Count ,business.industry ,General Medicine ,Middle Aged ,Nomogram ,Prognosis ,medicine.disease ,Kidney Neoplasms ,Blood Cell Count ,Logistic Models ,chemistry ,030220 oncology & carcinogenesis ,Multivariate Analysis ,Female ,Neoplasm Recurrence, Local ,business ,Kidney cancer ,Follow-Up Studies - Abstract
BACKGROUND Several nomograms were developed for predicting the potential recurrence and cancer death risk in renal cell carcinoma patients. The combination of TNM classification and appropriately selected clinical classifiers allows for the creation of simple and effective risk calculators. MATERIAL AND METHODS There were 230 patients with renal cell cancer enrolled in this study. Basic parameters of blood count, serum creatinine and sodium concentrations, and histopathological features of the tumors were analyzed. A determination of whether any of the tested parameters could be used to assess the prognosis of kidney cancer was performed. RESULTS When the platelet cell count (PLT) increased by 10 thousand/µL, the risk of metastasis was higher by 5%, and cancer recurrence and death by 10%. A low-risk recurrence group was identified: T1b, PLT230, Na of 140.6 mmol/L. A high-risk recurrence group was identified: T3a, PLT280, Na of 143.4 mmol/L. A low-risk cancer specific mortality group was identified: T2a, absence of metastases, preoperative creatinine level of 85.6 µmol/L, and the value of PLT 227.0×103. A high-risk cancer specific mortality group was identified: T3a, the presence of metastases in the lungs (M), serum creatinine before treatment level of 97.9 µmol/L, and the value of PLT 299.5×10³. CONCLUSIONS Preoperative PLT, serum sodium, and tumor staging were independent risk factors for local recurrence. Blood PLT, serum sodium, creatinine, and tumor staging were useful indicators for estimating 5-year cancer specific survival.
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- 2018
25. Evaluation of the Predictive Role of Blood-Based Biomarkers in the Context of Suspicious Prostate MRI in Patients Undergoing Prostate Biopsy
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Pascal A. T. Baltzer, Victor M. Schuettfort, Abdulmajeed Aydh, Frederik König, Shahrokh F. Shariat, Piotr Bryniarski, Dadjar I. Hostermann, Hadi Mostafaei, Keiichiro Mori, Fahad Quhal, Andrzej Paradysz, Pawel Rajwa, Bernhard Grubmüller, Takafumi Yanagisawa, Nico C. Grossmann, Benjamin Pradere, Ekaterina Laukhtina, Reza Sari Motlagh, Nicolai A. Huebner, and Stephan Korn
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medicine.medical_specialty ,Prostate biopsy ,PNI ,Medicine (miscellaneous) ,Context (language use) ,Gastroenterology ,Article ,NLR ,Prostate cancer ,Prostate ,Internal medicine ,Biopsy ,medicine ,biopsy ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,Odds ratio ,Nomogram ,prostate cancer ,medicine.disease ,medicine.anatomical_structure ,Medicine ,dNLR ,business ,MRI - Abstract
The aim of this study was to assess the predictive value of pre-biopsy blood-based markers in patients undergoing a fusion biopsy for suspicious prostate magnetic resonance imaging (MRI). We identified 365 consecutive patients who underwent MRI-targeted and systematic prostate biopsy for an MRI scored Prostate Imaging–Reporting and Data System Version (PI-RADS) ≥ 3. We evaluated the neutrophil/lymphocyte ratio (NLR), derived neutrophil/lymphocyte ratio (dNLR), platelet/lymphocyte ratio (PLR), systemic immune inflammation index (SII), lymphocyte/monocyte ratio (LMR,) de Ritis ratio, modified Glasgow Prognostic Score (mGPS), and prognostic nutrition index (PNI). Uni- and multivariable logistic models were used to analyze the association of the biomarkers with biopsy findings. The clinical benefits of biomarkers implemented in clinical decision-making were assessed using decision curve analysis (DCA). In total, 69% and 58% of patients were diagnosed with any prostate cancer and Gleason Grade (GG) ≥ 2, respectively. On multivariable analysis, only high dNLR (odds ratio (OR) 2.61, 95% confidence interval (CI) 1.23–5.56, p = 0.02) and low PNI (OR 0.48, 95% CI 0.26–0.88, p = 0.02) remained independent predictors for GG ≥ 2. The logistic regression models with biomarkers reached AUCs of 0.824–0.849 for GG ≥ 2. The addition of dNLR and PNI did not enhance the net benefit of a standard clinical model. Finally, we created the nomogram that may help guide biopsy avoidance in patients with suspicious MRI. In patients with PI-RADS ≥ 3 lesions undergoing MRI-targeted and systematic biopsy, a high dNLR and low PNI were associated with unfavorable biopsy outcomes. Pre-biopsy blood-based biomarkers did not, however, significantly improve the discriminatory power and failed to add a clinical benefit beyond standard clinical factors.
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- 2021
26. Novel hematological biomarkers predict survival in renal cell carcinoma patients treated with nephrectomy
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Andrzej Paradysz, Piotr Bryniarski, Marcin Życzkowski, Kamil Suliga, Kamil Bujak, Pawel Rajwa, and Monika Slabon-Turska
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medicine.medical_specialty ,renal cell carcinoma ,Multivariate analysis ,medicine.medical_treatment ,030232 urology & nephrology ,renal cell cancer ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Renal cell carcinoma ,Clinical Research ,Internal medicine ,Clinical endpoint ,medicine ,platelet-lymphocyte ratio ,In patient ,neutrophil-lymphocyte ratio ,Surgical approach ,medicine.diagnostic_test ,business.industry ,Complete blood count ,Patient survival ,General Medicine ,medicine.disease ,Nephrectomy ,derived neutrophil-lymphocyte ratio ,030220 oncology & carcinogenesis ,Immunology ,business ,lymphocyte-monocyte ratio - Abstract
Introduction The association between novel blood-based inflammatory indices and patient survival has been reported with reference to various cancers. The aim of this study was to investigate the prognostic value of preoperative platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), derived neutrophil-lymphocyte ratio (dNLR) and lymphocyte-monocyte ratio (LMR) in patients with renal cell carcinoma (RCC) treated with nephrectomy. Material and methods From 2003 to 2012, 455 patients who underwent partial or radical nephrectomy for RCC were enrolled in the study. The study endpoints were overall survival (OS) and cancer-specific survival (CSS). Results The median follow-up was 70 months. Groups of patients with high levels of PLR, NLR and dNLR and a low level of LMR more often underwent radical nephrectomy, had a higher cancer stage in the TNM classification, and were more frequently diagnosed with tumor necrosis in histopathological examination. Both cancer-specific mortality and overall mortality were significantly higher in patients with high PLR, NLR and dNLR and low LMR. Multivariate analysis of CSS, adjusted for standard clinicopathological factors, identified only dNLR (p = 0.006) as an independent prognostic factor. PLR (p = 0.0002), dNLR (p = 0.0003) and NLR (p = 0.002), but not LMR (p = 0.1), achieved prognostic significance in multivariable analysis regarding OS. Conclusions Only dNLR was an independent prognostic factor for CSS and OS. Nevertheless, our study indicates that all examined complete blood count-based biomarkers may be useful tools in managing RCC patients treated with a surgical approach.
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- 2017
27. Application of Pneumatic Lithotripter and Holmium Laser in the Treatment of Ureteral Stones and Kidney Stones in Children
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Pawel Rajwa, Bartosz Muskała, Piotr Bryniarski, Rafał Bogacki, Marcin Życzkowski, Andrzej Paradysz, and Krzysztof Nowakowski
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Male ,Comparative Effectiveness Research ,medicine.medical_specialty ,Article Subject ,Adolescent ,Operative Time ,030232 urology & nephrology ,Holmium laser ,Solid-state ,lcsh:Medicine ,Lasers, Solid-State ,Holmium Lasers ,General Biochemistry, Genetics and Molecular Biology ,Kidney Calculi ,03 medical and health sciences ,0302 clinical medicine ,Lithotripsy ,Ureteroscopy ,Humans ,Medicine ,Child ,Urinary Tract ,Retrospective Studies ,General Immunology and Microbiology ,business.industry ,lcsh:R ,Follow up studies ,Treatment options ,General Medicine ,medicine.disease ,Surgery ,Treatment Outcome ,Child, Preschool ,030220 oncology & carcinogenesis ,Child population ,Operative time ,Female ,Laparoscopy ,Kidney stones ,business ,Follow-Up Studies ,Research Article - Abstract
Objective.Treatment options for urolithiasis in children include URSL and RIRS. Various types of energy are used in the disintegration of deposits in these procedures. We decided to evaluate the usefulness of URSL and RIRS techniques and compare the effectiveness of pneumatic lithotripters and holmium lasers in the child population based on our experience.Materials and Methods.One hundred eight (108) children who underwent URSL and RIRS procedures were enrolled in the study and divided into two (2) groups according to the type of energy used: pneumatic lithotripter versus holmium laser. We evaluated the procedures’ duration and effectiveness according to the stone-free rate (SFR) directly after the procedure and after fourteen (14) days and the rate of complications.Results.The mean operative time was shorter in the holmium laser group. A higher SFR was observed in the holmium laser but it was not statistically significant in the URSL and RIRS procedures. The rate of complications was similar in both groups.Conclusions.The URSL and RIRS procedures are highly efficient and safe methods. The use of a holmium laser reduces the duration of the procedure and increases its effectiveness in comparison with the use of a pneumatic lithotripter.
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- 2017
28. Estimation of the relationship between the polymorphisms of selected genes: ACE, AGTR1, TGFβ1 and GNB3 with the occurrence of primary vesicoureteral reflux
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Andrzej Paradysz, Marcin Życzkowski, Władysław Grzeszczak, Joanna Żywiec, Janusz Gumprecht, and Krzysztof Nowakowski
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Male ,0301 basic medicine ,Nephrology ,TGFbeta1 ,medicine.medical_specialty ,Voiding cystourethrogram ,Adolescent ,Urology ,AGTR1 ,030232 urology & nephrology ,Peptidyl-Dipeptidase A ,Vesicoureteral reflux ,Receptor, Angiotensin, Type 1 ,Transforming Growth Factor beta1 ,Young Adult ,Genes polymorphism ,03 medical and health sciences ,Primary vesicoureteral reflux ,GNB3 ,Kidney function ,0302 clinical medicine ,Internal medicine ,Genotype ,medicine ,Genetic predisposition ,Humans ,Genetic Predisposition to Disease ,Child ,ACE ,Vesico-Ureteral Reflux ,Polymorphism, Genetic ,Urology - Original Paper ,medicine.diagnostic_test ,Genitourinary system ,business.industry ,medicine.disease ,Heterotrimeric GTP-Binding Proteins ,030104 developmental biology ,Case-Control Studies ,Child, Preschool ,Female ,Gene polymorphism ,business ,Glomerular Filtration Rate - Abstract
Purpose Etiopathogenesis of VUR is composite and not fully understood. Many data indicate the importance of genetic predisposition. The aim of this study was to establish the relationship of selected polymorphisms: 14094 polymorphism of the ACE, polymorphism rs1800469 of TGFβ-1, rs5443 gene polymorphism of the GNB3 and receptor gene polymorphism rs5186 type 1 AGTR1 with the occurrence of the primary vesicoureteral reflux. Material The study included 190 children: 90 with the primary VUR confirmed with the voiding cystourethrogram and excluded secondary VUR and a control group of 100 children without a history of the diseases of the genitourinary tract. Methods The study was planned in the scheme: “tested case versus control.” Genomic DNA was isolated from the leukocytes of peripheral blood samples. The results were statistically analyzed in the Statistica 10 using χ 2 test and analysis of the variance Anova. Results Any of the four studied polymorphisms showed no difference in the distribution of genotypes between patients with primary vesicoureteral reflux and the control group. In patients with VUR and TT genotype polymorphism rs5443 GNB3 gene, the glomerular filtration rate was significantly higher than in patients with genotype CC or CT. Conclusions (1) No relationship was found between the studied polymorphisms (14094 ACE gene, rs1800469 gene TGFβ1, GNB3 gene rs5443, rs5186 AGTR1 gene) and the occurrence of primary vesicoureteral reflux. (2) TT genotype polymorphism rs5443 GNB3 gene may be a protective factor for the improved renal function in patients with primary vesicoureteral reflux in patients with genotype CC or CT.
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- 2016
29. Percutaneous Nephrolithotomy with Amplatz and Alken Dilators: An Eight-Year Single Tertiary Care Centre Experience
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Andrzej Paradysz, Paweł Stelmach, Mateusz Adamkiewicz, Piotr Bryniarski, Marcin Życzkowski, Pawel Rajwa, and Piotr Taborowski
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Adult ,Male ,medicine.medical_specialty ,Percutaneous ,medicine.medical_treatment ,Group ii ,030232 urology & nephrology ,Urology ,Tertiary care ,Tertiary Care Centers ,03 medical and health sciences ,Kidney Calculi ,0302 clinical medicine ,Postoperative Complications ,Urolithiasis ,Clinical Research ,medicine ,Humans ,Percutaneous nephrolithotomy ,Grade IIIa ,Nephrostomy, Percutaneous ,Retrospective Studies ,business.industry ,Retrospective cohort study ,General Medicine ,Middle Aged ,Dilatation ,Surgery ,030220 oncology & carcinogenesis ,Dilator ,Nephrostomy ,Female ,business - Abstract
BACKGROUND Percutaneous nephrolithotomy (PNL) is the standard procedure for patients with renal stones over 2 cm in diameter. We analyzed complications after this procedure focusing on two different methods of tract dilation. MATERIAL AND METHODS Between August 2008 and April 2016 222 percutaneous nephrolithotomies were performed in a total of 208 patients. The Group I (n=123) comprised patients where Alken dilatators were used, while Group II (n=99) comprised patients where Amplatz dilators were used. Efficacy was examined based on ultrasound and x-ray examination one month after the procedure. Complications were recorded using Clavien Dindo classification. RESULTS Efficacy was 85.3% and 86.8% in group I and II, respectively (p=0.77). Grade I complications were present in 14.6% and 3%, grade II were present in 9.7% and 8%, grade IIIa were present in 2.4% and 2%, grade IIIb were present in 1.6% and 2%, grade IVa were present in 1.6% and 7%, grade IVb were present in 3.2% and 1% in Group I and Group II, respectively. These differences were statistically significant (p=0.03). CONCLUSIONS Efficacy was comparable between Alken dilator and Amplatz dilator groups. In group I, there were more postoperative fevers >38.5 °C and a higher rate of urosepsis. On the other hand, in group II we observed more pleural injuries. All differences resulted from the type of access to the kidney (inter/infracostal), punctured calyx, and utilization (or not) of access sheath rather than type of dilators itself.
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- 2016
30. Physiotherapeutic assessment and management of chronic pelvic pain syndrome
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Andrzej Paradysz, Bartłomiej Burzyński, Tomasz Jurys, Katarzyna Cempa, and Kamil Burzynski
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Male ,medicine.medical_specialty ,Rectum ,Pelvic Pain ,chronic pelvic pain syndrome ,03 medical and health sciences ,0302 clinical medicine ,Scrotum ,medicine ,Humans ,case report ,physiotherapy techniques ,Clinical Case Report ,030212 general & internal medicine ,Physical Therapy Modalities ,Pelvic floor ,business.industry ,Pelvic pain ,Pelvic Floor ,Syndrome ,General Medicine ,Middle Aged ,Musculoskeletal Manipulations ,Perineum ,medicine.anatomical_structure ,Urethra ,030220 oncology & carcinogenesis ,Physical therapy ,Abdomen ,Chronic Pain ,medicine.symptom ,Manual therapy ,business ,Research Article - Abstract
Introduction: Chronic pelvic pain syndrome is difficult for the diagnosis and therapy and that means the patient attending the physician or physiotherapist may present various symptoms. There are no guidelines concern physiotherapy diagnosis and treatment of chronic pelvic pain syndrome. This study presents the physiotherapeutic assessment and management in men with pelvic pain symptoms. Patient concerns: Forty-six-year-old man attended the physiotherapy consulting room due to symptoms of pain in the perineum, lower abdomen, urethra, and scrotum for a year. Earlier, the patient had consulted a urologist who made a diagnosis of cystitis and prescribed medications that did not get results. Diagnosis: Ultrasound imaging and manual inspection (per rectum) of the pelvic floor was conducted by physiotherapist. Also, the abdominal and lower extremities muscles were assessed. Patient reported pain symptoms during examination of the musculus ischiocavernosus, puboanalis, pubococcygeus, iliococcygeus, coccygeus, and canalis pudentalis seu Alcocki. Interventions: The patient was given physiotherapeutic interventions consisting in the manual therapy of the lumbopelvic hip complex and the manual therapy per rectum. Outcomes: During 10th session of the physiotherapeutic treatment, patient reported improvement in pain symptoms. A month later, patient reported total alleviation of the pain symptoms during control visit. Conclusion: Therapy of chronic pelvic pain syndrome is a process that involves application of different therapies and different approaches. Functional and structural assessment and also therapy conducted by physiotherapist is becoming an integral part of urology and represents 1 possible conservative treatment form.
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- 2021
31. A non-inferiority study to analyze the safety of totally tubeless percutaneous nephrolithotomy
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Andrzej Paradysz, Piotr Bryniarski, Marcin Życzkowski, Pawel Rajwa, Piotr Taborowski, and Zbigniew Kaletka
- Subjects
medicine.medical_specialty ,Visual analogue scale ,medicine.medical_treatment ,Medicine (miscellaneous) ,Nephrolithotomy, Percutaneous ,Lithotripsy ,Postoperative Hemorrhage ,Tertiary care ,General Biochemistry, Genetics and Molecular Biology ,Kidney Calculi ,Non inferiority ,Internal Medicine ,medicine ,Humans ,Pharmacology (medical) ,Prospective Studies ,Percutaneous nephrolithotomy ,Genetics (clinical) ,Nephrostomy, Percutaneous ,Retrospective Studies ,Pain, Postoperative ,business.industry ,Length of Stay ,medicine.disease ,Confidence interval ,Surgery ,Treatment Outcome ,Reviews and References (medical) ,Renal vessels ,Drainage ,Kidney stones ,Analgesia ,business - Abstract
Background Totally tubeless percutaneous nephrolithotomy (ttPCNL) becomes increasingly frequently utilized in the treatment of kidney stones. This procedure emerged as an answer for patients' needs to minimize hospitalization time, pain intensity and discomfort due to nephrostomy tube. However, ttPCNL may be less safe for patients, as without nephrostomy tube bleeding from renal vessels is potentially more severe. Objectives The purpose of our study was to retrospectively evaluate the safety parameters of ttPCNL collected in a prospective manner. Material and methods This was a single tertiary care center, non-inferiority study with 2 arms (55 patients in each arm). The 1st group consisted of patients who underwent ttPCNL with the application of TachoSil® (Takeda, Osaka, Japan) as sealing material, while in the 2nd group, conventional PCNL with nephrostomy tube (cPCNL) was utilized. The primary goal was to prove that hemoglobin drop after surgery, as equivalent of safety, was not inferior than 1 g/dL. The secondary endpoints comprised visual analogue scale (VAS) of pain, additional pain treatment and hospital stay. Results The mean hemoglobin drop after ttPCNL was insignificantly lower in comparison with cPCNL group (mean: -0.35 g/dL; confidence interval (CI) = -0.8, 0.21). Visual analogue scale of pain and pain treatment were comparable between groups. Hospital stay was significantly shorter in the ttPCNL group. Conclusions Totally tubeless PCNL can be considered a safe option after uncomplicated lithotripsy - what is important, it is characterized by a shorter hospitalization time. Postoperatively, pain intensity is comparable between both groups.
- Published
- 2018
32. Correlation between malnutrition, body mass index and complications in patients with urinary bladder cancer who underwent radical cystectomy
- Author
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Rafał Bogacki, Grzegorz Swalarz, Marcin Słojewski, Marcin Matuszewski, Kajetan Juszczak, Piotr Maciukiewicz, Mateusz Kadłubowski, Piotr Bryniarski, Krzysztof Czurak, Marta Swalarz, D. Gajewska, Ewa Genge, Tomasz Drewa, and Andrzej Paradysz
- Subjects
Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,030232 urology & nephrology ,Medicine (miscellaneous) ,Overweight ,Cystectomy ,Asepsis ,General Biochemistry, Genetics and Molecular Biology ,Body Mass Index ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Weight loss ,Risk Factors ,Internal medicine ,Internal Medicine ,medicine ,Humans ,Pharmacology (medical) ,Genetics (clinical) ,Aged ,Bladder cancer ,business.industry ,Malnutrition ,Middle Aged ,medicine.disease ,Urinary Bladder Neoplasms ,030220 oncology & carcinogenesis ,Reviews and References (medical) ,Female ,medicine.symptom ,Underweight ,business ,Body mass index - Abstract
Background Nutrition is the 3rd most important factor in surgery, following anesthesia and asepsis. Until now, it has been a poorly explored field of urology. The relationship between malnutrition and postoperative complications has been proven beyond doubt in general surgery, where 30% of patients are operated in a malnutrition state. Objectives The aim of our work was to assess the influence of malnutrition, defined by nutritional risk screening (NRS) scale and body mass index (BMI), on postoperative results in patients with bladder cancer after radical cystectomy. Material and methods The research was carried out at 8 urological centers between 2012 and 2014, and included patients with bladder cancer at stage from T2 to T4, who underwent radical cystectomy. The degree of malnutrition was assessed with the aid of the NRS 2002 questionnaire. Other examined parameters were BMI, age, type of operation, and the number of complications, the latter of which were measured by applying the Clavien-Dindo scale. Results A total of 125 patients were enrolled in our study, out of whom 64 (51.2%) were undernourished. According to the BMI, most of the patients were overweight - 50 (40%) or had normal body weight - 49 (39.2%); 24 (19.2%) were obese, and 2 (1.6%) were underweight. Conclusions There was no relationship between malnutrition, defined by the NRS scale, and postoperative complications, and we did not find a significant relationship between the other tested variables. We observed only 1 significant relationship between the nutrition state, measured by BMI scale, and the degree in Clavien-Dindo scale. Body mass index under 18.5 and over 30 increased postoperative complications. Nowadays, the recommended scale is NRS 2002, which is based mostly on loss of weight. In our patients, qualitative malnutrition is more probable than quantitative malnutrition.
- Published
- 2018
33. Sacrocolpopexy with Polypropylene Tape as Valuable Surgical Modification during Cystectomy with Orthotopic Ileal Bladder: Functional Results
- Author
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Andrzej Paradysz, Zbigniew Kaletka, Krzysztof Nowakowski, Piotr Bryniarski, Marcin Życzkowski, Bartosz Muskała, and Rafał Bogacki
- Subjects
Male ,medicine.medical_specialty ,Article Subject ,medicine.medical_treatment ,Urinary Bladder ,Urology ,lcsh:Medicine ,Urinary incontinence ,Urinary Diversion ,Cystectomy ,Polypropylenes ,General Biochemistry, Genetics and Molecular Biology ,Surgical methods ,law.invention ,Ileal bladder ,Quality of life ,Randomized controlled trial ,Ileum ,law ,Surveys and Questionnaires ,medicine ,Humans ,Orthopedic Procedures ,General Immunology and Microbiology ,Urinary retention ,business.industry ,lcsh:R ,Urinary diversion ,General Medicine ,Middle Aged ,Urodynamics ,Urinary Bladder Neoplasms ,Case-Control Studies ,Quality of Life ,Clinical Study ,Female ,medicine.symptom ,business - Abstract
Introduction. Urinary diversion is very often associated with urinary retention and urinary incontinence. In this study, a surgical modification during cystectomy with orthotopic ileal neobladder is presented.Material and Methods. Female patients enrolled in the study (n-24) were subjected to sacrocolpopexy during the operation. Apart from oncological control, the follow-up consisted of 1-hour inlay test and questionnaires (UDI-6 and IIQ-7) in the 3rd, 6th, and 12th month after the operation. In the 12th month after the surgery, the urodynamic pressure-flow test was performed. Outcomes were compared with the control group (n-18) in which sacrocolpopexy was not implemented.Results. The study group was characterised by reduced urinary retention and improved continence.Conclusion. Sacrocolpopexy during cystectomy with orthotopic ileal bladder is a valuable surgical method which provides patients with a better quality of life.
- Published
- 2015
34. Cochlear Function Monitoring after Spinal Anesthesia
- Author
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Agata Janecka-Placek, Andrzej Paradysz, Hanna Misiołek, and Grażyna Lisowska
- Subjects
Adult ,Male ,medicine.medical_specialty ,Time Factors ,Adolescent ,medicine.medical_treatment ,Otoacoustic Emissions, Spontaneous ,Hemodynamics ,Lithotripsy ,Audiology ,Anesthesia, Spinal ,Cochlear function ,Fentanyl ,Young Adult ,Clinical Research ,otorhinolaryngologic diseases ,Humans ,Medicine ,Postoperative Period ,Cochlea ,Bupivacaine ,medicine.diagnostic_test ,business.industry ,Hearing Tests ,Spinal anesthesia ,Auditory Threshold ,General Medicine ,Middle Aged ,Hair Cells, Auditory, Outer ,Acoustic Stimulation ,Anesthesia ,Urologic Surgical Procedures ,Audiometry, Pure-Tone ,Female ,sense organs ,Audiometry ,business ,medicine.drug - Abstract
BACKGROUND The aim of the study was to examine the effect of spinal anesthesia on the function of cochlear outer hair cells (OHCs), determined by means of objective distortion product otoacoustic emissions (DPOAE) testing. To the best of our knowledge, our study was the second OAE-based analysis of cochlear function during spinal anesthesia, and the only experiment including such a large group of patients. MATERIAL AND METHODS The study included 20 patients (18 men and 2 women) subjected to a scheduled uretherorenoscopic lithotripsy with routine spinal anesthesia with 10 mg (2 ml) of 0.5% hyperbaric bupivacaine and 50 μg (1 ml) of fentanyl. The levels of DPOAEs and background noise at 1000-6000 Hz were recorded prior to and immediately after the anesthesia, and on the postoperative day 2. RESULTS We did not find significant differences between DPOAEs values recorded prior to and immediately after the anesthesia. The only exception pertained to 5652 Hz, at which a significantly higher level of DPOAEs was observed immediately after the anesthesia. The levels of DPOAEs at 2002 Hz and 2380 Hz collected on the postoperative day 2 were significantly higher than the respective baseline values. Irrespective of the frequency and time of testing, we did not find any significant differences between the recorded levels of background noise. CONCLUSIONS Our findings point to the lack of a detrimental effect of spinal anesthesia on objectively evaluated cochlear function, and thus suggest that this method is safe, even for OHCs, which are extremely susceptible to exogenous and endogenous injuries.
- Published
- 2015
35. Impact of Testosterone Replacement Therapy in Patients with Hypogonadism and High-Grade Prostate Intraepithelial Neoplasia or Atypical Small Acinar Proliferation in Prostate Biopsy
- Author
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Piotr Bryniarski, Rafał Bogacki, Zbigniew Kaletka, Andrzej Paradysz, Krzysztof Nowakowski, Mieczysław Fryczkowski, and Marcin Życzkowski
- Subjects
PCA3 ,Intraepithelial neoplasia ,medicine.medical_specialty ,Atypical small acinar proliferation ,Prostate biopsy ,medicine.diagnostic_test ,business.industry ,Biomedical Engineering ,Urology ,Bioengineering ,Testosterone (patch) ,General Medicine ,medicine.anatomical_structure ,Prostate ,medicine ,In patient ,Testosterone replacement ,business ,General Psychology - Published
- 2015
36. The Relationship Between Red Cell Distribution Width and Cancer-Specific Survival in Patients With Renal Cell Carcinoma Treated With Partial and Radical Nephrectomy
- Author
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Marcin Życzkowski, Ewelina Jantos, Andrzej Paradysz, Karolina Jakubowska, Ewa Gabrys, and Pawel Rajwa
- Subjects
0301 basic medicine ,Erythrocyte Indices ,Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Kaplan-Meier Estimate ,Hematocrit ,Nephrectomy ,03 medical and health sciences ,0302 clinical medicine ,Renal cell carcinoma ,Medicine ,Humans ,Stage (cooking) ,Carcinoma, Renal Cell ,Aged ,Neoplasm Staging ,Retrospective Studies ,Receiver operating characteristic ,medicine.diagnostic_test ,business.industry ,Red blood cell distribution width ,Middle Aged ,medicine.disease ,Prognosis ,Kidney Neoplasms ,030104 developmental biology ,Oncology ,ROC Curve ,030220 oncology & carcinogenesis ,Female ,business ,Body mass index ,Kidney cancer - Abstract
The aim of the study was to evaluate the influence of red cell distribution width (RDW) on cancer-specific survival (CSS) in patients who undergo nephrectomy for renal cell carcinoma (RCC).A total number of 434 patients with pathologically proven RCC treated with radical or partial nephrectomy between 2003 and 2012 were identified in a single tertiary academic center. To evaluate the accuracy of RDW for CSS prediction, a receiver operating characteristic (ROC) curve was plotted. Patients were divided into 2 groups, with low and high RDW, according to the optimal cutoff value, which was determined according to the ROC curve. The association between groups and CSS was analyzed using the Kaplan-Meier method with log-rank testing. The Cox proportional hazards regression model was applied to perform univariate and multivariate analysis for CSS.Median follow-up was 2146 days. There were no differences between subjects with high and low RDW in terms of sex, age, body mass index, histological type of tumor, frequency of partial nephrectomy, and TNM stage. Patients with high RDW had significantly lower hematocrit, hemoglobin level, and red blood cell count. Tumor necrosis and larger tumor size were significantly more prevalent in the group of patients with high RDW. CSS was significantly lower in patients with RDW ≥ 13.9% compared with patients with RDW 13.9%. After adjustment for pathological and clinical covariates RDW remained an independent predictor for CSS in a multivariable model for CSS.Our study revealed that the RDW might be an easily obtainable prognostic marker in RCC patients treated with nephrectomy.
- Published
- 2017
37. Pelvico-calyceal system rupture due to staghorn calculus with urinoma formation in a boy with neurofibromatosis type 1 and quadriplegia
- Author
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Piotr Adamczyk, Ewa Kluczewska, Agnieszka Zachurzok-Buczyńska, Elżbieta Trembecka-Dubel, Zuzanna Gamrot, Andrzej Paradysz, Jolanta Myga-Porosiło, Katarzyna Ziora, and Maria Szczepańska
- Subjects
medicine.medical_specialty ,Percutaneous ,kamica układu moczowego ,business.industry ,Urinary system ,Acute kidney injury ,Nephrolithiasis ,medicine.disease ,Urinoma ,Surgery ,Catheter ,Pneumonia ,krwiomocz ,zaciek moczowy ,Urine leakage ,urinoma ,Pediatrics, Perinatology and Child Health ,medicine ,Pediatrics, Perinatology, and Child Health ,Neurofibromatosis ,Differential diagnosis ,business ,nerwiakowłókniakowatość typu 1 ,Neurofibromatosis type 1 ,Hematuria - Abstract
Nephrolithiasis is a rare condition in children. The urinary tract rupture related to stones formation or migration is atypical in children, but creates serious consequences. We present a case of a 17-year-old quadriplegic patient with neurofibromatosis type 1 and urinoma due to the rupture of calyceal fornices in the course of nephrolithiasis. The boy was admitted with symptoms of severe pneumonia complicated with sepsis and prerenal acute kidney injury. Abdominal ultrasound revealed stone casts in both renal pelvises. Antibiotics, fluid therapy and diuretics were used to improve patient's condition. On the 28th day gross hematuria was observed. The patient's condition was stable, without signs of pain or discomfort. Abdomen ultrasound showed heteroechogenic structure (125 mm × 100 mm × 100 mm) localized between the lower surface of the liver and the right kidney. Contrast CT scan confirmed urinoma under the right kidney capsula. Because of the high risk of its rupture, decision of invasive evacuation of perirenal fluid was made. Using the percutaneous catheter 700 ml of bloody fluid was drained. After 10 days catheter was removed without recurrence of urinoma. Concluding, in children with prolonged immobilization this condition should be taken into consideration in differential diagnosis, also special attention should be paid for accompanying scarce symptoms.
- Published
- 2014
38. Gangrene of the penis, scrotum, and perineum, occurred after radiotherapy of rectal cancer
- Author
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Bartosz Muskała, Marcin Zyczkowski, Rafał Bogacki, Andrzej Paradysz, Krzysztof Nowakowski, and Piotr Bryniarski
- Subjects
Gangrene ,medicine.medical_specialty ,business.industry ,Colorectal cancer ,medicine.medical_treatment ,surgical treatment ,Case Report ,General Medicine ,medicine.disease ,Surgery ,Perineum ,Radiation therapy ,General state ,radiation ,medicine.anatomical_structure ,Scrotum ,medicine ,multidisciplinary approach ,gangrene ,business ,Surgical treatment ,rectal cancer ,Penis - Abstract
We present a case of a 58-year-old man hospitalized because of gangrene of the penis and scrotum, after radiochemotherapy for rectal cancer. At the time of the admission the patient presented with extensive gangrene with necrosis affecting the scrotum and the penis. During the first day of hospitalization the patient was operated. Due to the progress of the disease he had to be operated again. The status of the patient, which initially was very bad, was gradually improving. He was discharged from the hospital after 59 days in a good general state with good wound healing.
- Published
- 2013
39. The presence of prostate cancer at biopsy is predicted by a number of genetic variants
- Author
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Aniruddh, Kashyap, Wojciech, Kluźniak, Dominika, Wokołorczyk, Adam, Gołąb, Andrzej, Sikorski, Marcin, Słojewski, Bartłomiej, Gliniewicz, Jerzy, Świtała, Tomasz, Borkowski, Andrzej, Borkowski, Andrzej, Antczak, Łukasz, Wojnar, Jacek, Przybyła, Marek, Sosnowski, Bartosz, Małkiewicz, Romuald, Zdrojowy, Paulina, Sikorska-Radek, Józef, Matych, Jacek, Wilkosz, Waldemar, Różański, Jacek, Kiś, Krzysztof, Bar, Piotr, Bryniarski, Andrzej, Paradysz, Konrad, Jersak, Jerzy, Niemirowicz, Piotr, Słupski, Piotr, Jarzemski, Michał, Skrzypczyk, Jakub, Dobruch, Paweł, Domagała, Krzysztof, Piotrowski, Anna, Jakubowska, Jacek, Gronwald, Tomasz, Huzarski, Tomasz, Byrski, Tadeusz, Dębniak, Bohdan, Górski, Bartłomiej, Masojć, Thierry, van de Wetering, Janusz, Menkiszak, Mohammad R, Akbari, Jan, Lubiński, Steven A, Narod, Cezary, Cybulski, and Maria Małgorzata, Sąsiadek
- Subjects
Adult ,Male ,Oncology ,PCA3 ,Cancer Research ,medicine.medical_specialty ,Prostate biopsy ,Biopsy ,Polymorphism, Single Nucleotide ,Prostate cancer ,Prostate ,Internal medicine ,medicine ,Humans ,Alleles ,Aged ,Digital Rectal Examination ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Prostatic Neoplasms ,Cancer ,Rectal examination ,Middle Aged ,Prostate-Specific Antigen ,medicine.disease ,Prostate-specific antigen ,medicine.anatomical_structure ,Area Under Curve ,business - Abstract
Several single nucleotide polymorphisms (SNPs) have been associated with an elevated risk of prostate cancer risk. It is not established if they are useful in predicting the presence of prostate cancer at biopsy or if they can be used to define a low-risk group of men. In this study, 4,548 men underwent a prostate biopsy because of an elevated prostate specific antigen (PSA; ≥4 ng/mL) or an abnormal digital rectal examination (DRE). All men were genotyped for 11 selected SNPs. The effect of each SNP, alone and in combination, on prostate cancer prevalence was studied. Of 4,548 men: 1,834 (40.3%) were found to have cancer. A positive association with prostate cancer was seen for 5 of 11 SNPs studied (rs1800629, rs1859962, rs1447295, rs4430796, rs11228565). The cancer detection rate rose with the number of SNP risk alleles from 29% for men with no variant to 63% for men who carried seven or more risk alleles (OR = 4.2; p = 0.002). The SNP data did not improve the predictive power of clinical factors (age, PSA and DRE) for detecting prostate cancer (AUC: 0.726 vs. 0.735; p = 0.4). We were unable to define a group of men with a sufficiently low prevalence of prostate cancer that a biopsy might have been avoided. In conclusion, our data do not support the routine use of SNP polymorphisms as an adjunct test to be used on the context of prostate biopsy for Polish men with an abnormal screening test.
- Published
- 2013
40. The dietary isoflavone biochanin-A sensitizes prostate cancer cells to TRAIL-induced apoptosis
- Author
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Ewelina Szliszka, Zenon P. Czuba, Wojciech Król, Anna Mertas, and Andrzej Paradysz
- Subjects
Male ,medicine.medical_specialty ,Cell Survival ,Urology ,Apoptosis ,Biology ,Biochanin A ,TNF-Related Apoptosis-Inducing Ligand ,chemistry.chemical_compound ,Prostate cancer ,Immune system ,DU145 ,Cell Line, Tumor ,Internal medicine ,LNCaP ,medicine ,Humans ,Membrane Potential, Mitochondrial ,Dose-Response Relationship, Drug ,Molecular Structure ,Transcription Factor RelA ,Prostatic Neoplasms ,Flow Cytometry ,medicine.disease ,Genistein ,Isoflavones ,Diet ,Receptors, TNF-Related Apoptosis-Inducing Ligand ,Endocrinology ,Microscopy, Fluorescence ,Oncology ,chemistry ,Cancer cell ,Cancer research ,Tumor necrosis factor alpha ,Signal Transduction - Abstract
Biochanin-A, a major dietary isoflavone in soy and red clover, possesses anticancer and chemopreventive properties. Induction of apoptosis by naturally occurring dietary agents is an important event for cancer chemoprevention. Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) triggers apoptosis selectively in cancer cells but not in normal cells. Soluble or expressed in immune cells, molecules TRAIL plays a significant role in surveillance and defense mechanisms against tumours. Prostate cancer is an ideal disease for nutritional prevention. The TRAIL-mediated apoptosis pathway in prostate cancer cells is an attractive target for chemopreventive activities of dietary agents. LNCaP and DU145 prostate cancer cells are resistant to TRAIL-induced apoptosis. We showed that biochanin-A markedly augmented TRAIL-induced cytotoxicity and apoptosis in both prostate cancer cell lines. Then, we investigated the mechanisms by which biochanin-A enhanced TRAIL-mediated apoptosis using the LNCaP cell line. The isoflavone sensitized the TRAIL-resistant LNCaP cells through the inhibition of transcription factor NF-κB(p65) activity, increased the expression of the death receptor TRAIL-R2 (DR5), and disrupted mitochondrial membrane potential (ΔΨm). Our study confirmed that biochanin-A overcame TRAIL-resistance by engaging both intrinsic and extrinsic apoptotic pathways and by regulating the NF-κB activity. The results suggested a potential role of biochanin-A in prostate cancer chemoprevention through the enhancement of TRAIL-mediated apoptosis.
- Published
- 2013
41. The G84E mutation in the HOXB13 gene is associated with an increased risk of prostate cancer in Poland
- Author
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Pawel Domagala, Piotr Bryniarski, Józef Matych, Tadeusz Dębniak, Jacek Wilkosz, Konrad Jersak, Wojciech Kluźniak, Jerzy Niemirowicz, Andrzej Sikorski, Steven A. Narod, Mohammad R. Akbari, Jan Lubinski, Cezary Cybulski, Krzysztof Bar, Andrzej Borkowski, Bartłomiej Gliniewicz, Dominika Wokołorczyk, Romuald Zdrojowy, Piotr Słupski, Aniruddh Kashyap, Piotr Jarzemski, Andrzej Antczak, Anna Jakubowska, Tomasz Borkowski, Tomasz Byrski, Bartosz Małkiewicz, Jacek Kiś, Tomasz Huzarski, Lukasz Wojnar, Waldemar Różański, Jerzy Switała, Paulina Sikorska-Radek, Michał A. Skrzypczyk, Andrzej Paradysz, Marek Sosnowski, Jakub Dobruch, Jacek Przybyła, Jacek Gronwald, and Adam Gołąb
- Subjects
Oncology ,Gynecology ,education.field_of_study ,medicine.medical_specialty ,business.industry ,Urology ,Population ,Odds ratio ,medicine.disease ,Familial prostate cancer ,Prostate cancer ,medicine.anatomical_structure ,Prostate ,Internal medicine ,Genotype ,Mutation (genetic algorithm) ,medicine ,Allele ,education ,business - Abstract
BACKGROUND The G84E mutation in the HOXB13 gene has been associated with a high lifetime risk of prostate cancer in North America (about 20-fold). The geographical and ethnic extent of this recurrent allele has not yet been determined. METHODS We assayed for the presence of the G84E mutation in 3,515 prostate cancer patients and 2,604 controls from Poland and estimated the odds ratio for prostate cancer associated with the allele. RESULTS The G84E mutation was detected in 3 of 2,604 (0.1%) individuals from the general population in Poland and in 20 of 3,515 (0.6%) men with prostate cancer (Odds ratio [OR] = 5.0; 95% CI: 1.5–16.7; P = 0.008). The allele was present in 4 of 416 (1.0%) men with familial prostate cancer (OR = 8.4, 95% CI: 1.9–37.7; P = 0.005). CONCLUSIONS The G84E mutation predisposes to prostate cancer in Poland, but accounts for only a small proportion of cases. We expect that the G84E founder mutation might be present in other Slavic populations. Prostate 73: 542–548, 2013. © 2013 Wiley Periodicals, Inc.
- Published
- 2013
42. Ten-year treatment outcomes including blood cell count disturbances in patients with simple renal cysts
- Author
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Andrzej Paradysz, Zbigniew Kaletka, Piotr Bryniarski, Bartosz Muskała, Marcin Życzkowski, and Grzegorz Prokopowicz
- Subjects
Blood Platelets ,Male ,Pathology ,medicine.medical_specialty ,Time Factors ,complications ,Renal function ,Hematocrit ,Preoperative care ,Body Mass Index ,Hemoglobins ,chemistry.chemical_compound ,Clinical Research ,Preoperative Care ,Polycystic kidney disease ,Humans ,Medicine ,Cyst ,simple renal cyst ,Aged ,Postoperative Care ,Creatinine ,medicine.diagnostic_test ,business.industry ,blood pressure ,General Medicine ,Kidney Diseases, Cystic ,medicine.disease ,Blood Cell Count ,Surgery ,Treatment Outcome ,Blood pressure ,chemistry ,Case-Control Studies ,Female ,business ,red blood cells ,Glomerular Filtration Rate ,Kidney disease - Abstract
BACKGROUND The simple renal cyst is the most common benign kidney disease. It may cause pain and hypertension, especially if significantly enlarged. As in polycystic kidney disease, blood cell count disturbances are frequently observed in simple renal cysts. The aim of our study was to assess such disturbances, changes in blood pressure, and complication rate in our patients undergoing surgery due to simple renal cyst in the last 10 years. MATERIAL AND METHODS 210 patients with simple renal cysts were underwent surgery between 2002 and 2012. Two different kinds of operation were conducted: aspiration of cyst fluid with injection of sclerosing agent, and laparoscopic/retroperitoneoscopic decortications of the cyst wall. A control group comprised 134 patients with benign prostate hyperplasia. The following data were obtained: cyst burden, hematocrit, hemoglobin, red blood cells, thrombocytes, occurrence of pain, and blood pressure before and after the operation. Complications were collected and presented in Clavien score. RESULTS Hematocrit, hemoglobin, and red blood cells were significantly increased in the experimental group. A positive correlation was observed between cyst burden and the parameters mentioned above. Of 91 patients with hypertension, 56 (61.7%) had blood pressure reduction after the operation. Treatment relieved the loin pain in 132 (88%) patients. Complications occurred in 15 (7.4%) patients. CONCLUSIONS Patients with simple renal cysts have high values of red blood cells, hematocrit, and hemoglobin. Treatment decreases blood pressure in patients with hypertension. Complications after treatment are rare and mild.
- Published
- 2013
43. An inherited NBN mutation is associated with poor prognosis prostate cancer
- Author
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Tomasz Borkowski, Bartosz Małkiewicz, Piotr Jarzemski, Jacek Przybyła, Piotr Słupski, Jacek Wilkosz, Paulina Sikorska-Radek, Adam Gołąb, Andrzej Borkowski, Tomasz Byrski, Konrad Jersak, Jacek Gronwald, Józef Matych, Anna Jakubowska, Wojciech Kluźniak, Dominika Wokołorczyk, Andrzej Paradysz, Ł Wojnar, Romuald Zdrojowy, Jerzy Świtała, Piotr Bryniarski, Michał A. Skrzypczyk, Pawel Domagala, Tadeusz Dębniak, Aniruddh Kashyap, Cezary Cybulski, Marek Sosnowski, Andrzej Antczak, Tomasz Huzarski, Andrzej Sikorski, Jerzy Niemirowicz, Bohdan Górski, Jan Lubinski, Bartłomiej Gliniewicz, Jakub Dobruch, Jacek Kiś, Steven A. Narod, Waldemar Różański, and Krzysztof Bar
- Subjects
Oncology ,Adult ,Male ,Cancer Research ,medicine.medical_specialty ,Poor prognosis ,Genotype ,Genes, BRCA1 ,Subgroup analysis ,Cell Cycle Proteins ,Kaplan-Meier Estimate ,Biology ,Protein Serine-Threonine Kinases ,Genetics & Genomics ,NBS1 ,survival ,Prostate cancer ,Internal medicine ,NBN ,medicine ,Biomarkers, Tumor ,Humans ,Genetic Predisposition to Disease ,Allele ,CHEK2 ,Aged ,Aged, 80 and over ,BRCA1 Protein ,Nuclear Proteins ,Prostatic Neoplasms ,Odds ratio ,Middle Aged ,medicine.disease ,BRCA1 ,Prognosis ,Checkpoint Kinase 2 ,aggressive prostate cancer ,Mutation (genetic algorithm) ,Mutation ,Cancer research - Abstract
Background: To establish the contribution of eight founder alleles in three DNA damage repair genes (BRCA1, CHEK2 and NBS1) to prostate cancer in Poland, and to measure the impact of these variants on survival among patients. Methods: Three thousand seven hundred fifty men with prostate cancer and 3956 cancer-free controls were genotyped for three founder alleles in BRCA1 (5382insC, 4153delA, C61G), four alleles in CHEK2 (1100delC, IVS2+1G>A, del5395, I157T), and one allele in NBS1 (657del5). Results: The NBS1 mutation was detected in 53 of 3750 unselected cases compared with 23 of 3956 (0.6%) controls (odds ratio (OR)=2.5; P=0.0003). A CHEK2 mutation was seen in 383 (10.2%) unselected cases and in 228 (5.8%) controls (OR=1.9; P
- Published
- 2012
44. The comparison of laparoscopic and microsurgical varicocoelectomy in infertile men with varicocoele on paternity rate 12 months after surgery: a prospective randomized controlled trial
- Author
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Pawel Rajwa, Marcin Życzkowski, Piotr Bryniarski, Piotr Taborowski, Andrzej Paradysz, and Zbigniew Kaletka
- Subjects
Infertility ,Adult ,Male ,medicine.medical_specialty ,Microsurgery ,Urologic Surgical Procedures, Male ,Pregnancy Rate ,Urology ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,media_common.quotation_subject ,Varicocele ,030232 urology & nephrology ,Fertility ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Randomized controlled trial ,law ,Pregnancy ,medicine ,Clinical endpoint ,Humans ,Infertility, Male ,media_common ,030219 obstetrics & reproductive medicine ,business.industry ,medicine.disease ,Surgery ,Pregnancy rate ,Erectile dysfunction ,Reproductive Medicine ,Female ,Laparoscopy ,business - Abstract
Summary The best surgical approach for varicocoelectomy is still unknown, however more and more physicians favour subinguinal microsurgery. The aim of this study was to find whether microsurgical approach is superior to laparoscopic varicocoelectomy in terms of pregnancy rate, fertility potential, endocrinological function of the testis, erectile dysfunction and testicle volume increase. It was a prospective, non-masked, parallel-group randomized controlled trial with one to one allocation. It was conducted at authors’ institution and designed as per protocol study. From 2012 till 2015 84 patients were randomly allocated to two groups. First group consisted of 42 patients who underwent laparoscopic varicocoelectomy, whereas patients from the second group underwent microsurgical varicocoelectomy. The indications for varicocoelectomy consisted of infertility >1 year, palpable left-sided varicocoele and at least one impaired semen parameter (sperm concentration
- Published
- 2016
45. Basic Parameters of Blood Count as Prognostic Factors for Renal Cell Carcinoma
- Author
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Piotr Bryniarski, Grzegorz Prokopowicz, Andrzej Paradysz, Marcin Życzkowski, Rafał Bogacki, and Krzysztof Nowakowski
- Subjects
Male ,medicine.medical_specialty ,Article Subject ,030232 urology & nephrology ,lcsh:Medicine ,Gastroenterology ,Preoperative care ,Disease-Free Survival ,General Biochemistry, Genetics and Molecular Biology ,Metastasis ,03 medical and health sciences ,0302 clinical medicine ,Renal cell carcinoma ,Internal medicine ,Preoperative Care ,medicine ,Carcinoma ,Humans ,Mean platelet volume ,Carcinoma, Renal Cell ,Survival rate ,Aged ,Retrospective Studies ,General Immunology and Microbiology ,Platelet Count ,business.industry ,lcsh:R ,General Medicine ,Middle Aged ,medicine.disease ,Kidney Neoplasms ,Surgery ,Survival Rate ,030220 oncology & carcinogenesis ,T-stage ,Female ,business ,Kidney cancer ,Research Article ,Follow-Up Studies - Abstract
Background. Renal cell carcinoma is the most common type of kidney cancer. Taking account of morbidity and mortality increase, it is evident that searching for independent prognostic factors is needed.Aim of the Study. The aim of the study was to analyze routinely performed blood parameters as potential prognostic factors for kidney cancer.Material and Methods. We have retrospectively reviewed the records of 230 patients treated for renal cell carcinoma in the years 2000–2006. Preoperative blood parameters, postoperative histopathological results, and staging and grading were performed. To estimate the risk of tumor recurrence and cancer specific mortality (CSM) within five years of follow-up, uni- and multivariate Cox and regression analyses were used. To assess the quality of classifiers and to search for the optimal cut-off point, the ROC curve was used.Results. T stage of the tumor metastasis is the most important risk factor for early recurrence and cancer specific mortality (p<0.001). The preoperative platelet count (PLT) above 351 × 103/uL (95.3%; 55.1%) and AUC of 77% are negative prognostic factors and correlate with increased cancer specific mortality (CSM) during the five-year follow-up (p<0.001). Increased risk of local recurrence was observed for PLT above 243.5 × 103/ul (59%; 88%) and AUC of 80% (p=0.001). The opposite was observed in the mean platelets volume (MPV) for cancer specific mortality (CSM). The cut-off point for the MPV was 10.1 fl (75.4%; 55.1%) and for the AUC is of 68.1% (p=0.047).Conclusions. Many analyzed parameters in univariate regressions reached statistical significance and could be considered as potential prognostic factors for ccRCC. In multivariate analysis, only T stage, platelet count (PLT), and mean platelet volume (MPV) correlated with CSM or recurrent ccRCC.
- Published
- 2016
46. PSA mass as a marker of prostate cancer progression after radical prostatectomy
- Author
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Andrzej Paradysz, Piotr Bryniarski, and Mieczysław Fryczkowski
- Subjects
Biochemical recurrence ,Male ,medicine.medical_specialty ,obesity ,medicine.medical_treatment ,Urology ,Kaplan-Meier Estimate ,urologic and male genital diseases ,Body Mass Index ,Prostate cancer ,Clinical Research ,Predictive Value of Tests ,Recurrence ,Biomarkers, Tumor ,Odds Ratio ,Medicine ,Humans ,Aged ,Prostatectomy ,Receiver operating characteristic ,business.industry ,Prostatic Neoplasms ,General Medicine ,PSA mass ,Middle Aged ,Prostate-Specific Antigen ,medicine.disease ,prostate cancer ,radical prostatectomy ,Log-rank test ,Molecular Weight ,Prostate-specific antigen ,Logistic Models ,ROC Curve ,Predictive value of tests ,hemodilution ,Disease Progression ,business ,Body mass index - Abstract
Summary Background Obese patients with prostate cancer may have lower preoperative PSA concentration due to hemodilution. Lower PSA concentration may falsely affect assessing the risk of progression after radical prostatectomy (RP). The aim of this study was to determine preoperative PSA mass as the absolute amount of PSA protein secreted into circulation, and evaluation of its usefulness in prediction of biochemical recurrence after RP. Material/Methods 177 patients after RP due to prostate cancer were included in the study. On the basis of formulas, PSA mass was calculated {PSA mass [μg] = (weight [kg])0.425 × (height [cm])0.72 × 0.007184 × 1.670 × PSA concentration [ng/ml]}. Patients were divided into 3 groups according to increasing values of PSA mass. The following features were assessed and compared between these groups (χ-square test): pathologic stage T3, nodal metastases, positive surgical margins, biochemical and local recurrence and the rate of death. Cancer-specific survival was assessed depending on PSA mass (Kaplan-Meier curves with log rank test). The usefulness of PSA mass in prediction of biochemical recurrence was compared with PSA concentration (logistic regression with ROC curves). Results Pathologic stage T3, nodal metastases, positive surgical margins and progression were more common in patients with higher levels of PSA mass (p
- Published
- 2011
47. The impact of adjuvant therapy in patients with biochemical recurrence on prostate cancer progression and mortality five years after radical prostatectomy
- Author
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Mieczysław Fryczkowski, Marian Suchodolski, Maciej Szczębara, Andrzej Paradysz, and Piotr Bryniarski
- Subjects
Oncology ,Biochemical recurrence ,medicine.medical_specialty ,prostate ,Urological Oncology ,Prostatectomy ,business.industry ,Urology ,medicine.medical_treatment ,Cancer ,General Medicine ,prostate cancer ,medicine.disease ,Surgery ,Radiation therapy ,Prostate cancer ,Internal medicine ,medicine ,Adjuvant therapy ,cancer ,Clinical significance ,Adverse effect ,business ,hereditary prostate - Abstract
Introduction. The clinical significance of biochemical recurrence (BCR) after radical prostatectomy (RP) due to prostate cancer (PCa) is not unambiguous, sometimes being independent from the real progression. BCR is followed by a greater risk of adverse events and almost always results with the necessity for implementation of adjuvant therapy (AT). The aim of the following study was to examine the impact of AT in patients with BCR together with PCa progression and mortality 5-years after RP. Material and methods. Two hundred forty-seven patients after RP, who were treated in the period from 1995 to 2009, underwent the retrospective analysis. They were divided into three groups according to the applied AT after prior BCR diagnosis. The first group (n - 39) included patients treated with radiotherapy, along with hormonotherapy. The second group (n - 63) covers patients receiving hormonotherapy only. The third group (n - 145) consists of patients without BCR. Five-year general and disease-specific survival was evaluated and choice prognostic factors were compared. results. Five-year overall survival was 74.2% in group I, 88.3% in group II, and 98.7% in group III. Diseasespecific survival was: 76.9%, 90.5%, and 100% (p = 0.001), respectively. BCR was diagnosed in 102 (41.5%) patients; while in another 24 (23.5%) of them progression was diagnosed after the AT was applied. Conclusions. The risk of BCR 5-years after RP is greater in patients with high initial concentration of PSA, higher Gleason score, and clinical advancement. Five-year overall and disease-specific survivals are higher among patients after hormonotherapy alone compared to those after both radio- and hormonotherapy.
- Published
- 2011
48. Enhanced TRAIL-mediated apoptosis in prostate cancer cells by the bioactive compounds neobavaisoflavone and psoralidin isolated from Psoralea corylifolia
- Author
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Łukasz Sędek, Zenon P. Czuba, Andrzej Paradysz, Wojciech Król, and Ewelina Szliszka
- Subjects
Male ,Psoralea corylifolia ,Apoptosis ,Biology ,Pharmacology ,Psoralea ,TNF-Related Apoptosis-Inducing Ligand ,Psoralidin ,chemistry.chemical_compound ,Coumarins ,Cell Line, Tumor ,LNCaP ,Humans ,Cytotoxic T cell ,Cytotoxicity ,Benzofurans ,Prostatic Neoplasms ,General Medicine ,Flow Cytometry ,biology.organism_classification ,Isoflavones ,Microscopy, Fluorescence ,chemistry ,Cancer cell ,Tumor necrosis factor alpha - Abstract
Numerous compounds detected in medical plants and dietary components or supplements possess chemopreventive, antitumor and immunomodulatory properties. Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) is an important endogenous anticancer factor that induces apoptosis selectively in cancer cells. However, some tumor cells are resistant to TRAIL-mediated apoptosis. Naturally occurring agents could sensitize TRAIL-resistant cancer cells and augment their apoptotic activity. We examined the cytotoxic and apoptotic effects of neobavaisoflavone and psoralidin in combination with TRAIL on LNCaP prostate cancer cells. The cytotoxicity was evaluated by MTT and LDH assays. The apoptosis was detected using Annexin V-FITC by flow cytometry and fluorescence microscopy. The LNCaP cells were shown to be resistant to TRAIL-induced apoptosis. Our study demonstrated that neobavaisoflavone and psoralidin sensitized TRAIL-resistant cells and markedly augmented TRAIL-mediated apoptosis and cytotoxicity in prostate cancer cells. Cotreatment of LNCaP cells with 100 ng/ml TRAIL and 50 µM neobavaisoflavone or 50 µM psoralidin increased the percentage of the apoptotic cells to 77.5 ± 0.5% or 64.4 ± 0.5%, respectively. The data indicate the potential role of the bioactive compounds isolated from the medicinal plant Psoralea corylifolia (neobavaisoflavone and psoralidin) in prostate cancer chemoprevention through enhancement of TRAIL-mediated apoptosis.
- Published
- 2011
49. Surgical intervention, adverse effects and radiotherapy: A retrospective single center study
- Author
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Marcin Życzkowski, M. Kępiński, Pawel Rajwa, G. Rempega, P. Stelmach, J. Ryszawy, and Andrzej Paradysz
- Subjects
Radiation therapy ,medicine.medical_specialty ,business.industry ,Urology ,Intervention (counseling) ,medicine.medical_treatment ,Emergency medicine ,Medicine ,business ,Single Center ,Adverse effect - Published
- 2018
50. Chalcones and Dihydrochalcones Augment TRAIL-Mediated Apoptosis in Prostate Cancer Cells
- Author
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Zenon P. Czuba, Bogdan Mazur, Wojciech Król, Ewelina Szliszka, and Andrzej Paradysz
- Subjects
Male ,Chalcone ,chalcones and dihydrochalcones ,Pharmaceutical Science ,TRAIL ,Article ,apoptosis ,chemoprevention ,prostate cancer ,Analytical Chemistry ,Flow cytometry ,TNF-Related Apoptosis-Inducing Ligand ,lcsh:QD241-441 ,chemistry.chemical_compound ,Chalcones ,lcsh:Organic chemistry ,Annexin ,Cell Line, Tumor ,Drug Discovery ,LNCaP ,medicine ,Humans ,Cytotoxic T cell ,Physical and Theoretical Chemistry ,Cytotoxicity ,Membrane Potential, Mitochondrial ,medicine.diagnostic_test ,Chemistry ,Organic Chemistry ,Prostatic Neoplasms ,Drug Synergism ,Biochemistry ,Chemistry (miscellaneous) ,Apoptosis ,Cancer research ,Molecular Medicine ,Tumor necrosis factor alpha - Abstract
Chalcones and dihydrochalcones exhibit chemopreventive and antitumor activity. TRAIL (tumor necrosis factor-related apoptosis-inducing ligand) is a natural endogenous anticancer agent. We examined the cytotoxic and apoptotic effect of chalcones and dihydrochalcones on TRAIL-mediated apoptosis in LNCaP prostate cancer cells. The cytotoxicity was evaluated by the MTT and LDH assays. The apoptosis was detected using annexin V-FITC by flow cytometry and fluorescence microscopy. The ΔΨm was evaluated using DePsipher staining by fluorescence microscopy. Our study showed that two tested chalcones (chalcone and 2’,6’dihydroxy-4’-methoxychalcone) and three dihydrochalcones (2’,6’-dihydroxy-4’4-dimethoxydihydrochalcone, 2’,6’-dihydroxy-4’-methoxydihydro- chalcone, and 2’,4’,6’-trihydroxydihydrochalcone, called phloretin) markedly augmented TRAIL-induced apoptosis and cytotoxicity in LNCaP cells and confirmed the significant role of chalcones in chemoprevention of prostate cancer. Keywords
- Published
- 2010
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