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Biomedical subjects

W Oosterlinck

Publications and source records attributed to W Oosterlinck.

At least 55 records · Page 3Linked to original sources
PubMed1997

PSA evolution: a prognostic factor during treatment of advanced prostatic carcinoma with total androgen blockade. Data from a Belgian multicentric study of 546 patients.

OBJECTIVES: To study the prognostic value of the prostate-specific antigen (PSA) response and its relationship with other initial prognostic factors during the treatment of advanced prostatic carcinoma with total androgen blockade. METHODS: Five hundred forty-six patients with advanced loco-regional (M0) or distant metastatic (M1) prostatic carcinoma treated with flutamide combined with either orchiectomy or LHRH analogues were included in this analysis. Initial patients characteristics and the PSA response were evaluated in relation to progression-free survival using a univariate and multivariate (Cox regression) analysis. RESULTS: The following prognostic factors were indicative of a decrease in progression-free survival: the absence of PSA normalization (< 4 ng/ml) after 3 or 6 months, M1 stage, high G grade, ECOG performance status > 1, presence of pain and absence of dysuria. In M1 patients the combination of PSA normalization after 3 or 6 months with initial G grade and ECOG performance status had the strongest predictive value. CONCLUSIONS: This study demonstrates that PSA normalization after 3 or 6 months along with initial tumor stage, grade and health status of the patient are the most important prognostic factors related to progression-free survival in the hormonal treatment of advanced prostatic carcinoma.

Aged↗
PubMed1997

Current trends in the treatment of hypospadias.

The surgical treatment of hypospadias continues to inspire urologists to develop new techniques. Views on the physiopathology of hypospadias have changed a great deal over the last ten years. Treatment techniques have also changed over the last ten years. An analysis of current trends in the treatment of hypospadias therefore appears justified.

Age Factors↗
PubMed1997

The use of Emla cream as anaesthetic for minor urological surgery in children.

A number of minor urological surgical procedures can be readily carried out in children in outpatient clinics with the availability of a good topical local anaesthetic. In boys, the separation of preputial adhesions, frenulotomy, meatoplasty, meatal dilatation following circumcision or meatal surgery, the removal of smegma and excision of penile skin lesions can be performed as outpatient treatment. In girls, hymenal abnormalities, meatal abnormalities and labial adhesions come into consideration for its use. Success is dependent on a good estimation of the mental capacity of the child to undergo a local surgical procedure and correct use of the anaesthetic.

Ambulatory Surgical Procedures↗
PubMed1996

Outpatient pelvic-floor therapy in girls with daytime incontinence and dysfunctional voiding.

OBJECTIVES: Analysis of an experience in treating girls with dysfunctional voiding with an outpatient pelvic-floor therapy consisting of voiding and drinking schedule, pelvic-floor relaxation biofeedback, instructions on toilet behavior, and uroflowmetry. METHODS: The files of 50 girls (between 6 and 13 years of age) with urodynamically proven dysfunctional voiding who participated in the training program were analyzed retrospectively. Thirty-five girls received anticholinergics during the entire course of the training. The long-term absence of diurnal incontinence was used as the criterion for the success of the therapy. The duration of treatment before reaching this success was used as a parameter to measure the intensity of therapy. For a portion of the study group, a comparison is made with the duration of the preceding therapies to demonstrate indirectly the cumulative effect of the pelvic-floor therapy. RESULTS: Forty-six girls (92%) normalized their flow and bladder capacity after therapy and saw their daytime incontinence disappearing. All of these girls achieved this result in a maximum of 18 sessions within a 6-month period. At the follow-up examination after 6 months, five of the girls had relapsed (10%), which brings the ultimate success after 6 months of follow-up to 82%. CONCLUSIONS: Pelvic-floor therapy seems to be a reasonable and meaningful component in the treatment of bladder dysfunction in which detrusor-sphincter dyscoordination plays a role.

Adolescent↗
PubMed1996

Tolerability and safety of flutamide in monotherapy, with orchiectomy or with LHRH-a in advanced prostate cancer patients. A Belgian multicenter study of 905 patients.

OBJECTIVE: In a multicenter study, 905 patients with newly diagnosed advanced prostate cancer treated with flutamide were followed for safety and side effects. METHODS: Flutamide was administered in monotherapy (75 patients (8%)) or as part of total androgen blockade (TAB groups): the latter group had orchiectomy (196 patients (22%)) or an LHRH (634 patients (70%)). RESULTS: The incidence of gastrointestinal complaints such as loss of appetite, vomiting/nausea and diarrhea (+/- 15%) was similar in the TAB and the monotherapy groups. Eighteen patients (2%) were withdrawn because of severe diarrhea. Hot flushes was the most frequently reported adverse event in TAB groups (40% of patients), leading to withdrawal in 4 patients (0.4%). Breast tenderness occurred most frequently in the monotherapy group (49%) and was reported as severe in 7% of the patients. Only 0.8% of the patients were withdrawn because of liver function changes. No unexpected potentially dangerous adverse events were reported. CONCLUSION: Flutamide alone or in combination therapy appears to be safe and well tolerated.

Appetite↗
PubMed1995

Factors affecting recurrence and progression in superficial bladder tumours.

Prognostic factors in superficial bladder tumours are highly correlated with each other. In this study, their relative importance is examined and grouping of patients in three different prognostic groups suggested. 576 patients (from EORTC protocols 30790 and 30782) were analysed. They have been followed from 3 months to 8.6 years with a median of 4 years. 76 patients developed an invasive tumour (> or = T2); the shortest time to invasion was 12 weeks, the longest was 6.6 years. Time from invasion to death ranged from 3 weeks to 4.4 years with a median of 2 years. Prognostic factors contributing to recurrence, invasion and survival were investigated: age, sex, size of largest tumour, number of tumours, T-category, G-grade, time from diagnosis (years), prior recurrence rate/year, site of involvement. The relative importance of these factors was measured by performing a multivariate analysis based on Cox's proportional hazards regression model. Based on the most important prognostic factors and their association with invasion and death, an index was computed reflecting the risk of both invasion and death due to malignant disease, respectively. The index was used to assign patients to one of three prognostic groups. Three main factors determined patient's prognosis: tumour size, G-grade and prior recurrence rate/year. The model coefficients for invasion were 0.51 (recurrence rate < 1/year, 1-3/year, > 3/year), 84 (grade 1, 2, 3), 0.48 (size < 1.5, 1.5-3, > 3 cm) and for death due to malignant disease 0.89 (recurrence rate), 0.73 (grade) and 0.44 (size), respectively. Risk groups are suggested based on the index. Additional treatment in patients with superficial transitional cell carcinoma of the bladder may be decided depending on the risk group to which the patient belongs.

Adolescent↗
PubMed1995

Experience with augmentation cystoplasty. A review.

Good experience with clam cystoplasty is reported for 28 patients (14 female), 89% of whom had a neuropathic bladder. Prolonged conservative treatment had failed in all cases. The efficacy of the operation in terms of continence, increased bladder compliance, and bladder capacity was confirmed. Complications were common and included inability to void (70%) requiring clean intermittent catheterisation (CIC), recurrent urinary tract infection (59%) and stone formation (22%). Due to these complications, further surgery was required for 44% of the patients. Although clam enterocystoplasty is an efficient way to reconstruct a functionally disturbed urinary tract, careful patient selection is essential. Lifetime follow-up and recognition of the most frequent complications is mandatory.

Adolescent↗
PubMed1995

Prognostic factors in advanced prostatic carcinoma treated with total androgen blockade. Flutamide with orchiectomy or with LHRH analogues. A Belgian multicentric study of 546 patients.

Prognostic factors were evaluated in advanced loco-regional (M0) or distant metastatic (M1) prostatic carcinoma treated with total androgen blockade (flutamide with either orchiectomy of LHRH-analogues), in 546 patients from a Belgian multicentric study. After a mean follow-up of 16.5 months (maximum 37 months) 113 (21%) patients had progressed (90 were patients with M1 disease (31%)). The estimated median progression-free survival exceeded 37.5 months. The results of a univariate analysis show that the following parameters are important prognostic factors with respect to progression-free survival in these patients: M stage, G grade, ECOG performance status, weight loss, concomitant disease, pain, dysuria and haemoglobin (Lee-Desu test, p < or = 0.01). From a multivariate analysis (Cox regression) the following prognostic factors were indicative of a decrease in progression-free survival: M1 stage, high initial G grade, ECOG performance status > I, high serum PSA, presence of concomitant disease, presence of pain and absence of dysuria. Age did not appear to be a statistically significant prognostic factor.

Aged↗
PubMed1995

Intravesical adjuvant chemotherapy for superficial transitional cell bladder carcinoma: results of 2 European Organization for Research and Treatment of Cancer randomized trials with mitomycin C and doxorubicin comparing early versus delayed instillations and short-term versus long-term treatment. European Organization for Research and Treatment of Cancer Genitourinary Group.

The European Organization for Research and Treatment of Cancer genitourinary group has completed 2 parallel prospective randomized studies, one with 30 mg. mitomycin C and the other with 50 mg. doxorubicin as adjuvant intravesical treatment after transurethral resection of superficial transitional cell bladder carcinoma. These studies were designed to compare early (the day of resection) versus delayed (between 7 and 15 days after resection) instillations and short-term (6 months) versus long-term (12 months) treatment. The results indicate that in regard to recurrence rate patients having a delayed and short-term treatment do worse than those having early instillations (for 6 or 12 months) or those having prolonged treatment (either immediate or delayed). With an average followup of 4 years survival, progression beyond T1 disease, development of distant metastases and appearance of a second primary were not influenced by the therapeutic regimen. A multivariate analysis of prognostic factors is presented, which indicates that after adjustment for these factors, patients in the delay, no maintenance arm have a significantly higher recurrence rate than the other patients.

Administration, Intravesical↗
PubMed1994

Physiopathology of renal colic and the therapeutic consequences.

NSAID are by far the most efficient therapy in renal colic treatment as they directly interfere with the physiopathology of a renal colic. Other therapies that have been standard are now shown to be insufficient or even contraindicated. Hydratation during a renal colic seems to be unimportant. The efficiency of stone-expulsive drugs has still to be proven.

Analgesics, Opioid↗
PubMed1994

Chemolysis of calcium containing urinary calculi. A review.

A review of current literature and research on chemolysis of calcium containing urinary stones is made. The type of chemolytic solution is dependent upon the composition of the stone. Calcium phosphates can be desolved with Suby or Renadecin solution although it is often tedious and time consuming procedure. Calcium oxalate, the major urinary stone component, can not be dissolved by these solutions. EDTA and other strong calcium chelators cannot be used because of their local toxicity. Certain enzymes can digest the organic matrix of the stone. The indication to chemolysis of stones are rather restricted.

Calcium↗
PubMed1994

Analysis of urinary calculi.

Urinary calculi are often small (< 5 mg) and can be composed of many very different constituents. The highly variable composition has lead to the development of many different methods of calculi analysis. In general the analytical methods can be divided in chemical and physical methods. Chemical methods are destructive and need several mg of sample. The smallest stones can not be analyzed with chemical methods. Qualitative and semi-quantitative chemical analysis methods are not accurate and can lead to clinical significant errors. Quantitative, instrumental, chemical analysis is accurate and makes no clinical significant errors, but these consume too much sample. None of the chemical methods of stone analysis makes it possible to distinguish the mineral constituents with similar chemical composition, e.g. the calcium phosphates, from one another and they usually can not identify "unexpected" stones. Physical methods need less sample than chemical methods and physical methods can distinguish the different minerals in the stones. Thermal analysis can give quantitative results but needs relatively much sample. Optical methods can analyze a few grains of stone but gives only qualitative results. Both methods can not be used to analyze an "unexpected" stone. Best suited methods for the analysis of calculi are X-ray diffractometry and IR spectroscopy. X-ray diffractometry can detect crystalline minerals in low concentrations. IR spectroscopy can detect both crystalline and amorphous minerals. Both methods can be used for semi-quantitative stone analysis and can analyze less than one mg of stone sample. X-ray diffractometry and IR spectroscopy are also the best methods to identify "unexpected" stone constituents.

Calcium Oxalate↗
PubMed1994

Total androgen blockade in the treatment of hormone-resistant metastasized prostate carcinoma. A literature review.

Once hormone resistance has been developed in metastasized prostate cancer, the main aim of therapy is to ensure quality of life. Total androgen blockade which neutralizes the androgens of adrenal origin provides a therapeutic modality which gives +/- 16% objective and +/- 50% subjective response during several months. The two drugs actual available in Belgium are flutamide and cyproterone acetate. Especially flutamide has been used for this purpose. As the number and intensity of side effects is low, this can be considered as a first choice treatment when prostate cancer escapes its first line therapy.

Androgen Antagonists↗
PubMed1993

A prospective European Organization for Research and Treatment of Cancer Genitourinary Group randomized trial comparing transurethral resection followed by a single intravesical instillation of epirubicin or water in single stage Ta, T1 papillary carcinoma of the bladder.

A total of 431 eligible patients with solitary, primary or recurrent stages Ta and T1 transitional cell carcinoma of the bladder was included in a randomized multicenter trial to compare a single intravesical instillation of 80 mg. epirubicin with water given immediately after resection, with respect to the disease-free interval and recurrence rate. The interval to initial recurrence was significantly better in favor of the epirubicin group. After a mean followup of 2 years it became evident that the recurrence rate after a single epirubicin instillation was decreased by nearly half with the same trend being found in all subgroups examined. Toxicity was mainly restricted to bladder irritation in plus or minus 10% of the cases. Pathology review brought considerable changes in T category from stages T1 to Ta (53%). Changes in grade were less pronounced but nevertheless important.

Administration, Intravesical↗
PubMed1993

A plea for cold biopsy, fulguration and immediate bladder instillation with Epirubicin in small superficial bladder tumors. Data from the EORTC GU Group Study 30863.

The sensitivity of cystoscopy to distinguish infiltrating from superficial bladder tumors is very high. Only 28 (5.6%) of 501 single tumors, which were considered to be superficial by the urologist at visual inspection, were found to be infiltrating on pathological examination. If the size of the tumor and/or the cytological grade are considered, one can further reduce the number of infiltrating tumors missed, but it was impossible to identify them all. The recurrence rate of tumors at the resection site 4 weeks after TUR suggests the importance of trauma of the bladder mucosa in promoting recurrence. A single instillation of Epirubicin immediately after TUR prevents implantation of tumor cells and reduces the recurrence rate to nearly 50%. A combination of cold forceps biopsy and fulguration may be the most reasonable treatment for small bladder tumors.

Administration, Intravesical↗
PubMed1993

Watertight sutures with fibrin glue: an experimental study.

A rat model was developed to test the watertightness of sutures and used to evaluate the value of fibrin glue (Tissucol, Immuno France, Tisseel, Immuno U.S., Inc.) in making conventional sutures watertight. Fibrin glue raised the mean hydrostatic pressure to which the skin suture resisted from 9.1 to 26.3 cm H2O, thus indicating that it enhances suture watertightness immediately after surgery. After 3 and 6 days, the pressure was increased, respectively, from 24.8 to 47.9 and from 56.5 to 73.3 cm H2O. For bladder sutures, the results are comparable.

Animals↗