Blogs@BJUI

Editorial: Obesity is associated with worse oncological outcomes in patients treated with radical cystectomy

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Michael R. Abern, Stephen J. Freedland and Brant A. Inman Division of Urologic Surgery, Duke University Medical Center, Durham, NC, USA Obesity is a worldwide epidemic: it is estimated over 300 million adults are obese and over 1 billion are overweight. As obesity is a risk factor for cancers and is modifiable, the authors of this report retrospectively analyse the association between body mass index (BMI) and outcomes in a large multinational cohort of bladder cancer patients that underwent…

EWTD: Quantity or Quality?

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The European Working Time Directive (EWTD) was due to be in full implementation from August 2009 limiting junior doctors to a 48-hour week averaged over a 6-month period. The reality of this is somewhat different from the legislation. In truth, the questions needed to be asked were - was it ever feasible? What was the training impact in a craft-based speciality going to be? Where are we now? The detrimental effects to training in a reduced working environment has been documented in both hemispheres.…

Prostate Cancer Outcomes Study Meets Twitter Face to Face

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The International Urology Journal Club on Twitter discussion for February 2103 was based upon the recently published Prostate Cancer Outcomes Study in the New England Journal of Medicine on 31 January 2013. The originally planned discussion paper that was only hours away from being announced when it became apparent through Twitter notification by @NEJM that the PCOS paper was going to be published that day. With this news, ‘urology twitter’ spoke loud and clearly (well, tweeted to be technically…

The Journal that never sleeps

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Thank you all for your overwhelming support of the new web and paper versions of the BJUI. For those who have missed it, please check out the web journal at: www.bjui.org. We hope you had a relaxing holiday period – we certainly did and recharged our batteries. Despite this, the editorial team at the BJUI handled 76 articles between Christmas 2012 and New Year’s Day 2013; an average of 10 per day. This is a reflection of the global popularity of the BJUI. We have papers coming…

Editorial: Oncological outcomes: open vs robotic prostatectomy

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John W. Davis and Prokar Dasgupta* Departments of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA and *Guy’s Hospital, Kings College London, London, UK e-mail: [email protected] For men at significant risk of dying from untreated prostate cancer within reasonably estimated remaining life spans, which technique offers the best disease-free survival: open radical prostatectomy (RP) or robot-assisted RP (RARP)? The practice patterns in many countries…

Through My Father’s Eyes

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Growing up with a father who was a general surgeon, now retired, I was frequently exposed to the life and practice of a doctor. I witnessed a caring, compassionate physician rush off in the middle of the night to take out an appendix or manage a local trauma or an acute abdomen. What I was also witnessing was traditional and now, almost historic, medicine at its finest. The days of constant call, pay-for-service, and the prestige of medicine were in their hayday. Since then, the transition to…

BJUI at USICON

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BJUI had a very successful meeting at USICON in Pune. The hospitality was superb and a very well organised meeting. BJUI was represented by myself as Chairman of the Executive and by Prof Prokar Dasgupta as our new Editor. Prokar and his USICON counterparts put on a superb three hour symposium on how to organise a research project for publication. This symposium was extremely well attended with a vigorous interaction with the audience - it was very lively. In addition, Prokar had a significant input…

Editorial: Phosphodiesterase Inhibitors (PDEi) improve orgasm. The power of meta-analysis?

Ever since the potential utility of meta-analyses in the assessment of clinical data was brought to the notice of the urological community by Peter Boyle [1], they have been used increasingly. Indeed this approach to evaluation of drug effects has become de rigueur for healthcare providers and regulatory bodies. In particular, invaluable insight has been given into the benefit : risk ratios of drugs in BPH/LUTS and overactive bladder. Even to the extent, where sufficiently large databases…

Urologist as the Go-to Adrenal Surgeon?

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What do Galen, da Vinci, and Vesalius have in common? All three, in all their detailed description of human anatomy, failed to note the existence of the adrenal glands. In fact, it was Bartholomeus Eustachius (yes, the one of the “tube”) who in 1563 was the first to document the glands’ existence. Meanwhile, it took another three centuries for Thomas Addison to recognize the physiologic importance of the adrenals. Soon thereafter, Charles Brown-Sequard, who appears to have toyed not…

The Flaws of the PIVOT Study of Radical Prostatectomy versus Observation; Don’t Give up on PSA Just Yet.

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A recent editorial in the BMJ by Christopher Parker (Treating prostate cancer. BMJ 2012; 345: e5122) uses the “best available evidence” from the PIVOT study (Wilt TJ, et al) to argue the case for watchful waiting for low risk prostate cancer and question the need to diagnose the condition at all. Unfortunately the PIVOT trial was marred by a number of serious flaws that should make us doubt its conclusions. The original design of the PIVOT trial included a randomisation of 2000 patients…
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