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Pilot Study Removes Standard Hospital Bed As Focal Point Of Labor
A University of Toronto pilot study that re-conceptualized the hospital labour room by removing the standard, clinical bed and adding relaxation-promoting equipment had a 28 per cent drop in infusions of artificial oxytocin, a powerful drug used to advance slow labours.

Tiller Murder Unlikely To Stall Abortion Debate In Kansas
Antiabortion-rights legislators in Kansas plan to push for harsher restrictions on abortion when the next legislative session begins in January 2010, despite increased tensions following the murder of abortion provider George Tiller, the AP/Indianapolis Star reports.According to state House Judiciary Committee Chair Lance Kinzer (R), the debate over abortion rights should continue in the state because some laws aimed at restricting abortion access are not being enforced properly. This year, Kinzer pushed legislation (S.B. 218) to strengthen the state"s restrictions on abortions performed later in pregnancy, but the bill was vetoed by former Gov. Kathleen Sebelius (D). Gov. Mark Parkinson (D) has said his views are "very similar" to those of Sebelius on abortion rights. On Monday, he called on advocates on both sides of the issue to tone down their rhetoric. Parkinson also has said that Kansas should aim to reduce unplanned pregnancies.State Rep. Tom Sawyer (D), who supports abortion rights, said he would like to see legislators take one year off of debating the issue, adding that he thinks this is unlikely. He said, "It"d be nice to have one session where we didn"t have to debate it," adding, "People who are adamant, who keep bringing up these issues, are going to keep bringing them up. I don"t think [Tiller"s murder] is going to slow them down."However, state House Speaker Mike O"Neal (R) said tensions over abortion rights "will calm down a great deal" in the coming months. He added, "All those issues are still there. As long as the parties on both sides behave themselves and not let the rhetoric get out [of] hand, I think we can stay focused on the issues." State Sen. Tim Huelskamp (R) said that abortion-rights opponents likely will focus in the short term on the Board of Healing Arts, which licenses and regulates physicians, and the courts. A criminal case against a Planned Parenthood clinic in Johnson County, Kan., is pending (Hanna, AP/Indianapolis Star, 6/5).
News of the day
Application Of Innovative Laser Research Could Lead To Earlier Bone Disorder Diagnosis
A new laser technique that could lead to bone disorders being diagnosed earlier is to be tested in a hospital for the first time. The study, which it"s hoped will pave the way for future clinical trials, will apply a revolutionary approach known as SORS (Spatially Offset Raman Spectroscopy), to examine specific substances in non see-through surfaces deeper than has previously been possible, without damaging the surface. The research team hope ultimately that the method can be used both to detect and screen for early signs of diseases such as osteoarthritis and osteoporosis.
Cardiovascular

Prostate Cancer Gene 3 (PCA3): Development And Internal Validation Of A Novel Biopsy Nomogram

UroToday.com - In this paper, we investigated 809 prostate cancer patients subjected to >10 cores at initial or repeat prostate biopsy from two prospective, multi-center studies from Europe and North America It has been demonstrated that the urinary marker Prostate CAncer gene 3 (PCA3) represents a novel prostate cancer (PCa) detection marker capable of increasing accuracy of multivariable biopsy nomograms.[1] The paper reports the first PCA3-based nomograms which accurately identify individuals at risk of harboring PCa (AUC=0.73). If a PCA3 score in combination with established risk factors is available, this novel tool assists clinicians in deciding whether further prostatic evaluation is necessary. Despite these promising results it must be emphasized that novel markers such as PCA3 do not replace established risk factors such as PSA and its sub-forms, digital rectal findings and/or prostate volume. [2] [3] However, this combination resulted in significant improvements in accuracy (between 2% to 5%) of biopsy outcome prediction. This increment of +5% related to one single marker (PCA3) is remarkable since Shariat et al. recently added 7 novel diagnostic markers to a multivariable model predicting biochemical recurrence after radical prostatectomy which were related to a gain in accuracy by "only" +15% (AUC=0.72 to AUC=0.87). [4] Although this study involves the largest PCA 3 biopsy-verified patient cohort to date, it needs to be acknowledged that our findings are still based on a relatively small sample size. Specifically, PCA3 score cut-off analyses need further investigation in different biopsy settings (e.g. initial vs. repeat) [5, 6] or in further sub- stratification (e.g. PSA cut-offs 0-2.5 ng/ml vs. 2.6-4 ng/ml) in larger scale studies, respectively. [7] In fact, it may be argued that, similar to PSA [8], a PCA3 score is better displayed as a continuously increasing risk according to increasing scores and that cut-off values may not be indicated. For example, as suggested by the current paper, the PCA3 score used as a continuous risk variable demonstrated the highest univariable accuracy (AUC=0.68) outperforming other previously published PCA3 cut-offs (AUC=0.62- 0.63) or PSA (AUC=0.53). However, this result could not be confirmed in multivariable analysis. In conclusion, our results are clearly encouraging - demonstrating that PCA3 is one of the novel markers alleviating PSA"s dilemma of low specificity. But larger scale studies are also clearly warranted to replicate our findings and to externally validate the first PCA3 nomogram. References: 1. Chun FK, de la Taille A, van Poppel H, Marberger M, Stenzl A, Mulders PF, Huland H, Abbou CC, Stillebroer AB, van Gils MP et al: Prostate Cancer Gene 3 (PCA3): Development and Internal Validation of a Novel Biopsy Nomogram. Eur Urol 2009. 2. Kattan MW: Judging new markers by their ability to improve predictive accuracy. J Natl Cancer Inst 2003, 95(9):634-635. 3. Chun FK, Karakiewicz PI, Briganti A, Gallina A, Kattan MW, Montorsi F, Huland H, Graefen M: Prostate cancer nomograms: an update. Eur Urol 2006, 50(5):914-926; discussion 926. 4. Shariat SF, Karam JA, Walz J, Roehrborn CG, Montorsi F, Margulis V, Saad F, Slawin KM, Karakiewicz PI: Improved prediction of disease relapse after radical prostatectomy through a panel of preoperative blood-based biomarkers. Clin Cancer Res 2008, 14(12):3785-3791. 5. Chun FK, Briganti A, Graefen M, Montorsi F, Porter C, Scattoni V, Gallina A, Walz J, Haese A, Steuber T et al: Development and external validation of an extended 10-core biopsy nomogram. Eur Urol 2007, 52(2):436-444. 6. Chun FK, Briganti A, Graefen M, Porter C, Montorsi F, Haese A, Scattoni V, Borden L, Steuber T, Salonia A et al: Development and external validation of an extended repeat biopsy nomogram. J Urol 2007, 177(2):510-515. 7. Briganti A: Editorial Comment on: Prostate Cancer Gene 3 (PCA3): Development and Internal Validation of a Novel Biopsy Nomogram. Eur Urol 2009. 8. Thompson IM, Ankerst DP, Chi C, Goodman PJ, Tangen CM, Lucia MS, Feng Z, Parnes HL, Coltman CA, Jr.: Assessing prostate cancer risk: results from the Prostate Cancer Prevention Trial. J Natl Cancer Inst 2006, 98(8):529-534. Written by Felix K. Chun, MD1, et al. as part of Beyond the Abstract on UroToday.com 1 Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg UroToday - the only urology website with original content written by global urology key opinion leaders actively engaged in clinical practice. To access the latest urology news releases from UroToday, go to: www.urotoday.com Copyright © 2009 - UroToday


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