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Narrow Band Imaging Improves Early Bladder Cancer Detection - Renal and Urology News |
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June 19, 2015
NBI was superior at detecting early bladder tumors and carcinoma in situ, compared with WLI cystoscopy.
Narrow band imaging (NBI) demonstrates high sensitivity in detecting primary non-muscle invasive bladder cancer (NMIBC), a new Chinese study confirms.
In a head-to-head comparison with white-light imaging (WLI) cystoscopy, NBI was superior at revealing early bladder tumors and carcinoma in situ.
Previous single-center studies investigating NBI have shown favorable results. So investigators led by Zhangqun Ye, MD, and Jia Hu, MD, of Tongji Hospital in Wuhan, China, further evaluated NBI in a prospective, randomized, multi-center study. At 8 research centers, 384 patients suspected of having bladder cancer were evaluated by NBI and WLI cystoscopy in a randomized order. Urologists used a cystoscope that could switch between white light and filtered narrow band light of 415 nm and 540 nm. Suspicious areas were mapped on separate bladder charts for NBI and WLI, and biopsies were taken.
According to results published in Scientific Reports, 78 patients had a confirmed urothelial carcinoma. The researchers determined that NBI significantly demonstrated 97.7% diagnostic sensitivity compared with 66.7% for WLI. The specificities were 50% and 25%, respectively, and the false positive rates were 50% and 75%, respectively. The researchers also evaluated 300 biopsy specimens and found 98.8% and 75.5% sensitivities for NBI and WLI, respectively.
Among the 41 cancers detected by NBI alone, 16 were pTa, 21 pT1, and 4 pTis. No pTis stage samples were detected by WLI.
“WLI may fail to detect small papillary and subtle flat carcinoma in situ lesions, which could progress and become invasive. More effective endoscopic methods are needed to detect bladder tumors due to these carcinomas,” the researchers remarked.
Narrow band light is better absorbed by hemoglobin and may increase the visibility of capillaries in the surface mucosa and blood vessels in the submucosa and enhance contrast of superficial tumors. However, a diagnostic standard for NBI images is needed before it can be widely used in clinical practice, according to the researchers.
Source
- Ye, Z, et al. Scientific Reports; 5:10905; doi: 10.1038/srep10905.
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Erectile Dysfunction Linked to Gout - Renal and Urology News |
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June 19, 2015
Gout increased the risk of erectile dysfunction in men by 21%.
Men with gout are at increased risk erectile dysfunction (ED), according to a new study.
Researchers led by Wei-Sheng Chung, MD, of Taichung Hospital in Taichung City, Taiwan, compared 19,383 men with gout and 77,472 controls without gout randomly selected from the general population. Subjects were aged 64 years or younger. Gout sufferers had a 21% increased risk of ED in adjusted analysis, the researchers reported online ahead of print in The Journal of Rheumatology.
Compared with patients who did not have gout or comorbidities, those with both gout and any comorbidity had a 2-fold increased risk of developing ED.
The incidence of ED increased with age in both cohorts, but it was greater among men in the gout cohort.
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Vitamin D May Slow CKD Progression in Children - Renal and Urology News |
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June 19, 2015
In a study, renal survival increased by 8.2% with each 10 nmol/L increment in baseline levels of 25-hydroxyvitamin D.
Normal levels of vitamin D are associated with less proteinuria and attenuate renal failure progression in children with chronic kidney disease (CKD), new study findings suggest.
Rukshana Shroff, MD, a pediatric nephrologist at the Great Ormond Street Hospital for Children in London, U.K., and colleagues studied 167 children with CKD (median estimated glomerular filtration rate [eGFR) 51 mL/min/1.73 m2). The cohort had a median age of 11.4 years.
The study was a post hoc analysis of the ESCAPE trial, a randomized, controlled study demonstrating that strict blood pressure (BP) control with a fixed dose of an ACE inhibitor (ramipril) shows progression of kidney disease.
At baseline, patients with the lowest 25-hydroxyvitamin D (25(OH)D) levels had the highest proteinuria levels. After ACE inhibitor treatment for a median of 8 months, those with higher 25(OH)D levels continued to have lower levels of proteinuria, the researchers reported online ahead of print in the Journal of the American Society of Nephrology.
Results also showed that lower 25(OH)D levels are positively associated with loss of eGFR. The median annualized loss of eGFR was -1.74 mL/min/1.73 m2 across the study cohort. The annualized loss of eGFR was significantly greater in patients with baseline 25(OH)D levels below 50 nmol/L compared with those who had levels of 50 nmol/L or higher. The 5-year renal survival rate was 75% in patients with baseline 25(OH)D levels of 50 nmol/L or higher compared with 50% among those with lower levels, a significant between-group difference.
The beneficial effect of 25(OH)D on renal disease progression was attenuated, but remained significant, after starting ACE inhibitor therapy: The 5-year renal survival rate was 73% in patients with 25(OH)D levels of 50 nmol/L or higher compared with 57% in patients with lower levels. The researchers defined renal survival using a composite endpoint of annualized loss of eGFR greater than 50% or progression to end-stage renal disease (eGFR less than 10 mL/min/1.73 m2) or need for renal replacement therapy. The researchers calculated that renal survival increased by 8.2% with each 10 nmol/L increase in baseline 25(OH)D.
“Vitamin D is an effective, easily available, safe, and cheap nutritional supplement that may be a useful adjunctive treatment to [renin-angiotensin-aldosterone-system] blockade to retard progressive renal function decline,” the authors concluded.
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Analyst Rating Update on NxStage Medical, Inc. - American Trade Journal |
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As many as 6 brokerage firms have rated Nxstage Medical (NASDAQ:NXTM) at 2. Research Analysts at Zacks have ranked the company at 3, suggesting the traders with a rating of hold for the short term. 1 rated the company as strong sell. The stock garnered a place in the hold list of 1 stock Analysts. 4 analysts rated the company as a strong buy.
Several Brokerage firms have commented on company shares. In a research note released to the investors, Canaccord Genuity maintains its rating on NxStage Medical, Inc. (NASDAQ:NXTM).The analysts at the brokerage house have a current rating of Buy on the counter. In a recent information released to the investors, Canaccord Genuity raises the new price target from $24 per share to $27 per share. NxStage Medical, Inc. (NASDAQ:NXTM): The stock price is expected to reach $ 21 in the short term. The number of analysts agreeing with this consensus is 4. The higher estimate for the short term price target is at $24 while the lower estimate is at $15. The standard deviation of the price stands at $4.24.
NxStage Medical, Inc. (NASDAQ:NXTM) : On Friday heightened volatility was witnessed in NxStage Medical, Inc. (NASDAQ:NXTM) which led to swings in the share price. The shares opened for trading at $15.4 and hit $15.89 on the upside , eventually ending the session at $15.7, with a gain of 2.15% or 0.33 points. The heightened volatility saw the trading volume jump to 622,180 shares. The 52-week high of the share price is $19.63 and the company has a market cap of $993 million. The 52-week low of the share price is at $11.5 . NxStage Medical, Inc. (NxStage) is a medical device company that develops, manufactures and markets products for the treatment of kidney failure, fluid overload and related blood treatments and procedures. The Companys primary product is the NxStage System One (System One). It also sells needles and blood tubing sets primarily to dialysis clinics for the treatment of end-stage renal disease (ESRD). It operates in two segments: System One and In-Center. It distributes its products in three markets: home, critical care and in-center. In the System One segment it derives its revenues from the sale and rental of the System One and PureFlow SL equipment, and the sale of disposable products in the home and critical care markets. In the In-Center segment, it derives its revenues from the sale of blood tubing sets and needles for hemodialysis primarily for the treatment of ESRD patients at dialysis centers and needles for apheresis, which is referred to as the in-center market.
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