ABSTRACT
Prostate cancer is the second most frequently diagnosed cancer among men worldwide, and it represents a substantial worldwide health issue, primarily impacting men as they grow older. Understanding its epidemiology and etiology is crucial for crafting efficient preventive measures and enhancing treatment results. The epidemiology of this disease provides valuable insights into its prevalence and distribution. Age is a critical factor, with the risk of prostate cancer increasing with advancing years. Incidence rates are notably higher in developed countries, suggesting a role for lifestyle and environmental factors. Furthermore, there are significant racial and geographical disparities in prostate cancer incidence, with African-American men experiencing both a higher incidence and more aggressive forms of the disease. On the other hand, hormones, especially testosterone and its conversion to dihydrotestosterone (DHT), contribute to prostate cell growth and, potentially, cancer. Genetics also plays a pivotal role, with certain gene mutations, like Breast Cancer gene 1 & 2 (BRCA1 and BRCA2), elevating risk. Dietary habits and lifestyle choices influence susceptibility, with diets low in fruits and vegetables and high in saturated fats linked to higher risk. Chronic inflammation, often tied to prostatitis, may further increase susceptibility to prostate cancer. This review article explores the complex realm of prostate cancer, providing insights into its occurrence, factors that elevate risks, and the fundamental factors that play a role in its emergence and how we can prevent it.
ABSTRACT
Introduction YouTube, the world's largest video platform, hosts thousands of educational surgical videos that many trainees rely on to enhance their understanding and proficiency in various surgical procedures. Consequently, a crucial inquiry arises regarding the trustworthiness of these videos as a valuable resource for these trainees. In this article, we address this question by focusing on one of the most frequently performed surgical procedures in the field of urology and assessing the effectiveness of these videos as an educational tool for urology trainees (ST3+: Specialty Training Year 3 and above). Methodology We conducted a comprehensive search on YouTube for all videos related to 'Testicular Exploration'. After applying specific inclusion and exclusion criteria, we identified a total of nine eligible videos for analysis. These videos were assessed using the LAParoscopic Surgery Video Educational GuidelineS (LAP-VEGaS) scoring system, which categorized them into two distinct groups. The first group, known as the 'high-quality group', included videos that scored 11 points or higher according to the LAP-VEGaS scoring criteria. The second group, termed the 'low-quality group', consisted of videos that scored less than 11 points using the LAP-VEGaS scoring tool. Additionally, we collected data on various metrics, such as video view counts, duration, likes and dislikes counts, comments count, like ratio, view ratio, and power index, and performed a comparative analysis between the two aforementioned groups. Results Between April 2013 and September 2023, the selected videos exhibited an average total view count of 95,546±138,000. The videos had an average duration of 6.35±2.26 minutes. Furthermore, the mean values for both likes and dislikes were 461.55±581 and 2.89±2.86, respectively. In contrast, the mean like ratio, view ratio, and power index were 0.98±0.0112, 176,00±13,100, and 173.80±131, respectively. The mean LAP-VEGaS scores for videos related to testicular exploration were 9.94±2.05. It is noteworthy that the first group had a statistically higher number of dislikes; however, the view count, comments count, likes count, and view ratio were statistically lower in the same group. Conclusion Videos related to testicular exploration on YouTube exhibit notably low quality and do not serve as a valuable resource for urology trainees. Key factors such as video duration, total view count, and viewer interactions (including likes, dislikes, and comments) should not be relied upon as indicators of educational video quality. Consequently, it is advisable for urology trainees to refrain from using YouTube as a primary source for learning about testicular exploration. Instead, they should seek guidance and support from experienced senior colleagues, educational supervisors, or consultants to explore more reliable sources of information for this surgical procedure.
ABSTRACT
The association between lichen planus (LP) with subsequent hematometra and acute urinary retention (AUR) is quite rare, and few cases reported that association. In such cases, if the patient is left untreated, then possible kidney injury and bladder wall rupture may arise from that retention. In this case, we reported a patient who is known to have a background history of long-standing LP that presented with a history and features suggestive of AUR and was found to be caused by hematometra on an ultrasound scan.
ABSTRACT
BACKGROUND: Video-assisted thoracoscopic surgery (VATS) is a safe and effective surgical approach for pulmonary resection. VATS can be accomplished with only a single incision, resulting in less postoperative pain and paresthesia, better cosmetic results, and greater patient satisfaction. Single-port VATS (spVATS) has become increasingly common for lung resection. We assess the early surgical and oncological outcomes after adopting this new technique at our tertiary cancer center as the first institution to do so in the country. METHOD: Medical records for 257 patients in a tertiary cancer center, with a diagnosis of non-small cell lung cancer, pulmonary metastasis, or other chest-confined pathology, were accessed to obtain perioperative outcomes, pathologic results, post-operative follow-up data, and early surgical and oncological outcomes. All patients underwent spVATS for limited or major lung resection. Simple descriptive analysis was utilized. RESULTS: spVATS was either performed with curative intent (79.8%, N = 205), or as a diagnostic procedure (20.2%, N = 52). Resection types were subcategorized for curative intent group as limited (73.6%, N = 151), lobectomy (16.6%, N = 34), and complex (9.7%, N = 20). Resection with a negative margin (R0) rate was 100% for the primary lung cancer (PLC) patients and 97% for the pulmonary metastasectomy (PM) group. The complication rate was 5%. Three-year disease-free survival was 87% and 68.5% for PLC and PM group, respectively. The 3-year overall-survival was 91.3% for the PLC and 82.8% for PM. Operation duration showed a downtrend over the study period in each curative subcategory with a borderline difference in the limited resection (P value = 0.05). CONCLUSION: All the spVATS procedures were successfully performed without perioperative severe complications or mortality, regardless of complexity. R0 resection was excellent. Middle- and long-term efficacies of spVATS for lung cancer require further follow-up. With proper training, appropriate indication and meticulous application, adopting spVATS is safe and feasible technique that does not compromise surgical and oncological outcomes.