Renal trauma in the west of Ireland--a regional review.

We herein present a regional review of the management of renal trauma in the west of Ireland. The majority of renal injuries occur as a result of blunt trauma and are amenable to conservative management. We sought to streamline the management of renal trauma in the west of Ireland. With the current restructuring of the Irish Health Service, it is important to acknowledge the role of the urologist in the management of trauma patients.

Differential mechanisms of bicalutamide-induced apoptosis in prostate cell lines.

Bicalutamide is a non-steroidal antiandrogen used in the treatment of prostate cancer. Although widely accepted as an androgen receptor antagonist, the mechanism by which it induces apoptosis remains unclear. Defining exact pathways by which bicalutamide induces its apoptotic effects would help to advance its clinical applications. We aimed to (a) examine the apoptotic effects of bicalutamide at 24 h and (b) comment on the role of the caspases and calpains in mediating bicalutamide-induced apoptosis in androgen-dependent and androgen-independent cells. PWR-1E, PC-3 and DU-145 cells were treated with bicalutamide and assessed for apoptosis by flow cytometry at 24 h. DU-145 cells were used to compare differences between two different metastatic receptor-negative cells and to verify apoptotic induction at 48 h. To delineate a specific pathway of action for bicalutamide, PC-3 and PWR-1E cells were pretreated with specific inhibitors of caspase-dependent (zVAD-FMK) and caspase-independent pathways (calpain 2 inhibitor). Bicalutamide induced apoptosis in androgen-dependent PWR-1E cells via a caspase-dependent and calpain-independent mechanism. In androgen-independent PC-3 cells, bicalutamide also induced apoptosis by mechanisms that were partially inhibited by pan-caspase inhibition but were partially calpain dependent. Understanding into how bicalutamide exerts its effects in androgen-independent cells will yield further insights into the treatment of hormone-refractory disease.

The impact of acute urological admissions on the surgical workload in a general hospital.

Urological services remain underdeveloped in the existing Irish Hospital network. Outside of the main teaching centres patients frequently present to their local hospital with acute urological problems and are referred to specialist units following preliminary investigations. Over six months we examined the impact of emergency urological presentations on the general surgical workload in an acute general hospital. A total of 54 of patients were admitted with urological presentations representing 6.7% of total surgical admissions. The average length of stay was 4.9 days and a total of 24.5% were transferred to urological units for inpatient treatment. Urology outpatient referrals were required for 40%. This paper illustrates the impact of urological admissions on peripheral hospitals and the need to expand urological services in regional hospitals to reduce the amount of patients transferred to tertiary centres for routine urological procedures.

Procidentia: a reversible cause of hydronephrosis in an 80-year-old woman.

We describe an unusual presentation of hydronephrosis in an 80-year-old woman who was managed conservatively after transfer to a specialist unit. This case highlights the role of accurate history taking and a focused physical examination in elderly female patients presenting with renal failure and hydronephrosis.