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Original Article
Germline Mutations in HOXB13 and Prostate-Cancer Risk
Prostate cancer is the most common noncutaneous cancer diagnosed in men in the United States, with more than 240,000 new cases expected in 2011. Despite the demonstration of a strong familial component, identification of the genetic basis for hereditary prostate cancer has been challenging. Linkage…
- January 12, 2012
- Ewing C.M., Ray A.M., Lange E.M., et al.
- N Engl J Med 2012; 366:141 - 149
Prostate cancer runs in families. However, the genes that affect the incidence remain largely undefined. The authors have identified a rare germline variant of a homeobox gene, HOXB13, in four families with a history of prostate cancer.
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Perspective
Prostate-Cancer Screening — What the U.S. Preventive Services Task Force Left Out
Forty years after prostate-specific antigen (PSA) was identified and nearly 20 years after it became available for prostate-cancer screening, the U.S. Preventive Services Task Force (USPSTF) recently recommended against PSA-based screening. In the interim, untold millions of men have been tested.…
- November 24, 2011
- Brett A.S. and Ablin R.J.
- N Engl J Med 2011; 365:1949 - 1951
- Free Full Text
A preventive-services task force omitted three key issues in recommending against PSA screening: the impossibility of addressing the probabilities and uncertainties coherently during routine visits, variable management of PSA levels, and a lack of cost-effectiveness.
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Perspective
Stratifying Risk — The U.S. Preventive Services Task Force and Prostate-Cancer Screening
On October 11, 2011, the U.S. Preventive Services Task Force (USPSTF) issued a draft report on prostate specific antigen (PSA)–based screening for prostate cancer, giving it a grade D recommendation. Grade D means that "the USPSTF recommends against the service" because it has concluded that…
- November 24, 2011
- Schröder F.H.
- N Engl J Med 2011; 365:1953 - 1955
- Free Full Text
The USPSTF's grade D recommendation contradicts the common view that PSA screening saves lives by reducing the risk of death from prostate cancer. Decisions about screening should be made by informed patients and their clinicians, weighing particular risk factors.
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Clinical Practice
Screening for Prostate Cancer
Foreword. This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations. Stage. A 50-year-old,…
- November 24, 2011
- Hoffman R.M.
- N Engl J Med 2011; 365:2013 - 2019
- Free Full Text
- CME
- Full Text Audio
Current recommendations for prostate-specific antigen testing are reviewed, as well as the initial results of two randomized trials. The potential risks of screening, including morbidity from overdiagnosis and overtreatment, are described.
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Perspective
One Man at a Time — Resolving the PSA Controversy
Who should decide about screening for prostate cancer: expert panels of clinicians and methodologists, primary care clinicians, specialists, or fully informed patients themselves? The U.S. Preventive Services Task Force recently released a draft recommendation on screening for prostate cancer,…
- November 24, 2011
- McNaughton-Collins M.F. and Barry M.J.
- N Engl J Med 2011; 365:1951 - 1953
- Free Full Text
Evidence of a possible small benefit from PSA screening supports a grade C recommendation — not the U.S. Preventive Services Task Force's proposed grade D — for men 55 to 69 years of age, who should participate in screening decisions after discussion with a primary care provider.
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Correspondence
HRAS Mutation Mosaicism Causing Urothelial Cancer and Epidermal Nevus
To the Editor: Mosaicism of an oncogenic AKT1 mutation causes Proteus syndrome, which is associated with epidermal nevi and an increased risk of cancer. The occurrence of oncogenic mutations in mosaicism may increase a person's risk for malignant conditions. Somatic RAS mutations occur in 30% of…
- November 17, 2011
- N Engl J Med 2011; 365:1940 - 1942
- Free Full Text
To the Editor: Mosaicism of an oncogenic AKT1 mutation causes Proteus syndrome, which is associated with epidermal nevi and an increased risk of cancer.¹ The occurrence of oncogenic mutations in mosaicism may increase a person's risk for malignant ...
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Images in Clinical Medicine
Bryant's and Stabler's Signs after a Difficult Delivery
Figure 1.
- November 10, 2011
- Heyman S.R.G. and Vervloessem D.
- N Engl J Med 2011; 365:1824
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A neonate presented after birth with scrotal and right inguinal ecchymosis. He had been born at term after a difficult vaginal delivery that ultimately required both fundal pressure and vacuum extraction. The thorax was not manipulated during birth.
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Images in Clinical Medicine
Patent Urachus
Figure 1.
- October 6, 2011
- Tsai M.-S. and Yeh M.-L.
- N Engl J Med 2011; 365:1328
- Free Full Text
A 1-day-old male neonate was evaluated for a 2.5-cm mass arising from the umbilicus. The mass was covered in granulation tissue. When the patient cried, straw-colored fluid leaked intermittently from an orifice in the lesion.
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Clinical Decisions
Treatment of a 6-Year-Old Girl with Vesicoureteral Reflux — Polling Results
In late July, we presented the case of a 6-year-old girl with persistent bilateral vesicoureteral reflux in Clinical Decisions, an interactive feature designed to assess how readers would manage a clinical problem for which there may be more than one appropriate approach to the care of the patient.…
- August 25, 2011
- Lamas D.J., Ingelfinger J.R., Rosenbaum L.S.
- N Engl J Med 2011; 365:e17
- Free Full Text
- Interactive/Multimedia
In late July, we presented the case of a 6-year-old girl with persistent bilateral vesicoureteral reflux. Readers' votes in favor of watchful waiting, antibiotic prophylaxis, or surgical repair are shown by country.
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Review Article
Medical Progress: Febrile Urinary Tract Infections in Children
Acute pyelonephritis is the most common serious bacterial infection in childhood; many affected children, particularly infants, have severe symptoms. Most cases are readily treated, provided diagnosis is prompt, though in some children fever may take several days to abate. Approximately 7 to 8% of…
- July 21, 2011
- Montini G., Tullus K., Hewitt I.
- N Engl J Med 2011; 365:239 - 250
- CME
Approximately 7 to 8% of girls and 2% of boys have a UTI during the first 8 years of life. Not all UTIs involve the kidney, but acute pyelonephritis is one of the most common serious bacterial infections in children. This review summarizes diverse views on this topic.
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Clinical Decisions
Treatment of a 6-Year-Old Girl with Vesicoureteral Reflux
Case Vignette. CASE VIGNETTE A 6-year-old girl was recently referred to your clinic for further evaluation and management of vesicoureteral reflux, which had first been discovered after she presented at 1 year of age with a temperature of 39.5°C and irritability. Culture of a urine specimen at…
- July 21, 2011
- N Engl J Med 2011; 365:266 - 270
- Free Full Text
A 6-year-old girl presents with persistent bilateral vesicoureteral reflux, discovered after a urinary tract infection at 1 year of age. Would you recommend prophylaxis, careful follow-up without antibiotics, or repair of the vesicoureteral reflux? Vote and comment at NEJM.org.
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Original Article
Radiotherapy and Short-Term Androgen Deprivation for Localized Prostate Cancer
In the 1980s, advances in both surgery and radiotherapy for clinically localized prostate cancer led to their acceptance as successful treatments, with considerable reductions in harmful side effects as compared with earlier treatments. In the 1990s, reversible androgen suppression with the use of…
- July 14, 2011
- Jones C.U., Hunt D., McGowan D.G., et al.
- N Engl J Med 2011; 365:107 - 118
- Free Full Text
- CME
A course of androgen-deprivation therapy before and during radiotherapy prolonged 10-year survival by about 7% among men with intermediate-risk prostate cancer. The risk of erectile dysfunction from the addition of hormone therapy was also about 7% higher.
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Editorial
Risk-Based Management of Prostate Cancer
Randomized trials (EORTC 22863; SPCG-7; and TROG 9601) (Table 1) have established external-beam radiation therapy plus hormonal therapy (combined therapy) as a standard of care for men with adenocarcinoma of the prostate that is locally advanced (stage T3 or T4) or high-risk localized disease…
- July 14, 2011
- D'Amico A.V.
- N Engl J Med 2011; 365:169 - 171
Randomized trials (EORTC 22863¹; SPCG-7²; and TROG 9601³) (Table 1) have established external-beam radiation therapy plus hormonal therapy (combined therapy) as a standard of care for men with adenocarcinoma of the prostate that is locally advanced (stage ...
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Perspective
The Risks and Benefits of 5α-Reductase Inhibitors for Prostate-Cancer Prevention
The use of 5α-reductase inhibitors for prevention of prostate cancer continues to be widely discussed within the scientific and medical communities. Much of this discussion has been fueled by the findings of two large randomized, placebo-controlled trials — the Prostate Cancer Prevention Trial…
- July 14, 2011
- Theoret M.R., Ning Y.-M., Zhang J.J., et al.
- N Engl J Med 2011; 365:97 - 99
- Free Full Text
5α-reductase inhibitors' potential benefits in preventing prostate cancer and potential increased risk for high-grade cancers have been central issues for the FDA, which convened its Oncologic Drugs Advisory Committee to address the topic last December.
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Images in Clinical Medicine
Nonobstructive Hydronephrosis with Secondary Polycythemia
Figure 1.
- July 7, 2011
- Sung C.-C. and Lin S.-H.
- N Engl J Med 2011; 365:e1
- Free Full Text
A 34-year-old nonsmoking man was referred for evaluation of a history of polycythemia that required monthly phlebotomy. His medical history was significant for congenital nephrogenic diabetes insipidus, with a urine output of approximately 12 to 15 liters per day.
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Original Article
Abiraterone and Increased Survival in Metastatic Prostate Cancer
For the past 70 years, depleting or blocking the action of androgens has been the standard of care for men with advanced prostate cancer. Androgen deprivation results in a decrease in the concentration of prostate-specific antigen (PSA) as well as tumor regression and relief of symptoms in most…
- May 26, 2011
- de Bono J.S., Logothetis C.J., Molina A., et al.
- N Engl J Med 2011; 364:1995 - 2005
- Free Full Text
- CME
In this study, abiraterone acetate inhibited androgen synthesis and prolonged survival by 4 months among men with castration-resistant prostate cancer that had progressed with docetaxel chemotherapy.
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Case Records of the Massachusetts General Hospital
Case 16-2011 — A 67-Year-Old Man with Recurrent Prostate Cancer
Presentation of Case. Dr. Philip J. Saylor (Medical Oncology): A 67-year-old man was seen in the multidisciplinary genitourinary cancer clinic at this hospital because of recurrent prostate cancer. Approximately 18 months earlier, needle biopsies of the prostate were performed because of an…
- May 26, 2011
- Smith M.R., Zietman A.L., Finkelstein J.S., Wu C.-L.
- N Engl J Med 2011; 364:2044 - 2051
- CME
A 67-year-old man was seen at this hospital because of an elevated serum level of prostate-specific antigen 18 months after radical prostatectomy and external-beam radiation therapy for prostate cancer. A management decision was made.
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Editorial
Expanding Treatment Options for Metastatic Prostate Cancer
Prostate cancer is an androgen-receptor–dependent disease, and the blocking of androgen-receptor signaling is a hallmark of prostate-cancer therapeutics. Although most patients initially benefit from therapy involving deprivation of gonadal androgen, the disease eventually progresses after 12 to…
- May 26, 2011
- Antonarakis E.S. and Eisenberger M.A.
- N Engl J Med 2011; 364:2055 - 2058
Prostate cancer is an androgen-receptor–dependent disease, and the blocking of androgen-receptor signaling is a hallmark of prostate-cancer therapeutics. Although most patients initially benefit from therapy involving deprivation of gonadal androgen, the ...
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Images in Clinical Medicine
Calcified Vasa Deferentia
Figure 1.
- May 26, 2011
- Banerji J.S. and Devasia A.
- N Engl J Med 2011; 364:2043
- Free Full Text
A 60-year-old man with advanced diabetic nephropathy and secondary hyperparathyroidism underwent radiographic imaging of the abdomen and pelvis as part of an evaluation for nephrolithiasis.
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Editorial
Alemtuzumab in Kidney-Transplant Recipients
Over the past decade, the use of induction therapy in organ-transplant recipients to intensify immunosuppression during the peritransplantation period has contributed to a reduction in early rejection rates and graft loss in the first year after transplantation. It is now common practice to select…
- May 19, 2011
- Markmann J.F. and Fishman J.A.
- N Engl J Med 2011; 364:1968 - 1969
Over the past decade, the use of induction therapy in organ-transplant recipients to intensify immunosuppression during the peritransplantation period has contributed to a reduction in early rejection rates and graft loss in the first year after ...
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American Association for the Study of Liver Diseases

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Browse Urology/Prostate Disease General

Showing 1 to 20 of 266 Articles

Filter Results

Germline Mutations in HOXB13 and Prostate-Cancer Risk

Prostate-Cancer Screening — What the U.S. Preventive Services Task Force Left Out

Stratifying Risk — The U.S. Preventive Services Task Force and Prostate-Cancer Screening

Screening for Prostate Cancer

One Man at a Time — Resolving the PSA Controversy

HRAS Mutation Mosaicism Causing Urothelial Cancer and Epidermal Nevus

Bryant's and Stabler's Signs after a Difficult Delivery

Patent Urachus

Treatment of a 6-Year-Old Girl with Vesicoureteral Reflux — Polling Results

Medical Progress: Febrile Urinary Tract Infections in Children

Treatment of a 6-Year-Old Girl with Vesicoureteral Reflux

Radiotherapy and Short-Term Androgen Deprivation for Localized Prostate Cancer

Risk-Based Management of Prostate Cancer

The Risks and Benefits of 5α-Reductase Inhibitors for Prostate-Cancer Prevention

Nonobstructive Hydronephrosis with Secondary Polycythemia

Abiraterone and Increased Survival in Metastatic Prostate Cancer

Case 16-2011 — A 67-Year-Old Man with Recurrent Prostate Cancer

Expanding Treatment Options for Metastatic Prostate Cancer

Calcified Vasa Deferentia

Alemtuzumab in Kidney-Transplant Recipients

Medical Meetings Conferences and Meetings

American Association for the Study of Liver Diseases

Trends: Most Viewed (Last Week)