Edgar Paez - Academia.edu (original) (raw)

Papers by Edgar Paez

AIDS care, Jan 25, 2015

We sought to understand how HIV-infected patients, their providers, and HIV care researchers prio... more We sought to understand how HIV-infected patients, their providers, and HIV care researchers prioritize self-reported domains of clinical care. Participants rank-ordered two lists of domains. A modified Delphi process was used for providers and researchers. Approximately 25% of patients were interviewed to discuss rationale for rank order choices. List 1 included anger, anxiety, depression, fatigue, physical function, pain, and sleep disturbance. List 2 included alcohol abuse, cognitive function, HIV stigma, HIV and treatment symptoms, medication adherence, positive affect, sexual risk behavior, sexual function, social roles, spirituality/meaning of life, and substance abuse. Seventy-four providers, 80 HIV care researchers, and 66 patients participated. Patients ranked context-based domains, such as HIV stigma, more highly than providers, while health behaviors, such as drug or alcohol use, ranked lower. Patients described a need to address wider-context challenges such as HIV stigm...

BJU International

Introduction: Neo-adjuvant chemotherapy has been shown to confer a survival advantage compared to... more Introduction: Neo-adjuvant chemotherapy has been shown to confer a survival advantage compared to primary cystectomy (PC) alone for muscle invasive bladder cancer (MIBC). We report long-term survival outcomes of patient undergoing neo-adjuvant chemotherapy followed by cystectomy for MIBC. Methods: All patients undergoing radical cystectomy at a tertiary referral centre for MIBC (T2-T4, N0-2, M0) of the bladder in the period 01/01/04 to 31/12/11 were identified from a departmental database. Patient who had prior neo-adjuvant chemotherapy (NAC group) were identified by cross–checking with oncology records. Retrospective review of records was undertaken to capture demographic details, pathological findings on cystectomy specimen and disease specific survival. Results: 284 patients with complete follow-up data were included (72 NAC and 212 PC). The male to female ratio was 1.5:1 and overall median follow-up was 94 months. The median time between completion of chemotherapy to cystectomy ...

BJU International

Introduction Neoadjuvant platinum combination chemotherapy has been shown to confer a survival be... more Introduction Neoadjuvant platinum combination chemotherapy has been shown to confer a survival benefit in patients with muscle invasive bladder cancer (MIBC) undergoing cystectomy. This survival benefit has to be nevertheless balanced against chemo-toxicity. We present our experience at a UK tertiary referral centre. Methods Patients undergoing cystectomy for MIBC between 2004–2011 were identified from a departmental database. Patients having neoadjuvant chemotherapy (gemcitibine/cisplatin) were identified by cross-checking with oncology records. Review of the records was carried out to identify demographic details, pathological findings at cystectomy and survival outcomes. Results We identified 192 patients with MIBC with complete datasets – 69 underwent neoadjuvant chemotherapy (NAC) and 123 underwent primary cystectomy (PC). The male:female ratio was 2.6:1 and median follow-up was 47 months. The overall median survival was 20 months. Kaplan Meier analysis showed an overall 5 year...

International Journal of Cancer Therapy and Oncology, 2014

We describe the case of a 65 year-old male presenting with a tender right testicular mass, confir... more We describe the case of a 65 year-old male presenting with a tender right testicular mass, confirmed to be a tumour on ultrasound. The patient underwent a radical inguinal orchidectomy and histology revealed multiple adenomatoid tumours in epididymis and tunica vaginalis. This is an infrequent benign tumour of mesothelial origin that has rarely been reported as multiple lesions in the literature. Immunohistochemistry demonstrates that adenomatoid tumour and mesotheliomas share the expression of podoplanin (D2-40) which is helpful to differentiate them from carcinomas. On the other hand adenomatoid tumour is differentiated from mesothelioma on morphological grounds since the former does not exhibit cellular atypia, mitotic activity or bland focal tumour necrosis. Although testis preserving surgery can be an option for benign adenomatoid tumours, most patients (as in our case) proceed to orchidectomy as diagnosing them confidently can be difficult.

Current Urology, 2011

With a global increase in the routine performance of prostate specific antigen levels in men, the... more With a global increase in the routine performance of prostate specific antigen levels in men, there continues to be a steady increase in prostate biopsies. Despite the rapid developments in radiological imaging of the prostate, modifications in prostate specific antigen evaluations (free/total levels) and development of biomarkers for prostate cancer detection, transrectal ultrasound guided biopsies continue to be a methodology

McLoughlin/Top Tips in Urology, 2013

Urologic Oncology: Seminars and Original Investigations, 2013

Journal of Endourology, 2007

To report our results with percutaneous removal of calculi from reconstructed bladders. Twelve pa... more To report our results with percutaneous removal of calculi from reconstructed bladders. Twelve patients with reconstructed bladders who underwent endoscopic cystolithotomy were identified from our departmental database, and retrospective review of case notes and imaging was performed. Access was gained via an ultrasound-guided new tract in 9 patients (75%). An old suprapubic tract site was used in two patients, and the Mitrofanoff stoma was the route of access in one patient. The procedure was successful, with stone clearance achieved in all 12 cases. No major complications were observed. At a median follow up of 24 months, stone recurrence was observed in 5 patients (42%), 4 of whom underwent repeat procedures. Follow-up showed no change in continence in the patient with a Mitroffanoff stoma. Percutaneous cystolithotomy is a safe and effective minimally invasive option for removal of stones in a reconstructed bladder. We recommend endoscopic removal as the treatment of choice in these patients.

Ecancermedicalscience, 2012

To evaluate the impact of early re-resection on the incidence of tumour recurrence and progressio... more To evaluate the impact of early re-resection on the incidence of tumour recurrence and progression in patients with pT1 high-grade non-muscle invasive bladder cancer (HG-NMIBC). From 2001 to 2008, 486 consecutive patients were diagnosed with pT1 HG-NMIBC. Data were collected retrospectively which included patient demographics, histological parameters including the presence of detrusor muscle at initial TUR and at re-resection, adjuvant intravesical therapy, and recurrence and progression rates. Early re-resection was performed within six weeks of initial TUR. Patients comprised those who underwent an early re-resection (Group A, n = 172) and those who did not (Group B, n = 314). At initial TUR, detrusor muscle was present in 61% (n = 105) of patients in Group A and 76% (n = 240) of patients in Group B. At early re-resection, detrusor muscle was present in 77.9% of cases. A residual tumour was present in 54.6% of re-resected cases. The overall incidence of tumour recurrence was 35% a...

AIDS care, Jan 25, 2015

We sought to understand how HIV-infected patients, their providers, and HIV care researchers prio... more We sought to understand how HIV-infected patients, their providers, and HIV care researchers prioritize self-reported domains of clinical care. Participants rank-ordered two lists of domains. A modified Delphi process was used for providers and researchers. Approximately 25% of patients were interviewed to discuss rationale for rank order choices. List 1 included anger, anxiety, depression, fatigue, physical function, pain, and sleep disturbance. List 2 included alcohol abuse, cognitive function, HIV stigma, HIV and treatment symptoms, medication adherence, positive affect, sexual risk behavior, sexual function, social roles, spirituality/meaning of life, and substance abuse. Seventy-four providers, 80 HIV care researchers, and 66 patients participated. Patients ranked context-based domains, such as HIV stigma, more highly than providers, while health behaviors, such as drug or alcohol use, ranked lower. Patients described a need to address wider-context challenges such as HIV stigm...

BJU International

Introduction: Neo-adjuvant chemotherapy has been shown to confer a survival advantage compared to... more Introduction: Neo-adjuvant chemotherapy has been shown to confer a survival advantage compared to primary cystectomy (PC) alone for muscle invasive bladder cancer (MIBC). We report long-term survival outcomes of patient undergoing neo-adjuvant chemotherapy followed by cystectomy for MIBC. Methods: All patients undergoing radical cystectomy at a tertiary referral centre for MIBC (T2-T4, N0-2, M0) of the bladder in the period 01/01/04 to 31/12/11 were identified from a departmental database. Patient who had prior neo-adjuvant chemotherapy (NAC group) were identified by cross–checking with oncology records. Retrospective review of records was undertaken to capture demographic details, pathological findings on cystectomy specimen and disease specific survival. Results: 284 patients with complete follow-up data were included (72 NAC and 212 PC). The male to female ratio was 1.5:1 and overall median follow-up was 94 months. The median time between completion of chemotherapy to cystectomy ...

BJU International

Introduction Neoadjuvant platinum combination chemotherapy has been shown to confer a survival be... more Introduction Neoadjuvant platinum combination chemotherapy has been shown to confer a survival benefit in patients with muscle invasive bladder cancer (MIBC) undergoing cystectomy. This survival benefit has to be nevertheless balanced against chemo-toxicity. We present our experience at a UK tertiary referral centre. Methods Patients undergoing cystectomy for MIBC between 2004–2011 were identified from a departmental database. Patients having neoadjuvant chemotherapy (gemcitibine/cisplatin) were identified by cross-checking with oncology records. Review of the records was carried out to identify demographic details, pathological findings at cystectomy and survival outcomes. Results We identified 192 patients with MIBC with complete datasets – 69 underwent neoadjuvant chemotherapy (NAC) and 123 underwent primary cystectomy (PC). The male:female ratio was 2.6:1 and median follow-up was 47 months. The overall median survival was 20 months. Kaplan Meier analysis showed an overall 5 year...

International Journal of Cancer Therapy and Oncology, 2014

We describe the case of a 65 year-old male presenting with a tender right testicular mass, confir... more We describe the case of a 65 year-old male presenting with a tender right testicular mass, confirmed to be a tumour on ultrasound. The patient underwent a radical inguinal orchidectomy and histology revealed multiple adenomatoid tumours in epididymis and tunica vaginalis. This is an infrequent benign tumour of mesothelial origin that has rarely been reported as multiple lesions in the literature. Immunohistochemistry demonstrates that adenomatoid tumour and mesotheliomas share the expression of podoplanin (D2-40) which is helpful to differentiate them from carcinomas. On the other hand adenomatoid tumour is differentiated from mesothelioma on morphological grounds since the former does not exhibit cellular atypia, mitotic activity or bland focal tumour necrosis. Although testis preserving surgery can be an option for benign adenomatoid tumours, most patients (as in our case) proceed to orchidectomy as diagnosing them confidently can be difficult.

Current Urology, 2011

With a global increase in the routine performance of prostate specific antigen levels in men, the... more With a global increase in the routine performance of prostate specific antigen levels in men, there continues to be a steady increase in prostate biopsies. Despite the rapid developments in radiological imaging of the prostate, modifications in prostate specific antigen evaluations (free/total levels) and development of biomarkers for prostate cancer detection, transrectal ultrasound guided biopsies continue to be a methodology

McLoughlin/Top Tips in Urology, 2013

Urologic Oncology: Seminars and Original Investigations, 2013

Journal of Endourology, 2007

To report our results with percutaneous removal of calculi from reconstructed bladders. Twelve pa... more To report our results with percutaneous removal of calculi from reconstructed bladders. Twelve patients with reconstructed bladders who underwent endoscopic cystolithotomy were identified from our departmental database, and retrospective review of case notes and imaging was performed. Access was gained via an ultrasound-guided new tract in 9 patients (75%). An old suprapubic tract site was used in two patients, and the Mitrofanoff stoma was the route of access in one patient. The procedure was successful, with stone clearance achieved in all 12 cases. No major complications were observed. At a median follow up of 24 months, stone recurrence was observed in 5 patients (42%), 4 of whom underwent repeat procedures. Follow-up showed no change in continence in the patient with a Mitroffanoff stoma. Percutaneous cystolithotomy is a safe and effective minimally invasive option for removal of stones in a reconstructed bladder. We recommend endoscopic removal as the treatment of choice in these patients.

Ecancermedicalscience, 2012

To evaluate the impact of early re-resection on the incidence of tumour recurrence and progressio... more To evaluate the impact of early re-resection on the incidence of tumour recurrence and progression in patients with pT1 high-grade non-muscle invasive bladder cancer (HG-NMIBC). From 2001 to 2008, 486 consecutive patients were diagnosed with pT1 HG-NMIBC. Data were collected retrospectively which included patient demographics, histological parameters including the presence of detrusor muscle at initial TUR and at re-resection, adjuvant intravesical therapy, and recurrence and progression rates. Early re-resection was performed within six weeks of initial TUR. Patients comprised those who underwent an early re-resection (Group A, n = 172) and those who did not (Group B, n = 314). At initial TUR, detrusor muscle was present in 61% (n = 105) of patients in Group A and 76% (n = 240) of patients in Group B. At early re-resection, detrusor muscle was present in 77.9% of cases. A residual tumour was present in 54.6% of re-resected cases. The overall incidence of tumour recurrence was 35% a...