Symptoms and General Pathology

All Conditions

Neoplasms

Urinary Tract, Sexual Organs, and Pregnancy Conditions

Hypothermia

Urologic Neoplasms

Body Temperature Changes

Urogenital Neoplasms

Urogenital Diseases

Female Urogenital Diseases

Pregnancy Complications

Female Urogenital Diseases and Pregnancy Complications

Male Urogenital Diseases

Urologic Diseases

Central Nervous System Depressants

All Drugs and Chemicals

Pharmaceutical Solutions

Micronutrients

Antineoplastic Agents

Vitamins

Anesthetics

Bupivacaine

Vitamin A

Retinol palmitate

Retinol

Patients covered with a 41 centigrade degrees double layered cotton cloth

Patients receive active prewarming with an air forced blanket ( full body blanket) 30 minutes prior to the operation

Core temperature and 4-points skin temperatures measurements will be recorded all over the operation. Patients will be delivered 2 Litre/minute oxygen with a nasal cannula.Iv hydration will be continued by room temperatured balanced electrolyte solution with an infusion rate of 2mL/kg/hr. Spinal anesthesia will be applied at the level of L3-L4 by a 25 Gauge Quincke needle with a dose of 12.5-15 mg hyperbaric bupivacaine in the sitting position.

Patients in Group II will receive active prewarming with an air forced blanket (full body blanket) 30 minutes prior to the operation

Negin Nayebi, MD

Zeki Tuncel Tekgül, Assoc Prof

Halide Hande Şahinkaya, Specialist

In this randomized prospective single-blind study,American Society of Anesthesiologists physical status classification system ( ASA )I-II-III patients aged 50-80 years undergoing transurethral bladder resection will be randomly divided into two groups. First group will be covered with 41 centigrade degrees double layered cotton cloth. Second group will receive active prewarming. Core temperature of all patients will be monitorized via tympanic membrane. Skin temperature will be monitorized from 4 different body areas. Spinal anesthesia will be applied at the level of L3-L4 by a 25 Gauge quincke needle with a dose of 12.5-15 mg hyperbaric bupivacaine. Pinprick test will be used for sensorial block assessment. T10 sensorial block will be our goal. Hemodynamic parameters will be recorded. Skin temperature will be monitorized before and after spinal anesthesia and changes will be recorded. Operation time, amount and temperature of irrigation fluids, transfusion requirement, discharge time from postoperative care unit will also be recorded. Shivering score and thermal comfort scale will be used. The two groups will be compared for the temperature changes.

In this prospective single-blind study, patients will be divided into 2 groups with computer-based randomization technique. All patients will have a fasting time of 2 hours for clear fluid and 6 hours for solid food. Patients will be taken to the premedication room before the operation. Written and verbal approval will be taken from all patients. Tympanic membrane will be used for core temperature measurement by Citizen ear thermometer,every 15 minutes.Adult skin temperature probe will be used for continuous peripheral temperature measurement from four different body areas (T1:Cervical7 (C7) dermatome, T2:C6 dermatome T3:Lumbar 5( L5 )dermatome, T4: L4 dermatome). The two groups will have an infusion of balanced electrolyte solution with a rate of 8 Mililitre/Kilogram/ hour(mL/kg/hour). Patients in Group I will be covered with a 41 centigrade degrees double layered cotton clothes. Patients in Group II will receive active prewarming with a forced-air warming blanket (WarmCare full body blanket) 30 minutes prior to the operation. 0.1 mg/kg intravenous (iv) midazolam hydrochloride will be administered for premedication. Patients will be transferred to operating room, covered with warmed double layered cotton clothes. Standard monitoring (pulse oximetry, noninvasive blood pressure, electrocardiography) will be applied to the patients. Core temperature and 4-points skin temperature measurements will be recorded. Patients will be delivered 2 Liter/minute oxygen with a nasal cannula. Iv hydration will be continued by room temperature balanced electrolyte solution with an infusion rate of 2mililiter/kilogram/hour. Spinal anesthesia will be applied at the level of L3-L4 by a 25 Gauge Quincke needle with a dose of 12.5-15 mg hyperbaric bupivacaine in the sitting position. Then patients will be taken supine position. Hemodynamic measurements will be continued. Core temperature measurements will be done every 15 minutes. Peripheral skin temperature measurements will be continuous. 1st, 2nd ,3rd,4th ,5th ,6th, 7th, 8th, 9th and 10th minutes and every 5 minutes measurements will be recorded during the operation. Pinprick test will be used for sensorial block assessment. T10 sensorial block will be our goal. The time for adequate sensorial block (T10) will be recorded. The patients will be repositioned (lithotomy) before the beginning of surgery. 5 mg iv ephedrine and 0.5 mg iv atropine will be administered when the blood pressure will be %80 of the baseline pressure and heart rate. Operating time, amount and temperature of irrigation fluids, transfusion requirement will be recorded. All patients will be transferred to post anesthesia care unit (PACU). Core temperature measurements will be continued every 15 minutes at PACU. Shivering scale and thermal comfort scale will be used during and after the operation. 25 mg iv meperidine will be administered when the patient's shivering score will be more than 3. Length of PACU stay will be recorded.

The study covers 2 groups. Group I will be covered with warmed double layered cotton cloth. Group II will be covered with air forced blanket.

Male patients scheduled for transurethral bladder resection

Effect of Prewarming On Skin Temperature Changes

Effect of Prewarming On Skin Temperature Changes After Spinal Anesthesia in Transurethral Resection of The Bladder

F0 will be defined as temperature which measured at C7 dermatome from palmar side of the 3rd finger with adult skin probe

S0 will be defined as temperature which measured at C6 dermatome from ventral side of styloid process with adult skin probe

T0 will be defined as temperature which measured at L5 dermatome plantar side of 1st toe with adult skin probe

M0 will be defined as temperature which measured at L4 dermatome above the medial malleolus with adult skin probe

F1will be defined as temperature which measured at C7 dermatome from palmar side of the 3rd finger with adult skin probe

F2 will be defined as temperature which measured at C7 dermatome from palmar side of the 3rd finger with adult skin probe

F3 will be defined as temperature which measured at C7 dermatome from palmar side of the 3rd finger with adult skin probe

F4 will be defined as temperature which measured at C7 dermatome from palmar side of the 3rd finger with adult skin probe

F5 will be defined as temperature which measured at C7 dermatome from palmar side of the 3rd finger with adult skin probe

F6 will be defined as temperature which measured at C7 dermatome from palmar side of the 3rd finger with adult skin probe

F7 will be defined as temperature which measured at C7 dermatome from palmar side of the 3rd finger with adult skin probe

F8 will be defined as temperature which measured at C7 dermatome from palmar side of the 3rd finger with adult skin probe

F9 will be defined as temperature which measured at C7 dermatome from palmar side of the 3rd finger with adult skin probe

F10 will be defined as temperature which measured at C7 dermatome from palmar side of the 3rd finger with adult skin probe

F15 will be defined as temperature which measured at C7 dermatome from palmar side of the 3rd finger with adult skin probe

F20 will be defined as temperature which measured at C7 dermatome from palmar side of the 3rd finger with adult skin probe

F25 will be defined as temperature which measured at C7 dermatome from palmar side of the 3rd finger with adult skin probe

F30 will be defined as temperature which measured at C7 dermatome from palmar side of the 3rd finger with adult skin probe

F35 will be defined as temperature which measured at C7 dermatome from palmar side of the 3rd finger with adult skin probe

F40 will be defined as temperature which measured at C7 dermatome from palmar side of the 3rd finger with adult skin probe

F45 will be defined as temperature which measured at C7 dermatome from palmar side of the 3rd finger with adult skin probe

F50 will be defined as temperature which measured at C7 dermatome from palmar side of the 3rd finger with adult skin probe

F55 will be defined as temperature which measured at C7 dermatome from palmar side of the 3rd finger with adult skin probe

F60 will be defined as temperature which measured at C7 dermatome from palmar side of the 3rd finger with adult skin probe

S1 will be defined as temperature which measured at C6 dermatome from ventral side of styloid process with adult skin probe

S2 will be defined as temperature which measured at C6 dermatome from ventral side of styloid process with adult skin probe

S3 will be defined as temperature which measured at C6 dermatome from ventral side of styloid process with adult skin probe

S4 will be defined as temperature which measured at C6 dermatome from ventral side of styloid process with adult skin probe

S5 will be defined as temperature which measured at C6 dermatome from ventral side of styloid process with adult skin probe

S6 will be defined as temperature which measured at C6 dermatome from ventral side of styloid process with adult skin probe

S7 will be defined as temperature which measured at C6 dermatome from ventral side of styloid process with adult skin probe

S8 will be defined as temperature which measured at C6 dermatome from ventral side of styloid process with adult skin probe

S9 will be defined as temperature which measured at C6 dermatome from ventral side of styloid process with adult skin probe

S10 will be defined as temperature which measured at C6 dermatome from ventral side of styloid process with adult skin probe

S15 will be defined as temperature which measured at C6 dermatome from ventral side of styloid process with adult skin probe

S20 will be defined as temperature which measured at C6 dermatome from ventral side of styloid process with adult skin probe

S25 will be defined as temperature which measured at C6 dermatome from ventral side of styloid process with adult skin probe

S30 will be defined as temperature which measured at C6 dermatome from ventral side of styloid process with adult skin probe

S35 will be defined as temperature which measured at C6 dermatome from ventral side of styloid process with adult skin probe

S40 will be defined as temperature which measured at C6 dermatome from ventral side of styloid process with adult skin probe

S45 will be defined as temperature which measured at C6 dermatome from ventral side of styloid process with adult skin probe

S50 will be defined as temperature which measured at C6 dermatome from ventral side of styloid process with adult skin probe

S55 will be defined as temperature which measured at C6 dermatome from ventral side of styloid process with adult skin probe

S60 will be defined as temperature which measured at C6 dermatome from ventral side of styloid process with adult skin probe

T1 will be defined as temperature which measured at L5 dermatome plantar side of 1st toe with adult skin probe

T2 will be defined as temperature which measured at L5 dermatome plantar side of 1st toe with adult skin probe

T3 will be defined as temperature which measured at L5 dermatome plantar side of 1st toe with adult skin probe

T4 will be defined as temperature which measured at L5 dermatome plantar side of 1st toe with adult skin probe

T5 will be defined as temperature which measured at L5 dermatome plantar side of 1st toe with adult skin probe

T6 will be defined as temperature which measured at L5 dermatome plantar side of 1st toe with adult skin probe

T7 will be defined as temperature which measured at L5 deramatome plantar side of 1st toe with adult skin probe

T8 will be defined as temperature which measured at L5 dermatome plantar side of 1st toe with adult skin probe

T9 will be defined as temperature which measured at L5 dermatome plantar side of 1st toe with adult skin probe

T10 will be defined as temperature which measured at L5 dermatome plantar side of 1st toe with adult skin probe

T15 will be defined as temperature which measured at L5 dermatome plantar side of 1st toe with adult skin probe

T20 will be defined as temperature which measured at L5 dermatome plantar side of 1st toe with adult skin probe

T25 will be defined as temperature which measured L5 dermatome at plantar side of 1st toe with adult skin probe

T30 will be defined as temperature which measured at L5 dermatome plantar side of 1st toe with adult skin probe

T35 will be defined as temperature which measured at L5 dermatome plantar side of 1st toe with adult skin probe

T40 will be defined as temperature which measured at L5 dermatome plantar side of 1st toe with adult skin probe

T45will be defined as temperature which measured at L5 dermatome plantar side of 1st toe with adult skin probe

T50 will be defined as temperature which measured at L5 dermatome plantar side of 1st toe with adult skin probe

T55 will be defined as temperature which measured at L5 dermatome plantar side of 1st toe with adult skin probe

T60 will be defined as temperature which measured at L5 dermatome plantar side of 1st toe with adult skin probe

M1 will be defined as temperature which measured at L4 dermatome above the medial malleolus with adult skin probe

M2 will be defined as temperature which measured at L4 dermatome above the medial malleolus with adult skin probe

M3 will be defined as temperature which measured at L4 dermatome above the medial malleolus with adult skin probe

M4 will be defined as temperature which measured at L4 dermatome above the medial malleolus with adult skin probe

M5 will be defined as temperature which measured at L4 dermatome above the medial malleolus with adult skin probe

M6 will be defined as temperature which measured at L4 dermatome above the medial malleolus with adult skin probe

M7 will be defined as temperature which measured at L4 dermatome above the medial malleolus with adult skin probe

M8 will be defined as temperature which measured at L4 dermatome above the medial malleolus with adult skin probe

M9 will be defined as temperature which measured at L4 dermatome above the medial malleolus with adult skin probe

M10 will be defined as temperature which measured at L4 dermatome above the medial malleolus with adult skin probe

M15 will be defined as temperature which measured at L4 dermatome above the medial malleolus with adult skin probe

M20 will be defined as temperature which measured at L4 dermatome above the medial malleolus with adult skin probe

M25 will be defined as temperature which measured at L4 dermatome above the medial malleolus with adult skin probe

M30 will be defined as temperature which measured at L4 dermatome above the medial malleolus with adult skin probe

M35 will be defined as temperature which measured at L4 dermatome above the medial malleolus with adult skin probe

M40 will be defined as temperature which measured at L4 dermatome above the medial malleolus with adult skin probe

M45 will be defined as temperature which measured at L4 dermatome above the medial malleolus with adult skin probe

M50 will be defined as temperature which measured at L4 dermatome above the medial malleolus with adult skin probe

M55 will be defined as temperature which measured at L4 dermatome above the medial malleolus with adult skin probe

M60 will be defined as temperature which measured at L4 dermatome above the medial malleolus with adult skin probe

centigrade degree , Timpanic membrane will be used for core temperature measurement by Citizen ear thermometer, CTD504,

centigrade degree , Tympanic membrane will be used for core temperature measurement by Citizen ear thermometer, CTD504,

thermal comfort will be rated on a 100mm visual analog scale (VAS),with zero indicating intense cold and 100mm representing intense heat

0: no shivering 1:piloerection or peripheral vasoconstriction but no visible shivering 2: muscular activity in only one muscle group 3:muscular activity in more then one muscle group but not generalized shivering 4:shivering involving the whole body

Bozyaka Training and Research Hospital

MD, Anesthesiology Resident

Digestive System Diseases

Genital Neoplasms, Female

Gastrointestinal Neoplasms

Digestive System Neoplasms

Gastrointestinal Diseases

Genital Diseases, Female

Genital Diseases

Intraocular pressure will be measured by electronic tomometer (tonopen) at different point of time after induction of anaesthesia in patients undergoing robotic assisted surgery under steep Trendelenberg position. Anterior chamber depth will be measured by ultrasound at the same time intervals.

Electronic tonometer will be used as gold standard for intraocular pressure measurement in supine position after induction of anaesthesia and every 2 hours intraoperatively and at end of surgery.

IOP by tonometer

Anterior chamber depth will be measured by ultrasound in supine position after induction of anaesthesia and every 2 hours intraoperatively and at end of surgery.

Anterior chamber depth measurement by ultrasound

Sohan L Solanki, MD

Intra ocular pressure (IOP) may theoretically increase due to steep Trendelenberg position and studies showed that IOP reaches peak levels after steep Trendelenberg position on an average of 13 mmHg higher than preanesthesia induction values. Major determinants of IOP are aqueous humor flow, choroidal blood volume, central venous pressure and extra ocular muscle tone.

Hassen GW et al measured anterior chamber depth in 2 patients with glaucoma and compared the anterior chamber depth (ACD) with the intraocular pressure measured by tonometer. They concluded that bedside ultrasound could be useful in evaluating patient with suspected increased IOP, who are unable to open their eyes.

Intra ocular pressure (IOP) may theoretically increase due to steep Trendelenberg position and studies showed that IOP reaches peak levels after steep Trendelenberg position on an average of 13 mmHg higher than preanesthesia induction values. Major determinants of IOP are aqueous humor flow, choroidal blood volume, central venous pressure and extra ocular muscle tone. During the robotic surgery there are two theories explaining the increase of IOP, first, gravitational forces increase central venous pressure which in turn affect orbital venous pressure and increase IOP. Second, intraperitoneal carbon dioxide causes increased choroidal blood volume which may result in IOP increase. One study reported that low end tidal carbon dioxide was a significant predictor of the IOP increase. Continuous absorption of carbon dioxide from peritoneum and increased pressure on diaphragm results in lower delivered tidal volumes and subsequently increased arterial carbon dioxide levels leading to increased choroidal blood flow and increased IOP.

Hassen GW et al measured anterior chamber depth in 2 patients with glaucoma and compared the anterior chamber depth (ACD) with the intraocular pressure measured by tonometer. They concluded that bedside ultrasound could be useful in evaluating patient with suspected increased IOP, who are unable to open their eyes. It can also be used for serial examination and follow-up of treatment success. They also mentioned that, it is necessary to conduct a prospective study with a larger sample size, to evaluate if there is agreement between measurements using a tonometer and measurements of the ACD using ultrasound. In addition, it is essential to determine the cut off normal ACD for evaluation of IOP.

Correlation Between Intraocular Pressure Measurement by Tomometer and Anterior Chamber Depth Measurement by Ultrasound

Correlation Between Intraocular Pressure Measurement by Tomometer and Anterior Chamber Depth Measurement by Ultrasound in Steep Trendelenberg Position During Robotic Assisted Surgery

Intra operative recordings of IOP will be after induction and thereafter will be measured every 2 hours and at the end of surgery.

Intra operative recordings of anterior chamber depth will be measured after induction of anaesthesia, every 2 hours intraoperatively and at end of surgery.

Tata Memorial Centre

Assistant Professor, Department of Anesthesiology, Critical Care and Pain

Prostatic Neoplasms

Genital Neoplasms, Male

Genital Diseases, Male

Prostatic Diseases

The mpMRIs were performed on a 1.5T GE MR unit or on a 3T GE or Philips MR units. All mpMRIs included T2-weighted imaging, diffusion-weighted imaging (maximal b value: 2000 s/mm²) and dynamic contrast-enhanced imaging.

1. Ass of targeted suspect lesions

   On each mpMRI,radiologist will contour lesions that were targeted at subsequent biopsy based on reports. Contours will be disclosed to readers who will assess,for each lesion:
   * Likert score("gut feeling"ie subjective ass of the likelihood that lesion is clinically significant prostate cancer(5-level scale))
   * PI-RADSv2, PI-RADSv2.1 score(by strictly applying the published PI-RADS criteria)
   * EPE score(ie the likelihood of extraprostatic extension;5-level subjective scale without predefined criteria)
   * Max diameter
2. Def of add suspect lesions Readers could define suspect"additional targets"(AT);for each AT,they will provide the same criteria. It is expected that, for these suspect AT,at least one score is≥3
3. Ass of lobes Scores of prostate lobes will be automatically calculated based on 2 previous steps of reading. However,in lobes with no suspect lesion,readers could define whether same criteria are1or2,in peripheral zone and transition zone

Assessment of the accuracy of the PI-RADS v2.1 score for predicting the presence of ISUP ≥2 prostate cancer at subsequent biopsy in the dataset of the 171 MRIs for 21 different readers.

The interpretation of prostate multiparametric MRI (mpMRI) is difficult and requires expertise. As a result, it suffers from substantial inter-reader variability. The so-called Prostate Imaging Reporting and Data System (PI-RADS) scoring system has been launched in 2012 to try and standardise prostate mpMRI interpretation. It is a 5-level score that assesses the likelihood that suspicious focal prostatic lesions seen on mpMRI are clinically significant prostate cancers. Despite the use of semi-objective criteria for each category of the score, the inter-reader reproducibility of the first two versions (PI-RADS v1 launched in 2012 and PI-RADS v2 launched in 2015) was moderate at best, even for experienced readers. The last version (PI-RADS v2.1) has been launched in March 2019 in an effort to improve the inter-reader reproducibility. This version has not been evaluated yet.

The purpose of our study is to evaluate the accuracy and inter-reader reproducibility of the PI-RADS v2.1 score on a large set of 171 prostate MRIs using 21 readers of varying experience.

Twenty-one readers (14 seniors and 7 juniors) from 9 different institutions and with varying experience in prostate mpMRI accepted to participate to the study.

Reader will assess the dataset independently and will be blinded to the other readers' results. They also be blinded to clinical and biochemical data.

Evaluation of the PI-RADS v2.1 Score Using Multiple Readers

Accuracy of the PI-RADS v2.1 Score for Characterizing ISUP ≥2 Prostate Cancers on Multiparametric MRI: a Multiple Reader Study

Analysis at the lesion level will be favored to get an evaluation of the influence of experience of readers scoring the exact same set of lesions.

The PI-RADS v2.1 score is made by several components who have different diagnostic weights. The added value of the following components will be assessed:

* Lesions DCE+: do they correspond more often to ISUP ≥2 cancers than DCE- lesions?
* Lesions with DWI score of 4: is a size of 10-14 mm more predictive of ISUP ≥2 cancers than a size \< 10 mm?
* Lesions with a T2w score of 2 and a DWI score of 4 in the PI-RADS v2.1 score: what is the proportion of ISUP ≥2 cancers?

- This part will be only exploratory and narrative. It is aimed at evaluating, at least for the most experienced readers, if there are circumstances in which the Likert score (i.e. "gut feeling") is more predictive of ISUP ≥2 cancers than the PI-RADS v2.1 score.

Because targeted and systematic biopsy may miss cancer foci, follow-up data will be retrieved from the patients' files. Patients with no follow-up data within the last year will be reached by phone to update their follow-up.The patients with initial biopsy showing no cancer or ISUP 1 cancer and who were subsequently diagnosed with ISUP ≥2 cancers during the 3-year follow-up will be reported and described.

Hospices Civils de Lyon

Skin and Connective Tissue Diseases

Melanoma

Antibodies

Antibodies, Monoclonal

Immune Checkpoint Inhibitors

Immunoglobulins

Immunologic Factors

humanized anti-PD-1 monoclonal antibody is to be injected intravenously 1mg/kg or 3mg/kg or 10mg/kg until disease progresses or unacceptable tolerability occurs.

humanized anti-PD-1 monoclonal antibody (JS001) is a programmed death-1 (PD-1) immune checkpoint inhibitor antibody, which selectively interferes with the combination of PD-1 with its ligands, PD-L1 and PD-L2, resulting in the activation of lymphocytes and elimination of malignancy theoretically.

humanized anti-PD-1 monoclonal antibody Toripalimab (JS001)

Jun Guo, Phd MD

This is a mono-center, open-label, phase 1 study evaluating the humanized anti-PD-1 antibody JS001, as a monotherapy in patients with advanced melanoma or urological cancers who have failed in routine systemic treatment. The study will be conducted in 2 parts: dose escalation and cohort expansion to investigate tolerability and efficacy.

This is a mono-center, open-label, phase 1 study evaluating the humanized anti-PD-1 antibody JS001, as a monotherapy in patients with advanced solid tumor (melanoma or urological cancers) who have failed in previous routine systemic treatment. The study will be conducted in 2 parts: dose escalation and cohort expansion. In the first part, nine patients are injected with different dosage of the humanized anti-PD-1 antibody (1mg/kg or 3mg/kg or 10mg/mg, three patients in one group ) once and observed carefully in the following 4 weeks. If no dose-limiting toxicity (DLT) occurs, then they are injected every 2 weeks until disease progresses or unacceptable toxicity occurs. This part is to confirm DLT, maximum tolerated dose (MTD) and recommended dose (RD). In the second part, 6-12 patients are enrolled in each dosage group and injected with the humanized anti-PD-1 antibody every 2 weeks until disease progresses or unacceptable toxicity occurs. This part is to further analyze safety and efficacy of the humanized anti-PD-1 antibody.

Safety and Tolerability of Recombinant Humanized Anti-PD-1 Monoclonal Antibody Toripalimab for Patients With Advanced Solid Tumors

A Phase I, Open Label, Single Center and Dose Escalation Study Investigating Tolerance and Pharmacokinetics of Single and Multiple Doses of Recombinant Humanized Anti-PD-1 Monoclonal Antibody for Injection in Patients With Advanced Solid Tumors

Shanghai Junshi Bioscience Co., Ltd.

Nutritional and Metabolic Diseases

Behaviors and Mental Disorders

Obesity

Malnutrition

Alcohol Drinking

Postoperative Complications

Anti-Infective Agents

Ethanol

Intervention: Patients allocated to the intervention group receive weekly counselling sessions in 6 weeks as an integrated prehabilitation program tailored to meet the individual patient's need for risk reduction at surgery. It is introduced via the surgical 'Engage in the process of change'. The smoking and alcohol cessation intervention follows the Gold Standard Programme and patients in the intervention group are introduced to a standardized exercise training programme taking individualized needs into account. Nutritional support is also individualized.

Treatment as ususal covers shorter interventions, e.g. advice, brief counselling, and handing out the national folders on smoking and alcohol and surgery. Patients are ensured that they are free to access support to lifestyle changes in the community.

Patients screened positive for minimun 1 SNAP factor will be offered enrollment in the study and have an individualized plan for the prehabilitation intervention.

Prehabilitation

Hanne Tønnesen, Professor MD

Susanne V Lauridsen, PhD

Hanne Tonnesen, Professor MD

Despite knowledge about the effect of preventive measures in lifestyle, smoking,nutrition, alcohol and physical activity (SNAP), there is a lack of systematic assessment of the overall lifestyle of the patient before surgery and knowledge about how lifestyle interventions can be organized in connection with cancer surgery. The intention with prehabilitation is to optimize the individual's risk factors and personal burdens that can affect the clinical and patient reported outcomes after surgery. The aim of this study is to evaluate the efficacy of intensive SNAP interventions compared to treatment as usual (TAU) in ptt undergoing urological cancer surgery on surgical risk reduction.

The project contains three clinical intervention studies, in total including 100 urological cancer patients screened positive for at least 1 SNAP factor:

I. Efficacy and preferences of intensive SNAP-Interventions among patients with at least one SNAP factor and undertaking neo-adjuvant chemotherapy before radical cystectomy. A randomised controlled trial with nested interviews (42 patients).

II. Implementation and preferences of intensive SNAP-Interventions among patients with kidney cancer undergoing nephrectomy/partial nephrectomy. An implementation feasibility study including interviews (20 patients).

III. Reach out and effect as well as preferences of perioperative intensive smoking cessation intervention via the municipality clinic compared to the surgical department among smokers with non-invasive bladder cancer treated with Trans-Urethral Resection of the Bladder (TUR-B). A randomised controlled trial with nested interviews (38 patients).

The intervention groups receive minimum five educational sessions tailored to individual needs over six weeks perioperatively. The control groups receive standard care.

Randomised Controlled Trials, Implementation feasibilty trial, Interviews nested

Outcome assessors will not know if patients were allocated to intervention or control group

STRONG for Surgery & Strong for Life - Against All Odds: Intensive Prehabilitation for Risk Reduction in Cancer Surgery

STRONG for Surgery & Strong for Life - Against All Odds: Intensive Prehabilitation Including Smoking, Nutrition, Alcohol and Physical Activity for Risk Reduction in Cancer Surgery

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Effect of Prewarming On Skin Temperature Changes	NCT05063292	Spinal Anesthes... Hypothermia Fol... Prewarming Core Temperatur... Urological Canc...	Patients in Gro...	50 Years - 80 Years	Bozyaka Training and Research Hospital
Correlation Between Intraocular Pressure Measurement by Tomometer and Anterior Chamber Depth Measurement by Ultrasound	NCT02818530	Urological Canc... Gastrointestina... Malignant Femal...	IOP by tonomete... Anterior chambe...	18 Years - 70 Years	Tata Memorial Centre
Effect of Prewarming On Skin Temperature Changes	NCT05063292	Spinal Anesthes... Hypothermia Fol... Prewarming Core Temperatur... Urological Canc...	Patients in Gro...	50 Years - 80 Years	Bozyaka Training and Research Hospital
Evaluation of the PI-RADS v2.1 Score Using Multiple Readers	NCT04299997	Prostate Cancer Urological Canc...	Assessment of t...	-	Hospices Civils de Lyon
Safety and Tolerability of Recombinant Humanized Anti-PD-1 Monoclonal Antibody Toripalimab for Patients With Advanced Solid Tumors	NCT02836795	Melanoma Urological Canc...	humanized anti-...	18 Years - 70 Years	Shanghai Junshi Bioscience Co., Ltd.
STRONG for Surgery & Strong for Life - Against All Odds: Intensive Prehabilitation for Risk Reduction in Cancer Surgery	NCT04088968	Risk Reduction Urological Canc... Surgery Life Style	Prehabilitation	18 Years - 100 Years	Bispebjerg Hospital
Correlation Between Intraocular Pressure Measurement by Tomometer and Anterior Chamber Depth Measurement by Ultrasound	NCT02818530	Urological Canc... Gastrointestina... Malignant Femal...	IOP by tonomete... Anterior chambe...	18 Years - 70 Years	Tata Memorial Centre
Safety and Tolerability of Recombinant Humanized Anti-PD-1 Monoclonal Antibody Toripalimab for Patients With Advanced Solid Tumors	NCT02836795	Melanoma Urological Canc...	humanized anti-...	18 Years - 70 Years	Shanghai Junshi Bioscience Co., Ltd.

Spots Global Cancer Trial Database for urological cancer