Tenotomía longitudinal ecoguiada para el tratamiento de fascitis plantar. Nota técnica y revisión sistemática / Ultrasound-guided longitudinal tenotomy for plantar fasciitis. Technical note and systematic review

Resumen: Introducción: la fascitis o fasciosis plantar es una causa de dolor en el pie, en la cual frecuentemente se encuentran casos resistentes al tratamiento conservador. La cirugía queda reservada para los pacientes que no han respondido a tratamientos conservadores, ondas de choque o infiltraciones con corticosteroides. El objetivo de este trabajo es realizar una revisión sistemática de la literatura disponible y describir una técnica para el tratamiento de la fascitis o fasciosis plantar consistente en el rasgado longitudinal de la aponeurosis plantar asistido con ecografía. Material y métodos: se realizó una búsqueda sistemática de publicaciones previas sobre la tenotomía longitudinal en el tratamiento de la fascitis plantar. Se incluyeron los encabezados de temas médicos o MeSH (Medical subjects headings por sus siglas en inglés), en inglés: Curettage, Tenotomy y Plantar Fasciitis. La búsqueda electrónica incluyó las bases de datos de PubMed, Embase, Cochrane central register of controlled trials, Trip database y National Institute for Health and Care Excellence (NICE por sus siglas en inglés). Se realizó una descripción detallada de la técnica con la intención de que pueda ser reproducida. Conclusión: la tenotomía longitudinal representa una alternativa para el tratamiento de la fascitis plantar. Se basa en la extrapolación del conocimiento en el territorio Aquíleo con una base fisiopatológica de respaldo. Se trata de una técnica no invasiva que se puede realizar de forma ambulatoria y que permitiría la rápida incorporación del paciente a sus actividades. La tenotomía longitudinal podría evitar al paciente someterse a cirugías de mayor envergadura.

Abstract: Introduction: plantar fasciitis or fasciosis is a cause of foot pain with cases resistant to conservative treatment. Surgery is reserved for patients who have not responded to conservative treatment, shock waves, or corticosteroid injections. The aim of this publications is to carry out a systematic review of the available literature and to describe a specific technique for the treatment of plantar fasciosis consisting of the longitudinal tearing of the plantar aponeurosis assisted with ultrasound. Material and methods: a systematic search was carried out for previous publications on longitudinal tenotomy in the treatment of plantar fasciitis. The Medical Subject Headings (MeSH) terms «Curettage¼, «Tenotomy¼ and «Plantar Fasciitis¼ were included. The electronic search included PubMed, Embase, Cochrane central register of controlled trials, Trip database, and National Institute for Health and Care Excellence (NICE) databases. A detailed description of the technique was included with the intention that it can be reproduced. Conclusion: longitudinal tenotomy represents an alternative for the treatment of plantar fasciitis. It is based on the extrapolation of knowledge in the Achilles tendon territory with a supporting pathophysiological basis. It is a non-invasive technique that can be performed on an outpatient basis and that would allow the rapid incorporation of the patient to their activities. Longitudinal tenotomy would prevent the patient from undergoing major surgeries.

[Ultrasound-guided longitudinal tenotomy for plantar fasciitis. Technical note and systematic review]. / Tenotomía longitudinal ecoguiada para el tratamiento de fascitis plantar. Nota técnica y revisión sistemática.

INTRODUCTION: plantar fasciitis or fasciosis is a cause of foot pain with cases resistant to conservative treatment. Surgery is reserved for patients who have not responded to conservative treatment, shock waves, or corticosteroid injections. The aim of this publications is to carry out a systematic review of the available literature and to describe a specific technique for the treatment of plantar fasciosis consisting of the longitudinal tearing of the plantar aponeurosis assisted with ultrasound. MATERIAL AND METHODS: a systematic search was carried out for previous publications on longitudinal tenotomy in the treatment of plantar fasciitis. The Medical Subject Headings (MeSH) terms "Curettage", "Tenotomy" and "Plantar Fasciitis" were included. The electronic search included PubMed, Embase, Cochrane central register of controlled trials, Trip database, and National Institute for Health and Care Excellence (NICE) databases. A detailed description of the technique was included with the intention that it can be reproduced. CONCLUSION: longitudinal tenotomy represents an alternative for the treatment of plantar fasciitis. It is based on the extrapolation of knowledge in the Achilles tendon territory with a supporting pathophysiological basis. It is a non-invasive technique that can be performed on an outpatient basis and that would allow the rapid incorporation of the patient to their activities. Longitudinal tenotomy would prevent the patient from undergoing major surgeries.

INTRODUCCIÓN: la fascitis o fasciosis plantar es una causa de dolor en el pie, en la cual frecuentemente se encuentran casos resistentes al tratamiento conservador. La cirugía queda reservada para los pacientes que no han respondido a tratamientos conservadores, ondas de choque o infiltraciones con corticosteroides. El objetivo de este trabajo es realizar una revisión sistemática de la literatura disponible y describir una técnica para el tratamiento de la fascitis o fasciosis plantar consistente en el rasgado longitudinal de la aponeurosis plantar asistido con ecografía. MATERIAL Y MÉTODOS: se realizó una búsqueda sistemática de publicaciones previas sobre la tenotomía longitudinal en el tratamiento de la fascitis plantar. Se incluyeron los encabezados de temas médicos o MeSH (Medical subjects headings por sus siglas en inglés), en inglés: Curettage, Tenotomy y Plantar Fasciitis. La búsqueda electrónica incluyó las bases de datos de PubMed, Embase, Cochrane central register of controlled trials, Trip database y National Institute for Health and Care Excellence (NICE por sus siglas en inglés). Se realizó una descripción detallada de la técnica con la intención de que pueda ser reproducida. CONCLUSIÓN: la tenotomía longitudinal representa una alternativa para el tratamiento de la fascitis plantar. Se basa en la extrapolación del conocimiento en el territorio Aquíleo con una base fisiopatológica de respaldo. Se trata de una técnica no invasiva que se puede realizar de forma ambulatoria y que permitiría la rápida incorporación del paciente a sus actividades. La tenotomía longitudinal podría evitar al paciente someterse a cirugías de mayor envergadura.

First record of Trichodina heterodentata (Ciliophora: Trichodinidae) in banded knifefish Gymnotus carapo (Gymnotidae) cultured in Brazil / Primeiro registro de Trichodina heterodentata (Ciliophora: Trichodinidae) em tuvira Gymnotus carapo (Gymnotidae), cultivado no Brasil

The aim of this study was to report the first record of Trichodina heterodentata in banded knifefish Gymnotus carapo. Banded knifefish cultivated in the municipality of Jataí, state of Goiás, in the central western region of Brazil, experienced fish mortality rates of 3-4% per tank. Macroscopic analysis found that fish had lesions on their skin and gills. Smears of the integument and gills were confectioned and air-dried at room temperature and impregnated with silver nitrate to identify the Trichodinidae species causing the lesions. The trichodinid were identified as T. heterodentata, and their characteristics were compared to those from T. heterodentata recorded from other species of host fish. It was observed that the presence of T. heterodentata was associated with inadequate fish management, low water quality, high rates of stocking density, and inadequate nutritional management.

O objetivo deste estudo foi relatar o primeiro registro de Trichodina heterodentata em tuviras Gymnotus carapo. Um cultivo de tuviras no município de Jataí, estado de Goiás, na região Centro-Oeste do Brasil, apresentou taxas de mortalidade de peixes de 3-4% por tanque. A análise macroscópica constatou que os peixes tinham lesões na pele e brânquias. Raspados do tegumento e brânquias foram confeccionadas e secas ao ar à temperatura ambiente e impregnadas com nitrato de prata para identificar as espécies de Trichodinidae causadoras das lesões. Os tricodinídeos foram identificados como T. heterodentata, e suas características foram comparadas com as de T. heterodentata registradas para outras espécies de peixes hospedeiros. Observou-se que a presença de T. heterodentata estava associada ao manejo inadequado dos peixes, baixa qualidade da água, altas taxas de densidade de estocagem e manejo nutricional inadequado.

First record of Trichodina heterodentata (Ciliophora: Trichodinidae) in banded knifefish Gymnotus carapo (Gymnotidae) cultured in Brazil

Abstract The aim of this study was to report the first record of Trichodina heterodentata in banded knifefish Gymnotus carapo. Banded knifefish cultivated in the municipality of Jataí, state of Goiás, in the central western region of Brazil, experienced fish mortality rates of 3-4% per tank. Macroscopic analysis found that fish had lesions on their skin and gills. Smears of the integument and gills were confectioned and air-dried at room temperature and impregnated with silver nitrate to identify the Trichodinidae species causing the lesions. The trichodinid were identified as T. heterodentata, and their characteristics were compared to those from T. heterodentata recorded from other species of host fish. It was observed that the presence of T. heterodentata was associated with inadequate fish management, low water quality, high rates of stocking density, and inadequate nutritional management.

Resumo O objetivo deste estudo foi relatar o primeiro registro de Trichodina heterodentata em tuviras Gymnotus carapo. Um cultivo de tuviras no município de Jataí, estado de Goiás, na região Centro-Oeste do Brasil, apresentou taxas de mortalidade de peixes de 3-4% por tanque. A análise macroscópica constatou que os peixes tinham lesões na pele e brânquias. Raspados do tegumento e brânquias foram confeccionadas e secas ao ar à temperatura ambiente e impregnadas com nitrato de prata para identificar as espécies de Trichodinidae causadoras das lesões. Os tricodinídeos foram identificados como T. heterodentata, e suas características foram comparadas com as de T. heterodentata registradas para outras espécies de peixes hospedeiros. Observou-se que a presença de T. heterodentata estava associada ao manejo inadequado dos peixes, baixa qualidade da água, altas taxas de densidade de estocagem e manejo nutricional inadequado.

First record of Trichodina heterodentata (Ciliophora: Trichodinidae) in banded knifefish Gymnotus carapo (Gymnotidae) cultured in Brazil / Primeiro registro de Trichodina heterodentata (Ciliophora: Trichodinidae) em tuvira Gymnotus carapo (Gymnotidae), cultivado no Brasil

The aim of this study was to report the first record of Trichodina heterodentata in banded knifefish Gymnotus carapo. Banded knifefish cultivated in the municipality of Jataí, state of Goiás, in the central western region of Brazil, experienced fish mortality rates of 3-4% per tank. Macroscopic analysis found that fish had lesions on their skin and gills. Smears of the integument and gills were confectioned and air-dried at room temperature and impregnated with silver nitrate to identify the Trichodinidae species causing the lesions. The trichodinid were identified as T. heterodentata, and their characteristics were compared to those from T. heterodentata recorded from other species of host fish. It was observed that the presence of T. heterodentata was associated with inadequate fish management, low water quality, high rates of stocking density, and inadequate nutritional management.

O objetivo deste estudo foi relatar o primeiro registro de Trichodina heterodentata em tuviras Gymnotus carapo. Um cultivo de tuviras no município de Jataí, estado de Goiás, na região Centro-Oeste do Brasil, apresentou taxas de mortalidade de peixes de 3-4% por tanque. A análise macroscópica constatou que os peixes tinham lesões na pele e brânquias. Raspados do tegumento e brânquias foram confeccionadas e secas ao ar à temperatura ambiente e impregnadas com nitrato de prata para identificar as espécies de Trichodinidae causadoras das lesões. Os tricodinídeos foram identificados como T. heterodentata, e suas características foram comparadas com as de T. heterodentata registradas para outras espécies de peixes hospedeiros. Observou-se que a presença de T. heterodentata estava associada ao manejo inadequado dos peixes, baixa qualidade da água, altas taxas de densidade de estocagem e manejo nutricional inadequado.

First record of Trichodina heterodentata (Ciliophora: Trichodinidae) in banded knifefish Gymnotus carapo (Gymnotidae) cultured in Brazil.

The aim of this study was to report the first record of Trichodina heterodentata in banded knifefish Gymnotus carapo. Banded knifefish cultivated in the municipality of Jataí, state of Goiás, in the central western region of Brazil, experienced fish mortality rates of 3-4% per tank. Macroscopic analysis found that fish had lesions on their skin and gills. Smears of the integument and gills were confectioned and air-dried at room temperature and impregnated with silver nitrate to identify the Trichodinidae species causing the lesions. The trichodinid were identified as T. heterodentata, and their characteristics were compared to those from T. heterodentata recorded from other species of host fish. It was observed that the presence of T. heterodentata was associated with inadequate fish management, low water quality, high rates of stocking density, and inadequate nutritional management.

The use of the simplified International Index of Erectile Function (IIEF-5) as a diagnostic tool to study the prevalence of erectile dysfunction.

The purpose of this research was to determine the prevalence of erectile dysfunction (ED) in a non-selected population using the abridged 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool. In a non-institutionalized population and during a free screening program for prostate cancer (Prostate Cancer Awareness Week of Santa Casa Hospital, Porto Alegre, Brazil), from 26 to 30 July 1998, all men who were attending were invited to complete a sexual activity questionnaire (the abridged 5-item version of the International Index of Erectile Function-IIEF-5) as a diagnostic tool for ED. The possible scores for the IIEF-5 range from 5 to 25, and ED was classified into five categories based on the scores: severe (5-7), moderate (8-11), mild to moderate (12-16), mild (17-21), and no ED (22-25). Of the 1071 men who participated in the program, 965 (90.1%) were included in this study. Of the responding men 850 were Caucasian (88%) and 115 were black (12%). The mean age of the men was 60.7 y, ranging from 40 to 90 y old. In this sample the prevalence of all degrees of ED was estimated as 53.9%. In this group of men, the degree of ED was mild in 21.5%, mild to moderate in 14.1%, moderate in 6.3%, and severe in 11.9%. According to age the rates of ED were: 40-49 (36.4%); 50-59 (42.5%); 60-69 (58.1%); 70-79 (79.4%), and over 80 y (100%) showed ED (P<0.05). The Pearson coefficients between the variables age and IIEF-5 showed a statistically significant inverse (negative) relation (r=-0.3449; P<0.05). ED is highly prevalent in men over 40 and this condition showed a clear relationship to aging, as demonstrated in other studies published. The simplified IIEF-5, as a diagnostic tool, showed to be an easy method, which can be used to evaluate this condition in studies with a great number of men.

Is there any relation between serum levels of total testosterone and the severity of erectile dysfunction?

The objective of this study was to correlate the severity of erectile dysfunction (ED) with the total testosterone serum levels (TT) in a normal population. During a screening program for the early diagnosis of prostate cancer, 1071 men aged from 40 to 90 y, were invited to answer the questionnaire of the Simplified International Index of Erectile Function (IIEF-5) as a method to diagnose and classify ED. The IIEF-5 scores ranged from 1 to 25 and the ED was classified into five groups according to the scores: severe (1-7), moderate (8-11), mild-moderate (12-16), mild (17-21) and no ED (22-25). Besides the questionnaire, all subjects had their TT serum levels determined based on the blood sample obtained between 08:00 and 10:00. The analysis of the relationship between the different degrees of ED and TT levels was then studied. Of the 1071 men, 965 were included in the study (90.1%). Eighty-eight percent of these were Caucasian and 12% black. The mean age of the population was 60.7 y. The prevalence of all degrees of ED was 53.9%. The degree of ED was mild in 21.5%, mild to moderate in 14.3%, moderate in 6.3% and severe in 11.9%. The variation of TT serum concentrations was similar (P>0.05) in the different age groups. Furthermore, the TT serum levels were not different for individuals with and without ED (P>0.05) and similar concentrations of TT was observed in the different severity degrees of ED (P>0.05). Only one (0.7%) man in the group of individual with maximal score had subnormal levels of TT. ED presented a clear association with the subjects' aging, but neither correlation between TT levels and ED, nor with its severity, could be demonstrated in the present study.

Effect of microcrystalline cellulose grade and process variables on pellets prepared by extrusion-spheronization.

This study evaluated the effects of spheronizer load and speed on the size, circularity, microporosity, compressibility, and friability of pellets prepared by extrusion-spheronization of wet microcrystalline cellulose (MCC) masses with a water content shown by mixer torque rheometry to ensure maximum consistency. Two MCC grades with different mean particle size were used. Both gave pellets with good particle size, sphericity, and compressibility, under a wide range of spheronization conditions. Modification of pellet properties of interest (including size and porosity) was possible by adjustment of spheronization conditions and MCC grade; in particular, pellet porosity was greater with MCC of larger particle size.

Effects of population disjunction on isozyme variation in the widespread Pilgerodendron uviferum.

Geographical range is considered a good predictor of the levels of isozyme variation in plants. Widespread species, often consisting of historically larger and more continuous populations, maintain higher polymorphism and are less affected by drift, which tends to erode genetic variation in more geographically restricted species. However, widespread species occurring in small and disjunct populations may not fit this pattern. In this study we examined genetic variation in Pilgerodendron uviferum, a conifer endemic to temperate forests of southern South America, and is such a widespread and habitat-restricted species. Twenty populations along the whole range of Pilgerodendron were analysed by isozyme electrophoresis to resolve 14 putative genetic loci. Eleven were polymorphic in at least one population although only six of them were polymorphic in more than one population. We found reduced within-population levels of isozyme variation, with only 11% polymorphic loci (0.95 criterion), 1.2 mean number of alleles per locus, and mean observed and expected heterozygosities of 0.024 and 0.033, respectively. Most genetic diversity was found within populations (H(T)=0.039, H(S)=0.033, F(ST) 15%). Greater polymorphism and lower divergence was estimated in the more geographically restricted and closely related Fitzroya. Thus, total range, in combination with information on the degree of among-population isolation, may be a better predictor of the levels of polymorphism than range size alone.

Effects of L-arginine on the kidney levels of malondialdehyde in rats submitted to renal ischaemia-reperfusion.

OBJECTIVE: To evaluate the effects of L-arginine, a nitric oxide donor, on kidney levels of malondialdehyde (MDA, a product of cellular lipid peroxidation), serum creatinine levels, and urinary volume in rats undergoing unilateral renal ischaemia-reperfusion. MATERIALS AND METHODS: Wistar rats (117) were randomly distributed into three experimental groups (of four subgroups each) in which were assessed renal cell-lipid peroxidation (kidney levels of MDA), serum creatinine levels and urinary volume. The rats underwent unilateral nephrectomy followed by contralateral renal ischaemia-reperfusion with or with no pretreatment with L-arginine (200 mg/kg) given intraperitoneally. RESULTS: Pretreatment with L-arginine caused significantly higher kidney levels of MDA than in the untreated group (P < 0.05). Furthermore, L-arginine given before surgery attenuated the increase in serum creatinine and significantly increased urinary volume in rats subjected to renal ischaemia-reperfusion (P < 0.05). CONCLUSION: L-arginine tended to be of benefit for renal function during renal ischaemia-reperfusion in rats. Pretreatment with L-arginine (200 mg/kg intraperitoneally) seems to increase the renal damage by increasing kidney levels of MDA.

Extrusion-Spheronization of blends of carbopol 934 and microcrystalline cellulose.

We evaluated the effects of several process variables on the pharmaceutical and drug release properties of extrusion-spheronization pellets of blends of Carbopol 934 and microcrystalline cellulose (MCC) containing a high proportion of Carbopol. The model drug was theophylline. Rheological monitoring during mixing was by mixer torque rheometry. Carbopol:MCC blends wetted with a CaCl2 solution showed different rheological behavior compared to blends with a high proportion of MCC wetted with water only. In contrast to previous suggestions, the optimal wetting point for extrusion did not coincide with the point of peak torque, but occurred just beyond this point, at much lower torque. The influence of process variables on blend properties was investigated with a three-variable factorial design (Carbopol:MCC ratio, wetting liquid proportion, CaCl2:Carbopol ratio), and the influence of process variables on pellet properties with a four-variable design (the variables listed plus extrusion screen hole diameter). Blend torque values were strongly influenced by CaCl2 proportion, while mean pellet diameter was influenced by Carbopol:MCC ratio. Mean pellet diameter also differed depending on whether the pellets contained theophylline. The observed among-formulation differences in theophylline release kinetics were largely explained by differences in pellet size and theophylline hydration state. Compaction of pellets to form tablets markedly modified the drug release profile, making it biphasic.

Prevalence of Peyronie's disease in men over 50-y-old from Southern Brazil.

The pathogenesis of Peyronie's disease still remains an enigma and few epidemiological studies are available. The purpose of this study was to determine the prevalence of Peyronie's disease in males older than 50 y. From 26 to 30 July 1998, 1071 men attended the 'Prostate Cancer Awareness Week of Santa Casa Hospital, Porto Alegre, Brazil'. In the prostate exam they also consented to be screened for Peyronie's disease. They underwent the 5-item International Index of Erectile Function (IIEF-5) questionnaire for evaluation of the erectile condition. The presence of a well-defined plaque in the penis was the diagnostic criterion for Peyronie's disease. The men were examined by five senior residents, under supervision by the staff Urologist. Men younger than 50 y as well as patients under intracavernous injection therapy for erectile dysfunction were excluded from the study. Chi2 test was used for statistical analysis. Nine hundred and fifty-four (89.1%) out of the 1071 men with a mean age of 62 y (ranging from 52 to 77) were included in the study. Peyronie's disease plaques were found in 35 men (3.67%). Eight hundred and forty-five (88.6%) were Caucasians. There was no significant statistical difference regarding age (P > 0.05). The presence of erectile dysfunction in the men with Peyronie's disease and without this condition, was 68.6% and 53.5%, respectively (P > 0.05). From this data we can conclude that the prevalence of Peyronie's disease is higher than in formerly reported studies. Further observations should be carried out in different communities and in other groups of patients in order to confirm our results.

Interactions between hydroxypropylcelluloses and vapour/liquid water.

Understanding of the uptake of water vapour or liquid water by cellulose-based polymers is important because of the influence of these processes on many of the biologically or technologically relevant properties of these polymers. In this work we studied these processes in the cases of twelve hydroxypropylcelluloses with low or medium-high degrees of substitution (L-HPCs and HPCs, respectively), characterization of which showed significant differences in structural and physical parameters (substitution pattern, crystallinity, particle size, specific surface area, and intraparticular porosity). Water vapour sorption-desorption isotherms determined to characterize the uptake of water vapour were fitted well by the Young-Nelson model, the optimized parameters of which indicated that at all relative humidities the capacity to bind water vapour as a surface monolayer is greater for HPCs than L-HPCs, but the capacity to absorb water vapour internally is greater for L-HPCs than HPCs. Guggenheim-Anderson-deBoer (GAB) models fitted the sorption-desorption isotherms less well. Differential scanning calorimetry (DSC) experiments showed all sorbed water vapour to be held as non-freezing water. Isoperibol microcalorimetry experiments carried out to investigate interactions with liquid water showed enthalpies of hydration/dissolution of between -62.86 and -71.35 J g(-1) for L-HPCs and between -82.95 and -99.80 J g(-1) for HPCs, and DSC showed average numbers of non-freezing water molecules per polymer repeat unit of 2.65-4.19 for L-HPCs and 18.10-22.42 for HPCs. DSC characterization of the kinetics of the water uptake by 10 mg compacts obtained by direct compression of hydroxypropylcelluloses showed faster uptake by L-HPC compacts than by HPC compacts, among which there were significant differences in capacity for diffusive uptake. The explanations of the above differences in terms of the different substituent contents, particle sizes and porosities of the HPCs is supported by multiple linear regression analyses.

Long-term results of penile vein ligation for erectile dysfunction due to cavernovenous disease.

PURPOSE: We now know that outflow restriction is essential for maintaining a rigid erection, which can be achieved after satisfactory smooth muscle relaxation. The aim of this study was to assess retrospectively the efficacy of penile vein surgical ligation in patients with a follow-up of at least 3 years. MATERIALS AND METHODS: Thirty-two men with impotence due to cavernovenous occlusive disease underwent penile vein ligation for management of organic erectile dysfunction. Cavernovenous occlusive disease was diagnosed by gravity cavernosometry. RESULTS: Long-term evaluation revealed sustained potency without adjunctive therapy in only 7 patients (21.87%). Twenty-five patients (78.12%) did not show any improvement in the erectile mechanism. Associated complications included penile shortening in 4 (12.5%), hypoesthesia of the glans area in 2 (6.25%), and Peyronie's disease in 1 (3.2%). CONCLUSION: Based on these data, we conclude that the long-term success of penile vein ligation is poor.

Penile straightening with crural graft of the corpus cavernosum.

PURPOSE: We present a surgical alternative to penile straightening in Peyronie's disease that avoids penile shortening by using tissue from the crural segment of the corpora cavernosa as a graft. MATERIALS AND METHODS: We treated 7 patients with stable Peyronie's disease and satisfactory penile rigidity but significant curvature that precluded intercourse with this technique. An incision is made in the fibrous area and after stretching the gap is covered with a graft removed from the crural segment of the corpora cavernosa. RESULTS: In 6 of the 7 men straightening was satisfactory but in 1 it was not complete. No patient reported worse penile rigidity postoperatively. Donor site healing was uneventful. CONCLUSIONS: Use of tissue from the corpus cavernosum to correct penile curvature is effective. However, our results are preliminary, and long-term effectiveness and safety must be confirmed in a larger number of cases.

A comparison of cellactose with two ad hoc processed lactose-cellulose blends as direct compression excipients.

Three processed lactose-cellulose blends of similar composition, particle size and true density were compared as direct compression excipients: one was prepared by dry granulation, one by extrusion-spheronization, and the commercial product Cellactose. Differences among their flow properties depended solely on their different sphericities. Unlike those of the other blends, Cellactose particles exhibited numerous macropores. The mean yield pressures of all three blends were similar to those of direct compression lactoses. Cellactose tablets prepared at a punch pressure that largely eliminated macropores (pores >1 microm) had better mechanical properties but much poorer disintegration than tablets of the other blends prepared at the same punch pressure. However, the tensile strength and disintegration time of Cellactose tablets both fell rapidly as macropore volume was increased by reducing punch pressure, while the enthalpy of wetting/dissolution rose. The strength and water-resistance of well-compacted Cellactose tablets is attributed to the spatial distribution of lactose and cellulose in Cellactose particles, rather than to beta-lactose content or extra-particular structural features.

The stability of theophylline tablets with a hydroxypropylcellulose matrix.

The behavior of 40:60 anhydrous theophylline/hydroxypropylcellulose (HPC) direct compression tablets obtained using a variety of hydroxypropylcelluloses with low or medium-high degrees of substitution (L-HPCs and HPCs, respectively) was determined immediately following their preparation and after storage for 6 months at 20 degrees C and a relative humidity (RH) of either 70.4% or 93.9%. The lower relative humidity did not bring about hydration of the active principle in any formulation, but the higher relative humidity totally hydrated the drug in all except one L-HPC formulation, in which hydration remained incomplete. Both relative humidities caused significant tablet swelling, with L-HPC formulations being more affected than HPC formulations. Drug release was slowed by hydration of the active principle, but accelerated with tablet swelling. The lower relative humidity caused significant alteration of drug release characteristics in only two L-HPC formulations, release from which was accelerated, while the higher relative humidities only failed to cause such alterations in two HPC formulations, with release from all except one of the others slowed (in the exceptional formulation, which exhibited incompletely hydrated theophylline and the greatest swelling of all, release was accelerated).

Evaluation of low-substituted hydroxypropylcelluloses (L-HPCs) as filler-binders for direct compression.

The aims of this study were to assess the potential value of low-substituted hydroxypropylcelluloses (L-HPCs) as excipients of direct compression, and to investigate relationships between the chemical and physical properties of the polymers and (a) the powder rheological behavior and (b) drug release profiles from direct compressed tablets elaborated with (1:1) theophylline:L-HPC mixtures. Experiments were performed with five L-HPC varieties of different nominal particle sizes and degree of substitution. The products were characterized with regard to the moisture content, density, IR and Raman spectroscopy, hydroxypropyloxy content, heat of hydration, particle size, specific surface and porosity, and important differences were found in relation with all these properties. The differences in specific surface principally determine the flow and compaction properties of the powders, and the mechanical and microstructural properties of the tablets. The control of the hydroxypropyloxy content and the particle size of the L-HPCs allow the theophylline release profile to be regulated.

Experience with early catheter removal after radical retropubic prostatectomy.

PURPOSE: We tested the hypothesis that early catheter removal may be accomplished safely after radical prostatectomy. MATERIALS AND METHODS: Cystography on postoperative day 4 or 5 in 42 of 67 consecutive patients who underwent radical retropubic prostatectomy revealed no extravasation in 30 and the urethral catheter was removed (group 1). The control group included 25 patients who did not undergo cystography, and the catheter was removed 14 days postoperatively (group 2). RESULTS: Immediate and late continence was achieved in 14 (46.7%) and 25 (83.3%) cases in group 1, and in 8 (32%) and 22 (88%) cases in group 2, respectively (p>0.05). Catheterization was performed easily without any endoscopic or surgical procedure in 2 patients (6.7%) in group 1 who presented in urinary retention after catheter removal. Wound infection and pelvic abscess developed in 1 case (3.3%). There were no late complications. In group 2 urinary retention developed in 1 patient (4%), wound infection in 1 (4%) and hematuria in 1 (4%). Two patients (8%) had late vesical neck contracture at 4 and 10 months, respectively, which required urethrotomy in 1. In 1 patient (4%) a stricture in the anterior urethra was dilated. CONCLUSIONS: Our study shows that early catheter removal may be accomplished safely in most patients after radical retropubic prostatectomy, and was not associated with a higher complication rate.