RESUMO
A 36-year-old Caucasian man was diagnosed with a 72-h-lasting priapism that occurred after the assumption of a Herbal supplement based on Tribulus terrestris, which is becoming increasingly popular for the treatment of sexual dysfunction. The patient underwent a cavernoglandular shunt (Ebbehoj shunt) in order to obtain complete detumescence, from which derived negative post-episode outcomes on sexual function. All patients consuming non-FDA-approved alternative supplements such as Tribulus terrestris should be warned about the possible serious side effects.
Assuntos
Disfunção Erétil/tratamento farmacológico , Fitoterapia , Preparações de Plantas/farmacologia , Priapismo , Tribulus/efeitos adversos , Adulto , Drenagem/métodos , Humanos , Masculino , Priapismo/diagnóstico , Priapismo/etiologia , Priapismo/fisiopatologia , Priapismo/terapia , Automedicação/efeitos adversosRESUMO
OBJETIVO: El objetivo de este estudio era correlacionar los resultados obtenidos con la resonancia magnética por espectroscopia 3T (RMNE3T) con los obtenidos por la evaluación histológica de las muestras de biopsia de próstata transperineal guiada por ecografía. MÉTODOS: 34 Pacientes fueron incluidos en el estudio. Todos los pacientes tenían la sospecha de cáncer de próstata por elevación del PSA y/o tacto rectal anormal. Los pacientes fueron sometidos a RMNE 3T y posteriormente biopsia transperineal guiada por ecografía. RESULTADOS: De los 22 pacientes (22/34) que presentaban anomalías en la RMNE 3T, 9 tuvieron el diagnóstico histológico de adenocarcinoma. De los 13 restantes, 6 fueron diagnosticados de hiperplasia benigna de próstata y 7 de inflamación intersticial crónica o PIN de alto grado. De 12 pacientes (12/34) que no presentaban alteraciones periféricas en la próstata en la RMNE 3T, ninguno tenía adenocarcinoma o inflamación en la histología. La sensibilidad, especificidad, valor predictivo positivo y valor predictivo negativo fueron del 100%, 48%, 40% y 100% respectivamente. DISCUSIÓN: En este estudio correlacionamos los valores obtenidos por RMNE 3T con los resultados del examen histológico de las biopsias de próstata. Nuestro trabajo muestra que el 72% de los voxeles en los que había un cambio en el cociente de Cit/(Cho+ Cr) correspondían con áreas de enfermedad del tejido prostático. De éstas, el 73,2% eran positivas para adenocarcinoma y el 26% para inflamación intersticial crónica o PIN de alto grado. En la literatura, se observa que el cáncer de próstata se puede distinguir de áreas de tejido benigno en la zona periférica, en base a los valores de la ratio Cit/(Cho+cr) (17), aunque algunas condiciones benignas, tales cómo la prostatitis o el PIN de alto grado, pueden alterar estos valores (18-19). CONCLUSIONES: En conclusión, el uso de la RMNE 3T antes de la realización de biopsias de próstata puede representar una ayuda válida para el urólogo en el diagnóstico de CaP, permitiéndole evitar biopsias de próstata innecesarias que pudieran ser negativas. Además, también sería posible reducir el número total de biopsias, disminuyendo así la exposición del paciente a riesgos innecesarios asociados con la biopsia
OBJECTIVES: The aim of our study was to correlate the results obtained by 3T Magnetic Resonance Spectroscopic Imaging (MRSI3T) with those obtained by histological examination of samples of the trans-perineal ultrasound-guided prostate biopsy (TPUS-B). METHODS: 34 patients were enrolled in the study. All patients had a clinical suspicion of cancer due to increased PSA and/or positive digital rectal examination. Patients were subjected to an MRSI 3T examination and subsequently to TPUS-B. RESULTS: Of the 22 (22/34) patients who presented abnormalities MRSI at 3T, 9 had a histological diagnosis of Prostate adenocarcinoma. Of the remaining 13 patients, 6 were found to be histologically positive for Benign Prostatic Hypertrophy and 7 Chronic Interstitial Inflammation or High Grade Prostatic Intraepithelial Neoplasia. 12 (12/34) patients found to have no peripheral alterations in their prostate on 3T MRSI, none were positive for ADK or inflammation on histology. The sensitivity, specificity, positive predictive value and negative predictive value were 100%, 48%, 40% and 100% respectively. DISCUSSION: In this study, we correlated the values obtained from 3T MRSI with the results of histologically examined prostate biopsies. Our work shows that 72.8% of the voxels in which there was a change in ratio of Cit/(Cho + Cr), corresponded to areas of prostate tissue disease. Of these, 73.2% were positive for ADK and 26.8% for CII or HG PIN. In literature, it is noted that PCa can be distinguished from areas of benign tissue, in the peripheral zone, on the basis of the values of the ratio Cit/(Cho + Cr) (17), although some benign conditions, such as prostatitis or PINHG, can alter these values (18-19). CONCLUSIONS In conclusion, the use of MRSI 3T before performing prostate biopsies may represent a valid aid for the urologist in the diagnosis of PCa, allowing them to avoid unnecessary prostate biopsies that may be negative. Furthermore, it would also be possible to reduce the total number of biopsies, thus decreasing patient ex posure to the unnecessary risks associated with biopsy
Assuntos
Humanos , Masculino , Espectroscopia de Ressonância Magnética , Espectroscopia de Ressonância Magnética/métodos , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/radioterapia , Hiperplasia Prostática/induzido quimicamente , Hiperplasia Prostática/complicações , Espectroscopia de Ressonância Magnética/instrumentação , Espectroscopia de Ressonância Magnética/uso terapêutico , Neoplasias da Próstata/metabolismo , Neoplasias da Próstata/patologia , Hiperplasia Prostática/metabolismo , Hiperplasia Prostática/patologiaRESUMO
OBJECTIVES: To identify the predictive variables affecting the outcome after radical surgery for bladder cancer by a newer statistical methodology, i.e. nonparametric combination (NPC). METHODS: A multicenter study enrolled 1,312 patients who had undergone radical cystectomy for bladder cancer in 11 Italian oncological centers from January 1982 to December 2002. A statistical analysis of their medical history and diagnostic, pathological and postoperative variables was performed using a NPC test. The patients were included in a comprehensive database with medical history and clinical and pathological data. Five-year survival was used as the dependent variable, and p values were corrected for multiplicity using a closed testing procedure. The newer nonparametric approach was used to evaluate the prognostic importance of the variables. All of the analyses were performed using routines developed in MATLAB© and the significance level was set at α = 0.05. RESULTS: A significant prognostic predictive value (p < 0.01) for tumor clinical staging, hydronephrosis, tumor pathological staging, grading, presence of concomitant carcinoma in situ, regional lymph node involvement, corpora cavernosa invasion, microvascular invasion, lymphatic invasion and prostatic stroma involvement was found. CONCLUSIONS: The NPC test could handle any type of variable (categorical and quantitative) and take into account the multivariate relation among variables. This newer methodology offers a significant contribution in biomedical studies with several endpoints and is recommended in presence of non-normal data and missing values, as well as solving high-dimensional data and problems relating to small sample sizes.
Assuntos
Cistectomia/métodos , Avaliação de Resultados da Assistência ao Paciente , Estatística como Assunto , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células de Transição/cirurgia , Interpretação Estatística de Dados , Feminino , Humanos , Hidronefrose/complicações , Itália , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Estadiamento de Neoplasias , Valor Preditivo dos Testes , Prognóstico , Próstata/patologia , Estudos Retrospectivos , Estatísticas não Paramétricas , Neoplasias da Bexiga Urinária/cirurgiaRESUMO
An HLA-B27 genetic profile patient is fully investigated by molecular analyses after an anamnestic assessment of multi-site ecosystems, following the holistic vision of human being.VDRL and Widal-Wright (WWR) resulted positive, showing at Wrights reaction a title of 1:40. Of all the enzymatic activities measured, only the ALP enzymatic pool activities showed a low increasing value of 297 U/L. Of all later acute phase proteins, Only C3 c protein value (127 mg/dL) and fibrinogen (376 mg/dL) were altered. Cultural and molecular oropharyngeal ecosystem investigation resulted significantly positive to Mycoplasmas(Mhand Uu) and Chlamydia trachomatis(Ct) together with a spread of saprophytic flora. From an accurate anamnesis, several and severe uro-genital clinical symptomatology emerged from birth until the beginning of rheumatologic symptomatologies that were confirmed by oldest Mh, Uu and Ctsilent chronic infections between these ecosystems. The molecular HPV research was negative, while the Thin prep pap-test was indicative of vaginosis and cellular reactive changes associated with inflammation. Parasitological research resulted positive for presence of 5-7 newly-formed G. lambliacysts for microscopic field, while digestibility test was positive for presence of several free fatty acid crystals. The remarkable presence of indigested meat fibre and several mucous dense filaments were observed. The pH value was 6.5, while blood faecal test was positive. The values observed were: ferritin 12 microg/L (10-120), total iron-binding capacity (TIBC) 310 &mgr;g/dL (300+-20), unsaturated iron-binding capacity (UIBC) 286 microg/dL (200-220) and iron seric level 24 microg/dL (60-130). Faecal research highlighted a very scarce presence of E. coli, resulting in 102 UFC/g of stool. Of all enteroinvasive pathogens, researched by molecular analyses, only Yersinia spp. was positive. After several specific cycles of antibiotic and antinflammatory therapies, the patient improved its general health condition considerably and showed almost complete regression of aching inguinal lymph node inflammation. In a picture of a worsening inflammatory process, produced by pathogens like Mycoplasmas, chronic silent or low grade inflammation atypical agents, in young HLA-B27 positive patient, VDRL test resulted positive. This value represents the first non-specific unique spy to reveal the precocious immunological signal in order to register the beginning of early innate immune system decay, keeping in mind that mycoplasmal and chlamydial infections are the triggering of cancer in patients genetically susceptible.
Assuntos
Artrite Reativa/etiologia , Chlamydia trachomatis/isolamento & purificação , Antígeno HLA-B27/genética , Mycoplasma/isolamento & purificação , Adolescente , Fosfatase Alcalina/metabolismo , Artrite Reativa/tratamento farmacológico , Complemento C3/análise , Feminino , Humanos , Pessoa de Meia-Idade , Orofaringe/microbiologia , Yersinia/isolamento & purificaçãoRESUMO
A case of a genetically HLA-B27 patient fully investigated by molecular analyses, following a holistic vision and an anamnestic assessment of multi-site ecosystems is repeated. VDRL, Lupus anti-coagulant (LAC) and Widal-Wright (WWR), resulted positive. The antibodies (IgG/IgA anti-Ct) against chronic Chlamydia trachomatis inflammation were positive. In the context of all the enzymatic activities in reference range, the AMS and the ALP enzymatic activities showed an increasing trend and a time course augment depending respectively. Cultures, parasitological, digestibility tests and molecular analyses were then performed to investigate the different human ecosystems. Parasitological research and digestibility test were performed, resulting a latent chronic bowel inflammation, including certain enteroinvasive pathogens, such as, Salmonella, Shigella, Yersinia and Campylobacter (Enteric Pathogens Group, EPG) and Escherichia Coli pathogens (Escherichia Coli Pathogens Group, ECPG). The Salmonella typhi-DNA resulted positive, while 90% of the total microbic charge (TMC) was represented by C. freundi in culture analyses. Interpreting the VDRL positive test as early triggering of autoimmune disease, a few acute phase proteins as a pauci-symptomatic chronic phlogistic process, the amylase and alkaline phosphatase alterations as tissue markers of early intestinal inflammation, the Widal's reaction positivity together with the precocious clinical and faecal manifestations, this study suggests the prime triggering role of these atypical pathogens to cause a chronic low grade autoimmune response against the tissue/organ susceptible target, causing inflammaging phenomenon in young patient with chronic latent infection by Salmonella typhi, leading to Reiter's syndrome, in HLA-B27 positive patient.
Assuntos
Artrite Reativa/etiologia , Bactérias/isolamento & purificação , Antígeno HLA-B27/análise , Inflamação/complicações , Intestinos/microbiologia , Adulto , Antibacterianos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Artrite Reativa/tratamento farmacológico , Artrite Reativa/imunologia , Humanos , Imunossupressores/uso terapêutico , Inflamação/etiologia , MasculinoRESUMO
In this report, we evaluated the case history of a patient with longstanding chronic pharyngitis who had periodic clinical manifestation for three years after a flu vaccine administration, and after various treatments tried to resolve the chronic pharyngitis with unsuccessful antibiotic and anti-inflammatory therapies. The patient occasionally presented a slight ocular inflammation, while dysuria occurred after sexual activity. The search for common pathogens by use of pharyngeal swabs resulted only in Corynebacterium ulcerans growth. After this first result, we focused our investigations on ocular and uro-genital infections of Chlamydiaceae (Ct and Cp) and Mycoplasmataceae (Mh and Uu) families. We examined the patient?s pharynx using molecular and culture techniques from three different sites. Although several infectious agents, including viruses and bacteria, causing chronic pharyngitis are reported in the literature, these ocular and uro-genital pathogens are seldomly routinely investigated in the same patient in ORL. Furthermore, while episodes of chronic pharyngitis is one of the most common clinical manifestation in ENT patients, these atypical pharyngitis represent ever-increasing infections which must always be considered and researched by suitable instruments such as PCR. Only from the collection of detailed medical history and careful observations of clinical manifestation, indicative of an oral chronic pathologic phenomenon of low intensity initiated several years previously, starting with sudden outbreak and relapse like a bout of flu, we suggest to study these atypical infecting agents frequently localized in the urogenital human area, awhich would allow to highlight and to recognize these clinical cases that manifest themselves as chronic inflammation of jugulodigastric lymph nodes, remaining still unrecognized and rarely associated to chlamydial infection, confused with the response to flu vaccination. After several specific cycles of antibiotic therapy, the patient's health improved considerably and showed almost complete regression of jugulodigastric lymph node inflammation.
Assuntos
Combinação Amoxicilina e Clavulanato de Potássio/uso terapêutico , Antibacterianos/uso terapêutico , Infecções por Chlamydia/tratamento farmacológico , Vacinas contra Influenza/efeitos adversos , Faringite/tratamento farmacológico , Adulto , Doença Crônica , Humanos , Linfonodos , Masculino , Recidiva , Vacinação/efeitos adversosRESUMO
Recent studies underscore the importance of oxygen supply in bladder cancer. Tumour growth stimulates the production of vasoactive factors to increase oxygen delivery to tissues by vasodilatation. Any vasoconstrictor mediator could impair this vasodilatation reducing the oxygen supply. 8-Iso-PGF2 alpha is a potent vasoconstrictor agent. The aim of this work is to determine 8-Iso-PGF2 alpha release in healthy bladder mucosa and in superficial bladder cancer in order to investigate a pathophysiological vasoconstrictor answer of the superficial bladder cancer. The study was conducted on a sample of 12 patients; for every subject studied 8-Iso-PGF2 alpha release was assayed in healthy bladder mucosa and in superficial bladder tumour. 8-Iso-PGF2 alpha release was significantly reduced (p less than 0.001) in superficial bladder cancer compared with healthy bladder mucosa. The inhibition of the production of a powerful vasoconstrictor such as 8-Iso-PGF2 alpha in the vascular homeostatic mechanism of bladder cancer can represent a response of the tumor tending to contrast an antagonist effect of vasodilatation and the necessary to support the oxygen supply.
Assuntos
Dinoprosta/análogos & derivados , Consumo de Oxigênio , Neoplasias da Bexiga Urinária/metabolismo , Bexiga Urinária/metabolismo , Vasoconstritores/metabolismo , Dinoprosta/biossíntese , Dinoprosta/farmacologia , Feminino , Humanos , Masculino , Mucosa/metabolismo , Mucosa/patologia , Células Tumorais Cultivadas , Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/patologia , Vasoconstritores/farmacologia , Vasodilatação/efeitos dos fármacosRESUMO
The aim of the present study is to investigate oxidative stress produced by experimental hypoxia and hyperoxia in young and old pampiniform plexus rats, in order to evaluate the oxidative role of oxygen. Oxidative stress causing molecular and cellular dysfunction increases in hypertension and can therefore be considered a state of oxidative stress. This consideration makes us reflect on the responsibility of oxidative stress in the veins of the pampiniform plexus, notoriously under high hydrostatic pressure. After experimental hypoxia and hyperoxia we studied the 8-iso-PGF2alpha release (a specific index of cellular oxidative stress) in young and old left pampiniform plexus rats. The basal 8-iso-PGF2alpha release showed a statistically significant difference P=0.0067 between young and old rats PP. After hypoxia and hyperoxia, the release was higher in young rats as compared to normoxia, respectively P=0.0001 and P=0.0002. After hypoxia the release was not modified in old rats P=0.544 while after hyperoxia the release was increased in old rats as compared to control P less than 0.0001. The results show how chronic hypoxia and hyperoxia represent two important causes of oxidative stress and lipid peroxidation in pampiniform plexus rats. In young rats an increase of oxidative stress suggests that pampiniform plexus is sensitive to variations of oxygen supply. In old rats the pampiniform plexus is liable to a reduction of oxygen-sensing mechanisms and it is possible that the missing oxidative answer to the hypoxia in old rats is attributable in all likelihood to adaptation to a hypoxic condition typical of aging.
Assuntos
Hiperóxia/metabolismo , Hipóxia/metabolismo , Estresse Oxidativo/fisiologia , Testículo/fisiologia , Envelhecimento/fisiologia , Animais , Antioxidantes/metabolismo , Doença Crônica , Dinoprosta/análogos & derivados , Dinoprosta/sangue , Peroxidação de Lipídeos/efeitos dos fármacos , Masculino , Ratos , Ratos WistarRESUMO
Chronic hypoxia is related to many pathological conditions: aging, heart and respiratory failure, sleep apneas, smoke, chronic obstructive pulmonary disease (COPD), diabetes, hypertension and arteriosclerosis, all characterized by reductions of sleep-related erections (SREs) and by erectile dysfunction (ED). Sleep-related erections occur naturally during rapid eye movement (REM) sleep in sexually potent men. Hypoxia is also a physiological condition at altitude. The level of inspired oxygen decreases progressively with the increase of altitude; for this reason, this study was performed to evaluate the relationship of SREs with hypoxic environment. SREs have been recorded by an erectometer (RigiScan) on three mountain climbers (mean age: 32.5) during a 26-day stay at an altitude ranging from 2000 to 5600 m above sea level. Twenty-four records have been made at progressively increasing altitudes. A data analysis was carried out on a statistical mean of the three values of each variable and an analysis of variance (ANOVA) and Newman-Keuls test were carried out for multiple comparison among groups. At altitudes over 4450 m, we found lack of rigidity at 80-100% and 60-79%. Mean % of rigidity and rigidity time of 80-100% (tip and base) decreased progressively with altitude. No significant reductions were shown in rigidity time at 0-19% and at 20-39% (tip and base), of total number, of total and mean duration of SREs. Pathological rigidometric records at high altitude in sexually potent men at sea level clarify the primary role of hypoxia in physiopathological ED pathway.
Assuntos
Altitude , Disfunção Erétil/fisiopatologia , Hipóxia/fisiopatologia , Ereção Peniana/fisiologia , Adulto , Humanos , MasculinoRESUMO
The study investigates relationship between simple renal cyst enlargement studied by ultrasonography and anti-hypertensive treatment. To this purpose we enrolled 42 patients with newly diagnosed hypertension affected by simple renal cysts. Fourteen were randomly assigned to treatment with ACE-Inhibitors (group 1), twelve to diuretics (group 2) and sixteen to Ca-Antagonists (group 3). Patient performed a basal ultrasonography to evaluate basal cyst dimension before starting anti-hypertensive treatment. Following 12 months of the anti-hypertensive regimen, a new echograph was performed to evaluate changes in cyst size. A control group consisting of 15 patients with normal blood pressure and simple renal cysts was enrolled (group 0). An enlargement of cysts was detected in all patients. However, the enlargement observed in patients treated by Ca-Antagonists was significantly greater than that observed in the other groups (p<0.05). Our study supports the hypothesis that Ca-Antagonists may favor cyst enlargement by enhancing cyclic AMP production. In fact, cAMP and cAMP agonists stimulate fluid secretion by lining cells of the cyst wall, inducing cyst enlargement.
Assuntos
Anti-Hipertensivos/uso terapêutico , Hipertensão/diagnóstico por imagem , Hipertensão/tratamento farmacológico , Doenças Renais Císticas/diagnóstico por imagem , Idoso , Análise de Variância , Anti-Hipertensivos/efeitos adversos , Feminino , Humanos , Doenças Renais Císticas/induzido quimicamente , Masculino , Pessoa de Meia-Idade , UltrassonografiaRESUMO
The Peyronie's disease or Induratio Penis Plastica, represents one of the most controversial and uncertain points of the modern andrology, since its real etiology is still disputable. Consequently also the non-surgical therapy results as still confused and variable as shown in the considerable number of drugs utilized till now. Our study takes into consideration the injection therapy, by the use of the Betamethasone (corticosteroid), and it tries to explain, how it is possible, the real efficacy of drug versus placebo. The randomized study includes 30 patients. The valuation of the results has been effected in reference to three parameters: disappearance of pain, decrease of plaque volume and consistency of 50%, decrease subjective penile curvature. The data obtained show no significant differences between group A (treated with Betamethasone) and group B (treated with placebo). At twelve months of mean follow-up the pain at erection disappeared in 66.6% of the patients of group A, in 53.3% of the patients of group B. The curvature diminished in 20% of the patients of group A and in 26.6% of the patients of group B. A decrease in plaque volume and consistency was noted in 40% of the patients of group A and in 40% of the patients of group B. The data show that probably the clinical results of the therapy is to refer to a mechanical effect of injected volume and not to the drug action itself.
Assuntos
Betametasona/uso terapêutico , Glucocorticoides/uso terapêutico , Induração Peniana/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , PlacebosRESUMO
Cytogenetic investigations and molecular analysis of the Y chromosome by the polymerase chain reaction amplification of sequence-tagged sites (STS-PCR) technique were performed in 126 patients affected by idiopathic oligo-azoospermia following accurate selection of cases. Seventeen patients evidenced an abnormal karyotype. Fourteen patients with a normal karyotype had microdeletions of the Y chromosome within interval 6. In azoospermic patients microdeletions were scattered along different subintervals, while in oligozoospermic patients they were clustered in subinterval 6E. The size of the deletion was not apparently related to the severity of the disease. These results suggest that cytogenetic analysis and the STS-PCR technique can detect a genetic cause of infertility in about one-quarter of patients with idiopathic oligo-azoospermia.
Assuntos
Aberrações Cromossômicas , Oligospermia/genética , Cromossomo Y , Adulto , Deleção Cromossômica , Humanos , Hibridização in Situ Fluorescente , Técnicas In Vitro , Cariotipagem , Masculino , Pessoa de Meia-Idade , Oligospermia/patologia , Testículo/patologiaRESUMO
We evaluated the immune response after BCG treatment in superficial bladder cancer analyzing the modifications induced on lymphocytic sub-populations. In 21 patients with superficial bladder cancer we performed TURB and after 12 days began the induction cycle of 6 weeks with Pasteur BCG (75 mg/50 micromilligrams), followed by one instillation monthly for one year. Before treatment every patients underwent Mantoux intradermoreaction, blood-count and determination of peripheral blood lymphocytic subpopulations. Blood-count and lymphocytic subpopulations were repeated after 1 week, after 6 weeks, after 3 months and after 1 year. During cystoscopy after 3 months every patients underwent vesical biopsy. CD4+ and CD8+ are mainly interested among lymphocytic subpopulations at the beginning: BCG decreased CD4+ value in the patients with complete response and then it increased CD4+ and reversed the ratio between CD4+ and CD8+ on vesical mucosa.
Assuntos
Vacina BCG/uso terapêutico , Subpopulações de Linfócitos/imunologia , Neoplasias da Bexiga Urinária/terapia , Administração Intravesical , Idoso , Vacina BCG/administração & dosagem , Biópsia , Contagem de Células Sanguíneas , Terapia Combinada , Estudos de Avaliação como Assunto , Feminino , Seguimentos , Humanos , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Recidiva Local de Neoplasia , Teste Tuberculínico , Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/imunologia , Neoplasias da Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/cirurgiaAssuntos
Adjuvantes Imunológicos/efeitos adversos , Vacina BCG/efeitos adversos , Carcinoma de Células de Transição/terapia , Tuberculose Miliar/complicações , Tuberculose Pulmonar/complicações , Neoplasias da Bexiga Urinária/terapia , Adjuvantes Imunológicos/uso terapêutico , Administração Intravesical , Idoso , Vacina BCG/uso terapêutico , Humanos , Masculino , Recidiva Local de NeoplasiaRESUMO
Y chromosome molecular analysis was performed using the STS-PCR technique in 50 patients with oligozoospermia. Microdeletions of interval 6 of the Y chromosome were detected in seven patients, in six of whom subinterval E was affected. All patients retained the RBM1 and DAZ genes, while in one deletion involved the SPGY gene. The size of the deletion was not apparently related to the severity of the disease. These results suggest the presence of an oligozoospermia critical region on the Y chromosome within subinterval E of interval 6.
Assuntos
Deleção Cromossômica , Oligospermia/genética , Proteínas de Ligação a RNA/genética , Cromossomo Y , Adulto , Proteína 1 Suprimida em Azoospermia , Humanos , Masculino , Pessoa de Meia-Idade , Família Multigênica , Reação em Cadeia da PolimeraseRESUMO
This study presents the use and effects of a low mineral content water called "Monteferrante" on patients with urinary stone disease. We evaluated the blood and urine sample of twenty stone formers and ten healthy volunteers at three and six months after "Monferrante" water intake. Besides a benefic increasing of diuresis, the results show: an increase of: urinary magnesium (p < 0.001), urinary calcium (p < 0.01), uricosuria (p < 0.01), and reduction of: blood uric acid (p < 0.01), blood sodium (p < 0.05), azotemia (p < 0.05) and cholesteremia (p < 0.01). The "Monferrante" oligomineral water can be considered as an efficacy presidium in the prevention of stone disease.
Assuntos
Águas Minerais/uso terapêutico , Cálculos Urinários/terapia , Adulto , Idoso , Cálcio/urina , Feminino , Seguimentos , Humanos , Magnésio/urina , Masculino , Pessoa de Meia-Idade , Recidiva , Cálculos Urinários/metabolismoRESUMO
BCG has been shown in prospective randomized clinical trials to provide superior therapeutic results when composed to transurethral resection alone, or to adjuvant therapy with Thiotepa or Adriamicin. Even if the mechanism by which BCG mediate antitumor activity are not clearly established, an association between the immunological response and antitumoral activity is known IL-1 and TNF alfa are the monokines that have multiple biological effects, including linfocyte proliferation, production of fever, augmentation of cytotoxicity and production of cytokines. The goal of this study is show the response from LPS induced and not peripheral monocytes of superficial bladder cancer patients BCG treated and not, i.e. the levels of TNF alfa, IL-1 and not IL-6.
Assuntos
Adjuvantes Imunológicos/uso terapêutico , Vacina BCG/uso terapêutico , Monócitos/química , Monocinas/análise , Neoplasias da Bexiga Urinária/terapia , Seguimentos , Fatores de Tempo , Neoplasias da Bexiga Urinária/imunologiaRESUMO
Mechanism by which intravesical BCG treatment mediates antitumor activity are currently poorly understood. We initiated studies to determine the sequence and the factors that produce the immunological events. During the inflammatory answer a lot of molecules are produced. Chemokines MCP-1 and RANTES induces the mast-cell recruitment, that begins the "immunological fall". In our study 5 patients with superficial bladder cancer treated with BCG present an improvement of this cytokines correlated with a tumor-free status.
Assuntos
Adjuvantes Imunológicos/uso terapêutico , Vacina BCG/uso terapêutico , Quimiocina CCL2/imunologia , Monócitos/imunologia , Neoplasias da Bexiga Urinária/imunologia , Neoplasias da Bexiga Urinária/terapia , HumanosRESUMO
PSA half-life was calculated in 37 patients after radical prostatectomy to identify earlier patients with residual disease. The half-life calculated in patients potentially "cured" with absolute PSA values inferior to 0.5 ng/ml after 28 days, was significantly different (P = 0.0008) from the group of patients "uncured" (PSA > 1.0 ng/ml) and from those ones that, despite of detectable PSA level, had evidence of recurrence in the following follow-up. In comparison with the absolute value, the PSA half-life is able to define in the group of patients potentially "cured" those who could have a recurrence in the future.
Assuntos
Adenocarcinoma/sangue , Adenocarcinoma/cirurgia , Antígeno Prostático Específico/sangue , Prostatectomia , Neoplasias da Próstata/sangue , Neoplasias da Próstata/cirurgia , Adenocarcinoma/patologia , Idoso , Seguimentos , Meia-Vida , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias da Próstata/patologiaRESUMO
The orthotopic ileal neobladder is a completely detubularized, low pressure, high capacity reservoir created from the ileum without any valve. After cystoprostatectomy, a bowel segment of 40-60 cms is dissected free at a distance of 15 cms from the ileo-cecal valve. The bowel is detubularized and configurated in a cylinder. Then the neobladder is anatomized to the urethra and ureters. From 1989 to 1995 20 patients underwent ileal orthotopic urinary diversion according to Hautmann. Two patients died, the others are still disease free (mean follow up 36 months). The high capacity and low pressure allow a good continence control, while among metabolic alterations the most frequent is metabolic acidosis. The ileal neobladder represents a valid alternative to any form of cutaneous urinary diversion and is associated to a low incidence of complications.