RESUMO
OBJECTIVE: No reports have evaluated the treatment effects of tadalafil by age group in a positive, noninterventional observational study of Japanese men. The present study aimed to evaluate the treatment effects of tadalafil by age group in a positive, noninterventional observational study of Japanese men. We therefore divided patients into 2 groups about the age of 70 years and investigated the treatment effects of tadalafil regarding voiding and storage functions by age group. METHODS: Changes from baseline in each parameter (International Prostate Symptom Score [IPSS], quality of life [QOL] score, Overactive Bladder Symptom Score [OABSS], and residual urine volume) at 4, 12, and 24 weeks after initiating tadalafil for benign prostatic hyperplasia (BPH) patients were compared between groups (50-69 years vs. ≥70 years). In addition, side effects of tadalafil were investigated by age group. RESULTS: In the 50-69 years group, significant improvements from baseline were seen in IPSS total and QOL score for all time points. In addition, significant improvements in IPSS storage subscore from baseline were observed at the 4- and 24-week time points. In the ≥70 years group, significant improvements from baseline were seen in IPSS total, IPSS voiding and storage subscores, and QOL score at each time point. CONCLUSIONS: Tadalafil 5 mg once daily appeared effective in clinical settings for elderly BPH patients even over 70 years old.
Assuntos
Sintomas do Trato Urinário Inferior , Noctúria , Hiperplasia Prostática , Idoso , Humanos , Sintomas do Trato Urinário Inferior/tratamento farmacológico , Masculino , Noctúria/tratamento farmacológico , Inibidores da Fosfodiesterase 5/uso terapêutico , Hiperplasia Prostática/complicações , Hiperplasia Prostática/tratamento farmacológico , Qualidade de Vida , Tadalafila/uso terapêutico , Resultado do TratamentoRESUMO
Objective: The treatment effects of vibegron have not previously been evaluated in a prospective, non-interventional observational study of elderly Japanese patients, particularly those ≥80 years old. In addition, no reports have referred to residual urine volume in switching cases. We therefore grouped patients by condition and investigated the treatment effects of vibegron on Overactive Bladder Symptom Score (OABSS), Overactive Bladder Questionnaire Short Form (OAB-q SF), and residual urine volume in each group. Methods: This multicenter, prospective, non-interventional, observational study consecutively enrolled OAB patients with total OABSS score ≥3 and OABSS question 3 score ≥2. Sixty-three patients from six centers were recruited. Vibegron 50 mg once daily was administered for 12 weeks as first-line monotherapy (first-line group), monotherapy switching from antimuscarinics or mirabegron due to failure of prior therapy (no washout period), or combination therapy with antimuscarinics (second-line group). OABSS, OAB-q SF, and residual urine volume were collected after 4 and 12 weeks. Adverse events were also recorded at each visit. Results: Of the 63 patients registered, 61 were eligible for analysis (first line, n=36; second line, n=25). The OABSS, excluding daytime frequency scores, and OAB-q SF scale showed significant improvement in all conditions. Switching from mirabegron to vibegron significantly reduced residual urine volume. No serious treatment-related adverse events were encountered. Conclusion: Vibegron 50 mg once daily significantly improved OABSS and OAB-q SF even in patients ≥80 years old. Notably, switching from mirabegron to vibegron resulted in significant improvements to residual urine volume.
RESUMO
We report the first case of successful continuation of pregnancy after repair of a midgestational uterine rupture with the use of a fibrin-coated collagen fleece (TachoComb, Nycomed, Linz, Austria). For midgestational uterine rupture, adequate uterine repair and close surveillance of preterm labor could improve perinatal outcome by permitting continuation of the pregnancy.
Assuntos
Aprotinina/administração & dosagem , Fibrinogênio/administração & dosagem , Hemostasia Cirúrgica/métodos , Complicações na Gravidez/cirurgia , Trombina/administração & dosagem , Ruptura Uterina/cirurgia , Adulto , Perda Sanguínea Cirúrgica/prevenção & controle , Cerclagem Cervical , Cesárea , Combinação de Medicamentos , Transfusão de Eritrócitos , Feminino , Humanos , Recém-Nascido , Masculino , Gravidez , Resultado da GravidezRESUMO
We report an extremely rare case of a multicystic malignant mesothelioma in the tunica vaginalis with an unusually indolent clinical course. A 48-year-old man presented with a one-month history of painless swelling of right scrotal contents. Ultrasonography and computed tomography (CT) revealed a multicystic mass in the right scrotal sac with evidence of neither distant nor lymph node metastases. The testicular tumor markers were within the normal limits. Inguinal orchiectomy was performed under the suspicion of a malignant tumor. The cystic tumor consisted of fibrocellular, microcystic and adenomatoid elements microscopically was diagnosed biphasic malignant mesothelioma of tunica vaginalis but no invasion into the testis, epididymis and also scrotum. The patient has been disease-free for 72 months and is being followed on an outpatient basis with no further adjuvant therapy.
Assuntos
Mesotelioma Cístico/cirurgia , Neoplasias Testiculares/cirurgia , Humanos , Imageamento por Ressonância Magnética , Masculino , Mesotelioma Cístico/patologia , Pessoa de Meia-Idade , Orquiectomia , Neoplasias Testiculares/patologiaRESUMO
BACKGROUND: Uterine lipoleiomyoma is a rare, fat-containing, benign tumor. The clinical features and optimal treatment of this tumor remain unclear. CASE: An 80-year-old woman with an extensive cardiac history was referred for assessment of a huge pelvic mass. Magnetic resonance imaging demonstrated a uterine tumor with inhomogeneously high signal intensity. A fat suppression technique showed heterogeneous suppression of the signal intensity, with areas of increased enhancement after Gd-DTPA administration. Hysteroscopy revealed no abnormal findings in the endometrium. She underwent a simple total abdominal hysterectomy, with a preoperative diagnosis of uterine liposarcoma. Histological examination revealed a uterine lipoleiomyoma. Ten days after surgery, she died due to acute non-occlusive mesenteric ischemia. CONCLUSION: In cases where the radiological appearance of a uterine tumor in an elderly patient is suspicious for liposarcoma, the possibility of a benign lipoleiomyoma should be considered. Careful consideration of the patient's preoperative condition and familiarity with uterine fat-containing tumors are essential for determining an optimal therapeutic approach.
Assuntos
Leiomioma/diagnóstico , Lipoma/diagnóstico , Neoplasias Uterinas/diagnóstico , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Evolução Fatal , Feminino , Humanos , Leiomioma/cirurgia , Lipoma/cirurgia , Lipossarcoma/diagnóstico , Neoplasias Uterinas/cirurgiaRESUMO
BACKGROUND: Although spontaneous regression has been reported in several cancers, it is generally believed that this rare phenomenon does not occur in epithelial ovarian cancer. CASE: We presented a stage IV epithelial ovarian cancer patient with long-term disease-free survival after palliative local irradiation alone against recurrence. The recurrent supraclavicular lymph node was almost completely necrotic, and the swelling of the para-aortic lymph node spontaneously regressed. CONCLUSION: The histologic features and unexpected clinical course in this patient strongly suggest that spontaneous regression occurred in recurrent epithelial ovarian cancer.
Assuntos
Cistadenocarcinoma Seroso/terapia , Recidiva Local de Neoplasia/terapia , Neoplasias Ovarianas/terapia , Adulto , Quimioterapia Adjuvante , Cistadenocarcinoma Seroso/patologia , Feminino , Humanos , Histerectomia , Excisão de Linfonodo , Metástase Linfática , Recidiva Local de Neoplasia/patologia , Neoplasias Ovarianas/patologia , Radioterapia Adjuvante , Remissão EspontâneaRESUMO
Metastasis to a lower-extremity bone is an extremely rare event in patients with endometrial carcinoma. A 64-year-old woman presented with progressive right leg pain but no gynecologic complaints. A diagnostic workup revealed primary endometrial carcinosarcoma with an isolated tibial metastasis. Though the patient received only local irradiation to the tibial lesion, complete resolution of symptoms resulted. Six months after the radiotherapy, the intraabdominal disease progressed and the patient died. We note that tibial metastasis is one of the possible presenting symptoms in patients with endometrial malignant tumors. Irradiation can improve their quality of life and so may be effective in the management of symptomatic tibial metastasis.