scholarly journals Can We Use the Silodosin as Second Line Treatment of Benign Prostate Hyperplasia?

Author(s):  
Bekir Voyvoda ◽  
Onur Memik ◽  
Onur Karslı ◽  
Murat Üstüner ◽  
Levent Özcan

Objective: We aimed to investigate the efficacy of silodosin in patients with lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH) refractory to previous α-adrenergic receptor (AR) blocker therapy. Materials and Methods: Patients who did not benefit from alpha-blocker therapy but avoided surgical treatment constitute the population of our study. Seventy-five patients were studied in each group; Group 1 was given 8 mg of silodosin, while Group 2 continued the previous alpha-blocker treatment. Results: The initial mean international prostate symptom score (IPSS) was calculated as 20.81±0.97 in Group 1, in the third month there was a decrease of 17.12±1.25 (p<0.05). No significant change was observed in Group 2. In addition, a significant decrease was observed in IPSS subscores (storage and voiding symptoms) in Group 1 compared to baseline at the third month. There was an improvement in residual urine in the silodosin group and no improvement in the other group. Conclusion: In patients with BPH who refuse surgical treatment and could not achieve adequate symptom relief with other α-blockers in routine practice, silodosin was found superior in terms of LUTS recovery. Silodosin is also an effective option in patients who cannot undergo surgical treatment due to comorbidities.

Author(s):  
Bekir Voyvoda ◽  
Ömür Memik ◽  
Murat Üstüner ◽  
Onur Karslı ◽  
Levent Özcan

Objective: Our study aimed to the efficacy of silodosin in patients with LUTS associated with BPH who were not-responder to previous ARs blocker therapy. Methods: Patients who did not benefit from alpha blockers treatment, but did not want surgical treatment are included in this study. At enrollment, 75 patients and 75 patients were assigned to group 1 and group 2, respectively. Group 1 received silodosin 8 mg, group 2 received their previous α blocker. Results: Although, in group 1 mean IPSS score at baseline was 20,81±0,97, and it significantly decreased to 17,12±1,25 at third months, in group 2 no significant changes were observed. On the other hand in group 1 a decrease was also observed for both IPSS sub score was significantly reduced at third months, when it is compared with baseline. At the end of the third month, a significant improvement in this parameter was observed after switching to silodosin, as compared with first value (p< 0,05). As to the residual urine, significant improvement was observed in the silodosin group but no significant improvement was observed in group 2. Conclusion: This study was conducted to investigate the effectiveness and safety of silodosin in patients with BPH who had not achieved satisfactory symptom control with other α blockers in routine clinical practice before surgical treatment. Thus, at least patients who have different comorbidities will be protected from morbidities of surgery.


JMS SKIMS ◽  
2009 ◽  
Vol 12 (1) ◽  
pp. 3-7
Author(s):  
Aejaz A Baba ◽  
Bajpai Minu

Background: We evaluated the effects of alpha-1 blocker therapy on clinical and radiological abnormalities in patients of posterior urethral valve with bladder neck hypertrophy. Materials and Methods: A total of 74 patients with posterior urethral valves were seen at our department between 2003 and 2007. Out of these 24 had radiological evidence of bladder neck hypertrophy. Those patients with bladder neck hypertrophy who were seen before June 2006 and did not receive alpha-1 blocker (prazocin) therapy after valve ablation were assigned to group 1 (n=10). Group 2 consisted of 14 age matched patients with bladder neck hypertrophy and comparable prognostic factors who received alpha-1 blocker therapy after valve ablation (n=14). Micturating cystourethrography (MCU) was done periodically and a novel method used to calculate bladder neck hypertrophy. Trends in symptoms and radiological changes were evaluated throughout follow-up. Results: Mean patient age at presentation was 3.02±2.68 years in group 1 and 3.12±3.4 years in group 2. Bladder neck hypertrophy decreased from 2.3±1.0 to 2.0±0.5 in a mean time of 52.0 (34-52) weeks in group 1 where as it decreased from 2.2±0.5 to 1.6±0.3 in a mean time of 32.0 (22-52) weeks. Symptomatically patients in group 2 who received alpha-1 blocker therapy after valve ablation were better and had quick resolution of bladder neck hypertrophy. Conclusions: Use of alpha-1 blocker therapy in patients of posterior urethral valve with bladder neck hypertrophy helps in quick resolution of bladder neck hypertrophy. J Med Sci 2009;12(1):3-7.


Author(s):  
Inmaculada Méndez ◽  
Juan Pedro Martínez-Ramón ◽  
Cecilia Ruiz-Esteban ◽  
José Manuel García-Fernández

Burnout is a reality in the teaching profession. Specifically, teaching staff usually have higher burnout rates. The present study aims to analyze the different burnout profiles and to verify if there were differences between burnout profiles in depressive symptomatology and in the self-esteem of the teachers at school. The total number of participants was 210 teachers from 30 to 65 years. The first scale was the Maslach burnout inventory, the second scale was the Self-Rating depression scale and the third scale was the Rosenberg Self-Esteem Scale. The latent class analysis identified three burnout profiles: the first group with a high level of emotional exhaustion, low personal accomplishment and depersonalization (high burnout); the second group with low emotional exhaustion, low depersonalization and high personal accomplishment (low burnout) and the third group with low depersonalization, low emotional exhaustion and low personal accomplishment (moderate burnout). The results revealed that there were differences in depressive symptomatology (group 1 obtained higher scores than group 2 and group 3) and self-esteem (group 2 obtained higher scores than group 1). The psychological balance and health of teachers depend on preventing the factors that have been associated with this syndrome.


2021 ◽  
pp. 1-10 ◽  
Author(s):  
Noor Hamdan ◽  
Hugues Duffau

OBJECTIVE Maximal safe resection is the first treatment in diffuse low-grade glioma (DLGG). Due to frequent tumor recurrence, a second surgery has already been reported, with favorable results. This study assesses the feasibility and functional and oncological outcomes of a third surgery in recurrent DLGG. METHODS Patients with DLGG who underwent a third functional-based resection using awake mapping were consecutively selected. They were classified into group 1 in cases of slow tumor regrowth or group 2 if a radiological enhancement occurred during follow-up. All data regarding clinicoradiological features, histomolecular results, oncological treatment, and survival were collected. RESULTS Thirty-one patients were included, with a median age of 32 years. There were 20 astrocytomas and 11 oligodendrogliomas in these patients. Twenty-one patients had medical oncological treatment before the third surgery, consisting of chemotherapy in 19 cases and radiotherapy in 8 cases. No neurological deficit persisted after the third resection except mild missing words in 1 patient, with 84.6% of the patients returning to work. The median follow-up duration was 13.1 ± 3.4 years since diagnosis, and 3.1 ± 2.9 years since the third surgery. The survival rates at 7 and 10 years were 100% and 89.7%, respectively, with an estimated median overall survival of 17.8 years since diagnosis. A comparison between the groups showed that the Karnofsky Performance Scale score dropped below 80 earlier in group 2 (14.3 vs 17.1 years, p = 0.01). Median residual tumor volume at the third surgery was smaller (2.8 vs 14.4 cm3, p = 0.003) with a greater extent of resection (89% vs 70%, p = 0.003) in group 1. CONCLUSIONS This is the first consecutive series showing evidence that, in select patients with progressive DLGG, a third functional-based surgery can be achieved using awake mapping with low neurological risk and a high rate of total resection, especially when reoperation is performed before malignant transformation.


Author(s):  
A. V. Syrkina ◽  
I. E. Pashkova ◽  
A. R. Monakhov ◽  
O. V. Silina ◽  
E. V. Chekletsova ◽  
...  

Background. In young children, the most common liver disease leading to transplantation is biliary atresia. Liver transplantation has fundamentally improved the survival rate of children with biliary atresia. Studies on developmental outcomes in children are mostly limited to small samples; there are no such studies in the Russian Federation.Objective: to determine the cognitive outcomes in children undergoing one-stage or two-stage surgical treatment of biliary atresia.Materials and Methods. 83 children were divided into groups: 36 children underwent transplantation without previous surgical interventions (group 1), 47 children underwent the Kasai palliative portoenterostomy (group 2). Inclusion criteria: 24 months of age or younger at the moment of transplantation, no medical history of neurological pathology. All children were examined before transplantation and at 1, 3, 6 and 12 months after liver transplantation. Psychomotor development was assessed using the Griffiths Psychomotor Development Scale for children under 24 months (translated by E.S. Keshishian), the Griffiths Intellectual Development Scale for children aged 2 to 8 years, and the Modified Checklist for Autism in Toddlers, Revised, for children 16-30 months old.Results. All children had developmental delays at the time of transplantation. Up to 50% of the children had signs of cachexia, with a shoulder circumference of less than 3 percentile. Only two children showed obvious hepatic encephalopathy in the form of depressed consciousness. After liver transplantation, 94% of group 1 children recovered their preoperative psychomotor development levels, and only 68% in group 2 made these gains. At 3 and 6 months after transplantation, about 80% of group 1 children showed normal psychomotor development, whereas in group 2, only 61% did. By 12 months after liver transplantation, the difference between the groups was more evident: 83.3% of group 1 children and only 53.2% of group 2 children were developing according to age. The difference between the groups was statistically significant (p < 0.05).Conclusion. Children who received one-stage treatment of biliary atresia and underwent liver transplantation have better neuropsychological development within a year after surgery than children with two-stage surgical treatment.


1998 ◽  
Vol 4 (2) ◽  
pp. 234-238
Author(s):  
M. Mohebali ◽  
E. Fallah ◽  
S. Jamshidi ◽  
H. Hajjaran

Sixteen dogs were randomly divided into four groups. Group 1 received autoclaved Leishmania infantum vaccine with BCG. Group 2 received autoclaved L. major vaccine with BCG. Group 3 received BCG alone and Group 4 received normal saline. Dogs received the vaccines intradermally three times each at 30-day intervals. All dogs were tested at 2-month intervals with the leishmanin skin test and anti-Leishmania ELISA. Ninety days after the third dose, each dog received an intraperitoneal challenge of 2.5 X 10 [6] infective promastigotes of L. infantum. Necropsy was performed on all dogs to investigate for parasites. All of the dogs in the unvaccinated groups were infected with L. infantum but of the dogs in the vaccinated groups, only one dog was infected


2018 ◽  
Vol 99 (2) ◽  
pp. 291-296
Author(s):  
A E Samigullina ◽  
V A Vybornykh

Aim. Study of somatic and obstetric and gynecologic morbidity of women of the Kyrgyz Republic after Cesarean section. Methods. Retrospective cohort study was conducted in 2016 in Kyrgyz state medical institute of retraining and advanced training. Three regions of the Kyrgyz Republic were selected: Bishkek, Jalal-Abad and Issyk-Kul regions. 908 pregnant women after abdominal delivery were chosen as the subject of the study and divided into three groups: group 1 (Bishkek) - 305 pregnant women, group 2 (Jalal-Abad region) - 300 females, group 3 (Issyk-Kul region) - 303 females. The age was 15 to 49 years. The incidence of gynecologic and extragenital pathology and complications during previous pregnancies were studied. Results. Gynecologic pathology in past medical history was revealed in 15.8% of females, while women from group 1 are statistically significantly more likely to have gynecologic diseases than women from group 3. Females from group 2 had gynecologic pathology more rarely. In the structure of gynecologic incidence, sexually transmitted infections take the first place, cervical ectopy takes the second place and uterine fibroids - the third place. Extragenital pathology was detected in 38.2% of pregnant women. In its structure the first ranked place is taken by urinary tract diseases (12.3%), the second one - by infectious and parasitic diseases (11.6%), and the third place - by cardiovascular diseases (3.2%). Pathological course of pregnancy was also more frequent in group 1 than in group 2; there was no significant difference with group 3. Spontaneous abortion interrupted previous pregnancy in 19.8% of women, 5% had premature births, significantly more frequently in group 1, as well as preeclampsia. Conclusion. The most unfavorable region is the city of Bishkek, female residents of Jalal-Abad region are less susceptible to diseases; in general, gynecologic pathology was revealed in 15.8% of females, extragenital pathology - in 38.2% of pregnant women; pathological course of pregnancy was statistically more frequent in group 1 than in group 2, without significant difference with group 3.


Author(s):  
A.P. Voznyuk ◽  
◽  
S.I. Anisimov ◽  
S.Y. Anisimova ◽  
L.L. Arutyunyan ◽  
...  

Purpose. To evaluate the efficacy and safety of femtolaser-assisted phacoemulsification in glaucomatous eyes in the long-term follow-up. Materials and methods. A retrospective analysis of the results of the surgical treatment of patients with combined cataract and glaucoma pathology was analyzed. The patients were divided into groups depending on the method of surgical intervention: 1) phacoemulsification with femtolaser support (26 eyes, 23 patients); 2) phacoemulsification (36 eyes, 30 patients); Results. Before surgery, there were no statistically significant differences in IOP and corneal hysteresis (СН) between groups 1 and 2. The mean values of IOP cc, IOP g and СН of group 1 before surgery were 22.7±6.1 mm Hg, 20.9±6.9 mm Hg, 8.5±1.6 mm Hg; 2 group – 22.9±8.7 mm Hg, 21.6±8.9 mm Hg, 8.9±1.6 mm Hg respectively. Average values of IOP cc, IOP g and CН 5 years after the surgical treatment in group 1 were 15.3±1.2 mm Hg, 14.4±3.4 mm Hg, 9.6±4.2 mm Hg; in group 2 – 18.0±4.2 mm Hg, 16.1±4.2 mm Hg, 8.8±2.2 mm Hg respectively. In both groups, stabilization of IOP and CH indices was noted, which remained throughout the entire observation period, which shows the normalization of the biomechanical properties of the corneoscleral membrane of the eye in the long-term postoperative period. Conclusion. Femtolaser accompaniment of phacoemulsification is an effective and safe method of cataract surgery for combined pathology. Key words: femtolaser, cataract, glaucoma, phacoemulsification.


2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Martina Maritati ◽  
Trentini Alessandro ◽  
Nunzia Zanotta ◽  
Manola Comar ◽  
Tiziana Bellini ◽  
...  

Abstract Background Although HIV-related deaths have decreased dramatically following the introduction of antiretroviral therapy (ART), HIV infection itself causes increased morbidity and mortality for both non-AIDS-related events or chronic inflammation and immune activation. The use of certain antiretroviral drugs can contribute to this process. Methods We investigated 26 potential biomarkers in serum samples from HIV-1 infected patients virologically suppressed under ART. The main objective of our study was to evaluate if virological suppression achieved with a triple drug regimen containing tenofovir disoproxil fumarate co-formulated with emtricitabine (TDF/FTC) as backbone, could correlate with a better immunological and inflammatory profile in relation to the third class of antiretroviral drug administered. The eligible patients were then divided into 3 groups in relation to the third drug associated with TDF/FTC: nucleoside reverse transcriptase inhibitors (NNRTI) (Group 1, n = 16), protease inhibitors (PI) (Group 2, n = 17) and integrase inhibitors (INI) (Group 3, n = 16). Results Inflammatory cytokines and chemokines were more represented in Group 2 than in Group 3 (IL-1Ra, p = 0.013; IL-12p70 p = 0.039; TNF-α p = 0.041; IL-8, p = 0.027; MIP1 β, p = 0.033). Eotaxin showed lower levels in Group 1 compared to Group 2 (p = 0.010), while IP-10 was significantly lower in Group 1 compared to both Group 2 and Group 3 (p = 0.003 and p = 0.007, respectively). Conclusions Our results seem to discourage the administration of PI as a third drug in a virologically effective antiretroviral regimen, as its use is linked to the detection of higher levels of pro-inflammatory mediators in comparison with INI and NNRTI.


1985 ◽  
Vol 1 (S1) ◽  
pp. 186-188
Author(s):  
T. Orlowski ◽  
S. Chabielski ◽  
A. Badowski ◽  
Z. Dumanski

The pathology of mixed injuries resulting from simultaneous action of several damaging factors on the organism is still insufficiently known. Peritonitis is the most frequent complication of injuries to the abdominal organs. Co-existence of peritonitis with radiation sickness impairs considerably the results of therapeutic management and prognosis. Surgical treatment is indicated in the latent period of radiation sickness or only in the period of recovery. In the case of diffuse peritonitis, the time of performing the operation is of essential importance for the prognosis. Thepurposeof the reportedinvestigationswas the study of the effect of ionizing radiation before exposure of the organism on the course of diffuse peritonitis and a trial of prolonging with an antibiotic the preliminary stage of the disease in which surgical treatment is effective. Investigations were carried out on 160 male Wistar rats weighing 250g on the average, divided into five groups. Group 1 served as control. In Group 2, the rats were only exposed to radiation.


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