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Biomedical subjects

A Saita

Publications and source records attributed to A Saita.

13 recordsLinked to original sources

Incidence of prostate cancer in Sicily: results of a multicenter case-findings protocol.

OBJECTIVE: To establish the incidence of prostate cancer (PCa) in Sicily in patients who entered an early detection protocol. METHODS: From February 2002 to February 2004, 16,298 subjects aged 40-75 entered the protocol. Patients with suspicious DRE, PSA>10 ng/ml, PSA<or=2.5 ng/ml, from 2.6 to 4 ng/ml or from 4.1 to 10 ng/ml with F/T PSA of <or=15%, <or=20% and <or=25% respectively underwent needle biopsy according to an extensive protocol. RESULTS: 3266 patients were eligible for biopsy; PSA was <or=4 in 12.7% and <or=10 ng/ml in 63.9% of patients. A PCa was found in 1171 cases (36.9%) with a relationship between PCa incidence and PSA and age respectively (chi2-test, p<0.0001); 51.8% of patients with PCa had a PSA<10 and 8.8% a PSA<4 ng/ml; 49% were clinically staged as T1c. The estimated odds ratios for each age group showed increased risk for PCa in the fourth decade with PSA between 2.6 and 4 ng/ml (12.5 times higher) and in the fifth decade with PSA between 4.1 and 10 ng/ml (6.2 times higher). CONCLUSIONS: Age and serum PSA levels are the major risk factors for PCa. On their basis it is possible to modulate the most suitable timing for early diagnosis in individual patients.

Adult↗

Our experience with nifedipine and prednisolone as expulsive therapy for ureteral stones.

OBJECTIVES: We evaluated the effect of nifedipine associated with prednisolone in ureteral stone passage. MATERIAL AND METHODS: In our department we enrolled 50 patients with radiopaque ureteral stones. Stone size was 15 mm or less. The patients were divided into two groups: group I included 25 patients who received 30 mg oral treatment of slow-release nifedipine (for a maximum of 20 days) and 25 mg of prednisolone (for a maximum of 10 days) daily. Group II was made up of 25 patients who received 25 mg of prednisolone daily. On request, both groups could use non-steroidal anti-inflammatory drugs. RESULTS: The mean expulsion time was 6 days in group I and 10 days in group II. The average stone size was 12 mm in group I and 12.8 mm in group II. Six patients suspended therapy in group I (5 erythema, 1 stomachache), and seven in group II (3 because of intolerable pain, 4 stomachache). The expulsion success rates were 68% in group I and 81% in group II. CONCLUSIONS: For ureteral stones that do not cause an emergency situation, such as obstructive uropathy, infection or intolerable pain, we suggest expulsive medical treatment with nifedipine and prednisolone, if there are no contraindications to drug use.

Administration, Oral↗

ESWL: Comparing two analgesic techniques. Our experience.

OBJECTIVE: We compared the effects of intramuscular analgesia versus intramuscular analgesia associated with topical application of Luan (gel containing lidocaine 1%) on the efficacy of extracorporeal shockwave lithotripsy (ESWL). MATERIAL AND METHODS: From January 2001 to November 2002, 300 patients (mean age 46) were treated for kidney or upper ureteral radiopaque stones with ESWL, using a Dornier Compact Delta magneto lithotripter. The patients were divided into two groups: group A, 180 patients, received intramuscular analgesia with Ketorolac 30 mg, Tramadolo 100 mg and, during treatment, intravenous betametasone 4 mg. Group B, 120 patients, received the same pharmacological treatment associated with topical application of Luan. RESULTS: At 3 months, the stone-free rate in group A was 61% compared with 79% in group B. The energy of treatment was less than 13 kV in group A and less than 15 kV in group B. CONCLUSIONS: For ESWL treatment of kidney stones of 20 mm or less and ureteral stones of 15 mm or less, we suggest local analgesia with topical Luan and intramuscular analgesia. This approach increases the success rate of ESWL and reduces the discomfort associated with treatment.

Administration, Topical↗

Role of Ca 15-3 in patients with biochemically suspected prostate cancer and multiple negative ultrasound-guided prostate biopsies.

Ca 15-3 is an aspecific tumor marker characteristic of cancer proliferation. Elevated serum levels seem to be closely correlated with cancer progression in non-urological tumors. This study assessed the role of Ca 15-3 as an aspecific tumor marker in patients with borderline prostate-specific antigen (PSA) biochemically suspected of prostate cancer (PCa) and with multiple negative prostate biopsies. The study is based on prospective analysis of 103 patients: (a) 33 patients (group A) presented lower urinary tract symptoms secondary to BPH with normal serum PSA values, DRE and TRUS negative for suspected PCa; (b) 31 patients (group B) with histologically diagnosed PCa; (c) 39 patients (group C) with borderline serum PSA values, DRE and TRUS normal, two ultrasound (US)-guided random prostate biopsies negative for PCa. Ca 15-3 was determined in the entire study series by the IRMA method, using as range the values proposed for the investigated non-urological tumors (38 UI/l).Ca 15-3 was within normal range in all group A patients (control), while the values were elevated in 27/31 of group B patients (PCa) and in 11/39 of group C (PCa suspected) patients. A third biopsy was performed in all 39 group C patients with borderline PSA and it was PCa-positive in 13 patients (33.3%, subgroup C3). In this series Ca 15-3 was increased in 9 of 13 patients (subgroup C3alpha), while the remaining four patients (subgroup C3beta) presented values within the normal range. On 26 group C patients who were negative for PCa to third biopsy (subgroup C4), 24 patients had Ca 15-3 levels within normal range (subgroup C4alpha) with histologic findings of BPH in 23 cases and granulomatous chronic prostatitis in one case, while two patients (subgroup C4beta) had elevated Ca 15-3 concentrations associated with lymphoplasmacytic chronic prostatitis. We hypothesize that Ca 15-3, as a specific tumor marker, could be an interesting and inexpensive second step diagnostic tool for PCa in patients with borderline PSA and multiple negative prostate biopsies, as it could indicate whether a repeated biopsy should be performed in a short time, having excluded other concomitant tumors. However, further prospective studies will be necessary to confirm this hypothesis.

Adenocarcinoma↗

[Mepartricine and prostatitis. Clinical experience and rationale for use].

BACKGROUND: The purpose of this study was to report our experience on the use of Mepartricine in the treatment of chronic and sub-acute prostatitis and to analyse, on the basis of the literature, the role of estrogens, the target of Mepartricine in the development and maintenance of prostatic inflammatory reactions. METHODS: In a retrospective study the data of 110 patients who presented with lower urinary tract symptoms suggestive of prostatitis, from January 1994 to February 1999 have been evaluated: 65 of this patients had an abacterial prostatitis, and 45 a bacterial prostatitis. The Mearers-Stamey test was used to localize inflammation and pathogens to prostate. The clinical symptoms presented were essentially pelvic and perineal pain and irritative and obstructive voiding symptoms. The treatment was based on antibiotic therapy indicated by the sensitivity to antibiotic assay. In abacterial prostatitis, in cases of Chlamidia, Mycoplasma and Ureaplasma positivity, the treatment was based on macrolides and tetracycline use. All the patients received Mepartricine by oral supply, 1 daily tablet (40 mg) for 60 days. RESULTS: After two months of treatment remarkable improvements in symptoms were obtained despite the persistent bacteriological positivity in the prostatic secretion in 68% of cases. Therefore antinflammatory antiedemic and decongestant effects of Mepartricine on prostatic inflammation, are observed. CONCLUSIONS: The data of the literature show data estrogens modulate inflammatory reactions: it is possible that their decrease can produce, at prostatic level, antinflammatory effects improving urethro-prostatic bladder functions. Personal experience seems to confirm this supposition and so we think that Mepartri-cine can be considered and excellent coadjuvant in the treatment of prostate inflammation, independent of etiology.

Adult↗

Immunohistochemical and molecular analysis in recurrent urethral stricture.

The authors have analyzed the most recent additions to the literature of immunohistochemical and molecular assessment of acquired urethral strictures and report on their data obtained in a selected clinical series. Innovative immunohistochemical studies in patients presenting with plurirecurrent symptoms suggest that urethral mesenchymal changes caused by tissue de-epithelialization may be the underlying cause of stricture. This condition may be congenital or acquired. It may determine aberrant connective tissue formation induced by abnormal fibroblastic activation with formation of over abundant hyperdense collagen scar tissue.

Aged↗

Endoprosthesis implantation in the treatment of recurrent urethral stricture: a multicenter study. Sicilian-Calabrian Urology Society.

PURPOSE: This study was conducted by nine urology departments in southern Italy to assess the efficacy of and tolerance to treatment of recurrent urethral stricture using a permanent prosthesis. PATIENTS AND METHODS: Since 1992, 99 prostheses have been implanted to treat inflammatory and iatrogenic (seven departments) or all types (two departments) of urethral strictures. The Urolume Wallstent was used in 94 cases. Three centers implanted more than one prosthesis when this was indicated. Local anesthesia was used by six centers, spinal anesthesia by two, and local or general by one. At three centers, urethrotomy was performed immediately prior to implantation; two centers used dilation to 30F, and two centers performed urethrotomy 24 or 36 hours before implantation. The median follow-up is 29.1 months (range 3-53 months). RESULTS: The results were good in 52%, fair in 34%, and poor in 14% of patients. The maximum flow rate increased >75% in 82% of patients. All departments reported complete reepithelialization of the urethra by 6 months. The short-term complications (7-28 days) were perineal discomfort (86%) and dribbling (14%). The long-term complications were painful erection (44%), mucous hyperplasia (44%), recurring stricture (29%), and incontinence (14%). All departments performed resection for hyperplasia in many cases. CONCLUSION: Permanent urethral endoprostheses can produce excellent results in patients with recurrent urethral strictures.

Adult↗

[Treatment of unusual testicular tumors].

In this work the authors make a description of the rare testis tumors. They underline the several histologic features and the difficulty of early diagnosis due to the absence of reliable markers, and as for the malignancies the unclear role of the radio and chemotherapy. The difference in terms of classification and of lack in the therapeutic standards is clear if compared with the germ cell tumors. These pathologies require an early surgical approach by using the available diagnostic imaging tools and bioptic examination.

Humans↗

[Use of stents in postoperative recurrent urethral stenosis].

We have started study after a publication (1) about our experience on 1376 urethrotomies executed above 784 patients; the 11% of these stenosis have been consequent on endoscopic or open surgery. In the 23% of these patients we have made more than two urethrotomies and in 4% of these the endoscopic operation has not been resolutive. We described the use of the urethral wall stent in 13 patients with recurring urethral strictures. The stainless steel stent is self expanding when released from its endoscopic introducer. We have desobstructed the 100% of the patients and obtained a max flow between 15 and 24 ml/sec. We haven't had problems of re-epithelialization if excluded two patients where observed a stabilized exuberant re-epithelialization without uroflowmetry variations. It is considered that this endoscopic technique offers a simple, safe and effective alternative to multiple dilatations and urethrotomies in patients with bulbar urethral strictures.

Catheterization↗

Tracheal reconstruction with jejunal loop autograft.

An experimental study on tracheal reconstruction using a jejunal loop autograft, is reported. Eight dogs divided into 2 groups have been used. In the first group the jejunal loop was prepared using a single vascular pedicle including both the artery and the vein and was revascularized with the superior thyroid artery and its collateral vein. In the second group the jejunal loop was prepared with two different vascular pedicles, revascularizing the artery with the superior thyroid artery and the vein with the jugular vein. In this group a sylastic T-tube was placed inside the loop. The procedure and preliminary results, are reported.

Animals↗

An unusual Z-system in the obliquely striated muscles of crinoids: three-dimensional structure and computer simulations.

The peculiar functional structure of the Z-line in the obliquely striated muscles of some feather stars is described. It is known that cross-striated muscles are characterized by linear and continuous Z-bands, and obliquely striated muscles by disconnected, obliquely aligned Z-elements. Owing to this discontinuous organization, the sarcomere can perform wide active lengthenings, shortenings, and even 'super-elongations' in the helical fibres. In contrast, the obliquely striated fibres of crinoids show markedly continuous and homogeneous oblique Z-lines; such a structure is not compatible with 'super-performances' like sliding and shearing of the sarcomere elements, but instead could allow functions comparable to those characteristic of a cross-striated muscle (quick, short movements, mechanically amplifiable by bone levers). This odd situation, only interpretable in terms of evolutionary constraint, could be considered opposite and symmetrical to that of cross-striated 'super-contracting' muscles, where the Z-line is exceptionally fragmented to allow the sarcomere to super-contract. The possible architecture of a significant parameter such as the Z-line, which determines muscle fibre potential capacities, is analysed in detail: through qualitative-quantitative evaluation of electron micrographs, supported by statistical analysis of the data; and by computer simulations. The data obtained suggest that the most realistic conformation of the whole Z-complex in these muscles consists of a multiple system of continuous, ribbon-like helical planes running in parallel along the fibre from end to end and regularly cutting it with a constant thickness. The proposed model seems morphologically compatible with the experimentally verified situations and functionally compatible with the mechanical requirements for a normal contraction and for a balanced distribution of the involved strengths.

Animals↗