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Biomedical subjects

D Prezioso

Publications and source records attributed to D Prezioso.

At least 19 recordsLinked to original sources
PubMed2006

[Antibacterial prophylaxis in endourological procedures].

AIM: Antibiotic prophylaxis for the prevention of postsurgical infections is a common practice in urologic surgery, as well as in endourologic procedures, both in at risk patients (local or systemic risk factors: age, immunological status, metabolic disorders, poor general conditions) or with a positive urine culture, but also in patients with urine previously sterile. As Gram-negative strains are the most common pathogens, it is reasonable to use a quinolone or a beta-lactam. METHODS: One-hundred and thirty-one patients (range 21-89 years) underwent transurethral cystoscopy (52 cases), vesical catheterism (44 cases), extracorporeal shockwave lithotripsy (17 cases) and transrectal prostatic biopsy (18 cases). An antimicrobial prophylaxis with ciprofloxacin 500 mg (22 patients, 16.8%), levofloxacin 500 mg (54 patients, 41.2%) and prulifloxacin 600 mg (55 patients, 42%) was administered. RESULTS: Globally, the incidence of urinary tract infections during 15 days after surgery was 8.4% (11 cases out of 131): ciprofloxacin 9.1%, levofloxacin 11.1% and prulifloxacin 5.5%, respectively. The patients compliance with the prophylactic treatment was good or excellent in 122 cases (93.1%) and poor in 9 cases (6.9%). No major differences between antibiotics used in prophylaxis were detected, keeping into account the limited size of the global population and subgroups defined by the endourological procedures. CONCLUSIONS: Prulifoxacin, with a broad antimicrobial spectrum, favourable pharmacokinetic properties and easy to use, can be considered a valid and well tolerated therapeutic option for the antibacterial prophylaxis in endourological procedures, both in hospital and in outpatient setting.

Adult↗
PubMed2005

Home and office uroflowmetry for evaluation of LUTS from benign prostatic enlargement.

A group of 107 patients with lower urinary tract symptoms (LUTS) from benign prostatic enlargement (BPE) participated to the HOUSE Study (Home and Office Uroflowmetry Specific Evaluation). Patients received routine investigation, consisting of medical history taking, physical examination including digital rectal examination, prostate-specific antigen (PSA), assessment of symptoms listed both on the International Prostate Symptom Score and on ICS-male questionnaire. We examined the results of uroflowmetry evaluation in this population; data were analysed to observe if any circadian changes of parameters obtained with home uroflowmetry could be detected. We searched a correlation between Q(max), Q(ave) and ICS-benign prostatic hyperplasia symptom score: a significantly inverse correlation was found only for Q(max), confirming Q(max) as a reliable parameter to quantify subjective symptoms. When examining the multiple flow curves recorded in the same patient with home uroflowmetry, voided volume and flow time had usually higher values during night-time: the existence of circadian changes of uroflowmetry parameters in patients with LUTS from BPE was confirmed, and lower values of average and maximum flow rates during sleep hours were recorded in the same patient. In conclusion, when evaluating the natural history or treatment outcome of individual patients or group of patients in clinical trials for evaluation of BPE and LUTS, an assessment including multiple measurements may be useful and of value.

Aged↗
PubMed2001

Estrogen receptor beta expression in human prostate tissue.

Estrogen receptor subtype beta (ERbeta) is highly expressed in rat prostate epithelium, but its presence in human prostate needs to be confirmed. Here we investigated the expression of ERbeta in five benign (normal and/or hyperplastic) and 10 malignant (Gleasons' score 2-7) prostate tissue specimens using immunohistochemistry. Immunohistochemistry was performed on formalin-fixed, paraffin-embedded tissue sections, using a commercially available ERbeta polyclonal antibody developed against the C-terminal amino acid residue. Nuclear ERbeta expression was found in the nuclei of glandular epithelium of benign prostate tissue specimens; faint nuclear ERbeta positivity was also present in a few stromal cells around normal epithelium. Nuclear ERbeta specific immunostaining was undetectable in all prostate cancer sections.

Animals↗
PubMed2001

Aims and methods. LUTS suggestive of BPH.

OBJECTIVE: Few epidemiological studies are available on Italian patients with lower urinary tract symptoms and their QoL. QUIBUS (QUality of life Investigated in BPH patients with Urinary Symptoms) is an observational longitudinal study aimed at evaluating symptoms and QoL in a large sample of Italian patients and investigating their correlation with demographic, social and clinical characteristics of BPH. PATIENTS AND METHODS: Patients with lower urinary tract symptoms and prostate enlargement suggestive of BPH (both old and new diagnosis) were enrolled between November 1998 and May 1999 in 31 Italian centers of urology. This longitudinal investigation consists of an enrollment visit, in which demographic, social and clinical aspects are recorded as baseline data, and a follow-up visit after 1 year of treatment freely assigned by the investigators. Symptoms and QoL are assessed by means of IPSS, ICS-BPH (at both visits) and SF-36 (only at the follow-up visit) questionnaires. RESULTS: 1,033 patients were enrolled. The follow-up visit is still under evaluation. In this series of papers the baseline results are presented and discussed in terms of (i) medical management, (ii) life-style, (iii) symptoms, bothersomeness and QoL, (iv) sexual function of a large and representative sample of Italian patients and (v) uroflowmetry.

Adult↗
PubMed2001

Life-style in patients with LUTS suggestive of BPH.

BACKGROUND: Owing to the existing controversy about the role of life-style in the pathogenesis of BPH, the possible associations of LUTS and prostate enlargement with alcohol intake, coffee consumption, smoking, physical activity, body mass index (BMI) and concomitant diseases were studied in the large series of patients of the QUIBUS study. RESULTS: Among concomitant diseases, essential hypertension was the most represented. However no apparent additive or synergistic influence on symptoms was recorded in this subset of the population. Coffee consumption was not associated with prostate volume or LUTS. Alcohol consumption was associated with urgency and intermittence and with an overall higher IPSS. No major influence on symptoms was found in smokers. Physical activity was associated with a lower frequency of incomplete bladder emptying, repeated urination, intermittence and urgency. The postulated existence of an association between BMI and BPH was not confirmed in this study. When a prediction of the IPSS scores was tempted by entering the life-style factors in a multiple regression model, they were able to explain at best 5% of the variance of the dependent variable. CONCLUSION: Life-style patterns bear a greater influence on individual symptoms than on total scores. This difference is sometimes high enough to recommend specific life-style measures to patients with LUTS and prostate enlargement.

Adult↗
PubMed1999

galectin-1 and galectin-3 expression in human bladder transitional-cell carcinomas.

Galectin-1 and galectin-3 are galactoside-binding proteins involved in different steps of tumor progression and potential targets for therapy. We have investigated the expression of these galectins in 38 human bladder transitional-cell carcinomas of different histological grade and clinical stage and in 5 normal urothelium samples. Galectin-1 mRNA levels were highly increased in most high-grade tumors compared with normal bladder or low-grade tumors. Western blot and immuno-histochemical analysis of normal and neoplastic tissues revealed a higher content of galectin-1 in tumors. Galectin-3 mRNA levels were also increased in most tumors compared with normal urothelium, but levels were comparable among tumors of different histological grade.

Adult↗
PubMed1999

Role of neoadjuvant treatment in clinically confined prostate cancer. Takeda NHT Italian Group.

OBJECTIVE: This prospective, randomized, multicenter comparative trial studied the effect of neoadjuvant hormonal treatment (NHT) prior to radical, prostatectomy. METHODS: Histopathologic tissue specimens were obtained from 91 consecutive patients (aged 60-70 years) who underwent a radical prostatectomy for stage B prostate adenocarcinoma. The patients had received NHT for three months. Specimens were compared with those from 48 age-matched control patients who underwent similar surgery for stage B disease without receiving preoperative therapy. RESULTS: Treated tumors with an acinar pattern were distinguishable from the untreated tumors by neoplastic acini that appeared shrunken and areas of individual infiltrating tumor cells separated by an abundant interglandular connective tissue. The epithelial tumor cells had inconspicuous nucleoli, nuclear shrinkage, chromatin condensation and pyknosis, cytoplasmic clearing, and enlargement by coalescence of vacuoles and rupture of cell membranes. No mitotic figures were seen in any treated tumors. CONCLUSIONS: Preliminary results show a benefit for patients receiving NHT in regard to the histologic indicators that we evaluated.

Adenocarcinoma↗
PubMed1999

Changes in tissue transglutaminase activity and expression during retinoic acid-induced growth arrest and apoptosis in primary cultures of human epithelial prostate cells.

We treated primary epithelial cells from human normal prostate (NEPC) and prostate cancer (CEPC) with all-trans-retinoic acid (RA) to study whether it regulates the activity of tissue transglutaminase (tTGase), an enzyme that accumulates in cells undergoing apoptosis. tTGase activity was assessed by [14C]spermidine incorporation; tTGase, P53, Bcl-2, and p21 protein levels were evaluated by Western blotting; and RA receptors (RAR alpha, -beta, and -gamma), tTGase, retinol-binding protein (RBP), and cellular RBP type I transcripts were determined by semiquantitative RT-PCR. After 72-96 h of 10(-6) mol/L RA treatment, cell growth inhibition and apoptosis were associated with increased tTGase activity in both NEPC and CEPC, and with increased tTGase protein and messenger ribonucleic acid levels only in NEPC. Moreover, RA down-regulated RAR alpha and -beta and increased RBP messenger ribonucleic acid levels in NEPC, whereas it increased RAR beta gene expression and decreased Bcl-2 protein levels in CEPC. Our results suggest that RA induces tTGase gene expression and enzyme activity in normal prostate cells, and that RA-regulated pathways are impaired in cancer cells. Moreover, down-regulation of Bcl-2 protein and up-regulation of RAR beta suggest that retinoid may act on the genetic defect responsible for prostate cancer progression.

Apoptosis↗
PubMed1998

Leuprorelin 1-month depot as neoadjuvant therapy for prostate cancer. Takeda NHT Italian Group.

In the last few years, the role of neoadjuvant hormonal treatment (NHT) prior to radical prostatectomy has been largely debated and investigated in randomized multicenter trials as well as in large single-institution studies. We have initiated a prospective randomized comparative trial with parallel groups in patients with clinically limited disease to contribute to the clarification of the possible role of NHT; to evaluate the efficacy of NHT with leuprolide plus cyproterone acetate in 'maintaining' the stage of the disease; to reduce the percentage of pathological overstaging, and mainly to accurately assess the pathological modifications induced by NHT. The present paper is an interim report of the results.

Adenocarcinoma↗
PubMed1997

Prostate-specific antigen (protein and mRNA) analysis in the differential diagnosis and staging of prostate cancer.

We analyzed complexed and free prostate-specific antigen (PSA), the free/total PSA and complexed/free PSA ratios, acid phosphatase, and prostatic phosphatase in serum from 36 patients with prostatic carcinoma and from 48 non-neoplastic control patients (20 with prostatitis and 28 with benign prostatic hyperplasia). Receiver-operating characteristic plots showed that serum PSA was the most efficient variable, singly used, in discriminating neoplastic from non-neoplastic patients. At a cut-off value of 10.0 ng/ml, serum PSA had a diagnostic sensitivity of 87% and a diagnostic specificity of 83%. In particular, three patients with prostatic carcinoma and twenty non-neoplastic controls had serum PSA levels of between 4 and 10 ng/ml. The subsequent analysis of the serum free/total PSA ratio, in this subgroup, using a cut-off level of 15%, allowed us to classify correctly all prostatic cancer cases and 18/20 non-neoplastic diseases. We next analyzed PSA mRNA in circulating cells using an improved reverse-transcriptase polymerase chain reaction dot blot procedure, from six patients with prostatic carcinoma with distant metastases, and in seventeen with localized cancer. The analysis had a high sensitivity (up to dilutions 1:10(6) of total RNA from prostatic cancer cells vs total RNA from normal blood cells). The analysis revealed circulating micrometastatic cells in 3/6 (50%) cases of metastatic cancer and in 4/17 cases of localized cancer. To conclude, serum total PSA combined with the free/total PSA ratio is a very efficient algorithm in discriminating neoplastic from non-neoplastic prostatic diseases, while other mRNA species must be analyzed, in addition to PSA mRNA, in circulating cells to increase the efficiency in detecting metastatic prostatic cancer.

Diagnosis, Differential↗
PubMed1997

Different expression patterns of somatostatin receptor subtypes in cultured epithelial cells from human normal prostate and prostate cancer.

The transcripts of five SRIH receptor subtypes (SSTR1, SSTR2, SSTR3, SSTR4, and SSTR5) were investigated by RT-PCR in epithelial cells (EC) and stromal cells (SC) from primary cultures of five normal human prostates and six prostate cancers. Primary cultures of prostate EC were established in serum-free keratynocyte medium with 5% FCS, epidermal growth factor, and bovine pituitary extract; SC were cultured in MEM with 10% FCS. Total RNA was extracted from EC and SC using a modified guanidine thiocyanate method. RT-PCR was performed after deoxyribonuclease treatment, using SSTR1-, SSTR2-, SSTR3-, SSTR4-, and SSTR5-specific-primers and adding glyceraldehyde-3-phosphate dehydrogenase-specific primers as internal control. A PCR product of the expected size of 334 bp, corresponding to SSTR1, was expressed only in EC from prostate cancer, whereas the expected 461-bp product of SSTR2 was found only in EC from normal prostate. SSTR3 messenger RNA was undetectable in normal and cancer EC, whereas SSTR4 and SSTR5 were present in both cell types. SSTR1, SSTR2, SSTR3, SSTR4, and SSTR5 messenger RNAs were not expressed in SC from both normal and cancer prostates. The RT-PCR method clearly demonstrated SSTRs' expression in the human prostate EC in vitro with differences between normal and tumoral samples. Our results may explain the ineffectiveness of some SSTR2 selective SRIH analogues in the treatment of prostate cancer and suggest that the absence of SSTR2 could represent a growth advantage in prostate cancer.

Aged↗
PubMed1996

The international terazosin trial: a multicentre study of the long-term efficacy and safety of terazosin in the treatment of benign prostatic hyperplasia. The ITT Group.

OBJECTIVE: To evaluate the long-term efficacy and safety of terazosin in the treatment of benign prostatic hyperplasia (BPH). METHODS: Thirty-three sites in 13 countries enrolled men with BPH who had an International Prostate Symptom Score (IPSS) > or = 12 [corrected]. After a 2-week, no-treatment lead-in period and a 26-week, single-blind treatment period, patients responding to terazosin were randomly assigned to receive either terazosin or placebo for a 24-week, double-blind withdrawal period. RESULTS: Of the initial 427 patients enrolled, 378 were evaluable, 273 of whom completed the single-blind period, of which 186 patients were randomized. During the single-blind treatment period, IPSS, quality-of-life score (QOL), peak flow rate (PFR), and nocturia score (NOC) improved significantly (p < or = 0.05). During the double-blind withdrawal period, IPSS, QOL, PFR, and NOC deteriorated significantly in the placebo group compared with the terazosin group. The most common adverse event resulting in premature termination from the study was dizziness. There were no clinically important mean reductions in diastolic blood pressure (DBP) for patients normotensive at baseline. Terazosin significantly reduced mean DBP in hypertensive patients during the single-blind period and maintained the reduction during the double-blind period. CONCLUSION: Treatment with terazosin has a beneficial effect on BPH, continuing for at least 12 months, and can be safely considered for medium- to long-term use in those who benefit.

Adrenergic alpha-Antagonists↗
PubMed1996

[Mepartricin 150.000 (40 mg) vs mepartricin 50.000 U (13 mg) in the treatment of BIP. Double blind clinical trial].

A group of 25 patients with uncomplicated BPH was treated mepartricin 150,000 U (40 mg) once in the evening for 60 days and the results were compared with those obtained in 25 patients treated with mepartricin 50,000 U (13 mg) t.d.s. Efficacy and tolerance of both treatment schemes were good. In the group treated with on single dose at night some symptoms such as nocturia and pollakiuria regressed more rapidly.

Aged↗
PubMed1996

[Mepartricin in BPH. A new dosage approach].

The authors assessed the validity of a treatment with mepartricin in BPH at the dose of 150,000 U in a once-a-day evening administration for 6 months. The results from the controlled study were compared with those obtained in a homogeneous group of patients treated with placebo. The analysis of the data obtained would suggest a preferential opinion in favour of the group treated with mepartricin which was effective in improving the symptomatology. Some hypothesis are put forward to interpret the results.

Aged↗
PubMed1996

[Double-blind evaluation of mepartricin 150.000 U (40 mg) compared with placebo in benign prostatic hypertrophy].

The therapeutic efficacy and tolerance of a new 150,000 U (40 mg) formulation of mepartricin (to be administered once-a-day in the evening) were evaluated during a double-blind study against placebo in 2 groups of uncomplicated BPH patients treated for 60 days. The data obtained disclosed a positive pharmaco-therapeutic effect of this new formulation coupled with excellent local and systemic tolerance. At the end of trial the various objective and subjective parameters considered showed marked improvement in the group treated with mepartricin, with statistically significant differences from the placebo-treated group. The treatment efficacy was judged positive in 74-78% of cases by patients and physicians in the mepartricin group and in 36.4% of cases in the placebo group.

Administration, Oral↗