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Biomedical subjects

E Schick

Publications and source records attributed to E Schick.

At least 19 recordsLinked to original sources
PubMed1996

A multicenter, randomized, double-blind, placebo-controlled study to evaluate the safety and efficacy of terazosin in the treatment of benign prostatic hyperplasia.

OBJECTIVES: This study was designed to evaluate the safety and efficacy of the selective alpha 1-adrenoceptor blocker terazosin in the treatment of benign prostatic hyperplasia (BPH). METHODS: Two hundred twenty-four patients aged 50 to 80 years, who had a diagnosis of BPH based on medical history, physical examination, and digital palpation, were recruited from 11 different sites between January 1992 and January 1994. The study consisted of a screening phase, a placebo phase, a double-blind dose-titration phase, and a double-blind maintenance phase. RESULTS: Of the patients recruited, 164 entered the double-blind phase and of these 134 were evaluable. Only 11 patients withdrew because of an adverse event, 7 in the terazosin and 4 in the placebo group. Compared to placebo, terazosin significantly increased peak and mean urine flow rates without significantly affecting voided volume or postvoid residual volume. It significantly improved both the obstructive and irritative symptoms associated with BPH. Fifty-one patients from the terazosin group reported a total of 120 adverse events compared with 83 reported by 42 patients in the placebo group. The majority of these events were mild to moderate. Seventeen terazosin-treated patients reported hypotension-related adverse events and 4 withdrew from the study. However, concurrent treatment with antihypertensive agents did not affect the blood pressure response of the terazosin group. CONCLUSIONS: Overall, this study showed terazosin to be safe and effective in relieving the signs and symptoms of BPH and should be considered as a treatment alternative.

Adrenergic alpha-Antagonists↗
PubMed1995

[Dermatomyositis-like skin changes with long-term hydroxyurea (Litalir) therapy].

We report on dermatomyositis-like adverse cutaneous reactions following long-term maintenance therapy with hydroxyurea in two patients suffering from chronic myelogenous leukaemia (CML). In addition to non-specific side effects, such as xerosis, pruritus and hyperpigmentation, both patients presented with more specific skin changes, i.e. erythematous lesions, scaling, and partially atrophic areas distributed in a linear fashion on the dorsal aspects of the hands and fingers. In addition, teleangiectatic erythema of the face was present in both patients, and this was associated with oedema of the eyelids in one patient. Despite these dermatomyositis-like features there were no clinical signs of muscular involvement, and muscle-specific enzymes were within normal ranges. Skin biopsy specimens revealed an interface dermatitis characterized by a lichenoid cell infiltrate, vacuolar alteration of basal cells, necrotic keratinocytes within the spinous zone, focal hypergranulosis, ortho-hyperkeratosis and telangiectases in the upper part of the dermis. Analogous histopathological findings have been documented in lichen planus-like skin changes on the hands following hydroxyurea therapy. It seems doubtful whether there are actually any major differences between those skin changes described as dermatomyositis-like and those interpreted as lichen planus-like in patients receiving long-term hydroxyurea therapy.

Aged↗
PubMed1995

Influence of activation and differentiation of cells on the effectiveness of photodynamic therapy.

Photodynamic therapy combines photosensitizers absorbing light in the red spectral region and irradiation with light of the corresponding wavelength. To analyse the influence of cell differentiation on susceptibility to photodynamic therapy, we compared the proliferation inhibition induced by photodynamic therapy on normal human keratinocytes, spontaneously transformed human keratinocyte cell line HaCat and on squamous cell carcinoma lines. Cells were irradiated with polychromatic methylene blue as well as the precursor of protoporphyrin, 5-aminolevulinic acid. When incubated with Photosan-3, normal human keratinocytes exhibited and ED50 about 10-fold lower than the other cell lines studied. When methylene blue and 5-aminolevulinic acid were used, photodynamic therapy had comparable effects on all cell types. Stimulation of normal human keratinocytes with either EGF-alpha or IFN-gamma resulted in an increase susceptibility to photodynamic therapy when 5-aminolevulinic acid was used. This effect was more pronounced in the case of EGF-alpha. Our experiments suggest that activation and differentiation are two important parameters determining susceptibility to photodynamic therapy.

Aminolevulinic Acid↗
PubMed1995

[The importance and significance of post-micturitional bladder residue in the evaluation of prostatism].

The presence of a significant post-voiding residue is often considered to be secondary to bladder neck obstruction and frequently constitutes the main indication for transurethral resection of the prostate. In order to validate this approach, the files of 350 patients presenting with symptoms of prostatism and assessed by urodynamic studies were analysed retrospectively. The results of the study demonstrated that, regardless of the value of the residue, approximately 30% of patients were not obstructed despite a high post-voiding residue (PVR), while approximately 70% of patients with minimal or no PVR were considered to be obstructed on the basis of urodynamic criteria. These results therefore demonstrate that the presence of a post-voiding residue is not indicative of bladder neck, but reflects a lesion of the detrusor. Considered alone, it therefore should not constitute an indication for transurethral resection of the prostate.

Humans↗
PubMed1993

Frequency-volume chart pattern in a healthy female population.

Very few data are available on what should be considered a normal frequency-volume chart. To establish baseline figures we studied the voiding diaries of 33 normal women. A computer program was developed using 12 parameters. A normal pattern was established for young and middle-aged women. These data may be used as a reference when analysing the charts of patients with voiding dysfunction.

Adult↗
PubMed1992

Agreement between clinical methods of measurement of urinary frequency and functional bladder capacity.

We assessed the agreement between 2 methods of data gathering of particular interest in urology: patient questionnaire and examination vs. frequency-volume charts. One hundred consecutive patients consulting our out-patient clinic were chosen for this study; 88 completed the study. Urinary frequency and bladder capacity were evaluated in each patient by using the above methods. The agreement between different methods of measurement was assessed by determining whether the 2 methods were interchangeable, a condition occurring if results of both methods fall within predetermined limits of variability. The results showed poor agreement between subjectively estimated urinary frequency and chart-determined urinary frequency. Moreover, different methods of measuring bladder capacity (endoscopic vs. chart) gave different results. Since chart-determined data are probably a more valid indication of urinary habits, we suggest that frequency-volume charts should be used more often in the investigation and follow-up of patients with micturition disorders.

Circadian Rhythm↗
PubMed1990

Does urethral instrumentation affect uroflowmetry measurements?

Uroflowmetry was performed before and after urethral catheterisation in 129 patients. Uroflowmetry measurements were significantly modified by urethral instrumentation. In males, both maximum and mean flow rates decreased following urethral catheterisation, while in females only the maximum flow rate decreased, the mean flow rate remaining unchanged. Voided volume increased (and consequently residual urine decreased) in females after catheterisation, but did not change significantly in males. False positive results were encountered in 32% of patients and false negative results in 11% when flowmetry was done immediately after catheterisation. Uroflowmetry after urethral instrumentation is not recommended.

Adolescent↗
PubMed1988

Pericardial pseudotumor. Echocardiographic observation of juxtacardiac pulmonary collapse.

Despite its value in the diagnosis of pericardial disease, two-dimensional echocardiography also is known to produce confounding results. Ten patients had juxtacardiac masses simulating pericardial tumor implants on echocardiographic examination ("pericardial pseudotumor") caused by juxtacardiac pulmonary atelectasis or lobar collapse. The atelectatic nature of these masses was based on echocardiographic delineation of pericardial and pleural anatomy, combined with ancillary radiographic and CT studies. Drainage of pleural fluid also led to disappearance of the masses on echocardiographic examination, suggesting that the masses were an ultrasonic manifestation of pulmonary atelectasis resulting from surrounding compressive effusive fluid. Finally, clinical follow-up failed to show development of malignant disease in any patient. The possibility of pericardial pseudotumor should be considered when ultrasound studies show juxtacardiac masses within large collections of pleural fluid, especially in the clinical absence of malignant disease.

Adult↗
PubMed1987

Relevance of constipation to enuresis, urinary tract infection and reflux. A review.

Little attention has been afforded the relevance of constipation to urinary symptoms. Problems of definition and measurement have contributed to this problem. A review of the literature suggests that rectal dilatation may influence the function of the urinary tract leading to urinary tract infection and enuresis. Our studies indicate that constipation may, by causing uninhibited bladder contractions, cause urinary tract infection, enuresis and vesicoureteral reflux.

Child↗
PubMed1986

Constipation a commonly unrecognized cause of enuresis.

Constipation was confirmed by history, rectal examination, and rectal manometric studies in 22 of 25 children with enuresis. Treatment of constipation resulted in resolution of enuresis. Uninhibited bladder contractions, observed in enuretic constipated children, were also noted in children with constipation alone, suggesting that constipation is a commonly unrecognized etiologic factor in enuresis.

Child↗
PubMed1986

Constipation associated with vesicoureteral reflux.

Seventeen children who had vesicoureteral reflux underwent urodynamic and rectal manometric studies. All had uninhibited bladder contractions. All had rectal dilatation confirming the presence of constipation by rectal balloon manometry. The recurrent association of constipation with ureteral reflux suggests the possibility of a nonfortuitous association.

Child↗
PubMed1985

Objective assessment of resistance of female urethra to stress. A scale to establish degree of urethral incompetence.

During urethral pressure profile (UPP) studies under gradually increasing stress, the maximum urethral closure pressure decreases. This observation led to a simple urodynamic test which allows the estimation of the maximum stress (intensity of cough) tolerated by the urethra before leakage begins. The determination of this critical pressure forms the basis of the urethral incompetence scale. The urethra of a female patient can be characterized by the amplitude of this maximum stress (in cm H2O) the urethra can handle and still remain continent. The cough intensity scale has been divided into 5 segments, defining 5 degrees of urethral incompetence. The critical pressure, which determines the degree of urethral incompetence is a constant value for a given patient, provided the bladder volume is kept constant and the position of the patient during the examination is unchanged. This method establishes the functional status of the female urethra as far as its sphincteric capabilities are concerned under different stress conditions. It represents the degree of pressure transmission from the abdominal cavity to the proximal urethra during stress. It evaluates objectively the functional results of different surgical or medical therapeutic modalities to cure genuine stress incontinence. It allows a better selection of patients with unstable bladder and genuine stress incontinence who will more likely benefit from a retropubic cystourethropexy.

Female↗
PubMed1985

Effects of oxybutynin on vesicoureteral reflux in children.

We reviewed retrospectively 40 children seen from 1980 to 1984 with vesicoureteral reflux in 53 ureters. All patients had a hyperreflexic bladder on urodynamic evaluation with or without vesicoperineal dyssynergia but they were otherwise neurologically normal. All except 1 child received prophylactic antibiotics. Of the children 37 received oxybutynin therapy for bladder hyperreflexia for 3 to 18 months. Reflux disappeared or became grade I in 62.3 per cent of the ureters. Of the children manifesting urinary incontinence at the time of urodynamic study reflux disappeared or became grade I in 78.6 per cent. Reflux resolved or became grade I in 20 per cent of the children with no urinary incontinence. Of those patients with recurrent reflux at the onset of urinary incontinence and bladder instability reflux resolved or became grade I in 80 per cent. Oxybutynin therapy for hyperreflexic bladder resulted in an average increase in bladder capacity of 97 cc (54.2 per cent), which was maintained after cessation of treatment. These data suggest that bladder instability can be an important factor in causing and perpetuating reflux. Therapy aimed at decreasing intravesical pressure will enhance resolution or downgrading of reflux.

Child↗
PubMed1985

Constipation, bladder instability, urinary tract infection syndrome.

Forty-seven children with recurrent urinary tract infection were noted to have large fecal reservoirs by rectal examination and rectal manometry. Constipation was accompanied in the majority by enuresis and/or encopresis. Urodynamic studies indicated uninhibited bladder contractions. Aggressive treatment of the constipation resulted in cessation of infection in 44 patients, enuresis in 22 of 32 patients and encopresis in 20 of 21 patients and an improvement in bladder function with cessation of all other forms of treatment.

Child↗