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Biomedical subjects

H Navratil

Publications and source records attributed to H Navratil.

At least 55 records · Page 3Linked to original sources
PubMed1990

A multicenter, double-blind, placebo-controlled trial of the efficacy of prazosin in the treatment of dysuria associated with benign prostatic hypertrophy.

An 8-center, double-blind, placebo-controlled trial of 39 patients with benign prostatic hypertrophy was conducted to assess the effects of prazosin HCl treatment on functional urologic variables after a treatment period of 4 weeks. The randomized groups were comparable for demographic variables and symptoms, except for the mean residual urinary volume, which was significantly higher in the prazosin HCl group. Prazosin HCl elicited statistically significant improvements in the mean prostatic urethral pressure and prostate area (Mann-Whitney U test: p = 0.001 for both variables as compared with the placebo group). Functional bladder capacity also improved significantly in the group receiving the test drug (Mann-Whitney U test: p = 0.05, as compared with the placebo group). Clinical improvements were also observed in the mean maximum urinary flow, decreased nocturia frequency, and residual urinary volume. Patient preference significantly favored the prazosin HCl treatment (Mann-Whitney U test: p = 0.001). Seven patients on prazosin HCl and 5 receiving placebo reported one or more side effects during the trial phase; these were mild to moderate and disappeared or were tolerated. No statistically significant effects on blood pressure or heart rate were observed.

Double-Blind Method↗
PubMed1990

Preliminary clinical evaluation of leuprorelin acetate depot injection in France, in the management of prostatic cancer.

In a preliminary multicentre clinical trial of 3.75 mg leuprorelin acetate depot 18 previously untreated patients with metastatic prostatic cancer were treated with the depot given subcutaneously once every 4 weeks for 28 weeks. Patients also received 100 mg nilutamide taken orally three times a day for the first 14 days of treatment to prevent flare-up. Leuprorelin acetate suppressed the serum testosterone concentration to castration levels; luteinizing hormone levels were also suppressed. The incidence of progressive disease was low and partial response occurred in five patients after treatment. No side-effects were assigned to the flare-up period. It is concluded that leuprorelin acetate depot is a safe and efficacious treatment for metastatic prostatic cancer.

Aged↗
PubMed1990

[Penile extensibility and erectile function. Preliminary results].

Extensibility, one of the main biomechanical functions of the penis, has been studied in 422 subjects. Preliminary results showed that a) the flaccid penis was extensible; b) this extensibility was significantly correlated with both age and erectile function. Thus, the more penile extensibility decreased, the more erectile function became impaired. This loss of extensibility is caused by fibrosis of the penis, that mainly affects the corpus cavernosa and, by reducing distensibility, impairs the vascular events involved in erection. Evaluation of the extensibility of the flaccid penis is a new, simple, no-invasive and reproducible clinical test. It contributes to the etiologic diagnosis of impotence by detecting tissular anomalies of the erectile corpora.

Adolescent↗
PubMed1989

Prevention of the transient adverse effects of a gonadotropin-releasing hormone analogue (buserelin) in metastatic prostatic carcinoma by administration of an antiandrogen (nilutamide).

Gonadotropin-releasing hormone (GnRH) analogues administered for the treatment of advanced prostatic cancer induce a transient increase in plasma testosterone levels during the first week of treatment, often with a secondary rise in plasma levels of prostatic acid phosphatase and a flareup of disease. To determine whether the antiandrogen nilutamide (Anandron) blocks these effects, we carried out a multicenter, placebo-controlled study of nilutamide in men with prostatic cancer treated with the GnRH analogue buserelin. Thirty-six men with disseminated prostatic cancer and elevated plasma levels of prostatic acid phosphatase were randomly assigned to two groups. Group 1 included 17 men who received buserelin (500 micrograms daily subcutaneously) and nilutamide (300 mg daily by mouth); group 2 included 19 men treated with buserelin and placebo. Symptoms were assessed, and plasma was collected before treatment, daily for 14 days, and on days 18, 22, and 29 after the initiation of treatment. Bone pain appeared or worsened in 5 of the 17 men in group 1 and in 12 of the 19 men in group 2 (P less than 0.05). Acute urinary obstruction occurred in one man in group 2. Despite similar changes in the plasma testosterone levels in both groups, the median concentration of plasma prostatic acid phosphatase decreased almost immediately in group 1, but increased transiently, then decreased on day 14 in group 2. Median levels of prostate-specific antigen decreased immediately in group 1 and decreased on day 8 in group 2. We conclude that nilutamide can prevent the adverse consequences of the buserelin-induced transient rise in plasma testosterone levels in men with advanced prostate cancer treated with a GnRH analogue.

Acid Phosphatase↗
PubMed1989

[Acute epididymitis and antibiotherapy. Measurement of the epididymal diffusion of pefloxacin].

Acute epididymitis is a common infection in the young sexually active adult. Etiologically, the organisms most frequently found are Chlamydia trachomatis, Neisseria gonorrhea and gram negative bacilli. Pefloxacin is a novel quinolone whose antibacterial spectrum and bactericidal activity allow it to be considered for use in the treatment of orchitis and epididymitis Prior to clinical study the authors investigated the degree of epididymal diffusion of Pefloxacin. Ten subjects underwent extraction of an epididymal sample by direct access to the epididymis through a transverse scrotal incision under peridural anesthesia. Three days before surgery, Pefloxacin was administrated at the rate of 400 mg every 12 hours by the oral route. On the day of the operation, the subject receive a 400 mg infusion over one hour, 2 hours before epididymal biopsy. Blood specimens were also extracted. Pefloxacin assays were performed by HPLC following a method derived from that of Montay. The trough concentration of Pefloxacin inhibiting 90% of sensitive strains (MIC 90) is less than or equal to 2 micro-g/ml. The majority of sensitive organisms have minimum bactericidal concentrations equal to twice the MIC 90. The epididymal concentrations that the authors measured are situated at values of 8.15 to 21.80 miro-g/g tissue (mean 13.44). These data allow the use of Pefloxacin to be considered an option in the treatment of epididymitis.

Acute Disease↗
PubMed1987

[Trans-intestinal cutaneous ureterostomy].

On the basis of a personal series of 243 cases of transintestinal cutaneous ureterostomy, including 216 cases following total cystectomy, the authors initially review the technical factors determining success, stressing in particular the quality of the uretero-intestinal anastomoses and the careful formation of the parietal tract and the cutaneous stoma. They then analyse their results, defining successively the operative mortality attributable to the diversion (reduced by 2% once the technique has been mastered) the early non-fatal complications (14.8% of intestinal obstructions, only requiring re-operation in 4.5% of cases; 11% of urinary fistula, most of which resolved spontaneously; 8% of faecal fistulae, requiring re-operation in 2/3 of cases; 3.7% of ischaemic necroses of the cutaneous stoma) and finally the late complications affecting the uretero-intestinal anastomoses (17% of stenoses, mostly unilateral), the intestinal graft (0.8% of calculi on non-absorbable sutures: 5.3% of stenoses of the cutaneous stoma; 6% of mucosal prolapses) and the equipment, which has made enormous progress in recent years. Renal function is only preserved when renal failure was not present pre-operatively. The authors conclude on the unquestionable value of transintestinal cutaneous ureterostomy as a high urinary diversion procedure, while recognising that it does not constitute either the ideal solution nor the exclusive solution, particularly after total cystectomy.

Colon, Sigmoid↗
PubMed1986

[Cancer of the prostate. Results and causes of failure after exclusive radiotherapy in 131 cases treated at in locoregional stage between 1972 and 1981].

A retrospective study was carried out to evaluate results of exclusively physical treatment by external radiotherapy of 131 cases of cancer of prostate treated between 1972 and 1981. Median follow up has been for 8 years in 19 cases (stage A), 61 cases (stage B) and 51 cases (stage C). Patients were treated exclusively by external irradiation after histopathologic diagnosis and assessment of possible extension of tumor. High energy photons were developed by a linear accelerator and irradiation carried out through four portals, two anteroposterior, two lateral, with precise guidance by rectal and bladder opacification. Irradiation delivered to a pelvic volume over 5 weeks was subsequently reduced to the prostate bed until a total dose of about 65 to 70 Gy has been given. Primary glandular chains received 60 to 65 Gy, and critical organs, bladder, rectum, small intestine a smaller dose of less than the tolerance levels for these organs. Clinical, biologic and scintiscan examinations were repeated every three months. Results are presented as actuarial survival, as survival without local recurrence and a detailed analysis of failure of treatment. The 8-year survival rate was 60% for stage A, 47% for stage B and 33% for stage C. Unsuccessful cases were evaluated in terms of isolated metastases, metastases associated with local recurrence and isolated local recurrence. The highest incidence of ineffectiveness of therapy was noted in patients with distant metastases (26%), the rate being higher (41%) in stage C cases than in stage B cases (19%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1986

[Malignant pheochromocytoma. Apropos of a case report].

Pheochromocytoma was diagnosed in a male of 38 on the basis of severe and progressive hypertension associated with marked increases in urinary catecholamines and vanilmandelic acid. Left extra-adrenal topography was examined by tomography and confirmed by surgical treatment involving exeresis of the primary tumor and the metastatic latero-aortic lymph nodes, thus corroborating the diagnosis of malignancy. Complementary post-operative radiotherapy was performed on the abdomen. Eighty months later the patient is making good progress.

Adult↗
PubMed1985

[Clinical approach to male infertility].

The clinical approach to male infertility involves uncertainties, and various circumstances must be considered: 1. If no pregnancy occurs in the case of a couple whose sexual relations are "normal" and regular, and who have used no form of contraceptive for one year, the evaluation must systematically include both the woman and the man. 2. In the case of a man wishes to know his capacity for procreating, what are the possibilities for improvement? 3. Are there ways of predicting male infertility? If there are, the socioprofessional and iatrogenic risks should be more fully investigated. 4. What are the current possibilities for male contraception? In practical terms, the case of the infertile couple offers the widest field for clinical and paraclinical investigations. An exploratory strategy must guide this evaluation, assuring efficacy and taking account of current therapeutic possibilities, which are still unfortunately limited. The change in attitudes is clearly expressed by the number of couples who resort to adoption or artificial insemination rather than continue examinations and treatments when there is little chance of achieving pregnancy.

Cervix Mucus↗
PubMed1985

[Re-establishment of urinary continuity by uretero-ureterostomy in renal transplantation. Apropos of 135 cases].

Uretero-ureteral anastomosis was performed in 135 patients (40 women and 95 men) during kidney transplantation using either cadaver (120 cases) or living donor (15 cases) organs. The ureter of the retained kidney was linked proximal to the transplantation, whether or not there had been previous contemporary nephrectomy. Results were highly interesting: no mortality, no need to remove graft for urinary complications and no ureteral anastomotic stenosis. Urological complications were absent in 108 cases (80%) while 17 cases (12.6%) developed a urinary fistula, only 5 of which required surgical intervention Hematoma related to the nephrostomy occurred in 6 cases (4.4%) but operation was necessary in only 2 of these cases. Overall need for repeat surgery involved only 7 patients (5.2%) during the month following transplantation. One of 2 cases of hematoma operated upon required partial excision of the transplantation kidney due to the presence of an intraparenchymatous arteriovenous fistula. A curious finding was that of the 17 cases developing fistulae most of them had received live donor kidneys (5/15) whereas only 12 occurred in the 120 cadaver kidney transplants. Prevention of fistulae appears to be assisted by spatulation of the ureter rather than by its bevelled section, and the maintenance of a long ureteral loop to avoid traction. It is suggested that certain postoperative urine losses may be the result of a hyper-diuresis, without actual dehiscence of the anastomosis. In 4 patients with a urine output of more than 1.5 litres at the time of transplantation, the kidney proximal to the ureteral ligature became infected, and a second nephrectomy was necessary in 4 cases.

Adolescent↗