Pharmacokinetics of quinolone derivatives in the prostate.
The pharmacokinetics of six quinolone derivatives were investigated in the human and dog prostate. The possible therapeutic applications of these findings are discussed.
Animals↗
Biomedical subjects
J Aagaard
Publications and source records attributed to J Aagaard.
MICs of ciprofloxacin and trimethoprim for Escherichia coli: influence of pH, inoculum size and various body fluids.
The influence of pH, inoculum size, human urine and prostatic extract on the MICs of ciprofloxacin and trimethoprim for Escherichia coli was investigated. There was no influence by the bacterial inoculum size within wide ranges on either drug. An increase in pH had a variable influence on the MICs of trimethoprim for E. coli but lowered those of ciprofloxacin considerably. Human prostatic extract increased the trimethoprim MIC for E. coli but lowered those of ciprofloxacin as compared to Mueller Hinton broth. Human urine increased the MICs of both drugs for E. coli.
Animals↗
Bacterial prostatitis: new methods of treatment.
Four different clinical categories of prostatitis are recognized at present: acute bacterial prostatitis, chronic bacterial prostatitis, nonbacterial prostatitis, and prostatodynia. Treatment results of chronic bacterial prostatitis have, in the past, been rather poor. In addition to local factors (e.g., prostatic calculi), the poor results may well be due, in part, to lack of penetration of the various drugs used into the prostatic tissue and fluid, mostly because of unfavorable lipid solubility, degree of ionization, protein binding, and unfavorable pH gradients from the plasma to prostatic fluid. All of these factors determine the diffusion of a drug into prostatic tissue and fluid. The minimum inhibitory concentrations (MIC) of the various drugs used and the concentration of the drugs actually obtained in the prostate, combined with the influence of pH, inoculum size, and effect of prostatic fluid and prostatic extract on MIC, are important factors in determining at least the theoretical efficacy of various drugs in the treatment of chronic bacterial prostatitis. The new fluoroquinolones have excellent penetration into both animal and human prostates and very low MIC for the infecting organisms and should, from a theoretical standpoint, be ideal in the treatment of chronic bacterial prostatitis. Few clinical studies have been done, and only prospective, randomized clinical trials will determine the relative efficacy of the various quinolones in the treatment of chronic bacterial prostatitis.
Acid-Base Equilibrium↗
Prostatic tissue levels of ofloxacin.
The prostatic tissue levels of ofloxacin were determined in 20 patients undergoing transurethral resection of the prostate. Ofloxacin was administered in two separate dosages of 300 mg PO from twenty-two to two hours preoperatively. The ofloxacin plasma concentrations ranged from 3.73 to 1.85 micrograms/mL at the time of surgery, and the tissue concentrations ranged from 4.55 to 1.94 micrograms/mL. The ofloxacin tissue/plasma ratios ranged from 0.9 to 1.2. These findings indicate that ofloxacin may be useful in prophylaxis prior to transurethral prostatic surgery and also in the treatment of bacterial prostatitis.
Administration, Oral↗
Five-year mortality in lithium-treated manic-depressive patients.
A hundred and thirty-three affective disorder patients who received prophylactic treatment with lithium were followed prospectively for 5 years and their mortality was recorded. Twenty-two patients died during the period, 13 from natural causes and nine from definite or probable suicide. The observed mortality was significantly greater than the expected overall, and also when natural causes and suicide were considered independently. No patients died from lithium intoxication or lithium-induced side effects. Patients who died from suicide were all bipolars or suffered from affective disorder with uncertain polarity. They were significantly younger than the patients who died from natural causes, they tended to lead isolated lives and they suffered a violent death. The older patients who died from natural causes had often had physical illness and alcohol abuse prior to the start of lithium treatment. The results of the study speak in favour of the establishment of comprehensive treatment programmes possibly in the framework of specialised affective disorder clinics.
Adolescent↗
An experimental study of hot air thermocoagulation in cardiac surgery.
Recently a thermocoagulator using hot air has been developed. It has been used for haemostatic purposes in a number of cases of liver, pulmonary and retroperitoneal cancer surgery. An experimental animal study was undertaken to evaluate the use of the thermocoagulator during cardiac surgery. Since the thermocoagulator produces coagulation necrosis, the epi-/myocardium including the epicardial coronary arteries was investigated microscopically for acute and chronic histopathological changes. The investigation demonstrated that the thermocoagulator is an effective hemostatic tool during cardiac surgery. The histological examination of the hearts has shown that the technique does not damage the myocardium or the coronary arteries neither at the time of application nor in the long term.
Animals↗
Experimental model for the study of bladder mast cell degranulation and smooth muscle contraction.
Explore the source record for details and available documents.
Animals↗
Treatment of iatrogenic oesophageal perforation diagnosed with delay.
The number of iatrogenic perforations of the oesophagus has increased during the last decade and the condition still carries a high morbidity and mortality. The mortality increases considerably if treatment is delayed for more than 24 hours. In our department all patients with iatrogenic perforation of the thoracic oesophagus are treated in the same way: antibiotics and gastric decompression followed by thoracotomy with cleavage of the mediastinum and closure of the defect if it can be visualized and if the oesophageal wall is vital. During the last decade we have treated 15 patients in whom treatment was delayed for more than 24 hours. Two of the patients (13%) died during the postoperative course. We find that our strategy is associated with a low mortality.
Adult↗
[Reoperation because of mechanical heart valve prosthesis dysfunction].
Thromboembolism, haemolysis, prosthetic endocarditis and paravalvular leakage are the commonest complications of introduction of mechanical heart valve prosthesis. Malfunction of the cusps inside the sewing ring is a rare but serious condition, which is due to partial or total prevention of the free movements of the cusps or valves resulting in symptoms of valvular stenosis or incompetence. Twenty-six valvular prosthesis (2.3%) were replaced on account of malfunction. Fifteen out of the 26 patients were submitted to emergency operation and 11 to elective intervention. Four out of the 26 patients died preoperatively or during the postoperative course, corresponding to a lethality of 15%. The operative lethality was associated with emergency operations exclusively. The authors conclude that patients with previously well functioning valvular prosthesis who develop symptoms of cardiac failure should be referred to the cardiological centre where the operation was carried out as rapidly as possible instead of institution of traditional medical treatment.
Adult↗
Predictors of outcome in prophylactic lithium treatment: a 2-year prospective study.
The purpose of this study of 133 affective disorder patients consecutively referred to start prophylactic lithium treatment was to identify informative predictors of outcome. Non-adherence to treatment was mainly predicted by substance abuse and many earlier admissions. Non-response among the 78 patients adhering to lithium treatment was mainly predicted by female sex, young age and previously chronic course. The overall response rate was rather poor and an excess mortality rate was found. It is suggested that patients with substance abuse should not be offered prophylactic lithium treatment unless intensive control and support is practicable, and patients with a chronic course need a more effective treatment than lithium can offer.
Adult↗
Transurethral resection versus transurethral incision of the prostate. A prospective randomized study.
In this ongoing study, patients with an estimated prostate size of no more than 20 gm are randomized to undergo either transurethral resection of the prostate (TURP) or transurethral incision (TUIP) at the 6 o'clock position. To date, 93 patients have been included, and 3 months postoperatively, 80 to 90 per cent of the patients in each group reported improvement. There was also a significant decrease in symptom scores and a significant increase in maximum urinary flow rate, with great variation within each group but without difference between the groups. In both groups, there appears to be some deterioration over time. Operating time, estimated blood loss, time to catheter removal postoperatively, and duration of postoperative hospital stay were all significantly in favor of TUIP. Loss of ejaculation was reported by 37 per cent of patients after TURP and by 13 per cent after TUIP (not statistically significant). There was no difference between the groups in the need for further surgery. Therefore, TUIP is recommended as an alternative to TURP in patients with small prostates.
Adult↗
Reasons for delay of endocrine treatment in cancer of the prostate (until symptomatic metastases occur).
The VACURG studies showed that 1) In early (stage I and II) cancer of the prostate, radical prostatectomy dose not increase survival compared with initial placebo treatment, it is therefore a definite option (and possibly advisable) to initially just observe the patients with early cancer of the prostate (the "watch and see" or "watchful waiting" policy), 2) 1.0 mg as well as 5.0 mg DES daily retards progression from stage III to stage IV but does not improve survival in stage III, 3) 5.0 mg DES daily is associated with increased risk of cardiovascular death, and 4) in stage IV patients, early endocrine treatment (e.g. 1 mg DES) is advisable, especially in younger patients with high-grade tumors.
Combined Modality Therapy↗
[Fathers of first infants--preparatory courses about delivery, experience of delivery and paternity leave].
In the Central Hospital in Randers, 233 fathers of first infants replied to a questionnaire which illustrated their attitudes to the preparatory courses about delivery, experience of delivery and attitudes to paternity leave. 65% of the fathers participated in the course and 74% stated that they considered that this had been profitable. Where 77% of the men were concerned, these considered that participation in delivery had been a positive experience. 73% of the men had planned paternity leave around the time of delivery, which emphasizes the need for this arrangement.
Delivery, Obstetric↗
[Twin pregnancy with intrauterine fetal death of one twin after the 1st trimester].
Explore the source record for details and available documents.
Female↗
Adherence to lithium prophylaxis: I. Clinical predictors and patient's reasons for nonadherence.
Of a group of 133 patients given long-term prophylactic lithium treatment, approximately 25 percent discontinued the treatment prematurely within the first six months. Young male patients dominated in the nonadherent group. Clinically the nonadherent patients were characterized by having had an early onset of the illness, a large number of previous hospital admissions and a recent allocation to the diagnostic category of affective disorder. Furthermore, the presence of personality disorders and substance abuses characterized the nonadherent patients. Diagnostic grouping according to polarity did not allow for any distinction between the adherent and nonadherent patients. One half of the nonadherent patients mentioned the development of somatic side effects as their main reason for discontinuing the treatment. Psychological discomfort, such as development of concentration difficulties or impaired memory, was not stated as a reasons for discontinuation. One fourth of the nonadherent patients had their diagnoses, and consequently their treatment, changed by the physician in charge and one fourth neglected instructions and disregarded appointments.
Adult↗
Adherence to lithium prophylaxis: II. Multivariate analysis of clinical, social, and psychosocial predictors of nonadherence.
The purpose of this prospective study of 133 affective disorder patients, consecutively referred to start long-term lithium therapy, was to identify predictors of importance for nonadherence. The nonadherent group was defined as the 31 (23.3%) patients who stopped treatment within the first six months. In the multivariate logistic analysis the most informative clinical, social, and psychosocial predictors were, in rank order: many admissions to mental hospitals, death or divorce of parent in childhood, heavy smoking, short duration of the mental disorder diagnosed as affective, not married, never economically active, and early onset of the affective disorder. The logical consequence of the results is to offer the subgroup of patients with an individually calculated high probability of nonadherence intensive control and support during the first month of lithium treatment.
Adult↗
Total hepatofugal portal blood flow in cirrhosis demonstrated by transhepatic portography.
We investigated 108 patients with cirrhosis of the liver and portal hypertension by percutaneous transhepatic portography to demonstrate the occurrence and frequency of total hepatofugal portal blood flow. Sixteen patients (14.8%) had a total hepatofugal portal blood flow. The aetiology of portal hypertension and the portal pressure did not differ from that in the group of patients with hepatopetal portal blood flow. A significantly higher percentage of patients in the group with hepatofugal flow had gastro-oesophageal varices (P less than 0.025). All patients with varices had bled. Half of the patients in the group with hepatofugal blood flow had a false splenoportographic diagnosis of portal vein thrombosis. In conclusion, total hepatofugal postal blood flow exists more often than hitherto assumed. Hepatofugal blood flow does not relieve portal hypertension nor prevent development of gastrooesophageal varices or bleeding.
Adult↗
Clinical predictors of course and outcome in delusional psychosis.
The purpose of the study was to examine whether clinical variables of first-admitted patients with delusional psychosis were of predictive importance of course and outcome illuminated through the dimensions: psychotic symptoms, impairment, remission, and relapse at 2-year follow-up. Male, sex, age below 30 years, unmarried, long duration of psychosis, and absence of psychosocial stress prior to first admission were all statistically predictive of poor outcome. Concerning nonspecific psychological distress high mean values on the subscales of helplessness-hopelessness, dread and antisocial history were correlated to poor outcome as was low mean value of active expression of hostility. Concerning psychopathology assessed by PSE individual items as lost emotions, thought insertion, thought broadcast, primary delusions and certain auditory hallucinations (voices discussing/commenting subject in third person) predicted poor outcome. Further classes of PSE symptoms as perceptual disorder, thought disorder, and delusions of influence predicted poor outcome too. Other prognostic unfavourable variables were systematisation of delusions, severe preoccupation with present delusions and no suspicion of attempt at concealment of delusions and hallucinations.
Adolescent↗