Biomedical subjects
P Hanno
Publications and source records attributed to P Hanno.
Re: Quality of life of incontinent men after radical prostatectomy.
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A quantitatively controlled method to study prospectively interstitial cystitis and demonstrate the efficacy of pentosanpolysulfate.
A randomized, prospective, double-blind, placebo-controlled study was conducted at 7 clinical centers on 148 patients. Patients received orally either 100 mg. pentosanpolysulfate (a synthetic polysaccharide) 3 times per day or a placebo. Of the patients on drug therapy 32% showed significant improvement compared to 16% of those on placebo (p = 0.01). This study provides a model to assess this disease quantitatively in a prospective manner using a method whereby the patients globally assess their symptoms as either worse or improved by 0, 25, 50, 75 or 100%. Patients on drug therapy also experienced a significant decrease in pain and urgency (p = 0.04 and 0.01) on analogue scales when compared to placebo and also more drug patients showed an average increase of more than 20 ml. in voided volume than did placebo patients (p = 0.02). All adverse effects were minor, with 7 in the drug group and 10 in the placebo group. The results support the concept that some patients with the interstitial cystitis syndrome may have abnormal bladder surface glycosaminoglycans.
Metallic staples refluxing to the upper urinary tract: a source of renal calculi in patients with ileal conduit urinary diversion.
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Immunohistochemical analysis of the urinary bladder: a comparative study of the cellular immune response of patients diagnosed as having interstitial cystitis, noninterstitial cystitis voiding dysfunctions, and normal controls.
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Pentosan polysulfate sodium for therapy of interstitial cystitis. A double-blind placebo-controlled clinical study.
Pentosan polysulfate sodium (PPS) was compared with placebo for the symptomatic therapy of interstitial cystitis in a double-blind, multicenter study. A total of 110 patients were enrolled and treated for three months. In this study, overall improvement of greater than 25 percent was reported by 28 percent of the PPS-treated patients and by 13 percent of the placebo-treated patients (p = 0.03). The investigators' overall evaluation provided similar results, 26 percent vs 11 percent in favor of PPS (p = 0.04). Improvement in pain and pressure to urinate also favored PPS over placebo and approached statistical significance (p = 0.07 and 0.08). The incidence of adverse reactions was 6 percent in the PPS-treated group and 13 percent in the placebo-treated group. All adverse reactions were minor, and treatment was discontinued by 1 patient in the PPS group and 2 in the placebo group. In this study, PPS was found to be significantly more effective than, and equally as safe as, placebo.
Diagnosis of interstitial cystitis.
We reviewed clinical and histological findings in 55 patients with interstitial cystitis and 21 with voiding dysfunction secondary to other pathological conditions. Of our interstitial cystitis patients 36% would fail to meet the research definition proposed at a recent National Institutes of Health workshop. Detrusor mastocytosis was present in 64% of our interstitial cystitis patients compared to 80% of the noninterstitial cystitis group. There was no statistically significant difference in mean detrusor mast cell counts between interstitial cystitis and noninterstitial cystitis patients. Biopsies of 12 patients who did meet the proposed National Institutes of Health research definition were evaluated by immunohistochemical techniques. Early results are inconclusive. These studies indicate that interstitial cystitis is a complex disease whose diagnosis presently still must be made from a symptom complex rather than from objective histological criteria, including mastocytosis or the presence of any specific immunoreactive cell.
Testicular plasmacytoma.
The case of a sixty-five-year-old man with multiple myeloma and a testicular plasmacytoma is described. This represents the thirty fourth reported case of testicular plasmacytoma and the first in which immunoperoxidase histochemistry has been used to demonstrate that the testicular plasma cells contain immunoglobulin of the same isotype as the patient's paraprotein. The clinical and morphologic features of previously reported testicular plasmacytoma are reviewed.
Therapeutic principles of antimicrobial therapy and new antimicrobial agents.
It is important that newly developed antibiotics be used so as to increase our ability to eradicate infection, rather than to complicate the treatment of infection by spawning the creation of organisms resistant to multiple antibiotics. One must peruse the literature with a very critical eye, as most new agents are touted as tremendous advances on past antibiotics. With rising medical costs becoming of ever-greater significance, proper choice of antimicrobial agent assumes more importance as well. The proper bacterial coverage in a given clinical setting, duration of treatment, and drug pharmacokinetics and the concept of the "total cost" of administering an antibiotic (taking into account fixed and variable hospital costs) all must be considered. Although it is virtually impossible to become experienced in using all of the currently available antibiotics, it is not necessary, either. Based on the literature and discussion with infectious disease colleagues, one can choose to use one or two antimicrobials in each broad class and gain the benefits of that class for his or her patients.
Use of nitrofurantoin macrocrystals after transurethral prostatectomy.
A prospective randomized study of 223 consecutive patients with sterile urine undergoing transurethral prostatectomy was undertaken to examine the effects of nitrofurantoin macrocrystals on postoperative urine cultures. Patients were divided into 3 groups; group 1 received no postoperative antibiotics, group 2 received nitrofurantion for 5 days postoperatively and group 3 received nitrofurantoin for 10 days postoperatively. Nitrofurantoin decreases the incidence of short-term (24 hours after catheter removal) postoperative bacteriuria, while having no effect on long-term (4 weeks) bacteriuria following transurethral prostatectomy. The use of postoperative nitrofurantoin is supported by its tendency to reduce the incidence of short-term urinary infection in patients with the same organisms found in cultures of the prostatic tissue. However, there was no long-term advantage in prolonging therapy for greater than 5 days. There was no difference in morbidity in the immediate postoperative period among the 3 groups.
Selective arterial embolization of idiopathic priapism.
We report a case of idiopathic priapism that was only identified as high-flow or arterial priapism after drainage of the corpora cavernosa. Following failure of conservative and surgical treatment attempts, two consecutive embolizations of a unilateral penile artery were performed with gelgoam particles.