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Biomedical subjects

P Turchi

Publications and source records attributed to P Turchi.

At least 19 recordsLinked to original sources
PubMed2005

Testosterone replacement therapy in male late onset hypogonadism: available pharmacological strategies.

During the last few years, the general aging of the population and the growing knowledge about male hormonal changes in older age have lead the scientific community to focus on the clinical aspects of secondary hypogonadism in aging males. This syndrome is well defined by the term late-onset hypogonadism (LOH). Although the pathophysiology and the diagnostic aspects have been studied and defined and various preparations are available, the debate on androgen supplementation therapy is still ongoing. As the spectrum of effects of endogenous testosterone is essentially based on its metabolism to dihydrotestosterone and estradiol, testosterone is the treatment of choice for male hypogonadism. The aim of the therapy is to establish a physiological concentration of serum testosterone in order to correct the androgen deficiency, relieve its symptoms and prevent long-term sequelae. All of the available products, despite their varying pharmacodynamic and pharmacokinetic profiles, are able to reach this goal. Here we examine the indications for therapy, the characteristics of the different routes of administration and how to monitor therapy in order to make the treatment safe and effective.

Adult↗
PubMed2000

Frequency and determinants of erectile dysfunction in Italy.

OBJECTIVE: To analyze the prevalence and risk factors for erectile dysfunction (ED) in Italy in a cross-sectional study. METHODS: Eligible for the study were men aged 18 years or more, randomly identified by 143 general practitioners among their registered patients during the period January 1996 to February 1997. ED was defined as the impossibility to achieve and maintain an erection sufficient for satisfactory sexual performance. RESULTS: Of the 2, 010 men interviewed, 257 (12.8%) reported ED. The prevalence increased with age, from 2% in men aged 18-39 to 48% in those >70 years (tested for trend, p = 0.0001). A history of cardiopathy, diabetes, hypertension, neuropathy, thrombotic/hemorrhagic stroke, peripheral vascular disorders, pelvic/medullary injury and pelvic surgery/radiation all increased the risk of ED. The association of hypertension and diabetes tends to increase the risk of ED. In comparison with nondiabetic and nonhypertensive men, the odds ratio (OR) was 1.4 (95% confidence interval (CI), 0.7-3.2) for hypertensive men without diabetes, 4.6 (95% CI, 1.6-13.7) for diabetic men without hypertension and 8.1 (95% CI, 1.2-55.0) for men with diabetes and hypertension. In comparison with never smokers, the OR of ED was 1.7 (95% CI, 1.2-2.4) for current smokers and 1.6 (95% CI, 1.1-2.3) for ex-smokers and increased with duration of the habit. CONCLUSIONS: The study offers a quantitative estimate of the prevalence of ED and of its main risk factors in Italian men.

Adolescent↗
PubMed2000

[Tridimensional ultrasonography in andrology].

Three-dimensional ultrasound has already been employed to improve detection and characterization of the masses in various organs. The system can also be expected to improve qualitative evaluation of vessel pathology. Three-dimensional ultrasound could offer an additional contribution even in Andrology, in at least three fields: in the best evaluation of the anatomical structures; in most accurate measurement of the volumes of the organs; in the study of the Peyronie's disease, for the availability of the coronal plain.

Humans↗
PubMed2000

[Unexplained male infertility and testicular microlithiasis].

In this study we analyse the frequency of testicular microlithiasis in a group of otherwise infertile healthy men, visited at the Andrology Service of Prato Hospital. Here the ultrasound machine is located in the ambulatory and it is possible to use it during the first visit of the patient, as we have done in 250 consecutive infertile men. This examination, easy and not invasive, has been performed to evaluate the pampiniform plexus to find possible varicocele, epydidimis for obstructive signs and testes for the presence or absence of parenchymal calcifications or masses. We found 106 positive sonographic records (42.4%) for scrotal diseases. Between them, two cases of testicular microlithiasis (0.8% of 250 consecutive ultrasound examinations and 1.7% in the last twelve months). Our data, although with a lower incidence than literature, show the importance of ultrasound examination in absence of specific diagnostic questions too, in the study of male infertility. Clinical management of testicular microlithiasis is difficult, due to loss of treatment and to cancer risk. A long term follow up is request, with periodical (6-12 months) sonographic controls. A classification (here we propose) can be useful for a more precise monitoring.

Adult↗
PubMed1997

Determination of an effective dose of eltenac and its comparison with that of flunixin meglumine in horses after experimentally induced carpitis.

OBJECTIVES: To titrate a clinically effective eltenac dosage (0.1, 0.5, and 1.0 mg/kg of body weight), compared with vehicle only, and to compare efficacy of the most effective eltenac dosage with that of 1.1 mg of flunixin meglumine/kg. ANIMALS: 40 healthy horses, ranked after model induction on the basis of lameness severity, were randomly assigned to 5 treatment groups, with 4 replicates of 10 horses each. PROCEDURE: On day -5, after surgical preparation of the left carpal region, 0.7 ml of Freund's complete adjuvant was injected into the intercarpal space. Horses were observed daily, from the day of carpitis induction to day 0, when stride length was used as the method of ranking horses for randomization to treatment assignment. Treatments were administered i.v. once daily for 3 consecutive days, starting on day 0. Prior to carpitis induction on day -5, and at time 0 (pretreatment), 2, 4, 12, 24, 36, 48, 60, 72, and 96 hours after treatment initiation, resting respiratory rate and pulse, rectal temperature, carpal circumference, carpal flexion angle, stride length, carpal hyperthermia, and signs of carpal pain were recorded. RESULTS: Compared with the vehicle and 0.1 mg of eltenac/kg, 0.5 and 1.0 mg/kg caused statistically significant improvements (ie, reduction of carpal circumference, increase in carpal flexion angle, and increase in stride length of the affected limb), but values did not differ significantly between the 2 dosages. Thus, a dose-response plateau for eltenac was reached at 0.5 mg/kg. Comparison with flunixin meglumine at a dosage of 1.1 mg/kg did not indicate significant differences between the 2 treatment groups at the pivotal time of 96 hours for carpal circumference, carpal flexion angle, stride length, carpal hyperthermia, and signs of carpal pain. Adverse reactions were not observed. CLINICAL RELEVANCE: Under conditions of this study, a dosage plateau for eltenac was determined (0.5 mg/kg) that was statistically equivalent to eltenac (1.0 mg/kg) and flunixin meglumine (1.1 mg/kg) in a 3-day i.v. dosing regimen.

Analysis of Variance↗
PubMed1995

Sedative and analgesic effects of detomidine and romifidine in horses.

In a double blind study, eight horses were treated intravenously at seven-day intervals with detomidine at doses of 10, 20 and 40 micrograms/kg, or with romifidine at doses of 40, 80 and 120 micrograms/kg, or with a placebo solution. Their sedative and analgesic effects were evaluated by objective measurements and by a clinician at 15-minute intervals for three hours and the horses' instability in stocks, locomotor ataxia and heart rate were recorded simultaneously. The administration of both drugs at all doses resulted in sedation. The sedation achieved with romifidine was significantly shallower and shorter-lived than with detomidine at the recommended doses (P < 0.05). The results obtained with the highest dose of romifidine were in some cases significantly inferior and shorter-lived than those obtained with the medium dose (P < 0.05). Detomidine at the 10 micrograms/kg dose was similar in its effects to the two highest doses of romifidine. At all doses detomidine had analgesic properties against the effects of electrical pain stimulation at the withers, the coronary bands on the front and hind legs, and in the perianal region, which were dose-dependent in depth and duration, whereas romifidine was devoid of any analgesic effect. Instability and ataxia were more pronounced with detomidine than with romifidine but the effects were only slight to moderate and not regarded as a hindrance to procedures for which sedation is needed. Bradycardia was evident with both drugs at all doses; its severity and duration was related to the sedative properties of the drugs and was dose related. No other side effects were observed.

Analgesics↗
PubMed1993

Treatment of abacterial prostato-vesiculitis with nimesulide.

The efficacy and tolerability of nimesulide were assessed in the treatment of patients with prostato-vesiculitis. In a noncomparative investigation, 30 patients received oral nimesulide 100mg twice daily for three 10-day cycles. Micturition-related symptoms were resolved in 20 patients and clear amelioration of inflammatory signs was observed with transrectal ultrasound in 16 patients. Abnormal sperm forms decreased from 57 to 49% (p < 0.001). In a comparative investigation, 40 patients received nimesulide 200mg twice daily or ketoprofen 100mg twice daily via the rectal route. Patients and physicians expressed an overall opinion on efficacy in favour of nimesulide. In a pharmacokinetic study of healthy volunteers who received oral nimesulide 100mg as a single dose, the mean maximum nimesulide concentration (0.58 +/- 0.13 mg/L) in seminal fluid was achieved after 2 hours while the maximum seminal fluid: blood plasma ratio 0.32 +/- 0.02 was observed after 4 hours. These data suggest that nimesulide is an effective NSAID in the treatment of abacterial prostato-vesiculitis and also demonstrate that this drug has a favourable disposition within the genital tract.

Adolescent↗
PubMed1993

[Echographic aspects of gynecomastia].

Gynecomastia is a size increase of man's breast, due to non neoplastic ductal and glandular stroma proliferation. Prevalent ductal proliferation defines the "florid" type, while prevalent stroma increase defines the "quiescent" type. Pseudo-gynecomastia is a non glandular volume increase. Sonography is able to recognize the different parts of normal male breast and to diagnose gynecomastia. Moreover by sonography we can distinguish three echo-patterns linked to the anatomopathologic pattern which can lead therapy.

Gynecomastia↗
PubMed1992

[Recent diagnostic and therapeutic aspects in male sexual impotence].

Male sexual impotence is the symptom of an alteration of central and peripheral mechanism neuropsychoendocrine, vascular and neurological. Nowadays it affects 8-10% of sexually active population. In some diseases, like diabetes and uremia, it can reach very high percentages of incidence. At our Andrology Center 35% of referrals are represented by sexual complaints. In the last years the diagnostic accuracy has increased, narrowing the percentage of unknown causes. Vasculopathy represents the most relevant pathological condition associated with impotence: it can affect both arterial and venous vessels. The new medical technologies and procedures permit an increase of the life span but often affecting the quality of life. Therefore, the iatrogenic causes of impotence, both pharmacological and surgical, are growing. A modern diagnostic approach starts with an accurate clinical history and physical examination, followed by an NPT (nocturnal penile tumescence) test and/or ICI (intracavernosal injection) with a standard dose of PGE1 and Doppler flowmetry of penile arteries. An endocrine evaluation (LH, testosterone and prolactin) is also performed. Further investigation of a vascular dysfunction is represented by more invasive procedures, like arteriography, cavernosography and cavernosometry. A suspect of neurological disease is confirmed by sacral evoked potentials. According to the findings of these examinations, a correct therapeutical approach can be applied in 100% of cases. An endocrine treatment is adequate only when a clear reduction of T plasma level or hyperprolactinemia are present. The treatment of other central disorders causing psychoneuroendocrine impotence is promising, but still under investigation. The intracavernosal injection of vasoactive drugs, apart from having revolutionized the diagnostic approach to the impotent patient, represents a clear standpoint in medical management of impotence, particularly in vascular and neurological diseases. The great advancement in the technology of penile prostheses has allowed the development of valuable and reliable tools to be used in selected cases.

Adult↗
PubMed1992

[The Rigiscan system in the diagnosis of male sexual impotence].

The article reviews historical basis of Nocturnal Penile Tumescence (NPT) test and the evolution of techniques to perform it. From complex and time-consuming instruments, modern technology has brought us to the use of the Rigiscan system. This is a transportable (home or office usable), computerized method to detect change of penile rigidity and circumference during sleep-related spontaneous-or daytime induced-erections. While the instrument was mainly developed to perform NPT tests, it is nowadays used to record penile rigidity in realtime after the intracavernous injection of vasoactive drugs. In our experience, normal parameters to refer for a NPT evaluation are: number of erectile episodes: 4-5 per night; mean duration od episodes: > 30 minutes; increase of penile circumference: > 3 cm (base loop) and > 2 cm (tip loop); maximal rigidity: > 70% (both base and tip). Reference parameters for realtime monitoring after intracavernous injection of PGEI are: latency of response: < 12 minutes; duration (with a stable plateau): > 30 minutes; constant plateau: > 70%; increase of penile circumference: > 3 cm (base) and > 2 cm (tip). The use of these reference parameters, together with the data coming from other procedures (e.g. penile arterial flow with the Doppler), allows a better diagnostic accuracy in the approach to sexual impotence.

Diagnosis, Computer-Assisted↗
PubMed1992

[Endocrine therapy of sexual impotence in men].

Male sexual activity is in all mammalian species, included man, androgen-dependent. The role of testosterone (T) starts already during intrauterine life. It continues thereafter, inducing the development of sexual secondary characteristics and libido. Therefore T has represented the "classical" treatment of male sexual dysfunctions. In the therapeutic routinary use T is employed ad ester, like cipionate, enanthate and other i.m., undecanoate per os. When a pituitary defect is present and the testicular receptors are functioning a treatment with HCG can be employed.

Chorionic Gonadotropin↗
PubMed1990

Ultrasound monitoring of testis and prostate maturation in hypogonadotropic hypogonadic males during gonadotropin-releasing hormone treatment.

The effects of the administration of gonadotropin-releasing hormone (GnRH) on the increase of testis and prostate volume was monitored by ultrasound in six patients affected by idiopathic hypogonadotropic hypogonadism. A significant increase of testis volume was observed after 90 and 180 days (6.65 versus 3.32 mL, 99.1% net increase and 8.47 mL, 176.8% increase, respectively) of pulsatile GnRH treatment. A similar increase of prostate volume was observed at day 90 (12.67 versus 7.78 mL, 70.3% net increase) and day 180 (14.70 mL, 97.7% increase). The ultrasound monitoring of the modifications of testis and prostate volume may represent a biological assay of the effects of GnRH treatment and offer additional data on the response of target organs to the hormonal treatment.

Adult↗
PubMed1989

[Treatment of male genital infections with enoxacin].

Inflammatory disease such as prostatitis and prostatovesiculitis, can affect the fertility potential of the male population. In this study, the Authors tested the therapeutical efficacy of a second generation quinolone, enoxacin, in patients suffering from vesicular and/or prostatic inflammations. This drug has been shown to diffuse into the prostatic fluid, achieving therapeutical concentrations either in acute or chronic pathological conditions. Thirty infertile patients referring to our Andrology Center and showing seminal signs (leukocytes, abnormal sperm forms, chemical and physical alterations, etc) of genital tract inflammations were found to have positive sperm culture for enoxacin-sensitive strains. Further investigations (echotomography) showed that they were affected by prostatic and/or vesicular subacute chronic inflammations. The mean age was 32.2 (range 20-36) ys. All the patients discontinued any previous treatment for at least 90 days. Enoxacin was administered at the dose of 300 mg b.i.d. for two cycles of 10 days each, with intervals of 20 days. At the beginning and at the end of the treatment (days 0 and 60), semen analysis and culture were performed. A paired-T test was employed for the statistical evaluation of data. 26.6% of patients ad an altered fluidification before treatment. Only 10.0% of them showed the same sign after treatment. A condition of hyperviscosity was present in 50% and 16.6% of patients before and after treatment respectively. Likewise, an elevated number of leukocytes (greater than 10(6)/ml) occurred in the ejaculates of 43.3% of patients and in 23.3% after enoxacin treatment. Enoxacin treatment was efficacious in 89.2% of cases, in presence of either Gram positive or Gram negative bacteria.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗