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Biomedical subjects

S Alloussi

Publications and source records attributed to S Alloussi.

At least 19 recordsLinked to original sources
PubMed2005

[Therapy for overactive detrusor using propiverine].

BACKGROUND: Our aim was to evaluate the efficacy and tolerability of propiverine hydrochloride (propiverine) in daily practice and to check the risk-benefit relation using previously collected data on 4,390 patients. PATIENTS AND METHODS: A total of 2,932 patients with symptoms of overactive bladder were treated with propiverine over a period of 12 weeks using a multicentre post marketing surveillance. At three visits (inclusion, after 4 weeks, after 12 weeks), parameters from the micturition diary (incontinence episodes, frequency of micturition, micturition volume) were recorded. RESULTS: The number of incontinence episodes during daytime decreased during therapy from 3.6+/-3.8 to 1.2+/-2.3. The number of episodes at night decreased from 1.5+/-2.1 to 0.4+/-0.8 (both P<0.001). The mean volume per micturition improved during therapy (from 142.7 ml to 213.3 ml; +49.5%; P<0.0001). Some 85% of the investigators judged the efficacy of propiverine to be good or very good, 2.1% as not sufficient. The most frequent adverse event was dry mouth (17.3% of the patients after 12 weeks) mostly with low severity. More than 70% of the patients reported good or very good tolerability. Only 0.6% of the patients reported insufficient tolerability.

Adolescent↗
PubMed1999

A placebo-controlled, multicentre study comparing the tolerability and efficacy of propiverine and oxybutynin in patients with urgency and urge incontinence.

OBJECTIVE: To assess the tolerability and efficacy of propiverine and oxybutynin in patients with urgency and urge incontinence in a randomized, double-blind placebo-controlled clinical trial. PATIENTS AND METHODS: In all, 366 patients (149 on propiverine, 145 oxybutynin and 72 placebo, ratio 2:2:1) with urgency and urge incontinence were recruited in 32 study centres. Propiverine (group 1, 15 mg three times daily), oxybutynin (group 2, 5 mg twice daily) or placebo (group 3) were administered for 4 weeks, using the double-dummy technique. The dosages were selected specifically to compare the tolerability profile of propiverine with the commonly used therapeutic dosage of oxybutynin. Tolerability was assessed by directly questioning the patients about adverse events at four visits (V-1 before and V0 after a 1-week 'washout' period, V1 after 1 week and V4 after 4 weeks of treatment) during a 5-week surveillance period, and by tolerability ratings of the physicians. Efficacy was assessed using urodynamics at V0 and V4, evaluating the cystometric bladder capacity at maximal and first desire to void, and postvoid residual urine, according to the criteria of the International Continence Society. Additionally, a voiding protocol, overall assessment of clinical symptomatology and efficacy ratings by the physicians were documented. RESULTS: A remarkably high percentage of adverse events was reported in the washout period (VO: 13%, 16% and 18% in groups 1-3, respectively). At V4, the clinically most relevant symptom (dry mouth) occurred in 53% of patients in group 1, in 67% of group 2 and in 28% of group 3. Furthermore, dry mouth was less severe in group 1 than group 2. In contrast to groups 2 and 3, only patients in group 1 showed increasing tolerability during the treatment (from V1 to V4). These tolerability results were further supported by the overall tolerability assessment ('very good' or 'good' tolerability in 67% of group 1, in 59% of group 2 and in 83% of group 3). The urodynamic assessment of efficacy (comparing V0 and V4) showed a statistically significant increase in the mean (sd) maximal cystometric bladder capacity in group 1, being 222 (77) mL at V0 and 311 (125) mL at V4, an increase of 89 (108) mL, and in group 2, at 226 (75) mL and 322 (123) mL, an increase of 96 (106) mL, compared with group 3, at 211 (77) mL and 263 (93) mL, an increase of only 52 (92) mL. The cystometric bladder capacity at first desire to void also increased in group 1 (93 to 160 mL) and group 2 (89 to 160 mL), whereas in group 3 there were only minor changes (93 to 120 mL). Changes in the residual urine volume within and between the treatment groups were minimal and clinically irrelevant. The overall assessment of efficacy showed significant differences between the drugs when compared with placebo. CONCLUSION: Propiverine is a safe and effective drug in the treatment of urgency and urge incontinence; it is as effective as oxybutynin, but the incidence of dry mouth and its severity is less with propiverine than with oxybutynin. The availability of alternative pharmacotherapeutics such as propiverine should reduce the therapeutic failure rate and improves the success rate in the treatment of patients suffering from urgency and urge incontinence.

Benzilates↗
PubMed1995

[Orthotopic urinary bladder replacement in the woman. Initial clinical experiences].

Ileum neobladder after cystectomy is mainly reserved for male patients. Female patients are normally excluded from this kind of urinary diversion for fear of incontinence following orthotopic bladder substitution. In addition as in the male, the question of urethral recurrence of urothelial carcinoma is still not settled. We report on seven cases of successful orthotopic bladder reconstruction in females by means of an ileum neobladder according to Hautmann with follow up of up to 4.5 years. One of these patients had a complicated bladder-vaginal fistula and almost complete loss of bladder function because of a shrunken bladder after radiation therapy for a cervical carcinoma and the other six had undergone radical cystectomy because of bladder carcinoma. The ileum neobladder is anastomosed with the preserved urethral stump. The original method of ileum neobladder is extended by a colposuspension plasty according to Marshall-Marchetti, which is the means of achieving continence. The first results are encouraging and open further possibilities for bladder reconstruction in the female.

Adenocarcinoma↗
PubMed1994

[Radiotelemetric manometry of the urinary bladder].

The standard procedure for manometric investigation of bladder function involves the use of a urethral catheter. The presence of this foreign body causes irritations, however, with a resultant increase in urethral resistance. This perturbs the micturition process, but it can be avoided by a new telemetric method of intravesical pressure measurements. A very small pressure gauge and radio emitter are introduced into the bladder, and the values measured are transmitted to an external receiver. Thus, for the first time, is possible to perform physiological studies of bladder function that do not require catheterization or special positioning of the patient and are well tolerated. Some examples are described, which show that this method allows repeated catheter-free investigations over longer periods of time and accurate evaluation of the effects of pharmacological products on bladder function.

Adult↗
PubMed1993

Ossifying renal tumor of infancy.

Ossifying renal tumor of infancy is a rare but distinctive tumor that presents as a mass in the pelvicaliceal system. It is usually suspected to be a calculus until surgical exploration reveals dense tumor attachment to the renal parenchyma. The histogenesis of this lesion has not been established. We present a case of this unusual neoplasm. A renal sparing procedure was performed on this biologically benign tumor. Followup after 20 months showed no evidence of recurrence.

Female↗
PubMed1993

Vasopressin deficiency in primary nocturnal enuresis. Results of a controlled prospective study.

The lack of circadian rhythmicity of plasma arginine vasopressin (AVP) in primary nocturnal enuresis (PNE) in some children is known. The original test protocol is time-consuming and needs excellent compliance by children and parents. The goals of the presented study are the introduction of a simple screening test and the evaluation of the response of treatment using intranasal synthetic vasopressin. Fifty-five children (aged 8.2 +/- 3.1 years) with PNE and 15 children (aged 7.9 +/- 2.4 years) of a control group were investigated. Using a standardized protocol, AVP levels were measured by radioimmunoassay (RIA) under controlled water intake 3 times per day over a period of 72 h. Fourteen of 55 tested children (25.5%) with PNE had a significant decrease in nocturnal AVP when compared to the control group. We measured also an increased nocturnal urine volume and a lower urine osmolality in this enuretic group. Eight of 14 patients (57.1%) with plasma AVP deficiency (AVPD) also had bladder instability. Nine of 14 patients (64.3%) with AVPD with or without concomitant bladder instability were totally dry during desmopressin treatment, but only 2 (14.3%) remained dry after discontinuation of treatment. Our data suggest that nocturnal urine osmolality measurement may reflect AVPD and predict a positive treatment outcome.

Administration, Intranasal↗
PubMed1992

[Experiences up to now with the ultrasound dissection instrument in gynecologic oncology].

The energy of high frequency ultrasound is used to disrupt cellular structures. Since the water content of each individual cell is of utmost importance for the physical destruction of the cell, there may be a tissue-selective effect in respect of tissues such as epithelium (high water content) and mesenchyma (low water content). The various therapeutic modalities are described in the following four cases. Ultrasonic tumor destruction was highly effective with regard to maximum reduction of tumor masses, especially for tumor sites which could not be removed by conventional tumor surgery. Blood vessels and nerves surrounded by tumor could be carefully and completely dissected--even in advanced stages. Peritoneal metastases from an ovarian carcinoma could be removed entirely, as well as the metastases within a tumor bulk (e.g. ureter within tumor mass); also the layers of tissue which were lost could be visualized again. So far, no increase in complications during and after surgery has been observed.

Adult↗
PubMed1992

[Carcinoma of the kidney with production of renin. A special form of hypertension].

A correlation between the tumour and hypertension was investigated in 129 patients with renal cancer. Forty-one patients (31.8%) suffered from hypertension. Primary increased renin secretion was detected in 6 of these patients (14.6%). The renin activity quotient measured in the renal veins between the renal tumour and the contralateral kidney was between 4 and 7. Secondary hyperaldosteronism was detected in only 2 of the patients with a significantly different renin activity in the renal veins. The renin level detected in the tumour itself of these 6 patients was significantly higher than the level detected in the parenchyma of the same kidney. Renin was demonstrated immunohistochemically in the tumours of these patients. The blood pressure returned to normal after nephrectomy in 5 patients and a marked fall in blood pressure was observed in the 6th patient. Cell cultures of 3 tumours revealed autonomous renin production. Renin-secreting renal carcinomas represent a rare form of renal hypertension, which is why the possibility of renal cancer should also be considered when investigating a case of hypertension.

Aldosterone↗
PubMed1990

Effect of prolonged galactose consumption on galactose tolerance in young healthy humans.

This study was carried out on two groups of healthy young subjects. One group (n = 8) was given a single oral dose of galactose (0.5 g/kg body weight), and a single measurement of blood galactose was made 40 min later. A second group (n = 16) was given a daily supplement of 0.5 g/kg galactose for 15 days, and blood galactose and galactitol were measured. On the first day of the test period, some subjects seemed to tolerate galactose less well than others: galactitol appeared in their plasmas and could be related to a significantly higher galactosaemia than that of subjects without detectable galactitol in the plasma. However, after 15 days of galactose intake, the less galactose-tolerant subjects appeared to have adapted, as indicated by the significant decrease in the blood galactose and the disappearance of galactitol. No change was found in the galactose-tolerant subjects. No significant difference was found between males and females.

Adult↗
PubMed1990

Nephrogenic adenoma of the bladder in a child--immunohistochemical and lectinhistochemical investigations.

A morphological study of a 6-year-old girl with a nephrogenic adenoma of the bladder is presented. The tumor developed 4 years after multiple reconstructive operations of the urinary tract. Immuno- and lectinhistochemically, the tubular structure of the lesion resembled that of a collecting tubule. A conservative approach was the treatment of choice in the absence of microscopically malignant changes.

Adenoma↗
PubMed1990

Value of selective reversible sacral nerve blockade in the diagnosis and treatment of the urge syndrome.

Interstitial cystitis, neurogenic disturbances of bladder emptying resulting from incomplete supranuclear lesions and idiopathic detrusor hyperreflexia are clinically always associated with frequency, nocturia, urgency or urgency incontinence (urge syndrome). These disturbances of bladder emptying are difficult to distinguish, even urodynamically. With selective sacral nerve blockade, it is possible to differentiate between forms urodynamically using a nerve-blocking anesthetic. Reversible selective sacral nerve blockade is also the treatment for idiopathic detrusor hyperreflexia.

Adult↗
PubMed1990

Acute spinal intradural extramedullary hematoma: a nonsurgical approach for spinal cord decompression.

The authors present the case of a 60-year old man with a spontaneous spinal intradural hematoma in the thoracic and lumbar region, which was caused by anticoagulant therapy and led to a severe progressive transverse lesion. After substitution of coagulation factors, a small catheter was inserted into the subarachnoid space via a lumbar puncture. By alternating irrigation and suction removal of the blood clot, restoration of the cerebrospinal fluid passage was possible along with a marked improvement in the neurological deficits. At 8 months' follow-up, the patient had completely recovered from the severe paraparesis and bladder dysfunction.

Catheterization↗
PubMed1989

Effect of 5% galactose diet on galactose and dulcitol in plasma and lens of male and female pigs.

The study was performed to compare the galactose tolerance of male and female pigs to 5% galactose and 25% hydrolysed whey (HW; containing 5% galactose) diets. Plasma galactose and dulcitol levels were measured throughout the diet period and correlated with the lens dulcitol contents at the end of the period. On the first day of the diet there was no significant difference between male and female blood galactose levels after galactose ingestion. The consumption of HW resulted in a significant 30% decrease in the blood galactose peak in females; there was no parallel difference in males on the HW diet. The 30-day diet induced a significant decrease in galactosaemia peaks resulting from galactose ingestion in both males and females, indicating an activation of galactose metabolism. The HW diet resulted in an equivalent decrease in peak galactosaemia only in males, cancelling the initial differences observed between males and females. The final dulcitol content in the lenses appeared to be correlated with plasma galactose but not with plasma dulcitol. However, the differences in plasma galactose between males and females, or between the two diets, resulted in smaller and often non-significant differences in lens dulcitol.

Analysis of Variance↗
PubMed1989

The effects of 5% and 25% galactose diets on lens polyols, glutathione and protein glycation in male and female pigs.

The cataractogenic effect of a galactose diet was studied in male and female pigs in relation to the daily galactose intake. Two experiments were performed. In the first, 10 male and 10 female pigs were maintained on a 5% galactose diet for 30 days; galactose was given either as pure sugar or as hydrolyzed whey. In the second experiment, 18 castrated male and 21 female pigs were fed a 25% galactose diet for 49 days. Galactose was given as whey, hydrolyzed whey or as an alternating diet. Lenses were analyzed for sugar-alcohols, glutathione and protein glycation, and compared to lenses of pigs on a control standard diet. The 5% galactose diet induced large accumulation of dulcitol in the lens, which was similar whether galactose was ingested alone or as hydrolyzed whey. Glutathione and inositol contents were slightly below control values only in males on the galactose alone diet, perhaps indicating initiation of a cataractogenic process. No change was observed in females. The lenses of females on control diet were different from those of control males: having decreased glutathione, inositol and sorbitol contents and higher protein glycation. The 25% galactose diet resulted in an approximately 10 times higher lens dulcitol accumulation and advanced lens damage as measured by loss of inositol and increase in protein glycation. These changes were more severe in males than in females. The data indicate that there is a relationship between total galactose intake and dulcitol accumulation.

Animals↗
PubMed1988

Computed tomographic and angiographic findings in renal oncocytoma.

Nine cases with histologically proven renal oncocytoma are presented. In all cases, ultrasonography gave the first indication of a tumour and intravenous urography was tumour-specific in only six, whilst angiography was so in only four of the cases with peripheral extension beyond the normal organ limits. Examination by computed tomography showed retrospectively, in the three cases with smaller oncocytomas up to 3 cm in diameter, findings that seemed promisingly characteristic: without contrast medium, the tumour appeared homogeneously hyperdense in comparison with normal renal parenchyma, but homogeneously hypodense after injection of contrast medium. One of the smaller oncocytomas, however, showed regions of heterogeneity both with and without contrast medium. Only one oncocytoma of 4 cm diameter presented the central stellate, low-attenuation "scar" described by Quinn et al. The angiographic criteria cited by Ambos were fulfilled in only three of the larger oncocytomas. In four of the cases, the tumour was enucleated and the organ left in situ on the basis of frozen section diagnosis. Those patients with tumours extending outside the organ or those of questionable diagnosis on frozen section were treated by nephrectomy. In one patient, the pathologist suspected metastasis from the thyroid; hemithyroidectomy confirmed on oncocytic adenoma of the left thyroid lobe.

Adenoma↗