PubMed Health⌕ Search

Biomedical subjects

T Hald

Publications and source records attributed to T Hald.

At least 37 records · Page 2Linked to original sources
PubMed1996

[Evaluation of symptoms in patients with benign prostatic hyperplasia].

Benign prostatic hyperplasia (BPH) is the most common cause of voiding dysfunction in elderly men. With the age related demographic changes in the western world, the epidemiological and economical burden of BPH is anticipated to increase. BPH is clinically diagnosed on a variety of more or less well defined symptomatic, macroscopical, and physiological criteria, whereas the histological diagnosis is straightforward. Yet, no symptom is specific for BPH and numerous other diseases have to be considered when a patient presents with symptoms of bladder outlet obstruction. A BPH questionnaire is useful when weighing the pros and cons for intervention. Furthermore, a symptom index represents a valuable indicator for the quality of care provided. Through the last decades a number of BPH questionnaires have been introduced. This article scrutinizes various BPH indices and provides an introduction to the prerequisites of clinical questionnaires.

Aged↗
PubMed1996

Prostatic specific antigen and benign prostatic hyperplasia.

The aim of this study on patients (n = 51) with urodynamically proven obstruction was to search for correlations between serological levels of prostatic specific antigen (PSA) and age of patients, volume of prostate and prostatic morphology as evaluated on transurethral resection specimens. No correlations could be found between PSA levels and morphological parameters such as degree of inflammation and relative degree of stromal or epithelial hyperplasia. Significant correlations were demonstrated between PSA levels and age of patients and prostatic volume.

Age Factors↗
PubMed1996

Benign prostatic hyperplasia. Does a correlation exist between prostatic morphology and irritative symptoms?

Fifty-two consecutive patients with prostatism who underwent a prostatectomy were investigated with regard to irritative symptom score, age, prostate volume, urine culture results, degree of detrusor instability, inflammation in the prostate, and stromal, glandular or mixed prostatic histopathology. We did not find any statistical correlations between irritative symptom score and the mentioned parameters. This indicates that irritative symptoms should rather be attributed to extraprostatic factors such as e.g. bladder reaction.

Age Factors↗
PubMed1995

Validation of the self-administered Danish Prostatic Symptom Score (DAN-PSS-1) system for use in benign prostatic hyperplasia.

OBJECTIVE: To validate the Danish Prostatic Symptom Score (DAN-PSS-1), a self-administered quality-of-life questionnaire comprising 12 questions related to voiding problems and the perceived bother of each individual symptom. METHODS: Using published results from several comparisons of other symptom scoring systems with DAN-PSS-1, the test-retest reliability, internal consistency, construct and content validity, and responsiveness of the DAN-PSS-1 system were assessed. RESULTS: The system was internally consistent (Cronbach's alpha = 0.73), the median test-retest reliability of answers to each question was 83.5% (range 0-99.7%) and the questionnaire was well understood by the patients. The DAN-PSS-1 system demonstrated a high degree of construct validity, correlating with the extensively used Madsen-Iversen score system (Spearman's correlation coefficient, rs = 0.51) and with the patients' answers to questions about how bothersome their symptoms were (rs = 0.71). The DAN-PSS-1 system discriminated clearly between patients with benign prostatic hyperplasia (BPH) and control subjects (an area under the receiver operating characteristic curve of 0.94). Finally, the DAN-PSS-1 was sensitive to changes following intervention, with scores decreasing from a median of 20 to zero 4 months after patients underwent transurethral prostatectomy and from a median of 11.5 to 7.5 (65%) after patients had received 4 months treatment with an alpha-blocker. CONCLUSIONS: The DAN-PSS-1 system is reliable, valid and responsive, and therefore can be recommended for assessing the severity of symptoms among patients presenting with lower urinary tract complaints suggestive of BPH and in the follow-up after intervention.

Adrenergic alpha-Antagonists↗
PubMed1995

Detrusor in ageing and obstruction.

It is disputed whether fibrosis of the detrusor is a consequence of obstruction or ageing. In the present study, bladder wall morphology was analyzed semiquantitatively in biopsies from "normal" young persons, infravesically obstructed and non-obstructed elderly persons. Fibrosis occurring around and inside muscle fascicles was demonstrated to the same degree with obstruction as well as ageing. Our results give rise to the question whether "prostatism" is related to obstruction per se or to ageing or both.

Aged↗
PubMed1994

Review of current treatment of benign prostatic hyperplasia.

The treatment of benign prostatic hyperplasia is changing, with many new modalities being tested: Some are already used routinely, others are still investigational. Surgery, however, is still the principal treatment, producing an 85-90% improvement in symptoms and urodynamics. Stents are being used more frequently, particularly in patients with a high operative risk. Balloon dilation can be performed in small glands; however, the durability of results remains in doubt. Thermotherapy has been found to produce histologic changes in the prostate and may change the urodynamics as well. Finally, drug treatment, which is currently limited to a-blocking agents and 5 a-reductase inhibitors, has proven to be effective symptomatically, with small, but significant changes in urodynamics.

Humans↗
PubMed1993

[Pharmacological treatment of benign prostatic hyperplasia].

Over the last five to ten years, new treatment modalities have appeared at an increasing pace. The emerging pharmacological treatment modalities have all been used on a large scale. The exact indications and limitations of these methods have not yet been definitely established. Careful analysis of the symptomatology is crucial in counseling the patient. The Danish Prostatic Symptom Score model (DAN-PSS) is proposed. However, treatment benefits should exceed harm and there must be a reasonable cost-effectiveness. Pharmacological agents that reduce prostatic size and/or the tone in the prostate are effective in treatment of benign prostatic hyperplasia. Selective alpha-1 blockers seem to be useful in patients with uncomplicated benign prostatic hyperplasia and mild to moderate symptoms. The side effects of hormone therapy are prohibitive for use in patients with a benign disease. Data currently available indicate a yet to be defined role for 5-alpha-reductase inhibitors.

Adrenergic alpha-Antagonists↗
PubMed1993

Review of current medical treatment of benign prostatic hyperplasia.

Over the last 5-10 years new treatment modalities have appeared at an increasing pace. The emerging pharmacological treatment modalities have all been used on a large scale. The exact indications and limitations of these methods have not yet been definitely established. Careful analysis of the symptomatology is crucial in counselling the patient. The Danish prostatic symptom score model is proposed. However, treatment benefits should exceed harm and there must be a reasonable cost-effectiveness. The established clinical experience with pharmacological agents that reduce prostatic size and/or the tone in the prostate are effective in the treatment of benign prostatic hyperplasia. Selective alpha 1 blockers seem to be useful in patients with uncomplicated benign prostatic hyperplasia and mild to moderate symptoms. The side effects of hormone therapy are inhibitive for use in patients with a benign disease. Data currently available indicate a role for 5 alpha-reductase inhibitors yet to be defined.

Adrenergic alpha-Antagonists↗
PubMed1993

Extraperitoneal pelvioscopy in staging of bladder carcinoma and detection of pelvic lymph node metastasis.

This study was carried out to examine the efficacy of extraperitoneal pelvioscopy in detecting pelvic metastasis in patients scheduled to undergo radical cystectomy without preoperative chemo- or radiotherapy. The results of pelvioscopy were compared with those obtained by laparotomy. 54 consecutive patients underwent pelvioscopy without complications. Three were technically insufficient. Lymphatic tissue was biopsied in 29 (54%). Pelvioscopy demonstrated tumor dissemination in 5 patients (9.3%): 2 had pT4b tumor, 2 pelvic nodal metastases and 1 both. The remaining 49 patients with benign pelvioscopy were scheduled for laparotomy but 7 patients did not undergo the procedure: 3 had extrapelvic metastasis, 1 bronchial carcinoma, 1 aortic aneurysm, 1 refused surgery and 1 had pulmonary insufficiency. Accordingly, 42 patients underwent open exploration which demonstrated pelvic metastasis in 11: 9 had nodal metastasis, 1 a pT4b tumor and 1 both. Consequently the sensitivity of pelvioscopy in detecting pelvic metastasis was calculated at only 31%. This result indicates that extraperitoneal pelvioscopy should be considered a screening procedure rather than an accurate staging procedure for pelvic metastasis.

Adult↗
PubMed1993

A new patient weighted symptom score system (DAN-PSS-1). Clinical assessment of indications and outcomes of transurethral prostatectomy for uncomplicated benign prostatic hyperplasia.

A patient weighted symptom score system, the Danish Prostatic Symptom Score (DAN-PSS-1), including a disease specific self administered quality of life questionnaire, is presented. The model was evaluated pre- and postoperatively in 29 patients apparently suffering from uncomplicated benign prostatic hyperplasia. The score system is based on the severity of 12 symptoms related to bladder storage and voiding function, and three questions related to sexual function (symptom score). For each of these parameters the patient must also evaluate its influence on his daily life (bother score). In the 29 patients with uncomplicated benign prostatic hyperplasia (BPH) bother scores exceeded symptom scores for the irritative symptoms but not for the obstructive symptoms, and surprisingly the symptom score was less improved than the bother score 6 months after transurethral resection of the prostate (TUR-P). Furthermore the postvoiding dribble was worsened after the operation. We find that this model, DAN-PSS-1, assists in creating a solid base for the indication for and the evaluation of treatment of uncomplicated BPH.

Aged↗
PubMed1992

Nonsurgical, nonpharmacologic treatment of benign prostatic hyperplasia.

New treatment modalities are becoming available for benign prostatic hyperplasia. Permanent or temporary stenting of the prostatic urethra, balloon dilatation of the prostate, and hyperthermia and thermotherapy are in the forefront. None of the methods has found a definite place in the spectrum of indications. Prospective trials are needed to ascertain the safety, efficacy, and durability of results.

Aged↗
PubMed1992

Recombinant interleukin-2 and lymphokine-activated killer cell treatment of advanced bladder cancer: clinical results and immunological effects.

The purpose of this study was to evaluate the efficacy of treatment with recombinant interleukin-2 (rIL-2) and lymphokine-activated killer cells in patients with advanced bladder cancer and to study the induced changes in the distribution of leukocyte subsets in blood and tumor. Nine patients with metastatic transitional cell cancer of the bladder were treated with a continuous infusion of rIL-2 combined with lymphocytes stimulated in vitro with rIL-2. None of the patients responded to the therapy despite substantial changes observed in the immunological cells, both in tumor and blood. The rIL-2 infusion induced migration of leukocytes to the tumors, which was related to increased expression of the adhesion molecule VLA-1 on both peripheral blood mononuclear cells and the endothelial cells of small tumor vessels. Only T-cells, predominately expressing IL-2 receptors, and macrophages infiltrated the tumors. Natural killer cells remained few or absent in the tumors, even though the natural killer cells in peripheral blood were activated by the treatment. This study shows that the present technique of rIL-2 and lymphokine-activated killer cell therapy is able to induce substantial changes in the immune system of patients with metastatic bladder cancer. However, this treatment did not induce tumor regression, which may be due to the advanced stage of disease.

Adult↗