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Biomedical subjects

Timothy Moon

Publications and source records attributed to Timothy Moon.

5 recordsLinked to original sources
PubMed2005

Diagnosis of prostatic inflammation: efficacy of needle biopsies versus tissue blocks.

OBJECTIVES: To assess the variation of inflammation found on single needle biopsies, we compared our results using multiple needle biopsies and surgical samples taken from predetermined areas of prostates removed from patients with prostate cancer. METHODS: Biopsies and tissue blocks were taken from 25 prostates that had been removed at prostate cancer surgery. These samples were taken from the contralateral side from the cancer whenever possible. The biopsies were taken from the apex, middle, and base, and blocks were taken from the peripheral and transition zones of the middle region. The biopsies were evaluated for density of inflammatory cells and their histologic location (glandular vs. periglandular vs. stromal). RESULTS: Inflammation was generally periglandular, with multifocal and diffuse patterns. The severity of the inflammation was quite variable. The overall inflammatory cell counts did not differ among the regions except for lower levels at the base. Correlation coefficients demonstrated significant correlations of the middle region biopsies with the peripheral zone and transition zone blocks (P = 0.02 and P = 0.016); the apical biopsies also correlated with the transition zone blocks. CONCLUSIONS: Our results suggest that individual, transrectal needle biopsies taken consistently from the peripheral zone or transition zone of the apex or middle region of prostates from patients with incidental prostatitis may serve as well as multiple biopsies for evaluating the degree of inflammation.

Biopsy↗
PubMed2005

Treatment of benign prostatic hyperplasia in hypertensive men.

As the proportion of the US population over the age of 65 continues to rise, it is likely that the number of individuals with concomitant benign prostatic hyperplasia and hypertension will also increase. To reduce morbidity and mortality, it is important to treat patients with hypertension optimally. Evidence from outcome trials suggests that alpha1 blockers should not be used as first-line antihypertensive therapy. Although some clinicians previously recommended alpha1 blocker monotherapy for patients with both hypertension and benign prostatic hyperplasia, the most recent American Urologic Association and Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure guidelines recommend independent treatment with the most appropriate pharmacologic agents for each condition. When treating patients with benign prostatic hyperplasia, clinicians should be aware of the potential impacts that alpha1 blockers may have on blood pressure and potential adverse events in patients who are normotensive as well as in patients with treated hypertension.

Adrenergic alpha-Antagonists↗
PubMed2003

A randomized, placebo controlled, multicenter study to evaluate the safety and efficacy of rofecoxib in the treatment of chronic nonbacterial prostatitis.

PURPOSE: We determine the effects of treatment with rofecoxib and placebo in patients with chronic prostatitis. MATERIALS AND METHODS: Patients diagnosed with chronic nonbacterial prostatitis were randomized to 6 weeks of 25 or 50 mg., rofecoxib or placebo in a double-blind multicenter study with a 1-week run in of placebo. End points included the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) (average pain score item 4 primary end point), and patient global assessment questions of pain, disease activity and response to therapy. RESULTS: A total of 161 patients were randomized in the study. The NIH-CPSI total, domain and pain scores significantly decreased from baseline in all groups and, although the mean scores numerically favored the rofecoxib groups, the difference was not significantly different among groups. There was a trend for the percentage of patients with a 25% (or 6 point) improvement in total score being superior on rofecoxib versus placebo with the difference being significantly different (p <0.05) for the 50 mg. rofecoxib group. Patient global assessment of pain, response to therapy and disease activity also favored rofecoxib over placebo (p <0.05, p = 0.07, p = 0.06, respectively). Of the patients 79% on 50 mg. rofecoxib versus 59% on placebo reported no or mild pain, and 56% of patients on 50 mg. rofecoxib versus 27% on placebo experienced significant improvement in quality of life (p <0.005). Rofecoxib was generally well tolerated. CONCLUSIONS: To our knowledge this study is the first to evaluate rofecoxib versus placebo in patients with prostatitis and the first large multicenter treatment study to use the NIH-CPSI. Subjective assessment with patient global questions may be more sensitive to change than the NIH-CPSI and, therefore, may be a better tool to use in future therapeutic trials. Although 6 weeks of rofecoxib treatment appear to benefit many men diagnosed with chronic prostatitis/chronic pelvic pain syndrome further studies are needed.

Adult↗
PubMed2003

Long-term safety and efficacy of tamsulosin for the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia.

PURPOSE: We evaluated the long-term (up to 6 years) safety and efficacy of the selective alpha 1A-adrenoceptor antagonist tamsulosin in patients with lower urinary tract symptoms associated with benign prostatic hyperplasia. MATERIALS AND METHODS: A total of 609 patients were enrolled in a 4-year multicenter open label extension study. Subjects entered the study after completion of a 1-year open label trial that included patients who previously completed up to 57 weeks of double-blind, placebo controlled studies. Maintenance doses (0.4 or 2 x 0.4 mg daily) established in the 1-year study were continued. Efficacy and safety were assessed every 3 months. Primary efficacy evaluations were changes from baseline maximum urine flow rate and total American Urological Association symptom index, and the responder rates for those 2 end points. Secondary end points were changes in American Urological Association subset scores, Boyarsky symptom scores, average urine flow rate, post-void residual urine volume, quality of life index and investigator global assessment. RESULTS: Of the 609 patients who entered the 4-year extension study 159 had a 2-year or greater prior experience with tamsulosin, yielding a potential 6-year experience on the medication. Of this 159 patient subset 109 completed the whole 6 years. Initial rapid improvements from baseline in primary and secondary end points were maintained each year throughout the duration of the study. Tamsulosin was well tolerated, confirming the safety profile demonstrated in earlier studies. Orthostatic hypotension was observed in 1.3% of the patients. CONCLUSIONS: This study demonstrates the sustained efficacy, safety and excellent long-term tolerability of tamsulosin for up to 6 years in patients with lower urinary tract symptoms associated with benign prostatic hyperplasia.

Adrenergic alpha-Antagonists↗