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PubMed1995

Medical therapy for benign prostatic hyperplasia.

Benign prostatic hyperplasia (BPH) is a common clinical entity in elderly men. We review the epidemiology of BPH and the mechanisms by which it causes bladder outlet obstruction. The currently available medical therapies are examined with respect to mechanism of action, effectiveness, side effects, and cost. They are briefly compared with the more traditional treatment options of watchful waiting and transurethral prostatectomy. A logical approach to the treatment of symptomatic BPH is discussed.

Adrenergic alpha-Antagonists↗
PubMed2002

GABAergic neurosteroid modulation of ethanol actions.

Systemic administration of ethanol elevates plasma and cerebral cortical GABAergic neuroactive steroids. The increase in neurosteroids is responsible for specific behavioural and electrophysiological actions of ethanol in rodents. This article recapitulates the current knowledge of the novel interaction between ethanol and neurosteroids and addresses the potential mechanism for ethanol-induced increase in brain neurosteroid levels. Ethanol-induced increase in the cortical neurosteroid content is modified by neurosteroid biosynthesis inhibitors and completely prevented by adrenalectomy in male rats. In line with this, adrenalectomy prevented the anticonvulsant and hypnotic effects of acute ethanol administration. It is speculated that acute ethanol administration might resemble acute stress and increase neuroactive steroids due to activation of hypothalamic-pituitary adrenal axis. Ethanol-induced increases in neuroactive steroids might be responsible for the antidepressant, anxiolytic, spatial learning deficits and drug discriminatory actions in rodents. Thus ethanol-induced increases in neuroactive steroids represent a novel mechanism of ethanol's action, responsible for several pharmacological and behavioural actions of ethanol. The development of new therapeutic strategies for alcoholism may arise based on the novel interaction between ethanol and neurosteroids in the brain.

Animals↗
PubMed1997

Benign prostatic hyperplasia in elderly men. What are the special issues in treatment?

BPH is an age-related condition that can give rise to urinary symptoms. As the proportion of elderly men in the population rises, the number with symptomatic BPH requiring advice on possible treatments will increase. A range of effective treatments is available, and although there are certain absolute indications for surgery, patients with moderate or severe symptoms require counseling to reach a decision on the treatment modality most appropriate for them. Concomitant age-related disease and use of multiple medications add to the complexity of treating elderly men for BPH. In every case of BPH, the risks of each treatment option should be weighted against the potential benefits and a joint decision reached by physician and patient.

Adrenergic alpha-Antagonists↗
PubMed2005

Evaluation and medical management of benign prostatic hyperplasia.

Benign prostatic hyperplasia (BPH) is common among aging men. Untreated BPH may lead to complications including urinary tract infection, acute urinary retention, and obstructive nephropathy. Diagnosing BPH can be challenging because lower urinary tract symptoms are found in conditions other than BPH, and prostate size correlates poorly with symptoms of obstruction. Nonetheless, a careful medical history and physical examination, along with prudent use of diagnostic tests, can yield an accurate diagnosis. We review the evaluation of men with suspected BPH and indications for referral to a urologist for invasive therapy. We also review supporting evidence and treatment considerations for saw palmetto and the 2 major classes of prescription medications, alpha1-adrenergic antagonists and 5alpha-reductase inhibitors.

Adrenergic alpha-Antagonists↗
PubMed1999

Understanding and managing common baldness.

BACKGROUND: Society places importance on physical attributes especially the appearance of our hair. Common baldness or androgenetic alopecia is a normal physiological process of hair loss in genetically predisposed individuals. Premature or accelerated hair loss can engender considerable negative thoughts and anxiety associated with feelings of diminished attractiveness. OBJECTIVE: To enable general practitioners to recognise the various treatment options available, therefore offering patients reasonable hope and informed choices. DISCUSSION: Common baldness can be prevented by currently available mediums and regrowth may be achieved in a significant percentage of cases. Correct use of these agents requires an understanding of the pathogenesis of androgenetic alopecia, its natural history and the time course of response to treatment.

Alopecia↗
PubMedDate not supplied

Androgenetic alopecia in men: the scale of the problem and prospects for treatment.

While the precise incidence of androgenetic alopecia is unknown, it is universally acknowledged to be the most common hair problem in men. Balding is generally associated with ageing; consequently, the desire to prolong a youthful appearance inevitably leads to demands for effective treatments. Further, changing attitudes in modern society have resulted in people becoming concerned about their appearance and less tolerant about conditions that might be alleviated by medical intervention. The importance of hair loss upon quality of life has been underestimated by the medical profession. Clinicians failing to accept hair loss as an important medical problem ignore the real distress suffered by a significant proportion of those affected. New options for treatment that selectively target the metabolic pathways involved in the balding process are showing promise. The first generation of such drugs, Propecia, is now available in some countries and other molecules are currently under development.

Adult↗