Imaging with prostate-specific membrane antigen (PSMA) in prostate cancer.

Radioimmunoscintigraphy using a radio-labelled antibody to prostate-specific membrane antigen (PSMA) has growing applications as a means of tissue-specific imaging based on functional characteristics and complements traditional staging investigations. Clinical applications in men with carcinoma of the prostate are being refined, and this study reports outcomes with this technique in our practice. Prostatic immunoscintigraphy scans were performed with In-111 CYT 356 in 49 men with carcinoma of the prostate, obtaining sequential images in two and three dimensions at 10 min, 24 and 48 h.

Interpretation of the ALLHAT interim analysis and implications for the treatment of patients with BPH.

The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) was designed to see if the effects of doxazosin, amlodipine and lisinopril were superior to those of chlorthalidone on the incidence of cardiovascular disease in high-risk patients with hypertension. Earlier this year, following an interim analysis of 24,335 patients, the doxazosin treatment arm was stopped amid reports of an increased incidence of secondary cardiovascular endpoints relative to chlorthalidone. This paper will offer some insight into the interpretation of the ALLHAT interim data, and clarify any issues around the use of alpha-1 adrenoceptor antagonists, such as doxazosin, in the management of patients with benign prostatic hyperplasia.

The immunotherapy of prostate cancer.

Advanced prostate cancer remains incurable with standard treatment options. Immunotherapy may be a realistic alternative given the growing evidence that the immune response can affect the growth of other solid tumours and the regulation of both specific and shared prostate cancer antigens. Early studies suggest that both non-specific and specific vaccines can effect relevant animal models and clinical trials based on these observations are now in progress.

Pre-treatment staging of prostate cancer: recent advances and future prospects.

No abstract

Prevalence of prostatic intra-epithelial neoplasia (PIN) in biopsies from hospital practice and pilot screening: clinical implications.

As high grade PIN is commonly associated with concomitant cancer, current literature recommends re-biopsy of patients with high grade PIN. This paper describes the prevalence of high grade prostatic intra-epithelial neoplasia (PIN) from three independent clinical settings, reported by a single pathologist (MCP). High grade PIN was diagnosed in biopsies from 131 of the 1205 (11%) of patients in whom cancer was suspected in hospital practice, 42 of the 202 (20%) asymptomatic men screened for prostate cancer and 29 of the 118 (25%) patients presenting with prostatism in a case finding study.

Morning vs evening dosing with doxazosin in benign prostatic hyperplasia: efficacy and safety.

Three hundred and fifty-three patients with symptomatic benign prostatic hyperplasia were randomized to doxazosin or placebo, with morning or evening dosing, to compare the effect of dosing time on the efficacy and safety of doxazosin treatment. After 24 weeks of treatment, the mean International Prostate Symptom Score had decreased by 6.8 units in the doxazosin group compared with 4.

Prostate cancer and sexual function.

Erectile dysfunction is a condition affecting 1 in every 10 men. Although its occurrence is related to ageing, illness and its necessary therapy can play a major role. Prostate cancer can lead to erectile dysfunction both psychologically through depression and emotional distress, and physically through therapy for the disease.

The prostate, men and men's health.

Benign prostatic hyperplasia (BPH) is the most prevalent disease in the ageing male and the incidence of symptomatic disease is likely to increase in the millenium with increased life expectancy. BPH can have a severe impact on quality of life, including sexual function, and yet many men do not seek medical attention for this and many other diseases. Surgery is no longer a mandatory treatment for BPH.

5 alpha-reductase inhibitors: what's new?

Purpose Of Review: Medical therapy is now the first-line treatment for most men with symptomatic benign prostatic hyperplasia. This review aims to highlight the recent contributions to our understanding of 5 alpha-reductase inhibitor usage.

Recent Findings: For the last decade, finasteride has been the only available 5 alpha-reductase inhibitor, acting upon the type 2 isoenzyme of 5-alpha reductase.

Vitamin D receptor-dependent antitumour effects of 1,25-dihydroxyvitamin D3 and two synthetic analogues in three in vivo models of prostate cancer.

Objective: To determine the in vitro and in vivo effects of 1,25-dihydroxyvitamin D3 (calcitriol) and two newer less hypercalcaemic analogues, EB1089 and CB1093 (as the use of calcitriol as a therapeutic agent in humans has been limited by hypercalcaemia) in three rodent models of prostate cancer.

Materials And Methods: The highly metastatic MAT LyLu Dunning prostate model, PAIII tumours in Lobund-Wistar rats and LNCaP xenografts in nude mice were used. Vitamin D receptor (VDR) expression and binding were assessed in all cell lines.

Clinical significance of alpha1-adrenoceptor selectivity in the management of benign prostatic hyperplasia.

Alpha1-adrenoceptor antagonists have been shown to provide effective relief from symptoms of benign prostatic hyperplasia (BPH) with attendant improvements in quality of life. Although the alpha1A-adrenoceptor subtype predominates over other subtypes of alpha1 adrenoceptors in the prostate gland, there is no evidence that a subselective alpha-adrenoceptor antagonist provides a clinical advantage over a selective alpha1-adrenoceptor antagonist in the treatment of patients with BPH. The pharmacokinetic profiles of alpha1A-adrenoceptor antagonists and their documented penetration of the blood-brain barrier (CNS adverse effects) preclude a clinical benefit of subselective alpha-adrenoceptor blockers over selective alpha1 blockers.

Co-occurrence of developmental disabilities with birth defects.

This article begins with a discussion of the concepts of comorbidity and co-occurrence of diseases and health conditions. These concepts are then applied to the literature on the population-based prevalence of developmental disabilities and birth defects. Most of the existing literature focuses on co-occurrence and obtains data from both clinical and administrative sources.

Benign prostatic hyperplasia: solutions to an ageing problem.

As the population ages, the demand for treatment of the symptoms of benign prostatic hyperplasia has never been higher. Equally the choice of treatments has never been greater. This review considers the medical and surgical options.

A comparison of medical induction and dilation and evacuation for second-trimester abortion.

Objective: The purpose of this study was to compare complication rates of patients who undergo dilation and evacuation or medical abortion between 14 and 24 weeks of gestation.

Study Design: We present a retrospective cohort study of 297 women who underwent either dilation and evacuation or medical abortion. Statistical methods included the Student t test, the chi(2) test, the Fisher exact test (where appropriate), and logistic regression.

Protein insufficiency and linear growth restriction in phenylketonuria.

Objectives: To study the role of protein sufficiency, age, calorie sufficiency, and phenylalanine levels in children with phenylketonuria (PKU) and determine how these affect linear growth.

Methods: Age, growth measures, plasma prealbumin, and mean phenylalanine levels were analyzed from a chart review of 38 children with early and continuously treated PKU.

Results: A regression model was calculated investigating the effects of prealbumin, age, body mass index, and mean phenylalanine level on height.

Prevalence of spina bifida and anencephaly during the transition to mandatory folic acid fortification in the United States.

Background: In 1992, the United States Public Health Service recommended that all women of childbearing age consume 400 microg of folic acid daily. The Food and Drug Administration authorized the addition of synthetic folic acid to grain products in March 1996 with mandatory compliance by January 1998. The impact of these public health policies on the prevalence of neural tube defects needs to be evaluated.

The clinical role of alpha-blockers in the treatment of benign prostatic hyperplasia.

Benign prostatic hyperplasia (BPH) is a highly prevalent condition that represents a significant health problem, which is likely to worsen as the population continues to age. alpha-1 adrenoceptor antagonists have been used in the treatment of this condition for well over 20 years and much is now known about their effects on the urinary tract. As these drugs have improved, their use as a first line treatment option in patients with lower urinary tract symptoms (LUTS), secondary to BPH, has continued to increase.