OBJECTIVE: To examine the effect of a peripherally active fatty acid amide hydrolase (FAAH) inhibitor ASP3652 on safety and efficacy outcomes in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Inhibition of FAAH is hypothesized to reduce the excitability of urinary tract afferents including nociceptors. MATERIALS AND METHODS: In this adaptive, randomized, double-blind, placebo-controlled study, adult male patients with moderate to severe CP/CPPS were treated for 12 weeks with an oral dose of ASP3652 (25, 75, 150, or 300 mg twice daily, or 300 mg once daily), or placebo. A Bayesian model was used for adaptive prospective modeling of randomization, study continuation decisions, and analysis of the efficacy variables. RESULTS: The study was stopped for futility at preplanned interim analysis when 239 patients were randomized (226 were included in the intention-to-treat set): the 25 mg group showed the largest reduction of the primary end point National Institutes of Health Chronic Prostatitis Symptom Index total score (7.0 points), but the placebo group showed a mean reduction of 7.3 points (difference: 0.3 [95% confidence interval: -1.9, 2.6]). Micturition outcomes improved compared with placebo in all ASP3652 groups; for example, in the 300 mg twice daily group, voiding frequency decreased by -1.10 (95% CI: -2.0, -0.2) voids/24 hours vs placebo. Safety outcomes were comparable across the treatment groups. CONCLUSION: ASP3652 was generally safe and well-tolerated. It did not show efficacy on pain symptoms in patients with CP/CPPS. However, the results indicate that FAAH inhibition may attenuate lower urinary tract symptoms. Dedicated studies in patients with lower urinary tract dysfunction are needed to confirm this.
- MeSH
- amidohydrolasy antagonisté a inhibitory MeSH
- biologická dostupnost MeSH
- dospělí MeSH
- dvojitá slepá metoda MeSH
- inhibitory enzymů * aplikace a dávkování farmakokinetika MeSH
- lidé středního věku MeSH
- lidé MeSH
- monitorování léčiv metody MeSH
- pánevní bolest * diagnóza farmakoterapie etiologie MeSH
- prostatitida * komplikace diagnóza farmakoterapie MeSH
- symptomy dolních močových cest * diagnóza farmakoterapie etiologie MeSH
- výsledek terapie MeSH
- vztah mezi dávkou a účinkem léčiva MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
- Názvy látek
- amidohydrolasy MeSH
- fatty-acid amide hydrolase MeSH Prohlížeč
- inhibitory enzymů * MeSH
BACKGROUND: The potential role of genitourinary infection in the etiology of prostate cancer (CaP) has been extensively investigated for 30 years. Two basic approaches have been used: tissue-based methods (polymerase chain reaction, immunohistochemistry, and in situ hybridization) and serologic assays (enzyme-linked immunosorbent assay, immunofluorescence, etc.). The objective of this review was to answer the question of whether infection of the male genitourinary tract may have a role in the etiology of CaP. MATERIALS AND METHODS: We have carried out a systematic review of the evidence that was published in the MEDLINE/PubMed database until December 2011. The search terms included "prostate cancer," "infection," and the explicit names of the various infectious agents. Additional studies were identified using a reference search. A total of 74 papers were included in the review, which cover the following infectious agents: human papillomavirus, cytomegalovirus, herpes simplex virus, Epstein-Barr virus, human herpesvirus, BK virus, JC virus, chlamydia, mycoplasma, ureaplasma, trichomonas, neisseria, treponema, Propionibacterium acnes, xenotropic murine leukemia virus-related virus and Candida albicans. RESULTS: Despite the variable study designs and methodological approaches that were used, most of the pathogens that were studied were unlikely to be directly involved in prostate carcinogenesis. CONCLUSIONS: The role of infection in the etiology of CaP has yet to be determined despite 30 years of research efforts. A discovery of an infectious agent that is associated with CaP would be of great medical importance; however, such a link would have to be firmly established before impacting on patient care.
- Klíčová slova
- Etiology, Infection, Prostate cancer, Serology, Sexually transmitted diseases,
- MeSH
- bakteriální infekce komplikace diagnóza MeSH
- hodnocení rizik MeSH
- lidé MeSH
- mykózy komplikace diagnóza MeSH
- nádory prostaty diagnóza etiologie MeSH
- rizikové faktory MeSH
- virové nemoci komplikace diagnóza MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
- systematický přehled MeSH
BACKGROUND: The aim of the study was to evaluate prostate transrectal ultrasonography findings in men with congenital hypogonadism treated by long term testosterone replacement therapy. METHODS: We have gradually included 31 men with congenital hypogonadism in period of 2001-2011. The average follow-up was 7.3 years (2 months - 10.8 years). We have used Sustanon® 250 i.m. every 3 weeks or Nebido® i.m. every 3 months for continual testosterone replacement therapy. We performed to all patients the transrectal ultrasonography of prostate and seminal vesicles by biplanar rectal probe every 6 months. RESULTS: During the transrectal ultrasonography we observed in 22 (71.0 %) patients changes in prostatic tissue. In case of 12 patients were diagnosed asymptomatic prostatic cysts, in 9 patients prostatolithiasis and in 5 patients changes in echogenity of prostatic tissue. In 2 patients was found simultaneous occurrence of prostatic cyst and prostolithiasis, in further 2 patients simultaneous occurrence of hyperechogenic prostatic lesion and prostatolithiasis. The above described findings were diagnosed in 5 patients in the treatment lasting from 3 to 5 years, for the other 17 men with hormone replacement therapy longer than 5 years. CONCLUSIONS: The study presents long term results of complex treatment in patients with disorders of sexual development, onset and progress of puberty. The long term treatment of these patients in interdisciplinary cooperation of endocrinologist and andrologist may significantly contribute to clarify an impact of testosterone replacement therapy on prostate development.
- MeSH
- dospělí MeSH
- hormonální substituční terapie * škodlivé účinky MeSH
- hypogonadismus vrozené farmakoterapie MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- nemoci prostaty chemicky indukované diagnostické zobrazování MeSH
- prostata diagnostické zobrazování MeSH
- testosteron škodlivé účinky terapeutické užití MeSH
- ultrasonografie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- testosteron MeSH
This review article provides information on the impact of HIV-1 on male reproductive functions. HIV-positive patients of reproductive age with now a long-term prognosis may wish to have children. If only one partner is infected, natural conception brings the risk of virus transmission. The article reviews the reproduction possibilities for HIV-positive couples and explains the ways to reduce the risk of transmitting the virus to the healthy partner or a child. Assisted reproduction techniques, especially intrauterine insemination, in vitro fertilization and intracytoplasmic sperm injection in combination with sperm washing can successfully reduce the risk of HIV transmission. Current trends and dilemmas of infertility treatment in HIV-positive couples are discussed.
- MeSH
- asistovaná reprodukce * MeSH
- HIV infekce komplikace přenos MeSH
- HIV-1 * MeSH
- lidé MeSH
- mužská infertilita etiologie terapie MeSH
- vertikální přenos infekce * MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- přehledy MeSH
HPV has carcinogenic effects at several anatomical sites in women and men. Whether the presence of HPV in the genitourinary tract of men is associated with a higher prostate cancer risk has been a matter of research for a long-time and the results are still not fully conclusive. Similarly, the question of the reservoir of HPV infection in men is not clearly resolved. HPV DNA presence and types were evaluated by means of polymerase chain reaction in the tissue of 146 patients with benign prostate hyperplasia and prostate cancer. HPV-specific antibodies were analyzed by enzyme-linked immunosorbent assay in the sera of all patients and 172 controls. In addition, 256 biopsies taken from non-tumorous tissues were analyzed. No statistically significant differences were observed in HPV DNA prevalence between patients with benign prostate hyperplasia (2%) and patients with prostatic cancer (2%; P = 1.000). The seropositivity rates did not differ significantly between groups of subjects except for antibodies against HPV 6 VLPs which were found more often in prostate cancer patients (adjusted P = 0.018). Similarly, no difference in the seroprevalence rates for HPV 16 E6 and/or E7 oncoproteins between groups of patients and healthy controls was detected. The overall HPV prevalence in 256 healthy tissue samples was 4%. The results indicate that HPV infection is not associated with prostate oncogenesis in men. However, they imply that multiple tissues of the male genitourinary tract may be important reservoirs for the transmission of some HPV types.
- MeSH
- biopsie MeSH
- DNA virů izolace a purifikace MeSH
- ELISA MeSH
- genotyp MeSH
- infekce papilomavirem komplikace virologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory prostaty epidemiologie virologie MeSH
- Papillomaviridae klasifikace genetika izolace a purifikace patogenita MeSH
- polymerázová řetězová reakce MeSH
- prevalence MeSH
- protilátky virové krev MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
- Názvy látek
- DNA virů MeSH
- protilátky virové MeSH
BACKGROUND: Infection plays a role in the pathogenesis of many human malignancies. Whether prostate cancer (PCa) - an important health issue in the aging male population in the Western world - belongs to these conditions has been a matter of research since the 1970 s. Persistent serum antibodies are a proof of present or past infection. The aim of this study was to compare serum antibodies against genitourinary infectious agents between PCa patients and controls with benign prostate hyperplasia (BPH). We hypothesized that elevated serum antibody levels or higher seroprevalence in PCa patients would suggest an association of genitourinary infection in patient history and elevated PCa risk. METHODS: A total of 434 males who had undergone open prostate surgery in a single institution were included in the study: 329 PCa patients and 105 controls with BPH. The subjects' serum samples were analysed by means of enzyme-linked immunosorbent assay, complement fixation test and indirect immunofluorescence for the presence of antibodies against common genitourinary infectious agents: human papillomavirus (HPV) 6, 11, 16, 18, 31 and 33, herpes simplex virus (HSV) 1 and 2, human cytomegalovirus (CMV), Chlamydia trachomatis, Mycoplasma hominis, Ureaplasma urealyticum, Neisseria gonorrhoeae and Treponema pallidum. Antibody seroprevalence and mean serum antibody levels were compared between cases and controls. Tumour grade and stage were correlated with serological findings. RESULTS: PCa patients were more likely to harbour antibodies against Ureaplasma urealyticum (odds ratio (OR) 2.06; 95% confidence interval (CI) 1.08-4.28). Men with BPH were more often seropositive for HPV 18 and Chlamydia trachomatis (OR 0.23; 95% CI 0.09-0.61 and OR 0.45; 95% CI 0.21-0.99, respectively) and had higher mean serum CMV antibody levels than PCa patients (p = 0.0004). Among PCa patients, antibodies against HPV 6 were associated with a higher Gleason score (p = 0.0305). CONCLUSIONS: Antibody seropositivity against the analyzed pathogens with the exception of Ureaplasma does not seem to be a risk factor for PCa pathogenesis. The presence or higher levels of serum antibodies against the genitourinary pathogens studied were not consistently associated with PCa. Serostatus was not a predictor of disease stage in the studied population.
- MeSH
- Alphapapillomavirus imunologie MeSH
- Chlamydia trachomatis imunologie MeSH
- Cytomegalovirus imunologie MeSH
- dospělí MeSH
- druhová specificita MeSH
- ELISA MeSH
- fluorescenční protilátková technika nepřímá MeSH
- hyperplazie prostaty krev imunologie MeSH
- komplement fixační testy MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské urogenitální nemoci imunologie mikrobiologie virologie MeSH
- Mycoplasma hominis imunologie MeSH
- nádory prostaty krev imunologie MeSH
- Neisseria gonorrhoeae imunologie MeSH
- prostata patologie chirurgie MeSH
- prostatektomie MeSH
- protilátky bakteriální krev MeSH
- protilátky virové krev MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Simplexvirus imunologie MeSH
- studie případů a kontrol MeSH
- Treponema pallidum imunologie MeSH
- Ureaplasma urealyticum imunologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- protilátky bakteriální MeSH
- protilátky virové MeSH
Approximately 15% of men with newly diagnosed cancer are younger than 55 years, and about 26% of them are younger than 20 years. However the most common cause of fertility disorders is oncological treatment itself, the oncological diseases, changes in anatomy, and primary or secondary hormonal insufficiency are also significant factors. The chemotherapy, radiation, or their combination reduce sperm count, impair sperm motility and cause disorders in morphology and DNA integrity. Prognosis of sperm production recovery depends on the type of cancer, stage of the disease, patient age, drug treatment, treatment route and dosage, and pre-treatment male fertility.
- MeSH
- antitumorózní látky škodlivé účinky MeSH
- lidé MeSH
- mužská infertilita etiologie MeSH
- nádory terapie MeSH
- radioterapie škodlivé účinky MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- antitumorózní látky MeSH
As life expectancy of patients infected by Human Immunodeficiency Virus (HIV) has prolonged, they are treated by physicians of different specialities. This article focuses on urologic complications of HIV infection. Urinary tract infections in HIV positive patients are more frequent than in otherwise healthy individuals and less common microorganisms can be involved. Sexually transmitted diseases are a commonplace. Certain malignancies of the genitourinary tract are more often diagnosed in HIV positive than in HIV negative population. Impairment of kidney function is usually caused by HIV-associated nephropathy. Acute renal failure can also occur. Indinavir causes urinary stones formation. Male circumcision is an effective method of HIV transmission prevention.
- MeSH
- HIV infekce komplikace prevence a kontrola MeSH
- infekce močového ústrojí komplikace MeSH
- lidé MeSH
- nefropatie doprovázející AIDS komplikace MeSH
- urogenitální nádory komplikace MeSH
- urologické nemoci komplikace MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- přehledy MeSH
AIM: The aim of the study is to investigate the value of preoperative power Doppler sonography with 3D reconstruction (3D-PDS) for diagnostics of extraprostatic extension of prostate cancer. PATIENTS AND METHODS: In the prospective study we examined 146 patients with clinically localized prostate cancer who underwent radical prostatectomy. Prior to surgery, each patient underwent 3D-PDS, transrectal ultrasound (TRUS), and digital rectal examination (DRE). Furthermore, we determined the prostate volume, prostate specific antigen (PSA) level, PSA density (PSAD), and Gleason score. The risk of locally advanced cancer was assessed using Partin tables. We determined the sensitivity, specificity, and predictive values of these diagnostic procedures. We plotted the receiver operating characteristic (ROC) curves and calculated the areas under the curves (AUC). Multivariate logistic regression was used to identify the significant predictors of extraprostatic tumor extension. Based on this we developed diagnostic nomograms maximizing the probability of accurate diagnosis. RESULTS: The significant differences between patients with organ confined and locally advanced tumor (based on the postoperative assessment) were observed in the PSA levels (P < 0.014), PSAD (P < 0.004), DRE (P < 0.037), TRUS (P < 0.003), and 3D-PDS (P < 0.000). The highest AUC value of 0.776 (P < 0.000) was found for 3D-PDS. The observed AUC value for TRUS was 0.670 (P < 0.000) and for PSAD 0.639 (P < 0.004). In multivariate regression analysis, the PSAD, preoperative Gleason score, and 3D-PDS finding were identified as significant preoperative predictors of extraprostatic tumor extension. CONCLUSION: Our data suggest that the 3D-PDS is a valuable preoperative diagnostic examination to identify locally advanced prostate cancer. Therefore, it can be used to maximize the probability of the accurate diagnosis of extraprostatic tumor extension.
- MeSH
- interpretace obrazu počítačem metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- multivariační analýza MeSH
- nádory mužských pohlavních orgánů sekundární MeSH
- nádory prostaty diagnostické zobrazování patologie chirurgie MeSH
- prospektivní studie MeSH
- prostatektomie MeSH
- rizikové faktory MeSH
- semenné váčky patologie MeSH
- senioři MeSH
- senzitivita a specificita MeSH
- ultrasonografie dopplerovská metody MeSH
- zobrazování trojrozměrné metody MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- hodnotící studie MeSH
- srovnávací studie MeSH
Alterations of CD44 glycoproteins have been shown to play an important role in progression of various malignancies, including urothelial cancer. We investigated expression patterns of CD44s and CD44v6 in transitional cell carcinoma (TCC) of the urinary bladder in relation to tumour grade, proliferative activity, and immunoreactivity for p53. The selected markers were detected immunohistochemically in 122 samples of TCC. We found a close relationship between CD44s and CD44v6 expression and tumour grade. The extension of positive staining for CD44s and CD44v6 towards the luminal surface was a predominant feature of differentiated carcinomas (grades 1 and 2), suggesting deranged maturation of cancer cells related to their neoplastic transformation. Heterogeneous expression of CD44s and CD44v6 predominated in poorly differentiated tumours (G3-4). However, areas of squamous differentiation within the high-grade tumours displayed strong immunoreactivity for both CD44s and CD44v6. The proliferative activity and p53 overexpression increased with the dedifferentiation of the tumour. The results of this study are discussed in relation to the significance of CD44 expression in TCC and to the explanation for controversial results reported in previous studies on the relationship between CD44 expression and the biological behaviour of urothelial cells.
- MeSH
- antigen Ki-67 metabolismus MeSH
- antigeny CD44 genetika MeSH
- buněčné dělení MeSH
- CD antigeny genetika MeSH
- glykoproteiny genetika MeSH
- karcinom z přechodných buněk genetika imunologie patologie MeSH
- lidé MeSH
- nádorový supresorový protein p53 metabolismus MeSH
- nádory močového měchýře genetika imunologie patologie MeSH
- staging nádorů MeSH
- urotel imunologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- antigen Ki-67 MeSH
- antigeny CD44 MeSH
- CD antigeny MeSH
- CD44v6 antigen MeSH Prohlížeč
- glykoproteiny MeSH
- nádorový supresorový protein p53 MeSH