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Aditya Dutta, Sukanya Panja, Renu K Virk, Jaime Yeji Kim, Roseann Zott, Serge Cremers, David M Golombos, Deli Liu, Juan Miguel Mosquera, Elahe A Mostaghel, Christopher E Barbieri, Antonina Mitrofanova, Cory Abate-Shen
BACKGROUND: Although men on active surveillance for prostate cancer (PCa) may benefit from intervention with 5α-reductase inhibitors (5-ARIs), it has not been resolved whether 5-ARIs are effective for delaying disease progression and, if so, whether specific patients are more likely to benefit. OBJECTIVE: To identify molecular features predictive of patient response to 5-ARIs. DESIGN, SETTING, AND PARTICIPANTS: Nkx3.1 mutant mice, a model of early-stage PCa, were treated with the 5-ARI finasteride, and histopathological and molecular analyses were performed...
April 3, 2017: European Urology
Teemu J Murtola, Anniina Virkku, Kirsi Talala, Ulf-Håkan Stenman, Kimmo Taari, Teuvo Lj Tammela, Anssi Auvinen
PURPOSE: Prostate cancer (PCa) screening with prostate-specific antigen (PSA) reduces PCa mortality, but leads to overdiagnosis of indolent PCa. Use of 5-alpha reductase inhibitors (5-ARIs) lowers PSA and in theory could affect performance of PSA-based screening. We evaluated outcomes of PCa screening among 5-ARI users. MATERIALS AND METHODS: The study was performed within the Finnish Randomized Study of Screening for Prostate Cancer. Of 80,454 men, 31,866 were randomized to be screened at four-year intervals during 1996-2004...
February 16, 2017: Journal of Urology
Olga Starobinets, John Kurhanewicz, Susan M Noworolski
The purpose of this study was to determine whether 5α-reductase inhibitors (5-ARIs) affect the discrimination between low-grade prostate cancer and benign tissues on multiparametric MRI (mpMRI). Twenty men with biopsy-proven Gleason 3 + 3 prostate cancer and 3 T mpMRI were studied. Ten patients (Tx) had been receiving 5-ARIs for at least a year at scan time. Ten untreated patients (Un) were matched to the treated cohort. For each subject two regions of interest representing cancerous and benign tissues were drawn within the peripheral zone of each prostate, MR measures evaluated, and cancer contrast versus benign (contrast = (MRTumor  - MRHealthy )/MRHealthy ) calculated...
May 2017: NMR in Biomedicine
Lauren P Wallner, Julia R DiBello, Bonnie H Li, Stephen K Van Den Eeden, Sheila Weinmann, Debra P Ritzwoller, Jill E Abell, Ralph D'Agostino, Ronald K Loo, David S Aaronson, Kathryn Richert-Boe, Ralph I Horwitz, Steven J Jacobsen
OBJECTIVE: To compare the risk of prostate cancer mortality among men treated with 5- alpha reductase inhibitors (5-ARIs) with those treated with alpha-adrenergic blockers (ABs) in community practice settings. PATIENTS AND METHODS: A retrospective matched cohort (N=174,895) and nested case-control study (N=18,311) were conducted in 4 regions of an integrated health care system. Men 50 years and older who initiated pharmaceutical treatment for benign prostatic hyperplasia between January 1, 1992, and December 31, 2007, and had at least 3 consecutive prescriptions were followed through December 31, 2010...
December 2016: Mayo Clinic Proceedings
Ankur Bansal, Aditi Arora
OBJECTIVE: To evaluate the effects of short term use of finasteride and dutasteride on the amount of intraoperative blood loss and microvessel density (MVD) of prostatic stromal and suburethral tissues in the patients with benign prostatic hyperplasia (BPH) prior to transurethral resection of prostate (TURP). METHODS: The study involved 450 male patients who planned to have TURP and were prospectively randomized into 3 groups (150 patients each). Group 1 received placebo, group 2 received finasteride 5 mg/day and group 3 received dutasteride 0...
January 11, 2017: Journal of Endourology
Chris Olesovsky, Anil Kapoor
Benign prostatic hyperplasia (BPH) is an age-related phenomenon associated with prostatic enlargement and bladder outlet obstruction that can cause significant lower urinary tract symptoms (LUTS). These LUTS have a negative impact on an individual's quality of life, which is why treatment of symptomatic BPH has become a major priority. Although surgical interventions exist for treating BPH, pharmacological therapies are often preferred due to their minimal invasiveness and high degree of effectiveness. The three classes of drugs approved for treating BPH include α-blockers, 5-α-reductase inhibitors (5-ARIs) and phosphodiesterase 5 (PDE-5) inhibitors...
August 2016: Therapeutic Advances in Urology
Josephina G Kuiper, Irene D Bezemer, Maurice T Driessen, Averyan Vasylyev, Claus G Roehrborn, Fernie J A Penning-van Beest, Ron M C Herings
BACKGROUND: Previous studies have suggested a greater benefit for various outcomes in men diagnosed with benign prostatic hyperplasia (BPH) who are treated with dutasteride than for men treated with finasteride. This study investigates whether the rates of BPH-related prostate surgery and acute urinary retention (AUR) differ between dutasteride and finasteride users in the Netherlands. METHODS: From the PHARMO Database Network, men aged ≥50 years with a dispensing of dutasteride or finasteride with or without concomitant alpha-blocker treatment between March 1, 2003 and December 31, 2011 were selected...
August 31, 2016: BMC Urology
Vincenzo Favilla, Giorgio Ivan Russo, Salvatore Privitera, Tommaso Castelli, Raimondo Giardina, Aldo E Calogero, Rosita A Condorelli, Sandro La Vignera, Sebastiano Cimino, Giuseppe Morgia
Lower urinary tract symptoms (LUTS) secondary to benign prostatic obstruction (BPO) represent one of the most common clinical complaints in adult men. Several drugs used for LUTS/BPO may strongly affect sexual function and bother. The aim of this systematic review and meta-analysis was to evaluate the impact of combination therapy with alpha-blockers (AB), 5-alpha reductase inhibitors (5-ARI) on the risk of erectile dysfunction(ED) and libido alterations (LA) from randomized clinical trial (RCT). Based on the inclusion and exclusion criteria, five RCTs involving 6131 patients were included in the analysis...
September 2016: Aging Male: the Official Journal of the International Society for the Study of the Aging Male
Zachary Hamilton, J Kellogg Parsons
Prevention is an important treatment strategy for diminishing prostate cancer morbidity and mortality and is applicable to both early- and late-stage disease. There are three basic classifications of cancer prevention: primary (prevention of incident disease), secondary (identification and treatment of preclinical disease), and tertiary (prevention of progression or recurrence). Based on level I evidence, 5-alpha reductase inhibitors (5-ARIs) should be considered in selected men to prevent incident prostate cancer...
April 2016: Current Urology Reports
J Quentin Clemens, Howard B Goldman, Kelly H Zou, Xuemei Luo, David Russell, Douglass S Chapman, Canan B Esinduy, Jennifer T Anger
PURPOSE: We examined diagnostic tests and treatment patterns in men with new onset benign prostatic hyperplasia using consolidated national electronic health record data. MATERIALS AND METHODS: The Humedica® electronic health record database consists of de-identified patient records from approximately 25 million patients in the United States. Using this database, men with a new benign prostatic hyperplasia diagnosis (benign prostatic hyperplasia, bladder neck obstruction, urinary retention and incomplete bladder emptying) between July 1, 2009 and June 30, 2012 were included in study...
July 2016: Journal of Urology
Teemu J Murtola, Elina K Karppa, Kimmo Taari, Kirsi Talala, Teuvo L J Tammela, Anssi Auvinen
Randomized clinical trials have shown that use of 5α-reductase inhibitors (5-ARIs) lowers overall prostate cancer (PCa) risk compared to placebo, while the proportion of Gleason 8-10 tumors is elevated. It is unknown whether this affects PCa-specific survival. We studied disease-specific survival by 5-ARI usage in a cohort of 6,537 prostate cancer cases diagnosed in the Finnish Prostate Cancer Screening Trial and linked to the national prescription database for information on medication use. Cox proportional hazards regression was used to estimate hazard ratios and 95% confidence intervals for prostate cancer-specific deaths...
June 15, 2016: International Journal of Cancer. Journal International du Cancer
Furio Pirozzi Farina, Antonella Pischedda
Treatment-induced sexual dysfunctions (SD) are a recurrent and controversial topic in recent literature on the adverse events related to the use of 5-alpha-reductase inhibitors (5ARIs) (1, 2). In order to deal adequately with the various aspects of this topic, it is necessary to first cover some of the steps that allow a better definition and understanding of the subject.
December 2015: Archivio Italiano di Urologia, Andrologia
A La Torre, G Giupponi, D Duffy, A Conca, T Cai, A Scardigli
UNLABELLED: Sexual dysfunction is a potential side effect of BPH (benign prostatic hyperplasia) and LUTS (lower urinary tract symptoms) drugs: this article is a critical review of the current literature. Many studies have been published on this topic. Methodological flaws limit the conclusions of these studies, mainly because of the lack of diagnostic criteria for ejaculatory and sexual desire dysfunction. Few of these studies are RCTs. The α-blocker (also called α1-adrenergic antagonist, alpha-adrenoceptor antagonist, alpha-blocker or AB) and 5-ARI (also called 5α-reductase inhibitor or testosterone-5-alpha reductase inhibitor) drugs can in particular cause erectile dysfunction, ejaculatory disorders and reduction of sexual desire...
January 2016: Pharmacopsychiatry
David Robinson, Hans Garmo, Pär Stattin, Karl Michaëlsson
BACKGROUND: Lower urinary tract symptoms are common among older men and 5-α reductase inhibitors (5-ARI) are a group of drugs recommended in treating these symptoms. The effect on prostate volume is mediated by a reduction in dihydrotestosterone; however, this reduction is counterbalanced by a 25% rise in serum testosterone levels. Therefore, 5-ARI use might have systemic effects and differentially affect bone mineral density, muscular mass and strength, as well as falls, all of which are major determinants of fractures in older men...
2015: PloS One
Johann Fontana, Holger Wenz, Kirsten Schmieder, Martin Barth
BACKGROUND: This study was designed to evaluate the potential of the dynamic autoregulation index (ARI) to serve as an early warning system for an imminent clinical deterioration after subarachnoid hemorrhage (SAH). METHODS: All patients received a baseline digital subtraction angiography and a computed tomography (CT) prior to treatment. The clinical status, the ARI, and the transcranial Doppler (TCD) values were evaluated daily until discharge from the intensive care unit (ICU)...
May 2016: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
Gisele Lima Bezerra, Carlos Rocha Gomes Torres, Mateus Rodrigues Tonetto, Alvaro Henrique Borges, Milton Carlos Kuga, Matheus Coelho Bandeca, Leily Macedo Firoozmand
The objective of this study is to assess, in vitro, the shear bond strength of orthodontic brackets fixed with remineralizing adhesive systems submitted to thermomechanical cycling, simulating one year of orthodontic treatment. Sixty-four bovine incisor teeth were randomly divided into 4 experimental groups (n = 16): XT: Transbond XT, QC: Quick Cure, OL: Ortholite Color, and SEP: Transbond Plus Self-Etching Primer. The samples were submitted to thermomechanical cycling simulating one year of orthodontic treatment...
2015: TheScientificWorldJournal
Seth A Strope, Joel Vetter, Sean Elliott, Gerald L Andriole, Margaret A Olsen
OBJECTIVE: To assess the impact of surgery for benign prostatic hyperplasia (BPH) on use of medication (5-alpha reductase inhibitors, alpha blockers, antispasmodics), we assessed preoperative and postoperative medication utilization among surgically treated men. PATIENTS AND METHODS: Using the Truven Health Analytics MarketScan Commercial Claims Database, we defined a cohort of men aged <65 years who had surgical therapy for BPH with either transurethral resection of the prostate (TURP) or laser procedures from 2007 through 2009...
December 2015: Urology
Kentaro Yamakawa, Pradeep S Rajendran, Tatsuo Takamiya, Daigo Yagishita, Eileen L So, Aman Mahajan, Kalyanam Shivkumar, Marmar Vaseghi
Vagal nerve stimulation (VNS) has been shown to have antiarrhythmic effects, but many of these benefits were demonstrated in the setting of vagal nerve decentralization. The purpose of this study was to evaluate the role of afferent fiber activation during VNS on efferent control of cardiac hemodynamic and electrophysiological parameters. In 37 pigs a 56-electrode sock was placed over the ventricles to record local activation recovery intervals (ARIs), a surrogate of action potential duration. In 12 of 37 animals atropine was given systemically...
November 2015: American Journal of Physiology. Heart and Circulatory Physiology
Ralph R Scholten, Fred K Lotgering, Maria T Hopman, Arie Van Dijk, Maureen Van de Vlugt, Mirian C H Janssen, Marc E A Spaanderman
Formerly preeclamptic women are at risk for cardiovascular disease. Low plasma volume may reflect latent hypertension and potentially links preeclampsia with chronic cardiovascular disease. We hypothesized that low plasma volume in normotensive formerly preeclamptic women predisposes to hypertension. We longitudinally studied n=104 formerly preeclamptic women in whom plasma volume was measured 3 to 30 months after the preeclamptic pregnancy. Cardiovascular variables were assessed at 2 points in time (3-30 months postpartum and 2-5 years thereafter)...
November 2015: Hypertension
Sara C Martinez, Mirnela Byku, Eric L Novak, Ari M Cedars, Pirooz Eghtesady, Philip A Ludbrook, Joseph J Billadello
OBJECTIVE: Obesity affects adults with congenital heart disease (CHD). The effect of an increased body mass index (BMI) with respect to morbidity and mortality has not been evaluated in adults with complex CHD. Our objective was to evaluate the effects of increased BMI on heart failure and mortality in univentricular patients who had undergone Fontan palliation. METHODS: A query of Fontan patients' first appointments at the Washington University Center for Adults with CHD between 2007 and 2014 yielded 79 patients...
January 2016: Congenital Heart Disease
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