Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0376358 (prostate cancer)
 59,338 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of paraplegia occurring after a spinal anaesthetic is reported. The 79-year-old man was admitted for a fractured neck of femur. Twenty years previously, he had had pharyngeal surgery and a tracheostomy. He had also undergone a prostatectomy for prostate cancer, and had been on oestrogen therapy for two years. He complained of dyspnoea at rest and his chest film showed diffuse pulmonary opacities. In order to avoid possible intubation and respiratory complications, spinal anaesthesia was performed without any problems in the L4 space. After the surgery, the patient recovered all his motor and sensory functions in the lower limbs. On the second postoperative day, he suffered from a motor paralysis of the right leg, which spread to the left leg on the fourth day. NMR imaging showed several vertebral metastases, together with anterior and lateral epidural invasion responsible for cord compression. Treatment with tetracosactide was begun, but the patient died six weeks later in his home, not having recovered any neurological function at all in his lower limbs. In fact, it was only after the procedure that the anaesthetist was informed that, at the time the prostate cancer had been diagnosed, vertebral body metastases, of which the patient had not been informed, were already present. The part played by the spinal anaesthetic in the occurrence of the paraplegia is not clear. It is reminded that such a technique should be used with extreme care in patients having a neoplasm with a very often high incidence of vertebral metastases.
 ...
PMID:[Paraplegia after spinal anesthesia]. 150 98

In seven studies of complicated and recurrent urinary tract infections, 285 patients were treated with norfloxacin 400 mg b.i.d. for 7-90 days. The majority of the patients were men, and many were elderly. Underlying diseases included nephrolithiasis, pyelonephritis, prostatism, bacterial prostatitis, prostate cancer, retroperitoneal fibrosis, quadriplegia/paraplegia, neurogenic bladder, and urethral stricture. Many of the infections were due to Pseudomonas aeruginosa or other multiply resistant strains. More than 95% of the pretreatment bacterial isolates were susceptible to norfloxacin. The bacteriologic cure rate ranged from 67 to 100%. Of 45 patients with chronic bacterial prostatitis, 40 (89%) were cured. Few failures of treatment were due to the emergence of bacterial resistance. Of 29 recurrent infections, 6 (20%) were caused by resistant bacteria. Both clinical and laboratory adverse reactions were infrequent and minor, and rarely required discontinuation of therapy. Norfloxacin appears to be an effective drug with an excellent safety profile for the treatment of complicated and recurrent UTIs.
 ...
PMID:Review of norfloxacin in complicated and recurrent urinary tract infections. 219 65

We treated 191 patients with histologically proved locally advanced stage (T3 or T4) and/or metastatic prostate cancer with a biodegradable depot formulation of a luteinizing hormone-releasing hormone analogue (Zoladex). After an initial increase in serum testosterone in week 1 of therapy a continuous decrease of testosterone to castrate levels was obtained. With a monthly injection of the luteinizing hormone-releasing hormone analogue 4 patients (2 per cent) experienced a transient increase in bone pain, 1 had ureteral obstruction and 1 suffered paraplegia during the first few weeks of therapy. Over-all objective and subjective responses were similar to those obtained by castration or estrogen therapy. The absence of local and systemic (long-term) side effects proves the validity of this approach for patients with advanced prostatic cancer.
 ...
PMID:Long-term therapy with a depot luteinizing hormone-releasing hormone analogue (Zoladex) in patients with advanced prostatic carcinoma. 297 Nov 19

Ketoconazole in high doses causes castrate levels of testosterone within twenty-four to forty-eight hours; therefore it is extremely useful in the initial medical treatment of patients with metastatic prostate cancer who need a prompt therapeutic response. Review of 17 patients who presented with severe radicular pain or acute paraparesis/paraplegia showed that there was frequent delay in urologic consultation, pathologic confirmation, and initiation of efficacious therapy. In fact, 5 of 12 patients (42%) who received radiation therapy prior to effective hormonal therapy suffered significant morbidity and mortality. The case is made for the use of ketoconazole for initial empirical therapy for these patients.
 ...
PMID:Ketoconazole in initial management and treatment of metastatic prostate cancer to spine. 317 17

A retrospective analysis of data from the treatment of 95 men with nonbacteremic urinary tract infections (UTIs) (clean-catch urinary bacterial count greater than or equal to 10(5) colony-forming units/ml) who received norfloxacin (400 mg orally twice daily) was performed. Treatment duration ranged from a required minimum of seven days to a maximum of 30 days. If an underlying anatomic or functional condition existed that might decrease the likelihood of a favorable medical response and/or require prolonged treatment, the patient's UTI was considered "complicated." In addition to eight patients with polymicrobic UTIs (usually involving enterococci or Pseudomonas aeruginosa), 48 men (i.e., 51 percent of the total population) had an identifiable complication. Complications included benign prostatic hypertrophy in 13 patients; prostatic cancer in four; urethral stricture in four; quadriplegia/paraplegia with indwelling urinary catheter in four; prostatism in three; and other conditions commonly recognized as altering the response to antibiotic treatment. Among the 95 patients treated, 76 (80 percent) were considered to have had a cure and five (5 percent) showed improvement. Fourteen patients (15 percent) failed to show a response to treatment. Of the 48 patients with UTI and defined complications, 36 (75 percent) had a cure, three (6 percent) showed improvement, and therapy failed in nine (19 percent). Ninety-seven percent (105 of 108) of the pretreatment bacterial isolates were susceptible to norfloxacin. In addition to the three resistant organisms that were present prior to therapy, three organisms (two P. aeruginosa and one Enterobacter) persisted and acquired resistance during therapy. Five adverse clinical experiences and six adverse laboratory experiences were noted. Only one of the former (mild heartburn) was thought to be drug related, and no adverse experience was considered serious or required discontinuation of treatment. Gastrointestinal tolerability of oral norfloxacin was good.
 ...
PMID:Norfloxacin in the treatment of urinary tract infections in men with and without identifiable urologic complications. 330 Mar 14

Metastatic carcinoma of the prostate is a common cause of spinal cord compression. In this review of 37 men who underwent laminectomy for this condition this was the first presentation of previously undiagnosed cancer in 11 (29%). One year after decompression 17 (50%) were alive. Twenty patients (59%) could walk after laminectomy. All but 8 were relieved of pain and bladder function was improved in 13 (38%). Those ambulant before laminectomy (7) and those with occult prostate cancer did particularly well. Poor results were associated with a rapid onset of paraparesis and pre-operative progression to paraplegia. A delay in diagnosis was detrimental to outcome. A high index of suspicion in patients with carcinoma of the prostate is essential so that early diagnosis can be made before paraplegia is established. Carcinoma of the prostate must always be excluded in men with cord compression of unknown aetiology.
 ...
PMID:Cord compression and carcinoma of the prostate: is laminectomy justified? 408 36

Of 35 patients with prostate carcinoma and suspected spinal cord compression 26 (74%) had myelograms and/or magnetic resonance imaging studies demonstrating epidural spinal cord compression. In 5 of 26 patients (19%) spinal cord compression was the first indication of prostate cancer. All patients were initially treated with radiation, steroids and androgen deprivation therapy. Three patients underwent laminectomy. Of 12 patients (100%) ambulatory at presentation 12 remained ambulatory. Of 12 patients (83%) who were paraparetic at presentation 10 were ambulatory after treatment. However, 2 of these patients subsequently had recurrent compression and became paraplegic. Overall, 7 of 26 patients (27%) had recurrent compression. Of 5 patients who either presented with paraplegia or in whom paraplegia developed secondary to recurrent spinal cord compression 4 remained paraplegic despite treatment. The average survival of these 5 patients after treatment was 3.9 months versus 18 months for the group as a whole. In ambulatory or paraparetic patients radiation, androgen deprivation therapy and steroids are effective palliative therapy. However, patients who present with paraplegia or in whom paraplegia developed secondary to recurrent compression are often not palliated by this combination therapy. Prophylactic radiation of vertebral metastases discovered concurrently with compressive metastases may be valuable in preventing paraplegia.
 ...
PMID:Spinal cord compression secondary to prostate carcinoma: treatment and prognosis. 842 13

Matrix metalloproteinases (MMPs) play a significant role during the development and metastasis of prostate cancer (CaP). CaP cells secrete high levels of MMPs and low levels of endogenous MMP inhibitors (TIMPs), thus creating an excess balance of MMPs. Established CaP cell lines that express high levels of MMPs frequently metastasize to the bone and the lungs. Drugs such as Taxol and alendronate that reduce cell motility and calcium metabolism reduce bony metastasis of xenografted CaP tumors. We tested several synthetic, nontoxic inhibitors of MMPs that can be administered orally, including doxycycline (DC) and chemically modified tetracyclines (CMTs) on CaP cells in vitro and on a rat CaP model in vivo. Among several anti-MMP agents tested, CMT-3 (6-deoxy, 6-demethyl,4-de-dimethylamino tetracycline) showed highest activity against CaP cell invasion and cell proliferation. Micromolar concentration of CMT-3 and DC inhibited both the secretion and activity of MMPs by CaP cells. When tested for in vivo efficacy in the Dunning rat CaP model by daily oral gavage, CMT-3 and DC both reduced the lung metastases (> 50%). CMT-3, but not DC, inhibited tumor incidence (55 +/- 9%) and also reduced the tumor growth rate (27 +/- 9.3%). More significantly, the drugs showed minimum systemic toxicity. Ongoing studies indicate that CMT-3 may inhibit the skeletal metastases of CaP cells and delay the onset of paraplegia due to lumbar metastases. These preclinical studies provide the basis for clinical trials of CMT-3 for the treatment of metastatic disease.
 ...
PMID:MMP inhibition in prostate cancer. 1041 36

The literature on spinal cord involvement in prostate cancer is reviewed by searching the Medline from 1965 to 1997 and references in publications on the subject. The objective was to identify the clinical characteristics and treatment modalities of the disease. Prostate cancer is the leading cause of metastatic spinal cord disease in men. The tumour reaches the spinal column mainly by the venous route. The frequency of involvement in decreasing order is thoracic spine, lumbar spine and cervical spine. The tumour usually exerts compression of the cord from the extradural space. However, intradural and intramedullary metastases have devastating effects. The patients have other neurological and urological symptoms prior to the onset of paraplegia. But in some, spinal cord compression may be the first symptom of prostate cancer. Plain X-rays may suffice in diagnosis but MRI is the single most valuable investigation for anatomic definition or localization of spinal cord secondaries. All forms of treatment are palliative. Treatment options, singly or in combination, include hormonal manipulation, radiotherapy and laminectomy each often with high dose corticosteroids. Recurrence of symptoms after an initial relief with hormonal manipulation signifies escape of the tumour from endocrine control and portends a poor prognosis.
 ...
PMID:Symptomatic spinal cord involvement in prostate cancer. 1195 73

This was a ten-year, hospital-based retrospective study for the incidence and clinical pattern of prostate cancer in southeastern Nigeria. Clinical information extracted from the files included the TNM stage, histo-pathological grading, level of prostatic acid phosphatase (PAP), mode of presentation and clinical and biochemical response to intravenous and oral diethylstilboestrol diphosphate (Honvan)/ orchidectomy. There were 145 patients, mean age 66.6 + 9.8 years, giving an incidence of 61.3 per 10(5), with 54% under 70 years. Most patients (81.4%) presented late, with 62% metastatic. Over 98% were adenocarcinomas, 77% of which were moderate to well-differentiated cancers. PAP was elevated in 109 patients (75%), (representing 92% of all advanced tumours), and normal in 36 (25%). Forty-two percent of poorly differentiated cancers had normal levels of PAP. Most patients presented with urinary retention (56%), prostatism (44%), anaemia (41%), recurrent UTI (35%), bone pains (20%), haematuria (18%), backache (16%) and paraplegia (6%). Nearly 79% responded to treatment with lowered PAP levels and improved quality of life, within a mean of 26.3+/-13.8 months (range 5-78); objective 81 (58%), subjective 32 (23%), no response 27 (19%). Among paraplegics, 78% had full, and 22% had partial motor recovery. Patients with poorly differentiated cancers had only a 33% two-year survival rate. This study confirmed an upward, though moderate trend in the incidence of prostate cancer in Nigeria. The use of PAP instead of PSA as the tumor marker, a local diet with high fish content but lower animal fat, and poor hospital access may account for the lower incidence in the southeast. Poor health education may account for the high rate of late presentations.
 ...
PMID:The changing pattern of prostate cancer in Nigerians: current status in the southeastern states. 1212 88


1 2 Next >>