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Prague, Czech Republic

Tilandyova P.,Ustav patologickej anatomie | Kajo K.,Ustav patologickej anatomie | Kliment J.,Urologicka Klinika | Plank L.,Ustav patologickej anatomie | Lasabova Z.,Ustav Molekulovej Biologie
Klinicka Onkologie | Year: 2010

Prostate cancer is one of the most common malignant diseases in men above the age of 50. A genetic predisposition and/or acquired genetic and epigenetic changes together with life-style contribute to the development of the disease. The most studied epigenetic modification in prostate cancer is the methylation of the cytosine located within the dinucleotide CpG of promoter regions of different genes by methylation specific PCR. The evidence of gene silencing by DNA methylation in genes like GSTP1, APC or RASF1 is a common and relatively specific event in prostate cancer. DNA methylation testing can be performed on tissue samples or urine, ejaculate or serum. Translational research is searching for new biomarkers for early detection and prognosis of prostate cancer, but because of large methodological differences in applied techniques and patient cohorts, the investigations have yielded promising, but also some controversial results. More prospective randomized trials and standardized methods are needed to assess the true value of methylation for the diagnosis and prognosis of prostate cancer.

The ideal treatment of ED considering the patient's welfare should be easy to administer, non-invasive, painless and highly effective, with minimal side effects. Modern, oral first-line erectile dysfunction therapy using phosphodiesterase 5 inhibitors is safe, effective and well tolerated. Intracavernosal therapy as the second-line therapy is safe and effective in diabetic patients, in men with cardiovascular disease and in men who have undergone radical prostatectomy. A new method of erectile dysfunction therapy is low- intensity extracorporeal shock wave therapy which produces neovascularization. Lifestyle changes (intensive exercise and decrease in Body Mass Index) can improve erectile function. © 2014, Ambit Media a.s. All rights reserved.

Medical examination of children with incontinence is primarily carried out by a paediatrician. Basic examination enables differentiation between functional voiding disorder and more serious forms of incontinence. In the case of functional voiding disorder, treatment is initiated by the paediatrician. When basic treatment fails, or in the case of suspected organic anomaly the paediatrician should refer the child to a specialized clinic for advanced examination.

Erectile dysfunction is defined as an inability to achieve and maintain an erection sufficient for satisfactory sexual intercourse. Erectile dysfunction incidence is common worldwide. Erectile dysfunction may be the first clinical manifestation of endothelial dysfunction. Erectile dysfunction shares risk factors with cardiovascular disease and is a predictor of a serious cardiovascular event in men who are 30-60 years of age and in diabetic patients over a period of two to five years. © 2014, Ambit Media a.s. All rights reserved.

Martan A.,Gynekologicko Porodnicka Klinika | Masata J.,Gynekologicko Porodnicka Klinika | Svabik K.,Gynekologicko Porodnicka Klinika | El-Haddad R.,Gynekologicko Porodnicka Klinika | And 2 more authors.
Ceska Gynekologie | Year: 2015

Objective: The objective of this study was to evaluate the cure effect of a transurethral injection of Bulkamid® for recurrent female stress and mixed urinary incontinence in women who had undergone failed tape surgery. Our hypothesis was that cure effect of Bulkamid® is positive in patients when previous tape anti-incontinence surgery has been unsuccessful. Design: Retrospective clinical study. Settings: Department of Obstetrics and Gynecology, 1st Medical Faculty, Charles University and General Faculty Hospital in Prague Materials and methods: This retrospective study featured 34 patients with recurrent urinary incontinence (SUI: 28, mixed: 6 - predominant symptom was SUI) after unsuccessful tape anti-incontinence surgery. 25 of the patients had undergone anti-incontinence surgery more than once. The cure effect of a transure-thral injection of Bulkamid® was evaluated an average of 29 months after the surgery; the minimum period after surgery was 6 months. Subjective assessment of the leakage of urine was based on the International Consultation on Incontinence Questionnaire - Short form (ICIQ-UI SF) filled in before and after surgery. An improvement in urinary incontinence was defined as a drop in the score of more than 50%. Objective assessment of leakage of urine was assessed by cough test. The cure effect was evaluated by VAS (Visual Analogue Scale) score and by using the five-point Likert score. Ethical committee approval was obtained, and all subjects gave written informed consent to participate in the study. Results: The mean age of patients was 71.03 years, mean body mass index (BMI) 29.12 and mean parity 1.91. The cough test showed that 4/34 (11.8%) of patients had negative results for this test after the operation. The ICIQ-UI SF questionnaire showed that 14/34 (41.2%) of our patients were dry or improved after surgery. The mean VAS score was 62.4 after the operation. The Likert score was 4 or 5 (cured or improved) after the operation for 88.2% of patients. Conclusions: Our hypothesis that the cure effect of Bulkamid® operation would be positive in patients who have undergone previous unsuccessful tape anti-incontinence surgery was partially confirmed. The Likert and VAS scores indicate that the effect of Bulkamid® surgery is good; however, an evaluation of the cure effect of this procedure based on the ICIQ-UI SF score is less positive. This kind of operation, which is minimally invasive, is less arduous for patients, and it is also suitable for patients who have refused further surgical treatment.

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