Controversies regarding testosterone supplementation in the prostate cancer patient

Clinical interest has recently increased for the concept of testosterone replacement therapy (TRT) to ameliorate the signs and symptoms of low testosterone levels (ie, hypogonadism). Any history of prostate cancer has been traditionally considered as an absolute contraindication to TRT. Because there are many younger patients with improved survival rates and cure after having undergone radical prostatectomy, TRT is considered more frequently by urologists for prostate cancer patients who are biochemically and pathologically free of disease. The purpose of this communication is to review the literature, formulate general guidelines for TRT in prostate cancer patients, and identify areas of future research.     

Rhabdomyolysis and severe muscle weakness secondary to colistin therapy

Rhabdomyolysis is a clinical condition that causes renal failure up to 40%. Rhabdomyolysis may be traumatic or nontraumatic. Colistin (polymyxin E) is an effective antibiotic. Nephrotoxicity is a frequently encountered side effect. The nephrotoxic effect of colistin is thought to be associated with increased membrane permeability, cell swelling and lysis, and the development of acute tubular necrosis. Here, we report a case of nontraumatic rhabdomyolysis associated with the use of colistin. There is only one report of rhabdomyolysis secondary to colistin in the literature, and there is no report of a case developing severe tetraparesis, as in our case.     

Subclinic arterial and left ventricular systolic impairment in autosomal dominant polycystic kidney disease with preserved renal functions

The International Journal of Cardiovascular Imaging - Subclinical atherosclerosis and cardiovascular events are common even in young normotensive patients with autosomal dominant polycystic kidney...     

Methamphetamine causes lipid peroxidation and an increase in superoxide dismutase activity in the rat striatum

The administration of methamphetamine to experimental animals results in damage to nigrostriatal dopaminergic neurons. In the present study, we demonstrated that both the acute repeated and the chronic administration of methamphetamine causes an increase in thiobarbituric acid reactive substances, which are indicators of lipid peroxidation, and superoxide dismutase activity in the rat striatum. The results of present study strengthen the notion that reactive oxygen species may play an important role in the methamphetamine-induced neurotoxicity.     

Colloid cyst of the third ventricle

Summary The authors have added 54 new cases to the 200 published in the literature. The clinical manifestations of colloid cysts of the third ventricle are thoroughly analyzed, as are also diagnostic procedures, including EEG and EKG. Photographs of gross specimens illustrate the text.

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Zusammenfassung Die Autoren fügen den 200 in der Literatur bereits beschriebenen Colloidcysten des III. Ventrikels 54 weitere Fälle hinzu.Die klinischen Erscheinungen werden, auch mit diagnostischen Hilfsmitteln, einschließlich EEG und EKG genau analysiert. Photographien der makroskopischen Präparate illustrieren den Text.

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Résumé Les auteurs ajoutent 54 nouveaux cas de kystes colloïdaux du 3e ventricule aux 200 cas déjà publiés dans la littérature.Les manifestations cliniques sont analysées exactement à l'aide des diagnostiques cliniques y compris l'EEG et l'EKG. Des photogrammes des préparations macroscopiques illustrent le texte.

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This article is dedicated to the memory of ProfessorAlbert Kuntz.     

Intrathoracic extramedullary haemopoiesis

Intrathoracic extramedullary haemopoiesis is a rare condition accompanying chronic haematologic diseases. A 25 year old male β-thalassaemia intermedia patient with bilateral posterior mediastinal masses is reported. Computed tomography and magnetic resonance imaging provide detailed information for evaluation of thalassaemia and similar haemolytic diseases. In geographic areas where thalassaemia is prevalent, to avoid unnecessary surgical interventions, extramedullary haemopoiesis should be considered in differential diagnosis of patients who have chronic anaemia with asymptomatic intrathoracic tumours.     

Management of sildenafil treatment failures

PURPOSE OF REVIEW: Although oral type 5 phosphodiesterase inhibitors are considered as first-line therapy for the majority of causes of erectile dysfunction, because of their high efficacy, ease of use, and acceptable safety profile, there are some who fail to respond, mainly because of end-organ failure. This communication reviews the management of sildenafil failures in light of recent advances. RECENT FINDINGS: Sildenafil failures can be attributed to either lack of efficacy or side effects; issues may involve the physician, patient, and his partner. Physicians may contribute to sildenafil failure and discontinuation because of inadequate instructions, lack of adequate follow-up, suboptimal dosing, lack of adequate trial, and insufficient clarification about safety issues. Studies have demonstrated that progression of endothelial dysfunction and diminished cavernosal smooth-muscle content are recognized organic factors which cause end-organ dysfunction and ultimately treatment failure. SUMMARY: Proper counseling, medication optimization, and modifying associated risk factors can provide success in men who had initially failed sildenafil therapy for erectile dysfunction. Other treatment modalities that may be considered when sildenafil failure occurs include vacuum devices, intraurethral, and intracavernosal administration of vasoactive drugs alone or combined with sildenafil. Penile prosthesis implantation is considered as a last resort, if all first-line and second-line therapies fail.