8 research outputs found
Metabolic profile in patients with prostate cancer
No full textPurpose of the study. To evaluate the levels of metabolic markers in patients with prostate cancer (PCa) in comparison with patients with benign prostatic hyperplasia (BPH).Patients and methods. 108 patients were included in the study. The majority of patients had comorbidities: coronary heart disease, hypertension, and almost one third of patients had type 2 diabetes mellitus. Median (Me) age was 67 (64–74), body mass index was 25.9–34.7. The main study group included 54 patients with histologically verified prostate cancer, the comparison group consisted of 54 patients with benign prostatic hyperplasia (BPH). The level of basic biochemical parameters, glomerular filtration rate, lipidogram, total prostate-specific antigen (PSA), total testosterone was determined in all patients.Results. When comparing anamnestic and biochemical parameters, the groups were not statistically significantly different. When comparing the groups by lipid status, it turned out that in the group with RPW, in contrast to the group of patients with BHP, statistically significantly higher levels of total cholesterol (5.13 (3.3–10,4) and 4.60 (2.5–6.3)) mmol/L, respectively, p = 0.023), low–density lipoproteins (2.93 (0.8–5.9) and 2.60 (0.9–4.2) mmol/L, respectively, p = 0.035), triglycerides (2.10 (1.0–8.0) and 1.70 (0.5–7.3) mmol/L, respectively, p = 0.048). In case of dyslipidemia, an increased risk of developing PCa was identified. Correlation analysis revealed a direct moderate relationship between total PSA levels and total cholesterol concentration (r = 0.51).Conclusion. Our study revealed that in the PCa group, there was a higher level of total cholesterol, low-density lipoproteins, and triglycerides, in contrast to the group of patients with BPH. Additionally, in the group of patients with BPH, dyslipidemia was a risk factor in the development of PCa, which should be taken into account in PCa prevention and diagnosis
Dyslipidemia and risk of prostate canсer in patients with urologic diseases
No full textAim. To assess the impact of homeostasis parameters on risk of prostate cancer.Materials and Methods. The study included 108 patients with urologic diseases and with (n = 54) or without (n = 54) prostate cancer. Median age in both groups was 67 (interquartile range 64-73) years. Clinicopathological data and blood test results have been collected from outpatient and inpatient records. In particular, we measured serum levels of total testosterone and prostate-specific antigen.Results. Risk factors for prostate cancer include increased total cholesterol (p = 0.023), low-density lipoprotein cholesterol (p = 0.035), total triglycerides (p = 0.048), and total testosterone (p = 0.002). High levels of total testosterone directly correlated with the tumor stage (r = 0.56). The concentration of prostate-specific antigen correlated with the lipid parameters and remained a reliable diagnostic criterion (p = 0.002).Conclusion. The association of hyper/dyslipidemia with prostate cancer provides an opportunity to improve its prevention by routine lipid screening in high-risk groups
THE INFLUENCE OF CORONARY BYPASS ON ENDOTHELIAL AND ERECTILE DYSFUNCTION IN ISCHEMIC HEART DISEASE
No full textAim. To evaluate coronary bypass grafting under artificial circulation conditions on endothelial and erectile dysfunction in patients with ischemic heart disease (CHD). Material and methods. Totally 117 patients participated in the study, with stable CHD at the mean age 55,8±5,3 y. o., planned to CBG. In all patients we used questionnaire “International Index of Erectile dysfunction” (IIED), registration of nocturnal penile tumescenses (NPT), post compression tests on brachial and cavernous arteries. All patients were divided into two groups, those with and without erectile dysfunction (ED) (n=60, n=57, resp.). Results. By the results of the investigation in patients with ED after CBG there was significant worsening of erectile function. It was found, that the existence of ED before operation is an important prognostic factor for its progression after the operation. Others, with non-affected erectile function, after the operation had higher chances to save it. Even more, it was found that in patients without preoperational ED by 6 months after CBG there was tendency to improvement of EZVD comparing with baseline values, but in group with ED this tendency was not found. Also in patients without ED in all stages of study there was significantly better vasoregulating function of endothelium on brachial artery comparing to ED patients. The same tendency was found and on cavernous arteries. While analyzing the prevalence of cardiovascular events after CBG it was found that in ED group 4 patients (7%) cardiovascular events developed, but without ED — did not. Conclusion. So the presence of ED might be a significant marker of worse outcome in CHD patients, underwent CBG
Coronary heart disease and the course of newly detected prostate cancer
No full textIntroduction. In recent years, the clinical and practical interest in malignant neoplasms and diseases of the cardiovascular system has been extremely high. These nosologies are the leading causes of hospitalisations and deaths worldwide.Objective. To assess the prevalence of coronary heart disease and risk factors among patients with newly diagnosed prostate cancer, as well as to identify their relationship with the severity of prostate cancer.Materials & methods. The study included 140 newly diagnosed prostate cancer (PCa) patients with a median age of 65 [62; 70] years. All patients had the level of prostate-specific antigen, pelvic MRI, prostate biopsy with determination of Gleason score, all patients filled out the questionnaire of the International Index of Erectile Function (IIEF-5). Depending on the presence of coronary heart disease (CHD), all patients were divided into two groups: Group 1 — 94 (67%) PCa patients without CHD; Group 2 — 46 (33%) PCa patients with CHDResults. In a comparative analysis, the groups did not differ in indicators such as age, BMI, prostate volume, incidence of diabetes mellitus type 2, and lipid status level. However, in PCa patients with CHD, erectile dysfunction was statistically significantly more pronounced than in patients without CHD (10 vs 18 IIEF5 points, p = 0.03), respectively. In terms of PSA levels, it turned out that in Group 2, this indicator was significantly higher than in Group 1 (15.8 ng/ml vs 10.1 ng/ml, p = 0.03), respectively, which indicates possibly more high malignancy of the process. Furthermore, in Group 2, patients with a high grade PCa according to the classification of The International Society of Urological Pathology (ISUP) 4 / 5 were statistically significantly more common compared to patients of Group 1 (12 (26%) vs. 10 (11%), p = 0.01), respectively. In a comparative analysis of patients depending on the risk of a possible PCa recurrence of , which was taken into account by such parameters as PSA level, Gleason index + ISUP grade, it turned out that in Group 2 there were statistically significantly more patients with a higher risk of PCa progression compared to Group 1 (20 (44%) vs 26 (28%), p = 0.02), respectively.Conclusion. PCa patients with concomitant CHD are characterized by a higher waist circumference, they had lower indicators of erectile function, a more pronounced comorbid background, and more often had a history of stroke. In addition, PCa patients with CHD had a high grade PCa and a higher risk of PCa progression
Comparison of thulium and holmium lasers with conventional transurethral bladder resection for non-muscle invasive bladder cancer
No full textIntroduction. The gold standard of treatment for intermediate- and high-risk non-muscle-invasive bladder cancer (NMIBC) is transurethral resection of the bladder (TURB) in combination with intravesical therapy. However, this procedure may cause serious complications. At the same time, studies of various lasers for the treatment of NMIBC have demonstrated their safety and efficacy. Despite this, the topic has not yet been fully explored and is not widely practiced in clinical oncology, making further research necessary.Objective. To compare thulium and holmium lasers with conventional TURB for management of non-muscle-invasive bladder cancer (NMIBC).Materials & methods. In our study, depending on the treatment approach, 84 NMIBC-patients were divided into three groups. Group 1 included 27 patients (34.14%), who underwent laser thulium bladder resection; group 2 included 25 patients (29.76%), who underwent laser holmium bladder resection, and group 3 included 32 patients (38.1%), who underwent standard TURB. Prior to surgery, all patients received a standard set of preoperative general clinical and instrumental examinations for bladder cancer, and the choice of surgical approach was based on informed patient consent, taking into account the benefits and risks of the three treatment options. All surgeries were performed in accordance with established protocols.Results. In the TURB group, the surgery time was the longest and totalled in 20.5 ± 7.4 min. Laser technologies reduce the surgery time to 16.3 ± 5.3 min for a holmium laser and to 14.7 ± 5.2 min for a thulium laser. Also, in groups 1 and 2, a shorter duration of postoperative bladder irrigation was noted (4.4 ± 1.8 and 4.7 ± 1.6 hours) and shorter periods of postoperative bladder catheterisation (1.5 ± 0.08 and 1.6 ± 0.08 days) compared to group 3, where these indicators were 16.4 ± 2.5 hours and 2.5 ± 0.13 days, respectively. Among patients undergoing either holmium or thulium surgery, a higher rate of disease-free survival has been noted. Independent prognostic factors that influence the prognosis of NMIBC in all groups include the type of surgery, history of bladder tumors, and pathological stage.Conclusion. The use of laser technology, such as thulium and holmium laser, in bladder wall resection for NMIBC shows promising results and provides a good clinical outcome that is comparable to (and in some cases, superior to) standard TURB
Основные медико-статистические данные о случаях злокачественных новообразований мочевого пузыря в г. Санкт-Петербурге и различных регионах России 2012–2021 гг.
No full textBackground. Bladder cancer is the most common malignancy of the urinary tract and one of the most common neoplasias in this group. The incidence and mortality rates of the population from bladder cancer differ significantly in different geographical regions of Russia.Aim. To assess the main epidemiological indicators of malignant neoplasms of the bladder in residents of Saint Petersburg and the regions of Russia.Materials and methods. The main epidemiological indicators of malignant bladder neoplasms in Saint Petersburg, Russia and individual federal districts for the period 2012–2021 were studied: crude and standardized rates of morbidity, mortality, prevalence, age structure of patients, the number of cases of diagnosis of the disease at various stages, indicators of one-year mortality and 5-year survival, data on completed cases of treatment of bladder neoplasms. Sources of information: Form No. 7 “Information on cases of malignant diseases” and the database of the Medical Information and Analytical Center (Saint Petersburg).Results. During the period 2012–2021 in Russia, there was an increase in the incidence and prevalence of malignant neoplasms of the bladder. At the same time, mortality rates decreased, and 5-year survival rates increased. This fact indicates the effectiveness of the treatment of patients in this category. In more than 50 % of cases, the disease was detected at stage I of the pathological process, which is due to the proper level of diagnosis. The main medical and statistical indicators in patients with malignant bladder neoplasms in Saint Petersburg are comparable to the average Russian data, and in a number of parameters they exceed them.Conclusion. Oncourological assistance to the population with malignant neoplasms of the bladder in Saint Petersburg is provided properly. The study of medical and statistical indicators in dynamics can be used to improve the algorithms of medical and diagnostic care for cancer patients.Введение. Рак мочевого пузыря является наиболее распространенным злокачественным новообразованием мочевыводящих путей и одной из самых часто встречаемых неоплазий в этой группе. Показатели заболеваемости и смертности населения от рака мочевого пузыря существенно различаются в разных географических регионах России.Цель исследования – оценка основных эпидемиологических показателей злокачественных новообразований мочевого пузыря у жителей г. Санкт-Петербурга и регионов России.Материалы и методы. Изучены основные эпидемиологические показатели злокачественных новообразований мочевого пузыря в Санкт-Петербурге, России и отдельных федеральных округах за период 2012–2021 гг.: грубые и стандартизованные показатели заболеваемости, смертности, распространенности, возрастная структура пациентов, число случаев диагностики заболевания на различных стадиях, показатели одногодичной летальности и 5-летней выживаемости, данные о законченных случаях лечения новообразований мочевого пузыря. Источники информации: форма № 7 «Сведения о случаях злокачественных заболеваний» и база данных Медицинского информационно-аналитического центра (Санкт-Петербург).Результаты. За период 2012–2021 гг. в России отмечалось повышение показателей заболеваемости и распространенности злокачественных новообразований мочевого пузыря. При этом показатели смертности снижались, а 5-летней выживаемости – повышались. Данное обстоятельство свидетельствует об эффективности проводимого лечения пациентов данной категории. Более чем в 50 % случаев заболевание выявлялось на I стадии патологического процесса, что обусловлено надлежащим уровнем диагностики. Основные медико-статистические показатели у больных со злокачественными новообразованиями мочевого пузыря в Санкт-Петербурге сопоставимы со среднероссийскими данными, а по ряду параметров превосходят их.Заключение. Онкоурологическая помощь населению со злокачественными новообразованиями мочевого пузыря в Санкт-Петербурге оказывается надлежащим образом. Изучение медико-статистических показателей в динамике может применяться при совершенствовании алгоритмов лечебно-диагностической помощи онкологическим больным
Эректильная дисфункция и психоэмоциональные аспекты больных ишемической болезнью сердца, подвергшихся коронарному шунтированию
No full textThe impact of erectile dysfunction on psychoemotional state of patients undergone coronary artery bypass graft surgery was evaluated. The International Index of Erectile Function, postcompression cavernous artery dilation test, nocturnal penile tumescence recording and psychophysiological exam were used. It was found that ischemic heart disease patients have higher incidence of associated psychoemotional and erectile dysfunctions.Проведена оценка влияния эректильной дисфункции на психоэмоциональные аспекты пациентов, подвергшихся коронарному шунтированию. Обследование включало в себя опросник «Международный индекс эректильной функции», регистрацию ночных пенильных тумисценций, посткомпрессионные тесты на кавернозных артериях, психофизиологическое обследование. Оказалось, что у пациентов с ишемической болезнью сердца высока частота выявления психоэмоциональных и эректильной дисфункций, взаимно потенцирующих друг друга
Erectile dysfunction after operations on the organs of small tanks (review of literature)
No full textMalignant neoplasms of the pelvic organs in men are an actual problem of modern medicine. In connection with a steady increase in the incidence of the need for surgical treatment on the pelvic organs increases. Despite the constant improvement of surgical technologies, a number of complications that significantly reduce the quality of life, the main one of which is erectile dysfunction, accompanies these surgical interventions. This article provides an overview of the world literature on the development of erectile dysfunction in patients undergoing surgical treatment of prostate cancer, bladder cancer, rectal cancer. The advantages of using nerve-sparing technology are reflected. Conclusions are drawn about the need for an integrated approach to the problem of erectile dysfunction, an interdisciplinary approach to the diagnosis and treatment of erectile dysfunction in patients after radical surgery on pelvic organs, based on close interaction of physicians of different specialties.Злокачественные новообразования органов малого таза у мужчин, являются актуальной проблемой современной медицины. В связи с неуклонным ростом заболеваемости возрастает необходимость хирургического лечения на органах малого таза. Несмотря на постоянное совершенствование хирургических технологий, данные оперативные вмешательства сопровождаются рядом осложнений, значительно снижающих качество жизни, основным из которых является эректильная дисфункция. В данной статье приведен обзор данных мировой литературы по развитию эректильной дисфункции у пациентов, перенесших хирургическое лечения рака предстательной железы, рака мочевого пузыря, рака прямой кишки. отражены преимущества применения нервосберегающих технология. Сделаны выводы о необходимости интегрированный подхода к проблеме эректильной дисфункции, междисциплинарного подхода к диагностике и лечению расстройств эрекции у пациентов после радикальной операции на органах малого таза, основанного на тесном взаимодействии врачей разных специальностей
