Overactive bladder - pharmacological treatment

The Guidelines Project, an initiative of the Brazilian Medical Association, aims to combine information from the medical field in order to standardize producers to assist the reasoning and decision-making of doctors. The information provided through this project must be assessed and criticized by the physician responsible for the conduct that will be adopted, depending on the conditions and the clinical status of each patient.

Comparison and Efficacy of Low-Dose and Standard-Dose Tamsulosin and Alfuzosin in Medical Expulsive Therapy for Lower Ureteral Calculi: Prospective, Randomized, Comparative Study

PURPOSE: Typically in Korea, for a standard dose (0.4 mg) of tamsulosin, two low doses (0.2 mg) are administered. The aim of this study was to evaluate and compare the efficacy of tamsulosin (0.2 mg and 0.4 mg) and alfuzosin (10 mg) in the treatment of lower ureteral stones. MATERIALS AND METHODS: A total of 141 patients presenting with a single 4- to 10-mm sized lower ureteral stone were randomly assigned to 4 groups. Patients in group 1 (n=41) and group 2 (n=30) received an oral dose of 0.2 mg tamsulosin once and twice daily, respectively, and patients in group 3 (n=36) received a daily oral dose of 10 mg alfuzosin. Patients in group 4 (n=34) received trospium chloride only. The spontaneous passage of stones, the stone expulsion time, and adverse effects were evaluated. RESULTS: There were no significant differences in patient background, including age, sex, BMI, stone size, stone side, and symptom duration. The spontaneous stone passage rate through the ureter was higher and the stone expulsion time was faster in groups 1, 2, and 3 than in group 4. There were no statistically different changes in groups 1, 2, and 3. The adverse effects observed in all groups were comparable and were mild. CONCLUSIONS: Tamsulosin at 0.2 mg and 0.4 mg and alfuzosin (10 mg) proved to be safe and effective. A first cycle of medical expulsive therapy with tamsulosin 0.2 mg could be considered as an option in the management of single lower ureteral stone.

Parkinson's disease diagnosis and impact on hormonal level

Functional imaging of the dopamine transporter [DAT] defines integrity of the dopaminergic system and has its main clinical application in patients with mild, incomplete, or uncertain parkinsonism. The radiopharmaceutical, DaTSCAN uses an iodine containing compound [ioflupane 123]. When injected into the bloodstream, it passes through the blood brain barrier and becomes attached to dopamine transporters in the nigrostriatal dopaminergic system [i.e. that system which has degenerated in Parkinson's with consequent reduction of dopamine production]. Parkinson's is characterized by severe loss of dopamine neurons and dopamine transports associated with them. Differenciation between [P.D.] and Essential Tremor [E T] is explained, with the impact of [P D] on hormonal level

The Effect of Tamsulosin and Nifedipine on Expulsion of Ureteral Stones after Extracorporeal Shock Wave Lithotripsy / 대한비뇨기과학회지

PURPOSE: We evaluated the effect of tamsulosin and nifedipine on expulsion of ureteral stones after extracorporeal shock wave lithotripsy(ESWL). MATERIALS AND METHODS: We evaluated 96 upper or lower ureteral stone patients. All patients received a single session of ESWL with a piezolith- 3000 and received twice-a-day oral treatment of 5mg trospium chloride. The patients were randomly divided into three groups. Group 1 received once a day oral therapy of 0.2mg tamsulosin. Group 2 received once a day oral therapy of 30mg nifedipine. Group 3 was used as the control group. All patients took oral medication for 2 weeks, and then we analyzed the stone expulsion rate, side effects, and mean numbers of emergency room(ER) visits for pain control. RESULTS: There were no differences in the 3 groups in stone size, location, age, and sex. The total stone expulsion rate was significantly higher in group 1(84.4%) compared with group 3(60.6%)(p=0.032). Patients with lower ureteral stones in group 1 showed a higher expulsion rate(94.1%) than those of group 3(66.7%)(p=0.042). There was no difference in stone expulsion rates between group 2(67.7%) and group 3(60.6%). CONCLUSIONS: These result suggest that adjunctive medical therapy with tamsulosin after an ESWL increased the stone expulsion rate of ureteral stones, especially lower ureteral stones.