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PubMedDate not supplied

Care of patients with haemoglobin abnormalities: history and biology.

Haemoglobinopathies refer to a range of genetically inherited disorders of red blood cell haemoglobin and include sickle cell disorders and thalassaemias. They occur most commonly in populations whose ancestors come from Africa, Asia, Mediterranean Islands, and the Middle and Far East. Haemoglobin (Hb) abnormalities (or haemoglobinopathies) are caused by (i) abnormalities of the protein structure; (ii) imbalanced globin chain production owing to reduced rate of synthesis of normal a or b globin chains; or (iii) a combination of the two. This article will focus on the biological basis of sickle cell disorders and will discuss the history and pathology of the conditions.

Adult↗
PubMed2006

Penile erection during transurethral surgery.

Intraoperative penile erection during endoscopic surgery, although an infrequent occurrence, is a troublesome complication and a challenge to the urologist. It is difficult to perform the procedure during penile erection, because various complications may occur. The etiology is unclear, and a number of pharmacological remedies have been discussed in the literature. Herein, we describe the treatment and outcomes for 3 patients with intraoperative penile erection and provide a brief review of the associated literature. Intraoperative penile erection is a rare event during transurethral procedures, with a frequency of approximately 0.1% in our institution. To our knowledge, no generally accepted protocols for the prevention or treatment of this phenomenon have been reported in the literature. We recommend intracorporeal injection of 250 microg of phenylephrine: detumescence occurred rapidly in all patients after a single injection. The mode of administration is simple, and no complications have been reported.

Adult↗
PubMed1996

A case of unrelenting pursuit of castration.

OBJECTIVE: Explore the limitations of the classification of body dysmorphic disorder. CLINICAL PICTURE: A chinese male relentlessly pursued castration to relieve painful erections which were never substantiated. The testes and corporaspongiosum had been removed. No psychotic symptom was prominent. TREATMENT: Cognitive therapy and psychotropics were tried. OUTCOME: The remaining corpora cavernosa was removed subsequently. CONCLUSION: The distorted somatic perception and secondary cognitive amplification (painful erections) could represent a variant of body dysmorphic disorder involving internal body image; diagnostic classifications should accommodate such a category.

Adult↗
PubMed2005

A review of the evidence for the efficacy and safety of trazodone in insomnia.

OBJECTIVE: Trazodone, a triazolopyridine antidepressant, is currently the second most commonly prescribed agent for the treatment of insomnia due to its sedating qualities. Given trazodone's widespread use, a careful review of the literature was conducted to assess its efficacy and side effects when given for treatment of insomnia. DATA SOURCES: In April 2003, a MEDLINE search was conducted using the search terms trazodone and insomnia and trazodone and sleep and restricted to 1980-2003, human subjects, and English language. As trazodone has been implicated in cardiac disorders, a further search was conducted using the term cardiac and trazodone. STUDY SELECTION: All clinical trials that measured any endpoint for insomnia efficacy were included in the assessment. A total of 18 studies were identified from the literature search. In addition, commonly used texts were consulted for information regarding adverse effects related to trazodone. DATA EXTRACTION: Because so few studies were identified by the literature search, all were evaluated and described. DATA SYNTHESIS: Evidence for the efficacy of trazodone in treating insomnia is very limited; most studies are small, conducted in populations of depressed patients, raise issues of design, and often lack objective efficacy measures. Side effects associated with trazodone are not inconsequential, with a high incidence of discontinuation due to side effects, such as sedation, dizziness, and psychomotor impairment, which raise particular concern regarding its use in the elderly. There is also some evidence of tolerance related to use of trazodone. CONCLUSION: Given the relative absence of efficacy data in patients with insomnia and the adverse events associated with trazodone's use in general, it is uncertain whether the risk/benefit ratio warrants trazodone's use in nondepressed patients with insomnia.

Adult↗
PubMed2005

Sonographic evaluation of penile trauma.

OBJECTIVE: The purpose of this presentation is to illustrate the normal sonographic anatomy of the penis and various imaging manifestations of penile trauma. METHODS: Penile trauma cases were collected and reviewed retrospectively from our archive. RESULTS: The normal sonographic anatomy of the penis and various pathologic conditions of patients with penile trauma are discussed. CONCLUSIONS: Sonography (especially with color Doppler sonography) is a useful imaging method for evaluating penile anatomy and various pathologic features in patients with penile trauma.

Hematoma↗
PubMed1976

[Effects of lesions in the pontine tegmentum on the sleep stages in the rat].

1. Limited coagulations of the locus coeruleus and subcoeruleus nuclei have been performed in rats and the sleep-waking cycle was continuously monitored during 9 days. The cortical and diencephalic noradrenaline content was mesured at the termination of the experiment, on the 10th post lesion day. 2. The bilateral destruction of the locus coeruleus is followed by the appearance of a uro-genital syndrome consisting of hema turia, bladder distension and penile erection. The states of sleep are disturbed during the first two days (increase of slow-wave sleep and decrease of paradoxical sleep times) and thereafter return to normal. Additionally, an hyperthermia appears during the third experimental day. The cortical and diencephalic noradrenaline content decrease to 70%. 3. The simultaneous lesion of both locus coeruleus and subcoeruleus nuclei is followed by the appearance of an aphagia adipsia syndrome in addition to the uro-genital syndrome. After these lesions, it is no long possible to find paradoxical sleep episodes in polygraphic recordings while the amount of slow wave sleep is normal. Cortical and diencephalic noradrenaline content decrease more than 50%. 4. In normal rats direct injection of 6 hydroxydopamine directly in both locus coeruleus and nuclei subcoeruleus had no discernable effects either on the behaviour or on the states of sleep. The cortical noradrenaline content decreased 30% below control values. 5. These results are consistent with but do not prove the hypothesis that part of the pontine tegmentum might play an important role in triggering paradoxical sleep episodes. The role of these regions in the regulation of internal temperature, food consumption and bladder motricity is also discussed.

Animals↗
PubMed2000

[Topical therapy in erectile dysfunction].

All forms of pharmacological therapy result in a relaxation of the corporeal smooth muscle. Intracorporeal injection of vasoactive drugs was introduced around 15 years ago and still is the most effective therapy in erectile dysfunction. Resulting in a consistent success rate of 70-80% this form of therapy will find numerous applications, even after the introduction of effective oral agents such as sildenafil. Prostaglandin E1 and--less frequently used--the combination of papaverine and phentolamine are the mainstay of intracorporeal injection therapy. Intraurethral prostaglandin (MUSE) has recently become available and is somewhat less effective than injection therapy. Externally applied drugs (nitroglycerin paste on the penile shaft and minoxidil solution on the glans penis) have not succeeded in the long run. Vacuum erection devices represent a form of physical topical therapy that is very versatile and also effective but rather infrequently applied.

Administration, Topical↗