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Only about 50% of individuals reporting symptoms recall these symptoms as being bothersome, and an even smaller percentage of bothered individuals seek treatment (21,51). Once these risk factors have been clearly recognized, potential targets for prevention of symptom development can be identified. The majority of studies focused exclusively on women (16 studies) and on populations ≥40 years of age (16 studies). Only two studies dealt exclusively with men, and three studies investigated both men and women. The disparities in incidence rates between studies likely reflect confounders in epidemiologic studies based on survey questionnaires, including study population heterogeneity, age-related variations, population sampling procedures, self-selection and attrition, analyses of non- responders, survey methods, differences in symptom definitions, assessment, and quantification. Further longitudinal studies are needed to assess risk factors for symp- tom progression and regression or remission. The majority of the research has been cross-sectional, demonstrating associations, but not causal pathways, of risk factors and conditions. The findings regarding physical activity were further supported by two case-control studies (70,75) and one meta-analysis (76). Common underlying pathophysiology between these two conditions have been hypothesized (98), but given that the vast majority of research in this area is cross-sectional, there is no indication that one condition precedes the other. Prostate volume is likely to increase when the transition zone is either visible with a clear border (103,107) (Figure 2) or enlarged on trans-rectal ultrasound at baseline (108). Internal prostatic architecture on 40 transrectal ultrasonography predicts future prostatic growth: natural history of prostatic hyperplasia 20 in a 15-year longitudinal community-based study. Age- Age (year) related differences in internal prostatic architecture on transrectal ultrasonography: results of a community based survey in Japan. However, a small but significant reduction in detrusor contractility was observed, and the prevalence of detrusor overactivity increased with follow-up. These changes in bladder function would explain the exaggerated voiding and storage symptoms in elderly men. Probability of prostatectomy was double in men with prostate enlargement and voiding symptoms compared with those without these two symptoms (probability also increased with increasing age) (120). Autopsy studies have observed a histologi- cal prevalence of 8%, 50%, and 80% in the 4th, 6th, and 9th decades of life, respectively (128). Prostate volume also increases with age; data from the Krimpen and Baltimore Longitudinal Study of Aging suggest a prostate growth rate of 2. These and other (139) findings suggest an autosomal dominant pattern of inheritance. Three studies have shown positive associations, while another two did not find any association between them (72,162,164,165). One potential explanation is that metabolic syndrome, which promotes systemic inflammation and oxidative stress, mediates the connection between the two (169). Observational studies comparing black, Asian, and white men have produced variable results. Other studies have noted a diminished likelihood of aggressive prostate cancer in patients with larger prostate volumes (190,191).
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Necropsy—The gross examination of the organs and tissues of a dead body to determine the cause of death or pathological conditions. Neurotoxicity—The occurrence of adverse effects on the nervous system following exposure to a chemical. Octanol-Water Partition Coefficient (Kow)—The equilibrium ratio of the concentrations of a chemical in n-octanol and water, in dilute solution. Organophosphate or Organophosphorus Compound—A phosphorus-containing organic compound and especially a pesticide that acts by inhibiting cholinesterase. Pesticide—General classification of chemicals specifically developed and produced for use in the control of agricultural and public health pests. Pharmacokinetics—The dynamic behavior of a material in the body, used to predict the fate (disposition) of an exogenous substance in an organism. Utilizing computational techniques, it provides the means of studying the absorption, distribution, metabolism, and excretion of chemicals by the body. Pharmacokinetic Model—A set of equations that can be used to describe the time course of a parent chemical or metabolite in an animal system. There are two types of pharmacokinetic models: data-based and physiologically-based. A data-based model divides the animal system into a series of compartments, which, in general, do not represent real, identifiable anatomic regions of the body, whereas the physiologically-based model compartments represent real anatomic regions of the body. These models advance the importance of physiologically based models in that they clearly describe the biological effect (response) produced by the system following exposure to an exogenous substance. The models also utilize biochemical information, such as air/blood partition coefficients, and metabolic parameters. Prevalence—The number of cases of a disease or condition in a population at one point in time. Prospective Study—A type of cohort study in which the pertinent observations are made on events occurring after the start of the study. The q1* can be used to calculate an estimate of carcinogenic potency, the incremental excess cancer risk per unit of exposure (usually μg/L for water, mg/kg/day for food, and μg/m3 for air). Reference Concentration (RfC)—An estimate (with uncertainty spanning perhaps an order of magnitude) of a continuous inhalation exposure to the human population (including sensitive subgroups) that is likely to be without an appreciable risk of deleterious noncancer health effects during a lifetime. The inhalation reference concentration is for continuous inhalation exposures and is appropriately expressed in units of mg/m3 or ppm. Reference Dose (RfD)—An estimate (with uncertainty spanning perhaps an order of magnitude) of the daily exposure of the human population to a potential hazard that is likely to be without risk of deleterious effects during a lifetime. Reproductive Toxicity—The occurrence of adverse effects on the reproductive system that may result from exposure to a chemical.
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Slit-lamp biomicroscopy shows conjunctival and ciliary injection, with aqueous flare and cells. But recurrences are the rule, with subsequent iris atrophy and posterior synechia formation. Rare anterior segment findings include corneal immune ring opacity, conjunctival ulcers, episcleritis and scleritis (17, 18). The classic fundus finding is the necrotizing, obliterative retinal vasculitis affecting both arteries and veins in the posterior pole (7). Vascular sheathing with perivascular exudates, arteriolar attenuation, venous dilatation and tortuousity, and branch and central retinal vein occlusion are common posterior pole findings. Fluorescein angiography is useful in determining the extent of retinal and disc vasculitis. In the same study abnormal leakage of dye from peripheral retinal capillaries and venules was found in 6 % of patients who had no visual complaints as well as no abnormal findings on fundus exam (19). Cataract formation is the most common anterior segment complication after recurrent inflammation, occurring in upto 36 % of cases (20). Posterior synechiae, iris atrophy, and peripheral anterior synechia may develop during the course of repeated ocular inflammatory attacks. Peripheral anterior synechia or iris bombÕ from pupillary seclusion may cause secondary glaucoma. Retinal atrophy with optic atrophy is the end result of repeated episodes of posterior segment inflammation. During acute inflammation, the ciliary body and choroid show diffuse infiltration with neutrophils. In late, chronic stages, there is proliferation of collagen fibers, sometimes with formation of a cyclitic membrane thickening of the choroid and sometimes hypotony and Phthisis bulbi. Abnormalities of neutrophil functions, such as enhanced migration and generation of free radicals, and elevated levels of circulating activated T lymphocytes have been reported (22, 23). In systemic lupus erythematosus, the retinal vasculitis is in the form of obliterative arteriolitis. Systemic vasculitic diseases should also be considered in the differential diagnosis. The most commonly used anti-inflammatory drugs are corticosteroids, cytotoxic agents, cyclosporine, and colchicine. In posterior segment inflammation, oral corticosteroids are used in combination with immunosuppressive drugs, and then the steroids are gradually tapered. In chronic cases, maintenance doses (15-30 mg/day) of prednisone may be required in combination with immunosuppressives. The mode of action of this slow-acting alkylating agent is similar to that of cyclophosphamide.
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Long term results of neuromodulation by sacral nerve stimulation for lower urinary tract symptoms: a retrospective single center study. Pathophysiology of edema formation in children with nephrotic syndrome not due to minimal change disease. Long-term results of open transvesical prostatectomy from a contemporary series of patients. Prostatic zinc and prostate specific antigen: an experimental evaluation of their combined diagnostic value. Methicillin-resistant Staphylococcus aureus endocarditis after transurethral prostatic resection. Timing, safety, and efficacy of thoracoscopic evacuation of undrained post-traumatic hemothorax. Complications of voiding cystourethrography in the evaluation of infants with prenatally detected hydronephrosis. Long-term (7 to 8-year) experience with finasteride in men with benign prostatic hyperplasia. Medical management of benign prostatic hyperplasia-are two drugs better than one. High-pressure bladder: an underlying factor mediating renal damage in the absence of reflux. Serenoa repens treatment modifies bax/bcl-2 index expression and caspase-3 activity in prostatic tissue from patients with benign prostatic hyperplasia. The impact of medical therapy on surgery for benign prostatic hyperplasia: a study comparing changes in a decade (1992-2002). Incidence and prevalence of lower urinary tract symptoms suggestive of benign prostatic hyperplasia in primary care-the Triumph project. Low incidence of acute urinary retention in the general male population: the triumph project. Relationship between age, prostate volume, prostate-specific antigen, symptom score and uroflowmetry in men with lower urinary tract symptoms. Clinical diagnosis of bladder outlet obstruction in men with lower urinary tract symptoms: reliability of commonly measured parameters and the role of idiopathic detrusor overactivity. High-dose therapy and autologous hematopoietic stem cell transplantation for patients with primary systemic amyloidosis: a Center for International Blood and Marrow Transplant Research Study. Cohort study on effects of parathyroid surgery on multiple outcomes in primary hyperparathyroidism. Detection of telomerase activity in prostate massage samples improves differentiating prostate cancer from benign prostatic hyperplasia. Should the diagnosis of benign prostatic hyperplasia be made on prostate needle biopsy.
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When a toilet is flushed or a sink is drained, the water (and other material) begins to rotate about the drain on the way down. Assuming no initial rotation and a flow initially directly straight toward the drain, explain what causes the rotation and which direction it has in the northern hemisphere. Is there a real force that throws water from clothes during the spin cycle of a washing machine? In one amusement park ride, riders enter a large vertical barrel and stand against the wall on its horizontal floor. Riders feel as if they are pinned to the wall by a force something like the gravitational force. This is a fictitious force sensed and used by the riders to explain events in the rotating frame of reference of the barrel. Explain in an inertial frame of reference (Earth is nearly one) what pins the riders to the wall, and identify all of the real forces acting on them. Action at a distance, such as is the case for gravity, was once thought to be illogical and therefore untrue. What is the ultimate determinant of the truth in physics, and why was this action ultimately accepted? Anna says a satellite in orbit is in freefall because the satellite keeps falling toward Earth. Tom says a 2 satellite in orbit is not in freefall because the acceleration due to gravity is not 9. A non-rotating frame of reference placed at the center of the Sun is very nearly an inertial one. Action at a distance, such as is the case for gravity, was once thought to be illogical and therefore untrue. What is the ultimate determinant of the truth in physics, and why was this action ultimately accepted? Anna says a satellite in orbit is in freefall because the satellite keeps falling toward Earth. Tom says a 2 satellite in orbit is not in freefall because the acceleration due to gravity is not 9. Draw a free body diagram for a satellite in an elliptical orbit showing why its speed increases as it approaches its parent body and decreases as it moves away. Many other examples have since been discovered, and we now expect to find such underlying order in complex situations. Calculate it in meters per second squared and convert to rotations, how many kilometers should the odometer read? How many revolutions do the tires make, neglecting any backing up and any change in radius due to wear?
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