Prostate

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  • Prostate cancer can often be found early by testing the amount of prostate-specific antigen (PSA), discussed in detail below, in your blood. Prostate cancer may also be found on a digital rectal exam (DRE), in which your doctor inserts a gloved finger into the rectum.

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  • Prostate cancer is the most common male cancer diagnosed in Western populations. Autopsy studies have shown that with increasing age, the majority of men will develop microscopic foci of cancer (often termed “latent” prostate cancer) and that this is true in populations that are at both high and low risk for the invasive form of the disease (1). However, only a small percentage of men will develop invasive prostate cancer. The prevalence of prostate cancer is, thus, very common; but to most men, prostate cancer will be only incidental to their health and death....

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  • Prostate cancer is one of the most common types of cancer in men and its treatment was constricted to surgery for confined state and androgen ablation for advanced disease until new options have become available. The present book covers a broad range of novel aspects of prostate cancer diagnosis, treatment and patient care, as well as new research on relevant cell biology.

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  • Diagnosis and Treatment by Clinical State The disease continuum—from the appearance of a preneoplastic and invasive lesion localized to the prostate, to a metastatic lesion that results in symptoms and, ultimately, mortality from prostate cancer—can span decades. Management at all points is centered on competing risks that are defined by considering the disease as a series of clinical states (Fig. 91-1).

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  • The European Association of Urology (EAU) Guidelines Group for Prostate Cancer have prepared this guidelines document to assist medical professionals assess the evidence-based management of prostate cancer. The multidisciplinary panel of experts include urologists, radiation oncologists, a medical oncologist, and a pathologist. Where possible a level of evidence (LE) and/or grade of recommendation (GR) have been assigned (1). Recommendations are graded in order to provide transparency between the underlying evidence and the recommendation given (Tables 1 and 2)...

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  • “Advances in Prostate Cancer” is an addition to the InTech collection of three previous books about prostate cancer and aims at providing a comprehensive overview of specific aspects of the latest research and current knowledge relating to this tumor entity to scientists and clinicians. For this purpose a series of research articles, clinical investigations and reviews that deal with a wide range of relevant aspects pertinent to the epidemiology, diagnosis, patient care, treatment and basic biology of prostate cancer were included.

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  • TRUS is the imaging technique most frequently used to assess the primary tumor, but its chief use is directing prostate biopsies, not staging. No TRUS finding consistently indicates cancer with certainty. CT lacks sensitivity and specificity to detect extraprostatic extension and is inferior to MRI in visualization of lymph nodes. In general, MRI performed with an endorectal coil is superior to CT to detect cancer in the prostate and to assess local disease extent.

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  • Harrison's Internal Medicine Chapter 91. Benign and Malignant Diseases of the Prostate Benign and Malignant Diseases of the Prostate: Introduction Benign and malignant changes in the prostate increase with age. Autopsies of men in the eighth decade of life show hyperplastic changes in 90% and malignant changes in 70% of individuals. The high prevalence of these diseases among the elderly, who often have competing causes of morbidity and mortality, mandates a risk-adapted approach to diagnosis and treatment. This can be achieved by considering these diseases as a series of states.

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  • The PSA criteria used to recommend a diagnostic prostate biopsy have evolved over time. The goal is to increase the sensitivity of the test for younger men more likely to die of the disease and to reduce the frequency of detecting cancers of low malignant potential in elderly men more likely to die of other causes. Age-specific reference ranges reduce the upper limit of normal for younger men and increase it for older men. Different thresholds alter the sensitivity and specificity of detection. The threshold for performance of a biopsy was 4.0 ng/mL, which has been reduced to 2.6...

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  • Pathology The noninvasive proliferation of epithelial cells within ducts is termed prostatic intraepithelial neoplasia. PIN is a precursor of cancer, but not all PIN lesions develop into invasive cancers. Of the cancers identified, 95% are adenocarcinomas; the remainder are squamous or transitional cell tumors or, rarely, carcinosarcomas. Metastases to the prostate are rare, but in some cases colon cancers or transitional cell tumors of the bladder invade the gland by direct extension.

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  • Brachytherapy Brachytherapy is the direct implantation of radioactive sources into the prostate. It is based on the principle that the deposition of radiation energy in tissues decreases as a function of the square of the distance from the source (Chap. 81). The goal is to deliver intensive irradiation to the prostate, minimizing the exposure of the surrounding tissues. The current standard technique achieves a more homogeneous dose distribution by placing seeds according to a customized template based on CT and ultrasonographic assessment of the tumor and computer-optimized dosimetry.

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  • For patients with a rising PSA after radiation therapy, salvage prostatectomy can be considered if the disease was "curable" at the outset, if persistent disease has been documented by a biopsy of the prostate, and if no metastatic disease is seen on imaging studies. Unfortunately, case selection is poorly defined in most series, and morbidities are significant. As currently performed, virtually all patients are impotent after salvage radical prostatectomy, and ~45% have either total urinary incontinence or stress incontinence.

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  • Benign Disease Symptoms Benign proliferative disease may produce hesitancy, intermittent voiding, a diminished stream, incomplete emptying, and postvoid leakage. The severity of these symptoms can be quantitated with the self-administered American Urological Association Symptom Index (Table 91-2), although the degree of symptoms does not always relate to gland size. Resistance to urine flow reduces bladder compliance, leading to nocturia, urgency, and, ultimately, urinary retention.

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  • 2,000 new cases are diagnosed every year. Of these men, approximately 20% will undergo prostate surgery. Before and After Radical Prostate Surgery provides concise information and management tips that will be useful for men (and their partners) in the hospital and at home,

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  • The prostate is a small gland in men. It is part of the male reproductive system. The prostate is about the size and shape of a walnut. It sits low in the pelvis, below the bladder and just in front of the rectum. The prostate helps make semen, the milky fluid that carries sperm from the testicles through the penis when a man ejaculates. The prostate surrounds part of the urethra, a tube that carries urine out of the bladder and through the penis.

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  • A picture, it has been said, is worth a thousand words. In this third edition of the Atlas of Prostatic Diseases, I have tried to tell the story of the prostate in images and illustrations rather than words, keeping the text pithy and very focused. In this busy information world, none of us has time to plough through dense and lengthy tomes; instead, all of us prefer to come straight to the point. Succinctness is what I have tried to achieve here. In today’s world, less is more.

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  • For decades we have been learning about the interplay between tumors and the immune system. Our knowledge seemed somewhat incomplete and indirect, like listening to the ocean waves through a shell. Only recently, cancer immunotherapy has started to become a reality, with Provenge (Dendreon Corporation, WA), an autologous antigen-presenting cell preparation, earning the approval of United States Food and Drug Administration (FDA) for the treatment of advanced prostate cancer in 2010.

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  • Prostate cancer treatment dates back almost 100 years. However, in an era of rapid developments and innovations in cancer research and uro-oncology, there is an increasing need to update our knowledge and especially to guide our practice by innovations and evidence-based medicine. Prostate cancer is still evolving following improvements in disease detection and better understanding of disease characteristics.

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  • Tuyển tập các báo cáo nghiên cứu khoa học ngành y học tạp chí Medical Sciences dành cho các bạn sinh viên ngành y tham khảo đề tài: A 12 Week, Open Label, Phase I/IIa Study Using Apatone® for the Treatment of Prostate Cancer Patients Who Have Failed Standard Therapy...

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  • Benign prostatic hyperplasia (BPH) is the most common neoplastic condition afflicting men and constitutes a major health factor impacting patients in every part of the world. Bladder neck obstruction secondary to BPH can result in significant medical complications including renal failure, urinary retention, recurrent urinary tract infection, bladder stones, significant hematuria, and marked and disruptive bladder symptoms

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