BACKGROUND Malignant lymphoma involving the prostate is rare, and to the authors' knowledge the factors determining patient outcome have not been studied in a large series. METHODS The authors evaluated the clinical and pathologic findings in 60 cases of non‐Hodgkin's lymphoma and 2 cases of Hodgkin's lymphoma involving the prostate. A variety of clinical and histologic findings were considered as factors predictive of patient outcome. RESULTS Lymphoma tended to occur in elderly men, with a mean age at diagnosis of 62 years (range, 5‐89 years), although 6 patients were age < 40 years (ages 5, 19, 30, 32, 38, and 38 years, respectively). Clinical signs and symptoms were due to lower urinary tract obstruction. Twenty‐two patients (35%) presented with primary extranodal lymphoma of the prostate with a variety of histologic subtypes, including small lymphocytic (4 patients); follicular center cell, diffuse, small cell (2 patients); follicular center cell, Grade 1 (according to the revised European‐American classification (small cleaved) (1 patient); Grade 2 (mixed) (1 patient); diffuse large B‐cell (12 patients); and high grade B‐cell lymphoma, Burkitt‐like (2 patients). At the time of presentation, none of these patients had hepatosplenomegaly, inguinal lymphadenopathy, or an abnormal complete blood count. Thirty other patients (48%) with previously documented lymphoma at other sites developed prostatic involvement; these secondary prostatic lymphomas displayed a variety of subtypes, including small lymphocytic (8 patients, all with concomitant leukemia); follicular center cell lymphoma, diffuse, small cell (2 patients); follicular center, Grade 1 (small cell) (1 patient); follicular center, Grade 2 (1 patient); diffuse large B‐cell (11 patients); peripheral T‐cell lymphoma (2 patients); high grade B‐cell lymphoma, Burkitt‐like (1 patient); Burkitt's lymphoma (1 patient); Hodgkin's lymphoma (nodular sclerosing [1 patient] and mixed cellularity [1 patient]); and unknown (1 patient). Ten cases were not classifiable as primary or secondary lymphomas. Twenty‐five patients died of malignant lymphoma, 14 died of unknown or other causes, 18 patients were alive 12‐20 months after diagnosis (8 primary and 10 secondary tumors; 3 had persistent lymphoma; all treated since 1981), and 5 were lost to follow‐up. Lymphoma specific survival was 64% at 1 year (95% confidence interval [CI], 51‐80%), 50% at 2 years (95% CI, 36‐68%), 33% at 5 years, 33% at 10 years, and 16% at 15 years. There was no difference in median survival after diagnosis of prostatic involvement between primary and secondary lymphoma (23 months vs. 28 months, respectively) or among histologic types. CONCLUSIONS Although malignant lymphoma involving the prostate is rare, it should be considered in the differential diagnosis of lower urinary tract obstruction, particularly in patients with a previous history of lymphoma. Cancer 1998;83:732‐738. © 1998 American Cancer Society.

Objective: To evaluate the efficacy of trimetazidine (TMZ) in the prevention of contrast-induced nephropathy (CIN) in patients with high serum creatinine levels undergoing coronary angiography/angioplasty. Methods: TMZ (20 mg thrice daily) was administered orally for 72 h starting 48 h before the procedure. All patients were given intravenous saline (0.9%) at a rate of 1 ml/kg of body weight per hour for 24 h starting 12 h beforehand. Serum creatinine levels were measured before the procedure, 48 h and 7 days after the procedure. Increase in serum creatinine level exceeding 0.5 mg/day or one quarter of the basal value is considered as CIN. Venous blood samples for serum total antioxidant capacity (TAC) measurement were drawn before and after coronary angiography. Results: Basal serum creatinine levels and TAC were similar in TMZ and control groups. Serum creatinine levels in the control group increased significantly 2 days after the procedure, and returned to the baseline values on the seventh day. However, it did not change significantly on the second day, and even significantly decreased on the seventh day in the TMZ group. CIN developed in 2.5% (1/40) of patients in the TMZ group and in 16.6% (7/42) of patients in the control group (p,0.05). TAC values were not different between treatment groups. Conclusion: TMZ along with isotonic saline infusion is more effective than isotonic saline alone in reducing the risk of CIN in patients with pre-existing renal dysfunction. C ontrast-induced nephropathy (CIN) is a serious complication of coronary angiography that is associated with considerably increased mortality and morbidity, including the need for short-term haemodialysis, extended hospitalisation and permanent impairment of renal function.1 2 CIN after coronary angiography is observed more frequently in patients with chronic renal insufficiency, particularly in patients with diabetes mellitus and/or dehydration and/or congestive heart failure.2-5 Larger doses of contrast medium and intravascular injection of contrast agent are also associated with higher incidence of CIN.6 CIN has been reported to occur in 11-44% of patients with moderate renal insufficiency.2 3 6 7 Pre-existing renal dysfunction is the greatest independent predictor of CIN, and its severity directly correlates with the incidence of CIN. 3 6 8-10 Previous reports suggest that the formation of reactive oxygen radicals, renal medullar ischaemia during reperfusion after contrast-induced vasoconstriction and direct tubular damage secondary to the contrast agent have an important role in the injury mechanisms of CIN.11-14 Many types of prophylaxis regimens have been used in an attempt to prevent CIN. But, to date only hydration with isotonic saline is generally accepted in the prevention of CIN. [14][15][16][17][18] Trimetazidine (TMZ) has been described as a cellular antiischaemic agent. 19 Previous studies demonstrated that TMZ prevents the deleterious effects of ischaemia-reperfusion at both the cellular and the mitochondrial levels, and exert...

In the present study, we focused on some of the non-nutritional correlates of obesity in a representative population of an urban area in a developing country. Obesity prevalence rate in Turkish children living in Aydin was higher in children from a higher socio-economic group in contrast to reports from many developed countries.

Dual-energy X-ray absorptiometry (DXA), the "gold standard" for diagnosis of osteoporosis, is not recommended for population screening, and thus quantitative ultrasound (QUS) of the calcaneus is gaining popularity. The aim of the present study was to evaluate the relationship between QUS values and anthropometric and lifestyle factors, and to assess the diagnostic performance of QUS in predicting DXA-defined osteoporosis. Eight hundred and thirty-two women and 87 men aged 40-88 years were included in the study. Anthropometric measurements, the questionnaire, and QUS and DXA measurements were performed by trained physicians. Both QUS and DXA T-scores were lower for women than for men. Postmenopausal women had significantly lower QUS T-scores compared to premenopausal women (P < 0.001). Age over 50, female sex, sedentary lifestyle, fracture history, presence of chronic disease, and > or =5 years since menopause were associated with QUS T-scores lower than -1.00 by multivariate analysis. Low QUS T-scores were related to lack of direct sun exposure, high parity, fair skin color, and no education by univariate analysis (P < 0.005). A weak correlation was found between calcaneal QUS and DXA T-scores at lumbar spine (r = 0.310, P < 0.001) and femoral neck (r = 0.288, P < 0.001). The sensitivity and specificity of the QUS test were 73.7% and 57.4%, respectively, regarding the identification of osteoporotic patients. Lower QUS T-scores were associated with several osteoporotic risk factors, and the sensitivity and specificity of QUS for predicting DXA-defined osteoporosis were at optimum values at ages between 50 and 59 years. We conclude that, even though the accuracy of QUS for predicting DXA-defined osteoporosis is not remarkably high, it can be applied to identify subjects at risk in this age group in developing countries and rural districts who should be the focus of fracture prevention.

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