International Prostate Symptom Score: From 1 Different Sources
(IPSS) a self-administered questionnaire, completed by men with *lower urinary tract symptoms, which consists of seven questions based on the extent of symptoms and a single quality-of-life question. It gives a numerical score, on a scale of 0 to 35, to indicate the severity of the patient’s symptoms. A score of 0–7 indicates mild symptoms, 8–19 moderate symptoms, and 20–35 severe symptoms. The quality-of-life question is scored from 0–6.
A sign or indication of disorder or disease, especially when experienced by an individual as a change in normal function, sensation or appearance.... symptom
A method of assessing at birth whether or not a baby requires resuscitation. The newborn is routinely assessed at 1 minute of age and again at 5 minutes, and a value of 0, 1 or 2 given to each of ?ve signs: colour, heart rate, muscle tone, respiratory (or breathing) e?ort, and the response to stimulation. A total score of 7 or more indicates that the newborn child is in excellent condition. An Apgar score of 5 or less at 15 or 20 minutes predicates an increased risk of subsequent CEREBRAL PALSY.... apgar score
This is an accessory sex gland in males which is wrapped round the URETHRA as this tube leaves the URINARY BLADDER. Opening into the urethra, the gland secretes an alkaline ?uid during ejaculation and is a constituent of SEMEN. The gland grows during adolescence and is sensitive to the concentrations of sex hormones.... prostate gland
A measure of an individual’s or group’s lack of normal social amenities such as proper housing, diet and warmth. It was devised in the 1980s to help assess the medical services needed by a socially deprived population.... deprivation score
A World Health Organisation classi?cation of all known diseases and syndromes. The diseases are divided according to system (respiratory, renal, cardiac, etc.) or type (accidents, malignant growth, etc.). Each of them is given a three-digit number to facilitate computerisation. This classi?cation allows mortality and morbidity rates to be compared nationally and regionally. A revised ICD is published every ten years; a similar classi?cation is being developed for impairments, disabilities and handicaps.... international classification of disease (icd)
Classification of health and health-related domains that describe body functions and structures, activities and participation. The domains are classified from body, individual and societal perspectives. Since an individual’s functioning and disability occurs in a context, this classification includes a list of environmental factors.... international classification of functioning, disability and health (icf) a
A classification of diseases, conditions and other reasons for attendance for primary care. This classification is an adaptation of the ICD but makes allowance for the diagnostic uncertainty that prevails in primary care.... international classification of health problems in primary care (ichppc)
A systematic taxonomy of the consequences of injury and disease. See “disability”; “handicap”; “impairment”.... international classification of impairments, disabilities and handicaps (icidh)
The official classification of the World Organisation of Family Doctors. It includes three elements of the doctor-patient encounter: the reason for the encounter; the diagnosis; and the treatment or other action or intervention.... international classification of primary care (icpc)
A list of diagnoses and identifying codes used by medical practitioners and other health care providers. The coding and terminology provide a uniform language that permits consistent communication on claim forms. Data from earlier time periods were coded using the appropriate revision of the ICD for that time period. Changes in classification of causes of death in successive revisions of the ICD may introduce discontinuities in cause of death statistics over time.... international statistical classification of diseases and related health problems, tenth revision (icd-10)
This is a walnut-sized gland that surrounds the beginning of the urethra in men. It secretes the alkaline transport fluid that mixes with sperm from the testes to form semen. The prostate needs adequate anabolic steroid stimulation for its health and growth, especially testosterone. Because of diminished healthy hormone levels, pelvic congestion, and decreased blood (and hormone) circulation, or because of sexually transmitted or urinary tract infections, a male may get prostatitis. (See BPH.)... prostate
Score expressed as a deviation from the mean value, in standard deviation units. ... z score
a scoring system to assess the state of the maternal cervix and position of the fetal head to determine the ease or difficulty with which labour may be induced.... bishop score
a quantification of the amount of calcium seen in the coronary arteries on a CT scan, calcium being a marker of severe coronary artery disease.... calcium score
a clinical scoring system used to predict the one- and two-year survival rates of patients with chronic liver disease. The score is determined by the assessment of two clinical signs (the presence of ascites and *hepatic encephalopathy) and three biochemical markers (serum bilirubin level, serum albumin level, and prothrombin time).... child–turcotte–pugh score
see Schneiderian first- and second-rank symptoms.... first-rank symptom
an assessment tool that predicts a ten-year risk of developing cardiovascular disease based on gender, age, total and HDL cholesterol, blood pressure, and smoking, thereby enabling preventative treatment. It does not incorporate the presence of diabetes or familial history of cardiovascular disease into the scoring.... framingham risk score
Disease of the PROSTATE GLAND can affect the ?ow of URINE so that patients present with urological symptoms.
Prostatitis This can be either acute or chronic. Acute prostatitis is caused by a bacterial infection, while chronic prostatitis may follow on from an acute attack, arise insidiously, or be non-bacterial in origin.
Symptoms Typically the patient has pain in the PERINEUM, groins, or supra pubic region, and pain on EJACULATION. He may also have urinary frequency, and urgency.
Treatment Acute and chronic prostatitis are treated with a prolonged course of antibiotics. Patients with chronic prostatitis may also require anti-in?ammatory drugs, and antidepressants.
Prostatic enlargement This is the result of benign prostatic hyperplasia (BPH), causing enlargement of the prostate. The exact cause of this enlargement is unknown, but it affects 50 per cent of men between 40 and 59 years and 95 per cent of men over 70 years.
Symptoms These are urinary hesitancy, poor urinary stream, terminal dribbling, frequency and urgency of urination and the need to pass urine at night (nocturia). The diagnosis is made from the patient’s history; a digital examination of the prostate gland via the rectum to assess enlargement; and analysis of the urinary ?ow rate.
Treatment This can be with tablets, which either shrink the prostate – an anti-androgen drug such as ?nasteride – or relax the urinary sphincter muscle during urination. For more severe symptoms the prostate can be removed surgically, by transurethral resection of prostate (TURP), using either electrocautery or laser energy. A new treatment is the use of microwaves to heat up and shrink the enlarged gland.
Cancer Cancer of the prostate is the fourth most common cause of death from cancer in northern European males: more than 10,000 cases are diagnosed every year in the UK and the incidence is rising by 3 per cent annually.
Little is known about the cause, but the majority of prostate cancers require the male hormones, androgens, to grow.
Symptoms These are similar to those resulting from benign prostatic hypertrophy (see above). Spread of the cancer to bones can cause pain. The use of a blood test measuring the amount of an ANTIGEN, PROSTATE SPECIFIC ANTIGEN (PSA), can be helpful in making the diagnosis – as can an ULTRASOUND scan of the prostate.
Treatment This could be surgical, with removal of the prostate (either via an abdominal incision, total prostatectomy, or transurethrally), or could be by radiotherapy. In more advanced cancers, treatment with anti-androgen drugs, such as cyprotexone acetate or certain oestrogens, is used to inhibit the growth of the cancer.... prostate gland, diseases of
An ENZYME produced by glandular tissue in the PROSTATE GLAND. When the gland enlarges (see PROSTATE, DISEASES OF), greater amounts of PSA are secreted, raising the concentration of the enzyme in the blood. This is especially so in cancer of the prostate, and testing the level of PSA is an indicator that the disease may be present. There is much controversy about the use of PSA as a screening test. Its proponents claim that its use reduces deaths from prostate cancer; its opponents suggest that it does this only by bringing to light many cases that needed no treatment and would not have caused death in any case. Further, if the level of PSA is very high, the disease is already advanced; where the result is equivocal it is uncertain whether the bene?ts of treatment outweigh the risks.... prostate specific antigen (psa)
Adeno-carcinoma. A hormone-related tumour in elderly men. Enlargement of the gland may be benign or carcinomatous. Fibrosis (hardening) may arise from inflammation. Obstruction of the outlet of the bladder through swelling of the gland (prostatism) may cause uraemia.
Symptoms. Bladder irritability; increased frequency during the night. Feeble forked stream of urine. Sometimes blood. Three quarters of such tumours are located in the posterior lobe of the prostate gland – readily accessible to the examining finger through the front wall of the rectum. Rectal examination reveals a hard rugged prostate. Cystoscopy confirms. Bone pains in the low back or pelvis reflect a stage where the tumour has already spread. Anaemia, weight loss, urgency.
All symptoms are worse by alcohol and spicy foods.
Harvard University scientists report: heavy consumption of animal fat, especially the fat in red meat appears to increase the chance that a man will develop advanced prostate cancer.
Of therapeutic value. Comfrey, Echinacea, Horsetail, Poke root, Thuja, Cornsilk, Goldenseal.
Tea. Combination. Comfrey leaves, Horsetail, Cornsilk. Equal parts. 2-3 teaspoons to each cup boiling water. Drink freely.
Formula No. 1. Echinacea 2; Comfrey 1; Poke root half; Thuja half. Mix. Dose: Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons. Thrice daily in water or cup of Cornsilk tea.
Formula No. 2. (Alternative) Echinacea 2; Goldenseal 1; Gotu Kola 1; Poke root half. Mix. Dose: Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons in water or cup of Cornsilk tea.
Bee pollen. Of value.
Garlic. Of value.
Diet. See: DIET – CANCER.
There is a very low incidence of prostate cancer in countries where Soya products are widely consumed – Soya contains a female hormone which is a protector factor.
Supplements. Morning and evening.
Vitamin A 7500iu or more. Large doses may be required. Vitamin C 1-2g. Vitamin E 200iu. Calcium 500mg. Selenium 100mcg. Zinc.
Study. Men with prostate cancer may not need to undergo radical prostatectomy (removal of the prostate gland). A 10-year follow-up study of men with early prostate cancer left untreated showed that 10 years later only 8.5 per cent of the 223 patients had died from prostate cancer. The survival rate of 86.8 per cent in the untreated group was nearly identical to a subgroup who met all the conditions for radical prostatectomy. (Journal of American Medical Association, 22/29 April 1992)
Commonly treated with female sex hormone or by orchidectomy.
It would appear that surgical removal of the gland offers little benefit, and possibly a disadvantage to patients wishing to leave well alone, particularly the elderly. Treatment by a general medical practitioner or oncologist. ... cancer – prostate gland
a numerical score from two to ten, which is the sum of the two *Gleason grades given to the most common and second most common pattern of prostate cancer seen in the tumour.... gleason score
see INR.... international normalized ratio
a scoring system used for newborn babies who may be withdrawing from maternal opioids or other (usually nonprescription) drugs. See neonatal abstinence syndrome.... lipsitz score
an assessment tool for newborn babies, consisting of a chart in which a combination of *vital signs, neurological involvement, observation of blue skin and lips, and level of behavioural response indicate the appropriate level of concern. It is colour-coordinated from red to green to enable standardized escalation of concerns about the sick baby.... neonatal early warning score
(PVP) a technique to vaporize the prostate by means of a high-energy laser, used to relieve *lower urinary tract symptoms due to benign prostatic hyperplasia (see prostate gland). It is associated with less blood loss and a shorter hospital stay than a traditional TURP (see resection), but can only be used on smaller prostates.... photoselective vaporization of the prostate
see Schneiderian first- and second-rank symptoms.... second-rank symptom
(TURP) see resection.... transurethral resection of the prostate
(TUVP) a technique that vaporizes (rather than resects) prostate tissue; it is associated with less bleeding during the procedure. TUVP is used to treat *lower urinary tract symptoms thought to be due to benign prostatic hyperplasia (see prostate gland) or urinary retention.... transurethral vaporization of the prostate
a measure of bone mineral density used to evaluate the degree of bone thinning detected on *DEXA scanning. An individual’s T score is the number of standard deviations above or below the mean reference value for young healthy adults. By convention, a score above –1 is considered normal, a score between –1 and –2.5 indicates osteopenia, and a score below –2.5 indicates *osteoporosis.... t score
see UICC.... union international contre le cancer
a malignant tumour (*carcinoma) of the prostate gland, a common form of cancer in elderly men. In most men it progresses slowly over many years and gives symptoms similar to those of benign enlargement of the prostate (see prostate gland). Before it was possible to test for *prostate specific antigen (PSA), the tumour had often invaded locally, spread to regional lymph nodes, and metastasized to bone before clinical presentation. By checking elevated levels of PSA or *PCA3, prostate cancer can be detected 5–10 years before the tumour would present symptomatically. If the disease is confined to the prostate, the patient may be offered active surveillance or radical *prostatectomy, radical radiotherapy, or *brachytherapy; *cryotherapy or *HIFU are available in specialized centres. In elderly patients, it may be enough to monitor the tumour growth. If the disease is outside the prostate, androgen deprivation therapy may be used; this may be achieved by *gonadorelin analogues, *anti-androgens, surgical castration, or oestrogen therapy.... prostate cancer
(PSA) a protease enzyme produced by the glandular epithelium of the prostate. Its effect is to liquefy the semen within the ejaculate. Overall PSA has a half-life of 2–3 days. Increased quantities are secreted when the gland becomes enlarged or inflamed, and levels of PSA in the blood are significantly elevated in cancer of the prostate. Although there is no clear ‘cut-off’ level for normality, over 4 ng/ml in the blood is associated with a 20% risk of prostate cancer, even in patients with normal-feeling prostates on rectal examination. Age-specific PSA reference ranges are often used. Newer PSA assays can measure free PSA and compare it to the total PSA in the blood. Low free:total PSA ratios indicate a greater risk of prostate cancer and improve the discrimination between cancer and benign disease in men with a PSA in the range 4–10 ng/ml. PSA levels tend to be much higher in advanced prostate cancer and the rate of fall on treatment (e.g. after radical prostatectomy or radiotherapy) is a good prognostic indicator of response.... prostate specific antigen
in DSM-5, a psychiatric disorder characterized by one or more chronic somatic symptoms about which patients are excessively concerned, preoccupied, or fearful, formerly called somatization disorder. These fears and behaviours cause significant distress and dysfunction, and although patients may make frequent use of health-care services, they are rarely reassured and often feel their medical care has been inadequate. The disorder can disrupt personal and family relationships and lead to unnecessary medical and surgical treatment. It is sometimes treated with *cognitive behavioural therapy, *psychotherapy, and/or *antidepressants.... somatic symptom disorder
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