New medical treatments for lower urinary tract symptoms due to benign prostatic hyperplasia and future perspectives

Background: Lower Urinary Tract Symptoms (LUTS) in men are a common clinical problem in urology and have been historically strictly linked to benign prostatic hyperplasia (BPH), which may lead to bladder outlet obstruction (BOO). New molecules have been approved and have entered the urologists' armamentarium, targeting new signaling pathways and tackling specific aspects of LUTS. Objective of this review is to summarize the evidence regarding the new medical therapies currently available for male non-neurogenic LUTS, including superselective α1-antagonists, PDE-5 inhibitors, anticholinergic drugs and intraprostatic onabotulinum toxin injections. Methods: The National Library of Medicine Database was searched for relevant articles published between January 2006 and December 2015, including the combination of "BPH", "LUTS", "medical" and "new". Each article's title, abstract and text were reviewed for their appropriateness and their relevance. One hundred forty eight articles were reviewed. Results: Of the 148 articles reviewed, 92 were excluded. Silodosin may be considered a valid alternative to non-selective α1-antagonists, especially in the older patients where blood pressure alterations may determine major clinical problems and ejaculatory alterations may be not truly bothersome. Tadalafil 5 mg causes a significant decrease of IPSS score with an amelioration of patients' QoL, although with no significant increase in Qmax. Antimuscarinic drugs are effective on storage symptoms but should be used with caution in patients with elevated post-void residual. Intraprostatic injections of botulinum toxin are well-tolerated and effective, with a low rate of adverse events; however profound ameliorations were seen also in the sham arms of RCTs evaluating intraprostatic injections. Conclusion: New drugs have been approved in the last years in the medical treatment of BPH-related LUTS. Practicing urologists should be familair with their pharmacodynamics and pharmacokinetics

Diversité des espèces végétales au sein des agro-forêts à base d’anacardier dans la commune de Savalou au Benin

Cette étude sur la diversité des espèces végétales des agro-forêts à base de l’anacardier vise essentiellement la connaissance des espèces végétales ligneuses compagnes à Anacardium occidentale dans la commune de Savalou. Pour ce faire, ces agro-forêts ont été étudiées en y effectuant un inventaire floristique à travers 157 placettes installées. Les informations ainsi obtenues ont été traitées par une analyse de la diversité alpha et Bêta. L’approche méthodologique adoptée a permis de recenser, 37 espèces ligneuses regroupées dans 18 familles dans les agro-forêts de la commune de Savalou. Les familles les plus représentées sont les Caesalpiniaceae (5 espèces). En outre, le regroupement en trois zones (Ouest, Centre et Est) des espèces a permis de montrer que l’indice de diversité de Shannon varie de 1,6 bit à 2,48 bits alors que l’équitabilité de Pielou oscille entre 0,34 à 0,51. Les solutions envisagées pour une gestion durable des agro-forêts basées sur l’anacardier concernent les modes d’accès et de valorisation de la la terre agricole et la nécessité de la conservation de la biodiversité.Mots clés: Commune de Savalou, agro-forêts à base d’anacardier, diversité biologique, gestion

Bulletin de la Recherche Agronomique du Bénin Local responses to HIV/AIDS: Coping strategies developed by affected households to adapt their farming systems to AIDS context in Southern Benin Réponses locales au HIV/SIDA : Adaptations apportées par les mén

Abstract HIV pandemic seen before as an urban concern has become a great problem in rural areas and specifically for agricultural sector. In response to the pandemic, the affected households have developed various coping strategies. Thus, it was important to identify and analyze these strategies, in order to improve them and help the affected households to attain food security. To this end, this research was conducted in Southern-Benin and involved two groups of households: HIV/AIDS affected households and non-affected households (control group). 144 households were selected for each group, so a total of 288 households. The methodology consisted of comparative analysis of the adjustments made by the households of the two groups, as well for pre-affection period and for affection period. From these comparisons, the adjustments made by the two groups were identified and those related to HIV/AIDS were deduced. Chi square test and t-statistic were used to check the differences between the two groups of households. The results showed that the main coping strategies developed by the AIDS affected households were: the social reorganization of the farm work, the recourse to hired labor, the priority given to home gardens, the sale of farm land and later the borrowing of land from thirds, the diversification of their activities with a focus on livestock production. Key words: farming systems, HIV/AIDS, local responses, sociology, Benin. Réponses locales au HIV/SIDA : Adaptations apportées par les ménages affectés à leurs systèmes de production au Sud-Bénin Résumé Le VIH/SIDA considéré comme un problème essentiellement urbain touche de plus en plus le milieu rural. Ce milieu étant la principale zone de production, les répercussions de la pandémie sur le secteur agricole et sur les ménages agricoles sont énormes. Ces ménages, en réponse à la pandémie, ont développé diverses stratégies d'adaptation qu'il est fondamental d'analyser, en vue de les améliorer et de renforcer la capacité desdits ménages à subvenir à leurs besoins de façon autonome. C'est dans ce but que la présente étude a été initiée. Elle a été conduite au Sud-Bénin auprès de deux groupes de ménages à savoir les ménages affectés et les ménages non affectés (groupe témoin). Au total, 288 ménages ont été sélectionnés à raison de 144 par groupe. La méthodologie adoptée a essentiellement consisté en une analyse comparative des ajustements opérés par les ménages des deux groupes, aussi bien pour la période pré-affection que pour la période d'affection. De cette comparaison, les ajustements communs aux deux groupes ont été identifiés et ceux imputables au SIDA déduits. Les tests t et Chi deux ont été utilisés pour tester les différences entre les deux groupes. Il ressort que les ajustements spécifiques aux ménages affectés par le SIDA étaient notamment : la réorganisation sociale du travail, le recours à la main-d'oeuvre salariée, la priorité accordée aux champs de case, la diversification des activités avec une place de plus en plus importante à l'élevage, la vente de terre et puis le recours à l'emprunt auprès des tiers

Salvage Hemiablation High Intensity Focused Ultrasound for unilateral radio-recurrent prostate cancer|Hémiablation prostatique de sauvetage par des ultrasons focalisés à haute intensité pour des récidives unilatérales après radiothérapie prostatique

Objective. - To report the oncological and functional outcomes of salvage hemiablation high-intensity focused ultrasound (HIFU) in patients with unilateral radio-recurrent prostate cancer.Patients and methods. - Patients with biochemical recurrence (BCR) after primary radiation therapy and evidence of unilateral organ confined recurrence based on a complete match between mpMRI and MRI targeted biopsies were included. Patients with distant metastasis were excluded. Patients were followed with serial serum PSA determinations. BCR were defined using the Phoenix criteria. Complications were graded according to the Clavien score. IIEF-5 question-naire was used to assess erectile dysfunction. Urinary incontinence was reported using physician reported rates.Results. - A total of 10 consecutive patients (median age: 71 years, IQR: 69-76) were prospectively enrolled. The median pre-treatment PSA and post-treatment PSA nadir were 3.1 ng/mL (IQR: 1.54-8.59) and 1.52 ng/mL (IQR: 0.76-2.2), respectively. At a median follow-up of 41.5 (IQR: 18-58) months, 50% of patients experience BCR. BCR free-survival rates at 24 and 36 months were 75% (CI95%: 31-93) and 60% (CI95%: 20-85), respectively. Urinary in continence grade II occurred in two patients and the remaining patients were pad-free. One patient developed de novo erectile dysfunction requiring PDE5I. The erectile function scores decreased from a mean of 10.1 to 8.7.Conclusion. - Hemiablation HIFU is an alternative to whole gland therapy in patients with unilateral radio- recurrent prostate cancer, which offers limited urinary and rectal morbidity, and preserves functional outcomes. (C) 2019 Elsevier Masson SAS. All rights reserved

ETHNOBOTANIC ASSESSMENT OF DEBARKED MEDICINAL PLANTS IN SOUTHERN BENIN: THE CASE OF LOKOLI SWAMPY FOREST AND LAMA PROTECTED FOREST

This study was focused on identifying medicinal plants species subject to bark harvesting in two forests of Southern Benin (Lama Protected Forest and Lokoli Swampy Forest). Ethnobotanical survey was conducted in nine surrounding villages of both forests. 261 survey participants of various socio-professional groups (traditional healers, bark collectors, farmers, and others) answered questionnaires. Collected data provided information about the species being debarked, diseases treated, the frequency and debarking methods applied as well as the people perception of their impact on the health of trees after debarking and the sustainable palliative debarking method applied or proposed by local population. A total of 70 medicinal species belonging to 26 families were identified of which 26 bark species were mostly used. The use of tree bak was locality and socio-prefessional groups dependents as well as ethny, age and sex. Species with highest used score were: Khaya senegalensis, Anogeissus leiocarpa, Dialium guineense, Adansonia digitata, Mangifera indica and Diospyros mespiliformis in Lama Forest and Nauclea diderrichii, Bridelia ferruginea, Syzygium owariense and Ficus trichopoda in Lokoli Forest. The most important human diseases recorded were stomach pains, dysentery and frotalen. According to socio-professional groups, Traditional healers were mostly related in tree bark used in spirituality while Collectors harvested mainly species involved in commercialization. Stakeholders with a negative impact on the resources seem to be collectors applying unsustainable debarking procedures such as tree logging or girdling. However, certain sustainable debarking method have been proposed such as cambium protecting (by collectors) and botanical gardens set up (by traditional healers)