Radiologik Dj 2018.8.1 Free Download For Mac
Benign prostatic hyperplasia (BPH) is a histological diagnosis associated with unregulated proliferation of connective tissue, smooth muscle and glandular epithelium. BPH may compress the urethra and result in anatomic bladder outlet obstruction (BOO); BOO may present as lower urinary tract symptoms (LUTS), infections, retention and other adverse events. BPH and BOO have a significant impact on the health of older men and health-care costs. As the world population ages, the incidence and prevalence of BPH and LUTS have increased rapidly. Although non-modifiable risk factors – including age, genetics and geography – play significant roles in the etiology of BPH and BOO, recent data have revealed modifiable risk factors that present new opportunities for treatment and prevention, including sex steroid hormones, the metabolic syndrome and cardiovascular disease, obesity, diabetes, diet, physical activity and inflammation.
We review the natural history, definitions and key risk factors of BPH and BOO in epidemiological studies. INTRODUCTION Benign prostatic hyperplasia (BPH) is a histological diagnosis associated with unregulated proliferation of connective tissue, smooth muscle and glandular epithelium within the prostatic transition zone. Prostate tissue is composed of two basic elements: A glandular element composed of secretory ducts and acini; and a stromal element composed primarily of collagen and smooth muscle. In BPH, cellular proliferation leads to increased prostate volume and increased stromal smooth muscle tone. McNeal describes two phases of BPH progression.
Google Chrome Free Download For Mac
DEFINITIONS OF BPH AND BOO IN EPIDEMIOLOGICAL STUDIES A persistent challenge in the interpretation of data from population based studies of BPH and BOO is the heterogeneity of the case definitions in the literature. Investigators have utilized many different definitions for BPH, including histological analysis of prostate tissue, radiologic benign prostate enlargement (BPE), decreased urinary flow rates, urodynamic studies consistent with BOO, need for BPH surgery, AUR, and physician-diagnosed BPH and LUTS. LUTS describes a distinct phenotype of a group of disorders affecting the prostate and bladder that share a common clinical manifestation. In recent years, LUTS has become the preferred term for studying urinary symptoms in male populations, because it allows for a broad, epidemiological description of urinary symptoms without identification of organ- or disease- specific etiologies. The most commonly used measures of LUTS in epidemiologic studies are the American Urological Association Symptom Index (the AUA-SI) and its internationally validated counterpart, the International Prostate Symptom Score (I-PSS).
The AUA-SI and I-PSS are robust and reliable metrics for measuring male LUTS. The AUA, European Association of Urology and the World Health Organization International Consultation on Urologic Disease recommend the routine use of the I-PSS in the clinical evaluation of patients with suspected BPH and BOO., The terms BPH, BOO and LUTS remain interconnected in the contemporary treatment and study of urinary disorders in older men. However, prior epidemiological studies have not consistently utilized the term “BOO.” Instead, the two terms routinely used in the literature to describe the clinical manifestations of BPH – i.e., the adverse clinical effects of BOO – are “BPH” and “LUTS.” Therefore, the remainder of this review will focus primarily on epidemiological risk factors associated with the etiologies of BPH and male LUTS. PUBLIC HEALTH EFFECTS OF BPH AND BOO: ADVERSE EVENTS AND COSTS BPH and BOO have substantial adverse effects on the public health. Despite widespread use of medical therapy, BPH remains, on a population level, associated with a substantial incidence of BOO-associated adverse events, including LUTS, urinary infections, bladder calculi, urinary retention and acute renal failure.
In a study of 3.7 million US men presenting to emergency rooms in the state of California, for example, the incidence of urinary retention increased 25% from 2007 to 2010., Another important public health issue is the costs associated with diagnosis and treatment. In 2000, BPH accounted for $1.1 billion dollars in direct health-care expenditures, 4.4 million office visits, 117,000 emergency room visits, 105,000 hospitalizations and 21-38 million h in lost productivity in the US estimated annual costs of BPH treatment in the US total at least $3.9 billion dollars.,.
Age The prevalence of BPH rises markedly with age. Genetics Evidence suggests that there are genetic components to both BPH and LUTS. One case control analysis, in which cases were men less than 64 years of age who underwent surgery for BPH, noted 4-fold and 6-fold increase in the age-specific risks of BPH surgery among all male relatives and brothers, respectively, of cases. Sex steroid hormones: Testosterone, dihydrotestosterone and estrogen In prostatic secretory cells, the hormone 5-alpha reductase converts testosterone to DHT, a potent stimulator of prostate growth that, in addition to being necessary for prostate development, appears to play a central role in BPH pathogenesis. Multiple studies have explored associations of endogenous sex steroid hormones – namely testosterone, DHT and estrogen – with BPH and LUTS.
At least 7 observational studies have reported no associations and 5 inverse associations of serum testosterone (total, bioavailable, or free) with BPH or LUTS., No studies to date have reported an increased risk of BPH or LUTS with higher serum testosterone levels. Furthermore, data from a subset of men in the Proscar long-term efficacy and Safety trial demonstrate low testosterone (. The metabolic syndrome and cardiovascular disease A notable and relatively recent development in the epidemiology of BPH and BOO is the recognition that modifiable life-style factors influence the natural history of these conditions. Accumulating data suggest that many of the same metabolic disturbances associated with cardiovascular disease – and the life-style factors that alter these disturbances – influence the risk of BPH and LUTS. These observations are important because they suggest novel targets for prevention and treatment. Obesity Prior studies have consistently observed that increased adiposity is positively associated with prostate volume: The greater the amount of adiposity, the greater the prostate volume.
Body weight, body mass index (BMI) and waist circumference have all been positively associated with prostate volume in multiple different study populations. In the BLSA cohort, for example, each 1 kg/m 2 increase in BMI corresponded to a 0.41 cc increase in prostate volume.
Moreover, obese (BMI ≥ 35 kg/m 2) participants had a 3.5-fold increased risk of prostate enlargement compared with non-obese (BMI. Diabetes and disruptions in glucose homeostasis Disruptions in glucose homeostasis at multiple different levels – from alterations in serum insulin growth factor (IGF) concentrations to diagnosis of clinical diabetes – are associated with higher likelihoods of BPH, BPE and LUTS. Diet There are some indications that both macronutrients and micronutrients may affect the risk of BPH and LUTS, although the patterns are inconsistent. Inflammation A majority of observational studies suggests that inflammation is linked to the development of BPH and LUTS.
The mechanisms underlying this relationship are unclear. One potential explanation is that the metabolic syndrome, which promotes systemic inflammation and oxidative stress, mediates the connection. CONCLUSION In summary, BPH and BOO are of significant importance to public health, affecting tens of millions of older men globally. Current disease trends in the US, Europe and other regions suggest that the incidence and prevalence of these conditions will increase in the near future due to aging of the world population and the increased prevalence of the metabolic syndrome and its components, thereby placing even greater burdens on finite resources. While age and genetic factors play a role in the development of BPH and BOO, many modifiable variables contribute as well - factors that potentially may be altered in order to delay onset, prevent progression or diminish symptoms.
Potential strategies include inhibition of DHT synthesis with five-alpha reductase inhibitors, modulation of metabolic risk factors with comprehensive life-style interventions incorporating diet change and physical activity and suppression of inflammatory pathways with NSAIDs.
Radiologik Scheduler schedules program blocks for Radiologik DJ creating a full-time automated radio station along with Radiologik DJ. It chooses tracks from playlists in iTunes with a little bit of extra logic to figure out times and artist separation. It builds these segments in 30, 60, 90, or 120-minute blocks anywhere inside of a week schedule.
The resolution of the script statements is in seconds. It runs the appropriate script 20 minutes before the start time and sends that set of tracks and directions to Radiologik DJ's program queue. Advanced features ( What's New in Radiologik Scheduler. Radiologik Scheduler schedules program blocks for Radiologik DJ creating a full-time automated radio station along with Radiologik DJ.
It chooses tracks from playlists in iTunes with a little bit of extra logic to figure out times and artist separation. It builds these segments in 30, 60, 90, or 120-minute blocks anywhere inside of a week schedule. The resolution of the script statements is in seconds. It runs the appropriate script 20 minutes before the start time and sends that set of tracks and directions to Radiologik DJ's program queue.
Free Software For Mac
Advanced features include automatic placement of voiceover intros and outros, time announcements, date matching picking of file titles, exact time search fitting for to-the-second programming, and special scheduling of ad traffic.