BACKGROUNDUsing a selective α-blocker for medical expulsive therapy (MET) is a cost-effective treatment approach widely used for ureteral stones.OBJECTIVETo evaluate the efficacy of silodosin, a selective α-1a receptor antagonist, in this setting.DESIGN, SETTING, AND PARTICIPANTSThis was a multicenter, phase 2 study conducted in adult patients with a unilateral ureteral calculus of 4-10mm. Of 239 patients in the safety population, six discontinued due to adverse events.INTERVENTIONPatients were randomized 1:1 to receive silodosin 8 mg or placebo for up to 4 wk.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSISThe primary outcome was spontaneous stone passage, analyzed using logistic regression. Secondary outcomes included time to stone passage, emergency room (ER) visits, hospital admissions, analgesic use, and incidence and severity of pain.RESULTS AND LIMITATIONSNo significant differences between the silodosin and placebo groups were observed for passage rate of all stones (52% vs 44%, respectively; p=0.2). However, silodosin achieved a significantly greater rate of distal ureter stone passage than placebo (p=0.01). Significant differences were not observed for ER visits, hospital admission, or use of analgesics. The number of patients in the intent-to-treat population was slightly below the calculated sample size (232 vs 240) and sample sizes were not calculated for subgroup analyses.CONCLUSIONSThis is among the first prospective, randomized, multi-institutional trials to examine the efficacy of a selective α-1a antagonist as MET in patients with ureteral calculi and did not demonstrate a benefit to the entire ureter. However, silodosin was found to be well tolerated and beneficial in facilitating the passage of distal ureteral stones, warranting additional future studies on distal stone elimination.PATIENT SUMMARYIn this report, we looked at the efficacy of silodosin for the treatment of ureteral stones. We found that silodosin increased passage of distal ureteral stones.

2013-05-13·International Thermal Spray Conference

Influence of Surface Contamination on the Adhesion Strength of HVOF Coatings

作者: White, B. ; Estrada, C. ; Barr, J.

AbstractBase metal surfaces are typically prepared for thermal spraying by chemically cleaning followed by grit blasting. In common practice, HVOF coatings are applied within 2-4 h or the entire cleaning process is repeated to prevent in-service adhesion failures. This study was initiated to assess the effect of long wait times on the adhesion strength of WC-Ni coatings. Test coupons were chemically cleaned, grit blasted, and then set out in shop conditions for up to 48 hrs. Some were also subjected to different forms of contamination including dirty fingerprints, grease, penetrating oil, surface rust, tape residue, and paint. Pull test and metallographic examination results show that none of the contaminants had an influence on the adhesion strength of the HVOF coatings.

2013-01-01·Journal of Urology

Rapid Efficacy of the Highly Selective α _1A -Adrenoceptor Antagonist Silodosin in Men With Signs and Symptoms of Benign Prostatic Hyperplasia: Pooled Results of 2 Phase 3 Studies

Article

作者: Volinn, Weining ; Hill, Lawrence A. ; Marks, Leonard S. ; Gittelman, Marc C. ; Hoel, Gary

PURPOSEWe evaluated the efficacy and safety of silodosin for treatment of benign prostatic hyperplasia symptoms in 2 randomized, placebo controlled, phase 3 studies.MATERIALS AND METHODSMen 50 years or older with an International Prostate Symptom Score of 13 or greater and peak urinary flow rate of 4 to 15 ml per second received placebo or 8 mg silodosin daily with breakfast for 12 weeks. The primary end point was International Prostate Symptom Score change from baseline to last observation. Change in peak urinary flow rate was a secondary end point. Differences in treatment efficacy were assessed by ANCOVA.RESULTSOf 923 patients (mean age 65 years) 466 received silodosin and 457 placebo. After 0.5 week (range 3 to 4 days) of treatment patients receiving silodosin vs placebo achieved significant improvement in total International Prostate Symptom Score (difference -1.9, p <0.0001) and irritative (-0.5, p = 0.0002) and obstructive (-1.4, p <0.0001) subscores. The mean ± SD change from baseline in total International Prostate Symptom Score was -4.2 ± 5.3 for silodosin vs -2.3 ± 4.4 for placebo. Differences (silodosin vs placebo) in International Prostate Symptom Score and subscores increased by week 12 (p <0.0001). Mean change from baseline in peak urinary flow rate (ml per second) 2 to 6 hours after initial dose was greater (p <0.0001) with silodosin (2.8 ± 3.4) than placebo (1.5 ± 3.8). Differences remained significant (p <0.001) through week 12. The most common treatment emergent adverse event was (mostly mild) retrograde ejaculation (silodosin 28.1% of patients, placebo 0.9%). Few patients receiving silodosin (2.8%) discontinued because of retrograde ejaculation. Proportions of patients with treatment emergent orthostatic hypotension were similar for silodosin (2.6%) and placebo (1.5%).CONCLUSIONSTreatment with silodosin produced rapid improvement in urinary symptoms that was sustained for 12 weeks. Silodosin was well tolerated with a low incidence of orthostatic hypotension.

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