Urinary Diseases Research Articles

The role of probiotics in women with recurrent urinary tract infections.

Urinary tract infections (UTIs) still represent a significant bother for women and result in high costs to the health system. Increasing antimicrobial resistance has stimulated interest in non-antibiotic prophylaxis of recurrent UTIs. Evidence shows that the microorganisms inhabit many sites of the body, including the urinary tract which has long been assumed to be sterile in healthy individuals, might have a role in maintaining urinary health. Studies of the urinary microbiota (UM) have identified remarkable differences between healthy populations and those with urologic diseases. The depletion of these organisms in women susceptible to UTIs raised the question of whether artificial supplementation of these microorganisms as probiotics could lower infection rates. In the literature, probiotic interventions were shown to have some efficacy in the treatment and prevention of urogenital infections. Despite previous controversy regarding the use of probiotics, as treatment for UTIs, there are increasing signs that it may be possible to use them as a first step in regulating the UM so as to reduce the risk of or as a treatment for certain urinary diseases. However, further future clinical trials, involving large numbers of patients, will be mandatory to achieve definite evidence of the preventive and curative role of probiotics in UTIs. Details about correct formulations in terms of amount of bacteria, viability and associated growth factors, will be required in order to standardize the administration schedule and achieve homogeneous and comparable results on selected patients.

The study of Gluquamin anti-aggregant properties for experimental renal failure

Topicality. Chronic kidney disease (CKD) is one of the most common urinary system diseases, which leads not only to inevitable renal failure, but also to kidneys hemodynamics worsening and platelet activity increase. Therefore, when searching for a new agents for CKD treatment, it is advisable to study their anti-aggregant properties.Aim. Experimental study of Gluquamin drug effect on the platelet aggregation in con-ditions of renal failure development to justify its use in CKD therapy. Materials and Methods. Heiman’s active nephritis was used as a model of renal failure. The stimulated platelet aggregation was determined in rats using turbidimetric method with an aggregometer.Results and Discussion. Under the influence of Gluquamin on the 120th day of study there was a significant decrease of the ADP-induced platelet aggregation relatively to untreat-ed animals, which indicates a decrease of the blood level of activated platelet forms. Also in rats there was a decrease of the collagen-stimulated aggregation, which indicates a decrease of the sensitivity of platelets to the components of the vascular wall and basal membranes. At the same time according to Gluquamin influence degree was superior to the activity of compara-tive drugs quercetin and lespephril.Conclusions. Under the conditions of renal failure development on the background of glomerulonephritis in rats Gluquamin has a pronounced anti-aggregant effect, normalizes he-modynamics, rheological properties of blood and is a promising drug in CKD therapy.

Kinetics of urease inhibition by different fractions of Cassia fistula

Urease serves as the basis for Helicobacter pylori infection of stomach as well as urinary tract infection by Proteus, Klebsiella, Pseudomonas and Staphylococus species. Ureolytic activity by these pathogens causes various gastric and urinary diseases. Urease inhibitors can be used as potential approach for treatment of these infections. Cassia fistula, an ayurvedic medicinal plant also named as Aragvadha (a disease killer), was explored as source of urease inhibitors. In the present study, we evaluated the five different extracts viz. aqueous, methanol, hexane, chloroform and ethyl acetate for their urease inhibition potential. Except chloroform extract, all four samples exhibited more than 50% urease inhibitory activity. The IC50 of ethyl acetate sample was 0.27 mg/ml lower than standard thiourea. The inhibition kinetics of all four samples was studied. Line weaver Burk plot and Dixon plots revealed the ethyl acetate sub fraction as most potent inhibitor as it exhibited competitive mode of inhibition with Ki of 280 μg/ml. All the other samples exhibited mixed and uncompetitive mode of inhibition. Further characterization of bioactive compounds in the ethyl acetate sample was performed using GC-MS. The analysis identified 26 compounds in the sample. Mome-inositol, a derived sugar was found to be major compound (80.83%). From the present observation it can be concluded that C. fistula plant needs to be explored further for identifying the lead molecule to treat various ureolysis based diseases.

Pine needles attenuate receptor activator for nuclear factor-B ligand (RANKL)-induced trabecular bone loss by inhibiting osteoclast differentiation

BackgroundThe leaf of Pinus densiflora known as pine needles has been used to treat vascular disease, gastrointestinal diseases, and urinary diseases in traditional medicine. We evaluated anti-osteoporotic effect of water extract of Pinus densiflora (WEPN) on acute bone loss and osteoclastogenesis induced by receptor activator for nuclear factor-κB ligand (RANKL). MethodsAfter oral administration of WEPN (0.25g/kg) for 5 days, femora were collected, and bone parameter [trabecular bone volume/tissue volume (BV/TV), trabecular thickness (Tb. Th), trabecular separation (Tb. Sp), trabecular number (Tb. N), and bone mineral density (BMD)] were analyzed by micro-CT analysis. Anti-osteoclastic effect of WEPN was examined using tartrate-resistant acid phosphatase activity and activation of RANKL signaling pathway. ResultsWe found that WEPN significantly attenuated RANKL-induced decrease of BV/TV, Tb.Th., Tb.N, and BMD but increase of Tb. Sp in femora. WEPN dose-dependently decreased osteoclastogenesis accompanied by inhibiting the activation of RANKL signaling components (JNK, p38, and p65) and mRNA expression level of osteoclast specific genes (NFATc1, c-Fos, TRAP, cathepsin K, DC-STAMP, and carbonic anhydrate). ConclusionWEPN inhibition on osteoclastogenesis could contribute to attenuate RANKL-induced trabecular bone loss in vivo. Therefore, it might suggest that WEPN could be prescribed in traditional medicine or used in health functional food to prevent or treat osteoporotic bone diseases.

Effects of flavonoids from Pyrrosiae folium on pathological changes and inflammatory response of diabetic nephropathy

Diabetic nephropathy (DN) is closely related to immune-mediated inflammatory damage. Pyrrosiae folium is used commonly for the urinary system diseases with a good efficacy, which contains abundant flavonoids (SWHT). This study was performed to investigate the therapeutic effect of SWHT on DN and its effect on inflammatory response. In this study, the main active components of SWHT were identified by high performance liquid chromatography (HPLC). The results showed that SWHT mainly contained mangiferin and isomucoside. Rat model of diabetic nephropathy (DN) was established by feeding high glucose & high fat diet and injecting streptozocin (STZ). Then the rats were randomly divided into control group, DN model group, positive control group, and SWHT groups (50, 100, 200 mg·kg⁻¹, ig). The levels of AGEs and RAGE in serum were measured by ELISA after 12 weeks of drug administration. The serum creatinine, blood urea nitrogen and total protein levels were detected by using test kit. HE staining and transmission electron microscopy were applied to observe the pathological changes and structure of renal tissue. Western blot and ELISA were used to detect the protein expression and content levels of interleukin 6 (IL-6), tumor necrosis factor (TNF-α) and IL-1β in renal tissue. Results showed that SWHT significantly decreased serum AGEs and RAGE levels in DN rats; decreased serum creatinine, blood urea nitrogen and total urinary protein levels, improved renal pathological damages and reduced basement membrane thickening in DN rats. In addition, SWHT down-regulated the protein expression levels of inflammatory mediators IL-6, TNF-α and IL-1β. The research studies indicated that SWHT component had a potential anti-diabetic nephropathy activity, and its improvement effect on pathological damages may be related to reducing inflammation. This provides the basis for the scientific and rational application of P. folium, and also provides active components for further development of Chinese medicine for diabetic nephropathy.

Ethnobotanical investigation on medicinal plants in Algoz area (South Kordofan), Sudan

BackgroundThe inhabitants of western Sudan use traditional medicine for the treatment of various ailments due to lack of medical doctors and unaffordable prices of pharmaceutical products. The present study is the first documentation of the traditional plant knowledge on medicinal uses of plants by healers in Algoz (South Kordofan), Sudan.MethodEthnobotanical data were collected over a period from March to November 2015 using semi-structured interviews with 30 healers (24 male and 6 female) living in the investigated area. Quantitative indices such as use categories, use value (UV) and informant consensus factor (ICF) were intended to evaluate the importance of medicinal plant species.ResultsA total of 94 medicinal plants, which belong to 45 families and 81 genera, were recorded in the study area. The most represented families are Leguminosae with 20 species followed by Combretaceae (6 species), Rubiaceae (5 species) and Asteraceae (4 species). The reported species were belonging to herbs (43%), trees (28%), shrubs (22%), climbers (4%) and parasites (3%). Root and stem (21% each) were the most plant parts used. A majority of remedies are administered orally (67%) where infusion (36%) and maceration (32%) are the most used methods. The highest ICF (0.87) was reported for poisonous animal bites followed by urinary system diseases (0.89), blood system disorders (0.88) and gynaecological diseases (0.87). Anastatica hierochuntica, Ctenolepis cerasiformis, Echinops longifolius, Cleome gynandra, Maerua pseudopetalosa, Martynia annua, Oldenlandia uniflora, Opuntia ficus-indica, Solanum dubium, Sonchus cornutus, Tribulus terrestris and Drimia maritima were reported for the first time in this study.ConclusionThe number of medicinal plants reported in this paper reflects evidence that Algoz area had a high diversity of medicinal plants which will continue to play an important role in the healthcare system in the study area.

Intermittent Self-catheterization in Older Adults: Predictors of Success for Technique Learning

PurposeThe main goal of this retrospective study is to explore the predictors of success in learning clean intermittent self-catheterization (CISC) in patients over 65 years of age. The secondary goal is to assess whether in this population, the risk of failure to perform CISC is greater, compared with patients under 65 with similar pathologies.MethodsAll patients older than 65 consulting between January 2011 and January 2016 for learning CISC were included. A control population younger than 65 matching with sex, body mass index, and pathology was selected.ResultsOne hundred sixty-nine of the 202 patients (83.7%) over 65 succeeded in learning CISC. Obesity (P<0.05), low pencil and paper test (PP test) (P<0.01) and low functional independence measure (FIM) (P<0.01) scores were risk factors of failure. No significant differences were found with sex or pathology. In multivariate analysis, low PP test perineum access (odds ratio [95% confidence interval], 2.30 [1.32–4.42]), low FIM motor (1.04 [1.01–1.08]), and FIM cognition (1.18 [1.03–1.37]) scores were independent factors of learning failure. Compared to control group, age over 65 was not predictive of failure (P=0.15).ConclusionsOur study shows that success in learning CISC does not depend on age but on difficulties in mobility, access to perineum and probably cognitive disorders.

RISK FACTORS OF CARDIOVASCULAR DISORDERS IN NEWBORNS WITH INTRSUTERINE GROWTH RESTRICTION

In order to improve early diagnosis of cardiovascular disorders in newborns with intrauterine growth restriction by comparing obstetric and perinatal history data with the presence of myocardial dysfunction, the study involved examination of 167 newborns, of whom 62 full-term newborns were found to have intrauterine growth restriction and 105 healthy newborns with uncomplicated early neonatal period.The study implied assessment of obstetric history and clinical and instrumental examination.The study showed that the incidence of asymmetric IUGR was significantly higher than of symmetric IUGR (p = 0.0003). The gender distribution was dominated by female newborns (64.52 ± 6.08%, p = 0.028 and 35.48 ± 6.08% respectively).Abnormal pregnancy was observed in 44/62 (70.97 ± 5.76%), p = 0.0001 women, of whom 30/44 (68.18 ± 7.02%, p = 0.002) were mothers of newborns with aIUGR and 14/44 (31.82 ± 7.02%) with sIUGR. Acute respiratory disease (ARD) during pregnancy was diagnosed in 11/62 (17.74 ± 4.85%) women. Somatic disorders (cardiovascular, endocrine, respiratory and urinary diseases) were found in 43/62 (69.35 ± 5.86%, p = 0.0007) women, of whom 9/43 (20.93 ± 6.2%) of mothers had a comorbidity of somatic pathology (a combination of cardiac with other somatic disorders) and 100% of newborns of these mothers had myocardial dysfunction. Neonatal group with IUGR was found to have a statistically significant relationship between ARD during pregnancy and extragenital pathology, that is, every fourth woman (25.58 ± 6.65%, p = 0.011) with a somatic pathology suffered from ARD.In 30/62 (48.39 ± 6.35%) newborns with IUGR in the early neonatal period examination showed myocardial dysfunction of the heart ventricles, namely systolic dysfunction in 9/30 (30.0 ± 8.37%) children and diastolic dysfunction in 21 / 30 (70.0 ± 8.37%, p = 0.007) of the newborns. Clinically important was a statistically significant relationship between the development of cardiovascular disorders and the presence of extragenital pathology in mothers (p = 0.02).Hereditary cardiovascular diseases (hypertonic and / or coronary heart disease, congenital heart defects in first and second degree relatives) were determined in 11/62 (17.74 ± 4.85%) of the examined children. Moreover, 24/62 (38.71 ± 6.19%) of mothers suffered from cardiovascular disorders (congenital heart disease, hypertensive disease, heart rhythm disturbances, secondary cardiomyopathy). Myocardial dysfunction of the ventricles was diagnosed in 12/24 (50.0 ± 10.21%) of newborns. Cardiovascular disorders were more frequently found in mothers of newborns with aIUGR (74.07 ± 8.43%, p = 0.03).Examination did not reveal any specific signs of postnatal dysadaptation of the cardiovascular system, but showed “marble skin” in 18/62 (29.03 ± 5.76%) newborns. Auscultation showed systolic noise in the projection of the pulmonary artery valve in 37/62 (59.68 ± 6.23%) children, of the tricuspid valve in 7/62 (11.29 ± 4.02%). The tendency to bradycardia (heart rate 114.84 ± 6.30 beats / min) was observed in 32/62 (51.61 ± 6.35%) newborns.Conclusions: 1) The study showed the presence of myocardial dysfunction in 100% of newborns with IUGR that were born from mothers with comorbid somatic disorders (a combination of cardiac and other somatic diseases) 2) in newborns with IUGR, ante- and perinatal factors, taking into account both internal and external influences may be a risk factor for the development of cardiovascular disorders in the neonatal period. 3) the most significant risk factors for the development of cardiovascular disorders in newborns with IUGR include somatic maternal diseases, ARD during pregnancy, abnormal pregnancy, and comorbid somatic diseases. 4) the obtained data can be used to predict the risk of cardiovascular disorders in newborns, taking into account the characteristics of obstetric and perinatal history.

Black Raspberry Extract Enhances LDL Uptake in HepG2 Cells by Suppressing PCSK9 Expression to Upregulate LDLR Expression.

Black raspberry extract (BRE) has been widely used for treating prostate and urinary diseases and hyperlipidemia in Asia due to its significant lipid-lowering effects. The aim of this investigation was to evaluate the antihypercholesterolemia activity of BRE and the potential molecular mechanisms responsible for its antihypercholesterolemia activity by regulation of proprotein convertase subtilisin/kexin type 9 (PCSK9) expression in the human liver cell line HepG2. Reporter-based functional assay was used to identify herbal extracts that suppress PCSK9 expression in the HepG2 cells. Quantitative real-time polymerase chain reaction, Western blot analysis, and immunofluorescence staining were used to evaluate whether BRE modulates low-density lipoprotein receptor (LDLR) expression by repressing the hepatic expression of PCSK9. The LDLR activity of the HepG2 cells was determined using an LDL uptake assay. Our finding revealed that BRE modulates LDLR expression by suppressing the hepatic expression of PCSK9. We found that the combination of simvastatin and BRE caused the synergic induction of LDLR expression and LDL-C uptake, whereas simvastatin alone increased the expression of PCSK9 in the HepG2 cells. These results clearly demonstrated that the BRE from black raspberry suppressed simvastatin-induced PCSK9 expression and improved LDL-C uptake by hepatocytes through the induction of LDLR expression. These results suggest that the suppression of PCSK9 expression by BRE may potentiate the hypolipidemic effect of statins.

Anatomical studies on medicinal and endangered CAM plants of Milkweed family from Thar Desert, Rajasthan, India.

The present investigation was carried out to screen anatomical features of Sarcostemma viminale (L.) R.Br., Ceropegia bulbosa Roxb. var. bulbosa and var. lushii (Grah.), belonging to family Asclepiadaceae. Plant specimens were collected from semi-arid region of Thar Desert in Rajasthan. These plants are medicinally important and endangered, have been traditionally used as an antimicrobial, antifungal, anticancerous and antioxidant. Sarcostemma viminale (L.) R.Br. is used to cure diarrhoea, oedema and tuberculosis. Ceropegia species is used to cure deafness. Tubers are used in the treatment of kidney stone, urinary tracts diseases and eaten by ladies to enhance fertility and viability. The microscopical illustrations revealed interesting features i.e. presence of stone cells, rosette crystals, oil globules, phloem fibers, intraxylary phloem, pericycle patches, large medullary rays, annular vessels, more amount of palisade, mesophyll and multi-cellular trichomes etc. These features supported the habitat condition of Thar Desert and its Crassulacean Acid Metabolism (CAM) nature. This study provides referential pharmaco-botanical information for identification, authentication, standardization and detection of adaptation strategies and to develop a protocol to conserve them for further use.

Профилактика рецидивов инфекционных заболеваний мочевыводящих путей и отеков у беременных путем применения препаратов клюквы

Профилактика рецидивов инфекционных заболеваний мочевыводящих путей и отеков у беременных путем применения препаратов клюквы

Stem Cell Tracing Through MR Molecular Imaging.

Stem cell therapy opens a new window in medicine to overcome several diseases that remain incurable. It appears such diseases as cardiovascular disorders, brain injury, multiple sclerosis, urinary system diseases, cartilage lesions and diabetes are curable with stem cell transplantation. However, some questions related to stem cell therapy have remained unanswered. Stem cell imaging allows approval of appropriated strategies such as selection of the type and dose of stem cell, and also mode of cell delivery before being tested in clinical trials. MRI as a non-invasive imaging modality provides proper conditions for this aim. So far, different contrast agents such as superparamagnetic or paramagnetic nanoparticles, ultrasmall superparamagnetic nanoparticles, fluorine, gadolinium and some types of reporter genes have been used for imaging of stem cells. The core subject of these studies is to investigate the survival and differentiation of stem cells, contrast agent's toxicity and long term following of transplanted cells. The promising results of in vivo and some clinical trial studies may raise hope for clinical stem cells imaging with MRI.

Cell-free DNA: the role in pathophysiology and as a biomarker in kidney diseases.

Cell-free DNA (cfDNA) is present in various body fluids and originates mostly from blood cells. In specific conditions, circulating cfDNA might be derived from tumours, donor organs after transplantation or from the foetus during pregnancy. The analysis of cfDNA is mainly used for genetic analyses of the source tissue -tumour, foetus or for the early detection of graft rejection. It might serve also as a nonspecific biomarker of tissue damage in critical care medicine. In kidney diseases, cfDNA increases during haemodialysis and indicates cell damage. In patients with renal cell carcinoma, cfDNA in plasma and its integrity is studied for monitoring of tumour growth, the effects of chemotherapy and for prognosis. Urinary cfDNA is highly fragmented, but the technical hurdles can now be overcome and urinary cfDNA is being evaluated as a potential biomarker of renal injury and urinary tract tumours. Beyond its diagnostic application, cfDNA might also be involved in the pathogenesis of diseases affecting the kidneys as shown for systemic lupus, sepsis and some pregnancy-related pathologies. Recent data suggest that increased cfDNA is associated with acute kidney injury. In this review, we discuss the biological characteristics, sources of cfDNA, its potential use as a biomarker as well as its role in the pathogenesis of renal and urinary diseases.

The role of TGF-β superfamily signaling in neurological disorders.

The TGF-β superfamily signaling is involved in a variety of biological processes during embryogenesis and in adult tissue homeostasis. Faulty regulation of the signaling pathway that transduces the TGF-β superfamily signals accordingly leads to a number of ailments, such as cancer and cardiovascular, metabolic, urinary, intestinal, skeletal, and immune diseases. In recent years, a number of studies have elucidated the essential roles of TGF-βs and BMPs during neuronal development in the maintenance of appropriate innervation and neuronal activity. The new advancement implicates significant roles of the aberrant TGF-β superfamily signaling in the pathogenesis of neurological disorders. In this review, we compile a number of reports implicating the deregulation of TGF-β/BMP signaling pathways in the pathogenesis of cognitive and neurodegenerative disorders in animal models and patients. We apologize in advance that the review falls short of providing details of the role of TGF-β/BMP signaling or mechanisms underlying the pathogenesis of neurological disorders. The goal of this article is to reveal a gap in our knowledge regarding the association between TGF-β/BMP signaling pathways and neuronal tissue homeostasis and development and facilitate the research with a potential to develop new therapies for neurological ailments by modulating the pathways.

Pain beliefs of patients and the nonpharmacological methods they use to manage the pain

This study was performed to determine the pain beliefs of patients and nonpharmacological methods they use to manage their pain. This was a descriptive study conducted with the participation of 163 patients who were hospitalized in the medical and surgical clinics of a university hospital in May 2011. The study data were collected using personal information forms, a nonpharmacological methods form, and a pain belief scale. The data were evaluated using number, percentage, an independent sample t-test, and analysis of variance. The mean age of the patients was 52.7±16.6 years, and it was determined that 23.3% were hospitalized for urinary system diseases, while 21.5% were hospitalized for musculoskeletal system diseases. It was observed that 93.8% of the patients described experiencing pain in the past, while 22.7% described experiencing severe pain within the previous week. The types of pain most frequently described by the patients were headaches (24.8%), joint pain (21.6%), and lumbar pain (19.6%). It was determined that 72.3% of the patients used medication for pain, and that 49.1% also resorted to nonpharmacological methods for their pain. Frequently preferred nonpharmacological methods included hot and cold therapy, massage, and herbal methods. The mean organic score on the pain belief scale (23.6±4.57) was higher than the mean psychological score (19.9±2.64). Evaluating the pain beliefs of patients and the nonpharmacological methods used is important for effective management of pain.

The Analysis of Computer Data regarding Obesity and Associated Diseases in Cats Examined at Private Veterinary Practices

Background: Cats can be defined as being overweight if their bodyweight is 15% above optimum weight and classified as obese if they are more than 30% above their optimum weight. There is a general agreement among investigators that the incidence of excess body weight in cats is increasing. Obesity has considerable impacts on the health of cats and is linked to a variety of health issues including orthopedic disease, diabetes mellitus and non-allergic skin conditions. The purpose of the present study was to evaluate the relationship between obesity and associated diseases in cats examined at some veterinary practices in Istanbul-Turkey.Materials, Methods &amp; Results: Data of 2,272 patients examined at four private veterinary practices in Istanbul was studied to reveal the association between body weight and diseases. Information regarding sex, age and neutering status was also considered for each patient. Patients were classified according to their body weight to three groups as lightweight (female: 3.0 kg and under, male: 4.5 kg and under), optimum -weight (female: 3.0-4.5 kg, male: 4.5-5.5 kg) and overweight/obese (female: 4.5 kg and over, male: 5.5 kg and over). Accounting all adult cats treated by the clinics, diagnoses of osteoarthritis, heart diseases, dermatological diseases, hepatic lipidosis, metabolic syndrome - diabetes mellitus, lameness, gastrointestinal diseases, musculoskeletal diseases, neoplasia and urinary diseases were statistically evaluated. Considering data coming from 2,272 cats, which were referred to veterinary practices, 33.12%, were classified as overweight-obese, 40.04% were optimum-weight and 26.84% were lightweight. It was determined that overweight-obese cats were more likely to be diagnosed with osteoarthritis and hepatic lipidosis compared to other groups (P &lt; 0.05). Overweight-obese cats were more likely to be diagnosed with gastrointestinal disease and neoplasia compared to lightweight cats (P &lt; 0.05).Discussion: Obesity in cats is very common and the prevalence of combined overweight and obesity has been reported on a range from 20% to 40% in developed countries. Associated with the increasing welfare, as in humans, the incidence of obesity in the pet population is also increasing. The data studied for this research was evaluated with regard to diseases associated with obesity. It was determined that overweight-obese cats were more likely to be diagnosed with osteoarthritis and hepatic lipidosis compared to the other groups (P &lt; 0.05). Overweight-obese cats were more likely to be diagnosed with gastrointestinal disease and neoplasia compared to lightweight cats (P &lt; 0.05). However, an association between overweight or obesity and heart disease, metabolic syndrome - diabetes mellitus, lameness, musculoskeletal disease or urinary diseases was not found. A percentage of 19.95 of the patients over 2 years of age were classified in the overweight-obese group. These findings require that weight gain needs to be prevented before the animals reach obese status. Dietary management and physical exercise are essential for managing obesity in pets. In this study, it was aimed to explain the importance of weight management in preventing overweight or obesity associated diseases to cat owners by using the results, which demonstrate that overweight or obese animals are statistically more likely to develop associated diseases. Veterinary practitioners can also use this data to strongly advocate for the maintenance of feline patients at ideal body condition.

Fiber type-specific afferent nerve activity induced by transient contractions of rat bladder smooth muscle in pathological states.

Bladder smooth muscle shows spontaneous phasic contractions, which undergo a variety of abnormal changes depending on pathological conditions. How abnormal contractions affect the activity of bladder afferent nerves remains to be fully tested. In this study, we examined the relationship between transient increases in bladder pressure, representing transient contraction of bladder smooth muscle, and spiking patterns of bladder afferent fibers of the L6 dorsal root, in rat pathological models. All recordings were performed at a bladder pressure of approximately 10 cmH2O by maintaining the degree of bladder filling. In the cyclophosphamide-induced model, both Aδ and C fibers showed increased sensitivity to transient bladder pressure increases. In the prostaglandin E2-induced model, Aδ fibers, but not C fibers, specifically showed overexcitation that was time-locked with transient bladder pressure increases. These fiber type-specific changes in nerve spike patterns may underlie the symptoms of urinary bladder diseases.

Urine sediment evaluation in the dog and cat

Microscopic examination of the urine sediment is an integral part of urinalysis and a useful, cost-effective diagnostic tool in the everyday practice. Diagnostic investigation of urinary diseases and several systemic metabolic diseases make the microscopic evaluation of urine sediment a priority along with the physical and biochemical examination of urine. The different methods of urine collection (midstream voiding, catheterization or percutaneous cystocentesis) have advantages and disadvantages and the clinician has to decide on the best fitted method of urine collection, according to the medical background of the animal and the case-specific objectives of urinalysis. Proper handling and timely analysis of urine sample are essential for a valid microscopic evaluation. The microscopic examination of urinary sediment is usually conducted in stained or unstained “wet-mounted” preparations; occasionally, air-dried Giemsa-stained sediment smears are examined.Normal urine is sterile and may contain small numbers of cells (white and red blood cells, epithelial cells), few crystals, occasional casts, fat droplets and spermatozoa (male animals). In contrast, large numbers of cells or casts, presence of unusual types of crystals, neoplastic cells, parasites and microorganisms comprise abnormal findings, necessitating a more specialized diagnostic approach. This review focuses on the technical aspects pertaining to the proper sediment microscopic examination, the normally expected elements of sediment and the clinically relevant interpretation of abnormal findings.

Advances in comprehensive evaluation of detrusor function

In addition to urinary system diseases, systemic multiple organ factors can induce lower urinary tract symptoms (LUTS). At present, transurethral resection of the prostate (TURP) is still the gold standard for the treatment of benign prostatic hyperplasia (BPH). In the past, to evaluate the efficacy of TURP, people used to focus on subjective urination symptoms improvement and objective examination results, and rarely analyzed the function of detrusor itself and status of organs. This paper reviews the relationship between detrusor function and diseases. Key words: Lower urinary tract symptoms; Metabolic syndrome; Detrusor underactivity; Aging

Delirium is associated with increased mortality in the geriatric population

Objective: The aim of this study was to investigate the prevalence of delirium and its association with mortality rates in elderly inpatients.Methods: The medical records of 1435 patients over 65 years old who were treated at a regional university hospital and were referred to the university’s Consultation and Liaison Psychiatry Clinic for psychological evaluation were retrospectively analyzed. Patients with and without a diagnosis of delirium were compared. The National Survival Database was used to determine mortality rates.Results: The prevalence of delirium was 25.5%. The delirium group was older (p < .0001) and had a larger proportion of males (p < .0001). Mortality rate was higher in the delirium group at 1, 2, 3, 4, and 5 years (p < .0001 for all). Age, gender, lower urinary system diseases, chronic liver disease, solid hematologic malignancy, infections, and Alzheimer’s disease emerged as significant parameters associated with mortality. Multivariate analysis of these parameters indicated that comorbid diseases (lower urinary system diseases, chronic liver disease, solid hematologic malignancy, infections, and Alzheimer’s disease) are risk factors for mortality independent of demographic data such as age and gender.Conclusions: Independent of all other factors, delirium is associated with higher mortality risk.