Urinary Research Articles

Влияние позы на эффективность мочеиспускания у мальчика с дисфункциональным мочеиспусканием

Dysfunctional voiding in children without organic pathology of the spinal cord in childhood is now becoming more common. Unproductive voiding with the presence of residual voiding of more than 30% of the functional bladder volume for a long time leads to inflammatory diseases of the lower urinary tract. The physiological process of emptying the bladder requires a certain concentration of the child's attention, controlled activation of voiding reflexes and correct body position, especially for boys. Dysfunctional voiding is often formed in physiologically healthy boys with systematic emptying of the bladder in a sitting position, which disrupts the natural configuration of the pelvic floor muscles. Article represents a clinical case of a child with recurrent urinary infection and ineffective urination at the age of 12 y/o, whose treatment was based on training pelvic reflexes and voiding in a standing position, which in its turn had allowed normalization of the miction parameters and stopped the recurrent low urinary tract infection.

Artificial intelligence algorithm for neoplastic cell percentage estimation and its application to copy number variation in urinary tract cancer.

Bladder cancer is characterized by frequent mutations, which provide potential therapeutic targets for most patients. The effectiveness of emerging personalized therapies depends on an accurate molecular diagnosis, for which the accurate estimation of the neoplastic cell percentage (NCP) is a crucial initial step. However, the established method for determining the NCP, manual counting by a pathologist, is time-consuming and not easily executable. To address this, artificial intelligence (AI) models were developed to estimate the NCP using nine convolutional neural networks and the scanned images of 39 cases of urinary tract cancer. The performance of the AI models was compared to that of six pathologists for 119 cases in the validation cohort. The ground truth value was obtained through multiplexed immunofluorescence. The AI model was then applied to 41 cases in the application cohort that underwent next-generation sequencing testing, and its impact on the copy number variation (CNV) was analyzed. Each AI model demonstrated high reliability, with intraclass correlation coefficients (ICCs) ranging from 0.82 to 0.88. These values were comparable or better to those of pathologists, whose ICCs ranged from 0.78 to 0.91 in urothelial carcinoma cases, both with and without divergent differentiation/ subtypes. After applying AI-driven NCP, 190 CNV (24.2%) were reclassified with 66 (8.4%) and 78 (9.9%) moved to amplification and loss, respectively, from neutral/minor CNV. The neutral/minor CNV proportion decreased by 6%. These results suggest that AI models could assist human pathologists in repetitive and cumbersome NCP calculations.

Значение видео-уродинамического исследования в выборе метода лечения детей с нейрогенными дисфункциями мочевого пузыря

Video urodynamics is the standard for assessment of the lower urinary tract in children with neurogenic urinary disorders aiming to provide more information about the condition of the lower urinary tract v. retrograde urethrocystography. Video urodynamics parameters are used as possible indicators for choosing various surgical treatment options, however, all work is focused on adult patients, and data for the pediatric cohort were not available as yet. The purpose of this research was the evaluation of the role of video urodynamics and retrograde urethrocystography in the selection of effective conservative and surgical treatment of neurogenic urinary disorders in children. Materials and methods used: 112 patients aged 1,8 to 18 y/o with neurogenic urinary disorders were included in the study, of whom 101 were those who had been proven effectively treated with conservative M-cholinoblockers or had successfully undergone minimally invasive surgery as follows: intradetrusor injection of botulinum toxin (n=21), transurethral correction of VUR (n=17), simultaneous execution of two of these interventions (n=22). Based on the results of video urodynamic and cystographic examination of these patients with the CHAID technique, the classification trees were built in order to evaluate the effective treatment (conservative/surgical). Results: the median age of patients was 9,0 years [7,8-12,0]. The first classification tree containing the parameter “presence of VUR according to the results of retrograde cystography.” The sensitivity of the obtained model for the effectiveness of surgical treatment was 83,3% v. 73,2% for conservative treatment. The accuracy was 79,2%. The ROC-AUC value was 0,783. The second classification tree contained the maximum Pves value according to the results of the video urodynamics, presence of hyperactivity, presence of VUR. The sensitivity of the obtained model for the effectiveness of surgical treatment was 93,3% v. 97,6% for conservative treatment. The accuracy was 95,0%. The ROC-AUC value was 0,972. Comparison of ROC-AUC values by the Delong test revealed statistically significant differences between these binary classification metrics (p<0.001). Conclusion: the parameters of video urodynamics have greater diagnostic accuracy in effective prediction of both conservative and surgical treatment methods compared to the retrograde urethrocystography.

The General and Systemic Consequences of Obesity in Cats and Dogs

Obesity, is a life-threatening condition common among various animals, is a multisystemic disorder that may affect the gastrointestinal system, urinary system, reproductive system, respiratory system, and musculoskeletal system. According to various studies, more than 50% of cats and dogs are obese. Many proinflammatory and inflammatory cytokines, hormones, and enzymes play a part in the production of fat tissues that lead to obesity. Excessive deposition of fats give rise to conditions involving inflammation, oxidative stress and damage, immunomodulation, hyperlipidemia, dyslipidemia, neoplasia, hypothyroidism, and insulin resistance. This review paper acquires the knowledge of various scientific manuscripts to discuss the development and consequences of obesity in pets especially cats and dogs.

Draft genome sequence of multidrug resistant Proteus mirabilis strain MAD23

Genome sequencing became one of the important tools for diagnosis of microorganisms. Proteus mirabilis is an enteric Gramnegative bacterium causes gastrointestinal and urinary tract infections in human and animals. Here, the draft sequencing of Proteus mirabilis (MAD23) strain was performed. The strain was collected from Chinese duck cecum suffering from diarrhea. Bacteria was identified by biochemical tests and characteristic swarming pattern on the plate. Antimicrobial susceptibility test was performed by VITEC-2 MS system. Also, draft genome sequencing was conducted using the Illumina platform NovaSeq sequencer. The genome is about 3,729,695 bp long, GC content is of 38.9%., number of contigs is 123, largest contig is 137547pb, smallest contig is 513, total of protein-coding sequences (CDSs) is 3410, and number of RNA genes is 72. Genome Pairwise comparisons of Proteus mirabilis MAD23 with other vs. type strain was detected based on is DDH, GC content, δ- value, genome size and number of proteins. Neighbour-Joining phylogenetic trees show relationship between Proteus mirabilis MAD23 and the close strains of Proteus species based on 16S rRNA sequences. In addition, analysis of the sequence reveals presence of many antibiotic resistance genes as dfrA1, sul2, dfrA32, aadA2b, aph(3’)-Ia, aadA1, aph(6)-Id, aph(3’’)-Ib, ere(A), aadA1, aadA2b, tet(J), tet(C), floR, and Cat genes.These genes encoding the resistance to different antibiotics including Aminoglycosides, Macrolides, Aminocyclitol, Tetracycline and Amphenicol. This work is considered as an important study can help in more understanding of WGS in Proteus spp. and recognize the genes that related to antibiotic resistance in this pathogen.

Clinical characteristics, predisposing factors and outcomes for Enterococcus faecalis versus Enterococcus faecium bloodstream infections: a prospective multicentre cohort study.

Enterococcal BSI is associated with significant morbidity and mortality, with fatality rates of approximately 20-30%. There are microbiological and clinical differences between E. faecalis and E. faecium infections. The aim of this study was to investigate differences in predisposing factors for E. faecalis and E. faecium BSI and to explore prognostic factors. This study was a post-hoc analysis of PROBAC, a Spanish prospective, multicenter, cohort in 2016-2017. Patients with E. faecalis or E. faecium BSI were eligible. Independent predictors for BSI development in polymicrobial and monomicrobial BSI and in-hospital mortality in the monomicrobial group were identified by logistic regression. A total of 431 patients were included. Independent factors associated with E. faecium BSI were previous use of penicillins (aOR 1.99 (95% CI 1.20-3.32)) or carbapenems (2.35 (1.12-4.93)), hospital-acquired BSI (2.58 (1.61-4.12)), and biliary tract source (3.36 (1.84-6.13)), while congestive heart failure (0.51 (0.27-0.97)), cerebrovascular disease (0.45 (0.21-0.98)), and urinary tract source (0.49 (0.26-0.92)) were associated with E. faecalis BSI. Independent prognostic factors for in-hospital mortality in E. faecalis BSI were Charlson Comorbidity Index (1.27 (1.08-1.51)), SOFA score (1.47 (1.24-1.73)), age (1.06 (1.02-1.10)), and urinary/biliary source (0.29 (0.09-0.90)). For E. faecium BSI, only SOFA score (1.34 (1.14-1.58) was associated with in-hospital mortality. The factors associated with E. faecium and E. faecalis BSI are different. These variables may be helpful in the suspicion of one or other species for empiric therapeutic decisions and provide valuable information on prognosis.

Effect of ensifentrine on dyspnea in patients with moderate-to-severe chronic obstructive pulmonary disease: pooled analysis of the ENHANCE trials

ABSTRACT Background Dyspnea is a critical component of chronic obstructive pulmonary disease (COPD). Ensifentrine, a novel PDE3/PDE4 inhibitor, was evaluated in the Phase 3 ENHANCE-1/2 clinical trials. Here, we report the effect of ensifentrine on dyspnea using pooled data from the ENHANCE trials. Methods The pooled population (ensifentrine, n = 975; placebo, n = 574) included patients aged 40–80 years with post-bronchodilator FEV1/FVC <0.7, FEV1 30–70% predicted, mMRC Dyspnea Scale score ≥ 2, and a smoking history ≥ 10 pack-years. Patients taking dual LAMA/LABA or LAMA/LABA/ICS triple therapy were excluded. Dyspnea measures included the Transition Dyspnea Index (TDI), Evaluating Respiratory Symptoms (E-RS), and rescue medication use. Results After 24 weeks, ensifentrine significantly improved TDI scores (least-squares mean difference, 0.97; 95% CI, 0.64, 1.30; p < 0.001) and across all TDI subdomains. Ensifentrine-treated patients were more likely to be TDI responders at week 24 (p < 0.001), which was consistent across clinically-relevant subgroups. Ensifentrine-treated patients had improved E-RS breathlessness subdomain scores (p = 0.053) and reduced rescue medication use (p = 0.002). The most common adverse reactions were back pain (ensifentrine, 1.8% vs placebo, 1.0%), hypertension (1.7% vs 0.9%), urinary tract infection (1.3% vs 1.0%), diarrhea (1.0% vs 0.7%). Conclusion Ensifentrine produced clinically meaningful improvements in multiple dyspnea measures in patients with symptomatic, moderate-to-severe COPD. A limitation of this study was the exclusion of patients taking dual LAMA/LABA and LAMA/LABA/ICS triple therapy. Clinical trial registration www.clinicaltrials.gov identifiers are ENHANCE-1: NCT04535986; ENHANCE-2: NCT04542057.

Outcomes after laser enucleation of the prostate with and without significant storage symptoms.

To test for differences in recovery of lower urinary tract symptoms (LUTS) between patients with storage-positive vs -negative symptoms after laser enucleation of the prostate (LEP). Consecutive storage-positive (severe storage symptoms, International Prostate Symptom Score [IPSS] storage subscore >8) vs storage-negative patients treated with LEP (November 2017-September 2022) within our tertiary-care database were identified. Mixed linear models tested for changes in IPSS and quality of life (QoL) at 1, 3 and 12 months after LEP. Multiple linear regression models tested for LUTS and QoL recovery risk factors at 1, 3 and 12 months. Of 291 study patients, 180 (62%) had storage-positive symptoms. There were no differences between storage-positive and -negative patients in mean adjusted total IPSS, IPSS-storage, IPSS-voiding and QoL at 12 months after LEP. In multiple linear regression models, storage-positive status was identified as a risk factor for higher IPSS at 1 month (β coefficient 2.98, P = 0.004) and 3 months (β coefficient 2.24, P = 0.04), as well as for more unfavourable QoL at 1 month (βcoefficient 0.74, P = 0.006) and 3 months (β coefficient 0.73, P = 0.004) after LEP. Conversely, at 12 months there were no differences between storage-positive vs -negative patients. Storage-positive patients appear to experience similar long-term benefits from LEP compared to storage-negative patients. However, significant storage symptoms are associated with higher total IPSS and less favourable QoL at 1 and 3 months after LEP. These findings advocate for the consideration of LEP also in storage-positive cases with the need for thorough patient education especially in the initial post-LEP period.

Prevalence and determinants of failure to thrive in children with vesico-ureteral reflux.

To assess the prevalence and determinants of failure to thrive (FTT) among patients with vesico-ureteral reflux (VUR) and evaluating the effects of supplementation on growth in patients with urinary solute losses. We retrospectively enrolled 1277 patients with VUR (mean age at diagnosis = 6.5 months). Patients with FTT were screened for renal tubular function impairment (TFI). If fractional excretion of sodium (FENa) >2% or blood bicarbonate <20 mmol/L, supplementation was provided. Among 1277 patients, 56 (4.4%) had FTT. Of these, 42 (75%) presented extrarenal causes of FTT, 3 (5.4%) had chronic kidney disease (CKD), 9 (16.1%) had TFI, and 2 (3.5%) had CKD and TFI. FTT occurred in 8/208 patients (3.8%) with and in 48/1069 patients (4.5%) without (p = 0.68) recurrent urinary tract infections (UTIs). At multiple logistic regression, birthweight <10th percentile, preterm birth, TFI, identified or suspected syndromes and other diseases were predictors of FTT. Eleven (19.6%) patients with FTT had TFI; five with increased FENa and/or acidosis received supplementation and showed catch-up growth. The remaining six patients exhibited spontaneous catch-up growth. FTT was found in <5% of children with VUR. It was not determined by recurrent UTIs and was mainly associated with extrarenal causes. Supplementation with sodium and bicarbonates could be useful in selected cases.

Emerging pathogens Aerococcus urinae and Aerococcus sanguinicola from a Canadian tertiary care hospital.

Background: Aerococcus urinae and Aerococcus sanguinicola are emerging pathogens linked with urinary tract infections. We present a case series of A. urinae and A. sanguinicola isolates characterizing the spectrum of clinical presentation, microbiological characteristics and antimicrobial sensitivities. Methods: Retrospective chart review was performed on patients who grew positive cultures for A. urinae and A. sanguinicola identified on MALDI-TOF in Saskatchewan from January to June 2023. Demographic and clinical variables, antimicrobial susceptibility and prescription were documented. Results: This cohort (n=115) had a median age 82 years. A. urinae and A. sanguinicola infections spanned from urinary tract infection (n=96) to urosepsis (n=6). These infections were predominantly monomicrobial (73.9%) and were susceptible to ceftriaxone, penicillin G and vancomycin. Antimicrobials were seldom prescribed within the urinary tract infection cohort (31.2%). Conclusion: Untreated A. urinae and A. sanguinicola infections can precipitate into urosepsis. The reported antimicrobial susceptibility for these Aerococcus isolates should be utilized to provide appropriate antimicrobial coverage.

Estimation of urinary volume through ultrasonography in dog cadavers and experimental models.

The urinary volume and residual urine volume are pieces of information that can provide relevant clinical data for dogs and cats, especially those hospitalized. Thus, the present study aimed to evaluate mathematical formulas described in human and veterinary literature to estimate urinary volume in dogs and experimental models. For this purpose, nine male dog cadavers and twelve experimental models were used to evaluate residual volume, small, medium, and large, using three different formulas. Data were obtained by three different examiners: two ultrasonographers and one nonultrasonographer. Each examiner recorded three longitudinal and transverse images, obtaining measurements of width, length, and height at each proposed volume. The measurements were then averaged, and the result was added to the formulas, thus estimating urinary volume. All three formulas achieved higher accuracy in estimating smaller volumes, with a gradual decrease as urinary volume increased. The error of all formulas was less than 10%, even when compared with evaluations in experimental models and dogs. There was variation in estimation between ultrasonographers and nonultrasonographer examiners; however, this variation was low, allowing for the assertion that both can apply the technique. Thus, it is concluded that estimating urinary bladder volume using mathematical formulas and 2D ultrasound is accurate and, therefore, an alternative and viable option for evaluating the urinary tract.

Sacituzumab Govitecan in patients with breast cancer brain metastases and recurrent glioblastoma: a phase 0 window-of-opportunity trial

Sacituzumab Govitecan (SG) is an antibody-drug conjugate that has demonstrated efficacy in patients with TROP-2 expressing epithelial cancers. In a xenograft model of intracranial breast cancer, SG inhibited tumor growth and increased mouse survival. We conducted a prospective window-of-opportunity trial (NCT03995706) at the University of Texas Health Science Center at San Antonio to examine the intra-tumoral concentrations and intracranial activity of SG in patients undergoing craniotomy for breast cancer with brain metastases (BCBM) or recurrent glioblastoma (rGBM). We enrolled 25 patients aged ≥18 years diagnosed with BCBM and rGBM to receive a single intravenous dose of SG at 10 mg/kg given one day before resection and continued on days 1 and 8 of 21-day cycles following recovery. The PFS was 8 months and 2 months for BCBM and rGBM cohorts, respectively. The OS was 35.2 months and 9.5 months, respectively. Grade≥3 AE included neutropenia (28%), hypokalemia (8%), seizure (8%), thromboembolic event (8%), urinary tract infection (8%) and muscle weakness of the lower limb (8%). In post-surgical tissue, the median total SN-38 was 249.8 ng/g for BCBM and 104.5 ng/g for rGBM, thus fulfilling the primary endpoint. Biomarker analysis suggests delivery of payload by direct release at target site and that hypoxic changes do not drive indirect release. Secondary endpoint of OS was 35.2 months for the BCBM cohort and 9.5 months for rGBM. Non-planned exploratory endpoint of ORR was 38% for BCBM and 29%, respectively. Exploratory endpoint of Trop-2 expression was observed in 100% of BCBM and 78% of rGBM tumors. In conclusion, SG was found to be well tolerated with adequate penetration into intracranial tumors and promising preliminary activity within the CNS. Trial Registration: Trial (NCT03995706) enrolled at Clinical Trials.gov as Neuro/Sacituzumab Govitecan/Breast Brain Metastasis/Glioblastoma/Ph 0: https://clinicaltrials.gov/study/NCT03995706?cond=NCT03995706.

Outcomes 10-years after traumatic spinal cord injury in Botswana - a long-term follow-up study

Study designProspective follow-up study.ObjectivesTo describe outcomes, survival, and attendance to routine follow-up visits 10 years post-SCI.SettingThe national SCI-rehabilitation center in Botswana.MethodsAll persons who were admitted with traumatic SCI during a 2-year period, 2011–2013, and survived up to 2 years post-injury were included. Data were collected from the medical records from the follow-up assessment closest to 10 years post-SCI and included demographic and clinical characteristics, functional outcomes, and secondary complications. Data regarding mortalities were received from relatives. Statistical comparisons were made, when possible, between those who attend follow-up assessment and those who did not, and between those who survived up to 10 years post-SCI and those who died.ResultsThe follow-up rate was 76% (19/25) of known survivors. No statistically significant factors were found to affect the follow-up rate. Secondary complications rates were for pressure ulcers and urinary tract infections 21%. Self-catheterisation and suprapubic catheter were the preferred methods to manage neurogenic bladder dysfunction. Ten persons (26%) had deceased since 2nd follow-up assessment. The causes of death were probably SCI-related in more than half of the cases.ConclusionsThis was a follow-up study at year 10 after acute TSCI in Botswana conducted at the national SCI-rehabilitation center. The study supports previous reports regarding the importance of that having specialized SCI units and the need of structured follow-ups, a responsible person in charge of scheduling, and updated patient registers. We found high follow-up rate, low rates of complications and of patients being lost to follow-up.

The bacterial displacement test: an in vitro microbiological test for the evaluation of intermittent catheters and urinary tract infection.

Intermittent catheters (ICs) are commonly used in bladder management but catheter-associated urinary tract infections (CAUTIs) remain challenging. Insertion tips may reduce the risk of CAUTIs by minimizing bacterial transfer along the urinary tract. However, there are few laboratory tests to evaluate such technologies. We describe the use of an adapted in vitro urethra agar model to assess bacterial displacement by ICs. Simulated urethra agar channels (UACs) were prepared with catheter-specific sized channels in selective media specific to the challenge organisms. UACs were inoculated with E. coli and E. faecalis before insertion of ICs and enumeration of UAC sections were performed following insertion. Four ICs were evaluated: Cure Catheter® Closed System (CCS), VaPro Plus PocketTM, Bard® Touchless® Plus, and SpeediCath® Flex Set. CCS demonstrated significantly reduced bacterial displacement along the UACs compared to the other ICs and was also the only IC with undetectable levels of bacteria towards the end of the UAC (representing the proximal urethra). The bacterial displacement test demonstrated significant differences in bacterial transfer between the test ICs with insertion tips which may reflect their different designs. This method is useful for evaluating CAUTI prevention technology and may help guide future technology innovations.

Urothelial cancer: State of art in ukraine and improvement pathways

Aim: This study aims to assess the effectiveness of urothelial cancer treatment in Ukraine, utilizing population-based data from the National Cancer Registry. The primary goal is to evaluate trends and approaches to therapy, with a focus on overall survival rates in patients with urothelial tumors. Materials and methods: A retrospective cross-sectional analysis was conducted based on the National Cancer Registry, involving 12,698 patients (2008-2020) with urothelial tumors of the upper urinary tract (UTUC) and bladder cancer (BC) who underwent surgical treatment. Demographic indicators, surgical interventions, complications, and survival rates were analyzed. Results: Average age for all patients was 70 years. The number of patients undergoing radical treatment was 1820 (15%) among BC and 573 (59%) among UTUC. The 30-day readmission rate was low for both, with a slightly higher preference for UTUC (2,3 vs. 4,6%). Whereas grade III or higher Cl-Dindo complications were seen in only 0,2% of cases. Notable findings include low frequency of neoadjuvant (7%) and adjuvant chemotherapy (28%) among patients with invasive urothelial carcinomas. Median eGFR for invasive UTUC before and after surgery was 63,2 and 51,4 mL/min respectively (P=0,00054). Directly opposite trend was seen in BC - 61,2 and 68,7 mL/min respectively (P=0,0026). For BC, the overall survival rates by stages were: I — 73%, II — 49%, III — 18%, and IV — 11% (chi-square=1807.207; P=0.000001). As for UTUC, the 5-year overall survival rates corresponded to the literature data, but there was a pronounced negative trend towards a decrease in this indicator after a 10-year period for all stages (chi-square=146.298; P=0.000003). Conclusion: The study emphasizes the importance of effective systemic treatments, adherence to treatment guidelines, and the need for multidisciplinary consultations among Ukrainian patients with urothelial cancer.

Effective Immobilization of Novel Antimicrobial Peptides via Conjugation onto Activated Silicon Catheter Surfaces

Antibiotic-resistant microorganisms have become a serious threat to public health, resulting in hospital infections, the majority of which are caused by commonly used urinary tract catheters. Strategies for preventing bacterial adhesion to the catheters’ surfaces have been potentially shown as effective methods, such as coating thesurface with antimicrobial biomolecules. Here, novel antimicrobial peptides (AMPs) were designed as potential biomolecules to prevent antibiotic-resistant bacteria from binding to catheter surfaces. Thiolated AMPs were synthesized using solid-phase peptide synthesis (SPPS), and prep-HPLC was used to obtain AMPs with purity greater than 90%. On the other side, the silicone catheter surface was activated by UV/ozone treatment, followed by functionalization with allyl moieties for conjugation to the free thiol group of cystein in AMPs using thiol-ene click chemistry. Peptide-immobilized surfaces were found to become more resistant to bacterial adhesion while remaining biocompatible with mammalian cells. The presence and site of conjugation of peptide molecules were investigated by immobilizing them to catheter surfaces from both ends (C-Pep and Pep-C). It was clearly demonstrated that AMPs conjugated to the surface via theirN terminus have a higher antimicrobial activity. This strategy stands out for its effective conjugation of AMPs to silicone-based implant surfaces for the elimination of bacterial infections.

Nitrofuran Derivatives with Benzyl Groups are Promising Candidates as Antibacterial Agents Against Staphylococcus epidermidis

AbstractStaphylococcus epidermidis is a particular concern due to its high resistance to most antibiotics. We designed and synthesised a series of nitrofuran derivatives based on the chemical structure of nitrofurantoin. Among these derivatives, compared to nitrofurantoin, the nitrofuran derivatives with n‐alkyl groups did not effectively inhibit S. aureus with minimum inhibitory concentrations (MIC) values ranging from 16 to &gt;128 μM, while these with benzyl groups displayed potent antibacterial activity against S. aureus with MIC values ranging from 4 to 16 μM. It suggests benzyl groups play an important role in the nitrofuran derivatives against S. aureus. The nitrofuran derivatives with benzyl groups also displayed potent antibacterial activity against S. epidermidis with MIC values ranging from 2 to 8 μM. Especially, compound 20 exhibited MIC 2 μM (0.814 μg/mL) against S. epidermidis. The CC50s of compound 20 in 293 T cells and LX‐2 cells were 3.131 μg/mL and 30.51 μg/mL, respectively. While at 128 μg/mL of compound 20, no obvious red blood cell rupture was observed. It showed minimal cytotoxicity and hemolytic activity. These findings suggest that compound 20 could function as a potential antibacterial agent for treating Urinary tract infections (UTIs) caused by S. epidermidis.

Optimization of activity-driven event detection for long-term ambulatory urodynamics.

Lower urinary tract dysfunction (LUTD) is a debilitating condition that affects millions of individuals worldwide, greatly diminishing their quality of life. The use of wireless, catheter-free implantable devices for long-term ambulatory bladder monitoring, combined with a single-sensor system capable of detecting various bladder events, has the potential to significantly enhance the diagnosis and treatment of LUTD. However, these systems produce large amounts of bladder data that may contain physiological noise in the pressure signals caused by motion artifacts and sudden movements, such as coughing or laughing, potentially leading to false positives during bladder event classification and inaccurate diagnosis/treatment. Integration of activity recognition (AR) can improve classification accuracy, provide context regarding patient activity, and detect motion artifacts by identifying contractions that may result from patient movement. This work investigates the utility of including data from inertial measurement units (IMUs) in the classification pipeline, and considers various digital signal processing (DSP) and machine learning (ML) techniques for optimization and activity classification. In a case study, we analyze simultaneous bladder pressure and IMU data collected from an ambulating female Yucatan minipig. We identified 10 important, yet relatively inexpensive to compute signal features, with which we achieve an average 91.5% activity classification accuracy. Moreover, when classified activities are included in the bladder event analysis pipeline, we observe an improvement in classification accuracy, from 81% to 89.0%. These results suggest that certain IMU features can improve bladder event classification accuracy with low computational overhead.Clinical Relevance: This work establishes that activity recognition may be used in conjunction with single-channel bladder event detection systems to distinguish between contractions and motion artifacts for reducing the incorrect classification of bladder events. This is relevant for emerging sensors that measure intravesical pressure alone or for data analysis of bladder pressure in ambulatory subjects that contain significant abdominal pressure artifacts.

Trends in urine sampling rates of general practice patients with suspected lower urinary tract infections in England, 2015–2022: a population-based study

ObjectivesInappropriate prescribing of antibiotics is a key driver of antimicrobial resistance. This study aimed to describe urine sampling rates and antibiotic prescribing for patients with lower urinary tract infections (UTIs)...

Complete Growth Inhibition of Pseudomonas aeruginosa by Organo-Selenium-Incorporated Urinary Catheter Material

To further investigate the inhibition of Pseudomonas aeruginosa’s in vitro growth and biofilm formation by an organo-selenium-incorporated polyurethane (PU) catheter material. P. aeruginosa, Staphylococcus aureus, and Candida albicans were incubated in vitro with organo-selenium and control polyurethane catheter materials in the presence of glutathione. Growth was evaluated by a colony-forming-unit (CFU) count and visualized with confocal laser scanning microscopy. Two different PU catheter materials were used. Using tin-catalyzed PU catheter material, complete inhibition of S. aureus was seen at 1% selenium (Se), whereas no inhibition was seen for P. aeruginosa at up to 3.0% Se. Whereas, using a thermoplastic PU catheter material, 1.5% Se and 2% Se organo-selenium caused several logs of growth inhibition of P. aeruginosa, and 2.5% selenium, incorporation showed complete inhibition (8 logs). Samples with lower than 1.5% selenium did not show adequate growth inhibition for P. aeruginosa. Similar in vitro growth inhibition was achieved against a multidrug-resistant C. albicans strain. It was concluded that optimal inhibition of P. aeruginosa in vitro growth and biofilm formation occurs with 2.5% selenium incorporated as organo-selenium in a thermoplastic PU catheter material. These results suggest that reduced incidence of CAUTIs (catheter associated urinary tract infections) with P. aeruginosa and other bacteria and fungi can be achieved by using organo-selenium-incorporated catheters.