Is Onabotulinum Toxin-A Combined Injection in the Bowel Patch and the Bladder Remnant a Safe Alternative to Bladder Re-Augmentation?

OBJECTIVE: To assess both the safety and efficacy, in terms of symptomatic improvement, of botulinum toxin injections distributed in the bowel patch and the bladder remnant of failed augmented bladders. MATERIALS AND METHODS: A retrospective study was performed on patients with augmented bladders who had presented with clinical and/or urodynamic failure and had received an onabotulinum1 toxin-A (BTX-A) injection at both the bowel and the bladder level due to refractoriness to oral treatment. The primary variable tested was safety, which was assessed by analysing the adverse effects according to the Clavien-Dindo classification. Subjective improvement was assessed by means of the Treatment Benefit Scale (TBS) as a secondary variable. RESULTS: Eight patients who underwent a total of 23 procedures were analysed. The mean age at first injection was 23 years. The mean interval between bladder augmentation and first BTX-A injection was 65.11 months. The mean interval between BTX-A injections was 11.6 months. No adverse effects due to systemic absorption were recorded. The only postoperative complication was an afebrile urinary infection (Clavien-Dindo 2) in 2 out of 23 procedures (8.7%). Eighty-six percent (19/22) of the procedures yielded a symptomatic benefit (TBS 1 and 2). CONCLUSION: Injection of onabotulinum toxin-A in both the bowel patch and the bladder remnant appears to be a safe and efficient technique for the symptomatic treatment of patients with bladder augmentation who have shown clinical and/or urodynamic failure in response to a conservative treatment. This procedure allows bladder re-augmentation to be delayed or even avoided.

Totally fluoroless retrograde intrarenal surgery technique in prestented patients: tips and tricks.

Treatment of urolithiasis has evolved greatly as retrograde intrarenal surgery (RIRS) has gained popularity nowadays being a gold standard therapy for renal stones up to 2 cm. Endourological procedures are traditionally fluoroscopic guided; thus, an increasing concern is the harm of radiation exposure, especially in the pediatric population. Therefore, performing fluoroless RIRS should be a feasible option for pediatric urologists. Herein, we describe the technique of totally fluoroless RIRS in presented patients and the tips to avoid radiation use at most.

Simulation of arsenic retention in constructed wetlands.

The software RCB-arsenic was developed previously to simulate the metalloid behavior in a constructed wetland (CW). The model simulates water flow and reactive transport by contemplating the major processes of arsenic (As) retention inside of CW. The objective of this study was to validate the RCB-arsenic model by simulating the behavior of horizontal flow CW for As removal from water. The model validation was made using data from a 122-day experiment. Two CWs prototypes were used: one planted with Eleocharis macrostachya (CW_planted) and another one unplanted (CW_unplanted) as a control. The prototypes were fed with synthetic water prepared using well water and sodium arsenite (NaAsO2). In the RCB-arsenic model, a CW prototype was represented using a 2D mesh sized in accordance with the experiment. For simulation of As retention in CW, data addition was established in two stages that considered the mechanisms in the system: (1) aqueous complexation, precipitation/dissolution, and adsorption on granular media and (2) retention by plants: uptake (absorption) and rhizofiltration (adsorption). Simulation of As outlet (µg/L) in stage_1 was compared with CW_unplanted; the experimental mean was 40.79 ± 7.76 and the simulated 39.96 ± 6.32. As concentration (µg/L) in stage_2 was compared with CW_planted, the experimental mean was 9.34 ± 4.80 and the simulated 5.14 ± 0.72. The mass-balance simulation and experiment at 122 days of operation had a similar As retention rate (94 and 91%). The calibrated model RCB-arsenic adequately simulated the As retention in a CW; therefore, it constitutes a powerful tool of design.

Biocompatibility and drug release behavior of scaffolds prepared by coaxial electrospinning of poly(butylene succinate) and polyethylene glycol.

Scaffolds constituted by electrospun microfibers of poly(ethylene glycol) (PEG) and poly(butylene succinate) (PBS) were studied. Specifically, coaxial microfibers having different core-shell distributions and compositions were considered as well as uniaxial micro/nanofibers prepared from mixtures of both polymers. Processing conditions were optimized for all geometries and compositions and resulting morphologies (i.e. diameter and surface texture) characterized by scanning electron microscopy. Chemical composition, molecular interactions and thermal properties were evaluated by FTIR, NMR, XPS and differential scanning calorimetry. The PEG component of electrospun fibers could be solubilized by immersion of scaffolds in aqueous medium, giving rise to high porosity and hydrophobic samples. Nevertheless, a small amount of PEG was retained in the PBS matrix, suggesting some degree of mixing. Solubilization was slightly dependent on fiber structure; specifically, the distribution of PEG in the core or shell of coaxial fibers led to higher or lower retention levels, respectively. Scaffolds could be effectively loaded with hydrophobic drugs having antibacterial and anticarcinogenic activities like triclosan and curcumin, respectively. Their release was highly dependent on their chemical structure and medium composition. Thus, low and high release rates were observed in phosphate buffer saline (SS) and SS/ethanol (30:70 v/v), respectively. Slight differences in the release of triclosan were found depending on fiber distribution and composition. Antibacterial activity and biocompatibility were evaluated for both loaded and unloaded scaffolds.

Reactive transport simulation in a tropical horizontal subsurface flow constructed wetland treating domestic wastewater.

A promising approach to the simulation of flow and conversions in the complex environment of horizontal subsurface flow constructed wetlands (HSSF-CWs) is the use of reactive transport models, in which the transport equation is solved together with microbial growth and mass-balance equations for substrate transformation and degradation. In this study, a tropical pilot scale HSSF-CW is simulated in the recently developed CWM1-RETRASO mechanistic model. The model predicts organic matter, nitrogen and sulfur effluent concentrations and their reaction rates within the HSSF-CW. Simulations demonstrated that these reactions took place simultaneously in the same (fermentation, methanogenesis and sulfate reduction) or at different (aerobic, anoxic and anaerobic) locations. Anaerobic reactions occurred over large areas of the simulated HSSF-CW and contributed (on average) to the majority (68%) of the COD removal, compared to aerobic (38%) and anoxic (1%) reactions. To understand the effort and compare computing resources needed for the application of a mechanistic model, the CWM1-RETRASO simulation is compared to a process-based, semi-mechanistic model, run with the same data. CWM1-RETRASO demonstrated the interaction of components within the wetland in a better way, i.e. concentrations of microbial functional groups, their competition for substrates and the formation of intermediary products within the wetland. The CWM1-RETRASO model is thus suitable for simulations aimed at a better understanding of the CW system transformation and degradation processes. However, the model does not support biofilm-based modeling, and it is expensive in computing and time resources required to perform the simulations.

[Can bladder catheterization in pediatrics cause complications? The case of a urethral dysuria cystograph]. / El sondaje vesical en pediatría puede dar complicaciones? El caso de la cistografía ureteral miccional seriada.

A urethral dysuria cystograph (CUMS (Cistografia Ureteral Miccional Seriada)) is the first diagnostic procedure, by means of x-rays, to evaluate bladder-urethral reflux. It consists of a bladder catheter to administer a radiopaque contrast dye through the ureter. To use the aforementioned technique without any asepsis measures and without knowledge about it can lead to possible complications. By means of a retrospective study using a sample of 181 patients, the authors have evaluated the incidence of possible complications and/or subsequent discomfort due to a urethral dysuria cystograph (CUMS). As final results, by means of an after test telephone call, the authors observed that 96.7% of the children who underwent this technique did not manifest any type of complication nor urinary discomfort.

Wide host range plasmid probe for the heterologous transmission of escherichia coli lac genes

El operon lac de escherichia coli, es un sistema genético que ha sido útil para elucidar principios básicos de variación y expresión genética y para la construcción de cepas microbianas de proyección industrial. En este contexto, hemos derivado por clonación in vivo, un plasmidio de amplio rango de hospedero (pUCV3), que contiene los genes lac de e. coli, los cuales pueden ser ahora transmitidos con facilidad a todos los microorganismos capaces de incorporar replicones IncPa, grupo de compatibilidad al que pertenece pUCV3. Como ejemplo este plasmidio fue transmitido a bacterias marinas y a cytophaga johsonae, microorganismos en los cuales se apreció la expresión regulada del sistema lac. En consecuencia, pUCV3, puede ser usado como sonda para evaluar en comportamiento del operón lac en variados transfondos genéticos microbianos

Incidence of enteroinvasive Escherichia coli in Spain. A 14-month prospective study.

Between February 1984 and May 1985, a prospective study was performed in patients with acute enteritis to determine the incidence of enteroinvasive Escherichia coli (ECEI) in our environment. Eight hundred and forty-three strains of E. coli were studied by agglutination with antisera for serogroups O28ac, 029, 0112, 0124, 0136, 0144, 0152 and 0164. Eleven strains were found to pertain to one or another of these serogroups: 6 to 029, 2 to 0124, 2 to 0164 and 1 to 0143. Of these, only the two corresponding to 0124 invaded HeLa cells and had a positive Sereny test. These strain were lysine decarboxylase and lactose negative and did not produce gas. In 125 strains that did not belong to any of the enteroinvasise serogroups indicated, but had been isolated from patients with febrile enteritis in which no other enteropathogen could be isolated (32 strains), or had metabolic characteristics of enteroinvasive Escherichia coli (93) strains, the Sereny test and invasion of HeLa cells were studied. In every case, both tests were negative.