ABSTRACT
BACKGROUND: Low-intensity shockwave therapy (Li-SWT) can improve bladder function through enhancement of angiogenesis and nerve regeneration and suppression of inflammation and overactivity. In this trial, we aimed to evaluate the efficacy of Li-SWT on persistent storage symptoms after transurethral surgery (TUS) for benign prostatic obstruction (BPO). METHODS: Between July 2020 and July 2022, 137 patients with persistent storage symptoms; urgency episodes/24 h ≥ 1 and daytime frequency ≥8, for at least three months after TUS for BPO were randomly allocated to Li-SWT versus sham versus solifenacin 10 mg/day in 3:1:1 ratio. The primary end point was the percent reduction from baseline in overactive bladder symptom score (OABSS) at 3-month follow-up. The changes in 3-day voiding diary parameters, quality of life (QoL) score, peak flow rate and residual urine at 3 and 6-month follow-up were compared. Treatment-related adverse effects were also evaluated. RESULTS: Baseline data were comparable between groups. The percent reduction from baseline in OABSS at 3-month follow-up was significantly higher in Li-SWT compared to sham (-55% versus -11%), and it was comparable between Li-SWT and solifenacin-10 (-55% versus -60%). Li-SWT achieved significant improvement like solifenacin-10 in 3-day voiding diary parameters and QoL score at 3-month follow-up. This improvement remained comparable between Li-SWT and solifenacin-10 at 6-month follow-up. No adverse effects related to Li-SWT were noted apart from tolerable pain during the procedure. Solifenacin-10 was associated with bothersome adverse effects in 73% of the patients with 11.5% discontinuation rate. CONCLUSIONS: Li-SWT ameliorates persistent storage symptoms and promotes QoL after TUS for BPO, with comparable efficacy and better tolerance compared to solifenacin.
Subject(s)
Prostatic Hyperplasia , Quality of Life , Transurethral Resection of Prostate , Humans , Male , Aged , Transurethral Resection of Prostate/methods , Transurethral Resection of Prostate/adverse effects , Prostatic Hyperplasia/therapy , Prostatic Hyperplasia/surgery , Prostatic Hyperplasia/complications , Middle Aged , Solifenacin Succinate/administration & dosage , Solifenacin Succinate/therapeutic use , Treatment Outcome , Follow-Up Studies , Extracorporeal Shockwave Therapy/methods , Urinary Bladder, Overactive/therapy , Urinary Bladder, Overactive/etiology , Postoperative Complications/etiology , Postoperative Complications/therapy , Double-Blind MethodABSTRACT
Entrustable professional activities (EPAs) are units of professional practice that could be observed, assessed, monitored, documented, and entrusted. EPAs when entrusted, outline the physician's qualifications, and shape the scope of practice. This insight highlights the importance of development of EPAs in all medical specialties including dermatology to ensure the best standards for patient's care. Development of EPAs-based training program is considered a challenge for clinical educators. In this paper, we describe practical tips and reflections on our experience in developing EPAs in dermatology doctoral training program that could be a guide for dermatology educators to implement EPAs in dermatology training programs.
Subject(s)
Clinical Competence , Dermatology , Education, Medical, Graduate , Dermatology/education , Humans , Education, Medical, Graduate/methods , Curriculum , Faculty, Medical/educationABSTRACT
The present study aimed to contribute to the limited research on buffalo (Bubalus bubalis) semen traits by incorporating genomic data. A total of 8465 ejaculates were collected. The genotyping procedure was conducted using the Axiom® Buffalo Genotyping 90 K array designed by the Affymetrix Expert Design Program. After conducting a quality assessment, we utilized 67,282 SNPs genotyped in 192 animals. We identified several genomic loci explaining high genetic variance by employing single-step genomic evaluation. The aforementioned regions were located on buffalo chromosomes no. 3, 4, 6, 7, 14, 16, 20, 22, and the X-chromosome. The X-chromosome exhibited substantial influence, accounting for 4.18, 4.59, 5.16, 5.19, and 4.31% of the genomic variance for ejaculate volume, mass motility, livability, abnormality, and concentration, respectively. In the examined genomic regions, we identified five novel candidate genes linked to male fertility and spermatogenesis, four in the X-chromosome and one in chromosome no. 16. Additional extensive research with larger sample sizes and datasets is imperative to validate these findings and evaluate their applicability for genomic selection.