The efficacy and safety of medication for treating overactive bladder in patients with Parkinson's disease: a meta-analysis and systematic review of randomized double-blind placebo-controlled trials.

INTRODUCTION AND HYPOTHESIS: The goal of this meta-analysis was to determine the efficacy and safety of medication for treating overactive bladder (OAB) in patients with Parkinson's disease (PD). METHODS: Papers containing predefined key terms were searched in the PubMed, Embase, Web of Science, and Cochrane Library databases up to December 2021 to collect randomized double-blind placebo-controlled trials (RCTs). The review process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statements. Two reviewers independently assessed the risk of bias using the modified Jadad scale and Cochrane risk-of-bias tool. The GRADEpro GDT was employed to evaluate the strength of evidence based on the findings of this meta-analysis. RESULTS: We eventually included four RCTs involving 313 patients (163 patients in the medication group and 150 patients in the placebo group). Of these, the therapeutic agent in two RCTs was mirabegron (121 and 106 patients and controls, respectively, representing 3/4 -2/3 of the patients). The results showed that the number of micturition episodes per 24 h (MD -1.33; 95% CI -2.30 to -0.36; p = 0.007), the number of nocturia episodes per 24 h (MD -0.33; 95% CI -0.58 to -0.08; p = 0.009) and the number of urinary incontinence episodes per 24 h (MD -0.72; 95% CI -1.32 to -0.12; p = 0.02) were significantly lower in the medication group than in the placebo group. The OAB symptom score (MD -2.84; 95% CI -4.67 to -1.00; p = 0.002) and quality of life score (MD 15.15; 95% CI 12.33 to 17.96; p < 0.0001) of the medication group were significantly improved compared with those of the placebo group. However, no significant difference in the daily frequency of urinary urgency episodes was identified between the medication group and the placebo group (MD -0.79; 95% CI -1.71 to 0.14; p = 0.09). There were no significant differences between the two groups in terms of drug-related adverse events (OR 1.69; 95% CI 0.41 to 6.99; p = 0.47), especially in PD patients receiving mirabegron therapy. CONCLUSIONS: Medication was effective for OAB symptoms in patients with PD, and patients tolerated adverse events well.

Smart Sensing Multifunctionalities Based on Barium Strontium Titanate Thin Films.

Sensors that have low power consumption, high scalability and the ability of rapidly detecting multitudinous external stimulus are of great value in cyber-physical interactive applications. Herein, we reported the fabrication of ferroelectric barium strontium titanate ((Ba70Sr30)TiO3, BST) thin films on silicon substrates by magnetron sputtering. The as-grown BST films have a pure perovskite structure and exhibit excellent ferroelectric characteristics, such as a remnant polarization of 2.4 µC/cm2, a ferro-to-paraelectric (tetragonal-to-cubic) phase transition temperature of 31.2 °C, and a broad optical bandgap of 3.58 eV. Capacitor-based sensors made from the BST films have shown an outstanding average sensitivity of 0.10 mV·Pa-1 in the 10-80 kPa regime and work extremely steadily over 1000 cycles. More importantly, utilizing the Pockels effect, optical manipulation in BST can be also realized by a smaller bias and its electro-optic coefficient reff is estimated to be 83.5 pmV-1, which is 2.6 times larger than in the current standard material (LiNbO3) for electro-optical devices. Our work established BST thin film as a powerful design paradigm toward on-chip integrations with diverse electronics into sensors via CMOS-comparable technique.

Meta-Analysis of the Efficacy and Safety of Ketamine on Postoperative Catheter-Related Bladder Discomfort.

Objectives: We conducted meta-analysis to demonstrate the efficacy and safety of ketamine on postoperative catheter-related bladder discomfort (CRBD). Methods: A systematic search was performed through PubMed, Embase, and Cochrane Library to identify all randomized controlled trials that used ketamine in postoperative CRBD. This study was carried out by using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. We used RevMan version 5.3.0. to analyze the data. Results: Five RCTs involving 414 patients were included in the analysis. The incidence and severity of postoperative CRBD were assessed at 0, 1, 2, and 6 h. According to our results of meta-analysis, ketamine reduced the incidence of postoperative CRBD at 2 h (RR 0.39; 95% CI, 0.21-0.71; p = 0.002, I2 = 40%) and 6 h (RR 0.29; 95% CI, 0.16-0.50; p < 0.0001, I2 = 0%) significantly; however, there were no statistical differences at 0 h (RR 0.81; 95% CI, 0.35-1.88; p = 0.62, I2 = 96%) and 1 h (RR 0.57; 95% CI, 0.13-2.54; p = 0.46, I2 = 97%). In two studies, we compared the incidence of moderate-to-severe CRBD between groups according to the scaling system (none, mild, moderate, and severe), and data are presented as numbers. Patients in the ketamine group showed a significantly lower severity of CRBD than those in the placebo group at 1 h (RR 0.09; 95% CI, 0.03-0.31; p = 0.0001) and 2 h (RR 0.06; 95% CI, 0.01-0.44; p = 0.005). In contrast, there were no meaningful differences between the two groups in the severity of CRBD at 0 h (RR 0.18; p = 0.84) or 6 h (RR 0.20; 95% CI, 0.03-1.59; p = 0.13). There were no meaningful differences on the rate of adverse events between the ketamine group and control group, mainly including postoperative nausea and vomiting (RR 1.24; 95% CI, 0.89-1.72; p = 0.21), diplopia (RR 3.00; 95% CI, 0.48-18.67; p = 0.24), and hallucination (RR 3.00; 95% CI, 0.32-28.24; p = 0.34). Conclusion: Our meta-analysis demonstrated that a sub-hypnotic dose of ketamine administration can reduce the incidence and severity of postoperative CRBD without causing evident side effects.

Tadalafil 5 mg Once Daily Improves Lower Urinary Tract Symptoms and Erectile Dysfunction: A Systematic Review and Meta-analysis.

OBJECTIVES: We carried out a systematic review and meta-analysis to assess tadalafil 5 mg once-daily for the treatment of lower urinary tract symptoms (LUTS) and erectile dysfunction (ED). METHODS: A literature review was performed to identify all published randomized double-blind, placebo-controlled trials of tadalafil 5 mg once-daily for the treatment of LUTS and ED. The search included the following databases: MEDLINE, EMBASE, and the Cochrane Controlled Trials Register. The reference lists of the retrieved studies were also investigated. RESULTS: Thirteen publications involving a total of 3973 patients were used in the analysis, including 13 RCTs that compared tadalafil 5 mg once-daily with placebo. We found that tadalafil 5 mg once-daily was effective in improving LUTS suggestive of BPH and treating ED over 12 weeks in our meta-analysis. Total International Prostate Symptom Score (IPSS) (SMD = - 2.02, 95% CI = - 2.52 to -1.53, P < 0.00001); Benign Prostatic Hyperplasia Impact Index (BPH-II) (SMD = -0.58, 95% CI = -0.84 to -0.33, P < 0.00001); International Index of Erectile Function-erectile function (IIEF) domain (standardized mean difference [SMD] = 5.18, 95% confidence interval [CI] = 4.13-6.23, P < 0.00001) indicated that tadalafil 5 mg once-daily was more effective than the placebo. Safety assessments included discontinuations due to adverse event (odds ratio (OR) = 1.79, 95% CI = 1.12-2.85, P = 0.01) indicated that tadalafil 5 mg once-daily was well tolerated. CONCLUSIONS: This meta-analysis indicates that tadalafil 5 mg once-daily to be an effective treatment for LUTS and ED with a low occurrence of side effects.