What are the causes and consequences of bladder overdistension? ICI-RS 2011.

AIMS: To report the outcome of the think tank on prolonged bladder overdistension from the 3rd ICI-RS meeting. METHODS: Prolonged bladder overdistension was discussed after acute urinary retention, its terminology, its prevalence, pathophysiology, and consequences, as well as prophylactic and therapeutic aspects. RESULTS: Acute prolonged bladder overdistension (ApBO) is a consequence of undetected or inadequately treated acute retention, and is mostly due to regional anesthesia, prolonged childbirth, or extensive surgery. Currently, there is no agreed terminology. A primary, temporary neurogenic detrusor dysfunction causing retention is associated with decreased or absent bladder sensation therefore patients do not complain, and management is delayed. Therapeutically, the first intervention is to drain the bladder. Recovery depends on whether reversible or irreversible damage has occurred. There are no good data to support the use of drugs or sacral neuromodulation. Intravesical electrostimulation is the only treatment that has specifically addressed this problem with encouraging results. There are no recent reports on the effect of surgery for myogenic bladder damage. CONCLUSION: ApBO is an important, but often unrecognized medical complication. There is a need for defining the terminology, for studies to record the incidence of different types of bladder overdistension, and to establish management strategies. Apart from clean intermittent self catheterization (CIC) there are no data justifying pharmacological or other therapies. Therefore, prevention is of paramount importance and there is a need to develop and test preventative strategies, which should then be incorporated in surgical registries.

Detoxification of actual pretreated corn stover hydrolysate using activated carbon powder.

A technique for the removal of acetic acid from an actual pretreated corn stover hydrolysate was investigated. A powdered form of activated carbon previously shown to be effective in the removal of acetic acid from a synthetic hydrolysate was utilized. The method proved to be effective at lowering acetic acid levels while exhibiting minimal adsorption of the desired sugars from the hydrolysate, although at a lower efficiency in the actual hydrolysate than in the synthetic hydrolysate. Results are obtained for temperatures between 25 and 35 degrees C and agitation rates between 150 and 350 rpm in shake flasks. Adsorption isotherm and kinetic rate data are presented. Temperature differences over this range did not have an effect on adsorption characteristics. Five stages of detoxification were necessary to lower acetic acid concentration to the maximum 2 g/L desired for fermentation.