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BACKGROUND: To describe the oral treatments people living with interstitial cystitis/bladder pain syndrome (IC/BPS) are using to treat their urologic condition in the UK. METHOD: A questionnaire hyperlink encompassing current and previous medications taken for IC/BPS with other sociodemographic and diagnostic indices was available to the Bladder Health UK website. Interested and fully consented individuals accessed and completed the survey. RESULTS: A total of 601 accessed the questionnaire of whom 173 participants responded (response rate: 28.7%) with a mean ± SD O'Leary/Sant scores of 20.12 ± 9.38. A sample size of 171 was estimated to be used in the survey. A fifth of the participants were not on any treatment at all. Amitriptyline was the most prevalent medication in use both alone and in combination. A shift in the use of unapproved (for IC/BPS) antidepressant, smooth muscle relaxant, opioids, gabapentenoids, and antibiotics was observed in the sample. There were no significant differences between the mean (SD) O'Leary/Sant scores of cohorts currently taking oral medications and those not taking it. More than two-thirds of the participants had been diagnosed with the disease more than 5 years. Just under a half (47.4%) of participants reported a history of allergy. CONCLUSION: Our study provides contemporary evidence that the treatments used for managing IC/BPS encompass a broad range of medications both recommended and not recommended by current guidelines. The latter suggests patients are willing to try novel treatments when more conventional ones are ineffective.
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Cistitis Intersticial , Estudios Transversales , Cistitis Intersticial/diagnóstico , Cistitis Intersticial/tratamiento farmacológico , Humanos , Encuestas y Cuestionarios , Resultado del Tratamiento , Reino Unido , Vejiga UrinariaRESUMEN
OBJECTIVE: To evaluate disease perception in a cohort of patients with interstitial cystitis/painful bladder syndrome (IC/PBS) using the Brief Illness Perception-Questionnaire (BIP-Q) and to evaluate how this might relate to disease severity. MATERIALS AND METHODS: The study is a cross-sectional survey amongst members of Bladder Health UK who had previously received a clinical diagnosis of IC/PBS. A hyperlink containing the questionnaire was sent to the patient group's website and interested members accessed and completed the survey. Participants' inclusion was based on a prior clinical diagnosis of IC/PBS, current O'Leary Sant scores supportive of the diagnosis, and age between 18 and 80. A sample size of 171 was used in the study. The Brief Illness Perception Questionnaire (BIP-Q) and the O'Leary/Sant symptoms and problem indices questionnaire were used to collect data. A multivariable logistic regression analysis was used to test the relationship between items of BIP-Q and severity of IC/PBS. Content analysis was used for the causal domain and subsequently analysed as percentages. RESULTS: Six hundred and one members accessed the questionnaire of whom 159 returned completed questionnaires. One hundred and twenty-two of 159 (≥75%) respondents believe that their illness will continue indefinitely. The majority of the respondents indicated that IC/PBS had a negative impact on their daily lives, caused them worry and made them emotionally unstable. Of the 8 BIP-Q items, those most predictive of disease severity were (adjusted odd ratio and confidence intervals): consequence 0.094 (0.023-0.386); treatment control 2.702 (1.256-5.812); identity 0.141 (0.033-0.600); concern 9.363 (1.521-57.632). CONCLUSIONS: Our findings show that IC/PBS negatively impacts participant's quality of life and emotional wellbeing. Higher expectation for treatment benefit and increasing levels of patient concern are predictive for severity of IC/PBS.
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Cistitis Intersticial , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Cistitis Intersticial/diagnóstico , Humanos , Persona de Mediana Edad , Percepción , Calidad de Vida , Adulto JovenRESUMEN
PURPOSE: This work represents the efforts of the SIU-ICUD workgroup on this topic and comprehensive literature search of English language manuscripts regarding urologic surgery in spinal cord injury using key words of urologic surgery and spinal cord injury. Articles were compiled, and recommendations in the chapter are based on group discussion and intensive communication. The purpose is to review what has been published during the last decades on urological surgery for neurogenic bladder after spinal cord injury. METHODS: Surgical techniques applied in spinal cord injured patients for neurogenic bladder dysfunction have been reviewed and the published material evaluated. RESULTS: There are several techniques that can be used to treat neurogenic dysfunctions and symptoms in refractory cases where conservative treatment failed. The number of publications is small as are the number of patients with spinal cord injury in which they have been performed. The choice of techniques proposed to the patients depends on the exact functional pathology in bladder, bladder neck and urethral sphincter. The final informed choice will be made by the patient. CONCLUSION: There are surgical urological techniques available to treat neurologic dysfunctions in spinal cord injured patients.
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Traumatismos de la Médula Espinal/complicaciones , Vejiga Urinaria Neurogénica/cirugía , Procedimientos Quirúrgicos Urológicos , Humanos , Uretra , Vejiga Urinaria Neurogénica/etiologíaRESUMEN
PURPOSE OF REVIEW: Intravesical antibiotics (IVA) has been used for prophylaxis and treatment of recurrent urinary tract infections (rUTIs). However, there is a lack of comprehensive evidence and consensus on its use. We conducted a systematic review to collect all available data about the effectiveness of IVA in prevention and treatment of rUTIs and to give an overview on the outcomes to date. METHODS: A systematic review was carried out for all English language articles from inception to August 2017, according to the Cochrane and PRISMA standards using MEDLINE, Scopus, Biomed Central, EMBASE, CINAHL, and Web of Science with references cross-checked and individual urology journals hand-searched. RESULTS: After an initial identification of 658 studies, we screened 37 abstracts and 18 full-text papers of which 11 were included in our final review. This included 285 patients with a mean age of 52 years and a female:male ratio of 129:117. The IVA used was gentamicin, neomycin/polymyxin, neomycin or colistin and IVA was used for rUTIs as prophylaxis in 5 studies (n = 168) and treatment in 6 studies (n = 117). Overall, a good reduction in symptomatic UTI was seen in 78%, with a short-term success rate and discontinuation rates of 71% (120/168) and 8% (14/168) in the prophylaxis group and 88% (103/117) and 5% (6/117) in the treatment groups respectively. There was a change in the sensitivity of organisms in 30% (50/168) and 23% (27/117) in the treatment and prophylaxis groups respectively. Twenty patients discontinued their IVA instillations which were higher for the non-gentamicin group (11%) compared to the gentamicin group (5%). The side effects were minor and included allergy, suprapubic discomfort, autonomic dysreflexia, urinary tract infections and diarrhoea. Intravesical antimicrobial instillation seems to be a relatively safe and effective method for the prophylaxis and treatment of recurrent UTIs, especially in the short term. It gives clinicians an alternative treatment modality in high-risk patients predisposed to UTIs where all other forms of systemic treatments have failed.
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Antibacterianos/administración & dosificación , Infecciones Urinarias/tratamiento farmacológico , Administración Intravesical , Antibacterianos/uso terapéutico , Profilaxis Antibiótica , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevención Secundaria , Resultado del TratamientoAsunto(s)
Imágenes de Resonancia Magnética Multiparamétrica , Próstata , Biopsia , Masculino , UltrasonografíaRESUMEN
OBJECTIVE: To compare the performance of three continence management devices and absorbent pads used by men with persistent urinary incontinence (>1 year) after treatment for prostate cancer. PATIENTS AND METHODS: Randomised, controlled trial of 56 men with 1-year follow-up. Three devices were tested for 3 weeks each: sheath drainage system, body-worn urinal (BWU) and penile clamp. Device and pad performance were assessed. Quality of life (QoL) was measured at baseline and follow-up with the King's Health Questionnaire. Stated (intended use) and revealed (actual use) preference for products were assessed. Value-for-money was gathered. RESULTS: Substantial and significant differences in performance were found. The sheath was rated as 'good' for extended use (e.g. golf and travel) when pad changing is difficult; for keeping skin dry, not leaking, not smelling and convenient for storage and travel. The BWU was generally rated worse than the sheath and was mainly used for similar activities but by men who could not use a sheath (e.g. retracted penis) and was not good for seated activities. The clamp was good for short vigorous activities like swimming/exercise; it was the most secure, least likely to leak, most discreet but almost all men described it as uncomfortable or painful. The pads were good for everyday activities and best for night-time use; most easy to use, comfortable when dry but most likely to leak and most uncomfortable when wet. There was a preference for having a mixture of products to meet daytime needs; around two-thirds of men were using a combination of pads and devices after testing compared with baseline. CONCLUSIONS: This is the first trial to systematically compare different continence management devices for men. Pads and devices have different strengths, which make them particularly suited to certain circumstances and activities. Most men prefer to use pads at night but would choose a mixture of pads and devices during the day. Device limitations were important but may be overcome by better design.
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Prostatectomía/efectos adversos , Neoplasias de la Próstata/cirugía , Incontinencia Urinaria/epidemiología , Incontinencia Urinaria/etiología , Incontinencia Urinaria/terapia , Almohadillas Absorbentes , Anciano , Anciano de 80 o más Años , Humanos , Masculino , Persona de Mediana Edad , Prótesis e Implantes , Calidad de VidaRESUMEN
OBJECTIVE: To describe and assess the evolution of an enhanced recovery programme (ERP) for open radical cystectomy. PATIENTS AND METHODS: We introduced a mentored ERP for radical cystectomy in January 2011. The programme underwent service evaluation and multiple changes in August 2012 that we define as marginal gains. We present a retrospective review of 133 consecutive patients undergoing open radical cystectomy, grouped according to the three stages of the ERP from October 2008 to April 2013: (1) non-ERP group (October 2008 to December 2010): n = 69; (2) ERP-1 group (January 2011 to July 2012): n = 37; and (3) ERP-2 group (August 2012 to April 2013): n = 27. Primary outcomes were length of hospital stay (LOS), readmission, morbidity at 90 days using the Clavien classification system and mortality. Secondary outcomes were time to flatus, ileus rates, re-operation rates and oncological outcomes. RESULTS: There were no differences in patient demographics among any of the groups for: age, gender, BMI, American Society of Anesthesiologists score and the use of neoadjuvant chemotherapy. There were no differences in readmission, morbidity and mortality rates. The overall 90-day mortality was six patients (4.5%). There were significant differences in ileus rates between the non-ERP, the ERP-1 and the ERP-2 groups: 44.9% (31 patients), 29.7% (11 patients) and 14.8% (four patients), respectively (P = 0.017). There was a significant difference in the presence of pathological lymphadenopathy in the ERP-2 group: non-ERP group, 10.1%; ERP-1 group, 16.2%; and ERP-2 group, 44.4%; P = 0.002. There was also a difference in the mean (sd) lymph node yield in ERP-2: non-ERP group, 8.4 (5.4) nodes; ERP-1, 8.2 (6.4) nodes; and ERP-2, 16.7 (5.4) nodes (P < 0.001). The median (range) LOS was 14 (7-91) days, 10 (6-55) days and 7 (3-99) days in the non-ERP, ERP-1 and ERP-2 groups, respectively (P < 0.001). CONCLUSIONS: Auditing an already successful ERP and implementing a number of marginal gains has led to a significant decrease in the median LOS for radical cystectomy. The LOS for open radical cystectomy at University Hospital Southampton has halved. In the second phase of our ERP, our median LOS is 7 days.
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Cistectomía , Tiempo de Internación/estadística & datos numéricos , Readmisión del Paciente/estadística & datos numéricos , Neoplasias de la Vejiga Urinaria/rehabilitación , Derivación Urinaria/rehabilitación , Anciano , Anciano de 80 o más Años , Auditoría Clínica , Cistectomía/métodos , Femenino , Flatulencia , Fluidoterapia , Estudios de Seguimiento , Humanos , Ileus , Masculino , Evaluación de Programas y Proyectos de Salud , Calidad de la Atención de Salud , Recuperación de la Función , Estudios Retrospectivos , Tasa de Supervivencia , Resultado del Tratamiento , Neoplasias de la Vejiga Urinaria/mortalidad , Neoplasias de la Vejiga Urinaria/cirugía , MicciónRESUMEN
Objective: This systematic meta-analysis aimed to assess the effectiveness of triptorelin therapy in reducing lower urinary tract symptoms (LUTS) in men with prostate cancer (PCa). Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. PubMed, Web of Science and EMBASE databases were searched for studies conducted between 2013 and 2023. Eligible studies included PCa patients undergoing androgen deprivation therapy (ADT) with triptorelin, with reported baseline and follow-up International Prostate Symptom Scores (IPSS) and quality of life (QoL) data. The Newcastle-Ottawa Scale (NOS) was used to assess the risk of bias, and a random-effects model was applied for the meta-analysis. Results: A total of 29 articles were identified, and three studies met the inclusion criteria. Triptorelin therapy showed a clinically significant reduction in IPSS over 48 weeks in PCa patients with moderate to severe LUTS. The meta-analysis revealed a pooled effect size of 1.05 (95% CI: 0.65; 1.45), indicating a statistically significant improvement in LUTS. QoL also improved in patients receiving triptorelin therapy, although heterogeneity among the studies and a moderate to high risk of bias were noted. Conclusion: Triptorelin therapy demonstrated a positive impact on LUTS in PCa patients. The meta-analysis showed significant reductions in IPSS scores and improved QoL after 48 weeks of triptorelin treatment. However, the results should be interpreted cautiously due to study heterogeneity and potential biases. Further well-designed studies are needed to confirm these findings and determine the optimal use of triptorelin for managing LUTS in men with PCa. Implications for Practice: Triptorelin therapy may offer an effective treatment option for men with PCa experiencing moderate to severe LUTS. Its positive impact on QoL can lead to improved patient well-being and treatment adherence. Clinicians should consider triptorelin as a potential treatment choice, especially in patients who may be reluctant to undergo surgical interventions for their LUTS. However, careful patient selection and close monitoring are essential due to the observed study heterogeneity and risk of bias. Future research should focus on evaluating triptorelin's cost-effectiveness and comparing its efficacy with other LH-RH agonists in managing LUTS in PCa patients.Video Abstract: URL (Reviewers/Editors to select from) Link 1: https://brighton.cloud.panopto.eu/Panopto/Pages/Viewer.aspx?id=071419c8-1ad5-4502-a222-b04300c2ca5e Link 2: https://brighton.cloud.panopto.eu/Panopto/Pages/Viewer.aspx?id=b6305a8a-b977-4fcd-a69e-b04300bed728.
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Several studies have shown that the levels of sex hormones in men with Alzheimer disease (AD) differ from men without AD. Therefore, male sex hormones have been postulated as risk modifiers in AD, possibly through immunomodulatory effects on known inflammatory AD risk factors, such as tumor necrosis factor α (TNF-α). We conducted a cross-sectional study of sex hormones and TNF-α levels in 94 community-dwelling men with AD. Comparisons were made with normal values derived from the literature. Men with AD had lower free testosterone levels than non-AD men (1-sample t test: age <80, P=0.0002; age ≥80, P<0.0001), and higher luteinizing hormone (LH) levels (Wilcoxon signed rank test: age <80, P=0.001; age ≥80, P<0.0001). Within the cohort of men with AD, there was a positive correlation between LH and TNF-α (Spearman r=0.25, P=0.019), and this remained significant after correcting for age (partial r=0.21, P=0.05). These data support the hypothesis that sex hormones and the immune system influence each other in AD. Furthermore, modulatory effects between LH and TNF-α may provide a mechanism for an effect of male sex hormones on AD risk.
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Enfermedad de Alzheimer/sangre , Hormona Luteinizante/sangre , Neuroinmunomodulación/fisiología , Testosterona/sangre , Factor de Necrosis Tumoral alfa/sangre , Anciano , Anciano de 80 o más Años , Enfermedad de Alzheimer/complicaciones , Enfermedad de Alzheimer/inmunología , Estudios Transversales , Humanos , Inmunoensayo , Inflamación/sangre , Inflamación/complicaciones , Inflamación/inmunología , MasculinoRESUMEN
Objectives: To test the feasibility of a randomised controlled trial (RCT) of aspirin and/or vitamin D3 in active surveillance (AS) low/favourable intermediate risk prostate cancer (PCa) patients with Prolaris® testing. Patients and Methods: Newly-diagnosed low/favourable intermediate risk PCa patients (PSA ≤ 15 ng/ml, International Society of Urological Pathology (ISUP) Grade Group ≤2, maximum biopsy core length <10 mm, clinical stage ≤cT2c) were recruited into a multi-centre randomised, double-blind, placebo-controlled study (ISRCTN91422391, NCT03103152). Participants were randomised to oral low dose (100 mg), standard dose (300 mg) aspirin or placebo and/or vitamin D3 (4000 IU) versus placebo in a 3 × 2 factorial RCT design with biopsy tissue Prolaris® testing. The primary endpoint was trial acceptance/entry rates. Secondary endpoints included feasibility of Prolaris® testing, 12-month disease re-assessment (imaging/biochemical/histological), and 12-month treatment adherence/safety. Disease progression was defined as any of the following (i) 50% increase in baseline PSA, (ii) new Prostate Imaging-Reporting and Data System (PI-RADS) 4/5 lesion(s) on multi-parametric MRI where no previous lesion, (iii) 33% volume increase in lesion size, or radiological upstaging to ≥T3, (iv) ISUP Grade Group upgrade or (v) 50% increase in maximum cancer core length. Results: Of 130 eligible patients, 104 (80%) accepted recruitment from seven sites over 12 months, of which 94 patients represented the per protocol population receiving treatment. Prolaris® testing was performed on 76/94 (81%) diagnostic biopsies. Twelve-month disease progression rate was 43.3%. Assessable 12-month treatment adherence in non-progressing patients to aspirin and vitamin D across all treatment arms was 91%. Two drug-attributable serious adverse events in 1 patient allocated to aspirin were identified. The study was not designed to determine differences between treatment arms. Conclusion: Recruitment of AS PCa patients into a multi-centre multi-arm placebo-controlled RCT of minimally-toxic adjunctive oral drug treatments with molecular biomarker profiling is acceptable and safe. A larger phase III study is needed to determine optimal agents, intervention efficacy, and outcome-associated biomarkers.
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Objective: To examine the effect of the COVID-19 pandemic on gonadorelin analogue prescription for community patients in England. Materials and methods: We included data from all primary-care patients who had relevant prescriptions dispensed in the community in England. Descriptive statistics and interrupted time series analysis over 22 months (15 months before and 7 months after lockdown) was evaluated. Results: A total of 22 months' worth of data were analyzed (or 1 041 638 total items, monthly average 47 347 items). Goserelin; leuprorelin, and triptorelin are the medicines most used by total quantity in the study period. Simple descriptive statistics show that mean values have declined during the pandemic. The Interrupted Time Series (ARIMA Modeling) shows declining trends.After the pandemic's onset, we observe a statistically significant downward trend for goserelin (P = .017) and leuprorelin (P = .014). As these are the major constituents of the model, we interpret this overall data as showing a significant downward category trend. Aside from linearity, a significant step change was noted for leuprorelin (P = .029) showing an increase in prescription items with a similar effect that is close to being statistically significant for goserelin (P = .051).The actual cost of medicines shows minimal variation suggesting that prices of individual medicines have remained stable. The regional data showed variation but this was not statistically significant. In all cases, the Oct-20 figures are lower "year on year." This novel work reports the impact of a global pandemic on prescription volumes of prostate cancer (PCa) medicines. Conclusions: A worrying decrease in prescription medicines raises concerns for the care of PCa patients. We encourage diagnosed patients to discuss their planned care with their doctor.
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Epidemiological data suggest that pre-eclampsia (PE) is associated with an increased risk of post-delivery metabolic dysregulation. The aim of the present case-control observational study was to examine the global plasma proteomic profile 1 year postpartum in women who developed PE during pregnancy (n = 5) compared to controls (n = 5), in order to identify a novel predictive marker linking PE with long-term metabolic imbalance. Key findings were verified with enzyme-linked immunosorbent assay (ELISA) in a separate cohort (n = 17 women with PE and n = 43 controls). One hundred and seventy-two proteins were differentially expressed in the PE vs. control groups. Gene ontology analysis showed that Inflammatory|Immune responses, Blood coagulation and Metabolism were significantly enriched terms. CD14, mapping to the inflammatory response protein network, was selected for verification based on bibliographic evidence. ELISA measurements showed CD14 to be significantly increased 1 year postpartum in women with PE during pregnancy compared to controls [PE group (median ± SD): 296.5 ± 113.6; control group (median ± SD): 128.9 ± 98.5; Mann-Whitney U test p = 0.0078]. Overall, the identified proteins could provide insight into the long-term disease risk among women with PE during pregnancy and highlight the need for their postpartum monitoring. CD14 could be examined in larger cohorts as a predictive marker of insulin resistance and type II diabetes mellitus among women with PE.
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Receptores de Lipopolisacáridos/sangre , Periodo Posparto/sangre , Preeclampsia/sangre , Adulto , Biomarcadores/sangre , Proteínas Sanguíneas/análisis , Estudios de Casos y Controles , Estudios de Cohortes , Diabetes Mellitus Tipo 2/epidemiología , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Resistencia a la Insulina , Embarazo , Proteómica , Factores de RiesgoRESUMEN
BACKGROUND: PROACTIVE is a psycho-educational support intervention for prostate cancer patients managed on Active Surveillance. PROACTIVE is composed of two interdependent components: group workshops and internet-delivered information modules. AIMS: We conducted a feasibility study to determine the practicality of delivering PROACTIVE at two prostate cancer centres. METHODS AND RESULTS: The feasibility study was a mixed-methods randomized parallel-group exploratory trial. Participants were randomised using a ratio of 3:1 PROACTIVE group to treatment as usual. Qualitative semi-structured interviews and quantitative measures were completed at baseline, intervention completion (week 6), and at 6-month follow-up. Interview transcripts were analysed thematically using Framework analysis. Descriptive statistics were used to examine recruitment and retention rates and changing trends in outcome measures. Most aspects of the research design and PROACTIVE intervention were acceptable to those participating in the study. In particular, participants valued the opportunity to share and discuss experiences with other prostate cancer patients on Active Surveillance and receive detailed authoritative information. However, three issues were identified: (a) a low response rate (13 participants recruited, response rate 16%), (b) low utilisation of internet delivered information modules, (c) self-perceived low levels of anxiety amongst participants with the majority perceiving their cancer as not impacting on their day-to-day life or causing anxiety. CONCLUSIONS: Due to these significant research design issues, it is not recommended PROACTIVE be evaluated in a large-scale randomised controlled trial. Further research is required to explore the impact of Active Surveillance on anxiety amongst men with localized prostate cancer managed by Active Surveillance.
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Ansiedad/terapia , Neoplasias de la Próstata/psicología , Anciano , Estudios de Factibilidad , Humanos , Masculino , Persona de Mediana Edad , Motivación , Evaluación de Resultado en la Atención de Salud , Educación del Paciente como AsuntoRESUMEN
The aim of this study was to evaluate a novel, generic, sensitive electroanalytical platform method for binding reactions, such as immuno or DNA assays. It was thought that silver nano-particles of 40 nM when attached to the analyte of interest would give an electroanalytical amplification of approx. 10(6) resulting from silver ions produced by dissolution of the nano-particles by a mild chemical oxidant such as ferricyanide. Ferricyanide has been widely used in biochemical measurement and has been shown to relatively stable in a biosensor device. Here we have demonstrated the use of silver nano-particles as a bio-conjugate in a 96 well sandwich assay format for measuring human chorionic gonadotropin (hCG) to a concentration of 0.2 mIU.
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Gonadotropina Coriónica/análisis , Inmunoensayo , Nanopartículas del Metal/química , Potenciometría/métodos , Plata/química , Ferricianuros/metabolismo , HumanosRESUMEN
AIMS: To identify the presence and geographical distribution of mast cell (MC) subtypes: MCT (tryptase positive-chymase negative) and MCTC (tryptase positive-chymase positive) in bladder tissue. METHODS: Bladder tissue was obtained from patients with painful bladder syndrome/interstitial cystitis (n=14) and normal histology from University Hospital Southampton tissue bank. Sequential tissue slices were immunohistochemically stained for MC subtypes using anti-MC tryptase (for MCT and MCTC) and anti-MC chymase (for MCTC). Stained sections were photographed, and positively stained MCs were quantified using ImageJ. Data were analysed using descriptive statistics and individual paired t-tests. RESULTS: There was a significant difference in the density of MCs between each layer of the disease bladder, with the greatest accumulation within the detrusor (p<0.001). There was a significant increase in MCTC subtype in the lamina (p=0.009) in painful bladder syndrome/interstitial cystitis. CONCLUSIONS: Our results suggest that mastocytosis is present within all layers of disease bladder, especially the muscle layer. The varying increase in MC subtypes in the lamina and mucosa may explain the variability in painful bladder syndrome/interstitial cystitis symptoms. A high influx of MCTC in the mucosa of individuals who also had ulceration noted within their diagnostic notes may be of the Hunner's ulcer subclassification. These findings suggest a relationship between the pathogenesis of MC subtypes and the clinical presentation of painful bladder syndrome/interstitial cystitis. A cohort study would further elucidate the diagnostic and/or therapeutic potential of MCs in patients with painful bladder syndrome/interstitial cystitis.
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Cistitis Intersticial/patología , Mastocitos/patología , Mastocitosis/patología , Vejiga Urinaria/patología , Biomarcadores/análisis , Biopsia , Quimasas/análisis , Cistitis Intersticial/enzimología , Cistitis Intersticial/terapia , Humanos , Inmunohistoquímica , Mastocitos/enzimología , Mastocitosis/enzimología , Mastocitosis/terapia , Valor Predictivo de las Pruebas , Pronóstico , Triptasas/análisis , Vejiga Urinaria/enzimologíaRESUMEN
AIMS: Biofilms are ubiquitous and when mature have a complex structure of microcolonies in an extracellular polysaccharide and extracellular DNA matrix. Indwelling medical devices harbour biofilms which have been shown to cause infections and act as reservoirs for pathogens. Urinary catheters are often in place for considerable periods of time and are susceptible to both encrustation and biofilm formation. Strategies for minimising biofilm occurrence underpin an active research area in biomedicine. Manuka honey has, inter alia, well-established antibacterial properties. This study aims to assess the influence of honey on early biofilm formation in an established in vitro model. METHODS: An established model of early biofilm formation using static bacterial cultures in vinyl 96-well plates was used to grow Escherichia coli, strain ATC 25922 and Proteus mirabilis, strain 7002. Planktonic cells were removed and the residual biofilm was stained with crystal violet, which were subsequently eluted and quantified spectrophotometrically. Manuka honey (Unique Manuka Factor 15+) was added either with the bacteria or up to 72â hours after. RESULTS: Biofilms in this model was developed over 3â days, after which growth stalled. Mixed (1:1) cultures of E. coli and P. mirabilis grew slower than monocultures. In mixed cultures, honey gave a dose-dependent reduction in biofilm formation (between 3.3 and 16.7%w/v). At 72â hours, all concentrations inhibited maximally (p<0.001). Application of honey to cultures after 24 and 48â hours also reduced the adherent bacterial biomass (p<0.05-p<0.01). CONCLUSION: Manuka honey at dilutions as low as 3.3% w/v in some protocols and at 10% or above in all protocols tested significantly inhibits bacterial attachment to a vinyl substrate and reduces further early biofilm development. No augmentation of growth over untreated controls was observed in any experiment.
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Biopelículas/efectos de los fármacos , Escherichia coli/efectos de los fármacos , Miel , Proteus mirabilis/efectos de los fármacos , Humanos , Catéteres UrinariosRESUMEN
Methodologies for the determination of vitamin B(2) in food matrixes and a premix using simple sample conditioning steps coupled with a convenient and cheap electrochemical sensing device are presented. Electrochemical analysis based on differential pulse voltammetry (DPV) coupled to carbon electrodes gave a well-defined reduction peak at -0.42 V versus a Ag/AgCl quasi-reference electrode. Using a straightforward sample preparation step, vitamin B(2) can be measured successfully in a nutritional premix and food products. Standard additions of riboflavin were used to confirm the analyte concentrations and to provide precision data.