ABSTRACT
We investigated the impact and predictive value of bladder function in patients with benign prostatic hyperplasia (BPH) on the efficacy of transurethral prostatectomy. Symptomatic, imaging, and urodynamic data of patients who underwent transurethral prostatectomy at West China Hospital of Sichuan University (Chengdu, China) from July 2019 to December 2021 were collected. Follow-up data included the quality of life (QoL), International Prostate Symptom Score (IPSS), and IPSS storage and voiding (IPSS-s and IPSS-v). Moreover, urinary creatinine (Cr), nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), and prostaglandin estradiol (PGE2) were measured in 30 patients with BPH and 30 healthy participants. Perioperative indicators were determined by subgroup analyses and receiver operating characteristic (ROC) curve analysis. Among the 313 patients with BPH included, patients with severe micturition problems had more improvements but higher micturition grades postoperatively than those with moderate symptoms. Similarly, good bladder sensation, compliance, and detrusor contractility (DC) were predictors of low postoperative IPSS and QoL. The urinary concentrations of BDNF/Cr, NGF/Cr, and PGE2/Cr in patients were significantly higher than those in healthy participants (all P < 0.001). After evaluation, only DC was significantly related to both urinary indicators and postoperative recovery of patients. Patients with good DC, as predicted by urinary indicators, had lower IPSS and IPSS-v than those with reduced DC at the 1st month postoperatively (both P < 0.05). In summary, patients with impaired bladder function had poor recovery. The combined levels of urinary BDNF/Cr, NGF/Cr, and PGE2/Cr in patients with BPH may be valid predictors of preoperative bladder function and postoperative recovery.
ABSTRACT
Global eutrophication and climate warming exacerbate production of cyanotoxins such as microcystins (MCs), presenting risks to human and animal health. Africa is a continent suffering from severe environmental crises, including MC intoxication, but with very limited understanding of the occurrence and extent of MCs. By analysing 90 publications from 1989 to 2019, we found that in various water bodies where MCs have been detected so far, the concentrations were 1.4-2803 times higher than the WHO provisional guideline for human lifetime exposure via drinking water (1 µg/L) in 12 of 15 African countries where data were available. MCs were relatively high in the Republic of South Africa (averaged 2803 µg/L) and Southern Africa as a whole (702 µg/L) when compared to other regions. Values were higher in reservoirs (958 µg/L) and lakes (159 µg/L) than in other water types, and much higher in temperate (1381 µg/L) than in arid (161 µg/L) and tropical (4 µg/L) zones. Highly significant positive relationships were found between MCs and planktonic chlorophyll a. Further assessment revealed high ecological risk for 14 of the 56 water bodies, with half used as human drinking water sources. Recognizing the extremely high MCs and exposure risk in Africa, we recommend routine monitoring and risk assessment of MCs be prioritized to ensure safe water use and sustainability in this region.