Women with chronic constipation have more bothersome urogenital symptoms.

BACKGROUND: The aim of our study was to characterize urogenital symptoms in women with and without constipation, and by severity of constipation. METHODS: This was a retrospective cohort study conducted at a pelvic floor disorder center in a tertiary healthcare facility from May 2007 through August 2019 and completed an intake questionnaire were included. We collected demographic, physical exam data and quality of life outcomes. The Urinary Distress Inventory (UDI-6) was used to assess urogenital symptoms. Women with constipation completed the Constipation Severity Instrument (CSI). We excluded women with a history of a bowel resection, inflammatory bowel disease, or pelvic organ prolapse symptoms. The cohort was then divided into two groups, constipated and non-constipated, and the prevalence and severity of urogenital-associated symptoms were compared. A secondary analysis was made among constipated subjects stratified by constipation severity based on CSI scores. RESULTS: During the study period, 875 women (59.5%) had chronic constipation. Women with chronic constipation were more likely to experience urogenital symptoms, such as dyspareunia, urinary hesitancy, and a sensation of incomplete bladder emptying (all p < 0.05). Moreover, on univariate analysis, women with high CSI scores (75 percentile or higher) were found to have higher UDI-6 scores, increased bladder splinting, pad use, urinary frequency and dyspareunia while on multivariate analysis higher UDI score, increased bladder splinting, urinary frequency and dyspareunia were significantly associated (p < 0.05). CONCLUSION: We found that the presence and severity of chronic constipation worsened the degree of bother from urogenital symptoms. Given that chronic constipation can modulate urogenital symptoms, our study suggests that pelvic floor specialists should assess the presence and severity of urogenital and bowel symptoms to provide comprehensive care.

Stress-induced hyperglycemia on complications in non-critically elderly hospitalized patients. / Hiperglucemia inducida por estrés en pacientes ancianos hospitalizados no críticos.

AIMS: Hospital complications and hyperglycemia are common in elderly patients during hospitalization. Our aim was to analyze the relationship between hyperglycemia and hospital complications in an ageing population. METHODS: We conducted an observational study to evaluate the association between maximum blood glucose (MBG) levels and hospital complications. Patients were stratified according to the quartiles of MBG levels. Diabetes mellitus (DM) was determined by patient history and/or admission glycated hemoglobin (HbA1c) level ≥6.5%. Hyperglycemia in patients without DM was defined as stress-induced hyperglycemia (SH). The composite primary end-point included frequent complications and/or all-cause hospital mortality. RESULTS: Among 461 patients, mean age 80±7.5years, 238 (51.6%) patients had DM, 20 had undiagnosed DM, and 162 (35.1%) developed hospital complications. Patients with complications had higher mean daily BG levels (215±84 vs 195±85mg/dl, P<.01). The incidence of complications was directly associated with severity of hyperglycemia according to the quartiles of MBG levels in patients without DM, namely SH (<140 mg/dl, 22.2%; 140-185mg/dl, 40%; 186-250mg/dl, 47%; >250mg/dl, 60%; P=.002), but not in patients with DM (<140mg/dl, 26.3%; 140-185mg/dl, 40.4%; 186-250mg/dl, 35.6%; >250mg/dl, 37.4%; P=.748). In the multivariate analyses, SH was independently associated with complications: OR 2.60 (CI95%: 1.2-5.6), 2.82 (CI95%: 1.2-6.5), 5.50 (CI95%: 1.4-20.8) for the second, third and fourth quartile respectively (P=.01), as compared to the first quartile. We found no association with readmissions and all-cause mortality. CONCLUSIONS: SH in elderly patients is associated with hospital complications, but not with all-cause mortality, compared to patients with diabetes or normoglycemia.

Resveratrol content in wines and musts from the south of Spain.

Trans- and cis-resveratrol and their glycosides have been determined in eighty-one samples including musts, substrate wines and commercial wines (red, white and Sherry-type wines) from the south of Spain. Sample analysis was performed using a direct injection technique by HPLC with photodiode array detector. Prior to the injection, the sample was filtered using a filter selected through a complete filtration study. Climatological data can affect total resveratrol levels. Values obtained for total resveratrol content in red wines ranged from 0.038 mg/l in a dry year to 1.164 mg/l for a normal year. The pressure applied to the berries to obtain must, has been object of study in order to ascertain its influence in final resveratrol content. For the same vintage, the total resveratrol content ranged from 0.032 mg/l in a wine, obtained from the lighest pressure musts, to 0.873 mg/l for those obtained from the highest pressure musts. No resveratrol has been found in Sherry wines, being present in the substrate wines in all cases.

Biochemical and genetic characterization of L-glutamate transport and utilization in Salmonella typhimurium LT-2 mutants.

Two systems for L-glutamate transport were found in Salmonella typhimurium LT-2 GltU+ (glutamate utilization) mutants. The first one is similar to the glt system previously described in Escherichia coli; by transductional analysis the structural gene, gltS, coding for the transport protein was located at minute 80 of the chromosome as part of the operon gltC-gltS, and its regulator, the gltR gene, near minute 90; the gltS gene product transports both L-glutamate and L-aspartate, is sodium independent, and is beta-hydroxyaspartate sensitive. The second transport system, whose structural gene was called gltF and is located at minute 0, was L-glutamate specific, sodium independent, and alpha-methylglutamate sensitive. Two aspartase activities occurred in S. typhimurium LT-2: the first one was present only in the GltU+ mutants, had a pH 6.4 optimum, was essential for both L-glutamate and L-aspartate metabolism, and mapped at minute 94, close to the ampC gene. The second one had a pH 7.2 optimum, could be induced by several amino acids, and thus may have a general role in nitrogen metabolism.

Lysis of a temperature conditional thiamineless mutant of Salmonella typhimurium by glucose and other hexoses.

The SM-3 mutant of Salmonella typhimurium was isolated as streptomycin resistant and temperature conditional thiamine auxotroph. At 37 C it required thiamine, although it behaves as a leaky mutant at this temperature in minimal liquid medium. At 30 degrees C it was able to growth without thiamine. In minimal-glucose-aminoacids at 37 C after an initial growth, cellular lysis occurred. The same happened with other hexoses, but it was not observable when glycerol or lactate were used as carbon source. Microscopic examination showed clumps of cellular debris, empty bagshapes and swelling of microorganisms, suggesting a cell wall defect. Sucrose 0.5 M protected SM-3 cells from osmotic fragility. At 30 C growth was normal and at 37 C in presence of exogenous thiamine full growth without bacteriolysis was obtained. Preliminary experiments of bacterial conjugation allowed the identification of a new locus involved in thiamine biosynthesis which was tentatively mapped in the pur A - pro B region of the chromosomal map of S. typhimurium.

panD, a new chromosomal locus of Salmonella typhimurium for the biosynthesis of beta-alanine.

Three mutants of Salmonella typhimurium LT2, which required either pantothenate or beta-alanine for growth, were obtained after treatment with N-methyl-N'-nitro-N-nitrosoguanidine. Their phenotype was: SM30 Pan-, SM31 Pan- Met-, SM32 Pan- Thi- (requirement for the thiazole-moiety of thiamine). Neither aspartate, dihydrouracil, nor beta-ureidopropionate replaced beta-alanine as growth factor. By conjugation it was found that the three genetic lesions (Pan-, Met-, Thi-) were located at about minute 128 of the bacterial chromosome. By transduction 63% linkage was found between the Pan and Met loci, and 84% between the Thi and Pan loci. Probably the thiazole auxotrophy was due to a lesion in the thiG locus. The new genetic locus responsible for the synthesis of beta-alanine was named panD.

Lysis of a temperature conditional thiamineless mutant of Salmonella typhimurium by glucose and other hexoses

The SM-3 mutant of Salmonella typhimurium was isolated as streptomycin resistant and temperature conditional thiamine auxotroph. At 37 C it required thiamine, although it behaves as a leaky mutant at this temperature in minimal liquid medium. At 30 degrees C it was able to growth without thiamine. In minimal-glucose-aminoacids at 37 C after an initial growth, cellular lysis occurred. The same happened with other hexoses, but it was not observable when glycerol or lactate were used as carbon source. Microscopic examination showed clumps of cellular debris, empty bagshapes and swelling of microorganisms, suggesting a cell wall defect. Sucrose 0.5 M protected SM-3 cells from osmotic fragility. At 30 C growth was normal and at 37 C in presence of exogenous thiamine full growth without bacteriolysis was obtained. Preliminary experiments of bacterial conjugation allowed the identification of a new locus involved in thiamine biosynthesis which was tentatively mapped in the pur A - pro B region of the chromosomal map of S. typhimurium.

Lysis of a temperature conditional thiamineless mutant of Salmonella typhimurium by glucose and other hexoses.

The SM-3 mutant of Salmonella typhimurium was isolated as streptomycin resistant and temperature conditional thiamine auxotroph. At 37 C it required thiamine, although it behaves as a leaky mutant at this temperature in minimal liquid medium. At 30 degrees C it was able to growth without thiamine. In minimal-glucose-aminoacids at 37 C after an initial growth, cellular lysis occurred. The same happened with other hexoses, but it was not observable when glycerol or lactate were used as carbon source. Microscopic examination showed clumps of cellular debris, empty bagshapes and swelling of microorganisms, suggesting a cell wall defect. Sucrose 0.5 M protected SM-3 cells from osmotic fragility. At 30 C growth was normal and at 37 C in presence of exogenous thiamine full growth without bacteriolysis was obtained. Preliminary experiments of bacterial conjugation allowed the identification of a new locus involved in thiamine biosynthesis which was tentatively mapped in the pur A - pro B region of the chromosomal map of S. typhimurium.

Mutants of Salmonella typhimurium lacking phosphoenolpyruvate carboxykinase and alpha-ketoglutarate dehydrogenase activities.

Two auxotrophic mutants (SM16 and SM51) of Salmonella typhimurium, which for aerobic growth, with hexoses as carbon source, required lysine and methionine (SM51 required also nicotinic acid), were isolated and characterized. The requirement for the amino acids disappeared in anaerobiosis. Neither lipoate nor 4-hydroxybenzoate was effective in supporting aerobic growth of the mutants. The lysine and methionine requirement for aerobic growth was due to the absence in the mutants of the enzymatic activities of the alpha-ketoglutarate dehydrogenase complex. The mutants could not use succinate as carbon source even after enrichment of the growth medium with acid-hydrolyzed casein and yeast extract. No phosphoenolpyruvate carboxykinase activity was found in the mutants, a phenomenon which explained their inability to use succinate. By interrupted conjugation and by transduction experiments, the positions of the three affected loci, pck, suc, and Nic, were located at approximately 17 to 19 min of the S. typhimurium chromosome; they were found to be closely linked. From different criteria, it appears as if the genetic lesions present in both mutants are due to deletion of a small chromosome fragment.

Growth inhibition by hexoses of a temperature-sensitive thiazoleless mutant of Salmonella typhimurium.

A Salmonella typhimurium mutant showing impairment in the utilization of hexoses was isolated after treatment with N-methyl-N'-nitro-N-nitrosoguanidine. At 30 C, it grew with hexoses (glucose, fructose, galactose, mannitol), glycerol, succinate, or acid-hydrolyzed casein. At 37 C, it failed to grow with any of the hexoses. Enzymatic determinations demonstrated, however, that the enzymes of the glycolytic pathway (up to the formation of triose phosphates) were present and active at 25 and 32 C. At 42 C, the mutant did not grow with any of the carbon sources used. At both 37 and 42 C, the mutant grew perfectly well with hexoses if yeast extract was present. The metabolite required for growth was thiamine or, specifically, its thiazole moiety. If glucose was added to a culture growing in glycerol, at 37 C, growth was inhibited. This inhibition was relieved by the addition of thiamine or thiazole. Thus, at 37 C and only in the presence of hexoses, the mutant manifests a requirement for thiazole. This auxotrophy is absolute at 42 C. These data indicate that, in this mutant, some derivative of hexoses inhibits the synthesis of thiazole, and that this inhibition is also dependent on the temperature of incubation. The position in the bacterial chromosome of the genetic locus of this lesion (thz(-)) was determined by conjugation and found to coincide with the only thiamine (thi) locus so far reported.