Hormonal changes during flower development in floral tissues of Lilium.

Much effort has been focussed on better understanding the key signals that modulate floral senescence. Although ethylene is one of the most important regulators of floral senescence in several species, Lilium flowers show low sensitivity to ethylene; thus their senescence may be regulated by other hormones. In this study we have examined how (1) endogenous levels of hormones in various floral tissues (outer and inner tepals, androecium and gynoecium) vary throughout flower development, (2) endogenous levels of hormones in such tissues change in cut versus intact flowers at anthesis, and (3) spray applications of abscisic acid and pyrabactin alter flower longevity. Results show that floral tissues behave differently in their hormonal changes during flower development. Cytokinin and auxin levels mostly increased in tepals prior to anthesis and decreased later during senescence. In contrast, levels of abscisic acid increased during senescence, but only in outer tepals and the gynoecium, and during the latest stages. In addition, cut flowers at anthesis differed from intact flowers in the levels of abscisic acid and auxins in outer tepals, salicylic acid in inner tepals, cytokinins, gibberellins and jasmonic acid in the androecium, and abscisic acid and salicylic acid in the gynoecium, thus showing a clear differential response between floral tissues. Furthermore, spray applications of abscisic acid and pyrabactin in combination accelerated the latest stages of tepal senescence, yet only when flower senescence was delayed with Promalin. It is concluded that (1) floral tissues differentially respond in their endogenous variations of hormones during flower development, (2) cut flowers have drastic changes in the hormonal balance not only of outer and inner tepals but also of androecium and gynoecium, and (3) abscisic acid may accelerate the progression of tepal senescence in Lilium.

Resource use and healthcare costs in patients with overactive bladder who initiate treatment with mirabegron or antimuscarinic monotherapy in Catalonia: the MIRACAT study.

INTRODUCTION AND AIM: Overactive bladder (OAB) negatively impacts patient quality of life and may be associated with high resource use. Our aim was to describe the resource use, costs and persistence associated with mirabegron (MB) or antimuscarinic (AM) treatment in patients with OAB. MATERIALS AND METHODS: Observational retrospective study of medical records in adult patients initiating OAB treatment with MB or AM in Catalonia. Healthcare resource use (visits, hospital stays, tests, medication, absorbent pads) in the first year after treatment initiation was collected. Associated costs were estimated (є, reference year 2019), as well as treatment persistence. Treatment discontinuation was defined as the absence of prescription for at least 45 days or treatment change. RESULTS: The mean cost per patient (SD) was є 1,640.20 (є 1,227.60) with MB and є 2,159.20 (є 2,264.40) with AM; the associated healthcare resource use cost was lower with MB compared to AM, except for OAB drug costs. Persistence after 12 months of treatment initiation was higher in MB (42.1%) compared to AM (33.0%), as was the median time until treatment discontinuation: 299 (95% CI: 270-328) vs 240 days (95% CI: 230-250). CONCLUSIONS: Lower healthcare resource use was observed with MB compared to AM in the first year of index treatment, resulting in a lower mean direct cost per patient and year, despite its higher acquisition cost. Increased treatment persistence, as well as rational use of available treatments improves OAB management and, in return, patients' quality of life.

Efficacy and safety of onabotulinumtoxin A injection in male patients with detrusor overactivity after stress urinary incontinence surgery.

INTRODUCTION AND OBJECTIVE: The use of onabotulinumtoxin A (BoNT-A) injection in male patients with detrusor overactivity (DO) after stress urinary incontinence (SUI) surgery has been scarcely described. Our aim was to assess results of this treatment in this specific population. MATERIALS AND METHODS: Retrospective analysis of men with previous SUI surgery who had been treated with a first injection of 100 U BoNT-A because of DO since 2010 in our department. Treatment response was assessed with the Treatment Benefit Scale: 1) greatly improved; 2) improved; 3) not changed; 4) worsened after treatment (Treatment Benefit Scale 1 or 2: treatment response). Complications were classified according to the Clavien-Dindo classification. Treatment continuation was considered present if, at the last visit, patients had received a BoNT-A injection within the preceding 12 months. Pre- and post-treatment urodynamic variables were compared. RESULTS: Eighteen patients were included, median age 71.1 (59.1-83.5) years. Twelve (66.7%) patients reported response to treatment. Two (11.1%) complications were detected: urinary retention requiring clean intermittent catheterization (Clavien-Dindo 2). No complications related to previous SUI surgery were detected. Fifteen (83.3%) patients had a follow-up >12 months (median follow-up 57 [15-89] months) and all of them had discontinued treatment at the end of follow-up. Urodynamic studies showed significant improvement in terms of DO and bladder compliance. CONCLUSION: Although most men with DO after SUI surgery respond to intradetrusor BoNT-A injection, all of them discontinue treatment due to personal reasons. It is a safe procedure, with urinary retention requiring clean intermittent catheterization being the most frequent complication.

Efficacy and safety of onabotulinumtoxin A injection in male patients with detrusor overactivity after stress urinary incontinence surgery. / Eficacia y seguridad de la inyección de onabotulinumtoxin A en pacientes varones con hiperactividad del detrusor tras la cirugía para incontinencia urinaria de esfuerzo.

INTRODUCTION AND OBJECTIVE: The use of onabotulinumtoxin A (BoNT-A) injection in male patients with detrusor overactivity (DO) after stress urinary incontinence (SUI) surgery has been scarcely described. Our aim was to assess results of this treatment in this specific population. MATERIALS AND METHODS: Retrospective analysis of men with previous SUI surgery who had been treated with a first injection of 100U BoNT-A because of DO since 2010 in our department. Treatment response was assessed with the Treatment Benefit Scale: 1) greatly improved; 2) improved; 3) not changed; 4) worsened after treatment (Treatment Benefit Scale 1 or 2: treatment response). Complications were classified according to the Clavien-Dindo classification. Treatment continuation was considered present if, at the last visit, patients had received a BoNT-A injection within the preceding 12 months. Pre- and post-treatment urodynamic variables were compared. RESULTS: Eighteen patients were included, median age 71.1 (59.1-83.5) years. Twelve (66.7%) patients reported response to treatment. Two (11.1%) complications were detected: urinary retention requiring clean intermittent catheterization (Clavien-Dindo 2). No complications related to previous SUI surgery were detected. Fifteen (83.3%) patients had a follow-up>12 months (median follow-up 57 [15-89] months) and all of them had discontinued treatment at the end of follow-up. Urodynamic studies showed significant improvement in terms of DO and bladder compliance. CONCLUSION: Although most men with DO after SUI surgery respond to intradetrusor BoNT-A injection, all of them discontinue treatment due to personal reasons. It is a safe procedure, with urinary retention requiring clean intermittent catheterization being the most frequent complication.

Urodynamic findings in Charcot-Marie-Tooth patients with lower urinary tract symptoms. / Hallazgos urodinámicos en pacientes con enfermedad de Charcot-Marie-Tooth con síntomas del tracto urinario inferior.

INTRODUCTION: Our aim was to describe the lower urinary tract symptoms (LUTS) and urodynamic findings in Charcot-Marie-Tooth (CMT) disease patients referred to our Urology Department. METHODS: Retrospective study of those patients with CMT disease diagnosed at the Neurology Department of our Tertiary Hospital and referred to our Urology Department since 2008 due to LUTS. We reviewed their clinical charts regarding the age at CMT disease diagnosis, type of CMT disease and the presence of other comorbidities which could cause LUTS. We collected data on the characterization of LUTS, findings of neurological examination and urodynamic findings. RESULTS: Seven patients were referred to our department due to the presence of LUTS. They were 3 male and 4 female, with median age at the moment of LUTS onset of 55 (29-67) years and median time from the diagnosis of the neuropathy to the onset of LUTS was 14 (1-37) years. Voiding symptoms were referred by 5 patients and urinary incontinence by 3 patients. Two patients presented recurrent urinary tract infection. Six urodynamic tests were performed which showed a neurogenic acontractile detrusor in 2 patients, detrusor underactivity in one patient, a delayed opening time in one patient, a neurogenic detrusor overactivity in one patient and a urodynamic stress incontinence in one patient. In one patient the urodynamic test was normal. CONCLUSIONS: Most of CMT patients with LUTS complained from voiding symptoms. Several urodynamic findings could be observed mostly during the voiding phase. We recommend performing urodynamic tests in CMT patients presenting with LUTS seeking for treatment or in those with related complications.

How to write an original article. / Cómo escribir un artículo original.

CONTEXT: A correctly drafted original article gives information on what was done, why it was done, how it was done, the result of what was done, and the significance of what was done. Many articles fail to report their results effectively. OBJECTIVE: To describe the characteristics of an original article and to give practical recommendations to prevent the most common errors in our environment. EVIDENCE ACQUISITION: We performed a systematic search of the terms "how to write a scientific article", "structure of the original article" and "publishing an article" in the databases PubMed and SCOPUS. We analysed the structure of an original article and the characteristics of its parts and prepared advice on the publication of an article. EVIDENCE SYNTHESIS: The journal's guidelines for authors should be read. It is usual for the original article to follow the IMRAD structure: Introduction, Methods, Results and Discussion. The introduction states briefly why the study was performed. The methods' section should give a detailed explanation of how the study was performed. The results should be clearly presented, with the help of tables, without repeating information. The discussion explains the relevance of the results and contrasts them with those of other authors. Any limitations and a conclusion supported by the results must be included. CONCLUSIONS: Writing an original article correctly requires practice and it must be supported by a good research work in order to be published.