scholarly journals Peroneal Electric Transcutaneous NeuroModulation (eTNM®): A Novel Method for the Treatment of the Overactive Bladder

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Jan Krhut ◽  
Lukas Peter ◽  
Michal Rejchrt ◽  
Martin Slovak ◽  
Barbora Skugarevska ◽  
...  
Keyword(s):  
Overactive Bladder ◽  
Low Voltage ◽  
Significant Proportion ◽  
Treatment Method ◽  
Medical Problem ◽  
Home Based ◽  
The Us ◽  
Novel Method ◽  
Technical Specifications ◽  
Noninvasive Neuromodulation

Overactive bladder syndrome (OAB) is a prevalent medical problem with a significant impact on the quality of life of the affected individuals. Pharmacotherapy is considered the main treatment method, although it is discontinued in a significant proportion of patients due to inefficacy or associated side effects. If pharmacotherapy fails, patients can undergo peripheral neuromodulation of the somatic nerves of the lower limb or sacral neuromodulation; however, neither of these represents an ideal therapeutic tool. The Peroneal electric Transcutaneous NeuroModulation (Peroneal eTNM®), based on the selective stimulation of the peroneal nerve, is the new fully noninvasive neuromodulation method intended to treat OAB. The URIS® neuromodulation system, engineered to provide Peroneal eTNM®, consists of the URIS® device, URIS® active electrodes, and the biofeedback foot sensor (BFS). The unique design of the URIS® device and URIS® active electrodes allows for the use of a low voltage and current during neuromodulation, which significantly reduces the unpleasant sensations. The BFS allows for precise localization of the active electrodes and for continuous adjustment of the voltage and frequency to achieve the optimal therapeutic effect. The URIS® system adopts several principles of telemedicine, which makes it compatible with the US Food and Drug Administration (FDA) and European Union (EU) regulations for home-based use. This article describes both the Peroneal eTNM® method and the URIS® neuromodulation system, including its technical specifications and data from laboratory testing. Preclinical and early clinical data demonstrate the feasibility of this new method for noninvasive OAB treatment and possible implications for clinical practice.

Establishing the Content Validity of the Kingʼs Health Questionnaire in Men and Women with Overactive Bladder in the US

2011 ◽  
Vol 4 (3) ◽  
pp. 177-187 ◽  
Author(s):  
Mary Kay Margolis ◽  
Vasudha Vats ◽  
Karin S. Coyne ◽  
Con Kelleher
Keyword(s):  
Overactive Bladder ◽  
Content Validity ◽  
Health Questionnaire ◽  
Men And Women ◽  
The Us

Genital elephantiasis and sexually transmitted infections – revisited

2006 ◽  
Vol 17 (3) ◽  
pp. 157-166 ◽  
Author(s):  
Somesh Gupta ◽  
C Ajith ◽  
Amrinder J Kanwar ◽  
Virendra N Sehgal ◽  
Bhushan Kumar ◽  
...  
Keyword(s):  
Sexually Transmitted Infections ◽  
Causative Agent ◽  
Significant Proportion ◽  
Medical Problem ◽  
Nucleic Acid Amplification ◽  
Sexually Transmitted ◽  
Laboratory Facilities ◽  
Laboratory Investigations ◽  
Polymerase Chain ◽  
The Tropics

Genital elephantiasis is an important medical problem in the tropics. It usually affects young and productive age group, and is associated with physical disability and extreme mental anguish. The majority of cases are due to filariasis; however, a small but significant proportion of patients develop genital elephantiasis due to bacterial sexually transmitted infections (STIs), mainly lymphogranuloma venereum (LGV) and donovanosis. STI-related genital elephantiasis should be differentiated from elephantiasis due to other causes, including filariasis, tuberculosis, haematological malignancies, iatrogenic, or dermatological diseases. Laboratory investigations like microscopy of tissue smear and nucleic acid amplification test for donovanosis, and serology and polymerase chain reaction for LGV may help in the diagnosis, but in endemic areas, in the absence of laboratory facilities, diagnosis largely depends on clinical characteristics. The causative agent of LGV, Chlamydia trachomatis serovar L1–L3, is a lymphotropic organism which leads to the development of thrombolymphangitis and perilymphangitis, and lymphadenitis. Long-standing oedema, fibrosis and lymphogranulomatous infiltration result in the final picture of elephantiasis. Elephantiasis in donovanosis is mainly due to constriction of the lymphatics which are trapped in the chronic granulomatous inflammatory response generated by the causative agent, Calymmatobacterium (Klebsiella) granulomatis. The LGV-associated genital elephantiasis should be treated with a prolonged course of doxycycline given orally, while donovanosis should be treated with azithromycin or trimethoprim-sulphamethoxazole combination given for a minimum of three weeks. Genital elephantiasis is not completely reversible with medical therapy alone and often needs to be reduced surgically.

Validating of a Novel Method for Electronically Recording Overactive Bladder Symptoms in Men

2015 ◽  
Vol 8 (3) ◽  
pp. 177-181 ◽  
Author(s):  
Jan KRHUT ◽  
Marcel GÄRTNER ◽  
Katarína ZVAROVÁ ◽  
Michael DESARNO ◽  
Peter ZVARA
Keyword(s):  
Overactive Bladder ◽  
Overactive Bladder Symptoms ◽  
Bladder Symptoms ◽  
Novel Method

scholarly journals Cost–effectiveness of overactive bladder treatments: from the US payer perspective

2019 ◽  
Vol 8 (1) ◽  
pp. 61-71 ◽  
Author(s):  
Brian Murray ◽  
Sam H Hessami ◽  
Dmitry Gultyaev ◽  
Johanna Lister ◽  
Roger Dmochowski ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Overactive Bladder ◽  
Payer Perspective ◽  
The Us

Patterns of gene flow between Negroes and whites in the US

1976 ◽  
Vol 8 (4) ◽  
pp. 309-333 ◽  
Author(s):  
K. F Dyer
Keyword(s):  
Economic Status ◽  
Significant Proportion ◽  
Relative Magnitude ◽  
Genetic Evidence ◽  
White Female ◽  
Negro Male ◽  
American Colonies ◽  
The Us ◽  
Total Magnitude ◽  
Made In

SummaryA review of the pattern and magnitude of nero–white mating in the US is presented from the time of the earliest arrival of negroes in the American colonies until the present, using historical, demographic, census and genetic evidence.The relative magnitude of negro male–white female matings compared to the converse are analysed in view of the different genetic outcomes of these two types of mating for X-linked genes. Contrary to many strongly stated opinions it is conclued from the historical evidence that, even from the earliest days of slavery, negro male–white female matings were a significant proportion of all negro–white matings. Census and demographic evidence suggests that their frequency increased so that from the time of the Civil War on they have formed a majority of inter-racial matings.Genetic evidence based on estimates of the amout of admixture of white genes in a number of negro populations is considered. Estimates of admixture for the X-linked genes G6PD, and those for colour blindness are as high or higher than those derived from comparable autosomal genes.Some observations on the total magnitude of negro–white mating, on the phenomenon of passing and on the relative socio-economic status of those involved are also made.The implication of the findings on these phenomena for investigations and hypotheses concerning differences in intelligence and intellectual abilites between the races, particulary spatial ability which is thought to be strongly influenced by a gene on the X chromosome, are considered.It is concluded that some of the assumptions made in proposing hypotheses regarding the origin and distribution of these abilities in the American negro are at variance with genetic, historical and sociological findings.

scholarly journals A modification of the Ponseti method for clubfoot management: a prospective comparative study

2021 ◽  
pp. 1-10
Author(s):  
Reda Ali Sheta ◽  
Mohamed El-Sayed ◽  
Hisham Abdel-Ghani ◽  
Sameh Saber ◽  
Amani Salah Eldin Mohammed ◽  
...  
Keyword(s):  
Treatment Method ◽  
Ponseti Method ◽  
Level Of Evidence ◽  
Home Based ◽  
Multicentre Cohort Study ◽  
Group A ◽  
Prospective Comparative Study ◽  
Group B ◽  
Multicentre Cohort

Purpose We aimed to compare our parent-based exercise programem’s efficacy with the foot abduction brace (FAB) Ponseti manipulation as a retention programme. Methods We conducted this prospective multicentre cohort study between August 2009 and November 2019. The included children were allocated into one of two groups according to the retention protocol. The Pirani and Laaveg-Ponseti scores were used to assess the feet clinically and functionally. Radiological assessment was performed using standing anteroposterior and lateral radiographs of the feet. We assessed the parents’ satisfaction and adherence to the retention method. SPSS version 25 was used for the statistical analysis. Results A total of 1265 feet in 973 children were included. Group A included 637 feet managed with FAB, while group B included 628 feet managed with our retention programme. All patients were followed up to the age of four years. At the final follow-up, Pirani scores in group A participants were excellent, good and poor in 515, 90, and 32 feet, respectivel, while in group B the scores were excellent, good and poor in 471, 110 and 44 feet, respectively. The mean total score of Laaveg-Ponseti was 87.81 (sd 19.82) in group A and 90.55 (sd 20.71) in group B (p = 0.02). Group B participants showed higher satisfaction with the treatment method (p = 0.011) and more adherence to the treatment (p = 0.013). Conclusion The deformity’s recurrence related to the brace’s non-compliance in the Ponseti method might be reduced by substituting the brace with our home-based daily stretching exercises. Level of Evidence II

scholarly journals MO273A NOVEL APPROACH TO ASSESS THE DEMOGRAPHIC AND CLINICAL CHARACTERISTICS OF IMMUNOGLOBULIN A NEPHROPATHY (IGAN) PATIENTS IN A US REAL-WORLD SETTING

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Raymond Przybysz ◽  
Rina Mehta ◽  
Gisela Rovira Tomas ◽  
Carolina Aldworth ◽  
Jim Doherty ◽  
...  
Keyword(s):  
Kidney Function ◽  
Clinical Characteristics ◽  
Index Date ◽  
Immunoglobulin A ◽  
Significant Proportion ◽  
Immunoglobulin A Nephropathy ◽  
Targeted Interventions ◽  
The Us ◽  
The Mean ◽  
Severe Deterioration

Abstract Background and Aims Immunoglobulin A nephropathy (IgAN) is a chronic glomerular disease that affects approximately 100,000-200,000 people in the US. Approximately 15-40% of IgAN patients will eventually progress to end stage kidney disease (ESKD) within 10-20 years of diagnosis, and there is currently no targeted therapy for this disease. Decreased kidney function, persistent proteinuria and hypertension are some of the clinical manifestations of IgAN, and with demographic aspects (e.g. ethnicity) are considered as predictors of disease progression. The aim of this study is to better understand the demographic and clinical characteristics of IgAN patients in the US identified via physician notes. Method This is a descriptive, retrospective study of adult (≥ 18 years) IgAN patients in Optum® Electronic Health Records (EHRs), between January 2007 and December 2019. Optum® EHRs contain de-identified clinical and medical administrative data from 96 million people in 50 states that come from more than 140,000 providers at 740 hospitals and over 7,000 clinics. Identification of IgAN patients is challenging because there are no specific ICD codes for this disease so we used natural language processing of physician notes and chose patients with at least two IgAN records with the first one considered to be the index date, and no negative mention, as well as a biopsy procedure. Here, we present the baseline demographic and clinical characteristics of the identified patients up to 12 months before and at the index date. Results A total of 1803 patients with a biopsy record (22% of all patients with at least two IgAN records in their EHRs in our study) were included in this analysis; results are presented in Table 1. The mean age was 48 years, and the majority of patients were male (60.9%) and white (75.7%). Proteinuria levels of ≥1 g/day were found in 34% of patients. The mean eGFR was 45 ml/min/1.73m2 and 21.6% of patients had severe deterioration of kidney function (eGFR <15). The mean creatinine level was 3 mg/dL. Pain, edema and fatigue/tiredness were reported in 39.6%, 18.1% and 13.4% of patients, respectively. Hypertension was reported in 73% of patients. Based on the ICD 9 (585.6) and ICD-10 (N18.6) codes for diagnosis, 17.5% of patients had ESKD in our study. Conclusion In our cohort, a significant proportion of patients were found to have high proteinuria levels and severe deterioration of kidney function or ESKD. Moreover, edema and fatigue were recorded for a noticeable proportion of patients. In addition to the commonly reported symptoms, our study also found that pain was reported in a high proportion of patients. These findings highlight the clinical and symptom burden to patients with IgAN, suggesting that future targeted interventions are needed to reduce the burden and delay the progression of this disease.

Abstract 134: Implementation of Home-Based Cardiac Rehabilitation in the VA

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
David W Schopfer ◽  
Nirupama Krishnamurthi ◽  
Hui Shen ◽  
Mary A Whooley
Keyword(s):  
Cardiac Rehabilitation ◽  
Artery Bypass ◽  
Coronary Intervention ◽  
The United States ◽  
Medical Centers ◽  
The United Kingdom ◽  
Home Based ◽  
Percutaneous Coronary ◽  
The Us ◽  
Va Hospitals

Objective: Referral to cardiac rehabilitation (CR) is one of nine performance measures for patients with ischemic heart disease (IHD), but fewer than 20% of eligible patients participate in the United States. Home-based CR programs (available in the United Kingdom, Australia, and Canada) have similar effects on morbidity and mortality as traditional (facility-based) CR, but they are not currently available or reimbursed in the US. We sought to determine whether implementing home-based programs could increase CR participation among patients with IHD. Methods: Using electronic health records from 134 VA medical centers, we identified 106,277 veterans hospitalized for acute myocardial infarction, percutaneous coronary intervention or coronary artery bypass grafting between 2010 and 2015. We compared the proportion of eligible patients who participated in CR at 13 VA hospitals that offered referral to either home-based CR or facility-based CR vs. 121 VA hospitals that offered referral to only facility-based CR (usual care). Results: The number of VA medical centers offering home-based CR increased from 2 in 2010 to 13 in 2015. Among the 20,949 eligible patients hospitalized at VA medical centers that implemented home-based CR between 2010 and 2015, CR participation increased from 11% to 26% (Figure). Among the 85,328 eligible patients hospitalized at VA medical centers that did not offer home-based CR, CR participation increased from only 8% to 11%. Conclusion: Among eligible patients with IHD, participation in CR more than doubled at VA medical centers that implemented home-based CR programs between 2010 and 2015, whereas participation increased by only 3% at VA medical centers that did not implement home-based CR programs. Home-based CR is an effective way of engaging patients who may otherwise decline to participate in CR.

Sign in / Sign up

Export Citation Format

Share Document