Overactive bladder

Urinary incontinence is a problem among both older and young women. The most common symptoms of this condition include urinary incontinence and an unpleasant odour. In order to conceal the ailments related to this problem, women change their lifestyle by limiting the amount of fluid consumed and not moving too far from home or places where toilets are located. The main source of information on this disease in women aged over 45 is books, magazines and websites. Medical personnel are only ranked behind them. In order to make a correct diagnosis of this disease and to start treatment, urodynamic examination, urinalysis, cystoscopy and imaging examinations should be performed. Urodynamic examination can be divided into two groups: invasive and non-invasive. The micturition diary is considered to be the basic urodynamic test. It allows for performing differential diagnosis of functional micturition disorders. It is characterized by high repeatability and correlation with clinical symptoms. Treatment options are dependent on the type of urinary incontinence. They may include conservative treatment, surgery and pharmacotherapy. Combining conservative methods with pharmacological or surgical methods brings the most beneficial results. Invasive methods are the last-line therapy.

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Maturity Onset Diabetes of the Young—New Approaches for Disease Modelling

International Journal of Molecular Sciences ◽

10.3390/ijms22147553 ◽

2021 ◽

Vol 22 (14) ◽

pp. 7553

Author(s):

Dawid Skoczek ◽

Józef Dulak ◽

Neli Kachamakova-Trojanowska

Keyword(s):

Clinical Symptoms ◽

Treatment Options ◽

Correct Diagnosis ◽

Vascular Complications ◽

Disease Modelling ◽

Endocrine Disorders ◽

Maturity Onset Diabetes ◽

Cell Dysfunction ◽

Onset Diabetes

Maturity-onset diabetes of the young (MODY) is a genetically heterogeneous group of monogenic endocrine disorders that is characterised by autosomal dominant inheritance and pancreatic β-cell dysfunction. These patients are commonly misdiagnosed with type 1 or type 2 diabetes, as the clinical symptoms largely overlap. Even though several biomarkers have been tested none of which could be used as single clinical discriminator. The correct diagnosis for individuals with MODY is of utmost importance, as the applied treatment depends on the gene mutation or is subtype-specific. Moreover, in patients with HNF1A-MODY, additional clinical monitoring can be included due to the high incidence of vascular complications observed in these patients. Finally, stratification of MODY patients will enable better and newer treatment options for MODY patients, once the disease pathology for each patient group is better understood. In the current review the clinical characteristics and the known disease-related abnormalities of the most common MODY subtypes are discussed, together with the up-to-date applied diagnostic criteria and treatment options. Additionally, the usage of pluripotent stem cells together with CRISPR/Cas9 gene editing for disease modelling with the possibility to reveal new pathophysiological mechanisms in MODY is discussed.

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Indications and outcomes of enterovesical and colovesical fistulas: systematic review of the literature and meta-analysis of prevalence

BMC Surgery ◽

10.1186/s12893-021-01272-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Stefano Granieri ◽

Francesco Sessa ◽

Alessandro Bonomi ◽

Sissi Paleino ◽

Federica Bruno ◽

...

Keyword(s):

Systematic Review ◽

Clinical Symptoms ◽

Rare Complication ◽

Meta Analysis ◽

Treatment Options ◽

Palliative Surgery ◽

Review Of The Literature ◽

Colovesical Fistula ◽

Level Of Evidence ◽

Meta Analyses

Abstract Background Entero-colovesical fistula is a rare complication of various benign and malignant diseases. The diagnosis is prominently based on clinical symptoms; imaging studies are necessary not only to confirm the presence of the fistula, but more importantly to demonstrate the extent and the nature of the fistula. There is still a lack of consensus regarding the if, when and how to repair the fistula. The aim of the study is to review the different surgical treatment options, focus on surgical indications, and explore cumulative recurrence, morbidity, and mortality rates of entero-vesical and colo-vesical fistula patients. Methods A systematic review of the literature was conducted according to PRISMA guidelines. Random effects meta-analyses of proportions were developed to assess primary and secondary endpoints. I2 statistic and Cochran’s Q test were computed to assess inter-studies’ heterogeneity. Results Twenty-two studies were included in the analysis with a total of 861 patients. Meta-analyses of proportions pointed out 5, 22.2, and 4.9% rates for recurrence, complications, and mortality respectively. A single-stage procedure was performed in 75.5% of the cases, whereas a multi-stage operation in 15.5% of patients. Palliative surgery was performed in 6.2% of the cases. In 2.3% of the cases, the surgical procedure was not specified. Simple and advanced repair of the bladder was performed in 84.3% and 15.6% of the cases respectively. Conclusions Although burdened by a non-negligible rate of complications, surgical repair of entero-colovesical fistula leads to excellent results in terms of primary healing. Our review offers opportunities for significant further research in this field. Level of Evidence Level III according to ELIS (SR/MA with up to two negative criteria).

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Non-Invasive Dengue Diagnostics—The Use of Saliva and Urine for Different Stages of the Illness

Diagnostics ◽

10.3390/diagnostics11081345 ◽

2021 ◽

Vol 11 (8) ◽

pp. 1345

Author(s):

Mahathir Humaidi ◽

Wei Ping Tien ◽

Grace Yap ◽

Choon Rong Chua ◽

Lee Ching Ng

Keyword(s):

Clinical Symptoms ◽

Detection Algorithm ◽

Acute Stage ◽

Serum Samples ◽

Non Invasive ◽

Fever Onset ◽

Dengue Transmission ◽

Dengue Diagnostics ◽

Potential Tool

Dengue diagnosis is largely dependent on clinical symptoms and routinely confirmed with laboratory detection of dengue virus in patient serum samples collected via phlebotomy. This presents a challenge to patients not amenable to venipuncture. Non-invasive methods of dengue diagnosis have the potential to enhance the current dengue detection algorithm. In this study, samples from dengue infected patients were collected between January 2012 until September 2012 and September 2013 until December 2013 in two different setups. Panel A samples (blood, urine, and saliva) were collected daily when the 39 patients were hospitalised and during their follow-up visits while Panel B samples (saliva) were collected from 23 patients during the acute stage of dengue. Using DENV PCR on Panel A, from day 2 to day 4 post fever onset, serum showed the best overall positivity followed by saliva and urine (100%/82.1%/67.9%). From day 5 until day 10 post fever onset, serum and urine had similar positivity (67.4%/61.2%), followed by saliva (51.3%). Beyond day 10 post fever onset, DENV was undetectable in sera, but urine and saliva showed 56.8% and 28.6% positivity, respectively. DENV in urine was detectable up until 32 days post fever. Panel B results showed overall sensitivity of 32.4%/36% (RNA/NS1) for DENV detection in saliva. Our results suggest that the urine-based detection method is useful especially for late dengue detection, where DENV is undetected in sera but still detectable in urine. This provides a potential tool for the physician to pick up new cases in an area where there is ongoing dengue transmission and subsequently prompt for intensified vector control activities.

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Circulating miRNAs Related to Epithelial–Mesenchymal Transitions (EMT) as the New Molecular Markers in Endometriosis

Current Issues in Molecular Biology ◽

10.3390/cimb43020064 ◽

2021 ◽

Vol 43 (2) ◽

pp. 900-916

Author(s):

Anna Zubrzycka ◽

Monika Migdalska-Sęk ◽

Sławomir Jędrzejczyk ◽

Ewa Brzeziańska-Lasota

Keyword(s):

Molecular Mechanisms ◽

Immune Cell ◽

Epithelial Mesenchymal Transition ◽

Clinical Symptoms ◽

Diagnostic Tools ◽

Endometrial Stromal Cells ◽

Disease Etiology ◽

Diagnostic Biomarkers ◽

Mesenchymal Transition ◽

Non Invasive

Endometriosis is a chronic gynecological disease defined by the presence of endometrial-like tissue found outside the uterus, most commonly in the peritoneal cavity. Endometriosis lesions are heterogenous but usually contain endometrial stromal cells and epithelial glands, immune cell infiltrates and are vascularized and innervated by nerves. The complex etiopathogenesis and heterogenity of the clinical symptoms, as well as the lack of a specific non-invasive diagnostic biomarkers, underline the need for more advanced diagnostic tools. Unfortunately, the contribution of environmental, hormonal and immunological factors in the disease etiology is insufficient, and the contribution of genetic/epigenetic factors is still fragmentary. Therefore, there is a need for more focused study on the molecular mechanisms of endometriosis and non-invasive diagnostic monitoring systems. MicroRNAs (miRNAs) demonstrate high stability and tissue specificity and play a significant role in modulating a range of molecular pathways, and hence may be suitable diagnostic biomarkers for the origin and development of endometriosis. Of these, the most frequently studied are those related to endometriosis, including those involved in epithelial–mesenchymal transition (EMT), whose expression is altered in plasma or endometriotic lesion biopsies; however, the results are ambiguous. Specific miRNAs expressed in endometriosis may serve as diagnostics markers with prognostic value, and they have been proposed as molecular targets for treatment. The aim of this review is to present selected miRNAs associated with EMT known to have experimentally confirmed significance, and discuss their utility as biomarkers in endometriosis.

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Predictors of mortality in patients with hereditary hemorrhagic telangiectasia

Orphanet Journal of Rare Diseases ◽

10.1186/s13023-020-01579-2 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

K. P. Thompson ◽

◽

J. Nelson ◽

H. Kim ◽

L. Pawlikowska ◽

...

Keyword(s):

Hereditary Hemorrhagic Telangiectasia ◽

Cox Regression ◽

Clinical Symptoms ◽

Vascular Malformations ◽

Smoking Status ◽

Treatment Options ◽

Gi Bleeding ◽

Cox Regression Analysis ◽

Predictors Of Mortality

Abstract Background Retrospective questionnaire and healthcare administrative data suggest reduced life expectancy in untreated hereditary hemorrhagic telangiectasia (HHT). Prospective data suggests similar mortality, to the general population, in Denmark’s centre-treated HHT patients. However, clinical phenotypes vary widely in HHT, likely affecting mortality. We aimed to measure predictors of mortality among centre-treated HHT patients. HHT patients were recruited at 14 HHT centres of the Brain Vascular Malformation Consortium (BVMC) since 2010 and followed annually. Vital status, organ vascular malformations (VMs) and clinical symptoms data were collected at baseline and during follow-up (N = 1286). We tested whether organ VMs, HHT symptoms and HHT genes were associated with increased mortality using Cox regression analysis, adjusting for patient age, sex, and smoking status. Results 59 deaths occurred over average follow-up time of 3.4 years (max 8.6 years). A history of anemia was associated with increased mortality (HR = 2.93, 95% CI 1.37–6.26, p = 0.006), as were gastro-intestinal (GI) bleeding (HR = 2.63, 95% CI 1.46–4.74, p = 0.001), and symptomatic liver VMs (HR = 2.10, 95% CI 1.15–3.84, p = 0.015). Brain VMs and pulmonary arteriovenous malformations (AVMs) were not associated with mortality (p > 0.05). Patients with SMAD4 mutation had significantly higher mortality (HR = 18.36, 95% CI 5.60–60.20, p < 0.001) compared to patients with ACVRL1 or ENG mutation, but this estimate is imprecise given the rarity of SMAD4 patients (n = 33, 4 deaths). Conclusions Chronic GI bleeding, anemia and symptomatic liver VMs are associated with increased mortality in HHT patients, independent of age, and in keeping with the limited treatment options for these aspects of HHT. Conversely, mortality does not appear to be associated with pulmonary AVMs or brain VMs, for which patients are routinely screened and treated preventatively at HHT Centres. This demonstrates the need for development of new therapies to treat chronic anemia, GI bleeding, and symptomatic liver VMs in order to reduce mortality among HHT patients.

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Comparative assessment of the efficiency of surgical methods of recurrent urinary incontinence

European Urology Supplements ◽

10.1016/s1569-9056(17)30910-7 ◽

2017 ◽

Vol 16 (3) ◽

pp. e1494

Author(s):

G.R. Kasyan ◽

R.V. Stroganov ◽

N.V. Tupikina ◽

M.Y. Gvozdev ◽

D.Y. Pushkar

Keyword(s):

Urinary Incontinence ◽

Comparative Assessment ◽

Surgical Methods

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Venus occlusion in the upper limbs in patients with CIDS

In a good rythm ◽

10.5604/01.3001.0011.6495 ◽

2018 ◽

Vol 1 (46) ◽

pp. 24-27

Author(s):

Anna Jędrzejczak ◽

Przemysław Mitkowski

Keyword(s):

Left Atrial ◽

Clinical Symptoms ◽

Treatment Options ◽

Electronic Devices ◽

Left Ventricular ◽

Venous Anatomy ◽

Device Implantation ◽

Vein Occlusion ◽

Venous Stenosis ◽

Vein Stenosis

Benefits of treatment with cardiological implantable electronic devices have been confirmed in numerous studies. Similarly to other treatment options this therapy is not free from complications. Among them venous stenoses and occlusions are observed. Its presence is related to impaired blood flow in the vessel as an effect of lead presence, endothelial malfunction and procoagulation. Despite vein occlusion is present in 9-11% of patients after device implantation and vein stenosis which is grater then 70% of diameter in 17-38% or even in some groups up to 50%, clinical symptoms are reported only in 1-3% of patients. What is interesting in 13,7% of individuals before implantation venous stenosis over 60% is present and occlusion in 4,4% patients. Significant venous stenosis is more frequently observed on the left side. Among risk factors responsible for stenosis one can find: numer of leads, total diameter of all leads, usage of anticoagulation and antiplatelet drugs, decreased ejection fraction, increased left ventricular end diastolic diameter, left atrial diameter, higher concentration of procoagulation and inflammatory markers. Presence of significant venous stenosis is important mainly before of up-grade procedures or lead replacement and knowledge about venous anatomy allows better planning of the subsequent procedure.

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“ADMINISTRATION OF PLATELET RICH PLASMA- A SHIFT IN ACCELERATED ORTHODONTICS– A REVIEW “

10.36106/2404489 ◽

2021 ◽

pp. 44-45

Author(s):

Saraa Angel .L ◽

Abhijeet Jaiswal

Keyword(s):

Human Population ◽

Orthodontic Treatment ◽

Tooth Movement ◽

Treatment Time ◽

Platelet Rich Plasma ◽

Invasive Procedures ◽

Non Invasive ◽

Surgical Methods ◽

Accelerated Orthodontics ◽

Economical Alternative

Increasing awareness towards self-appearance and aesthetics has led to increase in overall patients willing to undergo orthodontic treatment. Various surgical and non surgical methods have been tried to reduce the overall orthodontic treatment time. Painless, non invasive procedures are preferred over the traumatic methods. Platelet Rich Plasma (PRP) injection has recently gained popularity due to its safe , relatively painless and economical alternative in accelerating the tooth movement. This article briefs on the researches done in animal and human population so far using PRPand their cumulative effects on tooth movement.

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The most useful and commonly available acute rejection surveillance strategies are routine monitoring of myocardial function and donor-specific anti-HLA Abs monitoring

10.31219/osf.io/ebw68 ◽

2021 ◽

Author(s):

Moataz Dowaidar

Keyword(s):

Acute Rejection ◽

Cell Function ◽

Clinical Symptoms ◽

Contractile Function ◽

Therapy Monitoring ◽

Genomic Medicine ◽

Non Invasive ◽

Monitoring Tools ◽

Immune Mediated ◽

Routine Monitoring

Given the complexity of acute rejection (AR) pathogenesis and its vast spectrum of clinical symptoms, no methodology (invasive or non-invasive) can provide all the information needed to identify functionally and prognostically relevant AR, treatment selection, and therapy monitoring early. Only the use of EMBs in combination with non-invasive technologies and methods to detect subclinical changes in myocardial contractile function (e.g., TDI and STE), to detect alloimmune activation (e.g., IM assay, assessment of complement-activating donor-specific anti-HLA Abs (DSAbs), screening of circulating cfdDNA), and to predict the imminent risk of immune-mediated injury (e.g., assessment of complement-activating DSAbs).Searching for both ACR and AMR in all EMBs is a key prerequisite for accurate diagnosis and decision-making in individuals suspected of AR. Close non-invasive allograft surveillance to detect patients at high risk of AR, along with properly planned EMBs (depending on the particular risk profile of the patient), can improve AR surveillance while decreasing rsEMBs. Because rsEMBs are less prevalent after the first post-HTx year and largely symptom-driven diagnostic EMBs, ongoing development of comprehensive, non-invasive technology to monitor both ACR and AMR is of significant importance. This is especially helpful for detecting late subclinical AMR, which would otherwise go unreported.The most useful and commonly available AR surveillance strategies are routine monitoring of myocardial functions utilizing sensitive ECHO techniques (TDI and STE for acute subclinical dysfunction diagnosis) and DSAb monitoring. As a result, early and late use of HTx is strongly suggested. New IM technologies such as T-cell function assays and genomic medicine approaches such as GEP, circulating dd-cfdDNA screening and microRNA assessment are promising non-invasive monitoring tools for future clinical use, but it is still necessary to test the practical value of their individual or combined use for AR detection (including both ACR and AMR), not just for ACR.

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CBCT in orthodontics: a systematic review on justification of CBCT in a paediatric population prior to orthodontic treatment

European Journal of Orthodontics ◽

10.1093/ejo/cjy066 ◽

2018 ◽

Vol 41 (4) ◽

pp. 381-389 ◽

Cited By ~ 11

Author(s):

Annelore De Grauwe ◽

Irem Ayaz ◽

Sohaib Shujaat ◽

Simon Dimitrov ◽

Logan Gbadegbegnon ◽

...

Keyword(s):

Computed Tomography ◽

Systematic Review ◽

Orthodontic Treatment ◽

Cleft Lip ◽

Treatment Options ◽

Correct Diagnosis ◽

Conventional Radiography ◽

Paediatric Population ◽

Treatment Optimization ◽

Diagnostic Efficacy

Summary Background Taking into account radiation doses, safety, and protection, we highlighted the features in which cone-beam computed tomography (CBCT) can offer an advantage compared to the conventional two-dimensional imaging in paediatric dentistry before orthodontic treatment. Objective The aim of this article was to conduct a systematic review to assess the diagnostic efficacy of CBCT in the paediatric population at a pre-orthodontic phase. Search methods MEDLINE via PubMed was searched to identify all peer-reviewed articles potentially relevant to the review until 1 July 2018. Relevant publications were selected by two reviewers independently. Selection criteria The literature selection for this systematic review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and was based on predetermined inclusion criteria. Data collection and analysis Data were collected on overall study characteristics and examination characteristics of the selected studies. Methodological quality of the selected studies was evaluated. Original studies were assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. Thereafter, levels of evidence were obtained according to Grading of Recommendations Assessment, Development and Evaluation criteria. Results As a result of the QUADAS assessment, a total of 37 articles were included in the protocol. Following a proper protocol, CBCT was regarded as a reliable tool for assessment and management of impacted canine and root fracture. It provided a better evaluation of normal and pathological condylar shape and volume. CBCT was a superior choice for pre-surgical diagnostic applications in cleft lip and/or palate over a medical computed tomography based on its lower radiation exposure, shorter investigation time, and low purchase costs. Conclusions CBCT is justified only in those cases where conventional radiography fails to provide a correct diagnosis of pathology. Therefore, it cannot be regarded as a standard method of diagnosis. CBCT imaging may also be justified when it positively affects treatment options or provides treatment optimization. Registration None. Conflict of interest None to declare.

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