scholarly journals The possibilities of diagnosis and treatment of urogenital schistosomatosis in current conditions

2018 ◽  
Vol 6 (3) ◽  
pp. 5-11
Author(s):  
F. R. Asfandiyarov ◽  
V. Yu. Startsev ◽  
A. Yu. Kolmakov
Keyword(s):  
Bladder Cancer ◽  
Bladder Wall ◽  
Diagnosis And Treatment ◽  
Parasitic Infections ◽  
Wall Thickening ◽  
Oral Antibiotic ◽  
Outpatient Basis ◽  
Urogenital Schistosomiasis ◽  
Group I ◽  
Group Ii

Introduction.Globalization contributes to the increase in cases of “exotic” bacterial and parasitic infections importation from the countries of the tropical belt to the territory of our country and to European states.Purpose of research. Study and analysis of data on the methods of diagnosis and treatment of urogenital schistosomiasis at the present stageMaterials and methods. The study includes an analysis of the examination and treatment results of 181 patients with urogenital schistosomiasis (US) living in the province of Benguela, Republic of Angola. In 39 (21,5%) cases are revealed schistosomal bladder cancer. All patients with schistosomal bladder cancer (SBC) were operated. 142 patients (78.5%) were divided into two groups. Group I (n = 74) consisted of patients with uncomplicated MS, into group II (n = 68) patients had granulomatous proliferative inflammatory changes in the bladder.Results.Patients with US (n = 142) were examined on an outpatient basis. Cytological exmination of urine sediment (CEUS) showed that eggs of schistosomes were detected in 38 (26.8%) patients. Ultrasound showed specific granulomatous changes in the mucous membrane of the urinary bladder in 28 (19.7%) patients. In 7 (4.9%) cases it showed hydronephrosis, calcification. Bladder wall thickening were detected in 10 (7%) and 99 (69.7%) cases, respectively. Endoscopic examination showed the presence of granulomatous changes in the bladder in 68 (47.9%) patients. Patients of group I (n = 74) received «Praziquantel» in combination with oral antibiotic therapy, which resulted in the relief of macrohematuria and urination disorders. All patients of group II (n = 68) also underwent antibacterial and antiprotozoal therapy. In addition, 35 (24.6%) patients underwent transurethral resection of the bladder (TURB). The results of control observations showed the restoration of bladder mucous layer. Of the 33 (23.2%) patients in Group II who received only antibacterial and antiprotozoal therapy, granulomatous changes persisted in 7 (4.9%) patients. In connection with this, TURB was performed for these patients. Subsequent control studies showed regression of the formations in this group of patientsConclusions.CEUS and ultrasound are not sufficient for diagnosis of US. Cystoscopy is suitable for all patients with MS. It allows to estimate the volume of the bladder lesion, and to determine the indications for performing TURP in addition to the use of antiparasitic and antibacterial therapy.

CLINICAL SYMPTOMS, ULTRASOUND AND HISTOPATHOLOGY OF TUMORLIKE LESIONS OF THE BLADDER.

2017 ◽  
pp. 41-46
Author(s):  
Van Mao Nguyen ◽  
Thi Bich Chi Nguyen
Keyword(s):  
Bladder Cancer ◽  
Bladder Tumor ◽  
Clinical Symptoms ◽  
Bladder Wall ◽  
Lower Abdominal Pain ◽  
University Hospital ◽  
Wall Thickening ◽  
Health Examination ◽  
Ultrasound Images ◽  
Key Words Bladder Cancer

Background: Bladder cancer is one of the most frequent type of urinary cancer which has been ever increasing. For the better treatment, the early discovery and definite diagnosis of this disease played an important role. Objective: To describe some clinical symptoms and ultrasound features of tumorlike lesions of the bladder. To diagnose and classify the histopathology of tumorlike lesions of the bladder. Materials, method: cross - sectional study on 64 cases in Hue University Hospital and Hue central hospital from April, 2016 to February, 2017. Results: Hematuria was the most common reason that patients went to hospital (79.7%). Lower abdominal pain and irritation during urination accounting for 9.4% and 6.2% respectively. Only 3 patients with bladder cancer were accidentally discovered through periodic health examination (4.7%). The characteristics of hematuria in bladder tumor was flesh red urine (62.5%) and total hematuria (60.7%). With ultrasonography, the results of 64 patients were divided in 3 groups as follow: bladder tumor, which was the highest rate 87.5%, bladder polyp was 3.1% and focal bladder wall thickening was 9.4%. Of which, the vast majority of these ultrasound images was tumor - like lesions protruding in the lumen of the bladder (75%), the rest was wall thickening lesions (25%). Tumors were different in size, the biggest tumor was 7cm in diameter and the smallest was 0.6cm. Those with the diameter 3cm or bigger accounting for 42.2%, the smaller was 57.8%. Most cases have only one lesion (62.5%) and at lateral wall (46.6%). Histopathologically, cancer was 59/64 case (92.2%): urothelial carcinoma was 98.3 %, squamous cell carcinomawas 1.7% and 5 cases (7.8%) were benign. Most cancerous cases were poorly differentiated, grade II (50.9%) and grade III (32.2%). The stage T1NxMx was 20.3% and worse than T2MxNx was 79.7%. Conclusion: hematuria was the most popular symptom, suggesting bladder cancer. Clinical diagnosing bladder cancer was not high sensitive (61.01%). Ultrasound could detect bladder tumor with high sensitive (89.8%). These patients also needed histopathology classification to diagnose and finally choose the best method for the appropriate treatment. Key words: bladder cancer, histopathology, ultrasound, uroepithelial carcinoma, hematuria

RECURRENCE RATE AFTER REPEAT TRANSURETHRAL RESECTION AMONG PATIENTS WITH NEWLY DIAGNOSED T1 BLADDER CANCER

2021 ◽  
pp. 51-54
Author(s):  
Md. Shafiqur Rahman ◽  
Sanjeeb Bhakta Bista ◽  
Md. Sayedul Islam ◽  
A. S. M. Shafiul Azam ◽  
Md. Shamim Hossain ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Recurrence Rate ◽  
Transurethral Resection ◽  
Tumor Recurrence ◽  
Controlled Trial ◽  
Intravesical Therapy ◽  
Newly Diagnosed ◽  
Group I ◽  
Group Ii

Background: Transurethral resection of the bladder tumor (TURBT) is the cornerstone of diagnosis and TURBT followed by selective adjuvant intravesical chemotherapy or immunotherapy is the gold standard of treatment for the patients with non-muscle invasive bladder cancer (NMIBC). Even after complete resection of the tumor there is high risk of residual tumor and subsequent recurrence and progression of the disease. The recurrence of T1 tumor is found to be around 71 % within 5 years and High grade T1 lesions recur in more than 80% of the cases and progress in 50% of the patients within 3 years. Disease status at 3 months after initial resection is an important predictor of subsequent recurrence and progression. To assess the tumor recurrence rat Objective: e among patients with newly diagnosed T1 bladder cancer between repeat transurethral resection group and single TURBT group. Ra Type of study: ndomized controlled trial. Place of study: Department of urology, BSMMU, Dhaka, Bangladesh. This Randomi Materials And Methods: zed Controlled Trial was conducted in urology department of BSMMU, Dhaka, Bangladesh from February 2017 till September 2018. A total of 50 patients, diagnosed as a case of T1 bladder cancer and who fulll the selection criteria were randomly divided in two groups consisting of 25 patients in each group. After informed consent, repeat TUR was done after 4 weeks of the initial TURBT for only 22 patients in group I since 3 of the patients did not show up on the scheduled date of surgery. Whereas, repeat TUR was not done for other 25 patients in group II. All the patients in both the groups were further treated with intravesical therapy according to the histopathological report. The patients in both the groups were followed up at 3 months and 6 months of the initial intervention where detailed history was taken, relevant investigations were done and check cystoscopy was done. TURBT was done for recurrent tumors. Out of 22 patients in group I, 2 patients were excluded for follow up on the basis of repeat TUR ndings. Whereas in group II, 2 patients missed the follow up and one of them missed the normal scheduled dose of intravesical therapy. Hence, 22 patients completed the study in group II. The baseline variables like age and Results: sex were similar in both the groups with higher male predominance. There was no statistical signicant difference in tumor characteristics such as size, number and grade of the tumor between the two groups. Out of 22 patients in group I who underwent repeat TUR at 4 weeks of initial TUR, residual disease was found in 8 (36.36%) patients. One of the patient was found to have T2 disease and 1 patient had CIS during repeat TUR. These 2 patients were not followed up since the treatment strategy changed after the results of repeat TUR. After 6 months of follow up of all the patients, 2 (10%) out of 20 patients in group I were found to have tumor recurrence however, in group II, 9 (40.9%) patients had tumor recurrence. The tumor recurrence rate between the two groups was found to be statistically signicant (p=0.023). In the light of ndings of this Conclusion: study, it can be concluded that performing repeat transurethral resection in patients with newly diagnosed T1 bladder cancer at 4 weeks of initial TURBT, helps to detect signicant number of residual tumor and reduce early recurrence rate of the tumor.

scholarly journals Effectivity of intravescical thermo-chemotherapy prophylaxis for patients with high recurrence and progression risk for non-muscle invasive bladder cancer

2017 ◽  
Vol 89 (2) ◽  
pp. 102 ◽  
Author(s):  
Ali Serdar Gözen ◽  
Paolo Umari ◽  
Walter Scheitlin ◽  
Fuat Ernis Su ◽  
Yigit Akin ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
High Risk ◽  
Recurrent Disease ◽  
Bladder Wall ◽  
Invasive Bladder Cancer ◽  
Outpatient Basis ◽  
High Grade ◽  
Muscle Invasive Bladder Cancer ◽  
Muscle Invasive

Background&Aim: High grade non-muscle invasive bladder cancer (NMIBC) is common in urological practice. Most of these cancers are or become refractory to intravesical immunotherapy and chemotherapy. Here we evaluated the efficacy of combined local bladder hyperthermia and intravesical mitomycin-C (MMC) instillation in patients with high-risk recurrent NMIBC. Materials and methods: Between February 2014 and December 2015, 18 patients with high risk NMIBC were enrolled. Patients were treated in an outpatient basis with 6 weekly induction sessions followed by monthly maintenance sessions with intravesical MMC in local hyperthermia with bladder wall thermo-chemotherapy (BWT) system (PelvixTT system, Elmedical Ltd., Hod Hasharon, Israel). The follow-up regimen included cystoscopy after the induction cycle and thereafter with regular intervals. Time to disease recurrence was defined as time from the first intravesical treatment to endoscopic or histological documentation of a new bladder tumour. Adverse events were recorded according to CTC 4.0 (Common Toxicity Criteria) score system. Results: Mean age was 72 (32-87) years. 10 patients had multifocal disease, 9 had CIS, 6 had recurrent disease and 2 had highly recurrent disease (> 3 recurrences in a 24 months period). 6 patients underwent previous intravesical chemotherapy with MMC. The average number of maintenance sessions per patient was 7.6. After a mean follow-up of 433 days, 15 patients (83.3%) were recurrence-free. 3 patients had tumour recurrence after a mean period of 248 days without progression. Side effects were limited to grade 1 in 2 patients and grade 2 in 1 patient. Conclusions: BWT seems to be feasible and safe in high grade NMIBC. More studies are needed to identify the subgroup of patients who may benefit more from this treatment.

Pre-Clinical Evaluation of a Novel, Pneumatic, Ventricular Assist Device (Medos® HIA-VAD®) under Pathophysiological Conditions

1997 ◽  
Vol 20 (7) ◽  
pp. 389-396 ◽  
Author(s):  
F.R. Waldenberger ◽  
B. Meyns ◽  
H. Reul ◽  
R. Eilers ◽  
W. Flameng
Keyword(s):  
Coronary Artery ◽  
Myocardial Dysfunction ◽  
Left Ventricular ◽  
Assisted Circulation ◽  
Wall Thickening ◽  
Base Line ◽  
Assist Device ◽  
Circumflex Artery ◽  
Group I ◽  
Group Ii

To evaluate a new cardiac assist system, the Medos® HIA-VAD®, we studied the effects of mechanical unloading on regional and global myocardial dysfunction. As a model for the regional temporary contractile dysfunction we chose an anesthetized, open chest preparation in sheep. We occluded the diagonal coronary artery for 15 minutes and reperfused for 90 minutes. Hemodynamic parameters and wall thickening were monitored. Unloading with the 60-ml Medos® HIA-VAD® was performed either during ischemia (group II) or during reperfusion (group III). The recovery of non-uniformity indicated by post-ejection wall thickening was significantly faster (p<0.05) in both groups if compared to the non-assisted group (group I) (all groups n=4). Recovery of systolic wall thickening in the postischemic region in group I was only 76±12%, while it was 103±11% and 92±11% in groups II and III, respectively (p<0.05). In a canine model of global left ventricular failure, we occluded the left anterior descending coronary artery for 20 min, and after 5 minutes of reperfusion, the circumflex artery for 45 min (group I, n=5). After 5 min of CX occlusion in group II we performed assisted circulation for 90 min with the 10-ml (n=5) and the 25-ml (n=5) Medos® HIA-VAD®. In group I, no dog survided, in group II, all survided 4 hours of reperfusion (n=10). Lactate at the end of the experiment was 1.1±0.9 mmol/L (10-ml) and 1.1±0.2 mmol/L (25-ml) (p>0.05 vs. base line). We conclude that the Medos® HIA-VAD® is a reliable assist device that enhances myocardial recovery and allows sufficient peripheral circulation in the case of cardiogenic shock.

Role of adenosine receptors in late preconditioning against myocardial stunning in conscious rabbits

1997 ◽  
Vol 273 (3) ◽  
pp. H1324-H1332 ◽  
Author(s):  
C. Maldonado ◽  
Y. Qiu ◽  
X. L. Tang ◽  
M. V. Cohen ◽  
J. Auchampach ◽  
...  
Keyword(s):  
Adenosine Receptors ◽  
Myocardial Stunning ◽  
Rabbit Model ◽  
Stage I ◽  
Stage Ii ◽  
Wall Thickening ◽  
Late Preconditioning ◽  
Group I ◽  
Conscious Rabbits ◽  
Group Ii

Conscious rabbits underwent six 4-min coronary occlusions interspersed with 4-min periods of reperfusion for 2 consecutive days (days 1 and 2 of stage I); 2 wk later, they underwent the same protocol (days 1 and 2 of stage II) except that they received either 8-(p-sulfophenyl)theophylline (SPT) on day 1 (group I, n = 5) or 2-chloro-N6-cyclopentyl-adenosine (CCPA) on the day before day 1 (group II, n = 6). In both groups I and II, on day 1 of stage I, systolic wall thickening (WTh) remained significantly depressed for several hours, indicating myocardial stunning; on day 2, however, the total deficit of WTh was approximately 50% less than on day 1 (P < 0.01), indicating the development of late preconditioning (PC) against myocardial stunning. Despite administration of SPT, in group I the deficit of WTh during stage II was 55% less on day 2 than on day 1 (P < 0.05). Similar results were obtained in three other rabbits treated with PD-115199 on day 1. In group II, pretreatment with CCPA during stage II failed to decrease the deficit of WTh on day 1. This study presents a new conscious rabbit model for studying myocardial stunning that is relatively inexpensive and technically less demanding than larger animal models. In this model, the development of late PC against myocardial stunning is not blocked by nonselective blockade of adenosine receptors with either SPT or PD-115199, nor is it induced by activation of adenosine A1 receptors with CCPA, indicating that adenosine receptors are not involved in the pathogenesis of this phenomenon.

scholarly journals A Study to Evaluate Use of Platelet Indices in Hyperdestructive Thrombocytopenia: A Two-year Experience from Tertiary Care Rural Hospital

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Roniya Francis ◽  
Shruthi N Shetageri ◽  
Roopa A N ◽  
S R Raja Parthiban
Keyword(s):  
Tertiary Care ◽  
Study Groups ◽  
The Body ◽  
Parasitic Infections ◽  
Control Group ◽  
Platelet Destruction ◽  
Distribution Width ◽  
Platelet Indices ◽  
Group I ◽  
Group Ii

Background: Thrombocytopenia is one of the most common causes of abnormal bleeding and is defined as platelet counts < 1.5 lakhs/cumm. Three processes can cause thrombocytopenia, namely: Deficient platelet production, accelerated platelet destruction, and abnormal pooling of the platelets within the body. Of these, accelerated platelet destruction is the most common cause for thrombocytopenia and has variety of etiologies. The usefulness of bone marrow analysis in assessing accelerated platelet destruction is still debated. Therefore, a new simple and non-invasive diagnostic approach for thrombocytopenia is needed. Aims and Objectives: The present study was done with an aim to evaluate the use of platelet indices, namely, mean platelet volume (MPV), Platelet Distribution Width (PDW), and Platelet Large Cell Ratio (P-LCR) in differentiating the various causes of hyperdestructive thrombocytopenia. Materials and Methods: This was a prospective study conducted over a period of 2 years and consisted of 206 cases of hyperdestructive thrombocytopenia. After recording relevant clinical details, platelet count along with platelet indices – MPV, PDW, and P-LCR was recorded. Based on the etiopathology identified, cases were categorized into three groups: Group I: Immunologic – cases of Immune thrombocytopenic purpura (ITP), Group II: Non-immune: Cases of sepsis and other non-immune causes of platelet destruction, and Group III: Viral and parasitic infections. Platelet indices were compared between the study groups and the control group which included 100 healthy individuals. Comparison was done among the three study groups as well. Results & Conclusions: Dengue accounted for the highest number of 131 (89.72%) cases in the study. MPV, PDW, and P-LCR were significantly higher (P < 0.0001) when compared to the healthy controls except P-LCR in Group II. A statistically significant increase in MPV was noted among ITP cases when compared to other causes of thrombocytopenia. There wa

scholarly journals INFLUENCE OF RADIOACTIVE BACKGROUND ON SEXUAL FUNCTION IN MEN FROM DIFFERENT REGIONS OF UKRAINE

2021 ◽  
Vol 26 ◽  
pp. 479-497
Author(s):  
I. Gorpinchenko ◽  
◽  
Yu. Gurzhenko ◽  
V. Spyrydonenko ◽  
◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Ionizing Radiation ◽  
Sexual Function ◽  
Sexual Disorders ◽  
Sexual Dysfunctions ◽  
Outpatient Basis ◽  
Group I ◽  
Number Of Patients ◽  
Significant Difference ◽  
Group Ii

Objective. The article attempts to analyze the nature of sexual dysfunctions in patients living in areas exposed to ionizing radiation as a result of the Chornobyl accident. Materials and methods. A study of sexual function was carried out in 186 people (group I) living in the territories of Kyiv (Polisske, Chornobyl, Ivankiv, Borodianka, Vyshhorod, Makariv districts) and Zhytomyr (Malyn and Korosten districts) regions. The control group consisted of persons who were born and lived on the territory of IvanoFrankivsk and Chernivtsi regions (group II, n = 123). Diagnostics was carried out on an outpatient basis in accordance with the standards of the WHO and the Ministry of Health of Ukraine. Results. Analyzing the obtained research results, a significantly larger number of patients with sexual dysfunction was identified in group I (82.3 %) than in group II (44.7 %) (р < 0.01). Psychopathological disorders disturbed, respectively, 60.2 % and 41.4 % (p < 0.01). Complaints of decreased libido were presented by 25.8 % of the surveyed men exposed to ionizing radiation, and 6.5 % of them were concerned about a sharp depression of libido. In group II patients, this indicator was 14.6 % and 3.3 %, respectively. The integral index of «libido» of the ICEF questionnaire revealed a statistically significant difference between the groups (9.23 ± 0.89 and 12.22 ± 1.26, respectively; р < 0.05). In patients exposed to ionizing radiation as a result of the Chornobyl accident, the concentration of testosterone decreases, and the content of FSH, LH, as well as globulin, which makes sex hormones, increases. Erectile dysfunction in patients of group I was detected in 58.1 % of men, and in patients of group II – 35.0 % (р < 0.01). The difference in the integral indicators of the ICEF questionnaire between the groups was 1.3 times behind the «libido» domain. For other domains – by 1.5–1.6 times. In men living in the territories of Kyiv and Zhytomyr regions, erectile dysfunction occurs earlier and is characterized by a more severe course than in people born and lived in the territory of Ivano-Frankivsk and Chernivtsi regions. Both in terms of low rates of normal erection (in patients of groups I and II, respectively 3.8 % and 13.3 %), and for high percentages of existing moderate/severe ED (respectively 71.0 % and 45.5 %), persons from group I are characterized by significantly worse data than persons from group II (р < 0.01). Orgasm pathology was found in 40.3 % of patients in group I and in 25.2 % of patients in group II (р < 0.01). The quality of life index according to the QoL index in the context of existing sexual disorders in group I of patients was 4.7 ± 0.4, in patients of group II – 3.9 ± 0.2 (р < 0.05). Conclusions. The data obtained indicate a tendency for a more significant violation of sexual functions in men who were born and lived in territories exposed to radioactive contamination as a result of the Chornobyl accident. Key words: Chornobyl accident, radioactively contaminated areas, men, sexual dysfunctions.

scholarly journals Role of scoring system in prediction of difficult laparoscopic cholecystectomy

2017 ◽  
Vol 5 (1) ◽  
pp. 257
Author(s):  
Delie Rhezhii ◽  
Vikas Goyal ◽  
Nitin Nagpal ◽  
Shobhit Kumar Nemma ◽  
Monica Gupta
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Scoring System ◽  
Open Cholecystectomy ◽  
Bladder Wall ◽  
Scoring Systems ◽  
Gall Stones ◽  
Group I ◽  
Conversion To Open Cholecystectomy ◽  
Group Ii

Background: One of the most common reasons for admission to hospital is cholecystectomy and it has a mortality rate of 0.45% to 6%. Many risk factors have been found to be associated laparoscopic cholecystectomy that make it difficult like advance age, male gender, fever, obesity, previous abdominal surgeries, thick gall bladder lining, distention of bladder, presence of gall stones. There have been different scoring systems in literature that determine the risk of conversion to open cholecystectomy. The aim of present study is to determine the role of scoring system in predicting difficult laparoscopic surgery.Methods: The present prospective study was conducted for a period of 1 year in the Department of Surgery at Guru Gobind Singh Medical College, Faridkot, Punjab. The study included all the patients with symptomatic gall stones reporting to the OPD of the hospital. Patients were categorized into two groups after the surgery. Group I included patients who underwent successfully laparoscopic cholecystectomy and group II included those who were converted into an open case. In this study all the entities were provided with a score. Patients with score less than 4 were grouped as difficult. At the end of the study all the data were analyzed to see how scoring system can predict which patients will have easy or difficult laparoscopic cholecystectomy based on postoperative scoring. All the data was recorded in a tabulated form and analyzed using SPSS software.Results: The present prospective analytical study involved 112 subjects; out of these 94 were males and 18 females. The mean age of subjects was 48.2±3.7 years. There were 98 patients in Group I and 8 patients in group II who had didn’t show presence of peri cholecystic fluid. There was 1 patient in Group I and 5 patients in group II who had peri cholecystic fluid on ultrasound. There were 104 subjects with gall was thickness less than 4 mm. There were 95 patients in Group I and 9 patients in group II who had who had who had bladder wall thickness of less than 4 mm.Conclusions: The scoring tool evaluated in our study is useful in evaluating the risk of conversion of laparoscopic cholecystectomy into open cholecystectomy.

scholarly journals Focused Assessment with Sonography for Urinary Schistosomiasis (FASUS)—pilot evaluation of a simple point-of-care ultrasound protocol and short training program for detecting urinary tract morbidity in highly endemic settings

2019 ◽  
Author(s):  
J Remppis ◽  
A Verheyden ◽  
A L Bustinduy ◽  
T Heller ◽  
N García-Tardón ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Point Of Care ◽  
Clinical Care ◽  
Bladder Wall ◽  
Wall Thickening ◽  
Point Of Care Ultrasound ◽  
Urogenital Schistosomiasis ◽  
Urinary Schistosomiasis ◽  
Resource Limited ◽  
Therapeutic Algorithms

Abstract Background Urogenital schistosomiasis (UGS) causes inflammation and fibrosis of the urinary tract. In resource-limited settings, affordable tools for morbidity assessment in clinical care are needed. Point-of-care ultrasound has not yet been validated for UGS-related pathology. Methods We developed a protocol for Focused Assessment with Sonography for Urinary Schistosomiasis (FASUS), assessing pathology of the bladder wall, ureters and kidneys. Following standardized training, two clinicians performed FASUS on children and adults with hematuria in Lambaréné, Gabon. Recorded ultrasound clips were remotely reviewed by two ultrasound experts as a diagnostic reference. Results In 2015 and 2016, scans were performed in 118 patients. The image quality was sufficient in 90% of bladder views and more than 97% of kidney views. UGS-compatible pathology was detected in 51/118 (43%) by the operator and in 46/107 (43%) by the experts among baseline scans of sufficient quality. Inter-rater agreement between operators and experts was very good (κ > 0.8) for hydronephrosis and good (κ > 0.6) for bladder wall thickening. Conclusions FASUS is a promising clinical, point-of-care tool for detecting UGS-related urinary tract morbidity in symptomatic patients. Based on larger validation studies, appropriate diagnostic and therapeutic algorithms for the use of FASUS should be established.

scholarly journals LOCAL IMMUNE RESPONSE IN PATIENTS WITH CLASSIC AND NON-ULCER TYPE OF INTERSTITIAL CYSTITIS / BLADDER PAIN SYNDROME

2021 ◽  
Author(s):  
R. F. Sholan
Keyword(s):  
Mast Cells ◽  
Interstitial Cystitis ◽  
Plasma Cells ◽  
Bladder Wall ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Bladder Pain ◽  
Group I ◽  
Tnf Α ◽  
Group Ii

Several hypotheses regarding the pathophysiology of interstitial cystitis / bladder pain syndrome (IC / BPS) have been put forward, but no consensus has yet been reached. It is suggested that cytokines are involved in IC / BPS, as well as in inflammatory autoimmune diseases. Examining various biomarkers of bladder tissue, including mast cells is underway. However, few reports on a consistent immune activity profile are available. The aim of the study was to assess the cytokine profile, counts of mast cells and plasma cells as well as their relationship in patients with IC / BPS with and without Hunner's lesions. 44 women with Hunner's lesions of IC / BPS (group I) and 82 women with non-ulcer type (group II) were examined. Patients were questioned on the Pelvic Pain Symptom Scale, Urinary Frequency Scale (PUF), Visual Analogue Scale (VAS) and O'Leary-Santa Interstitial Cystitis Symptom Index (ICSI). Cystoscopy and hydrodistension of the bladder were performed under general anesthesia. In biopsies of the bladder wall, the number of plasma cells and mast cells was assessed, in urine - IL-1β, IL-6, IL-8, TNF-α. Statistical processing of the results was carried out using the Statistica software for Microsoft Excel release 6 (StatSoft, USA). The Student's t-test, Spearman's correlation coefficient were calculated. In patients with the Hunner type of IC / BPS, there was an insignificant increase in the scale indices and decreased magnitude for average volume, urination frequency, and maximum emptying volume. The maximum bladder capacity during hydrodistension was lowered by 42.01% (p <0.001). The level of IL-8 in group I was higher on average by 28.57% (p = 0.434) as compared with that in group II, IL-6 - by 13.46% (p = 0.638), TNF-α - by 9.09% (p = 0.244) and IL-1β – by 4.13% (p = 0.859). The number of mast cells in patients of group I vs. group II was higher by 40.65% (p <0.05). In group I, a marked relationship was found between count of mast cells and plasma cells (r = -0.555, p> 0.05), as well as between count of plasma cells and IL-6 level (r = -0.639, p <0.05). In group II, a significant connection was found between count of mast cells and TNF-α level (r = +0.562, p <0.05). Patients with Hunner's IC / BPS are characterized by severe inflammation, wherein mast cells are involved in induction. Determination of cytokines in urine can provide a non-invasive division of IC / BPS into ulcerative and non-ulcerative groups.

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