scholarly journals Repeated Onabotulinumtoxin-A Injections Provide Better Results than Single Injection in Treatment of Painful Bladder Syndrome

2013 ◽  
Vol 1;16 (1;1) ◽  
pp. E15-E23 ◽  
Author(s):  
Dr. Hann-Chorng Kuo
Keyword(s):  
Single Injection ◽  
Bladder Capacity ◽  
Painful Bladder Syndrome ◽  
Successful Outcome ◽  
Control Group ◽  
Success Rates ◽  
Onabotulinumtoxin A ◽  
Significant Difference ◽  
Painful Bladder

Background: Onabotulinumtoxin-A (BoNT-A) is effective for the treatment of interstitial cystitis/painful bladder syndrome (IC/PBS). However, long-term follow-up does not show successful outcome after a single injection. Objectives: To evaluate the efficacy and safety of repeated intravesical BoNT-A injections for treatment of IC/PBS and compare the success rates among patient groups receiving different injection numbers. Study Design: Prospective interventional study. Setting: Tertiary medical center. Methods: Intravesical injection of 100 U of BoNT-A was performed in 81 patients every 6 months for up to 4 times or until patients’ symptoms significantly improved. Patients who received a single injection served as active controls. Measured parameters included O’LearySant symptom indexes (ICSI) and problem indexes (ICPI), visual analogue score (VAS) for pain, voiding diary variables, urodynamic parameters, maximal bladder capacity under anesthesia, glomerulation grade, and global response assessment. Multiple measurements and KaplanMeier analysis were used for comparison of consecutive data and success rates among groups. Results: Among 81 patients, 20 received single injections, 19 received 2 injections, 12 received 3 injections, and 30 received 4 injections. The mean (± standard deviation) of ICSI, ICPI, total scores, VAS, functional bladder capacity, and daytime frequency all showed significant improvement after repeated BoNT-A treatment with different injections. Significantly better success rates were noted in patients who received 4 repeated injections (P = 0.0242) and 3 injections (P = 0.050), compared to those who received a single injection. However, there was no significant difference of long-term success rates among patients who received 2, 3, and 4 injections. Limitations: Lack of placebo control group is the main limitation. Conclusion: Repeated intravesical BoNT-A injections were safe and effective for pain relief and they increased bladder capacity and provided a better long-term success rate than a single injection did for treatment of IC/PBS. Key words: Botulinum toxin, IC/PBS, Intravesical treatment

scholarly journals Intravesical OnabotulinumtoxinA Injections for Refractory Painful Bladder Syndrome

2012 ◽  
Vol 3;15 (3;5) ◽  
pp. 197-202
Author(s):  
Hann-Chorng Kuo
Keyword(s):  
Interstitial Cystitis ◽  
Therapeutic Option ◽  
Bladder Capacity ◽  
Painful Bladder Syndrome ◽  
Control Group ◽  
Placebo Control ◽  
Bladder Pain ◽  
Institutional Review ◽  
Painful Bladder ◽  
Intravesical Injection

Background: Bladder pain associated with interstitial cystitis and painful bladder syndrome (IC/PBS) is frequently excruciating and intractable. The use of onabotulinumtoxinA (BoNT-A) for relief of this type of bladder pain has not been well described. Objectives: To evaluate the efficacy and safety of intravesical BoNT-A injection for treatment of IC/PBS refractory to conventional treatment. Study Design: Prospective, non-randomized study. Setting: A tertiary medical center in Taiwan. Methods: Sixty-seven patients with characteristic IC/PBS were enrolled. Intravesical injection of 100U of BoNT-A immediately followed by cystoscopic hydrodistention under intravenous general anesthesia. Changes of the urodynamic parameters, O’Leary-Sant Interstitial Cystitis Symptom Index (ICSI) and Interstitial Cystitis Problem Index (ICPI), visual analog score (VAS) for pain, functional bladder capacity, and global response assessment (GRA) were evaluated at baseline and 6 months after BoNT-A injection. Adverse events that occurred after this procedure were also assessed. Results: Significant improvement was shown after intravesical injection of 100 U of BoNT-A. Baseline and 6 months after injection scores were: ICSI and ICPI (23.6 ± 5.9 versus 15.2 ± 8.5, P = 0.000), VAS (5.3 ± 2.2 versus 3.3 ± 2.4, P = 0.000), functional bladder capacity (136 ± 77.6 versus 180 ± 78.2, P = 0.000) and GRA (0.3 ± 0.8 versus 1.4 ± 1.0, P = 0.000). Limitations: This study lacks a placebo control group so the placebo effect cannot be eliminated. This study also does not provide information about the efficacy of this treatment after 6 months. Conclusion: Intravesical onabotulinumtoxinA injection appears to be a safe and effective therapeutic option for analgesia and increased bladder capacity for patients with IC/PBS. Institutional Review: This study was approved by the Institutional Review Board of the Buddhist Tzu-chi General Hospital. Key words: Botulinum toxin, interstitial cystitis/painful bladder syndrome, intravesical treatment, bladder pain

Long-term treadmill training ameliorates endothelium-dependent vasorelaxation mediated by insulin and insulin-like growth factor-1 in hypertension

2015 ◽  
Vol 119 (6) ◽  
pp. 663-669 ◽  
Author(s):  
Yi-Yuan Lin ◽  
Shin-Da Lee ◽  
Chia-Ting Su ◽  
Tsung-Lin Cheng ◽  
Ai-Lun Yang
Keyword(s):  
Growth Factor ◽  
Insulin Receptor ◽  
Treadmill Training ◽  
Control Group ◽  
Insulin Like Growth Factor ◽  
Hypertensive Rats ◽  
Protein Levels ◽  
Significant Difference ◽  
Nos Inhibitors

Dysfunction of insulin and insulin-like growth factor-1 (IGF-1) is associated with the pathophysiology of hypertension. The influence of long-term exercise on vascular dysfunction caused by hypertension remains unclear. We investigated whether long-term treadmill training improved insulin- and IGF-1-mediated vasorelaxation in hypertensive rats. Eight-week-old male spontaneously hypertensive rats (SHR) were randomly divided into sedentary and exercise (SHR-EX) groups. The SHR-EX group was trained on a treadmill for 60 min/day, 5 days/wk, for 8 wk. Wistar-Kyoto rats (WKY) were used as the normal control group. After training, aortic insulin- and IGF-1-mediated vasorelaxation was evaluated in organ baths. Additionally, the roles of phosphatidylinositol 3-kinase (PI3K), nitric oxide synthase (NOS), and aortic protein expression were examined in the three groups. Compared with sedentary SHR and WKY groups, insulin- and IGF-1-mediated vasorelaxation was significantly enhanced to a nearly normal level in the SHR-EX group. After endothelial denudation, blunted and comparable vasorelaxation was found among the three groups. Pretreatment with selective PI3K and NOS inhibitors attenuated insulin- and IGF-1-mediated vasorelaxation, and no significant difference was found among the three groups after the pretreatment. The aortic protein levels of the insulin receptor (IR), IGF-1 receptor (IGF-1R), insulin receptor substrate-1 (IRS-1), and endothelial NOS (eNOS) were also significantly increased in the SHR-EX group compared with the other two groups. These results suggested that treadmill training elicited the amelioration of endothelium-dependent insulin/IGF-1-mediated vasorelaxation partly via the increased activation of PI3K and NOS, as well as the enhancement of protein levels of IR, IGF-1R, IRS-1, and eNOS, in hypertension.

scholarly journals Stigma and attitudes on epilepsy a study: with secondary school students

2007 ◽  
Vol 65 (suppl 1) ◽  
pp. 49-54 ◽  
Author(s):  
Brenda A. Reno ◽  
Paula T. Fernandes ◽  
Gail S. Bell ◽  
Josemir W. Sander ◽  
Li M. Li
Keyword(s):  
Epileptic Seizure ◽  
Pairwise Comparison ◽  
Control Group ◽  
First Year ◽  
School Students ◽  
Lecture Method ◽  
Significant Difference ◽  
Appropriate Education ◽  
Difference Test

PURPOSE: To evaluate whether an inappropriate attitude towards a person having an epileptic seizure contributes to the stigma found in society and whether an appropriate attitude helps to diminish it in the short term; to perform a long term investigation about information remembered and stigma perception after an educational lecture. METHOD: This study was performed in two steps: Step 1. Students of first year of high school of two schools in Campinas completed a questionnaire including the Stigma Scale of Epilepsy following a seizure demonstration. They were divided into three groups: a) one group had a demonstration of proper attitudes towards someone having an epileptic seizure; b) one group was shown incorrect procedures; c) control group. After the completion of the questionnaire, an educational lecture about epilepsy was given. Step 2: six months later, the questionnaire was re-administered. RESULTS: The comparison between the four groups (step 1 and step 2) show a significant difference (Anova (3,339)=2.77; p=0.042). Pairwise comparison using Fisher's Least-Significant-Difference Test showed a significant difference between the group shown incorrect procedures (step 1) versus step 2, and the control group (step 1) versus step 2, but no difference between the group shown correct procedures (step 1) versus step 2. DISCUSSION: Exhibiting proper attitudes towards a person experiencing an epileptic seizure may cause significant differences among the subjects’ degrees of stigma towards people with epilepsy. It is therefore fundamental that there should be de-stigmatization campaigns provided, to correct information and provide appropriate education.

scholarly journals What is the impact of methotrexate on liver in patients with juvenile idiopathic arthritis? Results of liver SWE performed in a single centre

2021 ◽  
Author(s):  
Vildan Güngörer ◽  
Mehmet Öztürk ◽  
Mustafa Yasir Özlü ◽  
Şükrü Arslan
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Shear Wave Elastography ◽  
Term Therapy ◽  
Control Group ◽  
Significant Difference ◽  
Group 2 ◽  
Long Term Therapy ◽  
And Control ◽  
The Impact

ABSTRACT Objectives Long-term therapy with low-dose methotrexate (MTX) is widely used in treatment of rheumatic diseases, in children. The purpose of this study was to evaluate liver elasticity in patients with juvenile idiopathic arthritis (JIA) who received MTX and compare the results with control group. Methods Liver elasticity was evaluated with shear wave elastography (SWE) technique in 25 patients aged 3–17 years who were followed up with JIA and received MTX and compared with 25 healthy controls of the same age and weight. Factors that had an effect on liver elasticity were examined. Results The mean SWE value of patients was 2.64 ± 2.13 m/s and 24.10 ± 18.50 kPa, whereas 1.83 ± 0.16 m/s and 10.09 ± 1.83 kPa in control group. There was a significant difference in liver elasticity in the patient and control groups. When the patients were evaluated as Group 1 (< 1000 mg) and Group 2 (≥ 1000 mg) according to the cumulative MTX dose, no significant difference was obtained. There was positive correlation between liver elasticity and weekly MTX dose and age. Conclusions Our study revealed that liver elasticity significantly decreased in patients who received MTX when compared with the control group. The elastography technique will be understood better over time and used safely in many areas.

Short and Long Term Outcome In Patients with Calcified Lesions Requiring Rotational Artherectomy

2021 ◽  
Vol 35 (2) ◽  
pp. 140-146
Author(s):  
Lima Asrin Sayami ◽  
Al Fazir Omar ◽  
Sheikh Ziarat Islam ◽  
Subasni Govindan ◽  
Zulaikha Zainal ◽  
...  
Keyword(s):  
P Value ◽  
Success Rates ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Operator Experience ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Short And Long Term ◽  
Procedural Success

Objective: Despite the evolution of interventional techniques and operator experience, percutaneous revascularization of complex coronary lesions especially calcified lesions remains challenging because of lower procedural success and higher restenosis rates. Limited data are available on the effect of rotational atherectomy (RA) plus stenting in the treatment of complex calcified lesions of coronary artery disease. This study was aimed to investigate the characteristics, short and long term outcomes in patients undergoing RA. Material and Methods: A database search was performed from the year 2008 to 2013 in National Heart institute, Malaysia. A total of 16009 patients who underwent PCIs were enrolled in 2 groups, RA group (258 patients) and non RA group (15751 patients). The Chi square test and Kaplan - Meier analysis were used. Results: Male patients (73.6%) and elderly population (63.2%) were predominant in this study.The RA group had more co-morbidities such as diabetic on insulin (34%) and chronic kidney disease (57%). The lesions in RA group were more complex with higher Type C lesion (68.8%) and longer lesion (20.6%) compared to non RA group. Despite higher patient risk profile, the success rate of revascularization remains high in RA group (99.3%) as in non RA group (97%) (p value 0.89%). More importantly there were no significant difference in in-hospital mortality, myocardial infarction and stent thrombosis in both group (p value 0.1). In 1 year Kaplan - Meier survival graph, there were better survival noted in non RA group (97.7%) compare to RA (89.6%) (p value <0.005), Conclusion: The use of RA allows debulking of a calcified lesion and possibly explains the higher acute procedural success rates. However, the lower 1-yearsurvival in the RA group highlights the higher associated baseline comorbitidity in this group. Therefore, besides coronary intervention, this RA group requires aggressive medical therapy through a multi-disciplinary approach. Bangladesh Heart Journal 2020; 35(2) : 140-146

scholarly journals Effect of a long-term peroral supplementation with sodium selenite and selenium lactate-protein complex on selenium status in goats and their kids

2009 ◽  
Vol 54 (No. 7) ◽  
pp. 324-332 ◽  
Author(s):  
L. Misurova ◽  
L. Pavlata ◽  
A. Pechova ◽  
R. Dvorak
Keyword(s):  
Glutathione Peroxidase ◽  
Protein Complex ◽  
Sodium Selenite ◽  
Selenium Concentration ◽  
Selenium Supplementation ◽  
Control Group ◽  
Glutathione Peroxidase Activity ◽  
Significant Difference ◽  
Average Activity

The aim of this study was to evaluate the effect of a long-term peroral selenium supplementation in the form of sodium selenite and selenium lactate-protein complex by comparing selenium concentrations and glutathione peroxidase activity in blood of goats and their kids as well as comparing selenium concentrations in goat colostrums. For the study, a total of 27 clinically healthy pregnant white shorthair goats were used. They were divided to three groups, i.e., the control group (C) without any selenium supplementation, sodium selenite group (E1) and selenium lactate-protein complex group (E2). For four months, experimental goats received 0.43 mg of selenium per animal per day in diet; goats from the control group were given 0.15 mg of selenium per animal per day. At the beginning of the experiment, goats of all groups showed an average selenium concentration of 96 &mu;g/l in whole blood. On the parturition day, samples of first colostrum from goats and heparinized blood from goats and kids were taken. In the control group (C), average blood selenium concentrations of 111.4 ± 33.5 &mu;g/l were observed on the parturition day. In both experimental groups, selenium concentrations were significantly higher (<I>P</I> < 0.05). Average selenium concentration in the sodium selenite group (E1) was 177.2 ± 34.8 &mu;g/l and in the group supplemented with selenium lactate-protein complex (E2) 159.0 ± 28.5 &mu;g/l. Average glutathione peroxidase (GSH-Px) activity in blood of control goats (C) was 581.9 ± 99.2 &mu;kat/l, in group E1 1 154.6 ± 156.2 &mu;kat/l and in group E2 1 011.6 ± 153.6 &mu;kat/l. GSH-Px activity in experimental groups was significantly higher (<I>P</I> < 0.05) as compared with the control group. Average selenium concentrations in colostrum was in the control group 40.1 ± 12.8 &mu;g/l, in E1 99.0 ± 29.9 &mu;g/l and in group E2 79.0 ± 17.7 &mu;g/l. Colostral selenium concentrations in experimental groups were significantly higher (<I>P</I> < 0.05) as compared with the control group. No significant difference in the monitored parameters was found between experimental groups. In kids of control mothers (kC), average selenium concentrations in blood on the parturition day were 62.4 ± 22.9 &mu;g/l; kids of mothers supplemented with sodium selenite (kE1) showed average selenium levels of 100.0 ± 31.2 &mu;g/l, and the average selenium concentration in kids of mothers receiving lactate-protein complex was 83.4 ± 20.1 &mu;g/l (kE2). Average GSH-Px activity in control kids (kC) was 402.1 ± 153.9 &mu;kat/l. Kids from kE1 showed average activity of GSH-Px 806.1 ± 254.9 &mu;kat/l and kids from group kE2 529.9 ± 119.8 &mu;kat/l. Statistically significant difference (<I>P</I> < 0.05) was found only between kC and kE1 which showed significantly higher selenium concentration and GSH-Px activity. The results of this study confirm that both forms of selenium administered in experimental groups (i.e., sodium selenite and selenium lactate-protein complex) had similar biological effect in goats. However, results obtained in kids indicate a better effect of supplementation with sodium selenite.

scholarly journals A Prospective Randomized Trial to Assess the Antireflux Effect of Antireflux Mucosectomy in the Porcine Model

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Xuan Li ◽  
Weifeng Zhang ◽  
Meihong Chen ◽  
Shuchun Wei ◽  
Xiangyang Zhao ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Proton Pump Inhibitor ◽  
Porcine Model ◽  
Gastroesophageal Junction ◽  
Control Group ◽  
Potential Efficacy ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background. Both long-term proton pump inhibitor use and surgical fundoplication have potential drawbacks as treatments for chronic gastroesophageal reflux disease (GERD). Our aim was to investigate the potential efficacy of antireflux mucosectomy (ARMS) in porcine and determine the optimal circumference of resection in relation to gastroesophageal junction (GEJ). Methods. Nine pigs were allocated into the following 3 groups by computerized randomization: group A: control, group B: 1/3 circumference of the esophagus, and group C: 2/3 circumference of the esophagus. We performed mucosectomy with a crescentic mucosal resection at 3 cm above the GEJ and 1 cm below the GEJ. The animals were kept on a liquid diet for 24 h prior to endoscopy. At 6 weeks, animals underwent esophagoscopy, barium radiography, gastric yield pressure (GYP), and gastric yield volume (GYV) determination. Results. The weight of swines has no significant difference, and all pigs had maintained their weight after the procedure. We both found scar formation at the GEJ in group B and C. Compared with group A and B, group C produced significantly higher GYP (24.23±3.42 mmHg, p=0.004) and significantly smaller GYV (2200.0±238.96 mL, p=0.028) after 6 weeks. Barium radiography showed that the width of the cardia was narrower (13.73±1.19 mm, p=0.032) in group C after 6-week postprocedure. Conclusion. Our study demonstrated the potential antireflux effect of ARMS. We also recommend the 2/3 circumference resection of mucosa at 3 cm distance from the GEJ.

P1417Short and long term efficiency of different therapeutic approaches to perimitral atrial flutter

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
P Kupo ◽  
R Pap ◽  
G Bencsik ◽  
L Saghy
Keyword(s):  
Retrospective Study ◽  
Atrial Flutter ◽  
Pulmonary Vein ◽  
Success Rates ◽  
Therapeutic Approaches ◽  
Significant Difference ◽  
Mitral Isthmus ◽  
Short And Long Term ◽  
Left Pulmonary Vein

Abstract Introduction Catheter ablation of perimitral flutter can be challenging, owing to difficult anatomy. The most commonly applied procedure is the creation of a mitral isthmus line (between the lower left pulmonary vein and the mitral anulus) or an anteroseptal line (between the upper right pulmonary vein and the anterior mitral anulus). Purpose Our study aimed to compare the short and long term efficacy of two different ablation methods. Methods In our retrospective study 45 consecutive patients diagnosed with perimitral flutter were included between 2009 and 2018. Results Radiofrequency ablation was performed in 48 cases in 31 patients (mitral isthmus line (n = 25, 52.1%); anteroseptal line (n = 23, 47.9%)). Arrhythmia-termination and sinus rhythm restoration could be achieved in 64.6% of the cases (mitral isthmus line: 16/25 (64.0%), anteroseptal line: 15/23 (65.2%). Comparing two different techniques, there was no significant difference (p = 0.85) in acute success rates. During 24.3 months of follow-up period, in 60.0% of the patients no recurrence occurred. The arrhythmia recurred in 6 cases (40.0%) after anteroseptal line ablation, and in 8 cases (53.3%) after mitral isthmus line ablation. No difference was found in the long term efficiency of two  different ablation techniques (p = 0.211). Conclusion In our retrospective study we found no significant difference in the short and long term efficiency of two different therapeutic approaches to perimitral atrial flutter.

Sign in / Sign up

Export Citation Format

Share Document