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Botulinum Toxin in Neurogenic Detrusor Overactivity
Carlos Arturo Levi D’Ancona,Rúiter Silva Ferreira,Mauricio Carneiro Rassi 대한배뇨장애요실금학회 2012 International Neurourology Journal Vol.16 No.3
Purpose: To evaluate the effects of botulinum toxin on urodynamic parameters and quality of life in patients with neurogenic detrusor overactivity. Methods: Thirty four adult patients with spinal cord injury and detrusor overactivity were selected. The patients received 300 units of botulinum toxin type A. The endpoints evaluated with the episodes of urinary incontinence and measured the maximum cystometric capacity, maximum amplitude of detrusor pressure and bladder compliance at the beginning and end of the study (24 weeks) and evaluated the quality of life by applying the Qualiveen questionnaire. Results: A significant decrease in the episodes of urinary incontinence was observed. All urodynamic parameters presented a significant improvement. The same was observed in the quality of life index and the specific impact of urinary problems scores from the Qualiveen questionnaire. Six patients did not complete the study, two due to incomplete follow-up, and four violated protocol and were excluded from the analyses. No systemic adverse events of botulinum toxin type A were reported. Conclusions: A botulinum toxin type A showed a significantly improved response in urodynamics parameters and specific and general quality of life.
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Noninvasive Urodynamic Evaluation
Carlos Arturo Levi D’Ancona,Jose Bassani,João Carlos Almeida 대한배뇨장애요실금학회 2012 International Neurourology Journal Vol.16 No.3
The longevity of the world’s population is increasing, and among male patients, complaints of lower urinary tract symptoms (LUTS) are growing. Testing to diagnose LUTS and to differentiate between the various causes should be quick, easy, cheap, specific, not too bothersome for the patient, and noninvasive or minimally so. Urodynamic evaluation is the gold standard for diagnosing bladder outlet obstruction (BOO) but presents some inconveniences such as embarrassment, pain, and dysuria; furthermore,19% of cases experience urinary retention, macroscopic hematuria, or urinary tract infection. A greater number of resources in the diagnostic armamentarium could increase the opportunity for selecting less invasive tests. A number of groups have risen to this challenge and have formulated and developed ideas and technologies to improve noninvasive methods to diagnosis BOO. These techniques start with flowmetry, an increase in the interest of ultrasound, and finally the performance of urodynamic evaluation without a urethral catheter. Flowmetry is not sufficient for confirming a diagnosis of BOO. Ultrasound of the prostate and the bladder can help to assess BOO noninvasively in all men and can be useful for evaluating the value of BOO at assessment and during treatment of benign prostatic hyperplasia patients in the future. The great advantages of noninvasive urodynamics are as follows: minimal discomfort, minimal risk of urinary tract infection, and low cost. This method can be repeated many times, permitting the evaluation of obstruction during clinical treatment. A urethral connector should be used to diagnose BOO, in evaluation for surgery, and in screening for treatment. In the future, noninvasive urodynamics can be used to identify patients with BOO to initiate early medical treatment and evaluate the results. This approach permits the possibility of performing surgery before detrusor damage occurs.
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Francisco Herrera-Chale,Jorge Carlos Ruiz-Ruiz,David Betancur-Ancona,Maira Rubi Segura-Campos 한국식품영양과학회 2016 Journal of medicinal food Vol.19 No.2
A Mucuna pruriens protein concentrate was hydrolyzed with a digestive (pepsin–pancreatin) enzymatic system. The soluble portion of the hydrolysate was fractionated by ultrafiltration and the ultrafiltered peptide fraction (PF) with lower molecular weight was purified by reversed-phase high-performance liquid chromatography. The PF obtained were evaluated by testing the biological activity in vitro. Fractions showed that the ability to inhibit the angiotensin-converting enzyme had IC50 values that ranged from 2.7 to 6.2 μg/mL. Trolox equivalent antioxidant capacity values ranged from 132.20 to 507.43 mM/mg. The inhibition of human platelet aggregation ranged from 1.59% to 11.11%, and the inhibition of cholesterol micellar solubility ranged from 0.24% to 0.47%. Hydrophobicity, size, and amino acid sequence could be factors in determining the biological activity of peptides contained in fractions. This is the first report that M. pruriens peptides act as antihypertensives, antioxidants, and inhibitors for human platelet aggregation and cholesterol micellar solubility in vitro.
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Gabriele Valli,Elisabetta Galati,Francesca De Marco,Chiara Bucci,Paolo Fratini,Elisa Cennamo,Carlo Ancona,Nicola Volpe,Maria Pia Ruggieri 대한응급의학회 2021 Clinical and Experimental Emergency Medicine Vol.8 No.4
Objective Given that there are no studies on diseases that occur by waiting for hospitalization, we aimed to evaluate the main causes of death in the emergency room (ER) and their relationship with overcrowding. Methods Patients who died in the ER in the past 2 years (pediatrics and trauma victims excluded) were divided into two groups: patients who died within 6 hours of arrival (emergency department [ED] group) and patients who died later (LD group). We compared the causes of death, total vital signs, diagnostic tests performed, and therapy between the groups. We assessed for possible correlation between the number of monthly deaths per group and four variables of overcrowding: number of patients treated per month, waiting time before medical visit (W-Time), mean intervention time (I-Time), and number of patients admitted to the ward per month (NPA). Results During the two years, 175 patients had died in our ER (52% in ED group and 48% in LD group). The total time spent in the ER was, respectively, 2.9±0.2 hours for ED group and 17.9± 1.5 hours for LD group. The more frequent cause of death was cardiovascular syndrome (30%) in ED group and sepsis (27%) and acute respiratory failure (27%) in LD group. Positive correlations between number of monthly deaths and W-Time (R2 0.51, P< 0.0001), and NPA (R2 0.37, P
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