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Purpose@#Substantive evidence supports a role of chronic stress in the development, maintenance, and even enhancement of functional bladder disorders such as interstitial cystitis/bladder pain syndrome (IC/BPS). Increased urinary frequency and bladder hyperalgesia have been reported in rodents exposed to a chronic stress paradigm. Here, we utilized a water avoidance stress (WAS) model in rodents to investigate the effect of chronic stress on vascular perfusion and angiogenesis. @*Methods@#Female Wistar-Kyoto rats were exposed to WAS for 10 consecutive days. Bladder neck tissues were analyzed by western immunoblot for vascular endothelial growth factor (VEGF) and nerve growth factor precursor (proNGF). Vascular perfusion was assessed by fluorescent microangiography followed by Hypoxyprobe testing to identify regions of tissue hypoxia. @*Results@#The expression of VEGF and proNGF in the bladder neck mucosa was significantly higher in the WAS rats than in the controls. There was a trend toward increased vascular perfusion, but without a statistically significant difference from the control group. The WAS rats displayed a 1.6-fold increase in perfusion. Additionally, a greater abundance of vessels was observed in the WAS rats, most notably in the microvasculature. @*Conclusions@#These findings show that chronic psychological stress induces factors that can lead to increased microvasculature formation, especially around the bladder neck, the region that contains most nociceptive bladder afferents. These findings may indicate a link between angiogenesis and other inflammatory factors that contribute to structural changes and pain in IC/BPS.
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Background@#Scapular dyskinesis is considered a risk factor for the shoulder pain that may warrant screening for prevention. Clinicians of all experience screen scapular dyskinesis using the scapular dyskinesis test yes-no classification (Y-N), yet its reliability in asymptomatic individuals is unknown. We aimed to establish Y-N’s intra- and inter-reliability between students and expert physical therapists. @*Methods@#We utilized a cross-sectional design using consecutive asymptomatic subjects. Six students and two experts rated 100 subjects using the Y-N. Cohen’s kappa (κ) and Krippendorff’s alpha (K-α) were calculated to determine intra- and inter-rater reliability. @*Results@#Intra- and inter-rater values for experts were κ=0.92 (95% confidence interval [CI], 0.91–0.93) and 0.85 (95% CI, 0.84–0.87) respectively; students were κ=0.77 (95% CI, 0.75–0.78) and K-α=0.63 (95% CI, 0.58–0.67). @*Conclusions@#The Y-N is reliable in detecting scapular dyskinesis in asymptomatic individuals regardless of experience.
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Purpose@#Lower urinary tract symptoms are known to significantly increase with age, negatively impacting quality of life and self-reliance. The urothelium fulfills crucial tasks, serving as a barrier protecting the underlying bladder tissue from the harsh chemical composition of urine, and exhibits signaling properties via the release of mediators within the bladder wall that affect bladder functioning. Aging is associated with detrimental changes in cellular health, in part by increasing oxidative stress in the bladder mucosa, and more specifically the urothelium. This, in turn, may impact urothelial mitochondrial health and bioenergetics. @*Methods@#We collected mucosal tissue samples from both young (3–4 months old) and aged (25–30 months old) rats. Tissue was evaluated for p21-Arc, nitrotyrosine, and cytochrome C expression by western immunoblotting. Urothelial cells were cultured for single-cell imaging to analyze basal levels of reactive oxygen species and the mitochondrial membrane potential. Mitochondrial bioenergetics and cellular respiration were investigated by the Seahorse assay, and measurements of adenosine triphosphate release were made using the luciferin-luciferase assay. @*Results@#Aging was associated with a significant increase in biomarkers of cellular senescence, oxidative stress, and basal levels of reactive oxygen species. The mitochondrial membrane potential was significantly lower in urothelial cell cultures from aged animals, and cultures from aged animals showed a significant decrease in mitochondrial bioenergetics. @*Conclusions@#Aging-related increases in oxidative stress and excessive reactive oxygen species may be contributing factors underlying lower urinary tract symptoms in older adults. The mechanisms outlined in this study could be utilized to identify novel pharmaceutical targets to improve aging-associated bladder dysfunction.
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Purpose@#The pathophysiology of nocturia and nocturnal polyuria (NP), conditions that become more prevalent with aging, may in part be explained by changes in hormones involved in water homeostasis. The purpose of this study was to analyze the impact of aging on urinary natriuretic peptides in nocturia and NP. @*Methods@#Patients aged ≥18 years completed 24-hour bladder diaries for assessment of nocturia and NP. They were divided into subgroups of ≥65 years old and <65 years old. Urine samples were collected and analyzed for natriuretic peptide (NT-proANP, NT-proBNP, and NT-proCNP) levels. Peptide levels were compared between patients with and without nocturia/NP and within age subgroups; correlation to the NP index (NPi) was determined. @*Results@#Compared to patients without nocturia (N=15), patients with nocturia (N=36) had higher median levels of urinary NT-proANP (15.8 pmol/mmol Cr vs. 10.9 pmol/mmol Cr, P=0.016) and NT-proBNP (6.3 pmol/mmol Cr vs. 4.5 pmol/mmol Cr, P=0.021), but showed no differences in NT-proCNP (2.4 pmol/mmol Cr vs. 2.5 pmol/mmol Cr, P=0.967). Patients ≥65 years old with nocturia had higher NT-proANP (29.8 pmol/mmol Cr vs. 11.0 pmol/mmol Cr, P<0.001) and NT-proBNP (9.6 pmol/mmol Cr vs. 5.0 pmol/mmol Cr, P<0.001) than patients <65 years old. Additionally, patients with NP (N=30) showed higher urinary NT-proANP (19.6 pmol/mmol Cr vs. 10.5 pmol/mmol Cr, P<0.001) and NT-proBNP (6.7 pmol/mmol Cr vs. 4.7 pmol/mmol Cr, P=0.020) compared to patients without NP (N=21). NP patients ≥65 years had higher NT-proANP (29.8 pmol/mmol Cr vs. 12.5 pmol/mmol Cr, P<0.001) and NT-proBNP (9.6 pmol/mmol Cr vs. 4.4 pmol/mmol Cr, P=0.004) than patients <65 years old. NPi positively correlated with urinary NT-proANP (RS=0.417, P=0.002) and NT-proBNP (RS=0.303, P=0.031), but not with NT-proCNP (RS=-0.094, P=0.510). @*Conclusions@#Since urinary NT-proANP and NT-proBNP were greater in aged patients with nocturia and NP, natriuretic peptides may contribute to the pathophysiology of these conditions and further research should aim to explore them as targets for management.
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Purpose@#To conduct a systematic review of preclinical and clinical peer-reviewed evidence linking alterations in oxidative stress biomarkers or outcome measures that were also prevalent in specific age-related lower urinary tract (LUT) disorders. @*Methods@#PubMed, Scopus, CINAHL, and Embase were searched for peer-reviewed studies published between January 2000 and March 2021. Animal and human studies that reported on the impact of oxidative stress in age-related LUT disorders through structural or functional changes in the LUT and changes in biomarkers were included. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocol was followed. @*Results@#Of 882 articles identified, 21 studies (13 animal; 8 human) met inclusion criteria. Across LUT disorders, common structural changes were increased bladder and prostate weights, ischemic damage, nerve damage and detrusor muscle hypertrophy; common functional changes included decreased bladder contraction, increased bladder sensation and excitability, decreased perfusion, and increased inflammation. The disorders were associated with increased levels of biomarkers of oxidative stress that provided evidence of either molecular damage, protective mechanisms against oxidative stress, neural changes, or inflammation. In all cases, the effect on biomarkers and enzymes was greater in aged groups compared to younger groups. @*Conclusions@#Increased oxidative stress, often associated with mitochondrial dysfunction, plays a significant role in the pathogenesis of age-related LUT disorders and may explain their increasing prevalence. This systematic review identifies potential markers of disease progression and treatment opportunities; further research is warranted to evaluate these markers and the mechanisms by which these changes may lead to age-related LUT disorders.
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Purpose@#To investigate urothelial cell proliferation, cytoskeleton, inflammation, and barrier function protein expressions in patients with interstitial cystitis/bladder pain syndrome (IC/BPS) after intravesical platelet-rich plasma (PRP) injections @*Methods@#A total of 19 patients with IC/BPS underwent 4 monthly intravesical PRP injections. Bladder biopsies were taken at the first and fourth PRP treatment. The bladder specimens were analyzed using the Western blot and immunochemical staining for progenitor cell markers for sonic hedgehog (Shh), CD34, and cytoskeleton proteins cytokeratin 5 (CK5), CK14, CK20; barrier function markers for zonula occludens-1 (ZO-1), E-cadherin, and intercellular adhesive molecule-1, tryptase and transforming growth factor-β (TGF-β). Global response assessment (GRA) was used to evaluate treatment outcomes. @*Results@#The mean age of patients was 55.6 years. After PRP injections, the functional bladder capacity and maximum flow rate increased, and the visual analogue scale (VAS) of pain, interstitial cystitis (IC) symptom index, IC problem index, O’Leary-Sant symptom score, and GRA improved in all patients. Urothelium Shh, CK5, ZO-1, E-cadherin, and TGF-β expressions increased significantly after repeated PRP injections. By subgrouping, according to PRP treatment outcomes, significant increases in Shh, E-cadherin, and ZO-1 expressions were noted only in patients with GRA ≥1 or improved VAS, but not in patients with GRA=0 and no improvement in VAS. @*Conclusions@#The level of urothelial barrier function protein and cell proliferation protein expression in the patients with IC/BPS was increased after repeat intravesical PRP injections. Intravesical repeat PRP injections may have potential to improve urothelial health and result in symptoms improvement in the patients with IC/BPS.
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Purpose@#Low nocturnal urine production (NUP) may be sufficient to rule out global polyuria (GP) in men. This study determines the sensitivity of indices for nocturnal polyuria (NP), defined as nocturnal polyuria index (NPi; nocturnal urine volume/24-hour urine volume) ≥0.33 or NUP ≥90 mL/hr, for detecting GP in women. @*Methods@#Data were analyzed from 2 prospective protocols involving subjects recruited from a urology ambulatory care unit and a continence clinic. Women ≥18 years with nocturia were included if they met either of 2 common criteria for GP: (1) ≥40 mL/kg/24 hr or (2) ≥3,000 mL/24 hr. @*Results@#Thirty-one women were included (NPi, 28.6 [21.3–40.7]; NUP, 100.8 [68.3–135.8] mL/hr). At the ≥40 mL/kg/24-hr cutoff, 40% and 63% of women reporting ≥1 nocturnal void(s) (n=30) had NPi ≥0.33 and NUP ≥90 mL/hr, respectively. Additionally, 53% and 71% of subjects reporting ≥2 nocturnal voids (n=17) had NPi ≥0.33 and NUP ≥90 mL/hr, respectively. At the ≥3,000 mL/24-hr cutoff, 38% and 69% of women reporting ≥1 nocturnal void(s) (n=13) had NPi ≥0.33 and NUP ≥90 mL/hr, respectively, and 63% and 88% of subjects reporting ≥2 nocturnal voids (n=8) had NPi ≥0.33 and NUP ≥90 mL/hr, respectively. By extension, 37%–62% of women with nocturia and GP did not have NP by NPi ≥0.33 criteria, and 12%–37% did not have NP by NUP ≥90 mL/hr criteria. @*Conclusions@#Indices of excess nighttime urination do not reliably predict GP in women. A full-length voiding diary may be particularly important in the evaluation of women with nocturia. Nocturia in women merits further consideration as a distinct entity.
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Objetivo. Evaluar la cobertura de artículos y revistas médicas mexicanas durante los 10 años de existencia de la base de datos mexicana Bibliomex Salud. Material y métodos. Se analizó si los artículos publicados por la Revista de Investigación Clínica (RIC) fueron registrados por Bibliomex: la ausencia de un manuscrito RIC en Bibliomex se consideró una falla por omisión. Se recuperó la identidad de las revistas mexicanas capturadas en dicho lapso. Del total de 744 manuscritos, se excluyeron 99 (22 extranjeros, 25 no referenciables y 52 inicialmente no capturados por Bibliomex). El remanente de 645 manuscritos se clasificó de acuerdo con el año en que comenzaron a registrarse: originales desde el inicio, cartas a los editores a partir de 1990, editoriales y respuestas a cartas a partir de 1993. Resultados. Bibliomex inició con 21 revistas mexicanas y actualmente captura más de 50 (12 durante los 10 años, y 27 en los últimos cinco a nueve años); tuvo 8 por ciento de omisiones en originales (46/597) y cartas (3/36) y 25 por ciento en editoriales y respuestas (3/12). Conclusiones: a) Ha mejorado sensiblemente la cobertura de Bibliomex en la segunda mitad de su vida tanto en manuscritos como en revistas: b) el uso de la información publicada por Bibliomex podría mejorarse con dos modificaciones de su proceso operativo; c) Bibliomex parece ser actualmente una base de datos adecuada para recabar información de producción biomédica mexicana que pudiera publicar periódicamente algún organismo interesado
Objetive. To evaluate the coverage of Mexican journals and manuscripts of biomedical research in a Mexican data base (Bibliomex Salud) during its 10 years of existence (1985-1994). Material and methods. All the manuscripts published by a single Mexican journal Revista de Investigación Clínica (RIG) were searched for in Bibliomex: the absence of a RIC manuscript in Bibliomex was considered a failure. Also, the number and identity of the Mexican journals included in Bibliomex was also noted. From a total of 744 manuscripts 99 were excluded (22 non-Mexican, 25 non-indexable, and 52 initially not indexed by Bibliomex). The remainder (645) were classified according to starting year of indexing: originals since the first year; letters to the editor since 1990; and editorials and authors' replies since 1993. Results. Bibliomex started out with 21 Mexican journals and now has more than 50 (12 indexed during the 10 years, 27 for the last 5-9 years, and 16 for the last 1-4 years). Regarding manuscripts, Bibliomex had an 8% failure rate in originals (46/597) and letters (3/36), and 25% in editorials and authors' replies (3/12). Conclusions. a) The coverage of Bibliomex has improved in its second half of life in the number of both journals and manuscripts indexed; b) the retrieval of information could be improved by two changes in the procedures of Bibliomex; c) Bibliomex seems to be a database which could be used to analyze Mexican research production at several levels (institutional, regional, and national).
Subject(s)
Bibliography of Medicine , Bibliometrics , Mexico , Catalogs, LibraryABSTRACT
En el tercer informe del Programa de los INS (Institutos Nacionales de Salud de México) se observó la presencia de imprecisión en 11 de los 30 sistemas evaluados y se atribuyeron a falta de precisión en el manejo de estándares de algunos participantes (3). Las mediciones de esa tercera fase Programa se realizaron silmuntáneamente en los sueros controles y en estándares acuosos de trabajo, esto es, en estándares que ya no tenían que ser manipulados sino que se incluían en el lote como si fueran muestras problemas (estos estándares INS fueron preparados especialmente para el Progrma). Se consideró de interés reanalizar los datos de los sistemas con imprecisión y/o inexactitud a base de comparar los datos originales versus los mismos datos recalculados con los estándares INS, y es el motivo de este informe. Sólo en una minoria de los sistemas (3 de 13) desapareceu los problemas al recalcular los datos con los Estándares INS (precisión en dos sistemas de glucosa y exactitud enb uno de urea: tabla 5). O sea, sólo en dos sistemas el manejo de sus estándares reperente en variabilidad de la concentración de los mismos. En los demás sistemas, el problema de manejo de estándares no repercute en la concentración sino que, más probablemente, la viaribilidad obedece a variaciones de los volúmenes de reactivos, sueros y/o estándares que mezclan en el proceso de medición
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Creatinine/standards , Glucose/standards , Urea/standards , Health Facilities/standards , Mexico , National Health ProgramsABSTRACT
El desarrollo de un nuevo metodo para la cuantificacion de amilasa en liquidos organicos (MC), el cual utiliza almidon sintetico de composicion definida como sustrato y la liberacion de un colorante como marcador, ha venido a desplazar al metodo habitual de Caraway (MY). En este estudio se establecieron los valores de referencia para amilasa serica mediante el MC en 192 sujetos mexicanos sin evidencia de enfermedad, proporcionando los resultados para las percentilas 5 y 95 (173.0 y 393.5 U/1) o las percentilas 2.5 y 97.5 (157.5 y 444.5 U/1) de la distribucion total.Se observaron dos fenomenos de especial significacion: a) Diferencia considerable respecto a los valores correspondientes en poblaciones anglo-sajonas o caucasicas (70 a 300 U/1); b) Variacion dependiente de la edad, con pico maximo de la amilasa serica en la cuarta decada de la vida (p < 0.05). factores genericos y/o dieteticos pueden determinar estas diferencias. Al comparar al MC con el MY en 150 sueros se encontraron evidencias de inespecificidad del ultimo. Finalmente, la precision fue sustancialmente mejor en el MC
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Adolescent , Adult , Middle Aged , Humans , Male , Female , Amylases , Isoenzymes , Reference Values , Age FactorsABSTRACT
Se evaluo la exactitud de un aparato portatil comercial que se utiliza para las mediciones de la citologia hematica. La evaluacion se realizo intersistemas (comparando dos aparatos portatiles de igual modelo). La comparacion intersistemas permitio establecer: a) el aparato portatil solo mide adecuadamente a la hemoglobina; b) todos los demas parametros de la citologia (hematocrito, numero de eritrocitos y los 3 indices eritrociticos) son influenciados, en mayor o menor grado, por el tamano del eritrocito: arroja resultados falsos en sangres que tienen micro o macrocitosis. Estos inhabilita al sistema portatil como un medio adecuado para caracterizar morfologicamente a las sangres problema. La comparacion intrasistema establecio que no es constante la calibracion de hemoglobina del aparato portatil que realiza el fabricante, lo cual plantea la necesidad de evaluar la exactitud de hemoglobina de dichos aparatos. Si se desean resultados confiables, el aparato portatil debe usarse solamente en las mediciones de hemoglobina una vez que se haya valido la exactitud de su calibracion
Subject(s)
Hematologic TestsABSTRACT
Se dosifico ferritina en 89 sueros mediante dos metodos: IRMA (immunorradiometroanalisis) y RIA (radioinmunoanalisis). Con la prueba de t pareada, la comparacion inter-metodos mostro que no habia diferencias significativas a niveles bajos (0.33 microgramo/L) y altos (805-1196 microgramo/L) pero que si la habia a niveles intermedios (46-422 microgramos/L). Con un experimento adicional en el que se midieron estandares de IRMA con el metodo de RIA, se demostro que las diferencias no eran atribuible a diferencias en los estandares. Este hallazgo pone de manifiesto los problemas de comparar datos, sean de sujetos mornales o enfermos, si estos son obtenidos con metodologias diferentes
Subject(s)
Humans , Female , Ferritins , Immunologic TechniquesABSTRACT
Se planteo un estudio retrospectivo del promedio de enfermos truncado (PET) en las mediciones de hierro serico en vista de que se descubrio la presencia de un error sistematico en dichas mediciones. El error sistematico se traducia en valores falsamente altos de hierro y de capacidad de fijacion de hierro, por lo cual no repercutia en el indice de saturacion. El PET fue exitoso al mostrar que el error sistematico se instauro bruscamente a principios de agosto de 1980, y que persistio hasta junio de 1981. No se pudo, por otra parte, establecer en forma inequivoca la causa del error sistematico. Este estudio confirma la utilidad del promedio de enfermos en los programas internos de nuestra institucion, ya que ofrece informacion que va a permitir preservar la buena calidad de las mediciones de hierro que se ha logrado desde julio de 1981 hasta la fecha actual
Subject(s)
Humans , Iron , Quality ControlSubject(s)
Infant , Child, Preschool , Adolescent , Adult , Middle Aged , Humans , Male , Female , Anemia, Hypochromic , Erythrocyte Indices , PorphyrinsABSTRACT
Se evalua la reserva insulinica de las celulas beta de los islotes de Langerhans mediante perfusion de arginina al 10% en 64 ninos (29 varones, 35 ninas) de edades comprendidas entre 3 anos 9 meses y 13 anos 4 meses; referidos al Servicio de Endocrinologia del Hospital Nacional de Ninos "Dr. Carlos Saenz Herrera" por retraso estatural y crecimiento lento. Se distribuyen en tres grupos: grupo A normal grupo B con retraso estatural sin patologia endocrina pero con patologia sistemica asociada; Grupo C con retraso del crecimiento en relacion a deficit de GH. Se determina glicemia, insulina y GH.Se encuentra significativa elevacion de la insulinemia a los 60 minutos excepto en dos ninos del grupo C, cuya respuesta maxima se obtuvo a los 30 minutos. No se encontro diferencia en el analisis de las insulinemias de los tres grupos entre si. Se obtuvo GH pero no en el Grupo C
Subject(s)
Child, Preschool , Child , Adolescent , Humans , Male , Female , Arginine , Islets of Langerhans , Growth Disorders , Insulin , Body HeightABSTRACT
Se evalua la utilidad de la prueba de esfuerzo como metodo rapido de deteccion de la secrecion GH en ninos de pequena talla para determinar cuales son normales y en que casos debe completarse el estudio con otras pruebas de estimulo. Se estudiaron 50 con edades entre 3 anos 9 meses y 18 anos. Se descartaron las diversas causas de retraso estatural, excepto el deficit de GH. En todos ellos se realizaron primero las pruebas de hipoglicemia insulinica y perfusion de arginina. Los pacientes con respuesta normal a la prueba de esfuerzo respondieron en igual forma a la insulina y a la arginina. Ningun paciente normal para la prueba de esfuerzo fue anormal o dudoso para las otras prueba. Es un metodo excelente para demostrar reseva hipofisaria normal em GH. Es una prueba fisiologica, carente de riesgos, de facil ejecucion y economica, pues solo requiere proceder dos muestras. Tiene como e obvio la limitacion de la edad y del estado fisico del paciente, pues se necesita su colaboracion