Botulinum toxin injections for adults with overactive bladder syndrome.

BACKGROUND: Overactive bladder syndrome is a common condition with a significant negative impact on quality of life. Intravesical injection of botulinum toxin is increasingly used as an intervention for refractory overactive bladder, with a considerable body of case reports and series in the literature suggesting beneficial effects. OBJECTIVES: The objective was to compare intravesical botulinum toxin injection with other treatments for neurogenic and idiopathic overactive bladder in adults. The hypotheses addressed were whether intravesical injection of botulinum toxin was better: than placebo or no treatment, pharmacological and other non-pharmacological interventions, whether higher doses of botulinum toxin were better than lower doses, whether botulinum toxin in combination with other treatments was better than other treatments alone, whether one formulation of botulinum toxin is better than another, and whether one injection technique was better than another. SEARCH STRATEGY: We searched the Cochrane Incontinence Group Specialised Trials Register (searched 22 November 2005). The register contains trials identified from MEDLINE, CINAHL, the Cochrane Central Register of Controlled Trials (CENTRAL), and handsearching of journals and conference proceedings. Additionally, all reference lists of selected trials were searched. No limitations were placed on the searches. SELECTION CRITERIA: All randomised or quasi-randomised controlled trials of treatment for overactive bladder syndrome in adults in which at least one management arm involved intravesical injection of botulinum toxin were included. Participants had either neurogenic or idiopathic overactive bladder with or without stress incontinence. Comparison interventions could include no intervention; placebo; lifestyle modification; bladder retraining; pharmacological treatments; surgery; bladder instillation techniques; neuromodulation; and different types, doses, and injection techniques of botulinum toxin. DATA COLLECTION AND ANALYSIS: Binary outcomes were presented as relative risk and continuous outcomes by mean differences. No data could be synthesised across studies due to differing designs and outcome measures. Data were tabulated where possible with results taken from trial reports where this was not possible. Where multiple publications were found, the reports were treated as a single source of data. MAIN RESULTS: Eight studies met the inclusion criteria. Results varied between studies. For the most part, studies reported superiority of botulinum toxin A to placebo in such outcomes as incontinence episodes, bladder capacity, maximum detrusor pressure, and quality of life. Low doses of botulinum toxin (100U to150U) appeared to have beneficial effects, but higher doses (300U) may have been more effective. Botulinum toxin appeared to have beneficial effects in overactive bladder that quantitatively exceeded the effects of intravesical resiniferatoxin. AUTHORS' CONCLUSIONS: Intravesical botulinum toxin shows promise as a therapy for overactive bladder symptoms, but as yet too little controlled trial data exist on benefits and safety compared with other interventions, or with placebo. Practitioners should be aware that at present there is little more than anecdotal evidence, in the form of case reports to support the efficacy of intravesical botulinum toxin; there is not much in the way of substantial, robust safety data. Furthermore, the optimal dose of botulinum toxin for efficacy and safety has not yet been demonstrated.

Watermelon growth, fruit yield and plant survival as affected by squash bug (Hemiptera: Coreidae) feeding.

Adult squash bugs, Anasa tristis (De Geer) (Heteroptera: Coreidae), were confined on watermelon plants at differing phenological stages and at densities of zero to four per plant in one trial and zero to 32 per plant in three additional trials. Squash bugs were allowed to feed on the plants until plants died or fruit matured. Plant foliage, roots, and fruit were harvested and weighed to determine effects on growth and productivity. Growth and fruit production was regressed on number of squash bugs and results indicated that an increasing density of squash bugs feeding on vining and flowering stage plants resulted in significant reductions in plant growth and fruit yield. When plants were infested at the fruit set stage of growth, there was either less effect or no effect on plant growth and fruit production. Plant mortality increased as the density of squash bugs increased regardless of the stage of growth when plants were infested with squash bugs.

Watermelon seedling growth and mortality as affected by Anasa tristis (Heteroptera: Coreidae).

Adult squash bugs, Anasa tristis (De Geer), were confined on seedling watermelon plants at densities of zero, one, two, and four per plant. Squash bugs were allowed to feed on the plants until plants died or reached 30 cm in height. Number of leaves and length of plant vine were recorded at 2- or 3-d intervals. Seedling foliage, stems, and roots were harvested and dried after plants reached 30 cm in height. Growth of seedlings was regressed on number of squash bugs and results indicated that an increasing density of squash bugs feeding on seedlings resulted in a significant reduction in plant growth. Additionally, increased density of squash bugs resulted in reduced weight of foliage and root dry biomass. Seedling mortality increased as the density of squash bugs increased.

Toxicity of biorational insecticides: activity against the green peach aphid, Myzus persicae (Sulzer).

The relationship between dose for each of four biorational insecticides (pyrethrins, neem extract, capsiacin extract, insecticidal soap) and mortality of the green peach aphid (Myzus persicae) was determined using a laboratory bioassay. These insecticides were toxic to aphids and paired mixtures of the insecticides provided synergistic activity as measured by aphid mortality under the laboratory bioassay conditions. Capsiacin extracts were found to provide low levels of mortality alone but acted synergistically in mixtures with the other insecticides and provided higher than expected levels of mortality. Activity as determined in the laboratory for each insecticide was not evident under field-use conditions in five separate experiments. Under field conditions and using common application methods, these insecticides did not provide significant levels of control of aphids.

Alterations in polyamine catabolic enzymes in human breast cancer tissue.

High concentrations of acetyl polyamines have been observed in human breast cancer compared with the equivalent normal tissue, however, no explanation as to the reason for the increases has been proposed. In this study, we show that changes in the enzymes responsible for the breakdown of acetyl polyamines occur in breast cancer tissue. Spermidine/spermine N1-acetyltransferase, the first and rate-limiting enzyme in polyamine catabolism, is increased in the tumor tissue whereas polyamine oxidase (PAO) is decreased. The changes in PAO correlate with prognostic factors, and activity decreases as the size and histological grade of tumors increase. The metabolism of polyamines by PAO generates locally high concentrations of hydrogen peroxide, a known inducer of apoptosis; thus, low PAO activity may contribute to the low level of apoptosis seen in tumor cells. Therefore, drugs that induce PAO activity may be a novel means of attacking tumor cells.

Influence of Temperature and Leaf Wetness Duration on Infection of Strawberry Leaves by Mycosphaerella fragariae.

ABSTRACT In controlled environment studies, the influence of temperature and wetness duration on infection of strawberry leaves by Mycosphaerella fragariae was quantified by inoculating plants with a conidial suspension and incubating them at various combinations of temperature (5 to 35 degrees C) and leaf wetness duration (0 to 96 h). Infection was expressed as the number of lesions per square centimeter of leaf surface and relative infection was used to develop an infection model. Younger leaves were more susceptible to infection. Regardless of temperature and duration of leaf wetness, only few lesions developed on the oldest (19 to 21 days old) and intermediate leaves (12 to 15 days old), respectively (maximum of 1.7 and 2.3 lesions per cm(2)) as compared to the youngest leaves (5 to 7 days old; maximum of 12.6 lesions per cm(2)). On the youngest leaves, lesions developed at all temperatures except at 35 degrees C, and the number of lesions, for all leaf wetness durations, increased gradually from 5 to 25 degrees C and decreased sharply from 25 to 30 degrees C. For temperatures of 15 and 20 degrees C, the number of lesions increased gradually when leaf wetness duration increased from 12 to 96 h. At 25 degrees C, the number of lesions increased with increasing leaf wetness from 12 to 48 h and then at a higher rate from 48 to 96 h. The optimal temperature for infection was 25 degrees C. For most temperatures, a minimum of 12 h of leaf wetness was necessary for infection (more than 1 lesion per cm(2)). Relative infection was modeled as a function of both temperature and wetness duration using a modified version of the Weibull equation (R (2) = 0.98). The resulting equations provided a precise description of the response of M. fragariae to temperature. The model was sufficiently flexible to account for most characteristics of the response of M. fragariae to wetness duration. The model was used to construct a risk chart that can be used to estimate the potential risk for infection based on observed or forecasted temperature and leaf wetness duration.

Effects of Temperature and Wetness Duration on Infection of Peanut Cultivars by Cercospora arachidicola.

ABSTRACT The effects of temperature and duration of wetness (relative humidity >/=95%) on infection of three peanut cultivars by Cercospora arachidicola were determined under controlled conditions. Plants of the Spanish cv. Spanco and the runner cvs. Florunner and Okrun were exposed to constant temperatures of 18 to 30 degrees C during 12-h periods of wetness each day that totaled 12 to 84 h following inoculation of leaves with conidia. Severity of disease, measured by either lesion density (number per leaf) or lesion size (diameter), was greatest for 'Spanco', intermediate for 'Florunner', and lowest for 'Okrun' in each of two experiments. Lesion density was evaluated further because it was an indicator of both the occurrence and degree of infection. Nonlinear regression analysis was employed to evaluate the combined effects of temperature (T) and wetness duration (W) on lesion density (Y). In the regression model, the Weibull function characterized the monotonic increase of Y with respect to W, while a hyperbolic function characterized the unimodal response of Y with respect to T. Parameters for the intrinsic rate of change with respect to W (b), the intrinsic rate of change with respect to T (f), the optimal value of T (g), and the upper limit (e) when T is optimum (T = g) were estimated for each cultivar and experiment. The effect of cultivar was characterized primarily by differences in the upper limit parameter e. In each experiment, e was greatest for 'Spanco', intermediate for 'Florunner', and least for 'Okrun'. The effect of cultivar on b followed a pattern similar to that for e in experiment 1, but not in experiment 2. Differences among cultivars for estimates of f and g were small and inconsistent. Estimates for g were precise for each cultivar and experiment and fell within the range of 22.3 to 23.2 degrees C. Cultivar responses to T and W were further evaluated using data pooled over the two experiments. Parameter e was estimated for each cultivar, but common values of b, f, and g were estimated. At e = 22.8 degrees C, lesion density approached an upper limit of 96, 17, and 6 lesions per leaf for the cvs. Spanco, Florunner, and Okrun, respectively. These fitted values approximated the observed values of 86, 25, and 9 lesions per leaf for the respective cultivars. Cultivars varied in their response to W at a given T. At 22.8 degrees C, one lesion per leaf was expected following 26, 30, and 36 h of wetness for 'Spanco', 'Florunner', and 'Okrun', respectively. If temperature was increased to 28 degrees C, one lesion per leaf was expected following 36, 44, and 54 h of wetness for the respective cultivars.

Comparison of two prophylactic single-dose intravenous antibiotic regimes in the treatment of patients undergoing elective colorectal surgery in a district general hospital.

Two hundred and twenty-nine patients were entered into a study to compare the effectiveness and safety of two single-shot antibiotic regimes in patients undergoing elective colorectal surgery in two district general hospitals. A single shot of intravenous (IV) latamoxef disodium was as effective as an IV combination of cefuroxime and metronidazole in control of wound infection following elective large bowel surgery when given as a bolus at the time of anaesthetic induction. The incidence of major wound infection was 6% and was evenly distributed in the two treatment groups. Half the major wound infections were associated with faecal fistulae. A single shot of IV antibiotic at the time of anaesthetic induction was safe, simple and an effective prophylaxis against major wound infection. There was a low incidence (1.3%) of serious postoperative bleeding and no serious adverse reactions were noted. The overall mortality was 9%. Death was significantly related to elderly patients, a poor performance status, operative contamination and wound infections.

Highly sensitive polarization-controlled optical switching with a photorefractive double phase conjugator.

Highly sensitive polarization-controlled optical switching is demonstrated experimentally through a photorefractive BaTiO(3) double-phase-conjugate mirror. A theoretical explanation is developed, and possible applications are mentioned.

Wavefront conjugation and amplification for optical communication through distorting media: experiment.

The laboratory performance of recently proposed new architectures for optical communication through distorting media is investigated. After phase-conjugating a weak beam with a mutually incoherent source a power amplification with a gain factor of 500 was demonstrated. The amplified beam can be employed for distortion-free optical communication by direct signal transmission. In a different configuration, wavefront matching applicable for coherent detection is proved to be feasible.

Aetiology of rheumatoid arthritis: an attempt to transmit an infective agent from patients with rheumatoid arthritis to baboons.

Thirty baboons were injected intravenously and intra-articularly with material from the joints of 19 patients with active rheumatoid arthritis or with control material. Fifteen of the 30 animals received synovial fluid cells or synovial membrane cells from 3 patients with seronegative arthritis. Ten animals received pooled cells from a total of 16 cases of seropositive arthritis. Five animals were given nonrheumatoid cells. No signs of arthritis were recognised in the 27 surviving animals during 3 years of observation. No significant biochemical, haematological, or serological changes occurred during this period, and no gross or microscopic evidence of synovial or systemic disease was found post mortem.

Real-time screen-aided multiple-image optical holographic matched-filter correlator.

The basic principle and experimental results of applying a specific contact screen for performing multiplex holographic filtering in a real-time coherent optical correlator are presented. The specific design and fabrication of a 1- and 2-D gray density contact screen as well as a 2-D dichromated gelatin phase screen are described. The 2-D density-type screen can yield nearly an equal intensity 5 x 5 array of spectrum islands at the Fourier plane of a Fourier transform lens in a coherent optical image processor. The main drawback of the density-type screen is the lack of required light efficiency at the Fourier plane because of the blocking of light by the silver particles in the screen. Dichromated gelatin phase screens can be made to alleviate this problem, but it is very difficult to fabricate a phase screen exactly according to our design due to inherent experimental limitations. Nevertheless a functional phase screen has been made for the desired correlation functions. Experimental results have demonstrated that the phase screen is reasonably efficient for the multiplex holographic filtering in the real-time correlator.