Prevalence of self-reported complications associated with intermittent catheterization in wheelchair athletes with spinal cord injury.

STUDY DESIGN: Cross-sectional study. OBJECTIVES: To identify the prevalence of complications associated with intermittent catheterization in wheelchair athletes with spinal cord injury (SCI). SETTING: International and national sporting events. METHODS: A total 130 competitive wheelchair athletes living with SCI completed a self-reported questionnaire during international or national sporting events. The questionnaire collected information regarding demographics, injury characteristics, method of bladder emptying, and complications related to intermittent catheterization. RESULTS: Overall, 84% (109/130) of wheelchair athletes used intermittent catheterization. Within this group, 77% of athletes (84/109) experienced at least one complication associated with intermittent catheterization. Twenty-seven percent (29/109) sustained urethral injuries and 63% (69/109) had at least one episode of urinary tract infection during the last 12 months. Almost one-fourth of male athletes (22/95, 23%) had a history of inflammation / infection of genital organs associated with intermittent catheterization. CONCLUSIONS: Here we report a high prevalence of self-reported complications associated with intermittent catheterization in wheelchair athletes with SCI. Considering their potential impact on lower urinary tract function, athletic performance, and health, further studies are needed to assess the role of preventative strategies to reduce complications related to intermittent catheterization in wheelchair athletes with SCI. SPONSORSHIP: Coloplast Brazil and Instituto Lado a Lado pela Vida (a nongovernmental, nonprofit organization based in São Paulo) and Wellspect provided funding for this study.

Bladder lesions as incidental findings during transurethral resection of the prostate: prevalence, diagnosis, and pathological findings.

PURPOSE: The purpose of this study was to determine the prevalence of bladder lesions diagnosed during transurethral resection of the prostate (TURP), to identify the associated risk factors, and to correlate the macroscopic descriptions with the pathological findings. METHODS: This was a single-center retrospective case series conducted at a hospital in the city of São Paulo, Brazil. We reviewed the medical and surgical records of patients who underwent TURP between January 2012 and December 2017. RESULTS: The final sample comprised 513 patients, with a mean age of 70.8 years. Bladder lesions were identified during TURP in 109 (21.2%) of the patients, and 90 of those lesions were submitted for pathological examination. The most common macroscopic finding was bullous edema, which was seen in 57 (63.3%) of the 90 lesions examined. The pathological analysis revealed chronic cystitis in 61 lesions (67.8%) and malignant lesions in 16 (17.8%). Of the 57 lesions described as bullous edema, 5 (8.8%) were found to be malignant. CONCLUSIONS: Alterations in the bladder mucosa appear to be more common among elderly patients who use an indwelling urinary catheter for a prolonged period and among patients with recurrent urinary tract infections. In addition, the risk of a bladder lesion being malignant is apparently higher in current and former smokers than in never smokers. Our findings suggest that at-risk patients should undergo biopsy or resection of incidental bladder lesions even if those lesions seem to be benign, due to the low level of agreement between the visual analysis and the pathological examination.

Single ZnO Nanowire-Based Gas Sensors to Detect Low Concentrations of Hydrogen.

Low concentrations of hazardous gases are difficult to detect with common gas sensors. Using semiconductor nanostructures as a sensor element is an alternative. Single ZnO nanowire gas sensor devices were fabricated by manipulation and connection of a single nanowire into a four-electrode aluminum probe in situ in a dual-beam scanning electron microscope-focused ion beam with a manipulator and a gas injection system in/column. The electrical response of the manufactured devices shows response times up to 29 s for a 121 ppm of H2 pulse, with a variation in the nanowire resistance appreciable at room temperature and at 373.15 K of approximately 8% and 14% respectively, showing that ZnO nanowires are good candidates to detect low concentrations of H2.

Development of a new pulsed source for photoacoustic imaging based on aperiodically poled lithium niobate.

We present the development of a source of deep-red radiation for photoacoustic imaging. This source, which is based on two cascaded wavelength conversion processes in aperiodically poled lithium niobate, emits 10 nanosecond pulses of over 500 µJ at 710 nm. Photoacoustic images were obtained from phantoms designed to mimic the optical and acoustic properties of oral tissue. Results indicate this device is a viable source of optical pulses for photoacoustic applications.

Obtención de monoglicéridos de aceite de ricino empleando glicerina refinada y cruda: estudio de las principales variables del proceso / Production of monoglycerides from castor oil using crude and refined glycerin: study of the main variables of the process

Los monoglicéridos son ampliamente usados como emulsionantes en las industrias alimentaria, farmacéutica y cosmética. En este estudio se reportó la producción de monoglicéridos de aceite de ricino por reacciones de glicerólisis usando glicerina USP y la glicerina cruda, subproducto del proceso de producción del biodiesel de palma. Se emplearon catalizadores básicos como hidróxidos metálicos y óxido de plomo, y ácidos como acetato de plomo. Los resultados señalan que los catalizadores basados en plomo proporcionaron mayores conversiones hacia los monoglicéridos que los basados en sodio, potasio y calcio. Se encontró que una alta relación molar de aceite/glicerina fue una variable determinante que favorece altas concentraciones de monoglicéridos. Finalmente, se demostró que el uso de glicerina cruda para la producción de monoglicéridos es factible, aunque en este caso la concentración de monoglicéridos obtenidos se disminuye aproximadamente en un 20% debido, probablemente, al envenenamiento de los catalizadores.

Monoglycerides are widely used as emulsifiers in food, pharmaceutical and cosmetic industries. In this article was reported the production of monoglycerides from castor oil, by glicerolysis reactions, using USP glycerine and crude glycerol derived from a palm-biodiesel production process. Metalic hydroxides and lead oxide were used as basic catalysts, while lead acetate was used as acid catalyst. Results showed that the lead-based catalysts exhibited higher conversions to monoglycerides respect to those based on sodium, potassium and calcium. We found that a high molar ratio oil/glycerol was a determinant variable that favors high concentrations of monoglycerides. Ultimatelly, it was shown that it is feasible to use crude glycerol for the production of monoglycerides, although in this case the concentration of monoglycerides is reduced 20% due to the poisoning of the catalysts.

Extracción del carotenoide licopeno del tomate chonto (Lycopersicum esculentum) / Extraction of the carotenoid lycopene from chonto tomato (Lycopersicum esculentum)

El licopeno, al cual el tomate debe su tonalidad roja, además de presentar grandes propiedades como colorate, es un poderoso antioxidante que ayuda a combatir enfermedades degenerativas. Debido a la importancia que se ha venido dando al licopeno por sus propiedades, en esta investigación se comparan los métodos de extracción arrastre con vapor y extracción con solventes, con base en el rendimiento obtenido y el pretratamiento dado a la muestra vegetal, caracterizando los extractos obtenidos mediante espectrometría visible UV. Además, se desarrollan extracciones para determinar tanto el contenido de licopeno en tomate chonto Lycopersicum esculentum, como otros parámetros del proceso de extracción: temperatura, relación masa de pulpa de tomate a volumen de solvente, tiempo de extracción y número de etapas. Con estos parámetros se propone el diseño básico de una planta piloto para la extracción de dicho carotenoide, disponiendo los equipos según el correspondiente diagrama de flujo y bajo las demás condiciones de operación necesarias para evitar la degradación y descomposición del licopeno a lo largo del proceso, y que permita obtener un rendimiento de 6 g de oleorresina/ Kg de pulpa

Obtención de oleorresina de pimentón (Capsicum annuum L) / Extraction of oleoresin from sweet pepper (Capsicum annuum L)

La oleorresina de pimentón (Capsicum annuum L.) contiene fundamentalmente carotenoides, capsaicinoides y algunas vitaminas. Tradicionalmente se usa en la industria alimentaria. Se obtiene mediante un proceso en las siguientes etapas: a) escaldado, b) troceado, c) secado, d) molienda, y e) extracción con solventes volátiles (hexano, acetona, acetato de etilo). Los pigmentos que se extraen se analizan mediante HPLC en fase reversa y se comparan con la oleorresina de paprika comercial importada por la empresa TECNAS©.El rendimiento que se obtiene en el laboratorio está entre 3 (por ciento) y 6 (por ciento). Los resultados muestran la importancia del escaldado y del secado: el escaldado permite alcanzar una humedad del 13,56 (por ciento) en 320 min (sin escaldar en el mismo tiempo se llega al 21,01 (por ciento) y el secado posibilita la extracción con solventes.

Concurrent validity, internal consistency and responsiveness of the portuguese version of the king's health questionnaire (KHQ) in women after stress urinary incontinence surgery

OBJECTIVE: To evaluate the concurrent validity, internal consistency and responsiveness of King's Health Questionnaire (KHQ) in patients who underwent sling procedures for the treatment of stress urinary incontinence. MATERIALS AND METHODS: We performed a prospective open label multicenter study in 4 tertiary referral centers. Sixty-eight female patients were enrolled with urodynamically diagnosed urinary stress incontinence. Patients were treated using surgical procedures, mostly (73 percent) with the synthetic sling procedure, which has been considered one of the gold standard methods for the treatment of urinary incontinence. The patients were assessed before and after one month of postoperative follow up, using the KHQ in its validated Portuguese version. Patients also underwent preoperative urodynamic test, Stamey incontinence grading, pad usage and the assessment of number of pads used per day. After surgery, patients underwent stress test, Stamey incontinence grading pad usage and the assessment of number of pads used per day. RESULTS: The concurrent validity showed good correlations in some domains of KHQ to clinical parameters. The internal consistency was higher after treatment compared to preoperative values. Objective parameters, such as pad usage and the assessment of number of pads used per day, had significant correlation with changes in post-treatment scores on KHQ. The responsiveness expressed in terms of standardized effect size (SES) and standardized response mean (SRM) was large. CONCLUSION: The results showed moderate concurrent validity, strong internal consistency and high responsiveness for KHQ, indicating that it is suitable for measuring outcomes in clinical trials among female patients with stress urinary incontinence.

Concurrent validity, internal consistency and responsiveness of the Portuguese version of the King's Health Questionnaire (KHQ) in women after stress urinary incontinence surgery.

OBJECTIVE: To evaluate the concurrent validity, internal consistency and responsiveness of King's Health Questionnaire (KHQ) in patients who underwent sling procedures for the treatment of stress urinary incontinence. MATERIALS AND METHODS: We performed a prospective open label multicenter study in 4 tertiary referral centers. Sixty-eight female patients were enrolled with urodynamically diagnosed urinary stress incontinence. Patients were treated using surgical procedures, mostly (73%) with the synthetic sling procedure, which has been considered one of the gold standard methods for the treatment of urinary incontinence. The patients were assessed before and after one month of postoperative follow up, using the KHQ in its validated Portuguese version. Patients also underwent preoperative urodynamic test, Stamey incontinence grading, pad usage and the assessment of number of pads used per day. After surgery, patients underwent stress test, Stamey incontinence grading pad usage and the assessment of number of pads used per day. RESULTS: The concurrent validity showed good correlations in some domains of KHQ to clinical parameters. The internal consistency was higher after treatment compared to preoperative values. Objective parameters, such as pad usage and the assessment of number of pads used per day, had significant correlation with changes in post-treatment scores on KHQ. The responsiveness expressed in terms of standardized effect size (SES) and standardized response mean (SRM) was large. CONCLUSION: The results showed moderate concurrent validity, strong internal consistency and high responsiveness for KHQ, indicating that it is suitable for measuring outcomes in clinical trials among female patients with stress urinary incontinence.

Male perineal sling with autologous aponeurosis and bone fixation: description of a technical modification

Post-prostatectomy urinary incontinence is an uncommon complication of adenomectomies, occurring in approximately 1 percent of cases and being more frequent following radical prostatectomies. There is a significant implication in the quality of life for these patients. The surgical techniques employed for its treatment are the implantation of an artificial sphincter, peri-urethral injections and suburethral slings. Considering the low efficacy of peri-urethral injections and the high cost of artificial sphincters, we present in this work a technical modification of the suburethral sling, whose preliminary results are satisfactory. The fundamental modification in this technique is due to the replacement of the synthetic material usually employed for making the sling for autologous tissue, constituted by an aponeurotic strip taken from the rectus muscle of abdomen. This modification aims to minimize risks of urethral erosion that, despite it was not described in this population due to the use of synthetic materials, is a possibility when facing the tension that is used over the bulbar urethra. In addition to such aspects the autologous aponeurosis does not have a cost except for a short prolongation of the surgical act.

Male perineal sling with autologous aponeurosis and bone fixation - description of a technical modification.

Post-prostatectomy urinary incontinence is an uncommon complication of adenomectomies, occurring in approximately 1% of cases and being more frequent following radical prostatectomies. There is a significant implication in the quality of life for these patients. The surgical techniques employed for its treatment are the implantation of an artificial sphincter, peri-urethral injections and suburethral slings. Considering the low efficacy of peri-urethral injections and the high cost of artificial sphincters, we present in this work a technical modification of the suburethral sling, whose preliminary results are satisfactory. The fundamental modification in this technique is due to the replacement of the synthetic material usually employed for making the sling for autologous tissue, constituted by an aponeurotic strip taken from the rectus muscle of abdomen. This modification aims to minimize risks of urethral erosion that, despite it was not described in this population due to the use of synthetic materials, is a possibility when facing the tension that is used over the bulbar urethra. In addition to such aspects the autologous aponeurosis does not have a cost except for a short prolongation of the surgical act.

A double-blind, randomized, placebo-controlled study, to assess the efficacy of alfuzosin in the treatment of patients with benign prostatic hyperplasia / Um estudo duplo cego, randomizado e controlado com placebo para avaliar a eficácia da alfuzosina no tratamento de pacientes com hiperplasia prostática benigna

Introduçäo: Os alfa-bloqueadores säo hoje as drogas de escolha no tratamento clínico de pacientes com hiperplasia prostática benigna (HPB). Os autores apresentam os resultados de um estudo prospectivo, randomizado, duplo-cego, e controlado por placebo da alfuzosina no tratamento de pacientes com HPB. Material e métodos: 31 pacientes foram randomizados em dois grupos: alfa-bloqueador seletivo alfuzosina na dose de 5 mg duas vezes ao dia (n=16) ou placebo (n=15) por 12 semanas. Os pacientes foram selecionados de acordo com critérios de inclusäo e exclusäo que, de forma geral, incluiram pacientes com 50 anos de idade ou mais, escore internacional de sintomas prostáticos (EISP) de 12 pontos, índice de qualidade de vida (IQV) de 3 pontos ou mais, e fluxo urinário máximo (Fmáx) entre 5 e 15 ml/s. Resultados: Näo houve diferença na taxa de melhora do EISP (37 por cento versus 29 por cento, p=0,446) e IQV (15 por cento versus 21 por cento, p=0,446) entre o grupo alfuzosina e o grupo placebo. No entanto, embora marginalmente significante, o Fmáx mostrou uma melhora marcante após a alfuzosina quando comparado ao placebo (50 por cento versus 5,5 por cento, p=0,06). A incidência de efeitos colaterais foi similar em ambos os grupos, alfuzosina e placebo (43,8 por cento versus 40 por cento, respectivamente). Conclusöes: O alfa-bloqueador alfuzosina näo é uma panacéia e, em alguns pacientes, a melhora clínica ocorre principalmente devido ao efeito placebo, que neste estudo resultou em aproximadamente 30 por cento de melhora do EISP (p=0,001), 21 por cento de melhora do IQV (p=0,017) e um aumento do Fmáx ò50 por cento em 26,5 por cento dos pacientes. Entretanto, o alfa-bloqueador alfuzosina tem um papel importante na abordagem clínica da HPB, já que seu mecanismo de açäo alivia o componente dinâmico da obstruçäo prostática, como demonstrado pela melhora do Fmáx.