Nevin Manimala

Urologiia. 2021 Jun;(3):70-74.

ABSTRACT

INTRODUCTION: Benign prostatic hyperplasia (BPH), and chronic prostatitis (CP) are considered to be among the most common causes of lower urinary tract symptoms (LUTS) in men. The combination of BPH with CP raises many questions when choosing the right treatment strategy. For a long time, bioregulators isolated from the prostate gland of cattle have been successfully used in the treatment of CP.

OBJECTIVE: to evaluate the effectiveness of bioregulatory peptides, in particular vitaprost, in the treatment of men with benign prostatic hyperplasia and chronic prostatitis.

MATERIALS AND METHODS: The study included 60 patients with BPH and CP, who were divided into two groups of 30 people. In the comparison group (CG), complex therapy with drugs from the group of alpha-blockers and fluoroquinolones was performed. In the main group (MG), a similar complex therapy was performed in combination with vitaprost tablets. The effectiveness of the treatment was evaluated after two weeks (visit 2) and after 4 weeks (visit 3).

RESULTS: In the MG, a more effective reduction in the severity of LUTs and manifestations of the inflammatory process was noted than in the HS. After 2 weeks of therapy in OG, the average score on the IPSS, QOL and NICH-CPSI questionnaires was lower by 2.4 points, 1.2 points and 2.5 points, respectively, the number of white blood cells in the prostate secret was on average 1.5 times less, and Qmax was higher by 1.4 ml/sec. The revealed differences were statistically significant (p<0.05). This trend continued after 4 weeks of therapy.

CONCLUSION: Thus, the use of bioregulatory peptides, in particular the drug vitaprost, in patients with BPH and CP helps to reduce the severity of LUTs and pain in a shorter time, has a positive effect on the dynamics of the inflammatory process, which leads to an improvement in the quality of life of patients in this category.

PMID:34251104

Urologiia. 2021 Jun;(3):61-69.

ABSTRACT

INTRODUCTION: Transurethral resection of the prostate (TURP) is the gold standard of BPH surgical treatment. It is of current interest to search for medications that can reduce the incidence of complications after TURP.

AIM: To evaluate the efficiency of Longidaza (rectal suppositories of 3000 IU) as part of combined therapy in order to prevent complications after TURP.

MATERIALS AND METHODS: The study included 202 patients who underwent TURP in 3 hospitals. The patients were divided into 2 groups: main group – 96 men taking standard postoperative therapy with Longidaza rectal suppositories N 20; control group – 106 men – taking standard postoperative therapy (tamsulosin 30 days; fluoroquinolone 5 days). Follow-up included IPSS, urinalysis, urine culture, ultrasound examination of the prostate volume (PV), post void residual urine, uroflowmetry at 1,2,3,6 months after surgery. Average preoperative indices: IPSS 27 [23; 30], Qol 5 [4; 6], prostate volume (PV) 71+/-19cc (30-272 c), Qmax 7.5+/-2.5ml/s (1,3-18,7 ml/s).

RESULTS: There was a significant improvement in IPSS, QoL, Qmax, PV, post void residual urine (PVR) compared to preoperative values during the entire observation period. There was no statistical difference between the main and control groups for these indexes in 6 months. In the main group had statistically lower incidence of bacteriuria at 3 (11% vs 17%) and 6 months (7% vs 17%), and leukocyturia at 3 (31% vs 46%) and 6 months of follow-up (20% vs 44%). Overall incidence of infectious complications and additional antibacterial drugs prescription was lower in the Longidaza group compared to the control group (17,7% vs 20,7%). Urethral strictures developed in 7 men in the main group, and 8 in the control group.

CONCLUSION: Our results show that prescription of Longidaza significantly reduces the incidence of leukocyturia and bacteriuria postoperatively, decreasing the rate of infectious complications in men after TURP.

PMID:34251103

Urologiia. 2021 Jun;(3):33-38.

ABSTRACT

AIM: To study the pathogenetic and clinical features of nephrolithiasis in patients with concomitant chronic cardiovascular diseases (CVD), particularly the chemical composition of renal stones, the frequency of relapses, as well as the daily dynamics of the urine specific gravity and acidity level as the main factors of stone formation.

MATERIALS AND METHODS: A total of 270 patients were treated in the Department of the urology No. 1 of the “Main Military Clinical Hospital named after N. N. Burdenko” of the Ministry of Defense of the Russian Federation during the period from 2008 to 2018. The main group included 184 patients suffering from nephrolithiasis, of which 72 had hypertension in combination with coronary heart disease, and in other 112 patients chronic heart failure (CHF of stage I, IIA and IIB in 55, 37 and 20 patients, respectively) was previously diagnosed. Data on the CVD were obtained from medical records; if necessary, patients were referred to an internist and/or cardiologist. The CHF was staged in accordance with the Strazhesco-Vasilenko (1935) classification. In the control group there were 86 patients with urolithiasis without any cardiovascular disorders. A retrospective analysis of the stone composition was performed using a NICOLET iS10 spectral analyzer. The urine specific gravity and acidity (pH) was determined using a semi-automatic analyzer CLINITEK Status Plus three times a day (both during hospital stay and 3 months after discharge). Statistical analysis was done using the SPSS program v.19. The absolute values (M+/-m) were calculated, as well as Min, ME, Mo, Max. Relative values, including Fischer criterion, were evaluated, taking into account the Bonferroni correction. Differences were significant if p-value was < 0.05.

RESULTS: There was no difference between groups in age (32; 64; 83). In both groups men were predominated (~ 75-78%). According to chemical analysis, stone composition in the control group was as following: oxalates (76.6%), uric acid (9.3%), phosphates (8.1%); mixed stones (6.7%). Independent of stage of CHF, respective figures were 51.4, 23.6, 8.3 and 16%, respectively. The follow-up of patients for 5 years showed that patients were admitted to the urological hospital with a stone recurrence on average 1.8 times, compared to 3 and 3.8 times with concomitant CVD and CHF, respectively. The most concentrated (specific gravity of 1035) and the most acidic (pH =5.5-5) urine in patients with CHF was found in the evening.

CONCLUSION: Chronic CVD has a significant impact on the clinical manifestations of urinary stone disease. The most pronounced changes are associated with CHF. Features of nephrolithiasis in patients with a CVD include the predominance of uric acid and urate stones, more frequent recurrences, shift in the peak of acidity and urine specific gravity from morning to evening hours.

PMID:34251098

Orthop Surg. 2021 Jun;13(4):1389-1397. doi: 10.1111/os.12985.

ABSTRACT

OBJECTIVE: To investigate the effects of improved perioperative sleep on pain, analgesic consumption, and postoperative nausea and vomiting (PONV) in patients who were undergoing total knee arthroplasty (TKA) or total hip arthroplasty (THA).

METHODS: Original studies published from 1 January 1970 to 30 September 2020 were queried in three unique databases using a common search term. The searches sought randomized controlled trials (RCT) investigating the effectiveness of sleep quality or quantity interventions for pain control early after TKA or THA. Grey literature was also searched by screening trial registers. There was no limitation on published language and patients. Two reviewers then assessed studies for eligibility. Eligible studies should have primary outcomes including perioperativeWe have comfirmed the edits. visual analogue scale (VAS) pain score and analgesic consumption; and secondary outcomes including side effects, such as PONV. Data extracted from the literature were abstracted into a comma-separated database spreadsheet using Microsoft Excel. A meta-analysis was then performed. Pooled statistics were calculated with weighting by inverse variance assuming a random effect model. I² was calculated as a quantifier of heterogeneity and interpreted according to the Cochrane manual. All data analysis was performed using Revman software.

RESULTS: From a total of 1285 potential records identified in the electronic search, six studies eventually fulfilled the eligibility criteria. The six controlled RCTs consisted of 207 patients in the sleep-improving group and 209 patients in the control group. The severity of rest pain was significantly lower in the sleep-improving group compared with the control group at day 1 and day 3 postoperatively; the severity of active pain was significantly lower in the sleep-improving group compared with the control group at day 3 postoperatively. Data concerning analgesic drugs could not undergo a meta-analysis due to the difference of eligible studies. No significant difference was found in the incidence of PONV between the sleep-improving group and the control group.

CONCLUSION: Improved perioperative sleep, regardless of quality or quantity, could significantly reduce the pain level at the early stage after TKA or THA, thus the total amount of analgesic drugs consumed was decreased, without significant increase in the incidence of PONV.

PMID:34251091 | DOI:10.1111/os.12985

Int J Geriatr Psychiatry. 2021 Jul 11. doi: 10.1002/gps.5602. Online ahead of print.

ABSTRACT

BACKGROUND: The characteristics of this pandemic increase the potential psychological impact on care homes workers (CHWs). The aims of this study were to analyze the mental health and health-related quality of life (HRQoL) of a broad sample of CHWs in Spain and to identify potential factors that have a significant effect on their mental health and HRQoL.

METHOD: This descriptive study comprised 210 CHWs who completed the Generalized Anxiety Disorder 7-item Scale, the Patient Health Questionnaire-9, the Impact Event Scale-Revised, the Insomnia Severity Index, and the Health-related Quality of Life Questionnaire. Sociodemographic and clinical data in relation to COVID-19 were also recorded. Descriptive statistics, univariable analysis and multivariable linear regression models were applied to identify factors associated with mental health and HRQoL.

RESULTS: 86.19% of participants were female; 86.67% were aged under 55 years; 11% were physicians and 64.19% were nurses or auxiliaries; 77.62% have themselves tested positive for Covid-19, and 67.94% of CHWs have directly treated patients with Covid-19. 49.28% had clinical depression; over half (58.57%) had clinical anxiety; 70.95% had clinical stress; and 28.57% had clinical insomnia. Increased use of tranquilizers/sedatives appears to be an explanatory variable of suffering greater anxiety, depression, stress and insomnia, and of having a worse HRQoL amongst our CHWs.

CONCLUSIONS: Our study confirms that symptomatology of anxiety, depression, stress, insomnia and HRQoL were affected amongst CHWs during the Covid-19 pandemic. This article is protected by copyright. All rights reserved.

PMID:34251057 | DOI:10.1002/gps.5602

Skin Res Technol. 2021 Jul 12. doi: 10.1111/srt.13076. Online ahead of print.

ABSTRACT

BACKGROUND: Although many hair disorders can be readily diagnosed based on their clinical appearance, their progression and response to treatment are often difficult to monitor, particularly in quantitative terms. We introduce an innovative technique utilizing a smartphone and computerized image analysis to expeditiously and automatically measure and compute hair density and diameter in patients in real time.

METHODS: A smartphone equipped with a dermatoscope lens wirelessly transmits trichoscopy images to a computer for image processing. A black-and-white binary mask image representing hair and skin is produced, and the hairs are thinned into single-pixel-thick fiber skeletons. Further analysis based on these fibers allows morphometric characteristics such as hair shaft number and diameters to be computed rapidly. The hair-bearing scalps of fifty participants were imaged to assess the precision of our automated smartphone-based device in comparison with a specialized trichometry device for hair shaft density and diameter measurement. The precision and operation time of our technique relative to manual trichometry, which is commonly used by hair disorder specialists, is determined.

RESULTS: An equivalence test, based on two 1-sided t tests, demonstrates statistical equivalence in hair density and diameter values between this automated technique and manual trichometry within a 20% margin. On average, this technique actively required 24 seconds of the clinician’s time whereas manual trichometry necessitated 9.2 minutes.

CONCLUSION: Automated smartphone-based trichometry is a rapid, precise, and clinically feasible technique which can significantly facilitate the assessment and monitoring of hair loss. Its use could be easily integrated into clinical practice to improve standard trichoscopy.

PMID:34251055 | DOI:10.1111/srt.13076

J Clin Lab Anal. 2021 Jul 12:e23891. doi: 10.1002/jcla.23891. Online ahead of print.

ABSTRACT

BACKGROUND: Vulvovaginal candidiasis (VVC) is a common vaginitis in females. The commonly used diagnostic method, 10% potassium hydroxide (KOH) smear microscopy, makes it not very easy to recognize fungi.

METHODS: Vaginal secretions were collected from clinically suspected VVC patients and divided into four groups and examined using KOH, CFW (Calcofluor White), FB 85(fluorescent brightener 85), and culture. The data were statistically analyzed.

RESULTS: In total, 110 patients with suspected VVC were recruited. The positive rates of KOH, CFW, FB 85, and the culture method were 68.2%, 64.5%, 61.8%, and 77%, respectively. According to the McNemar test, there was no statistically significant difference between the KOH, CFW, and the FB 85 methods (p > 0.05). However, CFW had a shorter diagnosis time than the KOH method and had a statistically significant difference (p < 0.001). Moreover, CFW has the highest sensitivity, specificity, and accuracy. In morphological recognition, it was easier to recognize fungal structures with CFW and FB 85 than with the KOH.

CONCLUSIONS: The fluorescent method is a good method for the diagnosis of VVC. And the fungi can be found more quickly. Similar to CFW, FB 85 is also a potential good fluorescent reagent for the diagnosis of VVC and has potential value for application in clinical fungal infection diseases.

PMID:34251053 | DOI:10.1002/jcla.23891

Aliment Pharmacol Ther. 2021 Jul 12. doi: 10.1111/apt.16464. Online ahead of print.

ABSTRACT

BACKGROUND: In 2019, the United States Food and Drug Administration detected above-regulation levels of the human carcinogen N-nitrosodimethylamine (NDMA) in ranitidine, resulting in a complete removal of the medication from the market. NDMA is known to cause gastrointestinal malignancies in animal models.

AIM: To determine if patients who were receiving ranitidine have a higher risk of developing cancers of the digestive tract compared to patients taking other anti-reflux medications.

METHODS: Using the nationwide database IBM Explorys, patients taking ranitidine were compared to patients on either famotidine or omeprazole. Incidence data of new malignancies of the oesophagus, stomach, liver, pancreas, and colon/rectum were obtained in 1-year intervals for up to 10 years. Two multivariable logistic regression models were used to calculate odds ratios (ORs), one adjusting for common risk factors for each cancer studied, and the other for demographic factors.

RESULTS: Patients on ranitidine who were compared to patients on famotidine had ORs of 0.51(95% CI 0.43-0.60), 0.43(95% CI 0.36-0.51), 0.39(95% CI 0.36-0.41), 0.54(95% CI 0.49-0.62), and 0.46(95% CI 0.43-0.49) of developing oesophageal, gastric, hepatocellular, pancreatic, and colorectal cancers, respectively (P < 0.001). Patients on ranitidine compared to omeprazole had ORs of 0.62(95% CI 0.52-0.72), 0.58(95% CI 0.49-0.68), 0.81 (95% CI 0.76-0.86), 0.68(95% CI 0.60-0.76), and 0.66(95% CI 0.62-0.70) of developing oesophageal, gastric, hepatocellular, pancreatic, and colorectal cancers respectively (P < 0.001).

CONCLUSIONS: Use of ranitidine was not associated with an increased odds of developing gastrointestinal malignancies compared to omeprazole or famotidine use.

PMID:34251045 | DOI:10.1111/apt.16464

Stat Med. 2021 Jul 30;40(17):3881-3886. doi: 10.1002/sim.8988.

NO ABSTRACT

PMID:34251038 | DOI:10.1002/sim.8988

Stat Med. 2021 Jul 30;40(17):3887-3888. doi: 10.1002/sim.8989.

NO ABSTRACT

PMID:34251037 | DOI:10.1002/sim.8989