Patient-Reported Side Effects of Intradetrusor Botulinum Toxin Type A for Idiopathic Overactive Bladder Syndrome

Objective: The aim of the study was a prospective assessment of patient-reported side effects in an open-label study after intradetrusor botulinum toxin injections for idiopathic overactive bladder (OAB). Patients and Methods: Botulinum toxin A injection was performed in 56 patients with idiopathic OAB. Patients were followed up for 6 months concerning side effects and patients' satisfaction. Results: Different types of side effects were assessed such as dry mouth (19.6%), arm weakness (8.9%), eyelid weakness (8.9%), leg weakness (7.1%), torso weakness (5.4%), impaired vision (5.4%) and dysphagia (5.4%). In all cases, symptoms were mild and transient. Urological complications such as gross hematuria (17.9%), acute urinary retention (8.9%) and acute urinary tract infection (7.1%) were noticed. In all cases, acute urinary retention was transient and treated with temporary intermittent self-catheterization. There was no statistically significant correlation between dosage and observed side effects. Patients' satisfaction rate was high (71.4%). Conclusion: Intradetrusor injection of botulinum toxin was associated with a high rate of neurourological side effects. In general, side effects were transient, mild and did not require special treatment. Copyright (C) 2010 S. Karger AG, Base

Opposite transcriptional regulation in skeletal muscle of AMP-activated protein kinase gamma3 R225Q transgenic versus knock-out mice

AMP-activated protein kinase (AMPK) is an evolutionarily conserved heterotrimer important for metabolic sensing in all eukaryotes. The muscle-specific isoform of the regulatory gamma-subunit of the kinase, AMPK gamma3, has an important role in glucose uptake, glycogen synthesis, and fat oxidation in white skeletal muscle, as previously demonstrated by physiological characterization of AMPK gamma3 mutant (R225Q) transgenic (TgPrkag3(225Q)) and gamma3 knock-out (Prkag3(-/-)) mice. We determined AMPK gamma3-dependent regulation of gene expression by analyzing global transcription profiles in glycolytic skeletal muscle from gamma3 mutant transgenic and knock-out mice using oligonucleotide microarray technology. Evidence is provided for coordinated and reciprocal regulation of multiple key components in glucose and fat metabolism, as well as skeletal muscle ergogenics in TgPrkag3(225Q) and Prkag3(-/-) mice. The differential gene expression profile was consistent with the physiological differences between the models, providing a molecular mechanism for the observed phenotype. The striking pattern of opposing transcriptional changes between TgPrkag3(225Q) and Prkag3(-/-) mice identifies differentially expressed targets being truly regulated by AMPK and is consistent with the view that R225Q is an activating mutation, in terms of its downstream effects. Additionally, we identified a wide array of novel targets and regulatory pathways for AMPK in skeletal muscle

Report on the nature and types of driver interactions including their potential future

The Baltic Sea is a dynamic environment responding to various drivers operating at different temporal and spatial scales. In response to climate change, the Baltic Sea is warming and the frequency of extreme climatic events is increasing (Lima & Wethey 2012, BACC 2008, Poloczanska et al. 2007). Coastal development, human population growth and globalization intensify stressors associated with human activities, such as nutrient loading, fisheries and proliferation of invasive and bloom-forming species. Such abrupt changes have unforeseen consequences for the biodiversity and the function of food webs and may result in loss of ecological key species, alteration and fragmentation of habitats. To mitigate undesired effects on the Baltic ecosystem, an efficient marine management will depend on the understanding of historical and current drivers, i.e. physical and chemical environmental conditions and human activities that precipitate pressures on the natural environment. This task examined a set of key interactions of selected natural and anthropogenic drivers in space and time, identified in Task 3.1 as well as WP1 and WP2 (e.g. physico-chemical features vs climate forcing; eutrophication vs oxygen deficiency vs bio-invasions; fisheries vs climate change impacts) by using overlay-mapping and sensitivity analyses. The benthic ecosystem models developed under Task 2.1 were used to investigate interactions between sea temperature and eutrophication for various depth strata in coastal (P9) and offshore areas (P1) of the Baltic Sea. This also included investigation on how the frequency and magnitude of deep-water inflow events determines volume and variance of salinity and temperature under the halocline, deep-water oxygen levels and sediment fluxes of nutrients, using observations and model results from 1850 to present (P1, P2, P6, P9, P12). The resulting synthesis on the nature and magnitude of different driver interactions will feed into all other tasks of this WP3 and WP2/WP4. Moreover, the results presented in this report improve the process-based and mechanistic understanding of environmental change in the Baltic Sea ecosystem, thereby fostering the implementation of the Marine Strategy Framework Directive

Von der Shop-Stewards-Bewegung zum National Minority Movement die britische Gewerkschaftsopposition zwischen Syndikalismus und Kommunismus 1919-1924

SIGLEFES Bonn(Bo133)-A83-3060 / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekDEGerman

The experience of participating in an internet-based cognitive behavioral therapy program among patients with cardiovascular disease and depression : a qualitative interview study

Background: Depression in conjunction with cardiovascular disease (CVD) is associated with worsening in CVD, higher mortality, and poorer quality of life. Despite the poor outcomes there is a treatment gap of depression in CVD patients. Recently we found that an Internet-based cognitive behavioral therapy (iCBT) tailored for CVD patients led to reduced symptoms of depression. However, we still have little knowledge about CVD patients experiences of working with iCBT. The aim of this study was therefore to explore CVD patients experiences of engaging in a tailored iCBT program. Methods: A qualitative interview study using inductive thematic analysis. Data was obtained from 20 patients with CVD and depressive symptoms who had participated in a randomized controlled trial (RCT) evaluating the impact of a nine-week iCBT program on depression. Results: Three main themes emerged: (1) Taking control of the disease, (2) Not just a walk in the park, and (3) Feeling a personal engagement with the iCBT program. The first theme included comments that the tailored program gave the patients a feeling of being active in the treatment process and helped them achieve changes in thoughts and behaviors necessary to take control of their CVD. The second theme showed that patients also experienced the program as demanding and emotionally challenging. However, it was viewed as helpful to challenge negative thinking about living with CVD and to change depressive thoughts. In the third theme patients reported that the structure inherent in the program, in the form of organizing their own health and the scheduled feedback from the therapist created a feeling of being seen as an individual. The feeling of being acknowledged as a person also made it easier to continuously work with the changes necessary to improve their health. Conclusions: Engaging in an iCBT program tailored for patients with CVD and depression was by the patients perceived as helpful in the treatment of depression. They experienced positive changes in emotions, thoughts, and behaviors which a result of learning to take control of their CVD, being confirmed and getting support. The patients considered working with the iCBT program as demanding and emotionally challenging, but necessary to achieve changes in emotions, thoughts, and behaviors.Funding Agencies: Swedish Research Council, European Commission [2015-02600]; ALF grants Region Östergötland [LIO-600321, LIO-687531]; Region Östergötland, Strategic Fund [LIO-719561]; Linköping University</p

Arm impairment and walking speed explain real-life activity of the affected Arm and leg after stroke

Objective: To determine to what extent accelerometer-based arm, leg and trunk activity is associated with sensorimotor impairments, walking capacity and other factors in subacute stroke. Design: Cross-sectional study. Patients: Twenty-six individuals with stroke (mean age 55.4 years, severe to mild motor impairment). Methods: Data on daytime activity were collected over a period of 4 days from accelerometers placed on the wrists, ankles and trunk. A forward stepwise linear regression was used to determine associations between free-living activity, clinical and demographic variables. Results: Arm motor impairment (Fugl-Meyer Assessment) and walking speed explained more than 60% of the variance in daytime activity of the more-affected arm, while walking speed alone explained 60% of the more-affected leg activity. Activity of the less-affected arm and leg was associated with arm motor impairment (R2=0.40) and independence in walking (R2=0.59). Arm activity ratio was associated with arm impairment (R2=0.63) and leg activity ratio with leg impairment (R2=0.38) and walking speed (R2=0.27). Walking-related variables explained approximately 30% of the variance in trunk activity. Conclusion: Accelerometer-based free-living activity is dependent on motor impairment and walking capacity. The most relevant activity data were obtained from more-affected limbs. Motor impairment and walking speed can provide some information about real-life daytime activity levels