Managing voiding dysfunction in young men

AbstractVoiding dysfunction is an uncommon condition in young men. With increased understanding of the etiology of chronic lower urinary tract dysfunction, there has been significant improvement in the management of the condition. We have reviewed the current literature and make suggestions about diagnosis, treatment, and further research on this topic. We searched the PubMed database for the management of voiding dysfunction in young men using the following terms: voiding dysfunction, lower urinary tract symptoms, young men, risk factor, urodynamics study, uroflowmetry, magnetic resonance imaging, primary bladder neck obstruction/bladder neck dysfunction, dysfunctional voiding/pseudodyssynergia, impaired detrusor contractility/detrusor underactivity, adrenergic antagonist, transurethral incision, urotherapy, baclofen, and botulinum toxin. Uroflowmetry is an important noninvasive examination for screening young men for possible voiding dysfunction. A videourodynamic study is recommended for patients with low urine flow. Primary bladder neck obstruction and dysfunctional voiding are the two most common diagnoses. α-Adrenergic antagonists and urotherapy are widely used for treating bladder neck obstruction and dysfunctional voiding, respectively. Botulinum toxin A may become a potential therapeutic option in the future. Although the published reports usually included a small number of patients and lacked randomization and a placebo-controlled group, these clinical studies still provide great advances in managing voiding dysfunction in young men. Further well-designed studies are warranted to support optimal management of these conditions

Correlation of the composite equilibrium score of computerized dynamic posturography and clinical balance tests

AbstractBackgroundThe computerized dynamic posturography has been widely used to access balance control in patients with balance dysfunction. A composite-equilibrium score (CS) can be calculated from the sensory organization test using the computerized dynamic posturography. However, the correlation between the composite equilibrium score and clinical tests and its ability to predict falls has rarely been explored in the past.MethodsA total of 60 patients with chief complaint of dizziness were enrolled in our study, and clinical assessments were done including the sensory organization test (SOT), Timed Up and Go test (TUG), Tinetti Performance-Oriented Mobility Assessment (POMA), and the dynamic gait index (DGI). The age and the subjective feeling of the severity of dizziness quantified by the visual analog scale (VAS) of each patient were also recorded.ResultsStatistical analysis revealed significant correlation between the composite equilibrium score and the TUG, POMA (gait, balance and total scores), and the DGI. However, there is statistically significant correlation between neither the CS and the age nor the VAS of dizziness. When grouping the DGI, POMA (total score), and the TUG cutoff to predict fall risks, the correlations to the CS can still be established except the TUG.ConclusionFrom the results of our study, the validity of the clinical tests was established in assessment of balance function, and clinicians can utilize these tools for preliminary evaluation of patient balance when computerized dynamic posturography is not available. In addition, CS can be used to predict the risk of falls

A Study of Three Sectors Employment Effects Resulting from Foreign Direct Investment- Empirical Analysis on the Data from Shanghai

With the development of China's reform policy, China's economy has integrating into the global economy. As a result, more and more foreign capital continues to flow into China. Since 1990, foreign direct investment (FDI) was mainly concentrated in the Yangtze River Delta region, and Shanghai enjoyed strong economic strength, thanks to its abundant human resources and convenient transportation network; as these are excellent qualities for attracting foreign investment, Shanghai became one of the major cities attracting FDI. FDI has had a tremendous impact on many aspects in Shanghai, including employment. Therefore, Shanghai was chosen as the research object of this paper. This paper is organized as follows. Firstly, a theoretical analysis of the employment effects of FDI is presented. Secondly, after combining the actual utilization of FDI and employment in Shanghai, an empirical analysis of the effects of FDI on employment's quantity, employment's distribution and employment quality is carried out by collecting relevant data and establishing regression models. This study finds that while FDI does exert a positive influence on the quantity of employment in Shanghai's tertiary industry, it is not conducive to primary and secondary industries. In addition, FDI has shown positive and negative impacts on the quality of employment. Lastly, some suggestions are proposed to enhance the positive role of FDI on employment

Outcomes and prognostic factors of simple partial cystectomy for localized bladder urothelial cell carcinoma

AbstractRadical cystectomy has remained the gold standard for recurrent superficial or muscle invasive bladder tumor. However, partial cystectomy still has a role in those who reject or have contraindications for radical cystectomy. In this study, we sought to identify predictors of bladder recurrence and overall survival after simple partial cystectomy. We included 27 patients with bladder tumor who received simple partial cystectomy without pelvic lymph node dissection between March 2000 and September 2013. Adjuvant chemotherapy or radiation therapy was prescribed according to the pathological results. Parameters were compared on the basis of bladder recurrence and overall survival. During a mean follow-up time of 39 months, five patients (18.5%) experienced bladder recurrence. An older age, a higher pathological stage, positive surgical margins, and distant metastases were significant predictors of overall survival (p = 0.031, p = 0.001, p = 0.001, and p = 0.011, respectively). Meanwhile, previous bladder instillation and positive surgical margins were significant predictors of bladder recurrence (p = 0.026 and p = 0.027, respectively). The rate of consecutive distant metastases (33.3%) was almost twice the rate of bladder recurrence (18.5%), and six patients developed consecutive distant metastases without first experiencing bladder recurrence. In patients who received a simple partial cystectomy as an alternative treatment, previous bladder instillation and positive surgical margins were significant predictors of bladder recurrence. Patients with an older age, positive surgical margins, and consecutive distant metastases had worse overall survival. Partial cystectomy with routine lymph node dissection may be a better option for achieving favorable long-term outcomes

Organic Electrochemical Transistors/SERS-Active Hybrid Biosensors Featuring Gold Nanoparticles Immobilized on Thiol-Functionalized PEDOT Films

In this study we immobilized gold nanoparticles (AuNPs) onto thiol-functionalized poly(3,4-ethylenedioxythiophene) (PEDOT) films as bioelectronic interfaces (BEIs) to be integrated into organic electrochemical transistors (OECTs) for effective detection of dopamine (DA) and also as surface-enhanced Raman scattering (SERS)—active substrates for the selective detection of p-cresol (PC) in the presence of multiple interferers. This novel PEDOT-based BEI device platform combined (i) an underlying layer of polystyrenesulfonate-doped PEDOT (PEDOT:PSS), which greatly enhanced the transconductance and sensitivity of OECTs for electrochemical sensing of DA in the presence of other ascorbic acid and uric acid metabolites, as well as amperometric response toward DA with a detection limit (S/N = 3) of 37 nM in the linear range from 50 nM to 100 μM; with (ii) a top interfacial layer of AuNP-immobilized three-dimensional (3D) thiol-functionalized PEDOT, which not only improved the performance of OECTs for detecting DA, due to the signal amplification effect of the AuNPs with high catalytic activity, but also enabled downstream analysis (SERS detection) of PC on the same chip. We demonstrate that PEDOT-based 3D OECT devices decorated with a high-density of AuNPs can display new versatility for the design of next-generation biosensors for point-of-care diagnostics