162 research outputs found
Percutaneous tibial nerve stimulation (PTNS) efficacy in the treatment of lower urinary tract dysfunctions. A systematic review
Background: Percutaneous Tibial Nerve Stimulation (PTNS) has been proposed for the treatment of overactive bladder syndrome (OAB), non-obstructive urinary retention (NOUR), neurogenic bladder, paediatric voiding dysfunction and chronic pelvic pain/painful bladder syndrome (CPP/PBS). Despite a number of publications produced in the last ten years, the role of PTNS in urinary tract dysfunctions remains unclear. A systematic review of the papers on PTNS has been performed with the aim to better clarify potentialities and limits of this technique in the treatment of OAB syndrome and in other above mentioned urological conditions. Methods. A literature search using MEDLINE and ISI web was performed. Search terms used were "tibial nerve" and each of the already mentioned conditions, with no time limits. An evaluation of level of evidence for each paper was performed. Results: PTNS was found to be effective in 37-100% of patients with OAB, in 41-100% of patients with NOUR and in up to 100% of patients with CPP/PBS, children with OAB/dysfunctional voiding and patients with neurogenic pathologies. No major complications have been reported.Randomized controlled trials are available only for OAB (4 studies) and CPP/PBS (2 studies). Level 1 evidence of PTNS efficacy for OAB is available. Promising results, to be confirmed by randomized controlled studies, have been obtained in the remaining indications considered. Conclusions: PTNS is an effective and safe option to treat OAB patients. Further studies are needed to assess the role of PTNS in the remaining indications and to evaluate the long term durability of the treatment. Further research is needed to address several unanswered questions about PTNS
Parameters of the Infrastructure of the Residential Area and Their Relationship with Cardiovascular Risk Factors
Aim. This study determined the level of public satisfaction with neighborhood design features in Kemerovo Oblast and their connection to cardiovascular disease risk factors.Subjects and methods. The study population included 1,598 respondents aged between 35 and 70, with 491 living in rural areas and others living in Kemerovo (1,221 women and 477 men). The assessment of neighborhood environment was done according to residents' subjective opinions about infrastructural features (the Neighborhood Environmental Walkability Scale). Depending on how participants responded to the questionnaire, some of these parameters were identified as adverse.Results. The residents of Kemerovo and rural areas of Kemerovo Oblast identified the following neighborhood design features as adverse: the lack of interesting places in neighborhood environment, the remote location of parks and restaurants, the absence of pavement, busy traffic, and a long distance between home and workplace. In the city, arterial hypertension prevalence was high among men, when grocery, fruit and clothing stores were distant, and among women, when banks, public transport stops were distant and the traffic was heavy. Lipid metabolism disorders were more common among women in urban areas, when there were no interesting places around. Obesity prevalence was high among urban female population, when the following adverse factors were present: the remote location of grocery stores, fruit stores, bank, pharmacy and public transport stops and the absence of pavement. Among rural male population, this risk factor was common when there were no pavements. The highest rate of carbohydrate metabolism disorders was found among women living in villages where the traffic is heavy and public transport stops are far away.Conclusion. The impact of infrastructure on the health status of the living population is a new direction of scientific research. Epidemiological studies in different geographic areas and population groups show significant differences in health status, morbidity and mortality from chronic noncommunicable diseases. To reduce the risks of developing diseases of the cardiovascular system, the formation of a socially comfortable health-saving environment is of great importance
Clinic-immunological aspects of chronic acquired toxoplasmosis in women of reproductive age
Toxoplasmosis is a widespread opportunistic parasitosis. The frequency of Toxoplasma invasion in women with a history of complications is 54.8 + 2.8%, and in women with normal pregnancies - 27.3 + 3.6%. Clinically manifest form of chronic acquired toxoplasmosis was detected by immuno-statistical method in 24 women. The most frequent symptoms of intoxication in these women were weakness, fatigue, headaches, and pain in muscles and joints. In one third of women with chronic acquired toxoplasmosis, there was an increase in the lymph nodes, usually the occipital, cervical, submandibular. Of the gynecological pathology, the most frequently examined women had an inflammation of the uterus appendages (45.8%), and a spontaneous miscarriage was often noted in history. The immunogram of patients with chronic acquired toxoplasmosis was characterized by a decrease in absolute and relative number of T-lymphocytes - CD3 (541.3 + 42.4 and 32.2 + 9.9%), an increase in the number of NK-cells.Π’ΠΎΠΊΡΠΎΠΏΠ»Π°Π·ΠΌΠΎΠ· ΠΎΡΠ½ΠΎΡΠΈΡΡΡ ΠΊ ΡΠΈΡΠΎΠΊΠΎ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΡΠΌ ΠΎΠΏΠΏΠΎΡΡΡΠ½ΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΏΠ°ΡΠ°Π·ΠΈΡΠΎΠ·Π°ΠΌ. Π§Π°ΡΡΠΎΡΠ° ΠΈΠ½Π²Π°Π·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΡΡΠΈ ΡΠΎΠΊΡΠΎΠΏΠ»Π°Π·ΠΌΠ°ΠΌΠΈ ΠΆΠ΅Π½ΡΠΈΠ½ Ρ ΠΎΡΡΠ³ΠΎΡΠ΅Π½Π½ΡΠΌ Π°Π½Π°ΠΌΠ½Π΅Π·ΠΎΠΌ ΡΠΎΡΡΠ°Π²Π»ΡΠ΅Ρ 54,8+2,8%, Π° Ρ ΠΆΠ΅Π½ΡΠΈΠ½ Ρ Π½ΠΎΡΠΌΠ°Π»ΡΠ½ΠΎ ΠΏΡΠΎΡΠ΅ΠΊΠ°Π²ΡΠΈΠΌΠΈ Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΡΠΌΠΈ - 27,3+3,6%. ΠΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈ ΠΌΠ°Π½ΠΈΡΠ΅ΡΡΠ½Π°Ρ ΡΠΎΡΠΌΠ° Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΏΡΠΈΠΎΠ±ΡΠ΅ΡΠ΅Π½Π½ΠΎΠ³ΠΎ ΡΠΎΠΊΡΠΎΠΏΠ»Π°Π·ΠΌΠΎΠ·Π° Π²ΡΡΠ²Π»Π΅Π½Π° ΠΈΠΌΠΌΡΠ½ΠΎΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ Ρ 24 ΠΆΠ΅Π½ΡΠΈΠ½. ΠΠ°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΠ°ΡΡΠΎ Ρ ΡΡΠΈΡ
ΠΆΠ΅Π½ΡΠΈΠ½ Π²ΡΡΡΠ΅ΡΠ°Π»ΠΈΡΡ ΡΠΈΠΌΠΏΡΠΎΠΌΡ ΠΈΠ½ΡΠΎΠΊΡΠΈΠΊΠ°ΡΠΈΠΈ ΠΊΠ°ΠΊ ΡΠ»Π°Π±ΠΎΡΡΡ, ΡΡΠΎΠΌΠ»ΡΠ΅ΠΌΠΎΡΡΡ, Π³ΠΎΠ»ΠΎΠ²Π½ΡΠ΅ Π±ΠΎΠ»ΠΈ, Π° ΡΠ°ΠΊΠΆΠ΅ Π±ΠΎΠ»ΠΈ Π² ΠΌΡΡΡΠ°Ρ
ΠΈ ΡΡΡΡΠ°Π²Π°Ρ
. Π£ 1/3 ΠΆΠ΅Π½ΡΠΈΠ½ Ρ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΏΡΠΈΠΎΠ±ΡΠ΅ΡΠ΅Π½Π½ΡΠΌ ΡΠΎΠΊΡΠΎΠΏΠ»Π°Π·ΠΌΠΎΠ·ΠΎΠΌ ΠΎΡΠΌΠ΅ΡΠ°Π»ΠΎΡΡ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠ΅ Π»ΠΈΠΌΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ·Π»ΠΎΠ², ΡΠ°ΡΠ΅ Π·Π°ΡΡΠ»ΠΎΡΠ½ΡΡ
, ΡΠ΅ΠΉΠ½ΡΡ
, ΠΏΠΎΠ΄ΡΠ΅Π»ΡΡΡΠ½ΡΡ
. ΠΠ· Π³ΠΈΠ½Π΅ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΠ°ΡΡΠΎ Ρ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½Π½ΡΡ
ΠΆΠ΅Π½ΡΠΈΠ½ - Π²ΠΎΡΠΏΠ°Π»Π΅Π½ΠΈΠ΅ ΠΏΡΠΈΠ΄Π°ΡΠΊΠΎΠ² ΠΌΠ°ΡΠΊΠΈ (45,8%), Π² Π°Π½Π°ΠΌΠ½Π΅Π·Π΅ ΡΠ°ΡΡΠΎ ΠΎΡΠΌΠ΅ΡΠ°Π»ΠΈΡΡ ΡΠ°ΠΌΠΎΠΏΡΠΎΠΈΠ·Π²ΠΎΠ»ΡΠ½ΡΠ΅ Π²ΡΠΊΠΈΠ΄ΡΡΠΈ. ΠΠΌΠΌΡΠ½ΠΎΠ³ΡΠ°ΠΌΠΌΠ° Π±ΠΎΠ»ΡΠ½ΡΡ
Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΏΡΠΈΠΎΠ±ΡΠ΅ΡΠ΅Π½Π½ΡΠΌ ΡΠΎΠΊΡΠΎΠΏΠ»Π°Π·ΠΌΠΎΠ·ΠΎΠΌ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΠ·ΠΎΠ²Π°Π»Π°ΡΡ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ΠΌ Π°Π±ΡΠΎΠ»ΡΡΠ½ΠΎΠ³ΠΎ ΠΈ ΠΎΡΠ½ΠΎΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠΈΡΠ»Π° Π’- Π»ΠΈΠΌΡΠΎΡΠΈΡΠΎΠ² - Π‘ΠΠ (541,3+42,4 ΠΈ 32,2+9,9%), ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΠ΅ΠΌ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²Π° NK- ΠΊΠ»Π΅ΡΠΎΠΊ
Sex and age specificities of the dynamics of anthropometric indicators characterizing obesity (according to a prospective epidemiological research)
Background. Overweight and obesity significantly increase the risk of premature death and the development of chronic diseases. Many anthropometric indices have been developed to verify obesity, although the best among them still remains undetermined.The aim. To determine the sex and age specificities of the dynamics of anthropometric indicators characterizing obesity.Materials and methods. The program was implemented in the period from 2015 to 2020. It provided for the implementation of a sample research. The baseline research included 1,124 women and 476 men. The average age was 54.9 Β± 9.75 years and 52.6 Β± 10.0 years, respectively. To identify gender specificities, all participants were divided into three age groups: 35β49 years old, 50β59 years old, and 60β70 years old. The observation period was 3 years. To determine the level of visceral fat, the VS-532 fat mass analyzer (Tanita Health Equipment HK Ltd., Hong Kong) was used. Body mass index (BMI), waist-hip index (WV/HV), visceral obesity index (VOI) were also calculated. Statistical processing of the results was carried out using the program Statistica 6.0 (StatSoft Inc., USA).Results. New cases of obesity developed in 30.6 % of the surveyed. There was an increase in the prevalence of obesity according to the criteria of WV (by 8.9 %) and VFL (by Β 5.4 Β %) and a Β decrease in the number of people who are obese according to WV/HV β by 4.2 %. Of all the indicators, only VOI showed a statistically significant decrease in the mean values over the observed period, while BMI, WV and VFL showed an increase.Conclusions. It is necessary to apply various criteria for the diagnosis of obesity, since individual indices are not able to fully reflect the gender and age specificities of the distribution of fat in the bod
Transperineal prostate biopsies for diagnosis of prostate cancer are well tolerated: a prospective study using patient-reported outcome measures
We aimed to determine short-term patient-reported outcomes in men having general anesthetic transperineal (TP) prostate biopsies. A prospective cohort study was performed in men having a diagnostic TP biopsy. This was done using a validated and adapted questionnaire immediately post-biopsy and at follow-up of between 7 and 14 days across three tertiary referral hospitals with a response rate of 51.6%. Immediately after biopsy 43/201 (21.4%) of men felt light-headed, syncopal, or suffered syncope. Fifty-three percent of men felt discomfort after biopsy (with 95% scoring <5 in a 0-10 scale). Twelve out of 196 men (6.1%) felt pain immediately after the procedure. Despite a high incidence of symptoms (e.g., up to 75% had some hematuria, 47% suffered some pain), it was not a moderate or serious problem for most, apart from hemoejaculate which 31 men suffered. Eleven men needed catheterization (5.5%). There were no inpatient admissions due to complications (hematuria, sepsis). On repeat questioning at a later time point, only 25/199 (12.6%) of men said repeat biopsy would be a significant problem despite a significant and marked reduction in erectile function after the procedure. From this study, we conclude that TP biopsy is well tolerated with similar side effect profiles and attitudes of men to repeat biopsy to men having TRUS biopsies. These data allow informed counseling of men prior to TP biopsy and a benchmark for tolerability with local anesthetic TP biopsies being developed for clinical use.Boris Hadaschik received funding from the German Research Foundation and the European Foundation for Urology. Karan Wadhwa is sponsored by a Medical Research Council Research Training Fellowship. No other funding was received for this work
Modern concepts of anal sphincter insufficiency and its treatment
The international clinical analysis of the treatment of topical issues - failure of the anal sphincter, which has not only medical but also social value is presented. The comparative analysis of effectiveness of suggested above operating methods and modern approaches of different surgical methods of anal incontinence correction was conducted.ΠΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½ ΠΌΠΈΡΠΎΠ²ΠΎΠΉ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠΉ Π°Π½Π°Π»ΠΈΠ· Π»Π΅ΡΠ΅Π½ΠΈΡ Π°ΠΊΡΡΠ°Π»ΡΠ½ΠΎΠΉ ΠΏΡΠΎΠ±Π»Π΅ΠΌΡ β Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΡΡΠΈ Π°Π½Π°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΡΠΈΠ½ΠΊΡΠ΅ΡΠ°, ΠΊΠΎΡΠΎΡΠ°Ρ ΠΈΠΌΠ΅Π΅Ρ Π½Π΅ ΡΠΎΠ»ΡΠΊΠΎ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠ΅, Π½ΠΎ ΠΈ ΡΠΎΡΠΈΠ°Π»ΡΠ½ΠΎΠ΅ Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅. ΠΡΠΎΠ²Π΅Π΄Π΅Π½ ΡΡΠ°Π²Π½ΠΈΡΠ΅Π»ΡΠ½ΡΠΉ Π°Π½Π°Π»ΠΈΠ· ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΠΊΠ°ΠΊ ΠΏΡΠ΅Π΄Π»Π°Π³Π°Π²ΡΠΈΡ
ΡΡ ΡΠ°Π½Π΅Π΅ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ²Π½ΡΡ
Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ², ΡΠ°ΠΊ ΠΈ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΠ΅ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄Ρ ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ
Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊ ΠΊΠΎΡΡΠ΅ΠΊΡΠΈΠΈ Π°Π½Π°Π»ΡΠ½ΠΎΠΉ ΠΈΠ½ΠΊΠΎΠ½ΡΠΈΠ½Π΅Π½ΡΠΈΠΈ
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