Prostate Stromal Tumor of Uncertain Malignant Potential: Case Report With 5-Year Follow-up

AbstractProstate stromal tumor of uncertain malignant potential is a term used to describe a specialized proliferation of stromal cells within the prostate. Most of these tumors tend to be benign, but some can present with local invasion or progress to prostatic stromal sarcoma with distant metastasis. We report a case of a 62-year-old male patient who presented to us with a diagnosis of stromal tumor of uncertain malignant potential. We have followed up the patient for 5 years with imaging, prostate-specific antigen checks, and annual prostate biopsies

Instrumental vetoes for transient gravitational-wave triggers using noise-coupling models: The bilinear-coupling veto

LIGO and Virgo recently completed searches for gravitational waves at their initial target sensitivities, and soon Advanced LIGO and Advanced Virgo will commence observations with even better capabilities. In the search for short duration signals, such as coalescing compact binary inspirals or "burst" events, noise transients can be problematic. Interferometric gravitational-wave detectors are highly complex instruments, and, based on the experience from the past, the data often contain a large number of noise transients that are not easily distinguishable from possible gravitational-wave signals. In order to perform a sensitive search for short-duration gravitational-wave signals it is important to identify these noise artifacts, and to "veto" them. Here we describe such a veto, the bilinear-coupling veto, that makes use of an empirical model of the coupling of instrumental noise to the output strain channel of the interferometric gravitational-wave detector. In this method, we check whether the data from the output strain channel at the time of an apparent signal is consistent with the data from a bilinear combination of auxiliary channels. We discuss the results of the application of this veto on recent LIGO data, and its possible utility when used with data from Advanced LIGO and Advanced Virgo.Comment: Minor changes; To appear in Phys. Rev.

Anticholinergic Drug Exposure and the Risk of Dementia: A Nested Case-Control Study

IMPORTANCE Anticholinergic medicines have short-term cognitive adverse effects, but itis uncertain whether long-term use of these drugs is associated with an increased risk of dementia.OBJECTIVE To assess associations between anticholinergic drug treatments and risk of dementia in persons 55 years or older.DESIGN, SETTING, AND PARTICIPANTS This nested case-control study took place in general practices in England that contributed to the QResearch primary care database. The study evaluated whether exposure to anticholinergic drugs was associated with dementia risk in 58 769 patients with a diagnosis of dementia and 225 574 controls 55 years or older matched by age, sex, general practice, and calendar time. Information on prescriptions for 56 drugs with strong anticholinergic properties was used to calculate measures of cumulative anticholinergic drug exposure. Data were analyzed from May 2016 to June 2018.EXPOSURES The primary exposure was the total standardized daily doses (TSDDs) of anticholinergic drugs prescribed in the 1 to 11 years prior to the date of diagnosis of dementia or equivalent date in matched controls (index date).MAIN OUTCOMES AND MEASURES Odds ratios (ORs) for dementia associated with cumulative exposure to anticholinergic drugs, adjusted for confounding variables.RESULTS Of the entire study population (284 343 case patients and matched controls), 179 365 (63.1%) were women, and the mean (SD) age of the entire population was 82.2 (6.8) years. The adjusted OR for dementia increased from 1.06 (95%CI, 1.03-1.09) in the lowest overall anticholinergic exposure category (total exposure of 1-90 TSDDs) to 1.49 (95%CI, 1.44-1.54) in the highest category (>1095 TSDDs), compared with no anticholinergic drug prescriptions in the 1 to 11 years before the index date. There were significant increases in dementia risk for the anticholinergic antidepressants (adjusted OR [AOR], 1.29; 95%CI, 1.24-1.34), antiparkinson drugs (AOR, 1.52; 95%CI, 1.16-2.00), antipsychotics (AOR, 1.70; 95% CI, 1.53-1.90), bladder antimuscarinic drugs (AOR, 1.65; 95%CI, 1.56-1.75), and antiepileptic drugs (AOR, 1.39; 95%CI, 1.22-1.57) all for more than 1095 TSDDs. Results were similar when exposures were restricted to exposure windows of 3 to 13 years (AOR, 1.46; 95%CI, 1.41-1.52) and 5 to 20 years (AOR, 1.44; 95%CI, 1.32-1.57) before the index date for more than 1095 TSDDs. Associations were stronger in cases diagnosed before the age of 80 years. The population-attributable fraction associated with total anticholinergic drug exposure during the 1 to 11 years before diagnosis was 10.3%.CONCLUSIONS AND RELEVANCE Exposure to several types of strong anticholinergic drugs is associated with an increased risk of dementia. These findings highlight the importance of reducing exposure to anticholinergic drugs in middle-aged and older people

Dietary considerations in the evaluation and management of nocturia

Aim: This narrative review investigates the effect of dietary intake on nocturnal voiding severity. The primary aims of this review are to provide a framework for future research and ultimately contribute to more comprehensive, lifestyle-centered guidelines for the management of nocturia. Methods: A literature search was conducted in Web of Science, PubMed, and Google Scholar databases using the keywords “nocturia”, “diuresis”, “natriuresis”, “food”, “diet”, and “nutrients”. Results: High fruit and vegetable consumption was negatively associated with nocturia. High intake of tea and dietary sodium showed a positive association with nocturia. Several foods have also been directly linked to changes in diuresis rate, glycemic control, and endogenous serum melatonin concentration, offering potential mechanisms for this observed effect. Overall quality of the evidence was low. Conclusion: At present, there is limited evidence to suggest that certain foods, electrolytes, and specific compounds may contribute to the pathogenesis of nocturia. A greater understanding of the impact of food and nutrients on body fluid metabolism is needed to further refine the evaluation and treatment of nocturia

How does the lower urinary tract contribute to bladder sensation? ICI-RS 2023

Aim: Bladder sensation is critical for coordinating voluntary micturition to maintain healthy bladder function. Sensations are initiated by the activation of sensory afferents that innervate throughout the bladder wall. However, the physiological complexity that underlies the initiation of bladder sensory signaling in health and disease remains poorly understood. This review summarises the latest knowledge of the mechanisms underlying the generation of bladder sensation and identifies key areas for future research. Methods: Experts in bladder sensory signaling reviewed the literature on how the lower urinary tract contributes to bladder sensation and identified key research areas for discussion at the 10th International Consultation on Incontinence—Research Society. Results: The importance of bladder sensory signals in maintaining healthy bladder function is well established. However, better therapeutic management of bladder disorders with exaggerated bladder sensation, including overactive bladder syndrome (OAB) and interstitial cystitis/bladder pain syndrome (IC/BPS) is limited by a lack of knowledge in a number of key research areas including; the contribution of different nerves (pudendal, pelvic, hypogastric) to filling sensations in health and disease; the relative contribution of stretch sensitive (muscular) and stretch-insensitive (mucosal) afferents to bladder sensation in health and disease; the direct and indirect contributions of the muscularis mucosae to bladder contraction and sensation; and the impact of manipulating urothelial release factors on bladder sensation. Conclusion: Disturbances in bladder sensory signaling can have severe consequences for bladder sensation and function including the development of OAB and IC/BPS. Advancing therapeutic treatments for OAB and IC/BPS requires a deeper understanding of the mechanisms underlying the generation of bladder sensation, and key areas for future research have been identified