Large-scale seroepidemiology identifies a nephro-vascular syndrome associated with autoimmune reactivity to tau

The microtubule-associated protein tau is involved in several neurodegenerative diseases and is currently being investigated as a plasma biomarker for the detection and monitoring of Alzheimer's disease and as an immunotherapeutical target in clinical trials. We assessed plasma anti-tau IgG reactivity in 40'098 unselected patients visiting a university hospital and healthy blood donors. We found that 4.97% patients and 1.58% healthy donors had natural anti-tau antibody titers >1.8 log10(EC50). In a multivariate model, female sex (P<0.001), age (P<0.001), cystitis (RR 1.59, 95%CI 1.14-2.16, P=0.004), other urinary disorders (RR 1.23, 95%CI 1.03-1.45, P=0.018), chronic kidney disease (RR 1.20, 95%CI 1.01-1.41, P=0.033), arterial embolism and thrombosis (RR 1.56, 95%CI 1.02-2.25, P=0.026) and atherosclerosis (RR 1.35, 95%CI 1.09-1.1.66, P=0.004) were independent predictors of anti-tau autoantibodies. We therefore conclude that anti-tau autoimmunity is associated with a systemic syndrome that includes vascular, kidney and urinary disorders. The expression of tau in these extraneural tissues suggests a potential role of autoimmunity in this syndrome.

RISK FACTORS FOR THE URINARY DISORDERS DEVELOPMENT IN MEN UNDER 60 YEARS OLD IN THE ACUTE PERIOD OF MYOCARDIAL INFARCTION

Relevance. The cardiovascular risk factors structure features in myocardial infarction, complicated by urinary disorders, in young and middle-aged men have been insufficiently studied. Aim. To evaluate the cardiovascular risk factors structure features in men under 60 years old with myocardial infarction, complicated by urinary disorders, to improve prevention and outcomes. Material and methods. The study included men 19-60 years old with type I myocardial infarction. The patients were divided into two age-comparable groups: I - study group, with acute kidney injury - 15 patients; II - control, without it - 496 patients. A comparative analysis of the main and additional cardiovascular risk factors frequency, analysis of their influence on the risk of urinary disorders in myocardial infarction (ANOVA) were performed. Results. The study group differed from the control group in the greater frequency of coronary artery bypass surgery (in the study group: 31.8%; in the control group: 8.4%; p = 0.0002), pacing (9.1 and 0.5%; respectively); p < 0.0001), history of atrial fibrillation and/or flutter (27.3 and 9.2%; p = 0.005), chronic cerebrovascular insufficiency (77.3 and 51.3%; p = 0,02), alcohol abuse (63.6 and 25.2%; p < 0.0001), frequent (four or more per year) colds (27.3 and 12.6%; p = 0,04), cardiac arrhythmias and conduction disturbances in the onset of coronary artery disease (61.9 and 24.9%; p = 0.0007), smoking for 20 years or more (36.4 and 16.8%; p = 0.003) , chronic kidney disease (46.7 and 16.2%; p = 0.02), chronic foci of internal organs infections (77.3 and 39.4%; p = 0.002), urine (27.3 and 8.6%; p = 0.006) and gallstone diseases (13.6 and 5.4%; p = 0.006). These indicators were the markers of the urinary disorders development in myocardial infarction. Conclusions. Men under 60 years old with urinary disorders in myocardial infarction are characterized by smoking, metabolic disorders, chronic kidney disease, heart rhythm and conduction disorders, alcohol abuse, frequent colds and chronic foci of internal organ infections. The data listed above should be used in the formation of high-risk groups for the development of urinary disorders, as well as for prognostic modeling.

Minimally invasive surgery for benign prostatic hyperplasia: causes, forms, and prevention of urinary disorders (literature review)

Benign prostatic hyperplasia (BPH) ranks 4th among all diagnoses in the group of men 50 years of age and older. With an increase in prostate volume of more than 20 cm³, patients develop lower urinary tract symptoms (LUTS), which negatively affect the quality of life of men. Currently, minimally invasive endovideosurgical methods of treating BPH have proven themselves successfully: transurethral resection (TUR) of monopolar or bipolar type, transurethral bipolar enucleation of the prostate (TUEP), holmium laser enucleation of the prostate (HoLEP). However, despite the clinical efficiency of endoscopic operations, the incidence of postoperative complications remains quite significant. After surgical intervention, the main causes of urinary disorders are detrusor overactivity or a decrease in its functional activity, as well as bladder obstruction. Prolonged bladder catheterization in the postoperative period prevents early recovery of independent urination, which is a risk factor for the development of urinary disorders. Stress urinary incontinence has a significant impact on patients, both physically and mentally. For the treatment of postoperative stress urinary incontinence, behavioral therapy, drug treatment of disorders, minimally invasive methods of treatment are used: injections of hyaluronic acid into the submucous layer of the urethra, botulinum toxin into the detrusor, as well as the technique of sacral neuromodulation. Surgical methods include the implantation of a synthetic sphincter or the installation of male sling.

Treatment with magnesium sulfate for urinary disorders

Based on his own observations and literary data, Voytashevsky (Nov. Khir. Arch., Vol. 3, book. 1)

Clinical, ultrasonographic, and postmortem findings in sheep and goats with urinary tract disorders

Background and Aim: In sheep and goats, most urinary disorders are incidental findings at the postmortem examination and do not present clinically. As such, the diagnosis of renal diseases in sheep and goats can be overlooked. Therefore, this study was carried out on sheep and goats to describe the clinical, ultrasonography (USG), and postmortem findings of various disorders affecting the urinary tract. Materials and Methods: A total of 58 animals (30 sheep and 28 goats) were examined, as well as were ten healthy control animals (five sheep and five goats) for a comparison. The animals were referred for various causes, including anorexia, frequent and painful urination, hematuria, decreased body weight, oliguria, and anuria. Results: The sheep and goats were categorized into ten groups of symptoms and disorders: Pelvic abscessation, pigmented urine, renal failure, pyelonephritis, cystitis, hydronephrosis, rupture of the urethra, rupture of the urinary bladder, rupture of the urinary bladder together with the urethra, and paralysis of the urinary bladder. Clinical presentation, USG, and postmortem examination results for each group were detailed. Many clinical presentations were nonspecific. USG examination of the urinary tract significantly facilitated the verification of the previously mentioned disorders. Conclusion: USG demonstrated superior performance in the early and confirmatory diagnosis of urinary disorders in sheep and goats. Therefore, it is recommended that routine USG be the preferred imaging modality for examining sheep and goats with urinary disorders and for determining their prognosis.

Monitoring bladder filling in patients with neurogenic urination disorders: the role of wearable hardware and software systems

Introduction. The use of wearable hardware and software systems to control bladder filling is considered one of the most important technologies for remote monitoring in patients with neurogenic urinary disorders. Materials and methods. A search, analysis and systematization of literature was carried out in the PubMed, e-library and Google Scholar databases using the keywords neurogenic urination disorders , neurogenic bladder , ultrasound diagnostics , ultrasound examination , monitoring , monitoring – total 211 sources, from which 46 were selected for writing the article. Theses and their abstracts, as well as conference abstracts were excluded from the analysis. Results. Ultrasound monitoring and bioimpedansometry, or a combination of both, allows for a non-invasive assessment of bladder volume, and the use of modern technologies, such as wireless communications and smartphone applications, allows the patient to maximize the individualization of the bladder emptying rhythm. Complicating moments in the use of these technologies are the conservatism of doctors, patient compliance, the lack of methodological developments and recommendations for the use of these monitoring technologies. Discussion. The monitoring of bladder filling allows to avoid unnecessary catheterizations reducing the risk of urinary tract infections. Also it allows forming a wake-up reflex in a child with enuresis when he or she feels an urge to urinate. These technologies are currently considered experimental. Additional research is required before introducing them into clinical practice. Conclusions. The use of wearable hardware and software systems for monitoring bladder filling and special applications in smartphones in patients with neurogenic urinary disorders is an important step in finding solutions for each individual patient. Clinical monitoring studies are needed in routine urological practice.

MAGNETIC LASER THERAPY OF IRRITATIVE URINARY DISORDERS AFTER SURGICAL TREATMENT OF BENIGN PROSTATIC HYPERPLASIA

Цель: Несмотря на четко определенные критерии отбора пациентов для лечения доброкачественная гиперплазия предстательной железы (ДГПЖ), часть больных остается неудовлетворенной результатами операции. Это вынуждает искать дополнительные методы лечения, которые могли бы войти в комплекс реабилитационных мероприятий для этой категории больных. Методы: В настоящем исследовании мы проанализировали группу пациентов из 69 больных, перенесших оперативное лечение по поводу ДГПЖ (как трансуретральную резекцию предстательной железы, так и открытую аденомэктомию), имевших в послеоперационном периоде выраженную ирритативную симптоматику. Результаты: Эффекты магнитно-лазерной терапии в зоне оперированной предстательной железы способны воздействовать на те звенья патогенеза ирритативных расстройств мочеиспускания, которые недоступны другим методам. Выводы: При правильном отборе пациентов применение магнитно-лазерной терапии на зону оперированной железы, задней уретры и мочевого пузыря позволяет достичь удовлетворяющего пациента результата операции в гораздо ранние сроки, нередко существенно сократить послеоперационной койко-день, в ряде случаев избежать длительного курса антибактериальной терапии или дорогостоящих α--адреноблокаторов. Purpose: Despite the clarity of the selection of patients for the treatment of benign prostatic hyperplasia (BPH), some of the patients are unsatisfied with the results of the operation. This forces us to look for additional methods of treatment that could be included in the complex of rehabilitation measures for this category of patients. Methods: In this study, we analyzed a group of patients from 69 patients who underwent surgical treatment for BPH (both transurethral resection of the prostate gland and open adenomectomy) who had severe irritative symptoms in the postoperative period. Results: The effects of magnetic laser therapy in the area of the operated prostate can affect those links in the pathogenesis of irritative urinary disorders that are inaccessible to other methods. Conclusions: With the correct selection of patients, the use of magnetic laser therapy on the area of the operated gland, posterior urethra and bladder allows achieving a satisfactory surgical result at a much earlier time, often significantly shortening the postoperative bed-day, in some cases avoiding a long course of antibiotic therapy or expensive α-adrenergic blockers.

Obsessive-Compulsive Disorders and Functional Urinary Disorders: A Fortuitous Association?

Although psychological factors are known to affect bladder and bowel control, the occurrence of functional urinary disorders in patients with psychiatric disorders has not been well-studied or described. A higher prevalence of functional lower urinary tract disorders have also been reported amongst patients with obsessive-compulsive (OC) disorders. A systematic literature search of PubMed, EMBASE, OVID Medline, PsycINFO, Clinical Trials Register of the Cochrane Collaboration Depression, Anxiety and Neurosis Group (CCDANTR), Clinicaltrials.gov and Google Scholar databases found five observational studies on the topic. Unfortunately, as only one study had a (healthy) control group, a meta-analytic approach was not possible. Overall, patients with OC symptoms appeared to have increased occurrence of functional urinary symptoms, e.g., overactive bladder, increase in urgency, frequency, incontinence and enuresis. This was even more common amongst patients with Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections (PANDAS) or Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) as opposed to patients with OCD alone. Several biological and behavioural mechanisms and treatment approaches were discussed. However, as the current evidence base was significantly limited and had moderate to serious risk of bias, no strong inferences could be drawn. Further well-designed cohort studies are necessary to better elucidate the observed associations and their management.