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Sweeney Clayton posted an update 6 months, 3 weeks ago
ICIQ-BD is a reliable tool to assess for LUTS, but filling the Bladder Sensation Score item was more likely to be incorrectly filled by manual workers and volunteers with less intellectually demanding current professions.
To report a contemporary series of Miami pouch (MP) enriched with a full technical description and step-by-step video to contribute to wider use.
A retrospective charts review of all patients who had a MP at our center between January 2016 and December 2017 was performed. The MP technique uses the terminal 15cm of ileum and the right colon to build an intestinal heterotopic pouch located in the right iliac fossa and connected to the skin by an efferent catheterizable tube. Primary outcome was continence defined as the absence of leakage between clean intermittent self-catheterization (CISC) with a maximal interval of 4 hours between each CISC.
Fifteen patients had MP during the study period. Thirty-day postoperative Clavien III complications were observed in 2 (13.3%) patients. At 39 months of median follow-up, continence was obtained for all patients except for 2 patients whom reported intermittent night-time leakages due to long intervals (5 to 7 hours) between 2 CISC. No significant alteration of renal function was reported and no stenosis of the efferent tube neither difficulty to perform CISC was observed.
For patients who are candidates for radical cystectomy and not eligible for orthotopic neobladder, intestinal heterotopic pouch with a cutaneous continent urinary diversions as MP may be a reliable alternative. Patients should be informed of the existence of a valid alternative to ileal conduit since it may fit their expectations of a preserved body image without urine collecting appliances.
For patients who are candidates for radical cystectomy and not eligible for orthotopic neobladder, intestinal heterotopic pouch with a cutaneous continent urinary diversions as MP may be a reliable alternative. Patients should be informed of the existence of a valid alternative to ileal conduit since it may fit their expectations of a preserved body image without urine collecting appliances.
To evaluate percutaneous tibial nerve stimulation (PTNS) maintenance therapy dropout rates and identify factors associated with compliance in an American population.
We retrospectively queried our PTNS database for patients from 2014-2019. Demographic, relevant clinical, and visit data were collected. Maintenance therapy was patient-driven and frequency of sessions was tapered based on symptomology. Upon completion of 12 initial sessions, we assessed dropout from maintenance at 3, 6, 9, and 12 months. Multiple variables were tested for correlation with dropout in patients continuing maintenance therapy for 1 year vs those who dropped out.
One hundred and sixty-three PTNS patients were identified, of which 104 completed initial therapy and 81 proceeded with maintenance therapy. At 3, 6, 9, and 12 months, maintenance continuation rates were 77.8% (63/81), 58.0% (47/81), 45.6% (37/81), and 39.5% (32/41), respectively. Primary reasons for dropout were worsening of urinary symptoms/lack of efficacy (n=21), time commitment (n=9), loss of insurance (n=5), medical comorbidities (n=4), request for alternative OAB treatment (n=2), and unknown (n=8). On both univariate and multivariate analysis, perceived symptom improvement (P<.01; HR=0.02, P< .01) was associated with continuing maintenance therapy. On only univariate analysis, neurological history (P=.02) and multiple sclerosis history (0.02) were associated with continuing therapy.
Only 39.5% of patients continue to undergo maintenance PTNS therapy after 1 year. Future studies are required to understand and ameliorate factors for low compliance in PTNS maintenance therapy.
Only 39.5% of patients continue to undergo maintenance PTNS therapy after 1 year. Future studies are required to understand and ameliorate factors for low compliance in PTNS maintenance therapy.Much psychological research uses pupil diameter measurements to investigate the cognitive and emotional effects of visual stimuli. A potential problem is that accommodating at a nearby point causes the pupil to constrict. This study examined to what extent accommodation is a confounder in pupillometry research. Participants solved multiplication problems at different distances (Experiment 1) and looked at line drawings with different monocular depth cues (Experiment 2) while their pupil diameter, refraction, and vergence angle were recorded using a photorefractor. Experiment 1 showed that the pupils dilated while performing the multiplications, for all presentation distances. Pupillary constriction due to accommodation was not strong enough to override pupil dilation due to cognitive load. Experiment 2 showed that monocular depth cues caused a small shift in refraction in the expected direction. We conclude that, for the young student sample we used, pupil diameter measurements are not substantially affected by accommodation.Attentional biases to emotional information may play a key role in the onset and course of schizophrenia. The aim of this experiment was to examine the attentional processing of four emotional scenes in competition (happy, neutral, sad, threatening) in 53 patients with schizophrenia and 51 controls. The eye movements were recorded in a 20-seconds free-viewing task. The results were (i) patients showed increased attention on threatening scenes, compared to controls, in terms of attentional engagement and maintenance; (ii) patients payed less attention to happy scenes than controls, in terms of attentional maintenance; (iii) whereas positive symptoms were associated with a late avoidance of sad scenes, negative symptoms were associated with heightened attention to threat. The findings suggest that a threat-related bias and a lack of sensitivity to positive information may represent an underlying psychological mechanism of schizophrenia. Importantly, schizophrenia symptoms modulated the attentional biases, which has aetiological and therapeutic implications.Threat generalization to novel instances is central to adaptive behavior. Most previous work has investigated threat generalization based on the perceptual similarity between past and novel stimuli. Few studies have explored generalization based on abstract, non-perceptual relations despite their importance for cognitive flexibility. In order to measure such rule-based generalization of threat without perceptual similarity, we developed a novel paradigm that prevents perceptual features from gaining predictive value. Our results demonstrate that participants responded according to the correct abstract rule and used it to successfully generalize their anticipatory behavioral threat responses (expectancy ratings, sudomotor nerve activity, and heart rate responses). Our results further show that participants flexibly adapted their responses to an unsignaled mid-session contingency reversal. Proteasome inhibitor review We interpret our results in the context of other rule-based generalization tasks and argue that variations of our paradigm make possible a wide range of investigations into the conceptual aspects of threat generalization.
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