What's known on the subject? and What does the study add?
One of the suggested factors for stent‐related symptoms is that excess distal intravesical stent mass may cause bladder irritation. There is ...a lack of studies investigating this in a randomised controlled fashion using a validated questionnaire.
This study compared two of the most commonly used length of stents (a 30 cm multi‐length vs a 24 cm long stent) and showed no significance difference in stent‐related symptoms in patients with either of these stents.
Objective
To investigate whether excessive redundant intravesical stent component contributes to the severity of stent‐related symptoms in patients with a ureteric stent. We compared stent‐related symptoms in patients who had either a standard 24 cm or multi‐length ureteric stent.
Patients and Methods
In all, 162 patients with upper urinary tract calculi requiring ureteric stent insertion were randomised to receive either a 6 F × 24 cm ContourTM or multi‐length 6 F × 22–30 cm Contour VLTM stent.
Patients were requested to complete the validated Bristol Ureteric Stent Symptom Questionnaire (USSQ) at 1 and 4 weeks after stent insertion and 4 weeks after removal.
The mean scores for each domain of the USSQ for both groups were compared using the Student's t‐test.
Any adverse events, e.g. stent migration, early removal of stent due to stent‐related symptoms and failure of stent insertion, were also recorded.
Results
In all, 153 patients who had successful stent insertion were requested to complete the USSQ and 74% of patients returned at least the week 1 questionnaire.
At 1 and 4 weeks with the stent in situ, comparison of the mean scores showed no significant difference in urinary symptoms, pain, general health, work performance, sexual dysfunction and number of days patients stayed in bed or reduced their routine activities.
Three (2%) patients had their stent removed early due to stent‐related symptoms and five (3%) had failed stent insertion.
Conclusions
This study did not find any difference in symptoms between the 24 cm or multi‐length Contour stents. However, the study was not powered to detect small differences particularly for the pain symptom domain.
Stents should only be used sparingly and the stent dwell‐time should be minimised.
Tropomyosins in Skeletal Muscle Diseases Kee, Anthony J.; Hardeman, Edna C.
Advances in Experimental Medicine and Biology,
2008, Letnik:
644
Book Chapter, Journal Article
Recenzirano
A number of congenital muscle diseases and disorders are caused by mutations in genes that encode the proteins present in or associated with the thin filaments of the muscle sarcomere.1 These genes ...include α-skeletal actin (ACTA1), β-tropomyosin (TPM2), α-tropomyosin slow (TPM3), nebulin (NEB), troponin I fast (TNNI2), troponin T slow (TNNT1), troponin T fast (TNNT3) and cofilin (CFL2). Mutations in two of the four tropomyosin (Tm) genes, TPM2 and TPM3, result in at least three different skeletal muscle diseases and one disorder as distinguished by the presence of specific clinical features and/or structural abnormalities—nemaline myopathy (TPM2 and TPM3)2,3 distal arthrogryposis (TPM2)4 cap disease (TPM2)5 and congenital fiber type disproportion (TPM3)6. These disease have overlapping clinical features and pathologies and there are cases of family members who have the same mutation, but different diseases (Table 1). The relatively recent discovery of nonmuscle or cytoskeletal Tms in skeletal muscle7 adds to this complexity since it is now possible that a disease-causing mutation could be in a striated isoform and a cytoskeletal isoform both present in muscle.
After deep venous thrombosis (DVT), many patients have impaired quality of life (QOL). We aimed to assess whether pharmacomechanical catheter-directed thrombolysis (PCDT) improves short-term or ...long-term QOL in patients with proximal DVT and whether QOL is related to extent of DVT.
The Acute Venous Thrombosis: Thrombus Removal with Adjunctive Catheter-Directed Thrombolysis (ATTRACT) trial was an assessor-blinded randomized trial that compared PCDT with no PCDT in patients with DVT of the femoral, common femoral, or iliac veins. QOL was assessed at baseline and 1 month, 6 months, 12 months, 18 months, and 24 months using the Venous Insufficiency Epidemiological and Economic Study on Quality of Life/Symptoms (VEINES-QOL/Sym) disease-specific QOL measure and the 36-Item Short Form Health Survey (SF-36) physical component summary (PCS) and mental component summary general QOL measures. Change in QOL scores from baseline to assessment time were compared in the PCDT and no PCDT treatment groups overall and in the iliofemoral DVT and femoral-popliteal DVT subgroups.
Of 692 ATTRACT patients, 691 were analyzed (mean age, 53 years; 62% male; 57% iliofemoral DVT). VEINES-QOL change scores were greater (ie, better) in PCDT vs no PCDT from baseline to 1 month (difference, 5.7; P = .0006) and from baseline to 6 months (5.1; P = .0029) but not for other intervals. SF-36 PCS change scores were greater in PCDT vs no PCDT from baseline to 1 month (difference, 2.4; P = .01) but not for other intervals. Among iliofemoral DVT patients, VEINES-QOL change scores from baseline to all assessments were greater in the PCDT vs no PCDT group; this was statistically significant in the intention-to-treat analysis at 1 month (difference, 10.0; P < .0001) and 6 months (8.8; P < .0001) and in the per-protocol analysis at 18 months (difference, 5.8; P = .0086) and 24 months (difference, 6.6; P = .0067). SF-36 PCS change scores were greater in PCDT vs no PCDT from baseline to 1 month (difference, 3.2; P = .0010) but not for other intervals. In contrast, in femoral-popliteal DVT patients, change scores from baseline to all assessments were similar in the PCDT and no PCDT groups.
Among patients with proximal DVT, PCDT leads to greater improvement in disease-specific QOL than no PCDT at 1 month and 6 months but not later. In patients with iliofemoral DVT, PCDT led to greater improvement in disease-specific QOL during 24 months.
Display omitted
The functional diversity of the actin microfilaments relies in part on the actin binding protein tropomyosin (Tm). The muscle-specific Tms regulate actin-myosin interactions and hence contraction. ...However, there is less known about the roles of the numerous cytoskeletal isoforms. We have shown previously that a cytoskeletal Tm, Tm5NM1, defines a Z-line adjacent cytoskeleton in skeletal muscle. Recently, we identified a second cytoskeletal Tm in this region, Tm4. Here we show that Tm4 and Tm5NM1 define separate actin filaments; the former associated with the terminal sarcoplasmic reticulum (SR) and other tubulovesicular structures. In skeletal muscles of Tm5NM1 knockout (KO) mice, Tm4 localization was unchanged, demonstrating the specificity of the membrane association. Tm5NM1 KO muscles exhibit potentiation of T-system depolarization and decreased force rundown with repeated T-tubule depolarizations consistent with altered T-tubule function. These results indicate that a Tm5NM1-defined actin cytoskeleton is required for the normal excitation-contraction coupling in skeletal muscle.
The cover image, by Anthony J. Kee et al., is based on the Short Report ER/Golgi trafficking is facilitated by unbranched actin filaments containing Tpm4.2, DOI: 10.1002/cm.21405.
Pulsed field gradient nuclear magnetic resonance (PFG-NMR) measurements were successfully applied to the
Al ( I = 5/2) nucleus in concentrated electrolytes to investigate the diffusion of aluminate ...ions Al(OH)
in simulant high-level nuclear waste (3 M NaOH) between 25 and 85 °C. The temperature-dependent diffusion coefficients obtained from
H,
Na, and
Al PFG-NMR were well fit by a Vogel-Fulcher-Tammann model and a power law equation. Comparison of
Al diffusion coefficients of 0.1 M Al(OH)
in ∼3 M MOH (where M = Na
, K
, (CH
)
N
) at room temperature varied in agreement with the expected changes in solution viscosity via Stokes-Einstein relationship, confirming that the dominant Al species at these conditions are Al(OH)
monomers. This
Al PFG-NMR study extends an established methodology to a previously unexplored nucleus enabling this experimental technique to be leverage for exploring ion transport, speciation, and solution structure in concentrated electrolytes.
PDF
