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Cystitis
Kinds of Cystitis Selected AbstractsThe legendary beginning of the International Consultation on Interstitial CystitisINTERNATIONAL JOURNAL OF UROLOGY, Issue 2003TOMOHIRO UEDA No abstract is available for this article. [source] Interstitial Cystitis and the Therapeutic Effect of Suplatast TosilateLUTS, Issue 2009Yukio HAYASHI Painful bladder syndrome (PBS)/interstitial cystitis (IC) can be a chronic and debilitating disease characterized by urinary urgency, frequency, and bladder pain, which are often very difficult to treat, regardless of currently-proposed treatments. Suplatast tosilate (IPD-1151T) is an immunoregulator that suppresses Th2 cytokine production, immunoglobulin E (IgE) synthesis, chemical mediator release from mast cells, and eosinophilic recruitment. In a preliminary, open-label clinical study of IPD-1151T in 14 women with IC, treatment with IPD-1151T significantly increased bladder capacity and decreased urinary urgency, urinary frequency, and lower abdominal pain, as measured by the IC symptom index, in patients with non-ulcerative IC. A concomitant reduction in immunological parameters (eosinophils, IgE, and urine T cells) was observed. Also, in basic experimental studies using hydrochloric acid-induced chronic cystitis rats, the oral administration of IPD-1151T (0.1,100 mg/kg/day) for 7 days after the induction of cystitis dose dependently increased the intercontraction intervals and micturition volume. In addition, the infiltration of mast cells and eosinophils into the bladder was suppressed by IPD-1151T. These findings suggest that IPD-1151T could be a new medicine for treating debilitating symptoms, such as bladder pain and urinary frequency in PBS/IC. [source] Protective Effect of Berberine on Cyclophosphamide-Induced Haemorrhagic Cystitis in RatsBASIC AND CLINICAL PHARMACOLOGY & TOXICOLOGY, Issue 5 2001Xinyun Xu Administration of 150 mg/kg cyclophosphamide intraperitoneally caused a serious haemorrhagic cystitis in rats after 12 hr, including bladder oedema, haemorrhage, and dramatic elevation of nitric oxide metabolites (nitrite+nitrate) in urine and in plasma. To explore whether cyclophosphamide-induced cystitis could be prevented by berberine, rats were pretreated with a single dose or two doses of berberine at 50, 100, or 200 mg/kg intraperitoneally then challenged with cyclophosphamide (150 mg/kg, intraperitoneally). The results indicated that pretreatment of rats with berberine could reduce cyclophosphamide-induced cystitis in a dose-dependent manner. Furthermore, we found that two doses of berberine showed greater protection against cyclophosphamide urotoxicity than when given a single dose. In addition, our data shows that a single dose of 200 mg/kg berberine, or two doses of 100, and 200 mg/kg berberine could completely block cyclophosphamide-induced bladder oedema and haemorrhage, as well as nitric oxide metabolites increase in rat urine and plasma. In conclusion, our findings suggest that berberine could be a potential effective drug in the treatment of cyclophosphamide-induced cystitis, and provides us with the bright hope in the prevention and treatment of cyclophosphamide urotoxicity. [source] L6-S1 spinal nerve stimulation reduces micturition frequency in anaesthetized rats with cyclophosphamide-induced cystitisBJU INTERNATIONAL, Issue 2 2006FRANÇOIS A. GIULIANO OBJECTIVE To further investigate the rationale for using spinal nerve stimulation (SNS) for treating bladder overactivity associated with cystitis in a rat model of cyclophosphamide-induced cystitis, as several studies suggested that symptoms associated with chronic cystitis could be treated using stimulation of sacral spinal nerves, but the mechanisms by which it works are unknown. MATERIALS AND METHODS Cystitis was induced by i.p. injection of cyclophosphamide 48 h before the experiments in anaesthetized male rats. Neurograms were taken by placing a recording electrode onto the pelvic nerve and a stimulating electrode on either the L6 or S1 ipsilateral spinal nerves. Two selected intensities were then evaluated for SNS in control and cyclophosphamide-treated rats during cystometry. RESULTS Cyclophosphamide resulted in significant bladder overactivity. There was no apparent difference in the neurograms generated in response to SNS of the S1 and L6 spinal nerves, and between cyclophosphamide and control rats. Intensities of 200 µA (A,-fibre-specific) and 2 mA (A,+ C-fibres) were chosen for SNS. Continuous SNS at 200 µA significantly reduced the frequency of voiding and non-voiding contractions in cyclophosphamide-treated rats. SNS at 2 mA resulted in the abolition of voiding contractions, accompanied by continuous leakage of urine. CONCLUSION SNS recruiting only A,-fibre produced fewer voiding contractions in cyclophosphamide-treated rats, to a level similar to that from the control rats. These results support the ability of SNS to decrease bladder overactivity in a pathophysiological model of chemical irritation of the bladder. [source] Urinary bladder biopsy with denuded mucosa: Denuding cystitis,Cytopathologic correlatesDIAGNOSTIC CYTOPATHOLOGY, Issue 5 2004Anil V. Parwani M.D., Ph.D. Abstract Denuding cystitis is often encountered in tissue biopsies of bladder mucosa performed by either cold-cup forceps or wire loop electrocautery to evaluate hematuria or to rule out recurrent urothelial carcinoma. Lack of urothelium in these biopsies is often a frustrating experience, leading to a nonspecific interpretation. In this study, 151 cases of denuding cystitis were retrieved from the surgical pathology files of The Johns Hopkins Hospital over a 4-year period (1996,1999). Patients under the age of 40 years and outside consultation material were excluded. Of the 151 cases of denuding cystitis, 48 patients were identified who had concurrent urinary cytologic studies. Of these patients, 35 were male (73%) and 13 were female (27%). Patient ages ranged from 43 to 85 years (mean, 67). Twenty-six of these 48 patients (54%) had at least one concurrently positive urinary cytology, which was histologically confirmed. All except three cases were high-grade urothelial carcinoma with the following histologic subtypes: flat carcinoma in situ (n = 11), noninvasive papillary (n = 9), and invasive urothelial carcinoma (n = 3). We conclude that urinary cytology is a sensitive modality that detects exfoliated carcinoma cells in patients with a histologic diagnosis of denuding cystitis. An inconclusive diagnosis of denuding cystitis on tissue might be related to biopsy method and technique, small sample size, or biopsy of cystoscopically abnormal urothelium that is denuded. A cytologic diagnosis of high-grade urothelial carcinoma in these cases leads to a timely clinical intervention for optimal patient management. Diagn. Cytopathol. 2004;30:297,300. © 2004 Wiley-Liss, Inc. [source] Expanding field of purinergic signalingDRUG DEVELOPMENT RESEARCH, Issue 1-2 2001Geoffrey Burnstock Abstract This article attempts to paint a broad picture of the extraordinary explosive recent developments in the purinergic signaling field. After a brief historical review and update of purinoceptor subtypes, the focus is on the physiological roles of purines and pyrimidines. These are considered both in terms of short-term signaling in neurotransmission, secretion, and vasodilatation and in long-term (trophic) signaling in development, regeneration, proliferation, and cell death. Examples of trophic signaling include cartilage development in limb buds, glial cell proliferation, development of skeletal muscle, changes in receptor expression in smooth-muscle phenotypes, maturation of testicular spermatids, and bone remodeling. Plasticity of purinoceptor expression in pathological conditions is described, including the increase in the purinergic component of parasympathetic nervous control of the human bladder in interstitial cystitis and outflow obstruction and in sympathetic cotransmitter control of blood vessels in hypertensive rats, the appearance of P2X7 receptors in the glomeruli of the kidney from diabetic and transgenic hypertensive animal models, and up-regulation of P2X1 and P2Y2 receptor mRNA in hearts of rats with congestive heart failure. The role of P2X3 receptors in nociception is considered, and a new hypothesis about purinergic mechanosensory transduction in the gut is explored. A personal view of some of the areas ripe for future development concludes this article, including a discussion of different strategies that could lead to the development of purinergic therapeutic agents. Drug Dev. Res. 52:1,10, 2001. © 2001 Wiley-Liss, Inc. [source] Fimbriae of uropathogenic Proteus mirabilisFEMS IMMUNOLOGY & MEDICAL MICROBIOLOGY, Issue 1 2007Sérgio P. D. Rocha Abstract Proteus mirabilis is a common causative agent of cystitis and pyelonephritis in patients with urinary catheters or structural abnormalities of the urinary tract. Several types of fimbriae, which are potentially involved in adhesion to the uroepithelium, can be expressed simultaneously by P. mirabilis: mannose-resistant/Proteus -like (MR/P) fimbriae, P. mirabilis fimbriae (PMF), uroepithelial cell adhesin (UCA), renamed by some authors nonagglutinating fimbriae (NAF), and ambient-temperature fimbriae (ATF). Proteus mirabilis is a common cause of biofilm formation on catheter material and MR/P fimbriae are involved in this process. The considerable serious pathology caused by P. mirabilis in the urinary tract warrants the development of a prophylactic vaccine, and several studies have pointed to MR/P fimbriae as a potential target for immunization. This article reviews P. mirabilis fimbriae with regard to their participation in uropathogenesis, biofilm formation and as vaccine targets. [source] Severe eosinophilic cystitis in a woman with anorexia nervosaINTERNATIONAL JOURNAL OF UROLOGY, Issue 8 2006JOE PHILIP Abstract, Eosinophilic cystitis is a rare inflammatory disorder. It is considered to be self limiting necessitating only supportive therapy. Surgical intervention is unusual. We report here an association between eosinophilic cystitis and anorexia nervosa in an adult woman requiring radical surgery for progressive relentless disease. Estrogen deficiency associated with a possible allergic etiology could explain this association. [source] Urodynamic effects and safety of modified intravesical oxybutynin chloride in patients with neurogenic detrusor overactivity: 3 years experienceINTERNATIONAL JOURNAL OF UROLOGY, Issue 8 2004MOTOAKI SAITO Abstract Background:, Intravesical oxybutynin chloride with hydroxypropylcellulose (HPC) (modified intravesical oxybutynin) has been reported to be effective for treatment of overactive bladder. We reported the short-term effects of modified intravesical oxybutynin previously. In the present article, we detail the results of a 3-year follow-up study of patients from our previous analysis and report the efficacy and side-effects of modified intravesical oxybutynin. Methods:, Modified intravesical oxybutynin (5 mg/10 mL, twice a day) was applied for more than 3 years to six neurogenic overactive detrusor patients (three men and three women, average age 53.3 years) who were not satisfied with oral anticholinergic agents or the other therapy. A cystometogram (CMG) was performed before, 1 week after and 3 years after the start of modified intravesical oxybutynin treatment. We evaluated the patient's satisfaction of this treatment after 4 weeks and again after 3 years. We compared the patients' answers before and after the therapy (excellent, good, fair, unchanged and worse). We also monitored systemic and topical side-effects in these patients during this period. Results:, CMG studies showed that two of six patients no longer exhibited uninhibited contraction 1 week after the treatment and that the cystocapacity of patients before, 1 week after and 3 years after the initial modified intravesical oxybutynin was 129.7 ± 19.4, 283.5 ± 40.4 and 286.8 ± 38.1 mL, respectively. For the evaluation of patients' satisfaction with this treatment, four patients considered the therapy excellent and one patient described it as good after both 4 weeks and after 3 years. Two patients dropped out of the study; one developed left ureteral cancer (2.25 years) and the other developed ileus (1.5 years). Dry mouth and acute cystitis were observed in both patients. Conclusion:, Modified intravesical oxybutynin is an effective and relatively safe option of therapy for overactive bladder patients. However, this therapy requires careful observation for emergent side-effects. [source] Interstitial cystitis, gynecologic pelvic pain, prostatitis, and their epidemiologyINTERNATIONAL JOURNAL OF UROLOGY, Issue 2003ANANIAS C. DIOKNO Abstract Aim: To determine a uniform definition of interstitial cystitis (IC) and to develop a strategy on how to study its epidemiology. Methods: Initially, the committee reviewed the literature regarding the definition of IC currently being used and information regarding its epidemiology. The committee held three 1-hour hearings and discussions on the opinions of invited IC specialists. The issues were presented and discussed. Consensus was sought when possible. The committee members met and summarized the gist of the three sessions. Results: A consensus emerged as to what constitutes IC. Interstitial cystitis must have the elements of chronic pelvic pain and urinary frequency and/or urgency. It was also the recommendation that the term IC be retained followed by chronic pelvic pain syndrome represented by the acronym IC/CPPS. A strategy on the epidemiologic study of IC/CPPS was also recommended. Conclusions: A consensus from this workshop has emerged in terms of defining the component of IC, the preferred terminology, and the strategy to study its epidemiology. [source] The basics behind bladder pain: A review of data on lower urinary tract sensationsINTERNATIONAL JOURNAL OF UROLOGY, Issue 2003J. J. WYNDAELE Abstract Interstitial cystitis is a syndrome consisting of frequency, urgency, and bladder pain that increases with bladder filling and improves temporarily after voiding. The exact cause or causes are not as yet fully understood. This leads to uncertainty in diagnosis and treatment. There is need for more knowledge, and to acquire this for more research. The fact that the condition causes pain, a pathologic stimulation of sensory fibres, makes understanding the basic sensory mechanisms in the lower urinary tract in normal and pathologic conditions mandatory. In this article we review the data on bladder sensation from the last 25 years and the possible relation with painful bladder syndrome. [source] Significance of complications of allergic diseases in young patients with interstitial cystitisINTERNATIONAL JOURNAL OF UROLOGY, Issue 2003TETSUO YAMADA Abstract Background: It was found that about one-half of interstitial cystitis (IC) patients have complications of allergic diseases. However, significance of the complications have not been studied. Patients and Methods: Thirty-four patients (age range 20 to 39 years old) meeting the diagnostic criteria of NIDDK established in 1987 were selected. Clinical allergic tests and significance of complications of allergic diseases were examined. Results: Eighty-six percent of young patients had complications of allergic diseases. In two patients, IC was a part of generalized allergic diseases. In 25 patients, IC was suggested to have some association with allergy. Of these 25 patients, there were alternating symptoms or proportionally changing symptoms of allergy and IC in 15 patients, and the number of eosinophils increased in six patients. Seven IC patients were considered to have developed allergic diseases only by chance without apparent association. Conclusions: Complications of allergic diseases are frequent, particularly in young IC patients. The results suggest the involvement of allergy in about 80% of IC patients with complications of allergic diseases. In only 6% of patients, IC was a part of generalized allergic disease. [source] Adjuvant hydrodistension under epidural anesthesia for interstitial cystitisINTERNATIONAL JOURNAL OF UROLOGY, Issue 9 2003TETSUO YAMADA ABSTRACT Background: Hydrodistension is the first choice of treatment for interstitial cystitis because it allows for diagnosis, bladder biopsy and treatment. However, the method and efficacy of hydrodistension are variable. We performed adjuvant hydrodistension and examined the efficacy and factors that influence prognosis. Methods: Fifty-two patients participated in the present study as subjects; they satisfied the diagnostic inclusion and exclusion criteria established by the National Institute of Diabetes, Digestive and Kidney Disease (NIDDK) in 1987, USA. Under epidural anesthesia, the bladder was repeatedly distended up to the maximal bladder capacity for treatment, diagnosis and biopsy. Hydrodistension was performed again on the following day for approximately 30 min under epidural anesthesia in a ward until macroscopic hematuria disappeared. Results: Five patients were classified into the good, 30 into the moderate and 17 into the poor response group. In the good response group, three patients had type I allergy and one patient did not fulfil all of the positive factors in the NIDDK criteria. The poor response group included one patient with collagen disease. The poor response group was further divided into two subgroups based on bladder capacity. One subgroup included eight patients with a bladder capacity of less than 100 mL and vesicoureteral reflux (VUR). The other subgroup included nine patients with a bladder capacity of more than 100 mL. Among these nine patients there were five patients who lacked one or two positive factors in the NIDDK criteria. Conclusion: Adjuvant hydrodistension under epidural anesthesia is effective for about 70% of patients for more than 3 months. It can be performed in a ward without any serious complications. It was observed that patients lacking one or two positive factors were included in the good and poor response groups. [source] Hyperbaric oxygen therapy for Wegener's granulomatosis with cyclophosphamide-induced hemorrhagic cystitisINTERNATIONAL JOURNAL OF UROLOGY, Issue 8 2002Isao Kuroda Abstract A 49-year-old man with Wegener's granulomatosis, who had been treated with cyclophosphamide, was admitted to our hospital experiencing gross hematuria. The hemorrhage was refractory to multiple conventional treatments. It progressed but later was resolved after a course of hyperbaric oxygen therapy. [source] Antibiotherapy and pathogenesis of uncomplicated UTI: difficult relationshipsJOURNAL OF APPLIED MICROBIOLOGY, Issue 6 2009A. Moura Abstract In a time when conventional antibiotics are becoming increasingly less effective for treatment of infections, the relationship between bacteria and antimicrobial resistance is becoming more and more complicated. This paper provides a current review of studies reported in the literature pertaining to the antibiotherapy of human urinary tract infections (UTI), in a way that helps the reader direct a bibliographic search and develop an integrated perspective of the subject. Highlights are given to (bio)pathogenesis of uncomplicated cystitis. Features associated with the antibiotherapy of UTI such as development of resistance are presented in the text systematically. This review discusses recent advances in the understanding of how the predominant uropathogen Escherichia coli interacts with its host and leads to infection; so one can understand some of the reasons behind antibiotherapy failures. [source] Blood ribavirin concentration in high-dose ribavirin for adenovirus-induced haemorrhagic cystitis , a case reportJOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 1 2008M. Homma PhD Summary Blood ribavirin concentration was monitored after the administration of high-dose oral ribavirin in a case of adenovirus-induced haemorrhagic cystitis post-stem-cell transplantation. Combination use of intravenous gamma immunoglobulin (15 g/3 days) and high-dose ribavirin (RBV; 9000 mg/4 days) provided plasma ribavirin concentration of 24·3 ,m and achieved virus eradication. High level of erythrocyte ribavirin (1085 ,m; mostly as phosphorylated metabolites) with long half-life (15 days) caused severe anaemia, which required several blood transfusions for 2 weeks after the cessation of the ribavirin treatment. It was suggested that blood transfusion and intensive haemoglobin level monitoring is necessary for at least 4 weeks after the RBV, because of the high accumulation of phosphorylated ribavirin in erythrocytes even after stopping ribavirin administration. [source] Simultaneous detection and differentiation of human polyomaviruses JC and BK by a rapid and sensitive PCR-ELAHA assay and a survey of the JCV subtypes within an Australian populationJOURNAL OF MEDICAL VIROLOGY, Issue 3 2004David M. Whiley Abstract Human polyomaviruses JCV and BKV can cause several clinical manifestations in immunocompromised hosts, including progressive multifocal leukoencephalopathy (PML) and haemorrhagic cystitis. Molecular detection by polymerase chain reaction (PCR) is recognised as a sensitive and specific method for detecting human polyomaviruses in clinical samples. In this study, we developed a PCR assay using a single primer pair to amplify a segment of the VP1 gene of JCV and BKV. An enzyme linked amplicon hybridisation assay (ELAHA) using species-specific biotinylated oligonucleotide probes was used to differentiate between JCV and BKV. This assay (VP1-PCR-ELAHA) was evaluated and compared to a PCR assay targeting the human polyomavirus T antigen gene (pol - PCR). DNA sequencing was used to confirm the polyomavirus species identified by the VP1-PCR-ELAHA and to determine the subtype of each JCV isolate. A total of 297 urine specimens were tested and human polyomavirus was detected in 105 specimens (35.4%) by both PCR assays. The differentiation of JCV and BKV by the VP1-PCR-ELAHA showed good agreement with the results of DNA sequencing. Further, DNA sequencing of the JCV positive specimens showed the most prevalent JCV subtype in our cohort was 2a (27%) followed by 1b (20%), 1a (15%), 2c (14%), 4 (14%) and 2b (10%). The results of this study show that the VP1-PCR-ELAHA is a sensitive, specific and rapid method for detecting and differentiating human polyomaviruses JC and BK and is highly suitable for routine use in the clinical laboratory. J. Med. Virol. 72:467,472, 2004. © 2004 Wiley-Liss, Inc. [source] Bone marrow transplantation for ,-thalassaemia major by an HLA-mismatched parentJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 3 2002CF Li Abstract: A six-year-old boy was diagnosed with ,-thalassaemia major during infancy. Since then, he required monthly blood transfusion and irregular iron chelation therapy. He had hepatosplenomegaly and elevated liver enzymes; the serum ferritin was up to 3800 ng/mL. An echocardiogram showed left-ventricular enlargement. His one-antigen-mismatched mother was chosen as a bone marrow donor. He was pretreated with intensive red blood cell transfusion and hydroxyurea for 6 weeks prior to conditioning. The conditioning included total body irradiation (300 cGy), busulfan (14 mg/kg), cyclophosphamide (160 mg/kg) and anti-thymocyte globulin (rabbit; 90 mg/kg). Marrow cell dose was 5.4 × 108/kg. Graft versus host disease (GVHD) prophylaxis included cyclosporine A (CSA) and methylprednisolone. Neutrophil engraftment occurred on day 23. Grade II acute GVHD occurred on day 45. The patient developed complications including septicaemia, haemorrhagic cystitis, intracranial haemorrhage and heart failure. He subsequently recovered from the complications without sequelae. The patient remained transfusion-independent at a follow-up examination after 18 months. This case suggested that a mismatched family member may be considered as a bone marrow donor for ,-thalassaemia major. In places where conventional treatment is not feasible, for example, in China, this approach may be an alternative option. A more intensive immunosuppressive regimen and a higher marrow cell dose may be important for successful engraftment. High-dose anti-thymocyte globulin may also prevent severe GVHD. [source] Melatonin attenuates ifosfamide-induced Fanconi syndrome in ratsJOURNAL OF PINEAL RESEARCH, Issue 1 2004Goksel Sener Abstract:, Regarding the mechanisms of ifosfamide (IFO)-induced nephrotoxicity and hemorrhagic cystitis, several hypotheses have been put forward, among which oxidative stress and depletion of glutathione (GSH) are suggested. This investigation elucidates the role of free radicals in IFO-induced toxicity and the protection by melatonin. Wistar albino rats were injected intraperitoneally with saline (0.9% NaCl; control-C group), melatonin (Mel group; 10 mg/kg daily for 5 days) or ifosfamide (50 mg/kg daily for 5 days; IFO group) or IFO + Mel. On the 5th day (120 hr) after the first IFO dose, animals were killed by decapitation and trunk blood was collected. Kidney and bladder tissues were obtained for biochemical and histological analysis. Urine was collected 24 hr before the rats were killed. The results demonstrated that IFO induced a Fanconi syndrome (FS) characterized by wasting of sodium, phosphate, and glucose, along with increased serum creatinine and urea. Melatonin markedly ameliorated the severity of renal dysfunction induced by IFO with a significant decrease in urinary sodium, phosphate, and glucose and increased creatinine excretion. Moreover, melatonin significantly improved the IFO-induced GSH depletion, malondialdehayde accumulation and neutrophil infiltration in both renal and bladder tissues. In the kidney, Na+,K+ -ATPase activity which was significantly reduced by IFO, was increased with melatonin treatment. Increased collagen contents of the kidney and bladder tissues by IFO treatment were reversed back to the control levels with melatonin. Our results suggest that IFO causes oxidative damage in renal and bladder tissues and melatonin, via its antioxidant effects, protects these tissues. These data suggest that melatonin may be of therapeutic use in preventing acquired FS due to IFO toxicity. [source] A study of environmental and behavioural factors that may be associated with feline idiopathic cystitisJOURNAL OF SMALL ANIMAL PRACTICE, Issue 3 2004M. E. Cameron The cause of cystitis in many cats remains unknown. The aim of this study was to determine whether or not any environmental or behavioural factors, particularly those that could be considered potentially stressful, were associated with feline idiopathic cystitis (FIC). The questionnaire-based study involved comparing 31 cats with FIC to 24 cats in the same households that did not have cystitis. They were also compared with a control population of 125 clinically healthy cats. Compared with the live-in controls and the control population, the cats with FIC were significantly more likely to be male, overweight and pedigree. Several stress factors were found to be associated with FIC. The factor that stood out most prominently was living with another cat with which there was conflict. The findings support the hypothesis that stress may be implicated in some cases of FIC. [source] Successful treatment of cyclophosphamide induced intractable hemorrhagic cystitis with recombinant FVIIa (NovoSeven®) after allogenic bone marrow transplantationJOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 10 2004M. Karimi [source] Anti-inflammatory properties of local anesthetics and their present and potential clinical implicationsACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 3 2006J. Cassuto Development of new local anesthetic agents has been focused on the potency of their nerve-blocking effects, duration of action and safety and has resulted in a substantial number of agents in clinical use. It is well established and well documented that the nerve blocking effects of local anesthetics are secondary to their interaction with the Na+ channels thereby blocking nerve membrane excitability and the generation of action potentials. Accumulating data suggest however that local anesthetics also posses a wide range of anti-inflammatory actions through their effects on cells of the immune system, as well as on other cells, e.g. microorganisms, thrombocytes and erythrocytes. The potent anti-inflammatory properties of local anesthetics, superior in several aspects to traditional anti-inflammatory agents of the NSAID and steroid groups and with fewer side-effects, has prompted clinicians to introduce them in the treatment of various inflammation-related conditions and diseases. They have proved successful in the treatment of burn injuries, interstitial cystitis, ulcerative proctitis, arthritis and herpes simplex infections. The detailed mechanisms of action are not fully understood but seem to involve a reversible interaction with membrane proteins and lipids thus regulating cell metabolic activity, migration, exocytosis and phagocytosis. [source] In vitro and in vivo pharmacodynamic properties of the fluoroquinolone ibafloxacinJOURNAL OF VETERINARY PHARMACOLOGY & THERAPEUTICS, Issue 6 2002M. Coulet The pharmacodynamic properties of a new veterinary fluoroquinolone antimicrobial agent, ibafloxacin, were evaluated. Minimal inhibitory concentrations (MIC), time-kill kinetics, postantibiotic effect (PAE) and postantibiotic subminimal inhibitory concentration effects (PA-SME) were determined against pathogenic canine Gram-negative and Gram-positive bacterial isolates from dermal, respiratory and urinary tract infections. The synergistic interactions between ibafloxacin and its main metabolite, 8-hydroxy-ibafloxacin were investigated. Finally, the efficacy of ibafloxacin was tested in in vivo canine infection models. Ibafloxacin had good activity against Pasteurella spp., Escherichia coli, Klebsiella spp., Proteus spp. and Staphylococcus spp. (MIC90=0.5 µg/mL), moderate activity against Bordetella bronchiseptica, Enterobacter spp. and Enterococcus spp. (MIC50=4 µg/mL) and low activity against Pseudomonas spp. and Streptococcus spp. The time-killing analysis confirmed that ibafloxacin was bactericidal with a broad spectrum of activity. The PAE and PA-SME were between 0.7,2.13 and 1,11.5 h, respectively. Finally, studies in dog models of wound infection and cystitis confirmed the efficacy of once daily oral ibafloxacin at a dosage of 15 mg/kg. Additional studies are needed to better define the importance of AUC/MIC (AUIC) and Cmax/MIC ratios on the outcome of fluoroquinolone therapy in dogs. [source] Interstitial Cystitis and the Therapeutic Effect of Suplatast TosilateLUTS, Issue 2009Yukio HAYASHI Painful bladder syndrome (PBS)/interstitial cystitis (IC) can be a chronic and debilitating disease characterized by urinary urgency, frequency, and bladder pain, which are often very difficult to treat, regardless of currently-proposed treatments. Suplatast tosilate (IPD-1151T) is an immunoregulator that suppresses Th2 cytokine production, immunoglobulin E (IgE) synthesis, chemical mediator release from mast cells, and eosinophilic recruitment. In a preliminary, open-label clinical study of IPD-1151T in 14 women with IC, treatment with IPD-1151T significantly increased bladder capacity and decreased urinary urgency, urinary frequency, and lower abdominal pain, as measured by the IC symptom index, in patients with non-ulcerative IC. A concomitant reduction in immunological parameters (eosinophils, IgE, and urine T cells) was observed. Also, in basic experimental studies using hydrochloric acid-induced chronic cystitis rats, the oral administration of IPD-1151T (0.1,100 mg/kg/day) for 7 days after the induction of cystitis dose dependently increased the intercontraction intervals and micturition volume. In addition, the infiltration of mast cells and eosinophils into the bladder was suppressed by IPD-1151T. These findings suggest that IPD-1151T could be a new medicine for treating debilitating symptoms, such as bladder pain and urinary frequency in PBS/IC. [source] LeuX tRNA-dependent and -independent mechanisms of Escherichia coli pathogenesis in acute cystitisMOLECULAR MICROBIOLOGY, Issue 1 2008Thomas J. Hannan Summary Uropathogenic Escherichia coli (UPEC) contain multiple horizontally acquired pathogenicity-associated islands (PAI) implicated in the pathogenesis of urinary tract infection. In a murine model of cystitis, type 1 pili-mediated bladder epithelial invasion and intracellular proliferation are key events associated with UPEC virulence. In this study, we examined the mechanisms by which a conserved PAI contributes to UPEC pathogenesis in acute cystitis. In the human UPEC strain UTI89, spontaneous excision of PAI IIUTI89 disrupts the adjacent leuX tRNA locus. Loss of wild-type leuX -encoded tRNA5Leu significantly delayed, but did not eliminate, FimB recombinase-mediated phase variation of type 1 pili. FimX, an additional FimB-like, leuX -independent recombinase, was also found to mediate type 1 pili phase variation. However, whereas FimX activity is relatively slow in vitro, it is rapid in vivo as a non-piliated strain lacking the other fim recombinases rapidly expressed type 1 pili upon experimental infection. Finally, we found that disruption of leuX, but not loss of PAI IIUTI89 genes, reduced bladder epithelial invasion and intracellular proliferation, independent of type 1 piliation. These findings indicate that the predominant mechanism for preservation of PAI IIUTI89 during the establishment of acute cystitis is maintenance of wild-type leuX, and not PAI IIUTI89 gene content. [source] Enhanced expression of mast cell growth factor and mast cell activation in the bladder following the resolution of trinitrobenzenesulfonic acid (TNBS) colitis in female rats,NEUROUROLOGY AND URODYNAMICS, Issue 6 2007Ruomei Liang Abstract Aims Chronic pelvic pain disorders often overlap. We have shown that acute colonic irritation can produce acute irritative micturition patterns and acutely sensitize bladder afferent responses to mechanical and chemical stimuli. We hypothesize that with time, colonic irritation can lead to neurogenic changes in the bladder and the development of chronic bladder sensitization. Methods Micturition patterns were measured in rats 60,90 days after the induction of trinitrobenzenesulfonic acid (TNBS) colitis in the resolution phase of this model. Total and activated mast cells (MCs) were quantified in the bladder, while mRNA levels of stem cell factor (SCF; a.k.a. MC growth factor) and nerve growth factor (NGF; a MC and nociceptive C-fiber stimulator) were quantified in the bladder and L6-S1 dorsal root ganglia (DRG). Results Following intra-rectal TNBS, voiding volume was reduced (P,<,0.005), while voiding frequency was increased (P,<,0.05), both by ,50%. Furthermore, both the percentage and density of activated bladder MCs were significantly elevated (P,<,0.05), although total MC counts were not statistically increased. At the molecular level, urinary bladder SCF expression increased twofold (P,<,0.005), as did NGF (P,<,0.01), while L6-S1 DRG levels were not significantly elevated. Conclusions Chronic cystitis in the rat as evidenced by changes in micturition patterns and the recruitment of activated MCs can occur during the resolution phase of TNBS colitis. These changes, of which MCs may play an important role, appear to be maintained over time and may occur via stimulation of convergent pelvic afferent input resulting in the upregulation of neurotrophic factors in the target organ. Neurourol. Urodynam. 26:887,893, 2007. © 2007 Wiley-Liss, Inc. [source] The molecular basis of urgency: regional difference of vanilloid receptor expression in the human urinary bladder,NEUROUROLOGY AND URODYNAMICS, Issue 3 2007Lu Liu Abstract Aim Treatments targeting vanilloid receptor TRPV1 are effective in some bladder disorders. Our aim was to determine the expression profiles of TRPV1 in regions of human bladder and test the hypothesis that there would be an upregulation of TRPV1 in mucosa of patients with bladder hypersensitivity but not idiopathic detrusor overactivity (IDO). Materials and Methods Women with sensory urgency (SU), interstitial cystitis (IC), and IDO were investigated by videourodynamics and cystoscopy. Control biopsies were used for comparison. Biopsies were dissected into mucosa and muscle, and evaluated for TRPV1 mRNA expression using quantitative competitive RT-PCR (QC-RT-PCR). Results TRPV1 mRNA from SU trigonal mucosa was significantly higher than control trigonal mucosa or SU bladder body mucosa. In contrast, in IDO patients, there was no difference between trigonal mucosa and body mucosa. In IC biopsies, RNA quality was substandard and unable to be used for analysis. The most striking finding was that TRPV1 mRNA expressed in SU trigonal mucosa was significantly inversely correlated with the bladder volume at first sensation of filling during cystometry. No such relationship was seen for IDO trigonal mucosa. No difference was seen in bladder body mucosa from any disease groups compared with age-matched control. Conclusions The symptoms of SU were associated with the increased expression of TRPV1 mRNA in the trigonal mucosa. No upregulation or regional differences of TRPV1 mRNA were seen in IDO patients. TRPV1 may play a role in SU and premature first bladder sensation on filling. Neurourol. Urodynam. 26:433,438, 2007. © 2006 Wiley-Liss, Inc. [source] A double-blind, randomized controlled trial of cystometry using saline versus 0.3 M potassium chloride infusion in women with overactive bladder syndrome,,NEUROUROLOGY AND URODYNAMICS, Issue 1 2007Joe Philip Abstract Aim To evaluate the effect of 0.3 M potassium chloride on cystometric parameters by comparing it with normal saline as a filling solution in women with overactive bladder (OAB). Patients and Methods Twenty-three women with significant OAB symptoms underwent consecutive cystometrograms (CMGs) using 0.9% normal saline (NS) and 0.3 M potassium chloride (KCl), the order of which was randomized for each patient. Individual CMGs were performed by separate investigators and both patients and investigators were blinded to the order in which each solution was given and to the results of the other CMG. Results Regardless of the nature of the filling solution, the order in which the CMGs were performed had little influence on either first desire to void (FDV, mean 83.5 ml vs. 117.8 ml for first and second CMGs respectively, P,=,0.10) or on maximum cystometric capacity (Cmax, mean 265.0 ml vs. 264.4 ml, P,=,0.98). KCl produced a significant (24%) reduction in mean Cmax compared to NS (mean 228.6 ml vs. 300.8 ml, P,=,0.001), irrespective of the order of infusion. Conclusion This comparative study using 0.3 M KCl versus NS as filling solutions suggests that intravesical potassium may not simply act on urothelial sensory nerve endings; it may also stimulate detrusor muscle contraction. These findings may influence the interpretation of the potassium sensitivity test in patients with OAB symptoms, particularly in those suspected of having interstitial cystitis. Neurourol. Urodynam. © 2006 Wiley-Liss, Inc. [source] How do you stretch a bladder?NEUROUROLOGY AND URODYNAMICS, Issue 1 2005A survey of UK practice, a literature review, a recommendation of a standard approach Abstract Aims To assess how and why hydrodistension of the bladder is performed by UK urologists and to compare this practise with the published literature on distension. To suggest a standardised technique for hydrodistension to allow comparison of diagnostic and therapeutic studies. Methods A questionnaire was sent to all UK consultant urologists. Questions addressed the indications for short bladder distension (SBD), details of technique, evaluation of outcome, and awareness of evidence base. The literature on bladder distension was reviewed. Results The majority of respondents perform SBD, principally in the diagnosis and therapy of interstitial cystitis (IC). There was considerable variation in the duration of distension, repetition of distension, the pressure used for distension, and the measurement of bladder capacity. The literature on the technique of hydrodistension is imprecise and no respondent was able to cite literature to support his or her practice. We suggest a simple, more objective technique for performing hydrodistension. Conclusions SBD is widely used. There is marked variability in technique and little more than anecdotal evidence to support any particular approach. Research into the evaluation and treatment of painful bladder syndrome in general and IC in particular would be facilitated by the adoption of a standardised technique. © 2004 Wiley-Liss, Inc. [source] BK virus-associated hemorrhagic cystitis in a pediatric lung transplant recipientPEDIATRIC TRANSPLANTATION, Issue 7 2007Okan Elidemir Abstract:, BKV was first postulated to be a potential pathogen in 1971 when it was isolated in the urine of a renal transplant recipient. The pathology of BKV is generally confined to the urinary tract. In renal transplant recipients, BKV has been associated with hemorrhagic cystitis, urethral stenosis, and interstitial nephritis. Reports of BKV infection in lung transplant recipients are limited to a few case reports in adult patients. A recent report revealed that up to 32% of adult lung transplant recipients may shed BKV in their urine without symptoms or renal dysfunction. To our knowledge, there are no published reports of pediatric lung transplant recipients with BKV-associated hematuria. We hereby report a case of BKV-induced hemorrhagic cystitis in a pediatric lung transplant recipient. [source] | ||||||||||||||||||||||||||||||||||