Navegando por Palavras-chave "urinary bladder, neurogenic"
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- ItemAcesso aberto (Open Access)Determining the variables associated to clean intermittent self-catheterization adherence rate: one-year follow-up study(Sociedade Brasileira de Urologia, 2011-12-01) Girotti, Marcia Eli [UNIFESP]; Maccornick, Sarita [UNIFESP]; Perissé, Humberto [UNIFESP]; Batezini, Nelson S [UNIFESP]; Almeida, Fernando G. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To determine adherence rate and variables associate with patients' adherence to Clean Intermittent Self Catheterization (CISC). MATERIALS AND METHODS: Patients refereed to CISC training program between July 2006 and May 2008, were prospectively evaluated with urodynamic, 3 days bladder diary (BD) and WHOQoL-bref questionnaire. After training to perform CISC, patients were evaluated at 2 weeks, monthly for 6 months and at 12 months with clinical visits and BD. Patients were considered adherent if they were performing at least 80% of the initial recommendation. RESULTS: Sixty patients (50.4 ± 19.9 years old) were trained to perform CISC (21 female and 39 male). Out of them, 30 (50%) had neurogenic and 30 (50%) had a non-neurogenic voiding dysfunction. The adherence rate at 6 and 12 months was 61.7%, 58%, respectively. Patients < 40 years old had adherence rate of 86%. Women and neurogenic patients had higher adherence rate than their counterparts (p = 0.024 and p = 0.016, respectively). In the WHOQoL-bref, patients that adhere to the program had a significant higher score on psychological and social relationships domains. There was not difference in pre and post training WHOQoL-bref scores. Educational background, marriage status, detrusor leak point pressure, Bladder Capacity, number of leakage episodes did not play a role on the adherence rate. CONCLUSION: Patients in CISC program present a reasonable adherence after one year. Women, neurogenic voiding dysfunction and patients under 40 years old were significantly more adherents. The psychological and social relationship status seems to positively interfere on adherence. CISC did not affect patient's QoL evaluated by WHOQoL-bref.
- ItemSomente MetadadadosEffects of Allogeneic Bone Marrow Derived Mesenchymal Stromal Cell Therapy on Voiding Function in a Rat Model of Parkinson Disease(Elsevier B.V., 2014-03-01) Campeau, Lysanne; Soler, Roberto [UNIFESP]; Sittadjody, Sivanandane; Pareta, Rajesh; Nomiya, Masanori; Zarifpour, Mona; Opara, Emmanuel C.; Yoo, James J.; Andersson, Karl-Erik; Wake Forest Univ; NYU; Universidade Federal de São Paulo (UNIFESP); Fukushima Med UnivPurpose: Cellular therapy induced transient urodynamic improvement in a rat model of Parkinson disease in which bladder dysfunction was noted after unilateral injection of 6-hydroxydopamine into the medial forebrain bundle. We sought to prolong the effect by injecting allogeneic rat bone marrow mesenchymal stromal cells before and after microencapsulation into the substantia nigra pars compacta.Materials and Methods: Female rats underwent unilateral stereotactic injection of 6-hydroxydopamine in the medial forebrain bundle. Injection was performed in the ipsilateral substantia nigra pars compacta using vehicle alone or vehicle with nonmicroencapsulated or microencapsulated rat bone marrow derived mesenchymal stromal cells. Rats were evaluated by cystometry 7, 14, 28 and 42 days after treatment. Brains were extracted for immunostaining.Results: At 42 days the nonmicroencapsulated group had lower threshold and intermicturition pressure, spontaneous activity and AUC than vehicle treated animals. Rats that received microencapsulated cells had lower threshold pressure at 28 days and lower spontaneous activity at 42 days than vehicle treated rats. Microencapsulated and nonmicroencapsulated rat bone marrow derived mesenchymal stromal cells were noted in the substantia nigra pars compacta up to 42 days after transplantation. At 42 days tyrosine hydroxylase positive neurons were more numerous in the substantia nigra pars compacta of the nonmicroencapsulated group, followed by the microencapsulated and vehicle treated groups.Conclusions: Urodynamic effects of the 6-hydroxydopamine lesion persisted up to 42 days after vehicle injection. Transplantation of nonmicroencapsulated rat bone marrow derived mesenchymal stromal cells improved urodynamic pressure by 42 days after treatment more markedly than microencapsulated cells. This was associated with more tyrosine hydroxylase positive neurons in the treated substantia nigra pars compacta of the nonmicroencapsulated group, suggesting that functional improvement requires a juxtacrine effect.
- ItemSomente MetadadadosEffects of Urinary Tract Infection in Patients With Bladder Augmentation and Kidney Transplantation(Elsevier B.V., 2008-12-01) Pereira, Daniel Alcantara [UNIFESP]; Barroso, Ubirajara [UNIFESP]; Machado, Paula [UNIFESP]; Medina Pestana, Jose Osmar [UNIFESP]; Rosito, Thiago Elias [UNIFESP]; Pires, Jesus [UNIFESP]; Almeida, Claudio [UNIFESP]; Ortiz, Valdemar [UNIFESP]; Macedo, Antonio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Purpose: We evaluated the rate of function decline of the renal allograft, in patients with augmented bladder. We also evaluated the prevalence of asymptomatic bacteriuria and urinary tract infection in these patients, and to demonstrate if these findings are predictors of allograft function decline, comparing children who underwent bladder augmentation with a control group.Materials and Methods: Among 170 children and adolescents undergoing renal transplantation at our institution 23 (14%) had previously undergone bladder augmentation. These patients were retrospectively compared (1:2 ratio) to 42 controls matched for gender, age, race, donor type, weight and immunosuppression protocol. the type of donor (living or cadaver), rate of acute tubular necrosis and cold ischemia time during transplantation were also similar between groups.Results: Mean followup was 18.0 +/- 13.9 months and 25.2 +/- 14.1 months for the augmented and nonaugmented bladder groups, respectively (p >0.05). the incidence of acute rejection within the first 12 months of kidney transplantation was 9% in the bladder augmentation group and 26% in controls (p >0.05). the rate of urinary tract infection or asymptomatic bacteriuria in the first 12 months after kidney transplantation was higher in the bladder augmentation group (19 patients, 83%) compared to controls (7 patients, 17%, p <0.001). Patients with augmented bladder had a higher number of hospital admissions (14 patients, 61%) compared to the control group (12 patients, 29%, p = 0.004). Despite the higher incidence of urinary tract infection in the augmented bladder group, there was no statistically significant difference in graft function between the groups at 6 months (1.1 +/- 0.3 mg/dl vs 1.0 +/- 0.3 mg/dl) or 12 months (1.0 +/- 0.2 mg/dl vs 1.2 +/- 0.7 mg/dl) after transplantation.Conclusions: Our study demonstrated that patients with transplanted kidney and augmented bladder had more asymptomatic bacteriuria and urinary tract infections than those without bladder augmentation. However, the rate of graft survival was similar between the groups.