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Strother M, Barlotta R, Uzzo R, Bloom E, Jazayeri SB, Bigalli AC, Schober J, Lee J, Bernstein A, Ginsburg K, Handorf E, Chen DY, Correa A, Greenberg R, Smaldone M, Viterbo R, Kutikov A. Symptomatic and functional recovery after transurethral resection of bladder tumor: Data from ecological momentary symptom assessment. Urol Oncol 2024; 42:117.e1-117.e10. [PMID: 38369443 PMCID: PMC11166544 DOI: 10.1016/j.urolonc.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 11/12/2023] [Accepted: 12/11/2023] [Indexed: 02/20/2024]
Abstract
OBJECTIVES To quantitatively describe the nature, severity, and duration of symptoms and functional impairment during recovery from transurethral resection of bladder tumors. MATERIALS AND METHODS All patients scheduled for transurethral resection were approached for enrollment in a text-message based ecological momentary symptom assessment platform. Nine patients reported outcomes were measured 7 days before surgery and on postoperative days 1, 2, 3, 5, 7, 10, and 14 using a 5-point Likert scale. Self-reported degree of hematuria was collected using a visual scale. Clinical data was collected via retrospective chart review. RESULTS A total of 159 patients were analyzed. Postoperative symptoms were overall mild, with the largest differences from baseline to postoperative day 1 seen in dysuria (median 0/5 vs. 3/5) and ability to work (median 5/5 vs. 4/5). Recovery was generally rapid, with 76% of patients reporting ≥4/5 agreement with the statement "I feel recovered from surgery" by postoperative day 2, although 15% of patients reported persistently lower levels of agreement on postoperative day 10 or 14. Patients undergoing larger resections (≥2cm) did take longer to return to baseline in multiple symptom domains, but the difference of medians vs. those undergoing smaller resections was less than 1 day across all domains. Multivariable analysis suggested that receiving perioperative intravesical chemotherapy was associated with longer time to recovery. 84% of patients reported clear yellow urine by postoperative day 3. CONCLUSION In this population, hematuria and negative effects on quality of life resulting from transurethral resection of bladder tumors were generally mild and short-lived, although a small number of patients experienced longer recoveries.
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Affiliation(s)
| | - Ryan Barlotta
- Department of Urology, Fox Chase Cancer Center, Philadelphia, PA
| | - Robert Uzzo
- Department of Urology, Fox Chase Cancer Center, Philadelphia, PA
| | - Evan Bloom
- Department of Urology, Fox Chase Cancer Center, Philadelphia, PA
| | - Seyed B Jazayeri
- Department of Urology, University of Florida Jacksonville, Jacksonville, FL
| | | | - Jared Schober
- Department of Urology, Fox Chase Cancer Center, Philadelphia, PA
| | - Jennifer Lee
- Lewis Katz School of Medicine at Temple University, Philadelphia, PA
| | - Adrien Bernstein
- Department of Urology, Fox Chase Cancer Center, Philadelphia, PA
| | - Kevin Ginsburg
- Department of Urology, Fox Chase Cancer Center, Philadelphia, PA
| | - Elizabeth Handorf
- Department of Biostatistics and Bioinformatics, Fox Chase Cancer Center, Philadelphia, PA
| | - David Yt Chen
- Department of Urology, Fox Chase Cancer Center, Philadelphia, PA
| | - Andres Correa
- Department of Urology, Fox Chase Cancer Center, Philadelphia, PA
| | | | - Marc Smaldone
- Department of Urology, Fox Chase Cancer Center, Philadelphia, PA
| | - Rosalia Viterbo
- Department of Urology, Fox Chase Cancer Center, Philadelphia, PA
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Zhu G, Yi X, Chen L, Liu Q. Association between gingival bleeding and hematuria as biomarkers of periodontitis and renal disease: a review. Odontology 2024; 112:19-26. [PMID: 37491546 DOI: 10.1007/s10266-023-00840-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 07/07/2023] [Indexed: 07/27/2023]
Abstract
Gingival bleeding is a common complaint and symptom in patients with periodontitis. In clinics, gingival bleeding is regarded as an important sign of gingival inflammation, which is also of great significance in predicting the activity of periodontitis. Existing research has indicated that periodontitis has an impact on distant sites, such as the kidney. Hematuria is the principal feature of glomerular disease, which can reflect the degree and condition of glomerular inflammation. Previous studies have revealed an association between periodontal diseases with renal diseases, so a study is necessary to discuss their representative signs of them. For the moment, there are no reports that are concerned about the correlation between gingival bleeding with hematuria. The main point of this text is to review the potential association between gingival bleeding with hematuria, reveal their underlying mechanisms, and provide instructions for the therapy of periodontitis and glomerular diseases.
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Affiliation(s)
- Guangxun Zhu
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xia Yi
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Lili Chen
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, 430022, China
| | - Qian Liu
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, 430022, China.
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Yoshimura S, Tanaka H, Kawabata S, Kozawa J, Takahashi H, Hidaka Y, Hotta M, Kashiwagi N, Tomiyama N. Effect of urinary glucose concentration and pH on signal intensity in magnetic resonance images. Jpn J Radiol 2022; 40:930-938. [PMID: 35396668 PMCID: PMC8993672 DOI: 10.1007/s11604-022-01273-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 03/16/2022] [Indexed: 11/26/2022]
Abstract
Purpose With advances in anti-diabetes drugs, increasing numbers of patients have high urinary glucose concentrations, which may alter magnetic resonance (MR) signal intensity. We sought to elucidate the effect of urinary glucose concentration and pH on transverse relaxation and MR signal intensity. Materials and methods The transverse relaxation rate (R2) was measured in samples with different glucose concentrations (in vitro) and in the urinary bladder of seven patients with diabetes and nine healthy volunteers (in vivo). The glucose concentration and pH in the in vitro samples and urine were measured. The signal intensity ratio of the bladder to adjacent tissues was obtained on T2-weighted imaging (WI), T1WI, and MR urography (in vivo). To clarify the effect of pH further, the urine of two healthy subjects was adjusted with acid and/or base to obtain various pH values (ex vivo). Results R2 increased significantly with high glucose concentrations in the in vitro study. In the in vivo study, high glucose concentration (p < 0.001) and low pH (p = 0.005) were significantly associated with high R2. R2 was higher (p = 0.002) and the signal in maximum-intensity projection images of MR urography was lower (p = 0.005) in patients with diabetes than in healthy subjects. Ex vivo study revealed that a decrease in pH in acid portion resulted in increased R2. Conclusion High concentrations of urinary glucose and low pH both enhance transverse relaxation, which, in turn, causes low signal intensity in urinary bladder on long echo time (TE) images, such as MR urography. Radiologists should be aware of this phenomenon when interpreting abnormally low-intensity bladders on long TE images.
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Affiliation(s)
- Sho Yoshimura
- Division of Health Science, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Hisashi Tanaka
- Division of Health Science, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Shuichi Kawabata
- Department of Medical Radiological Technology, Osaka University Hospital, 2-15 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Junji Kozawa
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Hiroto Takahashi
- Center for Twin Research, Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Yoh Hidaka
- Laboratory for Clinical Investigation, Osaka University Hospital, 2-15 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Masaki Hotta
- Laboratory for Clinical Investigation, Osaka University Hospital, 2-15 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Nobuo Kashiwagi
- Department of Future Diagnostic Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Noriyuki Tomiyama
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
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A Visual Scale for Improving Communication When Describing Gross Hematuria. Urology 2020; 148:32-36. [PMID: 33285214 DOI: 10.1016/j.urology.2020.10.054] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/14/2020] [Accepted: 10/13/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To create and validate a grading scale that facilitates communication between providers managing gross hematuria (GH). METHODS A blood simulant was used to create a spectrum of GH in 5 foley catheter tubes which were shown to a group of experienced urologists. The urologists were asked how they would adjust the continuous bladder irrigation rate if the samples represented the urine of hypothetical patients, and a 5-point scale was created by group consensus with pictures of the representative tubes printed onto a visual aid. Another cohort were then shown the 5 tubes at random and asked to describe the GH. Raters were then shown the visual aid and asked to assign a grade to the same samples. Fleiss' kappa analysis was used to measure inter-rater agreement, and therefore fidelity of the scale. RESULTS Fourteen urologists were surveyed to determine the samples used to create the 5-point scale. After the scale was created, 43 raters (22 nurses, 16 urologists, and 5 advanced practice providers) attempted match the tubes to their corresponding images on the printout. When asked to describe the degree of GH for the samples as they would in clinical practice, 28 different descriptors were used (mean 8.6 per sample). When using the 5-point GH scale, however, raters exhibited near perfect agreement in matching each sample to its corresponding severity on the scale (κ = 0.93, P < .001). CONCLUSION We created a clinically useful GH scale that improves communication and reduces ambiguous language among providers of varying levels of experience.
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Pre-Clinical Proof-of-Concept Study of a Bladder Irrigation Feedback System for Gross Haematuria in a Lab Setup. MULTIMODAL TECHNOLOGIES AND INTERACTION 2020. [DOI: 10.3390/mti4030059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Conventional continuous bladder irrigation (CBI) systems used in Urology have been labor-intensive and challenging for healthcare workers to manage consistently due to inter-observer variability in interpreting the blood concentration in the drainage fluid. The team has come up with a feedback system to control the saline flow-rate. It consists of a sensor probe that measures blood concentration in drainage fluid by measuring the light intensity absorbed by the samples. The other component is a gripper that adjusts the saline flow-rate based on the blood concentration detected. Results have shown that probe utilizing green color LED light can measure blood concentration between 0 and 18 percent. Besides, the gripper actuates to the blood concentration values detected accordingly. The quantification process reduces or even eradicates human error due to the subjective assessment of individual medical professionals.
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Meagher A, Thompson J, Vanderpuije J. Developing and testing a urine colour reference scale: a practice development project. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2014. [DOI: 10.1111/ijun.12047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Anna Meagher
- St. Vincent's Private Hospital Sydney; Darlinghurst NSW 2010 Australia
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