26 results on '"Sammer U"'
Search Results
2. Thermo-responsive aqueous two-phase system for two-level compartmentalization
- Author
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Huanqing Cui, Yage Zhang, Sihan Liu, Yang Cao, Qingming Ma, Yuan Liu, Haisong Lin, Chang Li, Yang Xiao, Sammer Ul Hassan, and Ho Cheung Shum
- Subjects
Science - Abstract
Abstract Hierarchical compartmentalization responding to changes in intracellular and extracellular environments is ubiquitous in living eukaryotic cells but remains a formidable task in synthetic systems. Here we report a two-level compartmentalization approach based on a thermo-responsive aqueous two-phase system (TR-ATPS) comprising poly(N-isopropylacrylamide) (PNIPAM) and dextran (DEX). Liquid membraneless compartments enriched in PNIPAM are phase-separated from the continuous DEX solution via liquid-liquid phase separation at 25 °C and shrink dramatically with small second-level compartments generated at the interface, resembling the structure of colloidosome, by increasing the temperature to 35 °C. The TR-ATPS can store biomolecules, program the spatial distribution of enzymes, and accelerate the overall biochemical reaction efficiency by nearly 7-fold. The TR-ATPS inspires on-demand, stimulus-triggered spatiotemporal enrichment of biomolecules via two-level compartmentalization, creating opportunities in synthetic biology and biochemical engineering.
- Published
- 2024
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3. Chronisches Schmerzsyndrom des Beckens: Neurostimulation, Neuromodulation und Akupunktur
- Author
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Walter, M., Sammer, U., and Kessler, T.M.
- Published
- 2012
- Full Text
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4. Point-of-care testing: a critical analysis of the market and future trends
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Abdul Raffay Khan, Wasif Latif Hussain, Ho Cheung Shum, and Sammer Ul Hassan
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point of care (POC) diagnosis ,medical technology (Med-Tech) innovations ,healthcare ,clinical diagnosis ,device development ,Technology (General) ,T1-995 - Abstract
Point-of-care testing (POCT) involves conducting diagnostic tests outside the laboratory. These tests are utilized for their quick and reliable results in detecting chronic diseases and acute infections. We examined the historical market value trends of the POCT industry and projected its future growth. POCT devices offer several advantages, such as portability, no specific storage requirements, and simplicity of use. However, issues such as inaccurate results can reduce demand for POCT compared to traditional laboratory testing alternatives. While the benefits of POCT are clear, it’s important to acknowledge the challenges. The accuracy of POCT devices can be compromised due to factors such as user error, environmental conditions, and limitations in technology. Furthermore, the cost-effectiveness of these devices is often a concern, particularly in resource-limited settings. The regulatory landscape for POCT is also complex and varies by region, which can pose challenges for manufacturers and end-users. Improvements in POCT devices’ sensitivity, specificity, cost, and turnaround time for test results could enhance their utility. Enhancements to a POCT device should be considered if they are economically viable and lead to a significant increase in demand. Our financial analysis of the POCT market revealed a positive growth trend. We identified potential areas for growth that could help the industry progress and expand in line with its projected growth in the coming years. The industry could focus on integrating intelligent technologies into POCT devices and collaborating with the innovative technology sector to increase revenue. It could also develop more sensitive and accurate POCT devices for non-communicable diseases. Another potential area of growth is in diseases that require continuous patient monitoring but where conventional clinical testing is time-consuming. Enhancing the POCT devices used in these areas could revolutionize medical diagnosis and potentially save many lives, provided they meet clinical standards.
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- 2024
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5. Plazenta als Heilmittel – Chancen und Risiken
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Johnson, S, additional, Pastuschek, J, additional, Groten, T, additional, Rödel, J, additional, Sammer, U, additional, and Markert, U, additional
- Published
- 2018
- Full Text
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6. Chronisches Schmerzsyndrom des Beckens: Neurostimulation, Neuromodulation und Akupunktur
- Author
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Walter, M., Sammer, U., Kessler, T.M., Walter, M., Sammer, U., and Kessler, T.M.
- Abstract
Zusammenfassung: Das chronische Schmerzsyndrom des Beckens ("chronic pelvic pain syndrome", CPPS) ist gemäß den Richtlinien der "European Association of Urology" charakterisiert als ein nicht-maligner Schmerz, der in Bezug auf die Strukturen des weiblichen oder männlichen Beckens über einen Zeitraum von mindestens 6Monaten wahrgenommen wird, ohne dass eine Infektion oder offensichtliche anderweitige Pathologie vorliegt. Das CPPS beeinträchtigt die Lebensqualität von Millionen von Menschen weltweit und hat einen ähnlich großen Einfluss wie andere chronische Krankheiten, z.B. Diabetes mellitus, Morbus Crohn oder kongestive Herzinsuffizienz. Trotz mehrerer etablierter Erstlinientherapien stellt die Behandlung des CPPS eine große Herausforderung dar, da viele Patienten therapierefraktär bleiben. Unkonventionelle Behandlungsmethoden wie Neurostimulation, Neuromodulation und Akupunktur können beim CPPS eine ausgezeichnete Wirkung zeigen und haben ein vorteilhaftes Nebenwirkungsprofil. So sollten diese vielversprechenden Therapieverfahren im klinischen Alltag vermehrt eingesetzt werden
- Published
- 2018
7. Mutterkuchen – Mal versuchen?! Eine wissenschaftliche Betrachtung von Plazenta-Präparaten als Heilmittel im Wochenbett
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Johnson, S, additional, Groten, T, additional, Pastuschek, J, additional, Rödel, J, additional, Sammer, U, additional, and Markert, U, additional
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- 2017
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8. 649 Bacteriuria in patients undergoing intradetrusor onabotulinumtoxinA injections for refractory neurogenic detrusor overactivity: Do we need antibiotic prophylaxis?
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Leitner, L., primary, Sammer, U., additional, Walter, M., additional, Knüpfer, S., additional, Schneider, M.P., additional, Seifert, B., additional, Mehnert, U., additional, and Kessler, T.M., additional
- Published
- 2016
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9. Chronisches Schmerzsyndrom des Beckens
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Walter, M, Sammer, U, Kessler, T M, University of Zurich, and Kessler, T M
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2748 Urology ,610 Medicine & health ,10046 Balgrist University Hospital, Swiss Spinal Cord Injury Center - Published
- 2012
10. Schnelle, nicht-genomische Aldosteroneffekte auf die renale Perfusion
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Schmidt, BMW, Sammer, U, Oehmer, S, Delles, C, Schneider, MP, and Schmieder, RE
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ddc: 610 - Published
- 2004
11. 763 Stopping urodynamic investigation at a bladder volume of 500 mL: Is it valid?
- Author
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Baumeister, P., primary, Chen, L., additional, Sammer, U., additional, Kozomara, M., additional, Birnböck, D., additional, Mehnert, U., additional, and Kessler, T.M., additional
- Published
- 2014
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12. 760 Pay attention to autonomic dysreflexia in patients with spinal cord injury during urodynamic investigation!
- Author
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Walter, M., primary, Sammer, U., additional, Guggenbühl-Roy, S., additional, Birnböck, D., additional, Knüpfer, S., additional, Mehnert, U., additional, Schubert, M., additional, and Kessler, T.M., additional
- Published
- 2014
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13. 764 Ice water test in patients with neurogenic lower urinary tract dysfunction: Before or after urodynamics?
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Kozomara-Hocke, M., primary, Suzuki, Bellucci C., additional, Sammer, U., additional, Kessler, T., additional, and Mehnert, U., additional
- Published
- 2014
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14. Rapid, nongenomic effects on renal perfusion
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Schmidt, BMW, Sammer, U, Oehmer, S, Delles, C, Schneider, MP, Schmieder, RE, Schmidt, BMW, Sammer, U, Oehmer, S, Delles, C, Schneider, MP, and Schmieder, RE
- Published
- 2004
15. Biogenic Nanoparticles: Synthesis, Characterisation and Applications
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Bilal Mughal, Syed Zohaib Javaid Zaidi, Xunli Zhang, and Sammer Ul Hassan
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biogenic synthesis ,nanomaterials ,nanoparticles ,drug delivery ,biochemical sensors ,Technology ,Engineering (General). Civil engineering (General) ,TA1-2040 ,Biology (General) ,QH301-705.5 ,Physics ,QC1-999 ,Chemistry ,QD1-999 - Abstract
Nanotechnology plays a big part in our modern daily lives, ranging from the biomedical sector to the energy sector. There are different physicochemical and biological methods to synthesise nanoparticles towards multiple applications. Biogenic production of nanoparticles through the utilisation of microorganisms provides great advantages over other techniques and is increasingly being explored. This review examines the process of the biogenic synthesis of nanoparticles mediated by microorganisms such as bacteria, fungi and algae, and their applications. Microorganisms offer a disparate environment for nanoparticle synthesis. Optimum production and minimum time to obtain the desired size and shape, to improve the stability of nanoparticles and to optimise specific microorganisms for specific applications are the challenges to address, however. Numerous applications of biogenic nanoparticles in medicine, environment, drug delivery and biochemical sensors are discussed.
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- 2021
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16. Chronisches Schmerzsyndrom des Beckens: Neurostimulation, Neuromodulation und Akupunktur
- Author
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Walter, M., Sammer, U., Kessler, T.M., Walter, M., Sammer, U., and Kessler, T.M.
- Abstract
Zusammenfassung: Das chronische Schmerzsyndrom des Beckens ("chronic pelvic pain syndrome", CPPS) ist gemäß den Richtlinien der "European Association of Urology" charakterisiert als ein nicht-maligner Schmerz, der in Bezug auf die Strukturen des weiblichen oder männlichen Beckens über einen Zeitraum von mindestens 6Monaten wahrgenommen wird, ohne dass eine Infektion oder offensichtliche anderweitige Pathologie vorliegt. Das CPPS beeinträchtigt die Lebensqualität von Millionen von Menschen weltweit und hat einen ähnlich großen Einfluss wie andere chronische Krankheiten, z.B. Diabetes mellitus, Morbus Crohn oder kongestive Herzinsuffizienz. Trotz mehrerer etablierter Erstlinientherapien stellt die Behandlung des CPPS eine große Herausforderung dar, da viele Patienten therapierefraktär bleiben. Unkonventionelle Behandlungsmethoden wie Neurostimulation, Neuromodulation und Akupunktur können beim CPPS eine ausgezeichnete Wirkung zeigen und haben ein vorteilhaftes Nebenwirkungsprofil. So sollten diese vielversprechenden Therapieverfahren im klinischen Alltag vermehrt eingesetzt werden
17. Urodynamics Are Essential to Predict the Risk for Upper Urinary Tract Damage after Acute Spinal Cord Injury.
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Birkhäuser V, Anderson CE, Kozomara M, Bywater M, Gross O, Kiss S, Knüpfer SC, Koschorke M, Leitner L, Mehnert U, Sadri H, Sammer U, Stächele L, Tornic J, Liechti MD, Brinkhof MWG, and Kessler TM
- Abstract
We used clinical parameters to develop a prediction model for the occurrence of urodynamic risk factors for upper urinary tract (UUT) damage during the first year after acute spinal cord injury (SCI). A total of 97 patients underwent urodynamic investigation at 1, 3, 6, and 12 months after acute SCI, within the framework of a population-based longitudinal study at a single university SCI center. Candidate predictors included demographic characteristics and neurological and functional statuses 1 month after SCI. Outcomes included urodynamic risk factors for UUT damage: detrusor overactivity combined with detrusor sphincter dyssynergia, maximum storage detrusor pressure (pDetmax) ≥ 40 cmH
2 O, bladder compliance < 20 mL/cmH2 O, and vesicoureteral reflux. Multivariable logistic regression was used for the prediction model development and internal validation, using the area under the receiver operating curve (aROC) to assess model discrimination. Two models showed fair discrimination for pDetmax ≥ 40 cmH2 O: (i) upper extremity motor score and sex, aROC 0.79 (95% CI: 0.69-0.89), C-statistic 0.78 (95% CI: 0.69-0.87), and (ii) neurological level, American Spinal Injury Association Impairment Scale grade, and sex, aROC 0.78 (95% CI: 0.68-0.89), C-statistic 0.76 (95% CI: 0.68-0.85). We identified two models that provided fair predictive values for urodynamic risk factors of UUT damage during the first year after SCI. Pending external validation, these models may be useful for clinical trial planning, although less so for individual-level patient management. Therefore, urodynamics remains essential for reliably identifying patients at risk of UUT damage.- Published
- 2023
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18. Temporal development of unfavourable urodynamic parameters during the first year after spinal cord injury.
- Author
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Anderson CE, Kozomara M, Birkhäuser V, Bywater M, Gross O, Kiss S, Knüpfer SC, Koschorke M, Leitner L, Mehnert U, Sadri H, Sammer U, Stächele L, Tornic J, Liechti MD, Brinkhof MWG, and Kessler TM
- Subjects
- Adult, Male, Female, Humans, Urodynamics, Longitudinal Studies, Urinary Bladder, Neurogenic etiology, Spinal Cord Injuries complications, Urinary Bladder, Overactive etiology, Vesico-Ureteral Reflux
- Abstract
Objectives: To describe the temporal development of and risk factors for the occurrence of unfavourable urodynamic parameters during the first year after spinal cord injury (SCI)., Patients and Methods: This population-based longitudinal study used data from 97 adult patients with a single-event traumatic or ischaemic SCI who underwent video-urodynamic investigation (UDI) at a university SCI centre. The first occurrences of unfavourable urodynamic parameters (detrusor overactivity combined with detrusor sphincter dyssynergia [DO-DSD], maximum storage detrusor pressure ≥40 cmH
2 O, bladder compliance <20 mL/cmH2 O, vesico-ureteric reflux [VUR] and any unfavourable parameter [composite outcome]) were evaluated using time-to-event analysis., Results: The majority of the population (87/97 [90%]) had at least one unfavourable urodynamic parameter. Most unfavourable urodynamic parameters were initially identified during the 1- or 3-month UDI, including 92% of the DO-DSD (78/85), 82% of the maximum storage pressure ≥40 cmH2 O (31/38), and 100% of the VUR (seven of seven) observations. No low bladder compliance was observed. The risk of DO-DSD was elevated in patients with thoracic SCI compared to those with lumbar SCI (adjusted hazard ratio [aHR] 2.38, 95% confidence interval [CI] 1.16-4.89). Risk of maximum storage detrusor pressure ≥40 cmH2 O was higher in males than females (aHR 8.33, 95% CI 2.51-27.66), in patients with a cervical SCI compared to those with lumbar SCI (aHR 14.89, 95% CI 3.28-67.55), and in patients with AIS Grade B or C compared to AIS Grade D SCI (aHR 6.17, 95% CI 1.78-21.39). No risk factors were identified for the composite outcome of any unfavourable urodynamic parameter., Conclusions: The first UDI should take place within 3 months after SCI as to facilitate early diagnosis of unfavourable urodynamic parameters and timely treatment. Neuro-urological guidelines and individualised management strategies for patients with SCI may be strengthened by considering sex and SCI characteristics in the scheduling of UDIs., (© 2022 The Authors. BJU International published by John Wiley & Sons Ltd on behalf of BJU International.)- Published
- 2023
- Full Text
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19. Neurogenic Lower Urinary Tract Dysfunction in the First Year After Spinal Cord Injury: A Descriptive Study of Urodynamic Findings.
- Author
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Kozomara M, Birkhäuser V, Anderson CE, Bywater M, Gross O, Kiss S, Knüpfer SC, Koschorke M, Leitner L, Mehnert U, Sadri H, Sammer U, Stächele L, Tornic J, Brinkhof MWG, Liechti MD, and Kessler TM
- Subjects
- Humans, Urinary Bladder, Spinal Cord Injuries complications
- Abstract
Purpose: We aimed to provide a real-world description of neurogenic lower urinary tract dysfunction within the first year after spinal cord injury with a focus on unfavorable urodynamic parameters that are associated with urological morbidity., Materials and Methods: Urodynamic investigations from 97 patients with traumatic or ischemic acute spinal cord injury and managed according to the European Association of Urology Guidelines on Neuro-Urology were analyzed at a single university spinal cord injury center at 1 month, 3 months, 6 months, and 12 months after injury. Unfavorable urodynamic parameters were defined as detrusor overactivity in combination with detrusor sphincter dyssynergia, maximum storage detrusor pressure of 40 cm H
2 O or higher, bladder compliance less than 20 mL/cm H2 O, and vesicoureteral reflux of any grade., Results: One or more unfavorable urodynamic parameter was observed in 87 out of 97 patients (90%) within the first year after spinal cord injury. Eighty-eight percent of the patients showed detrusor overactivity with detrusor sphincter dyssynergia, 39% a maximum storage detrusor pressure of 40 cm H2 O or higher, and 7% vesicoureteral reflux. No patient developed a low-compliance bladder., Conclusions: Using a standardized urodynamic follow-up schedule, we found unfavorable urodynamic parameters in a majority of the population within the first year after spinal cord injury. As early treatment based on urodynamic findings might reduce the risk of deterioration of upper and lower urinary tract function, thereby improving long-term outcomes, there is need for further research regarding recommendations for a urodynamic follow-up schedule during the first year after spinal cord injury.- Published
- 2023
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20. Human placentophagy: Effects of dehydration and steaming on hormones, metals and bacteria in placental tissue.
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Johnson SK, Groten T, Pastuschek J, Rödel J, Sammer U, and Markert UR
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- Adult, Bacteria growth & development, Eating physiology, Female, Humans, Infant, Newborn, Male, Oxytocin analysis, Postpartum Period, Pregnancy, Steam, Trace Elements analysis, Young Adult, Bacteria isolation & purification, Cooking methods, Desiccation, Feeding Behavior physiology, Metals analysis, Placenta chemistry, Placenta metabolism, Placenta microbiology, Placental Hormones analysis
- Abstract
Introduction: Human maternal placentophagy, the behavior of ingesting the own raw or processed placenta postpartum, is a growing trend by women of western societies. This study aims to identify the impact of dehydration and steaming on hormone and trace element concentration as well as microbial contamination of placental tissue., Methods: A total of nine placentas have been processed: six were studied for hormone and trace element concentrations; eight were studied for microbial contamination. The concentrations of CRH, hPL, oxytocin and ACTH in samples of raw, steamed dehydrated and raw dehydrated placental tissue were detected using ELISA. A yeast bioassay was performed in order to detect estrogen equivalent (EEQ) and gestagen equivalent (PEQ) active substances. Elements (As, Cd, Fe, Pb, Se, Hg) were analyzed using ICP-MS. Isolated colonies from tissue and placenta swab samples were identified using Vitek MS., Results: Following mean hormone concentrations were detected in raw placental tissue: CRH (177.88 ng/g), hPL (17.99 mg/g), oxytocin (85.10 pg/g), ACTH (2.07 ng/g), estrogen equivalent active substances (46.95 ng/g) and gestagen equivalent active substances (2.12 μg/g). All hormones were sensitive to processing with a significant concentration reduction through steaming and dehydration. Microorganisms mainly from the vaginal flora were detected on placenta swab samples and samples from raw, steamed, dehydrated and steamed dehydrated tissue and mostly disappeared after dehydration. According to regulations of the European Union the concentrations of potentially toxic elements (As, Cd, Hg, Pb) were below the toxicity threshold for foodstuffs., Conclusion: The commonly used protocols for preparation of placenta for its individual oral ingestion reduce hormone concentrations and bacterial contamination., (Copyright © 2018. Published by Elsevier Ltd.)
- Published
- 2018
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21. Urodynamic Investigation: A Valid Tool to Define Normal Lower Urinary Tract Function?
- Author
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Leitner L, Walter M, Sammer U, Knüpfer SC, Mehnert U, and Kessler TM
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- Adult, Female, Humans, Lower Urinary Tract Symptoms diagnosis, Male, Middle Aged, Prospective Studies, Surveys and Questionnaires, Urinary Bladder Neck Obstruction diagnosis, Urinary Bladder Neck Obstruction physiopathology, Urinary Bladder, Overactive diagnosis, Urinary Bladder, Overactive physiopathology, Young Adult, Lower Urinary Tract Symptoms physiopathology, Urinary Bladder physiology, Urinary Bladder physiopathology, Urodynamics
- Abstract
Objectives: To evaluate whether urodynamic investigation (UDI), the gold standard to assess refractory lower urinary tract symptoms (LUTS), is appropriate to select healthy volunteers with apparent normal lower urinary tract function as control subjects for comparative studies., Subjects and Methods: 42 healthy subjects (22 women, mean age 32±10 years; 20 men, mean age 37±12 years) without LUTS were included into this prospective single-centre cohort study. All subjects recorded a 3-day bladder diary, completed validated questionnaires regarding LUTS, and underwent neuro-urological assessment as well as free uroflowmetry. Same session repeat UDI was performed according to "Good Urodynamic Practice" recommended by the International Continence Society, but using an air-charged instead of a water-filled catheter, and evaluated by a blinded investigator., Results: All 3-day bladder diaries, LUTS questionnaires, neuro-urological assessments and free uroflowmetries were within normal limits. Overall (either during the first or second UDI), same session repeat UDI revealed pathological findings in 71% (30/42): Detrusor overactivity was detected in 14% (3/22) and 30% (6/20), post void residual >100mL in 14% (3/22) and 25% (5/20), bladder outlet obstruction in 9% (2/22) and 20% (4/20) and detrusor sphincter dyssynergia in 77% (17/22) and 65% (13/20) of our women and men, respectively. Repeatability of detrusor overactivity (κ = 0.78, 95% CI: 0.54-1.02) and detrusor sphincter dyssynergia (κ = 0.77, 95% CI: 0.55-0.98) showed substantial agreement between both UDIs. All other assessed urodynamic parameters had wide 95% limits of agreement for differences in the parameters indicating poor repeatability., Conclusions: More than 70% of our healthy subjects showed pathological urodynamic findings. Although UDI is the gold standard to assess refractory LUTS, it seems not to be applicable in healthy subjects to define normal lower urinary tract function. Therefore, we do not recommend using UDI to select healthy control subjects., Competing Interests: The authors have declared that no competing interests exist.
- Published
- 2016
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22. Antibiotic prophylaxis may not be necessary in patients with asymptomatic bacteriuria undergoing intradetrusor onabotulinumtoxinA injections for neurogenic detrusor overactivity.
- Author
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Leitner L, Sammer U, Walter M, Knüpfer SC, Schneider MP, Seifert B, Tornic J, Mehnert U, and Kessler TM
- Subjects
- Adult, Aged, Asymptomatic Infections, Female, Humans, Injections, Male, Middle Aged, Prospective Studies, Urination, Acetylcholine Release Inhibitors administration & dosage, Antibiotic Prophylaxis, Bacteriuria drug therapy, Botulinum Toxins, Type A administration & dosage, Urinary Bladder, Overactive drug therapy
- Abstract
Many of the patients undergoing intradetrusor onabotulinumtoxinA injections for refractory neurogenic detrusor overactivity (NDO) present with chronic bacteriuria. In these patients, antibiotic prophylaxis has been widely recommended since bacteriuria might impair treatment efficacy and cause urinary tract infections (UTI) but the evidence is limited. The aim of this study was to evaluate if an antibiotic prophylaxis is needed in patients with asymptomatic bacteriuria undergoing intradetrusor onabotulinumtoxinA injections. Between 06/2012 and 12/2014, a consecutive series of 154 patients undergoing a total of 273 treatment cycles were prospectively evaluated. Before treatment urine samples were collected, patients with no clinical signs for UTI underwent onabotulinumtoxinA injections, no antibiotic prophylaxis was given. Asymptomatic bacteriuria was found in 73% (200/273 treatments). Following treatment, UTI occurred in 5% (9/200) and 7% (5/73) of patients with and without bacteriuria, respectively. Intradetrusor onabotulinumtoxinA injections were clinically and urodynamically successful in 70% (192/273). There was no association between bacteriuria and treatment-related adverse events (odds ratio 0.64, 95% CI 0.23-1.81, p = 0.4) nor between bacteriuria and therapy failure (odds ratio 0.78, 95% CI 0.43-1.43, p = 0.4). Thus, we conclude that antibiotic prophylaxis needs to be critically reconsidered in patients undergoing intradetrusor onabotulinumtoxinA injections, especially taking into account the alarming antibiotic resistance worldwide.
- Published
- 2016
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23. More Than 15 Years of Experience with Intradetrusor OnabotulinumtoxinA Injections for Treating Refractory Neurogenic Detrusor Overactivity: Lessons to Be Learned.
- Author
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Leitner L, Guggenbühl-Roy S, Knüpfer SC, Walter M, Schneider MP, Tornic J, Sammer U, Mehnert U, and Kessler TM
- Subjects
- Acetylcholine Release Inhibitors administration & dosage, Adult, Botulinum Toxins, Type A administration & dosage, Drug Substitution, Female, Follow-Up Studies, Humans, Injections, Intramuscular, Male, Middle Aged, Multiple Sclerosis complications, Patient Compliance, Prospective Studies, Retrospective Studies, Spinal Cord Injuries complications, Spinal Dysraphism complications, Time Factors, Treatment Failure, Urinary Bladder, Neurogenic etiology, Urinary Bladder, Neurogenic physiopathology, Urinary Bladder, Overactive etiology, Urinary Bladder, Overactive physiopathology, Urodynamics, Acetylcholine Release Inhibitors therapeutic use, Botulinum Toxins, Type A therapeutic use, Urinary Bladder, Neurogenic drug therapy, Urinary Bladder, Overactive drug therapy
- Abstract
Background: Intradetrusor onabotulinumtoxinA (BoNT-ONA) injections have become a well-established therapy for refractory neurogenic detrusor overactivity (NDO). However, little is known about long-term outcome and patients' adherence to this treatment., Objective: To assess long-term outcomes of intradetrusor BoNT-ONA injections and patients' adherence to treatment., Design, Setting, and Participants: A consecutive series of 52 patients who underwent first intradetrusor BoNT-ONA injections for refractory NDO >10 yr ago were evaluated retrospectively and prospectively at a single university spinal cord injury (SCI) centre., Outcome Measurements and Statistical Analysis: Primary outcome was current neuro-urologic treatment. Secondary outcomes were urodynamic parameters. For data comparison, the paired/unpaired t test, chi-square test, and McNemar test were used., Results and Limitations: Mean duration since first intradetrusor BoNT-ONA injections was 12±2 yr. Most patients (61% [32 of 52]) suffered from SCI, 15% (8 of 52) from spina bifida, 14% (7 of 52) from multiple sclerosis (MS), and the remaining (10% [5 of 52]) from other neurologic disorders. Almost 60% (31 of 52) of all patients are continuing with intradetrusor BoNT-ONA injections but only 14% (1 of 7) of the patients with MS. Lack of clinical and/or urodynamic response (21% [11 of 52]) and switching to another treatment (antimuscarinics and/or neuromodulation) despite appropriate BoNT-ONA efficacy (19% [10 of 52]) were the reasons for discontinuation. In patients continuing BoNT-ONA treatment, the positive effect was sustained after repeat injections (p<0.05)., Conclusions: Although intradetrusor BoNT-ONA injections are a highly effective therapy for refractory NDO, approximately 40% of the patients discontinue treatment over time. All prospective neurologic patients should be given this information, and it needs to be considered in the treatment decision-making process., Patient Summary: Approximately 60% of the patients treated with intradetrusor onabotulinumtoxinA injections for refractory neurogenic detrusor overactivity continue this therapy long term with good therapeutic effects., Study Registration Number: NCT01293110., (Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.)
- Published
- 2016
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24. Do We Need Surveillance Urethro-Cystoscopy in Patients with Neurogenic Lower Urinary Tract Dysfunction?
- Author
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Sammer U, Walter M, Knüpfer SC, Mehnert U, Bode-Lesniewska B, and Kessler TM
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Biopsy, Female, Humans, Lower Urinary Tract Symptoms etiology, Male, Mass Screening, Middle Aged, Risk Factors, Urinary Bladder Neoplasms complications, Urinary Bladder Neoplasms epidemiology, Urinary Bladder Neoplasms etiology, Urinary Bladder, Neurogenic etiology, Urologic Diseases etiology, Young Adult, Cystoscopy, Lower Urinary Tract Symptoms diagnosis, Lower Urinary Tract Symptoms epidemiology, Urinary Bladder, Neurogenic diagnosis, Urinary Bladder, Neurogenic epidemiology, Urologic Diseases diagnosis, Urologic Diseases epidemiology
- Abstract
Purpose: To examine the value of surveillance urethro-cystoscopy in patients with neurogenic lower urinary tract dysfunction (NLUTD) in regard to the conflicting literature as it is generally agreed that patients with NLUTD are at increased risk for bladder cancer., Materials and Methods: In a cross-sectional study, a consecutive series of 129 patients (50 females, 79 males, mean age 51, range 18-88) suffering from NLUTD for at least 5 years was prospectively investigated using urethro-cystoscopy and bladder washing cytology at a single university spinal cord injury (SCI) center., Results: Due to suspicious urethro-cystoscopy and/or bladder washing cytology findings, 13 (10%) of 129 patients underwent transurethral resection of the bladder lesion and/or random bladder biopsies. Overall, 9 relevant histological findings were found in 5% (7/129) of our patients: bladder melanosis (n = 1), nephrogenic adenoma (n = 3), keratinizing squamous metaplasia (n = 1), intestinal metaplasia (n = 3), and muscle-invasive adenocarcinoma of the bladder (n = 1)., Conclusions: Using surveillance urethro-cystoscopy, we found relevant histological findings in 5% of our patients suffering from NLUTD for at least 5 years. Thus, surveillance urethro-cystoscopy might be warranted, although the ideal starting point and frequency remain to be determined in further prospective studies.
- Published
- 2015
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25. Glucose and glucose esters in the larval secretion of Chrysomela lapponica; selectivity of the glucoside import system from host plant leaves.
- Author
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Tolzin-Banasch K, Dagvadorj E, Sammer U, Kunert M, Kirsch R, Ploss K, Pasteels JM, and Boland W
- Subjects
- Animals, Biological Transport, Butyrates chemistry, Butyrates metabolism, Coleoptera physiology, Esters, Larva metabolism, Larva physiology, Betula metabolism, Coleoptera metabolism, Glucose chemistry, Glucose metabolism, Glucosides metabolism, Plant Leaves metabolism
- Abstract
Larvae of Chrysomela lapponica (Coleoptera: Chrysomelidae) sequester characteristic O-glucosides from the leaves of their food plants, namely Betula and/or Salix The present study focuses on birch-feeding larvae of C. lapponica from the Altai region in East Kazakhstan. As in other sequestering leaf beetle larvae, the compounds are transported intact via different membrane barriers into the defensive system, followed by glucoside cleavage and subsequent transformations of the plant-derived aglycones. Unlike previous studies with model compounds, we studied the sequestration of phytogenic precursors by analyzing the complex pattern of glucosides present in food plant Betula rotundifolia (39 compounds) and compared this composition with the aglycones present as butyrate esters in the defensive secretion. In addition to the analytic approach, the insect's ability, to transport individual glucosides was tested by using hydrolysis-resistant thioglucoside analogs, applied onto the leaf surface. The test compounds reach the defensive system intact and without intermediate transformation. No significant difference of the transport capacity and selectivity was observed between larvae of birch-feeding population from Kazakhstan, and previous results for larvae of birch-feeding population from the Czech Republic or willow-feeding populations. Overall, the transport of the phytogenic glucosides is highly selective and highly efficient, since only minor compounds of the spectrum of phytogenic glucoside precursors contribute to the limited number of aglycones utilized in the defensive secretion. Interestingly, salicortin 44 and tremulacin 60 were found in the leaves, but no aldehyde or esters of salicylalcohol. Surprisingly, we observed large amounts of free glucose, together with small amounts of 6-O-butyrate esters of glucose (27a/b and 28a/b).
- Published
- 2011
- Full Text
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26. Rapid nongenomic effects of aldosterone on the renal vasculature in humans.
- Author
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Schmidt BM, Sammer U, Fleischmann I, Schlaich M, Delles C, and Schmieder RE
- Subjects
- Adult, Aldosterone administration & dosage, Aldosterone blood, Blood Vessels drug effects, Cross-Over Studies, Double-Blind Method, Drug Combinations, Glomerular Filtration Rate drug effects, Humans, Injections, Intravenous, Male, Renal Circulation drug effects, Time Factors, Vascular Resistance drug effects, Vasoconstrictor Agents administration & dosage, Vasoconstrictor Agents blood, omega-N-Methylarginine administration & dosage, omega-N-Methylarginine pharmacology, Aldosterone pharmacology, Kidney blood supply, Vasoconstrictor Agents pharmacology
- Abstract
There is increasing evidence for the importance of rapid nongenomic effects of aldosterone on the human vasculature. In vitro animal experiments in renal arterioles also suggest the presence of such effects on the renal vasculature. We conducted a clinical study to explore these effects in vivo in humans. Thirteen healthy male volunteers were examined. Aldosterone (500 microg) or placebo was injected intravenously with or without coinfusion of N(G) monomethyl-L-arginine (L-NMMA) in a randomized, double-blinded 4-fold crossover design. Renal plasma flow and glomerular filtration rate were measured by constant infusion clearance technique using inulin and para-aminohippuric acid. Injection of aldosterone without concomitant infusion of L-NMMA changed the renal plasma flow and glomerular filtration rate not statistically significant compared with placebo. Coinfusion of L-NMMA unmasked the effect of aldosterone: aldosterone with L-NMMA decreased the glomerular filtration rate slightly (-1.4+/-6.2 mL/min), whereas infusion of L-NMMA alone increased the glomerular filtration rate (8.3+/-9.8 mL/min; P=0.004). L-NMMA alone decreased renal plasma flow by 58.2+/-97.5 mL/min, and aldosterone with L-NMMA decreased renal plasma flow by 190.0+/-213.7 mL/min (P=0.074). Accordingly, Aldosterone with L-NMMA increased renal vascular resistance much more than L-NMMA alone (1588+/-237 versus 614+/-240 dynxsxcm(-5); P=0.014). These data indicate that aldosterone acts via rapid nongenomic effects in vivo in humans at the renal vasculature. Antagonizing the endothelial NO synthase unmasks these effects. Therefore, rapid nongenomic aldosterone effects increase renal vascular resistance and thereby mediate arterial hypertension if endothelial dysfunction is present.
- Published
- 2006
- Full Text
- View/download PDF
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