Biomedical subjects

E Finazzi Agrò

Publications and source records attributed to E Finazzi Agrò.

7 recordsLinked to original sources

PubMed2005

Posterior tibial nerve stimulation: is the once-a-week protocol the best option?

AIM: Aim of our study was to compare the results of posterior tibial nerve stimulation (PTNS) performed weekly with those of PTNS performed 3 times per week in patients with overactive bladder syndrome. METHODS: Thirty-five patients (28 females, 7 males) with overactive bladder syndrome not responding to antimuscarinic therapy were enrolled in a prospective study. A total of 17 out of 35 patients were randomly assigned to group A and treated with a PTNS protocol based on weekly stimulation sessions; 18 out of 35 patients were randomly assigned to group B and treated with a PTNS protocol based on stimulation sessions performed 3 times per week. All subjects were evaluated by means of 24 h bladder diaries, quality of life questionnaires (I-QoL, SF36) and urodynamic evaluation before and after treatment. Patients were asked after each stimulation session to give their opinion on the efficacy of the treatment. We have considered ''success'' those patients who presented a reduction >50% of the micturition episodes/24 h (ME/24) or (if incontinent) of the incontinence episodes/24 h (IE/24). Results before and after treatments in both groups were collected and statistically compared. RESULTS: As a whole, 11/17 patients (63%) in group A and 12/18 patients (67%) in group B were considered ''success''; 4/11 (36%) incontinent patients in group A and 5/11 (45%) incontinent patients in group B were completely cured after treatment. In both groups, patients reported subjective improvement after 6-8 stimulation sessions. CONCLUSIONS: Our findings seem to show that the periodicity of stimulation does not effect the results of PTNS treatment. The advantage of more frequent stimulation sessions is to achieve earlier a clinical improvement.

Electric Stimulation Therapy↗

PubMed2003

Evaluating body composition of Italian prostate cancer patients without metastases.

Prostate cancer (PCa) is becoming an increasingly important public health problem worldwide, and anthropometric studies have revealed that body composition is a potential risk factor for this type of cancer. The objective of the present study was to compare Italians with PCa and no history of androgen deprivation therapy or bone metastases with healthy controls in terms of body composition. We recruited 11 PCa patients [mean age (+/-SD), 68.67+/-4.93 years; body mass index (BMI), 28.42+/-2.96 kg/m(2)] and 11 healthy controls matched for age and BMI. Anthropometric and body composition parameters were measured for all participants using dual X-ray absorptiometry and bioelectric impedance analysis techniques. We found that lean body mass, but not fat mass, was significantly lower for PCa patients in comparison with healthy controls (50.24+/-5.03 vs. 53.63+/-5.61 kg, p<0.05). Thus, PCa patients with no history of androgen deprivation therapy and no bone metastasis suffer muscle mass depletion.

Aged↗

PubMed2001

Urinary N-acetyl-beta-D-glucosaminidase concentration in patients with spinal cord injury: relationship with urodynamic parameters.

OBJECTIVES: To investigate the relationships between urinary N-acetyl-beta-D-glucosaminidase (NAG) concentrations and urodynamic parameters in patients with spinal cord injury (SCI). NAG has been proposed as a marker of renal damage. METHODS: Twenty-three patients with SCI were evaluated with urodynamic studies. Urine samples were collected from the 23 patients and 10 healthy volunteers, the NAG levels were evaluated, and the urodynamic parameters were compared with the urinary NAG levels. The patients were divided into two groups according to the amplitude of the hyperreflexic detrusor contractions (HDCs): group A, patients with an HDC amplitude of 40 cm H(2)O or greater, and group B, patients with an HDC amplitude of less than 40 cm H(2)O; group C was composed of healthy volunteers. The urinary NAG concentrations in the three groups were compared. RESULTS: A positive correlation was found between the urinary NAG levels and the HDC amplitude and detrusor leak point pressure (P = 0.015 and 0.007, respectively). The urinary NAG concentration was 3.38 U/g in group A, 2.14 U/g in group B, and 2.12 U/g in group C. The differences in the urinary NAG concentrations between groups A and B and between groups A and C were statistically significant (P = 0.03 and P <0.001, respectively). The concentrations between groups B and C were comparable. CONCLUSIONS: In our experience, the only urodynamic parameters that clearly and positively correlated with the urinary NAG levels were those expressing the amplitude of intravesical pressure. This result stresses the importance of reducing the intravesical pressure in patients with SCI using alternative treatments or surgical procedures if the usual conservative therapies are not effective.

Acetylglucosaminidase↗

PubMed2000

[Ultrasonography of the upper urinary tract in patients with spinal cord injury].

A lesion of the upper urinary tract (UUT) is a possible outcome of the bladder dysfunction following a spinal cord injury (SCI). The most common findings are hydronephrosis, bladder-ureteral reflux and pyelonephritis. Aim of the study was to evaluate the prevalence of UUT abnormalities, evaluable by ultrasound (US), in a population of SCI patients; furthermore we correlated the presence of such abnormalities to clinical findings. We evaluated 115 consecutive patients who underwent US scan of UUT. Mean time between injury and our evaluation was 81.5 +/- 100.2 months. Lesion level was cervical (38/115), dorsal (59/115) and lumbar (18/115). Eight patients emptied their bladder spontaneously, 105 by means of intermittent catheterization, while 2 were wearing indwelling catheter. Seventy-four patients used anticholinergics drugs. It was evaluated the presence of: hydronephrosis, renal stones and chronic pyelonephritis using US. Afterward the presence of such alterations was correlated to sex and age of patients, time between injury and our evaluation, method of bladder emptying and use of anticholinergics drugs. In 25/115 patients (21.7%) were found abnormalities of UUT. A significative correlation was found between presence of UUT lesions and older age. In our series, prevalence of UUT abnormalities observed by means of US in SCI patients is 21.7%. This finding could be due to correct management and strict follow up of the patients.

Adolescent↗

PubMed1999

Lower urinary tract dysfunction and disability status in patients with multiple sclerosis.

OBJECTIVE: To investigate the correlation between neurologic and urologic status in patients with multiple sclerosis (MS). MATERIALS AND METHODS: Between January 1993 and December 1995, 116 patients with MS symptoms were fully assessed neurologically and urologically with urodynamic studies. RESULTS: Urodynamic abnormalities were detected in 104 patients (89.6%). Several significant relationships between urinary tract findings and neurologic dysfunction were: (1) the relation between voiding disorder as the presenting symptom of the disease and a higher severity of bladder dysfunction; (2) the relation between reduced bladder sensation and longer duration of voiding disorders, lower detrusor uninhibited contractions threshold, and lower bladder capacity; and (3) the relation between voiding disorders and cerebellar system score. Finally, a significant inverse relationship was found between detrusor hypocontractility and neurologic status (from the Expanded Disability Status Scale, pyramidal system score, and Barthel Index). CONCLUSIONS: In this series a high incidence of patients reported voiding disorder as the presenting symptom of MS. These patients also showed a higher severity of urodynamic disorders. They should be rigorously followed up. Furthermore, our data suggest that although the most common cause of altered bladder control in MS is spinal cord pathology, involvement of cortical centers and/or peripheral neuronal lesions may occur.

Adult↗

PubMed1997

Voiding dysfunction in patients with spinal cord lesions at the thoracolumbar vertebral junction.

Neurogenic voiding dysfunction invariably follows a complete spinal cord lesion. With spinal shock urodynamic investigation will show an areflexic bladder if the sacral spinal cord has been damaged, otherwise, if the lesion involves the suprasacral cord, an overactive bladder will result. There are some exceptions to this rule, particularly in those with lesions of the thoracolumbar vertebral junction, where the sacral cord is located, it may be difficult to predict urodynamic dysfunction merely on the basis of the vertebral body involved. 46 patients with a complete SCI neurological lesion at the thoraco-lumbar vertebral junction underwent a neurourological evaluation including multi-channel urodynamic studies. Overall in 20 to 36% of the patients the urodynamic pattern was different from what one would have expected considering the anatomical level of the vertebral body involved. Urodynamic study is confirmed as an essential tool in the correct diagnostic and therapeutic approach to the voiding dysfunction in these type of patients.

Adolescent↗

PubMed1996

[Correlation between bladder echography and urodynamic examination in patients with multiple sclerosis].

Ultrasonography take a predominant place in the evaluation of urologic complications in SM patients. SM can cause urinary disorders according to entity and level of the primary lesion with important repercussion on the upper urinary tract. Aim of this work is to value the sensibility of ultrasonography in the identification of bladder wall abnormalities indicative of involvement of upper urinary tract, correlated with urodynamic evaluation. Since 1993 we performed 116 urological ultra sound in patients with Multiple Sclerosis. We considered pathologic bladders with wall abnormalities or with stones, considering those abnormalities as secondary to altered emptying of the bladder. 65 patients showed wall abnormalities while 51 patients had any alteration evaluated with ultrasonography. In the first group the amplitude of uninhibited detrusor contractions was 74 cmH2O, while in the second group it was 61 cm H2O: the difference was statistically significant. Furthermore the incidence of upper tract alterations was significantly higher in the first group (p = 0.005), even in absence of signs of renal failure. Thus, ultrasonography demonstrated a high sensibility in detecting bladder conditions possibly conducive to upper urinary tract deterioration.

Adult↗