Impact of Caffeine on Overactive Bladder Symptoms

Caffeine consumption is highly prevalent in the adult population. First-line treatment of overactive bladder (OAB) symptoms involves behavioral modification, which includes reduction of caffeine consumption. A literature review over the last 3 years has identified 10 peer-reviewed articles that investigated the effects and mechanisms of caffeine on OAB symptoms. The literature describes that caffeine can be associated to de novo OAB symptoms or their exacerbation. Those effects have been found to be dose dependent. Significant associations to age and gender cannot be made at this point due to limited studies. This review raises awareness of caffeine’s potential causal impact on OAB symptoms, which is important when counseling the general population and patients suffering from OAB. Since there is a lack of evidence-based data to support clinical recommendations, more controlled-randomized prospective studies are needed to assess the impact of caffeine on OAB symptoms that also control for dose, gender, and age.     

Complications and Long-Term Sequelae of Bladder Fistula Repair

Bladder fistulas involve an abnormal connection between bladder and either vagina or intestine. In this review chapter, we cover the etiology, clinical presentation, and various surgical approaches to repairing vesicovaginal and enterovesical fistulas. The long-term sequela after surgical repair includes recurrent incontinence, lower urinary tract symptoms, infection, and vaginal stenosis. Strategies to approach fistula repair to minimize these complications are emphasized.     

Cardiac Strain in a Swine Model of Regional Hibernating Myocardium: Effects of CoQ10 on Contractile Reserve Following Bypass Surgery

There is conflicting clinical evidence whether administration of coenzyme Q10 (CoQ10) improves function following coronary artery bypass graft surgery (CABG). Using a swine model of hibernating myocardium, we tested whether daily CoQ10 would improve contractile function by MRI at 4-week post-CABG. Twelve pigs underwent a thoracotomy and had a constrictor placed on the left anterior descending (LAD). At 12 weeks, they underwent off-pump bypass and received daily dietary supplements of either CoQ10 (10 mg/kg/day) or placebo. At 4-week post-CABG, circumferential strain measurements in the hibernating LAD region from placebo and CoQ10 groups were not different and increased to a similar extent with dobutamine (?14.7?±?0.6 versus ?14.8?±?0.1, respectively (NS)). Post-sacrifice, oxidant stress markers were obtained in the mitochondrial isolates and protein carbonyl in the placebo, and CoQ10 groups were 6.14?±?0.36 and 5.05?±?0.32 nmol/mg, respectively (NS). In summary, CoQ10 did not improve contractile reserve or reduce oxidant stress at 4-week post-CABG.     

Current Use of Statins for Primary Prevention of Cardiovascular Disease: Patient-Reported Outcomes and Adherence

Recent updates in atherosclerotic cardiovascular disease (ASCVD) risk assessment and management guidelines have expanded the global number of statin-indicated persons, prompting clinicians to rethink conversations about initiating new statin therapy. The benefits of statins in primary prevention of ASCVD are less convincing than in secondary prevention, although higher ASCVD risk is associated with greater statin benefit. Therefore, clinicians must engage patients in a shared decision about starting new statin therapy, which should involve discussion about the risks and benefits of therapy, patient perceptions, and health status. Research has identified nonadherence to statin therapy as a factor associated with reduced clinical benefits of statin therapy. Clinicians should be aware of patient-specific factors associated with nonadherence and implement strategies to improve adherence as indicated. Data on the impact of adherence improvement strategies and the accuracy of how we currently measure adherence are lacking. Additionally, research focusing on patient preferences and reported outcomes would greatly inform practice and improve clinician–patient relationships.     

Methodology for evaluating the sustainability of products and processes: application to alternative substitution techniques of chromium VI

Faced with increasing regulatory and social pressures, the industrial world must offer safer and more environmentally services while maintaining economic competitiveness. Thus, the development of sustainable activities is essential, and new interactive approaches to evaluate them are needed. In this context, the purpose of this study is to develop a methodology to analyse and compare the sustainability of alternative designs and productions during the preliminary phase of a project considering several criteria based on environment, economy, health and safety risks, and obsolescence risks. This paper describes, on one hand, the proposed methodology used to evaluate each criterion separately and to obtain the final integrated score. On the other hand, it proposes the application of the methodology to the comparison of surface treatment processes used in aircraft industry, to illustrate and validate the approach. The case study is about the comparison of an electrochemical process for the treatment of aluminium against corrosion: chromic acid anodizing, and alternatives without chromium, tartaric sulphuric acid anodizing and boric sulphuric acid anodizing.     

Contemporary Controversies in Digoxin Use in Systolic Heart Failure

Digoxin remains one of the oldest therapies for heart failure; however, its safety and efficacy have been controversial since its initial use. Questions that remain include the clinical efficacy of digoxin when added to contemporary medical therapy, when and if it should be added, and how to minimize adverse effects. In this review, we will summarize recent data on the use of digoxin in systolic heart failure and address some of the controversies regarding the role of digoxin in the modern era of heart failure treatment.     

Migration and changes in loneliness over a 4-year period: the case of older former Soviet Union immigrants in Israel

Both older adult and immigrant populations are at a high risk of loneliness. The current research compares older veteran Israelis to older immigrants who arrived in Israel from the former Soviet Union (FSU) after 1989. Early studies have found high levels of loneliness among older FSU immigrants; however, little is known regarding changes in loneliness among this group over time. The present study examines change in loneliness among older FSU immigrants and older veteran Jewish Israelis and its potential predictors. A prospective association between immigrant’s status and loneliness over time was examined using the second (2009/2010) and third (2013) waves of SHARE-Israel. The sample consisted of 208 FSU immigrants and 1080 veteran Jewish Israelis. Bivariate analyses indicated that in 2009/2010, older FSU immigrants were significantly lonelier than older veteran Jews, and more disadvantaged on all social and health variables measured. Yet, no significant differences emerged between the two groups with regard to loneliness in 2013. In the adjusted model, older immigrants presented positive change in loneliness (less loneliness over time) compared with veteran Jewish Israelis. Depressive symptoms explained a large part of the variance in change in loneliness. Potential explanations suggest that the long-term psychological adjustment process and the characteristics of the FSU immigrants in Israel as a large and relatively strong immigrant group have served as protective factors with regard to changes in loneliness over time.