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Percutaneous Tibial Nerve Stimulation as an Effective Third-Line Therapy for Overactive Bladder: A Comparative Review
No full textOveractive bladder (OAB) is a syndrome defined as increased frequency and urgency of urination, and nocturia with or without urge urinary incontinence in the absence of urinary tract infection or other pathology. Standard therapies for OAB include anticholinergic agents, β3-agonists, intravesical botulinum toxin, and percutaneous tibial nerve stimulation (PTNS). The purpose of this paper is to compare OAB treatment modalities and evaluate whether PTNS is an effective treatment for OAB. The significance of PTNS therapy for effectively improving OAB symptoms offers patients who do not tolerate oral medication side effects, or the prohibitive costs of the newer β3-agonists, a safe and effective treatment option. PTNS is an effective treatment for OAB, with fewer side effects than anticholinergic medications. PTNS was applied weekly for 12 weeks, resulting in a reduction in OAB symptoms. Studies have shown a decrease in frequency, urgency, and urge incontinence, with an accompanying improvement in quality of life.
Keywords: overactive bladder, treatments for overactive bladder, percutaneous tibial nerve stimulatio
Coronary Stent Infection: A Rare Complication of Percutaneous Coronary Intervention
No full textBackground Since the introduction of coronary stents, less than 40 cases of coronary stent infection have been reported worldwide. Although coronary stent infection is rare, the mortality rate is high. We report the first case of coronary stent infection from our institute, presented as pyrexia of unknown origin.
Case Presentation A 48-year-old male was presented with low-grade fever associated with cough and malaise on the 8th day of the PCI procedure. He priorly underwent a multivessel percutaneous coronary intervention (PCI) at another hospital. He was evaluated elsewhere and treated with antipyretics, but he continued to be symptomatic and failed to yield any conclusive diagnosis. He was referred to a higher center for further management.
Diagnosis and Intervention Post-PCI pyrexia of unknown origin was found with elevated C-reactive protein and leukocytosis, the whole-body positron emission tomography scan showed increased fluorodeoxyglucose uptake in the left atrioventricular groove along the stent, and blood culture grew Pseudomonas aeruginosa. He was treated with cefoperazone-sulbactam 3 gm twice daily for 4 weeks, followed by Tab. Ciprofloxacin 750 mg for 2 weeks, and the patient responded clinically. After 2 months, the patient presented with chest pain and underwent a coronary angiogram that revealed left circumflex (LCx) in-stent total occlusion with a pseudoaneurysm. He underwent coronary artery bypass grafting to the obtuse marginal and posterior descending artery. As the tissues could not be delineated, the stent was not retrieved from the LCx. His postoperative period was uneventful, and he did well at 2-year follow-up
Observing the Prevalence of Wolbachia Found in Tick Species from the Central VA Region
No full textResearch has found that ticks are considered the second highest global vector of disease. Ticks can serve as a vector for pathogens such as Rickettsia rickettsii (Rocky Mountain Spotted Fever), Borrelia burgdorferi (Lyme Disease), Borrelia miyamotoi (B. miyamotoi disease) and Borrelia hermsii (tick-borne relapsing fever). Tick species such as Dermacentor variabilis (American Dog ticks), Amblyomma maculatum (Gulf Coast ticks), Amblyomma americanum (Lone Star ticks), Ixodes scapulari (Black legged ticks), and Ixodes affinis can be found within the southeastern Virginia region. Ticks can also serve as a host for the endosymbiote Wolbachia. Hosts that possess Wolbachia can have their reproduction be negatively impacted through methods such as Parthenogenesis, Male Killing, Feminization, and Cytoplasmic Incompatibility. There are efforts in decreasing mosquito populations by utilizing Wolbachia. However, the method is in development. Currently, there is insufficient information and research regarding ticks and Wolbachia. The information regarding Wolbachia can be expanded upon for advancing the research involving decreasing tick populations. To better understand Wolbachia infection rates within ticks, a survey of the frequency of Wolbachia found in tick species within Central Virginia was performed. Ticks used in the study were collected from the central Virginia region. DNA extraction and isolation of each tick was performed, and then Polymerase Chain Reactions (PCR) on tick DNA (CO1) and potential Wolbachia DNA (WSPEC & 16s rRNA) were amplified. 1.7% agarose gels were used to perform gel electrophoresis on amplified CO1 and WSPEC DNA
Impact of Self-Esteem, Self-Talk and Confidence on Perceived Sports Performance
No full textThe purpose of this study was to examine the impact of Self-Esteem, Self-Talk and Confidence on Perceived Sports Performance. Past research has shown that athletes are influenced by Self-Esteem, Self-Talk and Confidence, which offered the opportunity to research the variables that further influence on Sports Performance. The present study hypothesized that collegiate athletes with higher scores on the Self-Esteem, Self-Talk and Confidence scales will have a higher Perceived Sports Performance score. Eighty-eight undergraduate student athletes were surveyed online to measure their Self-Esteem, Self-Talk, Confidence and Perceived Sports Performance levels. Self-Esteem was measured using the Rosenberg Self-Esteem scale. Self-Talk was measured using the Kock-Petersen Self-Talk scale. Confidence was measured using the Exercise Self-Efficacy Scale. Perceived Sports Performance was measured using the Perceived Sports Performance Scale. The hypothesis was supported by the results of the study. The results showed a significant positive relationship between Self-Esteem, Self-Talk, and Confidence on Perceived Sports Performance. While much research has been done on Self-Esteem, Self-Talk and Confidence in athletes, additional studies need to be conducted on the effects of these variables on actual physical performance rather than perceived performance
Para Sport Healthcare Providers’ Perspectives on the Concussion Continuum of Care
No full textContext: Para sport includes diverse athletes with varying impairment classifications. Current sport-related concussion (SRC) guidelines have limited para athlete considerations, which alters how healthcare providers (HCPs) serve athletes and warrants inquiry.
Purpose: To understand HCPs’ practices and perspectives for treating para athletes diagnosed with SRCs.
Methods: Using an exploratory mixed-method design, para sport HCPs caring for athletes with various impairment classifications and sports (e.g., wheelchair basketball) completed a validated web-based survey (n=21) and participated in semi-structured virtual interviews (n=11) discussing their experiences managing para athletes with SRCs. We calculated frequencies for survey responses and analyzed interview transcripts via phenomenology using multi-analyst triangulation and peer review as credibility strategies.
Results: HCPs noted a median experience managing 2.5 SRCs (range=0-104) per year across multiple sports. Most HCPs used the Sport Concussion Assessment Tool 6 (SCAT6) (85.7%) to guide examinations. The modified Balance Error Scoring System (mBESS; 66.7%), BESS (57.1%), or Wheelchair Error Scoring System (WESS; 52.4%) were used for balance testing. HCPs used VOMS (81.0%) or King-Devick (38.1%) for vestibular ocular-motor testing. HCPs noted the importance of developing classification-based and/or sport-based protocols for para athletes with intentional flexibility to promote individualized concussion healthcare. Building personal relationships with athletes helped providers determine whether reported signs and symptoms were concussion-related or due to pre-existing impairments (e.g., visual impairments). Multidisciplinary care was critical for successful management as the level of care varied widely across para sports due to limited education, access to resources, and funding available for providers who are often volunteers.
Conclusion: Para sport HCPs were receptive and used current SRC assessment tools, but reported a lack of effective adaptive guidelines as noted by variable athlete-specific modifications for SRC assessments and return-to-sport guidelines. Our findings emphasize the importance of developing and implementing ecologically valid para sport SRC healthcare