Botulinumtoxin bei nichtneurogenen Blasenfunktionsstörungen

Zusammenfassung: Die nichtneurogene überaktive Harnblase mit oder ohne Detrusorüberaktivität und/oder Inkontinenz ist ein belastendes Symptom für viele Menschen, das bis vor wenigen Jahren nur mit anticholinergen Medikamenten oder operativ behandelt werden konnte. Intradetrusorinjektionen mit BotulinumtoxinTypA stellen eine minimal-invasive Alternative für Patienten dar, die auf Anticholinergika nicht ansprechen oder diese nicht vertragen. Dieser Übersichtsartikel fasst die relevanten Arbeiten der letzten 6Jahre zu diesem Thema zusammen und gibt Auskunft über die Wirksamkeit, die Nebenwirkungen, die verwendeten Dosierungen und Injektionstechniken. Insgesamt zeigte sich eine gute initiale Wirksamkeit, die etwa ab dem 4. Tag nach Injektion beginnt und durchschnittlich bis zu 31Wochen anhalten kann. Es ist allerdings je nach Dosis mit einer Erhöhung der Restharnmengen zu rechnen, die auch die Anwendung von intermittierendem Selbstkatheterismus notwendig machen können. Die Anwendung von Botulinumtoxin in der Harnblase ist noch immer keine offiziell zugelassene Therapi

Lebensqualität bei deutschsprachigen Patienten mit Rückenmarkverletzungen und Blasenfunktionsstörungen: Validierung der deutschen Adaption des Qualiveen®-Fragebogens

Zusammenfassung: Hintergrund: Blasenfunktionsstörungen bei Rückenmarkverletzten können zu erheblichen Einschränkungen der Lebensqualität führen. Zur Erfassung existiert ein validierter Fragebogen in französischer Sprache. Ziel war es, den Fragebogen in deutscher Sprache zu validieren. Material und Methoden: Übersetzung, sprachliche und interkulturelle Adaption erfolgten in Kooperation mit einer Forschungsstelle für Gesundheitssystemforschung. Die so entstandene Version wurde von 439Patienten an 18 Zentren in Deutschland, Österreich und der Schweiz ausgefüllt. Die Daten wurden deskriptiv hinsichtlich klinischer und soziodemographischer Charakteristika ausgewertet. Die Gütekriterien der Items und Skalen wurden mit einer detaillierten Skalenanalyse geprüft. Ergebnisse: Die Stichprobe bestand aus 65,8% Paraplegikern und 32,8% Tetraplegikern. Interne Konsistenz, Reliabilität und Validität des Fragebogens waren sehr gut. Differenzielle Effekte in den erhobenen klinischen Variablen wurden sichtbar. Schlussfolgerungen: Der Qualiveen®-Fragebogen steht als erstes Instrument in deutscher Sprache zur Untersuchung des Einflusses von Blasenfunktionsstörungen auf die Lebensqualität bei Rückenmarkverletzten zur Verfügun

A multi-wavelength study of SXP 1062, the long period X-ray pulsar associated with a supernova remnant

SXP 1062 is a Be X-ray binary located in the Small Magellanic Cloud. It hosts a long-period X-ray pulsar and is likely associated with the supernova remnant MCSNR J0127-7332. In this work we present a multi-wavelength view on SXP 1062 in different luminosity regimes. We consider monitoring campaigns in optical (OGLE survey) and X-ray (SWIFT telescope). During these campaigns a tight coincidence of X-ray and optical outbursts is observed. We interpret this as typical Type I outbursts as often detected in Be X-ray binaries at periastron passage of the neutron star. To study different X-ray luminosity regimes in depth, during the source quiescence we observed it with XMM-Newton while Chandra observations followed an X-ray outburst. Nearly simultaneously with Chandra observations in X-rays, in optical the RSS/SALT telescope obtained spectra of SXP 1062. On the basis of our multi-wavelength campaign we propose a simple scenario where the disc of the Be star is observed face-on, while the orbit of the neutron star is inclined with respect to the disc. According to the model of quasi-spherical settling accretion our estimation of the magnetic field of the pulsar in SXP 1062 does not require an extremely strong magnetic field at the present time.Comment: accepted for publication in MNRA

The facilitatory effect of duloxetine combined with pelvic floor muscle training on the excitability of urethral sphincter motor neurons

INTRODUCTION AND HYPOTHESIS: Aim of this study was to investigate the excitability of sphincter motor neurons under the influence of pelvic floor muscle training (PFMT) and duloxetine. Due to their mechanisms of action, there might be a synergistic effect of duloxetine and PFMT in regard to the facilitation of spinal reflexes controlling urethral sphincter contractions and hence continence. METHODS: In ten healthy female subjects, clitoral electric stimulation (CES) and transcranial magnetic stimulation (TMS) were used to determine individual motor thresholds for external urethral sphincter (EUS) contractions before and after PFMT, duloxetine, and PFMT + duloxetine. RESULTS: PFMT and duloxetine alone significantly decreased the motor thresholds for EUS contractions during CES and TMS. However, the combined treatment reduced the motor threshold for EUS contractions significantly stronger compared to PFMT or duloxetine alone. CONCLUSIONS: The results are suggestive for a synergistic facilitatory effect of PFMT and duloxetine on sphincter motor neuron activation

A return to strong radio flaring by Circinus X-1 observed with the Karoo Array Telescope test array KAT-7

Circinus X-1 is a bright and highly variable X-ray binary which displays strong and rapid evolution in all wavebands. Radio flaring, associated with the production of a relativistic jet, occurs periodically on a ~17-day timescale. A longer-term envelope modulates the peak radio fluxes in flares, ranging from peaks in excess of a Jansky in the 1970s to an historic low of milliJanskys during the years 1994 to 2007. Here we report first observations of this source with the MeerKAT test array, KAT-7, part of the pathfinder development for the African dish component of the Square Kilometre Array (SKA), demonstrating successful scientific operation for variable and transient sources with the test array. The KAT-7 observations at 1.9 GHz during the period 13 December 2011 to 16 January 2012 reveal in temporal detail the return to the Jansky-level events observed in the 1970s. We compare these data to contemporaneous single-dish measurements at 4.8 and 8.5 GHz with the HartRAO 26-m telescope and X-ray monitoring from MAXI. We discuss whether the overall modulation and recent dramatic brightening is likely to be due to an increase in the power of the jet due to changes in accretion rate or changing Doppler boosting associated with a varying angle to the line of sight.Comment: 7 pages, 5 figures, accepted for publication in MNRAS 14 May 201

INTEGRAL observations of the Small Magellanic Cloud

The first INTEGRAL observations of the Small Magellanic Cloud (carried out in 2003) are reported in which two sources are clearly detected. The first source, SMC X-1, shows a hard X-ray eclipse and measurements of its pulse period indicate a continuation of the long-term spin-up now covering ~30 years. The second source is likely to be a high mass X-ray binary, and shows a potential periodicity of 6.8s in the IBIS lightcurve. An exact X-ray or optical counterpart cannot be designated, but a number of proposed counterparts are discussed. One of these possible counterparts shows a strong coherent optical modulation at ~2.7d, which, together with the measured hard X-ray pulse period, would lead to this INTEGRAL source being classified as the fourth known high mass Roche lobe overflow system.Comment: Accepted for publication in MNRA

The Orbital Solution and Spectral Classification of the High-Mass X-Ray Binary IGR J01054-7253 in the Small Magellanic Cloud

We present X-ray and optical data on the Be/X-ray binary (BeXRB) pulsar IGR J01054-7253 = SXP11.5 in the Small Magellanic Cloud (SMC). Rossi X-ray Timing Explorer (RXTE) observations of this source in a large X-ray outburst reveal an 11.483 +/- 0.002s pulse period and show both the accretion driven spin-up of the neutron star and the motion of the neutron star around the companion through Doppler shifting of the spin period. Model fits to these data suggest an orbital period of 36.3 +/- 0.4d and Pdot of (4.7 +/- 0.3) x 10^{-10} ss^{-1}. We present an orbital solution for this system, making it one of the best described BeXRB systems in the SMC. The observed pulse period, spin-up and X-ray luminosity of SXP11.5 in this outburst are found to agree with the predictions of neutron star accretion theory. Timing analysis of the long-term optical light curve reveals a periodicity of 36.70 +/- 0.03d, in agreement with the orbital period found from the model fit to the X-ray data. Using blue-end spectroscopic observations we determine the spectral type of the counterpart to be O9.5-B0 IV-V. This luminosity class is supported by the observed V-band magnitude. Using optical and near-infrared photometry and spectroscopy, we study the circumstellar environment of the counterpart in the months after the X-ray outburst.Comment: 12 pages, 13 figures and 3 tables. This paper has been accepted for publication in MNRA

Now you see it, now you don't - the circumstellar disk in the GRO J1008--57 system

Multiwavelength observations are reported here of the Be/X-ray binary pulsar system GRO J1008-57. Over ten years worth of data are gathered together to show that the periodic X-ray outbursts are dependant on both the binary motion and the size of the circumstellar disk. In the first instance an accurate orbital solution is determined from pulse periods, and in the second case the strength and shape of the Halpha emission line is shown to be a valuable indicator of disk size and its behaviour. Furthermore, the shape of the emission line permits a direct determination of the disk size which is in good agreement with theoretical estimates. A detailed study of the pulse period variations during outbursts determined the binary period to be 247.8, in good agreement with the period determined from the recurrence of the outbursts.Comment: Accepted for publication in MNRA

Very Large Baseline Array observations of Mrk 6 : probing the jet-lobe connection

We present the results of high-resolution VLBI (very long baseline interferometry) observations at 1.6 and 4.9 GHz of the radio-loud Seyfert galaxy, Mrk 6. These observations are able to detect a compact radio core in this galaxy for the first time. The core has an inverted spectral index (α1.6 4.9 = +1.0 ± 0.2) and a brightness temperature of 1 × 108 K. Three distinct radio components, which resemble jet elements and/or hotspots, are also detected. The position angles of these elongated jet elements point not only to a curved jet in Mrk 6, but also towards a connection between the AGN and the kpc-scale radio lobes/bubbles in this galaxy. Firmer constraints on the star formation rate provided by new Herschel observations (SFR <0.8 M⊙ yr-1) make the starburst-wind-powered bubble scenario implausible. From plasma speeds, obtained via prior Chandra X-ray observations, and ram pressure balance arguments for the interstellar medium and radio bubbles, the north-south bubbles are expected to take 7.5 × 106 yr to form, and the east-west bubbles 1.4 × 106 yr. We suggest that the jet axis has changed at least once in Mrk 6 within the last ≈107 yr. A comparison of the nuclear radio-loudness of Mrk 6 and a small sample of Seyfert galaxies with a subset of low-luminosity FR I radio galaxies reveals a continuum in radio properties.Peer reviewe

Improved annotation of 3' untranslated regions and complex loci by combination of strand-specific direct RNA sequencing, RNA-seq and ESTs

The reference annotations made for a genome sequence provide the framework for all subsequent analyses of the genome. Correct annotation is particularly important when interpreting the results of RNA-seq experiments where short sequence reads are mapped against the genome and assigned to genes according to the annotation. Inconsistencies in annotations between the reference and the experimental system can lead to incorrect interpretation of the effect on RNA expression of an experimental treatment or mutation in the system under study. Until recently, the genome-wide annotation of 3-prime untranslated regions received less attention than coding regions and the delineation of intron/exon boundaries. In this paper, data produced for samples in Human, Chicken and A. thaliana by the novel single-molecule, strand-specific, Direct RNA Sequencing technology from Helicos Biosciences which locates 3-prime polyadenylation sites to within +/- 2 nt, were combined with archival EST and RNA-Seq data. Nine examples are illustrated where this combination of data allowed: (1) gene and 3-prime UTR re-annotation (including extension of one 3-prime UTR by 5.9 kb); (2) disentangling of gene expression in complex regions; (3) clearer interpretation of small RNA expression and (4) identification of novel genes. While the specific examples displayed here may become obsolete as genome sequences and their annotations are refined, the principles laid out in this paper will be of general use both to those annotating genomes and those seeking to interpret existing publically available annotations in the context of their own experimental dataComment: 44 pages, 9 figure