Normal and pathological aging: physiology of aging

Understanding the mechanisms of aging has become an increasingly important issue as the world population ages. The concept of “normal” aging has been replaced by the concept of disease-free or optimum aging. Current medical practices aim to reduce age-related impairments. It is therefore necessary to identify, not only the intrinsic mechanisms of aging, but extrinsic influences as well, particularly lifestyle and environmental factors. The management of acute and chronic conditions, more frequent in elderly subjects, will also help the objective of medicine today, which is to prolong a healthy life. The contribution of genetic factors must also be examined and taken into account.La compréhension des mécanismes du vieillissement est devenue une question d'actualité avec l'accroissement de la durée de vie de la population. La notion de vieillissement dit « normal » a été remplacée par celle d'un vieillissement sans pathologie ou vieillissement optimum. Ainsi, la pratique médicale actuelle repose sur la recherche des éléments permettant de vieillir avec un minimum de handicaps. En plus des mécanismes intrinsèques du vieillissement, il est important de définir les éléments extrinsèques, en particulier l'hygiène de vie et les facteurs environnementaux. Par ailleurs, la prise en charge des pathologies aiguës ou chroniques, plus fréquentes chez le sujet âgé, permettra d'accroître la durée de vie sans déficiences, et ainsi de prolonger la vie en bonne santé. Il faudra aussi analyser et tenir compte de la contribution des facteurs génétiques

Modifications of urodynamic parameters in the scrapie ewes

Des explorations urodynamiques ont été effectuées chez 8 brebis nor males et chez 8 brebis atteintes de tremblante. Les brebis malades présentent un taux élevé de contractions vésicales en phase de remplissage (contrac tions non inhibées du détrusor) et une instabilité urétrale. Les autres para mètres de l'étude urodynamique ne sont pas modifiés de façon significative. Ces troubles du fonctionnement de l’appareil vésico-sphinctérien sont comparés à des troubles observés chez l’homme au cours de certaines affec tions du système nerveux central.Ewes (8 normal and 8 with scrapie) were submitted to an urodynamic study. Diseased ewes showed frequently contractions of the bladder known as uninhibited contractions of detrusor. They exhibited also an instability of urethra. The other values of cystomanometric analysis were not signifi cantly affected. Theses modifications of the bladder and urethra are compa red to some diseases observed in people suffering of central nervous system alterations

Idiopathic and neurogenic detrusor overactivity: do the different patterns have urodynamic characteristics related to gender or neurological condition?

International audienceObjectives: To evaluate the urodynamic characteristics of the two patterns (phasic, P and terminal, T) of detrusor overactivity (DO) according to gender and neurological condition.Materials and Methods: Urodynamic characteristics of DO were analysed in a population with proven urodynamic DO (127 women and 76 men, respectively with 48 and 43 neu-rological diseases (encephalic, incomplete medullar lesion or peripheral)). Phasic DO is characterized by phasic waves with or without leakage while terminal DO is defined by a single non-inhibited contraction resulting in incontinence. Parameters analysed for both patterns of DO (among other parameters) included: volume and amplitude of the first non-inhibited detrusor contraction (nIDC#1), and for phasic DO: duration of pressure rise during nIDC#1 and number of nIDC.Results: Phasic DO was observed in younger patients in the whole population whatever the gender (women: 55.9 years vs. 64.7 years, p = 0.0052; men: 57.4 years vs. 67.8 years, p = 0.0038). Volume at nIDC#1 was greater for neurological PDO (significant in women: 185 vs. 125 mL, p = 0.0223). Other parameters were not significantly different whatever the gender. Amplitude of nIDC#1 during PDO was significantly lower than that of nIDC during terminal DO (TDO) in both genders whatever the neurological condition (p < 0.0001). Volume at nIDC#1 in both patterns was dependent on the level of neurological lesion.Conclusion: The main difference between the patterns of DO is that PDO occurs in younger individuals. There is no significant difference between urodynamic characteristics of each pattern whatever gender or neurological status. Further studies will provide additional information on the impact of the level of neurological lesion on the pattern of DO

Idiopathic and neurogenic detrusor overactivity: do the different patterns have urodynamic characteristics related to gender or neurological condition?

Objectives To evaluate the urodynamic characteristics of the two patterns (phasic, P and terminal, T) of detrusor overactivity (DO) according to gender and neurological condition. Materials and Methods: Urodynamic characteristics of DO were analysed in a population with proven urodynamic DO (127 women and 76 men, respectively with 48 and 43 neurological diseases (encephalic, incomplete medullar lesion or peripheral)). Phasic DO is characterized by phasic waves with or without leakage while terminal DO is defined by a single non-inhibited contraction resulting in incontinence. Parameters analysed for both patterns of DO (among other parameters) included: volume and amplitude of the first non-inhibited detrusor contraction (NIDC#1), and for phasic DO: duration of pressure rise during NIDC#1 and number of NIDC. Results Phasic DO was observed in younger patients in the whole population whatever the gender (women: 55.9 years vs. 64.7 years, p = 0.0052; men: 57.4 years vs. 67.8 years, p = 0.0038). Volume at NIDC#1 was greater for neurological PDO (significant in women: 185 vs. 125 mL, p = 0.0223). Other parameters were not significantly different whatever the gender. Amplitude of NIDC#1 during PDO was significantly lower than that of NIDC during terminal DO (TDO) in both genders whatever the neurological condition (p < 0.0001). Volume at NIDC#1 in both patterns was dependent on the level of neurological lesion. Conclusion The main difference between the patterns of DO is that PDO occurs in younger individuals. There is no significant difference between urodynamic characteristics of each pattern whatever gender or neurological status. Further studies will provide additional information on the impact of the level of neurological lesion on the pattern of DO