To evaluate chronic stress and voluntary wheel running on murine beta-cell number, insulin-positive area, hind limb skeletal muscle morphology, autophagy protein abundance, and muscle atrophy gene expression. Forty male Balb/c mice were randomized into four groups: sedentary (N = 10: Sed), sedentary stressed (N = 10: St), exercise (N = 10: Ex), and exercise stressed (N = 10: ExSt). Body weight increased more in ExST than Ex by week four of stress; Ex weighed less than Sed and St mice at study conclusion. Islet area was increased in ExSt (24,223 ± 2670 µm2) vs. Ex mice (16,811 ± 2704 µm2), (P < 0.05) Average β-cell number per islet was higher in ExSt (93.2 ± 5.7) and St (91.0 ± 5.2) mice when compared to Ex (68.6 ± 3.7) or Sed (70.7 ± 4.8), (P < 0.05). Exercise, with or without stress (Ex, ExSt), increased muscle mass vs. Sed and St mice, (P < 0.05). Both the total AKT and the pAKT protein levels were increased in ExSt vs. Sed. TOPORS mRNA expression was reduced in the Ex and ExST compared to both Sed and St; Nedd41 real-time mRNA expression was reduced in Ex vs. Sed, and St. Beclin-1 protein abundance was reduced in Ex and ExSt vs. Sed. Eight weeks of chronic stress increased β-cell proliferation and islet area, but did not increase muscle ubiquitin-associated atrophy gene mRNA levels. Exercise coupled with stress appeared to improve muscle protein accumulation, and therefore could be a potential means to reduce muscle losses under conditions of mild stress or β-cell dysfunction.

You have accessJournal of UrologySexual Function/Dysfunction: Female1 Apr 2017PD44-07 FEMALE SEXUAL DYSFUNCTION: A WEST VIRGINIA UNIVERSITY CLINICAL EXPERIENCE Tyler Overholt, Dale Riggs, Barbara Jackson, Alex Battin, Henry Fooks, Mohammad Salkini, Adam Luchey, Stanley Kandzari, and Stanley Zaslau Tyler OverholtTyler Overholt More articles by this author , Dale RiggsDale Riggs More articles by this author , Barbara JacksonBarbara Jackson More articles by this author , Alex BattinAlex Battin More articles by this author , Henry FooksHenry Fooks More articles by this author , Mohammad SalkiniMohammad Salkini More articles by this author , Adam LucheyAdam Luchey More articles by this author , Stanley KandzariStanley Kandzari More articles by this author , and Stanley ZaslauStanley Zaslau More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2064AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES 40% of women in the United States experience concern with regard to sexual function. Female sexual function (FSF) can be broken down into different categories based on the domain involved, including desire, arousal, orgasm, and pain. There are multiple causes for FSF including physical, hormonal, and psychological etiologies, and patients may have additional risk factors that contribute to the dysfunction experienced including depression, obesity, and hypertension. This is especially relevant in West Virginia, which ranks among the highest for several of these risk factors. The presence of sexual dysfunction in patients with interstitial cystitis (IC) is significant and well documented. Herein, we report the data on 362 subjects indexed by the presence or absence of IC and compare the degree of sexual dysfunction associated with the disease. METHODS Domain values were obtained by employing the Female Sexual Function Index (FSFI), developed by Rosen, et. al,. This 19-item questionnaire evaluates FSD in six domains. Data was analyzed on an item-for-item basis and by the six domains of sexual dysfunction for our patients and compared to two control groups. The first consisted of 131 healthy volunteers (Rosen, 2000) and the second consisted of 127 patients with Female Sexual Arousal Disorder (FSAD). Statistical significance was determined with one-way ANOVA testing (P<0.05). RESULTS The table below compares our data with two comparison groups across the 6 domains measured by the FSFI. WVU patients with IC scored the lowest in arousal, lubrication, and orgasm, and had the lowest scores in each category compared with all other groups (P < 0.001). WVU patients without IC scored the lowest in arousal and desire, and had worse scores than the control in all categories. CONCLUSIONS This study is the first exploration of the Urologic patients in West Virginia with regard to FSF, and it highlights a vastly significant amount of sexual dysfunction within this population. West Virginia in 2015 had the 47th worst health ranking in the United States, with especially high prevalence of smoking, obesity, physical inactivity, heart disease and diabetes. Understanding the physical and psychological causes of female sexual dysfunction as well as the category of sexual function affected is critical for properly treating patients for their specific need. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e882 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Tyler Overholt More articles by this author Dale Riggs More articles by this author Barbara Jackson More articles by this author Alex Battin More articles by this author Henry Fooks More articles by this author Mohammad Salkini More articles by this author Adam Luchey More articles by this author Stanley Kandzari More articles by this author Stanley Zaslau More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Cite this article: Jessop M, Riggs D, Jackson B, Zaslau S (2017) Stress Related Induction of Bladder Urothelial Changes in Mice: A New Murine Model. J Genitourin Disord 1(1): 1003. *Corresponding author Stanley Zaslau, Section of Urology, Department of Surgery, Robert C. Byrd Health Science center, West Virginia University, Morgantown, PO Box 9238, USA, Tel: 304-293-1105; Fax: 304-293-2807; Email: szaslau@hsc. wvu.edu

Cite this article: Rogers A, Luchey A, Shapiro R, Riggs D, Jackson B, et al. (2017) Evaluation of Female Sexual Dysfunction (FSD) and Anti-depressants Use. J Genitourin Disord 1(1): 1002. *Corresponding author Stanley Zaslau, Department of Surgery, West Virginia University, Morgantown, WV 26506-9238, USA, Tel: 304293-1105; Fax: 304-293-2807; Email: Submitted: 29 March 2017 Accepted: 29 May 2017 Published: 31 May 2017 Copyright © 2017 Zaslau et al.

Acute and chronic stress have been reported to have differing effects on physical activity in rodents, but no study has examined a chronic stress protocol that incorporates stressors often experienced by rodents throughout a day. To examine this, the effects of the Unpredictable Chronic Mild Stress (UCMS) protocol on voluntary running wheel activity at multiple time points, and/or in response to acute removal of chronic stress was determined. Twenty male Balb/c mice were given access and accustomed to running wheels for 4 weeks, after which they were randomized into 2 groups; exercise (EX, n = 10) and exercise with chronic stress using a modified UCMS protocol for 7 hours/day (8: 00 a.m.-3: 00p.m.), 5 days/week for 8 weeks (EXS, n = 10). All mice were given access to running wheels from approximately 3: 30 p.m. to 7: 30 a. m. during the weekday, however during weekends mice had full-time access to running wheels (a time period of no stress for the EXS group). Daily wheel running distance and time were recorded. The average running distance, running time, and work each weekday was significantly lower in EXS compared to EX mice, however, the largest effect was seen during week one. Voluntary wheel running deceased in all mice with increasing age; the pattern of decline appeared to be similar between groups. During the weekend (when no stress was applied), EXS maintained higher distance compared to EX, as well as higher daily distance, time, and work compared to their weekday values. These results indicate that mild chronic stress reduces total spontaneous wheel running in mice during the first week of the daily stress induction and maintains this reduced level for up to 8 consecutive weeks. However, following five days of UCMS, voluntary running wheel activity rebounds within 2-3 days.

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Interstitial Cystitis1 Apr 2014PD9-08 SELF-REPORTED PHYSICAL ACTIVITY IN PATIENTS WITH NORMAL BODY MASS INDEX: EFFECT ON FEMALE SEXUAL DYSFUNCTION IN PATIENTS WITH PAINFUL BLADDER SYNDROME Stanley Zaslau, Dale Riggs, Barbara Jackson, Jill Osborne, and Randy Bryner Stanley ZaslauStanley Zaslau More articles by this author , Dale RiggsDale Riggs More articles by this author , Barbara JacksonBarbara Jackson More articles by this author , Jill OsborneJill Osborne More articles by this author , and Randy BrynerRandy Bryner More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.790AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The presence of Female Sexual Dysfunction (FSD) in patients with Painful Bladder Syndrome (PBS) is significant and well documented. We have previously reported that individuals with a normal Body Mass Index (BMI: 18.5-24.9) exhibited significantly less FSD than those over or underweight. The authors report herein the data on 337 subjects with normal BMI who self-reported physical activity in addition to the Female Sexual Function Index (FSFI). METHODS The FSFI is a 19-item questionnaire which evaluates FSD in the following six domains: desire, arousal, lubrication, orgasm, satisfaction, and pain. Each question in the survey is targeted to a specific indicator of FSD and the answers rated on a Lickert scale. Additionally, self-reported leisure time physical activity was measured by the Godin Leisure-Time Physical Activity Questionnaire and those scores grouped into 3 domains < 14 units (less than 7 kcal/kg/week), 14 to 23 units (between 7 and 13.9 kcal/kg/week) and > 24 Units (14 kcal/kg/week or more). RESULTS Subjects self-reporting high levels of physical activity showed significantly higher levels of Desire when compared to the other levels of self-reported activity (P < 0.001). Moderate levels of self-reported activity provided a significant increase in Arousal when compared to both low (P < 0.001) and high activity (p + 0.035). Significant differences were observed in the domains of Lubrication and Orgasm in all levels of self-reported activity (p < 0.001). High activity levels provided the greatest benefit when compared to both Moderate (P < 0.01) and Low (P < 0.001) self-reported activity. The greatest level of Satisfaction as indicated by the FSFI, was reported in the high activity group and this was significantly greater then both Moderate (P < 0.001) and Low (P < 0.001) self-reported activity levels. Both Moderate and High levels of self –reported activity provided equivalent protection in the domain of Pain when compared to Low activity (P < 0.001). CONCLUSIONS Increased physical activity provides significant protection from FSD in these patients suffering from PBS. Whether this benefit can be achieved across all BMI ranges remains to be evaluated and is a source of ongoing investigation. FSFI Domain Low Godin Score, < 14 Units, N = 97 Moderate Godin Score, 14 to 23 Units, N = 27 High Godin Score, 24 Units and Greater, N = 63 ANOVA DESIRE 1.99 +/- 0.04 2.02 +/- 0.03 2.30 +/- 0.01 P < 0.001 AROUSAL 1.92 +/- 0.15 2.13 +/- 0.15 2.05 +/- 0.18 P < 0.001 LUBRICATION 2.11 +/- 0.12 2.28 +/- 0.28 2.39 +/- 0.22 P < 0.001 ORGASM 1.96 +/- 0.10 2.49 +/- 0.19 2.61 +/- 0.17 P < 0.001 SATISFACTION 2.35 +/- 0.23 2.25 +/- 0.28 2.50 +/- 0.19 P < 0.001 PAIN 1.54 +/- 0.23 1.90 +/- 0.13 1.90 +/- 0.17 P < 0.001 © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e214-e215 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Stanley Zaslau More articles by this author Dale Riggs More articles by this author Barbara Jackson More articles by this author Jill Osborne More articles by this author Randy Bryner More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

BACKGROUND:Inositol Hexaphosphate (IP6) is a naturally occurring polyphosphorylated carbohydrate that is found in food sources high in fiber content. We hypothesized that IP6 would inhibit the cell growth rate of bladder cancer in vitro.METHODS:T24 and TCCSUP bladder cancer cell lines were treated with titrating doses of IP6 (0.3, 0.6 and 0.9 mM/well). Cell viability and vascular endothelial growth factor levels were measured.RESULTS:Significant reductions (p < 0.001) in cellular growth were noted in both cell lines at all doses and time points tested, with the exception of 0.3 mM IP6 at 24 hours in the T24 cell line. The percent inhibition of vascular endothelial growth factor was significantly higher than that observed in the TCCSUP cell line at 48 and 72 hours with 0.3 mM IP6 (p < 0.001). The T24 cells exhibited the same level of inhibition at 24 and 48 hours with 0.6 mM dose of IP6 and at 72 hours with the 0.3 mM dose (p < 0.001).CONCLUSIONS:In vitro treatment of bladder cancer with the common dietary polyphosphorylated carbohydrate IP6 significantly decreased cellular growth by anti-angiogenic mechanisms. We feel that this data warrants further investigation and consideration for initiation of clinical trials to evaluate the safety and clinical utility of this agent.

Sacral neuromodulation (SNM) has become a standard treatment option for patients suffering from urinary urge incontinence, urgency-frequency, and/or nonobstructive urinary retention refractory to conservative and pharmacologic treatment. Since its initial development, the manufacturer of InterStim therapy (Medtronic, Inc., Minneapolis, MN, USA), has introduced technical modifications, while surgeons and researchers have adapted and published various innovations and alterations of the implantation technique. In this article, we feature our SNM technique including patient selection, comprehensive dialogue/evaluation, procedure details, and appropriate follow up. Although there is often great variability in patients with lower urinary tract dysfunction, we maintain that great success can be achieved with a systematic and methodical approach to SNM.

Exercise and physical activity have been linked to the prevention of certain types of cancer such as colon and breast. As prostate cancer is the most common malignancy diagnosed in the male population, there is obvious interest in determining a possible effect of exercise on disease prevention and improvement of disease-related outcomes. Thus far, data has been conflicting and there has been no clear determination of prostate cancer prevention through exercise. However, as prostate cancer treatment carries many side effects which may be bothersome and health-threatening, researchers have examined the effects of exercise training on reducing treatment-related complications and improving outcomes and quality of life (QOL). In this review, we discuss the impact of exercise on reducing side effects of prostate cancer treatment and improving cancer-specific and overall survival outcomes, as well as improving QOL in prostate cancer patients.

BACKGROUND: Central to the education of future surgeons is residency which involves training and learning on patients. We examined the quality of surgical outcomes of vascular patients when residents were involved in their surgical case.STUDY DESIGN: A retrospective review was conducted using the data from the American College of Surgeons National Surgical Quality Improvement Program from the 2010 year vascular surgery patient cases. Statistical analysis was used to compare the cases with and without residents involved.RESULTS: There were a total of 363,431 from which we analyzed 2829 vascular surgery patients. Of those cases, 88% had a resident involved. Postgraduate year (PGY) 1 or 2 residents were involved in 12% and senior residents (PGY >= 3) were involved in 88% of surgeries. Preoperative pneumonia, cerebral vascular accident, dialysis, and smoking were significantly higher preoperative risk factors in the cases without the resident. Most of the patients were an American Society of Anesthesiology class III. Twenty-six percent of the patients were diabetic. The most common postoperative occurrences included transfusion requirement, postoperative pneumonia, and surgical site infections. Surgical site infections were the most common postoperative complication (4.6%). Cases with the resident involved had significantly more postoperative blood transfusions and on average took 15 more minutes to finish surgeries. A PGY 7 resident was predictive of prolonged hospital stay. The 30-day survival in the cases that had residents was 3.8% significantly higher compared with the cases that did not have residents.CONCLUSIONS: Resident involvement in surgeries does not significantly worsen surgical outcomes. (J Surg 69:638-642. (C) 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

The Cancer Journal for Clinicians reports there will be 69,250 newly diagnosed cases of bladder cancer in 2011, with 52,020 being men and 17,230 being women with an increase by 50% of annual cases since 1985. Approximately 1 in 5 of those who develop bladder cancer will die due to the disease (relative mortality 20.8%, [Siegel et al., 2011, Golijanin et al., 2006]). Bladder cancer has become the second most prevalent cancer after cancer of the prostate in middle-aged to elderly male individuals. Many patients do not die from their disease, but typically have multiple recurrences (Pelucchi et al., 2006). This lends to a fiveyear cost to Medicare attributed to bladder cancer of over one billion dollars (Yabroff et al., 2008). Tobacco use and exposure to aromatic amines are well established etiologic contributors to bladder cancer and by eliminating or reducing contact with these substances has been shown to reduce such risk. BCG (bacillus Calmette-Guerin) has become the standard of care in the treatment of carcinoma in situ as well as high grade T1 (invasion into the lamina propria) and when not appropriate, Mitomycin-C, has been proven to be an acceptable, albeit, less effective alternate. The goal of this chapter will be to describe novel agents that may show promise in the treatment of bladder cancer. This will include descriptions of the agents, their respective mechanism of action (e.g. molecular/biochemical pathways, cell cycle interaction, necrosis), clinical data, combinations of combinations of regimens and mode of delivery. and mode of delivery. A second goal of this chapter will be to consider whether any of these novel agents may have a role in the prevention of bladder cancer.

Objective: The purpose of this study was to determine the effectiveness of the Broselow tape in the evaluation of pediatric trauma patients. Methods: The trauma registry of a rural level I trauma center was examined. All pediatric trauma patients 16 years or younger were reviewed from 2002 to 2006, totaling 2358 patients. The Broselow tape measures to 146.5 cm. Patients whose height correlated with the tape and had their heights and weights in the medical record were included. The constant variable was the heights by which the estimated weights of the Broselow tape were compared with the actual weights of the patients. Results: A total of 657 patients matched this height and had both heights and weights in their record. Most children (349/657; 53.1%) fell outside the predicted weight range, and of these, 77.1% of the actual weights were greater than those predicted by the Broselow scale. This is observed across all age groups. In patients with heights less than 75 cm, two thirds of patients' weights correlated with the Broselow estimated weight; however, those that deviated did so by 2 to 3 color intervals larger. This deviation was statistically significant in all groups. Conclusions: In our population, the Broselow tape is an ineffective tool to predict weight in more than 50% of pediatric trauma patients. This may lead to the underdosing of emergency medications and blood products.

Objectives. Chronic prostatitis (CP) is associated with a variety of irritative and obstructive voiding symptoms. A significant number of patients also complain of sexual dysfunction. Ejaculatory dysfunction has been reported in more than half of patients with CP. Our goal was to determine whether CP is a risk factor for erectile dysfunction (ED).Methods. The Sexual Health Inventory for Men (SHIM) was administered in our clinic and online at the Interstitial Cystitis Network. 305 men completed the SHIM questionnaire, which included 47 controls (healthy volunteers), 150 men for evaluation of other urologic complaints (urology group), and 108 men being treated for CP. The total SHIM score and response to each SHIM question were analyzed using ANOVA.Results: In the control group, the mean SHIM score was 22.7 of a possible 25 points, and mean SHIM Q1 score was 4.0 of a possible 5 points. In the general urology group, the mean SHIM score was 21 and mean SHIM Q1 score was 3.3. In the CP group, the mean SHIM score was 17 and mean SHIM Q1 was 2.91. The results had statistical significance (p=0.05). Patients with CP have significantly lower total SHIM and SHIM Q1 scores when compared with controls and patients seen for urologic complaints. Patients with prostatitis are younger than those typically seen for general urologic complaints. Conclusion: CP is a risk factor for ED. Patients with CP should be questioned about ED as part of their routine urologic care and offered treatment options.

Interstitial Cystitis (IC) is a chronic and painful inflammation of the bladder wall that most often causes frequency and urgency to urinate. Interstitial cystitis (IC) affects at least 20,000 to 90,000 women in the United States (1) and one tenth as many men. Patients with IC usually present with pelvic pain, urgency and frequency of urination, and tend to follow a waxing and waning course. The diagnosis of IC remains one of exclusion, based entirely on clinical and cystoscopic criteria. The cause of IC is unknown and to date, there is no effective treatment to cure this disease; however, the treatments that are available may help relieve the symptoms, which include oral and intravesical therapies and surgery as a last resort. The lack of effective research models has hindered the development and understanding of this debilitating disease. Herein we review the pathogenisis, markers, and possible in vitro models of interstitial cystitis.

Depression is increasingly recognized as a risk factor for peripheral vascular disease in patients with no history of vasculopathy; as such this study evaluated vascular function in an established mouse model of chronic depression developed for behavioral research. 20 male Balb/cj mice were exposed to 6 weeks of unpredictable chronic mild stress (UCMS) to induce depression. The UCMS protocol consisted of random exposure to stressors including damp sawdust, social stress, exposure to predator sound/smell, reversal of the day/night cycle, and cage tilt. Depressive‐like behavior was evaluated using coat status/grooming in response to sucrose spray. Isometric tension development was assessed in aortic rings in response to acetylcholine and phenylephrine. Aortic responses to phenylephrine did not differ between groups, although acetylcholine‐induced relaxation was decreased in rings from mice exposed to the UCMS protocol. Parallel experiments indicated that acetylcholine‐induced NO generation was blunted in arteries of stressed mice versus controls. However, acetylcholine‐induced release of hydrogen peroxide was increased in mice receiving UCMS versus controls. These results may suggest that depression‐like behavior in mice is associated with an impaired vascular endothelial function and altered dilator signaling. The functional implications for these responses require further investigation.

You have accessJournal of Urology1 Apr 2009FEMALE SEXUAL DYSFUNCTION (FSD) IN PATIENTS WITH PAINFUL BLADDER SYNDROME (PBS): EVALUATION OF THE USE OF ANTI-DEPRESSANTS CLASSIFICATION Stanley Zaslau, Dale R Riggs, Barbara J Jackson, and Stanley J Kandzari Stanley ZaslauStanley Zaslau More articles by this author , Dale R RiggsDale R Riggs More articles by this author , Barbara J JacksonBarbara J Jackson More articles by this author , and Stanley J KandzariStanley J Kandzari More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(09)61497-XAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "FEMALE SEXUAL DYSFUNCTION (FSD) IN PATIENTS WITH PAINFUL BLADDER SYNDROME (PBS): EVALUATION OF THE USE OF ANTI-DEPRESSANTS CLASSIFICATION." The Journal of Urology, 181(4S), pp. 530–531 © 2009 by American Urological AssociationFiguresReferencesRelatedDetails Volume 181Issue 4SApril 2009Page: 530-531 Advertisement Copyright & Permissions© 2009 by American Urological AssociationMetricsAuthor Information Stanley Zaslau More articles by this author Dale R Riggs More articles by this author Barbara J Jackson More articles by this author Stanley J Kandzari More articles by this author Expand All Advertisement PDF downloadLoading ...