International journal of urology : official journal of the Japanese Urological Association
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Although the pathogenesis of interstitial cystitis/bladder pain syndrome remains unknown, there is a significant correlation of interstitial cystitis/bladder pain syndrome with other chronic pain disorders, such as irritable bowel syndrome, endometriosis and fibromyalgia syndrome. In this review, we highlight evidence supporting neural cross-talk in the dorsal root ganglia, spinal cord and brain levels, which might play a role in the development of chronic pain disorders through central sensitization. In addition, we focus on transient receptor potential V1 and transient receptor potential A1 as the receptor targets for chronic pain conditions, because transient receptor potential V1 and transient receptor potential A1 act as a nocisensor to mediate not only an afferent signal to the dorsal horn of the spinal cord, but also an efferent signal in the periphery through secretion of inflammatory agents, such as substance P and calcitonin gene-related peptide in nociceptive sensory neurons. ⋯ During tissue damage and inflammation, oxidative stress, such as reactive oxygen species or reactive carbonyl species is also generated endogenously. The highly diffusible nature might account for the actions of free radical formation far from the site of injury, thereby producing systemic pain conditions without central sensitization through neural cross-talk. Because oxidative stress is considered to induce activation of transient receptor potential A1, we also discuss exogenous and endogenous oxidative stress to elucidate its role in the pathogenesis of interstitial cystitis/bladder pain syndrome and other chronic pain conditions.
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The American Burn Association classifies a burn to the genitalia as a major injury. Isolated burns to the penis, scrotum or vulva are rare as a result of protection provided by the thighs and abdomen. Thus, burned genitalia represent an ominous sign of a more extensive total body surface area burn. ⋯ The typical profile for those sustaining a genital burn include younger patients (≤30 years-of-age), sustaining a median total body surface area burn of 12% from a scald injury, with extensive genitalia involvement. Length of stay for genital burns is usually extended and, as a result of concomitant injuries, is associated with a 20% in-hospital death rate.
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For developing the Japanese guideline for the prevention of health care-associated infection in urological practice, we surveyed the literature including standard precautions, environmental considerations in both the inpatient and outpatient settings, the management of urinary catheters, endoscopy techniques, and the disinfection and sterilization of instruments used in endoscopies and related procedures. The concept of this guideline is to show the minimum precautions that urologists and other medical professionals should observe when they work in the urological field. Standard precautions based on hand hygiene and the use of personal protective equipment should be observed in both the inpatient and outpatient settings. ⋯ Regarding the handling of urine containing Mycobacterium tuberculosis, airborne infection countermeasures are unnecessary, except for the laboratory personnel. For the procedures using urological endoscopes, aseptic techniques are recommended. Endoscopes and related devices should be used by sterilization or high-level disinfection, but formaldehyde gas cannot be used.