Summary Background Individuals with schizophrenia have functionally significant deficits in automatic and controlled social cognition, but no currently available pharmacologic treatments reduce these deficits. The neuropeptide oxytocin has multiple prosocial effects when administered intranasally in humans and there is growing interest in its therapeutic potential in schizophrenia. Methods We administered 40 IU of oxytocin and saline placebo intranasally to 29 male subjects with schizophrenia and 31 age-matched, healthy controls in a randomized, double-blind, placebo-controlled, cross-over study. Social cognition was assessed with The Awareness of Social Inference Test (TASIT) and the Reading the Mind in the Eyes Test (RMET). We examined the effects of oxytocin administration on automatic social cognition (the ability to rapidly interpret and understand emotional cues from the voice, face, and body); controlled social cognition (the ability to comprehend indirectly expressed emotions, thoughts, and intentions through complex deliberations over longer time periods); and a control task (the ability to comprehend truthful dialog and perform general task procedures) in individuals with and without schizophrenia using mixed factorial analysis of variance models. Results Patients with schizophrenia showed significant impairments in automatic and controlled social cognition compared to healthy controls, and administration of oxytocin significantly improved their controlled, but not automatic, social cognition, F(1, 58) = 8.75; p = 0.004. Conversely, oxytocin administration had limited effects on social cognition in healthy participants. Patients and controls performed equally well and there were no effects of oxytocin administration on the control task. Discussion Intact social cognitive abilities are associated with better functional outcomes in individuals with schizophrenia. Our data highlight the potentially complex effects of oxytocin on some but not all aspects of social cognition, and support the exploration of intranasal oxytocin as a potential adjunct treatment to improve controlled social cognition in schizophrenia. Published by Elsevier Ltd.

Multiple sclerosis (MS) is a unique neurological disease with a broad spectrum of clinical presentations that are time-and disease course-related. MS plaque location (intracranial and/or spinal) is a key feature in the pathophysiology of disease-related lower urinary tract symptoms (LUTS). The prevalence of these symptoms in MS patients is very high, with nearly 90% of them experiencing some degree of voiding dysfunction and/or incontinence. LUTS rarely present as primary MS manifestations and usually appear 6-8 years after the initial diagnosis. Symptom severity usually correlates with the disability status of patients.Patient assessment comprises clinical and advanced investigations. Each patient should be evaluated uniquely, after taking into account his/her symptoms, disease course and length, comorbidities, physical status, and medications. Basic investigation includes detailed history-taking, physical examination, and post-void residual volume measurement. Advanced evaluation consists of imaging and specific testing, with pivotal importance on urodynamic study.

Multiple sclerosis (MS) is a unique neurological disease with a broad spectrum of clinical presentations that are time-and disease course-related. Lower urinary tract symptoms (LUTS) are highly prevalent in this patient population, with approximately 90% showing some degree of voiding dysfunction and/or incontinence 6-8 years after the initial MS diagnosis. Major therapeutic goals include quality of life improvement and the avoidance of urological complicationsOwing to the wide divergence of clinical symptoms and disease course, evaluation and treatment differ between patients. Treatment must be customized for each patient based on disease phase, patient independence, manual dexterity, social support, and other medical-or MS-related issues. Ablative or irreversible therapies are indicated only when the disease course is stable. In most cases of "safe" bladder, behavioural treatment is considered first-line defense. Antimuscarinic drugs, alone or in combination with intermittent self-catheterization, are currently the mainstay of conservative treatment, and several other medications may help in specific disease conditions. Second-line treatment includes botulinum toxin A injection, neuromodulation, indwelling catheters, and surgery in well-selected cases.

Introduction: We sought to prospectively assess anxiety, pain, and embarrassment associated with diagnostic cystoscopy and multichannel urodynamic study (UDS). Methods: All consecutive patients undergoing diagnostic cystoscopy or UDS in our department over a period of nine months were asked to participate. Two anonymous auto-administered questionnaires were specifically designed to collect basic epidemiological data, document medical history, and assess the quality of information provided, along with prevalence and level (0-10 numerical visual analog rating scale) of anxiety, pain, and embarrassment experienced before and/or during the procedures. Statistical analysis was carried out to identify underlying factors that could have influenced patients' experience and ascertain potential correlations between anxiety, pain, and embarrassment. Results: 101 and 185 patients were respectively evaluated immediately after cystoscopy and UDS. Multivariate analysis repeatedly showed statistical correlations between anxiety, pain, and embarrassment, with regard to prevalence and level of intensity in both cystoscopy and UDS populations. Males and young patients were more likely to present anxiety, pain, or embarrassment during cystoscopy and UDS. Interestingly, patients who reported having received complete information before cystoscopy were significantly more likely to experience anxiety (62.6% vs. 20.0%; p=0.009). Conclusions:The present study demonstrated the major impact of gender and age on patients' experience. Interestingly, information provided before cystoscopy was reported to have a negative impact on patients' perception of anxiety; this could be partly prevented by optimizing the way information is provided to patients. IntroductionCystoscopy and multichannel urodynamic study (UDS) are essential and valuable diagnostic tools in our daily urological practice. Cystoscopy is part of the evaluation process in patients complaining of lower urinary tract symptoms (LUTS) and is undertaken repeatedly in patients being monitored for non-invasive bladder tumours. This procedure allows direct visual examination of the bladder cavity and wall to detect abnormalities, such as diverticula, stones, inflammation, and tumours. UDS is usually performed in patients complaining of LUTS or presenting neurological diseases suspected to impact the bladder-sphincter system. The procedure aims to diagnose lower urinary tract disorders through continuous measurement of abdominal, bladder, and urethral pressures during the filling and voiding phases. Despite their invasive nature, as recognized by the urological community, comprehensive evaluations of patients' experience during cystoscopy 1-5 and UDS 6-9 are scarcely reported in the literature. We prospectively assessed anxiety, pain, and embarrassment associated with such procedures and investigated factors that could potentially influence them to find potential ways of improving general tolerance during these examinations. Methods PatientsThe present study was approved by our h...

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SummaryBackground-Olfaction plays an important role in mammalian social behavior. Olfactory deficits are common in schizophrenia and correlate with negative symptoms and low social drive. Despite their prominence and possible clinical relevance, little is understood about the pathological mechanisms underlying olfactory deficits in schizophrenia and there are currently no effective treatments for these deficits. The prosocial neuropeptide oxytocin may affect the olfactory system when administered intranasally to humans and there is growing interest in its therapeutic potential in schizophrenia.Methods-To examine this model, we administered 40 IU of oxytocin and placebo intranasally to 31 patients with a schizophrenia spectrum illness and 34 age-matched healthy control participants in a randomized, double-blind, placebo-controlled, cross-over study. On each test day, participants completed an olfactory detection threshold test for two different odors: (1) lyral, a synthetic fragrance compound for which patients with schizophrenia have specific olfactory detection threshold deficits, possibly related to decreased cyclic adenosine 3′,5′-monophosphate (cAMP) signaling; and (2) anise, a compound for which olfactory detection thresholds change with menstrual cycle phase in women.Results-On the placebo test day, patients with schizophrenia did not significantly differ from healthy controls in detection of either odor. We found that oxytocin administration significantly and selectively improved olfactory detection thresholds for lyral but not for anise in patients with schizophrenia. In contrast, oxytocin had no effect on detection of either odor in healthy controls. ContributorsJosh Woolley designed the study and supervised all data collection and analysis and manuscript writing. Olivia Lam helped manage various aspects of the study including data collection and recruitment of participants and assisted with manuscript writing. Brandon Chuang assisted with data collection, data management, statistical analyses, and manuscript writing. Judith Ford consulted with the team about data analysis and helped edit the manuscript. Dan H. Mathalon assisted with study design and data analysis. Sophia Vinogradov assisted with study design and data analysis. All authors contributed to and have approved the final manuscript. Conflict of interest statementDan Mathalon is a consultant to Bristol Myers Squibb Inc. Sophia Vinogradov is a consultant to Brain Plasticity Institute. The remaining authors declare that they have no conflicts of interest. U.S. Department of Veterans Affairs VA Author ManuscriptVA Author Manuscript VA Author ManuscriptDiscussion-Our data indicate that oxytocin administration may ameliorate olfactory deficits in schizophrenia and suggest the effects of intranasal oxytocin may extend to influencing the olfactory system. Given that oxytocin has been found to increase cAMP signaling in vitro a possible mechanism for these effects is discussed.

The present review summarizes current knowledge of this frequent disease. Urologists must acquire a deeper understanding for better integration of practice recommendations.

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