Publications by authors named "Margaret Helmuth"

Aims: Men with lower urinary tract symptoms (LUTS) represent a heterogeneous group, and treatment decisions are often based on severity of symptoms and physical examination findings. Identification of clinically meaningful subtypes could allow for more personalized care. This study advances phenotyping efforts from the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) by adding data domains to previous phenotyping using urologic symptoms alone.

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  • The study investigates how residential air pollution, specifically particulate matter (PM), black carbon (BC), and sulfate, affects the progression of kidney disease in patients with primary glomerulopathies over a duration of at least two years.
  • Participants from two cohorts were analyzed to determine the link between air pollution exposure and decline in kidney function, measured by estimated glomerular filtration rate (eGFR).
  • Results indicate that higher exposure to air pollutants correlates with faster disease progression and increased systemic inflammation markers, suggesting air quality may significantly impact kidney health.
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Introduction: The decision to become a living donor requires consideration of a complex, interactive array of factors that could be targeted for clinical, policy, and educational interventions. Our objective was to assess how financial barriers interact with motivators, other barriers, and facilitators during this process.

Methods: Data were obtained from a public survey assessing motivators, barriers, and facilitators of living donation.

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  • The study aimed to explore structural changes in brain white matter in patients with overactive bladder (OAB) using diffusion tensor imaging (DTI).
  • Researchers assessed the microstructural integrity of the brain's white matter in OAB patients compared to matched controls and found significant differences in fractional anisotropy and mean diffusivity.
  • Results indicated that OAB patients had more abnormalities in specific brain areas, particularly associated with higher severity of OAB symptoms, emphasizing a link between urinary issues and brain structure changes.
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Introduction: Cure Glomerulonephropathy (CureGN) is an observational cohort study of patients with minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS), membranous nephropathy (MN), or IgA nephropathy. We developed a conventional, consensus-based scoring system to document pathologic features for application across multiple pathologists and herein describe the protocol, reproducibility, and correlation with clinical parameters at biopsy.

Methods: Definitions were established for glomerular, tubular, interstitial, and vascular lesions evaluated semiquantitatively using digitized light microscopy slides and electron micrographs, and reported immunofluorescence.

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The goal of this study was to develop the novel analytical approach and to perform an in-depth dynamic analysis of individual bladder diaries to inform which behavioral modifications would best reduce lower urinary tract symptoms, such as frequency and urgency. Three-day bladder diaries containing data on timing, volumes, and types of fluid intake, as well as timing, volumes, and bladder sensation at voids were analyzed for 197 participants with lower urinary tract symptoms. A novel dynamic analytic approach to bladder diary time series data was proposed and developed, including intra-subject correlations between time-varying variables: rates of intake, bladder filling rate, and urge growth rate.

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  • Overactive bladder (OAB) might be linked to issues in brain circuits, and a study used functional MRI to explore how OAB participants experience urinary urgency compared to controls when their bladder is filling.
  • Participants underwent MRI scans after drinking water while their urgency levels were measured; results showed two patterns: one group that did not respond to bladder filling and another group from OAB who had a strong response.
  • The study found that the OAB participants who had higher urgency also exhibited different brain connectivity patterns, particularly between sensorimotor areas and prefrontal regions, indicating distinct neurophysiological characteristics related to their urinary symptoms.
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Background: Hematuria is frequently present in podocytopathies, but its significance and prognostic value is not well described in these proteinuric kidney diseases. This study describes the prevalence and association between hematuria and kidney-related outcomes in these disorders.

Methods: Hematuria was assessed at the initial urinalysis in participants with the following podocytopathies-membranous nephropathy, minimal change disease, and FSGS-in the Nephrotic Syndrome Study Network and Cure Glomerulonephropathy cohorts with >24 months of follow-up.

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Rationale & Objective: Patients with glomerular disease (GN) may be at increased risk of severe COVID-19, yet concerns over vaccines causing disease relapse may lead to vaccine hesitancy. We examined the associations of COVID-19 with longitudinal kidney function and proteinuria and compared these with similar associations with COVID-19 vaccination.

Study Design: Observational cohort study from July 1, 2021, to January 1, 2023.

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  • Physical and psychological health can significantly influence lower urinary tract symptoms (LUTS), which are common in women and can be modified over time.
  • In a study involving 545 adult women, those with higher levels of depression and sleep disturbances reported more severe urinary symptoms, while better physical functioning correlated with milder symptoms.
  • Although all urinary symptoms decreased during the study, initial psychological factors did not predict the changes in LUTS over time.
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Introduction: Preeclampsia increases the risk for future chronic kidney disease (CKD). Among those diagnosed with CKD, it is unclear whether a prior history of preeclampsia, or other complications in pregnancy, negatively impact kidney disease progression. In this longitudinal analysis, we assessed kidney disease progression among women with glomerular disease with and without a history of a complicated pregnancy.

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The goal of this study was to perform an in-depth dynamic analysis of individual bladder diaries to inform which behavioral modifications would best reduce lower urinary tract symptoms, such as frequency and urgency. Three-day bladder diaries containing data on timing, volumes, and types of fluid intake, as well as timing, volumes, and bladder sensation at voids were analyzed for 197 participants with lower urinary tract symptoms. A novel dynamic analytic approach to bladder diary time series data was proposed and developed, including intra-subject correlations between time-varying variables: rates of intake, bladder filling rate, and urge growth rate.

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  • FSGS is a complex kidney disease with a poor outlook, linked to specific genetic changes in the APOL1 gene that may accelerate kidney failure.
  • This study analyzed data from patients with FSGS to understand how different genetic risk profiles (specifically APOL1 alleles) impact the progression of kidney disease.
  • Results showed that individuals with a high-risk APOL1 genotype experienced significantly faster declines in kidney function compared to those with lower risk, indicating a need for targeted patient care.
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Rationale & Objective: Adolescent- and adult-onset minimal change disease (MCD) may have a clinical course distinct from childhood-onset disease. We characterized the course of children and adults with MCD in the Cure Glomerulonephropathy Network (CureGN) and assessed predictors of rituximab response.

Study Design: Prospective, multicenter, observational study.

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Introduction: Caffeine has long been vilified as a cause for urinary urgency incontinence (UUI) along with other potential bladder irritants such as carbonation, alcohol, and acidic juices. The objective of this study was to assess the fluid intake behavior of people with urgency, UUI, and those with lower urinary tract symptoms (LUTS) without UUI or urgency to assess if they avoided certain potential bladder irritants or had different fluid intake. We hypothesized that patients with UUI would avoid caffeine as a self-management method more so than these other two groups.

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  • Limited data exists on how patients with overactive bladder (OAB) adjust their treatments over time, which is crucial for enhancing their care.
  • A study involving 349 women found that treatment levels varied significantly, with the majority using behavioral treatments or physical therapy rather than medications.
  • Factors such as initial treatment types, UUI severity, and existing health conditions influenced the highest level of treatment received during the year.
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  • The study investigates the impact of race, ethnicity, and socioeconomic status on acute care usage among patients with glomerular disease, noting gaps in existing knowledge.
  • Conducted as a prospective cohort study, it analyzed data from 1,456 adults and 768 children with confirmed glomerular disease in the CureGN cohort.
  • Results showed that Black and Hispanic individuals experienced higher acute care utilization rates compared to White and Asian participants, while socioeconomic factors were also linked to disease severity, though some findings varied after adjusting for multiple factors.
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Introduction: Understanding how Bipolar Disorder (BD) affects employment is limited by cross-sectional or short-term longitudinal designs. The aims for this study are to examine condition-related and other clinical predictors of longitudinal employment status and stability in those with BD compared to healthy controls (HC).

Methods: Participants were 358 individuals with BD and HC who were enrolled in the Heinz C.

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Purpose: We characterize patients with urinary urgency with vs without urgency urinary incontinence who presented to clinics actively seeking treatment for their symptoms.

Materials And Methods: Participants who enrolled in the Symptoms of Lower Urinary Tract Dysfunction Research Network were categorized into urinary urgency with vs without urgency urinary incontinence. Participants were followed for 1 year; their urinary symptoms, urological pain, psychosocial factors, bowel function, sleep disturbance, physical activity levels, physical function, and quality of life were compared.

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  • Bladder diaries are important for understanding lower urinary tract symptoms (LUTS), but many patients struggle to fill them out correctly.
  • A study involving 290 symptomatic adults showed that while 60% completed the diaries, the strongest correlations between bladder diary data and patient-reported outcome measures (PROMs) were found for daytime (r=0.75) and nighttime frequency (r=0.69).
  • Overall, while bladder diaries have limitations due to missing data, PROMs serve as a valid alternative, especially for tracking voiding frequency more conveniently.
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Background: The association of pelvic organ prolapse with overactive bladder and other lower urinary tract symptoms, and the natural history of those symptoms are not well characterized. Previous cross-sectional studies demonstrated conflicting relationships between prolapse and lower urinary tract symptoms.

Objective: This study primarily aimed to determine the baseline association between lower urinary tract symptoms and prolapse and to assess longitudinal differences in symptoms over 12 months in women with and without prolapse.

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  • - The study introduces a new method to categorize women with lower urinary tract symptoms (LUTS) by combining different types of data, such as personal health reports and bladder diaries, to better understand their diverse symptoms and causes.
  • - Using data from a multi-center study involving 545 women, the researchers employed advanced techniques to handle complex data sets, leading to the identification of five distinct symptom clusters, none defined by a single symptom alone.
  • - The findings reveal that each cluster shows unique patterns in symptoms and associated proteins, highlighting the clinical significance and potential for improved evaluation methods for LUTS, rather than conventional approaches.
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