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Sample records for continent ileocecal urinary

  1. Cecal rupture after continent ileocecal urinary diversion during total pelvic exenteration

    SciTech Connect

    Brand, E. )

    1991-09-01

    Continent ureteral diversion at the time of pelvic exenteration avoids an external appliance and allows patients to retain bladder reservoir function. The technical difficulty of this procedure requires meticulous attention to operative and perioperative care, particularly after pelvic irradiation. A patient with recurrent stage IIIB carcinoma of the cervix underwent total pelvic exenteration with reconstructive procedures including low rectal anastomosis, neovagina formation, and ileocecal (Indiana) continent diversion. Early catheterization of the reservoir began 2 weeks postoperatively. One week later cecal rupture occurred, not related to suture line (technical) failure. Because of the high wall tension and reduced compliance in the irradiated cecum, the authors do not recommend catheterization of the urinary reservoir before 4-6 weeks. In order for continent diversion to become the standard diversion in exenteration patients, the major complication rate must remain comparable to that of noncontinent diversion.

  2. Robotic Intracorporeal Continent Cutaneous Urinary Diversion: Primary Description.

    PubMed

    Goh, Alvin C; Aghazadeh, Monty A; Krasnow, Ross E; Pastuszak, Alexander W; Stewart, Julie N; Miles, Brian J

    2015-11-01

    The purpose is to present the first report and describe our novel technique for intracorporeal continent cutaneous diversion after robotic cystectomy. After completion of robot-assisted cystectomy using a standard six-port transperitoneal technique, three additional ports are placed, and the robot is redocked laterally over the patient's right side in the modified lateral position. Our technique replicates step-by-step the principles of the open approach. Ileocolonic anastomosis, ureteroenteral anastomoses, and construction of a hand-sewn right colonic pouch are all performed intracorporeally. Tapering of efferent ileal limb and reinforcement of the ileocecal valve are performed via the extraction site, while the stoma is matured through a prospective port site. Successful robotic intracorporeal creation of a modified Indiana pouch was achieved. Operative time for diversion was 3 hours, with negligible blood loss, and without any intraoperative complications. No major (Clavien III-V) 90-day complications were observed. At a follow-up of 1 year, the patient continues to catheterize without difficulty. We demonstrate the first description of robotic intracorporeal continent cutaneous urinary diversion after robot-assisted cystectomy. We present a systematic minimally invasive approach, replicating the principles of open surgery, which is technically feasible and safe with a good functional result. PMID:25556514

  3. 21 CFR 876.5270 - Implanted electrical urinary continence device.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... Implanted electrical urinary continence device. (a) Identification. An implanted electrical urinary device is a device intended for treatment of urinary incontinence that consists of a receiver implanted in... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Implanted electrical urinary continence...

  4. 21 CFR 876.5270 - Implanted electrical urinary continence device.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... Implanted electrical urinary continence device. (a) Identification. An implanted electrical urinary device is a device intended for treatment of urinary incontinence that consists of a receiver implanted in... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Implanted electrical urinary continence...

  5. Continent urinary diversion using an artificial urinary sphincter.

    PubMed

    Mitrofanoff, P; Bonnet, O; Annoot, M P; Bawab, F; Grise, P

    1992-07-01

    We report a new and simplified method of continent urinary diversion employing a modified AMS 800 artificial urinary sphincter (AUS). Our aim in using this artificial valve is to make a stoma continent, while allowing intermittent catheterisation. The AMS 800 pump is replaced by a subcutaneous injection port. This allows, by direct puncture, the accurate setting of the closing pressure by varying the volume of the intra-prosthetic liquid, with subsequent adjustment of this pressure as necessary. The cuff is placed on the subcutaneous part of the intestinal loop diversion. The pressure-regulating balloon is implanted within the area of abdominal pressure, retroperitoneally. After first confirming the efficacy of the system in 3 dogs, the device was placed in 2 patients. The first had a neuropathic bladder treated initially by enterocystoplasty with an appendicocutaneous stoma. Secondary leakage was subsequently controlled by placement of the device, with continuing excellent results at 32 months. The second patient was a girl in whom a urogenital rhabdomyosarcoma had been treated by anterior exenteration, radiotherapy and a sigmoid conduit diversion. This was subsequently converted to a continent reservoir by simple augmentation of the conduit and placement of the device, with a good result being maintained after a follow-up of 20 months. These two cases illustrate the best indications for this procedure, namely primary or secondary leakage from a supposedly continent urinary diversion, and conversion of a freely draining conduit into a continent reservoir. Although long-term results are still pending, our experience thus far encourages us to recommend this technique as a simple means of achieving a continent urinary diversion. PMID:1638370

  6. 21 CFR 876.5270 - Implanted electrical urinary continence device.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Implanted electrical urinary continence device. 876.5270 Section 876.5270 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5270 Implanted electrical urinary continence device....

  7. 21 CFR 876.5270 - Implanted electrical urinary continence device.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... (premarket approval). (c) Date PMA or notice of completion of a PDP is required. A PMA or a notice of..., 1976. Any other implanted electrical urinary continence device shall have an approved PMA or a...

  8. 21 CFR 876.5270 - Implanted electrical urinary continence device.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... (premarket approval). (c) Date PMA or notice of completion of a PDP is required. A PMA or a notice of..., 1976. Any other implanted electrical urinary continence device shall have an approved PMA or a...

  9. 21 CFR 876.5280 - Implanted mechanical/hydraulic urinary continence device.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Implanted mechanical/hydraulic urinary continence....5280 Implanted mechanical/hydraulic urinary continence device. (a) Identification. An implanted mechanical/hydraulic urinary continence device is a device used to treat urinary incontinence by...

  10. 21 CFR 876.5280 - Implanted mechanical/hydraulic urinary continence device.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ....5280 Implanted mechanical/hydraulic urinary continence device. (a) Identification. An implanted mechanical/hydraulic urinary continence device is a device used to treat urinary incontinence by the... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Implanted mechanical/hydraulic urinary...

  11. 21 CFR 876.5280 - Implanted mechanical/hydraulic urinary continence device.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ....5280 Implanted mechanical/hydraulic urinary continence device. (a) Identification. An implanted mechanical/hydraulic urinary continence device is a device used to treat urinary incontinence by the... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Implanted mechanical/hydraulic urinary...

  12. Brain-derived neurotrophic factor in urinary continence and incontinence.

    PubMed

    Song, Qi-Xiang; Chermansky, Christopher J; Birder, Lori A; Li, Longkun; Damaser, Margot S

    2014-10-01

    Urinary incontinence adversely affects quality of life and results in an increased financial burden for the elderly. Accumulating evidence suggests a connection between neurotrophins, such as brain-derived neurotrophic factor (BDNF), and lower urinary tract function, particularly with regard to normal physiological function and the pathophysiological mechanisms of stress urinary incontinence (SUI) and bladder pain syndrome/interstitial cystitis (BPS/IC). The interaction between BDNF and glutamate receptors affects both bladder and external urethral sphincter function during micturition. Clinical findings indicate reduced BDNF levels in antepartum and postpartum women, potentially correlating with postpartum SUI. Experiments with animal models demonstrate that BDNF is decreased after simulated childbirth injury, thereby impeding the recovery of injured nerves and the restoration of continence. Treatment with exogenous BDNF facilitates neural recovery and the restoration of continence. Serotonin and noradrenaline reuptake inhibitors, used to treat both depression and SUI, result in enhanced BDNF levels. Understanding the neurophysiological roles of BDNF in maintaining normal urinary function and in the pathogenesis of SUI and BPS/IC could lead to future therapies based on these mechanisms. PMID:25224451

  13. Effect of Nerve-Sparing Radical Prostatectomy on Urinary Continence in Patients With Preoperative Erectile Dysfunction

    PubMed Central

    2016-01-01

    Purpose: We aimed to assess whether nerve-sparing radical prostatectomy (nsRP) is associated with improved recovery of urinary continence compared to non–nerve-sparing radical prostatectomy (nnsRP) in patients with localized prostate cancer and preoperative erectile dysfunction. Methods: A total of 360 patients with organ-confined prostate cancer and an International Index of Erectile Function score of less than 17 were treated with nsRP or nnsRP in Seoul St. Mary’s Hospital. Patients who received neoadjuvant or adjuvant androgen deprivation therapy or had a history of prostate-related surgery were excluded. Recovery of urinary continence was assessed at 0, 1, 3, 6, and 12 months. Postoperative recovery of continence was defined as zero pad usage. The association between nerve-sparing status and urinary continence was assessed by using univariate and multivariate Cox regression analyses after controlling for known predictive factors. Results: Urinary continence recovered in 279 patients (77.5%) within the mean follow-up period of 22.5 months (range, 6–123 months). Recovery of urinary continence was reported in 74.6% and 86.4% of patients after nnsRP and nsRP, respectively, at 12 months (P=0.022). All groups had comparable perioperative criteria and had no significant preoperative morbidities. Age, American Society of Anesthesiologists score, and nerve-sparing status were significantly associated with recovery of urinary continence on univariate analysis. On multivariate analysis, age (hazard ratio [HR], 1.254; 95% confidence interval [CI], 1.002–1.478; P=0.026) and nerve-sparing status (HR, 0.713; 95% CI, 0.548–0.929; P=0.012) were independently associated with recovery of urinary continence. Conclusions: nsRP, as compared to nnsRP, improves recovery rates of urinary incontinence and decreases surgical morbidity without compromising pathologic outcomes. PMID:27032560

  14. 21 CFR 876.5280 - Implanted mechanical/hydraulic urinary continence device.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... cuff to pass on the urethra. (b) Classification. Class III (premarket approval). (c) Date PMA or notice of completion of a PDP is required. A PMA or a notice of completion of a PDP is required to be filed... implanted mechanical/hydraulic urinary continence device shall have an approved PMA or a declared...

  15. 21 CFR 876.5280 - Implanted mechanical/hydraulic urinary continence device.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Implanted mechanical/hydraulic urinary continence device. 876.5280 Section 876.5280 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5280 Implanted mechanical/hydraulic...

  16. Hypothesis That Urethral Bulb (Corpus Spongiosum) Plays an Active Role in Male Urinary Continence.

    PubMed

    Rehder, Peter; Staudacher, Nina M; Schachtner, Joerg; Berger, Maria E; Schillfahrt, Florian; Hauser, Verena; Mueller, Raphael; Skradski, Viktor; Horninger, Wolfgang; Glodny, Bernhard

    2016-01-01

    The proximal urethral bulb in men is enlarged, surrounds the bulbous urethra, and extends dorsally towards the perineum. During intercourse engorgement takes place due to increased blood flow through the corpus spongiosum. Antegrade ejaculation is facilitated by contraction of the bulbospongiosus muscles during climax. Micturition during sexual stimulation is functionally inhibited. Supporting the bulb may indirectly facilitate continence in a certain subset of patients with postprostatectomy incontinence. During physical activity with increased abdominal pressure, reflex contraction of the pelvic floor muscles as well as the bulbospongiosus muscles occurs to support sphincter function and limit urinary incontinence. Operations to the prostate may weaken urinary sphincter function. It is hypothesized that the distal urinary sphincter may be supported indirectly by placing a hammock underneath the urethral bulb. During moments of physical stress the "cushion" of blood within the supported corpus spongiosum helps to increase the zone of coaptation within the sphincteric (membranous) urethra. This may lead to urinary continence in patients treated by a transobturator repositioning sling in patients with postprostatectomy incontinence. This paper describes the possible role of the urethral bulb in male urinary continence, including its function after retroluminal sling placement (AdVance, AdVance XP® Male Sling System, Minnetonka, USA). PMID:27022393

  17. Hypothesis That Urethral Bulb (Corpus Spongiosum) Plays an Active Role in Male Urinary Continence

    PubMed Central

    Rehder, Peter; Staudacher, Nina M.; Schachtner, Joerg; Berger, Maria E.; Schillfahrt, Florian; Hauser, Verena; Mueller, Raphael; Skradski, Viktor; Horninger, Wolfgang; Glodny, Bernhard

    2016-01-01

    The proximal urethral bulb in men is enlarged, surrounds the bulbous urethra, and extends dorsally towards the perineum. During intercourse engorgement takes place due to increased blood flow through the corpus spongiosum. Antegrade ejaculation is facilitated by contraction of the bulbospongiosus muscles during climax. Micturition during sexual stimulation is functionally inhibited. Supporting the bulb may indirectly facilitate continence in a certain subset of patients with postprostatectomy incontinence. During physical activity with increased abdominal pressure, reflex contraction of the pelvic floor muscles as well as the bulbospongiosus muscles occurs to support sphincter function and limit urinary incontinence. Operations to the prostate may weaken urinary sphincter function. It is hypothesized that the distal urinary sphincter may be supported indirectly by placing a hammock underneath the urethral bulb. During moments of physical stress the “cushion” of blood within the supported corpus spongiosum helps to increase the zone of coaptation within the sphincteric (membranous) urethra. This may lead to urinary continence in patients treated by a transobturator repositioning sling in patients with postprostatectomy incontinence. This paper describes the possible role of the urethral bulb in male urinary continence, including its function after retroluminal sling placement (AdVance, AdVance XP® Male Sling System, Minnetonka, USA). PMID:27022393

  18. Laparoscopic radical prostatectomy with bladder neck preservation: positive surgical margin and urinary continence status

    PubMed Central

    Jaskulski, Jaroslaw; Jarecki, Piotr; Dudek, Przemysław; Szopiński, Tomasz; Chłosta, Piotr

    2014-01-01

    Introduction Preservation of the bladder neck (BN) has been controversial, as limited excision of the bladder neck may result in incomplete resection of the disease. Moreover, the urinary continence rate may not be improved. Aim To evaluate the effect of bladder neck sparing on urinary continence, and surgical margins status in prostate cancer (PCa) patients treated with laparoscopic radical extraperitoneal prostatectomy. Material and methods A retrospective analysis of 295 consecutive patients who had undergone laparoscopic radical extraperitoneal prostatectomy for clinically localised prostate cancer in a single institution was performed. Positive surgical margin (SM(+)) and urinary continence status at 3, 6, and 12 months were evaluated. Results The distribution of SM(+) for pT2, pT3, and pT4a was 15.3% (27/176), 49.1% (58/118), and 100% (1/1), respectively. Overall, there were 55.61%, 80.61%, and 84.69% of men continent at 3, 6, and 12 months, respectively. However, when limiting the analysis to those who did not receive adjuvant radiotherapy within 12 months following surgery, urinary continence rates were 59.23%, 85.86%, and 90.21% at 3, 6, and 12 months, respectively. Preoperative prostate-specific antigen (PSA) and pathological T stage were identified as significant predictors of positive surgical margins. Conclusions Conclusions: Laparoscopic radical extraperitoneal prostatectomy with bladder neck preservation has been a safe procedure which has resulted in good functional outcome. We observed a relatively high incidence of positive surgical margins which could be attributed to a large number of extracapsular disease cases. PMID:25337159

  19. Evolution of female urinary continence after physical therapy and associated factors

    PubMed Central

    2014-01-01

    Background Urinary incontinence (UI) is defined as any involuntary loss of urine that can influence the quality of life, personal hygiene and social interaction. The types of UI that most affect women are stress urinary incontinence, urge incontinence and mixed urinary incontinence. There are several risk factors that result in specific treatments. We aimed to investigate the evolution of female urinary continence after physical therapy intervention and its associated factors. Method A retrospective cross-sectional study was conducted with 71 participants who were discharged from physiotherapy sector from August 2006 to April 2012 and met the inclusion criteria. Results Among the studied variables, the number of sessions and completion of home pelvic floor exercises showed a significant association. The urinary continence appeared in 43.7% of the cases, and factors, performance of home exercises, and number of sessions showed a significant association. Conclusion The number of sessions and completion of home pelvic floor exercises showed a significant relationship with each other. PMID:24839462

  20. Indiana pouch continent urinary reservoir in patients with previous pelvic irradiation

    SciTech Connect

    Mannel, R.S.; Braly, P.S.; Buller, R.E. )

    1990-05-01

    Little information exists on the use of continent urinary reservoirs in patients with previous pelvic irradiation. We report the use of the Indiana pouch urinary reservoir in ten women with a history of pelvic irradiation for cervical cancer, of whom eight underwent a total pelvic exenteration for recurrent pelvic tumor and two had diversion for radiation-induced vesicovaginal fistula. All ten women achieved daytime continence, with a median time between catheterizations of 4.5 hours and a median pouch capacity of 500 mL. There was no evidence of leakage from the reservoir or significant ureteral reflux or obstruction on postoperative radiographic evaluation. No patient has required reoperation or had significant postoperative complications with the technique described.

  1. Percutaneous Imaging-Guided Access for the Treatment of Calculi in Continent Urinary Reservoirs

    SciTech Connect

    Davis, Winston Brooks; Trerotola, Scott O.; Johnson, Matthew S.; Patel, Nilesh H.; Namyslowski, Jan; Stecker, Michael S.; McLennan, Gordon; Shah, Himanshu; Bihrle, Richard; Foster, Richard

    2002-03-15

    Purpose: To describe our long-term experience with percutaneous access to continent urinary reservoirs for calculus removal. Patients and Methods: A retrospective study of 13 procedures in 10 patients was performed. In 2 of the 13 procedures, access and calculus removal was performed in a single session. In the other 11 procedures, initial access was obtained using ultrasonography,fluoroscopy, and/or computed tomography. The patients then returned ata later date for a second step where the access was dilated and the calculi were removed. Results: Access was achieved successfully in all cases with no complications. At mean follow-up time of 13.6 months (range 1-94 months) one patient had died of complications unrelated to her continent urinary reservoir. Another patient had been placed on suppressive antibiotics for recurrent calculi. The remaining patients were stone free and without late complication. Conclusions: Percutaneous removal of reservoir calculi can be performed safely, avoiding potential injury to the continence valve mechanism by a direct cystoscopic approach. We propose a two-stage procedure using CT guidance for initial access as the preferred technique.

  2. Quality of life related to urinary continence in adult spina bifida patients

    PubMed Central

    Dong, Caroline; Casey, Jessica T.; Greiman, Alyssa; Mukherjee, Shubhra; Kielb, Stephanie J.

    2015-01-01

    Introduction To analyze the correlations of bladder management technique, ambulatory status and urologic reconstruction on quality of life (QOL) as affected by urinary symptoms in adult spina bifida (SB) patients. Material and methods Sixty–six adult SB patients completed the RAND 36–Item Health Survey (mSF–36) and Incontinence Quality of Life (I–QOL). Demographic information, history of urinary reconstruction, and bladder management techniques were reviewed and analyzed with respect to survey scores. Results Mean age of patients was 32.3 (SD ±7.2) years and 44 patients (66.7%) were female. Forty–five patients (68.2%) were mainly ambulatory, 21 (31.8%) use a wheelchair and 10 (15.2%) had urologic reconstruction, while 56 (83.3%) did not. Twelve patients (18.2%) void, 42 (63.6%) perform clean intermittent catheterization (CIC), 4 (6.1%) use an indwelling catheter, 3 (4.5%) have an ileal conduit (IC) and 5 (7.6%) mainly use diapers. Mean mSF–36 General Health score was 56.5 (SD ±22.9) and mean I–QOL Sum score was 50.9 (SD ±21.7), where lower scores reflect lower QOL. mSF–36 and I–QOL scores did not significantly correlate with bladder management technique, ambulatory status or urologic reconstruction. A correlation was noted between I–QOL scales and most mSF–36 scales (all p <0.02). Conclusions In our cohort study of adult SB patients, bladder management technique and urologic reconstruction did not correlate with urinary (I–QOL) or general health (mSF–36) domains, although I–QOL and mSF–36 scores correlated closely, suggesting urinary continence is significantly related to general QOL. However, we are unable to identify a single factor that improves either urinary or general QOL. PMID:25914840

  3. Continent appendicocolostomy: a variation of the Mitrofanoff principle in pediatric urinary tract reconstruction.

    PubMed

    Elder, J S

    1992-07-01

    There are numerous options for continent urinary reconstruction in children. If the appendix is available and the bladder capacity is satisfactory, a Mitrofanoff procedure may be performed using the appendix as a catheterizable tube implanted into the bladder. However, in many patients the bladder is absent or too small for this type of reconstruction. An alternative technique, termed appendicocolostomy, is to implant the appendix under the tenia of a detubularized patch of cecum or sigmoid colon, which becomes part of a continent neobladder or is attached to the bladder itself. This procedure has been used in 12 children and 1 adult undergoing continent reconstruction. Urological diseases included bladder exstrophy (10 patients) and a neuropathic bladder (3). Two patients underwent undiversion of a sigmoid conduit, while in 7 of the remaining patients the bladder was included in the reservoir. In 1 patient histological examination of the tip of the appendix revealed an incidental invasive carcinoid tumor necessitating appendectomy and revision of the reconstruction. Otherwise, no complications have occurred. Three adults were scheduled for this procedure but the appendix was diseased and an alternative form of diversion was necessary. Followup ranged from 2 months to 4 years. All patients are totally dry with a capacity of 300 to 750 cc (mean 475 cc). The appendicocolostomy is a superior form of conduit reconstruction that should be considered when the appendix is available during continent reconstruction. However, in adults the appendix may be fibrotic, precluding its use. Because most boys with exstrophy and a small bladder capacity requiring augmentation cystoplasty must perform intermittent catheterization, attachment of the appendix to the reservoir is an alternative that allows for easier and less painful intermittent catheterization than catheterization of the reconstructed epispadiac penis. PMID:1613848

  4. Development of clinical practice guidelines for urinary continence care of adult stroke survivors in acute and rehabilitation settings.

    PubMed

    Fisher, Andrea R

    2014-01-01

    This study developed evidence-based clinical practice guidelines for the urinary continence care of adult stroke survivors in acute and rehabilitation settings. The research team conducted a comprehensive review of the literature on urinary continence interventions and outcomes. The team then developed a set of recommendations outlined in the resulting clinical practice guidelines titled Clinical Practice Guidelines (CPGs) for the Urinary Continence Care of Stroke Survivors in Acute and Rehabilitation Settings. The evaluation of the CPGs consisted of a two-part assessment and pilot implementation. An expert panel of 25 local and regional experts in stroke and continence care assessed the proposed CPGs. This assessment consisted of two stages: a) evaluating the guidelines using the Appraisal of Guidelines Research and Evaluation (AGREE) Instrument (http://www. agreetrust.org); and, b) conducting focus groups to identify barriers and facilitators to the implementation of the guidelines using the Ottawa Model of Research Use (OMRU). Results from the expert panel assessments/feedback contributed to the refinement of the CPGs as well as identification and construction of implementation strategies. Two sites conducted a three-month pilot implementation of three recommendations from the CPGs as selected by each site. The two inpatient sites were a rehabilitation setting and a mixed acute and rehabilitation setting. The implementation of the CPGs included the development of learning strategies tailored to the needs of each site and in addition to the creation of an online self-learning portal. This study assessed nurses' knowledge, attitudes, and beliefs regarding urinary continence challenges using a survey before and after the pilot. Chart reviews before and after the pilot implementation audited the nurses' urinary continence practices for patients and uptake of the selected guidelines' recommendations. Study findings suggested the implementation of the CPGs

  5. Efficacy of Duloxetine in the Early Management of Urinary Continence after Radical Prostatectomy

    PubMed Central

    Alan, Cabir; Eren, Ali E.; Ersay, Ahmet R.; Kocoglu, Hasan; Basturk, Gokhan; Demirci, Emrah

    2015-01-01

    Aim To evaluate the efficacy of early duloxetine therapy in stress urinary incontinence occurring after radical prostatectomy (RP). Material and Method Patients that had RP were randomly divided into 2 groups following the removal of the urinary catheter. Group A patients (n = 28) had pelvic floor exercise and duloxetine therapy. Group B patients (n = 30) had only pelvic floor exercise. The incontinence status of the patients and number of pads were recorded and 1-hour pad test and Turkish validation of International Consultation on Incontinence Questionnaire-Short Form test were applied to the patients at the follow-up. Results When the dry state of the patients was evaluated, 5, 17, 3, and 2 of 28 Group A patients stated that they were completely dry in the 3rd, 6th, 9th and 12th month respectively and pad use was stopped. There was no continence in 30 Group B in the first 3 months. Twelve, 6, and 8 patients stated that they were completely dry in the 6th, 9th and 12th month, respectively. But 3 of 4 patients in whom dryness could not be provided were using a mean of 7.6 pads in the first day and a mean of 1.3 pads after 1 year. When pad use of the patients was evaluated, the mean monthly number of pad use was determined to be 6.2 (4-8) in the initial evaluation, 2.7 (0-5) in the in 3rd month, 2 (0-3) in the 6th month and 1.6 (0-2) pad/d in the 9th month in the group taking medicine. The mean monthly number of pads used was determined to be 5.8 (4-8) in the initial evaluation, 4.3 (3-8) in the 3rd month, 3 (0-6) in the 6th month and 1.6 (0-6) pad/d in the 9th month in the group not taking medicine. Conclusion According to the results, early duloxetine therapy in stress urinary incontinence that occurred after RP provided early continence. PMID:26195963

  6. Continent catheterizable conduit for urinary diversion in children: Applicability and acceptability

    PubMed Central

    Solanki, Shailesh; Babu, Muniamjanappa Narendra; Jadhav, Vinay; Shankar, Gowri; Ramesh, Santhanakrishnan

    2015-01-01

    Background: Continent catheterizable conduit (CCC) has made clean intermittent catheterization (CIC) painless and easy. It is applicable in diverse clinical conditions. Nonetheless, convincing the parents for the need of conduit procedure is still difficult. Materials and Methods: A prospective study, included children who underwent CCC procedure from March 2008 to February 2013. The data were assessed for; diagnosis, type of conduit, number of preoperative counselling sessions before acceptance, role of “self-help group” in decision making, parental concern and satisfaction for the procedure. Results: Twenty-nine patients (males; 24, females; 5) underwent CCC procedure for various clinical conditions. The multiple preoperative counselling sessions and creation of “self-help groups” were helped them for decision making. The main concerns among parents were: (1) Impact of procedure on future fertility and sexual life. (2) Patency of native urethral channel. (3) Permanent urinary stoma over the abdomen. Conclusion: CCC procedures are applicable to a wide array of clinical situations with a good outcome. The acceptability of the CCC procedure improves with preoperative counselling of parent/child, initiation of preoperative per urethral CIC and creation of self-help groups. PMID:25659547

  7. “Total reconstruction” of the urethrovesical anastomosis contributes to early urinary continence in laparoscopic radical prostatectomy

    PubMed Central

    Liao, Xiaoxing; Qiao, Peng; Tan, Zhaohui; Shi, Hongbin; Xing, Nianzeng

    2016-01-01

    ABSTRACT Purpose: To demonstrate the effect of total reconstruction technique on postoperative urinary continence after laparoscopic radical prostatectomy (LRP). Material and Methods: LRP was performed using a standard urethrovesical anastomosis in 79 consecutive patients (Group-A) from June 2011 to October 2012, and a total reconstruction procedure in 82 consecutive patients (Group-B) from June 2012 to June 2013. The primary outcome measurement was urinary continence assessed at 1, 2, 4, 12, 24 and 52 weeks after catheter removal. Other data recorded were patient age, body mass index, International Prostate Symptoms Score, prostate volume, preoperative PSA, Gleason score, neurovascular bundle preservation, operation time, estimated blood loss, complications and pathology results. Results: In Group-A, the continence rates at 1, 2, 4, 12, 24 and 52 weeks were 7.59%, 20.25%, 37.97%, 58.22%, 81.01% and 89.87% respectively. In Group-B, the continence rates were 13.41%, 32.92%, 65.85%, 81.71%, 90.24% and 95.12% respectively. Group––B had significantly higher continence rates at 4 and 12 weeks after surgery (P<0.001 and P=0.001). There were no significant differences between the groups with respect to patient's age, body mass index, prostate-specific antigen level, prostate volume, IPSS, estimated blood loss, number of nerve-sparing procedures and postoperative complications. Conclusions: Total reconstruction technique in the procedure of urethrovesical anastomosis during LRP improved early recovery of continence. PMID:27256174

  8. Risk factors of postoperative complications after radical cystectomy with continent or conduit urinary diversion in Armenia.

    PubMed

    Tsaturyan, Arman; Petrosyan, Varduhi; Crape, Byron; Sahakyan, Yeva; Abrahamyan, Lusine

    2016-01-01

    To estimate the surgical volume and the incidence of in-hospital complications of RC in Armenia from 2005 to 2012, and to investigate potential risk factors of complications. The study utilized a retrospective chart review in a cohort of patients who had RC followed by either continent or conduit urinary diversion in all hospitals of Armenia from 2005 to 2012. A detailed chart review was conducted abstracting information on baseline demographic and clinical characteristics, surgical procedural details, postoperative management and in-hospital complications. Multivariable logistic regression analysis was applied to estimate the independent risk factors for developing 'any postoperative complication'. The total study sample included 273 patients (mean age = 58.5 years, 93.4 % men). Overall, 28.9 % (n = 79) of patients had at least one in-hospital complication. The hospital mortality rate was 4.8 % (n = 13). The most frequent types of complications were wound-related (10.3 %), gastrointestinal (9.2 %) and infectious (7.0 %). The ischemic heart disease (OR = 3.3, 95 % CI 1.5-7.4), perioperative transfusion (OR = 2.0, 1.1-3.6), glucose level [OR = 0.71 (0.63-0.95)], and hospital type (OR = 2.3, 95 % CI 1.1-4.7) were independent predictors of postoperative complications. The rate of RC complications in Armenia was similar to those observed in other countries. Future prospective studies should evaluate the effect of RC complications on long-term outcomes and costs in Armenia. Policy recommendations should address the issues regarding surgeon training and hospital volume to decrease the risk of RC complications. PMID:26933633

  9. Urinary Continence Outcomes after Puboprostatic Ligament Preserving Open Retropubic Radical Prostatectomy at a Sub-Saharan Hospital

    PubMed Central

    Kaggwa, S.; Galukande, M.

    2014-01-01

    Background. Open retropubic radical prostatectomy is a commonly performed procedure for clinically localized prostate cancer. The demand for high level functional outcomes after therapy is increasing especially for young age patients; in this regard refinements in the surgical technique have been made. There is limited data to show the success of some of these refinements in resource limited settings. Methods. A retrospective clinical study was performed over a 2-year period at Mengo Hospital, Urology Unit. Men with clinically localized prostate cancer and who consented to the procedure were eligible and were recruited. Consequently excluded were those that turned out to have advanced disease and those with severe comorbidities. Patients were followed up for 3 months after surgery. Data was entered using SPSS version 17 and analyzed. Results. A total of 24 men with clinically localized prostate cancer underwent open retropubic puboprostatic ligament preserving radical prostatectomy technique. Mean age was 66, range 54–75 years. Outcome. Two patients had stress incontinence and three were incontinent at 3 months. The urinary continence recovery rate was 19/24 (79%) at 3 months. Conclusion. Preservation of the puboprostatic ligament in open retropubic radical prostatectomy was associated with rapid and a high rate of return to urinary continence among men with clinically localized disease.

  10. Morphological analysis of the urethral muscle of the male pig with relevance to urinary continence and micturition.

    PubMed

    Ragionieri, Luisa; Ravanetti, Francesca; Gazza, Ferdinando; Botti, Maddalena; Ivanovska, Ana; Cacchioli, Antonio

    2016-03-01

    To investigate whether the pig could be considered a suitable model to study lower urinary tract function and dysfunction, the pelvic urethra of 24 slaughtered male pigs were collected, and the associated muscles were macroscopically, histologically and histochemically analyzed. In cross-sections of the urethra, a muscular complex composed of an inner layer of smooth muscle and an outer layer of striated muscle that are not separated by fascial planes was observed. A tunica muscularis, composed of differently oriented smooth muscle bundles, is only evident in the proximal part of the pelvic urethra while, in the remaining part, it contributes to form the prostatic fibromuscular stroma. The striated urethral muscle surrounds the pelvic urethra in a horseshoe-like configuration with a dorsal longitudinal raphe, extending from the bladder neck to the central tendon of perineum. Proximally to the bladder, it is constituted of slow-twitch and fast-twitch myofibers of very small diameter, and embedded in an abundant collagen and elastic fiber net. Moving caudally it is gradually encircled and then completely substituted by larger and compact myofibers, principally presenting circular orientation and fast-twitch histochemical characteristics. So, like in humans, the cranial tract of the muscular system surrounding the pelvic urethra is principally composed of smooth musculature. The striated component cranially may have a role in blocking retrograde ejaculation, while the middle and caudal tracts may facilitate urine and semen flow, and seem especially concerned with the rapid and forceful urethral closure during active continence. Some differences in the morphology and structure between pigs and humans seem due to the different morphology of the 'secondary' sexual organs that develop from the urethral wall and to the different effect of gravity on the mechanics of the urinary system in quadruped and bipedal mammals. PMID:26573248

  11. [A new approach to urinary continence disorders in women: urodynamic ultrasonic examination by the vaginal route].

    PubMed

    Beco, J; Sulu, M; Schaaps, J P; Lambotte, R

    1987-01-01

    The vesicourethral junction, the urethra cannot be seen when using the abdominal approach because of the interposition of the pubic symphysis. The ultrasonic vaginal approach makes it possible. 53 patients were ultrasonically observed during an urodynamic exploration. The simultaneous utilization of both methods has permit to observe the mechanisms of normal or pathological voiding. When initiating a voluntary micturition, an area (called "prepubic muscle") located in front of the pubic symphysis between the clitoris and the urethral meatus, exert a traction on the periurethral sphincteric area. This sphincteric area, which is well shown by ultrasound, contracts longitudinally (causing shortening of the urethra and opening of the bladder neck) and causes a drop in urethral closure pressure. The increase in the distance between the inferior part of the pubic symphysis and the anterior vaginal wall comes about because of slackening of the elevator ani muscles. This slackening occurs at different times before the bladder contracts. The urethra opens; the complete course of this organ is well defined. Things return to their previous state when voiding finishes. In the case of stress incontinence, the lack of transmission of pressure urodynamically found when the woman is coughing can be seen as a sliding mechanism within the space of Retzius and at the urethro-vesical junction behind the symphysis pubis. The degree of sliding depends on the strength of the cough. In all cases of pure stress incontinence without there being low urethral closure pressure, a maximum stress caused by coughing will produce more than 5 MM sliding before the urethra opens. If the urinary incontinence is due to low urethral closure pressure, the urethra opens without sliding of the urethro-vesical junction whenever the abdominal pressure increases. Urethral instability resembles voluntary voiding but without any voluntary command. "Prepubic" contractions, longitudinal contractions in the

  12. Gastroenterology and urology devices; effective date of requirement for premarket approval of the implanted mechanical/hydraulic urinary continence device. Food and Drug Administration, HHS. Final rule.

    PubMed

    2000-09-26

    The Food and Drug Administration (FDA) is issuing a final rule to require the filing of a premarket approval application (PMA) or a notice of completion of a product development protocol (PDP) for the implanted mechanical/hydraulic urinary continence device, a generic type of medical device intended for the treatment of urinary incontinence. This action is being taken under the Federal Food, Drug, and Cosmetic Act (the act), as amended by the Medical Device Amendments of 1976 (the amendments), the Safe Medical Devices Act of 1990 (the SMDA), and the Food and Drug Administration Modernization Act of 1997. PMID:11503643

  13. Infectious ileocecitis--appendicitis mimicking syndrome.

    PubMed

    Zganjer, M; Roic, G; Cizmic, A; Pajic, A

    2005-01-01

    The purpose of our study is to emphasize the central role of ultrasound (US) in finding the cause of abdominal pain in children. Ultrasound of the lower abdomen quadrant should be considered in all cases in which the clinical signs and symptoms are not diagnostic of appendicitis. There is a wide range of clinical syndromes and diseases which can easily be diagnosed using a high resolution ultrasound with adjunct of color and power Doppler. The spectrum of abnormalities includes appendicitis, mesenteric lymphadenitis, infectious ileocecitis, Crohn's disease, intussusception, ovarian cysts, and encysted cerebrospinal fluid. One of the most common causes of acute abdominal pain in children is acute terminal ileitis (infectious ileocecitis) with mesenteric lymphadenitis. Ultrasound is the best tool to rapidly differentiate this disease from acute appendicitis, and prevent unnecessary laparotomy (Ref. 12). PMID:16201735

  14. Chronic intussusception associated with ileocecal lymphosarcoma.

    PubMed

    Kobayashi, A; Akiyama, H; Kawai, S; Obe, Y; Egami, K

    1975-10-01

    A 1011/12-year-old boy with chronic ileocolic intussusception associated with ileocecal lymphosarcoma was decribed. The patient had abdominal pain of 3 months' duration, vomiting, and a firm mass with smooth surface in the right lower abdomen. Barium enema showed intussusception at the distal part of the ascending colon, which was irreducible by hydrostatic pressure. Barium by mouth revealed markedly distended small intestines, which were displaced to the left abdomen. The tumor was inoperable, and the boy died. PMID:1242386

  15. Long-term follow-up after ileocaecal continent cutaneous urinary diversion (Mainz I pouch): A retrospective study of a monocentric experience

    PubMed Central

    Khalil, Fahd; Fellahi, Saad; Ouslim, Hicham; Mhanna, Tarik; El Houmaidi, Amine; Aynaou, Mohammed; Boteng, Paapa Dua; Barki, Ali; Nouini, Yassine

    2015-01-01

    Objective To assess the long-term follow-up after ileocaecal continent cutaneous reservoir (ICCR) and to review the late complications. Patients and methods In all, 756 patients underwent an ICCR in our department, with long-term follow-up data available in 50 patients. The inclusion criterion was ICCR regardless of the indication and the exclusion criteria were orthotopic neobladder or other continent urinary diversions not performed with the ileocaecum. Patients were followed to record primary outcomes and late complications. Complications were stratified according to the Clavien–Dindo classification. Results The mean patient age was 44 years and pelvic malignancies were the first indication for urinary diversion. The mean (range) follow-up was 19 (9–36) years. A stoma stenosis was the most frequent outlet-related complication requiring re-intervention, followed by ischaemic outlet degeneration, and stoma incontinence. Six renal units (RUs) developed obstruction at the anastomotic site and were managed by open surgery. Three RUs had to be removed due to deterioration. A dederivation was necessary in three patients (6%). Conclusion The ICCR is a safe and established technique when an orthotopic pouch is impossible. The long-term follow-up shows acceptable complication rates and satisfactory continence conditions. However, large population studies are necessary to confirm this observation. PMID:26609442

  16. Penile vibratory stimulation in the recovery of urinary continence and erectile function after nerve-sparing radical prostatectomy: a randomized, controlled trial

    PubMed Central

    Fode, Mikkel; Borre, Michael; Ohl, Dana A; Lichtbach, Jonas; Sønksen, Jens

    2014-01-01

    Objective To examine the effect of penile vibratory stimulation (PVS) in the preservation and restoration of erectile function and urinary continence in conjunction with nerve-sparing radical prostatectomy (RP). Patients and Methods The present study was conducted between July 2010 and March 2013 as a randomized prospective trial at two university hospitals. Eligible participants were continent men with an International Index of Erectile Function-5 (IIEF-5) score of at least 18, scheduled to undergo nerve-sparing RP. Patients were randomized to a PVS group or a control group. Patients in the PVS group were instructed in using a PVS device (FERTI CARE® vibrator). Stimulation was performed at the frenulum once daily by the patients in their own homes for at least 1 week before surgery. After catheter removal, daily PVS was re-initiated for a period of 6 weeks. Participants were evaluated at 3, 6 and 12 months after surgery with the IIEF-5 questionnaire and questions regarding urinary bother. Patients using up to one pad daily for security reasons only were considered continent. The study was registered at http://clinicaltrials.gov/ (NCT01067261). Results Data from 68 patients were available for analyses (30 patients randomized to PVS and 38 patients randomized to the control group). The IIEF-5 score was highest in the PVS group at all time points after surgery with a median score of 18 vs 7.5 in the control group at 12 months (P = 0.09), but the difference only reached borderline significance. At 12 months, 16/30 (53%) patients in the PVS group had reached an IIEF-5 score of at least 18, while this was the case for 12/38 (32%) patients in the control group (P = 0.07). There were no significant differences in the proportions of continent patients between groups at 3, 6 or 12 months. At 12 months 90% of the PVS patients were continent, while 94.7% of the control patients were continent (P = 0.46). Conclusion The present study did not document a significant effect of

  17. [The UrEpik study: a descriptive epidemiological approach to lower urinary tract symptoms, sexual disorders and urinary continence in four countries].

    PubMed

    Fourcade, R O

    2005-11-01

    UrEpik is a cross-sectional, epidemiological study undertaken in four cities (Auxerre, Birmingham, Nijmegen and Seoul) to determine the prevalence of lower urinary tract symptoms, urinary incontinence and erectile dysfunction in men aged from 40 to 80 years and their female partners, if applicable. Numerous evaluation questionnaires were collected by post, telephone or direct contact from 4876 men and 3657 women. The prevalence of lower urinary tract disorders was significantly different from one country to another, but increased constantly with age in particular in men with an I-PSS between 8 and 19 for whom it increased by approximately 10% per decade. Incontinence in men seems to be an important problem both in terms of discomfort score and wearing of protection and it increases with age. Analysis of erectile dysfunction (ED) gave different results depending on the method of investigation used. The SFI (sexual functional index) showed a positive correlation between ED and age, which was not found by direct questioning. The psychological impact of ED varied according to culture and age of the subject. PMID:16425733

  18. The mechanism of continence after posterior urethroplasty

    PubMed Central

    Bagga, Herman S.; Angermeier, Kenneth W.

    2015-01-01

    The standard of care after a pelvic fracture urethral injury is a repair via a one-stage anastomotic posterior urethroplasty using a step-wise perineal approach. The initial injury, immediate postoperative management, and surgical repair can all affect urinary continence in these patients. Proximal continence mechanisms, particularly the bladder neck, are particularly important in maintaining urinary continence in these patients. Patients with bladder neck dysfunction should be counselled about the greater risk of urinary incontinence. PMID:26019981

  19. A Rare Case of MALT Lymphoma Underlying Ileocecal Intussusception.

    PubMed

    Adams, Kathryn M; Roe, Nicole M

    2016-08-01

    Intussusception is an extremely rare diagnosis in adults, with an etiologic process identified in the majority of cases. The authors describe an unusual case of mucosa-associated lymphoid tissue (MALT) lymphoma as the underlying cause of ileocecal intussusception in an elderly woman. The patient presented with complaints of abdominal pain of variable intensity that had increased in severity over the past several months. A contrast-enhanced computed tomographic scan revealed evidence of ileocecal intussusception, and a subsequent exploratory laparotomy revealed high-grade bowel obstruction. Early recognition of intussusception is critical to appropriate management and resolution. PMID:27455107

  20. Malignant lymphoma in the ileocecal region causing intussusception.

    PubMed

    Matsushita, M; Hajiro, K; Kajiyama, T; Ohana, M; Konishi, Y; Kusumi, F; Matsubayashi, Y; Sawami, H; Narusawa, H; Takahashi, Y

    1994-04-01

    A 67-year-old female was admitted with diarrhea. Preoperatively, we diagnosed intussusception due to malignant lymphoma in the ileocecal region by image and colonoscopic examinations. We resected the right hemicolon for the tumor, which was located mainly in the cecum, causing intussusception. The stenotic terminal ileum free of the tumor was invaginated within the cecum with infiltrating tumor, thus showing the appearance of an anthill. The growth of the tumor corresponded with Wood's constrictive type, in which intussusception rarely occurs. PMID:8012510

  1. 21 CFR 876.5320 - Nonimplanted electrical continence device.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... vagina and used to stimulate the muscles of the pelvic floor to maintain urinary or fecal continence... nonimplanted electrical continence device and the powered vaginal muscle stimulator for therapeutic use (§...

  2. 21 CFR 876.5320 - Nonimplanted electrical continence device.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... vagina and used to stimulate the muscles of the pelvic floor to maintain urinary or fecal continence... nonimplanted electrical continence device and the powered vaginal muscle stimulator for therapeutic use (§...

  3. 21 CFR 876.5320 - Nonimplanted electrical continence device.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... vagina and used to stimulate the muscles of the pelvic floor to maintain urinary or fecal continence... nonimplanted electrical continence device and the powered vaginal muscle stimulator for therapeutic use (§...

  4. 21 CFR 876.5320 - Nonimplanted electrical continence device.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... vagina and used to stimulate the muscles of the pelvic floor to maintain urinary or fecal continence... nonimplanted electrical continence device and the powered vaginal muscle stimulator for therapeutic use (§...

  5. 21 CFR 876.5320 - Nonimplanted electrical continence device.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... vagina and used to stimulate the muscles of the pelvic floor to maintain urinary or fecal continence... nonimplanted electrical continence device and the powered vaginal muscle stimulator for therapeutic use (§...

  6. Successful laparoscopic treatment of ileo-cecal endometriosis producing bowel obstruction.

    PubMed

    Fujimoto, A; Osuga, Y; Tsutsumi, O; Fujii, T; Okagaki, R; Taketani, Y

    2001-08-01

    Bowel endometriosis manifesting with ileus is difficult to diagnose, often requiring laparotomy for diagnosis and treatment. We report here a case of ileo-cecal endometriosis causing bowel obstruction. A diagnosis of intestinal endometriosis with menstruation-associated bowel symptoms was made, and the patient was successfully treated by laparoscopic ileo-cecal resection. PMID:11721734

  7. Hybrid natural orifice transluminal endoscopic surgery for ileocecal resection

    PubMed Central

    Takayama, Satoru; Hara, Masayasu; Sato, Mikinori; Takeyama, Hiromitsu

    2012-01-01

    Although laparoscopic colectomy is commonly performed around the world, an operative wound formed during the surgery is large but not sufficient enough to convert for the majority of open surgery. Thus, a certain sized skin incision is required to remove the resected colon. Here we report the case of a pure laparoscopic ileocecal resection which involves transanal specimen extraction. We present a case characterized by a laterally spreading type of tumor of the cecum. We performed a pure laparoscopic ileocecal resection and the resected specimen was removed transanally using colonoscopy. Intracorporeal functional anastomosis was then performed using a flexible linear stapling device under supporting barbed suture traction. The patient was discharged without complications on postoperative day 4. Laparoscopic colectomy performed with minimal incision could essentially increase the usage of this surgical technique. Although our method is restricted to flat or small lesions, we think it is a feasible and realistic solution for minimization of operative invasion because it involves specimen extraction through a natural orifice. PMID:22408718

  8. Large ileocecal submucosal lipoma presenting as hematochezia, a case report and review of literature

    PubMed Central

    Chehade, Hiba Hassan El Hage; Zbibo, Riad Hassan; Nasreddine, Walid; Abtar, Houssam Khodor

    2015-01-01

    Introduction Colonic lipomas are rare subepithelial benign tumors affecting mainly middle-aged women. They are usually asymptomatic and, hence, are discovered incidentally on autopsy, surgery, or colonoscopy. There is a wide range of presentations like abdominal pain, bleeding per rectum, intussusception, etc. The latter picture constitutes the usual presentation of an ileocecal lipoma. Only few cases of ileocecal lipomas presenting as lower GI bleeding have been reported in the literature. Presentation of case We present a case of an adult female patient who was admitted to our institution complaining of hematochezia and right lower quadrant pain. She was found to have chronic anemia. She was investigated by CT scan of the abdomen & pelvis and by colonoscopy which showed a fungating, submucosal mass with ulcerated base near the ileocecal valve. She underwent a colonic resection. The pathology came out as a submucosal benign pedunculated ileocecal lipoma. Discussion Colonic lipomas represent 4% of benign lesions of the gastrointestinal tract. They are usually asymptomatic hence are often discovered incidentally on colonoscopy, surgery or autopsy. The definitive diagnosis is made by pathological evaluation. Colonic lipomas are usually treated if they are symptomatic or there is any suspicion of malignancy. The treatment modalities include endoscopic and surgical resection. Conclusion We, hereby, describe a case of benign ileocecal lipoma that presented with hematochezia which is an unusual presentation. Also, there is a great controversy regarding the treatment of colonic lipomas. In this article, we tried to answer several questions concerning the management of ileocecal lipomas. PMID:25770697

  9. Occurrence of jejunojejunal and ileocecal intussusceptions in a thoroughbred stallion

    PubMed Central

    Sasani, Farhang; Javanbakht, Javad; Alidadi, Naser; Khaligh, Sahar Ghaffari; Hosseini, Ehsan

    2013-01-01

    A 4-year-old, 600.4 kg stallion horse of German thoroughbred breed was presented at the Tehran University Veterinary Medicine Teaching Hospital, Iran, with a history of weakness of 2–3 days duration. The stallion died of unknown cause on the previous day. Abnormal findings during physical examination included an estimated dehydration of 3% to 5%, dark red oral mucous membranes, elevated heart and respiratory rates, stiffened feces, and absence of intestinal motility on auscultation. Postmortem examination indicated the presence of a jejunojejunal and ileocecal intussusceptions, 46 cm in length; a torsion of jejunum proximal to the intussusceptions was also noted. An ulcerative lesion, 6 cm in diameter, was found on the mucosa of duodenum. Large amounts of sand, coat hair, and hay mantling in bloody discharge were observed in a colonic impaction. It was an acute case that was evident by the involvement of intussusception and ulceration, indicating desquamation of the necrotic epithelial cells with edema and distinct infiltration of neutrophils. Histopathological examination confirmed that the ileum was the intussiscipiens to the jejunum that subsequently passed through into the caecum, and the mesentery probably tore as a result of the intussusception.

  10. Promoting continence in women following childbirth.

    PubMed

    Steen, Mary

    Continence in women during pregnancy and following childbirth is an important issue that needs to be managed appropriately. Urinary and bowel problems can have numerous negative physical and psychological consequences, and women may be too embarrassed to seek help. Healthcare professionals need to encourage and support women to identify any changes in their normal bowel and bladder habits. They also need to have knowledge of the anatomy and physiology of the urinary, reproductive and digestive systems to understand how continence may be affected during pregnancy and following childbirth. PMID:24003819

  11. Continence and Quality-of-Life Outcomes 6 Months Following an Intensive Pelvic-Floor Muscle Exercise Program for Female Stress Urinary Incontinence: A Randomized Trial Comparing Low- and High-Frequency Maintenance Exercise

    PubMed Central

    Borello-France, Diane F; Downey, Patricia A; Zyczynski, Halina M; Rause, Christine R

    2008-01-01

    Background and Objectives: Few studies have examined the effectiveness of pelvic-floor muscle (PFM) exercises to reduce female stress urinary incontinence (SUI) over the long term. This study: (1) evaluated continence and quality-of-life outcomes of women 6 months following formalized therapy and (2) determined whether low- and high-frequency maintenance exercise programs were equivalent in sustaining outcomes. Subjects and Methods: Thirty-six women with SUI who completed an intensive PFM exercise intervention trial were randomly assigned to perform a maintenance exercise program either 1 or 4 times per week. Urine leaks per week, volume of urine loss, quality of life (Incontinence Impact Questionnaire [IIQ] score), PFM strength (Brink score), and prevalence of urodynamic stress incontinence (USI) were measured at a 6-month follow-up for comparison with postintervention status. Parametric and nonparametric statistics were used to determine differences in outcome status over time and between exercise frequency groups. Results: Twenty-eight women provided follow-up data. Postintervention status was sustained at 6 months for all outcomes (mean [SD] urine leaks per week=1.2±2.1 versus 1.4±3.1; mean [SD] urine loss=0.2±0.5 g versus 0.2±0.8 g; mean [SD] IIQ score=17±20 versus 22±30; mean [SD] Brink score=11±1 versus 11±1; and prevalence of USI=48% versus 35%). Women assigned to perform exercises once or 4 times per week similarly sustained their postintervention status. Discussion and Conclusions: Benefits of an initial intensive intervention program for SUI were sustained over 6 months. However, only 15 of the 28 women provided documentation of their exercise adherence, limiting conclusions regarding the need for continued PFM exercise during follow-up intervals of ≤6 months. PMID:18820095

  12. Ileocecal Obstruction Due to B-cell Non-Hodgkin Lymphoma.

    PubMed

    Negrean, Vasile; Graur, Florin; Moiş, Emil; Al-Hajjar, Nadim

    2016-01-01

    We report a rare case of non-Hodgkin lymphoma presented as an ileocecal mass. The patient was a 77-year-old man with history of symptoms of partial bowel obstruction, intermittent right iliac fossa pain, loss of weight, vomiting and fatigue. Clinical signs included moderate abdominal tenderness with a palpable mass in the right iliac fossa at the physical examination. Colonoscopy revealed an intussusception of the right colon causing a complete stenosis. The patient developed complete bowel obstruction during hospitalization that required emergent surgical intervention. Intraoperatively an ileocecal mass was found measuring 10-12 cm in diameter, causing complete stenosis at its level and bowel dilatation proximally. Multiple nodules were found in the liver and the parietal peritoneum as well. An ileotransverso-anastomosis was performed and biopsies of the nodules were taken. Pathological evaluation revealed a diffuse large B cell non-Hodgkin'™s lymphoma of the ileocecum and the parietal peritoneum. PMID:26988544

  13. Effects of aging on the architecture of the ileocecal junction in rats

    PubMed Central

    de Brito, Maria Cícera; Chopard, Renato Paulo; Cury, Diego Pulzatto; Watanabe, Ii Sei; Mendes, Cristina Eusébio; Castelucci, Patricia

    2016-01-01

    AIM: To evaluate the structural organization of the elastic and collagen fibers in the region of the ileocecal transition in 30 young and old male Wistar rats. METHODS: Histology, immunohistochemistry (IHC), transmission electron microscopy and scanning electron microscopy were employed in this study. The results demonstrated that there was a demarcation of the ileocecal region between the ileum and the cecum in both groups. RESULTS: The connective tissue fibers had different distribution patterns in the two groups. IHC revealed the presence of nitric oxide synthase, enteric neurons and smooth muscle fibers in the ileocecal junctions (ICJs) of both groups. Compared to the young group, the elderly group exhibited an increase in collagen type I fibers, a decrease in collagen type III fibers, a decreased linear density of oxytalan elastic fibers, and a greater linear density of elaunin and mature elastic fibers. CONCLUSION: The results revealed changes in the patterns of distribution of collagen and elastic fibers that may lead to a possible decrease in ICJ functionality. PMID:27602243

  14. Urinary Incontinence

    MedlinePlus

    ... of this page please turn Javascript on. Urinary Incontinence What Is Urinary Incontinence? Urinary incontinence means a person leaks urine by ... about what you can do. Types of Urinary Incontinence There are different types of urinary incontinence. Stress ...

  15. Severe viral oesophagitis, pharyngitis, and stomatitis as antecedents of ileocecal Crohn's disease

    PubMed Central

    Waluga, Marek; Budzyńska, Agnieszka; Kajor, Maciej; Hartleb, Marek

    2015-01-01

    We present a 22-year-old male who developed a severe erosive oesophagitis extending to the pharynx and oral cavity without obvious risk factors. Endoscopic image suggested viral aetiology that could not be confirmed by routine serological diagnostics of infections with cytomegalovirus, Epstein-Barr virus, and Herpes simplex virus. The histopathological evaluation also gave no definite clues to the aetiology of the inflammation. Treatment with acyclovir was ineffective, but gancyclovir therapy caused spectacular clinical improvement and healing of erosions. Two months later the patient presented febrile diarrhoea that was a symptom of ileocecal Crohn's disease proven by endoscopy, enterography, and histopathology. It is the first report of severe viral oesophagitis preceding clinical manifestation of Crohn's disease. This observation warrants further study towards the viral aetiology of oral, pharyngeal, and oesophageal erosions, frequently associated with Crohn's disease. PMID:25960815

  16. A continent ileostomy device.

    PubMed Central

    Pemberton, J H; van Heerden, J A; Beart, R W; Kelly, K A; Phillips, S F; Taylor, B M

    1983-01-01

    The feasibility of achieving fecal continence by mechanical occlusion of an end-ileostomy is explored. Accordingly, progressive stomal occlusion with an indwelling occluding device was evaluated in four healthy patients with Brooke ileostomies. Pre-occlusion clinical and physiologic tests were done, including fat balance, intestinal transit time, ileal motility and absorption, ileal compliance, ileal radiography, and ileoscopy. Progressive stomal occlusion was then employed until periods of occlusion of 5 to 8 hours were achieved after 10 to 16 weeks. Pre-occlusion tests were then repeated. Patients mastered use of the occluding device rapidly, and the device achieved reliable stomal continence in each patient. Whereas ileal capacity was small initially, intermittent occlusion resulted in a large, capacious ileal reservoir. Fasting ileal motility was increased slightly by stomal occlusion, although intestinal transit during feeding was not altered. Also, ileal absorption of glucose, electrolytes, vitamin B-12, and fat were not changed, and ileal mucosa at the site of occlusion remained intact endoscopically. The authors concluded that chronic intermittent occlusion of a Brooke ileostomy with an indwelling stomal device achieved enteric continence without impairing intestinal function. Images Fig. 1. Fig. 4. PMID:6847281

  17. Urinary incontinence

    MedlinePlus

    Loss of bladder control; Uncontrollable urination; Urination - uncontrollable; Incontinence - urinary ... Causes of urinary incontinence include: Blockage in the urinary system Brain or nerve problems Dementia or other mental health problems that make ...

  18. Predictors of early continence following robot-assisted radical prostatectomy

    PubMed Central

    Lavigueur-Blouin, Hugo; Noriega, Alina Camacho; Valdivieso, Roger; Hueber, Pierre-Alain; Bienz, Marc; Alhathal, Naif; Latour, Mathieu; Trinh, Quoc-Dien; El-Hakim, Assaad; Zorn, Kevin C.

    2015-01-01

    Introduction: Functional outcomes after robot-assisted radical prostatectomy (RARP) greatly influence patient quality of life. Data regarding predictors of early continence, especially 1 month following RARP, are limited. Previous reports mainly address immediate or 3-month postoperative continence rates. We examine preoperative predictors of pad-free continence recovery at the first follow-up visit 1 month after RARP. Methods: Between January 2007 and January 2013, preoperative and follow-up data were prospectively collected for 327 RARP patients operated on by 2 fellowship-trained surgeons (AEH and KCZ). Patient and operative characteristics included age, body mass index (BMI), staging, preoperative prostate-specific antigen (PSA), prostate weight, International Prostate Symptom Score (IPSS), Sexual Health Inventory for Men (SHIM) score and type of nerve-sparing performed. Continence was defined by 0-pad usage at 1 month follow-up. Univariate and multivariate logistic regression models were used to assess for predictors of early continence. Results: Overall, 44% of patients were pad-free 1 month post-RARP. In multivariate regression analysis, age (odds ratio [OR] 0.946, confidence interval [CI] 95%: 0.91, 0.98) and IPSS (OR: 0.953, CI 95%: 0.92, 0.99) were independent predictors of urinary continence 1 month following RARP. Other variables (BMI, staging, preoperative PSA, SHIM score, prostate weight and type of nerve-sparing) were not statistically significant predictors of early continence. Limitations of this study include missing data for comorbidities, patient use of pelvic floor exercises and patient maximal activity. Moreover, patient-reported continence using a 0-pad usage definition represents a semiquantitative and subjective measurement. Conclusion: In a broad population of patients who underwent RARP at our institution, 44% of patients were pad-free at 1 month. Age and IPSS were independent predictors of early continence after surgery. Men of advanced

  19. Microbiomes of Unreactive and Pathologically Altered Ileocecal Lymph Nodes of Slaughter Pigs

    PubMed Central

    Mann, Evelyne; Dzieciol, Monika; Metzler-Zebeli, Barbara U.; Wagner, Martin

    2014-01-01

    Microbe-laden dendritic cells are shifted to ileocecal lymph nodes (ICLNs), where microbes are concentrated and an adequate immune response is triggered. Hence, ICLNs are at a crucial position in immune anatomy and control processes of the local immune system. Pathological alterations in ICLNs, such as reactive hyperplasia, lymphadenitis purulenta, or granulomatosa, can harbor a multitude of pathogens and commensals, posing a potential zoonotic risk in animal production. The aim of this study was to characterize the microbial diversity of unreactive ICLNs of slaughter pigs and to investigate community shifts in reactive ICLNs altered by enlargement, purulence, or granulomatous formations. Pyrosequencing of 16S rRNA gene amplicons from 32 ICLNs yielded 175,313 sequences, clustering into 650 operational taxonomic units (OTUs). OTUs were assigned to 239 genera and 11 phyla. Besides a highly diverse bacterial community in ICLNs, we observed significant shifts in pathologically altered ICLNs. The relative abundances of Cloacibacterium- and Novosphingobium-associated OTUs and the genus Faecalibacterium were significantly higher in unreactive ICLNs than in pathologically altered ICLNs. Enlarged ICLNs harbored significantly more Lactobacillus- and Clostridium-associated sequences. Relative abundances of Mycoplasma, Bacteroides, Veillonella, and Variovorax OTUs were significantly increased in granulomatous ICLNs, whereas abundances of Pseudomonas, Escherichia, and Acinetobacter OTUs were significantly increased in purulent ICLNs (P < 0.05). Correlation-based networks revealed interactions among OTUs in all ICLN groups, and discriminant analyses depicted discrimination in response to pathological alterations. This study is the first community-based survey in ICLNs of livestock animals and will provide a basis to broaden the knowledge of microbe-host interactions in pigs. PMID:24141125

  20. Transcriptional Profiling of Ileocecal Valve of Holstein Dairy Cows Infected with Mycobacterium avium subsp. Paratuberculosis

    PubMed Central

    Hempel, Randy J.; Bannantine, John P.

    2016-01-01

    Johne’s disease is a chronic infection of the small intestine caused by Mycobacterium avium subspecies paratuberculosis (MAP), an intracellular bacterium. The events of pathogen survival within the host cell(s), chronic inflammation and the progression from asymptomatic subclinical stage to an advanced clinical stage of infection, are poorly understood. This study examines gene expression in the ileocecal valve (ICV) of Holstein dairy cows at different stages of MAP infection. The ICV is known to be a primary site of MAP colonization and provides an ideal location to identify genes that are relevant to the progression of this disease. RNA was prepared from ICV tissues and RNA-Seq was used to compare gene transcription between clinical, subclinical, and uninfected control animals. Interpretation of the gene expression data was performed using pathway analysis and gene ontology categories containing multiple differentially expressed genes. Results demonstrated that many of the pathways that had strong differential gene expression between uninfected control and clinical cows were related to the immune system, such as the T- and B-cell receptor signaling, apoptosis, NOD-like receptor signaling, and leukocyte transendothelial migration pathways. In contrast, the comparison of gene transcription between control and subclinical cows identified pathways that were primarily involved in metabolism. The results from the comparison between clinical and subclinical animals indicate recruitment of neutrophils, up regulation of lysosomal peptidases, increase in immune cell transendothelial migration, and modifications of the extracelluar matrix. This study provides important insight into how cattle respond to a natural MAP infection at the gene transcription level within a key target tissue for infection. PMID:27093613

  1. Anatomic basis for the continence-preserving radical retropubic prostatectomy.

    PubMed

    Steiner, M S

    2000-02-01

    The technique of continence-preserving anatomic radical retropubic prostatectomy focuses on the preservation of the following anatomic components of the external striated urethral sphincteric complex: (1) the entire circumference of the rhabdosphincter musculature, (2) the periurethral fascial investments (the pubourethral ligaments anterolaterally and median fibrous raphe posteriorly), and (3) the innervation of both the rhabdosphincter by way of the intrapelvic branch of the pudendal nerve (somatic) and the mucosal and smooth muscle components by way of the urethral branch of the inferior hypogastric plexus (autonomic). The clinical impact of preserving the external striated urethral sphincter and its innervation by performing a continence preserving anatomic retropubic prostatectomy is a shorter time to achieve urinary continence. PMID:10719925

  2. Epithelial PIK3R1 (p85) and TP53 Regulate Survivin Expression during Adaptation to Ileocecal Resection.

    PubMed

    Cohran, Valeria; Managlia, Elizabeth; Bradford, Emily M; Goretsky, Tatiana; Li, Ting; Katzman, Rebecca B; Cheresh, Paul; Brown, Jeffrey B; Hawkins, Jennifer; Liu, Shirley X L; De Plaen, Isabelle G; Weitkamp, Jörn-Hendrik; Helmrath, Michael; Zhang, Zheng; Barrett, Terrence A

    2016-07-01

    Intestinal adaptation to small-bowel resection (SBR) after necrotizing enterocolitis expands absorptive surface areas and promotes enteral autonomy. Survivin increases proliferation and blunts apoptosis. The current study examines survivin in intestinal epithelial cells after ileocecal resection. Wild-type and epithelial Pik3r1 (p85α)-deficient mice underwent sham surgery or 30% resection. RNA and protein were isolated from small bowel to determine levels of β-catenin target gene expression, activated caspase-3, survivin, p85α, and Trp53. Healthy and post-resection human infant small-bowel sections were analyzed for survivin, Ki-67, and TP53 by immunohistochemistry. Five days after ileocecal resection, epithelial levels of survivin increased relative to sham-operated on mice, which correlated with reduced cleaved caspase-3, p85α, and Trp53. At baseline, p85α-deficient intestinal epithelial cells had less Trp53 and more survivin, and relative responses to resection were blunted compared with wild-type. In infant small bowel, survivin in transit amplifying cells increased 71% after SBR. Resection increased proliferation and decreased numbers of TP53-positive epithelial cells. Data suggest that ileocecal resection reduces p85α, which lowers TP53 activation and releases survivin promoter repression. The subsequent increase in survivin among transit amplifying cells promotes epithelial cell proliferation and lengthens crypts. These findings suggest that SBR reduces p85α and TP53, which increases survivin and intestinal epithelial cell expansion during therapeutic adaptation in patients with short bowel syndrome. PMID:27157990

  3. Urinary Incontinence

    MedlinePlus

    ... you risk getting rashes, sores, skin infections and urinary tract infections. Also, you may find yourself avoiding friends and ... elderly and may be a sign of a urinary tract infection or an overactive bladder. Overflow incontinence This type ...

  4. Urinary Dysfunction

    MedlinePlus

    ... PCF Spotlight Glossary African American Men Living with Prostate Cancer Urinary Dysfunction Side Effects Urinary Dysfunction Bowel Dysfunction ... dysfunction is normal following initial therapy for localized prostate cancer. But it’s important to realize that not all ...

  5. Urinary catheters

    MedlinePlus

    ... that you use a catheter if you have: Urinary incontinence (leaking urine or being unable to control when ... Surgery Bladder Diseases Spinal Cord Injuries Urethral Disorders Urinary Incontinence Urine and Urination Browse the Encyclopedia A.D. ...

  6. Continent cutaneous diversion and external genitalia reconstruction in a child with severe variety urogenital sinus and ambiguous genitalia.

    PubMed

    Khemchandani, Sajni I

    2015-01-01

    The diagnosis and management of a child with ambiguous genitalia and severe variety of urogenital sinus with a high vesico-vaginal confluence is challenging. This 4-year-old female child had solitary right kidney with ectopic ureter opening in high variety of urogenital sinus with hypo-plastic urinary bladder and incontinence. We describe genitourinary reconstruction with complete functional rehabilitation in this child. This complex problem was managed with continent urinary diversion with Penn pouch and refashioning of external genitalia, rendering continence and near normal female external genitalia. The child and parents are happy with continence and aesthetically normal external genitalia. PMID:25829673

  7. Continents and Earth's rotational stability

    NASA Astrophysics Data System (ADS)

    Rose, I.; Buffett, B. A.

    2014-12-01

    Continents strongly constrain the planform of the mantle convection/plate tectonic system. They impose long wavelength structure on surface velocities and tend to collect subduction zones around their margins . Additionally, they may affect the ability of the underlying mantle to effectively cool, which would create persistent temperature gradients between subcontinental and suboceanic mantle. These effects will change the moment of inertia of the planet and may control its rotational dynamics. Configurations of the continents have been implicated for both Earth's apparent Cenozoic rotational stability as well as its potential for large scale true polar wander deeper in its past. Here we present investigations into how continents can affect Earth's long term rotational stability. We have developed a version of the mantle convection code Aspect with a free outer surface, allowing for isostatically compensated continents and dynamic topography due to plumes and slabs. This allows us to self-consistently calculate moment of inertia anomalies in mantle convection models with surface continents and lateral viscosity variations. We explore different surface fractions of continental material as well as different mantle viscosity structures to identify when continents have a controlling influence. Finally, we discuss implications for Earth history, during which both continental mass and mantle viscosity may have changed significantly.

  8. Bladder agenesis and incomplete kidney duplication: Ileal reservoir with continent diversion as definitive treatment

    PubMed Central

    Pacheco-Mendoza, Byron Alexis; González-Ledón, Fernando J.; Díaz-Pardo, Mario; Soto-Blanquel, Juan L.; Castelán-Martínez, Osvaldo Daniel

    2015-01-01

    Bladder agenesis is an extremely rare entity. A 12-year-old female patient presented with urinary incontinence, recurrent urinary tract infections, visible vaginal introitus and urethra, and two holes at the vulvar vestibule. An investigation revealed bladder agenesis. Surgery confirmed the absence of bladder, and ileal reservoir in omega (Ω) was performed with continent diversion. At the 30-month follow-up, there was no complication in clean intermittent catheterization. PMID:25844102

  9. Mountain building processes during continent continent collision in the Uralides

    NASA Astrophysics Data System (ADS)

    Brown, D.; Juhlin, C.; Ayala, C.; Tryggvason, A.; Bea, F.; Alvarez-Marron, J.; Carbonell, R.; Seward, D.; Glasmacher, U.; Puchkov, V.; Perez-Estaun, A.

    2008-08-01

    Since the early 1990's the Paleozoic Uralide Orogen of Russia has been the target of a significant research initiative as part of EUROPROBE and GEODE, both European Science Foundation programmes. One of the main objectives of these research programmes was the determination of the tectonic processes that went into the formation of the orogen. In this review paper we focus on the Late Paleozoic continent-continent collision that took place between Laurussia and Kazakhstania. Research in the Uralides was concentrated around two deep seismic profiles crossing the orogen. These were accompanied by geological, geophysical, geochronological, geochemical, and low-temperature thermochronological studies. The seismic profiles demonstrate that the Uralides has an overall bivergent structural architecture, but with significantly different reflectivity characteristics from one tectonic zone to another. The integration of other types of data sets with the seismic data allows us to interpret what tectonic processes where responsible for the formation of the structural architecture, and when they were active. On the basis of these data, we suggest that the changes in the crustal-scale structural architecture indicate that there was significant partitioning of tectonothermal conditions and deformation from zone to zone across major fault systems, and between the lower and upper crust. Also, a number of the structural features revealed in the bivergent architecture of the orogen formed either in the Neoproterozoic or in the Paleozoic, prior to continent-continent collision. From the end of continent-continent collision to the present, low-temperature thermochronology suggests that the evolution of the Uralides has been dominated by erosion and slow exhumation. Despite some evidence for more recent topographic uplift, it has so far proven difficult to quantify it.

  10. Extended Diaper Wearing: Effects on Continence in and out of the Diaper

    ERIC Educational Resources Information Center

    Tarbox, Rachel S. F.; Williams, W. Larry; Friman, Patrick C.

    2004-01-01

    Diaper use is widespread and possibly even increasing across diverse populations in the United States, ranging from infants to very old adults. We found no reports of an experimental analysis of the effect of wearing diapers on the frequency of urinary accidents and the attainment of continence skills (e.g., urinating in the toilet). In this…

  11. Urinary Diversion

    MedlinePlus

    ... M-F For More Information Society of Urologic Nurses and Associates United Ostomy Associations of America, Inc. Urology Care Foundation Wound, Ostomy and Continence Nurses Society MedlinePlus ​ Kidney and Urologic Disease Organizations Many ...

  12. The Current Role of the Artificial Urinary Sphincter in Male and Female Urinary Incontinence

    PubMed Central

    Islah, MAR; Cho, Sung Yong

    2013-01-01

    The evolution of the artificial urinary sphincter has affected the current surgical options for urinary incontinence. With its unique features, the artificial urinary sphincter (AUS) has been an attractive option for the treatment of urinary incontinence regardless of gender. The current paper discusses the indications, contraindications, types of devices, surgical approaches, outcomes, and complications of the AUS in the treatment of both male and female urinary incontinence. A PubMed review of the available literature was performed and articles reporting implantation of artificial urinary sphincters for urinary incontinence in both male and female patients were evaluated. There was a comparable satisfactory continence rate after the implantation of an AUS (59~97% in males vs. 60~92% in females). In comparison, there were some differences in the indications, contraindications, surgical approaches, outcomes, and complications of the AUS implanted for urinary incontinence in male and female patients. AUS implantation is a safe and effective surgical option for the treatment of urinary incontinence of various etiologies. Continuous evolution of the device has made it an attractive option for the treatment of both male and female urinary incontinence. PMID:23658862

  13. Urinary Incontinence

    MedlinePlus

    Urinary incontinence (UI) is loss of bladder control. Symptoms can range from mild leaking to uncontrollable wetting. It can happen to anyone, but it becomes more common with age. Women experience ...

  14. Traveling the Continents and Cruising the Oceans.

    ERIC Educational Resources Information Center

    Slack, Glenda

    Elementary school students learn about the continents and the oceans by completing a variety of activities, games, and puzzles. Students learn to spell the names of the oceans and continents; recognize the locations, sizes, and shapes of the continents; and use directions on maps by completing a pretest, word searches, mazes, crossword puzzles,…

  15. Urinary tuberculosis

    PubMed Central

    Riddle, P. R.

    1971-01-01

    The present incidence, clinical features and classification of urinary tuberculosis are discussed. Chemotherapy is the mainstay of treatment. The indications for surgical intervention are reviewed and procedures briefly described. ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 5 PMID:5169185

  16. Urinary Incontinence

    MedlinePlus

    ... Adults Making Your Wishes Known Home & Community Home › Aging & Health A to Z › Urinary Incontinence Font size A A A Print Share Glossary Basic Facts & Information Causes & Symptoms Diagnosis & Tests Care & Treatment Lifestyle & Management Other Resources Caregiving How ...

  17. Urinary Retention

    MedlinePlus

    ... the bladder does not empty completely. A health care provider performs this test during an office visit. The patient often receives ... urodynamic tests to diagnose urinary retention. The health care provider will perform these tests during an office visit. For tests that use ...

  18. Improving continence services for older people from the service-providers’ perspective: a qualitative interview study

    PubMed Central

    Orrell, Alison; McKee, Kevin; Dahlberg, Lena; Gilhooly, Mary; Parker, Stuart

    2013-01-01

    Objective To examine in depth the views and experiences of continence service leads in England on key service and continence management characteristics in order to identify and to improve our understanding of barriers to a good-quality service and potential facilitators to develop and to improve services for older people with urinary incontinence (UI). Design Qualitative semistructured interviews using a purposive sample recruited across 16 continence services. Setting 3 acute and 13 primary care National Health Service Trusts in England. Participants 16 continence service leads in England actively treating and managing older people with UI. Results In terms of barriers to a good-quality service, participants highlighted a failure on the part of commissioners, managers and other health professionals in recognising the problem of UI and in acknowledging the importance of continence for older people and prevalent negative attitudes towards continence and older people. Patient assessment and continence promotion regardless of age, rather than pad provision, were identified as important steps for a good-quality service for older people with UI. More rapid and appropriate patient referral pathways, investment in service capacity, for example, more trained staff and strengthened interservice collaborations and a higher profile within medical and nurse training were specified as being important facilitators for delivering an equitable and high-quality continence service. There is a need, however, to consider the accounts given by our participants as perhaps serving the interests of their professional group within the context of interprofessional work. Conclusions Our data point to important barriers and facilitators of a good-quality service for older people with UI, from the perspective of continence service leads. Further research should address the views of other stakeholders, and explore options for the empirical evaluation of the effectiveness of identified service

  19. [Follow-up after surgical replacement of the urinary bladder (urinary diversion)].

    PubMed

    Ubrig, B; Kories, C; Roth, S

    2013-01-01

    Surgical replacement of the urinary bladder is usually necessary after radical cystectomy for muscle invasive bladder cancer. Besides uro-oncological follow-up (local, urethral, and systemic recurrence; tumor in the upper tract) functional follow-up of the urinary diversion is indicated. Guidelines are still scarce. Long contact time and large surface area in continent pouches made from long intestinal segments lead to absorption of contents of urine and thus to acidosis and imbalances in serum electrolytes. Compensation depends on renal function. Exclusion of long ileal segments out of the intestinal passage may lead to malabsorption of Vitamin B12 and bile acids. 30 % and more of long-term survivors with continent pouches take Vitamin B12 and sodium bicarbonate. Special attention has to be paid to obstruction of the upper urinary tract, total renal function and to secondary malignancy in the bladder substitute. For the latter, sigma-rectum pouches, augmentation cystoplasties and continent pouches with incorporation of colonic segments are at special risk. Functional follow-up affords good understanding of the specific complications of the different types of urinary diversions. PMID:23386377

  20. Santosh PGI pouch: A new innovation in urinary diversion

    PubMed Central

    Devana, Sudheer Kumar; Sharma, Aditya Prakash; Singh, Shrawan Kumar

    2015-01-01

    Introduction To know the feasibility and outcome of the Santosh PGI pouch as a new innovative technique of continent cutaneous diversion (CCD) following cystectomy. Material and methods Twelve patients (eleven with carcinoma of the bladder and one with an exstrophy of the bladder) underwent CCD using the Santosh PGI pouch after cystectomy. A 50-cm segment of terminal ileum was isolated 15-20 cm proximal to the ileocecal junction. The ileal segment was folded into the form of an ‘S’ configuration. On the antimesenteric border three longitudinal incisions were performed of about 7 cm in length. The terminal 8 cm portion of the distal part of the pouch was used for creating the intussuscepted nipple valve. Demucosalization of the interior of the nipple, fixing the nipple valve with the serosa of the pouch wall and wrapping of the catheterizable channel with a pouch wall for providing continence was done. The uretero-pouch anastomosis was done using the serosal lined tunnel technique. The catheterizable channel was brought out through the right rectus muscle. Results Median follow-up of the patients was 13.5 months. No significant complications were noted in the pouch reconstruction. Duration of the pouch reconstruction was around 75-110 min. Postoperatively, one patient had a UTI and another had paralytic ileus on the follow-up. All patients were doing regular CIC with acceptable continence of up to 400 ml. No ureteroileal anastomotic stricture or difficulty in catheterizing the pouch was seen. Conclusions The Santosh PGI pouch, which is a type of CCD, is technically feasible, easy to reconstruct with acceptable continence and offers minimal morbidity. PMID:26251752

  1. Artificial urinary sphincters for male stress urinary incontinence: current perspectives

    PubMed Central

    Cordon, Billy H; Singla, Nirmish; Singla, Ajay K

    2016-01-01

    The artificial urinary sphincter (AUS), which has evolved over many years, has become a safe and reliable treatment for stress urinary incontinence and is currently the gold standard. After 4 decades of existence, there is substantial experience with the AUS. Today AUS is most commonly placed for postprostatectomy stress urinary incontinence. Only a small proportion of urologists routinely place AUS. In a survey in 2005, only 4% of urologists were considered high-volume AUS implanters, performing >20 per year. Globally, ~11,500 AUSs are placed annually. Over 400 articles have been published regarding the outcomes of AUS, with a wide variance in success rates ranging from 61% to 100%. Generally speaking, the AUS has good long-term outcomes, with social continence rates of ~79% and high patient satisfaction usually between 80% and 90%. Despite good outcomes, a substantial proportion of patients, generally ~25%, will require revision surgery, with the rate of revision increasing with time. Complications requiring revision include infection, urethral atrophy, erosion, and mechanical failure. Most infections are gram-positive skin flora. Urethral atrophy and erosion lie on a spectrum resulting from the same problem, constant urethral compression. However, these two complications are managed differently. Mechanical failure is usually a late complication occurring on average later than infection, atrophy, or erosions. Various techniques may be used during revisions, including cuff relocation, downsizing, transcorporal cuff placement, or tandem cuff placement. Patient satisfaction does not appear to be affected by the need for revision as long as continence is restored. Additionally, AUS following prior sling surgery has comparable outcomes to primary AUS placement. Several new inventions are on the horizon, although none have been approved for use in the US at this point. PMID:27445509

  2. Stress urinary incontinence

    MedlinePlus

    ... you urinate. Urinalysis to check for urinary tract infection. Urinary stress test: You stand with a full bladder ... out of the bed or chair Unpleasant odors Urinary tract infections Vaginal discharge The condition may get in the ...

  3. Urinary incontinence - injectable implant

    MedlinePlus

    ... repair; ISD repair; Injectable bulking agents for stress urinary incontinence ... Blaivas JM, Gormley EA, et al. Female Stress Urinary Incontinence Update Panel of the American Urological Association Education ...

  4. Continence outcomes following robotic radical prostatectomy: Our experience from 150 consecutive patients

    PubMed Central

    Gupta, Narmada P.; Yadav, Rajiv; Akpo, Emmanuel E.

    2014-01-01

    Introduction: Urinary continence is an important outcome parameter after robot assisted radical prostatectomy (RARP). We evaluated the continence outcomes following RARP using a double-layered urethrovesical reconstruction. Materials and Methods: One hundred fifty consecutive patients undergoing RARP and double-layered urethrovesical reconstruction were prospectively studied for preoperative, intraoperative and post operative parameters. Key points followed during surgery were: Minimal dissection of sphincteric complex, preservation of puboprostatic ligament, selective ligation of deep venous complex and both posterior and anterior reconstruction using the Von Velthoven stitch. Intraoperative bladder fill test was done at the end of anastomosis to rule out urine leak. Check cystogram was done prior to catheter removal in the outpatient department. Patients were subsequently followed at regular intervals regarding the status of urinary continence. All patients irrespective of adjuvant therapy were included in the analysis. Results: The mean age was 64 years (standard deviation ± 6.88), and mean serum PSA was 20.2 ng/ml. The mean BMI was 25.6 (SD: ±3.84). The mean prostate weight was 44.09 gm (range 18-103 gm, SD: ±15.59). Median days to catheter removal after surgery was 7 (range 4-14 days) days. Cystographically determined urinary leaks were seen in two patients. Urine leak was managed by delaying catheter removal for 1 week. Minimum 6 month follow up was available in 126 patients. ‘No pad’ status at 1 week, 1 month, 3 months, 6 months and 1 year was 15.1%, 54.9%, 78%, 90.5% and 94.1%, respectively. Conclusion: Excellent continence outcomes are observed in patients undergoing double-layered urethrovesical reconstruction. PMID:25378816

  5. Urinary Tract Infection (UTI)

    MedlinePlus

    ... Our ePublications > Urinary tract infection fact sheet ePublications Urinary tract infection fact sheet Print this fact sheet Urinary tract ... a doctor find out if I have a urinary tract infection (UTI)? To find out if you have a ...

  6. [Continent cecal-colonic reservoir. Surgical technique].

    PubMed

    Del Boca, C; Ferrari, C; Zanoni, V; Dieci, G; Grignani, G C; Musci, R

    1990-09-30

    The Authors discuss a recent case report treated with radial cystectomy associated with a secondary urinary derivation using the caecum-colon reservoir. After having reviewed the various surgical procedures involving the urinary derivations, the Authors describe the technique used by them paying particular attention to the positive aspects of having a low filling pressure reservoir controlled by a valid sphincter ileum-caecum valve. Considering the good postoperative result with this method, the Authors regard this procedure as an alternative to other urinary derivation techniques when carried out with correct indications. PMID:2287469

  7. Laparoscopic Mitrofanoff continent catheterisable stoma in children with spina bifida

    PubMed Central

    Reddy, Mallikarjun N.; Nerli, Rajendra B.; Patil, Ranjeet A.; Jali, Sujata M.

    2015-01-01

    Background: In 1980, Mitrofanoff described the creation of an appendicovesicostomy for continent urinary diversion. This procedure greatly facilitates clean intermittent catheterisation in patients with neurogenic bladder. The purpose of our study was to determine the clinical efficacy of the laparoscopic Mitrofanoff catheterisable stoma for children and adolescents with spina bifida. Materials and Methods: Review of hospital records revealed that 11 children with spina bifida underwent a laparoscopic Mitrofanoff procedure with at least 1-year of follow-up. A four-port transperitoneal laparoscopic approach was used to create a Mitrofanoff appendicovesicostomy. The child was followed-up in the urology clinic at 6 weeks, 3 months, 6 months, 1-year, and then semiannually after that. Questionnaires were administered to determine, from the children's perspective, the level of satisfaction with catheterisation and the psychosocial implications of catheterisation before and after the creation of the Mitrofanoff continent catheterisable stoma. Results: Of the 11 children, six were female, and five were male. The mean age at presentation to Paediatric urological services was 11 ± 3.22 years. Overall the mean operative time was 144.09 ± 17.00 min. Mean estimated blood loss was 37.36 ± 11.44 cc. None of the cases needed conversion to open. Patient satisfaction with their catheterisation was measured at 2.18 ± 0.98 preoperatively, Post-operatively, this improved to 4.27 ± 0.46. Statistical analysis using paired t-test showed significance with P < 001. Conclusions: Laparoscopic Mitrofanoff catheterisable stoma is feasible in children with spina bifida and is associated with reasonable outcome with early recovery, resumption of normal activities and excellent cosmesis. PMID:26168751

  8. Impact of Posterior Urethral Plate Repair on Continence Following Robot-Assisted Laparoscopic Radical Prostatectomy

    PubMed Central

    Kim, Isaac Yi; Hwang, Eun A; Mmeje, Chinedu; Ercolani, Matthew

    2010-01-01

    Purpose The objective of this study is to evaluate the continence rate following reconstruction of the posterior urethral plate in robot-assisted laparoscopic radical prostatectomy (RLRP). Materials and Methods A retrospective analysis of 50 men with clinically localized prostate cancer who underwent RLRP was carried out. Twenty-five patients underwent RLRP using the reconstruction of the posterior aspect of the rhabdosphincter (Rocco repair). Results of 25 consecutive patients who underwent RLRP prior to the implementation of the Rocco repair were used as the control. Continence was assessed at 7, 30, 90, and 180 days following foley catheter removal using the EPIC questionnaire as well as a follow-up interview with the surgeon. Results There was no statistically significant difference between the two groups in any of the patient demographics. At 7 days, the Rocco experimental group had a continence rate of 19% vs. 38.1% in the non-Rocco control group (p = 0.306). At 30 days, the continence rate in the Rocco group was 76.2% vs. 71.4% in the non-Rocco group (p = 1). At 90 days, the values were 88% vs. 80% (p = 0.718), respectively. At 180 days, the pad-free rate was 96% in both groups. Conclusion Rocco repair offers no significant advantage in the time to recovery of continence following RLRP when continence is defined as the use of zero pads per day. On the other hand, Rocco repair was associated with increased incidence of urinary retention requiring prolonged foley catheter placement. PMID:20376897

  9. Malone Antegrade Continence Enema in Patients with Perineal Colostomy After Rectal Resection.

    PubMed

    Wang, Jin-Hai; Xu, Jia-He; Ye, Feng; Xu, Xiang-Ming; Lin, Jian-Jiang; Chen, Wen-Bin

    2015-12-01

    The objective of this study was to evaluate the value of antegrade continence enema (Malone operation) in abdominoperineal resection (Miles' operation). Between January 2008 and May 2009, five cancer patients (two men and three women) underwent abdominoperineal resection and digestive reconstruction by perineal colostomy and Malone antegrade continence enema in our institution. Their functional results and quality of life were recorded. None of the patients died, but two had wound infections and one experienced urinary retention. Patients performed antegrade enema every 24 h with 2,000 mL of normal saline by themselves. The duration of the enema lasted for an average of approximately 35 min, and fecal contamination was not detected at 24 h. Patient satisfaction was determined to be 88 %. Malone antegrade continence enema associated with abdominoperineal resection and perineal colostomy provided acceptable continence. It preserved the body image of the patients and resulted in a satisfactory quality of life. It is a potential alternative for patients who are not willing to have a permanent colostomy. PMID:26730081

  10. Understanding Barriers to Continence Care in Institutions

    ERIC Educational Resources Information Center

    Tannenbaum, Cara; Labrecque, Danielle; Lepage, Christiane

    2005-01-01

    This work seeks to identify factors that facilitate or diminish care-providers' propensity to improve continence care in long-term care (LTC) settings. We conducted a cross-sectional qualitative study using focus group methodology in four long-term care institutions in Montreal, QC. Forty-two nurses, nursing assistants, and orderlies caring for…

  11. African Universities Tackle the Continent's Agricultural Crisis

    ERIC Educational Resources Information Center

    Lindow, Megan

    2009-01-01

    Pests, population growth, and depleted soil have wreaked havoc on agriculture in Africa, so universities across the continent are rethinking how they teach the topic. Some African universities have been building their own networks and pooling their limited resources to train more agricultural scientists and improve their responsiveness to the…

  12. Urinary incontinence - retropubic suspension

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/007374.htm Urinary incontinence - retropubic suspension To use the sharing features on ... may be because other problems are causing your urinary incontinence. Over time, some or all of the leakage ...

  13. [Infection and urinary lithiasis].

    PubMed

    Bruyere, F; Traxer, O; Saussine, C; Lechevallier, E

    2008-12-01

    Urinary infection is a risk factor for lithiasis. Urinary tract infection is a factor of gravity of urinary stone. The stone can exist before the infection which colonizes the stone, infected stone. The infection can be the cause of the stone, infectious stone (struvite stone). Infectious stones can be secondary to a non urinary infectious agent, oxalobacter formigenes (OF) and nanobacteria. The first-line treatment of struvite stone is percutaneous surgery. Perioperative antibiotics, renal urines and stone cultures are obligatory. PMID:19033073

  14. Male urinary incontinence and the urinary sheath.

    PubMed

    Smart, Clare

    This article addresses the assessment and management of male incontinence with a specific focus on the use of the male external catheter (MEC) or urinary sheath. Education and expertise when dealing with a man with urinary incontinence, as well as a tactful and sensitive attitude towards this embarrassing problem, are essential for a successful outcome. The urinary sheath is often perceived by nurses and patients as a difficult product to master and is prone to failure owing to incorrect fitting and management. With correct usage it can make a great difference to a patient's quality of life and avoid problems often associated with urinary catheters and pads such as urinary infection and skin excoriation. Detailed assessment of the patient as well as his suitability for the MEC is essential for a successful outcome. PMID:24820510

  15. [Urinary incontinence in castrated bitches. 2. Diagnosis and treatment].

    PubMed

    Arnold, S

    1997-01-01

    Urinary incontinence due to spaying is caused by a sphincter incompetence of the urethra. In practice the diagnosis is established by ruling out other causes of incontinence such as neurological disease, bacterial cystitis, urinary tract malformation, iatrogenic ureterovaginal fistula and neoplasia of the urinary tract. An accurate diagnosis of urethral sphincter incompetence is made by urethral pressure profilometry. A urethral closure pressure of 7.4 cm H2O allowed the differentiation of bitches with urinary incontinence, due to spaying, from healthy control dogs with a diagnostic accuracy of 91%. For therapy alpha-adrenergic drugs (Ephedrine or Phenylpropanolamine) are recommended, which result in continence in 74% and improvement in 24% of incontinent patients. In the absence of response estrogens may be used. If the medical therapy fails to achieve urinary continence, the endoscopic injection of collagen into the submucosa of the proximal urethra can be performed. This is a simple and minimally invasive procedure. It rarely leads to complications and may be repeated when necessary. The method is successful in 75% of cases. PMID:9281063

  16. Global anisotropy and the thickness of continents.

    PubMed

    Gung, Yuancheng; Panning, Mark; Romanowicz, Barbara

    2003-04-17

    For decades there has been a vigorous debate about the depth extent of continental roots. The analysis of heat-flow, mantle-xenolith and electrical-conductivity data all indicate that the coherent, conductive part of continental roots (the 'tectosphere') is at most 200-250 km thick. Some global seismic tomographic models agree with this estimate, but others suggest that a much thicker zone of high velocities lies beneath continental shields, reaching a depth of at least 400 km. Here we show that this disagreement can be reconciled by taking into account seismic anisotropy. We show that significant radial anisotropy, with horizontally polarized shear waves travelling faster than those that are vertically polarized, is present under most cratons in the depth range 250-400 km--similar to that found under ocean basins at shallower depths of 80-250 km. We propose that, in both cases, the anisotropy is related to shear in a low-viscosity asthenospheric channel, located at different depths under continents and oceans. The seismically defined 'tectosphere' is then at most 200-250 km thick under old continents. The 'Lehmann discontinuity', observed mostly under continents at about 200-250 km, and the 'Gutenberg discontinuity', observed under oceans at depths of about 60-80 km, may both be associated with the bottom of the lithosphere, marking a transition to flow-induced asthenospheric anisotropy. PMID:12700758

  17. Spreading continents kick-started plate tectonics.

    PubMed

    Rey, Patrice F; Coltice, Nicolas; Flament, Nicolas

    2014-09-18

    Stresses acting on cold, thick and negatively buoyant oceanic lithosphere are thought to be crucial to the initiation of subduction and the operation of plate tectonics, which characterizes the present-day geodynamics of the Earth. Because the Earth's interior was hotter in the Archaean eon, the oceanic crust may have been thicker, thereby making the oceanic lithosphere more buoyant than at present, and whether subduction and plate tectonics occurred during this time is ambiguous, both in the geological record and in geodynamic models. Here we show that because the oceanic crust was thick and buoyant, early continents may have produced intra-lithospheric gravitational stresses large enough to drive their gravitational spreading, to initiate subduction at their margins and to trigger episodes of subduction. Our model predicts the co-occurrence of deep to progressively shallower mafic volcanics and arc magmatism within continents in a self-consistent geodynamic framework, explaining the enigmatic multimodal volcanism and tectonic record of Archaean cratons. Moreover, our model predicts a petrological stratification and tectonic structure of the sub-continental lithospheric mantle, two predictions that are consistent with xenolith and seismic studies, respectively, and consistent with the existence of a mid-lithospheric seismic discontinuity. The slow gravitational collapse of early continents could have kick-started transient episodes of plate tectonics until, as the Earth's interior cooled and oceanic lithosphere became heavier, plate tectonics became self-sustaining. PMID:25230662

  18. Urinary diversion metabolic complications - underestimated problem.

    PubMed

    Krajewski, Wojciech; Piszczek, Radosław; Krajewska, Magdalena; Dembowski, Janusz; Zdrojowy, Romuald

    2014-01-01

    Bladder cancer is one of the most frequent human cancers. In 2011 more than six thousand people in Poland developed BC and more than three thousand died because of it. Treatment of bladder cancer depends on its stage. In less advanced tumours (Ta, Tcis, T1) transurethral resection of bladder tumor with adjuvant immunotherapy is often therapeutic. In more advanced cases (≥ T2) radical cystectomy is needed. There are several surgical types of post-cystectomy urinary diversion divided into two fundamental types - enabling and not enabling urine continence. The most common procedures include ureterocutaneostomy, ileal or colon conduit, orthopic ileal bladder, heterotopic continent bladder replacement (pouch) and urinary diversion via the rectum. Depending on type of cystectomy, various metabolic complications occur, because the absorptive-secretory function of used bowel segment is intact. Complications include bowel dysfunction, malabsorption of various vitamins, acid-base imbalance, electrolyte imbalance, abnormalities in bone metabolism, formation of renal calculi, secondary malignancies and disturbances in function of kidneys or liver. Early diagnosed complications can be treated easier, recognised in advanced stages are often irreversible. In our paper we present review of different approaches to bladder cancer treatment and metabolic complications occurring after these procedures. PMID:25166450

  19. Efficacy of Physiotherapy for Urinary Incontinence following Prostate Cancer Surgery

    PubMed Central

    Bakuła, Stanisław

    2014-01-01

    The study enrolled 81 with urinary incontinence following radical prostate-only prostatectomy for prostatic carcinoma. The patients were divided into two groups. The patients in Group I were additionally subdivided into two subgroups with respect to the physiotherapeutic method used. The patients of subgroup IA received a rehabilitation program consisting of three parts. The patients of subgroup IB rehabilitation program consist of two parts. Group II, a control group, had reported for therapy for persistent urinary incontinence following radical prostatectomy but had not entered therapy for personal reasons. For estimating the level of incontinence, a 1-hour and 24-hour urinary pad tests, the miction diary, and incontinence questionnaire were used, and for recording the measurements of pelvic floor muscles tension, the sEMG (surface electromyography) was applied. The therapy duration depended on the level of incontinence and it continued for not longer than 12 months. Superior continence outcomes were obtained in Group I versus Group II and the difference was statistically significant. The odds ratio for regaining continence was greater in the rehabilitated Group I and smaller in the group II without the rehabilitation. A comparison of continence outcomes revealed a statistically significant difference between Subgroups IA versus IB. The physiotherapeutic procedures applied on patients with urine incontinence after prostatectomy, for most of them, proved to be an effective way of acting, which is supported by the obtained results. PMID:24868546

  20. Urinary incontinence after radical prostatectomy – experience of the last 100 cases

    PubMed Central

    Szymański, Michał; Wolski, Jan Karol; Nadolski, Tomasz; Kalinowski, Tomasz; Demkow, Tomasz; Peczkowski, Piotr; Pilichowska, Małgorzata; Ligaj, Marcin; Michalski, Wojciech

    2011-01-01

    Radical prostatectomy (RP) is a recognized treatment method of organ-confined prostate cancer. Among post-surgery complications, urinary incontinence is a major one. The aim of this study was to determine the incontinence rate after RP and to analyze factors that might affect it. Between March 2007 and December 2008, 132 RP's were performed at Warsaw Cancer Center. A questionnaire to assess the condition before and after RP was developed by the authors and sent to all treated patients. The questionnaire focused on health status information, function in urinary domain, rate of returning to “normal” activity level as before RP and satisfaction from the treatment. The median age of patients was 62 years. Out of 132 patients 102 subjects (77.2%) responded to the questionnaire. Of all responders, 35 patients (34.3%) reported total urinary continence after RP. After RP 35(34.3%) patients reported total urinary continence and in 55(53.9%) patients urinary incontinence of medium degree was present. In 12 (11.8%) patients significant urinary incontinence developed. The most common cause of urine dripping (82% of patients with any degree of urinary incontinence) was associated with abdominal muscle pressure. No statistically significant association between urinary incontinence and adjuvant radiotherapy after RP or the surgeon performing the RP was found (>0.79, >0.803). Radical prostatectomy carries a certain risk of complications. We observed an 88.2% rate of significant (total and moderate degree) urinary continence. The adjuvant radiotherapy and surgeons, who performed the RP, did not affect the rate of incontinence. PMID:24578896

  1. Urinary incontinence in women.

    PubMed

    Wood, Lauren N; Anger, Jennifer T

    2014-01-01

    Urinary incontinence affects women of all ages. History, physical examination, and certain tests can guide specialists in diagnosing stress urinary incontinence, urgency urinary incontinence, and mixed urinary incontinence. First line management includes lifestyle and behavior modification, as well as pelvic floor strength and bladder training. Drug therapy is helpful in the treatment of urgency incontinence that does not respond to conservative measures. In addition, sacral neuromodulation, intravesical onabotulinumtoxinA injections, and posterior tibial nerve stimulation can be used in select patient populations with drug refractory urgency incontinence. Midurethral synthetic slings, including retropubic and transobturator approaches, are safe and efficacious surgical options for stress urinary incontinence and have replaced more invasive bladder neck slings that use autologous or cadaveric fascia. Despite controversy surrounding vaginal mesh for prolapse, synthetic slings for the treatment of stress urinary incontinence are considered safe and minimally invasive. PMID:25225003

  2. Lithospheric properties on a continent-continent collisional scenario: the Pyrenean range

    NASA Astrophysics Data System (ADS)

    Ledo, Juanjo; Campanyà, Joan; Fullea, Javier; Queralt, Pilar; Marcuello, Alex; Liesa, Montse; Muñoz, Josep Anton

    2013-04-01

    Continent-continent collision is a fundamental tectonic process that plays a primary role in the development and evolution of continents. The Pyrenees resulted from the continental collision between the Iberian and European plates during the Alpine orogeny. This mountain range offers an unique opportunity to study orogenic processes due to the well constrained geological evolution and the significant amount of geophysical data available. In this paper present a joint quantitative interpretation of the available geophysical and geochemical data along two transects across the Pyrenean orogeny. These new results confirm the previous hypothesis of partial melting of the subducted Iberian lower crust and constrain the depth of the lithosphere-astenosphere boundary (LAB). The bulk mantle electrical conductivity and seismic velocities have been modelled using the software package LitMod, which allows for coupled petrological and geophysical modeling of the lithosphere and sublithospheric upper mantle within an internally consistent thermodynamic-geophysical framework.

  3. Cystic fibrosis on the African continent.

    PubMed

    Stewart, Cheryl; Pepper, Michael S

    2016-07-01

    Cystic fibrosis (CF; OMIM 219700) is a life-shortening and costly autosomal recessive disease that has been most extensively studied in individuals of Caucasian descent. There is ample evidence, however, that it also affects other ethnicities. In Africa there have been several reports of CF, but there has been no concerted effort toward establishing the molecular epidemiology of this disease on the continent, which is the first step toward outlining a public health strategy to effectively address the needs of these patients. A literature search revealed reports from only 12 of the 54 African states on the molecular analysis of the mutations present in suspected CF patients, resulting in the identification of 79 mutations. Based on previous functional investigations, 39 of these cause CF, 10 are of varying clinical consequence, 4 have no associated evidence regarding whether they cause CF, 4 are synonymous, 5 are novel, and 21 are unique to Africa. We propose that CF be more thoroughly investigated on the continent to ensure that the public health needs of African CF patients-both those in Africa and those of African descent living elsewhere-are met.Genet Med 18 7, 653-662. PMID:26656651

  4. Urinary Tract Infections

    MedlinePlus

    ... can usually be found and treated before the kidneys become infected. If your doctor treats a urinary tract infection early and ... Tips on preventing urinary tract infections Drink plenty of water to flush out bacteria. Drinking cranberry juice may also help ...

  5. Pediatric Urinary Tract Infection

    MedlinePlus

    SBA National Resource Center: 800-621-3141 Pediatric Urinary Tract Infections and Catheterization in Children with Neurogenic Bladder and ... To protect the kidneys from damage – By preventing urinary tract infections (UTI) – By identifying and treating vesicoureteral remux (VUR). ...

  6. Urinary incontinence in extended care facilities: a literature review and proposal for continuous quality improvement.

    PubMed

    Heavner, K

    1998-12-01

    Despite inconsistencies in the literature regarding research design, definitions, outcomes measures, and maintenance programs, the majority of continence experts have accepted prompted voiding as a successful method for decreasing urinary incontinence in extended care facilities. Research findings to date lack a consistent definition of urinary incontinence, and no objective outcomes measures are available to evaluate the success of an intervention. Furthermore, maintenance of an intervention is often not included in the research design. The findings to date suggest that prompted voiding programs in extended care facilities can help decrease cost of care and dependence, increase self esteem, increase dignity, maintain skin health, and increase satisfaction with care among significant others. Implications for research include developing more structured approaches to maintaining continence, comprehensive training programs for extended care facility staff at all levels, and realistic maintenance protocols for interventions used to maintain continence. PMID:10026548

  7. Imaging Lithospheric Structure beneath the Indian continent

    NASA Astrophysics Data System (ADS)

    Maurya, S.; Montagner, J. P.; Mangalampally, R. K.; Stutzmann, E.; Burgos, G.; Kumar, P.; Davuluri, S.

    2015-12-01

    The lithospheric structure and thickness to the LAB are the most debated issues, especially beneath continents. In this context, the structure and thickness of the Indian lithosphere has been controversial. Paleomagnetic data reveals that the Indian continent moved northwards at exceptionally high speeds (18-20 cm/year) and subsequently slowed down to 4-5 cm/year after its collision with Asia ≈40 Myr ago. This super mobility has been explained by an unusually thin Indian lithosphere (≈100 km; Kumar et al., 2007) in contradiction with the thick lithosphere that commonly underlies old cratonic nuclei. It is pertinent to note that the thermobarometric estimates on the ultramafic xenoliths from 65 Myr kimberlites of the Central India (Babu et al. 2009) suggest an approximately 175 km thick lithosphere. Also, recent results of P and S wave travel time tomography of India suggest that the lithospheric roots are not uniformly thick on a regional scale. Although high velocity roots typical of Precambrian shields are preserved beneath a few cratons of the Indian shield, they seem to have suffered attrition, in the plume ravaged regions like the NDVP and the Southern SGT (Singh et al., 2014). We assembled a new massive surface wave database towards obtaining 3D isotropic and anisotropic models for the Indian sub-continent, using surface waves. This necessitated processing of data from more than 500 seismic broadband stations across India and surrounding regions. Surface waves group and phase dispersion measurements are performed in a broad frequency range (16-250s). Our phase velocity anomaly maps recover most of the known geological structures. The cratons are associated with high velocity (4-6%) anomalies till 200 sec, with the WDC being faster than the EDC. Slow velocities in NW India and very high velocity anomalies (6-8%) beneath the central part of the Indo-Gangetic plains are possibly associated with the subducting Indian lithosphere. The LAB depths inferred from

  8. The ribbon continent of northwestern South America

    NASA Astrophysics Data System (ADS)

    Altamira-Areyan, Armando

    The tectonic structure of the Plate Boundary Zone (PBZ) between the Caribbean Plate (CARIB) and the South American Plate (SOAM) is interpreted using models that require CARIB motion from the Pacific into the Atlantic. Those models can be subdivided into: (1) those in which the island arc rocks that are now in the CARIB-SOAM PBZ have collided with the northern South America margin, either obliquely or directly during the Cretaceous or during the Cenozoic, and (2) those in which the island arc rocks now in the CARIB-SOAM PBZ collided with the west coast of South America during the Cretaceous and were transferred to the northern margin by transform motion during the Cenozoic. Magnetic anomalies were first rotated in the Central and South Atlantic, holding Africa fixed to establish how much NOAM had converged on SOAM during the Cenozoic. WSW convergence was discovered to have been accommodated in the northern boundary of the CARIB. There is no evidence of convergence in the form of Cenozoic island arc igneous rocks on the north coast of South America. Those results are consistent only with models of Class (2) that call for transform movement of material that had collided with the west coast of South America along the CARIB-SOAM PBZ on the northern margin of South America. 40Ar/39Ar ages of island arc rocks from northern Venezuela were found to be older than ca 70 Ma, which is consistent with a requirement of models of Class (2) that those rocks are from an island arc which collided with the west coast of South America during Cretaceous times. Testing that conclusion using data from Ecuador, Colombia, Venezuela, the Netherlands Antilles, Trinidad and Tobago has led to the construction of a new ribbon continent model of the northwestern Cordillera of South America. Because the part of the ribbon continent on the north coast of South America has been experiencing substantial deformation in the Maracaibo block during the past 10 m.y., structures in that body have had to be

  9. The Effects of Undergarment Type on the Urinary Continence of Toddlers

    ERIC Educational Resources Information Center

    Simon, Jennifer L.; Thompson, Rachel H.

    2006-01-01

    There is a growing trend toward later toilet training of typically developing children. This trend is a problem for caregivers and professionals who work with young children, because it is associated with a number of costs and health risks in child-care settings. Results of a recent study (Tarbox, Williams, & Friman, 2004) suggest that wearing…

  10. Young Africans Tackle Their Continent's Environmental Issues

    NASA Astrophysics Data System (ADS)

    Olwoch, Jane Mukarugwiza

    2008-11-01

    Young African Scientists Session at the Fourth International Geosphere-Biosphere Programme Congress; Cape Town, South Africa, 7 May 2008; Africa is often described as a unique and diverse continent. This is reflected in its biodiversity, economic and social circumstances, and diversity in culture and environment. The Young African Scientists (YAS) session at the International Geosphere-Biosphere Programme Congress was one of the congress's highlights. Global environmental change research in Africa was presented to an audience that included visiting international and national scientists, policy makers, and a group of schoolchildren. From the uniqueness of Africa's paleoclimate to the diversity and complexity of current and future impacts of environmental change on Africa, the session not only provided an overview of current projects but also highlighted the problems that are intertwined with poverty. This session was sponsored by the Global Change System for Analysis, Research, and Training (START).

  11. Origin of Urinary Oxalate

    NASA Astrophysics Data System (ADS)

    Holmes, Ross P.; Knight, John; Assimos, Dean G.

    2007-04-01

    Urinary oxalate is mostly derived from the absorption of ingested oxalate and endogenous synthesis. The breakdown of vitamin C may also contribute small amounts to the urinary oxalate pool. The amount of oxalate absorbed is influenced by the oxalate content of the diet, the concentrations of divalent cations in the gut, the presence of oxalate-degrading organisms, transport characteristics of the intestinal epithelium, and other factors associated with the intestinal environment. Knowledge of pathways associated with endogenous oxalate synthesis is limited. Urinary oxalate excretion can be modified using strategies that limit dietary oxalate absorption and the ingestion of oxalogenic substrates such as hydroxyproline.

  12. Auditing urinary catheter care.

    PubMed

    Dailly, Sue

    Urinary catheters are the main cause of hospital-acquired urinary tract infections among inpatients. Healthcare staff can reduce the risk of patients developing an infection by ensuring they give evidence-based care and by removing the catheter as soon as it is no longer necessary. An audit conducted in a Hampshire hospital demonstrated there was poor documented evidence that best practice was being carried out. Therefore a urinary catheter assessment and monitoring tool was designed to promote best practice and produce clear evidence that care had been provided. PMID:22375340

  13. Urinary Tract Infections

    MedlinePlus

    ... kidneys, two ureters, a bladder, and a urethra. Urinary tract infections (UTIs) are the second most common type of infection in the body. You may have a UTI if you notice Pain or burning when you ...

  14. Percutaneous urinary procedures

    MedlinePlus

    ... Lingeman JE. Surgical management of upper urinary tract calculi. In: Wein AJ, Kavoussi LR, Novick AC, et ... CC, Nakada SY. Treatment selection and outcomes: renal calculi. Urol Clin North Am . 2007;34(3):409- ...

  15. Urinary incontinence - injectable implant

    MedlinePlus

    Injectable implants are injections of material into the urethra to help control urine leakage ( urinary incontinence ) caused by a ... into the tissue next to the sphincter. The implant procedure is usually done in the hospital. Or ...

  16. Current interventional management of male stress urinary incontinence following urological procedures

    PubMed Central

    Ostrowski, Ireneusz; Śledź, Emil; Ciechan, Janusz; Bukowczan, Jakub; Przydacz, Mikolaj; Wiatr, Tomasz; Stangel-Wojcikiewicz, Klaudia; Chłosta, Piotr L.

    2015-01-01

    Introduction Despite improvements in surgical techniques and implementation of minimally invasive procedures, male stress urinary incontinence affects a substantial number of patients after prostatic surgery. In response to increasing demand of optimal treatment modality, new alternatives to artificial urinary sphincter have recently been introduced. This review summarises the therapeutic surgical options with their outcomes in management of postprostatectomy stress incontinence. Material and methods We performed a literature review by searching the PubMed, Web of Science and Embase databases for articles published from January 2000 until April 2015 based on clinical relevance. Results Artificial urinary sphincter is currently considered the “gold standard” treatment of male stress urinary incontinence. Although the new devices in this group have recently been investigated, the AMS 800 remains the only widely used implant. Male slings and adjustable continence devices, achieve the social continence rates up to 60%. Periurethral injections of bulking agents, have limited efficacy of male stress incontinence. Argus sling and ProACT are both associated with substantial explantation rates. Stem cell therapy is a promising option but still requires additional testing. Conclusions The development of new alternatives to artificial urinary sphincter is constantly progressing. Although recently introduced minimally invasive treatment options have not yet surpassed the outcomes of the artificial urinary sphincter they should continue to be evaluated and compared against the gold standard. PMID:26568879

  17. [Recurrent urinary tract infection].

    PubMed

    Ali, Adel Ben; Bagnis, Corinne Isnard

    2014-09-01

    Recurrent urinary tract infection involves mainly women and exhibits an ecological as well as economical risk. 4% of all urinary tract infection are recurrent and usually secondary to general or local abnormalities. A multidisciplinary medical and surgical team (urology, nephrology, bacteriology, infectious disease) best performs diagnosis and treatment as well as rules out reversible etiology. Treatment relies on behavioral changes before offering cranberry products and/or antibioprophylaxis if necessary. PMID:25362782

  18. A report from the 42nd Annual Meeting of the International Continence Society (October 15-19 - Beijing, China).

    PubMed

    Rabasseda, X

    2012-11-01

    As Beijing was selected as the site for this year's International Continence Society (ICS) meeting, crowds of locals navigating through the subway train lines and tourists lining up for access to the Forbidden City and other landmarks were joined by a less numerous but a still significant number of researchers, scientists and practitioners working on urinary tract diseases and disorders going to the China National Convention Center to attend the podium and poster sessions. Located next to the Bird's Nest Olympic stadium and offering grand views over the Olympic park from the upper floor where non-discussion posters were displayed, the modern facilities allowed for a smooth, seamless meeting during which a number of highly relevant new findings were discussed. The following report summarizes selected presentations on pharmacotherapy and drug candidates for overactive bladder and other common diseases of the urinary tract. PMID:23170310

  19. [Urinary tract infections].

    PubMed

    Hörl, W H

    2011-09-01

    Urinary tract infections occur very frequently in the community and in hospitalized patients and are mainly caused by Escherichia (E.) coli. Depending on virulence determinants of uropathogenic microorganisms and host-specific defense mechanisms, urinary tract infections can manifest as cystitis, pyelonephritis (bacterial interstitial nephritis), bacteremia or urosepsis. Uncomplicated urinary tract infections in otherwise healthy women should be treated for 3-7 days depending on the antibiotic therapy chosen, even if spontaneous remission rates of up to 40% have been reported. Antibiotics of the first choice for empirical treatment of uncomplicated urinary tract infection are fluoroquinolones, pivmecillinam and fosfomycin. A huge problem is the increasing antimicrobial resistance of uropathogenic microorganisms. Complicated urinary tract infections associated with anatomical and/or functional abnormalities of the urinary tract and/or comorbidities such as diabetes or immunosuppressive therapy, need longer antibiotic treatment (e.g. 10-14 days) as well as interdisciplinary diagnostic procedures. Treatment of community acquired urosepsis includes cephalosporins of the third generation, piperacillin/tazobactam or ciprofloxacin. For nosocomial urosepsis the combination with an aminoglycoside or a carbapenem is recommended. PMID:21850538

  20. 21 CFR 876.5030 - Continent ileostomy catheter.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Continent ileostomy catheter. 876.5030 Section 876.5030 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5030 Continent...

  1. 21 CFR 876.5310 - Nonimplanted, peripheral electrical continence device.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ....5310 Nonimplanted, peripheral electrical continence device. (a) Identification. A nonimplanted, peripheral electrical continence device is a device that consists of an electrode that is connected by an electrical cable to a battery-powered pulse source. The electrode is placed onto or inserted into the body...

  2. 21 CFR 876.5310 - Nonimplanted, peripheral electrical continence device.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ....5310 Nonimplanted, peripheral electrical continence device. (a) Identification. A nonimplanted, peripheral electrical continence device is a device that consists of an electrode that is connected by an electrical cable to a battery-powered pulse source. The electrode is placed onto or inserted into the body...

  3. OxyContin: Prescription Drug Abuse. CSAT Advisory.

    ERIC Educational Resources Information Center

    Substance Abuse and Mental Health Services Administration (DHHS/PHS), Rockville, MD. Center for Substance Abuse Treatment.

    Recently, the media have issued numerous reports about the apparent increase in OxyContin abuse and addiction. OxyContin has been heralded as a miracle drug that allows patients with chronic pain to resume a normal life. It has also been called pharmaceutical heroin and is thought to have been responsible for a number of deaths and robberies in…

  4. 21 CFR 876.5030 - Continent ileostomy catheter.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Continent ileostomy catheter. 876.5030 Section 876.5030 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5030 Continent...

  5. Orthotopic urinary diversion after radical cystectomy in treatment of muscle invasive bladder cancer.

    PubMed

    Jovan, Hadži-Djokić; Vladan, Andrejević; Tomislav, Pejčić; Miodrag, Aćimović; Uroš, Babić; Miodrag, Stanić; Zoran, Džamić

    2014-01-01

    Surgical treatment of invasive carcinoma of the bladder in males includes total cystectomy removal of the prostate, seminal vesicles, and the distal parts of the urethers and the pelvic lymph node dissection as well. At this moment it is not possible to recommend a particular type of urinary diversion, but today in clinical practice commonly used derivative are ileal orthotopic neobladder as the continent one and ileal conduit as non-continent urinary diversion. Continent urinary diversion after radical cystectomy are the result of the application of technological innovation in surgery, but also knowledge, imagination and skill of well trained urologist. This type of operation significantly improves the quality of life in patients who underwent radical cystectomy, and the proposal is to operate whenever there is a possibility for this type of procedure. Also it is very important, during surgery to respect oncological principles, of complete removal of tumorous tissue and that the functional principle of ensur- ing that the patients have daytime and also nighttime continence later on after the surgery. PMID:25782228

  6. The further development of the active urine collection device: a novel continence management system.

    PubMed

    Tinnion, E; Jowitt, F; Clarke-O'Neill, S; Cottenden, A M; Fader, M; Sutherland, I

    2003-01-01

    Continence difficulties affect the lives of a substantial minority of the population. Women are far more likely than men to be affected by urinary incontinence but the range of management options for them is limited. There has been considerable interest in developing an external urine collection system for women but without success to date. This paper describes the development and preliminary clinical testing of an active urine collection device (AUCD), which could provide a solution for sufferers. The device uses stored vacuum, protected by a high bubble point filter, to remove urine as quickly as it is produced. This allows a small battery-operated pump to provide the required vacuum, enabling the device to be portable. Two different types of non-invasive patient/device interface were developed, and tested by volunteers: urinal and small pad. The slimline urinal was popular with users although liquid noise was a problem. The pad interface was successful on occasions but further work is necessary to produce a reliable pad. This study has successfully demonstrated that a prototype AUCD liquid handling system can remove urine at clinically relevant flowrates. While further development is required, volunteer tests have shown that the AUCD could be a useful advance in continence management. PMID:12885199

  7. Doug Nelson's Contributions to our Understanding of Young Continent-Continent Collisions

    NASA Astrophysics Data System (ADS)

    Klemperer, S. L.; Brown, L. D.; Jones, A. G.

    2002-12-01

    K. Douglas Nelson, Department Chair and Jessie Page Heroy Professor of Earth Sciences at Syracuse University, died suddenly of heart failure on August 17th, 2002, age 49. At the time of his death he was at the heights of an increasingly distinguished career, and had, just prior to his death, agreed to be an invited speaker in this session of the 2002 Fall AGU meeting. Doug began his professional career as a field structural geologist, writing his PhD on the Newfoundland Appalachians, and as a post-doc in South Island, New Zealand. From there he went to Cornell University to join COCORP; he learned to interpret deep seismic reflection data and became hooked on the value of geophysics to the study of large-scale processes in mountain belts. He became one of the proponents of taking the COCORP methodology overseas, to the world's type example of young, continent-continent collisions, the Himalaya. For 10 years from 1992, by now a faculty member at Syracuse, Doug provided operational and intellectual leadership to the INDEPTH program (International Deep Profiling of Tibet and the Himalaya). His talk in this session would undoubtedly have focused on our new understanding of Tibet that resulted in large part from the work that he led and supervised. From the initial conception of INDEPTH as a single reflection profile across Earth's highest mountain range and largest plateau, the program grew through three major stages to encompass a full range of geophysical and geological surveys in a transect that now reaches from the High Himalaya across Tibet. Doug more than anyone was the enthusiastic integrator in the large multi-national group of investigators (from the U.S., China, Canada and Germany), not bound by a single technique, and best able to synthesize the seemingly disparate observations from all the techniques. In recent years he was particularly interested in the combination of magneto-telluric with seismic results to better constrain interpretation of deep geology

  8. [Urinary incontinence - what can be done by the family doctor and when is the urologist needed?].

    PubMed

    Keller, Isabelle Sonja; Brachlow, Jan Frederic; Padevit, Christian; Kurz, Michael; John, Hubert

    2014-10-01

    About 15% of the women and 10% of the men past the age of 65 years suffer from urinary incontinence. In most cases, accurate history taking can help differentiate between urge incontinence, stress incontinence and overflow incontinence, and is essential in choosing the appropriate treatment. Initial diagnostic testing can be conducted by the general practitioner, especially tests to exclude urinary tract infections or to rule out an overactive bladder. Patient education on changes to fluid intake and voiding habits as well as advice on suitable incontinence products are important first steps in the management of urinary continence. Also, drug treatment can be initiated in general practice. Patients with refractory urinary incontinence, particularly those who did not respond to anticholinergic medication, should be referred to a urologist for further evaluation since there may be an underlying tumour or other disorder of the bladder that is causing the incontinence. PMID:25270747

  9. Prevalence of abnormal urodynamic test results in continent women with severe genitourinary prolapse.

    PubMed

    Rosenzweig, B A; Pushkin, S; Blumenfeld, D; Bhatia, N N

    1992-04-01

    Twenty-two clinically continent women with severe genitourinary prolapse were evaluated urodynamically to determine the prevalence of urodynamic abnormalities that could lead to potential urinary incontinence. Urodynamic testing found an occult incontinence disorder in 13 women (59%), of whom four had urine loss during cough pressure profiles after pessary placement, four had uninhibited detrusor contractions during retrograde medium-fill water cystometry, and five had both stress urinary incontinence and an unstable bladder. Therefore, nine of the 22 patients (41%) had uninhibited detrusor contractions during urodynamic testing. However, uroflowmetry did not reveal voiding dysfunction in this group, although peak flow rates appeared to be lower in the subgroup of women manifesting uninhibited detrusor contractions. Associated symptoms of frequency, nocturia, and urgency occurred in 41% of the women in this study; four of nine (44%) who had normal urodynamic test results, five of 13 (38%) who had abnormal test results, and five of nine (56%) who had an unstable bladder. Therefore, associated symptoms could not be used to determine which women would have abnormal urodynamic test results. These preliminary results suggest that women with genitourinary prolapse may be at risk for an occult incontinence disorder that is masked by the prolapse and that could manifest after corrective surgery for prolapse. Urodynamic testing is suggested for women with genitourinary prolapse who present with or without symptoms of incontinence, so that more data can be obtained to determine the importance of abnormal test results. PMID:1553172

  10. Urinary Adiponectin Excretion

    PubMed Central

    von Eynatten, Maximilian; Liu, Dan; Hock, Cornelia; Oikonomou, Dimitrios; Baumann, Marcus; Allolio, Bruno; Korosoglou, Grigorios; Morcos, Michael; Campean, Valentina; Amann, Kerstin; Lutz, Jens; Heemann, Uwe; Nawroth, Peter P.; Bierhaus, Angelika; Humpert, Per M.

    2009-01-01

    OBJECTIVE Markers reliably identifying vascular damage and risk in diabetic patients are rare, and reports on associations of serum adiponectin with macrovascular disease have been inconsistent. In contrast to existing data on serum adiponectin, this study assesses whether urinary adiponectin excretion might represent a more consistent vascular damage marker in type 2 diabetes. RESEARCH DESIGN AND METHODS Adiponectin distribution in human kidney biopsies was assessed by immunohistochemistry, and urinary adiponectin isoforms were characterized by Western blot analysis. Total urinary adiponectin excretion rate was measured in 156 patients with type 2 diabetes who had a history of diabetic nephropathy and 40 healthy control subjects using enzyme-linked immunosorbent assay. Atherosclerotic burden was assessed by common carotid artery intima-media-thickness (IMT). RESULTS A homogenous staining of adiponectin was found on the endothelial surface of glomerular capillaries and intrarenal arterioles in nondiabetic kidneys, whereas staining was decreased in diabetic nephropathy. Low-molecular adiponectin isoforms (∼30–70 kDa) were detected in urine by Western blot analysis. Urinary adiponectin was significantly increased in type 2 diabetes (7.68 ± 14.26 vs. control subjects: 2.91 ± 3.85 μg/g creatinine, P = 0.008). Among type 2 diabetic patients, adiponectinuria was associated with IMT (r = 0.479, P < 0.001) and proved to be a powerful independent predictor of IMT (β = 0.360, P < 0.001) in multivariable regression analyses. In a risk prediction model including variables of the UK Prospective Diabetes Study coronary heart disease risk engine urinary adiponectin, but not the albumin excretion rate, added significant value for the prediction of increased IMT (P = 0.007). CONCLUSIONS Quantification of urinary adiponectin excretion appears to be an independent indicator of vascular damage potentially identifying an increased risk for vascular events. PMID:19509019

  11. Study protocol: ICONS: Identifying continence options after stroke: A randomised trial

    PubMed Central

    2011-01-01

    Background Urinary incontinence following acute stroke is common, affecting between 40%-60% of people in hospital after a stroke. Despite the availability of clinical guidelines for urinary incontinence and urinary incontinence after stroke, national audit data suggest incontinence is often poorly managed. Conservative interventions (e.g. bladder training, pelvic floor muscle training and prompted voiding) have been shown to have some effect with participants in Cochrane systematic reviews, but have not had their effectiveness demonstrated with stroke patients. Methods/Design A cluster randomised controlled pilot trial designed to assess the feasibility of a full-scale cluster randomised trial and to provide preliminary evidence of the effectiveness and cost-effectiveness of a systematic voiding programme for the management of continence after stroke. Stroke services will be randomised to receive the systematic voiding programme, the systematic voiding programme plus supported implementation, or usual care. The trial aims to recruit at least 780 participants in 12 stroke services (4 per arm). The primary outcome is presence/absence of incontinence at six weeks post-stroke. Secondary outcomes include frequency and severity of incontinence, quality of life and cost-utility. Outcomes will be measured at six weeks, three months and (for participants recruited in the first three months) twelve months after stroke. Process data will include rates of recruitment and retention and fidelity of intervention delivery. An integrated qualitative evaluation will be conducted in order to describe implementation and assist in explaining the potential mediators and modifiers of the process. Trial Registration ISRCTN: ISRCTN08609907 PMID:21599945

  12. MedlinePlus: Urinary Incontinence

    MedlinePlus

    ... Also in Spanish Stress incontinence Also in Spanish Suprapubic catheter care Also in Spanish Urge incontinence Also in ... catheterization - male Skin care and incontinence Stress incontinence Suprapubic catheter care Urge incontinence Urinary catheters Urinary catheters - what ...

  13. Feline Lower Urinary Tract Disease

    MedlinePlus

    ... gland) can cause lower urinary tract disease in cats. Although they are much less common causes, FLUTD ... your veterinarian about the best diet for your cat. Many commercial diets are acceptable, but some urinary ...

  14. Urinary incontinence - vaginal sling procedures

    MedlinePlus

    ... types of surgeries that help control stress urinary incontinence . This is urine leakage that happens when you ... sling procedures are done to treat stress urinary incontinence. Before discussing surgery, your doctor will have you ...

  15. Surgery for Stress Urinary Incontinence

    MedlinePlus

    ... Education FAQs Surgery for Stress Urinary Incontinence Patient Education Pamphlets - Spanish Surgery for Stress Urinary Incontinence FAQ166, July 2014 ... Your Practice Patient Safety & Quality Payment Reform (MACRA) Education & Events Annual ... Pamphlets Teen Health About ACOG About Us Leadership & ...

  16. Urinary incontinence - vaginal sling procedures

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/007376.htm Urinary incontinence - vaginal sling procedures To use the sharing features ... are types of surgeries that help control stress urinary incontinence . This is urine leakage that happens when you ...

  17. Urinary incontinence surgery - female - discharge

    MedlinePlus

    ... this page: //medlineplus.gov/ency/patientinstructions/000134.htm Urinary incontinence surgery - female - discharge To use the sharing features ... Blaivas JM, Gormley EA, et al; Female Stress Urinary Incontinence Update Panel of the American Urological Association Education ...

  18. Multimetric Macroinvertebrate Indices for Mid-continent US Great Rivers

    EPA Science Inventory

    We developed a set of great river macroinvertebrate indices of condition (GRMICs) for the mid-continent great rivers. We used a multiscale (site, reach, landscape) multimetric abiotic stressor gradient to select macroinvertebrate assemblage metrics sensitive to human disturbance ...

  19. Stress urinary incontinence.

    PubMed

    Nygaard, Ingrid E; Heit, Michael

    2004-09-01

    Stress urinary incontinence, the complaint of involuntary leakage during effort or exertion, occurs at least weekly in one third of adult women. The basic evaluation of women with stress urinary incontinence includes a history, physical examination, cough stress test, voiding diary, postvoid residual urine volume, and urinalysis. Formal urodynamics testing may help guide clinical care, but whether urodynamics improves or predicts the outcome of incontinence treatment is not yet clear. The distinction between urodynamic stress incontinence associated with hypermobility and urodynamic stress incontinence associated with intrinsic sphincter deficiency should be viewed as a continuum, rather than a dichotomy, of urethral function. Initial treatment should include behavioral changes and pelvic floor muscle training. Estrogen is not indicated to treat stress urinary incontinence. Bladder training, vaginal devices, and urethral inserts also may reduce stress incontinence. Bulking agents reduce leakage, but effectiveness generally decreases after 1-2 years. Surgical procedures are more likely to cure stress urinary incontinence than nonsurgical procedures but are associated with more adverse events. Based on available evidence at this time, colposuspension (such as Burch) and pubovaginal sling (including the newer midurethral synthetic slings) are the most effective surgical treatments. PMID:15339776

  20. Urinary Tract Infections.

    ERIC Educational Resources Information Center

    Plummer, Nancy; Michael, Nancy, Ed.

    This module on urinary tract infections is intended for use in inservice or continuing education programs for persons who administer medications in long-term care facilities. Instructor information, including teaching suggestions, and a listing of recommended audiovisual materials and their sources appear first. The module goal and objectives are…

  1. [Urinary catheter biofilm infections].

    PubMed

    Holá, V; Růzicka, F

    2008-04-01

    Urinary tract infections, most of which are biofilm infections in catheterized patients, account for more than 40% of hospital infections. Bacterial colonization of the urinary tract and catheters causes not only infection but also other complications such as catheter blockage by bacterial encrustation, urolithiasis and pyelonephritis. About 50% of long-term catheterized patients face urinary flow obstruction due to catheter encrustation, but no measure is currently available to prevent it. Encrustation has been known either to result from metabolic dysfunction or to be of microbial origin, with urease positive bacterial species implicated most often. Infectious calculi account for about 15-20% of all cases of urolithiasis and are often associated with biofilm colonization of a long-term indwelling urinary catheter or urethral stent. The use of closed catheter systems is helpful in reducing such problems; nevertheless, such a system only delays the inevitable, with infections emerging a little later. Various coatings intended to prevent the bacterial adhesion to the surface of catheters and implants and thus also the emergence of biofilm infections, unfortunately, do not inhibit the microbial adhesion completely and permanently and the only reliable method for biofilm eradication remains the removal of the foreign body from the patient. PMID:18578409

  2. Phosphodiesterase type 5 inhibitor administered immediately after radical prostatectomy temporarily increases the need for incontinence pads, but improves final continence status

    PubMed Central

    Yamashita, Shinichi; Ito, Akihiro; Kawasaki, Yoshihide; Izumi, Hideaki; Kawamorita, Naoki; Adachi, Hisanobu; Mitsuzuka, Koji; Arai, Yoichi

    2016-01-01

    Purpose To evaluate the effects of phosphodiesterase type 5 inhibitor (PDE5i) on urinary continence recovery after bilateral nerve-sparing radical prostatectomy (BNSRP). Materials and Methods Between 2002 and 2012, 137 of 154 consecutive patients who underwent BNSRP in our institution retrospectively divided into 3 groups that included patients taking PDE5i immediately after surgery (immediate PDE5i group, n=41), patients starting PDE5i at an outpatient clinic after discharge (PDE5i group, n=56), and patients taking no medication (non-PDE5i group, n=40). Using self-administered questionnaires, the proportion of patients who did not require incontinence pads (pad-free patients) was calculated preoperatively and at 1, 3, 6, 12, 18, and 24 months after BNSRP. Severity of incontinence was determined based on the pad numbers and then compared among the 3 groups. Results Proportions of pad-free patients and severity of incontinence initially deteriorated in all of the groups to the lowest values soon after undergoing BNSRP, with gradual improvement noted thereafter. The deterioration was most prominent in the immediate PDE5i group. As compared to the non-PDE5i group, both the PDE5i and immediate PDE5i groups exhibited a better final continence status. Conclusions PDE5i improves final continence status. However, administration of PDE5i immediately after surgery causes a distinct temporary deterioration in urinary incontinence.

  3. Wrench faulting initiated by continent-continent collision between the Eratosthenes Seamount and Cyprus

    NASA Astrophysics Data System (ADS)

    Ehrhardt, A.; Schnabel, M.; Damm, V.; Huebscher, C. P.

    2010-12-01

    The Eratosthenes Seamount (ESM), located in the Eastern Mediterranean south of Cyprus, is considered to represent a continental fragment originating from the former African-Arabian continental margin. In the late Miocene the subduction of the African-Arabian Plate below the Anatolian Plate turned to continent-continent collision when the ESM collided with the island of Cyprus. This altered the tectonic pattern of the entire Eastern Mediterranean. Since the ESM blocks the northward drift of the African Plate south of Cyprus, the northward motion of the African-Arabian Plate (around 1cm/year) has to be compensated along wrench faults. The Baltim Hecateus Line (BHL) separates the ESM on its eastern side from the deep Levantine Basin. The BHL formed as an extensional fault system during the Triassic formation of the Levatine Basin. During the Upper Cretaceous and Eocene so called Syrian Arc inversion the BHL was reactivated. A set of recent multichannel seismic 2D lines (MCS), acquired with the R/V Maria S. Merian (MSM14-2) in 2010, will be presented here. The NW-SE trending lines show a transformal to transpressional nature of the Baltim Hecateus Line. We propose that the BHL converted to a transform fault during the incipient collision of the ESM with the island of Cyprus in order to compensate the northward motion of the African-Arabian Plate. At the eastern rim of the ESM the BHL continues beneath a prominent bathymetric escarpment. Whereas the escarpment matches the trace of the BHL it is covered below the thick Messinian Evaporites south and north of the ESM. Owing to the ductile properties of salt the Messinian evaporites decouple the sub salt sediments from the supra salt sediments. As a result no direct observations of the BHL are possible. However, seismic imaging reveals thrust folds at the western side of the Levantine Basin pointing to a transpressional nature of the BHL. The overlying sediments are thinned as a reaction to the transform motion. Due to a

  4. Urinary Tract Endometriosis.

    PubMed

    Kołodziej, Anna; Krajewski, Wojciech; Dołowy, Łukasz; Hirnle, Lidia

    2015-01-01

    Recently, occurrence of urinary tract endometriosis (UTE) is more frequently diagnosed. According to literature, it refers to approximately 0.3 to even 12% of all women with endometriosis. The pathogenesis of UTE has not been clearly explained so far. The actually proposed hypotheses include embryonic, migration, transplantation, and iatrogenic theory. Most frequently UTE affects bladder, less often ureters and kidneys. One-third of patients remains asymptomatic or exhibits only minor manifestations. In symptomatic patients main complaints include dysuria, urinary urgency, and/or frequency, painful micturition, and burning sensation in the urethra and discomfort in the retropubic area. Treatment of UTE is challenging and can be pharmacological, surgical or can be a combination of both methods. In this paper we present a review of the literature concerning the UTE, its diagnosis and treatment. PMID:26341760

  5. Neonatal Staphylococcus lugdunensis urinary tract infection.

    PubMed

    Hayakawa, Itaru; Hataya, Hiroshi; Yamanouchi, Hanako; Sakakibara, Hiroshi; Terakawa, Toshiro

    2015-08-01

    Staphylococcus lugdunensis is a known pathogen of infective endocarditis, but not of urinary tract infection. We report a previously healthy neonate without congenital anomalies of the kidney and urinary tract who developed urinary tract infection due to Staphylococcus lugdunensis, illustrating that Staphylococcus lugdunensis can cause urinary tract infection even in those with no urinary tract complications. PMID:26177232

  6. [Urinary calculi and infection].

    PubMed

    Trinchieri, Alberto

    2014-01-01

    Infection urinary stones resulting from urease-producing bacteria are composed by struvite and/or carbonate apatite. Bacterial urease splits urea and promotes the formation of ammonia and carbon dioxide leading to urine alkalinization and formation of phosphate salts. Proteus species are urease-producers, whereas a limited number of strains of other Gram negative and positive species may produce urease. Ureaplasma urealyticum and Corynebacterium urealyticum are urease-producers that are not isolated by conventional urine cultures, but require specific tests for identification. Primary treatment requires surgical removal of stones as complete as possible. Extracorporeal and endoscopic treatments are usually preferred, while open surgery is actually limited to few selected cases. Residual stones or fragments should be treated by chemolysis via ureteral catheter or nephrostomy or administration of citrate salts in order to achieve a stone-free renal unit. Postoperatively, recurrent urinary tract infection should be treated with appropriate antibiotic treatment although long-term antibiotic prophylaxis can cause resistance. Urinary acidification has been proposed for the prophylaxis of infection stones, but long-term acidification is difficult to achieve in urine infected by urease-producing bacteria. Urease inhibitors lead to prevention and/or dissolution of stones and encrustations in patients with infection by urea-splitting bacteria, but their use is limited by their toxicity. The administration of citrate salts involves an increase of the value of nucleation pH (pHn), that is the pH value at which calcium and magnesium phosphate crystallization occurs, in a greater way than the corresponding increase in the urinary pH due to its alkalinizing effect and resulting in a reduction of the risk of struvite crystallization. In conclusion prevention of the recurrence of infection stones can be achieved by an integrated approach tailored on the single patient. Complete

  7. [Urinary complications after anorectal surgery].

    PubMed

    Iusuf, T; Sârbu, V; Cristache, C; Popescu, R; Botea, F; Panait, L

    2000-01-01

    The prevalence of urinary complications after various anorectal operations was studied in a group of 273 patients. The overall prevalence of urinary complications was 26.7%; most of these complications affected men between 41 and 50, mainly after hemorrhoidectomy. In 10.6% of patients, bladder catheterization was needed. These urinary complications result from nervous reflexes originating from the anus and determined by the operative trauma and/or rectal distinction. In the treatment of these urinary complications, the role of the muses is essential for reassuring the patients. Parasympathomimetic drugs are often efficient. Urinary catheterization must be delayed until the 18th hour. Fluid restriction may be useful to prevent urinary retention. PMID:14870531

  8. A Geological Model for the Evolution of Early Continents (Invited)

    NASA Astrophysics Data System (ADS)

    Rey, P. F.; Coltice, N.; Flament, N. E.; Thébaud, N.

    2013-12-01

    Geochemical probing of ancient sediments (REE in black shales, strontium composition of carbonates, oxygen isotopes in zircons...) suggests that continents were a late Archean addition at Earth's surface. Yet, geochemical probing of ancient basalts reveals that they were extracted from a mantle depleted of its crustal elements early in the Archean. Considerations on surface geology, the early Earth hypsometry and the rheology and density structure of Archean continents can help solve this paradox. Surface geology: The surface geology of Archean cratons is characterized by thick continental flood basalts (CFBs, including greenstones) emplaced on felsic crusts dominated by Trondhjemite-Tonalite-Granodiorite (TTG) granitoids. This simple geology is peculiar because i/ most CFBs were emplaced below sea level, ii/ after their emplacement, CFBs were deformed into relatively narrow, curviplanar belts (greenstone basins) wrapping around migmatitic TTG domes, and iii/ Archean greenstone belts are richly endowed with gold and other metals deposits. Flat Earth hypothesis: From considerations on early Earth continental geotherm and density structure, Rey and Coltice (2008) propose that, because of the increased ability of the lithosphere to flow laterally, orogenic processes in the Archean produced only subdued topography (continents, Flament et al. (2008) proposed a theory for the hypsometry of the early Earth showing that, until the late Archean, most continents were flooded and Earth was largely a water world. From this, a model consistent with many of the peculiar attributes of Archean geology, can be proposed: 1/ Continents appeared at Earth's surface at an early stage during the Hadean/Archean. However, because they were i/ covered by continental flood basalts, ii/ below sea level, and iii/ deprived of modern-style mountain belts and orogenic plateaux, early felsic

  9. [Urinary incontinence in castrated bitches. Part 1: Significance, clinical aspects and etiopathogenesis].

    PubMed

    Arnold, S

    1997-01-01

    Acquired urinary incontinence occurs in 20% of spayed dogs and there exists a strong correlation between body weight and the risk of urinary incontinence. Bitches with a body weight of more than 20 kg have a risk of 30% white smaller dogs have a risk of 10%. A particular breed disposition exists in Boxers in which 65% are affected. Other breeds with a more than average disposition for urinary incontinence are Dobermans and Giant Schnauzers. Urinary incontinence due to spaying manifests itself mainly while the dogs are sleeping. The cause is a urethral sphincter incompetence which can be verified by a urethral pressure profile (UPP). The microtransducer method proved to be a suitable method for urodynamic studies. It could be demonstrated that the urethral closure pressure is significantly lower in incontinent bitches (4.6 +/- 2.3 cm H2O) than in continent bitches (18.6 +/- 10.5 cm H2O). In addition, the urethral closure pressure for continent bitches dropped significantly within 12 months after surgery. Histological examination revealed that the functional urethral closure cannot be explained by the extent of discernible structures of the urethral wall as seen by light microscopy. PMID:9411733

  10. The Eastern Tennessee Seismic Zone: Reactivation of an Ancient Continent-Continent Suture Zone

    NASA Astrophysics Data System (ADS)

    Powell, C. A.

    2014-12-01

    The eastern Tennessee seismic zone (ETSZ) may represent reactivation of an ancient shear zone that accommodated left-lateral, transpressive motion of the Amazon craton during the Grenville orogeny. Several different lines of evidence support this concept including velocity models for the crust, earthquake hypocenter alignments, focal mechanism solutions, potential field anomalies, paleomagnetic pole positions, and isotopic geochemical studies. The ETSZ trends NE-SW for about 300 km and displays remarkable correlation with the prominent New York - Alabama (NY-AL) aeromagnetic lineament. Vp and Vs models for the crust derived from a local ETSZ earthquake tomography study reveal the presence of a narrow, NE-SW trending, steeply dipping zone of low velocities that extends to a depth of at least 24 km and is associated with the vertical projection of the NY-AL aeromagnetic lineament. The low velocity zone is interpreted as a major basement fault. The recent Mw 4.2 Perry County eastern Kentucky earthquake occurred north of the ETSZ but has a focal depth and mechanism that are similar to those for ETSZ earthquakes. We investigate the possibility that the proposed ancient shear zone extends into eastern Kentucky using Bouguer and aeromagnetic maps. The southern end of the ETSZ is characterized by hypocenters that align along planes dipping at roughly 45 degrees and focal mechanisms that contain large normal faulting components. The NY-AL aeromagnetic lineament also changes trend in the southern end of the ETSZ and the exact location of the lineament is ambiguous. We suggest that the southern portion of the ETSZ involves reactivation of reverse faults (now as normal faults) that mark the ancient transition between a collisional to a more transpressive boundary between Amazonia and Laurentia during the formation of the super continent Rodinia.

  11. The Effect of Asymptomatic Urethral Caruncle on Micturition in Women with Urinary Incontinence

    PubMed Central

    Ozkan, Levend; Tarcan, Tufan

    2010-01-01

    Purpose The aim of this study was to evaluate the effect of asymptomatic urethral caruncle (UC) on micturition in women suffering from urinary incontinence. Materials and Methods A total of 232 patients participated in the study. UC was diagnosed in 50 of 232 patients with urinary incontinence during a physical examination in our clinic. All cases were divided into 2 groups: UC combined with urinary incontinence (group 1) and urinary incontinence only (group 2). Urodynamic evaluations were performed according to the International Continence Society standards. Results Both groups were similar in terms of voiding diary, pad test and residual urine volume. Urodynamic studies revealed no significant difference between group 1 and 2 (infravesical obstruction: 6% vs. 4.4%; overactive detrusor: 44% vs. 42.9% respectively). The rates of severe IPSS (37.8% vs. 20.9%) and severe cystocele (20.9% vs. 13.8%) were numerically higher in group 1 with no statistically significant difference. Conclusions Our results suggest that there is no effect of asymptomatic UC on lower urinary tract symptoms in women with urinary incontinence. Therefore, treating asymptomatic UC is unnecessary in these patients. However, during incontinence surgery, it is the surgeon's decision whether to treat asymptomatic UC. PMID:20428428

  12. Paliperidone Palmitate-induced Urinary Incontinence: A Case Report

    PubMed Central

    Karslıoǧlu, Ersin Hatice; Özalp, Elvan; Çayköylü, Ali

    2016-01-01

    Urinary incontinence, although rarely reported, is one of the most important adverse effects of antipsychotic medication. It can be an embarrassing, distressing, and potentially treatment-limiting. Several antipsychotics, including both typical and atypical varieties, are known to induce urinary incontinence. Many antipsychotic drugs target the neural pathways controlling continence by binding to receptors of some neurotransmitters such as serotonin, dopamine, acetylcholine, and adrenaline. Pharmacological management of incontinence should be considered if there is a risk of cessation of the antipsychotic therapy or any decline in patients’ compliance. Amitriptyline, desmopressin, ephedrine, and anticholinergics such as oxybutynin and trihexyphenidyl are the most frequently used agents to treat incontinence. We think that the frequency of incontinence is higher than reported in the literature, and that follow-up routines should include a form of standardized screening for all possible adverse effects, including incontinence, of any given antipsychotic. In this article, we report a case of urinary incontinence as an adverse effect of paliperidone palmitate use during maintenance therapy in a patient with schizophrenia. PMID:26792046

  13. Paliperidone Palmitate-induced Urinary Incontinence: A Case Report.

    PubMed

    Karslıoǧlu, Ersin Hatice; Özalp, Elvan; Çayköylü, Ali

    2016-02-29

    Urinary incontinence, although rarely reported, is one of the most important adverse effects of antipsychotic medication. It can be an embarrassing, distressing, and potentially treatment-limiting. Several antipsychotics, including both typical and atypical varieties, are known to induce urinary incontinence. Many antipsychotic drugs target the neural pathways controlling continence by binding to receptors of some neurotransmitters such as serotonin, dopamine, acetylcholine, and adrenaline. Pharmacological management of incontinence should be considered if there is a risk of cessation of the antipsychotic therapy or any decline in patients' compliance. Amitriptyline, desmopressin, ephedrine, and anticholinergics such as oxybutynin and trihexyphenidyl are the most frequently used agents to treat incontinence. We think that the frequency of incontinence is higher than reported in the literature, and that follow-up routines should include a form of standardized screening for all possible adverse effects, including incontinence, of any given antipsychotic. In this article, we report a case of urinary incontinence as an adverse effect of paliperidone palmitate use during maintenance therapy in a patient with schizophrenia. PMID:26792046

  14. Urinary extracellular microvesicles: isolation methods and prospects for urinary proteome.

    PubMed

    Wang, Danqi; Sun, Wei

    2014-08-01

    Extracellular microvesicles (EVs) are membranous vesicles, which are released from diverse cells. These EVs have also been found in a wide range of body fluids. The cargo of EVs, including proteins, lipids, carbohydrates, and nucleic acids, can be stably preserved in EVs. Researchers have found that EVs can mediate intercellular communication by shuttling the cargo components. Therefore, EVs can be used for the identification of disease-specific biomarkers. As one class of EVs, urinary exosomes can reflect the status of the renal system. Moreover, urinary exosome analysis can minimize the interference of high abundant proteins in the whole urine sample. Therefore, urinary exosomes have gained much attention in recent years. In this review, we present a comprehensive summary of urinary exosome studies in recent years, including collection, storage, and isolation methods. The normal and disease proteomic analyses of urinary exosomes are also presented. Thus, this review may provide a valuable reference for future research. PMID:24962155

  15. Prosthetic urinary sphincter

    NASA Technical Reports Server (NTRS)

    Helms, C. R.; Smyly, H. M. (Inventor)

    1981-01-01

    A pump/valve unit for controlling the inflation and deflation of a urethral collar in a prosthetic urinary sphincter device is described. A compressible bulb pump defining a reservoir was integrated with a valve unit for implantation. The valve unit includes a movable valve member operable by depression of a flexible portion of the valve unit housing for controlling fluid flow between the reservoir and collar; and a pressure sensing means which operates the valve member to relieve an excess pressure in the collar should too much pressure be applied by the patient.

  16. [Urinary antimicrobial prophylaxis].

    PubMed

    Nathanson, S; Deschênes, G

    2002-05-01

    Antibiotics are usually used to prevent childhood recurrent urinary tract infections: cystitis or pyelonephritis. The mechanism of action of these antibiotics, although imperfectly known, seems to be double: the antibiotic acts by its bactericidal effect, but also probably for minimal concentrations by reducing adhesion capability of bacteria to the urothelium. The most commonly used molecules are cotrimoxazole, trimethoprime, pivmecillinam, cefaclor and nalidixic acid. However all have not been studied rigorously as for their prophylactic capacity, and in particular very little is known for patients presenting with vesico-ureteral reflux. PMID:12053547

  17. Urogynecologic conditions: urinary incontinence.

    PubMed

    Kelley, Robert; Garely, Alan D

    2015-03-01

    Urinary incontinence (UI), the leakage of urine, is a condition that frequently goes untreated. There are many different types of UI, including stress and urge UI, and the etiology is multifactorial. Diagnosis can be made with a pertinent history, including use of a questionnaire; a pelvic examination; and direct observation. Additional testing can include physical maneuvers to elicit stress leakage and urodynamic studies. Treatment ranges from pelvic floor exercise to surgical support of the pelvic floor for stress UI and, typically, behavioral therapy and/or pharmacotherapy, starting with antimuscarinic drugs, for urge UI. PMID:25756372

  18. Urinary tuberculosis: modern issues.

    PubMed

    Wise, Gilbert J

    2009-07-01

    Tuberculosis remains an epidemic that affects one third of the world's population. The persistence of this disease is caused by a large pool of immune-compromised and lower socioeconomic populations. The advent of rapid transportation and migration has contributed to the persistence of this disease in developed and less developed nations. The emergence of drug-resistant strains has added an additional factor for the pervasiveness of tuberculosis. The genitourinary system is a primary target for hematogenous infections. This paper reviews the contemporary issues that affect the diagnosis and treatment of urinary tuberculosis. PMID:19570494

  19. Urinary tract infections.

    PubMed

    Wang, Alina; Nizran, Parminder; Malone, Michael A; Riley, Timothy

    2013-09-01

    Clinical presentation helps differentiate between upper and lower urinary tract infections (UTIs). UTIs are classified as either complicated or uncomplicated. A complicated UTI is associated with an underlying condition that increases the risk of failing therapy. Primary laboratory tests for UTIs consist of urinalysis and urine culture. The most common pathogen for uncomplicated cystitis and pyelonephritis is Escherichia coli. Nitrofurantoin, fosfomycin, and trimethoprim-sulfamethoxazole are first-line therapies for acute uncomplicated cystitis. Decisions regarding antibiotic agents should be individualized based on patients' allergies, tolerability, community resistance rates, cost, and availability. PMID:23958364

  20. Urinary Bladder Dysfunction in Transgenic Sickle Cell Disease Mice

    PubMed Central

    Claudino, Mário Angelo; Leiria, Luiz Osório Silveira; da Silva, Fábio Henrique; Alexandre, Eduardo Costa; Renno, Andre; Mónica, Fabiola Zakia; de Nucci, Gilberto; Fertrin, Kleber Yotsumoto; Antunes, Edson; Costa, Fernando Ferreira; Franco-Penteado, Carla Fernanda

    2015-01-01

    Background Urological complications associated with sickle cell disease (SCD), include nocturia, enuresis, urinary infections and urinary incontinence. However, scientific evidence to ascertain the underlying cause of the lower urinary tract symptoms in SCD is lacking. Objective Thus, the aim of this study was to evaluate urinary function, in vivo and ex vivo, in the Berkeley SCD murine model (SS). Methods Urine output was measured in metabolic cage for both wild type and SS mice (25-30 g). Bladder strips and urethra rings were dissected free and mounted in organ baths. In isolated detrusor smooth muscle (DSM), relaxant response to mirabegron and isoproterenol (1nM-10μM) and contractile response to (carbachol (CCh; 1 nM-100μM), KCl (1 mM-300mM), CaCl2 (1μM-100mM), α,β-methylene ATP (1, 3 and 10 μM) and electrical field stimulation (EFS; 1-32 Hz) were measured. Phenylephrine (Phe; 10nM-100μM) was used to evaluate the contraction mechanism in the urethra rings. Cystometry and histomorphometry were also performed in the urinary bladder. Results SS mice present a reduced urine output and incapacity to produce typical bladder contractions and bladder emptying (ex vivo), compared to control animals. In DSM, relaxation in response to a selective β3-adrenergic agonist (mirabegron) and to a non-selective β-adrenergic (isoproterenol) agonist were lower in SS mice. Additionally, carbachol, α, β-methylene ATP, KCl, extracellular Ca2+ and electrical-field stimulation promoted smaller bladder contractions in SS group. Urethra contraction induced by phenylephrine was markedly reduced in SS mice. Histological analyses of SS mice bladder revealed severe structural abnormalities, such as reductions in detrusor thickness and bladder volume, and cell infiltration. Conclusions Taken together, our data demonstrate, for the first time, that SS mice display features of urinary bladder dysfunction, leading to impairment in urinary continence, which may have an important role in

  1. Regulating continent growth and composition by chemical weathering

    PubMed Central

    Lee, Cin-Ty Aeolus; Morton, Douglas M.; Little, Mark G.; Kistler, Ronald; Horodyskyj, Ulyana N.; Leeman, William P.; Agranier, Arnaud

    2008-01-01

    Continents ride high above the ocean floor because they are underlain by thick, low-density, Si-rich, and Mg-poor crust. However, the parental magmas of continents were basaltic, which means they must have lost Mg relative to Si during their maturation into continents. Igneous differentiation followed by lower crustal delamination and chemical weathering followed by subduction recycling are possible solutions, but the relative magnitudes of each process have never been quantitatively constrained because of the lack of appropriate data. Here, we show that the relative contributions of these processes can be obtained by simultaneous examination of Mg and Li (an analog for Mg) on the regional and global scales in arcs, delaminated lower crust, and river waters. At least 20% of Mg is lost from continents by weathering, which translates into >20% of continental mass lost by weathering (40% by delamination). Chemical weathering leaves behind a more Si-rich and Mg-poor crust, which is less dense and hence decreases the probability of crustal recycling by subduction. Net continental growth is thus modulated by chemical weathering and likely influenced by secular changes in weathering mechanisms. PMID:18362343

  2. Continent X: The Geopolitical Lesson of Size, Shape, and Location.

    ERIC Educational Resources Information Center

    Byklum, Daryl

    1992-01-01

    Offers suggestions for teaching high school students about the relevance of a nation's size, shape, and location to its geopolitical influence. Includes a map of and suggested teaching procedures concerning the hypothetical "Continent X" and its five component nations. Suggests follow-up topics. (SG)

  3. Regulating continent growth and composition by chemical weathering

    USGS Publications Warehouse

    Lee, C.-T.A.; Morton, D.M.; Little, M.G.; Kistler, R.; Horodyskyj, U.N.; Leeman, W.P.; Agranier, A.

    2008-01-01

    Continents ride high above the ocean floor because they are underlain by thick, low-density, Si-rich, and Mg-poor crust. However, the parental magmas of continents were basaltic, which means they must have lost Mg relative to Si during their maturation into continents. Igneous differentiation followed by lower crustal delamination and chemical weathering followed by subduction recycling are possible solutions, but the relative magnitudes of each process have never been quantitatively constrained because of the lack of appropriate data. Here, we show that the relative contributions of these processes can be obtained by simultaneous examination of Mg and Li (an analog for Mg) on the regional and global scales in arcs, delaminated lower crust, and river waters. At least 20% of Mg is lost from continents by weathering, which translates into >20% of continental mass lost by weathering (40% by delamination). Chemical weathering leaves behind a more Si-rich and Mg-poor crust, which is less dense and hence decreases the probability of crustal recycling by subduction. Net continental growth is thus modulated by chemical weathering and likely influenced by secular changes in weathering mechanisms. ?? 2008 by The National Academy of Sciences of the USA.

  4. Children's Estimations of the Sizes of the Continents.

    ERIC Educational Resources Information Center

    Wiegand, Patrick; Stiell, Bernadette

    1996-01-01

    Examines children's knowledge and understanding of global spatial relationships. Utilizing cut-outs of continents to estimate their size in relation to Europe, the students consistently underestimated the size of Asia and overestimated Australia. Possible reasons for this are discussed and teaching approaches suggested. (MJP)

  5. 21 CFR 876.5310 - Nonimplanted, peripheral electrical continence device.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Nonimplanted, peripheral electrical continence device. 876.5310 Section 876.5310 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices §...

  6. 21 CFR 876.5310 - Nonimplanted, peripheral electrical continence device.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Nonimplanted, peripheral electrical continence device. 876.5310 Section 876.5310 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices §...

  7. Petroleum Technology Transfer Council boosts North Mid-continent technology

    SciTech Connect

    Lyle, D.

    1995-10-01

    The Kansas Tertiary Oil Recovery Project served as one of the primary models for the Petroleum Technology Transfer Council, so it`s fitting this series on regional applications should start with the North Mid-Continent organization. The technology transfer program is described.

  8. Miocene sedimentation and subsidence during continent-continent collision, Bengal basin, Bangladesh

    NASA Astrophysics Data System (ADS)

    Uddin, Ashraf; Lundberg, Neil

    2004-02-01

    The Bengal basin, a complex foreland basin south of the eastern Himalayas, exhibits dramatic variability in Neogene sediment thickness that reflects a complicated depositional and tectonic history. This basin originally formed as a trailing margin SE of the Indian continental crust, complicated by convergence with Asia to the north and oblique convergence with Burma to the east. Newly compiled isopach data and previously reported seismic data show evidence of thickening of basin fill toward the south, opposite of the pattern typically seen in foreland basins. This is presumably due to sedimentary loading of voluminous deltaic sediments near the continent-ocean boundary and basinward downfaulting analogous to that in the Gulf of Mexico. Isopach data show that there is considerable vertical relief along the base of the Miocene stratigraphic sequence, probably due to down-to-the-basin faulting caused by focused deltaic sedimentation and associated crustal flexure. In contrast, when viewed in east-west profile, basin shape is more typical of a foreland basin, with strata thickening eastward toward the Indo-Burman ranges, which reflects east-west convergence with Southeast Asia. Comparison of the lateral and vertical extent of the Bhuban and Boka Bil Formations with the Bouguer anomaly map of Bangladesh suggests that considerable subsidence of the Sylhet trough (in the northeastern part of the Bengal basin), which has the lowest gravity value of the region, had not taken place by the end of the Miocene. This post-Miocene subsidence is attributed to tectonic loading from southward thrusting of the Shillong Plateau along the Dauki fault. Relatively uniform Miocene isopachs across the Sylhet trough confirm that this began in the Pliocene, consistent with results of recent research on sediment provenance. In the northwest, in the region south of the Siwalik foreland basin, continental crust has not as yet been loaded, allowing relatively little accommodation space for

  9. Madagascar: Heads It's a Continent, Tails It's an Island

    NASA Astrophysics Data System (ADS)

    de Wit, Maarten J.

    Neither geologists nor biologists have a definition that is capable of classifying Madagascar unambiguously as an island or a continent; nor can they incorporate Malagasy natural history into a single model rooted in Africa or Asia. Madagascar is a microcosm of the larger continents, with a rock record that spans more than 3000 million years (Ma), during which it has been united episodically with, and divorced from, Asian and African connections. This is reflected in its Precambrian history of deep crustal tectonics and a Phanerozoic history of biodiversity that fluctuated between cosmopolitanism and parochialism. Both vicariance and dispersal events over the past 90 Ma have blended a unique endemism on Madagascar, now in decline following rapid extinctions that started about 2000 years ago.

  10. The Continent-Ocean Boundary of the South China Sea

    NASA Astrophysics Data System (ADS)

    Wan, Ling; Yao, Bochu; Zhang, Huodai; Han, Bin

    2014-05-01

    The Continent-Ocean Boundary of the South China Sea Ling Wan Bochu Yao Huodai Zhang Bin Han (Guangzhou Marine Geological Survey, Guangzhou, China, 510760) The determination of the Continent-Ocean Boundary (COB) of the South China Sea (SCS) is a key issue related to fully understanding the rifted continental margins and evolutionof the SCS. But the COB of the SCS is highly variable in different ways by different researcher. In this paper, we investigate the boundary between the continental and oceanic crust of this basin mainly relied on the multiple-channel seismic profiles constrained by free air gravity anomaly and magnetic anomaly. Based on the synthesied gephysical interpretation the COB of the SCS is relocated. Furthermore, the COB patterns of the SCS are presented.

  11. Mid-Continent rift system - a frontier hydrocarbon province

    SciTech Connect

    Lee, C.K.; Kerr, S.D. Jr.

    1983-08-01

    Geophysical evidence in the Mid-Continent has led to delineation of a rift system active during the Proterozoic Y Era. The Mid-Continent rift system can be traced by the Mid-Continent gravity high and corresponding aeromagnetic anomaly signature from the surface exposure of the Keweenawan Supergroup in the Lake Superior basin southwest in the subsurface through Wisconsin, Minnesota, Iowa, Nebraska, and Kansas. The aeromagnetic anomaly signature of the rift trend discloses where these sediments have been preserved. Thick accumulations of upper Proterozoic sediments are indicated by both upward continuation of the aeromagnetic profiles across the rift trend and gravity models which incorporate: 1) a deep mafic body to create the narrow gravity high, 2) anomalously thick crust to account for the more regional gravity low, and 3) sedimentary accumulations on the Precambrian surface to explain the small-scale notches which occur within the narrow gravity high. Reflection seismic data are virtually unknown in the rift area; however, data recently acquired by COCORP across the southern end of the feature in Kansas provide evidence of thick stratified sequences in the rift valley. Studies of the East African rift have revealed that the tropical rift valley is an exceptionally fertile environment for deposition and preservation of kerogenous material. The Sirte, Suez, Viking, Dnieper-Donetz, and Tsaidam basins are just a few of the rift basins currently classed as giant producers. The existence of a rift basin trend with thick accumulations of preserved sediments, demonstrably organic rich, introduces the northern Mid-Continent US as a new frontier for hydrocarbon exploration.

  12. Mid-continent natural gas reservoirs and plays

    SciTech Connect

    Bebout, D.G. )

    1993-09-01

    Natural gas reservoirs of the mid-continent states of Oklahoma, Kansas, and Arkansas (northern part) have produced 103 trillion cubic ft (tcf) of natural gas. Oklahoma has produced the most, having a cumulative production of 71 tcf. The major reservoirs (those that have produced more than 10 billion ft[sup 3]) have been identified and organized into 28 plays based on geologic age, lithology, and depositional environment. The Atlas of Major Midcontinent Gas Reservoirs, published in 1993, provides the documentation for these plays. This atlas was a collaborative effort of the Gas Research Institute; Bureau of Economic Geology. The University of Texas at Austin; Arkansas Geological Commission; Kansas Geological survey; and Oklahoma Geological Survey. Total cumulative production for 530 major reservoirs is 66 tcf associated and nonassociated gas. Oklahoma has the highest production with 39 tcf from 390 major reservoirs, followed by Kansas with 26 tcf from 105 major reservoirs. Most of the mid-continent production is from Pennsylvanian (46%) and Permian (41%) reservoirs; Mississippian reservoirs account for 10% production, and lower Paleozoic reservoirs, 3%. The largest play by far is the Wolfcampian Shallow Shelf Carbonate-Hugoton Embayment play with 25 tcf cumulative production, most of which is from the Hugoton and Panoma fields in Kansas and Guymon-Hugoton gas area in Oklahoma. A total of 53% of the mid-continent gas production is from dolostone and limestone reservoirs; 39% is from sandstone reservoirs. The remaining 8% is from chert conglomerate and granite-wash reservoirs. Geologically based plays established from the distribution of major gas reservoirs provide important support for the extension of productive trends, application of new resource technology to more efficient field development, and further exploration in the mid-continent region.

  13. Extreme events in gross primary production: a characterization across continents

    NASA Astrophysics Data System (ADS)

    Zscheischler, J.; Reichstein, M.; Harmeling, S.; Rammig, A.; Tomelleri, E.; Mahecha, M. D.

    2014-06-01

    Climate extremes can affect the functioning of terrestrial ecosystems, for instance via a reduction of the photosynthetic capacity or alterations of respiratory processes. Yet the dominant regional and seasonal effects of hydrometeorological extremes are still not well documented and in the focus of this paper. Specifically, we quantify and characterize the role of large spatiotemporal extreme events in gross primary production (GPP) as triggers of continental anomalies. We also investigate seasonal dynamics of extreme impacts on continental GPP anomalies. We find that the 50 largest positive extremes (i.e., statistically unusual increases in carbon uptake rates) and negative extremes (i.e., statistically unusual decreases in carbon uptake rates) on each continent can explain most of the continental variation in GPP, which is in line with previous results obtained at the global scale. We show that negative extremes are larger than positive ones and demonstrate that this asymmetry is particularly strong in South America and Europe. Our analysis indicates that the overall impacts and the spatial extents of GPP extremes are power-law distributed with exponents that vary little across continents. Moreover, we show that on all continents and for all data sets the spatial extents play a more important role for the overall impact of GPP extremes compared to the durations or maximal GPP. An analysis of possible causes across continents indicates that most negative extremes in GPP can be attributed clearly to water scarcity, whereas extreme temperatures play a secondary role. However, for Europe, South America and Oceania we also identify fire as an important driver. Our findings are consistent with remote sensing products. An independent validation against a literature survey on specific extreme events supports our results to a large extent.

  14. Extreme events in gross primary production: a characterization across continents

    NASA Astrophysics Data System (ADS)

    Zscheischler, J.; Mahecha, M. D.; Harmeling, S.; Rammig, A.; Tomelleri, E.; Reichstein, M.

    2014-01-01

    Climate extremes can affect the functioning of terrestrial ecosystems, for instance via a reduction of the photosynthetic capacity or alterations of respiratory processes. Yet the dominant regional and seasonal effects of hydrometeorological extremes are still not well documented. Here we quantify and characterize the role of large spatiotemporal extreme events in gross primary production (GPP) as triggers of continental anomalies. We also investigate seasonal dynamics of extreme impacts on continental GPP anomalies. We find that the 50 largest positive (increase in uptake) and negative extremes (decrease in uptake) on each continent can explain most of the continental variation in GPP, which is in line with previous results obtained at the global scale. We show that negative extremes are larger than positive ones and demonstrate that this asymmetry is particularly strong in South America and Europe. Most extremes in GPP start in early summer. Our analysis indicates that the overall impacts and the spatial extents of GPP extremes are power law distributed with exponents that vary little across continents. Moreover, we show that on all continents and for all data sets the spatial extents play a more important role than durations or maximal GPP anomaly when it comes to the overall impact of GPP extremes. An analysis of possible causes implies that across continents most extremes in GPP can best be explained by water scarcity rather than by extreme temperatures. However, for Europe, South America and Oceania we identify also fire as an important driver. Our findings are consistent with remote sensing products. An independent validation against a literature survey on specific extreme events supports our results to a large extent.

  15. Continents on the Move or "Where in the World Did Antarctica Come From?"

    ERIC Educational Resources Information Center

    CSTA Journal, 1995

    1995-01-01

    Presents an activity in which students trace the movement of the continents over the past 600 million years to help them understand how the continents' size and position have changed over time. Includes map puzzle pieces. (MKR)

  16. When you have urinary incontinence

    MedlinePlus

    ... rub baking soda into the stain, and then vacuum off the baking powder. You can also use ... management of urinary incontinence: behavioral and pelvic floor therapy, urethral and pelvic devices. In: Wein AJ, ed. ...

  17. Urinary Tract Infections in Adults

    MedlinePlus

    ... that obstructs the flow of urine—a kidney stone or enlarged prostate, for example—is at risk ... the urinary tract, such as an obstructive kidney stone or prostate enlargement that squeezes the urethra. Health ...

  18. Urinary Tract Infections (For Teens)

    MedlinePlus

    ... more serious infection that reaches the kidneys. continue Bacteria Are to Blame UTIs are usually caused by ... as soon as possible. previous continue Battling the Bacteria Only your health care provider can treat urinary ...

  19. Hyperammonemia in Urinary Tract Infections

    PubMed Central

    Kenzaka, Tsuneaki; Kato, Ken; Kitao, Akihito; Kosami, Koki; Minami, Kensuke; Yahata, Shinsuke; Fukui, Miho; Okayama, Masanobu

    2015-01-01

    Objectives The present study investigated the incidence of hyperammonemia in urinary tract infections and explored the utility of urinary obstruction relief and antimicrobial administration to improve hyperammonemia. Methods This was an observational study. Subjects were patients who were diagnosed with urinary tract infection and hospitalized between June 2008 and June 2009. We measured plasma ammonia levels on admission in patients who were clinically diagnosed with urinary tract infection and hospitalized. We assessed each patient's level of consciousness on admission using the Glasgow Coma Scale (GCS) and performed urine and blood cultures. We also assessed hearing prior to hospitalization using the Eastern Cooperative Oncology Group performance status (ECOG-PS). In cases with high ammonia levels on admission, plasma ammonia and GCS were measured 24 hours and 5–7 days later. Results Sixty-seven candidates were enrolled; of these, 60 cases (89.6%) with bacterial cell counts ≥104 CFU/mL were studied. Five cases (8.3%) presented with high plasma ammonia levels. Cases with hyperammonemia were significantly more likely to present with low GCS scores and urinary retention rate. All five cases received antimicrobial therapy with an indwelling bladder catheter to relieve urinary retention. The case 5 patient died shortly after admission due to complicated aspiration pneumonia; in the remaining cases, plasma ammonia levels were rapidly normalized and the level of consciousness improved. Conclusions The occurrence of hyperammonemia in urinary tract infections is not rare. The cause of hyperammonemia is urinary retention obstruction. Therefore, along with antimicrobial administration, relief of obstruction is important for the treatment of hyperammonemia caused by this mechanism. PMID:26292215

  20. Urinary conduits in gynecologic oncology

    SciTech Connect

    Hancock, K.C.; Copeland, L.J.; Gershenson, D.M.; Saul, P.B.; Wharton, J.T.; Rutledge, F.N.

    1986-05-01

    Over an 11-year period (1971 to 1981), 212 urinary conduit surgeries were performed by the Department of Gynecology at the University of Texas, M. D. Anderson Hospital and Tumor Institute at Houston. The urinary diversions were performed as part of the pelvic exenteration operation in 154 patients, for radiation injury in 48 patients, and for palliation of disease recurrence in ten patients. Ninety-three percent had prior pelvic radiotherapy. Various segments of the gastrointestinal tract were used, including the ileum (102), sigmoid colon (99), transverse colon (four), jejunum (four), and others (three). Fifty percent of abnormal preoperative intravenous pyelograms reverted to normal after urinary diversion. Revision of the stoma was required in 6%. Other complications included infection (18%), renal loss (17%), and urinary leaks and fistulae (3%). The overall perioperative mortality was 7%, decreasing from 11% in the first five years to 3% during the last six years. Ureteral stents were routinely used. When selecting a segment of bowel for a urinary conduit, both tissue quality and mobility are important. Mortality and morbidity of urinary conduit surgery continues to decrease with experience.

  1. How Do People Make Continence Care Happen? An Analysis of Organizational Culture in Two Nursing Homes

    ERIC Educational Resources Information Center

    Lyons, Stacie Salsbury

    2010-01-01

    Purpose: Although nursing homes (NHs) are criticized for offering poor quality continence care, little is known about the organizational processes that underlie this care. This study investigated the influence of organizational culture on continence care practices in two NHs. Design and Methods: This ethnographic study explored continence care…

  2. Exploring the dark continent with fibre Bragg gratings

    NASA Astrophysics Data System (ADS)

    Arkwright, John W.; Wang, David Hsiao-Chuan; Maunder, Simon A.; Blenman, Neil G.; Underhill, Ian; Patton, Vicki; Dinning, Phil G.

    2014-05-01

    The lower gastrointestinal tract has been referred to as the `Dark Continent' of the human body because it is so hard to access without resorting to a surgeon's blade. In response to an unmet clinical need we have developed a fibre optic manometry catheter that is now in clinical use across Australia and New Zealand. The unparalleled detail of colonic activity that these devices provide is being hailed as ground breaking by global experts. In this paper we present the design and clinical application of the catheters, and also some of the (sometimes surprising) requirements of our clinical colleagues.

  3. Slow Mid-Lithosphere Beneath the Mid-continent, USA

    NASA Astrophysics Data System (ADS)

    Bedle, H.; van der Lee, S.

    2005-12-01

    The Illinois basin is one of several basins within the North American craton. Despite years of study, the formational mechanisms of the basin remain largely unknown. While the crustal structure of the basin is well-defined from seismic studies, it remains unclear whether the basin is expressed in the sub-crustal structure; and, if the mantle structure provides clues towards an understanding the basin. We study the S-velocity structure of the upper-mantle using seismic tomography beneath the Illinois basin and its surrounding area. Since this area of the North American craton has been relatively stable since 1.4 Gy, significant deviations in S-velocities within the uppermost mantle are not expected. Nevertheless, a slower S-velocity in the upper-mantle of the Illinois basin was previously modeled in the 3D model NA04 (van der Lee and Frederiksen, 2005). To improve resolution and verify the existence of this seismically slow region, we fit seismic waveforms from 11 mid-continent events, using the methodology of Partitioned Waveform Inversion (Nolet, 1990). In doing so, we also incorporate constraints that are representative of the Illinois basin's crustal and sedimentary layering. The resultant 3D model, IL05, confirms the existence of a slow S-velocity structure in the uppermost mantle beneath this region. This anomalously slow region exists from the base of the crust to depths of ~100 km, and is slower than a cratonic average by about 200 m/s. The slow uppermost-mantle beneath the Illinois basin is then underlain by a faster lithosphere typical of the North American craton to depths of ~200 km. The coherency of this deeper cratonic lithosphere rules out a lithospheric delamination origin of the anomaly. The model IL05 points to a heterogeneous mantle beneath the mid-continent. Our imaging agrees with evidence of a heterogeneous mantle recently found in the form of sub-Moho reflectors from reprocessed seismic reflection surveys (McBride and Okure, 2004). The

  4. Currents in the mantle and the geology of continents

    NASA Astrophysics Data System (ADS)

    Wilson, J. Tuzo

    1991-02-01

    This paper is the first of a series which have considered the possible effects of currents in the mantle upon continents. It mentions effects of aging in oceans upon the direction of slope of coastal peneplains. When oceans are young the coasts are cliffs from which peneplains dip downward on the inland side. As the margins separate from the ridge they cool and the slopes reverse. It suggests how Jeffreys' arguments against convection currents breaking the lithosphere can be avoided and discusses the possibility that upwelling has penetrated beneath the southwestern United States.

  5. Female urinary incontinence rehabilitation.

    PubMed

    Di Benedetto, P

    2004-08-01

    Pelvic floor rehabilitation (PFR) is an important and recommended strategy for the treatment of many urogynecological disorders including urinary incontinence (UI). The recognised pioneer of PFR is the American gynecologist Arnold Kegel who, over 50 years ago, proposed pelvic floor muscle exercises (PFME) to prevent and/or treat female UI. Kegel's techniques were successfully used by others too, but as the years passed these techniques sank into unjustified oblivion. In the 1980s in Europe the medical world's interest in PFME techniques gained ground, contemporaneously with functional electrical stimulation (FES) and biofeedback (BFB). As a general rule, the least invasive and least dangerous procedure for the patient should be the first choice, and behavioural and rehabilitative techniques should be considered as the first line of therapy for UI. The behavioural approaches in women with UI and without cognitive deficits are tailored to the patient's underlying problem, such as bladder training or retraining (BR) for urge UI. BR has many variations but generally consists of education, scheduled voiding, and positive reinforcements. The rehabilitative approaches comprise BFB, FES, PFME, and vaginal cones (VC). BFB allows the subject to modify the unconscious physiological events, while FES is aimed at strengthening perineal awareness, increasing the tone and trophism of the pelvic floor, and inhibiting detrusor overactivity. PFME play an extremely important role in the conservative treatment of UI and overactive bladder, and many studies have demonstrated their effectiveness. Many authors have used the different methods for PFR in a heterogeneous manner: the best results were obtained when protocols requiring the contemporary use of 2 or more techniques were followed. PMID:15377984

  6. Palliative urinary conduit diversion in cases of intolerable urinary discomfort

    SciTech Connect

    Lyndrup, J.; Sorensen, B.L.

    1983-12-01

    Fifteen patients with incurable gynecological cancers, all primary radiation treated and all having severe urinary discomfort due to urinary tract injuries were retrospectively examined after urinary conduit diversion. All have been followed-up until termination or until all survivors had lived for 6 months after the operation. Twelve of the 15 were discharged from the hospital, 10 of whom survived the first 6 months. Of those discharged 82% of the cumulated sum of postoperative observations days was spent out of the hospital. At the end of the observation period nine patients had been supplied with a colostomy as well, thus having double stomas. All six patients still alive declared in retrospect that given the choice again, they would still be willing to undergo the operation.

  7. Composition of urinary calculi related to urinary tract infection.

    PubMed

    Ohkawa, M; Tokunaga, S; Nakashima, T; Yamaguchi, K; Orito, M; Hisazumi, H

    1992-09-01

    The composition of 3,084 urinary calculi was determined using an infrared spectrophotometer. Mixed calcium oxalate-calcium phosphate stones were most frequently implicated. Of the urinary calculi analyzed 199 were associated with urinary tract infection. Escherichia coli was most frequently isolated (43 strains) and urease-producing organisms, such as Proteus mirabilis, were cultured from 40 patients. The core culture of 20 staghorn calculi yielded 15 isolates from 14 stones. There were 13 identical species isolated from the urine and stone specimens of 13 patients (65%), including 7 strains of P. mirabilis. These results suggest that cultures of urine specimens of urolithiasis patients, especially those with staghorn calculi, may help to elucidate the bacteriology of the stones. PMID:1507358

  8. Catheter associated urinary tract infections

    PubMed Central

    2014-01-01

    Urinary tract infection attributed to the use of an indwelling urinary catheter is one of the most common infections acquired by patients in health care facilities. As biofilm ultimately develops on all of these devices, the major determinant for development of bacteriuria is duration of catheterization. While the proportion of bacteriuric subjects who develop symptomatic infection is low, the high frequency of use of indwelling urinary catheters means there is a substantial burden attributable to these infections. Catheter-acquired urinary infection is the source for about 20% of episodes of health-care acquired bacteremia in acute care facilities, and over 50% in long term care facilities. The most important interventions to prevent bacteriuria and infection are to limit indwelling catheter use and, when catheter use is necessary, to discontinue the catheter as soon as clinically feasible. Infection control programs in health care facilities must implement and monitor strategies to limit catheter-acquired urinary infection, including surveillance of catheter use, appropriateness of catheter indications, and complications. Ultimately, prevention of these infections will require technical advances in catheter materials which prevent biofilm formation. PMID:25075308

  9. [Infection-induced urinary stones].

    PubMed

    Bichler, K-H; Eipper, E; Naber, K

    2003-01-01

    Infection stones make up approximately 15% of urinary stone diseases and are thus an important group. These stones are composed of struvite and/or carbonate apatite. The basic precondition for the formation of infection stones is a urease-positive urinary tract infection. Urease is necessary to split urea into ammonia and CO(2). As a result, ammonia ions can form and at the same time alkaline urine develops, both being preconditions for the formation of struvite and carbonate apatite crystals. When these crystals are deposited infection stones form. Pathogenetically, various risk factors play a role: urinary obstruction, neurogenic bladder, dRTA, and MSK. If these infections are not treated and the stones are not removed, the kidney will be damaged. Modern methods are available for stone removal, e.g., ESWL and/or instrumental urinary stone removal. Here, especially less invasive methods are preferable. Any treatment must be adjusted to the patient individually. Patients should be examined frequently for recurrent urinary tract infections and stone recurrences, and new infections must be resolutely treated. Good therapy and prophylaxis are possible with present-day treatment modalities. PMID:12574884

  10. Continents as lithological icebergs: The importance of buoyant lithospheric roots

    USGS Publications Warehouse

    Abbott, D.H.; Drury, R.; Mooney, W.D.

    1997-01-01

    An understanding of the formation of new continental crust provides an important guide to locating the oldest terrestrial rocks and minerals. We evaluated the crustal thicknesses of the thinnest stable continental crust and of an unsubductable oceanic plateau and used the resulting data to estimate the amount of mantle melting which produces permanent continental crust. The lithospheric mantle is sufficiently depleted to produce permanent buoyancy (i.e., the crust is unsubductable) at crustal thicknesses greater than 25-27 km. These unsubductable oceanic plateaus and hotspot island chains are important sources of new continental crust. The newest continental crust (e.g., the Ontong Java plateau) has a basaltic composition, not a granitic one. The observed structure and geochemistry of continents are the result of convergent margin magmatism and metamorphism which modify the nascent basaltic crust into a lowermost basaltic layer overlain by a more silicic upper crust. The definition of a continent should imply only that the lithosphere is unsubductable over ??? 0.25 Ga time periods. Therefore, the search for the oldest crustal rocks should include rocks from lower to mid-crustal levels.

  11. Pressure injury prevention: continence, skin hygiene and nutrition management.

    PubMed

    Roosen, Kerri; Fulbrook, Paul; Nowicki, Tracy

    2010-08-10

    To prevent pressure injuries research indicates the importance of focusing on three key areas of practice: continence, skin hygiene and nutrition. These are a synergistic trio and many patients require considered management in all three areas. In addition to targeting specific aspects of nursing care in these areas, it is also crucial that there is organisational buy-in for strategic initiatives. Some of the ways that we achieved this are outlined below: Support from managerial level by presenting evidence and education to senior nurses and directors. Nurse unit managers completed individual ward action plans outlining their individual commitments to reducing pressure injuries. Providing support and education to staff to choose and use continence products effectively. Support from allied health colleagues in prevention of pressure injuries. After implementing the actions described above, pressure injury prevalence at the Prince Charles Hospital in Brisbane decreased from 13.78% in 2008 to 5.15% in 2010, representing a 62% reduction overall. Of these pressure injuries, 53% were stage one. PMID:20862898

  12. Permo-carboniferous hydrocarbon accumulations, Mid-continent, USA

    SciTech Connect

    Rascoe, B.; Adler, F.J.

    1983-06-01

    Approximately 19.4 billion bbl of oil and 119 tcf of nonassociated gas have been discovered in the Mid-Continent as of January 1, 1978. Although these volumes of hydrocarbons were trapped in thousands of fields throughout the Mid-Continent, the bulk of these resources were emplaced in a relatively few fields about 14.2 billion bbl of oil have been found in 111 significant and giant oil fields, and 103 tcf of nonassociated gas have been discovered in 57 significant and giant gas fields. PermoCarboniferous reservoirs are important in 101 of the large oil fields and 55 of the large gas fields; these fields contained 9.5 billion bbl of oil and 99 tcf of gas, respectively. Our calculations of the total oil and gas accumulations in Permo-Carboniferous reservoirs extrapolated from these data. About 2.1 billion bbl of oil and 5.1 tcf of nonassociated gas accumulated in Lower Carboniferous (Mississippian) reservoirs. Most of this oil and gas was stratigraphically trapped in Upper Mississippian sandstones and carbonates which are truncated at the pre-Pennsylvanian unconformity surface.

  13. Petroleum geology and hydrocarbon exploration in the continent of China

    SciTech Connect

    Xiaoguang Tong )

    1996-01-01

    The geological structure of the continent of China, which is formed by the amalgamation of three small-sized paleocratons and their peripheral orogenic belts, is very complex. Six big sedimentary basins developed on it: four of them are composite basins on the paleocratons; the other two basins are superimposed on the orogenic belts. In addition, there are a large number of small to middle-sized non-marine sedimentary basins. Up to now, the proved geological reserves in the continent of China are: oil, above 16 billion tons; natural gas, 1000 billion cubic meters. Last year, the annual oil output was more than 140 million tons; natural gas output reached 16 billion cubic meters. The six big basins are still the major exploration potential area. On the other hand, a lot of small to middle-sized reservoirs will be discovered in the small to middle-sized non-marine basins and coal-bearing basins in North China. Qiang Tang Basin and coalbed gas are two favorable frontiers.

  14. Petroleum geology and hydrocarbon exploration in the continent of China

    SciTech Connect

    Xiaoguang Tong

    1996-12-31

    The geological structure of the continent of China, which is formed by the amalgamation of three small-sized paleocratons and their peripheral orogenic belts, is very complex. Six big sedimentary basins developed on it: four of them are composite basins on the paleocratons; the other two basins are superimposed on the orogenic belts. In addition, there are a large number of small to middle-sized non-marine sedimentary basins. Up to now, the proved geological reserves in the continent of China are: oil, above 16 billion tons; natural gas, 1000 billion cubic meters. Last year, the annual oil output was more than 140 million tons; natural gas output reached 16 billion cubic meters. The six big basins are still the major exploration potential area. On the other hand, a lot of small to middle-sized reservoirs will be discovered in the small to middle-sized non-marine basins and coal-bearing basins in North China. Qiang Tang Basin and coalbed gas are two favorable frontiers.

  15. Treatment of continence in people with learning disabilities: 3.

    PubMed

    Stanley, R

    Behaviourism is a model of intervention for people with a learning disability which focuses on observable behaviour and methods of changing it. The behaviourist strategies do not typically place high value on some of the diagnostic labels that have been considered in the first two articles of this series (Vol 5(6): 364-8; Vol 5(8): 492-8). Rather, the behaviourist is concerned with the behaviours a particular individual shows. Behaviour modification is a particular methodology within psychotherapy that has many interpretations, ranging from a rigid orthodoxy through to an eclectic ecumenicism of theoretical models. The third article in this series on the management of continence in people with a learning disability examines the behavioural strategies that have been historically and are currently available to practitioners. The legacy of behaviour modification (1970s style) means that staff do sometimes perceive such strategies as treatment, whereas in fact the treatment is a combination of designing the environment, designing individual programmes and designing specific ways of developing more valuing forms of continence management. PMID:9015995

  16. Archean komatiite volcanism controlled by the evolution of early continents.

    PubMed

    Mole, David R; Fiorentini, Marco L; Thebaud, Nicolas; Cassidy, Kevin F; McCuaig, T Campbell; Kirkland, Christopher L; Romano, Sandra S; Doublier, Michael P; Belousova, Elena A; Barnes, Stephen J; Miller, John

    2014-07-15

    The generation and evolution of Earth's continental crust has played a fundamental role in the development of the planet. Its formation modified the composition of the mantle, contributed to the establishment of the atmosphere, and led to the creation of ecological niches important for early life. Here we show that in the Archean, the formation and stabilization of continents also controlled the location, geochemistry, and volcanology of the hottest preserved lavas on Earth: komatiites. These magmas typically represent 50-30% partial melting of the mantle and subsequently record important information on the thermal and chemical evolution of the Archean-Proterozoic Earth. As a result, it is vital to constrain and understand the processes that govern their localization and emplacement. Here, we combined Lu-Hf isotopes and U-Pb geochronology to map the four-dimensional evolution of the Yilgarn Craton, Western Australia, and reveal the progressive development of an Archean microcontinent. Our results show that in the early Earth, relatively small crustal blocks, analogous to modern microplates, progressively amalgamated to form larger continental masses, and eventually the first cratons. This cratonization process drove the hottest and most voluminous komatiite eruptions to the edge of established continental blocks. The dynamic evolution of the early continents thus directly influenced the addition of deep mantle material to the Archean crust, oceans, and atmosphere, while also providing a fundamental control on the distribution of major magmatic ore deposits. PMID:24958873

  17. Archean komatiite volcanism controlled by the evolution of early continents

    PubMed Central

    Mole, David R.; Fiorentini, Marco L.; Thebaud, Nicolas; Cassidy, Kevin F.; McCuaig, T. Campbell; Kirkland, Christopher L.; Romano, Sandra S.; Doublier, Michael P.; Belousova, Elena A.; Barnes, Stephen J.; Miller, John

    2014-01-01

    The generation and evolution of Earth’s continental crust has played a fundamental role in the development of the planet. Its formation modified the composition of the mantle, contributed to the establishment of the atmosphere, and led to the creation of ecological niches important for early life. Here we show that in the Archean, the formation and stabilization of continents also controlled the location, geochemistry, and volcanology of the hottest preserved lavas on Earth: komatiites. These magmas typically represent 50–30% partial melting of the mantle and subsequently record important information on the thermal and chemical evolution of the Archean–Proterozoic Earth. As a result, it is vital to constrain and understand the processes that govern their localization and emplacement. Here, we combined Lu-Hf isotopes and U-Pb geochronology to map the four-dimensional evolution of the Yilgarn Craton, Western Australia, and reveal the progressive development of an Archean microcontinent. Our results show that in the early Earth, relatively small crustal blocks, analogous to modern microplates, progressively amalgamated to form larger continental masses, and eventually the first cratons. This cratonization process drove the hottest and most voluminous komatiite eruptions to the edge of established continental blocks. The dynamic evolution of the early continents thus directly influenced the addition of deep mantle material to the Archean crust, oceans, and atmosphere, while also providing a fundamental control on the distribution of major magmatic ore deposits. PMID:24958873

  18. Correlation of Mid-Continent Virgilian (Late Pennsylvanian) Brachiopods

    SciTech Connect

    Weibel, C.P.

    1986-05-01

    Biostratigraphic correlations of Pennsylvanian strata in the Illinois basin with those of the Western Interior basin have been restricted largely to comparison of ostracode faunules and a few fusulinid occurrences. Seventeen brachiopod species from the Bogota and Greenup Limestone Members of the upper Mattoon Formation in east-central Illinois resemble species from Late Pennsylvanian Mid-Continent localities. Five Bogota species have relatively restricted ranges and are useful for correlation. Neochonetes granulifer var. transversalis is rare in the Douglas Group but abundant in the Shawnee and Wabaunsee. Lissochonetes geinitzianus var. plattsmouthensis ranges from uppermost Missourian to upper Shawnee and L. geinitzianus var. geronticus ranges from upper Wabaunsee to Lower Permian. Derbyia texana occurs in the Thrifty Formation of north Texas (probably upper Shawnee or lower Wabaunsee). Antiquatonia jemezensis has not been reported in the Mid-Continent but occurs in the upper Madera formation (probable Shawnee or early Wabaunsee) of New Mexico. A compositid from the younger Greenup Limestone Member is morphologically intermediate between the Early Pennsylvanian Composita wasatchensis and the middle Permian C. affinis. Other species from the Bogota and Greenup members range throughout the Upper Pennsylvanian, except for one linoproductid of Missourian affinities. This study, along with a previous study of brachiopods (Shumway Limestone Member) and of fusulinids, indicates that the Bogota is of middle Shawnee age, the Greenup is of upper Shawnee or lower Wabaunsee age, and the Missourian-Virgilian boundary in the Illinois basin is stratigraphically near the Omega Limestone Member.

  19. Climate control of terrestrial carbon exchange across biomes and continents

    SciTech Connect

    Ricciuto, Daniel M; Gu, Lianhong

    2010-07-01

    Understanding the relationships between climate and carbon exchange by terrestrial ecosystems is critical to predict future levels of atmospheric carbon dioxide because of the potential accelerating effects of positive climate carbon cycle feedbacks. However, directly observed relationships between climate and terrestrial CO2 exchange with the atmosphere across biomes and continents are lacking. Here we present data describing the relationships between net ecosystem exchange of carbon (NEE) and climate factors as measured using the eddy covariance method at 125 unique sites in various ecosystems over six continents with a total of 559 site-years. We find that NEE observed at eddy covariance sites is (1) a strong function of mean annual temperature at mid- and high-latitudes, (2) a strong function of dryness at mid- and low-latitudes, and (3) a function of both temperature and dryness around the mid-latitudinal belt (45 N). The sensitivity of NEE to mean annual temperature breaks down at ~ 16 C (a threshold value of mean annual temperature), above which no further increase of CO2 uptake with temperature was observed and dryness influence overrules temperature influence.

  20. Hydration of the lithospheric mantle by the descending plate in a continent-continent collisional setting and its geodynamic consequences

    NASA Astrophysics Data System (ADS)

    Massonne, Hans-Joachim

    2016-05-01

    At the beginning of continent-continent collision the descending plate dehydrates. The influence of this dehydration on the adjacent lithospheric mantle was studied. For this reason, pressure (P), temperature (T) and T-H2O pseudosections were calculated for an average mantle composition using the computer software PERPLE_X. These pseudosections were contoured by isopleths, for instance, for volumes of amphibole, chlorite, and serpentine. In addition, P-T pseudosections were considered for four psammopelitic rocks, common in the upper portion of the continental crust, in order to quantify the release of H2O in these rocks during prograde metamorphism. At pressures around 1 GPa, a maximum of slightly more than 10 vol.% chlorite, almost 20 vol.% amphibole, and some talc but no serpentine forms when only 1.8 wt.% H2O is added to the dry ultrabasite at temperatures of 600 °C. For example, hydrous phases amount to about 35 vol.% serpentine and 10 vol.% each of chlorite and amphibole at 1 GPa, 550 °C, and 5 wt.% H2O. The modelled psammopelitic rocks can release 0.8-2.5 wt.% H2O between 450 and 650 °C at 0.8-1.4 GPa. On the basis of the above calculations, different collisional scenarios are discussed highlighting the role of hydrated lithospheric mantle. In this context a minimum hydration potential of the front region of the descending continental plate is considered, which amounts to 4.6 × 1016 kg releasable H2O for a 1000 km wide collisional zone, due to a thick sedimentary pile at the continental margin. Further suggestions are that (1) the lower crustal plate in a continent-continent collisional setting penetrates the lithospheric mantle, which is hydrated during the advancement of this plate, (2) the maximum depths of the subduction of upper continental crust is below 70 km and (3) hydrated mantle above the descending crustal plate is thrust onto this continental crust.

  1. The place of science in a continent at the crossroads.

    PubMed

    Koech, D K

    2001-01-01

    I have mentioned it before and I want to repeat it now, that we in Africa share a common history, heritage and basic problems of development. We, therefore, have an inescapable responsibility of pooling our talents and resources in shaping our common destiny. In fulfillment of its mission, AFHES, through its organized con notgresses and this Journal, is an invaluable vessel for enabling us to promote better health for the peoples of this continent. Africa is a continent endowed with great potential that, for one reason or an notother, has been ignored or misused, resulting in the current crisis now enveloping the continent. There is the escalating debt burden, falling agricultural productivity and the ever-increasing population. Efforts to improve the situation are hampered by adverse factors such as malnutrition, HTV/AIDS, malaria and other causes of ill health; wars, poor environmental management and the ever-worrisome problem of refugees. At the sunrise of the 21st Century, we must wake up and reverse the current trend by focusing our resources on priority areas of development. The fight for freedom from the yoke of colonialism and the traumatic experience of apartheid has been won. In some African countries, however, the winning of the fight for freedom has opened up a new fight, a fight that is more fierce and bloody than that which set us free. These include civil strife and internecine wars giving rise to a new black Diaspora, which is far greater than the one experienced during the period of slavery and slave trade. People supposed to build these nations have either been killed or forced into exile. Those intellectually endowed have sought refuge in safer and economically developed countries and, by the same process, also weaken the al notready weak economies of their mother countries. They have, therefore, helped to strengthen the already strong economies of the developed nations. This is indeed, a sad situation that poses a formidable challenge to the

  2. Surgical treatment for stress urinary incontinence in women: novelties, concerns and ethics.

    PubMed

    Zimmern, Philippe E

    2012-01-01

    The International Continence Society (ICS) is the largest international body of nurses, physical therapists, drug researchers, clinicians, gynecologists, urologists and other specialists united yearly to discuss the topic of incontinence. This year, over 2500 attendees from all over the world participated in the annual meeting held in Glasgow, Scotland. Several presentations deserve recognition, but we will focus on a few key issues, such as the latest information on the surgical treatment of stress urinary incontinence, a novel approach to patient's study participation in randomized controlled trials via internet recruitment, and ethical concerns related to disclosure and transparency, as these are keenly relevant topics in women's health. PMID:22171771

  3. [Magnetic urethral closure device. Negative outcome after implantation for the treatment of female urinary incontinence].

    PubMed

    Anding, R; van Ahlen, H; Müller, S C; Latz, S

    2015-07-01

    We report on a negative outcome after implantation of a magnetic urethral closure device, consisting of one part screwed into the pubic bone and one part as a vaginal cone, for the treatment of urinary stress incontinence grade III. Continence was never achieved for the patient. The urethra narrowed over time due to erosion and scarring and the patient started intermittent catheterization, because spontaneous micturition was not possible. The magnet was broken, the bladder neck was eroded, several fragments were found in the bladder, and numerous fragments were scattered throughout the small pelvis. Surgery consisted of removing most of the fragments, followed by bladder neck closure and suprapubic diversion. PMID:25989875

  4. An unusual cause of urinary retention in a young female: a case report.

    PubMed

    Regmi, Subodh Kumar; Walia, Ritika; Kumar, Rajeev

    2014-01-01

    Inflammatory myofibroblastic tumors are commonly seen in young adults and adolescents and commonly present with painless hematuria. We report a case of a 38-year-old woman who presented to us with urinary retention due to a prolapsing tumor mass from the urethra, which was discovered to be an inflammatory myofibroblastic tumor arising from the bladder base and involving the bladder neck. The patient underwent a successful transurethral resection of the tumor and at 6-month follow-up was continent and symptom-free. PMID:23860360

  5. Neurogenic lower urinary tract dysfunction: how, when, and with which patients do we use urodynamics?

    PubMed

    Danforth, Teresa L; Ginsberg, David A

    2014-08-01

    Neurogenic lower urinary tract dysfunction (NLUTD) affects many patients and requires close monitoring. Initial studies establishing patients at risk for upper tract disease revealed that high detrusor leak point pressures were predictive of upper tract disease. Urodynamics in patients with NLUTD have specific challenges. Initial studies in patients after an acute injury should be delayed until after the spinal shock phase. In children with spinal dysraphism, studies should be done early to established potential risk. The goals are maintaining low bladder pressures, decreasing risk of infection, and maintaining continence. PMID:25063601

  6. Drug-Induced Urinary Calculi

    PubMed Central

    Matlaga, Brian R; Shah, Ojas D; Assimos, Dean G

    2003-01-01

    Urinary calculi may be induced by a number of medications used to treat a variety of conditions. These medications may lead to metabolic abnormalities that facilitate the formation of stones. Drugs that induce metabolic calculi include loop diuretics; carbonic anhydrase inhibitors; and laxatives, when abused. Correcting the metabolic abnormality may eliminate or dramatically attenuate stone activity. Urinary calculi can also be induced by medications when the drugs crystallize and become the primary component of the stones. In this case, urinary supersaturation of the agent may promote formation of the calculi. Drugs that induce calculi via this process include magnesium trisilicate; ciprofloxacin; sulfa medications; triamterene; indinavir; and ephedrine, alone or in combination with guaifenesin. When this situation occurs, discontinuation of the medication is usually necessary. PMID:16985842

  7. Urinary catheters - what to ask your doctor

    MedlinePlus

    ... 303:2172-2181. Payne CK. Conservative management of urinary incontinence: behavioral and pelvic floor therapy, urethral and pelvic ... review: randomized, controlled trials of nonsurgical treatments for urinary incontinence in women. Ann Intern Med . 2008;148:459- ...

  8. OxyContin® as currency: OxyContin® use and increased social capital among rural Appalachian drug users.

    PubMed

    Jonas, Adam B; Young, April M; Oser, Carrie B; Leukefeld, Carl G; Havens, Jennifer R

    2012-05-01

    Studies have shown that position within networks of social relations can have direct implications on the health behaviors of individuals. The present study examines connections between drug use and individual social capital within social networks of drug users (n = 503) from rural Appalachian Kentucky, U.S.A. Respondent driven sampling was used to recruit individuals age 18 and older who had used one of the following drugs to get high: cocaine, crack, heroin, methamphetamine, or prescription opioids. Substance use was measured via self-report and social network analysis of participants' drug use network was used to compute effective size, a measure of social capital. Drug network ties were based on sociometric data on recent (past 6 month) drug co-usage. Multivariate multi-level ordinal regression was used to model the independent effect of socio-demographic and drug use characteristics on social capital. Adjusting for gender, income, and education, daily OxyContin(®) use was found to be significantly associated with greater social capital, and daily marijuana use was associated with less social capital. These results suggest that in regions with marked economic disparities such as rural Appalachia, OxyContin(®) may serve as a form of currency that is associated with increased social capital among drug users. Interventions focusing on increasing alternate pathways to acquiring social capital may be one way in which to alleviate the burden of drug use in this high-risk population. PMID:22465379

  9. OxyContin® as Currency: OxyContin® Use and Increased Social Capital among Rural Appalachian Drug Users

    PubMed Central

    Jonas, Adam B.; Young, April M.; Oser, Carrie B.; Leukefeld, Carl G.; Havens, Jennifer R.

    2012-01-01

    Studies have shown that position within networks of social relations can have direct implications on the health behaviors of individuals. The present study examines connections between drug use and individual social capital within social networks of drug users (n=503) from rural Appalachian Kentucky, U.S.A. Respondent driven sampling was used to recruit individuals age 18 and older who had used one of the following drugs to get high: cocaine, crack, heroin, methamphetamine, or prescription opioids. Substance use was measured via self-report and social network analysis of participants’ drug use network was used to compute effective size, a measure of social capital. Drug network ties were based on sociometric data on recent (past 6 month) drug co-usage. Multivariate multi-level ordinal regression was used to model the independent effect of sociodemographic and drug use characteristics on social capital. Adjusting for gender, income, and education, daily OxyContin® use was found to be significantly associated with greater social capital, and daily marijuana use was associated with less social capital. These results suggest that in regions with marked economic disparities such as rural Appalachia, OxyContin® may serve as a form of currency that is associated with increased social capital among drug users. Interventions focusing on increasing alternate pathways to acquiring social capital may be one way in which to alleviate the burden of drug use in this high-risk population. PMID:22465379

  10. Simulation of active tectonic processes for a convecting mantle with moving continents

    USGS Publications Warehouse

    Trubitsyn, V.; Kaban, M.; Mooney, W.; Reigber, C.; Schwintzer, P.

    2006-01-01

    Numerical models are presented that simulate several active tectonic processes. These models include a continent that is thermally and mechanically coupled with viscous mantle flow. The assumption of rigid continents allows use of solid body equations to describe the continents' motion and to calculate their velocities. The starting point is a quasi-steady state model of mantle convection with temperature/ pressure-dependent viscosity. After placing a continent on top of the mantle, the convection pattern changes. The mantle flow subsequently passes through several stages, eventually resembling the mantle structure under present-day continents: (a) Extension tectonics and marginal basins form on boundary of a continent approaching to subduction zone, roll back of subduction takes place in front of moving continent; (b) The continent reaches the subduction zone, the extension regime at the continental edge is replaced by strong compression. The roll back of the subduction zone still continues after closure of the marginal basin and the continent moves towards the upwelling. As a result the ocean becomes non-symmetric and (c) The continent overrides the upwelling and subduction in its classical form stops. The third stage appears only in the upper mantle model with localized upwellings. ?? 2006 The Authors Journal compilation ?? 2006 RAS.

  11. Midurethral Slings for Women with Stress Urinary Incontinence

    PubMed Central

    2006-01-01

    Executive Summary Objective The objective of the current review was to evaluate the safety, efficacy, and cost-effectiveness of midurethral slings compared with traditional surgery. Background This assessment was undertaken in order to update and expand upon the health technology & policy assessment of tension-free vaginal tape (TVT, Gynecare Worldwide, a division of Ethicon Inc, a Johnson & Johnson company, Somerville, New Jersey) sling procedure for stress urinary incontinence published by the Medical Advisory Secretariat in February 2004. Since the publication of the 2004 assessment, a number of TVT-like sling alternatives have become available which employ the same basic principles as TVT slings: minimally invasive, midurethral placement, self-fixing, and tension-free. This update will evaluate the efficacy and safety of midurethral slings. Clinical Need Normal continence is controlled by the nervous system and involves co-ordination between bladder, urethra, urethral sphincter, and pelvic floor. Incontinence occurs when the relationship among the above components is compromised, either due to physical damage or nerve dysfunction. (1) Stress urinary incontinence is the most common form of urinary incontinence in women. It is characterized by the “complaint of involuntary leakage on effort or exertion, or on sneezing or coughing” when there is increased abdominal pressure without detrusor (bladder wall) contraction. (2) There are 2 factors which define stress urinary incontinence: a weakening in the support of the proximal urethra, causing urethral hyper-mobility and deficiency in the sphincter, causing urethral leakage. Both factors are thought to coexist. (1) Accurate tests are not available to distinguish these 2 types of stress urinary incontinence. Urinary incontinence is estimated to affect about 250,000 Canadian women and 8 million American women aged 65 and over. (3;4) The prevalence of stress urinary incontinence is very difficult to measure because

  12. A Zn isotope perspective on the rise of continents.

    PubMed

    Pons, M-L; Fujii, T; Rosing, M; Quitté, G; Télouk, P; Albarède, F

    2013-05-01

    Zinc isotope abundances are fairly constant in igneous rocks and shales and are left unfractionated by hydrothermal processes at pH < 5.5. For that reason, Zn isotopes in sediments can be used to trace the changing chemistry of the hydrosphere. Here, we report Zn isotope compositions in Fe oxides from banded iron formations (BIFs) and iron formations of different ages. Zinc from early Archean samples is isotopically indistinguishable from the igneous average (δ(66) Zn ~0.3‰). At 2.9-2.7 Ga, δ(66) Zn becomes isotopically light (δ(66) Zn < 0‰) and then bounces back to values >1‰ during the ~2.35 Ga Great Oxygenation Event. By 1.8 Ga, BIF δ(66) Zn has settled to the modern value of FeMn nodules and encrustations (~0.9‰). The Zn cycle is largely controlled by two different mechanisms: Zn makes strong complexes with phosphates, and phosphates in turn are strongly adsorbed by Fe hydroxides. We therefore review the evidence that the surface geochemical cycles of Zn and P are closely related. The Zn isotope record echoes Sr isotope evidence, suggesting that erosion starts with the very large continental masses appearing at ~2.7 Ga. The lack of Zn fractionation in pre-2.9 Ga BIFs is argued to reflect the paucity of permanent subaerial continental exposure and consequently the insignificant phosphate input to the oceans and the small output of biochemical sediments. We link the early decline of δ(66) Zn between 3.0 and 2.7 Ga with the low solubility of phosphate in alkaline groundwater. The development of photosynthetic activity at the surface of the newly exposed continents increased the oxygen level in the atmosphere, which in turn triggered acid drainage and stepped up P dissolution and liberation of heavy Zn into the runoff. Zinc isotopes provide a new perspective on the rise of continents, the volume of carbonates on continents, changing weathering conditions, and compositions of the ocean through time. PMID:23421593

  13. Comparison of different evaporation estimates over the African continent

    NASA Astrophysics Data System (ADS)

    Trambauer, P.; Dutra, E.; Maskey, S.; Werner, M.; Pappenberger, F.; van Beek, L. P. H.; Uhlenbrook, S.

    2014-01-01

    Evaporation is a key process in the water cycle with implications ranging, inter alia, from water management to weather forecast and climate change assessments. The estimation of continental evaporation fluxes is complex and typically relies on continental-scale hydrological models or land-surface models. However, it appears that most global or continental-scale hydrological models underestimate evaporative fluxes in some regions of Africa, and as a result overestimate stream flow. Other studies suggest that land-surface models may overestimate evaporative fluxes. In this study, we computed actual evaporation for the African continent using a continental version of the global hydrological model PCR-GLOBWB, which is based on a water balance approach. Results are compared with other independently computed evaporation products: the evaporation results from the ECMWF reanalysis ERA-Interim and ERA-Land (both based on the energy balance approach), the MOD16 evaporation product, and the GLEAM product. Three other alternative versions of the PCR-GLOBWB hydrological model were also considered. This resulted in eight products of actual evaporation, which were compared in distinct regions of the African continent spanning different climatic regimes. Annual totals, spatial patterns and seasonality were studied and compared through visual inspection and statistical methods. The comparison shows that the representation of irrigation areas has an insignificant contribution to the actual evaporation at a continental scale with a 0.5° spatial resolution when averaged over the defined regions. The choice of meteorological forcing data has a larger effect on the evaporation results, especially in the case of the precipitation input as different precipitation input resulted in significantly different evaporation in some of the studied regions. ERA-Interim evaporation is generally the highest of the selected products followed by ERA-Land evaporation. In some regions, the satellite

  14. Comparison of different evaporation estimates over the African continent

    NASA Astrophysics Data System (ADS)

    Trambauer, P.; Dutra, E.; Maskey, S.; Werner, M.; Pappenberger, F.; van Beek, L. P. H.; Uhlenbrook, S.

    2013-07-01

    Evaporation is a key process in the water cycle, with implications ranging from water management, to weather forecast and climate change assessments. The estimation of continental evaporation fluxes is complex and typically relies on continental-scale hydrological or land-surface models. However, it appears that most global or continental-scale hydrological models underestimate evaporative fluxes in some regions of Africa, and as a result overestimate stream flow. Other studies suggest that land-surface models may overestimate evaporative fluxes. In this study, we computed actual evaporation for the African continent using a continental version of the global hydrological model PCR-GLOBWB, which is based on a water balance approach. Results are compared with other independently computed evaporation products: the evaporation results from the ECMWF reanalysis ERA-Interim and ERA-Land (both based on the energy balance approach), the MOD16 evaporation product, and the GLEAM product. Three other alternative versions of the PCR-GLOBWB hydrological model were also considered. This resulted in eight products of actual evaporation, which were compared in distinct regions of the African continent spanning different climatic regimes. Annual totals, spatial patterns and seasonality were studied and compared through visual inspection and statistical methods. The comparison shows that the representation of irrigation areas has an insignificant contribution to the actual evaporation at a continental scale with a 0.5° spatial resolution. The choice of meteorological forcing data has a larger effect on the evaporation results, especially in the case of the precipitation input as different precipitation input resulted in significantly different evaporation in some of the studied regions. ERA-Interim evaporation is generally the highest of the selected products followed by ERA-Land evaporation. The satellite based products (GLEAM and MOD16) do not show regular behaviour when compared

  15. Effectiveness of deslorelin acetate subcutaneous implantation in a domestic queen with after-spaying urinary incontinence.

    PubMed

    Pisu, Maria Carmela; Veronesi, Maria Cristina

    2014-04-01

    A 2-year-old female ovariectomised Norwegian Forest cat with a history of post-spaying urinary incontinence was diagnosed with acquired urinary sphincter mechanism incompetence (USMI) after complete clinical and laboratory examination. Although there is no literature regarding the treatment of post-spaying USMI in cats, deslorelin acetate is successful in the treatment of post-spaying USMI in dogs. Deslorelin acetate implants have been shown previously to be effective for contraception and oestrus suppression in queens, and suppression of reproductive function in tomcats. Therefore, deslorelin acetate implant treatment was chosen for treatment of post-spaying USMI in this queen. Follow-up examinations were performed on days 8, 15 and 30 after deslorelin implant insertion. Urinary continence was restored about 25 days after implantation and maintained for at least 15 months, without treatment-related negative effects. In the present case report, the post-spaying urinary incontinence related to the acquired USMI was successfully treated with a deslorelin acetate implant. In addition, safe implantation was easy in cats and the single injection resulted in long-lasting efficacy. Further studies are needed to confirm the usefulness of deslorelin acetate treatment for post-spaying USMI in queens and to better delineate the duration of efficacy. PMID:23873046

  16. Integrating yoga therapy in the management of urinary incontinence: a case report.

    PubMed

    Vinchurkar, Suhas Ashok; Arankalle, Dhananjay Vijay

    2015-04-01

    A 63-year-old overweight female prediagnosed of stress urinary incontinence presented with exacerbated events of urine leakage. She was advised a residential lifestyle and behavioral program, primarily consisting of a monitored yoga therapy module, apart from her ongoing anticholinergic medicine, for 21 days. Assessments were based on a frequency volume chart, a bladder diary for the entire duration of treatment, and the International Consultation on Incontinence Modular Questionnaire-Urinary Incontinence Short Form questionnaire on the days of admission and discharge. A total of 1.9 kg of weight loss was observed during her stay. Usage of pad, as reported in her diary, reduced from 3 to 1 per day. Her International Consultation on Incontinence Modular Questionnaire-Urinary Incontinence Short Form score reduced from 16 to 9, indicating better continence. She expressed subjective well-being and confidence in her social interactions. This is probably the first case report demonstrating feasibility of integration of yoga therapy in the management of urinary incontinence. PMID:25539839

  17. [Chiroptera and zoonosis: an emerging problem on all five continents].

    PubMed

    Hance, P; Garnotel, E; Morillon, M

    2006-04-01

    Zoonosis is the cause of the vast majority of emerging diseases. Bats that occupy the second place in the mammal class play an important role. Whether they belong to the microchiroptera suborder or to the megachiroptera suborder, bats on all five continents have been implicated in transmission of numerous pathogens including not only viruses such as Lyssavirus (e.g. rabies), Hepanivirus (e.g. Hendra and Nipah virus) and recently coronavirus (e.g. SARS-like coronavirus and Ebola virus) but also fungus such as histoplasmosis. By modifying environmental conditions and encroaching on their biotope, human intervention has probably contributed to the introduction of chiropteras into an epidemiologic chain in which they previously had no place, thus promoting the emergence of new pathogens. PMID:16775933

  18. Asynchronous extinction of late Quaternary sloths on continents and islands

    PubMed Central

    Steadman, David W.; Martin, Paul S.; MacPhee, Ross D. E.; Jull, A. J. T.; McDonald, H. Gregory; Woods, Charles A.; Iturralde-Vinent, Manuel; Hodgins, Gregory W. L.

    2005-01-01

    Whatever the cause, it is extraordinary that dozens of genera of large mammals became extinct during the late Quaternary throughout the Western Hemisphere, including 90% of the genera of the xenarthran suborder Phyllophaga (sloths). Radiocarbon dates directly on dung, bones, or other tissue of extinct sloths place their “last appearance” datum at ≈11,000 radiocarbon years before present (yr BP) or slightly less in North America, ≈10,500 yr BP in South America, and ≈4,400 yr BP on West Indian islands. This asynchronous situation is not compatible with glacial–interglacial climate change forcing these extinctions, especially given the great elevational, latitudinal, and longitudinal variation of the sloth-bearing continental sites. Instead, the chronology of last appearance of extinct sloths, whether on continents or islands, more closely tracks the first arrival of people. PMID:16085711

  19. The evolving continents /2nd revised and enlarged edition/

    NASA Astrophysics Data System (ADS)

    Windley, B. F.

    The earth's history is traced through the tectonic evolution of the continental crust from the very beginning of the geological record, rather than by studying the stratigraphy of a particular area. The topics addressed include: Archean granulite-gneiss belts; Archean greenstone belts; crustal evolution in the Archean; early to mid-Proterozoic basic ultrabasic intrusion, basins, and belts; mid-Proterozoic anorogenic magmatism and abortive rifting; mid-late Proterozoic basins, dykes, glaciations, and life forms; late Proterozoic mobile belts; and crustal evolution in the Proterozoic. Also considered are: paleomagnetism and continental drift; paleoclimatology and the fossil record; Caledonian-Appalachian fold belt; the Hercynian fold belt; Pangaea and its breakup; plate tectonics and sea-floor spreading; island arcs; continental margin orogenic belts; the Western Americas; the Alpine fold belt; the Himalayas; and the evolving continents.

  20. Plasmodium vivax Diversity and Population Structure across Four Continents

    PubMed Central

    Koepfli, Cristian; Rodrigues, Priscila T.; Antao, Tiago; Orjuela-Sánchez, Pamela; Van den Eede, Peter; Gamboa, Dionicia; van Hong, Nguyen; Bendezu, Jorge; Erhart, Annette; Barnadas, Céline; Ratsimbasoa, Arsène; Menard, Didier; Severini, Carlo; Menegon, Michela; Nour, Bakri Y. M.; Karunaweera, Nadira; Mueller, Ivo; Ferreira, Marcelo U.; Felger, Ingrid

    2015-01-01

    Plasmodium vivax is the geographically most widespread human malaria parasite. To analyze patterns of microsatellite diversity and population structure across countries of different transmission intensity, genotyping data from 11 microsatellite markers was either generated or compiled from 841 isolates from four continents collected in 1999–2008. Diversity was highest in South-East Asia (mean allelic richness 10.0–12.8), intermediate in the South Pacific (8.1–9.9) Madagascar and Sudan (7.9–8.4), and lowest in South America and Central Asia (5.5–7.2). A reduced panel of only 3 markers was sufficient to identify approx. 90% of all haplotypes in South Pacific, African and SE-Asian populations, but only 60–80% in Latin American populations, suggesting that typing of 2–6 markers, depending on the level of endemicity, is sufficient for epidemiological studies. Clustering analysis showed distinct clusters in Peru and Brazil, but little sub-structuring was observed within Africa, SE-Asia or the South Pacific. Isolates from Uzbekistan were exceptional, as a near-clonal parasite population was observed that was clearly separated from all other populations (FST>0.2). Outside Central Asia FST values were highest (0.11–0.16) between South American and all other populations, and lowest (0.04–0.07) between populations from South-East Asia and the South Pacific. These comparisons between P. vivax populations from four continents indicated that not only transmission intensity, but also geographical isolation affect diversity and population structure. However, the high effective population size results in slow changes of these parameters. This persistency must be taken into account when assessing the impact of control programs on the genetic structure of parasite populations. PMID:26125189

  1. Plasmodium vivax Diversity and Population Structure across Four Continents.

    PubMed

    Koepfli, Cristian; Rodrigues, Priscila T; Antao, Tiago; Orjuela-Sánchez, Pamela; Van den Eede, Peter; Gamboa, Dionicia; van Hong, Nguyen; Bendezu, Jorge; Erhart, Annette; Barnadas, Céline; Ratsimbasoa, Arsène; Menard, Didier; Severini, Carlo; Menegon, Michela; Nour, Bakri Y M; Karunaweera, Nadira; Mueller, Ivo; Ferreira, Marcelo U; Felger, Ingrid

    2015-01-01

    Plasmodium vivax is the geographically most widespread human malaria parasite. To analyze patterns of microsatellite diversity and population structure across countries of different transmission intensity, genotyping data from 11 microsatellite markers was either generated or compiled from 841 isolates from four continents collected in 1999-2008. Diversity was highest in South-East Asia (mean allelic richness 10.0-12.8), intermediate in the South Pacific (8.1-9.9) Madagascar and Sudan (7.9-8.4), and lowest in South America and Central Asia (5.5-7.2). A reduced panel of only 3 markers was sufficient to identify approx. 90% of all haplotypes in South Pacific, African and SE-Asian populations, but only 60-80% in Latin American populations, suggesting that typing of 2-6 markers, depending on the level of endemicity, is sufficient for epidemiological studies. Clustering analysis showed distinct clusters in Peru and Brazil, but little sub-structuring was observed within Africa, SE-Asia or the South Pacific. Isolates from Uzbekistan were exceptional, as a near-clonal parasite population was observed that was clearly separated from all other populations (FST>0.2). Outside Central Asia FST values were highest (0.11-0.16) between South American and all other populations, and lowest (0.04-0.07) between populations from South-East Asia and the South Pacific. These comparisons between P. vivax populations from four continents indicated that not only transmission intensity, but also geographical isolation affect diversity and population structure. However, the high effective population size results in slow changes of these parameters. This persistency must be taken into account when assessing the impact of control programs on the genetic structure of parasite populations. PMID:26125189

  2. [Urinary tract infection associated with urinary calculi. 1. The significance of urinary tract infection in urinary calculi].

    PubMed

    Takeuchi, H; Okada, Y; Yoshida, O; Arai, Y; Tomoyoshi, T

    1989-05-01

    We investigated 158 cases of urinary stones (infection stones 56, metabolic stones 102) with special reference to pyuria, bacteriuria, stone culture and urease activities of isolated bacteria. Abacterial pyuria was noted in 9 out of 49 (18%) infection stones and in 53 of 77 (69%) metabolic stones. Bacteriuria was noted in 79% of the infection stones and 26% of the metabolic stones. Sixty-seven percent of the infection stones were infected with mainly urea splitting bacteria such as Proteus mirabilis and Staphylococcus. Twenty-three percent of metabolic stones were also infected. Though E. coli, a non-urea splitting bacteria, was isolated most frequently from metabolic stones, urease positive Staphylococcus and Pseudomonas were also isolated. Bacteria within stones could be predicted on the basis of urine culture results of only 20 of 41 infection stones and 8 of 24 metabolic stones. These facts are useful for selection of some antibiotics in the treatment of urinary tract infections associated with urinary calculi. Urinary infections of urea splitting bacteria in infection stones are thought to be initial factors of stone formation and those of non-urea splitting bacteria are to be superimposed. However, urea splitting bacteria in metabolic stones may convert them into infection stones in future. PMID:2801372

  3. Stagnant loop syndrome in patients with continent ileostomy (intra-abdominal ileal reservoir).

    PubMed Central

    Schjonsby, H; Halvorsen, J F; Hofstad, T; Hovdenak, N

    1977-01-01

    Intestinal absorption and bacteriology of the ileal contents were compared in seven patients with continent ileostomy and seven patients with conventional ileostomy. The absorption of vitamin B12 was reduced in five patients with continent ileostomy and subnormal in two patients with conventional ileostomy. Steatorrhoea was present in four patients with continent and one patient with conventional ileostomy. Increased concentrations of total anaerobic bacteria and Bacteroides were found in the ileum of the patients with continent ileostomy. After an oral dose of (1-14C) glycocholic acid there was no difference in the faecal excretion of radioactivity, whereas the 14CO2-expiration was increased in two patients with continent ileostomy. In four patients with continent ileostomy and malabsorption of B12, there was evidence of a stagnant loopsyndrome as oral lincomycin treatment resulted in increased absorption of B12 decreased excretion of faecal fat, and decreased concentrations of Bacteroides in the ileum. PMID:590837

  4. Inflammatory Pseudotumor of the Urinary Bladder

    PubMed Central

    Rosado, Elsa; Pereira, José; Corbusier, Florence; Demeter, Pieter; Bali, Maria Antonietta

    2015-01-01

    We report a case of an inflammatory pseudotumor of the urinary bladder in a 31 year-old woman. She presented at the emergency room with low abdominal pain and urinary symptoms. Abdominal ultrasound, computed tomography and magnetic resonance imaging were performed and revealed asymmetric thickening of the urinary bladder wall. Cystoscopy with urinary cytology revealed a benign nature of the process. The patient underwent partial cystectomy and the pathologic examination of the specimen revealed an inflammatory pseudotumor. We reviewed the clinical, imaging and pathological features of the inflammatory pseudotumor of the urinary bladder and discussed its differential diagnosis. PMID:25926919

  5. GOCE observations for Mineral exploration in Africa and across continents

    NASA Astrophysics Data System (ADS)

    Braitenberg, Carla

    2014-05-01

    The gravity anomaly field over the whole Earth obtained by the GOCE satellite is a revolutionary tool to reveal geologic information on a continental scale for the large areas where conventional gravity measurements have yet to be made (e.g. Alvarez et al., 2012). It is, however, necessary to isolate the near-surface geologic signal from the contributions of thickness variations in the crust and lithosphere and the isostatic compensation of surface relief (e.g. Mariani et al., 2013) . Here Africa is studied with particular emphasis on selected geological features which are expected to appear as density inhomogeneities. These include cratons and fold belts in the Precambrian basement, the overlying sedimentary basins and magmatism, as well as the continental margins. Regression analysis between gravity and topography shows coefficients that are consistently positive for the free air gravity anomaly and negative for the Bouguer gravity anomaly (Braitenberg et al., 2013; 2014). The error and scatter on the regression is smallest in oceanic areas, where it is a possible tool for identifying changes in crustal type. The regression analysis allows the large gradient in the Bouguer anomaly signal across continental margins to be removed. After subtracting the predicted effect of known topography from the original Bouguer anomaly field, the residual field shows a continent-wide pattern of anomalies that can be attributed to regional geological structures. A few of these are highlighted, such as those representing Karoo magmatism, the Kibalian foldbelt, the Zimbabwe Craton, the Cameroon and Tibesti volcanic deposits, the Benue Trough and the Luangwa Rift. A reconstruction of the pre-break up position of Africa, South and North America is made for the residual GOCE gravity field obtaining today's gravity field of the plates forming West Gondwana. The reconstruction allows the positive and negative anomalies to be compared across the continental fragments, and so helps

  6. Recent Aeromagnetic Anomaly views of the Antarctic continent

    NASA Astrophysics Data System (ADS)

    Ferraccioli, F.

    2012-04-01

    Antarctica is a keystone within the Gondwana and Rodinia supercontinents. However, despite intense geological research along the coastal fringes of Antarctica, the interior of the continent remains one of the most poorly understood regions on Earth. Aeromagnetic investigations are a useful tool to help disclose the structure and the evolution of continents from the Precambrian to the Cenozoic and Antarctica is no exception. Here I review a variety of aeromagnetic studies in East and West Antarctica performed since the completion of the first generation ADMAP -Antarctic Digital Magnetic Anomaly Project- in 2001. In western Dronning Maud, in East Antarctica, aeromagnetic data help delineate the extent of the Jurassic Jutulstraumen subglacial rift that is flanked by remnants of a Grenvillian-age (ca 1.1. Ga) igneous province and magmatic arc. Different magnetic signatures appear to characterize the Coats Land block but reconnaissance surveys are insufficient to fully delineate the extent and significance of the Coats Land block, a possible tectonic tracer of Laurentia within Rodinia (Loewy et al., 2011). Further in the interior of East Antarctica, a mosaic of distinct and hitherto largely unknown Precambrian provinces has recently been revealed by combining aeromagnetic and satellite magnetic data with models of crustal thickness constrained by gravity modeling and seismology (Ferraccioli et al., 2011, Nature). A major collisional suture may lie between the Archean Ruker Province and an inferred Proterozoic Gamburtsev Province but the age of final assembly of central East Antarctica remains uncertain and controversial. I favour a Grenville-age collisional event (linked to Rodinia assembly) or possibly older Paleoproteroic collision, followed by intraplate reactivation, as opposed to Neoproterozoic or Early Cambrian collision linked to East-West Gondwana assembly (Boger, 2011). New aerogeophysical surveys over Prince Elizabeth and Queen Mary Land could test this

  7. Major Odorants Released as Urinary Volatiles by Urinary Incontinent Patients

    PubMed Central

    Pandey, Sudhir Kumar; Kim, Ki-Hyun; Choi, Si On; Sa, In Young; Oh, Soo Yeon

    2013-01-01

    In this study, volatile urinary components were collected using three different types of samples from patients suffering from urinary incontinence (UI): (1) urine (A); (2) urine + non-used pad (B); and (3) urine + used pad (C). In addition, urine + non-used pad (D) samples from non-patients were also collected as a reference. The collection of urinary volatiles was conducted with the aid of a glass impinger-based mini-chamber method. Each of the four sample types (A through D) was placed in a glass impinger and incubated for 4 hours at 37 °C. Ultra pure air was then passed through the chamber, and volatile urine gas components were collected into Tedlar bags at the other end. These bag samples were then analyzed for a wide range of VOCs and major offensive odorants (e.g., reduced sulfur compounds (RSCs), carbonyls, trimethylamine (TMA), ammonia, etc.). Among the various odorants, sulfur compounds (methanethiol and hydrogen sulfide) and aldehydes (acetaldehyde, butylaldehyde, and isovaleraldehyde) were detected above odor threshold and predicted to contribute most effectively to odor intensity of urine incontinence. PMID:23823973

  8. Vaginal position and length in the bitch: relationship to spaying and urinary incontinence.

    PubMed

    Gregory, S P; Holt, P E; Parkinson, T J; Wathes, C M

    1999-04-01

    A study was undertaken to determine if the vagina might be a suitable site for the measurement of intra-abdominal pressure during cystometry in the bitch. The position of the cranial vagina and vaginal length were measured radiographically and the effects of spaying and urinary incontinence on these variables were evaluated in 30 continent and 30 incontinent bitches. The study used retrograde vaginourethrograms which had been obtained from animals used in a previous study. The cranial vagina was intra-abdominal on 36 of the vaginourethrograms, being least commonly intra-abdominal in incontinent bitches (11/30). Vaginal position was related linearly to vaginal length and continence status (P < 0.01), while its length was related to bodyweight (P < 0.01). Allowing for bodyweight, neutered animals had significantly shorter vaginas than entire bitches (P < 0.01). Measurement of intra-abdominal pressure with concomitant measurement of intravesical pressure is essential if accurate assessment of detrusor pressure is to be determined during cystometry. The vagina is unlikely to be a useful location from which to measure intra-abdominal pressure since any pressure-measuring catheter inserted into it may fall outside the abdominal pressure zone. This is particularly true of neutered and/or incontinent bitches, the groups in which urodynamic investigations of urinary incontinence are most frequently indicated. PMID:10340249

  9. First experience with the ATOMS® implant, a new treatment option for male urinary incontinence

    PubMed Central

    Cansino, Jose Ramón; Portilla, María Alejandra; Rodriguez, Simón Claudio; Hidalgo, Luis; De la Peña, Javier

    2014-01-01

    Introduction Urinary incontinence (UI) is defined as any complaint of involuntary urine leakage. A description is provided of our experience with the ATOMS® (Adjustable Transobturator Male System. Agency for Medical Innovations. A.M.I.) adjustable implant in patients with mild to moderate UI. Material and methods A retrospective study was made of the data referring to 13 patients treated with this adjustable system. Demographic and personal data were collected along with information on the etiology, severity, characteristics, duration of UI, complementary tests, surgery times, complications and results obtained. Results The full continence (no use of pad) recovery rate at the close of the study was 12/13 (92.3%). Three cases required a single filling during the mean 16 months of follow–up (range 4–32; median 14 months). A complication in the form of perineal hematoma was resolved with conservative treatment and a case of urinary retention was resolved by placing a bladder catheter for the duration of one week. Three patients experienced perineal–scrotal dysesthesias that disappeared spontaneously in the first three months. Conclusions The described adjustable continence system has been found to be very effective in males with mild to moderate UI. In our experience, the ATOMS® implant offers excellent results over the middle term with a very low rate of complications that were easily resolved in all cases. PMID:25667760

  10. A model of weathering intensity for the Australian continent

    NASA Astrophysics Data System (ADS)

    Wilford, J.

    2013-12-01

    Regolith encompasses all weathered materials in the zone between the Earth's surface and fresh bedrock at depth. This weathered zone includes the soil, which may constitute the whole of the regolith profile or represent only its upper part. Important hydrological and biogeochemical processes operate within the regolith, including the infiltration and storage of near-surface water and nutrients, which sustain agricultural productivity. The degree to which the regolith is weathered (or its weathering intensity) is intrinsically linked to the factors involved in soil formation including parent material, climate, topography, biota and time. The degree to which the bedrock or sediments are weathered has a significant effect on the nature and distribution of regolith materials. There is commonly a strong correlation between weathering intensity and the degree of soil development as well as the depth of the weathering front. Changes in weathering intensity correspond to changes in the geochemical and physical properties of bedrock, ranging from essentially unweathered parent materials through to intensely weathered and leached regolith where all traits of the original protolith (original unweathered rock) are overprinted or lost altogether. With increasing weathering intensity we see mineral and geochemical convergence to more resistant secondary weathered materials including clay, silica, and various oxides. A weathering intensity index (WII) over the Australian continent has been developed at a 100 m resolution using two regression models based on airborne gamma-ray spectrometry imagery and the Shuttle Radar Topography Mission (SRTM) elevation data. Airborne gamma-ray spectrometry measures the concentration of three radioelements -- potassium (K), thorium (Th) and uranium (U) at the Earth's surface. The total gamma-ray flux (dose) is also calculated based on the weighted additions of the three radioelements. In general K is leached with increasing weathering whereas Th

  11. Urinary tract infections and Candida albicans

    PubMed Central

    Behzadi, Payam; Behzadi, Elham

    2015-01-01

    Introduction Urinary tract candidiasis is known as the most frequent nosocomial fungal infection worldwide. Candida albicans is the most common cause of nosocomial fungal urinary tract infections; however, a rapid change in the distribution of Candida species is undergoing. Simultaneously, the increase of urinary tract candidiasis has led to the appearance of antifungal resistant Candida species. In this review, we have an in depth look into Candida albicans uropathogenesis and distribution of the three most frequent Candida species contributing to urinary tract candidiasis in different countries around the world. Material and methods For writing this review, Google Scholar –a scholarly search engine– (http://scholar.google.com/) and PubMed database (http://www.ncbi.nlm.nih.gov/pubmed/) were used. The most recently published original articles and reviews of literature relating to the first three Candida species causing urinary tract infections in different countries and the pathogenicity of Candida albicans were selected and studied. Results Although some studies show rapid changes in the uropathogenesis of Candida species causing urinary tract infections in some countries, Candida albicans is still the most important cause of candidal urinary tract infections. Conclusions Despite the ranking of Candida albicans as the dominant species for urinary tract candidiasis, specific changes have occurred in some countries. At this time, it is important to continue the surveillance related to Candida species causing urinary tract infections to prevent, control and treat urinary tract candidiasis in future. PMID:25914847

  12. Studies on human urinary arylamidases

    NASA Technical Reports Server (NTRS)

    Raina, P. N.; Ellis, S.

    1975-01-01

    Human urinary protein was found to contain enzymes that hydrolyze leucyl-, alanyl-, and glycyl-prolyl-beta-naphthylamides. The kinetic constants of these enzymes were determined and their chemical properties studied. The pH optima for the hydrolysis of the various naphthylamides were also determined. Glycyl-prolyl-arylaminade was inhibited by Co(2+) and Mn(2+), while two other arylamidases were slightly activated by Co(2+). p-Chloromercuriphenyl-sulfonate and puromycin significantly inhibited leucyl and alanyl arylamidases. The mean values for 24-hour urinary output for leucyl-, alanyl-, and glycyl-prolyl arylamidases in normal human male subjects were 4.32, 9.97, and 2.2 units, respectively.

  13. [Melanosis of the urinary bladder].

    PubMed

    Wöllner, J; Janzen, J; Pannek, J

    2016-01-01

    Melanosis of the bladder is rare. Only 10 cases have been described in the literature. We present the case of an 80-year-old woman with neurogenic lower urinary tract dysfunction due to spinal paralysis. During the diagnostic work-up which included cystoscopy, black spots in the bladder wall were observed. Histopathological evaluation revealed a benign suburothelial melanosis. Thus, with cystoscopic suspicion of a malignancy (melanoma), a biopsy is mandatory and regular cystoscopic follow-up is recommended. PMID:26358438

  14. Afferent nipple valve malfunction caused by anchoring collar: an unexpected late complication of the Kock continent ileal reservoir.

    PubMed

    Arai, Y; Okada, Y; Matsuda, T; Hida, S; Takeuchi, H; Kihara, Y; Yoshida, O

    1991-01-01

    In the construction of a Kock continent ileal reservoir for urinary diversion, significantly high rates of late postoperative complications regarding nipple valves, the efferent limb in particular, have been reported. There are only a few reports on afferent nipple valve malfunction. A total of 42 patients who underwent a Kock pouch operation and were observed for more than 12 months (mean 38 months) was evaluated in terms of afferent nipple valve malfunction. Late afferent nipple valve complications were observed in 10 of the 42 patients (24%). These complications included erosion of the polyester fiber fabric used as a collar (5 patients), stenosis of the afferent limb (2) and obstruction of the afferent nipple by a mucous plug or fungus ball (3). The latter 2 complications were due to mechanical or dynamic obstruction of urine flow caused by a nonabsorbable collar. None of the 10 patients had problems with efferent nipple valve function. Our results suggest that the peristaltic direction of the intestine and the use of nonabsorbable material as a collar are primarily responsible for the late afferent nipple valve complications. Further modifications are needed to produce a stable nipple valve. Otherwise, simpler and more reliable alternative techniques of antireflux anastomosis should be considered. PMID:1984094

  15. Convective Transport of Trace Gases in the Maritime Continent

    NASA Astrophysics Data System (ADS)

    Harris, Neil

    2015-04-01

    Passage of air through the Tropical Tropopause Layer (TTL) is the major route for troposphere to stratosphere transport. The UK CAST (Co-ordinated Airborne Studies in the Tropics) campaign took place in the West Pacific in January/February 2014. The field campaign was based mainly in Guam (13.5oN, 144.8oE) and had three components: CAST with the NERC FAAM BAe-146 research aircraft; the NASA ATTREX project based around the Global Hawk; the NCAR-led CONTRAST campaign based around the Gulfstream V (HIAPER) aircraft. Together, these aircraft were able to make detailed measurements of atmospheric structure and composition from the ocean surface to 20 km. The CAST team also made ground-based and ozonesonde measurements at the ARM site on Manus Island in Papua New Guinea during February 2014, and halocarbon measurements were made at several West Pacific sites. I will present an overview of the CAST campaign along with the results of high resolution global Unified Model studies and NAME (Numerical Atmospheric-dispersion Modelling Environment) trajectory calculations to look at the transport of air into the TTL in convective systems over the Maritime continent and West Pacific. I will focus on the transport of air from in and around the boundary layer and will assess the possible importance of natural and anthropogenic emissions for TTL composition.

  16. Volcanic passive margins: another way to break up continents.

    PubMed

    Geoffroy, L; Burov, E B; Werner, P

    2015-01-01

    Two major types of passive margins are recognized, i.e. volcanic and non-volcanic, without proposing distinctive mechanisms for their formation. Volcanic passive margins are associated with the extrusion and intrusion of large volumes of magma, predominantly mafic, and represent distinctive features of Larges Igneous Provinces, in which regional fissural volcanism predates localized syn-magmatic break-up of the lithosphere. In contrast with non-volcanic margins, continentward-dipping detachment faults accommodate crustal necking at both conjugate volcanic margins. These faults root on a two-layer deformed ductile crust that appears to be partly of igneous nature. This lower crust is exhumed up to the bottom of the syn-extension extrusives at the outer parts of the margin. Our numerical modelling suggests that strengthening of deep continental crust during early magmatic stages provokes a divergent flow of the ductile lithosphere away from a central continental block, which becomes thinner with time due to the flow-induced mechanical erosion acting at its base. Crustal-scale faults dipping continentward are rooted over this flowing material, thus isolating micro-continents within the future oceanic domain. Pure-shear type deformation affects the bulk lithosphere at VPMs until continental breakup, and the geometry of the margin is closely related to the dynamics of an active and melting mantle. PMID:26442807

  17. Volcanic passive margins: another way to break up continents

    PubMed Central

    Geoffroy, L.; Burov, E. B.; Werner, P.

    2015-01-01

    Two major types of passive margins are recognized, i.e. volcanic and non-volcanic, without proposing distinctive mechanisms for their formation. Volcanic passive margins are associated with the extrusion and intrusion of large volumes of magma, predominantly mafic, and represent distinctive features of Larges Igneous Provinces, in which regional fissural volcanism predates localized syn-magmatic break-up of the lithosphere. In contrast with non-volcanic margins, continentward-dipping detachment faults accommodate crustal necking at both conjugate volcanic margins. These faults root on a two-layer deformed ductile crust that appears to be partly of igneous nature. This lower crust is exhumed up to the bottom of the syn-extension extrusives at the outer parts of the margin. Our numerical modelling suggests that strengthening of deep continental crust during early magmatic stages provokes a divergent flow of the ductile lithosphere away from a central continental block, which becomes thinner with time due to the flow-induced mechanical erosion acting at its base. Crustal-scale faults dipping continentward are rooted over this flowing material, thus isolating micro-continents within the future oceanic domain. Pure-shear type deformation affects the bulk lithosphere at VPMs until continental breakup, and the geometry of the margin is closely related to the dynamics of an active and melting mantle. PMID:26442807

  18. Volcanic passive margins: another way to break up continents

    NASA Astrophysics Data System (ADS)

    Geoffroy, L.; Burov, E. B.; Werner, P.

    2015-10-01

    Two major types of passive margins are recognized, i.e. volcanic and non-volcanic, without proposing distinctive mechanisms for their formation. Volcanic passive margins are associated with the extrusion and intrusion of large volumes of magma, predominantly mafic, and represent distinctive features of Larges Igneous Provinces, in which regional fissural volcanism predates localized syn-magmatic break-up of the lithosphere. In contrast with non-volcanic margins, continentward-dipping detachment faults accommodate crustal necking at both conjugate volcanic margins. These faults root on a two-layer deformed ductile crust that appears to be partly of igneous nature. This lower crust is exhumed up to the bottom of the syn-extension extrusives at the outer parts of the margin. Our numerical modelling suggests that strengthening of deep continental crust during early magmatic stages provokes a divergent flow of the ductile lithosphere away from a central continental block, which becomes thinner with time due to the flow-induced mechanical erosion acting at its base. Crustal-scale faults dipping continentward are rooted over this flowing material, thus isolating micro-continents within the future oceanic domain. Pure-shear type deformation affects the bulk lithosphere at VPMs until continental breakup, and the geometry of the margin is closely related to the dynamics of an active and melting mantle.

  19. Capillary zone electrophoresis of humic acids from the American continent.

    PubMed

    Pacheco, Maria de Lourdes; Havel, Josef

    2002-01-01

    A multicomponent background electrolyte (BGE) was developed and its composition optimized using artificial neural networks (ANN). The optimal BGE composition was found to be 90 mM boric acid, 115 mM Tris, and 0.75 mM EDTA (pH 8.4). A separation voltage of 20 kV, 20 degrees C and detection at 210 nm were used. The method was applied to characterize several humic acids originating from various countries of the American continent: soil (Argentina), peat (Brazil), leonardite (Guatemala and Mexico) and coal (United States). Comparison with humic acids of International Humic Substances Society (IHSS) standard samples was also done. Well reproducible electropherograms showing a relatively high number of peaks were obtained. Characterization of the samples by elemental analysis and UV spectrophotometry was also done. In spite of the very different origins, the similarities between humic acids are high and by matrix assisted desorption/ionization-time of flight (MALDI-TOF)-mass spectrometry it was shown that most of the m/z patterns are the same in all humic acids. This means that humic acids of different origin have the same structural units or that they contain the same components. PMID:11840535

  20. The ocean-continent transition of western Iberia

    SciTech Connect

    Whitmarsh, R.B.; Miles, P.R.; Pinheiro, L.M. ); Boillot, G. ); Recq, M. )

    1991-08-01

    The western continental margin of the Iberian peninsular has the characteristic of a rifted non-volcanic continental margin with half-graben and tilted fault blocks seen in several places on multichannel seismic reflection profiles. The ocean-continent transition (OCT) is therefore expected to be where thinned continental crust and oceanic crust are juxtaposed, as elsewhere. The authors located the OCT off western Iberia in order to constrain the pre-lift fit of Iberia to North America. This fit is only marginally constrained by sea-floor spreading magnetic anomalies because the Cretaceous constant polarity interval is adjacent to the OCT. Thinned continental crust can be distinguished from oceanic crust by the nature of the lower crustal velocity structure. In 1986-1987, a series of seismic refraction profiles was shot across three parts of the Iberian Abyssal Plain, the OCT can be detected not only from seismic velocities but also by modeling magnetic anomalies. The chosen location of the OCT is consistent with the interpretation of subsequently acquired multichannel profiles. Off Galicia Bank, the OCT, recognized from seismic velocities and multichannel profiles, corresponds to a seabed peridotite ridge, which has been extensively sampled. In the Tagus Abyssal Plain, limited seismic data gives a less clear picture of the OCT.

  1. The antegrade continence enema procedure and total anorectal reconstruction

    PubMed Central

    Zbar, Andrew P.

    2014-01-01

    Patients may present with anal incontinence (AI) following repair of a congenital anorectal anomaly years previously, or require total anorectal reconstruction (TAR) following radical rectal extirpation, most commonly for rectal cancer. Others may require removal of their colostomy following sphincter excision for Fournier's gangrene, or in cases of severe perineal trauma. Most of the data pertaining to antegrade continence enema (the ACE or Malone procedure) comes from the pediatric literature in the management of children with AI, but also with supervening chronic constipation, where the quality of life and compliance with this technique appears superior to retrograde colonic washouts. Total anorectal reconstruction requires an anatomical or physical supplement to the performance of a perineal colostomy, which may include an extrinsic muscle interposition (which may or may not be ‘dynamized'), construction of a neorectal reservoir, implantation of an incremental artificial bowel sphincter or creation of a terminal, smooth-muscle neosphincter. The advantages and disadvantages of these techniques and their outcome are presented here. PMID:24759342

  2. Renal Function Outcomes and Risk Factors for Risk Factors for Stage 3B Chronic Kidney Disease after Urinary Diversion in Patients with Muscle Invasive Bladder Cancer

    PubMed Central

    Hatakeyama, Shingo; Koie, Takuya; Narita, Takuma; Hosogoe, Shogo; Yamamoto, Hayato; Tobisawa, Yuki; Yoneyama, Tohru; Yoneyama, Takahiro; Hashimoto, Yasuhiro; Ohyama, Chikara

    2016-01-01

    Objectives To assess the effects of urinary diversion on renal function, we retrospectively investigated renal function over 5 years after urinary diversion using a propensity score matching strategy. Methods Between May 1996 and November 2013, 345 consecutive adult patients underwent radical cystectomy and urinary diversion in our hospital; one hundred and fifteen patients with more than a 5-year follow-up were enrolled. Propensity scores were calculated using logistic analysis, and the data used in the analyses included age, gender, Eastern Cooperative Oncology Group Performance Status (ECOG-PS), clinical tumor stage, presence of cardiovascular disease; hypertension; and type 2 diabetes and preoperative eGFR at the initial visit. Multivariate logistic regression analysis was used to assess the risk factors for stage 3B chronic kidney disease (CKD) after the different types of urinary diversion. Results Continent and incontinent diversion were performed in 68 and 47 patients, respectively. The mean preoperative eGFR was significantly lower in the incontinent than in the continent group (P < 0.001). In propensity score-matched patients (n = 34 each), no significant differences were observed in pre- and postoperative eGFR and 5-year eGFR decrease rates between the groups. In the incontinent group, the number of postoperative stage 3B CKD patients was significantly increased than the continent group. Using multivariate analysis, independent risk factors significantly associated with stage 3B CKD at 5 years after surgery were older age, eGFR before surgery, incontinent diversion (cutaneous ureterostomy), and postoperative hydronephrosis. Conclusions The types of urinary diversion had no significant impact on renal function decline, whereas older age, preexisting impaired renal function, postoperative hydronephrosis, and cutaneous ureterostomy were independent risk factors for stage 3B CKD at 5 years after radical cystectomy. PMID:26901860

  3. 21 CFR 862.1780 - Urinary calculi (stones) test system.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Urinary calculi (stones) test system. 862.1780... Systems § 862.1780 Urinary calculi (stones) test system. (a) Identification. A urinary calculi (stones) test system is a device intended for the analysis of urinary calculi. Analysis of urinary calculi...

  4. 21 CFR 862.1780 - Urinary calculi (stones) test system.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Urinary calculi (stones) test system. 862.1780... Systems § 862.1780 Urinary calculi (stones) test system. (a) Identification. A urinary calculi (stones) test system is a device intended for the analysis of urinary calculi. Analysis of urinary calculi...

  5. 21 CFR 862.1780 - Urinary calculi (stones) test system.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Urinary calculi (stones) test system. 862.1780... Systems § 862.1780 Urinary calculi (stones) test system. (a) Identification. A urinary calculi (stones) test system is a device intended for the analysis of urinary calculi. Analysis of urinary calculi...

  6. [Male Urinary Incontinence--a Taboo Issue].

    PubMed

    Kozomara-Hocke, Marko; Hermanns, Thomas; Poyet, Cédric

    2016-03-01

    Male urinary incontinence is an underestimated and frequently not broached issue. The urinary incontinence is divided into stress-, urge incontinence and hybrid forms as well as overflow incontinence. The fact that there are increasingly more men over 60 means that the prevalence of the urinary incontinence is up to 40%, and urinary incontinence will increasingly gain importance in daily routine practice. Many investigations and therapies can be realized by the general practitioner. Already simple therapy approaches can lead to a considerable clinical improvement of male urinary incontinence. If the initial therapy fails or pathological results (i. e. microhaematuria, recurrent urinary tract infections, raised residual urine and so on) are found, the patient should be referred to a urologist. PMID:26934011

  7. [URINARY DISCOMFORTS IN PATIENTS AFTER RADICAL PROSTATECTOMY].

    PubMed

    Al'-Shukri, S Kh; Ananiĭ, I A; Amdiĭ, R E; Kuz'min, I V

    2015-01-01

    The authors showed the result of complication treatment of lower urinary tracts in 128 patients with localized prostate cancer. The patients underwent radical prostatectomy. Urinary discomforts included enuresis, urinary incontinence in postoperative period. Abnormalities of urine outflow due to urethral stricture were revealed in 6 (4,6%) patients by the 6 month after operation. These complications required surgical treatment. Urinary incontinence was noted in 20 (15,6%) patients in this period. It was stressful urinary incontinence in 16 (12,6%) and urgent - in 4 (3%). Patents with stressful urinary difficulty were advised to use the conservative treatment (pelvic floor muscle training and electrostimulation), but in case of inefficiency - surgical treatment. PMID:26390591

  8. Regenerative medicine based applications to combat stress urinary incontinence

    PubMed Central

    Thaker, Hatim; Sharma, Arun K

    2013-01-01

    Stress urinary incontinence (SUI), as an isolated symptom, is not a life threatening condition. However, the fear of unexpected urine leakage contributes to a significant decline in quality of life parameters for afflicted patients. Compared to other forms of incontinence, SUI cannot be easily treated with pharmacotherapy since it is inherently an anatomic problem. Treatment options include the use of bio-injectable materials to enhance closing pressures, and the placement of slings to bolster fascial support to the urethra. However, histologic findings of degeneration in the incontinent urethral sphincter invite the use of tissues engineering strategies to regenerate structures that aid in promoting continence. In this review, we will assess the role of stem cells in restoring multiple anatomic and physiological aspects of the sphincter. In particular, mesenchymal stem cells and CD34+ cells have shown great promise to differentiate into muscular and vascular components, respectively. Evidence supporting the use of cytokines and growth factors such as hypoxia-inducible factor 1-alpha, vascular endothelial growth factor, basic fibroblast growth factor, hepatocyte growth factor and insulin-like growth factor further enhance the viability and direction of differentiation. Bridging the benefits of stem cells and growth factors involves the use of synthetic scaffolds like poly (1,8-octanediol-co-citrate) (POC) thin films. POC scaffolds are synthetic, elastomeric polymers that serve as substrates for cell growth, and upon degradation, release growth factors to the microenvironment in a controlled, predictable fashion. The combination of cellular, cytokine and scaffold elements aims to address the pathologic deficits to urinary incontinence, with a goal to improve patient symptoms and overall quality of life. PMID:24179600

  9. Female urinary incontinence: effective treatment strategies.

    PubMed

    Castro, R A; Arruda, R M; Bortolini, M A T

    2015-04-01

    Urinary incontinence is a dysfunction that tremendously affects women's quality of life, involving social, emotional and economic aspects. Although various treatments for urinary incontinence have been described, it is important to know which of them are truly effective. This review seeks to determine the current available therapies for women with stress urinary incontinence and overactive bladder syndrome, based on the best scientific evidence. PMID:25307986

  10. Cranberries and lower urinary tract infection prevention

    PubMed Central

    Hisano, Marcelo; Bruschini, Homero; Nicodemo, Antonio Carlos; Srougi, Miguel

    2012-01-01

    Lower urinary tract infections are very common diseases. Recurrent urinary tract infections remain challenging to treat because the main treatment option is long-term antibiotic prophylaxis; however, this poses a risk for the emergence of bacterial resistance. Some options to avoid this risk are available, including the use of cranberry products. This article reviews the key methods in using cranberries as a preventive measure for lower urinary tract infections, including in vitro studies and clinical trials. PMID:22760907