Science.gov

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 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

  17. 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

  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. 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

  20. 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

  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. 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

  16. 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

  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. 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 ...

  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. 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…

  11. 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…

  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. 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

  17. 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

  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. 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). ...

  5. 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 ...

  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. 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

  12. 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.

  13. 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 ...

  14. 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 ...

  15. 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- ...

  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. 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…

  1. 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...

  2. 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...

  3. 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...

  4. 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...

  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. 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

  11. 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

  12. 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 ...

  13. 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 ...

  14. 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 ...

  15. 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 ...

  16. 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 ...

  17. 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 & ...

  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

    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

  13. 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

  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. [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

  16. 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

  17. 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

  18. 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

  19. 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.

  20. 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)

  1. 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.

  2. 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)

  3. 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 §...

  4. 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.

  5. 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

  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. 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

  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. 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

  3. 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.

  4. 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.

  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. [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

  9. 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

  10. 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

  11. 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.

  12. 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.

  13. 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.

  14. 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

  15. 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.

  16. 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.

  17. 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

  18. 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

  19. 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.

  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. 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

  3. 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

  4. [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

  5. 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

  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. 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

  12. 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

  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.

    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

  14. 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

  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. 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

  18. [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

  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

    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 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

  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. 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

  6. 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

  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. 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

  9. 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

  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. 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

  14. [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

  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 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

  1. 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.

  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

  11. Continence in patients with spina bifida: long term results.

    PubMed Central

    Malone, P S; Wheeler, R A; Williams, J E

    1994-01-01

    One hundred and forty four questionnaires relating to bladder and bowel control were sent to a random selection of patients with spina bifida throughout the United Kingdom. One hundred and seventeen questionnaires were returned, of which 109 were usable. Twenty eight out of 109 responders had undergone some form of urinary diversion, of whom 20 (71%) were reliably dry. The remaining 81 responders emptied their bladders by a variety of techniques including normal voiding, straining, expression, clean intermittent catheterisation, indwelling catheters, or they dribbled urine continuously. Only 31 (38%) of this group were reliably dry. Ninety four of 109 (86%) responders regularly sat on the toilet to evacuate their bowels and most used some aid such as manual evacuation, laxatives, suppositories, or enemas. Fifty five of 104 (53%) responders soiled regularly, 31 (56%) of whom were also wet. Forty seven per cent of dry patients (24/51) were faecally incontinent. Only 25 of 104 (24%) patients responding to all questions were reliably clean and dry. PMID:8129429

  12. Organic geochemistry of mid-continent Ordovician oils

    SciTech Connect

    Palmer, S.E.

    1985-01-01

    Early Paleozoic oils retain the biochemical imprint of oceanic life prior to evolution of land plants and vertebrates. Thus, these oils have geochemical features which make them unique with respect to younger oils, but also share some common properties with the latter. Characteristic mid-continent Ordovician oil features include predominance of n-C/sub 14/ to n-C/sub 19/ over n-C/sub 20/+ alkanes in the C/sub 15/+ saturate hydrocarbon fraction, low amounts of isoprenoids and abundant C/sub 27/ and C/sub 29/ diasteranes relative to normal steranes. Properties common to both Ordovician and younger oils are: nearly equal amounts of C/sub 15/+ n-alkanes, cycloalkanes, and aromatics and pristane/phytane ratios of 0.7 to 1.6. Collectively, these Ordovician oils have a relatively negative stable carbon isotopic composition but are not unique with respect to other marine oils. Although terpane distributions are generally similar to geologically-younger oils, the Ordovician oils contain significant amounts of C/sub 19/, C/sub 20/, and C/sub 21/ tricyclic diterpanes relative to the C/sub 23/ homolog as well as large contributions by C/sub 31/+ pentacyclic triterpanes. Presence of long-chained n-alkanes, C/sub 29/ steranes, and C/sub 24/ tetracyclic terpanes, which are generally accepted as input from land plants in, e.g., Tertiary deposits, are also present in Ordovician oils. The characteristics listed above describe oils from the Williston and Michigan basins as well as Ordovician oils from Kansas and Oklahoma.

  13. Stratigraphy, structure, and extent of the East Continent Rift Basin

    SciTech Connect

    Wickstrom, L.H. )

    1992-01-01

    The proven existence of pre-Mt. Simon sedimentary rocks named the Middle Run Formation in southwestern Ohio led to the establishment of the Cincinnati Arch Consortium, a joint industry-government partnership to investigate the areal extent, nature, and origin of this new unit. Utilizing available well, seismic, and potential-field data, the consortium has shown that the Middle Run was deposited in a Precambrian rift basin, named the East Continent Rift Basin (ECRB). These data indicate the ECRB assemblage consists of a large folded and faulted wedge of interlayered volcanic and sedimentary rocks, unconformably overlain by Cambrian strata. This wedge is estimated to be thickest (up to about 22,000 feet) on the western edge, where it is in fault contact with Grenville Province rocks. To the west, the ECRB may extend as far as central Illinois and postdates the Precambrian Granite-Rhyolite Province rocks. The contact between the ECRB and this older province appears to be in part an angular unconformity and in part block faulted. The northern limit of this basin was not encountered in the study area; this may indicate a connection with the Midcontinent Rift in Michigan. In central Kentucky, the boundary conditions are more complex. It appears that the ECRB is constricted between a large block of the Granite-Rhyolite Province to the west and the Grenville Front on the east. Large Cambrian extensional structures (Rough Creek Graben and Rome Trough) were overprinted on the Granite-Rhyolite and Grenville Provinces. The ECRB may have acted as a stable block between these Cambrian features. The relationships of the ECRB to overlying Paleozoic features may be profound. Indeed, the ECRB may prove to be the reason for the very existence of the Cincinnati and Kankakee Arches.

  14. Drifting continents and endemic goitre in northern Pakistan.

    PubMed Central

    Stewart, A G

    1990-01-01

    Although Baltistan, north east Pakistan, is in a region of iodine deficiency disorders, the distribution of goitre within the district, according to age and sex, has not been clearly defined. To establish the prevalence of the condition and to measure the reported difference in prevalence in the north and south of the district thyroid size was assessed in new patients attending the Aman clinic, Khapalu, and outlying areas between April and September from 1981 to 1986. Samples of potable water collected from villages were analysed for iodine (as iodide) concentrations in Britain. Population weighted prevalences were: in the north in males 20.4%, in females 28.1% and in the south in males 13.9%, in females 21.2%. There was an overall deficiency of iodine in the water (mean iodine (as iodide) concentrations (north) 11.0 nmol/l (1.4 micrograms/l), (south) 11.8 nmol/l (1.5 micrograms/l) (95% confidence interval -0.7 to 0.9). The differences followed the Main Karakoram Thrust, suggesting a geological goitrogen in the north, which might be minerals containing ions such as BF4- and SO3F-, and molybdenite and calcium, which are present in rocks in Baltistan. A new hypothesis for the genesis of endemic goitre is proposed--that is, that continents on crustal plates drift across the earth and collide, one plate sliding under the other and melting, giving rise to characteristic mineral assemblages in the overlying rocks. As the minerals weather out they enter the diet of the local population, where in the presence of iodine deficiency they produce or enhance iodine deficiency disorders. Despite the current iodised oil campaign by the Pakistani government with Unicef a long term working iodisation programme is still urgently needed. PMID:2372605

  15. Intraplate termination of transform faulting within the Antarctic continent

    NASA Astrophysics Data System (ADS)

    Storti, F.; Salvini, F.; Rossetti, F.; Phipps Morgan, J.

    2007-08-01

    The sector of Antarctica facing Australia east of 139 °E is characterized by the abundance of exceptionally long oceanic fracture zones that are collinear to post-rift right-lateral strike-slip fault systems developed at the northeastern edge of the Antarctic continent. High-resolution reflection seismic profiles indicate recent strike-slip activity at the southeastern edge of the Balleny Fracture Zone, similar to what is observed onshore in North Victoria Land. The architecture, kinematics, and timing of this intraplate deformation at the northeastern edge of Antarctica cannot be reconciled with typical plate tectonic kinematics, in particular, with a classical divergent plate boundary environment. Here we show that combined geological and geophysical data in northeastern Antarctica support the post-rift southeastward reactivation of the passive margin east of 139 °E along intraplate right-lateral strike-slip deformation belts. These deformation belts include oceanic transform faults and their collinear oceanic fracture zone and continental shear zone extensions. A striking consequence is that there is intraplate accommodation of transform fault slip in this region of Earth's surface along fracture zones and a long-active region of intracontinental deformation that is 'reusing' prior plate boundary fault zones. As the intraplate termination of plate boundary transform faulting is not predicted by classical plate tectonic theory; this region is one of the most clear examples of the transition from rigid to semi-rigid plate tectonic deformation during the formation and long-lived incubation of a potential new plate boundary.

  16. Northern and eastern margins of the Siberian continent in Triassic

    SciTech Connect

    Egorov, A.Yu. )

    1993-09-01

    Siliciclastic sedimentation has been predominant on the northern and eastern margins of the Siberian continent since the Triassic period. Seven transgression-regression cycles can be recognized in the Triassic succession: Griesbachien-Dienerian, Smithian-Low Spathian, Upper Spathian, Anissian (with subcycles), Ladian, Carnian, and Norlan (with subcycles). All zonal units were distinguished within transgressive portions of the cycles. Regressive portions of the cycles formed practically instantaneously. Very high sedimentation rate (300-3000 mm/1000 yr), specific structures of sedimentary rocks, and distribution of unconformities led to the conclusion that active avalanche sedimentation at the basin margins was of major significance. six facies regions are recognized in the sedimentation area: Taimyr, Kotuy-Anabar, Leno-Anabar, Bur-Olenek, Verkhoyansk, and Novosibirsk (New Siberian Islands). The main source areas were located at the Patoma Mountains for the eastern margin and at the Anabar anticline and Olenek uplift for the northern margin. Most sediments were transported to the eastern margin by a large river with a huge delta which was similar in size to the modern Lena's delta. Sediments were further distributed by contour streams. Local synsedimentary structures controlled the paleogeography of the entire area. The paleogeographical evolution of the eastern margin is the history of this delta development. The rifting activities with the trappean magmatism were the main events at the northern margin, especially in the Talmyr area. The pelagic sedimentation has been predominant in the New Siberian Islands area and most of the Laptev Sea aquatoria. The organic-rich sediments have been distinguished in Low Olenekian (Smithian), Low Anissian, Low Ladinian, and Low Carnian substages. Most of them could be hydrocarbon source rocks. Triassic oil and gas seeps have been discovered at the northern portion of the Vilyui syncline, near the Lena's delta and the Nordvic Bay.

  17. Preparation of northern mid-continent petroleum atlas

    SciTech Connect

    Gerhard, L.C.; Carr, T.R.; Watney, W.L.

    1997-02-13

    The prototype Digital Petroleum Atlas (DPA) Project is part of a long-term effort to develop a new methodology to provide efficient and timely access to the latest petroleum data and technology for the domestic oil and gas industry, public sector research organizations and local governmental units. The DPA provides real-time access through the Internet using widely available tools such as World-Wide-Web browsers. The latest technologies and information are published electronically when individual project components are completed removing the lag and expense of transferring technology using traditional paper publication. Active links, graphical user interfaces and database search mechanisms of the DPA provide a product with which the operator can interact in ways that are impossible in the paper publication. Contained in the DPA are forms of publication that can only be displayed in an electronic environment (for example, animated exploration histories through time). Improvement in data and technology access for the domestic petroleum industry represents one of the best and cost-effective options that is available for mitigating the continued decline in domestic production. The prototype DPA concentrated on developing methodologies and computerized procedures to generate and to publish a limited set of field and play studies concentrated in Kansas and to a lesser extent the Northern Mid-continent. Access is provided through the DPA to previously existing and new regional, play, field and individual well information. Methodologies, developed in year one of the prototype DPA Project, provide a published product and ongoing technology transfer activity that is continuously updated with the latest information and technology.

  18. Architecture and Kinematics of the Taiwan Arc-Continent Collision

    NASA Astrophysics Data System (ADS)

    Carena, S.; Suppe, J.; Wu, Y. M.; Kanda, R. V. S.

    2014-12-01

    In Taiwan two subduction zones come together in quasi-orthogonal, kinematically stable configuration. Under Taiwan the upper crust of Eurasia is decoupled from the rest of the lithosphere by a detachment that forms the main subduction interface between Eurasia (EU) and Philippine Sea plate (PSP). This interface is visible in both seismicity and crustal tomography at shallow depths and can be followed into the mantle to depths of 450-500 km using global tomography. The plate interface between EU and PSP in the upper 100 km changes from about 60 degrees in the south to vertical (south-central Taiwan) to overturned (north-central Taiwan). The Eurasian Moho is similarly folded, but it does not overturn. Shortening across the plate boundary is accomplished by a combination of subduction of Eurasian lithosphere, folding and thrusting in the Eurasian upper crust, and a secondary subduction zone within the PSP. We hypothesize that: (1) once arc-continent collision occurs, subduction of Eurasian continental lower crust and upper mantle can continue by lithospheric delamination and by continuity with the much larger Eurasian slab to the south; (2) the upper crust of EU deforms by faulting and folding; (3) the present convergence rate of about 90 mm/yr is limited to the last 2 Ma, whereas the long-term rate is about 30 mm/yr and in Taiwan the difference is being taken up by secondary subduction within the PSP margin; (4) a margin-parallel STEP (Subduction-Transform-Edge-Propagator) fault forms the northern limit of Eurasian subduction, which allows the whole system to propagate self-similarly southwestward.

  19. Smoke aerosol transport patterns over the Maritime Continent

    NASA Astrophysics Data System (ADS)

    Xian, Peng; Reid, Jeffrey S.; Atwood, Samuel A.; Johnson, Randall S.; Hyer, Edward J.; Westphal, Douglas L.; Sessions, Walter

    2013-03-01

    Smoke transport patterns over the Maritime Continent (MC) are studied through a combination of approaches, including a) analyzing AODs obtained from satellite products; b) aerosol transport modeling with AOD assimilation along with the atmospheric flow patterns; c) analyzing smoke wet deposition distributions; and d) examining forward trajectories for smoke events defined in this study. It is shown that smoke transport pathways are closely related to the low-level atmospheric flow, i.e., during June-Sept, smoke originating from the MC islands with a dominant source over central and southern Sumatra, and southern and western Borneo, is generally transported northwestward south of the equator and northeastward north of the equator with the cross-equatorial flow, to the South China Sea (SCS), the Philippines and even further to the western Pacific. During the October-November transitional period, smoke transport paths are more zonally oriented compared to June-September. Smoke originating from Java, Bali, Timor etc, and southern New Guinea, which are in the domain of easterlies and southeasterlies during the boreal summer (June-November), is generally transported westward. It is also found that smoke transport over the MC exhibits multi-scale variability. Smoke typically lives longer and can be transported farther in El Niño years and later MJO phases compared with non El Niño years and earlier MJO phases. During El Niño periods there is much stronger westward transport to the east tropical Indian Ocean. Finally, orographic effect on smoke transport over the MC is also clearly discernable.

  20. NASA Astronaut Urinary Conditions Associated with Spaceflight

    NASA Technical Reports Server (NTRS)

    Law, Jennifer; Cole, Richard; Young, Millennia H.; Mason, Sara

    2016-01-01

    INTRODUCTION: Spaceflight is associated with many factors which may promote kidney stone formation, urinary retention, and/or Urinary Tract Infection (UTI). According to ISS mission predictions supplied by NASA's Integrated Medical Model, kidney stone is the second and sepsis (urosepsis as primary driver) the third most likely reason for emergent medical evacuation from the International Space Station (ISS). METHODS: Inflight and postflight medical records of NASA astronauts were reviewed for urinary retention, UTI and kidney stones during Mercury, Gemini, Apollo, Mir, Shuttle, and ISS expeditions 1-38. RESULTS: NASA astronauts have had 7 cases of kidney stones in the 12 months after flight. Three of these cases occurred within 90 to 180 days after landing and one of the seven cases occurred in the first 90 days after flight. There have been a total of 16 cases (0.018 events per person-flights) of urinary retention during flight. The event rates per mission are nearly identical between Shuttle and ISS flights (0.019 vs 0.021 events per person-flights). In 12 of the 16 cases, astronauts had taken at least one space motion sickness medication. Upon further analysis, it was determined that the odds of developing urinary retention in spaceflight is 3 times higher among astronauts who took promethazine. The female to male odds ratio for inflight urinary retention is 11:14. An astronaut with urinary retention is 25 times more likely to have a UTI with a 17% infection rate per mission. There have been 9 reported UTIs during spaceflight. DISCUSSION: It is unclear if spaceflight carries an increased post-flight risk of kidney stones. Regarding urinary retention, the female to male odds ratio is higher during flight compared to the general population where older males comprise almost all cases due to prostatic hypertrophy. This female prevalence in spaceflight is even more concerning given the fact that there have been many more males in space than females. Terrestrial

  1. FAQs about Catheter-Associated Urinary Tract Infection

    MedlinePlus

    ... Tract Infection” What is “catheter-associated urinary tract infection”? A urinary tract infection (also called “UTI”) is an infection in the urinary system, which includes the bladder (which stores the ...

  2. Continent-continent collision at the Pacific/Australian plate boundary: Lithospheric deformation, mountain building, and subsequent scientific endeavors

    NASA Astrophysics Data System (ADS)

    Okaya, D. A.; Stern, T. A.; Davey, F. J.

    2012-12-01

    Continental collision occurs at strike-slip plate boundaries where transform motion and oblique convergence create processes of surficial mountain building and deformation within the deeper crust and lithospheric mantle. The Pacific/Australian transform plate boundary in South Island, New Zealand, is characterized by active oblique continent-continent collision with an associated Southern Alps orogen that exhibits both high exhumation rates and rapid strike-slip movement. Beginning in the 1990s, this system was the focus of a decade-long collaborative USA-New Zealand multi-disciplinary study to understand lithospheric structure and processes involved in this transpression. Funded primarily by the NSF Continental Dynamics program and the New Zealand Science Foundation, this project known as SIGHT (South Island Geophysical Transect) with its companion SAPSE (Southern Alps Passive Seismic Experiment) included the following disciplines that involved substantial field observation experiments: seismic reflection, explosion refraction, onshore-offshore wide-angle reflection/refraction, regional and teleseismic passive seismology, magnetotellurics, laboratory petrophysics, gravity, regional geological investigations, and rheological analyses. More than fifty scientists and students from both nations participated in the combined set of studies that have led to over forty-five journal publications, an AGU Monograph, and a dozen graduate theses. Primary results of the project indicate the Pacific-Australian strike-slip plate boundary (Alpine fault) is not vertical but is eastward dipping and rheologically weak based on diverse geophysical data. Most deformation is within the Pacific plate that hosts the Southern Alps orogen. High mantle seismic velocities vertically disposed beneath the orogen suggest Pacific and perhaps Australian mantle lithosphere contribute to a zone of plate-boundary-parallel distributed mantle shortening. The crustal root of the overlying Southern Alps

  3. Advances in Urinary Tract Endoscopy.

    PubMed

    Berent, Allyson C

    2016-01-01

    The use of endoscopy in veterinary medicine has become the mainstay of diagnosis and treatment in the subspecialty of small animal urology over the past decade. This subspecialty is termed endourology. With the common incidence of urinary tract obstructions, stones disease, renal disease, and urothelial malignancies, combined with the recognized invasiveness and morbidity associated with traditional surgical techniques, the use of endoscopic-assisted alternatives using interventional endoscopic techniques has become appealing to both owners and clinicians. This article provides a brief overview of some of the most common urologic procedures being performed in veterinary medicine. PMID:26440205

  4. A rare urinary bladder tumour

    PubMed Central

    Haddad-Lacle, Judella Edwina Maria; Haddad, Charles Joseph; Villas, Bruce

    2014-01-01

    This case report describes a 54-year-old man who presented to his primary care physician with low back pain. During his workup, an incidental finding of a bladder mass was diagnosed. He underwent transurethral resection of the bladder tumour and the resulting pathology was consistent with extra nodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma). Presentation of MALT lymphoma in the urinary bladder is rare. This malignancy is more commonly found in the stomach. The prognosis for this rare tumour is excellent. Our patient showed no sign of recurrence with transurethral excision and radiation alone. PMID:24835803

  5. Tumours of the urinary bladder

    PubMed Central

    Pamukcu, A. M.

    1974-01-01

    Tumours of the urinary bladder are uncommon in all domestic animals except cattle in certain regions. Where cattle eat bracken (Pteridium aquilinum) there is a high incidence of these tumours. Epithelial tumours are the most frequently encountered neoplasms in cattle and in dogs—the two species most studied. They are described under the following names: papilloma, adenoma, transitional cell carcinoma (with variants), squamous cell carcinoma, adenocarcinoma, and undifferentiated carcinoma. ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 5Fig. 6Fig. 7Fig. 8Fig. 9Fig. 10Fig. 11Fig. 12Fig. 13Fig. 14Fig. 15Fig. 16 PMID:4371741

  6. Quaternary Reorganization of North American Mid-continent Drainage Systems

    NASA Astrophysics Data System (ADS)

    Carson, E. C.; Rawling, J. E., III; Attig, J. W.; Bates, B. R.

    2013-12-01

    Identification of ancestral drainage systems in the North American mid-continent has been a topic of research and debate among geologists since the middle of the 19th Century. Over time our understanding of the significance of Quaternary glaciations in reshaping drainage patterns has grown. The ancestral Teays River, which drained large areas of the central Appalachians and flowed westward across Indiana and western Illinois, was dammed multiple times by Quaternary glaciers before finally being rerouted to the course of the modern central Ohio River. Similarly, the northward-flowing ancestral Pittsburgh River was dammed by pre-Illinoian glaciers; subsequent stream piracy converted this river system into the modern Allegheny, Monongahela and uppermost Ohio Rivers. Deposits and geomorphic features along the westward-flowing lower Wisconsin River indicate that the modern upper Mississippi River and Wisconsin River may have experienced a similar history of ice blockage, stream piracy, and radical rerouting. Coring into the Bridgeport strath terrace along the lower Wisconsin River reveals that the bedrock surface dips to the east, indicating the valley was cut by an eastward-flowing river. We believe the most likely scenario following this interpretation is that an ancestral river flowing along the modern upper Mississippi River valley made a sharp bend at Prairie du Chien, WI, and flowed eastward along the valley occupied by the modern lower Wisconsin River. This river, referred to here as the Wyalusing River, likely flowed northeastward into the Great Lakes (St. Lawrence) drainage until that path was blocked by ice advancing from the northwest. Subsequent stream piracy immediately south of the modern confluence of the Mississippi and Wisconsin Rivers rerouted these streams, converting them to the headwaters of the greater Mississippi drainage. The combined rerouting of these river systems into entirely different drainage basins necessitates significant fundamental

  7. The thermal influence of continents on a model-generated January climate

    NASA Technical Reports Server (NTRS)

    Spar, J.; Cohen, C.; Wu, P.

    1981-01-01

    Two climate simulations were compared. Both climate computations were initialized with the same horizontally uniform state of rest. However, one is carried out on a water planet (without continents), while the second is repeated on a planet with geographically realistic but flat (sea level) continents. The continents in this experiment have a uniform albedo of 0.14, except where snow accumulates, a uniform roughness height of 0.3 m, and zero water storage capacity. Both runs were carried out for a 'perpetual January' with solar declination fixed at January 15.

  8. Continent-ocean chemical heterogeneity in the mantle based on seismic tomography.

    PubMed

    Forte, A M; Dziewonski, A M; O'connell, R J

    1995-04-21

    Seismic models of global-scale lateral heterogeneity in the mantle show systematic differences below continents and oceans that are too large to be purely thermal in origin. An inversion of the geoid, based on a seismic model that includes viscous flow in the mantle, indicates that the differences beneath continents and oceans can be accounted for by differences in composition in the upper mantle superposed on mantle-wide thermal heterogeneities. The net continent-ocean density differences, integrated over depth, are small and cause only a low flux of mass and heat across the asthenosphere and mantle transition zone. PMID:17746544

  9. [Urinary incontinence in the elderly can be treated].

    PubMed

    van Houten, Paul

    2015-01-01

    A recent survey on the use of drugs for incontinence in the elderly stated that only anticholinergic drugs used for urge incontinence have a slight positive effect on incontinence episodes. However, this does not mean that there are no potential treatments for incontinence in the frail elderly. The Dutch surveillance on problems in the care sector, the 'National prevalence survey of care problems' ('Landelijke prevalentiemeting zorgproblemen'), shows that between 2004 and 2014 the prevalence of urinary incontinence dropped from 76% to 49%. This fall in prevalence is due to the policies developed by institutions, and by training for nurses and physicians. Successful treatment begins with assessment of functionality (mobility and cognition), assessment of relevant multimorbidity and reconsideration of the use of drugs with an impact on continence. As a next step, bladder retraining and pelvic floor exercises may be used if the elderly person is able to perform these exercises independently. An anticholinergic drug can be tried as a last resort if there is urge incontinence and there are no contraindications. PMID:26732219

  10. URINARY MUTAGENICITY AND COLORECTAL ADENOMA RISK

    EPA Science Inventory

    Abstract

    We investigated urinary mutagenicity and colorectal adenoma risk in a clinic-based, case-control study of currently nonsmoking cases (n = 143) and controls (n = 156). Urinary organics were extracted by C18/methanol from 12-h overnight urine samples, and mutagenici...

  11. Cranberry Juice for Urinary Tract Infection?

    MedlinePlus

    ... medlineplus/news/fullstory_157466.html Cranberry Juice for Urinary Tract Infection? Specialist says grocery-store varieties aren't strong ... popular belief, cranberry juice does not cure a urinary tract infection, a doctor says. Many people drink cranberry juice ...

  12. Isolated Primary Schwannoma of Urinary Bladder

    PubMed Central

    Bhat, Suresh; Paul, Fredrick

    2016-01-01

    Primary schwannoma of urinary bladder is a very rare tumour. It usually occurs in association with Von Recklinghausen’s disease. It arises from Schwann’s cells in the nerve sheath. We report here a very rare case of primary schwannoma of urinary bladder managed by complete transurethral resection. PMID:27437301

  13. Urinary Incontinence: Management and Treatment Options

    ERIC Educational Resources Information Center

    Griebling, Tomas L.

    2009-01-01

    Urinary incontinence, defined as the involuntary leakage of urine, is a common health problem in both women and men. Children may also suffer from this condition. Management and treatment of urinary incontinence depends primarily on the specific type of incontinence and the underlying problem causing the leakage for a given patient. Because…

  14. Urinary tract infection in girls - aftercare

    MedlinePlus

    Symptoms of urinary tract infection (UTI) should begin to improve within 1 to 2 days in most girls. The advice below may not ... Elder JS. Urinary tract infections. In: Kliegman RM, Stanton BF, ... NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, ...

  15. Dietary effect on urinary thioethers.

    PubMed

    Rosen, P B; Snodgrass, W R; Riggs, M

    1999-01-01

    Urinary thioethers are a biomarker for reactive metabolites, which are detoxified via glutathione. We conducted this study to establish the effect of diet on a sample of persons we screened to exclude exposure from such substances. Our second objective was to develop a distribution curve to be used for comparison to exposed populations. Volunteers were sought who did not work or live in locations where known toxic exposures were likely to occur. We mainly recruited office personnel and secretarial staff. We screened subjects for environmental exposures via a written questionnaire. Subjects gave us an initial random urine specimen before they were placed on a diet low in thioethers. We then measured urinary thioethers on these specimens with a modified Ellman technique. We compared 126 paired results. Results demonstrated that diet decreased urine thioether excretion in most cases (i.e., 75 of 126 had a decrease in thioethers). Initially, the difference in mean excretion at the time of prediet and postdiet, however, was not significant (p = .22). We removed 2 extreme outliers, the result of which was a significant difference in means (paired t test, p < .01). The standard deviation within each of the two groups did not differ significantly (p = .82). PMID:10634232

  16. Lymphoma of the Urinary Bladder

    PubMed Central

    Venyo, Anthony Kodzo-Grey

    2014-01-01

    Background. Lymphoma of the urinary bladder (LUB) is rare. Aims. To review the literature on LUB. Methods. Various internet databases were used. Results. LUB can be either primary or secondary. The tumour has female predominance; most cases occur in middle-age women. Secondary LUB occurs in 10% to 25% of leukemias/lymphomas and in advanced-stage systemic lymphoma. Less than 100 cases have been reported. MALT typically affects adults older than 60 years; 75% are female. Diffuse large B-cell lymphoma is also common and may arise from transformation of MALT. LUB presents with haematuria, dysuria, urinary frequency, nocturia, and abdominal or back pain. Macroscopic examination of LUBs show large discrete tumours centred in the dome or lateral walls of the bladder. Positive staining of LUB varies by the subtype of lymphoma; B-cell lymphomas are CD20 positive. MALT lymphoma is positively stained for CD20, CD19, and FMC7 and negatively stained for CD5, CD10, and CD11c. LUB stains negatively with Pan-keratin, vimentin, CK20, and CK7. MALT lymphoma exhibits t(11; 18)(q21: 21). Radiotherapy is an effective treatment for the MALT type of LUB with no recurrence. Conclusions. LUB is diagnosed by its characteristic morphology and immunohistochemical characteristics. Radiotherapy is a useful treatment. PMID:24511310

  17. Urinary Calprotectin and Posttransplant Renal Allograft Injury

    PubMed Central

    Bistrup, Claus; Marcussen, Niels; Pagonas, Nikolaos; Seibert, Felix S.; Arndt, Robert; Zidek, Walter; Westhoff, Timm H.

    2014-01-01

    Objective Current methods do not predict the acute renal allograft injury immediately after kidney transplantation. We evaluated the diagnostic performance of urinary calprotectin for predicting immediate posttransplant allograft injury. Methods In a multicenter, prospective-cohort study of 144 incipient renal transplant recipients, we postoperatively measured urinary calprotectin using an enzyme-linked immunosorbent assay and estimated glomerular filtration rate (eGFR) after 4 weeks, 6 months, and 12 months. Results We observed a significant inverse association of urinary calprotectin concentrations and eGFR 4 weeks after transplantation (Spearman r = −0.33; P<0.001). Compared to the lowest quartile, patients in the highest quartile of urinary calprotectin had an increased risk for an eGFR less than 30 mL/min/1.73 m2 four weeks after transplantation (relative risk, 4.3; P<0.001; sensitivity, 0.92; 95% CI, 0.77 to 0.98; specificity, 0.48; 95% CI, 0.31 to 0.66). Higher urinary calprotectin concentrations predicted impaired kidney function 4 weeks after transplantation, as well as 6 months and 12 months after transplantation. When data were analyzed using the urinary calprotectin/creatinine-ratio similar results were obtained. Urinary calprotectin was superior to current use of absolute change of plasma creatinine to predict allograft function 12 months after transplantation. Urinary calprotectin predicted an increased risk both in transplants from living and deceased donors. Multivariate linear regression showed that higher urinary calprotectin concentrations and older donor age predicted lower eGFR four weeks, 6 months, and 12 months after transplantation. Conclusions Urinary calprotectin is an early, noninvasive predictor of immediate renal allograft injury after kidney transplantation. PMID:25402277

  18. Prognostic Factors for Anastomotic Urinary Leakage Following Retropubic Radical Prostatectomy and Correlation With Voiding Outcomes.

    PubMed

    Cormio, Luigi; Di Fino, Giuseppe; Scavone, Carmen; Maroscia, Domenico; Mancini, Vito; Ruocco, Nicola; Bellanti, Francesco; Selvaggio, Oscar; Sanguedolce, Francesca; Lucarelli, Giuseppe; Carrieri, Giuseppe

    2016-04-01

    This study aimed to determine the occurrence and grade of cystographically detected urinary leakage (UL) in a contemporary series of open retropubic radical prostatectomy (RP), whether patients' clinical variables predict occurrence of UL, and whether occurrence of UL correlates with patients' voiding outcomes in terms of urinary continence and anastomotic stricture (AS). Enrolled patients underwent cystography 7 days after retropubic RP; in case of UL, the catheter was left in situ and cystography repeated at 7 days intervals until demonstrating absence of UL. Leakage was classified as grade I = extraperitoneal leak <6 cm, grade II = extraperitoneal leak >6 cm, grade III = leak freely extending in the small pelvis. Voiding was evaluated at 3, 6, and 12 months after RP using the 24-hour pad test and uroflowmetry; in cases of maximum flow rate <10 mL/s, urethrocystoscopy was carried out to determine presence and location of an AS. The first postoperative cystogram showed UL in 52.6% of patients (grade I in 48.1%, grade II in 21.5%, and grade III in 30.4% of the cases). Multivariate analysis demonstrated that patients with UL had significantly greater prostate volume (64.5 vs 34.8 cc, P < 0.001), loss of serum hemoglobin (4.77 vs 4.19 g/dL, P < 0.001), lower postoperative serum total proteins (4.85 vs 5.4 g/dL, P < 0.001), and higher rate of AS (20.6% vs. 2.8%, p < 0.001) than those without UL. Continence rate at 3, 6, and 12 months postoperatively was 34.2%, 76%, and 90%, respectively, in patients with UL compared with 77.5%, 80.3%, and 93% in patients without UL; such difference was statistically significant (P < 0.001) only at 3 months follow-up. ROC curve analysis showed that prostate volume and postoperative serum total proteins had the best AUC (0.821 and 0.822, respectively) and when combined, their positive and negative predictive values for UL were 90% and 93%, respectively. In conclusion, half of the patients undergoing open

  19. Prognostic Factors for Anastomotic Urinary Leakage Following Retropubic Radical Prostatectomy and Correlation With Voiding Outcomes

    PubMed Central

    Cormio, Luigi; Di Fino, Giuseppe; Scavone, Carmen; Maroscia, Domenico; Mancini, Vito; Ruocco, Nicola; Bellanti, Francesco; Selvaggio, Oscar; Sanguedolce, Francesca; Lucarelli, Giuseppe; Carrieri, Giuseppe

    2016-01-01

    Abstract This study aimed to determine the occurrence and grade of cystographically detected urinary leakage (UL) in a contemporary series of open retropubic radical prostatectomy (RP), whether patients’ clinical variables predict occurrence of UL, and whether occurrence of UL correlates with patients’ voiding outcomes in terms of urinary continence and anastomotic stricture (AS). Enrolled patients underwent cystography 7 days after retropubic RP; in case of UL, the catheter was left in situ and cystography repeated at 7 days intervals until demonstrating absence of UL. Leakage was classified as grade I = extraperitoneal leak <6 cm, grade II = extraperitoneal leak >6 cm, grade III = leak freely extending in the small pelvis. Voiding was evaluated at 3, 6, and 12 months after RP using the 24-hour pad test and uroflowmetry; in cases of maximum flow rate <10 mL/s, urethrocystoscopy was carried out to determine presence and location of an AS. The first postoperative cystogram showed UL in 52.6% of patients (grade I in 48.1%, grade II in 21.5%, and grade III in 30.4% of the cases). Multivariate analysis demonstrated that patients with UL had significantly greater prostate volume (64.5 vs 34.8 cc, P < 0.001), loss of serum hemoglobin (4.77 vs 4.19 g/dL, P < 0.001), lower postoperative serum total proteins (4.85 vs 5.4 g/dL, P < 0.001), and higher rate of AS (20.6% vs. 2.8%, p < 0.001) than those without UL. Continence rate at 3, 6, and 12 months postoperatively was 34.2%, 76%, and 90%, respectively, in patients with UL compared with 77.5%, 80.3%, and 93% in patients without UL; such difference was statistically significant (P < 0.001) only at 3 months follow-up. ROC curve analysis showed that prostate volume and postoperative serum total proteins had the best AUC (0.821 and 0.822, respectively) and when combined, their positive and negative predictive values for UL were 90% and 93%, respectively. In conclusion, half of the patients

  20. The continent-ocean transition of the Pearl River margin

    NASA Astrophysics Data System (ADS)

    Cameselle, A. L.; Ranero, C. R.; Franke, D.; Barckhausen, U.

    2013-12-01

    Rifted continental margins form by lithospheric extension and break-up. The continent to ocean transition (COT) architecture depends on the interplay between tectonic and magmatic processes, and thus, to study the COT variability of different systems is key to understand rifting. We use MCS data and magnetic lineations across the Pearl River margin (PRM) of South China Sea to investigate a previously poorly defined COT. The structure of the PRM presents different amounts of extension allowing the study of conjugate pairs of continental margins and their COT in a relative small region. We reprocessed about 2250 km of MCS data along 4 regional, crustal-scale lines and found that 3 of them possibly display the COT. The time-migrated seismic sections show differences in internal reflectivity, faulting style, fault-block geometry, the seismic character of the top of the basement, in the geometry of sediment deposits, and Moho reflections, that we interpret to represent clear continental and oceanic domains. The continental domain is characterized by arrays of normal faults and associated tilted blocks overlaid by syn-rift sedimentary units. The Moho is imaged as sub-horizontal reflections that define a fairly continuous boundary typically at 8-10 s TWT. Estimation of the thickness of the continental crust using 6 km/s average velocity indicates a ~22 km-thick continental crust under the uppermost slope passing abruptly to ~9-6 km under the lower slope. Comparatively the oceanic crust has a highly reflective top of basement, little-faulting, not discernible syn-tectonic strata, and fairly constant thickness (4-8 km) defined by usually clear Moho reflections. The COT occurs across a ~5-10 km narrow zone. Rifting resulted in asymmetric conjugate margins. The PRM shows arrays of tilted fault blocks covered by abundant syn-rift sediment, whereas the conjugate Macclesfield Bank margin displays abrupt thinning and little faulting. Seismic profiles also show a change in the

  1. Flexural Tectonics in Continents: Critical Stress amid Immeasurable Strain

    NASA Astrophysics Data System (ADS)

    Bilham, R. G.

    2012-12-01

    With a few notable exceptions, most fatalities from earthquakes in the past millennium have occurred in mid-continent regions along the southern edge of the Eurasian plate where earthquakes are not expected due to their infrequency, or absence, in local historical records. Although the spatial density geodetic measurement in many parts of the Indo-Eurasian collision zone is currently poor, geodetically estimated strain rates where these are sufficiently dense (e.g. North America) are now being considered an important option to quantify the stressing rate of regions where seismic productivity is low. Certain assumptions attend the use of surface strain as a measure of seismic productivity: that the observed surface strain rate provides a measure of strain at seismogeninc depths, that none of the observed strain is dissipated in aseismic processes, that currently measured rates are uniform in time, and perhaps most importantly, whether regional strain rate alone is an adequate measure of the failure process. The first of these assumptions can be violated in locations in continental collisional settings, such as India, where flexural stresses prevail. The minimum in-plane northerly directed compressional stress in the Indian plate required to support the Tibetan Plateau is overwhelmed by the flexural stresses caused by the depression of its northern edge. Flexure results in static stresses that vary with depth and latitude, but which, averaged over the entire plate vary negligibly with time, because the rocks of India stream through the >600 km wavelength flexural stress-field at rates of only 2 cm/yr. This theoretical result is consistent with India's mean north-south strain rate observed geodetically, which is less than a few nanostrain each year. The spatial distribution of flexural stress, however, varies spatially as a function of distance from the Himalayan front. Strain rates exceed 2 bars/km in a flexural trough between 1000-1800 km south of the Himalaya, and

  2. Correlation between mobile continents and elevated temperatures in the subcontinental mantle

    NASA Astrophysics Data System (ADS)

    Jain, Charitra; Rozel, Antoine; Tackley, Paul

    2016-04-01

    Rolf et al. (EPSL, 2012) and Coltice et al. (Science, 2012) have previously shown that continents exert a first order influence on Earth's mantle flow by affecting convective wavelength and surface heat flow. With stationary continents, Heron and Lowman (JGR, 2014) highlighted the decreasing role of continental insulation on subcontinental temperatures with higher Rayleigh number (Ra). However, the question whether there exists a correlation between mobile continents and elevated temperatures in the subcontinental mantle or not remains to be answered. By systematically varying parameters like core-mantle boundary (CMB) temperature, continental size, and mantle heating modes (basal and internal); we model thermo-chemical mantle convection with 2D spherical annulus geometry (Hernlund and Tackley, PEPI 2008) using StagYY (Tackley, PEPI 2008). Starting with a simple incompressible model having mobile continents, we observe this correlation. Furthermore, this correlation still holds when the model complexity is gradually increased by introducing internal heating, compressibility, and melting. In general, downwellings reduce the mantle temperature away from the continents, thereby resulting in correlation between mobile continents and elevated temperatures in the subcontinental mantle. For incompressible models (Boussinesq approximation), correlation exists and the dominant degree of convection varies with the continental distribution. When internal heating is switched on, correlation is observed but it is reduced as there are less cold regions in the mantle. Even for compressible models with melting, big continents are able to focus the heat underneath them. The dominant degree of convection changes with continental breakup. Additionally, correlation is observed to be higher in the upper mantle (300 - 1000 km) compared to the lower mantle (1000 - 2890 km). At present, mobile continents in StagYY are simplified into a compositionally distinct field drifting at the top of

  3. FSH and LH plasma levels in bitches with differences in risk for urinary incontinence.

    PubMed

    Reichler, Iris Margaret; Hung, Elisabeth; Jöchle, Wolfgang; Piché, Claude A; Roos, Malgorzata; Hubler, Madeleine; Arnold, Susi

    2005-05-01

    To determine whether the height of the plasma gonadotropin levels after spaying is associated with urinary incontinence, the concentrations of plasma follicle stimulating hormone (FSH) and luteinizing hormone (LH) were determined once in 191 intact and 308 spayed bitches. The bitches were grouped according to their risk for urinary incontinence and the medians of their respective gonadotropin levels were compared. For intact anestrous bitches, the FSH- and LH-plasma concentrations were 5.2 (4, 8) ng/mL (median (Q1, Q3)) and 0.5 (0.5-0.5) ng/mL, respectively. In the first year after spaying, the gonadotropin concentrations rose significantly, then stabilised at a level around 10 times those of intact bitches (FSH 62.5 (44, 91) ng/mL; LH 6.1(4, 11) ng/mL). The plasma gonadotropin concentrations of long-term spayed (>12 months) continent bitches (n=209) were higher (FSH 66.8 (46, 104) ng/mL; LH 6.5 (4, 11) ng/mL) than in spayed incontinent bitches (n=60) (FSH 51.5 (38, 74) ng/mL; LH 5.5 (3, 8) ng/mL), the latter also had a higher body weight. Multiple regression analysis showed that the FSH-plasma concentration and not the body weight was decisive for the occurrence of urinary incontinence. The results of this study suggest that levels of gonadotropins are associated, directly or indirectly in the pathophysiology of urinary incontinence after spaying. PMID:15826681

  4. Urinary incontinence in women: its prevalence and its management in a health promotion clinic.

    PubMed Central

    Harrison, G L; Memel, D S

    1994-01-01

    BACKGROUND. It has been suggested that regular clinics might improve the management of urinary incontinence in general practice. AIM. A study was undertaken to determine the prevalence of urinary incontinence among women in one general practice and the feasibility of using a health promotion clinic in its management. METHOD. Questionnaires were sent to a 10% sample of women aged 20 years and over on the practice register. Pregnant women were excluded. RESULTS. Of 384 questionnaires sent to eligible women, 314 were completed correctly (82%). The overall reported prevalence of urinary incontinence was 53%; 8% of these women had urge incontinence, 46% had stress incontinence and 43% had mixed incontinence. Incontinence was positively correlated with parity and with gynaecological operation other than hysterectomy and repair of prolapse but not with perineal suturing after childbirth, delivery of a baby weighing 9 lb (4.1 kg) or more or mode of delivery. Twenty seven out of 78 incontinent women (35%) who completed a second questionnaire admitted to worrying about their incontinence but only 10 (13%) had consulted their doctor about the problem. The main reason given for not consulting was that incontinence was a minor inconvenience only. The 167 incontinent women were offered an appointment at a women's clinic but only 13 attended. Of these, 10 were entered into a 12 week treatment trial. Various treatments were offered, such as the women being taught bladder training and pelvic floor exercises. One woman was lost to follow up, and for eight out of nine women their continence had improved, both subjectively and objectively. CONCLUSION. Urinary incontinence in women is a common problem. It can be successfully diagnosed and treated in general practice but low attendance makes the health promotion clinic setting an inefficient means of achieving this. PMID:8185987

  5. Urinary arsenic concentration adjustment factors and malnutrition.

    PubMed

    Nermell, Barbro; Lindberg, Anna-Lena; Rahman, Mahfuzar; Berglund, Marika; Persson, Lars Ake; El Arifeen, Shams; Vahter, Marie

    2008-02-01

    This study aims at evaluating the suitability of adjusting urinary concentrations of arsenic, or any other urinary biomarker, for variations in urine dilution by creatinine and specific gravity in a malnourished population. We measured the concentrations of metabolites of inorganic arsenic, creatinine and specific gravity in spot urine samples collected from 1466 individuals, 5-88 years of age, in Matlab, rural Bangladesh, where arsenic-contaminated drinking water and malnutrition are prevalent (about 30% of the adults had body mass index (BMI) below 18.5 kg/m(2)). The urinary concentrations of creatinine were low; on average 0.55 g/L in the adolescents and adults and about 0.35 g/L in the 5-12 years old children. Therefore, adjustment by creatinine gave much higher numerical values for the urinary arsenic concentrations than did the corresponding data expressed as microg/L, adjusted by specific gravity. As evaluated by multiple regression analyses, urinary creatinine, adjusted by specific gravity, was more affected by body size, age, gender and season than was specific gravity. Furthermore, urinary creatinine was found to be significantly associated with urinary arsenic, which further disqualifies the creatinine adjustment. PMID:17900556

  6. Association of urinary cadmium and myocardial infarction

    SciTech Connect

    Everett, Charles J. Frithsen, Ivar L.

    2008-02-15

    We conducted a cross-sectional analysis of individuals 45-79 years old in the National Health and Nutrition Examination Survey III (1988-1994) (NHANES III). Myocardial infarction was determined by electrocardiogram (ECG). Our sample included 4912 participants, which when weighted represented 52,234,055 Americans. We performed adjusted logistic regressions with the Framingham risk score, pack-years of smoking, race-ethnicity, and family history of heart attack, and diabetes as covariates. Urinary cadmium {>=}0.88 {mu}g/g creatinine had an odds ratio of 1.86 (95% CI 1.26-2.75) compared to urinary cadmium <0.43 {mu}g/g creatinine. This result supports the hypothesis that cadmium is associated with coronary heart disease. When logistic regressions were done by gender, women, but not men, showed a significant association of urinary cadmium with myocardial infarction. Women with urinary cadmium {>=}0.88 {mu}g/g creatinine had an odds ratio of 1.80 (95% CI 1.06-3.04) compared to urinary cadmium <0.43 {mu}g/g creatinine. When the analysis was restricted to never smokers (N=2187) urinary cadmium {>=}0.88 {mu}g/g creatinine had an odds ratio of 1.85 (95% CI 1.10-3.14) compared to urinary cadmium <0.43 {mu}g/g creatinine.

  7. The management of urinary incontinence.

    PubMed

    Barnard, R J

    1982-01-01

    Urinary incontinence is defined as the involuntary loss of urine which is a social or hygienic problem and is objectively demonstrable. It is common in the general population and not all patients will report the presence of the problem because of, among other things, embarrassment. Assessment is important and should be multi-disciplinary. It includes a history, physical examination and some simple tests. A bladder chart kept by the patient aids assessment. Most patients can then be categorized and further testing planned. These tests are usually invasive and include urodynamic tests and electromyographic studies. With their conclusion treatment can be instituted, such as bladder training, drugs and various aids and appliances. PMID:7095985

  8. Urinary Biomarkers of Brain Diseases

    PubMed Central

    An, Manxia; Gao, Youhe

    2016-01-01

    Biomarkers are the measurable changes associated with a physiological or pathophysiological process. Unlike blood, urine is not subject to homeostatic mechanisms. Therefore, greater fluctuations could occur in urine than in blood, better reflecting the changes in human body. The roadmap of urine biomarker era was proposed. Although urine analysis has been attempted for clinical diagnosis, and urine has been monitored during the progression of many diseases, particularly urinary system diseases, whether urine can reflect brain disease status remains uncertain. As some biomarkers of brain diseases can be detected in the body fluids such as cerebrospinal fluid and blood, there is a possibility that urine also contain biomarkers of brain diseases. This review summarizes the clues of brain diseases reflected in the urine proteome and metabolome. PMID:26751805

  9. Urinary diversion and bowel cancer.

    PubMed Central

    Stewart, M.

    1986-01-01

    A retrospective survey of 278 patients who underwent urinary diversion for benign disease has revealed an excess risk factor for cancer at the ureterocolic anastomosis of approximately 100 fold. No malignancies were detected in isolated ileal or colon conduits, although recently a few such cases have been reported. Coupling this experience with a review of the literature, it would appear that the tumour is of colonic origin, adenoma and adenocarcinoma occurring at, or close to, the ureteric implant into the colon after a long latency of approximately 25 years, often in young patients. Nitrate reducing bacteria and N.nitroso compounds have been demonstrated in rectal urines of patients with ureterocolic anastomoses and also in some isolated loop urines. In fact, N.nitrosation and, possibly, carcinogenesis appears to depend not so much upon the kind of diversion, but rather the presence or absence of a mixed bacterial flora in the urine. PMID:3954318

  10. The nature of urinary casts

    PubMed Central

    McQueen, E. G.

    1962-01-01

    The composition of hyaline casts has been investigated. The major constituent appears to be the urinary mucoprotein described by Tamm and Horsfall. Small amounts only of serum proteins are present. Neither the amounts excreted nor the concentration of Tamm-Horsfall protein appeared to determine the rate of cast formation. The only invariable association of hyaline cast formation was with the presence of significant amounts of serum proteins in the urine. In vitro it was found that aqueous solutions of serum albumin were particularly effective in producing precipitation of Tamm-Horsfall protein. This interaction was inhibited in normal urine but occurred to a greater extent in nephrotic urine and is suggested as the possible mechanism of hyaline cast formation. Images PMID:16810981

  11. Urinary tract infection in children.

    PubMed Central

    McKerrow, W; Davidson-Lamb, N; Jones, P F

    1984-01-01

    During 1968-77, 572 consecutive children with one or more positive urine cultures who were referred by their family doctors to one paediatric surgical outpatient clinic were investigated and prospectively recorded. An abnormality requiring treatment was found in 45%. The yield of positive findings and need for operation were greater in those referred after one infection than in those with recurrent infection. Among those under 2 years old 90% had an abnormality. One third of children with vesicoureteric reflux showed renal scarring at the time of first attendance. The results of medical and surgical treatment over five to 15 years of follow up were analysed. They emphasised the importance of culturing the urine whenever there may be urinary infection in a child and of investigating immediately those with a positive urine culture. PMID:6430447

  12. Interventional Radiology of the Urinary Tract.

    PubMed

    Berent, Allyson C

    2016-05-01

    Minimally invasive treatment options using interventional radiology and interventional endoscopy for urologic disease have become more common over the past decade in veterinary medicine. Urinary tract obstructions and urinary incontinence are the most common reasons for urinary interventions. Ureteral obstructions are underdiagnosed and a common clinical problem in veterinary medicine. Ureteral obstructions should be considered an emergency, and decompression should be performed as quickly as possible. Diagnostic imaging is the mainstay in diagnosing a ureteral obstruction and has changed in the last few years, with ultrasound and radiographs being the most sensitive tools in making this diagnosis preoperatively. PMID:26920646

  13. Urinary Tract Infections in the Older Adult.

    PubMed

    Nicolle, Lindsay E

    2016-08-01

    Urinary infection is the most common bacterial infection in elderly populations. The high prevalence of asymptomatic bacteriuria in both men and women is benign and should not be treated. A diagnosis of symptomatic infection for elderly residents of long-term care facilities without catheters requires localizing genitourinary findings. Symptomatic urinary infection is overdiagnosed in elderly bacteriuric persons with nonlocalizing clinical presentations, with substantial inappropriate antimicrobial use. Residents with chronic indwelling catheters experience increased morbidity from urinary tract infection. Antimicrobial therapy is selected based on clinical presentation, patient tolerance, and urine culture results. PMID:27394021

  14. Association Between Urinary Symptoms and Urinary Tract Infection in Patients With Multiple Sclerosis

    PubMed Central

    Nikseresht, Alireza; Salehi, Haideh; Foroughi, Amin Abolhasani; Nazeri, Masoume

    2016-01-01

    Background & Objective: Urinary dysfunctions occur in the majority of MS patients and these patients are at higher risks of developing UTI due to multiple reasons. We determined to study the association between different urinary symptoms and UTI in MS patients. Material & Method: Eighty seven MS patients that referred to our medical care center with an acute attack of the disease, from November 2012 to April 2014, were included in the study. Patients were classified into two groups based on their urine culture results UTI positive and non-UTI patients. The prevalence of different types of urinary symptoms was then compared among the two groups. Result: The mean age of our patients was 36.8 years old. From the total 87 patients, 83 (95.4%) were female. Overall 56.3% of patients displayed urinary symptoms. The most prevalent urinary problems were urinary incontinence and frequency (25.3% and 24.1%, respectively). A positive urinary culture was seen in 71.3% of the patients. The prevalence of urinary problems was significantly higher in UTI patients in comparison to non-UTI patients (64.5% and 40% in UTI and non-UTI patients, respectively; p=0.036). Separately none of the different urinary symptoms displayed a significant difference between UTI and non-UTI patients (p>0.05). Conclusion: Not a single symptom can be diagnostic of UTI, but MS patient with urinary tract infections do present more urinary symptoms and this can be an indication for further urine analysis and screening measures for MS patients who display more urinary symptoms. PMID:26573031

  15. Demographic, Dietary, and Urinary Factors and 24-h Urinary Calcium Excretion

    PubMed Central

    Curhan, Gary C.

    2009-01-01

    Background and objectives: Higher urinary calcium is a risk factor for nephrolithiasis. This study delineated associations between demographic, dietary, and urinary factors and 24-h urinary calcium. Design, setting, participants, & measurements: Cross-sectional studies were conducted of 2201 stone formers (SF) and 1167 nonstone formers (NSF) in the Health Professionals Follow-up Study (men) and Nurses' Health Studies I and II (older and younger women). Results: Median urinary calcium was 182 mg/d in men, 182 mg/d in older women, and 192 mg/d in younger women. Compared with NSF, urinary calcium as a fraction of calcium intake was 33 to 38% higher in SF (P values ≤0.01). In regression analyses, participants were combined because associations with urinary calcium were similar in each cohort and in SF and NSF. After multivariate adjustment, participants in the highest quartile of calcium intake excreted 18 mg/d more urinary calcium than those in the lowest (P trend =0.01). Caffeine and family history of nephrolithiasis were positively associated, whereas urinary potassium, thiazides, gout, and age were inversely associated, with urinary calcium. After multivariate adjustment, participants in the highest quartiles of urinary magnesium, sodium, sulfate, citrate, phosphorus, and volume excreted 71 mg/d, 37 mg/d, 44 mg/d, 61 mg/d, 37 mg/d, and 24 mg/d more urinary calcium, respectively, than participants in the lowest (P values trend ≤0.01). Conclusions: Intestinal calcium absorption and/or negative calcium balance is greater in SF than NSF. Higher calcium intakes at levels typically observed in free-living individuals are associated with only small increases in urinary calcium. PMID:19820135

  16. The Ocean-Continent Boundary Effect on Seismic Noise Recorded on Land

    NASA Astrophysics Data System (ADS)

    Stutzmann, E.; Gualtieri, L.; Capdeville, Y.; Farra, V.; Mangeney, A.

    2014-12-01

    Seismic noise in the period band 3-10s is generated at the surface of the ocean by the interaction of ocean gravity waves. Noise signal is dominated by Rayleigh waves and is recorded worldwide, both on the ocean seafloor and on continent. Microseismic Rayleigh waves, like any other elastic wave, loose energy when traveling from the ocean to the continent. Thus, the noise records on continent are affected by the propagation of microseismic waves, especially across the boundary between the ocean and the continent, the main structural boundary along the source-receiver path. At the ocean-continent boundary, Rayleigh waves dissipate a significant amount of energy (e.g. McGarr, 1969) and noise Love waves may be generated (e.g. Gregersen, 1977). In order to investigate the effect of the ocean-continent boundary on seismic noise records, we simulate the propagation of the seismic wavefield across the seafloor using the spectral-element method in the secondary microseismic period band (3-10s). A single noise source is located at the surface of the ocean and the signal is recorded at the seafloor, both in deep and shallow ocean regions and on continent. The seismograms computed in a model with continental slope are compared to those computed in a model with flat seafloor, for varying periods and slopes. In the presence of the continental slope, the seismic records are affected by a secondary virtual source, generated by the seafloor topography. The effect of the spatial distribution of noise sources is also investigated.

  17. Representations of OxyContin in North American newspapers and medical journals

    PubMed Central

    Whelan, Emma; Asbridge, Mark; Haydt, Susan

    2011-01-01

    BACKGROUND: There are public concerns regarding OxyContin (Purdue Pharma, Canada) and charges within the pain medicine community that media coverage of the drug has been biased. OBJECTIVE: To analyze and compare representations of OxyContin in medical journals and North American newspapers in an attempt to shed light on how each contributes to the ‘social problem’ associated with OxyContin. METHODS: Using searches of newspaper and medical literature databases, two samples were drawn: 924 stories published between 1995 and 2005 in 27 North American newspapers, and 197 articles published between 1995 and 2007 in 33 medical journals in the fields of addiction/substance abuse, pain/anesthesiology and general/internal medicine. The foci, themes, perspectives represented and evaluations of OxyContin presented in these texts were analyzed statistically. RESULTS: Newspaper coverage of OxyContin emphasized negative evaluations of the drug, focusing on abuse, addiction, crime and death rather than the use of OxyContin for the legitimate treatment of pain. Newspaper stories most often conveyed the perspectives of law enforcement and courts, and much less often represented the perspectives of physicians. However, analysis of physician perspectives represented in newspaper stories and in medical journals revealed a high degree of inconsistency, especially across the fields of pain medicine and addiction medicine. CONCLUSION: The prevalence of negative representations of OxyContin is often blamed on biased media coverage and an ignorant public. However, the proliferation of inconsistent messages regarding the drug from physicians plays a role in the drug’s persistent status as a social problem. PMID:22059195

  18. Heat Flow Partitioning Between Continents and Oceans - from 2D to 3D

    NASA Astrophysics Data System (ADS)

    Moresi, L. N.; Cooper, C. M.; Lenardic, A.

    2010-12-01

    Scalings derived from thermal network theory explain how the presence of continents can influence the Earth’s overall heat loss. Intuitively, it may seem that increasing the proportion of a planet’s surface area covered by continents would decrease the efficiency of heat transfer given that continents do not participate in convective overturn. However, this ignores the potential feedback between the insulating effect of continents and the temperature-dependent viscosity of the mantle (Lenardic et al, 2005, Cooper et al, 2007). When this feedback is considered, a clear regime exists in which the partial stagnation and insulation of the surface by buoyant continental crust can lead to an increase in heat flow compared to the uninsulated case. The numerical results used to verify the scalings have mostly been conducted in two dimensions in order to cover a very wide range of Rayleigh number, fraction of continental coverage, and continental thickness. However as more recent results show that the configuration of the crust also plays a role in determining the heat flow partitioning and global heat flow (See Lenardic et al, “Continents, Super-Continents, Mantle Thermal Mixing, and Mantle Thermal Isolation” in this session), we have begun to repeat this exhaustive and exhausting 2D study in 3D. Cooper, C.M., A. Lenardic, and L.-N. Moresi "Effects of continental insulation and the partioning of heat producing elements on the Earth's heat loss." Geophys. Res. Lett., 33 ,10.1029, 2006. Lenardic, A., L.-N. Moresi, A.M. Jellinek, and M. Manga "Continental insulation, mantle cooling, and the surface area of oceans and continents." Earth Planet. Sci. Lett., 234 ,317-333, 2005.

  19. Development of a Prosthesis for Urinary Control

    NASA Technical Reports Server (NTRS)

    Tenney, J. B.; Rabinowitz, R.; Tomkiewicz, Z.; Harrison, H. N.; Rogers, D. W.

    1986-01-01

    Report describes development and marketing of prosthetic sphincter for urinary control. With prosthetic device, patients void bladder every 3 to 4 hours. Periodic voiding keeps bladder muscles exercised and healthy and avoids bladder infections and kidney damage.

  20. Urinary incontinence - what to ask your doctor

    MedlinePlus

    ... I use to clean a mattress? How much water or liquids should I drink every day? Which foods or liquids can make my urinary incontinence worse? Are there activities I should avoid that may cause problems with ...

  1. URINARY BIOMARKER INTERPRETATION USING PHARMACOKINETIC MODELS

    EPA Science Inventory

    The issues involved with applying PBPK models in urinary biomarker interpretation were presented. Example scenarios were modeled, and absorbed doses were estimated for selected participants from a field study to illustrate the applicability and limitations of the methods.

  2. [Conservative treatment in male urinary incontinence].

    PubMed

    Kirschner-Hermanns, R; Anding, R

    2014-03-01

    Prevalence, pathophysiology, diagnostic and therapeutic approaches of urinary incontinence are well studied in women; however, studies on male urinary incontinence focus on incontinence following surgery of the bladder or prostate, predominantly incontinence after radical prostatectomy. Aging men suffer from incontinence, most frequently urge incontinence (overactive bladder, OAB), nearly as often as women do.The domain of conservative therapy of urinary stress incontinence in men is pelvic floor training. It remains unclear whether biofeedback procedures, electrostimulation therapy, or magnetic stimulation therapy can enhance pelvic floor training. There are data suggesting that an off-label therapy with Duloxetin®, a selective serotonin-noradrenaline reuptake inhibitor (SSNRI), improves urinary incontinence following radical prostatectomy. Antimuscarinic agents in combination with bladder training have been proven as safe and effective treatment in men with OAB. Data, however, suggest that men with OAB are far less frequently treated than women. PMID:24585116

  3. Urinary tract complications with rectal surgery.

    PubMed Central

    Beahrs, J R; Beahrs, O H; Beahrs, M M; Leary, F J

    1978-01-01

    The possibility of urinary tract injury should always be considered in the course of anterior resection or combined abdominoperineal resection of the lower colon and rectum. Controlled studies of ureteral and other injuries and fistulas cannot be made; but fortunately, unanticipated damage to the lower urinary tract does not occur often. The surgeon operating in the pelvis should be aware of the problems rarely encountered and should be capable of their management. If a urologic surgeon is available, consultation often is desirable. Prompt intraoperative recognition is most important so remedial procedures can be carried out immediately. Delay in recognition and treatment jeopardizes the patient's course and the function of the urinary tract. Postoperative urinary tract infections should be diagnosed early so prompt treatment can be instituted. PMID:646493

  4. Urinary catheters - what to ask your doctor

    MedlinePlus

    ... Elsevier Saunders; 2011:chap 69. Shamliyan TA, Kane RL, Wyman J, Wilt TJ. Systematic review: randomized, controlled ... TA, Wyman JF, Ping R, Wilt TJ, Kane RL. Male urinary incontinence: Prevalence, risk factors, and preventive ...

  5. The Interaction of Eastward Propagating Equatorial Modes with the Maritime Continent

    NASA Astrophysics Data System (ADS)

    Flatau, M. K.

    2015-12-01

    We examine the processes that contribute to blocking of the eastward propagating equatorial modes by the Maritime Continent. The recent study by Baranowski at al (2015) have shown that the propgation of Kelvin waves through the Maritime Continent is strongly influenced by the interaction of the waves with the diurnnal cycle of convection over the land which can either amplify or supress the convective forcing of the wave. This suggests that inorder for the wave to cross the Maritime Continent it has to be in phase with local convection. Another possible mechanism through which the Maritime Continent can influence approaching Kelvin waves and MJO's is their interacton with cyclonic disturbances generated by the lee vortices at the tips of Sumatra. Both of these mechanisms can be misrepresented by dynamic models and contribute to predictability barrier in this region These equatorial modes ate examined in Navy models forecasts of DYNAMO MJOs and n idealized experiments. While the models appear to predict the MJO and Kelvin wave approach to the Maritime continent their propagation is too slowa andn westward propagating disturbance are often too strong. We examine the contribution of lee vortices and local diurnal convection variability to this process

  6. Quality audit--a review of the literature concerning delivery of continence care.

    PubMed

    Swaffield, J

    1995-09-01

    This paper outlines the role of quality audit within the framework of quality assurance, presenting the concurrent and retrospective approaches available. The literature survey provides a review of the limited audit tools available and their application to continence services and care delivery, as well as attempts to produce tools from national and local standard setting. Audit is part of a process; it can involve staff, patients and their relatives and the team of professionals providing care, as well as focusing on organizational and management levels. In an era of market delivery of services there is a need to justify why audit is important to continence advisors and managers. Effectiveness, efficiency and economics may drive the National Health Service, but quality assurance, which includes standards and audit tools, offers the means to ensure the quality of continence services and care to patients and auditing is also required in the purchaser/provider contracts for patient services. An overview and progress to date of published and other a projects in auditing continence care and service is presented. By outlining and highlighting the audit of continence service delivery and care as a basis on which to build quality assurance programmes, it is hoped that this knowledge will be shared through the setting up of a central auditing clearing project. PMID:7551434

  7. Nosocomial urinary tract infections: A review.

    PubMed

    Iacovelli, Valerio; Gaziev, Gabriele; Topazio, Luca; Bove, Pierluigi; Vespasiani, Giuseppe; Finazzi Agrò, Enrico

    2014-01-01

    Nosocomial urinary tract infections are a common complication in healthcare systems worldwide. A review of the literature was performed in June 2014 using the Medical Literature Analysis and Retrieval System Online (MEDLINE) database, through either PubMed or Ovid as a search engine, to identify publications regarding nosocomial urinary tract infections (NUTIs) definition, epidemiology, etiology and treatment.According to current definitions, more than 30% of nosocomial infections are urinary tract infections (UTIs). A UTI is defined 'nosocomial' (NUTI) when it is acquired in any healthcare institution or, more generally, when it is related to patient management. The origin of nosocomial bacteria is endogenous (the patient's flora) in two thirds of the cases. Patients with indwelling urinary catheters, those undergoing urological surgery and manipulations, long-stay elderly male patients and patients with debilitating diseases are at high risk of developing NUTIs. All bacterial NUTIs should be treated, whether the patient is harboring a urinary catheter or not. The length of treatment depends on the infection site. There is abundance of important guidance which should be considered to reduce the risk of NUTIs (hand disinfection with instant hand sanitizer, wearing non-sterile gloves permanently, isolation of infected or colonized catheterized patients). Patients with asymptomatic bacteriuria can generally be treated initially with catheter removal or catheter exchange, and do not necessarily need antimicrobial therapy. Symptomatic patients should receive antibiotic therapy. Resistance of urinary pathogens to common antibiotics is currently a topic of concern. PMID:25451882

  8. Investigation of the dilated urinary tract.

    PubMed

    Parkhouse, H F; Barratt, T M

    1988-01-01

    Dilatation of the urinary tract does not necessarily imply obstruction, and other factors may be operative: maldevelopment, infection, reflux, and polyuria. Obstruction of the urinary tract in intra-uterine life is associated with renal dysplasia: the original obstructive lesion may be transient but the consequent dysplasia and dilatation may be permanent. Routine antenatal ultrasound identifies a new population of infants with urinary tract dilatation, many of whom remain asymptomatic and would not otherwise have come to medical attention: the natural history and appropriate schedules of investigation and management of this group are still being evaluated. Anatomical imaging by ultrasound establishes the presence and extent of dilatation. Micturating cystourethrography, intravenous urography and antegrade pyelography establish the site but not the functional significance of an obstructive lesion. Isotope renal scanning with 99mTc-DTPA may identify an acutely obstructed kidney with a decrease renal uptake, prolonged parenchymal transit time, and delayed clearance of the isotope from the renal pelvis after furosemide. However, such analyses often give equivocal results in infants with poor renal function and markedly dilated urinary tracts. Obstructive uropathy should be seen as a disturbance of the normal pressure-flow relationships in the urinary tract, and be defined and investigated as such. Antegrade perfusion with renal pelvic pressure measurements has technical pitfalls, but is the definitive method of establishing upper tract obstruction. Videocystourethrography is the established method of investigating the lower urinary tract in older children but needs further development to be applicable to infants. PMID:3153000

  9. The Formation of Urinary Calculi

    PubMed Central

    Joly, J. Swift

    1928-01-01

    Normal urine is always grossly super-saturated in regard to the stone-forming salts, which are kept in solution by the action of the colloids. This action is best explained by the theory of adsorption. The amount of the stone-forming salts which can be held in solution depends on the surface area of the colloid, and therefore on its state of subdivision. Precipitation of these salts is due to failure of the colloid to hold them in solution. It may be due to an insufficient quantity, but is more probably due to coagulation of the colloid. When precipitation occurs in the urinary passages, the crystals are usually retained in the lower calyx of the kidney. A crystalline deposit tends to grow into crystalline concretions under the action of surface energy, thus forming true primary calculi. Stones of this type soon irritate the wall of the cavity in which they are contained and cause a reactionary exudate. The laminated stone is formed by continued deposition of crystals, coupled with rhythmic precipitation of a foreign colloid derived from the exudate. Stones originating in infected media are formed in a similar manner. PMID:19986433

  10. Urinary tract stones in pregnancy.

    PubMed

    Swanson, S K; Heilman, R L; Eversman, W G

    1995-02-01

    The presence of stones during an otherwise uneventful pregnancy is a dramatic and potentially serious issue for the mother, the fetus, and the treating physicians alike. The incidence and predisposing factors are generally the same as in nonpregnant, sexually active, childbearing women. Unique metabolic effects in pregnancy such as hyperuricuria and hypercalciuria, changes in inhibitors of lithiasis formation, stasis, relative dehydration, and the presence of infection all have an impact on stone formation. The anatomic changes and physiologic hydronephrosis of pregnancy make the diagnosis and treatment more challenging. Presenting signs and symptoms include colic, flank pain, hematuria, urinary tract infection, irritative voiding, fever, premature onset or cessation of labor, and pre-eclampsia. The initial evaluation and treatment are again similar to those used for the nonpregnant population. The most appropriate first-line test is renal ultrasonography, which may, by itself, allow the diagnosis to be made and provide enough information for treatment. Radiographic studies, including an appropriately performed excretory urogram, give specific information as to size and location of the stones, location of the kidneys, and differential renal function and can be used safely, but the ionizing radiation risks should be considered. All forms of treatment with the exception of extracorporeal shock wave lithotripsy and some medical procedures are appropriate in the pregnant patient. Close coordination by the urologist, the obstetrician, the pediatrician, the anesthesiologist, and the radiologist is required for the appropriate care of these patients. PMID:7855714

  11. What caused the recent ``Warm Arctic, Cold Continents'' trend pattern in winter temperatures?

    NASA Astrophysics Data System (ADS)

    Sun, Lantao; Perlwitz, Judith; Hoerling, Martin

    2016-05-01

    The emergence of rapid Arctic warming in recent decades has coincided with unusually cold winters over Northern Hemisphere continents. It has been speculated that this "Warm Arctic, Cold Continents" trend pattern is due to sea ice loss. Here we use multiple models to examine whether such a pattern is indeed forced by sea ice loss specifically and by anthropogenic forcing in general. While we show much of Arctic amplification in surface warming to result from sea ice loss, we find that neither sea ice loss nor anthropogenic forcing overall yield trends toward colder continental temperatures. An alternate explanation of the cooling is that it represents a strong articulation of internal atmospheric variability, evidence for which is derived from model data, and physical considerations. Sea ice loss impact on weather variability over the high-latitude continents is found, however, to be characterized by reduced daily temperature variability and fewer cold extremes.

  12. Disintegration of urinary calculi by laser beam: drilling experiment in extracted urinary stones.

    PubMed

    Tanahashi, Y; Orikasa, S; Chiba, R; Tahira, K; Fukatsu, T; Miyakawa, T

    1979-06-01

    Disintegration of urinary calculi was attempted by the use of laser beam. As a first step, drilling of extracted urinary stones was attempted using a continuous wave CO2 laser and a pulse ruby laser. Stones were drilled easily by either laser beam. The power around 10 W of continuous CO2 laser beam was sufficient to drill through the stone. PMID:462477

  13. Correlation Between Mobile Continents and Elevated Temperatures in the Subcontinental Mantle

    NASA Astrophysics Data System (ADS)

    Jain, C.; Rozel, A. B.; Tackley, P.

    2015-12-01

    Rolf et al. (EPSL, 2012) and Coltice et al. (Science, 2012) have previously shown that continents exert a first order influence on Earth's mantle flow by affecting convective wavelength and surface heat flow. With stationary continents, Heron and Lowman (JGR, 2014) highlighted the decreasing role of continental insulation on subcontinental temperatures with higher Rayleigh number (Ra). However, the question whether there exists a correlation between mobile continents and elevated temperatures in the subcontinental mantle or not remains to be answered. Continental motion is attributed to the viscous stresses imparted by the convecting mantle and the extent of this motion depends on the heat budget of the mantle. Core-mantle boundary (CMB) heat flux, internal heating from decay of radioactive elements, and mantle cooling contribute to this heat budget. Out of these sources, CMB heat flux is not well defined. However, the recent determination of core's high thermal conductivity requires a CMB heat flow of at least 12 TW (de Koker et al., PNAS 2012; Pozzo et al., Nature 2012; Gomi et al., PEPI 2013). Thus it is necessary to characterize the impact of basal heating on mantle dynamics with mobile continents and self-consistent plate tectonics. By systematically varying parameters such as CMB temperature, continental size, mantle heating modes, and Rayleigh number; we model Boussinesq, incompressible, thermo-chemical mantle convection with 2D spherical annulus geometry using StagYY (Tackley, PEPI 2008). We observe the aforementioned correlation irrespective of the variations in basal heating and continental size (except for very small continents). Moreover, we see episodicity between correlation-anticorrelation with increasing convective vigour. Furthermore, the effect of radioactivity in the continental crust on this correlation is investigated. At present, mobile continents in StagYY are simplified into a compositionally distinct field drifting at the top of the mantle

  14. The effects of size, configuration and distribution of continents on the efficiency of heat transport

    NASA Astrophysics Data System (ADS)

    Cooper, C. M.; Moresi, L. N.; Lenardic, A.

    2011-12-01

    The addition of continents to the surface of a planet alters its interior dynamics; understanding this alteration is critical to understanding the thermal evolution of the Earth. Specifically, the increase in temperature induced by continental insulation can be compensated by an increase in the heat loss through the overturn of the oceanic lithosphere, thus contradicting the predicted reduction of global heat loss due to presence of continents (e.g., Lenardic et al, 2005; Cooper et al, 2006; Lenardic et al, 2011). We reconfirm this counterintuitive result with three-dimensional simulations. In addition, we explore variations in the configuration of continents on the surface. Within simulations with equivalent continental coverage, but varying configuration, there is a competition between the lateral size of the blocks and the natural horizontal scale of the convection pattern which influences the stability of the models over time, and the efficiency of heat transport. Smaller continental blocks tend to induce a stable planform with upwellings permanently avoiding the blocks. However, in cases with larger continental blocks, the imposed scale is larger than the preferred scale of the convection pattern and upwellings are unable to avoid the blocks altogether. The dependency on stability and efficiency of heat transport within the Earth on continental coverage and configuration suggests continents can play a significant role in the Earth's heat budget and thermal history. Cooper, C.M., A. Lenardic, and L.-N. Moresi "Effects of continental insulation and the partioning of heat producing elements on the Earth's heat loss." Geophys. Res. Lett., 33 ,10.1029, 2006; Lenardic, A., C.M. Cooper, and L.-N. Moresi "A note on continents and the Earth's Urey ratio", Physics of the Earth and Planetary Interiors, 2011; Lenardic, A., L.-N. Moresi, A.M. Jellinek, and M. Manga "Continental insulation, mantle cooling, and the surface area of oceans and continents." Earth Planet. Sci

  15. The Making of Early Continents and the Initiation of Plate Tectonics on Earth

    NASA Astrophysics Data System (ADS)

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

    2014-12-01

    We propose a simple, self-consistent model to explain a range of puzzling observation made in many Archean cratons including 1/ the marked petrological stratification of the lithospheric mantle; 2/ the multimodal polybaric volcanism of greenstone covers; 3/ the regional and temporal overlap between komatiitic-tholeiitic basalts and arc-volcanism; and 4/ the mid-lithospheric seismic discontinuity mapped across several cratons. This model also explains the possible transition from a stagnant-lid regime to a transient then steady-state plate tectonic regime. We performed several series of 2D thermo-mechanical numerical experiments to investigate the effect of an early continent on mantle convection. We considered a composite lid including 1/ a continent consisting of 55 km thick crust - made of TTG and continental flood basalts - above a 170-km-thick strongly depleted, strong and buoyant lithospheric mantle, and 2/ an oceanic lid including a 15-km-thick basaltic crust. These experiments show that the continent slowly spreads laterally toward the adjacent oceanic lid. The spreading and thinning of the continent drives exhumation of the fertile sub-continental mantle, which in turn promotes polybaric decompression melting producing komatiitic and tholeiitic basalts. Continental boudinage and rifting accompanying the spreading drives further upwelling and decompression melting to even shallower depths. This partial melting produces a moderately depleted mantle layer, progressively incorporated through cooling to the base of the continent. Our numerical experiments also show that spreading continents force the adjacent oceanic lid into the convective mantle, promoting subduction of the oceanic lid and temporal overlap between Archean komatiitic-tholeiitic basalts with arc-volcanism. Spreading and thinning of the continent lead to a sub-horizontal litho-tectonic fabric in the mantle, with a possible major discontinuity between the older strongly depleted mantle, and the

  16. Use of a percutaneously controlled hydraulic occluder for treatment of refractory urinary incontinence in three female cats.

    PubMed

    Wilson, Kendall E; Berent, Allyson C; Weisse, Chick W

    2016-03-01

    CASE DESCRIPTION 3 cats were referred for evaluation of chronic urinary incontinence. CLINICAL FINDINGS A presumptive diagnosis of urethral sphincter mechanism incompetence (USMI) was made in all 3 cats. Preoperatively, incontinence was mild in 1 cat (incontinence during sleep) and moderate to severe (incontinence while awake and at rest) in 2. Structural abnormalities noted during cystoscopy included urethrovestibular junction stenosis (n = 1), vaginal stenosis (1), short urethra (1), and intrapelvic bladder (1). TREATMENT AND OUTCOME All 3 cats were treated by means of implantation of an inflatable silicone hydraulic occluder (HO) via a ventral midline celiotomy. Immediately prior to HO implantation, patients underwent cystoscopy to detect any anatomic abnormalities and confirm the absence of ureteral ectopia. Following surgery, all 3 patients attained complete continence, needing 0 or 1 inflation of the device. Complications included cystoscopy-associated urethral tear (n = 1), constipation (1), stranguria (1), hematuria (2), and urinary tract infection (2). Device explantation was performed 14 weeks after surgery in 1 cat because of postoperative constipation. Constipation persisted and urinary incontinence recurred but was markedly improved following device removal in this cat (leakage of urine only when sleeping at follow-up 29 months after surgery [26 months after device explantation]). At the time of last follow-up, 2 of the 3 cats remained fully continent approximately 3 and 6 years after device implantation. CLINICAL RELEVANCE Findings suggested that implantation of an HO may be a safe and effective long-term treatment for some cats with USMI. Further studies are necessary to evaluate the potential for treatment-related complications and the long-term outcome. PMID:26885598

  17. General practitioners and women with urinary incontinence.

    PubMed Central

    Grealish, M; O'Dowd, T C

    1998-01-01

    BACKGROUND: Urinary incontinence is a common problem for adult women. It results in a large financial and psychosocial cost. Much urinary incontinence goes unreported. Women with urinary incontinence can be successfully assessed and treated in general practice but studies have shown that many GPs manage the condition inadequately. AIM: This study aims to examine GPs' awareness of urinary incontinence in women and their management of, and attitudes to, female urinary incontinence. METHOD: A qualitative study was conducted with 21 GPs responding to semi-structured interviews. Thematic analysis was carried out on these interviews, with recurrent views and experiences being identified and grouped. RESULTS: The interviews of 11 male and nine female GPs were suitable for analysis. GPs were aware of the prevalence and under-reporting of urinary incontinence in women. Many were unhappy with their own management of the condition and with the management options available to them. Male GPs in particular were reluctant to carry out gynaecological examinations, and few GPs expressed enthusiasm for teaching pelvic floor exercises or bladder drills. Medications were frequently used but generally considered ineffective or intolerable. The services of both public health nurses and practice nurses were under-used, largely because of lack of training in this area. Although incontinence nurses were employed in the area, many GPs did not know of their availability and, of those who did, few referred to them more than infrequently. CONCLUSION: This study demonstrates that many GPs avoid dealing with the problem of urinary incontinence in women and that they find it to be a difficult, chronic problem to treat. Specialist options seem not to be useful in general practice. The findings need to be explored in other GP settings. PMID:9624768

  18. Stable formation of the nipple valve in Kock pouch for diversion of the urinary tract.

    PubMed

    Okada, Y; Arai, Y; Oishi, K; Takeuchi, H; Yoshida, O

    1989-10-01

    Construction of a continent ileal urinary reservoir is associated with a high incidence of late complications because of malfunction of the nipple valve. Three important modifications in the operative procedures for the construction of the nipple valve were developed with significant improvements in late complication rates and end results. First is the use of Dacron (polyester fiber) fabric as a collar instead of Marlex mesh (polypropylene), which frequently causes erosion. The second is treatment of the mesentery using a CUSA (Cavitron Ultrasonic Surgical Aspirator) (Cavitron Co. Ltd.) instead of making Deaver's windows, thus preserving the blood supply to the nipple valves. Third is anchoring of the nipple valves to the anterior wall of the reservoir, preventing prolapse, the most frequent malfunction of the nipple valve. The incidence of malfunction of the nipple valve and the end results of this innovative urinary diversion using an internal reservoir were analyzed in relation to these modifications of the operative technique among 71 patients. To date, with an established mode of operation, the success rate is more than 95 per cent. PMID:2675358

  19. Urolastic for the treatment of women with stress urinary incontinence: 24-month follow-up

    PubMed Central

    Zajda, Janusz; Farag, Fawzy

    2015-01-01

    Introduction To evaluate the efficacy and durability of Urolastic, a new urethral bulking agent in women with stress urinary incontinence (SUI), after a follow-up of 24-months. Material and methods A follow-up study of women with SUI who received a Urolastic injection and successfully passed the 12-month follow-up. Assessment included the Stamey Grade, 1-h Pad weight test, and the International quality of life (I-QoL) score. Results Nineteen women who completed the 12-month follow-up were invited for the 24-month follow-up study. One patient did not respond to the correspondence. Four of the 18 patients who responded to the correspondence reported removal of the Urolastic implant at another facility, based on their desire. The explanation for this removal was painful intercourse (n = 1) or less than optimal dryness (n = 3). The overall objective improvement in continence status at 24-months was 66% compared to the 89% at the 12-month follow-up, while in addition the 1-h pad weight test showed >50% reduction in pad weight in 66% of patients compared to 84% at the 12-month follow-up. Adverse events reported were urinary tract infection (n = 1), local genital infection with erosion into the vagina (n = 1), painful intercourse (n = 2), and urgency (n = 4). Conclusions Urolastic is comparable to other bulking agents in terms of durability, efficacy, and complications. PMID:26568877

  20. Lower urinary tract development and disease.

    PubMed

    Rasouly, Hila Milo; Lu, Weining

    2013-01-01

    Congenital anomalies of the lower urinary tract (CALUT) are a family of birth defects of the ureter, the bladder, and the urethra. CALUT includes ureteral anomaliesc such as congenital abnormalities of the ureteropelvic junction (UPJ) and ureterovesical junction (UVJ), and birth defects of the bladder and the urethra such as bladder-exstrophy-epispadias complex (BEEC), prune belly syndrome (PBS), and posterior urethral valves (PUVs). CALUT is one of the most common birth defects and is often associated with antenatal hydronephrosis, vesicoureteral reflux (VUR), urinary tract obstruction, urinary tract infections (UTI), chronic kidney disease, and renal failure in children. Here, we discuss the current genetic and molecular knowledge about lower urinary tract development and genetic basis of CALUT in both human and mouse models. We provide an overview of the developmental processes leading to the formation of the ureter, the bladder, and the urethra, and different genes and signaling pathways controlling these developmental processes. Human genetic disorders that affect the ureter, the bladder and the urethra and associated gene mutations are also presented. As we are entering the postgenomic era of personalized medicine, information in this article may provide useful interpretation for the genetic and genomic test results collected from patients with lower urinary tract birth defects. With evidence-based interpretations, clinicians may provide more effective personalized therapies to patients and genetic counseling for their families. PMID:23408557

  1. Human Urinary Exosomes as Innate Immune Effectors

    PubMed Central

    Hiemstra, Thomas F.; Charles, Philip D.; Gracia, Tannia; Hester, Svenja S.; Gatto, Laurent; Al-Lamki, Rafia; Floto, R. Andres; Su, Ya; Skepper, Jeremy N.

    2014-01-01

    Exosomes are small extracellular vesicles, approximately 50 nm in diameter, derived from the endocytic pathway and released by a variety of cell types. Recent data indicate a spectrum of exosomal functions, including RNA transfer, antigen presentation, modulation of apoptosis, and shedding of obsolete protein. Exosomes derived from all nephron segments are also present in human urine, where their function is unknown. Although one report suggested in vitro uptake of exosomes by renal cortical collecting duct cells, most studies of human urinary exosomes have focused on biomarker discovery rather than exosome function. Here, we report results from in-depth proteomic analyses and EM showing that normal human urinary exosomes are significantly enriched for innate immune proteins that include antimicrobial proteins and peptides and bacterial and viral receptors. Urinary exosomes, but not the prevalent soluble urinary protein uromodulin (Tamm–Horsfall protein), potently inhibited growth of pathogenic and commensal Escherichia coli and induced bacterial lysis. Bacterial killing depended on exosome structural integrity and occurred optimally at the acidic pH typical of urine from omnivorous humans. Thus, exosomes are innate immune effectors that contribute to host defense within the urinary tract. PMID:24700864

  2. Lower urinary tract development and disease

    PubMed Central

    Rasouly, Hila Milo; Lu, Weining

    2013-01-01

    Congenital Anomalies of the Lower Urinary Tract (CALUT) are a family of birth defects of the ureter, the bladder and the urethra. CALUT includes ureteral anomalies such as congenital abnormalities of the ureteropelvic junction (UPJ) and ureterovesical junction (UVJ), and birth defects of the bladder and the urethra such as bladder-exstrophy-epispadias complex (BEEC), prune belly syndrome (PBS), and posterior urethral valves (PUV). CALUT is one of the most common birth defects and is often associated with antenatal hydronephrosis, vesicoureteral reflux (VUR), urinary tract obstruction, urinary tract infections (UTI), chronic kidney disease and renal failure in children. Here, we discuss the current genetic and molecular knowledge about lower urinary tract development and genetic basis of CALUT in both human and mouse models. We provide an overview of the developmental processes leading to the formation of the ureter, bladder, and urethra, and different genes and signaling pathways controlling these developmental processes. Human genetic disorders that affect the ureter, bladder and urethra and associated gene mutations are also presented. As we are entering the post-genomic era of personalized medicine, information in this article may provide useful interpretation for the genetic and genomic test results collected from patients with lower urinary tract birth defects. With evidence-based interpretations, clinicians may provide more effective personalized therapies to patients and genetic counseling for their families. PMID:23408557

  3. Mechanisms and geologic significance of the mid-lithosphere discontinuity in the continents

    NASA Astrophysics Data System (ADS)

    Karato, Shun-Ichiro; Olugboji, Tolulope; Park, Jeffrey

    2015-07-01

    The stable continents have a puzzling structure. Recent seismological studies have revealed a marked drop in seismic velocity at middle-lithosphere depths, but a generally small velocity drop at the lithosphere-asthenosphere boundary. The mid-lithosphere discontinuity has previously been attributed to changes in composition and/or crystal alignment (anisotropy) caused by metasomatic alteration, as well as to partial melting and/or accretion of intruded materials that occurred after the formation of the continents. We show that these models cannot easily explain the global presence of a large seismic velocity drop in the middle lithosphere and a small velocity change at the lithosphere-asthenosphere boundary. These models are also difficult to reconcile with long-term continental stability and, in particular, observations of nearly depth-invariant ages of rocks in the continental lithosphere that do not support the notion of late alteration events. Instead, we propose an elastically accommodated grain-boundary sliding model that predicts a substantial velocity drop at the mid-lithosphere discontinuity and a weak seismic signal at the lithosphere-asthenosphere boundary, as observed, without invoking late-stage modifications to the lithosphere. In this model, the mid-lithosphere discontinuity is a general feature of the stable continents, the precise depth of which depends primarily on temperature and water content. Consequently, the depth of the mid-lithosphere discontinuity may provide clues to the evolution of continents.

  4. Profiles on Rural Education in the Seven State Mid-Continent Region.

    ERIC Educational Resources Information Center

    Missouri Univ., Columbia. Office of Social and Economic Data Analysis.

    Based on interviews with State Education Department personnel, this report presents information regarding the status of rural education in the seven-state region (Colorado, Kansas, Missouri, Nebraska, North Dakota, South Dakota, and Wyoming) served by the Mid-Continent Regional Laboratory. Of the 2,400 school districts in this region, 93 percent…

  5. Papers presented to the Conference on Heat and Detachment in Crustal Extension on Continents and Planets

    NASA Technical Reports Server (NTRS)

    1985-01-01

    Several topics relative to heat and detachment in crustal extension on continents and planets are discussed. Rifting on Venus, heat flow and continental breakup, magnetism, the mountains and tectonic processes of Io, and the ductile extension of planetary lithospheres are among the topics covered.

  6. Listening to carers talking about the subjects of continence and toileting.

    PubMed

    Forbat, Liz

    Toilets and continence play critical roles in the lives of people who care for a relative at home. Issues around toileting are central to the relationship between the carer and the person being cared for, with the bathroom often becoming the most important place in the house. PMID:14768154

  7. Modeled summer background concentration nutrients and suspended sediment in the mid-continent (USA) great rivers

    EPA Science Inventory

    We used regression models to predict background concentration of four water quality indictors: total nitrogen (N), total phosphorus (P), chloride, and total suspended solids (TSS), in the mid-continent (USA) great rivers, the Upper Mississippi, the Lower Missouri, and the Ohio. F...

  8. Can individualized health care plans help increase continence in children with dysfunctional elimination syndrome?

    PubMed

    Boisclair-Fahey, Anne

    2009-10-01

    School-age children with dysfunctional elimination syndrome (DES) do not always have school support for their treatment plans, including an every 2-hr voiding schedule. The objective of this study was to increase school support of treatment plans by allowing access to bathrooms, thereby improving continence. An eight-question survey about bathroom access at schools was given to parents at baseline. The author contacted school nurses requesting that treatment plans be incorporated into individual health plans (IHPs) with teacher support of the IHP. Six weeks later, school nurses were contacted and parents completed a postintervention survey to determine whether IHPs were supported by teachers. Voiding diaries were used to document continence. Seventeen parents completed the survey at baseline, and 13 children were enrolled in the intervention. After the intervention, 100% of the children had IHPs and teacher support of treatment plans. Ninety-two percent had increased continence. IHPs improved teacher support of children's treatment plans and improved their continence. PMID:19342536

  9. Can Individualized Health Care Plans Help Increase Continence in Children with Dysfunctional Elimination Syndrome?

    ERIC Educational Resources Information Center

    Boisclair-Fahey, Anne

    2009-01-01

    School-age children with dysfunctional elimination syndrome (DES) do not always have school support for their treatment plans, including an every 2-hr voiding schedule. The objective of this study was to increase school support of treatment plans by allowing access to bathrooms, thereby improving continence. An eight-question survey about bathroom…

  10. Manipulation of the Family Photo Album: Esther Parada's Transplant--A Tale of Three Continents

    ERIC Educational Resources Information Center

    Eggemeyer, Valerie

    2004-01-01

    In this article, the author focuses on Esther Parada's non-traditional use of the Web to communicate her art, and offers a critique of Parada's work, "Transplant: A Tale of Three Continents," and suggestions for critiquing Web art in the school classroom. Parada creates an intersection between this new medium and the more traditional medium of…

  11. Mid-continent fall temperatures at the 10-cm soil depth

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Recommendations for applying N-fertilizer in autumn involve delaying applications until daily soil temperature at 10 cm depth is = or < 10° C. Daily soil temperature data during autumn were examined from 26 sites along a transect from 36° to 49° N latitude in the mid-continent USA. After soils first...

  12. Littoral and Shoreline Wood in Mid-continent Great Rivers (USA)

    EPA Science Inventory

    Less is known about the ecology of wood in great rivers than in smaller lotic systems. We used a probability survey to estimate the abundance of littoral and shoreline wood along the mid-continent great rivers of the United States: the Missouri, Upper Mississippi, and the Ohio Ri...

  13. Lost Continents? Children's Understanding of the Location and Orientation of the Earth's Land Masses.

    ERIC Educational Resources Information Center

    Wiegand, Patrick; Stiell, Bernadette

    1996-01-01

    Presents the results of an experiment that asked 53 middle school children to identify continent shapes and to arrange them to form a map of the world. Australia, Europe, and Asia were the most recognized. Misidentified and misaligned most consistently were Africa and Antarctica. Discusses possible reasons and teachers' responses. (MJP)

  14. Feldspar basalts in lunar soil and the nature of the lunar continents

    NASA Technical Reports Server (NTRS)

    Reid, A. M.; Ridley, W. I.; Harmon, R. S.; Warner, J.; Brett, R.; Jakes, P.; Brown, R. W.

    1974-01-01

    It is found that 25% on the Apollo-14 glasses have the same composition as the glasses in two samples taken from the Luna-16 column. The compositions are equivalent to feldspar basalt and anorthosite gabbro, and are similar to the feldspar basalts identified from Surveyor-7 analysis for lunar continents.

  15. A northern Cordilleran ocean-continent transect: Sitka Sound, Alaska, to Atlin Lake, British Columbia

    USGS Publications Warehouse

    Brew, D.A.; Karl, S.M.; Barnes, D.F.; Jachens, R.C.; Ford, A.B.; Horner, R.

    1991-01-01

    The 155 km wide, 310 km long Sitka Sound - Atlin Lake continent-ocean transect includes almost all the geologic, geophysical, and geotectonic elements of the Canadian Cordillera. It crosses the Chugach, Wrangellia, Alexander, Stikine, and Cache Creek terranes, the Gravina and Laberge overlap assemblages, intrusive and metamorphic belts, and neotectonic faults that bound major blocks. -from Authors

  16. Evaluation Plan of the Mid-continent Research for Education and Learning, FY1996-FY2000.

    ERIC Educational Resources Information Center

    Barley, Zoe

    This evaluation plan, which is updated annually, provides a synthesis of the various evaluation activities of Mid-continent Research for Education and Learning (McREL). During 1999, the fourth year of the Laboratory's contract period with the Office of Educational Research and Improvement, special studies and integrated studies were designed to…

  17. Rotational inertia of continents: A proposed link between polar wandering and plate tectonics

    USGS Publications Warehouse

    Kane, M.F.

    1972-01-01

    A mechanism is proposed whereby displacement between continents and the earth's pole of rotation (polar wandering) gives rise to latitudinal transport of continental plates (continental drift) because of their relatively greater rotational inertia. When extended to short-term polar wobble, the hypothesis predicts an energy change nearly equivalent to the seismic energy rate.

  18. Relationship between urease-producing bacteria, urinary pH and encrustation on indwelling urinary catheters.

    PubMed

    Hedelin, H; Bratt, C G; Eckerdal, G; Lincoln, K

    1991-05-01

    In 11 patients with long-term indwelling catheters the amount of catheter encrustation and urinary pH were measured and the urine regularly cultured over a prolonged period of time (median of 7 periods of 3 weeks). The mean urinary pH was related to the persistent presence of urease-producing micro-organisms (P. mirabilis) and urinary pH governed the precipitation of catheter encrustation. The critical pH appeared to be around 6.8. In patients with a mean urinary pH below this level the encrustation was minute (less than or equal to 2.9 mg phosphate). In patients with a mean urinary pH above 6.8 it was considerable but with a marked interindividual variation (35.5-138.7 mg phosphate). The composition of the encrustation was also strongly pH-related, with a much higher proportion present as magnesium ammonium phosphate in patients with a mean urinary pH above 6.8. The persistent presence of urease producers was not associated with a high pH or a more pronounced precipitation of phosphate in all patients. The amount of encrustation thus appears to depend not only on the presence of urease-producing micro-organisms but also on individual factors such as urinary composition. PMID:2039922

  19. A Preliminary Immunologic Study of Urinary Proteins

    PubMed Central

    Barcelo, Raymond; Pollak, Victor E.

    1966-01-01

    The clearances of seven different proteins were measured by a quantitative immunodiffusion technique in 15 patients with proteinuria. All urines were also studied by immunoelectrophoresis. The renal histology was evaluated in each case, and no correlation was found between histologic changes and the urinary protein excretion. This observation was confirmed by both immunodiffusion and immunoelectrophoretic techniques. No specific urinary protein excretion pattern was found in six patients with systemic lupus erythematosus. High-molecular-weight proteins were rarely found in urine, even when the glomerular basement membrane was definitely thickened. Low-molecular-weight proteins were often observed, but their clearances were variable. The results do not support the suggestion that protein clearances are valuable diagnostic and prognostic tools in renal diseases. They also do not support the view that glomerular filtration is the sole factor responsible for the final patterns of urinary proteins; tubular reabsorption is probably another important factor. ImagesFig. 1Fig. 4Fig. 5 PMID:20328484

  20. [Urinary infection by Saccharomyces cerevisiae: Emerging yeast?].

    PubMed

    Elkhihal, B; Elhalimi, M; Ghfir, B; Mostachi, A; Lyagoubi, M; Aoufi, S

    2015-12-01

    Saccharomyces cerevisiae is a commensal yeast of the digestive, respiratory and genito-urinary tract. It is widely used as a probiotic for the treatment of post-antibiotic diarrhea. It most often occurs in immunocompromised patients frequently causing fungemia. We report the case of an adult diabetic patient who had a urinary tract infection due to S. cerevisiae. The disease started with urination associated with urinary frequency burns without fever. The diagnosis was established by the presence of yeasts on direct examination and positivity of culture on Sabouraud-chloramphenicol three times. The auxanogramme gallery (Auxacolor BioRad(®)) allowed the identification of S. cerevisiae. The patient was put on fluconazole with good outcome. This observation points out that this is an opportunistic yeast in immunocompromised patients. PMID:26522963

  1. Chronic urinary retention in men: how we define it, and how does it affect treatment outcome.

    PubMed

    Negro, Carlo L A; Muir, Gordon H

    2012-12-01

    ' and 'PVR'. Chronic urinary retention (CUR) is defined by the International Continence Society as 'a non-painful bladder, which remains palpable or percussable after the patient has passed urine'. Abrams was the first to choose a residual urine volume >300 mL to define CUR as he considered it the minimum volume at which the bladder becomes palpable suprapubically. The UK National Institute for Health and Clinical Excellence lower urinary tract symptoms (LUTS) guidelines define CUR as a postvoid residual urine volume (PVR) of >1000 mL. No studies have specifically addressed the problem of quantifying the minimum amount of urine present in the bladder to define CUR. Nor did we find any publications objectively assessing at what amount of urine a bladder can be palpable. The ability to feel a bladder may rely on variables (i.e. medical skills and patient habitus). There is a marked variability of PVR, so the test should be repeated to improve precision. As defining CUR is difficult, structured management is challenging. Nearly all prospective trials exclude men with CUR from analysis, possibly anticipating a poor outcome and a high risk of complications. However, men with CUR are a clinically important group, comprising up to 25% of men undergoing transurethral resection of the prostate. Definition of CUR is imprecise and arbitrary. Most studies seem to describe the condition as either a PVR of >300 mL in men who are voiding, or >1000 mL in men who are unable to void. This confusion leads to an inability to design and interpret studies; indeed most prospective trials simply exclude these patients. There is a clear need for internationally accepted definitions of retention to allow both treatment and reporting of outcomes in men with LUTS, and for such definitions to be used by all investigators in future trials. PMID:22452619

  2. Dangerous Urinary Tract Infections Common in Nursing Homes

    MedlinePlus

    ... 159308.html Dangerous Urinary Tract Infections Common in Nursing Homes Study found 1 in 20 residents developed ... 2016 (HealthDay News) -- Urinary tract infections (UTIs) in nursing home residents can often have serious effects, including ...

  3. Is "Warm Arctic, Cold Continent" A Fingerprint Pattern of Climate Change?

    NASA Astrophysics Data System (ADS)

    Hoerling, M. P.; Sun, L.; Perlwitz, J.

    2015-12-01

    Cold winters and cold waves have recently occurred in Europe, central Asia and the Midwest to eastern United States, even as global mean temperatures set record highs and Arctic amplification of surface warming continued. Since 1979, Central Asia winter temperatures have in fact declined. Conjecture has it that more cold extremes over the mid-latitude continents should occur due to global warming and the impacts of Arctic sea ice loss. A Northern Hemisphere temperature signal termed the "Warm Arctic, Cold Continent" pattern has thus been surmised. Here we use a multi-model approach to test the hypothesis that such a pattern is indeed symptomatic of climate change. Diagnosis of a large model ensemble of historical climate simulations shows some individual realizations to yield cooling trends over Central Asia, but importantly the vast majority show warming. The observed cooling has thus likely been a low probability state of internal variability, not a fingerprint of forced climate change. We show that daily temperature variations over continents decline in winter due to global warming, and cold waves become less likely. This is partly related to diminution of Arctic cold air reservoirs due to warming-induced sea ice loss. Nonetheless, we find some evidence and present a physical basis that Arctic sea ice loss alone can induce a winter cooling over Central Asia, though with a magnitude that is appreciably smaller than the overall radiative-forced warming signal. Our results support the argument that recent cooling trends over central Asia, and cold extreme events over the winter continents, have principally resulted from atmospheric internal variability and have been neither a forced response to Arctic seas ice loss nor a symptom of global warming. The paradigm of climate change is thus better expressed as "Warm Arctic, Warm Continent" for the NH winter.

  4. Pivmecillinam treatment of chronic urinary tract infection.

    PubMed

    Kalager, T; Bøe, E; Digranes, A; Høisaether, P; Solberg, C O

    1978-01-01

    Twenty-eight patients with chronic urinary tract infections were treated with 400 mg pivmecillinam orally three times daily for 10 to 15 days. The diagnosis was confirmed by a history of cystitis or cystopyelitis four to six times annually, microscopy of urine sediment, and growth of pathogens in urine specimens obtained by suprapubic bladder puncture. Three days, three and six weeks after completion of therapy the success rates were 24/28, 20/28 and 19/28 respectively. Pivmecillinam was well tolerated. Two patients developed nausea and vomiting. Other side-effects were not observed. Pivmecillinam is a useful drug in the treatment of chronic urinary tract infections. PMID:204581

  5. Diagnostic imaging of lower urinary tract disease.

    PubMed

    Hecht, Silke

    2015-07-01

    Diagnostic imaging is routinely performed in small animals with lower urinary tract disease. Survey radiographs allow identification of radiopaque calculi, gas within the urinary tract, and lymph node or bone metastases. Cystography and urethrography remain useful in the evaluation of bladder or urethral rupture, abnormal communication with other organs, and lesions of the pelvic or penile urethra. Ultrasonography is the modality of choice for the diagnosis of most disorders. Computed tomography and magnetic resonance imaging are useful in evaluating the ureterovesical junction and intrapelvic lesions, monitoring the size of lesions, and evaluating lymph nodes and osseous structures for metastases. PMID:25813401

  6. Calcifying nanoparticles associated encrusted urinary bladder cystitis

    PubMed Central

    Jelic, Tomislav M; Roque, Rod; Yasar, Uzay; Tomchin, Shayna B; Serrato, Jose M; Deem, Samuel G; Tierney, James P; Chang, Ho-Huang

    2008-01-01

    Encrusted cystitis is a subtype of chronic cystitis characterized by multiple calcifications in the form of plaques located in the interstitium of the urinary bladder mucosa and frequently associated with mucosal ulcers. It is a very rare disease of controversial etiology. Our transmission electron microscopy of the calcified plaques of encrusted cystitis has revealed that the smallest formed particles (elementary units) of these calcifications are electron-dense shells surrounding an electron lucent core, diagnostic of calcifying nanoparticles (previously called nanobacteria). We pioneer the notion that calcifying nanoparticles are the causative agents of encrusted urinary bladder cystitis. PMID:18990947

  7. Urinary capillariosis in six dogs from Italy

    PubMed Central

    Mariacher, A.; Millanta, F.; Guidi, G.; Perrucci, S.

    2016-01-01

    Canine urinary capillariosis is caused by the nematode Pearsonema plica. P. plica infection is seldomly detected in clinical practice mainly due to diagnostic limitations. This report describes six cases of urinary capillariosis in dogs from Italy. Recurrent cystitis was observed in one dog, whereas another patient was affected by glomerular amyloidosis. In the remaining animals, the infection was considered an incidental finding. Immature eggs of the parasite were observed with urine sediment examination in 3/6 patients. Increased awareness of the potential pathogenic role of P. plica and clinical disease presentation could help identify infected animals. PMID:27354971

  8. Calcifying nanoparticles associated encrusted urinary bladder cystitis.

    PubMed

    Jelic, Tomislav M; Roque, Rod; Yasar, Uzay; Tomchin, Shayna B; Serrato, Jose M; Deem, Samuel G; Tierney, James P; Chang, Ho-Huang

    2008-01-01

    Encrusted cystitis is a subtype of chronic cystitis characterized by multiple calcifications in the form of plaques located in the interstitium of the urinary bladder mucosa and frequently associated with mucosal ulcers. It is a very rare disease of controversial etiology. Our transmission electron microscopy of the calcified plaques of encrusted cystitis has revealed that the smallest formed particles (elementary units) of these calcifications are electron-dense shells surrounding an electron lucent core, diagnostic of calcifying nanoparticles (previously called nanobacteria). We pioneer the notion that calcifying nanoparticles are the causative agents of encrusted urinary bladder cystitis. PMID:18990947

  9. Urinary Tract Infection and Neurogenic Bladder.

    PubMed

    McKibben, Maxim J; Seed, Patrick; Ross, Sherry S; Borawski, Kristy M

    2015-11-01

    Urinary tract infections (UTIs) are frequent, recurrent, and lifelong for patients with neurogenic bladder and present challenges in diagnosis and treatment. Patients often present without classic symptoms of UTI but with abdominal or back pain, increased spasticity, and urinary incontinence. Failure to recognize and treat infections can quickly lead to life-threatening autonomic dysreflexia or sepsis, whereas overtreatment contributes to antibiotic resistance, thus limiting future treatment options. Multiple prevention methods are used but evidence-based practices are few. Prevention and treatment of symptomatic UTI requires a multimodal approach that focuses on bladder management as well as accurate diagnosis and appropriate antibiotic treatment. PMID:26475949

  10. Urinary micafungin levels are sufficient to treat urinary tract infections caused by Candida spp.

    PubMed

    Grau, S; Luque, S; Echeverría-Esnal, D; Sorlí, L; Campillo, N; Montero, M; Álvarez Lerma, F; Plasencia, V; Horcajada, J P

    2016-08-01

    Six cases of patients diagnosed with urinary tract infection (UTI) successfully treated with micafungin are reported. Four were infected with fluconazole-resistant Candida spp. and two (with hepatic injury) were infected with fluconazole-sensitive Candida spp. Traditionally, echinocandins have not been considered for the treatment of UTIs. However, despite its low urinary excretion rate, therapeutic drug monitoring of micafungin urinary levels could be helpful in order to achieve optimal pharmacokinetic/pharmacodynamic (PK/PD) indices for treating UTIs caused by Candida spp. resistant to fluconazole. PMID:27424599

  11. Does the Urinary Microbiome Play a Role in Urgency Urinary Incontinence and Its Severity?

    PubMed Central

    Karstens, Lisa; Asquith, Mark; Davin, Sean; Stauffer, Patrick; Fair, Damien; Gregory, W. Thomas; Rosenbaum, James T.; McWeeney, Shannon K.; Nardos, Rahel

    2016-01-01

    Objectives: Traditionally, the urinary tract has been thought to be sterile in the absence of a clinically identifiable infection. However, recent evidence suggests that the urinary tract harbors a variety of bacterial species, known collectively as the urinary microbiome, even when clinical cultures are negative. Whether these bacteria promote urinary health or contribute to urinary tract disease remains unknown. Emerging evidence indicates that a shift in the urinary microbiome may play an important role in urgency urinary incontinence (UUI). The goal of this prospective pilot study was to determine how the urinary microbiome is different between women with and without UUI. We also sought to identify if characteristics of the urinary microbiome are associated with UUI severity. Methods: We collected urine from clinically well-characterized women with UUI (n = 10) and normal bladder function (n = 10) using a transurethral catheter to avoid bacterial contamination from external tissue. To characterize the resident microbial community, we amplified the bacterial 16S rRNA gene by PCR and performed sequencing using Illumina MiSeq. Sequences were processed using the workflow package QIIME. We identified bacteria that had differential relative abundance between UUI and controls using DESeq2 to fit generalized linear models based on the negative binomial distribution. We also identified relationships between the diversity of the urinary microbiome and severity of UUI symptoms with Pearson's correlation coefficient. Results: We successfully extracted and sequenced bacterial DNA from 95% of the urine samples and identified that there is a polymicrobial community in the female bladder in both healthy controls and women with UUI. We found the relative abundance of 14 bacteria significantly differed between control and UUI samples. Furthermore, we established that an increase in UUI symptom severity is associated with a decrease in microbial diversity in women with UUI

  12. Secondary or Transient Pseudohypoaldosteronism Associated With Urinary Tract Anomaly and Urinary Infection: A Case Report.

    PubMed

    Krishnappa, Vinod; Ross, Jonathan H; Kenagy, David N; Raina, Rupesh

    2016-09-01

    Hyponatremia with hyperkalemia in infancy is a rare presentation, but may be due to aldosterone deficiency or end organ resistance to its action. There are few cases associating this condition with urinary tract infections or anatomic abnormalities that predispose to infection. Clinicians should have a high index of suspicion in diagnosing secondary pseudohypoaldosteronism (PHA) due to its often atypical presentation. We describe ten month-old infant who presented with this condition and was found to have urinary tract infection complicating unilateral urinary tract anomaly, which may have strong association with renal tubular resistance to aldosterone. PMID:27516976

  13. Drugs for treating urinary schistosomiasis

    PubMed Central

    Kramer, Christine V; Zhang, Fan; Sinclair, David; Olliaro, Piero L

    2014-01-01

    Background Urinary schistosomiasis is caused by an intravascular infection with parasitic Schistosoma haematobium worms. The adult worms typically migrate to the venous plexus of the human bladder and excrete eggs which the infected person passes in their urine. Chronic infection can cause substantial morbidity and long-term complications as the eggs become trapped in human tissues causing inflammation and fibrosis. We summarised evidence of drugs active against the infection. This is new edition of a review first published in 1997. Objectives To evaluate the efficacy and safety of drugs for treating urinary schistosomiasis. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register, MEDLINE, CENTRAL, EMBASE and LILACS and reference lists of articles up to 23 May 2014. Selection criteria Randomized controlled trials (RCTs) of antischistosomal drugs and drug combinations compared to placebo, no intervention, or each other. Data collection and analysis Two researchers independently screened the records, extracted the data and assessed risk of bias. The primary efficacy outcomes were parasitological failure (defined as the continued presence of S. haematobium eggs in the urine at time points greater than one month after treatment), and percent reduction of egg counts from baseline. We presented dichotomous data as risk ratios (RR), and continuous data as mean difference (MD), alongside their 95% confidence intervals (CIs). Where appropriate we combined trials in meta analyses or tables. We assessed the quality of evidence using the GRADE approach. Main results We included 30 RCTs enrolling 8165 participants in this review. Twenty-four trials were conducted in children in sub-Saharan Africa, and 21 trials were over 20 years old. Many studies were assessed as being at unclear risk of bias due to inadequate descriptions of study methods. Praziquantel On average, a single 40 mg/kg dose of praziquantel reduced the proportion of people still

  14. 77 FR 39696 - Atlas Pipeline Mid-Continent WestTex, LLC; Pioneer Natural Resources USA, Inc.; Notice of Intent...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-05

    ... Energy Regulatory Commission Atlas Pipeline Mid-Continent WestTex, LLC; Pioneer Natural Resources USA... by Atlas Pipeline Mid-Continent WestTex, LLC and Pioneer Natural Resources USA, Inc. (Atlas and... provided landowners with a fact sheet prepared by the FERC entitled ``An Interstate Natural Gas Facility...

  15. 21 CFR 862.1785 - Urinary urobilinogen (nonquantitative) test system.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Urinary urobilinogen (nonquantitative) test system... Test Systems § 862.1785 Urinary urobilinogen (nonquantitative) test system. (a) Identification. A urinary urobilinogen (nonquantitative) test system is a device intended to detect and...

  16. 21 CFR 862.1785 - Urinary urobilinogen (nonquantitative) test system.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Urinary urobilinogen (nonquantitative) test system... Test Systems § 862.1785 Urinary urobilinogen (nonquantitative) test system. (a) Identification. A urinary urobilinogen (nonquantitative) test system is a device intended to detect and...

  17. 21 CFR 862.1785 - Urinary urobilinogen (nonquantitative) test system.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Urinary urobilinogen (nonquantitative) test system... Test Systems § 862.1785 Urinary urobilinogen (nonquantitative) test system. (a) Identification. A urinary urobilinogen (nonquantitative) test system is a device intended to detect and...

  18. 21 CFR 862.1785 - Urinary urobilinogen (nonquantitative) test system.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Urinary urobilinogen (nonquantitative) test system... Test Systems § 862.1785 Urinary urobilinogen (nonquantitative) test system. (a) Identification. A urinary urobilinogen (nonquantitative) test system is a device intended to detect and...

  19. 21 CFR 862.1785 - Urinary urobilinogen (nonquantitative) test system.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Urinary urobilinogen (nonquantitative) test system... Test Systems § 862.1785 Urinary urobilinogen (nonquantitative) test system. (a) Identification. A urinary urobilinogen (nonquantitative) test system is a device intended to detect and...

  20. 21 CFR 862.1340 - Urinary glucose (nonquantitative) test system.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Urinary glucose (nonquantitative) test system. 862... Test Systems § 862.1340 Urinary glucose (nonquantitative) test system. (a) Identification. A urinary glucose (nonquantitative) test system is a device intended to measure glucosuria (glucose in...

  1. 21 CFR 862.1340 - Urinary glucose (nonquantitative) test system.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Urinary glucose (nonquantitative) test system. 862... Test Systems § 862.1340 Urinary glucose (nonquantitative) test system. (a) Identification. A urinary glucose (nonquantitative) test system is a device intended to measure glucosuria (glucose in...

  2. Neonatal Urinary Ascites: A Report of Three Cases

    PubMed Central

    Gajjar, Priya; Nourse, Peter

    2015-01-01

    Urinary ascites in neonates is not a common condition. Three cases of urinary ascites are presented and each of them has a different aetiology. Neonates with urinary ascites usually present as clinical emergency, requiring resuscitation, ventilator support, and subsequent drainage of urine. The ultimate management depends on the site of extravasation and the underlying cause. PMID:25954559

  3. Anthelmintic resistance in sheep farms: update of the situation in the American continent.

    PubMed

    Torres-Acosta, J F J; Mendoza-de-Gives, P; Aguilar-Caballero, A J; Cuéllar-Ordaz, J A

    2012-09-30

    The present paper reviews the frequency of anthelmintic resistance in sheep farms in different countries of the American continent and describes some aspects that might influence the trend in sheep farms. The situation of anthelmintic resistance in sheep farms has been explored mainly in south of the continent (Argentina, Brazil and Uruguay) where sheep farming is an important industry. In those three countries, as well as in Paraguay, the first comprehensive surveys of anthelmintic resistance were performed among countries in the continent, which showed evidence of high frequency of sheep farms with anthelmintic resistance. Today, it is common to find sheep flocks with multiple-resistant worms. In North and Central America, a similar situation has been reported in sheep farms in the south of the United States of America, parts of Mexico and Costa Rica. On the other hand, other areas of the continent show low frequency of farms with anthelmintic resistance. From many areas no results have been published regarding situation on anthelmintic resistance or, alternatively, published results have received limited dissemination. Although the diagnosis of anthelmintic resistance is important for decision making of helminth management/control at the farm level, this is still an aspiration rather than a reality. For decades, researchers working on anthelmintic resistance in the American continent have expressed the need to change farmers' attitudes towards anthelmintic drugs. A common advice has been to check the anthelmintic drug efficacy regularly and reduce the dependence on these with alternative control measures. In spite of such advice, the challenge to stop/delay the advancement of anthelmintic resistance against the available anthelmintic drugs is still present. The evidence suggests that anthelmintic resistance is a growing phenomenon in the American continent. The situation described might be the tip of the iceberg, as anthelmintic resistance is still largely under

  4. Is there any correlation between continents and elevated temperatures in the subcontinental mantle?

    NASA Astrophysics Data System (ADS)

    Jain, Charitra; Rozel, Antoine; Tackley, Paul

    2015-04-01

    Rolf et al. (EPSL, 2012) and Coltice et al. (Science, 2012) have previously shown that continents exert a first order influence on Earth's mantle flow by affecting convective wavelength and surface heat flow. However, how continents influence the development and location of mantle plumes (upwellings) remains a topic of considerable debate. While Heron and Lowman (GRL, 2010; Tectonophysics, 2011) propose regions where downwelling has ceased (irrespective of overlying plate) as the preferred location for plumes, O'Neill et al. (Gondwana Research, 2009) show an anti-correlation between the average positions of subducting slabs at continental margins, and mantle plumes at continental/oceanic interiors. Continental motion is attributed to the viscous stresses imparted by the convecting mantle and the extent of this motion depends on the heat budget of the mantle. Core-mantle boundary (CMB) heat flux, internal heating from decay of radioactive elements, and mantle cooling contribute to this heat budget. Out of these sources, CMB heat flux is not well defined. However, the recent determination of core's high thermal conductivity requires a CMB heat flow of at least 12 TW (de Koker et al., PNAS 2012; Pozzo et al., Nature 2012; Gomi et al., PEPI 2013). Thus it is necessary to characterize the impact of basal heating on mantle dynamics with continents and self-consistent plate tectonics. By systematically varying parameters like CMB temperature, continental size, mantle heating modes (basal and internal), and Rayleigh number; we model Boussinesq, incompressible, thermo-chemical mantle convection in 2D spherical annulus geometry using StagYY (Tackley, PEPI 2008). We observe correlation between continents and elevated temperatures in the subcontinental mantle irrespective of the variations in basal heating and continental size (except for very small continents). Moreover, we see episodicity between correlation and anti-correlation with increasing Rayleigh number. Furthermore

  5. Best pharmacological practice: urinary tract infections.

    PubMed

    Nicolle, Lindsay

    2003-05-01

    Urinary tract infection is the most frequent bacterial infection. Acute uncomplicated urinary infection and acute non-obstructive pyelonephritis occur in young women with normal genitourinary tracts. Empirical short-course therapy is preferred for the management of acute cystitis, but evolving resistance requires continuing reassessment of optimal antimicrobial selection. Empirical trimethoprim or trimethoprim/sulfamethoxazole has been recommended, but increasing resistance to these agents suggests that pivmecillinam, nitrofurantoin and perhaps fosfomycin trometamol should be considered. Although flouroquinolones are effective as short-course therapy, widespread empirical use of these agents should be discouraged because of potential promotion of resistance. For acute non-obstructive pyelonephritis, flouroquinolones are the empirical oral treatment of choice, although urine culture results should direct continuing therapy. Complicated urinary tract infection occurs in men or women of all ages with underlying abnormalities of the genitourinary tract. Treatment of complicated urinary infection is individualised, taking into consideration the underlying abnormality and susceptibilities of the infecting organism. Asymptomatic bacteriuria should not be treated except in pregnant women, in patients prior to undergoing an invasive surgical procedure, or renal transplant recipients in the early postrenal transplant period. PMID:12739995

  6. [Ketamine-associated urinary tract damage].

    PubMed

    Chen, Wei-hao; Guan, Zhi-chen

    2011-08-18

    Ketamine is widely used as an anesthetic during surgical procedures in both animals and humans. As its unique effects of inducing the dissociative hallucinatory,vivid dreams, out-of-body experiences, and delirium, it has diverted from legitimate uses to the illicit drug market, and abusing ketamine has become a serious social problem. The abusers may use ketamine alone or mixe it with other drugs to get an intense pleasure. There are case reports from all over the world in recent years that abusing ketamine may induce severe lower urinary tract symptoms (LUTS), and a variety of anatomical and functional lesions can be found in the urinary tract if further examinations are administrated. There is no universally recognized treatment protocols for this syndrome. Ketamine cessation or even reduction is the most effective treatment to prevent deterioration of the urinary tract, and intravesical instillation of hyaluranic acid (cystitstat) and oral pentosan polysulphate (elmiron) may take effect. The pathogenesis of ketamine-associated urinary tract destruction is unclear, and further study is needed. PMID:21844983

  7. Urinary biomarkers in prenatally diagnosed unilateral hydronephrosis.

    PubMed

    Madsen, Mia Gebauer; Nørregaard, Rikke; Frøkiær, Jørgen; Jørgensen, Troels Munch

    2011-04-01

    The introduction of prenatal ultrasonography as a screening method entails an increasing number of infants diagnosed with prenatal hydronephrosis. Ureteropelvic junction obstruction accounts for 35% of prenatal hydronephrotic cases. Urinary tract obstruction that occurs during early kidney development affects renal morphogenesis, maturation and growth, and in the most severe cases this will ultimately cause renal insufficiency. A major challenge in the clinical management of these patients is to preserve renal function by selection of the 15%-20% who require early surgical intervention, leaving those for whom watchful waiting may be appropriate because of spontaneous resolution/stabilization without significant loss of renal function. Today, this requires medical surveillance, including repetitive invasive diuretic renograms relying on arbitrary threshold values, and therefore there is a need for non-arbitrary, non-invasive urinary biomarkers that may be used as predictors for renal structural changes and/or decreasing renal function, and thereby provide the surgeon with more clear indications for surgical intervention. In this review, we summarize the currently well-known facts about urinary biomarkers in ureteropelvic junction obstruction concerning renal function, and we also suggest potential novel urinary biomarkers. PMID:21220211

  8. Neural Control of the Lower Urinary Tract

    PubMed Central

    de Groat, William C.; Griffiths, Derek; Yoshimura, Naoki

    2015-01-01

    This article summarizes anatomical, neurophysiological, pharmacological, and brain imaging studies in humans and animals that have provided insights into the neural circuitry and neurotransmitter mechanisms controlling the lower urinary tract. The functions of the lower urinary tract to store and periodically eliminate urine are regulated by a complex neural control system in the brain, spinal cord, and peripheral autonomic ganglia that coordinates the activity of smooth and striated muscles of the bladder and urethral outlet. The neural control of micturition is organized as a hierarchical system in which spinal storage mechanisms are in turn regulated by circuitry in the rostral brain stem that initiates reflex voiding. Input from the forebrain triggers voluntary voiding by modulating the brain stem circuitry. Many neural circuits controlling the lower urinary tract exhibit switch-like patterns of activity that turn on and off in an all-or-none manner. The major component of the micturition switching circuit is a spinobulbospinal parasympathetic reflex pathway that has essential connections in the periaqueductal gray and pontine micturition center. A computer model of this circuit that mimics the switching functions of the bladder and urethra at the onset of micturition is described. Micturition occurs involuntarily in infants and young children until the age of 3 to 5 years, after which it is regulated voluntarily. Diseases or injuries of the nervous system in adults can cause the re-emergence of involuntary micturition, leading to urinary incontinence. Neuroplasticity underlying these developmental and pathological changes in voiding function is discussed. PMID:25589273

  9. [Urinary tract abnormalities associated with anorectal malformations].

    PubMed

    Tohda, A; Hosokawa, S; Shimada, K

    1995-08-01

    Anorectal malformation (ARM) is often associated with urological problems such as congenital urogenital anomalies, recto-urinary fistula, neurogenic bladder due to vertebral anomalies and operative complications. We analyzed 57 cases of ARM and discussed about the management of associated urogenital anomalies during neonatal and infantile period. The incidence of urogenital anomalies was 85.7% in high type, 65.5% in intermediate type and 38.1% in low type. Among these urinary tract anomalies, VUR was most common and was documented in 38.6% of ARM patients. Renal dysplasia, PUJ stenosis, megaureter and urethral stenosis was also common in these patients. Renal dysfunction was documented in 5 cases (2 in high type, 2 in intermediate and 1 in low type), mainly due to VUR and renal aplasia. These results show the need for evaluation of urinary tract during the neonatal and early infantile period even in low type ARM. The management of urinary tract anomalies associated with ARM is firmly related with the management of ARM itself, and we must be closely in co-operation with pediatric surgeons. PMID:7474624

  10. Psychosomatic Aspects of Urinary Incontinence in Women

    PubMed Central

    Debus, G.; Kästner, R.

    2015-01-01

    Urinary incontinence in women is a common problem. With increasing age its prevalence and severity of its manifestations increase. Among nursing home residents the frequency is between 43 and 77 %, 6 to 10 % of all admissions to nursing homes are due to urinary incontinence. The risk for urinary incontinence among women with cognitive deficits is 1.5- to 3.4-fold higher than for women without mental disorders. The most common form is stress incontinence (50 %), followed by mixed stress-urge incontinence (40 %) and purely urge incontinence (OAB = overactive bladder, 20 %). With regard to its cause, the latter remains unclarified in about 80 % of the cases. It is often difficult to treat. There are also cases in which urge incontinence is related to traumatic events. In such cases behavioural and psychotherapeutic options may be helpful. Almost inevitably every form of incontinence has psychological consequences: shame and insecurity are often results of uncontrolled loss of urine. Among others, in the long term, they lead to the avoidance of social contacts and possibly to depression and isolation. Consideration of the psychosomatics is important in the therapy for female urinary incontinence from three points of view: 1) the efficacy of treatment is better suited to the patient, 2) the treatment costs are lower, 3) the professional satisfaction of the responsible physician increases. PMID:25797959

  11. Antimicrobial Stewardship and Urinary Tract Infections

    PubMed Central

    Abbo, Lilian M.; Hooton, Thomas M.

    2014-01-01

    Urinary tract infections are the most common bacterial infections encountered in ambulatory and long-term care settings in the United States. Urine samples are the largest single category of specimens received by most microbiology laboratories and many such cultures are collected from patients who have no or questionable urinary symptoms. Unfortunately, antimicrobials are often prescribed inappropriately in such patients. Antimicrobial use, whether appropriate or inappropriate, is associated with the selection for antimicrobial-resistant organisms colonizing or infecting the urinary tract. Infections caused by antimicrobial-resistant organisms are associated with higher rates of treatment failures, prolonged hospitalizations, increased costs and mortality. Antimicrobial stewardship consists of avoidance of antimicrobials when appropriate and, when antimicrobials are indicated, use of strategies to optimize the selection, dosing, route of administration, duration and timing of antimicrobial therapy to maximize clinical cure while limiting the unintended consequences of antimicrobial use, including toxicity and selection of resistant microorganisms. This article reviews successful antimicrobial stewardship strategies in the diagnosis and treatment of urinary tract infections. PMID:27025743

  12. Effects of microgravity on urinary osteopontin

    NASA Technical Reports Server (NTRS)

    Hoyer, J. R.; Pietrzyk, R. A.; Liu, H.; Whitson, P. A.

    1999-01-01

    Increased risk of renal stone formation during space flight has been linked primarily to increased calcium excretion from bone demineralization induced by space flight. Other factors contributing to increased risk include increased urinary calcium oxalate supersaturation, while urinary citrate, magnesium and volume are all decreased. The aim of this study was to increase the predictive value of stone risk profiles for crew members during space flight by evaluating the excretion of urinary protein inhibitors of calcium crystallization so that more comprehensive stone risk profiles could relate mineral saturation to the concentrations of inhibitor proteins. Levels of urinary osteopontin (uropontin) are reported in a series of 14 astronauts studied before, during, and after space flights. During space flight, a compensatory increase in uropontin excretion was not observed. However, the uropontin excretion of a majority of astronauts was increased during the period after space flight and was maximal at 2 wk after landing. The downward shift in the molecular size of uropontin observed in samples obtained during space flight was shown to result from storage at ambient temperature during flight, rather than an effect of microgravity on uropontin synthesis.

  13. Indwelling urinary catheterisation: what is best practice?

    PubMed

    Yates, Ann

    Indwelling urinary catheterisation is a common procedure that is governed by best practice guidelines such as those provided by the National Institute of Health and Care Excellence (NICE), epic3 and the Royal College of Nursing. This article will look how these guidelines influence practice and also look at new innovations in catheter care. PMID:27172507

  14. [Rare differential diagnosis of urinary incontinence].

    PubMed

    Coutty, Nadège; Dubreucq, Sylvie; Delahousse, Guy; Cosson, Michel

    2003-04-01

    The authors report the case of a 55-year-old woman with prolapse presenting a differential diagnosis of urinary incontinence: a peritoneo-vaginal fistula with serous discharge in a patient with ascites and a history of hysterectomy. The only cases of peritoneo-vaginal fistula reported in the literature were discovered during extra-uterine pregnancy after hysterectomy. PMID:12765075

  15. Urinary Incontinence: Causes and Methods of Evaluation

    ERIC Educational Resources Information Center

    Griebling, Tomas L.

    2008-01-01

    This article presents the third of a multi-part series offering the most timely educational information, innovative approaches, products and technology solutions as well as coping and stigma-fighting approaches available on the subject of incontinence. Here, the author introduces the types and physiology of urinary incontinence. The author also…

  16. Ultrasound-guided urinary bladder biopsy through a urinary catheter in a bitch.

    PubMed

    Lopez, Julio; Norman, Brian C

    2014-01-01

    A 34.4 kg 5 yr old spayed female mixed-breed dog was presented for evaluation of a urinary bladder mass. The dog had a recent onset of hematuria and stranguria but otherwise appeared to be healthy. Abdominal ultrasound revealed a mass in the urinary bladder. The dog was sedated and a 10-French rubber catheter that had the blunt end removed was passed from the urethra to the urinary bladder. Using ultrasound guidance, ellipsoid cup biopsy forceps were advanced through the rubber catheter to the urinary bladder mass and biopsies were successfully obtained. The dog was discharged from the hospital a few hours after the procedure. Histopathology of the mass was consistent with polypoid cystitis. Follow-up surgical removal of the polyp was uneventful, and histopathology confirmed the presurgical biopsy diagnosis. Procurement of urinary bladder biopsies through a urinary catheter with ultrasound guidance was used as a minimally invasive alternative to either cystoscopy or surgery in a bitch. Use of this technique achieved a diagnosis without the need for specialized endoscopic equipment, anesthesia, or surgery. PMID:25251433

  17. Are urinary PAHs biomarkers of controlled exposure to diesel exhaust?

    PubMed Central

    Lu, Sixin S.; Sobus, Jon R.; Sallsten, Gerd; Albin, Maria; Pleil, Joachim D.; Gudmundsson, Anders; Madden, Michael C.; Strandberg, Bo; Wierzbicka, Aneta; Rappaport, Stephen M.

    2016-01-01

    Urinary polycyclic aromatic hydrocarbons (PAHs) were evaluated as possible biomarkers of exposure to diesel exhaust (DE) in two controlled-chamber studies. We report levels of 14 PAHs from 28 subjects in urine that were collected before, immediately after and the morning after exposure. Using linear mixed-effects models, we tested for effects of DE exposure and several covariates (time, age, gender and urinary creatinine) on urinary PAH levels. DE exposures did not significantly alter urinary PAH levels. We conclude that urinary PAHs are not promising biomarkers of short-term exposures to DE in the range of 106–276 μg/m3. PMID:24754404

  18. Profile of urinary arsenic metabolites during pregnancy.

    PubMed Central

    Hopenhayn, Claudia; Huang, Bin; Christian, Jay; Peralta, Cecilia; Ferreccio, Catterina; Atallah, Raja; Kalman, David

    2003-01-01

    Chronic exposure to inorganic arsenic (In-As) from drinking water is associated with different health effects, including skin, lung, bladder, and kidney cancer as well as vascular and possibly reproductive effects. In-As is metabolized through the process of methylation, resulting in the production and excretion of methylated species, mainly monomethylarsenate (MMA) and dimethylarsenate (DMA). Because a large percentage of the dose is excreted in urine, the distribution of urinary In-As, MMA, and DMA is considered a useful indicator of methylation patterns in human populations. Several factors affect these patterns, including sex and exposure level. In this study, we investigated the profile of urinary In-As, MMA, and DMA of pregnant women. Periodic urine samples were collected from early to late pregnancy among 29 pregnant women living in Antofagasta, Chile, who drank tap water containing 40 micro g/L In-As. The total urinary arsenic across four sampling periods increased with increasing weeks of gestation, from an initial mean value of 36.1 to a final value of 54.3 micro g/L. This increase was mainly due to an increase in DMA, resulting in lower percentages of In-As and MMA and a higher percentage of DMA. Our findings indicate that among women exposed to moderate arsenic from drinking water during pregnancy, changes occur in the pattern of urinary arsenic excretion and metabolite distribution. The toxicologic significance of this is not clear, given recent evidence suggesting that intermediate methylated species may be highly toxic. Nevertheless, this study suggests that arsenic metabolism changes throughout the course of pregnancy, which in turn may have toxicologic effects on the developing fetus. Key words: arsenic, arsenic metabolism, arsenic methylation, Chile, pregnancy, urinary arsenic. PMID:14644662

  19. Prevalence of asymptomatic urinary abnormalities among adolescents.

    PubMed

    Fouad, Mohamed; Boraie, Maher

    2016-05-01

    To determine the prevalence of asymptomatic urinary abnormalities in adolescents, first morning clean mid-stream urine specimens were obtained from 2500 individuals and examined by dipstick and light microscopy. Adolescents with abnormal screening results were reexamined after two weeks and those who had abnormal results twice were subjected to systemic clinical examination and further clinical and laboratory investigations. Eight hundred and three (32.1%) individuals had urinary abnormalities at the first screening, which significantly decreased to 345 (13.8%) at the second screening, (P <0.001). Hematuria was the most common urinary abnormalities detected in 245 (9.8%) adolescents who had persistent urine abnormalities; 228 (9.1%) individuals had non glomerular hematuria. The hematuria was isolated in 150 (6%) individuals, combined with leukocyturia in 83 (3.3%) individuals, and combined with proteinuria in 12 (0.5%) individuals. Leukocyturia was detected in 150 (6%) of all studied adolescents; it was isolated in 39 (1.6%) individuals and combined with proteinuria in 28 (1.1%) of them. Asymptomatic bacteriuria was detected in 23 (0.9%) of all studied adolescents; all the cases were females. Proteinuria was detected in 65 (2.6%) of all the studied adolescents; 45 (1.8%) individuals had <0.5 g/day and twenty (0.8%) individuals had 0.5-3 g/day. Asymptomatic urinary abnormalities were more common in males than females and adolescents from rural than urban areas (P <0.01) and (P <0.001), respectively. The present study found a high prevalence of asymptomatic urinary abnormalities among adolescents in our population. PMID:27215241

  20. Relationship of multispectral satellite data to land surface evaporation from the Australian continent

    NASA Technical Reports Server (NTRS)

    Smith, R. C. G.; Choudhury, B. J.

    1990-01-01

    Based on NOAA-9 AVHRR and Nimbus-7 SMMR satellite data, satellite indices of vegetation from the Australian continent are calculated for the period of May 1986 to April 1987. Visible (VIS) and near infrared (NIR) reflectances and the normalized difference (ND) vegetation index are calculated from the AVHRR sensor. The microwave polarization difference (PD) is also calculated as the difference between the vertically and horizontally polarized brightness temperatures at 37 GHz. ND, PD, VIS, and NIR indices were plotted against rainfall and water balance estimates of evaporation. It is concluded that direct satellite monitoring of annual evaporation across the Australian continent using PD or VIS satellite indices of vegetation biomass appears possible for areas with evaporation less than 600 mm/y and that use of the ND relationship at continental scale may underpredict monthly evaporation of forests relative to agriculture.

  1. A staff management system for maintaining improvements in continence with elderly nursing home residents.

    PubMed Central

    Burgio, L D; Engel, B T; Hawkins, A; McCormick, K; Scheve, A; Jones, L T

    1990-01-01

    We developed a staff management system for maintaining treatment gains achieved on a specialized continence unit located in a geriatric nursing home. Geriatric assistants learned to use a prompted voiding procedure to maintain improved dryness for 4 elderly residents. The staff management system included self-monitoring and recording of prompted voiding activities and supervisory monitoring and feedback based on group performance of these activities. Results show that the system was effective in maintaining prompted voiding activities with corresponding maintenance of improved patient continence. However, a gradual decline in staff performance was noted 4 to 5 months after the initiation of the system. During a subsequent phase of the study, provision of individual feedback restored staff performance to previous levels. Results are discussed in relation to the practicality of prompted voiding interventions in nursing home environments and the applicability of staff management systems in this setting. PMID:2335482

  2. Ophiolites in ocean-continent transitions: From the Steinmann Trinity to sea-floor spreading

    NASA Astrophysics Data System (ADS)

    Bernoulli, Daniel; Jenkyns, Hugh C.

    2009-05-01

    Before the theory of plate tectonics took hold, there was no coherent model for ocean-continent transitions that included both extant continental margins and fragmentary ancient examples preserved in orogenic belts. Indeed, during the early 1900, two strands of thought developed, one relying on the antiquity and permanence of continents and oceans, advocated by the mainstream of the scientific community and one following mobilist concepts derived from Wegener's hypothesis (1915) of continental drift. As an illustration of the prevailing North-American view, the different composition and thickness of continental and oceanic crust and the resulting isostatic response showed "how improbable it would be to suppose that a continent could founder or go to oceanic depth or that ocean floor at ± 3000 fathoms could ever have been a stable land area since the birth of the oceans" [H.H. Hess, Trans. R. Soc. London, A 222 (1954) 341-348]. Because of the perceived permanence of oceans and continents, mountain chains were thought to originate from narrow, elongated, unstable belts, the geosynclines, circling the continents or following "zones of crustal weakness" within them, from which geanticlines and finally mountain belts would develop. This teleological concept, whereby a geosyncline would inevitably evolve into a mountain chain, dominated geological interpretations of orogenic belts for several decades in the mid-twentieth century. However, the concept of permanence of oceans and continents and the concept of the geosyncline had already met with the critiques of Suess and others. As early as 1905, Steinmann considered the association of peridotite, "diabase" (basalt/dolerite) and radiolarite (a typical ocean-continent transition assemblage), present in the Alps and Apennines, as characteristic of the deep-ocean floor and Bailey (1936) placed Steinmann's interpretation into the context of continental drift and orogeny. Indeed, in both authors' writings, the concept of

  3. Image of the Moho across the continent-ocean transition, US east coast

    SciTech Connect

    Holbrook, W.S.; Purdy, G.M. ); Reiter, E.C.; Toksoez, M.N. )

    1992-03-01

    Strong wide-angle reflections from the Moho were recorded by ocean-bottom seismic instruments during the 1988 Carolina Trough multichannel seismic experiment, in an area where the Moho is difficult to detect with vertical-incidence seismic data. Prestack depth migration of these reflections has enabled the construction of a seismic image of the Moho across the continent-ocean transition of a sedimented passive margin. The Moho rises across the margin at a slope of 10{degree}-12{degree}, from a depth of about 33 km beneath the continental shelf to 20 km beneath the outer rise. This zone of crustal thinning defines a distinct, 60-70-km-wide continent-ocean transition zone. The authors interpret the Moho in the Carolina Trough as a Jurassic feature, formed by magmatic intrusion and underplating during the rifting of Pangea.

  4. Reducing inappropriate urinary catheter use: quality care initiatives.

    PubMed

    Buckley, Catherine; Clements, Charlotte; Hopper, Adrian

    Healthcare-acquired urinary infection presents a substantial burden for patients and the healthcare system. Urinary tract infections have not gained the same level of media attention as other healthcare-associated infections, yet interventions to reduce urinary catheter use are one of the top ten recommended patient safety strategies. To improve practice around urinary catheter placement and removal requires interventions to change the expectations and habits of nurses, medical teams and patients regarding the need for a urinary catheter. In the authors' trust, a redesign of the existing urinary catheter device record was undertaken to help avoid unnecessary placement of catheters, and resulted in a reduction of urinary catheters in situ longer than 48 hours. Other strategies included implementation of catheter rounds in a high-usage area, and credit-card-sized education cards. A catheter 'passport' was introduced for patients discharged with a catheter to ensure information for insertion and ongoing use were effectively communicated. PMID:25978469

  5. Clinical study of urinary excretion of Ga-67

    SciTech Connect

    Nakano, S.; Hasegawa, Y.; Ibuka, K.; Hashizume, T.; Noguchi, A.; Kojima, J.; Sasakuma, F.; Ishigami, S. )

    1990-04-01

    Ga-67 urinary excretion was examined in 59 patients. The 72-hour urinary excretion rate ranged from 4.3 to 67.8% of the injected dose. Within the first 24 hours, 60.9% of the 72-hour urinary excretion was excreted. There was no significant difference in the Ga-67 urinary excretion rate between males and females, nor between the Ga-67 positive and negative cases. A significant negative correlation was found between the 72-hour Ga-67 urinary excretion rate and the unsaturated iron binding capacity. Notably, four patients with hyperferremia, which was considered secondary to leukemia and/or chemotherapy or liver cirrhosis, excreted more than 46.8% of Ga-67 within 72 hours. A significant negative correlation was also found between the 72-hour Ga-67 urinary excretion rate and age. Urinary excretion of Ga-67 may be related to the glomerular filtration rate, which decreases with age.

  6. Cold cratonic roots and thermal blankets: How continents affect mantle convection

    USGS Publications Warehouse

    Trubitsyn, V.P.; Mooney, W.D.; Abbott, D.H.

    2003-01-01

    Two-dimensional convection models with moving continents show that continents profoundly affect the pattern of mantle convection. If the continents are wider than the wavelength of the convection cells (???3000 km, the thickness of the mantle), they cause neighboring deep mantle thermal upwellings to coalesce into a single focused upwelling. This focused upwelling zone will have a potential temperature anomaly of about 200??C, much higher than the 100??C temperature anomaly of upwelling zones generated beneath typical oceanic lithosphere. Extensive high-temperature melts (including flood basalts and late potassic granites) will be produced, and the excess temperature anomaly will induce continental uplift (as revealed in sea level changes) and the eventual breakup of the supercontinent. The mantle thermal anomaly will persist for several hundred million years after such a breakup. In contrast, small continental blocks (<1000 km diameter) do not induce focused mantle upwelling zones. Instead, small continental blocks are dragged to mantle downwelling zones, where they spend most of their time, and will migrate laterally with the downwelling. As a result of sitting over relatively cold mantle (downwellings), small continental blocks are favored to keep their cratonic roots. This may explain the long-term survival of small cratonic blocks (e.g., the Yilgarn and Pilbara cratons of western Australia, and the West African craton). The optimum size for long-term stability of a continental block is <3000 km. These results show that continents profoundly affect the pattern of mantle convection. These effects are illustrated in terms of the timing and history of supercontinent breakup, the production of high-temperature melts, and sea level changes. Such two-dimensional calculations can be further refined and tested by three-dimensional numerical simulations of mantle convection with moving continental and oceanic plates.

  7. Uppermost mantle structure of the Australian continent from Pn traveltime tomography

    NASA Astrophysics Data System (ADS)

    Sun, Weijia; Kennett, B. L. N.

    2016-03-01

    Past studies of the seismic structure of the Australian continent have dominantly exploited surface wave tomography for the mantle, with seismic refraction, receiver functions, and ambient noise used for crustal structure. The 3-D structure has been summarized in the Australian Seismological Reference Model (AuSREM), for which the zone immediately below the crust is the least well characterized. Pn traveltime tomography provides a way of improving structural information on the uppermost mantle across the continent. We have exploited waveforms from larger events across Australia recorded at both permanent and portable stations since 1993, supplemented by bulletin arrival times. To compensate for the large velocity contrasts, with much faster mantle wave speeds in the center and west, all events were relocated using the AuSREM model. After relocation, consistent patterns of traveltime residuals are obtained. We extract Pn as the first arrival in the distance range 1.8° to 15°. We use the FMTOMO approach to invert the travel-time residuals to generate a P wave speed structure with a resolution of 3°×3°. There is strong heterogeneity in Pn wave speed in the uppermost mantle across the continent. The fastest Pn wave speed of 8.36 km/s beneath the Precambrian cratons of western and central Australia is 3.99% faster than the global ak135 model, and the slowest Pn wave speed 7.66 km/s on the eastern margin is 4.74% slower. The slowest velocities in the uppermost mantle are found along the eastern margin of the Australian continent beneath the Phanerozoic orogenic belts, with links to Neogene volcanism.

  8. Fault Interaction and Earthquake Migration in Mid-Continents: Insights from Numerical Modeling

    NASA Astrophysics Data System (ADS)

    Liu, M.; Lu, Y.; Chen, L.; Luo, G.; Wang, H.

    2011-12-01

    Historic records in North China and other mid-continents show large earthquakes migrating among widespread fault systems. Mechanical coupling of these faults is indicated by complimentary seismic moment release on these faults. In a conceptual model (Liu et al., 2011, Lithosphere), the long-distance fault interaction and earthquake migration are explained as the consequences of regional stress readjustment among a system of intraplate faults that collectively accommodates tectonic loading at the plate boundaries. In such a system, failure of one fault (a large earthquake) can cause stress shifting on all other faults. Here we report preliminary results of numerical investigations of such long-distance fault interaction in mid-continents. In a set of elastic models, we have a model crust with internal faults loaded from the boundaries, and calculate the stress distribution on the faults when the system reaches equilibrium. We compare the results with those of a new model that has one or more of the faults weakened (ruptured). The results show that failure of one fault can cause up to a few MPa of stress changes on other faults over a large distance; the magnitude of the stress change and the radius of the impacted area are much greater than those of the static Coulomb stress changes associated with dislocation on the fault plane. In time-dependent viscoelasto-plastic models, we found that variations of seismicity on one fault can significantly affect the loading rates on other faults that share the same tectonic loading. Similar fault interactions are also found in complex plate boundary fault systems, such as between the San Andreas Fault and the San Jacinto Fault in southern California. The spatially migrating earthquakes resulting from the long-distance fault interactions in mid-continents can cause different spatial patterns of seismicity when observed through different time-windows. These results have important implications for assessing earthquake hazards in

  9. A study on the birth and globalization of sports originated from each continent

    PubMed Central

    Lee, Byung Jin; Kim, Tae Young

    2016-01-01

    The purpose of this research is to see how continent specific sports rose to its modern-day status through globalization. This research focuses on the historical background of how England’s football, America’s national pastime, baseball, Japan’s Judo, and Korea’s Taekwondo developed into sports in addition to the reasoning behind its globalization. Promoted by England and the rest of the European continent, Soccer is considered to be one of the world’s most popular sports and has served its function as a form of cultural imperialism. It has also advanced alongside commerce, missionary work and other types of cultural clashes. In America, baseball was used to integrate its multicultural society and developed so that the team captain leads the rest of his team. The sports of Oriental countries were reborn through modernization that was influenced by the modern rationality, education etc. of its Western counterparts. Judo and Taekwondo were introduced globally through the Olympic Games. As mentioned above the birth of sporting events has a close connection to a nation’s cultural background and globalization has taken different forms depending on which continent it originated from. PMID:26933653

  10. Two-step rise of atmospheric oxygen linked to the growth of continents

    NASA Astrophysics Data System (ADS)

    Lee, Cin-Ty A.; Yeung, Laurence Y.; McKenzie, N. Ryan; Yokoyama, Yusuke; Ozaki, Kazumi; Lenardic, Adrian

    2016-06-01

    Earth owes its oxygenated atmosphere to its unique claim on life, but how the atmosphere evolved from an initially oxygen-free state remains unresolved. The rise of atmospheric oxygen occurred in two stages: approximately 2.5 to 2.0 billion years ago during the Great Oxidation Event and roughly 2 billion years later during the Neoproterozoic Oxygenation Event. We propose that the formation of continents about 2.7 to 2.5 billion years ago, perhaps due to the initiation of plate tectonics, may have led to oxygenation by the following mechanisms. In the first stage, the change in composition of Earth's crust from iron- and magnesium-rich mafic rocks to feldspar- and quartz-rich felsic rocks could have caused a decrease in the oxidative efficiency of the Earth's surface, allowing atmospheric O2 to rise. Over the next billion years, as carbon steadily accumulated on the continents, metamorphic and magmatic reactions within this growing continental carbon reservoir facilitated a gradual increase in the total long-term input of CO2 to the ocean-atmosphere system. Given that O2 is produced during organic carbon burial, the increased CO2 input may have triggered a second rise in O2. A two-step rise in atmospheric O2 may therefore be a natural consequence of plate tectonics, continent formation and the growth of a crustal carbon reservoir.

  11. A study on the birth and globalization of sports originated from each continent.

    PubMed

    Lee, Byung Jin; Kim, Tae Young

    2016-02-01

    The purpose of this research is to see how continent specific sports rose to its modern-day status through globalization. This research focuses on the historical background of how England's football, America's national pastime, baseball, Japan's Judo, and Korea's Taekwondo developed into sports in addition to the reasoning behind its globalization. Promoted by England and the rest of the European continent, Soccer is considered to be one of the world's most popular sports and has served its function as a form of cultural imperialism. It has also advanced alongside commerce, missionary work and other types of cultural clashes. In America, baseball was used to integrate its multicultural society and developed so that the team captain leads the rest of his team. The sports of Oriental countries were reborn through modernization that was influenced by the modern rationality, education etc. of its Western counterparts. Judo and Taekwondo were introduced globally through the Olympic Games. As mentioned above the birth of sporting events has a close connection to a nation's cultural background and globalization has taken different forms depending on which continent it originated from. PMID:26933653

  12. Seasonal Variability of Rainfall Over Indonesia Maritime Continent Based on Trmm pr Observations

    NASA Astrophysics Data System (ADS)

    Yulihastin, Erma; Kodama, Yasu-Masa

    Temporal and spatial distribution of near surface rain and three types of rainfall namely shallow rain, convective rain, and stratiform rain over Indonesia Maritime Continent (90E-150E, 15S-15N) was investigated using Tropical Rainfall Measuring Mission Precipitation Radar in a 10-years dataset (1998-2007). This research also using least square method to confirm distribution of annual and semiannual oscillation of rainfall over Indonesia Maritime Continent (IMC). Climatology rainfall of shallow, stratiform, and convective have agreement to seasonal variability of rainfall over IMC that influenced by monsoon which was rainfall became increased from November to April and reached peak value in January. Conversely, rainfall decreased from May to October and reached lowest value in July. The distribution of shallow rain showed the unique seasonal rainfall for local region namely Sulawesi, Maluku, and closely region. Seasonal of shallow rain in those regions approve to local type of rainfall which was reach peak value in July and August. This rainfall type was opposite to equator rainfall and monsoon rainfall in the most of IMC regions which are dry season occured in the same period. Shallow rain may contributed to local rainfall type over IMC. It might be drived by increasing low level moisture and strongly of subsidence flow in boundary layer which is also influenced by enhancement of Sea Surface Temperature in Malacca Strait at the same period. Keyword: Indonesia Maritime Continent, Tropical Rainfall Measuring Mission, Seasonal Vari-ability

  13. Parallel Evolution of Copy-Number Variation across Continents in Drosophila melanogaster.

    PubMed

    Schrider, Daniel R; Hahn, Matthew W; Begun, David J

    2016-05-01

    Genetic differentiation across populations that is maintained in the presence of gene flow is a hallmark of spatially varying selection. In Drosophila melanogaster, the latitudinal clines across the eastern coasts of Australia and North America appear to be examples of this type of selection, with recent studies showing that a substantial portion of the D. melanogaster genome exhibits allele frequency differentiation with respect to latitude on both continents. As of yet there has been no genome-wide examination of differentiated copy-number variants (CNVs) in these geographic regions, despite their potential importance for phenotypic variation in Drosophila and other taxa. Here, we present an analysis of geographic variation in CNVs in D. melanogaster. We also present the first genomic analysis of geographic variation for copy-number variation in the sister species, D. simulans, in order to investigate patterns of parallel evolution in these close relatives. In D. melanogaster we find hundreds of CNVs, many of which show parallel patterns of geographic variation on both continents, lending support to the idea that they are influenced by spatially varying selection. These findings support the idea that polymorphic CNVs contribute to local adaptation in D. melanogaster In contrast, we find very few CNVs in D. simulans that are geographically differentiated in parallel on both continents, consistent with earlier work suggesting that clinal patterns are weaker in this species. PMID:26809315

  14. Longitudinal Study of Intestinal Symptoms and Fecal Continence in Patients With Conformal Radiotherapy for Prostate Cancer

    SciTech Connect

    Geinitz, Hans; Thamm, Reinhard; Keller, Monika; Astner, Sabrina T.; Heinrich, Christine; Scholz, Christian; Pehl, Christian; Kerndl, Simone; Prause, Nina; Busch, Raymonde; Molls, Michael; Zimmermann, Frank B.

    2011-04-01

    Purpose: To prospectively assess the intestinal symptoms and fecal continence in patients who had undergone conformal radiotherapy (CRT) for prostate cancer. Methods and Materials: A total of 78 men who had undergone definitive CRT for prostate cancer were evaluated. The patients were assessed before, during (treatment Weeks 4 and 6), and 2, 12, and 24 months after CRT completion. The intestinal symptoms and fecal continence were evaluated with comprehensive standardized questionnaires. Results: The intestinal symptoms were mostly intermittent, with only a small minority of patients affected daily. Defecation pain, fecal urge, and rectal mucous discharge increased significantly during therapy. Defecation pain and rectal mucous discharge had returned to baseline levels within 8 weeks and 1 year after CRT, respectively. However, fecal urge remained significantly elevated for {<=}1 year and then returned toward the pretreatment values. The prevalence of rectal bleeding was significantly elevated 2 years after CRT. Fecal continence deteriorated during CRT and remained impaired at 1 year after treatment. Incontinence was mostly minor, occurring less than once per week and predominantly affecting incontinence for gas. Conclusion: Intestinal symptoms and fecal incontinence increased during prostate CRT. Except for rectal bleeding, the intestinal symptoms, including fecal incontinence, returned to baseline levels within 1-2 years after CRT. Thus, the rate of long-term late radiation-related intestinal toxicity was low.

  15. Integrated Mid-Continent Carbon Capture, Sequestration & Enhanced Oil Recovery Project

    SciTech Connect

    Brian McPherson

    2010-08-31

    A consortium of research partners led by the Southwest Regional Partnership on Carbon Sequestration and industry partners, including CAP CO2 LLC, Blue Source LLC, Coffeyville Resources, Nitrogen Fertilizers LLC, Ash Grove Cement Company, Kansas Ethanol LLC, Headwaters Clean Carbon Services, Black & Veatch, and Schlumberger Carbon Services, conducted a feasibility study of a large-scale CCS commercialization project that included large-scale CO{sub 2} sources. The overall objective of this project, entitled the 'Integrated Mid-Continent Carbon Capture, Sequestration and Enhanced Oil Recovery Project' was to design an integrated system of US mid-continent industrial CO{sub 2} sources with CO{sub 2} capture, and geologic sequestration in deep saline formations and in oil field reservoirs with concomitant EOR. Findings of this project suggest that deep saline sequestration in the mid-continent region is not feasible without major financial incentives, such as tax credits or otherwise, that do not exist at this time. However, results of the analysis suggest that enhanced oil recovery with carbon sequestration is indeed feasible and practical for specific types of geologic settings in the Midwestern U.S.

  16. Lower urinary tract symptoms and falls risk among older women receiving home support: a prospective cohort study

    PubMed Central

    2013-01-01

    clinical relevance. Lack of correlation at six months may be due loss of less robust participants, illuminating the difficulty in following frailer groups over time. Further studies are needed to understand the contribution of urinary symptoms to falls risk, and clinicians should incorporate continence assessment within falls risk assessment. PMID:23672343

  17. Urinary metal concentrations among female welders.

    PubMed

    Arrandale, Victoria H; Beach, Jeremy; Cembrowski, George S; Cherry, Nicola M

    2015-01-01

    As part of a Canada-wide study of women entering non-traditional trades [Women's Health in Apprenticeship Trades-Metalworkers and Electricians (WHAT-ME)], we examined spot urine samples from women welders in Alberta to determine whether urinary metal concentrations exceeded those of the general population, to compare levels to previously published urinary concentrations in male welders and to examine the relationship with welding tasks. Women mailed-in urine samples collected close to the time of completing a detailed exposure questionnaire, including welding tasks on their most recent day welding at work. Of 53 welders working in their trade, 45 had urinary creatinine >0.3-≤3.0g l(-1) and were included in analyses. Seven metals were examined for which both population and male welder urinary concentrations were available: cadmium, chromium, cobalt, copper, manganese, nickel, and zinc. Principal component analysis was used to extract three components from natural log transformed creatinine-corrected metal concentrations. Of the 45 women, 17 reported more than one main task. Overall two thirds worked in fabrication, a third on pipe welding, and smaller numbers on repair, in construction or other tasks: manual metal arc welding was reported by 62%, semi-automatic arc welding by 47%, and arc welding with a tungsten electrode by 15%. In multiple regression analyses, little relation was found between urinary metals and task or type of welding, except for cadmium where lower levels were seen in those reporting semi-automatic manual welding (after adjustment for age and smoking). The proportion of women welders exceeding the selected general population 95th percentile was high for manganese (96%) and chromium (29%). Urinary metal concentrations were similar to those reported for male welders with only manganese, with a geometric mean in women of 1.91 µg g(-1) creatinine, and perhaps copper (11.8 µg g(-1) creatinine), consistently lower in male welders. Although not

  18. Seismotectonic features of the African plate: the possible dislocation of a continent

    NASA Astrophysics Data System (ADS)

    Meghraoui, Mustapha

    2014-05-01

    The African continent is made of seismically active structures with active deformation in between main substratum shields considered as stable continental interiors. Seismically active regions are primarily located along rift zones, thrust and fold mountain belts, transform faults and volcanic fields. The active tectonic structures generated large and destructive earthquakes in the past with significant damage and economic losses in Africa. Although some regions of the continent show a low-level of seismic activity, several large earthquakes (with M > 7) have occurred in the past. The presence of major active faults that generate destructive earthquakes is among the most important geological and geophysical hazards for the continent. National and International scientific projects dealing with the seismic hazards assessment are increasing in seismically active regions in Africa. The UNESCO-SIDA/IGCP (Project 601 http://eost.u-strasbg.fr/~igcp601/) support the preparation and implementation of the "Seismotectonic Map of Africa". Therefore, new seismotectonic data with the regional analysis of earthquake hazards became necessary as a basis for a mitigation of the earthquake damage. A database in historical and instrumental seismicity, active tectonics, stress tensor distribution, earthquake geology and paleoseismology, active deformation, earthquake geodesy (GPS) and gravity, crustal structure studies, magnetic and structural segmentation, volcanic fields, collision tectonics and rifting processes is prepared to constrain the geodynamic evolution of the continent. Taking into account the geological, tectonic and geophysical characteristics, we define six seismotectonic provinces that characterize the crustal deformation. With the previously identified Somalia tectonic block, the seismotectonic and geophysical framework of the continent reveal the existence of the Cameroon volcanic line, the South African tectonic block with transform faulting and Cape folding system

  19. Atmospheric dry deposition of trace elements at a site on Asian-continent side of Japan

    NASA Astrophysics Data System (ADS)

    Sakata, Masahiro; Asakura, Kazuo

    2011-02-01

    The sources of dry-deposited trace elements (As, Cd, Cr, Cu, Mn, Ni, Pb, Sb and V) and the factors controlling their dry deposition fluxes were investigated on the basis of two-year observations (April 2004-March 2006) at a site on the Asian-continent side of Japan, which has been strongly affected by air pollutants from the Asian continent. Dry deposition sampling was conducted using a water surface sampler connected to a wet-only precipitation sampler. The dry deposition of As, Cd, Pb and Sb showed a small contribution to atmospheric deposition (0.25-0.44 as ratios of annual dry/wet deposition fluxes). Moreover, the dry deposition fluxes of those elements increased negligibly during the period when their atmospheric particulate matter (PM) concentrations increased owing to transport from the Asian continent. Thus, the dry deposition of As, Cd, Pb and Sb from the Asian continent was not significant, because their overall dry deposition velocities are relatively low (mostly <1 cm s -1). Conversely, the annual dry deposition fluxes of Cr, Cu and Ni exceeded their annual wet deposition fluxes (2.5-12.4 as ratios of annual dry/wet deposition fluxes). Those overall dry deposition velocities were much higher (3.2-9.7 cm s -1), and the crustal enrichment factors (EFs) frequently exceeded ten. These results suggest that the dry deposition of Cr, Cu and Ni is dominated by considerably coarse particles from local anthropogenic sources. For Mn and V, the dry and wet depositions contributed almost equally to the annual deposition fluxes. Their monthly dry deposition fluxes correlated significantly with that of Al ( P < 0.001), and the EFs were close to unity, suggesting a large contribution of background soil to their dry deposition. The dry deposition fluxes of all the trace elements were dependent not on their atmospheric PM concentrations but on their overall dry deposition velocities. The particle size distributions of the elements in the atmosphere are likely the most

  20. Monitoring of Internet Forums to Evaluate Reactions to the Introduction of Reformulated OxyContin to Deter Abuse

    PubMed Central

    Coplan, Paul M; Black, Ryan A; Weber, Sarah E; Chilcoat, Howard D; Butler, Stephen F

    2014-01-01

    Background Reformulating opioid analgesics to deter abuse is one approach toward improving their benefit-risk balance. To assess sentiment and attempts to defeat these products among difficult-to-reach populations of prescription drug abusers, evaluation of posts on Internet forums regarding reformulated products may be useful. A reformulated version of OxyContin (extended-release oxycodone) with physicochemical properties to deter abuse presented an opportunity to evaluate posts about the reformulation in online discussions. Objective The objective of this study was to use messages on Internet forums to evaluate reactions to the introduction of reformulated OxyContin and to identify methods aimed to defeat the abuse-deterrent properties of the product. Methods Posts collected from 7 forums between January 1, 2008 and September 30, 2013 were evaluated before and after the introduction of reformulated OxyContin on August 9, 2010. A quantitative evaluation of discussion levels across the study period and a qualitative coding of post content for OxyContin and 2 comparators for the 26 month period before and after OxyContin reformulation were conducted. Product endorsement was estimated for each product before and after reformulation as the ratio of endorsing-to-discouraging posts (ERo). Post-to-preintroduction period changes in ERos (ie, ratio of ERos) for each product were also calculated. Additionally, post content related to recipes for defeating reformulated OxyContin were evaluated from August 9, 2010 through September 2013. Results Over the study period, 45,936 posts related to OxyContin, 18,685 to Vicodin (hydrocodone), and 23,863 to Dilaudid (hydromorphone) were identified. The proportion of OxyContin-related posts fluctuated between 6.35 and 8.25 posts per 1000 posts before the reformulation, increased to 10.76 in Q3 2010 when reformulated OxyContin was introduced, and decreased from 9.14 in Q4 2010 to 3.46 in Q3 2013 in the period following the reformulation

  1. [Urinary infection in the pregnant woman].

    PubMed

    Delcroix, M; Zone, V; Cheront, C; Adam, M H; Duquesne, G; Noel, A M

    1994-05-01

    Urinary tract infections are common during pregnancy. When unrecognized, they can be responsible for complications such as threatened premature labour and impaired intra-uterine development. Detection and appropriate treatment are thus essential. This article reviews the pathophysiology of urinary tract infections during pregnancy and the three major entities involved--different but related to each other--are detailed (significant asymptomatic bacteriuria or SAB, acute cystitis and acute pyelonephritis), together with their specific treatment. SAB tends to persist during pregnancy, then leading in the absence of treatment to a potentially serious complication (acute pyelonephritis) in approximately one woman in five. SAB should be sought at the first prenatal visit by microscopic and bacteriological examination of a properly obtained urine specimen. Lower genital infections should also be sought and treated, without forgetting to remind the patient of preventive measures (adequate hygiene, sufficient urine output, post-coital micturition, regular bowel habit). PMID:8036390

  2. [A case of ammonium urate urinary stone].

    PubMed

    Hara, Noboru; Koike, Hiroshi

    2004-05-01

    An 18-year-old female, who had undergone antireflux surgery for bilateral vesicoureteral reflux 5 years ago, was admitted to our department with complaints of fever and left-sided back pain. Bilateral renal stones and pyelonephritis were diagnosed after roentgenography, ultrasonography and urinalysis. Pyelonephritis was successfully treated with antibiotics and the left renal stone was completely disintegrated with extracorporeal shock wave lithotripsy. Spectrophotometric analysis revealed that the stone was composed of pure ammonium urate (AU). The patient had not experienced any episodes of urinary tract infection from the antireflux surgery until the present event, but had lost 20 kg in body weight during the last year due to a low-caloric diet and laxative abuse. AU urinary stones have been infrequently reported in Japan, and they are supposed to be associated with a low-caloric diet, laxative abuse, and anorexia nervosa. PMID:15237492

  3. Quantitative mass spectrometry of urinary biomarkers

    PubMed Central

    Jerebtsova, Marina; Nekhai, Sergei

    2015-01-01

    The effectiveness of treatment of renal diseases is limited because the lack of diagnostic, prognostic and therapeutic markers. Despite the more than a decade of intensive investigation of urinary biomarkers, no new clinical biomarkers were approved. This is in part because the early expectations toward proteomics in biomarkers discovery were significantly higher than the capability of technology at the time. However, during the last decade, proteomic technology has made dramatic progress in both the hardware and software methods. In this review we are discussing modern quantitative methods of mass-spectrometry and providing several examples of their applications for discovery and validation of renal disease biomarkers. We are optimistic about future prospects for the development of novel of specific clinical urinary biomarkers. PMID:25984422

  4. Management of urinary incontinence in women.

    PubMed Central

    O'Dowd, T C

    1993-01-01

    Control of micturition is a complex physiological and anatomical process which often fails in women. The sequelae of urinary incontinence in women range from inconvenience to social and psychological stigmatization. Surprisingly, many women are tolerant of often quite severe sequelae, despite a range of management techniques that exist to alleviate or cure incontinence. Some of the more successful techniques are well suited to general practice management and can be carried out by the patient under the supervision of her doctor, district nurse, practice nurse or midwife. This paper reviews the physiology of micturition, stress urinary incontinence and incontinence caused by detrusor instability, and the management techniques available to alleviate or cure the problem. PMID:8260222

  5. [Diagnosis of urinary stress incontinence in men].

    PubMed

    Goepel, M

    2014-03-01

    Male lower urinary tract symptoms (LUTS) occur more frequently with increasing age. LUTS can either be caused by benign prostatic syndrome (BPS) and consecutive subvesical obstruction as well as detrusor hyperactivity. On the other hand, stress urinary incontinence is mostly seen after surgical intervention in the pelvis like radical prostatectomy. Also high volume centers report persisting incontinence rates of 2-4 % after radical prostatectomy.The diagnostic procedure in men with LUTS is divided in two steps: basic diagnostics, followed by a conservative treatment option, and extended diagnostic procedures including measurement of bladder pressure during filling and voiding. In addition, radiologic examinations, including voiding cystouretherogram, retrograde cystogram, CT scan, MRI scan, are added according to the severity of the symptoms and the scheduled surgical procedure. According to the guidelines of the DGU, EAU, AUA, and ICS, this extended examination is also mandatory prior to any surgical procedure like suburethral tapes, artificial sphincters, and sacral foramen neuronal stimulators. PMID:24615463

  6. [Treatment of cystoceles with urinary stress incontinence].

    PubMed

    Sarf, I; Aboutaieb, R; Dakir, M; el Moussaoui, A; Rabii, R; Hafiani, M; Bennani, S; el Mrini, M; Meziane, F; Benjelloun, S

    1998-01-01

    Thirteen women were operated for cystocele associated with urinary stress incontinence. Cystoceles were grade I in 6 cases, grade II in 6 cases and grade III in 1 case. Five patients underwent retropubic colposuspension according to Burch (3 cases) and M.M.K. (2 cases). Eight patients were treated by RAZ's technique associated with anterior colporaphy in order to reduce the cystocele. In this latter group, only one recurrence was observed and was treated by repeat colporaphy with good results. Colposuspension associated with anterior colporaphy is a reliable method for the treatment of cystocele with urinary stress incontinence, associated with low morbidity and short hospitalization. Its results are probably comparable to those of retropubic colposuspension, at least for a 6 months follow-up. PMID:9827204

  7. Could Urinary Tract Infection Cause Female Stress Urinary Incontinence? A Clinical Study

    PubMed Central

    Heydari, Fatemeh; Motaghed, Zahra; Abbaszadeh, Fatemeh

    2016-01-01

    Background Stress urinary incontinence (SUI), the most common type of urinary incontinence (UI), is usually defined as leakage of urine during movement or activity which puts pressure on the bladder, such as coughing, sneezing, running or heavy lifting. It is reported in most countries that 15% to 40% of women struggle with SUI and its severe implications for daily life, including social interactions, sexuality, and psychological wellbeing. Objectives The aim of our study was to assess the relationship between urinary tract infection and the severity of stress urinary incontinence (SUI). Patients and Methods This research was a cross-sectional study conducted in a public urology clinic in Tehran. The study population was all females with complaints of SUI who visited the clinic during 2014. We compared Valsalva leak point pressure (VLPP) in two groups of patients, with and without history of urinary tract infection (UTI). Results According to the findings of our study, the mean VLPP was 83.10 cm H2O in the group with UTI history, and 81.29 cm H2O in those without history of UTI. The difference in VLPP between the two groups was not significant (P < 0.05), even after controlling for confounding variables including age, body mass index, history of hysterectomy and number of deliveries. Conclusions Our study did not confirm a significant relationship between UTI and severity of SUI as measured by VLPP. A decisive opinion would require extensive future studies by prospective methods. PMID:26981500

  8. Reactive Arthritis Caused by Urinary Tract Infection.

    PubMed

    Nishizaki, Yuji; Yamagami, Shinichiro; Inoue, Hisashi; Uehara, Yuki; Kobayashi, Shigeto; Daida, Hiroyuki

    2016-01-01

    We report the case of a 58-year-old man presenting with chest pain who underwent percutaneous coronary intervention (PCI). The patient subsequently developed a fever over 38°C, pain on micturition, and cloudy urine 3 days following PCI. Urine cultures were positive for Escherichia coli and Enterococcus faecalis, whereas blood cultures were negative. Arthritis occurred two weeks following urinary tract infection (UTI). We herein present a rare case of reactive arthritis caused by UTI following PCI. PMID:27150879

  9. Urinary tract infections in pregnant women.

    PubMed

    Santos, J F M; Ribeiro, R M; Rossi, P; Haddad, J M; Guidi, H G C; Pacetta, A M; Pinotti, J A

    2002-01-01

    Urinary tract infections are of great importance during pregnancy owing to undesirable complications such as fetal and maternal morbidity. This paper describes the functional alterations that occur in this condition and predispose to infection. Clinical presentation and subsidiary diagnosis are discussed, including asymptomatic bacteriuria, cystitis and pyelonephritis. In addition, the authors report drug options, and their safety and duration of treatment during pregnancy. PMID:12140719

  10. Urinary polypeptides related to collagen synthesis

    PubMed Central

    Krane, Stephen M.; Muñoz, Alberto J.; Harris, Edward D.

    1970-01-01

    Of the total urinary hydroxyproline in normal subjects and those with skeletal disorders, between 4 and 20% was nondialyzable. In some patients with Paget's disease of bone, hyperparathyroidism with osteitis fibrosa, hyperphosphatasia, and extensive fibrous dysplasia the total urinary hydroxyproline was sufficiently high to permit purification of this polypeptide hydroxyproline by gel filtration and ion exchange chromatography. The partially purified polypeptides had molecular weights between 4500 and 10,000 and amino acid compositions and physical properties resembling those of gelatin. The polypeptide fractions also contained neutral sugar and glucosamine. These fragments had been shown to be susceptible to cleavage by purified bacterial collagenase suggesting the presence of the sequence-Pro-X-Gly-Pro-Y-. After administration of proline-14C to patients with Paget's disease hydroxyproline-14C was excreted in the urine. The hydroxyproline-14C specific activity reached a peak in 2-4 hr and declined rapidly. The specific activity of the polypeptide (retentate) portion was severalfold greater than that of the raw urine and diffusate. When the labeled urines were subjected to gel filtration the hydroxyproline-14C fractions of highest molecular weight which were eluted first from the columns had the highest specific activities. Exposure of the hydroxyproline-14C-containing polypeptides to bacterial collagenase rendered them dialyzable. Four patients with hyperparathyroidism and osteitis fibrosa were studied before and after removal of a parathyroid adenoma, a period of transition from a predominance of bone collagen resorption to one of relatively increased bone collagen synthesis. The total urinary hydroxyproline fell rapidly after operation whereas the ratio of the polypeptide fraction to the total rose three- to fourfold. The results of these studies suggest that the urinary polypeptides represent fragments of collagen related to collagen synthesis. Changes in the

  11. Urinary Ascites - A Consequence of Intraoperative Injury.

    PubMed

    Ghosh, Sinjon; Chatterjee, Nandini; Mukhopadhyay, Mainak; Brahmachari, Ramkrishna; Maity, Pranab; Das, A K

    2015-09-01

    Patients with complications after surgery often pose enormous challenges to physicians. We report the case of a young lady developing fever, oliguria and intractable ascites refererred to us after undergoing abdominal surgery. She was diagnosed subsequently to have a urinoma with urinary ascites masquerading as a case of sepsis. Percutaneous nephrostomy followed by definitive repair and reimplantation of ureter later led to subsidence of the symptoms. PMID:27608874

  12. Giant Leiomyosarcoma of the Urinary Bladder

    PubMed Central

    Ribeiro, José G.A.; Klojda, Carlos A.B.; Araújo, Claudio P. De; Pires, Lucas A.S.

    2016-01-01

    The bladder leiomyosarcoma is a rare and agressive mesenchymal tumour, and adult women of reproductive age have a higher incidence of developing the bladder leiomyosarcoma. The pathophysiology of the disease is not certain, and its main symptoms are hematuria, dysuria and abdominal pain. There are not a considerable amount of cases described in the literature. We report a case of a giant leiomyosarcoma of the urinary bladder in a 31-year-old woman. PMID:27437302

  13. Iatrogenic foreign body in the urinary bladder.

    PubMed

    Shah, Safdar; Qureshi, Farhan; Rakhio, Sain

    2015-04-01

    A 60 years old man presented with a history of suprapubic pain, painful micturition, perineal pain, and acute retention of urine followed by catheterization. On abdominal ultrasound, there was a metallic needle found in the urinary bladder which was confirmed on pelvis X-ray. The needle was found to be a metallic piece of a resectoscope cutting loop which was removed through cystourethroscopy. PMID:25899202

  14. Factors associated with urinary incontinence in women.

    PubMed Central

    Yarnell, J W; Voyle, G J; Sweetnam, P M; Milbank, J; Richards, C J; Stephenson, T P

    1982-01-01

    Possible aetiological factors for urinary incontinence were examined in a prevalence study among a random sample of 1000 women aged 18 and over. Infective factors were not markedly associated with incontinence but mechanical factors such as parity and obesity were. No association was found, however, between a history of perineal damage at childbirth and incontinence. Women with incontinence had on average a higher score for a 'neuroticism' trait elicited by questionnaire than women without the disorder. PMID:7069357

  15. Managing lower urinary tract symptoms in men.

    PubMed

    MacKenzie, Kenneth R; Aning, Jonathan J

    2016-04-01

    Male lower urinary tract symptoms (LUTS) are common and increase in prevalence with age. Up to 90% of men aged 50 to 80 may suffer from troublesome LUTS. Men may attend expressing direct concern about micturition, describing one or more LUTS and the related impact on their quality of life. Frequently men may present for other medical or urological reasons such as concern regarding their risk of having prostate cancer or erectile dysfunction but on taking a history bothersome LUTS are identified. Men may present late in the community with urinary retention: the inability to pass urine. A thorough urological history is essential to inform management. It is important to determine whether men have storage or voiding LUTS or both. All patients must have a systematic comprehensive examination including genitalia and a digital rectal examination. Investigations performed in primary care should be guided by the history and examination findings, taking into account the impact of the LUTS on the individual's quality of life. Current NICE guidelines recommend the following to be performed at initial assessment: frequency volume chart (FVC); urine dipstick to detect blood, glucose, protein, leucocytes and nitrites; and prostate specific antigen. Men should be referred for urological review if they have: bothersome LUTS which have not responded to conservative management or medical therapy; LUTS in association with recurrent or persistent UTIs; urinary retention; renal impairment suspected to be secondary to lower urinary tract dysfunction; or suspected urological malignancy. All patients not meeting criteria for immediate referral to urology can be managed initially in primary care. Based on history, examination and investigation findings an individualised management plan should be formulated. Basic lifestyle advice should be given regarding reduction or avoidance of caffeinated products and alcohol. The FVC should guide advice regarding fluid intake management and all

  16. [Laparoscopy of the upper urinary tract].

    PubMed

    Stepushkin, S P; Chebanov, K O; Chaĭkovskiĭ, V P; Sokolenko, R V; Novikov, S P; Novikov, V O

    2014-01-01

    The upper urinary tract is a wide field for using of laparoscopy. The aim of this work was to analyze retrospectively our experience in the development of laparoscopic techniques of surgical treatment of upper urinary tract pathology. 137 patients with pathology of the upper urinary tract were operated laparoscopically in our department during three years (July 2010 - July 2013). There were performed: nephrectomy--75 (54.7%, nephroureterectomy--3, 2.2%, partial nephrectomy--12 (8.7%), adrenalectomy--11 (8%), resection of the adrenal gland--2 (1.5%), cystectomy--10 : (7.3%) ureterolithotomy--15 (11%) pelviolithotomy--3 (2.2%), pyeloplasty--4 (2.9%) nephropexy--2 (14%). The results were evaluated by the comparative analysis of laparoscopic surgery and similar open interventions that were performed in our clinic. The mean operative time after laparoscopic nephrectomy was 180 min (80-220), the mean blood loss during surgery was 150 ml (50-370). The patients discharged at 4-5 days after operation. Laparoscopic partial nephrectomy was performed at an average tumor size 2.7 cm (1.5-3.5). We used warm ischemia in 75% of cases. Its average time was 27 min (9-39), which was significantly greater than in the open resection--17 min (10-27). At the beginning of the development of laparoscopic adrenalectomy the average operative time was 140 min (110-270). In the future, as we got experience, it declined to 70 min (60-90) min. The mean blood loss was 70 ml (range 20-400). After laparoscopic cystectomy, ureterolithotomy, pelviolithotomy and pyeloplastic the patients discharged at 2-3 days. Intraoperative and postoperative complications were not noted. Laparoscopic surgery for treatment of pathology of the upper urinary tract is an alternative to the operations performed by the open approach. The oncological outcomes, functional results and complication rates are comparable for both types of surgery. PMID:25286605

  17. An association between urinary cadmium and urinary stone disease in persons living in cadmium-contaminated villages in northwestern Thailand: A population study

    SciTech Connect

    Swaddiwudhipong, Witaya; Mahasakpan, Pranee; Limpatanachote, Pisit; Krintratun, Somyot

    2011-05-15

    Excessive urinary calcium excretion is the major risk of urinary stone formation. Very few population studies have been performed to determine the relationship between environmental cadmium exposure and urinary stone disease. This population-based study examined an association between urinary cadmium excretion, a good biomarker of long-term cadmium exposure, and prevalence of urinary stones in persons aged 15 years and older, who lived in the 12 cadmium-contaminated villages in the Mae Sot District, Tak Province, northwestern Thailand. A total of 6748 persons were interviewed and screened for urinary cadmium and urinary stone disease in 2009. To test a correlation between urinary excretion of cadmium and calcium, we measured urinary calcium content in 1492 persons, who lived in 3 villages randomly selected from the 12 contaminated villages. The rate of urinary stones significantly increased from 4.3% among persons in the lowest quartile of urinary cadmium to 11.3% in the highest quartile. An increase in stone prevalence with increasing urinary cadmium levels was similarly observed in both genders. Multiple logistic regression analysis revealed a positive association between urinary cadmium levels and stone prevalence, after adjusting for other co-variables. The urinary calcium excretion significantly increased with increasing urinary cadmium levels in both genders, after adjusting for other co-variables. Elevated calciuria induced by cadmium might increase the risk of urinary stone formation in this environmentally exposed population. - Research highlights: {yields} Excessive calciuria is the major risk of urinary stone formation. {yields} We examine cadmium-exposed persons for urinary cadmium, calcium, and stones. {yields} The rate of urinary stones increases with increasing urinary cadmium. {yields} Urinary calcium excretion increases with increasing urinary cadmium. {yields} Elevated calciuria induced by cadmium may increase the risk of urinary stones.

  18. Transperineal ultrasonography in stress urinary incontinence: The significance of urethral rotation angles

    PubMed Central

    Al-Saadi, Wasan Ismail

    2015-01-01

    Objective To assess, using transperineal ultrasonography (TPUS), the numerical value of the rotation of the bladder neck [represented by the difference in the anterior (α angle) and posterior urethral angles (β angle)] at rest and straining, in continent women and women with stress urinary incontinence (SUI), to ascertain if there are significant differences in the angles of rotation (Rα and Rβ) between the groups. Patients, subjects and methods In all, 30 women with SUI (SUI group) and 30 continent women (control group) were included. TPUS was performed at rest and straining (Valsalva manoeuver), and the threshold value for the urethral angles (α and β angles) for each group were estimated. The degree of rotation for each angle was calculated and was considered as the angle of rotation. Results Both the α and β angles were significantly different between the groups at rest and straining, and there was a significant difference in the mean increment in the value of each angle. Higher values of increment (higher rotation angles) were reported in the SUI group for both the α and β angles compared with those of the control group [mean (SD) Rα SUI group 19.43 (12.76) vs controls 10.53 (2.98) °; Rβ SUI group 28.30 (12.96) vs controls 16.33 (10.8) °; P < 0.001]. Conclusion Urethral rotation angles may assist in the assessment and diagnosis of patients with SUI, which may in turn reduce the need for more sophisticated urodynamic studies. PMID:26966596

  19. Urinary porphyrin excretion in hepatitis C infection.

    PubMed

    Vogeser, M; Jacob, K; Zachoval, R

    1999-08-01

    A high prevalence of hepatitis C virus infection in porphyria cutanea tarda in some populations suggests a close link between viral hepatitis and alteration of porphyrin metabolism. Moreover, there is evidence of a role of porphyrinopathies in hepatocarcinogenesis. The aim of our study was to obtain data on the prevalence and patterns of heme metabolism alterations in patients with chronic hepatitis C virus infection. Urinary porphyrin excretion was prospectively studied in 100 consecutive outpatients with chronic hepatitis C infection without signs of photosensitivity, using an ion-pair high-performance liquid chromatography method. Increased total porphyrin excretion was found in 41 patients, with predominant excretion of coproporphyrins (whole study group: mean 146 microg/g creatinine, interquartile range 76-186; normal < 150), in 10 patients excretion exceeded 300 microg/g creatinine. In the majority of all patients studied (75/100) an increased ratio of the relatively hydrophobic coproporphyrin isomer I to isomer III was found. In just one case, urinary porphyrin pattern characteristic for chronic hepatic porphyria was present (uroporphyrin > coproporphyrin, heptacarboxyporphyrin III increased) but the total porphyrin excretion was only slightly elevated in this case. In the whole group, total urinary porphyrin excretion correlated well with serum bilirubin and was inversely correlated with albumin and thrombin time. In conclusion, secondary coproporphyrinuria occurs frequently in heptatitis C infection, whereas in Germany, preclinical porphyria cutanea tarda seems to be rare in these patients. PMID:10536928

  20. Proteus mirabilis and Urinary Tract Infections

    PubMed Central

    Schaffer, Jessica N.; Pearson, Melanie M.

    2015-01-01

    Proteus mirabilis is a Gram-negative bacterium which is well-known for its ability to robustly swarm across surfaces in a striking bulls’-eye pattern. Clinically, this organism is most frequently a pathogen of the urinary tract, particularly in patients undergoing long-term catheterization. This review covers P. mirabilis with a focus on urinary tract infections (UTI), including disease models, vaccine development efforts, and clinical perspectives. Flagella-mediated motility, both swimming and swarming, is a central facet of this organism. The regulation of this complex process and its contribution to virulence is discussed, along with the type VI-secretion system-dependent intra-strain competition which occurs during swarming. P. mirabilis uses a diverse set of virulence factors to access and colonize the host urinary tract, including urease and stone formation, fimbriae and other adhesins, iron and zinc acquisition, proteases and toxins, biofilm formation, and regulation of pathogenesis. While significant advances in this field have been made, challenges remain to combatting complicated UTI and deciphering P. mirabilis pathogenesis. PMID:26542036

  1. Lower urinary tract symptoms in men

    PubMed Central

    Hollingsworth, John M

    2014-01-01

    Benign prostatic hyperplasia (BPH) is a highly prevalent and costly condition that affects older men worldwide. Many affected men develop lower urinary tract symptoms, which can have a negative impact on their quality of life. In the past, transurethral resection of the prostate (TURP) was the mainstay of treatment. However, several efficacious drug treatments have been developed, which have transformed BPH from an acute surgical entity to a chronic medical condition. Specifically, multiple clinical trials have shown that α adrenoceptor antagonists can significantly ameliorate lower urinary tract symptoms. Moreover, 5α reductase inhibitors, alone or combined with an α adrenoceptor antagonist, can reverse the natural course of BPH, reducing the risk of urinary retention and the need for surgical intervention. Newer medical regimens including the use of antimuscarinic agents or phosphodiesterase type 5 inhibitors, have shown promise in men with predominantly storage symptoms and concomitant erectile dysfunction, respectively. For men who do not adequately respond to conservative measures or pharmacotherapy, minimally invasive surgical techniques (such as transurethral needle ablation, microwave thermotherapy, and prostatic urethral lift) may be of benefit, although they lack the durability of TURP. A variety of laser procedures have also been introduced, whose improved hemostatic properties abrogate many of the complications associated with traditional surgery. PMID:25125424

  2. Control of Urinary Drainage and Voiding

    PubMed Central

    2015-01-01

    Urine differs greatly in ion and solute composition from plasma and contains harmful and noxious substances that must be stored for hours and then eliminated when it is socially convenient to do so. The urinary tract that handles this output is composed of a series of pressurizable muscular compartments separated by sphincteric structures. With neural input, these structures coordinate the delivery, collection, and, ultimately, expulsion of urine. Despite large osmotic and chemical gradients in this waste fluid, the bladder maintains a highly impermeable surface in the face of a physically demanding biomechanical environment, which mandates recurring cycles of surface area expansion and increased wall tension during filling, followed by rapid wall compression during voiding. Afferent neuronal inflow from mucosa and submucosa communicates sensory information about bladder fullness, and voiding is initiated consciously through coordinated central and spinal efferent outflow to the detrusor, trigonal internal sphincter, and external urethral sphincter after periods of relative quiescence. Provocative new findings suggest that in some cases, lower urinary tract symptoms, such as incontinence, urgency, frequency, overactivity, and pain may be viewed as a consequence of urothelial defects (either urothelial barrier breakdown or inappropriate signaling from urothelial cells to underlying sensory afferents and potentially interstitial cells). This review describes the physiologic and anatomic mechanisms by which urine is moved from the kidney to the bladder, stored, and then released. Relevant clinical examples of urinary tract dysfunction are also discussed. PMID:24742475

  3. The relationship between kidney and urinary kininogenase

    PubMed Central

    Nustad, K.

    1970-01-01

    1. Rat kidneys which were perfused with saline contained both kininogenase (KGA) and kininase activity. These activities were separated by gel filtration on a Sephadex G-100 column. The kininase activity was excluded from the column whereas the KGA activity was retained. Kidney KGA activity was primarily found in the sedimentable fraction of the homogenate. 2. The kidney KGA activity was compared with the urinary KGA activity, and the following properties were found to be the same: molecular dimension, pH optimum, effect of inhibitors, and ability to liberate kinins from kininogens. 3. A urinary sample collected over 24 h contained about 8 times the KGA activity found in the corresponding kidneys at the end of the collection period. The urine: kidney ratio for alkaline phosphatase was about 0·01. 4. The ability of kidney and urinary samples to hydrolyse N-α-benzoyl-L-arginine ethyl ester (BAEE) at pH 8·5 paralleled the KGA activity. PMID:5420147

  4. Metabolism and Fitness of Urinary Tract Pathogens.

    PubMed

    Alteri, Christopher J; Mobley, Harry L T

    2015-06-01

    Among common infections, urinary tract infections (UTI) are the most frequently diagnosed urologic disease. The majority of UTIs are caused by uropathogenic Escherichia coli. The primary niche occupied by E. coli is the lower intestinal tract of mammals, where it resides as a beneficial component of the commensal microbiota. Although it is well-known that E. coli resides in the human intestine as a harmless commensal, specific strains or pathotypes have the potential to cause a wide spectrum of intestinal and diarrheal diseases. In contrast, extraintestinal E. coli pathotypes reside harmlessly in the human intestinal microenvironment but, upon access to sites outside of the intestine, become a major cause of human morbidity and mortality as a consequence of invasive UTI (pyelonephritis, bacteremia, or septicemia). Thus, extraintestinal pathotypes like uropathogenic E. coli (UPEC) possess an enhanced ability to cause infection outside of the intestinal tract and colonize the urinary tract, the bloodstream, or cerebrospinal fluid of human hosts. Due to the requirement for these E. coli to replicate in and colonize both the intestine and extraintestinal environments, we posit that physiology and metabolism of UPEC strains is paramount. Here we discuss that the ability to survive in the urinary tract depends as much on bacterial physiology and metabolism as it does on the well-considered virulence determinants. PMID:26185076

  5. Proteus mirabilis and Urinary Tract Infections.

    PubMed

    Schaffer, Jessica N; Pearson, Melanie M

    2015-10-01

    Proteus mirabilis is a Gram-negative bacterium and is well known for its ability to robustly swarm across surfaces in a striking bulls'-eye pattern. Clinically, this organism is most frequently a pathogen of the urinary tract, particularly in patients undergoing long-term catheterization. This review covers P. mirabilis with a focus on urinary tract infections (UTI), including disease models, vaccine development efforts, and clinical perspectives. Flagella-mediated motility, both swimming and swarming, is a central facet of this organism. The regulation of this complex process and its contribution to virulence is discussed, along with the type VI-secretion system-dependent intra-strain competition, which occurs during swarming. P. mirabilis uses a diverse set of virulence factors to access and colonize the host urinary tract, including urease and stone formation, fimbriae and other adhesins, iron and zinc acquisition, proteases and toxins, biofilm formation, and regulation of pathogenesis. While significant advances in this field have been made, challenges remain to combatting complicated UTI and deciphering P. mirabilis pathogenesis. PMID:26542036

  6. Catheter-associated urinary tract infections.

    PubMed

    Liedl, B

    2001-01-01

    In the past few years it has been clearly demonstrated that the concept of bacterial biofilm production permits an understanding and provides some explanation of the pathogenesis, diagnosis and treatment of catheter-associated urinary tract infections. This concept describes the colonization of catheter surfaces and the movement of bacteria against the urinary flow. It explains the antibacterial resistance of these matrix-enclosed sessile populations of bacteria. The catheter encrustation can be observed as mineralizing bacterial biofilm. The differentiation in swarming cells exposing a much higher activity of the enzyme urease is responsible for the predominant role of Proteus mirabilis in obstructing encrustations. The guidelines for the prevention of catheter-associated urinary tract infections were developed over the past decades by clinicians and are still valid. They can now be better understood taking into consideration these new theories. As overuse of urethral catheters and non-compliance of their recommended use are still apparent, educational and surveillance programmes are needed to help maintain good standards of care. PMID:11148750

  7. Lower urinary tract symptoms in men.

    PubMed

    Hollingsworth, John M; Wilt, Timothy J

    2014-01-01

    Benign prostatic hyperplasia (BPH) is a highly prevalent and costly condition that affects older men worldwide. Many affected men develop lower urinary tract symptoms, which can have a negative impact on their quality of life. In the past, transurethral resection of the prostate (TURP) was the mainstay of treatment. However, several efficacious drug treatments have been developed, which have transformed BPH from an acute surgical entity to a chronic medical condition. Specifically, multiple clinical trials have shown that α adrenoceptor antagonists can significantly ameliorate lower urinary tract symptoms. Moreover, 5α reductase inhibitors, alone or combined with an α adrenoceptor antagonist, can reverse the natural course of BPH, reducing the risk of urinary retention and the need for surgical intervention. Newer medical regimens including the use of antimuscarinic agents or phosphodiesterase type 5 inhibitors, have shown promise in men with predominantly storage symptoms and concomitant erectile dysfunction, respectively. For men who do not adequately respond to conservative measures or pharmacotherapy, minimally invasive surgical techniques (such as transurethral needle ablation, microwave thermotherapy, and prostatic urethral lift) may be of benefit, although they lack the durability of TURP. A variety of laser procedures have also been introduced, whose improved hemostatic properties abrogate many of the complications associated with traditional surgery. PMID:25125424

  8. Mesohabitat-specific Macroinvertebrate Assemblage Responses to Water Quality Variation in Mid-continent (North America) Great Rivers

    EPA Science Inventory

    We compared the responsiveness of macroinvertebrate assemblages to water quality stressors (ions, nutrients, dissolved metals and suspended sediment) in two mesohabitats within the main-channel macrohabitat of three mid-continent North American rivers, the Upper Mississippi, Miss...

  9. [Chronic irritative urinary syndrome. Diagnostic value of cystoscopy, urinary cytology and biopsy].

    PubMed

    Guzmán Esquivel, J; Manzanilla, H; Zungri Telo, E; Da Silva, E A

    1997-01-01

    Chronic irritative urinary syndrome (CIUS), is a diagnostic concern for urologists from the moment that it becomes chronic and there is no etiologic diagnostic available. The objective of this study is to find out the diagnostic value of Cystoscopy, Urinary cytology and Biopsy of the vesical mucosa. A prospective, descriptive study was conducted in 30 patients who developed CIUS. Cystoscopy showed visible damage in 7 patients (31.8%); urinary cytology, 22 patients with cytologic changes (73.3%); and vesical biopsy, 24 patients with histologic changes (80.0%). The authors conclude that CIUS occurs more frequently in females than in males, the age range with higher incidence are 43 and 45 years. The most common diagnosis are unspecific chronic inflammatory changes followed by metaplasia. PMID:9494162

  10. A unique extra-anatomic urinary diversion!

    PubMed

    Mishra, Vibash C; Rao, Amrith Raj; Desai, Anil R; Charig, Mark; Karim, Omer M A

    2004-02-01

    The ureter is often involved in pelvic malignancy, leading to obstruction, hydronephrosis, and deterioration of renal function. Decompression is provided either by retrograde stenting or by nephrostomy followed by antegrade stent insertion. We present an interesting case where an iatrogenic accident during antegrade stenting led to the placement of the lower end of the stent in the rectal stump. Although this led to a favorable outcome, in that it provided internal continent drainage, it cannot be recommended for emulation. However, it does show that a physician should not only have conventional wisdom but also a good measure of innovation and pragmatism. PMID:15006055

  11. Urinary Tract Infections in Older Women

    PubMed Central

    Mody, Lona; Juthani-Mehta, Manisha

    2014-01-01

    IMPORTANCE Asymptomatic bacteriuria and symptomatic urinary tract infections (UTIs) in older women are commonly encountered in outpatient practice. OBJECTIVE To review management of asymptomatic bacteriuria and symptomatic UTI and review prevention of recurrent UTIs in older community-dwelling women. EVIDENCE REVIEW A search of Ovid (Medline, PsycINFO, Embase) for English-language human studies conducted among adults aged 65 years and older and published in peer-reviewed journals from 1946 to November 20, 2013. RESULTS The clinical spectrum of UTIs ranges from asymptomatic bacteriuria, to symptomatic and recurrent UTIs, to sepsis associated with UTI requiring hospitalization. Recent evidence helps differentiate asymptomatic bacteriuria from symptomatic UTI. Asymptomatic bacteriuria is transient in older women, often resolves without any treatment, and is not associated with morbidity or mortality. The diagnosis of symptomatic UTI is made when a patient has both clinical features and laboratory evidence of a urinary infection. Absent other causes, patients presenting with any 2 of the following meet the clinical diagnostic criteria for symptomatic UTI: fever, worsened urinary urgency or frequency, acute dysuria, suprapubic tenderness, or costovertebral angle pain or tenderness. A positive urine culture (≥105 CFU/mL) with no more than 2 uropathogens and pyuria confirms the diagnosis of UTI. Risk factors for recurrent symptomatic UTI include diabetes, functional disability, recent sexual intercourse, prior history of urogynecologic surgery, urinary retention, and urinary incontinence. Testing for UTI is easily performed in the clinic using dipstick tests. When there is a low pretest probability of UTI, a negative dipstick result for leukocyte esterase and nitrites excludes infection. Antibiotics are selected by identifying the uropathogen, knowing local resistance rates, and considering adverse effect profiles. Chronic suppressive antibiotics for 6 to 12 months and

  12. Sex hormones and the female urinary tract.

    PubMed

    Miodrag, A; Castleden, C M; Vallance, T R

    1988-10-01

    Symptomatic clinical changes and urodynamic changes are apparent in the female urinary tract system during pregnancy, the menstrual cycle and following the menopause. The sex hormones exert physiological effects on the female urinary tract, from the ureters to the urethra, with oestrogens having an additional influence on the structures of the pelvic floor. High affinity oestrogen receptors have been identified in bladder, trigone, urethra and pubococcygeus muscle of women. Oestrogen pretreatment enhances the contractile response of animal detrusor muscle to alpha-adrenoceptor agonists, cholinomimetics and prostaglandins, as well as enhancing the contractile response to alpha-agonists in ureter and urethra. Progesterone on the other hand decreases tone in the ureter, bladder and urethra by enhancing beta-adrenergic responses. The dependence on oestrogens of the tissues of the lower urinary tract contributes to increased urinary problems in postmenopausal women. Urinary symptoms due to atrophic mucosal changes respond well to oestrogen replacement therapy. However, because they recur when treatment is stopped, continuous therapy with low dose natural oestrogens is recommended. Oestrogens may be of benefit in postmenopausal women with stress incontinence, but the doses necessary for clinical effect are higher than for the treatment of atrophic urethritis. The practice of adding a progestagen to long term oestrogen therapy to reduce the risk of endometrial carcinoma may, however, exacerbate stress incontinence by decreasing urethral pressure. Cyclical therapy with oestrogens may therefore be more appropriate particularly in women who are not suitable for surgery or have a mild degree of stress incontinence, along with other conservative measures such as pelvic floor exercises and alpha-adrenoceptor agonists. The place of oestrogen therapy in motor urge incontinence has not been determined. The risk of developing endometrial carcinoma as a result of long term high dose

  13. Dynamics of Urinary Calprotectin after Renal Ischaemia

    PubMed Central

    Ebbing, Jan; Seibert, Felix S.; Pagonas, Nikolaos; Bauer, Frederic; Miller, Kurt; Kempkensteffen, Carsten; Günzel, Karsten; Bachmann, Alexander; Seifert, Hans H.; Rentsch, Cyrill A.; Ardelt, Peter; Wetterauer, Christian; Amico, Patrizia; Babel, Nina; Westhoff, Timm H.

    2016-01-01

    Background: Urinary calprotectin has been identified as a promising biomarker for acute kidney injury. To date, however, the time-dependent changes of this parameter during acute kidney injury remain elusive. The aim of the present work was to define the time-course of urinary calprotectin secretion after ischaemia/reperfusion-induced kidney injury in comparison to neutrophil gelatinase—associated lipocalin, thereby monitoring the extent of tubular damage in nephron sparing surgery for kidney tumours. Methods: The study population consisted of 42 patients. Thirty-two patients underwent either open or endoscopic nephron sparing surgery for kidney tumours. During the surgery, the renal arterial pedicle was clamped with a median ischaemic time of 13 minutes (interquartile range, 4.5–20.3 minutes) in 26 patients. Ten retro-peritoneoscopic living donor nephrectomy patients and 6 nephron sparing surgery patients in whom the renal artery was not clamped served as controls. Urinary calprotectin and neutrophil gelatinase—associated lipocalin concentrations were repeatedly measured by enzyme-linked immunosorbent assay and assessed according to renal function parameters. Results: Urinary concentrations of calprotectin and neutrophil gelatinase—associated lipocalin increased significantly after ischaemia/reperfusion injury, whereas concentrations remained unchanged after nephron sparing surgery without ischaemia/reperfusion injury and after kidney donation. Calprotectin and neutrophil gelatinase—associated lipocalin levels were significantly increased 2 and 8 hours, respectively, post-ischaemia. Both proteins reached maximal concentrations after 48 hours, followed by a subsequent persistent decrease. Maximal neutrophil gelatinase—associated lipocalin and calprotectin concentrations were 9-fold and 69-fold higher than their respective baseline values. The glomerular filtration rate was only transiently impaired at the first post-operative day after ischaemia

  14. Effects of methylxanthines on urinary prostaglandin E excretion in rats.

    PubMed

    Takeuchi, K; Kogo, H; Aizawa, Y

    1981-04-01

    Effect of methylxanthines (theophylline, theobromine and caffeine) on urinary prostaglandin E (PGE) excretion in male rats was studied. Oral administration of xanthines significantly increased the urinary excretion of PGE. Dose-response studies showed that the maximal excretion of urinary PGE and water was obtained by administration of theophylline (50 mg/kg), where the increase in PGE was about 20 times that of the control. The excretion of urinary sodium, potassium and chloride was also markedly increased by xanthines, particularly, theophylline. Increases in urinary PGE excretion, urine volume and electrolytes excretion were inhibited by 10 mg/kg of indomethacin administered prior to theophylline. The increase of urinary PGE excretion after theophylline administration (50 mg/kg) preceded increases in water and sodium excretion. These results suggest that renal PGE mediates, at least in part, the diuretic effect of theophylline. PMID:7311144

  15. Evaluation of a behavioral treatment for female urinary incontinence

    PubMed Central

    Santacreu, Marta; Fernández-Ballesteros, Rocío

    2011-01-01

    Urinary incontinence is a medical, psychological, social, economic, and hygienic problem. Although it is difficult to state its prevalence, all authors agree that it is related to age and gender. This study aimed to carry out a urinary incontinence behavioral treatment in order to reduce urine leakages in 14 participants recruited from a senior center. The program consists of daily training of the pelvic floor muscles with a weekly control by a supervisor during a 2-month period and follow-up of results 2 months after the last control session. Urinary incontinence episodes were reduced by 75.67% after program completion. It appears that pelvic floor muscles training, carried out under controlled and constant supervision, significantly reduces urinary leakage. Moreover, maintaining this improvement after treatment depends on the continuation of the exercises as well as on the urinary leakage frequency baseline and the urinary leakage frequency during the last treatment session. PMID:21753868

  16. The management of urinary tract infections in octogenarian women.

    PubMed

    Robinson, Dudley; Giarenis, Ilias; Cardozo, Linda

    2015-07-01

    Urinary Tract Infections are common in women of all ages and the incidence increases with age. Whilst they are a common cause of lower urinary tract symptoms in all women they may be associated with increased morbidity in the elderly. Appropriate investigation and treatment in primary and secondary care are essential to effectively manage urinary tract infection and decrease morbidity and hospitalisation rates. Loss of endogenous oestrogen at the time of the menopause is associated with the urogenital atrophy and an increased incidence of urinary tract infection. Consequently vaginal oestrogen therapy may offer a rationale for treatment and prevent of urinary tract infection. The aim of this paper is to review the clinical management of elderly women presenting with primary and recurrent urinary tract infection. PMID:26006302

  17. Long-term outcomes of urinary tract reconstruction in patients with neurogenic urinary tract dysfunction

    PubMed Central

    Johnson, E. U.; Singh, Gurpreet

    2013-01-01

    The advent of specialized spinal units and better understanding of the pathophysiology of neurogenic urinary tract dysfunction has made long-term survival of these patients a reality. This has, in turn, led to an increase in quality and choice of management modalities offered to these patients including complex anatomic urinary tract reconstructive procedures tailored to the unique needs of each individual with variable outcomes. We performed a literature review evaluating the long-term outcomes of these reconstructive procedures. To achieve this, we conducted a world-wide electronic literature search of long-term outcomes published in English. As the premise of this review is long-term outcomes, we have focused on pathologies where evidence of long-term outcome is available such as patients with spinal injuries and spina bifida. Therapeutic success following urinary tract reconstruction is usually measured by preservation of renal function, improvement in quality-of-life, the satisfactory achievement of agreed outcomes and the prevention of serious complications. Prognostic factors include neuropathic detrusor overactivity; sphincter dyssynergia; bladder over distension; high pressure storage and high leak point pressures; vesicoureteric reflex, stone formation and urinary tract infections. Although, the past decade has witnessed a reduction in the total number of bladder reconstructive surgeries in the UK, these procedures are essentially safe and effective; but require long-term clinical and functional follow-up/monitoring. Until tissue engineering and gene therapy becomes more mainstream, we feel there is still a place for urinary tract reconstruction in patients with neurogenic lower urinary tract dysfunction. PMID:24235796

  18. Changes of urinary angiotensinogen concentration and its association with urinary proteins in diabetic rats

    PubMed Central

    Zhuang, Zhen; Bai, Qiong; A, Lata; Liang, Yaoxian; Zheng, Danxia; Wang, Yue

    2015-01-01

    Objective: It had been reported that angiotensinogen might be a marker for activation of renin-angiotensin system, which was associated with the development of diabetic nephropathy. The purpose of this study was to investigate the functional roles of AGT in DN in vitro. Methods: Diabetic rat models were built by single intraperitoneal injection of streptozotocin. The diabetic rats were divided into three groups, two of the three groups were treated with different doses of losartan, the other diabetic group was as control and normal rats acted as healthy control. In a 12-week investigation, we detected the changes of AGT in all rats’ blood and urine and the association between AGT concentration and RAS activation and urinary proteins were analyzed in this study. Results: The serum AGT of rats had no significant differences (P>0.05 for all). The urinary AGT of the diabetic rats was significantly different from the control group, moreover, the urinary AGT of the diabetic rats under different treatments was also obviously different (P<0.05 for all). Besides, the results of immunohistochemical assay indicated that AGT expression level was correlated with renal tissues damage. The level of AGT was positively associated with urinary protein (r=0.493, P<0.01) and negatively correlated with CCr (r=-0.474, P=0.007) and the dose of ARB (r=-0.575, P=0.001). Moreover, the dose of ARB was independently associated with urinary AGT (B=-2.963, P=0.024) in diabetic rats. Conclusion: Urinary AGT may be a marker for the activation of local RAS in kidney and independently associated with ARB. PMID:26722381

  19. Refertilization-driven destabilization of subcontinental mantle and the importance of initial lithospheric thickness for the fate of continents

    NASA Astrophysics Data System (ADS)

    Zheng, J. P.; Lee, C.-T. A.; Lu, J. G.; Zhao, J. H.; Wu, Y. B.; Xia, B.; Li, X. Y.; Zhang, J. F.; Liu, Y. S.

    2015-01-01

    Continents are underlain by thick, cold thermal boundary layers. Thermal contraction should render these boundary layers negatively buoyant and unstable; this is why old, cold oceanic lithospheres subduct. However, the ancient lithospheric roots of many continents appear to have existed for billions of years. In the common view, this preservation is due to the fact that the thermal boundary layers are compositionally distinct from the ambient mantle in that they are highly melt-depleted and dehydrated; the former provides positive buoyancy and the latter provides strength. Here, we show using mantle xenoliths that the Precambrian South China Block originally was underlain by highly depleted mantle, but has been refertilized via silicate melts generated from the asthenosphere. It is now more fertile than the ambient convecting mantle and is intrinsically denser by more than 1.5%. Achieving sufficient melt generation for refertilization is only possible if the lithosphere is thin enough to provide "headspace" for decompression melting. Thus, continental boundary layers thinner than the maximum depth of melting should experience refertilization, whereas thicker continents would altogether suppress melting and hence the potential for refertilization. We propose that refertilization, once initiated, will destabilize the base of the continent; this in turn will increase the amount of "headspace" and promote further refertilization, resulting in a positive feedback that could culminate in lithospheric destruction. By contrast, continents that are thick enough may not experience significant refertilization. This suggests that initial lithospheric thickness, as well as lithospheric composition, may be important for defining the fate of continents.

  20. The Genetics of Urinary Tract Infections and the Innate Defense of the Kidney and Urinary tract.

    PubMed

    Ambite, Ines; Rydstrom, Gustav; Schwaderer, Andrew L; Hains, David S

    2016-03-01

    The urinary tract is a sterile organ system. Urinary tract infections (UTIs) are common and often serious infections. Research has focused on uropathogen, environment, and host factors leading to UTI pathogenesis. A growing body of evidence exists implicating genetic factors that can contribute to UTI risks. In this review, we highlight genetic variations in aspects of the innate immune system critical to the host response to uropathogens. This overview includes genetic variations in pattern recognition receptor molecules, chemokines/cytokines, and neutrophil activation. We also comprehensively cover murine knockout models of UTI, genetic variations involved in renal scarring as a result of ascending UTIs, and asymptomatic bacteriuria. PMID:27617139

  1. A satellite-based perspective of convective systems over the Maritime Continent

    NASA Astrophysics Data System (ADS)

    Rowe, A.; Houze, R.; Virts, K.; Zuluaga, M. D.

    2014-12-01

    Data from TRMM, the A-Train satellites, and the Worldwide Lightning Location Network (WWLLN) have been used to study extreme weather throughout low latitudes, from deep convection over the Himalayas to oceanic mesoscale systems associated with the MJO. This study presents a more in-depth examination of convection over the Maritime Continent (Indonesia and Malaysia). During November to February, this area is the rainiest regional climate on Earth, thus constituting one of the atmosphere's primary heat sources. On multiple temporal and spatial scales, it is a complex region with clouds and precipitation having both oceanic and orographic influence. The November-February season encompasses both the eastward propagation of the MJO through this region and rainfall associated with the Asian-Australian monsoon. More specifically, the precipitation in this region is strongly modulated by MJO phases, pulsations of the monsoon, and the powerful diurnal effects of the islands and ocean. Through a feature-based analysis of convective and stratiform components of storms, the evolution of precipitating clouds in this region will be described using data from the November-February time period over multiple years. This analysis leads to an increased understanding of the characteristics of convection associated with the intraseasonal and diurnal variability during these months over the Maritime Continent. Previous work using A-Train data noted the prevalence of smaller separated MCSs over the region during the locally active phase of the MJO, and WWLLN data have shown a peak in lightning density as convection becomes deeper and more numerous leading up to this active period. By applying the analysis of the TRMM data in addition to the A-Train and WWLLN datasets, the relative roles of convective and stratiform components of MCSs to the behavior of convection can be determined during the MJO and monsoonal maxima of rainfall over the Maritime Continent.

  2. The Emerging Legacy of USArray: New Views of the Architecture of the North American Continent

    NASA Astrophysics Data System (ADS)

    Ritzwoller, M. H.

    2013-12-01

    In the decade that preceded the new millennium, seismologists on several continents dared to think big: envisioning, designing, and then building seismic arrays of unprecedented quality, resolution, and scale. In the US, their vision became USArray: thousands of broadband seismometers spanning the continent, professionally deployed, superbly maintained, with data ready in realtime quite literally at one's fingertips. For many young (and not so young) seismologists the building of USArray, particularly the Transportable Array, marks the crucial event of their scientific careers. An important part of the legacy of USArray will be an improved understanding of the architecture of the North American continent - one of its seminal motivations. A more dimly perceived motivation, but perhaps more important aspect of its legacy, will be its impact on the discipline of seismology. The impacts are profound and broad, but I will speak only about one small area: the transformation of array-based surface wave seismology. Innovations stimulated by USArray include the creation of ambient noise tomography, the reformulation of the tomographic inverse problem in terms of local differential filters applied to observed travel time and amplitude fields, the extrication of subtle signals that reveal robust and independent information about anisotropy in the crust and mantle, and the joint interpretation with other kinds of geophysical data. Interpreting the results of these innovations in a Bayesian framework helps to define another legacy of USArray, the replacement of single models with statistical distributions of model variables that can be assimilated by researchers in other fields or by seismologists in the future. As we transition to considering the scientific legacy of USArray, it is important to remember Beno Gutenberg's faith in the power of data to resolve scientific dispute. As he stated in the next to last sentence of his remarkable book Physics of the Earth's Interior

  3. Methane over the North American Continent - INTEX-NA, Summer 2004

    NASA Astrophysics Data System (ADS)

    Karen, B.; Blake, D.; Meinardi, S.; Blake, N.; Sachse, G.; Slate, T.

    2005-12-01

    During July and August of 2004, the INTEX-NA mission was flown over the North American continent as a part of the integrated ICARTT campaign. Its primary focus was to examine the intercontinental transport and transformation of chemically and radiatively important trace gases and aerosols across the region. As a part of the mission, methane (CH4) was sampled using both canisters and a fast response tunable diode laser, the DACOM instrument. Agreement between the two techniques was excellent. Sources of methane are both natural (wetlands, wildfires) and anthropogenically controlled (landfills, ruminants, petroleum production and use, coal mining). Although natural biogenic emissions would be expected to be near seasonal maximums, the majority of North American wetlands are located in Canada and Alaska, and were difficult to isolate during the mission. Overall distributions were well correlated with C2Cl4, a tracer of industrial and urban activity, and reflect the widespread impact of anthropogenic emissions. As expected for a gas with surface continental sources, variability was greatest in the near-surface atmosphere and decreased with increasing altitude and distance from the continent. Summer convective activity over the region resulted in elevated concentrations measured at altitudes above 6 km. Enhanced levels with distinctive trace gas signatures were observed for a variety of sources, including petroleum mining and distribution, coal mining, Canadian wildfires, and aged Asian plumes advected across the Pacific. Several flights during the mission were flown along the U.S. east coast to sample air masses transported off the continent to the Atlantic. In the near-surface over the ocean, clean boundary layer air with mixing ratios comparable to background CMDL levels at this time were encountered. At altitudes above about 4 km, CH4 was enhanced by roughly 20-50 ppb.

  4. High-Resolution Genotyping of Campylobacter upsaliensis Strains Originating from Three Continents

    PubMed Central

    Lentzsch, P.; Rieksneuwöhner, B.; Wieler, L. H.; Hotzel, H.; Moser, I.

    2004-01-01

    Ninety-six Campylobacter upsaliensis strains that originated from Australia, Canada, and Europe (Germany) and that were isolated from humans, dogs, and cats were serotyped for their heat-stable surface antigens. All of them were genotyped by enterobacterial repetitive intergenic consensus sequence PCR (ERIC-PCR) profiling, and 83 strains were genotyped by macrorestriction analysis with the endonuclease XhoI. Eighty-four percent of the strains belonged to five different serotypes (serotypes OI, OII, OIII, OIV, and OVI), with the proportions of strains in each serotype being comparable among the groups of strains from all three continents. Two serotypes, OIII and OIV, were prevalent at rates of 35 to 40%. Serotypes OI, OII, and OVI were detected at rates of 1.5 to 15%. Between 10 and 17.7% of the strains did not react with the available antisera. Analysis of the ERIC-PCR profiles revealed two distinct genotypic clusters, which represented the German and the non-European strains, respectively. XhoI macrorestriction yielded two genotypic clusters; one of them contained 80.2% of the German strains and 34.6% of the non-European strains, and the second cluster consisted of 65.4% of the non-European strains and 19.8% of the German strains. Fourteen strains from all three continents were analyzed for their 16S rRNA gene sequences. Only two minor variations were detected in four of the strains. In conclusion, C. upsaliensis has undergone diverging processes of genome arrangement on different continents during evolution without segregating into different subspecies. PMID:15297481

  5. Moisture transport by Atlantic tropical cyclones onto the North American continent

    NASA Astrophysics Data System (ADS)

    Xu, Guangzhi; Osborn, Timothy J.; Matthews, Adrian J.

    2016-07-01

    Tropical Cyclones (TCs) are an important source of freshwater for the North American continent. Many studies have tried to estimate this contribution by identifying TC-induced precipitation events, but few have explicitly diagnosed the moisture fluxes across continental boundaries. We design a set of attribution schemes to isolate the column-integrated moisture fluxes that are directly associated with TCs and to quantify the flux onto the North American Continent due to TCs. Averaged over the 2004-2012 hurricane seasons and integrated over the western, southern and eastern coasts of North America, the seven schemes attribute 7-18 % (mean 14 % ) of total net onshore flux to Atlantic TCs. A reduced contribution of 10 % (range 9-11 % ) was found for the 1980-2003 period, though only two schemes could be applied to this earlier period. Over the whole 1980-2012 period, a further 8 % (range 6-9 % from two schemes) was attributed to East Pacific TCs, resulting in a total TC contribution of 19 % (range 17-22 % ) to the ocean-to-land moisture transport onto the North American continent between May and November. Analysis of the attribution uncertainties suggests that incorporating details of individual TC size and shape adds limited value to a fixed radius approach and TC positional errors in the ERA-Interim reanalysis do not affect the results significantly, but biases in peak wind speeds and TC sizes may lead to underestimates of moisture transport. The interannual variability does not appear to be strongly related to the El Niño-Southern Oscillation phenomenon.

  6. Predictors of Urinary Morbidity in Cs-131 Prostate Brachytherapy Implants

    SciTech Connect

    Smith, Ryan P.; Jones, Heather A.; Beriwal, Sushil; Gokhale, Abhay; Benoit, Ronald

    2011-11-01

    Purpose: Cesium-131 is a newer radioisotope being used in prostate brachytherapy (PB). This study was conducted to determine the predictors of urinary morbidity with Cs-131 PB. Methods and Materials: A cohort of 159 patients underwent PB with Cs-131 at our institution and were followed by using Expanded Prostate Cancer Index Composite (EPIC) surveys to determine urinary morbidity over time. EPIC scores were obtained preoperatively and postoperatively at 2 and 4 weeks, and 3 and 6 months. Different factors were evaluated to determine their individual effect on urinary morbidity, including patient characteristics, disease characteristics, treatment, and dosimetry. Multivariate analysis of covariance was carried out to identify baseline determinants affecting urinary morbidity. Factors contributing to the need for postoperative catheterization were also studied and reported. Results: At 2 weeks, patient age, dose to 90% of the organ (D90), bladder neck maximum dose (D{sub max}), and external beam radiation therapy (EBRT) predicted for worse function. At 4 weeks, age and EBRT continued to predict for worse function. At the 3-month mark, better preoperative urinary function, preoperative alpha blockers, bladder neck D{sub max}, and EBRT predicted for worse urinary morbidity. At 6 months, better preoperative urinary function, preoperative alpha blockers, bladder neck D{sub max}, and EBRT were predictive of increased urinary problems. High bladder neck D{sub max} and poor preoperative urinary function predicted for the need for catheterization. Conclusions: The use of EBRT plus Cs-131 PB predicts for worse urinary toxicity at all time points studied. Patients should be cautioned about this. Age was a consistent predictor of worsened morbidity immediately following Cs-131 PB, while bladder D{sub max} was the only consistent dosimetric predictor. Paradoxically, patients with better preoperative urinary function had worse urinary morbidity at 3 and 6 months, consistent with

  7. Uterine Fibroid (Leiomyoma) with Acute Urinary Retention: A Case Series

    PubMed Central

    Jena, Saubhagya Kumar; Naik, Monalisha; Ray, Lipsa; Behera, Satyanarayan

    2016-01-01

    Uterine leiomyomas are an extremely rare cause of acute urinary retention in women. The delay in diagnosing uterine leiomyomas presenting with acute urinary retention further complicates the management. The rarity of the condition makes it difficult to plan either prospective or retrospective trials. Hence, most of the evidence comes from case reports or series. We report a case series of acute urinary retention in women with uterine leiomyomas and discuss the pathophysiology, diagnosis and management options. PMID:27190903

  8. Scale interaction between the MJO and the diurnal cycle of precipitation over the Maritime Continent

    NASA Astrophysics Data System (ADS)

    Peatman, Simon; Matthews, Adrian; Stevens, David

    2013-04-01

    The Maritime Continent is a highly-populated region of many islands and shallow oceans, located in the oceanic warm pool, between the Indian and Pacific Oceans. A strong diurnal cycle of precipitation exists due to onshore breezes causing strong convergence of moist air - enhanced by topographic effects - over the land during the day time, peaking during afternoon-evening. The respective diurnal cycle over the ocean is far weaker and does not peak until early in the morning. On intra-seasonal time-scales the greatest source of variability in the tropics is the Madden-Julian Oscillation (MJO). The convectively active part of the MJO propagates slowly (~5 ms-1) eastward through the warm pool from the Indian Ocean to the western Pacific, followed by the convectively suppressed part. The complex topography of the Maritime Continent means the exact nature of the propagation through this region is unclear. Model simulations of the MJO are often poor over the region, leading to errors in latent heat release and, subsequently, global errors in medium-range weather prediction and climate simulation. Using 14 northern hemisphere winters of high-resolution satellite data it is shown that, over regions where the diurnal cycle is strong, more than 80% of the variance in precipitation during an MJO cycle is accounted for by changes in the amplitude of the diurnal cycle. A canonical view of the MJO is of smooth eastward progression of a large-scale precipitation envelope over the warm pool. However, by computing "MJO harmonics" it is shown that the leading edge of the precipitation envelope advances over the islands of the Maritime Continent approximately 6 days or 2000 km ahead of the main body. This behaviour can be accommodated within existing theories of MJO propagation. When the active convective MJO envelope is over the eastern Indian Ocean, frictional moisture convergence and topographic blocking in the easterlies of the equatorial Kelvin wave response supply moisture to

  9. Gravity domains and assembly of the North American continent by collisional tectonics

    NASA Technical Reports Server (NTRS)

    Thomas, M. D.; Grieve, R. A. F.; Sharpton, V. L.

    1988-01-01

    A gravity trend map of North America, based on a horizontal Bouguer gravity gradient map produced from gravity data for Canada and the conterminous United States, is presented and used to define a continental mosaic of gravity trend domains akin to structural domains. Contrasting trend characteristics at gravity domain boundaries support the concept of outward growth of the continent primarily by accretionary tectonics. Gravity patterns, however, indicate a different style of tectonics dominated in the development of now-buried Proterozoic orogenic belts in the south-central United States, supporting a view that these belts formed along the leading edge of a southward-migrating Proterozoic continental margin.

  10. The CONTIN algorithm and its application to determine the size distribution of microgel suspensions

    SciTech Connect

    Scotti, A.; Liu, W.; Hyatt, J. S.; Fernandez-Nieves, A.; Herman, E. S.; Lyon, L. A.; Choi, H. S.; Kim, J. W.; Gasser, U.

    2015-06-21

    We review a powerful regularization method, known as CONTIN, for obtaining the size distribution of colloidal suspensions from dynamic light scattering data. We show that together with the so-called L-curve criterion for selecting the optimal regularization parameter, the method correctly describes the average size and size distribution of microgel suspensions independently characterized using small-angle neutron scattering. In contrast, we find that when using the default regularization process, where the regularizer is selected via the “probability to reject” method, the results are not as satisfactory.

  11. Continental scale shear wave splitting analysis: Investigation of seismic anisotropy underneath the Australian continent

    NASA Astrophysics Data System (ADS)

    Heintz, Maggy; Kennett, Brian L. N.

    2005-07-01

    The structure of the upper mantle beneath the Australian continent is investigated using teleseismic shear wave splitting to extract seismic anisotropy. Measurements have been performed on data recorded at 190 sites with portable broadband seismic recorders, spanning almost the entire surface of the continent since 1992. The average time span of the various deployments, primarily designed for surface wave tomography, is 6 months, which is rather limited for shear wave splitting analysis. However, the data set provides a full continental scale survey using the reasonably favourable distribution of seismicity to Australia. Seismic anisotropy has the potential to provide insights into the lithospheric structure and the possible mechanical coupling between the crust and the upper mantle, but prior results for Australia have indicated relatively small levels of splitting and a complex pattern. These results are confirmed with our new and far more extensive measurements across the whole continent. The pattern of seismic anisotropy from shear wave splitting beneath Australia is rather complex and is not correlated with the almost north-south absolute plate motion (APM) from recent models. Deviation of the asthenospheric mantle flow around the lithospheric roots associated with the extensive Archaean and Proterozoic zones of central and western Australia could be occurring, and so mantle flow-related anisotropy cannot be completely ruled out. Despite the limited geological outcrop, especially in Phanerozoic eastern Australia, that is almost entirely covered by sedimentary basins, some relationships can be highlighted between the orientation of the polarization plane of the fast S-waves and structural trends along, for instance, the Halls Creek orogen bordering the eastern edge of the Kimberley basin or along the New England and Lachlan fold belts in the southeastern part of the continent. Such relationships might account for anisotropy frozen in the lithosphere during post

  12. Homogeneous magnitude system of the Eurasian continent: S and L waves

    NASA Astrophysics Data System (ADS)

    Christoskov, L.; Kondorskaya, N. V.; Vanek, J.

    1983-07-01

    A research project was started by the Commission of Academies of Socialist Countries on Planetary Geophysics (KAPG) to establish a system of seismic reference stations of the Eurasian continent for determining reliable earthquake magnitudes. This system was called the Homogeneous Magnitude System (HMS), and seismologist of 13 institutions from Bulgaria, Czechoslovakia, German Democratic Republic, Poland, and the U.S.S.R. participated. The project was sponsored by the Commission on Practice of the International Association of Seismology and Physics of the Earth's Interior, which created a special working group for homogeneous magnitude system within its Subcommission on Magnitude.

  13. Magnetotelluric Imaging of an Arc-Continent Collision Beneath Central Taiwan

    NASA Astrophysics Data System (ADS)

    Bertrand, E. A.; Unsworth, M. J.; Chiang, C.; Chen, C.; Turkoglu, E.; Hsu, H.; Hill, G. J.

    2007-12-01

    Arc-continent collisions are a fundamental part of the plate tectonic cycle and play an important role in mountain building and the growth of continents. Studying this process in ancient orogens is often hindered by tectonic overprinting and poorly resolved synorogenic plate kinematics and tectonic settings. The Taiwan arc-continent collision between the Luzon arc and the Eurasian continental margin is one of the most active arc-continent collisions in the world. The current plate motions and surface geology are well understood, making Taiwan an ideal location for geophysical investigations of this important tectonic process. The Taiwan Integrated Geodynamical Research (TAIGER) project was initiated in 2004 to image the lithospheric structure beneath Taiwan. The project includes the acquisition of both active and passive seismic data plus detailed magnetotellurics (MT) surveys. MT is a passive geophysical technique which records time variations of natural electromagnetic fields at the surface of the Earth and can determine the subsurface resistivity. This parameter can be used to constrain lithospheric composition and strength. Over the fall of 2006 and spring of 2007, 82 long-period MT soundings were acquired in Taiwan. The fieldwork was accomplished by collaboration between the University of Alberta and National Central University of Taiwan. In fall 2007, collection of additional broadband MT will complement these data. The long-period data were processed using robust techniques and remotely referenced with a station on the PengHu islands (~100km from the nearest site) to reduce the influence of cultural noise. The conductive Taiwan strait separating PengHu from the mainland acts as an effective attenuator of cultural EM fields. Two closely spaced parallel transects across central Taiwan are formed by 46 of these stations with a nominal spacing of 5km. Dimensionality analysis of these transects using the McNeice-Jones tensor decomposition algorithm reveal local 3

  14. The role of the Malone antegrade continence enema (MACE) in the management of myelodeysplatic patients.

    PubMed

    Zamilpa, Ismael; Koyle, Martin A

    2009-01-01

    Myelodysplasia is a congenital neural tube defect commonly affecting bladder and bowel function. Management of fecal incontinence is paramount to achieve patient independence and self-confidence. When conservative measures fail alternative invasive methods can be successfully applied. The Malone antegrade continence enema (MACE) was introduced in the late 1980's to treat spina bifida patients with fecal incontinence refractory to conservative management. Since its introduction, multiple successful variations have been described and its role has expanded. Indeed, the MACE has revolutionized the care of myelodysplastic patients, their bowel function, and ultimately their self image. PMID:21791795

  15. Lithospheric strength across the ocean-continent transition in the NW of the Iberian Peninsula

    NASA Astrophysics Data System (ADS)

    Martín-Velázquez, Silvia; Martín-González, Fidel

    2014-05-01

    The main objective of this work is to investigate the relation between the strength of the lithosphere and the observed pattern of seismicity across the ocean-continent transition in the NW margin of the Iberian Peninsula. The seismicity is diffuse in this intraplate area, far from the seismically active margin of the plate: the Eurasia-African plate boundary, where convergence occurs at a rate of 4-5mm/year. The earthquake epicentres are mainly limited to an E-W trending zone (onshore seismicity is more abundant than offshore), and most earthquakes occur at depths less than 30 km, however, offshore depths are up to 150 km). Moreover, one of the problems to unravel in this area is that the seismotectonic interpretations of the anomalous seismicity in the NW peninsular are contradictory. The temperature and strength profiles have been modelled in three domains along the non-volcanic rifted West Iberian Margin: 1) the oceanic lithosphere of the Iberian Abyssal Plain, 2) the oceanic lithosphere near the ocean-continent transition of the Galicia Bank, and 3) the continental lithosphere of the NW Iberian Massif. The average bathymetry and topography have been used to fit the thermal structures of the three types of lithospheres, given that the heat flow and heat production values show a varied range. The geotherms, together with the brittle and ductile rheological laws, have been used to calculate the strength envelopes in different stress regimes (compression, shear and tensile). The continental lithosphere-asthenosphere boundary is located at 123 km and several brittle-ductile transitions appear in the crust and the mantle. However, the oceanic lithospheres are thinner (110 km near the Galicia Bank and 87 km in the Iberian Abbysal Plain) and more simple (brittle behaviour in the crust and upper mantle). The earthquake distribution is best explained by lithospheres with dry compositions and shear or tensile stress regimes. These results are similar can be compared to

  16. Evaluating mid-Holocene precipitation over Australasia and the Maritime Continent in climate models

    NASA Astrophysics Data System (ADS)

    Ackerley, Duncan; Reeves, Jessica

    2015-04-01

    The Australasian INTIMATE (INTegration of Ice-core, Marine and Terrestrial records) initiative (INQUA project #0809) was undertaken to develop a consistent chronological assessment of the climate of the past 30000 years over Australia, New Zealand and the Maritime Continent. Work has continued as part of SHAPE initiative (INQUA project #1302), but there has currently been little use of this comprehensive resource for evaluating the available climate model data. Therefore, this work presents the initial assessment of model simulations of the mid-Holocene over the Australasian and Maritime Continents (taken from the Paleoclimate Modelling Intercomparison Project, PMIP) in relation to those available data. The mid-Holocene (6 ka) encompasses a period after sea level stabilisation (around 8-7.5 ka) and before the onset of strong ENSO-related variability (post 4 ka). There is some evidence of possibly drier conditions over northern Australia with increased coastal dune activity, along with slightly wetter conditions over Borneo and Papua New Guinea. Weakening of the Southern Hemisphere mid-latitude westerlies (relative to the early Holocene) is also likely to have occurred, as evidenced by drier conditions in Western Tasmania and Victoria. The modelled results from the mid-Holocene simulations indicate that conditions were approximately 1-6% drier over much of continental Australia than at present. There is also evidence of slightly wetter conditions (1-3%) over the northern tip of Australia and parts of Papua New Guinea and Borneo. The Southern Hemisphere westerlies in the mid-latitudes (around 50S) are also weaker by 1-2 m s-1 in the model simulations. There are also differences in the seasonal cycle of precipitation and circulation in these models in response to the changes in the orbital parameters in the mid-Holocene relative to present day. The precipitation in the early half of the monsoon season (October, November and December-OND) is typically 10% higher in the

  17. The Promotion and Marketing of OxyContin: Commercial Triumph, Public Health Tragedy

    PubMed Central

    2009-01-01

    I focus on issues surrounding the promotion and marketing of controlled drugs and their regulatory oversight. Compared with noncontrolled drugs, controlled drugs, with their potential for abuse and diversion, pose different public health risks when they are overpromoted and highly prescribed. An in-depth analysis of the promotion and marketing of OxyContin illustrates some of the associated issues. Modifications of the promotion and marketing of controlled drugs by the pharmaceutical industry and an enhanced capacity of the Food and Drug Administration to regulate and monitor such promotion can have a positive impact on the public health. PMID:18799767

  18. Environmental factors of urinary stones mineralogy, Khouzestan Province, Iran

    NASA Astrophysics Data System (ADS)

    Zarasvandi, Alireza; Carranza, E. J. M.; Heidari, Majid; Mousapour, Esmaeil

    2014-09-01

    Urinary stone diseases in the Khouzestan province (southwest Iran) are growing in number and it required extensive studies on various factors of the urinary stones formation in this province. In this research, in addition to distribution of urinary stones in different areas of province, the role of bioenvironmental (race), climate (temperature) and geology (water hardness) factors in urinary stones diversity has been studied. Mineralogical studied using X-ray diffraction showed that uricite and whewellite are the most frequency mineral phases. Struvite, Cystine, hydroxyapatite, weddellite, and Niahite can be observed as urinary stones, too. These data show that the urinary stone in the Khouzestan province can divide into 7 groups: calcium oxalate, phosphate, calcium oxalate/ phosphate, Urate, Urate/calcium, Urate/calcium oxalate/phosphate, Cystine/calcium oxalate. Also the results which attained from temperature effect investigation on the mineralogy of urinary stones, confirms that from Mediterranean sub-humid climates (northeastern area) to warm and dry climates (south and southwest area), calcium oxalate stones and urate stones concentration decreases and increases respectively. Comparison of data related to the drinking water hardness and mineralogy of urinary stones in different areas of Khouzestan province show that the combination of drinking water (especially water hardness) affects mineralogy of urinary stones in some areas (such az Ramhormoz and Hendijan). Finally, the data suggest that frequency of calcium oxalate in women is more than that of men. Moreover, there is direct relationship between the age (>45 years) and the increase in frequency of Urate minerals.

  19. The role of urinary peptidomics in kidney disease research.

    PubMed

    Klein, Julie; Bascands, Jean-Loup; Mischak, Harald; Schanstra, Joost P

    2016-03-01

    Urinary peptidomics focuses on endogenous urinary peptide content. Many studies now show the usefulness of this approach for the discovery and validation of biomarkers in kidney diseases that are as varied as chronic kidney disease, acute kidney injury, congenital anomalies of the kidney and the urinary tract, and polycystic kidney disease. Most studies focus on chronic kidney disease and demonstrate that urinary peptidome analysis can substantially contribute to early detection and stratification of patients with chronic kidney disease. A number of multicenter studies are ongoing that aim further validation in a clinical setting and broaden the applicability of urinary peptides. The association of urinary peptides with kidney disease also starts to deliver information on the pathophysiology of kidney disease with emphasis on extracellular matrix remodeling. Bioinformatic peptide centric tools have been developed that allow to model the changes in protease activity involved in kidney disease, based on the urinary peptidome content. A novel application of urinary peptidome analysis is the back-translation of results obtained in humans to animals for animal model validation and improvement of readout in these preclinical models. In conclusion, urinary peptidomics not only contribute to detection and stratification of kidney disease in the clinic, but might also create a new impulse in drug discovery through better insight in the pathophysiology of disease and optimized translatability of animal models. PMID:26880450

  20. A biomechanical model to assess the contribution of pelvic musculature weakness to the development of stress urinary incontinence.

    PubMed

    Yip, Clare; Kwok, Ezra; Sassani, Farrokh; Jackson, Roy; Cundiff, Geoffrey

    2014-01-01

    A biomechanical model of the female pelvic support system was developed to explore the contribution of pelvic floor muscle defect to the development of stress urinary incontinence (SUI). From a pool of 135 patients, clinical data of 26 patients with pelvic muscular defect were used in modelling. The model was employed to estimate the parameters that describe the stiffness properties of the vaginal wall and ligament tissues for individual patients. The parameters were then implemented into the model to evaluate for each patient the impact of pelvic muscular defect on the vaginal apex support and the bladder neck support, a factor that relates to the onset of SUI. For the modelling analysis, the compromise of pelvic muscular support was demonstrated to contribute to vaginal apex prolapse and bladder neck prolapse, a condition commonly seen in SUI patients, while simulated conditions of restored muscular support were shown to help re-establish both vaginal apex and bladder neck supports. The findings illustrate the significance of pelvic muscle strength to vaginal support and urinary continence; therefore, the clinical recommendation of pelvic muscle strengthening, such as Kegel exercises, has been shown to be an effective treatment for patients with SUI symptoms. PMID:22494663

  1. Organic geochemistry of Mid-Continent middle and Late Ordovician oils

    SciTech Connect

    Longman, M.W.; Palmer, S.E.

    1987-08-01

    Ordovician oils in Mohawkian and Cincinnatian reservoirs of the US Mid-Continent retain the biochemical imprint of Middle and Upper Ordovician oceanic life before the evolution of land plants and most vertebrates. Thus, these oils have some geochemical features that distinguish them from younger oils. These features include (1) a predominance of n-C/sub 15/, n-C/sub 17/, and n-C/sub 19/ alkanes in the saturated hydrocarbon fraction, (2) relatively low amounts of longer chain n-alkanes, (3) low amounts of chlorophyll-derived isoprenoids, such as pristane and phytane, and (4) abundant C/sub 29/ sterane relative to C/sub 27/ with rearranged forms (diasteranes) predominant over normal steranes. Ordovician oils also generally contain little sulfur and have a somewhat variable light stable carbon isotopic composition with delta/sup 13/C/sub sat/ and delta/sup 13/C/sub aro/ values of -28 to -31 per thousand (PDB), but these features are typical of many marine oils. The unusual chemistry of these Ordovician oils supports the interpretation of Reed, Illich, and Horsfield (1986) that prokaryotic organisms provided the organic matter for most Ordovician oils. Although their claim for Gloeocapsamorpha (a problematic unicellular prokaryote, possibly a blue-green alga or an unusually large bacterium) cannot be proven from oil chemistry alone, knowing that indigenous Mid-Continent Ordovician oils were derived from prokaryotic organisms may aid in future exploration for these reservoirs. 7 figures, 3 tables.

  2. Polychlorinated terphenyl patterns and levels in selected marine mammals and a river fish from different continents.

    PubMed

    Rosenfelder, Natalie; Vetter, Walter

    2014-01-01

    Polychlorinated terphenyls (PCTs) are a class of persistent organic pollutants which have been used from the 1920s to the 1980s for similar purposes as polychlorinated biphenyls (PCBs). Comparably little data was available on the PCT distribution in the environment mainly due to analytical difficulties in their determination. By means of a calculation algorithm recently developed we now studied the PCT pattern in individual marine mammal samples and one fish sample from different continents. Altogether, 97 PCTs were detected in eight samples and twelve to 66 tetra- to nonachloroterphenyl (tetra- to nonaCT) congeners were detected in individual samples. PCTs were present in all marine mammal samples which originated from four continents, but the PCT pattern was varied. TetraCTs were dominant in the sample from Africa, Australia, Spitsbergen (European Arctic) and in a sample from the Baltic Sea, heptaCTs in samples from the North Sea and octaCTs in a sample from Iceland. The abundance of sumPCTs relative to PCB 153, estimated from the GC/ECNI-MS response corrected for the degree of chlorination, ranged from 0.9 to 8.8%, corresponding with ~0.22-2.2% of the total PCB content. The highest PCT level detected was 980 mg/kg lipid in a harbour seal from the North Sea, Germany. The results from this study indicated that samples from certain areas, e.g. the North Sea may still be polluted with PCTs. PMID:24211498

  3. Tectonic evolution of Late Cenozoic arc-continent collision in Taiwan

    SciTech Connect

    Teng, L.S. )

    1990-06-01

    The island of Taiwan is an active orogen formed by the collision between the Luzon arc and the Asian continent. The kinematic progression of the arc-continent collision can be reconstructed by superimposing the restored paleopositions of Luzon arc upon the precollisional Asian continental margin. The geological history of the collision can be interpreted from the rock records of the mountain ranges of Taiwan. By incorporating geological information into plate kinematics, the collision can be attributed to the northwesterly impingement of the Luzon arc upon the continental margin in the last 12 million years. During the initial stage of the collision, some of the continental materials might have been metamorphosed in the deep subduction zone, but no distinct effects can be perceived in the sedimentary record. In the Mio-Pliocene time (about 5 Ma), the accretionary wedge grew large enough to become a sediment source for the Luzon forearc basin and to induce foreland subsidence on the continental margin. In the early late Pliocene (about 3 Ma), drastic collision caused rapid uplift of the collision orogen that shed voluminous orogenic sediments into the forearc and foreland basins. Continued collision progressively accreted the forearc and foreland basins to the collision orogen from north to south to the present configuration.

  4. Implications of the Projected Future Climate on Water Resources in the Indian Sub-continent Basins

    NASA Astrophysics Data System (ADS)

    Shah, H. L.; Mishra, V.

    2014-12-01

    Sustainability of water resources is vital for agricultural and socio-economic development in India. In the recent few decades, India has been witnessing erratic nature of the Indian summer monsoon, which accounts for about 80% of the total annual rainfall. While there is a large uncertainty in the precipitation projections during the summer monsoon from the regional and global climate models, we need to understand sensitivity of water resources in the Indian sub-continental river basins under the projected future climate. This is particularly important as the Indian sub-continent is one of the most populated regions of the world. We evaluated changes in water budget in the 18 Indian sub-continental basins under the projected future climate using the Variable Infiltration Capacity (VIC) model. The VIC model was calibrated and evaluated using the observed streamflow as well as satellite derived evapotranspiration and soil moisture. After the successful calibration and evaluation, we performed a sensitivity analysis for the water balance variables. Finally, we used downscaled and bias corrected climate forcings to develop scenarios of changes in water balance under the future climate. Despite the intermodal variation, Indian basins are projected to experience wetter and warmer climate in future. Results indicate positive changes in evapotranspiration and runoff under the projected future climate; however, increases in total runoff are projected to be significant in most of the basins in the sub-continent.

  5. American Exceptionalism: Population Trends and Flight Initiation Distances in Birds from Three Continents

    PubMed Central

    Møller, Anders Pape; Samia, Diogo S. M.; Weston, Mike A.; Guay, Patrick-Jean; Blumstein, Daniel T.

    2014-01-01

    Background All organisms may be affected by humans' increasing impact on Earth, but there are many potential drivers of population trends and the relative importance of each remains largely unknown. The causes of spatial patterns in population trends and their relationship with animal responses to human proximity are even less known. Methodology/Principal Finding We investigated the relationship between population trends of 193 species of bird in North America, Australia and Europe and flight initiation distance (FID); the distance at which birds take flight when approached by a human. While there is an expected negative relationship between population trend and FID in Australia and Europe, we found the inverse relationship for North American birds; thus FID cannot be used as a universal predictor of vulnerability of birds. However, the analysis of the joint explanatory ability of multiple drivers (farmland breeding habitat, pole-most breeding latitude, migratory habit, FID) effects on population status replicated previously reported strong effects of farmland breeding habitat (an effect apparently driven mostly by European birds), as well as strong effects of FID, body size, migratory habit and continent. Farmland birds are generally declining. Conclusions/Significance Flight initiation distance is related to population trends in a way that differs among continents opening new research possibilities concerning the causes of geographic differences in patterns of anti-predator behavior. PMID:25226165

  6. Continent-wide survey reveals massive decline in African savannah elephants

    PubMed Central

    Schlossberg, Scott; Griffin, Curtice R.; Bouché, Philippe J.C.; Djene, Sintayehu W.; Elkan, Paul W.; Ferreira, Sam; Grossman, Falk; Kohi, Edward Mtarima; Landen, Kelly; Omondi, Patrick; Peltier, Alexis; Selier, S.A. Jeanetta; Sutcliffe, Robert

    2016-01-01

    African elephants (Loxodonta africana) are imperiled by poaching and habitat loss. Despite global attention to the plight of elephants, their population sizes and trends are uncertain or unknown over much of Africa. To conserve this iconic species, conservationists need timely, accurate data on elephant populations. Here, we report the results of the Great Elephant Census (GEC), the first continent-wide, standardized survey of African savannah elephants. We also provide the first quantitative model of elephant population trends across Africa. We estimated a population of 352,271 savannah elephants on study sites in 18 countries, representing approximately 93% of all savannah elephants in those countries. Elephant populations in survey areas with historical data decreased by an estimated 144,000 from 2007 to 2014, and populations are currently shrinking by 8% per year continent-wide, primarily due to poaching. Though 84% of elephants occurred in protected areas, many protected areas had carcass ratios that indicated high levels of elephant mortality. Results of the GEC show the necessity of action to end the African elephants’ downward trajectory by preventing poaching and protecting habitat.

  7. Repeated arc-continent collision as a key mechanism for continental growth

    NASA Astrophysics Data System (ADS)

    Aitchison, J.; Buckman, S.

    2011-12-01

    Prevailing 'consensus' models for the Phanerozoic development of eastern Australia invoke a retreating accretionary orogen model in which slab retreat results in development of offshore island arcs in front of marginal basins. Periodically these basins close and the arcs are retro-thrust back onto the continental margin. Implicit in this model is the notion that all elements develop in an upper plate location upon the accretionary margin and that west-dipping subduction beneath eastern Gondwana was a long-lived phenomenon. We suggest this concept is flawed and instead propose a new testable hypothesis that eastern Australia grew through a series of arc-continent collisions in which east-directed subduction beneath intra-oceanic island arcs led to their collision with eastern Australia. At least four such arc-continent collisions are posited in mid-Cambrian (Mt Stavely arc), Late Ordovician (Macquarie arc), mid-Devonian (Gamilaroi arc) and Late Permian (Gympie arc) times. This process effectively transferred new material to the continental crust resulting in net growth. When collisions were followed by subduction flip episodes of west-directed subduction beneath the continental margin ensued giving rise to the S- and I-type granites for which eastern Australia is famous.

  8. Paleokarst and fracture overprints in Mid-Continent carbonates in evaluation of horizontal drilling potential

    SciTech Connect

    Fritz, R.D.; Shelton, J.W. ); Esteban, M. ); Wilson, J.L.

    1991-03-01

    The Mid-Continent region, especially in Oklahoma and Arkansas, contains thick Paleozoic carbonate sections that are dolomitic and karstic in character. These sections commonly exhibit strong structural overprints, including intense fracturing, due primarily to Pennsylvanian orogenies. Because of their rather wide association with source rocks, these carbonates are thought to represent good potential targets for horizontal drilling. The Cambro-Ordovician Arbuckle Group, the Ordovician Viola Group, the Siluro-Devonian Hunton Group, and the Mississippian Limestone all contain zones that are locally productive. These stratigraphic units are either uniformly tight or they are heterogeneous with complex porosity profiles. In karst terranes both types commonly occur together; both require fracturing to increase porosity and permeability. Both youthful and mature stages of paleokarst are observed in the Arbuckle Group; the best porosity is developed in the youthful stage. These stages can develop microporous, planar porous, or macroporous types of reservoir geometry. All of these may be heterogeneous in nature, requiring fractures to interconnect porous intervals. Horizontal drilling is yet to be proved as a reliable method for increasing production efficiency in Mid-Continent carbonates. An evaluation of diagenetic history, especially karst processes, along with local and regional structural settings, may provide a key for improved understanding of the horizontal drilling potential in these carbonates.

  9. Phylogeography of the Microcoleus vaginatus (Cyanobacteria) from Three Continents – A Spatial and Temporal Characterization

    PubMed Central

    Dvořák, Petr; Hašler, Petr; Poulíčková, Aloisie

    2012-01-01

    It has long been assumed that cyanobacteria have, as with other free-living microorganisms, a ubiquitous occurrence. Neither the geographical dispersal barriers nor allopatric speciation has been taken into account. We endeavoured to examine the spatial and temporal patterns of global distribution within populations of the cyanobacterium Microcoleus vaginatus, originated from three continents, and to evaluate the role of dispersal barriers in the evolution of free-living cyanobacteria. Complex phylogeographical approach was applied to assess the dispersal and evolutionary patterns in the cyanobacterium Microcoleus vaginatus (Oscillatoriales). We compared the 16S rRNA and 16S-23S ITS sequences of strains which had originated from three continents (North America, Europe, and Asia). The spatial distribution was investigated using a phylogenetic tree, network, as well as principal coordinate analysis (PCoA). A temporal characterization was inferred using molecular clocks, calibrated from fossil DNA. Data analysis revealed broad genetic diversity within M. vaginatus. Based on the phylogenetic tree, network, and PCoA analysis, the strains isolated in Europe were spatially separated from those which originated from Asia and North America. A chronogram showed a temporal limitation of dispersal barriers on the continental scale. Dispersal barriers and allopatric speciation had an important role in the evolution of M. vaginatus. However, these dispersal barriers did not have a permanent character; therefore, the genetic flow among populations on a continental scale was only temporarily present. Furthermore, M. vaginatus is a recently evolved species, which has been going through substantial evolutionary changes. PMID:22761955

  10. Usefulness of Anorectal Manometry for Diagnosing Continence Problems After a Low Anterior Resection

    PubMed Central

    Samalavicius, Narimantas E.

    2016-01-01

    Purpose For several decades, the low anterior resection (LAR) with total mesorectal excision (TME) has been the gold standard for treating patients with rectal cancer. Up to 90% of patients undergoing sphincter-preserving surgery will have changes in bowel habits, so-called 'anterior resection syndrome.' This study examined patients' continence after a LAR for the treatment of rectal cancer. Methods This prospective study was performed between September 2014 and August 2015 at the National Cancer Institute and included 30 patients who underwent anorectal manometry preoperatively and at 3 and 4 months after a LAR, but 10 were excluded from further evaluation for various reasons. Wexner score was recorded preoperatively and 4 months after LAR (1 month after ileostomy repair). Results Postoperatively, 70% of patients complained of some degree of soiling (incontinence to liquid stool), and 30% experienced urgent defecation. Four months after surgery, these symptoms had somewhat abated. The anal resting pressure and the maximum squeezing pressure did not change significantly. Rectal capacity and compliance were reduced in all patients. The majority of patients demonstrated manometric anorectal changes and clinical anorectal function disorders during the first 4 months after surgery. The Wexner scores and the manometric findings showed no correlation. Conclusion Many patients undergoing a LAR with TME for the treatment of rectal cancer experience some degree of incontinence postoperatively. Anorectal manometry may be used as an additional tool for evaluating problems with continence after a LAR. No correlation between the Wexner score and the manometric findings was observed. PMID:27437391

  11. Comparing determinants of alien bird impacts across two continents: implications for risk assessment and management

    PubMed Central

    Evans, Thomas; Kumschick, Sabrina; Dyer, Ellie; Blackburn, Tim

    2014-01-01

    Invasive alien species can have serious adverse impacts on both the environment and the economy. Being able to predict the impacts of an alien species could assist in preventing or reducing these impacts. This study aimed to establish whether there are any life history traits consistently correlated with the impacts of alien birds across two continents, Europe and Australia, as a first step toward identifying life history traits that may have the potential to be adopted as predictors of alien bird impacts. A recently established impact scoring system was used in combination with a literature review to allocate impact scores to alien bird species with self-sustaining populations in Australia. These scores were then tested for correlation with a series of life history traits. The results were compared to data from a previous study in Europe, undertaken using the same methodology, in order to establish whether there are any life history traits consistently correlated with impact across both continents. Habitat generalism was the only life history trait found to be consistently correlated with impact in both Europe and Australia. This trait shows promise as a potential predictor of alien bird impacts. The results support the findings of previous studies in this field, and could be used to inform decisions regarding the prevention and management of future invasions. PMID:25165531

  12. Onset of oxidative weathering of continents recorded in the geochemistry of ancient glacial diamictites

    NASA Astrophysics Data System (ADS)

    Gaschnig, Richard M.; Rudnick, Roberta L.; McDonough, William F.; Kaufman, Alan J.; Hu, Zhaochu; Gao, Shan

    2014-12-01

    Glacial diamictites deposited in the Mesoarchean, Paleoproterozoic, Neoproterozoic, and Paleozoic eras record temporal variations in their average compositions that reflect the changing composition of the upper continental crust (UCC). Twenty six of the 27 units studied show elevated chemical index of alternation (CIA) and low Sr abundances, regardless of their age, documenting pervasive weathering of the average UCC. Lower abundances of transition metals reflect a shift towards more felsic crustal compositions after the Archean. Superimposed on this chemical difference is the signal of the rise of oxidative weathering of the continents, recorded by changes in the absolute and relative abundances of the redox sensitive elements Mo and V. Neoproterozoic and Paleozoic diamictites show pervasive depletion in Mo and V, reflecting their loss from the continents due to increasing intensity of oxidative weathering, as also recorded in some of the Paleoproterozoic diamictites. A few of the Paleoproterozoic diamictites deposited after the Great Oxidation Event show no depletion in Mo and V (e.g., Gowganda), but such signatures could be inherited from their provenance. In contrast, the pre-GOE Duitschland diamictite (ca. 2.3-2.5 Ga) from South Africa reveals evidence of intense oxidative weathering (i.e., large depletions in Mo), supporting a growing body of observations showing the presence of measurable atmospheric oxygen prior to permanent loss of the mass independent fractionation signal in sulfur isotopes.

  13. Convergence across a continent: adaptive diversification in a recent radiation of Australian lizards.

    PubMed

    Blom, Mozes P K; Horner, Paul; Moritz, Craig

    2016-06-15

    Recent radiations are important to evolutionary biologists, because they provide an opportunity to study the mechanisms that link micro- and macroevolution. The role of ecological speciation during adaptive radiation has been intensively studied, but radiations can arise from a diversity of evolutionary processes; in particular, on large continental landmasses where allopatric speciation might frequently precede ecological differentiation. It is therefore important to establish a phylogenetic and ecological framework for recent continental-scale radiations that are species-rich and ecologically diverse. Here, we use a genomic (approx. 1 200 loci, exon capture) approach to fit branch lengths on a summary-coalescent species tree and generate a time-calibrated phylogeny for a recent and ecologically diverse radiation of Australian scincid lizards; the genus Cryptoblepharus We then combine the phylogeny with a comprehensive phenotypic dataset for over 800 individuals across the 26 species, and use comparative methods to test whether habitat specialization can explain current patterns of phenotypic variation in ecologically relevant traits. We find significant differences in morphology between species that occur in distinct environments and convergence in ecomorphology with repeated habitat shifts across the continent. These results suggest that isolated analogous habitats have provided parallel ecological opportunity and have repeatedly promoted adaptive diversification. By contrast, speciation processes within the same habitat have resulted in distinct lineages with relatively limited morphological variation. Overall, our study illustrates how alternative diversification processes might have jointly stimulated species proliferation across the continent and generated a remarkably diverse group of Australian lizards. PMID:27306048

  14. Circumpolar oil-and-gas-bearing basins of the arctic part of the North American continent

    NASA Astrophysics Data System (ADS)

    Zabanbark, A.; Lobkovsky, L. I.

    2015-09-01

    Major geotectonic elements of the reviewed territory of the Arctic part of the North American continent are the Hyperborean Precambrian Platform, the Franklin folding belt, the northern part of the Precambrian Canadian platform, and the Mesozoic folding belt of Canada and Alaska. The rise of the Arctic slope of Alaska, the Beaufort Sea, and the Sverdrup basin are located in the southern margins of the Hyperborean Platform. The structure and peculiarities of development of these structural elements are genetically related to the evolution of this platform, as well as the current state of petroleum potential of the most promising exploration region of Arctic in the 21st century. The forced exploration of the Arctic regions of the United States and Canada has become an important milestone in the current development of the world energetics. Up to 100 oil, gas, and gas condensate fields have been discovered as a result of violent studies, and the potential oil and gas reserves in the Arctic part of the North American continent have been estimated to 30 billiion t and 50 trillion cubic meters, respectively. Many prospects are related to the continental slopes of all three above-mentioned basins; the total potential reserves of slopes are estimated as 10-12 billion t of oil and 20-25 trillion cubic meters of gas.

  15. Assessment of infective urinary tract disorders.

    PubMed

    Sixt, R; Stokland, E

    1998-06-01

    Urinary tract infection (UTI) is common in children, particularly in the youngest age groups. There is a risk for progressive deterioration of renal function in these children if aggravating factors such as gross reflux and/or outflow obstruction of the urinary tract are present. In this review the pros and cons of available scintigraphic and radiological imaging techniques for the work-up of these children are presented. Ultrasound can be used in the acute phase to exclude obstruction but can not reliably show transient or permanent parenchymal lesions. The presence of reflux can be established with X-ray or direct nuclide cystography. The X-ray technique gives good morphological information and has a grading system with prognostic relevance. Both techniques are invasive and great care must be taken to keep the radiation burden down with the X-ray technique. Indirect nuclide cystography following a renographic study is non-invasive but has a lower sensitivity than direct techniques. More experience is needed with the indirect technique to evaluate the consequences of its apparently low sensitivity. Urography has a limited place in the acute work-up of urinary tract infection but can be used to look for renal scarring 1-2 years after an acute pyelonephritis. The 99mTc dimercaptosuccinic acid (DMSA) scan can be used during the acute UTI to show pyelonephritic lesions with good accuracy and/or during the follow-up after six months to show permanent lesions. The acute DMSA scan can be omitted. An early treatment is more important than an early scan! PMID:9695664

  16. Ureteral fibroepithelial polyp causing urinary obstruction

    PubMed Central

    Shive, Melissa L.; Baskin, Laurence S.; Harris, Catherine R.; Bonham, Michael; MacKenzie, John D.

    2012-01-01

    Ureteral polyps are rare causes of ureteropelvic junction (UPJ) obstruction, particularly in children. We report a nine year-old boy with UPJ obstruction initially suggestive of an obstructive urinary stone. CT showed intraureteral calcification at the UPJ and hydronephrosis. A retrograde pyelogram showed narrowing at the UPJ and partial obstruction that was found to be a ureteral polyp. This case illustrates a rare cause of UPJ obstruction that should be considered when the imaging findings and presentation are atypical for more common etiologies of ureteral obstruction. PMID:23365709

  17. Aquaporins in Urinary Extracellular Vesicles (Exosomes)

    PubMed Central

    Oshikawa, Sayaka; Sonoda, Hiroko; Ikeda, Masahiro

    2016-01-01

    Since the successful characterization of urinary extracellular vesicles (uEVs) by Knepper’s group in 2004, these vesicles have been a focus of intense basic and translational research worldwide, with the aim of developing novel biomarkers and therapeutics for renal disease. Along with these studies, there is growing evidence that aquaporins (AQPs), water channel proteins, in uEVs have the potential to be diagnostically useful. In this review, we highlight current knowledge of AQPs in uEVs from their discovery to clinical application. PMID:27322253

  18. Characterization of Urinary Phthalate Metabolites Among Custodians.

    PubMed

    Cavallari, Jennifer M; Simcox, Nancy J; Wakai, Sara; Lu, Chensheng; Garza, Jennifer L; Cherniack, Martin

    2015-10-01

    Phthalates, a ubiquitous class of chemicals found in consumer, personal care, and cleaning products, have been linked to adverse health effects. Our goal was to characterize urinary phthalate metabolite concentrations and to identify work and nonwork sources among custodians using traditional cleaning chemicals and 'green' or environmentally preferable products (EPP). Sixty-eight custodians provided four urine samples on a workday (first void, before shift, end of shift, and before bedtime) and trained observers recorded cleaning tasks and types of products used (traditional, EPP, or disinfectant) hourly over the work shifts. Questionnaires were used to assess personal care product use. Four different phthalate metabolites [monoethyl phthalate (MEP), monomethyl phthalate (MMP), mono (2-ethylhexyl) phthalate (MEHP), and monobenzyl phthalate (MBzP)] were quantified using liquid chromatography mass spectrometry. Geometric means (GM) and 95% confidence intervals (95% CI) were calculated for creatinine-adjusted urinary phthalate concentrations. Mixed effects univariate and multivariate modeling, using a random intercept for each individual, was performed to identify predictors of phthalate metabolites including demographics, workplace factors, and personal care product use. Creatinine-adjusted urinary concentrations [GM (95% CI)] of MEP, MMP, MEHP, and MBzP were 107 (91.0-126), 2.69 (2.18-3.30), 6.93 (6.00-7.99), 8.79 (7.84-9.86) µg g(-1), respectively. An increasing trend in phthalate concentrations from before to after shift was not observed. Creatinine-adjusted urinary MEP was significantly associated with frequency of traditional cleaning chemical intensity in the multivariate model after adjusting for potential confounding by demographics, workplace factors, and personal care product use. While numerous demographics, workplace factors, and personal care products were statistically significant univariate predictors of MMP, MEHP, and MBzP, few associations persisted

  19. Reducing urinary tract infections in catheterised patients.

    PubMed

    Howe, Pam; Adams, John

    2015-01-20

    Urinary tract infections in catheterised patients continue to present a challenge in reducing healthcare-associated infection. In this article, an infection prevention and control team in one NHS trust reports on using audit results to focus attention on measures to reduce bacterial infections. Educational initiatives have an important role in reducing infection, but there is no single solution to the problem. Practice can be improved using a multi-targeted approach, peer review and clinical audit to allow for shared learning and experiences. These, along with informal education in the clinical area and more formal classroom lectures, can ultimately lead to improved patient outcomes. PMID:25585767

  20. Urinary tract infections in renal transplant recipients.

    PubMed

    Alangaden, George

    2007-11-01

    Urinary tract infection (UTI) is the most common infectious complication after renal transplantation. Although Escherichia coli remains the most common cause of UTI, Enterococcus spp and drug-resistant Enterobacteriaceae have emerged as important uropathogens in these patients. As a result, symptomatic UTIs warrant pathogen-specific antibiotic therapy guided by culture and susceptibility data. In the early transplant period, prophylaxis of UTI with trimethoprim-sulfamethoxazole is generally effective. Until the natural history and optimal management of asymptomatic bacteruria are better defined, therapy of asymptomatic bacteruria is generally unnecessary. PMID:17999883

  1. Stress Urinary Incontinence: Comparative Efficacy Trials.

    PubMed

    Lavelle, Erin Seifert; Zyczynski, Halina M

    2016-03-01

    Women seeking relief from symptoms of stress urinary incontinence (SUI) may choose from a broad array of treatment options. Therapies range from lifestyle/behavioral modification to surgical interventions, and differ in terms of both effectiveness and risk. Individualized treatment plans can be developed to address a patient's expectations and goals for treatment, as well as her tolerance for potential adverse events. This article reviews the highest-quality clinical trials comparing contemporary treatment options for women with SUI. Clinicians and patients can use this compendium to inform their treatment selection. PMID:26880507

  2. [Catheter-associated urinary tract infections].

    PubMed

    Liedl, B

    2015-09-01

    In patients with indwelling urethral catheters significant bacteriuria develops within 4 weeks of indwelling time in practically 100% of the cases. Catheter encrustation and obstruction can occur in approximately 40% of patients. Symptomatic ascending urinary tract infections, urethral complications and urolithiasis can occur in significant numbers in the long term. Regular educational and surveillance programs in nursing homes, hospitals and in home care are important to instruct personnel in hygiene procedures, to learn the indications for catheterization, to keep the indwelling time of catheters as short as possible, to detect any complications early and to initiate appropriate diagnostics and therapy by the urologist. PMID:26275988

  3. Aquaporins in Urinary Extracellular Vesicles (Exosomes).

    PubMed

    Oshikawa, Sayaka; Sonoda, Hiroko; Ikeda, Masahiro

    2016-01-01

    Since the successful characterization of urinary extracellular vesicles (uEVs) by Knepper's group in 2004, these vesicles have been a focus of intense basic and translational research worldwide, with the aim of developing novel biomarkers and therapeutics for renal disease. Along with these studies, there is growing evidence that aquaporins (AQPs), water channel proteins, in uEVs have the potential to be diagnostically useful. In this review, we highlight current knowledge of AQPs in uEVs from their discovery to clinical application. PMID:27322253

  4. Recurrent Urinary Tract Infections Management in Women

    PubMed Central

    Al-Badr, Ahmed; Al-Shaikh, Ghadeer

    2013-01-01

    Urinary tract infections (UTIs) are one of the most frequent clinical bacterial infections in women, accounting for nearly 25% of all infections. Around 50–60% of women will develop UTIs in their lifetimes. Escherichia coli is the organism that causes UTIs in most patients. Recurrent UTIs (RUTI) are mainly caused by reinfection by the same pathogen. Having frequent sexual intercourse is one of the greatest risk factors for RUTIs. In a subgroup of individuals with coexisting morbid conditions, complicated RUTIs can lead to upper tract infections or urosepsis. Although the initial treatment is antimicrobial therapy, use of different prophylactic regimens and alternative strategies are available to reduce exposure to antibiotics. PMID:23984019

  5. Notes concerning the peritonitis of urinary aetiology

    PubMed Central

    Bratu, 0; Ilie, C; Madan, V

    2008-01-01

    Urinary peritonitis (the uroperitoneum) is categorized as a difficult to diagnose clinical entity due to its poor manifestations. Vesical trauma following pelvis bone fracture is the most frequently involved in the uroperitoneum aetiology, followed by spontaneous vesical rupture and intraoperative iatrogenic lesions. One of the most important and constant signs that can occur is diffuse abdominal tension, without tenderness. The imagistic procedure that sets the diagnosis is retrograde cystography showing intraperitoneal urine effusion. Vesical rupture is a surgical emergency. The uroperitoneum is a particular type of peritonitis that has hidden and misleading symptoms which can delay the diagnosis long enough to endanger the patient's life. PMID:20108482

  6. Assessment of bioelectrical activity of synergistic muscles during pelvic floor muscles activation in postmenopausal women with and without stress urinary incontinence: a preliminary observational study

    PubMed Central

    Ptaszkowski, Kuba; Paprocka-Borowicz, Małgorzata; Słupska, Lucyna; Bartnicki, Janusz; Dymarek, Robert; Rosińczuk, Joanna; Heimrath, Jerzy; Dembowski, Janusz; Zdrojowy, Romuald

    2015-01-01

    Objective Muscles such as adductor magnus (AM), gluteus maximus (GM), rectus abdominis (RA), and abdominal external and internal oblique muscles are considered to play an important role in the treatment of stress urinary incontinence (SUI), and the relationship between contraction of these muscles and pelvic floor muscles (PFM) has been established in previous studies. Synergistic muscle activation intensifies a woman’s ability to contract the PFM. In some cases, even for continent women, it is not possible to fully contract their PFM without involving the synergistic muscles. The primary aim of this study was to assess the surface electromyographic activity of synergistic muscles to PFM (SPFM) during resting and functional PFM activation in postmenopausal women with and without SUI. Materials and methods This study was a preliminary, prospective, cross-sectional observational study and included volunteers and patients who visited the Department and Clinic of Urology, University Hospital in Wroclaw, Poland. Forty-two patients participated in the study and were screened for eligibility criteria. Thirty participants satisfied the criteria and were categorized into two groups: women with SUI (n=16) and continent women (n=14). The bioelectrical activity of PFM and SPFM (AM, RA, GM) was recorded with a surface electromyographic instrument in a standing position during resting and functional PFM activity. Results Bioelectrical activity of RA was significantly higher in the incontinent group than in the continent group. These results concern the RA activity during resting and functional PFM activity. The results for other muscles showed no significant difference in bioelectrical activity between groups. Conclusion In women with SUI, during the isolated activation of PFM, an increased synergistic activity of RA muscle was observed; however, this activity was not observed in asymptomatic women. This may indicate the important accessory contribution of these muscles in the

  7. Football practice and urinary incontinence: Relation between morphology, function and biomechanics.

    PubMed

    Roza, Thuane Da; Brandão, Sofia; Oliveira, Dulce; Mascarenhas, Teresa; Parente, Marco; Duarte, José Alberto; Jorge, Renato Natal

    2015-06-25

    Current evidence points to a high prevalence of urinary incontinence among female athletes. In this context, this study aims to assess if structural and biomechanical characteristics of the pubovisceral muscles may lead to urine leakage. Clinical and demographic data were collected, as well as pelvic Magnetic Resonance Imaging. Furthermore, computational models were built to verify if they were able to reproduce similar biomechanical muscle response as the one measured by dynamic imaging during active contraction by means of the percent error. Compared to the continent ones (n=7), incontinent athletes (n=5) evidenced thicker pubovisceral muscles at the level of the midvagina (p=0.019 and p=0.028 for the right and left sides, respectively). However, there were no differences neither in the strength of contraction in the Oxford Scale or in the displacement of the pelvic floor muscles during simulation of voluntary contraction, which suggests that urine leakage may be related with alterations in the intrafusal fibers than just the result of thicker muscles. Additionally, we found similar values of displacement retrieved from dynamic images and numerical models (6.42 ± 0.36 mm vs. 6.10 ± 0.47 mm; p=0.130), with a percent error ranging from 1.47% to 17.20%. However, further refinements in the mechanical properties of the striated skeletal fibers of the pelvic floor muscles and the inclusion of pelvic organs, fascia and ligaments would reproduce more realistically the pelvic cavity. PMID:25835786

  8. Concomitant repair of stress urinary incontinence with proximal urethrovaginal fistula: Our experience

    PubMed Central

    Chodisetti, Subbarao; Boddepalli, Yogesh; Kota, Malakonda Reddy

    2016-01-01

    Introduction: Proximal urethrovaginal fistula (UVF) located close to the bladder neck may cause extensive sphincter damage and is usually associated with continuous incontinence, which may mask the associated stress urinary incontinence (SUI). Simultaneous correction of SUI avoids a second surgery for SUI, which needs dissection in ischemic fields and carries a high risk of failure. The aim of this study is to describe our technique of concomitant repair of SUI with proximal UVF and our results. Methods: Between July 2010 and August 2014, 14 patients underwent UVF repair in Jackknife position by the interposition of a Martius flap and simultaneous correction of SUI by modified McGuire pubovaginal autologous fascial sling. The procedure was carried out a minimum of 3 months of presentation and after detailed preoperative evaluation. Results: After a mean follow-up of 28 months, all 14 patients were continent. None of the patients developed recurrence of the UVF. Two patients presented with retention immediately after catheter removal and clean intermittent catheterization training was given to both of them. Two patients became pregnant during the follow-up period and were advised cesarean section near term. Conclusions: Repair of proximal UVF and correction of SUI can be performed in the same session to avoid the operation in an ischemic field. PMID:27555683

  9. Urinary incontinence in the elderly and in the oldest old: correlation with frailty and mortality.

    PubMed

    Berardelli, Maurizio; De Rango, Francesco; Morelli, Michele; Corsonello, Andrea; Mazzei, Bruno; Mari, Vincenzo; Montesanto, Alberto; Lattanzio, Fabrizia; Passarino, Giuseppe

    2013-06-01

    Urinary incontinence (UI) is very common in the elderly and has personal and social implications. Many authors have pointed out the necessity to analyze UI in correlation with the overall quality of aging, to better understand this syndrome and define measures for its prevention and treatment. In the present study, we addressed this problem by analyzing the UI correlation with frailty, which has emerged in the last decade as the geriatric syndrome correlated with individual homeostatic capacity and then as the basis of the age-related physical decline. In addition, the monitoring of our sample for a long period allowed us to estimate the prognostic significance of UI by analyzing the correlation between UI and mortality. The analysis was performed in a large sample that included numerous ultra-nonagenarians, a population segment that is still poorly known for UI and other geriatric parameters. We found a strict correlation between UI and frailty, suggesting that UI is correlated to the homeostatic and physiological decline leading to frailty. In addition, we found that UI is an independent mortality risk factor in ultra-nonagenarians, suggesting that the neurological sensitivity needed to be continent is lost very soon when the frailty associated physiological decline begins. On the whole, our study suggests that UI is a marker of frailty and that UI patients should be monitored and, in case, treated in a timely manner to avoid, or to limit, the effects of frailty such as malnutrition, falls, and the consequent accumulation of disabilities. PMID:23496115

  10. Bethanechol for buprenorphine-related urinary hesitancy: a case series.

    PubMed

    Varma, Anjali; Smigiel, Joseph; Eck, Nancy; Brooks, Stephanie

    2011-09-01

    Constipation is a well-known side effect of buprenorphine, but urinary hesitancy is less frequently discussed and may go unrecognized. Reported are the 2 cases of men older than 50 years who experienced disabling urinary hesitancy with buprenorphine and naloxone combination (suboxone) and were successfully treated with bethanechol, a cholinergic medication. PMID:21844838

  11. Urinary tract infection in women - self-care

    MedlinePlus

    Most urinary tract infections (UTIs) are caused by bacteria that enter the urethra and travel to the bladder. This can lead ... BATHING AND HYGIENE To prevent future urinary tract infections, you ... make infections more likely. Change your pad each time you ...

  12. Haemangiosarcoma of the urinary bladder in a dog.

    PubMed

    Liptak, J M; Dernell, W S; Withrow, S J

    2004-04-01

    Haemangiosarcoma of the urinary bladder is reported in a dog. The bladder mass was detected incidentally during physical examination. Partial cystectomy with unilateral ureteroneocystostomy were performed to remove the tumour en bloc. Necrosis of the urinary bladder was diagnosed 10 days postoperatively and the dog was euthanased. PMID:15149071

  13. MX-INDUCED URINARY BLADDER EPITHELIAL HYPERPLASIA IN EKER RATS

    EPA Science Inventory

    MX-INDUCED URINARY BLADDER EPITHELIAL HYPERPLASIA IN EKER RATS

    Epidemiological studies have shown a positive association between chronic exposure to chlorinated drinking water and human cancer, particularly of the urinary bladder. MX (3- chloro-4-(dichloromethyl)-5-hydrox...

  14. Prophylactic antibiotics for children with recurrent urinary tract infections

    PubMed Central

    Robinson, Joan L; Finlay, Jane C; Lang, Mia Eileen; Bortolussi, Robert

    2015-01-01

    Prophylactic antibiotics for urinary tract infections are no longer routinely recommended. A large number of children must be given prophylaxis to prevent one infection and antibiotic resistance is a major concern when treating community-acquired urinary tract infections. The results of three recent significant studies are examined, with focus on the efficacy of prophylaxis, and recommendations are made. PMID:25722643

  15. Urinary and metabolic clearances of arginine vasopressin in normal subjects

    SciTech Connect

    Moses, A.M.; Steciak, E.

    1986-08-01

    Synthetic arginine vasopressin (AVP) was infused into 11 hydrated normal subjects at five different infusion rates ranging from 10 to 350 U kg min . Each infusion rate was continued for 1 h, and urinary determinations were made on the 30- to 60-min specimens during which time there was no further rise in plasma AVP. Urinary AVP concentrations ( U/ml) and excretion rates ( U/min) increased linearly with increasing infusion rates, and the concentration of AVP in urine increased 120 times more rapid than plasma. Urinary and metabolic clearances of AVP also increased linearly with the maximum urinary clearance being 60.6% of the creatinine clearance. The total metabolic clearance of AVP (including urinary clearance) was 17.8 times that of the urinary clearance of AVP alone. These data clarify the relationships between plasma and urinary AVP in normal hydrated subjects during AVP infusion under steady-state conditions and emphasize the potential advantage of measuring urinary AVP as a monitor of endogenous AVP secretion. AVP was measured by radioimmunoassay.

  16. The Management of Urinary Incontinence by Community-Living Elderly.

    ERIC Educational Resources Information Center

    Mitteness, Linda S.

    1987-01-01

    Explored ways elderly people (N=30) manage urinary incontinence. Subjects tended to dismiss their urinary incontinence as a normal part of aging and used various behavioral and psychological strategies to maintain their independence, usually without any assistance from the health professions. Management strategies commonly involved some degree of…

  17. Intermediate crust (IC); its construction at continent edges, distinctive epeirogenic behaviour and identification as sedimentary basins within continents: new light on pre-oceanic plate motions

    NASA Astrophysics Data System (ADS)

    Osmaston, Miles F.

    2014-05-01

    Introduction. The plate tectonics paradigm currently posits that the Earth has only two kinds of crust - continental and oceanic - and that the former may be stretched to form sedimentary basins or the latter may be modified by arc or collision until it looks continental. But global analysis of the dynamics of actual plate motions for the past 150 Ma indicates [1 - 3] that continental tectospheres must be immensely thicker and rheologically stiffer than previously thought; almost certainly too thick to be stretched with the forces available. In the extreme case of cratons, these tectospheric keels evidently extend to 600 km or more [2, 3]. This thick-plate behaviour is attributable, not to cooling but to a petrological 'stiffening' effect, associated with a loss of water-weakening of the mineral crystals, which also applies to the hitherto supposedly mobile LVZ below MORs [4, 5]. The corresponding thick-plate version of the mid-ocean ridge (MOR) process [6 - 8], replacing the divergent mantle flow model, has a deep, narrow wall-accreting axial crack which not only provides the seismic anisotropy beneath the flanks but also brings two outstanding additional benefits:- (i) why, at medium to fast spreading rates, MOR axes become straight and orthogonally segmented [6], (ii) not being driven by body forces, it can achieve the sudden jumps of axis, spreading-rate and direction widely present in the ocean-floor record. Furthermore, as we will illustrate, the crack walls push themselves apart at depth by a thermodynamic mechanism, so the plates are not being pulled apart. So the presence of this process at a continental edge would not imply the application of extensional force to the margin. Intermediate Crust (IC). In seeking to resolve the paradox that superficially extensional structures are often seen at margins we will first consider how this MOR process would be affected by the heavy concurrent sedimentation to be expected when splitting a mature continent. I reason

  18. Urinary Proteomics to Support Diagnosis of Stroke

    PubMed Central

    Dawson, Jesse; Walters, Matthew; Delles, Christian; Mischak, Harald; Mullen, William

    2012-01-01

    Accurate diagnosis in suspected ischaemic stroke can be difficult. We explored the urinary proteome in patients with stroke (n = 69), compared to controls (n = 33), and developed a biomarker model for the diagnosis of stroke. We performed capillary electrophoresis online coupled to micro-time-of-flight mass spectrometry. Potentially disease-specific peptides were identified and a classifier based on these was generated using support vector machine-based software. Candidate biomarkers were sequenced by liquid chromatography-tandem mass spectrometry. We developed two biomarker-based classifiers, employing 14 biomarkers (nominal p-value <0.004) or 35 biomarkers (nominal p-value <0.01). When tested on a blinded test set of 47 independent samples, the classification factor was significantly different between groups; for the 35 biomarker model, median value of the classifier was 0.49 (−0.30 to 1.25) in cases compared to −1.04 (IQR −1.86 to −0.09) in controls, p<0.001. The 35 biomarker classifier gave sensitivity of 56%, specificity was 93% and the AUC on ROC analysis was 0.86. This study supports the potential for urinary proteomic biomarker models to assist with the diagnosis of acute stroke in those with mild symptoms. We now plan to refine further and explore the clinical utility of such a test in large prospective clinical trials. PMID:22615742

  19. Urinary excretion of arsenic following rice consumption.

    PubMed

    Meharg, A A; Williams, P N; Deacon, C M; Norton, G J; Hossain, M; Louhing, D; Marwa, E; Lawgalwi, Y; Taggart, M; Cascio, C; Haris, P

    2014-11-01

    Patterns of arsenic excretion were followed in a cohort (n = 6) eating a defined rice diet, 300 g per day d.wt. where arsenic speciation was characterized in cooked rice, following a period of abstinence from rice, and other high arsenic containing foods. A control group who did not consume rice were also monitored. The rice consumed in the study contained inorganic arsenic and dimethylarsinic acid (DMA) at a ratio of 1:1, yet the urine speciation was dominated by DMA (90%). At steady state (rice consumption/urinary excretion) ∼40% of rice derived arsenic was excreted via urine. By monitoring of each urine pass throughout the day it was observed that there was considerable variation (up to 13-fold) for an individual's total arsenic urine content, and that there was a time dependent variation in urinary total arsenic content. This calls into question the robustness of routinely used first pass/spot check urine sampling for arsenic analysis. PMID:25145278

  20. A murine model of urinary tract infection

    PubMed Central

    Hung, Chia-Suei; Dodson, Karen W; Hultgren, Scott J

    2010-01-01

    Urinary tract infections (UTIs) inflict extreme pain and discomfort to those affected and have profound medical and socioeconomic impact. Although acute UTIs are often treatable with antibiotics, a large proportion of patients suffer from multiple recurrent infections. Here, we describe and provide a protocol for a robust murine UTI model that allows for the study of uropathogens in an ideal setting. The infections in the urinary tract can be monitored quantitatively by determining the bacterial loads at different times post-infection. In addition, the simple bladder architecture allows observation of disease progression and the uropathogenic virulence cascade using a variety of microscopic techniques. This mouse UTI model is extremely flexible, allowing the study of different bacterial strains and species of uropathogens in a broad range of mouse genetic backgrounds. We have used this protocol to identify important aspects of the host-pathogen interaction that determine the outcome of infection. The time required to complete the entire procedure will depend on the number of bacterial strains and mice included in the study. Nevertheless, one should expect 4 h of hands-on time, including inoculum preparation on the day of infection, transurethral inoculation, tissue harvest and post-harvest processing for a small group of mice (e.g., 5 mice). PMID:19644462