Science.gov

Sample records for continent ileocecal urinary

  1. The Indiana pouch continent urinary reservoir.

    PubMed

    Bihrle, R

    1997-11-01

    The right colon reservoir using a stapled plicated ileal efferent limb (Indiana continent urinary reservoir) has been demonstrated to be a reproducible durable form of continent diversion. The overall day and nocturnal continence rate of 94% compares favorably with all other forms of continent cutaneous diversion. Carefully following the technique of stapling and plicating the ileal efferent limb and ileocecal valve as described in this article nearly ensures adequate competence of the outlet valve. In the rare case in which incontinence occurs, it is almost always on the basis of high-pressure unit contractions of the reservoir. On occasion, patients who develop incontinence are observed to have high pressures within the reservoir despite complete detubularization of the right colon segment. When this problem is encountered it can be corrected successfully by adding an ileal patch augmentation to the previously detubularized reservoir. The issue of ureteral implantation in continent urinary diversions is as yet unsettled. Many authors have not used ureteral tenial tunnels and have reported a reflux rate of < 13%. Furthermore, these patients have not developed any long-term sequelae of their reflux. Although favorable results have been obtained without creating tunneled tenial reimplantation, we believe that continent cutaneous reservoirs are almost always colonized with bacteria, and an antireflux mechanism may offer protection against subsequent pyelonephritis. Closure of the reservoir traditionally has been conducted by hand at our institution; however, the development of smaller absorbable gastrointestinal anastomosis stapling devices offers the theoretic advantage of shortening the operative time. We anxiously await follow-up, including larger patient numbers and longer term follow-up of the absorbable staple technique. The use of continent cutaneous urinary diversion clearly has decreased as bladder replacement has become a more viable procedure over the past decade. Despite this, the urologic reconstructive surgeon must maintain the ability to perform continent cutaneous diversion in patients who are unwilling to accept the potential for nocturnal incontinence observed in all forms of bladder replacement as well as the patients who have ineffective sphincter mechanism or who need a urethrectomy due to their primary disease. PMID:9391530

  2. Promoting urinary continence in older women.

    PubMed

    Bardsley, Alison

    2014-10-28

    Continence promotion involves informing and educating the public and healthcare professionals that urinary incontinence is not an inevitable part of ageing, and can be treated or at least made more manageable. While awareness of urinary continence is improving slowly, the taboo around discussing incontinence remains. Women are at increased risk of developing urinary incontinence as they grow older because of physiological, functional and cognitive changes. Healthcare professionals can identify women with bladder symptoms by routinely asking trigger questions and can promote continence through education about lifestyle choices that aggravate or ameliorate urinary incontinence. This article discusses the main risk factors associated with urinary incontinence in older women and the ways in which healthcare professionals can help to identify those with symptoms of urinary incontinence. PMID:25335630

  3. 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

  4. 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... 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...

  5. 21 CFR 876.5270 - Implanted electrical urinary continence device.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Implanted electrical urinary continence device... 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...

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

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Implanted electrical urinary continence device... 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...

  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. Promoting urinary continence in women after delivery: randomised controlled trial

    PubMed Central

    Chiarelli, Pauline; Cockburn, Jill

    2002-01-01

    Objectives To test the effectiveness of a physiotherapist delivered intervention designed to prevent urinary incontinence among women three months after giving birth. Design Prospective randomised controlled trial with women randomised to receive the intervention (which entailed training in pelvic floor exercises and incorporated strategies to improve adherence) or usual postpartum care. Setting Postpartum wards of three tertiary teaching hospitals in the Hunter region, New South Wales, Australia. Participants Women who had forceps or ventouse deliveries or whose babies had a high birth weight (⩾4000 g), or both—676 (348 in the intervention group and 328 in the usual care group) provided endpoint data at three months. Main outcome measures Urinary incontinence at three months measured as a dichotomous variable. The severity of incontinence was also measured. Self report of the frequency of performance of pelvic floor exercises was recorded. Results At three months after delivery, the prevalence of incontinence in the intervention group was 31.0% (108 women) and in the usual care group 38.4% (125 women); difference 7.4% (95% confidence interval 0.2% to 14.6%, P=0.044). At follow up significantly fewer women with incontinence were classified as severe in the intervention group (10.1%) v (17.0%), difference 7.0%, 1.6% to 11.8%). The proportions of women reporting doing pelvic floor exercises at adequate levels was 84% (80% to 88%) for the intervention group and 58% (52% to 63%) for the usual care group (P=0.001). Conclusions The intervention promoting urinary continence reduced the prevalence of urinary incontinence after giving birth, particularly its severity, and promoted the performance of pelvic floor exercises at adequate levels; both continence and adherence to the programme were measured at three months after delivery in women who had forceps or ventouse deliveries or babies weighing 4000 g or more. What is already known on this topicIntensive pelvic floor exercise programmes can reduce urinary incontinence in selected groups of female patientsThe effectiveness of interventions promoting continence in reducing urinary incontinence in the female population overall has not been investigatedPelvic floor exercises are widely held to be an important component of continence promotion programmesWhat this study addsContinence promotion programmes delivered to a selected population are able to prevent urinary incontinence in that populationFew studies have examined the efficacy of compliance aiding strategies in helping women adhere to prescribed pelvic floor exercise programmes PMID:12028976

  11. [Augmentation cystoplasty and/or continent urinary diversion. Review of eleven cases].

    PubMed

    Daher, P; Zeidan, S; Ghorayeb, Z; Lteif, J

    2001-01-01

    Urinary incontinence secondary to neurogenic or malformafive bladders is a major problem influencing social insertion and has been totally transformed by bladder augmentation associated to continent urinary diversion as described by Mitroffanof. We present our experience in eleven cases and try to emphasize on three major points. Combining urinary continent diversion to bladder augmentation guarantees optimal urinary continence. Concomitant bladder neck closure is not necessary to obtain urinary continence; on the contrary, it eliminates a useful pop-off mechanism. Neocystoureterostomy is not requested for every refluxing ureter unless it could be realized on the original bladder. PMID:12416500

  12. 21 CFR 876.5280 - Implanted mechanical/hydraulic urinary continence device.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Implanted mechanical/hydraulic urinary continence....5280 Implanted mechanical/hydraulic urinary continence device. (a) Identification. An implanted... application of continuous or intermittent pressure to occlude the urethra. The totally implanted device...

  13. 21 CFR 876.5280 - Implanted mechanical/hydraulic urinary continence device.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Implanted mechanical/hydraulic urinary continence....5280 Implanted mechanical/hydraulic urinary continence device. (a) Identification. An implanted... application of continuous or intermittent pressure to occlude the urethra. The totally implanted device...

  14. 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....5280 Implanted mechanical/hydraulic urinary continence device. (a) Identification. An implanted... application of continuous or intermittent pressure to occlude the urethra. The totally implanted device...

  15. 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

  16. 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...

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

    PubMed Central

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

    2016-01-01

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

  18. 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

  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. Postoperative outcomes after continent versus incontinent urinary diversion at the time of pelvic exenteration for gynecologic malignancies

    PubMed Central

    Urh, Anze; Soliman, Pamela T.; Schmeler, Kathleen M.; Westin, Shannon; Frumovitz, Michael; Nick, Alpa M.; Fellman, Bryan; Urbauer, Diana L.; Ramirez, Pedro T.

    2014-01-01

    Objective To compare outcomes of patients undergoing continent or incontinent urinary diversion after pelvic exenteration for gynecologic malignancies. Methods Data on patients who underwent pelvic exenteration for gynecologic malignancies at The University of Texas MD Anderson Cancer Center between January 1993 and December 2010 were collected. A multivariate logistic regression model was used and statistical significance was P < 0.05. Results A total of 133 patients were included in this study. The mean age at exenteration was 47.6 (range, 30–73) years in the continent urinary diversion group and 57.2 (range, 27–86) years in the incontinent urinary diversion group (P < 0.0001). Forty-six patients (34.6%) had continent urinary diversion, and 87 patients (65.4%) had incontinent urinary diversion. The rates of postoperative complications in patients with continent and incontinent urinary diversion, respectively, were as follows: pyelonephritis, 32.6% versus 37.9% (P = 0.58); urinary stone formation, 34.8% versus 2.3% (P < 0.001); renal insufficiency, 4.4% versus 14.9% (P = 0.09); urostomy stricture, 13.0% versus 1.2% (P = 0.007); ureteral (anastomotic) leak, 4.4% versus 6.9% (P = 0.71); ureteral (anastomotic) stricture, 13.0% versus 23% (P = 0.25); fistula formation, 21.7% versus 19.5% (P = 0.82); and reoperation because of complications of urinary diversion, 6.5% versus 2.3% (P = 0.34). Among patients with continent urinary diversion, the incidence of incontinence was 28.3%, and 15.2% had difficulty with self-catheterization. Conclusion There were no differences in postoperative complications between patients with continent and incontinent conduits except that stone formation was more common in patients with continent conduits. PMID:23480870

  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. Closure of the bladder neck in patients undergoing continent vesicostomy for urinary incontinence.

    PubMed

    Reid, R; Schneider, K; Fruchtman, B

    1978-07-01

    The continent vesicostomy has been done on 24 patients, 10 of whom had severe urinary incontinence requiring closure of the bladder neck or urethra as well. Therefore, the bladder was converted to a closed cavity and intermittent catheterization is done through an abdominal stoma. No dressings or appliances are necessary. Bladder neck (or urethral) closure was successful in 8 of the 10 patients. One of the failures had been incontinent and was rendered continent on attempted bladder neck closure and there is urethral leakage at night in the other patient. Intermittent catheterization through a vesicostomy stoma has been cleaner and more aesthetically pleasing to the patients. The bladder neck closure has resulted in a dry perineum with fewer skin problems. PMID:671603

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

    PubMed Central

    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 underwear may facilitate the development of toileting skills. Based on these findings, we examined the effects of wearing disposable diapers, disposable pull-on training pants, and underwear on urinary continence of 5 typically developing toddlers in a child-care setting. Underwear decreased incontinence and increased continent urinations for 2 of the 5 participants, produced no improvement in 2 participants, and when combined with increased fluid intake and longer sitting periods, produced some favorable trends for the 5th participant. PMID:17020216

  4. Acid-base changes following urinary tract reconstruction for continent diversion and orthotopic bladder replacement.

    PubMed

    Lockhart, J L; Davies, R; Persky, L; Figueroa, T E; Ramirez, G

    1994-08-01

    A prospective determination of serum electrolytes, arterial blood gases, urinalysis and urine cultures was done in 31 patients who underwent a successful continent urinary reservoir or orthotopic bladder replacement. The patients who underwent reconstruction with a long detubularized intestinal segment (group 1-50 cm. long) demonstrated the greatest tendency for metabolic hyperchloremic acidosis (35.2%). In group 2 (patients with an orthotopic bladder replacement) only 1 individual (16.7%) had hyperchloremia, which proved to be the sole metabolic derangement encountered. In group 3 (individuals with a continent gastroileac reservoir) 2 patients (25%) had a slight tendency for compensated and asymptomatic alkalosis. Urinalyses and urine cultures in groups 1 and 2 demonstrated a trend toward urine alkalinity (52.1%) and asymptomatic bacteriuria (74%), respectively. On the contrary, among the patients undergoing a gastroileac reservoir (group 3), mild urinary acidity (pH between 5 and 6) was demonstrated in 4 (50%), while asymptomatic bacteriuria was present in 3 (37.5%). In this group symptomatic urinary acidity and/or ulceration of the ileal component has not occurred to date. Metabolic hyperchloremic acidosis predominates when longer colonic segments are used for reservoir construction. This abnormality is magnified in patients in whom an accessory small bowel was resected. The majority of the gastroileac reservoir patients showed electrolytic neutrality. With our surgical technique, the gastric secretory properties predominate over those of the ileum. The differences in homeostatic findings with the use of these varieties of bowel segments suggest that we could modify the final electrolytic environment by using different combinations of bowel and bowel length. PMID:8015066

  5. 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' recommendations improved nurses knowledge of the continence needs of stroke survivors. PMID:25638914

  6. Urethral compensatory mechanisms to maintain urinary continence after pudendal nerve injury in female rats

    PubMed Central

    Furuta, Akira; Suzuki, Yasuyuki; Asano, Koji; de Groat, William C.; Egawa, Shin; Yoshimura, Naoki

    2011-01-01

    Introduction and hypothesis To investigate the urethral compensatory mechanisms to maintain urinary continence after pudendal nerve injury. Methods In naive, acute pudendal nerve transection (PNT) and 4 weeks after PNT (PNT-4w) female rats, leak point pressures (LPPs) during bladder compression were measured before and after the application of hexamethonium (C6), propranolol and Nωnitro-L-arginine methyl ester (L-NAME), or terazosin and atropine. Responses to carbachol and phenylephrine of proximal and middle urethral muscle strips from naive and PNT-4w rats were also examined. Results LPPs were significantly decreased in PNT rats but not in PNT-4w rats. LPPs in PNT rats were significantly increased by C6 or L-NAME while LPPs in PNT-4w rats were significantly decreased by C6, or terazosin and atropine. Excitatory responses to carbachol and phenylephrine in the proximal urethral muscle were significantly larger in PNT-4w rats. Conclusions These results suggest that α1-adrenoceptor and muscarinic receptor-mediated contractility is upregulated in the proximal urethra 4 weeks after PNT. PMID:21445696

  7. [Secondary malignancies in urinary diversions].

    PubMed

    Kälble, T; Hofmann, I; Thüroff, J W; Stein, R; Hautmann, R; Riedmiller, H; Vergho, D; Hertle, L; Wülfing, C; Truß, M; Roth, S; von Rundstedt, F C; Albers, P; Gschwend, J; Herkommer, K; Humke, U; Spahn, M; Bader, P; Steffens, J; Harzmann, R; Stief, C G; Karl, A; Müller, S C; Waldner, M; Noldus, J; Kleinschmidt, K; Alken, P; Kopper, B; Fisch, M; Lampel, A; Stenzel, A; Fichtner, J; Flath, B; Rübben, H; Juenemann, K P; Hautmann, S; Knipper, A; Leusmann, D; Strohmaier, W; Thon, W F; Miller, S; Weingärtner, K; Schilling, A; Piechota, H; Becht, J E; Schwaibold, H; Bub, P; Conrad, S; Wenderoth, U; Merkle, W; Rösch, W; Otto, T; Ulshöfer, B; Westenfelder, M

    2012-04-01

    In contrast to ureterosigmoidostomy no reliable clinical data exist for tumor risk in different forms of urinary diversion using isolated intestinal segments.In 44 German urological departments, operation frequencies, indications, patient age, and operation dates of the different forms of urinary diversion, operated between 1970 and 2007, could be registered. The secondary tumors up to 2009 were registered as well and related to the numbers of the different forms of urinary diversions resulting in tumor prevalences.In 17,758 urinary diversions 32 secondary tumors occurred. The tumor risk in ureterosigmoidostomy (22-fold) and cystoplasty (13-fold) is significantly higher than in other continent forms of urinary diversion such as neobladders or pouches (p<0.0001). The difference between ureterosigmoidostomy and cystoplasty is not significant, nor is the difference between ileocecal pouches (0.14%) and ileal neobladders (0.05%) (p=0.46). The tumor risk in ileocecal (1.26%) and colonic neobladders (1.43%) is significantly higher (p=0.0001) than in ileal neobladders (0.5%). Of the 16 tumors that occurred following ureterosigmoidostomy, 16 (94%) developed directly at the ureterocolonic borderline in contrast to only 50% following urinary diversions via isolated intestinal segments.From postoperative year 5 regular endoscopic controls of ureterosigmoidostomies, cystoplasties, and orthotopic (ileo-)colonic neobladders are necessary. In ileocecal pouches, regular endoscopy is necessary at least in the presence of symptoms or should be performed routinely at greater intervals. Following neobladders or conduits, only urethroscopies for urethral recurrence are necessary. PMID:22476801

  8. Urinary Continence Following Repair of Intermediate and High Urogenital Sinus (UGS) in CAH. Experience with 55 Cases

    PubMed Central

    Bailez, Maria Marcela; Cuenca, Estela Susana; Dibenedetto, Victor

    2014-01-01

    Aim: To evaluate postoperative urinary continence in patients with congenital adrenal hyperplasia (CAH) with intermediate (IT) and high urogenital sinus (UGS) who underwent a UGS mobilization maneuver. Methods: We called IT to those that although needing an aggressive dissection to get to the vagina, still have enough urethra proximal to the vaginal confluence. Very low variants are excluded from this analysis. Dissection always started in the posterior wall of the UGS with an aggressive separation from the anterior rectal wall. If the wide portion of the vagina was reached dissection stopped and the UGS opened ventrally widening to the introitus. Nineteen patients were treated using this maneuver (Group 1). When more dissection was required the anterior wall of the UGS was dissected and carefully freed from the low retropubic space. Then the UGS was opened either ventrally or dorsally. Thirty three patients required this approach (Group 2). Combined procedures were used in three patients with high UGS (Group 3). Results: Mean age at the time of the repair and length of the UGS were 12.2 years (4 months–18 years) and 3.75 cm (3–8 cm) for G1; 8 years (5 months–17 years) and 6.34 cm (4–12 cm) in G2 and 8.3 years (2–14 years) and 11.5 cm (11–12 cm) in G3. All patients had been regularly followed. Mean age at last follow up was 14.3, 17, and 9.9 years for Groups 1, 2, and 3, respectively. All patients continue to void normally and are continent. All patients have two separate visible orifices in the vulva. Only three are sexually active. Conclusion: Urogenital sinus mobilization for vaginoplasty in girls with CAH does not compromise voiding function or urinary continence. PMID:25072036

  9. 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

  10. [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 sphincteric area and slackening of the levator ani muscles, alone or in association, explain why urethral closure pressure drops. Sometimes this drop is followed by an increase in bladder pressure. PMID:3330102

  11. 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

  12. 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

  13. 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 PVS. However, the method proved to be acceptable for most patients and there was a trend towards better erectile function with PVS. More studies are needed to explore this possible effect further. PMID:24127838

  14. 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

  15. [APPLICATION OF ILEOCECAL GASTROPLASTY IN EXPERIMENT].

    PubMed

    Lazirskiy, V A

    2015-10-01

    Results of gastroplasty, using ileocecal intestinal segment in experimental animals were presented. Functional state of transplant was estimated using data of angiography, manometry, morphological investigations. In accordance to angiographic data sufficient blood supply of transplant was obtained from a. ileocolica. While manometric and roentgenologic investigations duodenal reflux into small intestine and esophagus was not revealed. Colono-small bowel reflux, determined using hydropression method, was registered in 150 - 170 mm H2O pressure. In accordance to results of morphological investigations in a large bowel reservoir the quantity of goblet cells and the mucus production have enhanced, promoting elimination of inflammation. PMID:26946669

  16. Evaluation of the Effectiveness of Nurse-Led Continence Care Treatments for Chinese Primary Care Patients with Lower Urinary Tract Symptoms

    PubMed Central

    2015-01-01

    Background The aim of this study was to evaluate whether community-based nurse-led continence care interventions are effective in improving outcomes for adult Chinese primary care patients with lower urinary tract symptoms (LUTS). Research Design and Subjects A case-controlled intervention study was conducted. An intervention group of 360 primary care patients enrolled into a nurse-led continence care programme were recruited by consecutive sampling. A control group of 360 primary care patients with LUTS identified by screening were recruited from the waiting rooms of primary care clinics by consecutive sampling. Both groups were monitored at baseline and at 12 months. Measures Outcome measures included symptom severity, health-related quality of life (HRQOL), self-efficacy, global health and self-reported health service utilization at 12-months. The effect of the continence care programme on symptom severity and HRQOL was assessed by the difference-in-difference estimation, using independent t-test and multiple liner regression. Chi-square test was used to compare the self-efficacy, global health and self-reported health service utilization between the two groups at 12-months. Results After adjusting for baseline severity and socio-demographics, the intervention group had significant improvements in LUTS severity (P<0.05) and HRQOL (P<0.05). Improvements in the amount of urine leakage were not significantly different between the two groups. A higher proportion of subjects in the intervention group reported increased self-efficacy (43.48% vs. 66.83%), improved global health condition (17.74% vs. 41.5%), having doctor consultation (18.5% vs. 8.06), having medication due to LUTS (26.50% vs.11.29%) and having non-drug therapy due to LUTS (59.5% vs.9.68%). Conclusions Community-based nurse-led continence care can effectively alleviate symptoms, improve health-related quality of life, and enhance self-efficacy and the global health condition of Chinese male and female primary care patients with LUTS. PMID:26076486

  17. Orthotopic continent urinary diversion an ileal low pressure neobladder with an afferent tubular segment: how I do it.

    PubMed

    Perimenis, P; Studer, U E

    2004-05-01

    The surgical technique described here is not more complex than that of an ileal conduit but has significant advantages. The aboral end of an isolated portion of the distal ileum is formed into a low pressure, high capacity bladder substitute that combines Goodwin's 'cup-patch' technique and Couvelaire's ileo-urethral anastomosis. Although the neobladder is constructed from only about 40 cm of ileum, it achieves a capacity of 500 ml within a few weeks, simultaneously with rapid improvement of urinary incontinence. The procedure described is easy to perform and its long-term functional results have passed the test of time. Aside from the surgical technique per se, success with this method of bladder substitution is mainly ascribed to meticulous postoperative care and follow-up. PMID:15063902

  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. Urinary reconstruction in vertebral, anorectal, cardiac, trachea-esophageal, renal abnormalities and limb defects association with chronic renal failure and penile duplication.

    PubMed

    Muramatsu, Masaki; Shishido, Seiichiro; Nihei, Hiroshi; Hamasaki, Yuko; Hyodo, Yoji; Kawamura, Takeshi; Aikawa, Atsushi

    2015-01-01

    Various urological complications in VATER association require careful management. A 15-year-old boy with VATER association, including a hypoplastic lower urinary tract and diphallia, presented with chronic kidney disease and incontinence after a right loop ureterostomy. In order to acquire urinary continence without renal function impairment, an ileocecal reservoir with umbilical catheterizable stoma was created as a urinary reconstruction. The ectopic posterior penis was resected for cosmetic reasons, and the stump of the hypoplastic urethra was opened at the perineal skin. Clean intermittent self-catheterization through the umbilicus using disabled bilateral limbs was then achieved. This report describes the management of VATER association in a patient with complicated urological anomalies. PMID:25115674

  20. Ileocecal intussusception corrected by resection within the cecum in two horses.

    PubMed

    Beard, W L; Byrne, B A; Henninger, R W

    1992-06-15

    Irreducible ileocecal intussusceptions pose a difficult surgical problem. Strangulating ileocecal intussusceptions involving the ileum and jejunum were identified in 2 horses undergoing exploratory laparotomy because of colic. Surgical correction in both horses was achieved by amputation of the ileocecal intussusception from within the cecal lumen, via typhlotomy. The inverted ileal stump was blindly stapled near the ileocecal orifice after pulling the intussusceptum into the cecum. A jejunocecostomy was performed to reestablish intestinal continuity. PMID:1639709

  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, 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 (§...

  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, 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 (§...

  5. 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 (§...

  6. 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

  7. Lipomatosis of Terminal Ileum and Ileocecal Valve: Multidetector Computed Tomography Findings

    PubMed Central

    Parlak, Selcuk; Okay, Aysun Erdogan; Altin, Levent; Toprak, Ugur; Kuscuoglu, Gizem; Karademir, Mehmet Alp

    2014-01-01

    Intestinal lipomatosis also known as lipohyperplasia is a rare disease. Diffuse infiltration of the fatty tissue mainly in the submucosal layer is characteristic. It is usually asymptomatic and found incidentally. We report a case of lipomatosis in the terminal ileum and ileocecal valve. Multidetector computed tomography (MDCT) with contrast enhancement showed fatty infiltration of the terminal ileum and ileocecal valve. PMID:25763082

  8. Large cell neuroendocrine carcinoma of the ileocecal junction with well differentiation adenocarcinoma.

    PubMed

    Wang, Xuming; Li, Yan; Feng, Hua; Wang, Chengxin; Chen, Jiaxun; Liu, Lijiang

    2015-01-01

    Neuroendocrine tumors are unique and rare tumors originating from neuroendocrine cells. Large cell neuroendocrine tumors have been found in almost every organ such as gastrointestinal tract, bronchopulmonary, pancreas, uterine cervix, urinary bladder and salivary gland, but primary sites in gastrointestinal tract and lung are the most frequent. These neoplasms show neuroendocrine differentiation in organizational structure, which requires further confirmation with immunohistochemistry or electron microscope. In immunohistochemistry staining, pure neuroendocrine areas are diffusely stained positive for synaptophysin (Syn), chromogranin (CgA) and CD56.At least two neuroendocrine markers (Syn, CgA or CD56) must be diffusely stained positive to establish a diagnosis for large cell neuroendocrine carcinoma. We studied a rare case of large cell neuroendocrine tumor that was originated from the ileocecal junction and showed CgA, Syn and CD56 triple-negative. The tumor, however, showed typical morphologic and immunohistochemical features of neuroendocrine differentiation; it also exhibited well differentiation and a significant peritumoral lymphoid reaction. Furthermore, we also found the intracytoplasmic neurosecretory granules through the electron micrograph examination. PMID:26071581

  9. Urinary Diversions

    PubMed Central

    Davis, Ian

    1991-01-01

    Once the bladder has been removed or declared non-functional, some form of urinary diversion must be performed. The diversion can be as simple as bringing the ureters to the skin and as complicated as the creation of a functioning neobladder. The indications for and expectations of the most common types of diversion are explained. Some new techniques for continent diversion are described. PMID:21229045

  10. 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.

  11. 21 CFR 876.5310 - Nonimplanted, peripheral electrical continence device.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ..., 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 at... maintain urinary continence. When necessary, the electrode may be removed by the user. (b)...

  12. 21 CFR 876.5310 - Nonimplanted, peripheral electrical continence device.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., 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 at... maintain urinary continence. When necessary, the electrode may be removed by the user. (b)...

  13. 21 CFR 876.5310 - Nonimplanted, peripheral electrical continence device.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ..., 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 at... maintain urinary continence. When necessary, the electrode may be removed by the user. (b)...

  14. 21 CFR 876.5310 - Nonimplanted, peripheral electrical continence device.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ..., 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 at... maintain urinary continence. When necessary, the electrode may be removed by the user. (b)...

  15. 21 CFR 876.5310 - Nonimplanted, peripheral electrical continence device.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ..., 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 at... maintain urinary continence. When necessary, the electrode may be removed by the user. (b)...

  16. Lymphangitic spread from the appendiceal adenocarcinoma to the ileocecal valve, mimicking Crohn's disease.

    PubMed

    Murdock, Tricia; Lim, Nicholas; Zenali, Maryam

    2015-02-21

    Due to the anatomical peculiarity of the appendix, diagnosis of tumors arising from this area can be challenging by clinicoradiologic means. We report a case of a rare primary appendiceal signet ring carcinoma with an uncommon presentation. An 86-year-old woman was admitted to our hospital with subacute epigastric pain. Computed tomography demonstrated bowel wall thickening with fat stranding in the ileocecal region. The leading diagnostic consideration was inflammatory bowel disease. Upon colonoscopy, a swollen, distorted ileocecal valve was identified. The remaining colon was otherwise unremarkable. Extensive biopsy sampling of the ileocecal region and colon was performed. A lymphangitic signet ring carcinoma within the ileocecal region was diagnosed on biopsy; there was no dysplasia or carcinoma of the remaining biopsies. By cytomorphology and immunoprofile, a lymphangitic signet ring carcinoma of appendiceal origin was the primary consideration, further confirmed upon subsequent laparotomy. This case represents an unusual pattern of appendiceal tumor spread with localized, lymphangitic involvement, creating a milieu which closely simulates Crohn's disease on imaging modalities. PMID:25717258

  17. 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 ...

  18. Adult right-sided Bochdalek hernia with ileo-cecal appendix: Almeida-Reis hernia

    PubMed Central

    Costa Almeida, C.E.; Reis, Luis S.; Almeida, Carlos M. Costa

    2013-01-01

    INTRODUCTION Bochdalek hernia is one of the most common congenital abnormalities manifested in infants. In the adult is a rarity, with a prevalence of 0.176% of all diaphragmatic hernias. Right-sided Bochdalek hernias containing colon are even more rare, with no case described in the literature with ileo-cecal appendix. PRESENTATION OF CASE The authors present a case of a right-sided Bochdalek hernia in an adult female of 49 years old, presented with severe respiratory failure. During laparotomy for hernia correction, were found in an intrathoracic position the cecum and ileo-cecal appendix, the right colon and the transverse colon. DISCUSSION Although useful in patient evaluation, clinical history and physical examination are not helpful in making diagnosis because of their nonspecific character. CT scan is the most accurate exam for making diagnosis. Most of the times there is no hernial sac. Surgery is the treatment of choice, and it is always indicated even if asymptomatic. In general suture of the defect is possible. Due to patient's weak respiratory function we chose laparotomy by Kocher incision. CONCLUSION Being the first case of a right-sided Bochdalek hernia in the adult with a herniated ileo-cecal appendix, we name it Almeida-Reis hernia. PMID:23872263

  19. OxyContin

    MedlinePlus

    ... Get Information Drug Guide A Focus on Heroin & Opioids Breaking Points: Teens & Stress Parent Toolkit The Teen ... is the brand name for oxycodone hydrochloride, an opioid (narcotic) analgesic ( pain reliever ). OxyContin is a controlled- ...

  20. Promoting continence: simple strategies with major impact.

    PubMed

    Doughty, Dorothy B

    2003-12-01

    Urinary incontinence is a common problem, especially among women, yet it remains underreported and undertreated. This is partly due to patients' beliefs that little can be done and partly due to healthcare professionals' perception that treatment is limited to surgery, advanced behavioral strategies requiring specialized equipment, or containment devices. Nurses are in a strategic position to reduce the incidence of incontinence by teaching bladder health strategies (ie, fluid management, appropriate voiding intervals, constipation prevention, weight control, smoking cessation, and pelvic muscle exercises), actively assessing patients for incontinence, and initiating appropriate referrals and primary interventions. Patients with significant neurologic deficits, structural abnormalities such as pelvic organ prolapse, or urinary retention should be referred for further workup. However, most patients can be treated with primary continence restoration strategies, which include identifying and correcting reversible factors such as urinary tract infection or atrophic urethritis; instruction in pelvic floor muscle exercises; and instruction regarding urge inhibition strategies. Implementing these simple strategies can significantly improve bladder function and continence in the majority of patients. PMID:14712010

  1. [Evolution of urinary bladder substitution].

    PubMed

    Kock, N G

    1992-11-01

    The historical background to the currently used methods for continent bladder substitution is shortly outlined. The significance for the patient's quality of life of various methods for bladder reconstruction or urinary diversion is briefly discussed. The importance of reservoir configuration for achieving a high compliant urinary receptacle is pointed out. Factors affecting reabsorption of urinary constituents are stressed and the significance of an antireflux mechanism is discussed. Currently the majority of patients undergoing cystectomy for cancer or for other reasons can be offered bladder substitutes providing continence and easy emptying; that is, complete control over voiding. This can be achieved by orthotopic bladder reconstruction or by diverting the urine to the augmented and valved rectum or to the skin via a continent intestinal reservoir. PMID:1492767

  2. Periappendicitis during adalimumab treatment for ileocecal Crohn's disease in a 29-year-old male.

    PubMed

    Mizuno, Shinta; Nakazawa, Atsushi; Ogawa, Ayumi; Hisamatsu, Tadakazu; Hirose, Shigemichi; Tsukada, Nobuhiro

    2015-06-01

    A 29-year-old male was diagnosed with ileocolic Crohn's disease (CD) approximately 2 years ago. Adalimumab was prescribed as CD remission induction therapy. Three months after beginning adalimumab, watery diarrhea and lower abdominal pain developed. He was admitted under a diagnosis of CD exacerbation. Despite fasting and antibiotic treatment, symptoms of acute panperitonitis appeared. He was diagnosed as acute appendicitis and we performed emergency surgery for peritoneal drainage and ileocecal resection on the fifth hospital day. We diagnosed periappendicitis based on the operative findings. This is the first report of periappendicitis with CD during adalimumab treatment. PMID:26023062

  3. Ileocecal-colonic intussusception caused by cecal adenocarcinoma A case report.

    PubMed

    Verre, Luigi; Rossi, Rachele; Gaggelli, Ilaria; Piccolomini, Alessandro; Podzemny, Vlasta; Tirone, Andrea

    2012-01-01

    INTRODUCTION: Intussusception in adults is an infrequent cause of intestinal occlusion that is usually due to neoplasm lesions. The unspecific nature of the clinical presentation often delays diagnosis. It is most commonly emergency explorative laparotomy which clarifies the etiology of the occlusion. The authors report a case of intestinal occlusion caused by ileocecal-colonic invagination with a small cecal adenocarcinoma as lead point, in a 74-year-old woman. CASE REPORT: A 74-year-old woman came to the Emergency Department, complaining of crampy pain in the mid- and lower abdomen. An abdominal ultrasound revealed a "pseudokidney sign" apparently involving the cecum. Because there were no clear signs of occlusion, the patient was dicharged on the same day. Three days later, upon admission, the patient complained of episodes of abdominal pain with intervals of moderate well-being, associated with nausea, vomiting and an inability to pass stool (but not gas) for 36 hours. On clinical examination her abdomen was distended and tender on palpation in all quadrants, especially in the right iliac fossa where a large mass could be felt. Standard abdominal x-Ray documented gaseous distension of some loops of the jejunum-ileum with some air-fluid level. The patient underwent an abdominal CT scan which showed advanced intussusception that appeared to be ileocolic and multiple enlarged lymphnodes were found in the invaginated mesentery at the base of which there appears to be a thickening of the intestinal wall that is probably neoplastic in nature. The patient underwent explorative laparotomy. Ileocecal-colonic intussusception caused by a cecal growth 5 cm in diameter was found on examination of the surgical specimen. Histology showed that the cause of the large swelling of the ascending colon was a vegetating ulcerated adenocarcinoma (medium grade differentiation: G2), measuring 6.5x 4.0 cm, arising from a tubulovillous adenoma infiltrating the submucosa. CONCLUSIONS: Most cases of intussusception are caused by structural lesions, a large percentage of which are malignant, especially in the colon. In our patient the lead point was a small cecal polyp which, together with the last loop of the ileum and the ileocecal valve, was pulled into the ascending colon. Although most cases of intussusception in adults are diagnosed at the operating table, noninvasive diagnostic tools like ultrasonography and CT scanning are very useful. Treatment in adults is usually surgical and involves en bloc resection of the lesion. Manual reduction of the intussusception is not advisable because of the risk of dissemination if the lead point is malignant. KEY WORDS: Cecal adenocarcinoma, Itestinal resection, Intussusception in adults. PMID:23070265

  4. Urinary Bladder

    MedlinePlus

    ... Anatomy & Physiology » Urinary System » Components of the Urinary System » Urinary Bladder Cancer Registration & Surveillance Modules Anatomy & Physiology Intro to the Human Body Body Functions & Life Process Anatomical Terminology Review Quiz ...

  5. 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 age and those with significant lower urinary tract symptoms prior to RARP should be counselled on the increased risk of urinary incontinence in the early stages. PMID:25737770

  6. Female urinary stress incontinence.

    PubMed

    Cervigni, M; Gambacciani, M

    2015-10-01

    Urinary incontinence (UI) is more common than any other chronic disease, such as hypertension, depression or diabetes, with the prevalence estimated between 9 and 74%. Among the various forms of urinary incontinence, stress incontinence (SUI) is the most prevalent (50%), with urgency incontinence (UUI) representing 11% and mixed type (MUI) 36% (3% not classified). Nowadays, the restoration of urinary continence is one of the greatest challenges for the well-being and quality of life of women. The introduction of minimally invasive surgical procedures changed the anti-incontinence surgery, leading to similar, or even better results as traditional, invasive techniques. The development of the mid-urethral slings offers a viable alternative to surgical correction of SUI. These further developments of mini-sling procedures are appropriate for local anesthesia, less traumatic, 'tension-free' (to ensure continence without obstruction), simple, rapid and repeatable. The latest minimally invasive approaches can be performed in day surgery, with clear advantages compared to traditional procedures. A novel approach through the use of vaginal laser techniques could represent an additional opportunity, as a non-invasive, outpatient method to treat SUI. PMID:26366798

  7. 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

  8. Urinary Incontinence

    MedlinePlus

    ... Home » Urinary Incontinence Heath and Aging Urinary Incontinence Causes of Incontinence What’s Happening? Diagnosis Types of ... provider about what you can do. Causes of Incontinence Incontinence can happen for many reasons. For example, ...

  9. 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.

  10. 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

  11. Microbiomes of unreactive and pathologically altered ileocecal lymph nodes of slaughter pigs.

    PubMed

    Mann, Evelyne; Dzieciol, Monika; Metzler-Zebeli, Barbara U; Wagner, Martin; Schmitz-Esser, Stephan

    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

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

    PubMed

    Hempel, Randy J; Bannantine, John P; Stabel, Judith R

    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

  13. 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

  14. Follow the Stream: Imaging of Urinary Diversions.

    PubMed

    Moomjian, Lauren N; Carucci, Laura R; Guruli, Georgi; Klausner, Adam P

    2016-01-01

    Urinary diversion is a surgical technique to redirect the stream of urine, most often after cystectomy. Cystectomy may be performed both for benign and for malignant conditions. Bladder cancer is the most common indication for cystectomy, and most patients who undergo radical cystectomy and urinary diversion have muscle-invasive or high-risk non-muscle-invasive bladder cancer. There are two major surgical approaches for urinary diversions performed after radical cystectomy: continent and incontinent diversions. For incontinent urinary diversions, a cutaneous ostomy is used for continuous urine drainage (eg, ileal conduit). With a continent diversion procedure, the patient may void through the native urethra or self-catheterize through a surgically created stoma. The goals of imaging after urinary diversion are to assess postoperative anatomy, detect postoperative complications, evaluate for residual or recurrent tumor and metastatic disease, and monitor for upper tract distention and/or deterioration. Multiple imaging modalities and techniques may be used to evaluate urinary diversions, including computed tomographic and magnetic resonance urography, intravenous pyelography, ultrasonography, pouchography, loopography, and nephrostomy studies. Knowledge of the expected postoperative appearance after urinary diversions and potential postoperative complications is crucial because many complications may be clinically silent. Radiologists must be able to recognize the expected postoperative appearance as well as complications to facilitate appropriate diagnosis and treatment of patients after cystectomy and urinary diversion. (©)RSNA, 2016. PMID:27058730

  15. 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

  16. 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.

  17. [Continent derivation of urine (a Modo) Mainz II].

    PubMed

    Panchev, P; Kumanov, Kh; Ianev, K; Georgiev, M; Slavov, Ch; Kirilov, S

    1999-01-01

    The improved intestinal dissection technique and antibiotic agents, and the development of new resorptive suture materials have led to renewed surge of interest in ureterosigmoidostomy as a practicable procedure for continent derivation. Based on data from urodynamic assessment of diverse forms of urinary derivation, M Fisch and R Hohenfellner in 1991 propose a modification of the classical technique of ureterosigmoidostomy, coined with the term Sigmarectum pouch or Mainz pouch (M Fisch, R. Wammack, R Hohenfellner 1991). Over the period 1992 through 1999, 46 operations type "Mainz II" are performed in the Department of Urology--University Hospital "Alexandrovska". The series includes 41 men and 5 women with age range 42 to 80 years. All patients present urinary bladder tumors. The usual surgical technique is used. The severest postoperative complications include: urinary fistulae--3 (6.52%), local relapse--4 (8.69%) and distant metastases--2 (4.35%). In six patients the outcome is fatal (0.7%). This type of continent derivation following cystectomy is recommended since it is convenient, practically atraumatic and well tolerated by the patients. Complications encountered seldom necessitate operative intervention. PMID:11484241

  18. Surgical management of pediatric urinary incontinence.

    PubMed

    Dave, Sumit; Salle, Joao Luiz Pippi

    2013-08-01

    The surgical management of pediatric urinary incontinence secondary to neurogenic bladder and congenital anomalies is challenging, and continues to evolve with new surgical innovations. The goal of these surgical procedures is to achieve complete and socially acceptable urinary dryness, while preserving volitional voiding where possible, without causing damage to the upper tracts. This review focuses on recent studies and highlights the pros and cons of these advances, based on our experience. The short-term success in achieving urinary continence has to be tempered with the long-term implications of these reconstructive procedures, about which our knowledge is limited. PMID:23832825

  19. 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…

  20. Urinary Incontinence

    MedlinePlus

    Urinary incontinence (UI) is loss of bladder control. Symptoms can range from mild leaking to uncontrollable wetting. It can ... or lift a heavy object. This is stress incontinence. If bladder muscles become too active, you may ...

  1. Urinary Diversion

    MedlinePlus

    Advertisement Resize Text: Toggle navigation Find a Urologist Submit About Us What We Do Foundation History Leadership ... Diseases Information Clearinghouse (NKUDIC) Urinary Diversion MedlinePlus Ostomy Advertisement Patient Education Materials We provide free patient education ...

  2. 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

  3. The response of blood flow between the internal thoracic and ileocecal arteries to inotropic agents in a canine model.

    PubMed

    Tada, Y; Tsuboi, H; Suzuki, K; Katoh, T; Zempo, N; Fujimura, Y; Esato, K

    1998-01-01

    The pharmacologic response of coronary artery bypass conduits is of great importance. This study was designed to clarify the response of blood flow between the internal thoracic artery (ITA) and the ileocecal artery (ICA) to inotropic agents. The responses of the ITA and ICA to epinephrine, dopamine, isoproterenol, and dobutamine were examined by collecting free-flowing blood from a canine model. There were no significant differences in the response to inotropic agents between the ITA and the ICA. Epinephrine and dopamine increased the graft flow, whereas isoproterenol and dobutamine decreased the graft flow percentages of the cardiac output. These results suggest that the flow response to inotropic agents is equivalent in canine ITA and ICA grafts. PMID:9505320

  4. Ileocecal adenocarcinoma with overexpression of P53 protein metastasized to the thenar muscle: report of a rare case and review of literature

    PubMed Central

    Yi, Cuihua; Liu, Zhiyan; Chu, Yunxia; Li, Shuguang; Liu, Lian; Li, Jisheng; Yu, Xuejun

    2015-01-01

    Metastatic malignancies of the hand are rare and metastases to the skeletal muscle from the gastrointestinal system are even much rare. Here we present a case of metastatic ileocecal adenocarcinoma to the thenar muscle, which is the first report of thenar muscle metastasis from ileocecal adenocarcinoma with P53 mutation. To date, only two other cases of thenar muscle metastasis have been documented, one is from squamous cell carcinoma of the lung and the other is from rectal carcinoma. The present 67-year-old Chinese man of poorly differentiated adenocarcinoma of the ileocecal region developed metastatic carcinoma in the right thenar eminence, which presented with swelling and pain. Magnetic resonance imaging of the right hand revealed a well-defined enhanced mass in the right thenar muscle. It was proved to be metastatic adenocarcinoma using core needle biopsy, which was supported to be gastrointestinal origination by positive immunoreaction with CDX2. Positive immunoreaction with P53 protein indicated the poor prognosis of the patient. Further systemic evaluation including computerized tomography scans revealed extensive metastases to liver, right kidney, right abdominal wall, left axillary and right subclavicular lymph nodes, and skin of the right thigh. Treatment was given with palliative systemic chemotherapy. After 8 cycles of chemotherapy, the swelling and pain of the right thenar were ameliorated, and the patient regained full use of his right hand and his quality of life was improved. The patient died of liver metastasis 9 months after the diagnosis of the right thenar metastasis. In conclusion, here we display a case of thenar skeletal muscle metastasis from P53 mutated ileocecal adenocarcinoma, who survived 9 months after diagnosis of the rare metastasis. If an oncological patient presents an intramuscular mass, muscle metastasis must be included in the differential diagnosis. Metastatic hand tumors generally indicate systemic spread, so the treatment is usually palliative and the prognosis is poor. The primary objective of treatment is improvement of the patient’s quality of life. PMID:26722571

  5. 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

  6. Urinary Incontinence: Bladder Training

    MedlinePlus

    MENU Return to Web version Urinary Incontinence | Bladder Training for Urinary Incontinence What is bladder training? Bladder training is a way of learning to manage urinary incontinence. It is generally used ...

  7. Continent elevation, mountains, and erosion: Freeboard implications

    NASA Astrophysics Data System (ADS)

    Whitehead, J. A.; Clift, Peter D.

    2009-05-01

    To the simplest approximation, Earth's continental crust is a floating aggregate on the planet's surface that is first attracted to subduction zones and, upon arrival, thickened by mountain building (then producing some extension). Thickened regions are thinned again by erosion. A comparison between 65 Ma and the present shows that the modern state is significantly more mountainous. An estimated average continental elevation increase relative to average ocean floor depth of about 54 m and sea level decrease relative to the ocean floor of about 102 m add up to a 156-m increase of continent elevation over sea level since 65 Ma. Both are affected most strongly by the roughly 1.7% continent surface area decrease caused by Cenozoic mountain building. This includes contributions from erosion. Volumes of sediments in deltas and submarine fans indicate an average thickness of 371 m deposited globally in the ocean basins since 65 Ma. This relatively large change of continent area over a short span of Earth history has significant consequences. Extrapolating, if continent area change exceeded 5% in the past, either severe erosion or flooded continents occurred. If continent elevation (freeboard) remains at the present value of a few hundred meters, the past continent-ocean area ratio might have been quite different, depending on earlier volumes of continental crust and water. We conclude that, along with the ages of ocean basins, continental crustal thickening exerts a first-order control on the global sea level over hundreds of million years.

  8. Continent Elevation, Mountains, Erosion and Freeboard

    NASA Astrophysics Data System (ADS)

    Whitehead, J. A.; Clift, P. D.

    2008-12-01

    To the simplest approximation, continental crust is aggregated floating surface material that is attracted to subduction zones and then thickened by mountain building upon arrival. The thickened regions are thinned again by divergence by erosion and to a lesser extent by the viscous/plastic divergence of young mountain belts. A laboratory model with two fluid layers shows this. A comparison between the present and 65 Ma shows that an estimated average continent elevation increase of about 168 m and average sea level decrease relative to the ocean floor about 109 m are both affected most strongly by a roughly 2 percent continent surface area decrease from mountain building (crustal thickening). Sea level is also affected by contributions from erosion. Volumes of sediments in deltas and submarine fans indicate an average erosion depth of 630 m globally from the continents to the ocean basins since 65 Ma. If continent area change exceeds 5 percent in the past there would have been periods of either severe erosion or flooded continents. If continent elevation has always been held to the present value of a few hundred meters (freeboard), the relative areas of continents and oceans might have been quite different in the past, depending on the past volumes of crust and water. Therefore, crustal thickening is now recognized together with the effects of the ages of ocean basins as a first order control on global sea level over hundreds of million years.

  9. Urinary incontinence - injectable implant

    MedlinePlus

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

  10. Bony Pelvis Dimensions in Women With and Without Stress Urinary Incontinence

    PubMed Central

    Berger, Mitchell B.; Doumouchtsis, Stergios K.; DeLancey, John O.

    2012-01-01

    AIMS To test the null hypothesis that bony pelvis dimensions are similar in women with and without stress urinary incontinence, both in the postpartum and midlife periods. METHODS Secondary analyses were performed of two case-control studies comparing women with stress urinary incontinence to asymptomatic controls. One study examined primiparas in the first 9–12 months postpartum; the other study involved middle-aged women. Stress urinary incontinence was confirmed by full-bladder stress test. All subjects underwent pelvic magnetic resonance imaging. The interspinous and intertuberous diameters, subpubic angle and sacrococcygeal joint-to-the inferior pubic point distance were measured from the images independently by two authors. RESULTS In the young cohorts, we compared primiparas with de novo postpartum stress urinary incontinence to both continent primiparas and nulliparas. Postpartum stress urinary incontinence is associated with a wider subpubic angle. There is also a trend towards wider interspinous and intertuberous diameters in the stress-incontinent primiparas as compared to the continent cohorts, although this did not reach statistical significance with our sample sizes. By contrast, no significant differences in bony pelvis dimensions were identified when comparing middle-aged women with stress urinary incontinence and their continent controls. CONCLUSIONS Bony pelvis dimensions are different in women with stress urinary incontinence than in matched continent controls. However, these differences are only identified in young primiparas in the postpartum period, not in middle-aged women. PMID:22674676

  11. 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 urinary (YOOR-uh-nair-ee) tract infection (UTI)? A UTI is an infection anywhere in the ...

  12. 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

  13. Urinary schistosomiasis.

    PubMed

    Bamgbola, Oluwatoyin F

    2014-11-01

    Schistosomiasis is the second most common socio-economically devastating parasitic disease after malaria, affecting about 240 million residents of developing countries. In Africa, it predominantly manifests as urogenital disease, and the main infective agent is Schistosoma hematobium. Endemicity is propagated by poor socio-economic status and environmental degradation due to rapid urbanization. Recreational swimming is a potent medium for the spread of disease in children and adolescents. Most affected individuals are asymptomatic. The male and female worms are equipped with an extraordinary capacity for immune evasion and are able to co-habit for several decades within the pelvic venous plexus. Eggs deposited in the bladder wall resist elimination by type 1 T lymphocytes. Instead, they are sustained by pro-fibrogenic encapsulation (as modulated by type 2 helper cells). Progressive bladder disease results in obstructive uropathy and predisposes to (mostly) squamous cell carcinoma. Schistosomal glomerulopathy manifests as a clinical spectrum of asymptomatic proteinuria, nephrosis and/or nephritic syndrome. Findings on renal biopsy may be influenced by co-morbidity with Salmonella bacteria, amyloidosis and hepatitis C infection. Potentially fatal Katayama fever and spinal radiculopathy may ensue in tourists visiting an endemic zone. Early detection by urine microscopy is hampered by low urinary excretion rates of the parasite eggs. Although useful in travelers with newly acquired disease, the results of the serological antibody assay may be false positive in residents of an endemic zone. Cystoscopy, however, may be invaluable. Due to its safety, effectiveness and once-daily dosing, praziquantel is the drug of choice. An integrated approach that includes mass chemotherapy, environmental health programs and public health education is the most cost-effective preventive strategy. PMID:24469437

  14. 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

  15. 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…

  16. 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

  17. 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…

  18. Urinary incontinence

    PubMed Central

    Swanson, J. Graham; Kaczorowski, Janusz; Skelly, Jennifer; Finkelstein, Murray

    2005-01-01

    OBJECTIVE To examine age-specific prevalence and correlates of urinary incontinence (UI) among community-dwelling women. DESIGN A questionnaire survey used a modified Dillman method. SETTING Two family practice clinics in Hamilton, Ont. PARTICIPANTS Questionnaires were mailed to 1082 women 45 years old and older. Ninety women were disqualified; 606 recipients responded. MAIN OUTCOME MEASURES Self-reported prevalence of UI and potential risk factors. RESULTS Overall response rate was 61% (606/992); 51% (311/606; 95% confidence interval 47.3% to 55.3%) reported an episode of UI during the last month. Of the 311 women reporting UI, 35.7% perceived it as a problem, 27% had had it for less than a year, 41.9% had had it for 1 to 4 years, and 31.1% had had it for 5 years or longer. Three kinds of UI were reported: 34% (106/311) reported stress UI, 14.5% (45/311) reported urge UI, and 51.4% (160/311) reported a mixed pattern. In multivariate analysis, the overall prevalence of incontinence increased significantly with “usually having a cough,” “being troubled by swollen ankles,” “giving birth,” “ever smoking cigarettes,” and “being troubled by headaches.” Stress UI was associated with “usually having a cough” and “ever smoking cigarettes.” Urge UI was associated with “having troubles with constipation” and “swollen ankles.” Mixed incontinence was associated with “get sick more than other people,” “usually having a cough,” “taken hormones for menopause,” and body mass index in the 50th to 75th percentile or greater. Age was not significantly associated with prevalence of UI or any of its subtypes. Only 40% of incontinent women indicated they had discussed urine loss with their physicians; 70% of these women felt satisfied with physicians’ responses. CONCLUSION Incontinence occurs in more than half of community-dwelling women 45 years old and older. Almost one of five women in the community reported UI that affected normal activities. Treating the effect of incontinence will require further understanding of women’s coping skills and self-perceptions. Prevalence does not appear to increase with age. PMID:16926957

  19. Significance of preoperatively observed detrusor overactivity as a predictor of continence status early after robot-assisted radical prostatectomy

    PubMed Central

    Yanagiuchi, Akihiro; Miyake, Hideaki; Tanaka, Kazushi; Fujisawa, Masato

    2014-01-01

    Several recent studies have reported the involvement of bladder dysfunction in the delayed recovery of urinary continence following radical prostatectomy (RP). The objective of this study was to investigate the significance of detrusor overactivity (DO) as a predictor of the early continence status following robot-assisted RP (RARP). This study included 84 consecutive patients with prostate cancer undergoing RARP. Urodynamic studies, including filling cystometry, pressure flow study, electromyogram of the external urethral sphincter and urethral pressure profile, were performed in these patients before surgery. Urinary continence was defined as the use of either no or one pad per day as a precaution only. DO was preoperatively observed in 30 patients (35.7%), and 55 (65.5%) and 34 (40.5%) were judged to be incontinent 1 and 3 months after RARP, respectively. At both 1 and 3 months after RARP, the incidences of incontinence in patients with DO were significantly higher than in those without DO. Of several demographic and urodynamic parameters, univariate analyses identified DO and maximal urethral closure pressure (MUCP) as significant predictors of the continence status at both 1 and 3 months after RARP. Furthermore, DO and MUCP appeared to be independently associated with the continence at both 1 and 3 months after RARP on multivariate analysis. These findings suggest that preoperatively observed DO could be a significant predictor of urinary incontinence early after RARP; therefore, it is recommended to perform urodynamic studies for patients who are scheduled to undergo RARP in order to comprehensively evaluate their preoperative vesicourethral functions. PMID:25038181

  20. Stress urinary incontinence

    MedlinePlus

    ... when the bladder bulges into the vagina (prolapse). Artificial urinary sphincter . This is a device used to ... It is easier to do than placing an artificial urinary sphincter. Retropubic suspensions lift the bladder and ...

  1. [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

  2. Deep Structure of the Indian Continent

    NASA Astrophysics Data System (ADS)

    Maurya, Satish; Montagner, Jean-paul; Kumar, Ravi; Kumar, Prakash; Burgos, Gael

    2014-05-01

    The Indian sub-continent experienced remarkable tectonic and geological events. Breakup of Indian subcontinent from the Gondwana supercontinent possibly due to a large plume, about 130 Myr ago. Paleomagnetic data demonstrates that the Indian continent moved northwards from 65Myr at exceptionally high speeds (18-20cm/year) and subsequently slowed down to 4-5cm/year after its collision with Asia approx 40Myr 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 a 65Myr kimberlites of the Central India (Babu et al. 2009) suggest an approximately 175 km thick lithosphere. Also, analysis of heat flow data and P-T estimates on mantle xenoliths from the Dharwar craton reveal low mantle heat flow, 14-20 mW m-2, that indicate a thick lithosphere beneath south India (Roy and Mareschal, 2011). Upper mantle heterogeneities and depth localization of anisotropy structures beneath India are poorly known. In order to solve these issues, we have to follow a multidisciplinary approach to investigate the lithospheric and asthenospheric structure underneath the Indian cratons and the Indian plate. Seismological studies (receiver functions, SKS splitting, anisotropic and surface waves studies of the Indian continent) in conjunction with heat flow, petrological and paleomagnetic data planning to be utilized to image and interpret the 3D-tomographic velocity and anisotropic structure of the whole continent and trace its evolution through time. In this work, we present the high resolution phase velocity maps with azimuthal anisotropy of fundamental and higher mode surface waves propagating across India.

  3. 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

  4. Shaping Bladder and Bowel Continence in Developmentally Retarded Preschool Children.

    ERIC Educational Resources Information Center

    Richmond, Glenn

    1983-01-01

    A program to improve bowel and bladder continence with four developmentally retarded preschoolers used a regular schedule and social and liquid reinforcement, verbal reprimand, and correction for accidents. Ss showed improvement in bowel and bladder continence. (Author/CL)

  5. 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

  6. Efficacy of physiotherapy for urinary incontinence following prostate cancer surgery.

    PubMed

    Rajkowska-Labon, Elżbieta; Bakuła, Stanisław; Kucharzewski, Marek; Sliwiński, Zbigniew

    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

  7. 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

  8. 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

  9. 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.

  10. Surgery for Stress Urinary Incontinence

    MedlinePlus

    ... Management Education & Events Advocacy For Patients About ACOG Surgery for Stress Urinary Incontinence Home For Patients Search ... Stress Urinary Incontinence FAQ166, July 2014 PDF Format Surgery for Stress Urinary Incontinence Special Procedures What is ...

  11. Burn resuscitation on the African continent.

    PubMed

    Rode, H; Rogers, A D; Cox, S G; Allorto, N L; Stefani, F; Bosco, A; Greenhalgh, D G

    2014-11-01

    A survey of members of the International Society of Burn Injuries (ISBI) and the American Burn Association (ABA) indicated that although there was difference in burn resuscitation protocols, they all fulfilled their functions. This study presents the findings of the same survey replicated in Africa, the only continent not included in the original survey. One hundred and eight responses were received. The mean annual number of admissions per unit was ninety-eight. Fluid resuscitation was usually initiated with total body surface area burns of either more than ten or more than fifteen percent. Twenty-six respondents made use of enteral resuscitation. The preferred resuscitation formula was the Parkland formula, and Ringer's Lactate was the favoured intravenous fluid. Despite satisfaction with the formula, many respondents believed that patients received volumes that differed from that predicted. Urine output was the principle guide to adequate resuscitation, with only twenty-one using the evolving clinical picture and thirty using invasive monitoring methods. Only fifty-one respondents replied to the question relating to the method of adjusting resuscitation. While colloids are not available in many parts of the African continent on account of cost, one might infer than African burn surgeons make better use of enteral resuscitation. PMID:24560434

  12. 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). ...

  13. 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

  14. Relationship between mode of delivery and development of urinary incontinence: A possible link is demonstrated

    PubMed Central

    Saadia, Zaheera

    2015-01-01

    Background Urinary incontinence is a major problem faced by many mothers and has been traditionally linked to diverse ways of delivery. However, there is still a lack of clinical data, which can corroborate this notion. Thus, the present study was conducted to evaluate the correlation of urinary incontinence developed in women under different modes of delivery that have been used during childbirth. The study was conducted by considering three ways of delivery such as vaginal, cesarean section and the use of instruments during childbirth. The results were compared in each group in terms of number of women that developed or experienced urinary incontinence with those who have no problem at all or have minor problems. Methods The study was conducted at Qassim University Clinic, and Maternity and Child Hospital Buraidah from Jan–May 2015 as a descriptive cross sectional study. The objective was to determine the core reasons as to why women tend to develop some urinary incontinence after delivery. First 111 women without urinary incontinence and 100 women with urinary incontinence were asked retrospectively about the number of vaginal deliveries they had underwent. Then another group (111 without urinary incontinence and 100 with urinary continence were asked about the number of instrumental deliveries they had undegone. The same was repeated (111 women without urinary incontinence and 100 with urinary incontinence) for women with cesarean section. Results Having five or more vaginal births had a significantly (p<0.001) high risk for development of urinary incontinence (n=74, 66.67%) as compared to no urinary incontinence (n=8, 8.0%). In the group who had no cesarean section, there was a significantly (p <0 .001) larger proportion of participants with urinary problems (n = 100, 90.09%) than those without urinary problems (n = 61, 61.0%). For participants who have had an instrumental delivery, there was a significantly (p =0 .014) larger proportion of participants with urinary problems (n = 22, 19.82%) than those without urinary problems (n = 8, 8.0%). However, for participants that have not had an instrumental delivery, there was a significantly larger amount of participants without urinary problems than those with urinary problems (p <0 .001). Conclusion Women with 5 or more vaginal deliveries as well as instrumental deliveries were more liable to develop urinary incontinence in this study. This may be because vaginal deliveries and instrumental deliveries lead to perineal damage. This is further supported by the results of this study showing that women who never had cesarean section were more likely to report urinary incontinence PMID:26715925

  15. 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…

  16. 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).

  17. Slab Rollback Instability and Super-Continent Dispersal

    NASA Astrophysics Data System (ADS)

    Bercovici, D.; Long, M. D.

    2014-12-01

    Super-continents coalesce over subduction zone complexes and their subsequent dispersal is usually attributed to heating and upwelling of continent-insulated mantle. This dispersal mechanism, however, requires considerable mantle internal heating. Alternatively, the super-continent configuration may be mechanically unstable and disperse regardless of heating mode. In particular, increased drag on plates or subducting slabs (e.g., by accumulating continents) causes them to slow down and trenches to rollback. Once subcontinental slabs are slightly separated, resistance to their descent increases, inducing further trench migration. Slabs thus undergo a rollback instability, which disperses super-continents. A simple theoretical model illustrates this instability and shows there are two equilibrium states, one unstable super-continent state where slabs are conjoined, and one stable state where slabs are widely separated. Slab rollback from the unstable to stable states occurs at typical slow tectonic speeds, and over a period commensurate with the age of ocean basins and the Wilson cycle.

  18. Developing an Internationally-Applicable Service Specification for Continence Care: Systematic Review, Evidence Synthesis and Expert Consensus

    PubMed Central

    Wagg, Adrian S.; Newman, Diane K.; Leichsenring, Kai; van Houten, Paul

    2014-01-01

    Background Global demographic trends suggest that the incidence of both urinary and faecal incontinence will rise in the coming years, bringing significant health and economic implications for both patients and payers. There is limited organisational evidence to guide payers and providers about service configuration which will deliver efficient guideline-compliant, high-quality patient care. Objectives To create, using evidence from a systematic review, qualitative data and expert consensus an internationally applicable service specification for continence care. Method Evidence was obtained from a systematic and grey literature review of published randomised controlled trials and quasi-experimental studies reporting efficacy of continence service design at the level of the community dwelling patient with either bladder or bowel incontinence, governmental reports and policy frameworks supplemented by data from 47 semi-structured interviews with clinicians, patients, patient-representatives and policy experts from four geographies broadly representative of different healthcare systems. Results A number of themes related to current and potential future organisation of continence care were identified from the data. A modular service specification with eight core components was created including case detection, initial assessment and treatment, case co-ordination, caregiver support, community-based support, specialist assessment and treatment, use of containment products, and use of technology. Within this framework important key recommendations are: ensure robust referral pathways, shift assessment for case coordination to nurses specializing in continence care, promote self-management and technology, use comprehensive assessment tools and service performance targets based on outcome and operational measures. Conclusions This study has defined practice gaps in the provision of continence services and described eight core components of a service specification for incontinence that commissioners and payers of health and social care could consider using to provide high-quality continence care. A shift towards a community-delivered, nurse-led model appears to be associated with clinical and cost-effective care for people with bladder and bowel incontinence. PMID:25121511

  19. 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.

  20. The innervation of the muscles of continence.

    PubMed Central

    Snooks, S. J.; Swash, M.

    1986-01-01

    Electrophysiological evidence is presented that suggests that the innervation of the human puborectalis muscle differs from that of the external anal sphincter muscle. The latter is innervated by branches of the pudendal nerves, and the former by direct branches of the sacral plexus that enter the muscle from its pelvic surface. The striated urinary sphincter musculature also receives a dual innervation. The periurethral component is innervated by perineal branches of the pudendal nerves and the intramural portion by a different pathway, probably consisting of supralevator branches derived from the pelvic nerves. These findings are relevant to understanding the embryological derivation of these muscles and have practical importance in the surgery of this region of the body, particularly in the treatment of incontinence. PMID:3947015

  1. [Urinary sediment analysis].

    PubMed

    Baños-Laredo, Martha E; Núñez-Álvarez, Carlos A; Cabiedes, Javier

    2010-01-01

    Urinary analysis is one of the most requested tests in the clinical laboratory. This test includes the physical, chemical and microscopic analysis of urine. This last one allows for the observation of urinary sediment (US) in search of formed elements (cellular cast, leukocytes, etc.), with different diagnostic uses. Urinary analysis can be assessed by manual or automated methods. In the laboratory diagnosis of autoimmune diseases, US analysis is mainly oriented towards the assessment of renal function in patients with lupus nephritis (LN) as this is a common clinical manifestation associated to systemic lupus erythematosus (SLE). Additionally, its value lies mainly for diagnostic criteria and evaluation of kidney injury, as well as for several damage indexes directed to patients with SLE. In the last years, several groups have sought to establish new urinary biomarkers of kidney damage in patients with SLE; however, this requires a greater number of studies to determine their true diagnostic value in this patients group. PMID:21794729

  2. 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- ...

  3. 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 ...

  4. Urinary Tract Infections

    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 ...

  5. [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

  6. 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

  7. Dynamic topography over the Antarctic continent

    NASA Astrophysics Data System (ADS)

    Anderson, L.; Ferraccioli, F.; Eagles, G.; Steinberger, B. M.; Ritsema, J. E.

    2012-12-01

    Our knowledge of dynamic topography in Antarctica remains in an infancy stage compared to other continents. We assess the space-time variability in dynamic topography in Antarctica by analysing grids of global dynamic topography from present-day to 80 Ma based on the tomographic model S40RTS. Our model reveals that the Gamburtsev Province and Dronning Maud Land, two of the major nucleation sites for the East Antarctic Ice Sheet (EAIS) were ~500 m higher 60 Ma ago. The increased elevation may have facilitated ephemeral ice cap development in the early Cenozoic. Between ca 25 and 50 Ma the northern Wilkes Subglacial Basin was ca 200 m higher than today and a major increase in regional elevation (>600 m) occurred over the last 20-15 Ma over the northern and southern Victoria Land in the Transantarctic Mountains (TAM). The most prominent signal is observed over the Ross Sea Rift (RSR) where predicted Neogene dynamic topography exceeds 1,000 m. The flow of warm mantle from the West Antarctic Rift System (WARS) may have driven these dynamic topography effects over the TAM and RSR. However, we found that these effects are comparatively less significant over the Marie Byrd Land Dome and the interior of the WARS. If these contrasting dynamic topography effects are included, then the predicted elevations of the Ross Sea Embayment ca 20 Ma ago are more similar to the interior of the WARS, with significant implications for the early development of the West Antarctic Ice Sheet

  8. [Urinary tract infections].

    PubMed

    Hrl, 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

  9. 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

  10. 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…

  11. Are adults content or continent after repair for high anal atresia? A long-term follow-up study in patients 18 years of age and older.

    PubMed Central

    Hassink, E A; Rieu, P N; Severijnen, R S; vd Staak, F H; Festen, C

    1993-01-01

    OBJECTIVE: This study investigated the current state of fecal and urinary continence in an extensive group of adults after operative correction for high anorectal malformations and how they cope with their incontinence. SUMMARY BACKGROUND DATA: Normal fecal continence is hardly to be expected after correction for high anorectal malformation; despite this, it is commonly accepted that for most patients fecal continence improves with growing age and that most adult patients have no problems. Until now, however, few long-term follow-up studies in small groups of adults have been performed to assess continence after operative repair for high anorectal malformation. METHODS: Fifty-eight adult patients (median age, 26.0 years; range, 18.1 to 56.9 years) with an operatively corrected high anorectal malformation were evaluated by questionnaire with respect to their current state of fecal and urinary continence and mode of control of defecation. RESULTS: Seven patients have a permanent ileostoma or colostoma. Of the 51 patients with anal defecation, 61% control defecation by themselves, whereas 35% control defecation by using enemas or bowel irrigations, and 4% do not have any control at all. Besides medical therapy, 65% take dietary measures to influence defecation. According to existing scoring methods, 41% reached good and 49% fair control of defecation, whereas only 10% had poor control. Current control of defecation was reached from a median age of 15.0 years (range, 5 to 31 years). CONCLUSION: Conclusively, the authors can say that after correction for high anorectal malformation nobody reached normal fecal continence. Most patients with anal defecation reached good and fair control of defecation, however. Of all 58 patients, 84% are satisfied with their level of cleanliness. PMID:8343000

  12. Apparent digestibility of nutrients in diets with different energy density, as estimated by direct and marker methods for pigs with or without ileo-cecal cannulas.

    PubMed

    Mroz, Z; Bakker, G C; Jongbloed, A W; Dekker, R A; Jongbloed, R; van Beers, A

    1996-02-01

    The objective of this study were a) to compare the apparent total tract digestibility (TD) between non-cannulated (intact) and cannulated (steered ileo-cecal valve technique, SICV) pigs fed diets differing in energy density (Exp. 1) and b) to compare the direct vs marker (Cr2O3) methods for estimation of the TD and apparent ileal digestibility (ID) in SICV-cannulated pigs (Exp. 2). In Exp. 1, 24 intact and 18 SICV-cannulated castrates of approximately 40 kg initial BW were randomly assigned to six treatments in a 2 x 3 x 2 factorial arrangement (two pig types, three carbohydrate sources, and two fat levels). In Exp. 2, the same SICV-cannulated pigs from Exp. 1 were given those treatments in a 2 x 3 x 2 factorial arrangement (two methods of digestibility estimation, three carbohydrates sources, and two fat levels). In both experiments either cornstarch, soybean hulls, or pure cellulose, without or with fat, were incorporated into a barely-soybean meal based diet to alter energy density. Daily diets were isoenergetic (based on NEf), and water supply was .33 L/MJ of NEf. In Exp. 1, the pig type effect on the TD of DM, OM, CP, and the pig type x carbohydrate interactions for the TD of DM, OM, and crude fiber (CF) were significant (P < .05), merely due to a larger difference found for the diet enriched with cellulose. In Exp. 2, the TD and ID evaluated with the marker method were significantly lower (except for the TD of CF) than with the direct method, mainly because Cr recovery was below 100%. Overall, the marker method seems to be superior because the TD means obtained from Cr ratios were closer to the TD obtained from intact pigs. In general, the SICV technique seems to be suitable for long-term digestibility studies to measure the TD and ID in the same pig fed low-or high-fiber diets. PMID:8690677

  13. 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. Although Doug cannot now write the synthesis of the INDEPTH-3 results from central Tibet, nor lead the final INDEPTH-4 campaign across the northern margin of Tibet that he was already planning, our picture of Tibet, and hence of all continent-continent collisions, has changed and grown far richer as a result of his efforts. Among other things, INDEPTH has traced the top of the Indian plate descending beneath the Himalaya, located the likely limit of penetration of Indian mantle beneath central Tibet, and amassed considerable evidence for widespread melt within the Tibetan crust. The first observation, identification of the suture in an active collision, was a natural outgrowth of Doug's earlier contributions to the geometry of the Applachians and Ouachitas. The second observation directly relates to Doug's interest in the evolution of the deep crust/uppermost mantle in old orogens through delamination. The last observation, that melt is widespread in Tibet, was perhaps the most surprising result of the INDEPTH surveys, and the one that Doug used to greatest effect in his synthesis of deformation and crustal evolution around the Tertiary Indus-Tsangpo suture. Doug's articulate and enthusiastic arguments on the inferred role of low viscosity of the middle crust of the Tibetan plateau have been widely echoed in the latest generation of models by many authors that appeal to the flow of crustal material outwards from the central plateau to its southern and eastern margins. This emphasis on crustal mobility in young continent-continent collisions is already influencing our interpretations of ancient orogens.

  14. 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

  15. Postpartum stress urinary incontinence: lessons from animal models

    PubMed Central

    Gill, Bradley C; Moore, Courtenay; Damaser, Margot S

    2010-01-01

    Postpartum stress urinary incontinence (SUI) is associated with chronic SUI in later life, which is 240% more likely to occur in women who deliver vaginally than those who did not. The etiology of SUI is multifactoral and has been associated with defects in both neuromuscular and structural components of continence. Specifically, clinical studies have demonstrated that pudendal nerve damage occurs during vaginal delivery, supporting the concept that neuromuscular damage to the continence mechanism can result in postpartum SUI. Urethral hypermobility and the loss of pelvic floor support, such as that involved in pelvic organ prolapse, have also been associated with SUI. Animal models provide an opportunity to investigate these injuries, individually and in combination, enabling researchers to gain further insight into their relative contributions to the development of SUI and the effectiveness of potential therapies for it. This article discusses the use of animal models of postpartum SUI in addition to the broad insights into treatment efficacy they provide. PMID:21113428

  16. [Prevalence and risk factors of urinary incontinence in female workers of hotels].

    PubMed

    Fontana, L; Falconi, G; Di Martino, T; Iavicoli, I

    2007-01-01

    The International Continence Society defines urinary incontinence (UI) as "a condition in which involuntary loss of urine is a social or hygienic problem and is objectively demonstrable". There are three different jorms of UI. stress urinary incontinence, urge urinary incontinence and mixed incontinence. The aim of this study was to investigate the prevalence of UI in a group of female workers in the hotel sector. The International Consultation on Incontinence Questionnaire Urinary Incontinence short form (ICIQ-UI Short Form) was administered to all female workers and data were collected about age, body mass index, number of vaginal and Caesarean delivery. Results showed a prevalence of UI widely bigger in the plans waitress than in video display terminal workers and suggest the hypothesis that manual handling of loads representing a possible occupational risk for UI. PMID:18409860

  17. Equatorial Electrojet Observations in the African Continent

    NASA Astrophysics Data System (ADS)

    Yizengaw, E.; Moldwin, M. B.; Mebrahtu, A.; Damtie, B.; Pfaff, R.; Zesta, E.

    2008-12-01

    Although Satellite observations in the African sector show unique equatorial ionospheric structures that can severely impact navigation and communication systems, the study of ionospheric disturbances in this region is difficult due to the lack of ground-based instruments. This has created a gap in global understanding of the physics behind the evolution and formation of plasma irregularities in the equatorial region, which imposes limitations on ionospheric density modeling efforts. Therefore, in order to have a more complete global understanding of equatorial ionosphere motion, the international space science community has begun to develop an observational infrastructure in the African sector. This includes the deployment of a number of arrays of small instruments, including the AMBER magnetometer array, through the International Heliophysical Year (IHY) cooperative program with the United Nations Basic Space Science (UNBSS) program. Two AMBER magnetometers have been deployed successfully at Adigrat (~6°N magnetic) in Ethiopia and at Medea in Algeria (28°N magnetic), and became fully operational on 03 August 2008. The remaining two AMBER magnetometers will be deployed soon in Cameroon and Namibia. One of the prime scientific objectives of AMBER is to understand the processes governing electrodynamics of the equatorial ionosphere as a function of latitude, local time, magnetic activity, and season in the African region. The most credible driving mechanism of ionospheric plasma (E × B drift) can be estimated using two magnetometers, one right at the equator and the other about 6 off the equator. Therefore, using the AMBER magnetometer at Adigrat and the INTERMAGNET magnetometer located at Addis Ababa (0.9°N magnetic) in Ethiopia, the equatorial electrojet (E × B drift) activities in that longitudinal sector of the African continent is estimated. The paper also presents the comparison between the estimated vertical drift and the drift values obtained from the vector electric field instrument observation onboard the C/NOFS satellite. The evolution of equatorial ionospheric irregularities will also be presented using data from the growing number of ground- and space-based (on Low-Earth-Orbit (LEO) satellites) GPS receivers in the African region.

  18. 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

  19. 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

  20. Components of the Urinary System

    MedlinePlus

    ... Anatomy & Physiology » Urinary System » Components of the Urinary System Cancer Registration & Surveillance Modules Anatomy & Physiology Intro to the Human Body Body Functions & Life Process Anatomical Terminology Review Quiz ...

  1. 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 ...

  2. 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 ...

  3. 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 ...

  4. [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

  5. 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…

  6. The controversy surrounding OxyContin abuse: issues and solutions

    PubMed Central

    Jayawant, Sujata S; Balkrishnan, Rajesh

    2005-01-01

    This paper overviews the controversies surrounding the abuse of prescription analgesic OxyContin® (oxycodone hydrochloride; Purdue Pharma, Stamford, CT, USA). It discusses solutions to this medication-related issue, which has been touted as reaching epidemic proportions. Relevant literature from 1990 to 2004 was identified through a MEDLINE search, and a thorough internet-based search was conducted to obtain the latest updates and government reports. OxyContin became popular as a street drug through its ability to induce a quick heroin-like euphoria. The media hype surrounding OxyContin abuse and the “black box” warning on its label may have added to the abuse and diversion. The US Food and Drug Administration took steps by writing letters to Purdue Pharma, the manufacturers of OxyContin. Purdue Pharma developed a database to identify OxyContin abusers throughout the nation and also launched campaigns to educate patients through the internet. Further suggestions to managing the abuse of OxyContin include: community pharmacists’ assessment of behavioral risk factors that could lead to patient medication abuse; medication abuse risk management courses for physicians; development of a national database linking all pharmacies specifically designed to identify abusers; and tamper-resistant prescription pads for controlled substances, which seems the most plausible and immediate solution to this problem. PMID:18360547

  7. 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 dense spacing of MCS lines perpendicular to the strike of the Baltim Hecateus Line it was possible to trace the line also in the salt covered parts south and north of the ESM.

  8. [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 clearance of the stone must be achieved by primary surgical procedure and residual fragments should be extensively treated. In the case of persistent infection, conservative measures, such as acidification and urease inhibitors or citrate administration, should be adopted to minimize its effect on urinary saturation with respect to struvite. PMID:24874306

  9. Mean Elevation of Continents and Survival of Islands

    NASA Astrophysics Data System (ADS)

    Zhang, Y.

    2009-12-01

    Continental mean elevation is controlled by tectonic uplift (including all solid earth processes and volcanic activities) and erosion, so is the mean thickness of continents. Assuming that a continent is large enough so that various tectonic processes can be averaged to behave similarly, the balance between uplift and erosion results in a steady state mean elevation that increases with the area of a continent (Zhang, 2005). The model fits the mean elevation of continents well, but many islands depart from the curve of mean elevation versus land area. Here I explore the elevation and survival of the islands. An island is small so that one cannot assume it would display average character in terms of tectonic processes. Oceanic islands are there largely because of recent volcanic activities leading to an uplift rate much higher than the average uplift rate. On the other hand, once such special conditions fade away, islands are eroded rapidly. Based on the modeling of Zhang (2005), the half-erosion time to erode an island is roughly proportional to the square root of the land area of the island. Hence, scaling from the half-erosion time of the largest continent (about 100 Myr, Harrison, 1994), the half-erosion time for islands once tectonic activity stops can be estimated. For example, the half-erosion time for Hawaii Island is estimated to be 1.3 Myr, roughly consistent with the rate of disappearing of older Hawaiian Islands. The half-erosion time is 0.16 Myr for the present-day Easter Island, and 10 Myr for Madagascar once uplift stops. In view of the short erosion time scale, the islands are present and survive because of special tectonics, such as volcanic activities, recent separation from continents, etc. References: C.G.A. Harrison (1994) Geol. Rundsch. 83, 431-447. Y. Zhang (2005) Earth Planet. Sci. Lett. 237, 524-531.

  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. [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

  12. 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

  13. Current trends in the evaluation and management of female urinary incontinence

    PubMed Central

    Smith, Phillip P.; McCrery, Rebecca J.; Appell, Rodney A.

    2006-01-01

    Despite its common occurrence and often seemingly obvious causes, female urinary incontinence requires a thorough and thoughtful evaluation for its proper diagnosis and treatment. With rare exceptions, urinary incontinence is the result of failure of the sphincter mechanism to resist bladder pressures encountered during daily activities. This may be the result of sphincter failure, overactivity of the bladder detrusor muscle or both. In uncomplicated cases, the diagnosis is usually based on an evaluation in the office. Urodynamic and cystoscopic study may be helpful in complex, resistant and recurring cases of urinary incontinence of any cause. Most cases of incontinence may be classified as stress, urge or mixed urinary incontinence. Treatment of stress urinary incontinence focuses on supplementing the urethral continence mechanisms, particularly the urethral supports and periurethral striated muscle function. The current paradigm for the treatment of urge incontinence centres on pharmacologic therapy, primarily by correcting detrusor overactivity with antimuscarinic drugs. Other therapies aimed at altering sensorimotor function may be used in resistant cases. The treatment of mixed urinary incontinence requires consideration of the contribution of each of its components. With proper diagnosis, effective treatment is possible for most patients. PMID:17098954

  14. 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

  15. 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

  16. 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.

  17. [Urinary antimicrobial prophylaxis].

    PubMed

    Nathanson, S; Deschnes, 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

  18. 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.

  19. 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

  20. 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.

  1. 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 sediment accumulation. The Miocene here is very thin. Deltaic progradation across most of Bangladesh during the Miocene followed earlier, more proximal progradation across Assam, immediately northeast of the Bengal basin, and has been followed by continued progradation into the southern Bangladesh coastal and offshore region.

  2. 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 the pathogenesis of the enuresis and infections observed the SCD patients. PMID:26241312

  3. Neurogenic aspects of stress urinary incontinence

    PubMed Central

    Sajadi, Kamran P.; Gill, Bradley C.; Damaser, Margot S.

    2011-01-01

    Purpose of review Vaginal childbirth is a significant risk factor for stress urinary incontinence (SUI). Women with SUI demonstrate dysfunction of the pelvic floor and pudendal nerve. Animal models of SUI have been developed to investigate its pathophysiology and for preclinical testing of potential treatments. Recent findings Vaginal distension, a method of simulating childbirth injury in animals, produces a reliable decrease in leak point pressure (LPP), a measure of urethral resistance to leakage and quantification of SUI severity in animals. In addition to ischemia and direct tissue damage, vaginal distension causes denervation of the external urethral sphincter (EUS). Pudendal nerve crush produces a similar decrease in LPP, whereas combined PNC and vaginal distension injury delays recovery of LPP compared with either single injury alone. Neurophysiologic studies have elucidated the results of each injury and their combination on pudendal nerve and EUS function. Urethrolysis, electrocautery, and pudendal nerve transection produce more durable functional impairment via both structural damage and denervation. Pubourethral ligament injury eliminates the structural support of the urethra, but its neurologic effects are unknown. Summary Animal models demonstrate a complex interplay between tissue damage and pudendal nerve dysfunction, and provide insight into the importance of neuroregeneration in the recovery of continence. PMID:20706117

  4. Oceanic plateaus, the fragmentation of continents, and mountain building

    SciTech Connect

    Nur, A.; Ben-Avraham, Z.

    1982-05-10

    Many anomalous rises in today's oceans may be submerged continental fragments detached from previous continents, ancient island arcs, or basaltic piles formed by hot spots and spreading centers. These rises are embedded in their respective moving oceanic plates and are fated to be consumed at active margins. Where such rises are being consumed at present, e.g., the Nazca Ridge, they cause cessation of volcanism, disruption of the downgoing slab, and possible shifts in plate boundary configuration. Many past rises, including numerous continental fragments have been recognized within mountain belts as allochthonous terranes. They constitute a large portion of the orogenic belts in the North Pacific from Mexico through western North America, Alaska, east Siberia, Japan and in New Zealand. The orogenic deformation in these belts is possibly the result of the accretion of the allochtronous terranes. Many terranes have been accreted with substantial deformation also in the Alpine chain, well before major continent-continent collisions. It is suggested, therefore, that the accretion of fragments may be the common process of the deformation phase of mountain building. Subduction of normal oceanic crust may be insufficient for deformation, whereas full continent-continent collision may be necessary. The general validity of this conclusion depends critically on whether allochthonous terranes caused orogenic deformation in the Andes or not. Most of the accreted fragments with continental affinites in the Mesozoic-Cenozoic orogenic belts of the world can be traced back to the breakup of Gondwana, beginning with a Pacifica domain in the Permian through a larger India domain in the early Mesozoic and continuing through the separation of the Somalia plate in the near future. The reasons for this 250 million year breakup process are not known, but some kind of thermal process, possible of mantle-wide scale, is implied.

  5. Urinary infections in children.

    PubMed

    Mishra, Om Prakash; Abhinay, Abhishek; Prasad, Rajniti

    2013-10-01

    Urinary tract infection (UTI) is a common infection in infants and children. During infancy, boys are more commonly affected than girls and thereafter, female preponderance is found. Presentation varies among different age groups. Clinical features in neonates and young infants are non-specific, manifest as septicemia where a high index of suspicion is needed. Older children typically present as simple or complicated UTI. Rapid diagnosis, institution of early treatment and further evaluation by imaging modalities are of utmost importance. The prevention of recurrent UTI and detection of congenital anomalies of kidney and urinary tract are major objectives in the management. Use of ultrasound is required to detect underlying congenital abnormalities, whereas voiding cystourethrogram and dimercaptosuccinic acid (DMSA) scan are useful in the diagnosis of obstructive uropathy and vesicoureteric reflux and renal scar, respectively. The children requiring surgical interventions are to be recognised early to prevent recurrent UTI. The treatment of vesicoureteric reflux by chemoprophylaxis in lower grades and surgical treatment in higher grades are important consideration in prevention of recurrent UTI. This is required to prevent renal parenchymal damage and scarring that can cause hypertension and progressive renal insufficiency in later life. PMID:23881478

  6. Hydration of the lithospheric mantle by the descending plate in a continent-continent collisional setting

    NASA Astrophysics Data System (ADS)

    Massonne, Hans-Joachim

    2014-05-01

    When continents collide, can the orogenic crust be thickened by the process of wholesale underthrusting of the descending plate (Zhou & Murphy, 2005)? Actually, thick lithospheric plates collide after complete subduction of the oceanic plate in between. Thus, the role of the lithospheric mantle below the upper plate must be considered to answer this question. As the descending plate, especially its former near-surface region, significantly dehydrates, the hydration of this mantle portion was studied. For this reason, pressure (P) - temperature (T) and T- H2O pseudosections were calculated for an average mantle composition using the computer software PERPLEX (Connolly, 2005). These pseudosections were contoured by isopleths for volumes of amphibole, chlorite, and serpentine. It can be easily recognized from the produced graphs that considerable amounts of amphibole and chlorite can result from addition of some water to the dry ultrabasite. In the P-range 8 to 15 kbar, a maximum of nearly 20 vol.% amphibole and 10 vol.% chlorite forms when only 1.5 wt.% H2O is added at temperatures up to 700C. This amount of chlorite continuously disappears with rising temperatures up to 800C and somewhat more. In the given P-range, serpentine forms only below 600C and H2O contents >2 wt.% added. For example, at 550C and 5 wt.% H2O hydrous phases amount to about 35 vol.% serpentine, 10 vol.% of each chlorite and amphibole and very little biotite in the studied ultrabasite. As the hydration of the lithospheric mantle below the upper plate would change its rheological properties, the following geodynamic scenario is conceivable: The tip of the descending continental plate hydrates this mantle portion and weakens it. This allows the buoyant tip of this plate to penetrate the lithospheric mantle close to the interface of mantle and overlying crust. As the dehydration of the penetrating continental crust continues by heating, the hydration and weakening of the mantle is also ongoing to cause a significant penetration and, thus, a wholesale thrusting of the descending plate under the other continental plate, eventually with a thin hydrated mantle region in between. For example, pelitic rocks, common in the upper portion of continental crust, can release about 2.5 wt.% H2O between 450 to 650C at 10-15 kbar (e.g. Massonne et al., 2013). A pile of 3 km of such rocks extending over 300 km perpendicular to the initial orogenic front could supply so much water to produce a 500 m thick weak zone in the mantle with about 20 vol.% amphibole and 10 vol.% chlorite over 3000 km. The termination of the underthrust process can be caused by heating of the frontal portion of the underthrust plate to 650C and more, which is then not anymore capable to hydrate the lithospheric mantle. Connolly, J.A.D., 2005. Earth Planet. Sci. Letters 236, 524-541. Massonne, H.-J. et al., 2013. Lithos 156-159, 171-185. Zhou, H.-W. & Murphy, M.A., 2005. J. Asian Earth Sci. 25, 445-457

  7. Mantle temperature under drifting deformable continents during the supercontinent cycle

    NASA Astrophysics Data System (ADS)

    Yoshida, Masaki

    2013-04-01

    The thermal heterogeneity of the Earth's mantle under the drifting continents during a supercontinent cycle is a controversial issue in earth science. Here, a series of numerical simulations of mantle convection are performed in 3D spherical-shell geometry, incorporating drifting deformable continents and self-consistent plate tectonics, to evaluate the subcontinental mantle temperature during a supercontinent cycle. Results show that the laterally averaged temperature anomaly of the subcontinental mantle remains within several tens of degrees (±50 °C) throughout the simulation time. Even after the formation of the supercontinent and the development of subcontinental plumes due to the subduction of the oceanic plates, the laterally averaged temperature anomaly of the deep mantle under the continent is within +10 °C. This implies that there is no substantial temperature difference between the subcontinental and suboceanic mantles during a supercontinent cycle. The temperature anomaly immediately beneath the supercontinent is generally positive owing to the thermal insulation effect and the active upwelling plumes from the core-mantle boundary. In the present simulation, the formation of a supercontinent causes the laterally averaged subcontinental temperature to increase by a maximum of 50 °C, which would produce sufficient tensional force to break up the supercontinent. The periodic assembly and dispersal of continental fragments, referred to as the supercontinent cycle, bear close relation to the evolution of mantle convection and plate tectonics. Supercontinent formation involves complex processes of introversion, extroversion or a combination of these in uniting dispersed continental fragments, as against the simple opening and closing of individual oceans envisaged in Wilson cycle. In the present study, I evaluate supercontinent processes in a realistic mantle convection regime. Results show that the assembly of supercontinents is accompanied by a combination of introversion and extroversion processes. The regular periodicity of the supercontinent cycles observed in previous 2D and 3D simulation models with rigid nondeformable continents is not confirmed. The small-scale thermal heterogeneity is dominated in deep mantle convection during the supercontinent cycle, although the large-scale, active upwelling plumes intermittently originate under drifting continents and/or the supercontinent. Results suggest that active subducting cold plates along continental margins generate thermal heterogeneity with short-wavelength structures, which is consistent with the thermal heterogeneity in the present-day mantle convection inferred from seismic tomography models. References: [1] Yoshida, M. Mantle temperature under drifting deformable continents during the supercontinent cycle, Geophys. Res. Lett., 2013, in press. [2] Yoshida, M. and M. Santosh, Mantle convection modeling of supercontinent cycle: Introversion, extroversion, or combination?, 2013, submitted.

  8. Priority pharmacogenetics for the African continent: focus on CYP450.

    PubMed

    Alessandrini, Marco; Pepper, Michael S

    2014-02-01

    Countries in Africa have a high burden of communicable disease, and are experiencing an increase in noncommunicable diseases due to the effects of globalization, industrialization and urbanization. The costs incurred through adverse drug reactions and nonresponsiveness to therapy further aggravates the situation, and the application of pharmacogenetic principles is likely to provide some relief. Having undertaken an extensive evaluation of CYP450 reports in Africa, our objective was to map out areas of need based on regional disease burdens. The data confirms a paucity of CYP450 reports and illustrates large regions for which no population information exists. There is a dire need to address the health problems of Africa, and wide-scale pharmacogenetic profiling of these populations will add significantly to improving patient care on the continent. Priority pharmacogenetics for the African continent gives precedence to the profiling of clinically relevant pharmacogenetic biomarkers, and defines the immediate need in the context of disease burden. PMID:24533717

  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. 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.

  13. Mid-continent rift system: a frontier hydrocarbon province

    SciTech Connect

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

    1984-04-01

    The Mid-continent rift system can be traced by the Mid-continent geophysical anomaly (MGA) from the surface exposure of the Keweenawan Supergroup in the Lake Superior basin southwest in the subsurface through Wisconsin, Minnesota, Iowa, Nebraska, and Kansas. Outcrop and well penetrations of the late rift Keweenawan sedimentary rocks reveal sediments reflecting a characteristic early continental rift clastic sequence, including alluvial fans, deep organic-rich basins, and prograding fluvial plains. Sedimentary basins where these early rift sediments are preserved can be located by upward continuation of the aeromagnetic profiles across the rift trend and by gravity models. Studies of analog continental rifts and aulacogens show that these gravity models should incorporate (1) a deep mafic rift pillow body to create the narrow gravity high of the MGA, and (2) anomalously thick crust to account for the more regional gravity low. Preserved accumulations of rift clastics in central rift positions can then be modeled to explain the small scale notches which are found within the narrow gravity high. Indigenous oil in Keweenawan sediments in the outcrop area and coaly partings in the subsurface penetrations of the Keweenawan clastics support the analogy between these rift sediments and the exceptionally organic-rich sediments of the East African rift. COCORP data across the rift trend in Kansas show layered deep reflectors and large structures. There is demonstrable source, reservoir, and trap potential within the Keweenawan trend, making the Mid-Continent rift system a frontier hydrocarbon province.

  14. Mid-Continent rift system: a frontier hydrocarbon province

    SciTech Connect

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

    1984-04-01

    The Mid-Continent rift system can be traced by the Mid-Continent geophysical anomaly (MGA) from the surface exposure of the Keweenawan Supergroup in the Lake Superior basin southwest in the subsurface through Wisconsin, Minnesota, Iowa, Nebraska, and Kansas. Outcrop and well penetrations of the late rift Keweenawan sedimentary rocks reveal sediments reflecting a characteristic early continental rift clastic sequence, including alluvial fans, deep organic-rich basins, and prograding fluvial plains. Sedimentary basins where these early rift sediments are preserved can be located by upward continuation of the aeromagnetic profiles across the rift trend and by gravity models. Studies of analog continental rifts and aulacogens show that these gravity models should incorporate (1) a deep mafic rift pillow body to create the narrow gravity high of the MGA, and (2) anomalously thick crust to account for the more regional gravity low. Preserved accumulations of rift clastics in central rift positions can then be modeled to explain the small scale notches which are found within the narrow gravity high. Indigenous oil in Keweenawan sediments in the outcrop area and coaly partings in the subsurface penetrations of the Keweenawan clastics support the analogy between these rift sediments and the exceptionally organic-rich sediments of the East African rift. COCORP data across the rift trend in Kansas show layered deep reflectors and large structures. There is demonstrable source, reservoir, and trap potential within the Keweenawan trend, making the Mid-Continent rift system a frontier hydrocarbon province.

  15. Comparative estimate of volcanism intensity on continents and in oceans

    SciTech Connect

    Ronov, A.B.; Khain, V.E.; Balukhovskii, A.N.

    1980-12-01

    A quantitative estimate of the volume of volcanogenic rocks and the volcanism intensity during different stages in the Earth's development indicates that the total volume of the tholeiitic basalts of Layer II of the oceans exceeds by 20 times that of the synchronous late Mesozoic-Cenozoic volcanics of the continents and is almost 5 times greater than the volume of the volcanogenic rocks of the entire Phanerozoic sequence of the continents. The absolute maxima of volcanism, determined on the basis of the area and volume of the corresponding volcanics, belong to the Late Cretaceous and Miocene intervals. Changes in the volcanic eruption areas took place synchronously in the Pacific, Atlantic, and Indian Oceans. The volcanism intensity, expressed in the volume of its products in km/sup 3/ per m.y., increases in the oceans from Late Jurassic to Pliocene time. During the Riphean and Vendian intervals, the volcanism intensity on the continents remained at an extremely low level, then increased during early Paleozoic time, and underwent a marked jump, beginning in the Devonian Period. Since Late Jurassic time, the intensity of global volcanism increased unusually sharply and reached its culmination during Neogene time.

  16. 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)

  17. When you have urinary incontinence

    MedlinePlus

    ... chap 69. Shamliyan TA, Kane RL, Wyman J, Wilt TJ. Systematic review: randomized, controlled trials of nonsurgical ... 459-73. Shamilyan TA, Wyman JF, Ping R, Wilt TJ, Kane RL. Male urinary incontinence: Prevalance, risk ...

  18. Variations of human urinary proteome.

    PubMed

    Chen, Yong

    2015-01-01

    The study on dynamic analysis of human urinary proteome is the foundation that we discriminate certain various urinary proteins as potential bio-marker derived from the disease itself or normal physiological change. In our results, based on RPLC-MS/MS and spectral count to study pooled and individual urine samples and other researchers' studies, it can be known that the content of many urinary proteins maintain relatively stable. We have reason to believe that the relatively stable urinary protein is a very valuable resource as biomarkers. Many similar proteins such as prostaglandin-H2 D-isomerase and apolipoprotein D proteins have been proved our hypothesis. The following field, the number, preservation and treatment methods of urine sample, the standardization of analysis method and data processing, and suitable quantitative method, is ought to the focus of future study. PMID:25355572

  19. Imaging of the Urinary Tract

    MedlinePlus

    ... tract is the body’s drainage system for removing wastes and extra water. The urinary tract includes two ... kidneys filter about 3 ounces of blood, removing wastes and extra water. The wastes and extra water ...

  20. [Surgical therapy of chronic anal fissure--do additional proctologic operations impair continence?].

    PubMed

    Pfeifer, J; Berger, A; Uranüs, S

    1994-07-01

    78 patients with chronic anal fissures have been mainly operated on by lateral internal sphincterotomy (LATS). Continence have been evaluated by questionnaire at least 9 months postoperatively. Patient without any additional proctological operation had minor disturbances of continence in 17%. Patient with additional operations had disturbances of continence in 30%. Especially the subgroup of patients with LATS and haemorrhoidectomy had bad results. In this group only 45% were fully continent. PMID:7924599

  1. 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

  2. Implementation of clinical guidelines for female urinary incontinence: a comparative analysis of organizational structures and service delivery.

    PubMed

    Knight, Ruth; Procter, Susan

    1999-07-01

    The aim of the study was to explore and compare the development of continence services in two contrasting trusts. The first was a community trust which had initiated a top-down purchaser-led continence service. The second was a combined acute and community trust which had introduced a bottom-up, organic continence service based on staff development. The research used a qualitative, interpretative design. Evidence-based guidelines for female urinary incontinence (FUI) were analysed and key organizational features elicited. These were used to frame and analyse 20 semi-structured interviews with a range of community-based professionals who provided a service to women suffering from urinary incontinence. The interviews identified practitioner knowledge and awareness of the evidence pertaining to the management and treatment of FUI and also the features of the organizational structure of service provision in their locality which facilitated or constrained the implementation of evidence-based treatment in this area. The findings suggest that evidence-based guidelines were more closely adhered to in practice, in the trust using organic approaches to service development. Top-down, purchaser led approaches were more prescriptive and circumscribed the scope of professional practice. This adversely affected access to services for women suffering from urinary incontinence. Organic approaches to service development produce more flexible, responsive services. It is difficult, however, to integrate this approach with strategic planning as the flexibility required maybe incompatible with managerial responsibilities for defining roles and organizational functions. PMID:11560644

  3. 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

  4. 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…

  5. Catchment sediment yield in Africa: a continent-wide analysis

    NASA Astrophysics Data System (ADS)

    Vanmaercke, Matthias; Poesen, Jean; Broeckx, Jente; Nyssen, Jan

    2014-05-01

    While several studies compiled and analyzed measured contemporary catchment sediment yield (SY, [t/km²/y]) values for various regions of the world, Africa remains strongly underrepresented in these studies. We therefore conducted a review on published SY data for Africa, explored the spatial variability of these SY data and examined which environmental factors explain this variability. We collected SY measurements of at least one year for 682 African catchments across the continent (> 8340 catchment-years) from 84 publications and reports. Catchment areas range from 0.02 km² to > 3,800,000 km². Observed SY values range between 0.2 and 15,699 t/km²/y (median: 160 t/km²/y, average: 634 t/km²/y). Correlation and partial correlation analyses showed that spatial variation of SY in Africa is mainly explained by differences in seismic activity, topography, vegetation cover and annual runoff depth. Other factors such as lithology, catchment area or reservoir impacts showed less clear correlations. Based on these findings we propose a simple regression model that allows simulating the observed regional patterns of SY in Africa fairly well. This model predicts an average SY of 42 t/km²/y for the entire African continent, a value that corresponds closely to earlier estimates of the sediment output of the African continent to the oceans. The fact that SY shows the strongest correlation with seismic activity, while climatic variables explain little of the observed variation can be considered surprising as Africa is relatively inactive in terms of seismic activity and is characterized by a very large climatic variability. This suggests that processes such as tectonically related rock-fracturing and earthquake-triggered landslides may have a stronger influence on contemporary SY-values than previously assumed.

  6. Variations in Tectonic Styles of Arc-Continent Collisions

    NASA Astrophysics Data System (ADS)

    van Staal, C.; Zagorevski, A.; Castonguay, S.; Massonne, H.; McNicoll, V.; Willner, A. P.

    2011-12-01

    Ancient arc-continent collisions are commonly informally described as hard or soft, although the differences between these two are rarely defined. We define a hard collision where the overriding arc (including infant arcs preserved in obducted ophiolites) has been significantly thickened in proximity to the suture zone due to internal deformation. Upper plate deformation involved progressive underthrusting and thickening of parts of the arc-forearc terrane, presumably as a result of progressive widening of the subduction channel into the hangingwall. The Late Cretaceous Kohistan arc collision with Eurasia or India is an example of a hard collision. A more ancient example of a well-studied arc-continent collision is the Early-Middle Ordovician, (Taconic) collision between the Laurentian Humber margin and the Notre Dame arc in the Northern Appalachians. The collision was hard where the arc was built on continental crust (Dashwoods), because parts of both the ophiolitic forearc basement (Baie Verte oceanic tract) and the leading edge of the arc block were locally intensely deformed and metamorphosed with conditions ranging from high pressure greenschist to amphibolite and/or granulite facies conditions. However, where the Notre Dame arc transgresses from a continental to an oceanic substrate, the style of collision appears to change from hard to soft and more resembles the relatively soft Late Cretaceous collision between the infant arc preserved in the Semail ophiolite and the Arabian continental margin. Subsequent Ordovician-Silurian collisions involving arc blocks in the Appalachians are generally soft or show a more intermediate character between hard and soft such as the China-Luzon arc collision in central Taiwan. Here most of the forearc block appears to have been deformed and subducted, whereas the arc itself remained relatively undeformed. Other orogens (e.g. Canadian Cordillera) may show a similar variation in style of arc-continent collisions.

  7. Liquid level control in an aerated continous-flow fermentor.

    PubMed

    Anderson, K W; Grulke, E; Gerhardt, P

    1985-06-01

    An electronic liquid level control system was developed to maintain constant working volume in a continuously fed and aerated fermentor from which spent medium was continously withdrawn by microfiltration in an external recycle loop. The level control system was comprised of an admittance sensor in the fermentor and an external transmitter and controller, which together regulated the speed of a recycle pump and thus the rate of liquid withdrawal from the fermentor. During test bacterial culture the liquid level was maintained usually within +/- 1% and always within +/- 5%. The control system could be applied to various other types and scales of continuous-flow fermentors. PMID:18553759

  8. 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.

  9. 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

  10. 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

  11. 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.

  12. 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.

  13. Importance of continence advice for people with multiple sclerosis.

    PubMed

    Griffith, Gwen

    Bladder and bowel problems are a common feature in patients with multiple sclerosis (MS). This article demonstrates how patients benefit from specialist input relating to continence as part of a multidisciplinary neurological rehabilitation service (MNRS). The implementation of the MNRS has offered a 'one-stop' referral system for people with an acquired or progressive neurological condition. The patient's condition should be such that active and effective rehabilitation can take place. One of the key aims of the service is to enable people to function as independently as possible by improving/maintaining their physical, social, and psychological well-being through appropriate assessment and treatment regimes. The Multiple Sclerosis Society recommends the involvement of specialist nurses and specialist multidisciplinary teams in the management of patients. The recommended standards suggest that people with MS should be put in contact with a specialist multidisciplinary team in their area where appropriate treatment in relation to tone management, posture, fatigue management and continence can be provided. Without specialist advice, patients may develop more serious and intractable problems in the longer term. The author will describe how working in a specialized team has moved towards meeting these recommendations and in so doing has enhanced care for people with MS. PMID:12514469

  14. 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.

  15. 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

  16. 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

  17. 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

  18. 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.

  19. 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.

  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 future well being of the conti notnent. Civil strife has resulted in the increased numbers of displaced persons and has caused a big setback in the fight against diseases and causes of ill health. In addition, there are new challenges created by emergence of new infections, re-emergence of diseases that had been put under control; and the changing epidemiological patterns and manifestations of existing diseases. Since disease and ill health know no bound notary, we must all be prepared to find solutions to diseases and causes of ill health that continuously haunt this continent. As health experts, we are concerned. We should not be responding to health emergencies occasioned by civil strife. We need peace as it will guarantee not only freedom and personal security, but it will also guarantee our future and the future of those to come after us. We are well aware that as is the case with developed nations, the development of our continent rests on the utilization of research findings, which must be useful, contextual and must stand the test of time. This is our mission and our hope. Africa is at the crossroads. We must not despair or quit, lest we become irrel notevant both to ourselves and to the rest of mankind. Let African governments give science a chance. As I have said several times before and I am still saying it now, quitters never win and winners never quit. We have no alternative but to be winners! PMID:17650041

  2. Self-consistent formation of continents on early Earth

    NASA Astrophysics Data System (ADS)

    Noack, Lena; Van Hoolst, Tim; Breuer, Doris; Dehant, Véronique

    2013-04-01

    In our study we want to understand how Earth evolved with time and examine the initiation of plate tectonics and the possible formation of continents on Earth. Plate tectonics and continents seem to influence the likelihood of a planet to harbour life [1], and both are strongly influenced by the planetary interior (e.g. mantle temperature and rheology) and surface conditions (e.g. stabilizing effect of continents, atmospheric temperature), and may also depend on the biosphere. Earth is the only terrestrial planet (i.e. with a rocky mantle and iron core) in the solar system where long-term plate tectonics evolved. Knowing the factors that have a strong influence on the occurrence of plate tectonics allows for prognoses about plate tectonics on terrestrial exoplanets that have been detected in the past decade, and about the likelihood of these planets to harbour Earth-like life. For this purpose, planetary interior and surface processes are coupled via 'particles' as computational tracers in the 3D code GAIA [2,3]. These particles are dispersed in the mantle and crust of the modelled planet and can track the relevant rock properties (e.g. density or water content) over time. During the thermal evolution of the planet, the particles are advected due to mantle convection and along melt paths towards the surface and help to gain information about the thermo-chemical system. This way basaltic crust that is subducted into the silicate mantle is traced in our model. It is treated differently than mantle silicates when re-molten, such that granitic (felsic) crust is produced (similar to the evolution of continental crust on early Earth [4]), which is stored in the particle properties. We apply a pseudo-plastic rheology and use small friction coefficients (since an increased reference viscosity is used in our model). We obtain initiation of plate tectonics and self-consistent formation of pre-continents after a few Myr up to several Gyr - depending on the initial conditions and applied rheology. Furthermore, our first results indicate that continents can stabilize plate tectonics, analogous to the results obtained by [5]. The model will be further developed to treat hydration and dehydration of oceanic crust as well as subduction of carbonates to allow for a self-consistent 3D model of early Earth including a direct link between interior and atmosphere via both outgassing [6] and regassing. References [1] Ward, P.D. and Brownlee, D. (2000), Rare Earth, Springer. [2] Hüttig, C. and Stemmer, K. (2008), PEPI, 171(1-4):137-146. [3] Plesa, A.-C., Tosi, N. and Hüttig, C. (2013), in: Integrated Information and Computing Systems for Natural, Spatial, and Social Sciences, IGI Global, 302-323. [4] Arndt, N.T. and Nisbet, E.G. (2012), Annu. Rev. Earth Planet. Sci., 40:521-549. [5] Rolf, T. and Tackley, P.J. (2011), GRL, 38:L18301. [6] Noack, L., Breuer, D. and Spohn, T. (2012), Icarus, 217(2):484-498.

  3. 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

  4. Nightly sildenafil use after radical prostatectomy has adverse effects on urinary convalescence: Results from a randomized trial of nightly vs on-demand dosing regimens

    PubMed Central

    Hyndman, Matthew Eric; Bivalacqua, Trinity J.; Feng, Zhaoyong; Mettee, Lynda Z.; Su, Li-Ming; Trock, Bruce J.; Pavlovich, Christian P.

    2015-01-01

    Introduction: This is a report on urinary function results from a randomized trial of nightly versus on-demand sildenafil after nerve-sparing radical prostatectomy (RP), a secondary objective. We analyzed the effects of these sildenafil administration schemes on urinary health-related quality of life after RP. Methods: In total, 100 potent men were equally randomized to nightly and on-demand sildenafil 50 mg after minimally-invasive RP for 1 year. Health-related quality of life questionnaires were administered at various postoperative intervals. Urinary function was assessed using appropriate expanded prostate cancer index composite (EPIC) subscales. Analyses of covariance and linear mixed-effects modeling were used to compare the effects of treatment over time on urinary recovery, controlling for age, nerve-sparing score, and time from surgery. Results: The nightly (n = 50) and on-demand (n = 50) sildenafil groups were well-matched at baseline. Nightly sildenafil patients had worse EPIC urinary bother and urinary irritative/obstructive subscale scores at 3 and 6 months after RP, even after controlling for multiple variables. On mixed-model analyses, the differences between groups for these EPIC subscales (4.9 and 2.5, respectively) were greater than documented thresholds for clinical significance. Increasing nerve-sparing score was associated with improvements in EPIC urinary summary, bother, incontinence, and function scores; time from surgery was associated with improvements in all EPIC urinary health-related quality of life subscales. Conclusions: In this specific population and drug dose, we found that on-demand short-acting phosphodiesterase-5 inhibitor (PDE5i) dosing may be more effective after RP to maximize early urinary health-related quality of life. In preoperatively potent men, nightly sildenafil 50 mg impaired urinary health-related quality of life more than on-demand use in the early months after nerve-sparing RP, independent of effects on urinary continence. PMID:26788231

  5. 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

  6. Urinary markers for bladder cancer

    PubMed Central

    Smith, Zachary L.

    2013-01-01

    Bladder cancer has the fifth highest incidence of all malignancies in the United States, with a propensity to recur, requiring lifelong surveillance after diagnosis. Urinary markers of disease have been of extreme interest in this field in an effort to simplify surveillance schedules and improve early detection of tumors. Many markers have been described, but most remain investigational. However, some markers have undergone clinical trials and are approved for clinical use. In this review, urinary markers and their application for screening and surveillance of bladder cancer are discussed. PMID:23864929

  7. 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

  8. 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-based products (GLEAM and MOD16) show a different seasonal behaviour compared to the other products. The results from this study contribute to a better understanding of the suitability and the differences between products in each climatic region. Through an improved understanding of the causes of differences between these products and their uncertainty, this study provides information to improve the quality of evaporation products for the African continent and, consequently, leads to improved water resources assessments at regional scale.

  9. Diseases of the Equine Urinary System.

    PubMed

    McLeland, Shannon

    2015-08-01

    Uncommon diseases of the equine urinary system span a variety of etiologies and frequently have nonspecific clinical presentations. Because of the infrequency of equine urinary disease and inconsistencies in clinical symptoms, diagnosis and subsequent treatment of urinary disease in this species may be challenging. This article reviews various diseases of the equine urinary system, morphologies, and potential discriminating clinical and clinicopathologic presentations to aid the clinician in determining a definitive diagnosis in practice. PMID:26021521

  10. 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 women with stress urinary incontinence may not tell their health practitioner about their symptoms due to embarrassment associated with stress urinary incontinence. A cross-sectional postal survey of 15,904 adults aged 40 and over who were registered with a local GP in Leicestershire, United Kingdom, revealed that 18% to 34% of respondents had symptoms of SUI. (5) Just over 9% reported symptoms “sometimes,” while almost 3% reported symptoms “most of the time.” Stress urinary incontinence was most common for women in their 50s. A more recent study suggests that 24% of women aged 18 to 44 years and 37% of women aged 45 and over have symptoms of stress urinary incontinence. (6) Stress urinary incontinence has been associated with a broad range of psychosocial stress and disablement, such as difficulties with activities of daily living, avoidance of social activities, fear of unpleasant odour, and embarrassment. (7) Economic burden may include the cost of pads, drugs, and devices, and the inability to participate in the work force in severe cases. Midurethral Slings Suburethral slings differ according to several criteria including placement, approach, method of fixation, and sling material. This review will evaluate slings which fulfill all of the following criteria: Midurethral placement (as opposed to bladder neck placement) Self-fixing (no sutures, bone anchors, etc.) Minimally invasive (using local, epidural, or general anesthesia) “Tension-free” placement The different types of midurethral slings available vary according to 3 main parameters: Implant material, i.e., monofilament, multifilament, elastic, non-elastic, smooth, serrated, etc., Delivery instruments, i.e., needles, curved trocars, disposable, reusable, etc., Surgical approach As any one, or any combination of these parameters may vary across the different sling brands, it is difficult to ascribe observed differences in efficacy and safety across slings to any one factor. Review Strategy The literature published between January 2000 and February 2006 was searched in the following databases: OVID Medline, In Process and Other Non-Indexed Citations, Embase, Cochrane Database of Systematic Reviews and CENTRAL, INAHTA. The database search was supplemented with a search of relevant Web sites, and a review of the bibliographies of selected papers. The search strategy can be viewed in Appendix 1. Inclusion Criteria General population with SUI Randomized controlled studies, health technology assessments, guidelines Female subjects Midurethral, self-fixing, and minimally invasive slings/tapes English language The search strategy yielded 391 original citations. Studies were excluded for a variety of reasons, such as using traditional, suburethral slings as opposed to midurethral slings, not including patients with stress urinary incontinence, including males in the study, case reports, and not reporting the outcomes of interest. There were 13 randomized controlled trials identified that compared midurethral slings to other midurethral slings or traditional surgery. (8-20) (Table 1) Three of the randomized controlled trials (15;17;20) have had subsequent updated articles of longer term results. (21-23) The results of the randomized controlled trials have been stratified into 2 groups: TVT versus colposuspension and comparisons of midurethral slings. No randomized controlled trials were identified that compared a midurethral sling other than TVT to colposuspension. Summary of Findings Effectiveness At this time, there does not appear to be one procedure that is more effective than another at curing stress urinary incontinence. TVT appears to have similar cure rates to open colposuspension; and the various midurethral sling types seem to have similar cure rates. Procedure Time and Length of Hospital Stay The procedure time and the length of hospital stay for TVT are significantly shorter than the procedure time and length of stay for colposuspension. The procedure time and length of hospital stay for all midurethral slings appears to be similar. Complications The most frequently reported complications were bladder perforations, de novo voiding difficulties and device problems. Quality of Life Quality of life was not consistently reported in all of the randomized controlled trials. In the studies that reported quality of life there does not appear to be a significant difference in quality of life scores between the sling procedures. PMID:23074494

  11. Dysfunction of the continent ileostomy: clinical features and bacteriology.

    PubMed Central

    Kelly, D G; Phillips, S F; Kelly, K A; Weinstein, W M; Gilchrist, M J

    1983-01-01

    The pathogenesis and treatment of dysfunction of the continent ileostomy was investigated in 12 patients, five of whom had asymptomatic malabsorption and seven of whom had acute complaints. The number of anaerobic bacteria in jejunal aspirates was increased in patients with pouch malfunction (range 10(3) to 10(8)/g aspirate), but the microbiology of ileal effluent and the morphology of the ileal mucosa could not be correlated with dysfunction. Bile acid breath tests and lactose tolerance tests were not, however, reliable indicators of jejunal bacterial overgrowth. The symptoms, the malabsorption, and the number of jejunal and ileal anaerobic bacteria decreased in patients during treatment with metronidazole, implicating overgrowth of anaerobic bacterial flora in the pathogenesis of the syndrome. Images Fig. 4 PMID:6826102

  12. 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.

  13. [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

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

    PubMed

    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

    2005-08-16

    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 approximately 11,000 radiocarbon years before present (yr BP) or slightly less in North America, approximately 10,500 yr BP in South America, and approximately 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

  15. Convergent structure of multitrophic communities over three continents.

    PubMed

    Segar, Simon T; Pereira, Rodrigo A S; Compton, Steve G; Cook, James M

    2013-12-01

    Ecological theory predicts that communities using the same resources should have similar structure, but evolutionary constraints on colonisation and niche shifts may hamper such convergence. Multitrophic communities of wasps exploiting fig fruits, which first evolved about 75MYA, do not show long-term 'inheritance' of taxonomic (lineage) composition or species diversity. However, communities on three continents have converged ecologically in the presence and relative abundance of five insect guilds that we define. Some taxa fill the same niches in each community (phylogenetic niche conservatism). However, we show that overall convergence in ecological community structure depends also on a combination of niche shifts by resident lineages and local colonisations of figs by other insect lineages. Our study explores new ground, and develops new heuristic tools, in combining ecology and phylogeny to address patterns in the complex multitrophic communities of insect on plants, which comprise a large part of terrestrial biodiversity. PMID:24134201

  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. 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

  18. Plasmodium vivax Diversity and Population Structure across Four Continents

    PubMed Central

    Koepfli, Cristian; Rodrigues, Priscila T.; Antao, Tiago; Orjuela-Snchez, Pamela; Van den Eede, Peter; Gamboa, Dionicia; van Hong, Nguyen; Bendezu, Jorge; Erhart, Annette; Barnadas, Cline; Ratsimbasoa, Arsne; 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 19992008. Diversity was highest in South-East Asia (mean allelic richness 10.012.8), intermediate in the South Pacific (8.19.9) Madagascar and Sudan (7.98.4), and lowest in South America and Central Asia (5.57.2). 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 6080% in Latin American populations, suggesting that typing of 26 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 (0.110.16) between South American and all other populations, and lowest (0.040.07) 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

  19. 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

  20. Investigations into the development of continent-ocean transform boundaries

    NASA Astrophysics Data System (ADS)

    Lorenzo, Juan Manuel

    1991-06-01

    A two-stage evolutionary model is proposed to explain the tectonic, stratigraphic, and igneous features observed along continent-ocean transform boundaries. New data sets are analyzed consisting of: (1) 14,000 km of multi-channel and single-channel seismic (MCS) reflection profiles for the Falkland/Malvinas Plateau (South Atlantic); and (2) a 200 km of deep penetration MSC profile, five expanded spread profiles (ESP's), physical property values from ODP Site 763, and shipboard gravity data for the Exmouth Plateau (N.W. Australia). Four major depositional sequences are defined and mapped for the Falkland Plateau. In the Exmouth, seismic reflectors are tied to lithological and age unit boundaries using ESP-derived physical properties. ESP models are shown comparable to in situ downhole derived measurements. During the first stage, at the time of rifting, extensional detachment surfaces develop at a high angle to the future transform and are later sheared by strike-slip faulting. Final transform rupture occurs within a 10-15 km region, attended by large fault block rotation and mafic intrusions in conditions of pure shear. During the second stage, the continental rim is underplated when the oceanic ridge abuts the continent. This has produced a 10 km thick, 7.3 km/s layer under the Exmouth margin, resulting in a permanent isostatic uplift of the crust and tilting of syn-rift sediments. Gravity modeling suggests this layer comprises a 3 g/cu cm mixture of mafic and felsic rocks. The thermal evolution for the transform is examined using a two-dimensional heat conduction model, and the results are presented.

  1. Mapping the Western Boundary of the North American Continent

    NASA Astrophysics Data System (ADS)

    Gu, Y. J.; Kocon, K.; Okeler, A.

    2009-12-01

    Despite progress in understanding the tectonic history of the Western Canadian Sedimentary Basin (WCSB), the characteristics of mantle fabric/flow and the definition of the tectonic boundary between cratons (east/northeast) and terranes (west) remain poorly understood due to limited data coverage. In this study we present greatly improved constraints on the mantle lithosphere using data from the Canadian Rockies and Alberta NEtwork (CRANE), a newly installed broadband array in southern-central Alberta and parts of Saskatchewan. The SKS splitting parameters determined from multiple Mw>6.5 earthquakes are well correlated for stations in the vicinity of the Canadian Rockies. A northeast-southwest trending fast direction is consistent with the present-day absolute plate motion, and is approximately parallel to the direction of maximum horizontal stress. In contrast, substantially lower splitting times and northwest-southeast fast-splitting orientations are observed beneath eastern-central Alberta, a region characterized by enhanced heat-flow and below-average seismic velocities. The anomalous shear-wave splitting patterns could be the mantle expression of a hidden tectonic boundary between stable continent and accreted terranes. Base on this hypothesis, streamlined mantle flow around the edges of moving continental `keels' could induce strong north-south oriented horizontal strain. Geometrical imperfections such as a divot or an abandoned plume conduit on the continental root could cause further disruptions to the mantle flow beneath this region, giving rise to both radial and azimuthal anisotropy. While the mantle flow pattern beneath the entire WCSB remain debatable, the sharp change in splitting parameters across central Alberta could mark the western edge of the North American continent.

  2. Clustered and transient earthquake sequences in mid-continents

    NASA Astrophysics Data System (ADS)

    Liu, M.; Stein, S. A.; Wang, H.; Luo, G.

    2012-12-01

    Earthquakes result from sudden release of strain energy on faults. On plate boundary faults, strain energy is constantly accumulating from steady and relatively rapid relative plate motion, so large earthquakes continue to occur so long as motion continues on the boundary. In contrast, such steady accumulation of stain energy does not occur on faults in mid-continents, because the far-field tectonic loading is not steadily distributed between faults, and because stress perturbations from complex fault interactions and other stress triggers can be significant relative to the slow tectonic stressing. Consequently, mid-continental earthquakes are often temporally clustered and transient, and spatially migrating. This behavior is well illustrated by large earthquakes in North China in the past two millennia, during which no single large earthquakes repeated on the same fault segments, but moment release between large fault systems was complementary. Slow tectonic loading in mid-continents also causes long aftershock sequences. We show that the recent small earthquakes in the Tangshan region of North China are aftershocks of the 1976 Tangshan earthquake (M 7.5), rather than indicators of a new phase of seismic activity in North China, as many fear. Understanding the transient behavior of mid-continental earthquakes has important implications for assessing earthquake hazards. The sequence of large earthquakes in the New Madrid Seismic Zone (NMSZ) in central US, which includes a cluster of M~7 events in 1811-1812 and perhaps a few similar ones in the past millennium, is likely a transient process, releasing previously accumulated elastic strain on recently activated faults. If so, this earthquake sequence will eventually end. Using simple analysis and numerical modeling, we show that the large NMSZ earthquakes may be ending now or in the near future.

  3. Stones and urinary tract infections.

    PubMed

    Miano, Roberto; Germani, Stefano; Vespasiani, Giuseppe

    2007-01-01

    The term infection stones refers to calculi that occur following urinary tract infections (UTIs) caused by urease-producing gram-negative organisms. They consist of magnesium ammonium phosphate, carbonate apatite and monoammonium urate. Alkaline urine is most favorable to their formation. Urinary tract obstruction, neurogenic bladder, voiding dysfunction, temporary or indwelling urinary catheters, distal renal tubular acidosis and medullary sponge kidney are considered the main risk factors for developing infection stones. Urinalysis and urine culture are essential for diagnosis. A typical finding on imaging is a moderately radiopaque, staghorn or branched stone. Curative treatment is possible only by eliminating all of the stone fragments and by eradicating UTI. A variety of operative and pharmaceutical approaches is available. Metaphylactic treatment is mandatory to prevent recurrences. The relationship between urinary stones and UTIs is well known and shows two different clinical pictures: (1) stones that develop following UTIs (infection stones) which play a key role in stone pathogenesis, and (2) stones complicated by UTIs (stones with infection) which are metabolic stones that passively trap bacteria from coexistent UTIs and may consist of calcium or non-calcium. This article presents an overview of infection stones, analyzing the epidemiology, composition, pathogenesis, diagnosis, treatment and prevention of this type of calculi. PMID:17726350

  4. [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

  5. NW Indian Ocean crustal thickness, micro-continent distribution and ocean-continent transition location from satellite gravity inversion

    NASA Astrophysics Data System (ADS)

    Kusznir, N. J.; Tymms, V.

    2009-04-01

    Satellite gravity anomaly inversion incorporating a lithosphere thermal gravity anomaly correction has been used to determine Moho depth, crustal thickness and lithosphere thinning factor for the NW Indian Ocean and to map ocean-continent transition location (OCT) and micro-continent distribution. Input data is satellite gravity (Sandwell & Smith 1997) and digital bathymetry (Gebco 2003). Crustal thicknesses predicted by gravity inversion under the Seychelles and Mascarenes are in excess of 30 km and form a single micro-continent extending southwards towards Mauritius. Thick crust (> 25 km) offshore SW India is predicted to extend oceanwards under the Lacadive and Maldive Islands and southwards under the Chagos Archipelago. Superposition of illuminated satellite gravity data onto crustal thickness maps from gravity inversion clearly shows pre-separation conjugacy of the thick crust underlying the Chagos and Mascarene Islands. Maps of crustal thickness from gravity inversion show a pronounced discontinuity in crustal thickness between Mauritius-Reunion and the Mascarene Basin which is of Late Cretaceous age and pre-dates recent plume volcanism. Gravity inversion to determine Moho depth and crustal thickness variation is carried out in the 3D spectral domain and incorporates a lithosphere thermal gravity anomaly correction for both oceanic and continental margin lithosphere (Chappell & Kusznir 2008). Failure to incorporate a lithosphere thermal gravity anomaly correction gives a substantial over-estimate of crustal thickness predicted by gravity inversion. The lithosphere thermal model used to predict the lithosphere thermal gravity anomaly correction may be conditioned using magnetic isochron data to provide the age of oceanic lithosphere (Mueller et al. 1997). The resulting crustal thickness determination and the location of the OCT are sensitive to errors in the magnetic isochron data. An alternative method of inverting satellite gravity to give crustal thickness, incorporating a lithosphere thermal gravity correction, which does not use magnetic isochron data provides an isochron independent prediction of crustal thickness and OCT location. For continental margin lithosphere, the lithosphere thermal perturbation is calculated from the lithosphere thinning factor (1-1/beta) obtained from crustal thinning determined by gravity inversion and breakup age for thermal re-equilibration time. A correction is made for crustal volcanic addition due to decompression melting during breakup and sea-floor spreading.

  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 identify common geologic units that extend across both the now-separate continents. Tracing the geologic units is important for mineral exploration, which is demonstrated with the analysis of correlations of the gravity signal with selected classes of mineral occurrences, for instance those associated to Greenstone belts. Alvarez, O., Gimenez M., Braitenberg C., Folguera, A. (2012) GOCE Satellite derived Gravity and Gravity gradient corrected for topographic effect in the South Central Andes Region. Geophysical Journal International, 190, 941-959, doi: 10.1111/j.1365-246X.2012.05556.x Braitenberg C., Mariani P., De Min A. (2013) The European Alps and nearby orogenic belts sensed by GOCE, Boll. Bollettino di Geofisica Teorica ed Applicata, doi:10.4430/bgta0105 Braitenberg C. (2014) Exploration of tectonic structures with GOCE in Africa and across-continents, J.of Applied Earth Observation and Geoinformation (in Review). Mariani P., Braitenberg C., Ussami N. (2013). Explaining the thick crust in Parana' basin, Brazil, with satellite GOCE-gravity observations. Journal of South American Earth Sciences, 45, 209-223, doi:10.1016/j.jsames.2013.03.008.

  7. 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 hypothesis further and contribute towards understanding the role that the inherited Precambrian architecture exerted on the location and development of the East Antarctic Rift System, which was active both before and during Gondwana break-up. Over Wilkes Land, aeromagnetic data offer tantalizing new glimpses into the extent of Precambrian basement provinces that have been extensively studied in formerly adjacent Australia. An over 1,900 km long magnetic low is traced from a new magnetic anomaly compilation along the margin of the Archean-Proterozoic Mawson continent, and is interpreted as delineating part of a Neoproterozoic rift system that heralded Rodinia break-up. Aeromagnetic data are also helping in deciphering Phanerozoic crustal growth along the paleo-Pacific active margin of Gondwana. In northern Victoria Land aeromagnetic anomaly interpretation, coupled with geochemical and structural observations is clarifying the architecture and evolution of Cambro-Ordovician terranes that were affected by the Ross Orogen. In the Antarctic Peninsula aeromagnetic and aerogravity data suggest the existence of several distinct arc provinces that may have docked against the Gondwana margin during the Cretaceous age Palmer Land event. Aeromagnetic interpretation over the West Antarctic ice sheet provides new insights into the extent of Cenozoic magmatism and rift basins within the West Antarctic Rift System and into the inland extent of the Jurassic Weddell Sea Rift

  8. 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 and U typically show increases due to their association in clays and oxides in the profile. These geochemical relationships underpin the first model prediction. In the case where no gamma-ray data is available or where the bedrock is very low in radioelements (e.g. basalt, quartz-rich sandstone) surface relief is used as surrogate in the second prediction model. The two models are combined to generate a weathering intensity index of the Australian continent. The weathering intensity index has been developed for erosional landscapes but also provides useful information on deposition processes and materials. The weathering intensity prediction is evaluated with surface geochemistry (compared with geochemical indices) and previous regolith-landform mapping. The use of the weathering intensity index in natural resource management and mineral exploration is discussed.

  9. Major odorants released as urinary volatiles by urinary incontinent patients.

    PubMed

    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

  10. 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

  11. 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

  12. Managing Urinary Incontinence in Patients with Dementia: Pharmacological Treatment Options and Considerations.

    PubMed

    Orme, Susie; Morris, Vikky; Gibson, William; Wagg, Adrian

    2015-07-01

    Urinary incontinence and lower urinary tract symptoms are highly prevalent in late life and are strongly associated with dementia and frailty. Incontinence is extremely common among those living in long-term care and is most commonly due to urgency incontinence. Although national and international guidelines for continence care exist, they often fail to consider the complex comorbidity found in patients with dementia and are often not followed; continence practices in long-term care may promote rather than prevent incontinence. The majority of those with dementia living in the community can be managed successfully with standard treatments, both pharmacological and non-pharmacological; the expectations and aims of treatment of both the patient and their caregivers should be considered. A dementia diagnosis does not preclude management of incontinence, but treatment options may be more limited in those with advanced dementia who are unable to retain information and modify behaviors. High-quality data to guide the choice of pharmacological agent in those with dementia are lacking. Oxybutynin has been shown to have significant adverse cognitive effects, but data to support the use of trospium, solifenacin, darifenacin, and fesoterodine are limited. No data are available for mirabegron. Neither age, frailty, nor dementia should be considered a barrier to pharmacological management, but consideration should be given to the total anticholinergic load. Evidence to guide the treatment of incontinence in this vulnerable patient group is scarce, and available guidelines adapted for each individual's situation should be applied. PMID:26169438

  13. TVT-Secur mini-sling for stress urinary incontinence: a review of outcomes at 12 months.

    PubMed

    Walsh, Colin A

    2011-09-01

    • Synthetic mid-urethral slings (MUSs) are considered the first choice surgical procedure for stress urinary incontinence. Recent publications have raised concerns about the efficacy of third generation single-incision mini-slings. The present paper is a systematic review of studies reporting 12-month outcomes after the TVT-Secur (TVT-S) procedure. • Pubmed/Medline online databases, abstracts from recent International Continence Society and International Urogynecological Association annual scientific meetings and the Clinicaltrials.gov and Controlled-trials.com online trial registries were searched for English-language articles containing the terms 'TVT-Secur', 'TVT Secur' or 'mini-sling'. The primary outcomes were objective and subjective cure rates at 12 months. Secondary outcomes included peri-operative (vaginal perforation, urinary retention, urinary tract infection [UTI]) and postoperative (mesh exposure, de novo overactive bladder (OAB), dyspareunia and return to theatre) complication rates. • Among 1178 women undergoing the TVT-S procedure, from 10 studies, both objective and subjective cure rate at 12 months was 76%, with objective cure significantly higher in women undergoing the 'U-type' approach. Vaginal perforation was a complication in 1.5% of cases, with a 2.4% incidence of mesh exposure in the first year. The incidence of de novo OAB symptoms was 10%. Rates of urinary retention (2.3%), UTI (4.4%), dyspareunia (1%) and return to theatre for complications (0.8%) were low. In the first year after a TVT-S procedure 5% of women required repeat continence surgery. • Longer-term studies and randomized comparisons with more established MUSs are required before TVT-S should be routinely used in the surgical treatment of stress urinary incontinence. PMID:21756280

  14. [Urinary tract infection in pregnancy].

    PubMed

    Herráiz, Miguel Angel; Hernández, Antonio; Asenjo, Eloy; Herráiz, Ignacio

    2005-12-01

    Urinary tract infections, asymptomatic bacteriuria (AB), acute cystitis (AC) and acute pyelonephritis (AP), are favored by the morphological and functional changes involved in pregnancy. AB increases the risk of preterm labor, low birth weight and AP. AB should be detected by uroculture (other methods are not sufficiently effective) and treated early. Approximately 80% of cases are caused by Escherichia coli. The risks and effectiveness of the distinct antibiotic regimens should be evaluated: fosfomycin trometamol in monotherapy or as short course therapy is safe and effective for the treatment of AB and AC. AP is the most frequent cause of hospital admission for medical reasons in pregnant women and can lead to complications in 10% of cases, putting the lives of the mother and fetus at risk. Currently outpatient treatment of AP is recommended in selected cases. Adequate follow-up of pregnant women with urinary tract infections is required due to frequent recurrence. PMID:16854357

  15. The Role of Magma During Continent-Ocean Transition

    NASA Astrophysics Data System (ADS)

    Bastow, Ian; Keir, Derek; Rooney, Tyrone; Kendall, J.-Michael

    2010-05-01

    Passive margins worldwide are often considered magmatic because they are characterised by thick sequences of extrusive and intrusive igneous rocks emplaced around the time of continental breakup. Despite the global abundance of such margins, however, it is difficult to discriminate between different models of both extension and melt generation, since most ruptured during Gondwana breakup >100Ma and the continent-ocean transition (COT) is now hidden by thick, basaltic seaward dipping reflectors (SDRs). These margins are no longer tectonically active so the roles of faulting, stretching and magma intrusion in accommodating extension, and timing of SDRs emplacement during rift evolution have to be inferred from rifting models or from the geological record preserved at the fully developed passive margin. Similarly mantle processes during COT development have long since ceased, so whether breakup was characterized by broad thermal upwelling, small-scale convection or a fertile geoscientific mantle remains ambiguous. The East African rift in Ethiopia offers a unique opportunity to address all these problems because south-to-north it exposes subaerially the transition from continental rifting and incipient sea-floor spreading within a young flood basalt province. Here we present a suite of geophysical and geochemical observations from Ethiopia that document the significance of magma intrusion and extrusion as rifting evolves from an initially broad zone of stretching and faulting to a narrower axial graben in which magma injection dominates strain.

  16. 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

  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. Volcanism as a new constraint on the rheology of continents

    NASA Astrophysics Data System (ADS)

    Tait, S.; Devès, M.; King, G. C.; Grandin, R.; Tapponnier, P.

    2009-12-01

    Our knowledge of lithospheric rheology comes mostly from laboratory data using small-scale samples that are extrapolated to crustal and lithospheric scales, which requires careful analysis of the differences in boundary conditions. In the search for constraints on large-scale continental rheology, one useful observation has been neglected. That is the occurrence of volcanism genetically related to faulting activity, which can be used to obtain information about the rheology of the continents. The volcanism can be explained by a “Process zone heating” mechanism that occurs at fault system complexities. The rate of heating directly depends on the rheology, and we explore which conditions produce sufficient heat to melt independently the crust and the mantle of the continental lithosphere as required by the observations. By comparing the source depth given by modelling with the geochemical and petrological features of the volcanic products, we are able to discuss the strength profile required for the genesis of the magmas. A shift appears between the power flow law parameters obtained in the laboratory and the ones that are required for melting to occur. We describe and model here instances of volcanism along the North Anatolian Fault, Turkey, but the scope can be broadened to other cases.

  19. Cambrian arc-continent collision in the Paleozoides of Kazakhstan

    NASA Astrophysics Data System (ADS)

    Degtyarev, K. E.; Ryazantsev, A. V.

    2007-02-01

    A model of the Cambrian evolution of the Paleozoides in Kazakhstan is presented on the basis of consideration of Cambrian rock complexes. The Middle Cambrian collision of an island arc and a passive continental margin was the main event of this evolution. Three stages of the Paleozoides evolution are recognized in the Cambrian. The first, precollision stage embraces a time span from the Early Cambrian to the first half of the Amgian Age of the Middle Cambrian in which the following elements of the continent-ocean transitional zone may be reconstructed: passive continental margin-backarc basin with oceanic crust-island arc-oceanic basin. At the second, collision stage (the second half of the Amgian Age), the backarc basin was closed and the continental margin and island arc collided, forming a suture zone. At the third, postcollision stage (the Mayan Age of the Middle Cambrian-Early Ordovician), the structure of the convergent margin was complicated. The volcanic belt started to develop on the accreted continental margin. A system of ensimatic island arcs originated at the same time and migrated toward the outer basin. The active rifting was typical of the inner part of the continental margin.

  20. Genetic characteristics of infectious bursal disease viruses from four continents.

    PubMed

    Jackwood, Daral J; Sommer-Wagner, Susan

    2007-09-01

    Following the initial discovery of very virulent infectious bursal disease virus (vvIBDV) strains in Europe, these viruses spread to many parts of the world. In this study, we examined the phylogenetic relationship of never-before-published IBDV from 18 countries on four continents. All the samples were collected between 1997 and 2005 and were reported to be from broiler flocks experiencing higher than expected mortality which is often associated with acute very virulent infectious bursal disease. A total of 113 samples were imported into the U.S. and viral genetic material was used to determine the nucleotide sequence of the VP2 gene hypervariable region. Although all the samples were reported to be associated clinically with high mortality, genetic analysis suggests that some were not vvIBDV strains. Two viruses from South Africa were genetically similar to U.S. variant viruses. A majority (71/113) of the viruses examined had the amino acid Alanine at position 222 and sixty-seven of these suspect vvIBDV also had amino acids I242, I256, I294 and S299 which are highly conserved among vvIBDV strains. Phylogenetic analysis placed putative vvIBDV strains from many different countries and geographic regions in a single clade with some minor non-significant branching. PMID:17488648

  1. Mechanical controls on the deformation of continents at convergent margins

    NASA Astrophysics Data System (ADS)

    Audet, Pascal; Jellinek, A. Mark; Uno, Hideharu

    2007-12-01

    Spatial variations in the rigidity of continental plates (expressed in terms of an effective elastic thickness, Te) can have a profound influence on the style of deformation of ocean-continent convergent margins. Depending on the spatial distribution of Te, strains related to plate boundary forces can become concentrated where Te is small. We calculate Te and Te anisotropy in western Canada by using and comparing the wavelet and multitaper coherence methods. In addition to a nearly stepwise change in Te from the Cordillera to the craton, we show that weak axes of Te anisotropy are parallel with most compressive directions of horizontal stress components and fast axes of upper mantle seismic anisotropy. Maxima in the magnitude of Te anisotropy are spatially correlated with the locations of most earthquakes and the locations and directions of maxima in electrical anisotropy and conductivity. The pattern of brittle failure and seismicity is explained as a response to plate boundary forces acting on a plate of variable rigidity and is expected to induce the observed mechanical anisotropy and enhance the flow of crustal fluids, resulting in locally high electrical conductivities. Our combined results thus suggest for the first time that the elastic properties of continental lithosphere have a leading order influence on the deformation and evolution of convergent plate boundaries.

  2. Laboratory monitoring of OxyContin (oxycodone): clinical pitfalls.

    PubMed

    Von Seggern, Randal L; Fitzgerald, Charles P; Adelman, Leon C; Adelman, James U

    2004-01-01

    Some patients have headaches that are refractory to standard treatments, and they require chronic administration of opioid analgesics. The use of opioids in a clinical setting must be closely monitored due to the medications' potential for addiction, abuse, and fatal interactions. Limited access to opioids and the demand for them outside the clinical setting leads to another danger. Patients can mislead their providers into prescribing opioids, intending to sell the medications instead of using them to alleviate their own pain. For protection of the patient, as well as the community, it is vital that such activity be prevented. We recently encountered a patient we suspected of abusing or misusing OxyContin (oxycodone). In order to determine whether the patient was taking the medication as prescribed, we ordered a urine-based immunoassay drug screen. The results were negative; the patient appeared to not have oxycodone in his system. Based on these results, we dismissed the patient from our practice. At the patient's request, a second test was performed, this time using gas chromatography-mass spectrometry. It indicated that the patient did indeed have sufficiently high levels of oxycodone in the urine. The minimum level threshold was too high to detect the presence of oxycodone in the immunoassay. We would like to help prevent future misunderstandings such as we experienced. To do so, we will first present the case of our patient, followed by a discussion of the actions taken. Finally, we will provide an overview of analgesic monitoring systems. PMID:14979882

  3. 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.

  4. 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

  5. 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

  6. Urinary biomarkers of meat consumption

    PubMed Central

    Cross, Amanda J.; Major, Jacqueline M.; Sinha, Rashmi

    2011-01-01

    Background Meat intake has been positively associated with incidence and mortality of chronic diseases, including diabetes, heart disease, and several different cancers, in observational studies using self-report methods of dietary assessment; however, these dietary assessment methods are subject to measurement error. One method to circumvent such errors is the use of biomarkers of dietary intake, but currently there are no accepted biomarkers for meat intake. Methods We investigated four analytes (creatinine, taurine, 1-methylhistidine, and 3-methylhistidine) specifically found in meat and excreted in urine. Twenty-four hour urine samples were collected from 17 individuals on controlled diets containing varying levels of meats: vegetarian (0 g/day), low red meat (60 g/day), medium red meat (120g/day), and high red meat (420 g/day), as part of two randomized cross-over feeding studies. Results When compared to the low red meat diet or the vegetarian diet, the urinary levels of all four analytes were significantly higher in urine samples collected after 15 days of a high red meat diet (P<0.0001). Only urinary 1-methylhistidine and 3-methylhistidine were statistically significantly different for every diet type, increasing as the amount of meat in the diet increased (P<0.01 for 1-methylhistidine and P<0.05 for 3-methylhistidine). Furthermore, urinary excretion of 1-methylhistidine and 3-methylhistidine elevated with increasing meat intake in every individual. Conclusion Urinary 1-methylhistidine and 3-methylhistidine may be good biomarkers of meat intake. Impact To determine the public health impact of red meat on cancer risk, biomarkers are crucial to estimate true intake; these potential biomarkers should be further investigated in free-living populations. PMID:21527577

  7. [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

  8. 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

  9. Effect of Increasing Doses of Saw Palmetto on Lower Urinary Tract Symptoms: A Randomized Trial

    PubMed Central

    Barry, Michael J.; Meleth, Sreelatha; Lee, Jeannette Y.; Kreder, Karl J.; Avins, Andrew L.; Nickel, J. Curtis; Roehrborn, Claus G.; Crawford, E. David; Foster, Harris E.; Kaplan, Steven A.; McCullough, Andrew; Andriole, Gerald L.; Naslund, Michael J.; Williams, O. Dale; Kusek, John W.; Meyers, Catherine M.; Betz, Joseph M.; Cantor, Alan; McVary, Kevin T.

    2012-01-01

    Context Saw palmetto fruit extracts are widely used for treating lower urinary tract symptoms attributed to benign prostatic hyperplasia. However, recent clinical trials have questioned their efficacy, at least at standard doses (320 mg daily). Objective To determine the effect of a saw palmetto extract at up to three times the standard dose on lower urinary tract symptoms attributed to benign prostatic hyperplasia. Design Multicenter placebo-controlled randomized trial conducted from June, 2008 through October, 2010. Setting Eleven North American clinical sites. Participants Were men at least 45 years old, with a peak urinary flow rate ≥ 4 ml/sec, an AUA Symptom Index (AUASI) score ≥ 8 and ≤ 24, and no exclusions. Interventions One, two, and then three 320 mg daily doses of saw palmetto extract or placebo, with dose increases at 24 and 48 weeks. Main Outcome Measures Primary outcome was the difference in AUASI score from baseline to 72 weeks. Secondary outcomes were measures of urinary bother; nocturia; uroflow; postvoid residual; prostate-specific antigen; participants’ global assessments; and indices of sexual function, continence, sleep quality, and prostatitis symptoms. Results From baseline to 72 weeks, mean AUASI scores decreased from 14.4 to 12.2 points with saw palmetto and from 14.7 to 11.7 points with placebo. The group mean difference in AUASI score change from baseline to 72 weeks between the saw palmetto and placebo groups was 0.79 points favoring placebo (bound of the 95% confidence interval most favorable to saw palmetto was 1.77 points, one-sided P=0.91). Saw palmetto was no more effective than placebo for any secondary outcome. No attributable side effects were identified. Conclusions Increasing doses of a saw palmetto fruit extract did not reduce lower urinary tract symptoms more than placebo. (CAMUS study number NCT00603304 http://www.ClinicalTrials.gov) PMID:21954478

  10. 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...

  11. 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...

  12. 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...

  13. 21 CFR 862.1780 - Urinary calculi (stones) test system.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 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...

  14. 21 CFR 862.1780 - Urinary calculi (stones) test system.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 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...

  15. Urinary tract infections in children. An update.

    PubMed Central

    Zelikovic, I; Adelman, R D; Nancarrow, P A

    1992-01-01

    Urinary tract infection is a common and frequently recurring condition in children. The susceptibility of the host, the presence of urinary tract abnormalities, and the virulence of the urinary pathogens are of primary importance in the development of the infection. Renal parenchymal scarring, hypertension, and renal insufficiency are well-established complications of the infection in children. To reduce the risk of renal damage, diagnosis and treatment must be prompt. The diagnosis demands radiologic evaluation of the urinary tract in all boys, all children younger than 5 years, all patients with voiding dysfunction, and school-aged girls with recurrent infection to identify those patients with vesicoureteral reflux, obstruction, or other urinary tract abnormalities. Both voiding cystourethrography and renal ultrasonography are the initial examinations to use to determine the next appropriate study. Children with vesicoureteral reflux or with recurrent urinary tract infections should receive prophylactic antibiotic therapy and should be observed closely to prevent renal scarring. PMID:1441497

  16. [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

  17. 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

  18. Susceptibility of Urinary Tract Bacteria to Fosfomycin▿

    PubMed Central

    Maraki, Sofia; Samonis, George; Rafailidis, Petros I.; Vouloumanou, Evridiki K.; Mavromanolakis, Emmanuel; Falagas, Matthew E.

    2009-01-01

    We evaluated the in vitro activity of fosfomycin against urinary isolates in a region in Greece that exhibits considerable antimicrobial resistance by evaluating retrospectively relevant susceptibility data retrieved from the microbiological library of the University Hospital of Heraklion, Crete, Greece. We examined 578 urinary isolates. In total, 516 (89.2%) were susceptible to fosfomycin; 415 isolates were gram negative, and 101 isolates were gram positive. Fosfomycin appears to exhibit good levels of in vitro activity against the examined urinary isolates. PMID:19687248

  19. 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

  20. 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.

  1. National Instrument Facility for Electromagnetic Studies of the Continents (EMSOC)

    NASA Astrophysics Data System (ADS)

    Wannamaker, P. E.; Park, S. K.; Booker, J. R.; Egbert, G. D.; Jiracek, G. R.; Chave, A. D.

    2002-12-01

    EMSOC (Electromagnetic Studies of the Continents) is an NSF-supported, multi-institutional consortium that fosters research in electromagnetic (EM) studies of the Earth by maintaining and providing magnetotelluric (MT) equipment to U.S. institutions and their co-workers. The MT method measures electrical resistivity (or its inverse conductivity), which is one of only a handful of physical properties with which we can understand dynamic Earth processes. EMSOC-supported experiments, often a component of multidisciplinary studies, have mapped fluids and domains of probable weakness within the San Andreas fault zone, orogen-wide partial melting and mobility beneath the Tibetan Plateau, buoyant mantle supporting the High Sierra, and prograde fluid generation and rheological controls beneath the Southern Alps orogen of New Zealand. The EMSOC National Instrument Facility is a collaborative venture by the Universities of Washington, Utah, and California at Riverside formed in response to rising costs to NSF for rental of modern MT systems for experiments and the lack of commercial availability of long period (1-30,000 s) instruments. Starting in 1998, this facility has supported 27 projects by 10 institutions. EMSOC equipment has also allowed the exposure of the MT method to nonspecialists at the NSF-supported field geophysical education and research program SAGE (Summer of Applied Geophysical Experience). Allocation of the instruments is determined by a steering committee with representatives from six institutions, which convenes formally at every fall AGU meeting. Currently, EMSOC intends to modernize the existing pool of long period instruments, add magnetic sensors capable of recording at higher frequencies (>1000 Hz), and complete the establishment of an archive for all data collected with the EMSOC instruments in collaboration with the IRIS-DMC. Information about facility activities is available on the EMSOC web site vortex.ucr.edu/emsoc/index.html.

  2. 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

  3. Deep Upwelling Beneath the Northeastern Afro-Arabian Continent?

    NASA Astrophysics Data System (ADS)

    Cara, M.; Wittlinger, G.; Debayle, E.; Sieminski, A.; Montagner, J. P.; Lepine, J. C.

    2003-12-01

    A large low shear-wave velocity anomaly is observed at upper-mantle depths beneath the northeastern Afro-Arabian continent, from the Turkana depression, South-West of Ethiopia, to the Red sea and South of Arabia. The question of connection between this anomaly and a source of material rising from the lower mantle is of major concern for understanding how a plume associated with the African superswell could interact with the upper mantle structure in the region. Thanks to the deployment of five broadband stations in Ethiopia and Yemen (INSU-RLBM), complementing several sets of broad-band stations in Arabia, Ethiopia and Djibouti (IRIS, Geoscope, PASSCAL) we address this question by using two broadband seismological tools: 1) higher-mode surface wave tomography and 2) receiver function technique. Higher-mode surface waves tomography shows a clear low shear-wave velocity anomaly down to 400 km depth beneath the Ethiopian plateau and the Afar depression. In a paper by Debayle et al. (2001), no continuity of this anomaly with a deeper low-velocity anomaly is observed beneath Ethiopia. Instead, a deeper low-velocity anomaly (down to ~500-600 km depth) was observed farther north beneath the Red Sea and South of Arabia, suggesting a possible link with lower mantle material rising there. Applying a SVD receiver function technique to a set of broad-band records from Arabia to Ethiopia, including Yemen, we discuss the above suggestion by looking at the seismic discontinuities of the upper-mantle transition zone.

  4. Factors affecting continence after surgery for anal fistula.

    PubMed

    Lunniss, P J; Kamm, M A; Phillips, R K

    1994-09-01

    Anorectal physiology and continence were assessed prospectively before and after surgery in 50 patients with chronic perianal sepsis. Functional and physiological parameters were unchanged after surgery in 13 control patients who had sepsis but who did not undergo division of the anal sphincter. Group 1 comprised 22 patients with internal sphincter division alone (15 intersphincteric, seven trans-sphincteric treated by a loose seton technique) and group 2 consisted of 15 patients with a trans-sphincteric fistula laid completely open. In group 1 the median (interquartile range (i.q.r.)) resting pressure in the distal 1 cm of the anal canal was reduced from 68 (60-90) cmH2O before surgery to 44 (35-60) cmH2O after operation (P < 0.001); squeeze pressure was less affected, but function deteriorated in 11 of the 22 patients. The median (i.q.r.) resting pressure in group 2 patients also fell, from 68 (34-84) cmH2O before operation to 28 (20-54) cmH2O afterwards (P = 0.003); median (i.q.r.) maximum squeeze pressure decreased more, from 124 (76-170) cmH2O to 72 (48-112) cmH2O (P = 0.002). Functional deficit occurred in eight of the 15 patients. Incontinence was related to low resting pressure, reflecting internal sphincter integrity, and to local epithelial electrosensitivity (reflecting scarring), but not to squeeze pressure, fistula type or surgical treatment. PMID:7953425

  5. 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.

  6. 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.

  7. 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 medications with a known side effect of urinary retention are also associated with urinary retention during flight. However, not all cases of urinary retention surrounded medication use inflight. It is also known that UTI is a terrestrial cause of urinary retention. Furthermore, the treatment of urinary retention with a urinary catheter may be more likely to initiate a UTI in space than on the ground, as aseptic techniques can be particularly challenging with an inexperienced provider in a free-floating environment. Inflight urinary retention and UTI have proven to be highly associated and urinary risks should be considered collectively when planning for space flight.

  8. Prevention of urinary and fecal incontinence in adults.

    PubMed Central

    Shamliyan, Tatyana; Wyman, Jean; Bliss, Donna Z; Kane, Robert L; Wilt, Timothy J

    2007-01-01

    OBJECTIVES To assess the prevalence of and risk factors for urinary (UI) and fecal (FI) incontinence in adults in long-term care (LTC) settings and in the community, the effectiveness of diagnostic methods to identify adults at risk and patients with incontinence, and to review the effectiveness of clinical interventions to reduce the risk of incontinence. DATA SOURCES MEDLINE (PubMed), CINAHL, and Cochrane Databases. REVIEW METHODS Observational studies were reviewed to examine the prevalence and incidence of UI and FI and the association with risk factors. The effects of treatments on patient outcomes were analyzed from randomized controlled and multicenter clinical trials. The diagnostic values of the tests were compared from the original epidemiologic studies of different designs. Of the 6,097 articles identified, 1,077 articles were eligible for analysis. RESULTS The prevalence of UI, FI, and combined incontinence increased with age and functional dependency. Cognitive impairment, limitations in daily activities, and prolonged institutionalization in nursing homes were associated with a higher risk of incontinence. Stroke, diabetes, obesity, poor general health, and comorbidities were associated with UI and FI in community dwelling adults. Parity, anal trauma, and vaginal prolapse in women and urological surgery and radiation for prostate cancer in men are risk factors for UI and FI. Intensive individualized management and rehabilitation programs improved continence status in nursing home residents and adults after stroke. Self-administered behavioral interventions including pelvic floor muscle training with biofeedback and bladder training resolved UI in incontinent women. Electrical stimulation and sacral neuromodulation improved urge UI, but improvement for FI was inconsistent. Tension-free vaginal tape procedures and modified surgical techniques for prolapse to support the bladder neck resolved stress UI in the majority of treated women. Behavioral treatments of FI resulted in small improvements in severity and quality of life related to incontinence. The effects on FI of surgical techniques for hemorrhoids, rectal prolapse, rectal cancer, and anal fissures are not consistent across studies. Surgical interventions in patients with ulcerative colitis resulted in the same rates of fecal continence when compared to each other. The few clinical interventions to treat FI that were tested in well-designed trials had no clear evidence of better effects of the compared treatments. Instrumental outcomes to evaluate the effectiveness of treatments did not correlate with patient outcomes. Epidemiologic surveys to detect persons at risk and patients with undiagnosed UI have the same diagnostic value and less cost compared to professional examinations and diagnostic tests. Self-reported questionnaires and scales have unsatisfactory validity to diagnose FI. CONCLUSIONS Epidemiologic surveys are cost-effective ways to estimate the prevalence of UI in large nationally representative population groups. Routine clinical evaluation should include an assessment of the risk factors, symptoms, and signs of incontinence. Pregnant or menopausal women, women with vaginal prolapse, males treated for prostate disease, patients with rectal prolapse, and frail elderly and nursing home residents are high risk groups. Individualized management programs can improve continence in LTC facilities but are hard to sustain. Regular monitoring and documentation of the continence status in relation to implemented continence services should be quality of care indicators for nursing homes. Pelvic floor muscle trainings with biofeedback can resolve incontinence and improve quality of life. Surgery is effective in curing stress UI in females. Clinical interventions for UI in males and for FI in adults need future investigation. A list of research recommendations is offered. PMID:18457475

  9. Effectiveness of a program of therapeutic exercises on the quality of life and lumbar disability in women with Stress Urinary Incontinence.

    PubMed

    Lacombe, Adriana de Carvalho; Riccobene, Virginia Martello; Nogueira, Leandro Alberto Calazans

    2015-01-01

    Stress Urinary Incontinence (SUI) is a common condition and can cause social isolation and decreased quality of life. The literature demonstrates that perineal exercises are effective in promoting urinary continence and lumbar stability. This uncontrolled (group) pilot study, using a pre-test-post-test design, investigated whether a weekly session of Holistic Gymnastics(®) conducted during a one-year period, could change outcomes in a group of twenty women diagnosed with SUI. In the first and last evaluation, the subjects underwent a clinical examination and were asked to complete two questionnaires, one regarding quality of life and the other about lumbar disability. Improvement in the quality of life was observed in nine out of ten domains. There was also an improvement in lumbar disability. These results suggest that a program with therapeutic exercises can be effective in controlling urinary incontinence and improve the quality of life and lumbar disability in woman with SUI. PMID:25603747

  10. 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 is larger than needed to support surface topography, and is offset from its topographic high, consistent with dynamic thickening of the Pacific crust by the mantle thickening. Teleseismic shear wave splitting is evidence of a wide zone of distributed strain for the mantle portion of the plate boundary. The collective set of results from the South Island projects have led to a number of subsequent studies by various teams, based on follow-up questions, expanded observational expertise, and international collaborative alliances with in particular the New Zealand science community. These studies include a search for the full width of Pacific/Australian distributed mantle strain using marine OBS studies, the transition from strike-slip to plate boundary subduction to the north, the search and discovery of seismic tremor on the Alpine fault, and high resolution geophysical characterization of Alpine fault seismogenesis. The success of geophysically imaging a narrow island using both marine sides led different SIGHT scientists to carry out expanded efforts to study North Island subduction and separately Taiwan mountain building. These efforts benefited and were largely motivated from multi-disciplinary, multi-national collaborations as typically supported by the NSF Continental Dynamics program.

  11. Neural control of the lower urinary and gastrointestinal tracts: supraspinal CNS mechanisms.

    PubMed

    Drake, M J; Fowler, C J; Griffiths, D; Mayer, E; Paton, J F R; Birder, L

    2010-01-01

    Normal urinary function is contingent upon a complex hierarchy of CNS regulation. Lower urinary tract afferents synapse in the dorsal horn of the spinal cord and ascend to the midbrain periaqueductal gray (PAG), with a separate nociception path to the thalamus. A spino-thalamo-cortical sensory pathway is present in some primates, including humans. In the brainstem, the pontine micturition center (PMC) is a convergence point of multiple influences, representing a co-ordinating center for voiding. Many PMC neurones have characteristics necessary to categorize the center as a pre-motor micturition nucleus. In the lateral pontine brainstem, a separate region has some characteristics to suggest a "continence center." Cerebral control determines that voiding is permitted if necessary, socially acceptable and in a safe setting. The frontal cortex is crucial for decision making in an emotional and social context. The anterior cingulate gyrus and insula co-ordinate processes of autonomic arousal and visceral sensation. The influence of these centers on the PMC is primarily mediated via the PAG, which also integrates bladder sensory information, thereby moderating voiding and storage of urine, and the transition between the two phases. The parabrachial nucleus in the pons is also important in behavioral motivation of waste evacuation. Lower urinary tract afferents can be modulated at multiple levels by corticolimbic centers, determining the interoception of physiological condition and the consequent emotional motor responses. Alterations in cognitive modulation, descending modulation, and hypervigilance are important in functional (symptom-based) clinical disorders. PMID:20025025

  12. The impact of cavernosal nerve preservation on continence after robotic radical prostatectomy

    PubMed Central

    Pick, Donald L.; Osann, Kathryn; Skarecky, Douglas; Narula, Navneet; Finley, David S.; Ahlering, Thomas E.

    2014-01-01

    OBJECTIVE To evaluate associations between baseline characteristics, nerve-sparing (NS) status and return of continence, as a relationship may exist between return to continence and preservation of the neurovascular bundles for potency during radical prostatectomy (RP). PATIENTS AND METHODS The study included 592 consecutive robotic RPs completed between 2002 and 2007. All data were entered prospectively into an electronic database. Continence data (defined as zero pads) was collected using self-administered validated questionnaires. Baseline characteristics (age, International Index of Erectile Function [IIEF-5] score, American Urological Association symptom score, body mass index [BMI], clinical T-stage, Gleason score, and prostate-specific antigen level), NS status and learning curve were retrospectively evaluated for association with overall continence at 1, 3 and 12 months after RP using univariate and multivariable methods. Any patient taking preoperative phosphodiesterase inhibitors was excluded from the postoperative analysis. RESULTS Complete data were available for 537 of 592 patients (91%). Continence rates at 12 months after RP were 89.2%, 88.9% and 84.8% for bilateral NS, unilateral NS and non-NS respectively (P = 0.56). In multivariable analysis age, IIEF-5 score and BMI were significant independent predictors of continence. Cavernosal NS status did not significantly affect continence after adjusting for other co-variables. CONCLUSION After careful multivariable analysis of baseline characteristics age, IIEF-5 score and BMI affected continence in a statistically significant fashion. This suggests that baseline factors and not the physical preservation of the cavernosal nerves predict overall return to continence. PMID:21244602

  13. Approach to urinary tract infections.

    PubMed

    Najar, M S; Saldanha, C L; Banday, K A

    2009-10-01

    Urinary tract infection (UTI) is the most common infection experienced by humans after respiratory and gastro-intestinal infections, and also the most common cause of both community-acquired and nosocomial infections for patients admitted to hospitals. For better management and prognosis, it is mandatory to know the possible site of infection, whether the infection is uncomplicated or complicated, re-infection or relapse, or treatment failure and its pathogenesis and risk factors. Asymptomatic bacteriuria is common in certain age groups and has different connotations. It needs to be treated and completely cured in pregnant women and preschool children. Reflux nephropathy in children could result in chronic kidney disease; otherwise, urinary tract infections do not play a major role in the pathogenesis of end-stage renal disease. Symptomatic urinary tract infections occur most commonly in women of child-bearing age. Cystitis predominates, but needs to be distinguished from acute urethral syndrome that affects both sexes and has a different management plan than UTIs. The prostatitis symptoms are much more common than bacterial prostatic infections. The treatment needs to be prolonged in bacterial prostatitis and as cure rates are not very high and relapses are common, the classification of prostatitis needs to be understood. The consensus conference convened by National Institute of Health added two more groups of patients, namely, chronic prostatitis/chronic pelvic pain syndrome and asymptomatic inflammatory prostatitis, in addition to acute and chronic bacterial prostatitis. Although white blood cells in urine signify inflammation, they do not always signify UTI. Quantitative cultures of urine provide definitive evidence of UTI. Imaging studies should be done 3-6 weeks after cure of acute infection to identify abnormalities predisposing to infection or renal damage or which may affect management. Treatment of cystitis in women should be a three-day course and if symptoms are prolonged, then a seven day course of antibiotics should be given. Selected group of patients benefits from low-dose prophylactic therapy. Upper urinary tract infection may need in-patient treatment. Treatment of acute prostatitis is 30-day therapy of appropriate antibiotics and for chronic bacterial prostatitis a low dose therapy for 6-12 months may be required. It should be noted that no attempt should be made to eradicate infection unless foreign bodies such as stones and catheters are removed and correctable urological abnormalities are taken care of. Treatment under such circumstances can result only in the emergence of resistant organisms and complicate therapy further. PMID:20535247

  14. Urinary Biomarkers for Prostate Cancer.

    PubMed

    Tosoian, Jeffrey J; Ross, Ashley E; Sokoll, Lori J; Partin, Alan W; Pavlovich, Christian P

    2016-02-01

    In light of the overdiagnosis and overtreatment associated with widespread prostate-specific antigen-based screening, controversy persists surrounding the detection and diagnosis of prostate cancer (PCa). Given its anatomic proximity to the prostate, urine has been proposed as a noninvasive substrate for prostatic biomarkers. With greater understanding of the molecular pathways of carcinogenesis and significant technological advances, the breadth of potential biomarkers is substantial. In this review, the authors aim to provide an evidence-based assessment of current and emerging urinary biomarkers used in the detection and prognostication of PCa and high-grade PCa, with particular attention on clinically relevant findings. PMID:26614026

  15. 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

  16. Bedside Diagnosis Of Urinary Incontinence

    PubMed Central

    Lewis, John

    1985-01-01

    Urinary incontinence usually presents as stress incontinence, unstable bladder, incontinence of psychomotor impairment, or neurogenic bladder. While diagnosis may sometimes require specialist investigation, it is often possible on clinical grounds. The otherwise well woman with a long history of incontinence will have either stress incontinence or an unstable bladder; the differences are defined. The ill patient with a short history of incontinence associated with impaired alertness or mobility will usually have a reversible cause. Patients whose incontinence is due to a neurogenic cause fall into four main categories, and treatment is specific to each. PMID:20469443

  17. 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

  18. Actinomycosis of the urinary bladder

    PubMed Central

    Huang, Chun; Al-Essawi, Turki

    2013-01-01

    Actinomycosis of the urinary bladder is a rare anaerobic bacterial infection caused by Actinomyces isrealii. Initial diagnosis is often difficult and this disease is easily misdiagnosed as a urothelial or urachal tumour. The definitive diagnosis is usually made postoperatively via tissue pathology. We discuss a case of a 54-year-old male with a smoking history and a 2.5-week history of gross hematuria. Ultrasound, computed tomography and cystoscopy revealed a large inflammatory mass adherent to the right, anterior bladder wall, suggesting malignancy. Transurethral resection and histological pathology subsequently confirmed inflammatory urothelium and gram-positive bacteria consistent with actinomyces species. PMID:23914269

  19. The European Continent : Surface Expression of Upper Mantle Dynamics

    NASA Astrophysics Data System (ADS)

    Tondi, M. R.; Schivardi, R.; Molinari, I.; Morelli, A.

    2012-12-01

    The surface topography of Europe shows important variations, most of which are relatively well explained by isostatic compensation of density contrasts within the crust and lithosphere. However, not all of the density contrasts leading to topography reside within the lithosphere. The crucial problem is how to detect the extra topography signal, in addition to that associated with both crustal and lithospheric anomalies. Forte and Perry, 2000 estimate the amplitude of the dynamic topography by removal of the crustal isostatic topography signal from the surface of the Earth. Faccenna and Becker, 2010 infer the equivalent dynamic topography from the normal stress generated at the surface by mantle viscous flow driven by thermal anomalies. Here we consider the correlation between residual topography and mantle residual gravity anomalies. As shown by Pekeris, 1935 and Hager et al., 1985, the viscous mantle flow that is driven by the thermal density contrasts is responsible for the long-wavelength gravity anomalies observed at the surface. They have demonstrated that the gravitational effects of surface deformation caused by the flow is opposite in sign and comparable in magnitude to that of the driving density contrast. The 1°x1° recently assembled European crustal model, EPCrust (Molinari and Morelli, 2011) is used to estimate the effects of the isostatic crust and the mantle residual gravity anomalies. We calculate the correlation matrix between the residual topography and the mantle residual gravity anomalies and we define the regions where the sublithospheric mantle density, below the European continent, contributes to surface topography. To recover the residual topography, the effects of the isostatic crust is estimated with the Panasyuk and Hager (2000) algorithm and subtracted from the observed elevation (ETOPO-1). The mantle residual gravity anomalies are estimated as the differences between the produced gravity field of EPCrust and the observations. 3-D images of the European upper mantle isotropic shear-wave speeds and mass densities, recently recovered by combined inversion of surface-wave information and GRACE satellite gravity data (Tondi et al., 2012) are used to select the regions where the residual topography and the residual mantle gravity anomalies are strongly correlated (correlation coefficient is equal to 1). We assume surface uplift processes with negative density anomalies and downward pull with positive anomalies. Our work shows a strong correlation among the areas where, on the basis of our assumptions, the mantle dynamics have surface expression and the areas of low values of radial anisotropy: (1) the southern margins of the East European Craton, (2) the North-Eastern edges of the Arabian Plateau, (3) the northern edge of the CEVP (Central European Volcanic Province), (4) the North-Eastern part of the Atlantic Ocean, between Greenland and Iceland.

  20. 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 changes to the total discharge of the St. Lawrence and Mississippi Rivers. While it is unclear if the Teays River ever flowed into the St. Lawrence drainage or developed as a westward-flowing tributary to the buried Mahomet valley in Illinois, both the ancestral Pittsburgh and Wyalusing Rivers originated as headwaters of the St. Lawrence basin before being rerouted as part of the Mississippi basin. The areas formerly drained by the Pittsburgh and Wyalusing Rivers comprise ~8% of the modern Mississippi River basin, and modern discharge from those areas represent ~14% of the mean annual discharge of the Mississippi River. The transfer of this drainage area and discharge to the Mississippi basin is mirrored by an equivalent loss from the St. Lawrence system during the Quaternary as a direct result of glacially-driven drainage system reorganization.

  1. 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

  2. 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.

  3. 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...

  4. 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 ...

  5. Urinary kallikrein excretion in renal transplant patients.

    PubMed

    Brouhard, B H; Cunningham, R J; Berger, M; Petrusick, T W; Travis, L B

    1982-05-01

    Urinary kallikrein, as a reflection of the intrarenal kallikrein, is distinct from plasma kallikrein. The kallikrein-kinin system, activated via antigen-antibody complexes, has been implicated in the pathophysiology of acute transplant rejection. We studied urinary excretion of sodium, potassium, protein, and kallikrein following renal transplantation in nine patients, In four patients who took steroids daily and were followed from the time of transplantation (without rejection episodes), urinary kallikrein remained stable (3.7 +/- 0.5 EU/24 hr, x +/- SEM). Since sodium-retaining steroids influence urinary kallikrein excretion, two patients were studied 2 and 3 months post-transplantation while receiving alternate-day prednisone. Values from urinary kallikrein in these patients did not differ from those in patients taking steroids daily (3.7 +/- 0.5 versus 2.7 +/- 0.3 EU/24 hr). In three patients experiencing acute rejection episodes, urinary kallikrein excretion rose markedly (24 to 260 EU/24 hr) and remained elevated until the patients became oliguric. Furthermore, this rise occurred 1-3 days before the clinical diagnosis of rejection was made. For the group as a whole there was no significant correlation between urinary kallikrein excretion, the excretion of sodium or potassium, or urine volume. Although the number of patients studied is small, the increases observed in urinary kallikrein suggest that activation of the intrarenal kallikrein-kinin system is associated with acute transplant rejection. PMID:7047034

  6. 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…

  7. Sexually acquired Salmonella Typhi urinary tract infection.

    PubMed

    Wielding, Sally; Scott, Gordon

    2016-05-01

    We report a case of isolated urinarySalmonella entericaserotype Typhi in an HIV-positive man who has sex with men. He was clinically well and blood and stool cultures were negative, indicating that this may have been a sexually acquired urinary tract infection. PMID:25953964

  8. Urinary catheters - what to ask your doctor

    MedlinePlus

    ... of nonsurgical treatments for urinary incontinence in women. Ann Intern Med . 2008;148:459-473. Shamilyan TA, Wyman JF, Ping R, Wilt TJ, Kane RL. Male urinary incontinence: Prevalence, risk factors, and preventive interventions. Rev Urol . 2009;11:145-165.

  9. Analysis of naltrexone urinary metabolites.

    PubMed

    Ventura, R; de la Torre, R; Segura, J

    1988-01-01

    A reversed-phase HPLC method using ion-pair formation has been developed for the simultaneous determination of naltrexone and three urinary metabolites. The extraction of the free and conjugated metabolites was studied by liquid-solid procedures using styrene-divinylbenzene copolymers (Amberlite XAD-2) and bonded octadecyl silica supports (ODS-silica). Optimum recovery was obtained with ODS-silica extraction using 25% acetonitrile in a 5 mM diammonium phosphate buffer pH 2.1 as elution solvent. The chromatographic behaviour of naltrexone metabolites and naloxone (internal standard) was examined by varying the mobile phase composition. Increments of both the diammonium phosphate buffer concentration and the percentage of organic solvent in the eluent decreases the retention of compounds in a non-linear manner. Increments of the dodecyl sulphate (counter-ion) concentration, increases the retention time. The method was applied to determine the urinary levels of major naltrexone metabolites in a volunteer receiving a 50 mg oral dose. This is the first method reported which permits the simultaneous quantitative determination of naltrexone and its metabolites, 6beta-naltrexol, naltrexone glucuronide and 6beta-naltrexol glucuronide, in urine. PMID:16867358

  10. Ileocecal Intussusception Caused by an Appendiceal Neoplasm.

    PubMed

    Chua, Terence C; Gill, Preetjote; Gill, Anthony J; Samra, Jaswinder S

    2016-04-01

    Mucinous appendiceal neoplasm occurs in less than 1 % of appendicectomies. Majority of what is known in the literature is about pseudomyxoma peritonei, which exists as its disseminated form. Pictorial imagery of its pre-disseminated form is rarely observed. We present in a case report form a case of low-grade mucinous neoplasm of the appendix resulting in focal intussusception including images captured from this unique case that will become a learning case for readers of the journal. PMID:26831058

  11. 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 tectonic structure from NE to SW. On the two NE-most lines, crustal thinning and break-up occur over 20-40 km wide segments. To the SW, continental extension occurred over a comparatively broader ~100-110 km segment of tilted fault-block structure. We interpret, that this 3D structural variability and the narrow COT was caused by the lateral NE to the SW propagation of a spreading center. In the NE, early spreading center propagation during ongoing rifting stopped continental stretching, causing an abrupt break-up and a narrow COT to seafloor spreading. Later arrival of spreading center propagated to the SW, resulted in a comparatively broader segment with fault-block structures of extended continental crust. However, the COT to clear oceanic crust is narrow. Spreading center propagation in the basin is however not a simple phenomena and ridge jumps and abrupt cessation of spreading contributed to form narrow COT that laterally change to highly thinned continental crust segments. We suggest that the tectonic architecture of continental extension and the abrupt COT along the PRM have been controlled by 3D oceanic spreading center propagation to a degree larger than by the local lithospheric structure during rifting.

  12. 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 reverse to extensional surface stresses less than 800 km north of the flexural bulge. The high absolute stress levels that prevail in certain locations (>2 kbar) means that despite India's slow movement northward, existing zones of weakness are critically close to failure, and that the inferred 1 bar/millenium changes in surface stress attributable to India's northward motion (invisible to current geodesy) may be responsible for triggering local seismicity. Variable sediment rates in flexural troughs in the oceanic plate south of India suggest that the in-plane stresses responsible for the amplitude of the continental bulge have not been constant with time in the past several millions of years. It is also possible that anthropogenic loading and unloading of the Indian plate (groundwater withdrawal in the north and reservoir loading in central India) may be adversely perturbing the seismogenic charateristics of the flexural stress field.

  13. 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 undergoing open retropubic RP may present, 7 days postoperatively, some degree of cystographically detected UL; prostate volume, loss of serum hemoglobin, and postoperative serum total proteins could be used to predict it. UL delayed return to urinary continence without affecting long-term results, but led to a significantly higher rate of AS. PMID:27100451

  14. 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

  15. 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

  16. 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

  17. 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.

  18. Urinary stones in Eastern Saudi Arabia

    PubMed Central

    Alkhunaizi, Ahmed Mansour

    2016-01-01

    Introduction: Nephrolithiasis is a common problem worldwide especially in areas of the hot climate like Saudi Arabia. The aim of this analysis was to study the characteristics of urinary stones in Eastern Saudi Arabia and to report the following: Composition of urinary stones, age and gender distribution, seasonal variation of stone development, comorbid conditions associated with stone development and the incidence of urinary stones. Methods: All urinary stones that were submitted to the Johns Hopkins Aramco Healthcare, previously Saudi Aramco Medical Services Organization for analysis from January 2011 through January 2013 were analyzed. Results: A total of 384 urinary stones were collected and submitted for analysis from 347 patients. There was a male predominance with a male: female ratio of 3.9:1. The average age was 48.5 ± 12.8 years. Weight abnormality was predominant in both genders, and especially females. Calcium-based stones constituted the great majority (84.6%) followed by uric acid stones (12.8%). The other forms of stones were rare. More stones were recovered during the hot season, May to September. The calculated annual incidence of urolithiasis was 111/100,000 individuals. Conclusion: Calcium based stones are the most common urinary stones observed in Eastern Saudi Arabia. There is a clear association between the diagnosis of urinary stones and the hot season PMID:26834393

  19. Urinary tract infection in children

    PubMed Central

    2010-01-01

    Introduction Up to 11.3% of girls and 3.6% of boys will have had a urinary tract infection (UTI) by the age of 16 years, and recurrence of infection is common. Vesicoureteric reflux is identified in up to 40% of children being investigated for a first UTI, and is a risk factor for, but weak predictor of, renal parenchymal defects. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatment of acute urinary tract infection in children? What are the effects of interventions to prevent recurrence? We searched: Medline, Embase, The Cochrane Library, and other important databases up to July 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 25 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: antibiotics (short initial intravenous antibiotics, long initial intravenous antibiotics, initial oral antibiotics, single-dose or single-day courses of oral antibiotics, short courses of oral antibiotics, long courses of oral antibiotics, immediate empirical antibiotics, delayed antibiotics, prolonged delay of antibiotics, prophylactic antibiotics); immunotherapy; surgical correction of minor functional abnormalities; and surgical correction of moderate to severe vesicoureteric reflux. PMID:21733199

  20. Urinary Calculi and Risk of Cancer

    PubMed Central

    Shih, Chia-Jen; Chen, Yung-Tai; Ou, Shuo-Ming; Yang, Wu-Chang; Chen, Tzeng-Ji; Tarng, Der-Cherng

    2014-01-01

    Abstract Previous studies have shown that urinary calculi are associated with increased risks of urinary tract cancers. However, the association between urinary calculi and overall cancers is a largely undefined body of knowledge. We conducted a nationwide population-based cohort study using Taiwan's National Health Insurance Research Database from 2000 and 2009. Patients were excluded if they had antecedent cancers or urinary calculi before the enrollment. All study subjects were followed until the occurrence of cancer, dropout from the NHI program, death, or the end of 2010. Patterns of cancer incidence in patients with urinary calculi were compared with those of the general population using standardized incidence ratio (SIR). A total of 43,516 patients with urinary calculi were included. After a median follow-up of 5.3 years, 1891 patients developed cancer. The risk of overall cancers was significantly increased (SIR, 1.75; 95% confidence interval [CI], 1.68–1.83). We observed that urinary calculi was associated with higher risk of cancers of kidney (4.24; 95% CI, 3.47–5.13), bladder (3.30; 95% CI, 2.69–4.00), thyroid (2.50; 95% CI, 1.78–3.40), hematologic origin (2.41; 95% CI, 1.92–2.99), breast (1.84; 95% CI, 1.54–2.20), lung (1.82; 95% CI, 1.59–2.07), digestive tract (1.69; 95% CI, 1.57–1.82), and head and neck (1.54; 95% CI, 1.32–1.79), respectively. Our study shows that urinary calculi are associated with higher risk of systemic cancers in addition to urinary tract cancers. Further study is required to validate this association. PMID:25546684

  1. 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

  2. Dietary protein-induced increases in urinary calcium are accompanied by similar increases in urinary nitrogen and urinary urea: a controlled clinical trial.

    PubMed

    Bihuniak, Jessica D; Simpson, Christine A; Sullivan, Rebecca R; Caseria, Donna M; Kerstetter, Jane E; Insogna, Karl L

    2013-03-01

    To determine the usefulness of urinary urea as an index of dietary protein intake, 10 postmenopausal women were enrolled in and completed a randomized, double-blind, cross-over feeding trial from September 2008 to May 2010 that compared 10 days of a 45-g whey supplement with 10 days of a 45-g maltodextrin control. Urinary nitrogen, urinary calcium, urinary urea, and bone turnover markers were measured at days 0, 7, and 10. Paired sample t tests, Pearson's correlation statistic, and simple linear regression were used to assess differences between treatments and associations among urinary metabolites. Urinary nitrogen/urinary creatinine rose from 12.3±1.7 g/g (99.6±13.8 mmol/mmol) to 16.8±2.2 g/g (135.5±17.8 mmol/mmol) with whey supplementation, but did not change with maltodextrin. Whey supplementation caused urinary calcium to rise by 4.76±1.84 mg (1.19±0.46 mmol) without a change in bone turnover markers. Because our goal was to estimate protein intake from urinary nitrogen/urinary creatinine, we used our data to develop the following equation: protein intake (g/day)=71.221+1.719×(urinary nitrogen, g)/creatinine, g) (R=0.46, R(2)=0.21). As a more rapid and less costly alternative to urinary nitrogen/urinary creatinine, we next determined whether urinary urea could predict protein intake and found that protein intake (g/day)=63.844+1.11×(urinary urea, g/creatinine, g) (R=0.58, R(2)=0.34). These data indicate that urinary urea/urinary creatinine is at least as good a marker of dietary protein intake as urinary nitrogen and is easier to quantitate in nutrition intervention trials. PMID:23438496

  3. 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 excreting eggs in their urine by around 60% compared to placebo at one to two months after treatment (treatment failure: RR 0.42, 95% CI 0.29 to 0.59, 864 participants, seven trials, high quality evidence). The proportion of people cured with praziquantel varied substantially between trials, from 22.5% to 83.3%, but was higher than 60% in five of the seven trials. At one to two months following praziquantel treatment at 40 mg/kg, the mean number of schistosome eggs in the urine was reduced by over 95% in five out of six trials (678 participants, six trials, high quality evidence). Splitting praziquantel 40 mg/kg into two doses over 12 hours probably has no benefits over a single dose, and in a single trial of 220 participants the split dose caused more vomiting (RR 0.5, 95% CI 0.29 to 0.86) and dizziness (RR 0.39, 95% CI 0.16 to 0.94). Metrifonate A single dose of metrifonate 10 mg/kg reduced egg excretion (210 participants, one trial, at eight months), but was only marginally better than placebo at achieving cure at one month (RR 0.83, 95% CI 0.74 to 0.94, 142 participants, one trial). In a single trial comparing one, two and three doses, the absolute number of participants cured improved from 47% after one dose to 81% after three doses (93 participants, one trial, low quality evidence). Two small trials compared 40 mg/kg single dose praziquantel with two or three doses of 10 mg/kg metrifonate and found no clear evidence of differences in cure (metrifonate 2 x 10 mg/kg at one month: RR 1.03, 95% CI 0.8 to 1.34, 72 participants, one trial; metrifonate 3 x 10 mg/kg at three months: RR 0.33, 95% CI 0.07 to 1.57, 100 participants, one trial. In one trial both drugs performed badly and in one trial both performed well. Other drugs Three trials have evaluated the antimalarial artesunate; with inconsistent results. Substantial antischistosomal effects were only seen in one of the three trials, which was at unclear risk of bias due to poor reporting of the trial methods. Similarly, another anti-malarial mefloquine has been evaluated in two small trials with inconsistent effects. Adverse events were described as mild for all evaluated drugs, but adverse event monitoring and reporting was generally of low quality. Authors' conclusions Praziquantel 40 mg/kg is the most studied drug for treating urinary schistosomiasis, and has the strongest evidence base. Potential strategies to improve future treatments for schistosomiasis include the combination of praziquantel with metrifonate, or with antimalarial drugs with antischistosomal properties such as artesunate and mefloquine. Evaluation of these combinations requires rigorous, adequately powered trials using standardized outcome measures. Plain Language summary Drugs for treating urinary schistosomiasis What is urinary schistosomiasis and how is it treated? Urinary schistosomiasis is a disease caused by infection of people with the parasitic worm Schistosoma haematobium. These worms live in blood vessels around the infected person's bladder and the worm releases eggs which are released in the person's urine. If the urine is passed into ponds or lakes, the eggs can hatch and infect people that are washing or swimming there. Infection can cause blood in the urine and if left untreated can eventually lead to anaemia, malnutrition, kidney failure, or bladder cancer. Urinary schistosomiasis is diagnosed by looking for worm eggs in the urine. The disease occurs mainly in school-aged children and young adults in sub-Saharan Africa. The drug currently recommended for treatment is praziquantel, which can be given as a single dose, but other drugs such as metrifonate, artesunate, and mefloquine have also been evaluated. After examining the research published up to 23th May 2014, we included 30 randomized controlled trials, enrolling 8165 children and adults. What does the research say? On average, the standard dose of praziquantel cures around 60% of people at one to two months after treatment (high quality evidence), and reduces the number of schistosome eggs in the urine by over 95% (high quality evidence). Metrifonate, an older drug no longer in use, had little effect when given as a single dose but an improved effect when given as multiple doses two weeks apart. Two trials compared three doses of metrifonate with the single dose of praziquantel and found similar effects. Two more recent trials evaluated a combination of artesunate and praziquantel compared to praziquantel alone. In one trial artesunate improved cure and in one it made no difference. Authors conclusions Future treatments for schistosomiasis could include combining praziquantel with metrifonate, or with artesunate, but these need to be evaluated in high quality trials. PMID:25099517

  4. 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.

  5. 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.

  6. 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

  7. 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

  8. Kidneys and Urinary Tract (For Parents)

    MedlinePlus

    ... younger than 6 years old and affects more boys than girls. It's often treated with steroids. Urinary tract infections ( ... tract (the bladder and urethra). UTIs affect both boys and girls, but in school-age children, girls are more ...

  9. Urinary incontinence - tension-free vaginal tape

    MedlinePlus

    ... tape is surgery to help control stress urinary incontinence . This is urine leakage that happens when you ... free vaginal tape is placed to treat stress incontinence. Before discussing surgery, your doctor will have you ...

  10. 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.

  11. Conservative Management of Urinary Incontinence in Women

    PubMed Central

    Faiena, Izak; Patel, Neal; Parihar, Jaspreet S; Calabrese, Marc; Tunuguntla, Hari

    2015-01-01

    Urinary incontinence in women has a high prevalence and causes significant morbidity. Given that urinary incontinence is not generally a progressive disease, conservative therapies play an integral part in the management of these patients. We conducted a nonsystematic review of the literature to identify high-quality studies that evaluated the different components of conservative management of stress urinary incontinence, including behavioral therapy, bladder training, pelvic floor muscle training, lifestyle changes, mechanical devices, vaginal cones, and electrical stimulation. Urinary incontinence can have a severe impact on our healthcare system and patients’ quality of life. There are currently a wide variety of treatment options for these patients, ranging from conservative treatment to surgical treatment. Although further research is required in the area of conservative therapies, nonsurgical treatments are effective and are preferred by some patients. PMID:26543427

  12. Urinary Tract and How It Works

    MedlinePlus

    ... system for removing urine, which is composed of wastes and extra fluid. In order for normal urination ... The urinary tract is important because it filters wastes and extra fluid from the bloodstream and removes ...

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

    PubMed Central

    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 from the perspectives of NH stakeholders, including residents and interdisciplinary team members. Data were collected through participant observation, interviews, and archival records. Results: Human relations dimensions of organizational culture influenced continence care by affecting institutional missions, admissions and hiring practices, employee tenure, treatment strategies, interdisciplinary teamwork, and group decision making. Closed system approaches, parochial identity, and an employee focus stabilized staff turnover, fostered evidence-based practice, and supported hierarchical toileting programs in one facility. Within a more dynamic environment, open system approaches, professional identity, and job focus allowed flexible care practices during periods of staff turnover. Neither organizational culture fully supported interdisciplinary team efforts to maximize the bladder and bowel health of residents. Implications: Organizational culture varies in NHs, shaping the continence care practices of interdisciplinary teams and leading to the selective use of treatments across facilities. Human relations dimensions of organizational culture, including open or closed systems, professional or parochial identity, and employee or job focus are critical to the success of quality improvement initiatives. Evidence-based interventions should be tailored to organizational culture to promote adoption and sustainability of resident care programs. PMID:20008040

  14. 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

  15. Modeling Supercontinent Cycles in 3D Spherical Convection Simulations With Multiple Continents

    NASA Astrophysics Data System (ADS)

    Phillips, B. R.; Bunge, H.

    2004-12-01

    In 1966 J. Tuzo Wilson suggested that the Atlantic Ocean basin had closed and then reopened, a process now commonly termed the Wilson Cycle. Since then, numerous paleomagnetic studies have shown that Wilson's original idea may be extended to describe a global cycle, punctuated by the periodic formation of supercontinents such as Pangea, Rodinia, and Nuna, separated by time scales of several hundred million years (Myr). It is generally accepted that these motions are coupled to large scale mantle convection. Early two dimensional (2D) mantle convection models demonstrated the dynamic feasibility of such supercontinent cycles. However, fully 3D spherical mantle convection models incorporating multiple continents have yet to be explored. Here we present the first high resolution, 3D spherical mantle convection models with multiple continents. A global grid spacing of ˜50 km permits us to model vigorous convection at Rayleigh number 107. We study models incorporating between two and ten continents in predominantly internally heated flow with radially stratified viscosity. From these models we find that continents aggregate and disperse cyclically, with periods of several 100 Myr. Supercontinents remain intact for roughly 200 Myr. Moreover, the presence of multiple continents promotes the development of mantle thermal heterogeneity on the longest length scales (spherical harmonic degrees 1 and 2) in some models. These results agree well with geologic observations and place dynamic constraints on global mantle flow models.

  16. [Urinary tract infection in pregnancy].

    PubMed

    Duarte, Geraldo; Marcolin, Alessandra Cristina; Quintana, Silvana Maria; Cavalli, Ricardo Carvalho

    2008-02-01

    Several factors cause urinary tract infection (UTI) to be a relevant complication of the gestational period, aggravating both the maternal and perinatal prognosis. For many years, pregnancy has been considered to be a factor predisposing to all forms of UTI. Today, it is known that pregnancy, as an isolated event, is not responsible for a higher incidence of UTI, but that the anatomical and physiological changes imposed on the urinary tract by pregnancy predispose women with asymptomatic bacteriuria (AB) to become pregnant women with symptomatic UTI. AB affects 2 to 10% of all pregnant women and approximately 30% of these will develop pyelonephritis if not properly treated. However, a difficult-to-understand resistance against the identification of AB during this period is observed among prenatalists. The diagnosis of UTI is microbiological and it is based on two urine cultures presenting more than 10(5) colonies/mL urine of the same germ. Treatment is facilitated by the fact that it is based on an antibiogram, with no scientific foundation for the notion that a pre-established therapeutic scheme is an adequate measure. For the treatment of pyelonephritis, it is not possible to wait for the result of culture and previous knowledge of the resistance profile of the antibacterial agents available for the treatment of pregnant women would be the best measure. Another important variable is the use of an intravenous bactericidal antibiotic during the acute phase, with the possibility of oral administration at home after clinical improvement of the patient. At our hospital, the drug that best satisfies all of these requirements is cefuroxime, administered for 10-14 days. Third-generation cephalosporins do not exist in the oral form, all of them involving the inconvenience of parenteral administration. In view of their side effects, aminoglycosides are considered to be inadequate for administration to pregnant women. The inconsistent insinuation of contraindication of monofluorinated quinolones, if there is an indication, norfloxacin is believed to be a good alternative to cefuroxime. In cases in which UTI prophylaxis is indicated, chemotherapeutic agents are preferred, among them nitrofurantoin, with care taken to avoid its use at the end of pregnancy due to the risk of kernicterus for the neonate. PMID:19142482

  17. 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

  18. Congenital anomalies of the urinary tract.

    PubMed

    Pohl, Hans G; Belman, A Barry

    2014-01-01

    The upper urinary tract forms as a consequence of the reciprocal inductive signals between the metanephric mesenchyme and ureteric bud. A clue to the timing of events leading to an abnormality of the upper urinary tract can be the presence also of associated anomalies of internal genitalia since separation of these systems occurs at about the 10th week of gestation. Prenatal sonography has facilitated the detection of urological abnormalities presenting with hydronephrosis. Hydronephrosis suggests obstruction, but by itself cannot be equated with it. Instead, further radiographic imaging is required to delineate anatomy and function. Now, moreover, non-surgical management of CAKUT should be considered whenever possible. Despite the widespread use of prenatal screening sonography that usually identifies the majority of congenital anomalies of the urinary tract, many children still present with febrile urinary tract infection (UTI). Regardless of the etiology for the presentation, the goal of management is preservation of renal function through mitigation of the risk for recurrent UTI and/or obstruction. In the past many children underwent surgical repair aimed at normalization of the appearance of the urinary tract. Today, management has evolved such that in most cases surgical reconstruction is performed only after a period of observation - with or without urinary prophylaxis. The opinions presented in this section are not espoused by all pediatric urologists but represent instead the practice that has evolved at Children's National Medical Center (Washington DC) based significantly on information obtained by nuclear renography, in addition to sonography and contrast cystography. PMID:25088266

  19. Factors governing urinary tract stone disease.

    PubMed

    Watts, R W

    1989-07-01

    Urinary stone formation depends on the degree of saturation of the urine with respect to potential stone-forming substances. Urine contains a range of electrolytes which ionise to different and variable degrees and which interact with one another in ways which influence their solubilities. These ionisations are themselves influenced by the pH of the urine which is another variable factor. Urinary organic molecules, which may or may not ionise and which may bear surface charges, also influence the solubility of the low molecular weight stone-constituents. Some other substances in the urine, such as glycosaminoglycans, can modify the ability of inorganic micro-crystals to aggregate and form stones. Environmental factors, other urinary tract pathology and genetic influences all predispose to urolithiasis, but many cases lack either an identifiable specific cause or the presence of recognisable risk factors. In the risk factor model of calcium stone formation there are pre-renal risk factors which lead to urinary risk factors and hence to the chemical risk factors of supersaturation and decreased ability to inhibit crystallisation. There are, in addition to these general factors which may act synergistically to produce urinary stones, several specific single enzyme defects which alter the urinary composition in such a way as to produce stones of a highly characteristic composition. PMID:2702116

  20. Urinary prostasin in normotensive individuals: correlation with the aldosterone to renin ratio and urinary sodium.

    PubMed

    Olivieri, Oliviero; Chiecchi, Laura; Pizzolo, Francesca; Castagna, Annalisa; Raffaelli, Ricciarda; Gunasekaran, Muthukumar; Guarini, Patrizia; Consoli, Letizia; Salvagno, Gianluca; Kitamura, Kenichiro

    2013-06-01

    Prostasin, a glycosylphosphatidylinositol (GPI)-anchored serine protease, activates the epithelial sodium (Na) channel (ENaC), and prostasin is released in extracellular fluids, including urine. Previous data have suggested a direct association between urinary prostasin and the activation of an aldosterone-driven pathway, but a quantitative association has never been demonstrated in normotensive subjects. Similarly, physiological relationships with natriuresis or possible gender- or female hormone-related changes in urinary prostasin concentrations have never been investigated. We measured urinary prostasin by enzyme-linked immunosorbent assay in 43 healthy normotensive subjects of similar age presenting different urinary Na levels and in 15 women during the menstrual cycle and after oral estro-progestinic contraceptive (OC) therapy. Exosomal urinary prostasin was also estimated by western blotting of samples from six healthy subjects twice during the morning. Urinary prostasin presented a wide range of values (from 0.5 to 18.9?nM) without gender differences. It was positively correlated with the aldosterone to renin ratio (ARR) but not with circulating aldosterone or renin individually. Urinary prostasin was directly correlated with U-Na levels (up to 200?nmol Na), whereas it decreased for higher Na concentrations. In women, no significant changes of prostasin concentration were observed during menstrual phases. After OC therapy, prostasin increased (from 2.371.27 to 4.855.28?nM), although the increase was not statistically different (P=0.07). Prostasin was detectable in urinary exosomes and displayed a pattern similar to urinary prostasin in relation to urinary Na. In conclusion, urinary prostasin correlates with the ARR, and it is physiologically modulated by natriuresis in normotensive individuals. PMID:23344129

  1. Urinary Incontinence and Weight Change During Pregnancy and Postpartum: A Cohort Study

    PubMed Central

    Wesnes, Stian Langeland; Hunskaar, Steinar; Bo, Kari; Rortveit, Guri

    2010-01-01

    Weight gain during pregnancy may contribute to increased urinary incontinence (UI) during and after pregnancy, but scientific support is lacking. The effect of weight loss on UI postpartum is unclear. From 1999 to 2006, investigators in the Norwegian Mother and Child Cohort Study recruited pregnant women during pregnancy. This study was based on 12,679 primiparous women who were continent before pregnancy. Data were obtained from questionnaires answered at weeks 15 and 30 of pregnancy and 6 months postpartum. Weight gain greater than the 50th percentile during weeks 0–15 of pregnancy was weakly associated with higher incidence of UI at week 30 compared with weight gain less than or equal to the 50th percentile. Weight gain greater than the 50th percentile during pregnancy was not associated with increased prevalence of UI 6 months postpartum. For each kilogram of weight loss from delivery to 6 months postpartum among women who were incontinent during pregnancy, the relative risk for UI decreased 2.1% (relative risk = 0.98, 95% confidence interval: 0.97, 0.99). Weight gain during pregnancy does not seem to be a risk factor for increased incidence or prevalence of UI during pregnancy or postpartum. However, weight loss postpartum may be important for avoiding incontinence and regaining continence 6 months postpartum. PMID:20729349

  2. 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. Lett., 234 ,317-333, 2005.

  3. The Female Urinary Microbiome: a Comparison of Women with and without Urgency Urinary Incontinence

    PubMed Central

    Pearce, Meghan M.; Hilt, Evann E.; Rosenfeld, Amy B.; Zilliox, Michael J.; Thomas-White, Krystal; Fok, Cynthia; Kliethermes, Stephanie; Schreckenberger, Paul C.; Brubaker, Linda

    2014-01-01

    ABSTRACT Bacterial DNA and live bacteria have been detected in human urine in the absence of clinical infection, challenging the prevailing dogma that urine is normally sterile. Urgency urinary incontinence (UUI) is a poorly understood urinary condition characterized by symptoms that overlap urinary infection, including urinary urgency and increased frequency with urinary incontinence. The recent discovery of the urinary microbiome warrants investigation into whether bacteria contribute to UUI. In this study, we used 16S rRNA gene sequencing to classify bacterial DNA and expanded quantitative urine culture (EQUC) techniques to isolate live bacteria in urine collected by using a transurethral catheter from women with UUI and, in comparison, a cohort without UUI. For these cohorts, we demonstrated that the UUI and non-UUI urinary microbiomes differ by group based on both sequence and culture evidences. Compared to the non-UUI microbiome, sequencing experiments revealed that the UUI microbiome was composed of increased Gardnerella and decreased Lactobacillus. Nine genera (Actinobaculum, Actinomyces, Aerococcus, Arthrobacter, Corynebacterium, Gardnerella, Oligella, Staphylococcus, and Streptococcus) were more frequently cultured from the UUI cohort. Although Lactobacillus was isolated from both cohorts, distinctions existed at the species level, with Lactobacillus gasseri detected more frequently in the UUI cohort and Lactobacillus crispatus most frequently detected in controls. Combined, these data suggest that potentially important differences exist in the urinary microbiomes of women with and without UUI, which have strong implications in prevention, diagnosis, or treatment of UUI. PMID:25006228

  4. 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 younger moderately depleted accreted mantle. Our experiments show that early continents acted as kick-starters of subduction until plate tectonics became self-sustaining through the increasingly negative buoyancy of the oceanic lithosphere.

  5. Correlates of Urinary Incontinence in Community Dwelling Older Latinos

    PubMed Central

    Smith, Ariana L.; Wang, Pin-Chieh; Anger, Jennifer T.; Mangione, Carol M.; Trejo, Laura; Rodríguez, Larissa V.; Sarkisian, Catherine A.

    2013-01-01

    The prevalence of urinary incontinence (UI) has shown significant variability in the literature and is reflective of the definition and sampling methodologies used as well as the age group, ethnicity, and gender being studied. Our aim was to measure the prevalence and correlates of UI in a cross sectional sample of 572 older Latinos participating in Caminemos, a trial of a behavioral intervention to raise walking levels. Participants completed a baseline survey as well as a series of physical performance measures. UI was measured using the International Consultation on Incontinence item: “How often do you leak urine?” Potential correlates of UI were measured including: sociodemographic characteristics, body mass index, smoking history, physical activity medical comorbidity, physical performance, activities of daily living impairment, use of assistive ambulatory devices, cognitive function, physical and mental health-related quality of life (HRQoL), and depressive symptoms. The prevalence of UI in this community sample was 26.9%. Older Latinos reporting UI were more likely to be female, less physically active, have greater medical comorbidity, lower physical performance scores, greater ADL impairment, use assistive ambulatory devices, have worse cognitive function, have lower HRQoL, and have depressive symptoms. Multivariate logistic regression analysis revealed that medical comorbidity was independently associated with higher rates of UI (OR=1.66, 95% CI 1.30-2.12), while better cognitive function (OR=0.73, 95% CI 0.57-0.93) and higher weighted physical activity scores (OR=0.77, 95% CI 0.60-0.98) were independently associated with lower rates of UI. UI is highly prevalent but not ubiquitous among community-residing older Latinos, suggesting that UI is not an inevitable consequence of aging. Future studies should examine whether interventions that decrease comorbidity and cognitive decline and increase physical activity among older Latinos also improve continence status. PMID:20406311

  6. 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

  7. 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

  8. Cranberry and urinary tract infections.

    PubMed

    Guay, David R P

    2009-01-01

    Urinary tract infection (UTI) refers to the presence of clinical signs and symptoms arising from the genitourinary tract plus the presence of one or more micro-organisms in the urine exceeding a threshold value for significance (ranges from 102 to 103 colony-forming units/mL). Infections are localized to the bladder (cystitis), renal parenchyma (pyelonephritis) or prostate (acute or chronic bacterial prostatitis). Single UTI episodes are very common, especially in adult women where there is a 50-fold predominance compared with adult men. In addition, recurrent UTIs are also common, occurring in up to one-third of women after first-episode UTIs. Recurrences requiring intervention are usually defined as two or more episodes over 6 months or three or more episodes over 1 year (this definition applies only to young women with acute uncomplicated UTIs). A cornerstone of prevention of UTI recurrence has been the use of low-dose once-daily or post-coital antimicrobials; however, much interest has surrounded non-antimicrobial-based approaches undergoing investigation such as use of probiotics, vaccines, oligosaccharide inhibitors of bacterial adherence and colonization, and bacterial interference with immunoreactive extracts of Escherichia coli. Local (intravaginal) estrogen therapy has had mixed results to date. Cranberry products in a variety of formulations have also undergone extensive evaluation over several decades in the management of UTIs. At present, there is no evidence that cranberry can be used to treat UTIs. Hence, the focus has been on its use as a preventative strategy. Cranberry has been effective in vitro and in vivo in animals for the prevention of UTI. Cranberry appears to work by inhibiting the adhesion of type I and P-fimbriated uropathogens (e.g. uropathogenic E. coli) to the uroepithelium, thus impairing colonization and subsequent infection. The isolation of the component(s) of cranberry with this activity has been a daunting task, considering the hundreds of compounds found in the fruit and its juice derivatives. Reasonable evidence suggests that the anthocyanidin/proanthocyanidin moieties are potent antiadhesion compounds. However, problems still exist with standardization of cranberry products, which makes it extremely difficult to compare products or extrapolate results. Unfortunately, most clinical trials have had design deficiencies and none have evaluated specific key cranberry-derived compounds considered likely to be active moieties (e.g. proanthocyanidins). In general, the preventive efficacy of cranberry has been variable and modest at best. Meta-analyses have established that recurrence rates over 1 year are reduced approximately 35% in young to middle-aged women. The efficacy of cranberry in other groups (i.e. elderly, paediatric patients, those with neurogenic bladder, those with chronic indwelling urinary catheters) is questionable. Withdrawal rates have been quite high (up to 55%), suggesting that these products may not be acceptable over long periods. Adverse events include gastrointestinal intolerance, weight gain (due to the excessive calorie load) and drug-cranberry interactions (due to the inhibitory effect of flavonoids on cytochrome P450-mediated drug metabolism). The findings of the Cochrane Collaboration support the potential use of cranberry products in the prophylaxis of recurrent UTIs in young and middle-aged women. However, in light of the heterogeneity of clinical study designs and the lack of consensus regarding the dosage regimen and formulation to use, cranberry products cannot be recommended for the prophylaxis of recurrent UTIs at this time. PMID:19441868

  9. Promotion in urinary bladder carcinogenesis.

    PubMed Central

    Cohen, S M

    1983-01-01

    Aromatic amines, including 2-naphthylamine, 4-aminobiphenyl and benzidine, are known urinary bladder carcinogens in man and other species, but in rodents, aromatic amines and amides have usually induced liver tumors, occasionally also with tumors of the bladder and other tissues. Variations in organ specificity are related to differences in metabolism; for the production of bladder tumors, the rates of acetylation and deacetylation appear to be critical. Bladder specific carcinogens in rodents and other species have subsequently been identified, including N-butyl-N-(4-hydroxybutyl)nitrosamine (BBN) administered in the drinking water, N-[(4-(5-nitro-2-furyl)-2-thiazolyl]formamide (FANFT) in the diet and N-methyl-N-nitrosourea (MNU) instilled intravesically. When low doses of several bladder carcinogens (BBN, FANFT, 2-acetylaminofluorene, and 3,3'-dichlorobenzidine) are administered to rats, either simultaneously or sequentially, a synergistic effect is observed with respect to bladder carcinogenesis. In addition, a multistage carcinogenesis process has been demonstrated for the rat bladder using MNU or FANFT as initiators, and dietary sodium saccharin, sodium cyclamate, or tryptophan as promoters. Calculi (or pellets) appear to enhance the promotion process but are not necessary for it to occur. Recent studies also indicate that urine has a role in the promoting process. The urothelium normally has a very low mitotic rate. If mucosal proliferation is increased, such as during fetal development or during regeneration and repair of an ulcer, the bladder appears to be considerably more sensitive to the effects of promoting substances. For example, if sodium saccharin is administered to rats after ulceration of the bladder, even without prior administration of an initiator, bladder carcinoma develops. Under these conditions, the substance appears as a carcinogen. Human populations with increased bladder epithelial proliferation, such as fetus, infants, patients with bacterial cystitis or men with partially obstructive prostatism, may have increased susceptibility to the action of carcinogenic or promoting stimuli. PMID:6873031

  10. Behavioural treatment of urinary incontinence and encopresis in children with learning disabilities: transfer of stimulus control.

    PubMed

    Smith, L; Smith, P; Lee, S K

    2000-04-01

    Urinary and faecal incontinence present a considerable problem in people with learning disabilities, despite the general effectiveness of behavioural techniques in continence training. Children with learning disabilities and obsessional behaviour may be particularly resistant to toilet training, even where relatively cognitively able, and often despite a substantial degree of control over their eliminatory functions. Their resistance may be more appropriately regarded as a challenging behaviour and their incontinence better explained by factors other than a simple failure to learn. A 'stimulus-control' hypothesis proposes that the child's nappy (diaper)/potty/underwear has developed strong stimulus control over the elimination response. This report describes three case studies in which treatment-resistant children, aged between 8 and 12 years, with mild or moderate learning disabilities, were successfully treated for nappy-dependent nocturnal encopresis or diurnal urinary incontinence. The children were routine case referrals for whom previous attempts to train bowel or bladder control had failed. Behavioural techniques, such as 'shaping' (gradually increasing the proximity to the toilet), 'fading' (reducing the presence of the nappy), and rewards for eliminating, effected successful transfer of stimulus control over elimination from nappy to toilet. Treatment times varied, depending on the degree of the child's obsession and resistance to change. PMID:10795568

  11. The urethral plug II: an alternative treatment in women with genuine urinary stress incontinence.

    PubMed

    Nielsen, K K; Walter, S; Maegaard, E; Kromann-Andersen, B

    1993-10-01

    An improved design of the recently developed urethral plug was evaluated for the treatment of women with genuine urinary stress incontinence. The plug consists of an oval meatal plate, a soft stalk and 1 or 2 spheres along the stalk with fixed distances between the meatal plate and the spheres. Inside the stalk is a removable semi-rigid guide pin to ease insertion. Forty women were randomly allocated to treatment with either the 2-sphere or the 1-sphere plug during period 1 (2 weeks). In period 2 (2 weeks) the patients used the other plug. They then continued with what they judged to be the better plug in period 3 (2 months). Eighteen patients (45%) completed period 3 with the "preference" plug and 17 were subjectively and objectively continent or improved. Fourteen of these women preferred the 2-sphere device. The plugs were equally effective in patients with mild or severe incontinence. To accommodate variations in urethral length and to avoid the loss of plugs, the devices are available in different lengths. Six women developed urinary tract infections and 2 of these had a plug in the bladder. The urethral plug is an effective treatment in a group of women with stress incontinence. Removal by hand is advisable in order to avoid retention of plugs in the bladder. PMID:8261298

  12. 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

  13. Urinary bladder retroversion and neourethrocystostomy for treatment of inadvertent prostatectomy and urethrectomy in a dog.

    PubMed

    Flesher, Kathryn; Weisse, Chick; Berent, Allyson; Lin, Rebecca

    2016-03-01

    CASE DESCRIPTION A 15-month-old male Newfoundland was examined because of an inability to urinate, lethargy, inappetence, and intermittent vomiting that first became evident after bilateral cryptorchidectomy 2 days previously. The patient was referred for further evaluation and treatment. CLINICAL FINDINGS Results of physical examination, serum biochemical analysis, and abdominocentesis led to a diagnosis of uroperitoneum. Retrograde cystography indicated urinary tract obstruction. In view of the history of recent elective cryptorchidectomy, a diagnosis of uroperitoneum with urethral obstruction secondary to iatrogenic prostatectomy and urethrectomy was made. TREATMENT AND OUTCOME During a ventral midline celiotomy, the inadvertent prostatectomy and urethrectomy were found to have resulted in insufficient urethral length for primary repair. Surgical repair of the urethral defect was achieved by means of a novel technique of bladder retroversion and neourethrocystostomy at the apex of the bladder. A urethral stricture evident 1.5 months after surgery was initially treated with balloon dilatation, followed by temporary and then permanent placement of a self-expanding metallic stent. At the last follow-up 6.6 years after stent placement, the dog remained continent while receiving phenylpropanolamine and the owner was highly satisfied with the outcome. CLINICAL RELEVANCE Caudal intraabdominal bladder retroversion with apex neourethrocystostomy may be a viable alternative to more complex urethral lengthening procedures in dogs and can potentially preserve lower urinary tract function. This treatment might be considered for patients with urethral trauma or malignant neoplasia necessitating extensive urethral resection. Urethral strictures may be effectively managed with stenting. PMID:26885597

  14. 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

  15. Serum and Urinary NGAL in Septic Newborns

    PubMed Central

    Suchojad, Anna; Majcherczyk, Malgorzata; Jadamus-Niebroj, Danuta; Owsianka-Podlesny, Teresa; Brzozowska, Aniceta

    2014-01-01

    Neutrophil gelatinase-associated lipocalin (NGAL) is postulated to be a potentially new and highly specific/sensitive marker of acute kidney injury (AKI). The aim of this study was to assess the impact of inflammation on serum and urine NGAL in newborns that were treated due to infection. We determined serum and urine NGAL concentrations in 73 infants (51 with sepsis; 22 with severe sepsis) admitted to the Intensive Care Unit in the first month of life, for three consecutive days during the course of treatment for infection. 29 neonates without infection served as the control group. Septic patients, in particular, severe sepsis patients, had increased serum and urinary NGAL levels in the three subsequent days of observation. Five septic patients who developed AKI had elevated serum and urinary NGAL values to a similar extent as septic neonates without AKI. A strong correlation was found between the concentration of serum and urinary NGAL and inflammatory markers, such as CRP and procalcitonin. Serum and urinary NGAL levels were also significantly associated with NTISS (neonatal therapeutic intervention scoring system) values. We conclude that increased serum and urinary NGAL values are not solely a marker of AKI, and more accurately reflect the severity of inflammatory status. PMID:24579085

  16. 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

  17. Applications of urinary proteomics in biomarker discovery.

    PubMed

    Shao, Chen; Wang, Yan; Gao, YouHe

    2011-05-01

    Urine is an important source of biomarkers. This article reviews current advances, major challenges, and future prospects in the field of urinary proteomics. Because the practical clinical problem is to distinguish diseases with similar symptoms, merely comparing samples from patients of a particular disease to those of healthy individuals is inadequate for finding biomarkers with sufficient diagnostic power. In addition, the variation of expression levels of urinary proteins among healthy individuals and individuals under different physiological conditions adds to the difficulty in identifying biomarkers. We propose that establishing the natural variation in urinary protein expression among a healthy population can serve as a reference to help identify protein abundance changes that are caused by disease, not by individual variations or physiological changes. We also discuss that comparing protein expression levels between urine and plasma may reveal the physiological function of the kidney and that may facilitate biomarker discovery. Finally, we propose that establishing a data-sharing platform for data collection and integrating results from all urinary biomarker studies will help promote the development of urinary proteomics. PMID:21455690

  18. Serum and urinary NGAL in septic newborns.

    PubMed

    Smertka, Mike; Wroblewska, Jolanta; Suchojad, Anna; Majcherczyk, Malgorzata; Jadamus-Niebroj, Danuta; Owsianka-Podlesny, Teresa; Brzozowska, Aniceta; Maruniak-Chudek, Iwona

    2014-01-01

    Neutrophil gelatinase-associated lipocalin (NGAL) is postulated to be a potentially new and highly specific/sensitive marker of acute kidney injury (AKI). The aim of this study was to assess the impact of inflammation on serum and urine NGAL in newborns that were treated due to infection. We determined serum and urine NGAL concentrations in 73 infants (51 with sepsis; 22 with severe sepsis) admitted to the Intensive Care Unit in the first month of life, for three consecutive days during the course of treatment for infection. 29 neonates without infection served as the control group. Septic patients, in particular, severe sepsis patients, had increased serum and urinary NGAL levels in the three subsequent days of observation. Five septic patients who developed AKI had elevated serum and urinary NGAL values to a similar extent as septic neonates without AKI. A strong correlation was found between the concentration of serum and urinary NGAL and inflammatory markers, such as CRP and procalcitonin. Serum and urinary NGAL levels were also significantly associated with NTISS (neonatal therapeutic intervention scoring system) values. We conclude that increased serum and urinary NGAL values are not solely a marker of AKI, and more accurately reflect the severity of inflammatory status. PMID:24579085

  19. Meteor Shower observations from the Indian Sub-Continent (Visual Photographic and Radio)

    NASA Astrophysics Data System (ADS)

    Dabhade, R.; Savant, V.; Belapure, J.

    2011-01-01

    We review the present status of meteor shower observing from the Indian sub-continent. Some amateur groups are active in visual observations, although they are restricted by the lack of good observing sites. Ham radio appears to be promising as a technique to monitor the major meteor showers in this region. We present radio observations of the 2006 Quadrantids.

  20. 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...

  1. Long Aftershock Sequences within Continents and Implications for Earthquake Hazard Assessment

    NASA Astrophysics Data System (ADS)

    Stein, S. A.; Liu, M.

    2014-12-01

    Recent seismicity in the Tangshan region in North China has prompted concern about a repetition of the 1976 M7.8 earthquake that destroyed the city, killing more than 242,000 people. However, the decay of seismicity there implies that the recent earthquakes are probably aftershocks of the 1976 event. This 37-year sequence is an example of the phenomenon that aftershock sequences within continents are often significantly longer than the typical 10 years at plate boundaries. The long sequence of aftershocks in continents is consistent with a simple friction-based model predicting that the length of aftershock sequences varies inversely with the rate at which faults are loaded. Hence the slowly-deforming continents tend to have aftershock sequences significantly longer than at rapidly-loaded plate boundaries. This effect has two consequences for hazard assessment. First, within the heavily populated continents that are typically within plate interiors, assessments of earthquake hazards rely significantly on the assumption that the locations of small earthquakes shown by the short historical record reflect continuing deformation that will cause future large earthquakes. This assumption would lead to overestimation of the hazard in presently active areas and underestimation elsewhere, if some of these small events are aftershocks. Second, successful attempts to remove aftershocks from catalogs used for hazard assessment would underestimate the hazard, because much of the hazard is due to the aftershocks, and the declustering algorithms implicitly assume short aftershock sequences and thus do not remove long-duration ones.

  2. 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…

  3. 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.

  4. [Multicenter study on the application of a continence device for ++ostomized patients].

    PubMed

    La Torre, F; Nicastro, A; Persico Stella, L; Madrigali, S; Pallotti, M

    1995-04-01

    The restoration of continence is a fundamental step in the rehabilitation of stomised patients. The latest generation of continence prosthesis, represented by Conseal must be seen in this context. The authors performed a multicentre study based on a protocol using Conseal Uni in patients with low terminal digestive stomies (ileum or colostomy). The only criteria for patient selection was the absence of marked stomal and peristomal pathologies (large prolapse, fistula). The three centres taking part in the study inserted the new device in 50 patients (25 M; 25 F) with a mean age of 57.5 years (range 18-87) of whom 45 had undergone left terminal colostomy and 5 terminal ileostomy. A weekly evaluation was made of the use of the prosthesis for 4 weeks and a follow-up control was performed after 24 months in 22 patients. The results obtained shown that Conseal received a positive judgement in 88% of patients, better results were obtained in colostomized patients receiving irrigation (positive judgement in 100% of cases), whereas the success rate in non-irrigated patients only amounted to 50%. An additional application for the use of Conseal emerged from the study, namely its utilisation by ileostomised patients. Using various technical procedures, it was possible to obtain 8-hour continence in ileostomised patients. This result is of considerable importance since it shows the research, technological and clinical effort that has been made to achieve a form of continence in ileostomised patients. PMID:7675297

  5. 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...

  6. 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.

  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. 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)

  9. 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

  10. 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…

  11. 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.

  12. Where Britain Meets "The Continent": Language and Cultural Exchange in Children's Fiction.

    ERIC Educational Resources Information Center

    Lathey, Gillian

    2001-01-01

    Notes that children's perceptions of other cultures are formed, at least in part, by the books they read; yet the potential of children's literature in the United Kingdom as a site for international cultural exchange is limited by a lack of translations and a historical resistance in Britain toward the languages of the European continent. (SG)

  13. Educational Visions from Two Continents: What Tagore Adds to the Deweyan Perspective

    ERIC Educational Resources Information Center

    Samuel, Francis A.

    2011-01-01

    In this global village, it is relevant to look at two educational visionaries from two continents, John Dewey and Rabindranath Tagore. Dewey observed that the modern individual was depersonalized by the industrial and commercial culture. He, thus, envisioned a new individual who would find fulfillment in maximum individuality within maximum…

  14. 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.

  15. α1-, α2- and β-adrenoceptors in the urinary bladder, urethra and prostate

    PubMed Central

    Michel, Martin C; Vrydag, Wim

    2006-01-01

    We have systematically reviewed the presence, functional responses and regulation of α1-, α2- and β-adrenoceptors in the bladder, urethra and prostate, with special emphasis on human tissues and receptor subtypes. α1-Adrenoceptors are only poorly expressed and play a limited functional role in the detrusor. α1-Adrenoceptors, particularly their α1A-subtype, show a more pronounced expression and promote contraction of the bladder neck, urethra and prostate to enhance bladder outlet resistance, particularly in elderly men with enlarged prostates. α1-Adrenoceptor agonists are important in the treatment of symptoms of benign prostatic hyperplasia, but their beneficial effects may involve receptors within and outside the prostate. α2-Adrenoceptors, mainly their α2A-subtype, are expressed in bladder, urethra and prostate. They mediate pre-junctional inhibition of neurotransmitter release and also a weak contractile effect in the urethra of some species, but not humans. Their overall post-junctional function in the lower urinary tract remains largely unclear. β-Adrenoceptors mediate relaxation of smooth muscle in the bladder, urethra and prostate. The available tools have limited the unequivocal identification of receptor subtypes at the protein and functional levels, but it appears that the β3- and β2-subtypes are important in the human bladder and urethra, respectively. β3-Adrenoceptor agonists are promising drug candidates for the treatment of the overactive bladder. We propose that the overall function of adrenoceptors in the lower urinary tract is to promote urinary continence. Further elucidation of the functional roles of their subtypes will help a better understanding of voiding dysfunction and its treatment. PMID:16465187

  16. Resistance of bacteria in urinary tract infections.

    PubMed

    Chomarat, M

    2000-12-01

    Bacterial infection of the urinary tract is a common health problem in young women but also the most common nosocomial infection (>33%) contributing to the mortality of patients, and increasing the duration and cost of hospitalization. Escherichia coli is the most predominant organism and its prevalence varies in different studies. The high consumption of inappropriately prescribed antibiotics, combined with multiple pathology and frequent use of invasive devices, is a major factor contributing to high levels of resistance. There is a serious decrease in susceptibility of E. coli strains to amoxycillin, due to the presence of R-TEM enzymes, to cotrimoxazole and trimethoprim. Nitrofurantoin and fosfomycin-trometamol remain highly active against urinary Enterobacteriaceae, with over 90% of E. coli being susceptible. Knowledge of the most likely causative organisms and the prevalence of resistance pathogens to antimicrobial agents is essential to select antibiotics and to establish guidelines for the empirical treatment of urinary tract infections. PMID:11118863

  17. Diagnosis and management of urinary ectopia.

    PubMed

    Davidson, Autumn P; Westropp, Jodi L

    2014-03-01

    Ectopic ureters are the most common cause of urinary incontinence in young dogs but should be considered as a differential in any incontinent dog for which the history is not known. Ectopic ureters can be diagnosed with excretory urography, fluoroscopic urethrography or ureterography, abdominal ultrasonography, cystoscopy, helical computed tomography, or a combination of these diagnostic procedures. Other congenital abnormalities can also occur in dogs with ectopic ureters, including renal agenesis or dysplasia, hydronephrosis, and/or hydroureter and vestibulovaginal anomalies; therefore, the entire urinary system must be evaluated with ultrasonography if cystoscopy is the only other diagnostic tool used before surgery. Novel surgical techniques and adjunctive medical management have improved the prognosis for dogs with urinary ectopia. PMID:24580995

  18. [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

  19. [Cranberry juice and urinary tract infection].

    PubMed

    Raz, R; Chazan, B; Dan, M

    2004-12-01

    Cranberries have long been the focus of interest for their beneficial effects in preventing urinary tract infections (UTIs). Cranberries contain two compounds with anti-adherence properties, which prevent fimbriated E. coli from adhering to uroepithelial cells in the urinary tract. Approximately a dozen clinical trials have been performed testing the effects of cranberries on the urinary tract. However, these trials have a number of apparent limitations. Most importantly, the trials have used a wide variety of cranberry products, such as cranberry juice concentrate, juice cocktail, and cranberry capsules, and have employed different dosing regimens. Further research is required to clarify unanswered questions regarding the role of cranberries in protecting against UTI in general and in women with anatomical abnormalities in particular. PMID:15666710

  20. Cranberry juice and urinary tract infection.

    PubMed

    Raz, R; Chazan, B; Dan, M

    2004-05-15

    Cranberries have long been the focus of interest for their beneficial effects in preventing urinary tract infections (UTIs). Cranberries contain 2 compounds with antiadherence properties that prevent fimbriated Escherichia coli from adhering to uroepithelial cells in the urinary tract. Approximately 1 dozen clinical trials have been performed testing the effects of cranberries on the urinary tract. However, these trials suffer from a number of limitations. Most importantly, the trials have used a wide variety of cranberry products, such as cranberry juice concentrate, cranberry juice cocktail, and cranberry capsules, and they have used different dosing regimens. Further research is required to clarify unanswered questions regarding the role of cranberries in protecting against UTI in general and in women with anatomical abnormalities in particular. PMID:15156480

  1. 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

  2. Oceans and continents: Similarities and differences in the mechanisms of heat loss

    SciTech Connect

    Sclater, J.G.; Parsons, B.; Jaupart, C.

    1981-12-10

    The principal objective of this paper is to present a simple and self-consistent review of the basic physical processes controlling heat loss from the earth. To accomplish this objective, we give a short summary of the oceanic and continental data and compare and contrast the respective mechanisms of heat loss . In the oceans we concentrate on the effect of hydrothermal circulation, and on the continents we consider in some detail a model relating surface heat flow to varying depth scales for the distribution of potassium, thorium, and uranium. From this comparison we conclude that the range in possible geotherms at depths below 100 to 150 km under continents and oceans overlaps and the thermal structure beneath an old stable continent is indistinguishable from that beneath an ocean were it at equilibrium. Oceans and continents are part of the same thermal system. Both have an upper rigid mechanical layer where heat loss is by conduction and a lower thermal boundary layer where convection is dominant. The simple conductive definition of the plate thickness is an oversimplification. The observed distribution of area versus age in the ocean allows us to investigate the dominant mechanism of heat loss which is plate creation. This distribution and an understanding of the heat flow through oceans and continents can be used to calculate the heat loss of the earth. This heat loss is 10/sup 13/ cal/s (4.2 x 10/sup 13/W) of which more than 60% results from the creation of oceanic plate. The relation between area and age of the oceans is coupled to the ridge and subducting slab forces that contribute to the driving mechanism for plate motions. These forces are self-regulating and maintain the rate of plate generation required to achieve a balance between heat loss and heat generation.

  3. Differences in anal sensation in continent and incontinent patients with perineal descent.

    PubMed

    Miller, R; Bartolo, D C; Cervero, F; Mortensen, N J

    1989-01-01

    Neuropathic damage secondary to pelvic floor descent is considered to be an important aetiological factor in idiopathic faecal incontinence. Perineal descent however does not necessarily result in a loss of motor function or incontinence. To elucidate the role of anal sensation in the continence mechanism we measured mucosal electrosensitivity and thermal sensitivity in normal controls and in both continent and incontinent patients with perineal descent. A catheter carrying two platinum electrodes was used to assess mucosal electrosensitivity and a water perfused thermode 1 cm long to measure thermal sensory thresholds. In addition, routine anal manometry was performed. The degree of perineal descent and anorectal angle was assessed radiographically. Anal sensation was largely preserved in continent patients with perineal descent (Controls vs continent perineal descent, Mucosal electrosensitivity (ma), lower anal canal: 4 (2-7) vs 5 (2.6-8) ns; middle anal canal 4 (2-7) vs 4.2 (2-15) ns; upper anal canal 6.5 (4-13) vs 8.3 (3.6-16) p less than 0.05, thermal sensitivity, median threshold (degrees C), lower anal canal 0.92 (0.5-2.5) vs 0.95 (0.3-3.6) ns; middle anal canal 0.83 (0.4-1.5) vs 0.75 (0.2-2) ns; upper anal canal 0.98 (0.6-2.4) vs 2.2 (0.5-4.8) p less than 0.05). There was a severe impairment of anal sensation in the incontinent patients with perineal descent despite a greater degree of perineal descent in the continent group. Loss of anal sensation is associated with the development of incontinence and is likely to be involved in the pathogenesis of the condition. PMID:2708882

  4. Recurrent Urinary Tract Infections and Related Conditions (For Parents)

    MedlinePlus

    ... for Your Child All About Food Allergies Recurrent Urinary Tract Infections and Related Conditions KidsHealth > For Parents > Recurrent Urinary Tract Infections and Related Conditions Print A A A Text ...

  5. Urinary Tract Infection and Bacteriuria in Pregnancy.

    PubMed

    Glaser, Alexander P; Schaeffer, Anthony J

    2015-11-01

    Bacteriuria during pregnancy may be classified as asymptomatic bacteriuria, infections of the lower urinary tract (cystitis), or infections of the upper urinary tract (pyelonephritis). Lower tract bacteriuria is associated with an increased risk of developing pyelonephritis in pregnancy, which is itself associated with adverse maternal and fetal outcomes. Pregnant women should be screened for the presence of bacteriuria early in pregnancy. All bacteriuria in pregnancy should be treated, and antimicrobial choice in pregnancy should reflect safety for both the mother and the fetus. After treatment of bacteriuria, patients should be followed closely due to risk of recurrent bacteriuria. PMID:26475951

  6. Imaging of urinary tract disease. Current approaches.

    PubMed

    Choyke, P L; Meranze, S; Pahira, J J; Jaffe, M J; Grant, E G; Zeman, R K

    1984-11-01

    Current modalities and techniques used in imaging of the urinary tract offer prompt and accurate diagnoses as well as treatment in some cases. Careful planning and judgement in the choice of the imaging sequence is important in avoiding redundant or ill-advised tests. Individual tailoring will be necessary in some patients. It is hoped that with the rational use of the diagnostic tools now available and with the continued improvement in MRI technology, safe and accurate diagnoses will be expected in practically all patients with diseases of the urinary tract. PMID:6392777

  7. 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

  8. Urinary tract infections: treatment/comparative therapeutics.

    PubMed

    Olin, Shelly J; Bartges, Joseph W

    2015-07-01

    Urinary tract infection (UTI) occurs when there is compromise of host defense mechanisms and a virulent microbe adheres, multiplies, and persists in a portion of the urinary tract. Most commonly, UTI is caused by bacteria, but fungi and viruses are possible. Urine culture and sensitivity are the gold standards for diagnosis of bacterial UTI. Identifying the location of infection (eg, bladder, kidney, prostate) as well as comorbidities (eg, diabetes mellitus, immunosuppression) is essential to guide the diagnostic and therapeutic plan. Antimicrobial agents are the mainstay of therapy for bacterial UTI and selected ideally based on culture and sensitivity. PMID:25824394

  9. 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...

  10. 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...

  11. 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...

  12. 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

  13. Changing continent.

    PubMed

    Davis, Carol

    The need for better health care in South America is mirrored by the need for more, and better trained, nurses. Yet in many countries, nurses continue to have poor pay and conditions, as well as low status. Average monthly salaries in South America are in the range of 225 pounds to 281 pounds. While nurses typically work a 45-hour week, many moonlight to boost their income. Nursing remains largely unregulated except for laws which cover all healthcare staff. Low salaries are a major incentive for nurses to emigrate or leave the profession altogether. PMID:16438323

  14. 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, 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; thereby lacking the complexities of real Earth. We aim to further develop the code to allow for realistic continental growth and destruction.

  15. Recurrent urinary tract infections in children.

    PubMed Central

    Johnson, H. W.; Lirenman, D. S.; Anderson, J. D.; Nielsen, W. R.

    1993-01-01

    Urinary tract infections are common in children and present in various ways. Diagnosis is based on findings of pyuria and bacteriuria. Management includes adequate and timely investigation, appropriate antibiotics, treatment of underlying contributing factors, and follow-up advice. Images p1625-a p1628-a p1629-a PMID:8348023

  16. Arsenic and urinary bladder cell proliferation.

    PubMed

    Luster, Michael I; Simeonova, Petia P

    2004-08-01

    Epidemiologic studies have demonstrated that a close association exists between the elevated levels of arsenic in drinking water and the incidence of certain cancers, including transitional cell carcinomas of the urinary bladder. We have employed in vitro and in vivo models to examine the effects of sodium arsenite on the urinary bladder epithelium. Mice exposed to 0.01% sodium arsenite in drinking water demonstrated hyperproliferation of the bladder uroepithelium within 4 weeks after initiating treatment. This occurred in the absence of amorphous precipitates and was accompanied by the accumulation of trivalent arsenite (iAs(3+)), and to a lesser extent dimethylarsenic (DMA), arsenate (iAs(5+)), and monomethylarsenic (MMA) in bladder tissue. In contrast to the bladder, urinary secretion was primarily in the form of DMA and MMA. Arsenic-induced cell proliferation in the bladder epithelium was correlated with activation of the MAP kinase pathway, leading to extracellular signal-regulated kinase (ERK) kinase activity, AP-1 activation, and expression of AP-1-associated genes involved in cell proliferation. Activation of the MAP kinase pathway involved both epidermal growth factor (EGF) receptor-dependent and -independent events, the latter involving Src activation. Studies summarized in this review suggest that arsenic accumulates in urinary bladder epithelium causing activation of specific signaling pathways that lead to chronic increased cell proliferation. This may play a non-epigenetic role in carcinogenesis by increasing the proliferation of initiated cells or increasing the mutational rate. PMID:15276422

  17. Environmentally related diseases of the urinary tract

    SciTech Connect

    Goyer, R.A. )

    1990-03-01

    Nephrotoxicity from exposure to therapeutic agents and chemicals in the environment and workplace results in a broad spectrum of clinical renal disease that may mimic disorders from other causes. Nephrotoxic agents may, in fact, be responsible for some fraction of renal disease of undetermined etiology. Specific diagnosis and treatment by removal from exposure to the toxic agent is more likely in the early phase of the disorder. Measurement and characterization of proteinuria provides the most sensitive and reliable method of early detection. Increased urinary excretion of serum proteins with molecular weight in excess of 50,000, such as albumin and transferrin, is an early indicator of glomerular injury. Low-molecular-weight proteinuria (beta 2-microglobulin or retinol-binding protein) and enzymuria, particularly excretion of NAG, are sensitive indicators of renal tubular cell injury. Tests that reflect hypersensitivity reactions are often indicative of immunologically mediated nephrotoxicity but are not specific for the kidney. Cancers of the kidney and urinary bladder appear to be increasing and are most common among the socially active and affluent. Susceptibility of the urinary tract to toxicity and carcinogenicity reflect contact of excreted toxins with the epithelial cells of nephrons and urinary bladder. 45 references.

  18. Indwelling urinary catheterisation: what is best practice?

    PubMed

    Yates, Ann

    2016-05-12

    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

  19. 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

  20. Urinary metabolic signatures of human adiposity.

    PubMed

    Elliott, Paul; Posma, Joram M; Chan, Queenie; Garcia-Perez, Isabel; Wijeyesekera, Anisha; Bictash, Magda; Ebbels, Timothy M D; Ueshima, Hirotsugu; Zhao, Liancheng; van Horn, Linda; Daviglus, Martha; Stamler, Jeremiah; Holmes, Elaine; Nicholson, Jeremy K

    2015-04-29

    Obesity is a major public health problem worldwide. We used 24-hour urinary metabolic profiling by proton ((1)H) nuclear magnetic resonance (NMR) spectroscopy and ion exchange chromatography to characterize the metabolic signatures of adiposity in the U.S. (n = 1880) and UK (n = 444) cohorts of the INTERMAP (International Study of Macro- and Micronutrients and Blood Pressure) epidemiologic study. Metabolic profiling of urine samples collected over two 24-hour time periods 3 weeks apart showed reproducible patterns of metabolite excretion associated with adiposity. Exploratory analysis of the urinary metabolome using (1)H NMR spectroscopy of the U.S. samples identified 29 molecular species, clustered in interconnecting metabolic pathways, that were significantly associated (P = 1.5 × 10(-5) to 2.0 × 10(-36)) with body mass index (BMI); 25 of these species were also found in the UK validation cohort. We found multiple associations between urinary metabolites and BMI including urinary glycoproteins and N-acetyl neuraminate (related to renal function), trimethylamine, dimethylamine, 4-cresyl sulfate, phenylacetylglutamine and 2-hydroxyisobutyrate (gut microbial co-metabolites), succinate and citrate (tricarboxylic acid cycle intermediates), ketoleucine and the ketoleucine/leucine ratio (linked to skeletal muscle mitochondria and branched-chain amino acid metabolism), ethanolamine (skeletal muscle turnover), and 3-methylhistidine (skeletal muscle turnover and meat intake). We mapped the multiple BMI-metabolite relationships as part of an integrated systems network that describes the connectivities between the complex pathway and compartmental signatures of human adiposity. PMID:25925681

  1. 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

  2. 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.

  3. 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

  4. Urinary tract infection in children - aftercare

    MedlinePlus

    ... has been lethargic, irritable, or not drinking or eating well, these symptoms should begin to improve in 1 - 2 days after treatment begins. (Note: if your child has a brain or nervous system disorder or abnormal changes or defects in their urinary ...

  5. 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…

  6. 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

  7. [Female urinary incontinence: implications in the adolescence].

    PubMed

    Aran Catalán, Rosa M; Sanchis Cordellat, Francisco

    2012-01-01

    Involuntary urine leakage or urinary incontinence is frequent among elderly women, adult women, even among adolescent women. Adolescence is a time characterised by the importance of physical and emotional development, self-esteem being one of the key aspects to adolescent wellbeing. The main purpose of this study was to find the prevalence of urinary incontinence in a sample of female adolescents and the psychological consequences thereof The sample was comprised by a group of 154 adolescents aged 13 to 18 from a charter school. A questionnaire was developed to obtain information about possible urine leakage and a pilot test was run in order to verify its accuracy Results show that 94.2% of participants suffer from urinary incontinence occasionally. Another significant finding reveals that 27% of case reports had suffered from urinary tract infection (UTI) and participants felt upset about it. Results suggest the need to foster an effective health education among adolescents so they acquire a series of good practices that will ensure them a better quality of life during adulthood. PMID:22558715

  8. [Pharmacotherapy of urinary incontinence in the elderly].

    PubMed

    Becher, K F

    2016-04-01

    The prevalence and the incidence of Urinary Incontinence is growing. Women suffer predominantly from stress and mixed urinary incontinence and men from urge incontinence. In elderly people, the pathophysiological and the physiological change in the lower urinary tract system must be considered as well as an underlying multimorbidity. Stress urinary incontinence is among others caused by an insufficient urethral closure mechanism and urge incontinence is followed by unhibited detrusor contractions. Medical treatment is beside other important conservative options only one part of the treatment strategy in incontinence. Duloxetine, a serotonine-norepinephrine reuptake inhibitore can increase activity of the external urethral sphincter and is able to reduce incontinence episodes in up to 64 %. Antagonists of muscarinic receptors can reduce urgency, frequency and urge incontinence as well as increase bladder capacity significantly. In Germany, darifenacin, fesoterodin, oxybutynin, propiverine, solifenacin, tolterodine and trospium chloride are available to treat urge incontinence. The efficacy of these agents are almost comparable in the elderly with the exception of oxybutynin IR. However, tolerability is different and not well studied in the elderly population with the exception of fesoterodin. Side effects, especially dry mouth, dizziness and constipation often limit their use. None of the agents show ideal efficacy or tolerability in all patients. Last summer therefore a β3-agonist mirabegron was also introduced in Germany but was withdrawn. PMID:26886709

  9. 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

  10. Urinary creatinine concentrations in the U.S. population: implications for urinary biologic monitoring measurements.

    PubMed

    Barr, Dana B; Wilder, Lynn C; Caudill, Samuel P; Gonzalez, Amanda J; Needham, Lance L; Pirkle, James L

    2005-02-01

    Biologic monitoring (i.e., biomonitoring) is used to assess human exposures to environmental and workplace chemicals. Urinary biomonitoring data typically are adjusted to a constant creatinine concentration to correct for variable dilutions among spot samples. Traditionally, this approach has been used in population groups without much diversity. The inclusion of multiple demographic groups in studies using biomonitoring for exposure assessment has increased the variability in the urinary creatinine levels in these study populations. Our objectives were to document the normal range of urinary creatinine concentrations among various demographic groups, evaluate the impact that variations in creatinine concentrations can have on classifying exposure status of individuals in epidemiologic studies, and recommend an approach using multiple regression to adjust for variations in creatinine in multivariate analyses. We performed a weighted multivariate analysis of urinary creatinine concentrations in 22,245 participants of the Third National Health and Nutrition Examination Survey (1988-1994) and established reference ranges (10th-90th percentiles) for each demographic and age category. Significant predictors of urinary creatinine concentration included age group, sex, race/ethnicity, body mass index, and fat-free mass. Time of day that urine samples were collected made a small but statistically significant difference in creatinine concentrations. For an individual, the creatinine-adjusted concentration of an analyte should be compared with a "reference" range derived from persons in a similar demographic group (e.g., children with children, adults with adults). For multiple regression analysis of population groups, we recommend that the analyte concentration (unadjusted for creatinine) should be included in the analysis with urinary creatinine added as a separate independent variable. This approach allows the urinary analyte concentration to be appropriately adjusted for urinary creatinine and the statistical significance of other variables in the model to be independent of effects of creatinine concentration. PMID:15687057

  11. Catheter-associated urinary tract infections.

    PubMed

    Warren, J W

    1987-12-01

    The two most common indications for long-term catheterization are recalcitrant urinary incontinence and urinary obstruction that is not corrected by surgery. For incontinent patients, if behavioral changes, nursing care, special clothes, special bed clothes, and medications have not been successful, then a device to collect urine must be considered. For men such a device is a condom catheter; for women an analogous external collection device would be very useful. Suprapubic catheterization may offer an alternative but has been inadequately studied in this patient population. Long-term urinary catheterization has salutary effects for selected patients including patient comfort, family satisfaction, and nursing efficiency and effectiveness. To the patient for whom any physical movement is uncomfortable or painful, and indwelling catheter may be preferable to frequent changes of clothes. Similarly, the family of of severely impaired patients may want to accept the risks of urethral catheterization in order to keep the patient dry. Further, to the extent that the indwelling catheter is effective in decubitus ulcer prevention and/or management, long-term catheterization may diminish the risk of bacteremia or death from soft tissue infection. These benefits of long-term urethral catheterization, in addition to its risks, should be examined in future studies. Once a urethral catheter is in place, even with good catheter hygiene, bacterial entry can be postponed only temporarily; eventually all patients become bacteriuric. Indeed, as the catheter remains in place, organisms continue to enter, others leave or die, and the bacteriuria becomes complex, polymicrobial, and dynamic. Some organisms, particularly recognized uropathogens such as E. coli and K. pneumoniae, appear to reside in the urinary tract itself. Others, such as P. mirabilis, P. stuartii, and M. morganii, probably establish a niche within the urinary catheter, thus increasing their ability to cause subsequent bladder bacteriuria. The complications of long-term urinary catheterization include fevers, acute pyelonephritis, and bacteremias (such as seen in short-term catheterized patients), as well as catheter obstructions, urinary stones, chronic renal inflammation, local periurinary infections, vasicoureteral reflux, renal failure, and, for very long-term catheterized patients, bladder cancer. The thrust of catheter care for the long-term catheterized patient is to prevent complications of the omnipresent bacteriuria. Unfortunately, clinical opportunities for preventing complications are limited.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:3333661

  12. Behavioural Interventions for Urinary Incontinence in Community-Dwelling Seniors

    PubMed Central

    2008-01-01

    Executive Summary In early August 2007, the Medical Advisory Secretariat began work on the Aging in the Community project, an evidence-based review of the literature surrounding healthy aging in the community. The Health System Strategy Division at the Ministry of Health and Long-Term Care subsequently asked the secretariat to provide an evidentiary platform for the ministry’s newly released Aging at Home Strategy. After a broad literature review and consultation with experts, the secretariat identified 4 key areas that strongly predict an elderly person’s transition from independent community living to a long-term care home. Evidence-based analyses have been prepared for each of these 4 areas: falls and fall-related injuries, urinary incontinence, dementia, and social isolation. For the first area, falls and fall-related injuries, an economic model is described in a separate report. Please visit the Medical Advisory Secretariat Web site, http://www.health.gov.on.ca/english/providers/program/mas/mas_about.html, to review these titles within the Aging in the Community series. Aging in the Community: Summary of Evidence-Based Analyses Prevention of Falls and Fall-Related Injuries in Community-Dwelling Seniors: An Evidence-Based Analysis Behavioural Interventions for Urinary Incontinence in Community-Dwelling Seniors: An Evidence-Based Analysis Caregiver- and Patient-Directed Interventions for Dementia: An Evidence-Based Analysis Social Isolation in Community-Dwelling Seniors: An Evidence-Based Analysis The Falls/Fractures Economic Model in Ontario Residents Aged 65 Years and Over (FEMOR) Objective To assess the effectiveness of behavioural interventions for the treatment and management of urinary incontinence (UI) in community-dwelling seniors. Clinical Need: Target Population and Condition Urinary incontinence defined as “the complaint of any involuntary leakage of urine” was identified as 1 of the key predictors in a senior’s transition from independent community living to admission to a long-term care (LTC) home. Urinary incontinence is a health problem that affects a substantial proportion of Ontario’s community-dwelling seniors (and indirectly affects caregivers), impacting their health, functioning, well-being and quality of life. Based on Canadian studies, prevalence estimates range from 9% to 30% for senior men and nearly double from 19% to 55% for senior women. The direct and indirect costs associated with UI are substantial. It is estimated that the total annual costs in Canada are $1.5 billion (Cdn), and that each year a senior living at home will spend $1,000 to $1,500 on incontinence supplies. Interventions to treat and manage UI can be classified into broad categories which include lifestyle modification, behavioural techniques, medications, devices (e.g., continence pessaries), surgical interventions and adjunctive measures (e.g., absorbent products). The focus of this review is behavioural interventions, since they are commonly the first line of treatment considered in seniors given that they are the least invasive options with no reported side effects, do not limit future treatment options, and can be applied in combination with other therapies. In addition, many seniors would not be ideal candidates for other types of interventions involving more risk, such as surgical measures. Note: It is recognized that the terms “senior” and “elderly” carry a range of meanings for different audiences; this report generally uses the former, but the terms are treated here as essentially interchangeable. Description of Technology/Therapy Behavioural interventions can be divided into 2 categories according to the target population: caregiver-dependent techniques and patient-directed techniques. Caregiver-dependent techniques (also known as toileting assistance) are targeted at medically complex, frail individuals living at home with the assistance of a caregiver, who tends to be a family member. These seniors may also have cognitive deficits and/or motor deficits. A health care professional trains the senior’s caregiver to deliver an intervention such as prompted voiding, habit retraining, or timed voiding. The health care professional who trains the caregiver is commonly a nurse or a nurse with advanced training in the management of UI, such as a nurse continence advisor (NCA) or a clinical nurse specialist (CNS). The second category of behavioural interventions consists of patient-directed techniques targeted towards mobile, motivated seniors. Seniors in this population are cognitively able, free from any major physical deficits, and motivated to regain and/or improve their continence. A nurse or a nurse with advanced training in UI management, such as an NCA or CNS, delivers the patient-directed techniques. These are often provided as multicomponent interventions including a combination of bladder training techniques, pelvic floor muscle training (PFMT), education on bladder control strategies, and self-monitoring. Pelvic floor muscle training, defined as a program of repeated pelvic floor muscle contractions taught and supervised by a health care professional, may be employed as part of a multicomponent intervention or in isolation. Education is a large component of both caregiver-dependent and patient-directed behavioural interventions, and patient and/or caregiver involvement as well as continued practice strongly affect the success of treatment. Incontinence products, which include a large variety of pads and devices for effective containment of urine, may be used in conjunction with behavioural techniques at any point in the patient’s management. Evidence-Based Analysis Methods A comprehensive search strategy was used to identify systematic reviews and randomized controlled trials that examined the effectiveness, safety, and cost-effectiveness of caregiver-dependent and patient-directed behavioural interventions for the treatment of UI in community-dwelling seniors (see Appendix 1). Research Questions Are caregiver-dependent behavioural interventions effective in improving UI in medically complex, frail community-dwelling seniors with/without cognitive deficits and/or motor deficits? Are patient-directed behavioural interventions effective in improving UI in mobile, motivated community-dwelling seniors? Are behavioural interventions delivered by NCAs or CNSs in a clinic setting effective in improving incontinence outcomes in community-dwelling seniors? Assessment of Quality of Evidence The quality of the evidence was assessed as high, moderate, low, or very low according to the GRADE methodology and GRADE Working Group. As per GRADE the following definitions apply: High Further research is very unlikely to change confidence in the estimate of effect. Moderate Further research is likely to have an important impact on confidence in the estimate of effect and may change the estimate. Low Further research is very likely to have an important impact on confidence in the estimate of effect and is likely to change the estimate. Very Low Any estimate of effect is very uncertain Summary of Findings Executive Summary Table 1 summarizes the results of the analysis. The available evidence was limited by considerable variation in study populations and in the type and severity of UI for studies examining both caregiver-directed and patient-directed interventions. The UI literature frequently is limited to reporting subjective outcome measures such as patient observations and symptoms. The primary outcome of interest, admission to a LTC home, was not reported in the UI literature. The number of eligible studies was low, and there were limited data on long-term follow-up. Executive Summary Table 1: Summary of Evidence on Behavioural Interventions for the Treatment of Urinary Incontinence in Community-Dwelling Seniors Intervention Target Population Interventions Conclusions GRADE quality of the evidence 1. Caregiver-dependent techniques (toileting assistance) Medically complex, frail individuals at home with/without cognitive deficits and/or motor deficitsDelivered by informal caregivers who are trained by a nurse or a nurse with specialized UI training (NCA/CNS) Prompted voiding Habit retraining Timed voiding There is no evidence of effectiveness for habit retraining (n=1 study) and timed voiding (n=1 study).Prompted voiding may be effective, but effectiveness is difficult to substantiate because of an inadequately powered study (n=1 study).Resource implications and caregiver burden (usually on an informal caregiver) should be considered. Low 2. Patient-directed techniques Mobile, motivated seniorsDelivered by a nurse or a nurse with specialized UI training (NCA/CNS) Multicomponent behavioural interventionsInclude a combination ofBladder trainingPFMT (with or without biofeedback)Bladder control strategiesEducationSelf-monitoring Significant reduction in the mean number of incontinent episodes per week (n=5 studies, WMD 3.63, 95% CI, 2.07–5.19)Significant improvement in patient’s perception of UI (n=3 studies, OR 4.15, 95% CI, 2.70–6.37)Suggestive beneficial impact on patient’s health-related quality of life Moderate     PFMT alone Significant reduction in the mean number of incontinent episodes per week (n=1 study, WMD 10.50, 95% CI, 4.30–16.70) Moderate 3. Behavioural interventions led by an NCA/CNS in a clinic setting Community-dwelling seniors Behavioural interventions led by NCA/CNS Overall, effective in improving incontinence outcomes (n=3 RCTs + 1 Ontario-based before/after study) Moderate * CI refers to confidence interval; CNS, clinical nurse specialist; NCA, nurse continence advisor; PFMT, pelvic floor muscle training; RCT, randomized controlled trial; WMD, weighted mean difference; UI, urinary incontinence. Economic Analysis A budget impact analysis was conducted to forecast costs for caregiver-dependent and patient-directed multicomponent behavioural techniques delivered by NCAs, and PFMT alone delivered by physiotherapists. All costs are reported in 2008 Canadian dollars. Based on epidemiological data, published medical literature and clinical expert opinion, the annual cost of caregiver-dependent behavioural techniques was estimated to be $9.2 M, while the annual costs of patient-directed behavioural techniques delivered by either an NCA or physiotherapist were estimated to be $25.5 M and $36.1 M, respectively. Estimates will vary if the underlying assumptions are changed. Currently, the province of Ontario absorbs the cost of NCAs (available through the 42 Community Care Access Centres across the province) in the home setting. The 2007 Incontinence Care in the Community Report estimated that the total cost being absorbed by the public system of providing continence care in the home is $19.5 M in Ontario. This cost estimate included resources such as personnel, communication with physicians, record keeping and product costs. Clinic costs were not included in this estimation because currently these come out of the global budget of the respective hospital and very few continence clinics actually exist in the province. The budget impact analysis factored in a cost for the clinic setting, assuming that the public system would absorb the cost with this new model of community care. Considerations for Ontario Health System An expert panel on aging in the community met on 3 occasions from January to May 2008, and in part, discussed treatment of UI in seniors in Ontario with a focus on caregiver-dependent and patient-directed behavioural interventions. In particular, the panel discussed how treatment for UI is made available to seniors in Ontario and who provides the service. Some of the major themes arising from the discussions included: Services/interventions that currently exist in Ontario offering behavioural interventions to treat UI are not consistent. There is a lack of consistency in how seniors access services for treatment of UI, who manages patients and what treatment patients receive. Help-seeking behaviours are important to consider when designing optimal service delivery methods. There is considerable social stigma associated with UI and therefore there is a need for public education and an awareness campaign. The cost of incontinent supplies and the availability of NCAs were highlighted. Conclusions There is moderate-quality evidence that the following interventions are effective in improving UI in mobile motivated seniors: Multicomponent behavioural interventions including a combination of bladder training techniques, PFMT (with or without biofeedback), education on bladder control strategies and self-monitoring techniques. Pelvic floor muscle training alone. There is moderate quality evidence that when behavioural interventions are led by NCAs or CNSs in a clinic setting, they are effective in improving UI in seniors. There is limited low-quality evidence that prompted voiding may be effective in medically complex, frail seniors with motivated caregivers. There is insufficient evidence for the following interventions in medically complex, frail seniors with motivated caregivers: habit retraining, and timed voiding. PMID:23074508

  13. 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

  14. 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

  15. An exhumation history of continents over billion-year time scales.

    PubMed

    Blackburn, Terrence J; Bowring, Samuel A; Perron, J Taylor; Mahan, Kevin H; Dudas, Francis O; Barnhart, Katherine R

    2012-01-01

    The continental lithosphere contains the oldest and most stable structures on Earth, where fragments of ancient material have eluded destruction by tectonic and surface processes operating over billions of years. Although present-day erosion of these remnants is slow, a record of how they have uplifted, eroded, and cooled over Earth's history can provide insight into the physical properties of the continents and the forces operating to exhume them over geologic time. We constructed a continuous record of ancient lithosphere cooling with the use of uranium-lead (U-Pb) thermochronology on volcanically exhumed lower crustal fragments. Combining these measurements with thermal and Pb-diffusion models constrains the range of possible erosion histories. Measured U-Pb data are consistent with extremely low erosion rates persisting over time scales approaching the age of the continents themselves. PMID:22223803

  16. Image of the Moho across the continent-ocean transition, U.S. east coast

    NASA Astrophysics Data System (ADS)

    Holbrook, W. Steven; Reiter, Edmund C.; Purdy, G. M.; Toksöz, 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°-12°, 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. We interpret the Moho in the Carolina Trough as a Jurassic feature, formed by magmatic intrusion and underplating during the rifting of Pangea.

  17. 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.

  18. On the determination of the carbon balance of continents (Vladimir Ivanovich Vernadsky Medal Lecture)

    NASA Astrophysics Data System (ADS)

    Dolman, Albertus J. Han

    2013-04-01

    The carbon balance of regions, the size of continents, can be determined, albeit with significant uncertainty, by combining several bottom up and top down methods. The bottom up methods use eddy covariance techniques, biometric inventory measurements and modeling, while the top down methods use atmospheric observations and inverse models. There has been considerable progress in the last few years in determining these balances through more or less standard protocols, as highlighted for instance by studies of the REgional Carbon Cycle Assessment and Processes (RECAPP) project of the Global Carbon Project. Important areas where uncertainty creeps in are the scaling of point measurements in the bottom up methods, the sparseness of the observation network and the role of model and other errors in the inversion methods. Typically these balances hold for periods of several years. They therefore do not resolve the impact of anomalies in weather and climate directly. The role of management in these balances also differs for different continents. For instance in Europe management plays a strong role in the carbon balance, whereas for the Russian continent this is less important. Management in the European carbon balance may potentially override climatically driven variability. In contrast, for Russia, the importance of the role of forest is paramount, but there the vulnerability of the Arctic regions and permafrost is a key uncertainty for future behaviour. I hope to show the importance of these different aspects of the terrestrial carbon balance by comparing the two continents, and also discuss the significant uncertainty we still face in determining the carbon budgets of large areas. I will argue that we need to get a clearer picture of the role of management in these budgets, but also of the time variability of the budgets to be able to determine the impact of anomalous weather and the vulnerability in a future climate.

  19. 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.

  20. 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 mid-continents.

  1. 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.

  2. The Diurnal Cycle over the Maritime Continent and its Interaction with the MJO

    NASA Astrophysics Data System (ADS)

    Matthews, A. J.; Peatman, S.; Baranowski, D. B.; Stevens, D. P.; Heywood, K. J.; Flatau, P. J.; Schmidtko, S.

    2014-12-01

    The complex land-sea distribution and topography of the maritime continent acts to disrupt or even completely block the eastward propagation of the Madden-Julian Oscillation (MJO) from the Indian Ocean to the western Pacific. This leads to changes in tropical latent heat release and subsequent impacts on global circulation. Convection over the maritime continent is dominated by the diurnal cycle. Where the mean diurnal cycle is strong (over the islands and surrounding seas), 80% of the MJO precipitation signal in the maritime continent is accounted for by changes in the amplitude of the diurnal cycle. The canonical view of the MJO as the smooth eastward propagation of a large-scale precipitation envelope also breaks down over the islands of the Maritime Continent. Instead, a vanguard of precipitation jumps ahead of the main body by approximately 6 days or 2000 km. Hence, there can be enhanced precipitation over Sumatra, Borneo or New Guinea when the large-scale MJO envelope over the surrounding ocean is one of suppressed precipitation. This behaviour is discussed in terms of an interaction between the diurnal cycle and the MJO circulation. The diurnal cycle is also strong in the ocean. Seaglider measurements taken during the CINDY/DYNAMO campaign show the existence of a diurnal warm layer in the upper few metres of the ocean. This has a significant effect on the surface fluxes, of an order of Watts per square metre. The diurnal warm layer is favoured during the inactive phase of the MJO and may act to help precondition the atmosphere to convection. The activities of the MJO Task Force and Subseasonal to Seasonal Prediction project will be discussed in this context.

  3. [Six billion people: how the continents were populated--yesterday, today, and tomorrow].

    PubMed

    Dupaquier, J

    1998-01-01

    World population growth from settlement of the continents to future population size is broadly traced in this work. Population growth has accelerated greatly in the past two centuries and especially since 1950. The first billion was reached only in 1850, while the fifth billion, in 1986, required only 11 years. Past population growth was slow, irregular, and variable from continent to continent. Population estimates for prehistory have a margin of error of around 50%. Modern man first appeared in Africa or possibly the Middle East around 100,000 BC. The three great centers of population in China, India, and the Middle East and Mediterranean area developed during the Neolithic Revolution and have maintained their importance. At least 500,000 years ago, humans began using fire and clothing to escape the limits of their biotype and geographic area of origin. The peopling of the continents was not achieved by massive displacement of surplus population, but by movement of small groups into empty space where they proliferated. World population was an estimated 460-510 million in 1500, with probably 135 million in China, 95 million in India, and 80 million in Europe. The balance between fertility and mortality postulated by transition theory has not occurred in Europe. World population is projected to increase from 2.5 billion to 6 billion between 1950 and 2000, with 61% in Asia, 12% in Africa, 9% in Latin America, and 5% in Europe. The world rate of population growth is still about 1.4% annually. The demographic explosion will have been a transitory episode in human history, but revolutionary in its impact. PMID:12179517

  4. Intraplate mountain building in response to continent continent collision—the Ancestral Rocky Mountains (North America) and inferences drawn from the Tien Shan (Central Asia)

    NASA Astrophysics Data System (ADS)

    Dickerson, Patricia Wood

    2003-04-01

    The intraplate Ancestral Rocky Mountains of western North America extend from British Columbia, Canada, to Chihuahua, Mexico, and formed during Early Carboniferous through Early Permian time in response to continent-continent collision of Laurentia with Gondwana—the conjoined masses of Africa and South America, including Yucatán and Florida. Uplifts and flanking basins also formed within the Laurentian Midcontinent. On the Gondwanan continent, well inboard from the marginal fold belts, a counterpart structural array developed during the same period. Intraplate deformation began when full collisional plate coupling had been achieved along the continental margin; the intervening ocean had been closed and subduction had ceased—that is, the distinction between upper versus lower plates became moot. Ancestral Rockies deformation was not accompanied by volcanism. Basement shear zones that formed during Mesoproterozoic rifting of Laurentia were reactivated and exerted significant control on the locations, orientations, and modes of displacement on late Paleozoic faults. Ancestral Rocky Mountain uplifts extend as far south as Chihuahua and west Texas (28° to 33°N, 102° to 109°W) and include the Florida-Moyotes, Placer de Guadalupe-Carrizalillo, Ojinaga-Tascotal and Hueco Mountain blocks, as well as the Diablo and Central Basin Platforms. All are cored with Laurentian Proterozoic crystalline basement rocks and host correlative Paleozoic stratigraphic successions. Pre-late Paleozoic deformational, thermal, and metamorphic histories are similar as well. Southern Ancestral Rocky Mountain structures terminate along a line that trends approximately N 40°E (present coordinates), a common orientation for Mesoproterozoic extensional structures throughout southern to central North America. Continuing Tien Shan intraplate deformation (Central Asia) has created an analogous array of uplifts and basins in response to the collision of India with Eurasia, beginning in late Miocene time when full coupling of the colliding plates had occurred. As in the Laurentia-Gondwana case, structures of similar magnitude and spacing to those in Eurasia have developed in the Indian plate. Within the present orogen two ancient suture zones have been reactivated—the early Paleozoic Terskey zone and the late Paleozoic Turkestan suture between the Siberian and East Gondwanan cratons. Inverted Proterozoic to early Paleozoic rift structures and passive-margin deposits are exposed north of the Terskey zone. In the Alay and Tarim complexes, Vendian to mid-Carboniferous passive-margin strata and the subjacent Proterozoic crystalline basement have been uplifted. Data on Tien Shan uplifts, basins, structural arrays, and deformation rates guide paleotectonic interpretations of ancient intraplate mountain belts. Similarly, exhumed deep crustal shear zones in the Ancestral Rockies offer insight into partitioning and reorientation of strain during contemporary intraplate deformation.

  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. 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

  7. Transport and scavenging of biomass burning aerosols in the maritime continent

    NASA Astrophysics Data System (ADS)

    Lee, H. H.; Wang, C.

    2014-12-01

    Biomass burning frequently occurs in summertime over the maritime continent, especially in Malaysia peninsula, Sumatra, and Borneo. Under certain weather conditions, particulate matters emitted from such fires cause degrade of air quality and thus occurrence of often weekly long haze in downwind locations such as Singapore. It is possible that these biomass burning aerosols may have influenced convective clouds in the maritime continent though such cases have not been well simulated and understood. In order to improve understanding of the spatiotemporal coverage and influence of biomass burning aerosols in the maritime continent, we have used the Weather Research and Forecasting (WRF) model to study the transport of biomass burning aerosols from Malaysia peninsula, Sumatra, and Borneo, using biomass burning emissions from the Fire INventory from NCAR (FINN) version 1.0. We choose to use emissions from the month of August because the annual emissions peak often occurs within this month. Based on a multi-year ensemble simulation, we have examined the influences of various meteorological regimes on the aerosol transport and wet removal.

  8. Does the Maritime Continent region affect sea level change of the eastern Indian Ocean?

    NASA Astrophysics Data System (ADS)

    Llovel, W.; Lee, T.

    2014-12-01

    The Maritime Continent region, in particular, the Indonesian Sea, regulates the oceanic communication between the Pacific and Indian Oceans. Previous studies suggest that the freshwater transported from the South China Sea to the Indonesian Sea affects the magnitude and structure of the Indonesian throughflow, and the strong tidal mixing in the Indonesian Sea alters the time mean vertical structure of the water mass carried from the Pacific to the Indian Oceans. Sea level changes in the eastern Indian Ocean is known to be affected by those in the northwestern Pacific via coastal Kelvin wave propagation through the Indonesian Sea. However, whether the Maritime Continent region influences sea level changes in the eastern Indian Ocean has not been investigated. In this study, we used Argo floats and satellite altimeter data to study the near decadal change of sea level during the 2005-2013 period. We found that the steric sea level change in eastern Indian Ocean cannot be fully explained by either local forcing or the transmission of steric signal from the western Pacific. This implicates the potential role of the Maritime Continent region in regulating sea level changes in the eastern Indian Ocean.

  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. 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

  11. 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.

  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. 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.

  14. 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

  15. Contrasting introduction scenarios among continents in the worldwide invasion of the banana fungal pathogen Mycosphaerella fijiensis.

    PubMed

    Robert, S; Ravigne, V; Zapater, M-F; Abadie, C; Carlier, J

    2012-03-01

    Reconstructing and characterizing introduction routes is a key step towards understanding the ecological and evolutionary factors underlying successful invasions and disease emergence. Here, we aimed to decipher scenarios of introduction and stochastic demographic events associated with the global spread of an emerging disease of bananas caused by the destructive fungal pathogen Mycosphaerella fijiensis. We analysed the worldwide population structure of this fungus using 21 microsatellites and 8 sequence-based markers on 735 individuals from 37 countries. Our analyses designated South-East Asia as the source of the global invasion and supported the location of the centre of origin of M. fijiensis within this area. We confirmed the occurrence of bottlenecks upon introduction into other continents followed by widespread founder events within continents. Furthermore, this study suggested contrasting introduction scenarios of the pathogen between the African and American continents. While potential signatures of admixture resulting from multiple introductions were detected in America, all the African samples examined seem to descend from a single successful founder event. In combination with historical information, our study reveals an original and unprecedented global scenario of invasion for this recently emerging disease caused by a wind-dispersed pathogen. PMID:22256778

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

    PubMed Central

    2013-01-01

    Background Although lower urinary tract symptoms have been associated with falls, few studies have been undertaken to understand this relationship in vulnerable community dwelling older adults. The purpose of this study was to describe the relationship over time of falls risk and lower urinary tract symptoms among community based older women receiving home support services. Methods A prospective cohort study which took place in an urban setting in western Canada. Participants were 100 older women receiving home care or residing in assisted living with home support services and were followed for six months. Demographic characteristics were collected at baseline, with the Timed Up and Go (TUG), International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms (ICIQ-FLUTS), and self-report of falls collected at baseline, 3 and 6 months. Descriptive statistics were used to summarize demographic data. Differences between the three visits were analyzed using the Friedman test with post hoc analysis and associations between variables by the Spearman Rank-Order Correlation Coefficient. Results One hundred women initially enrolled; 88 and 75 remained at three months and six months. Mean age = 84.3 years; 91% reported at least one urinary symptom at baseline and 35% reported falling in the six months prior to enrollment; 15.9% reported falling between the baseline and three months and 14.6% between three and six months. Mean TUG scores at each time point indicated falls risk (27.21, 29.18 and 27.76 seconds). Significant correlations between TUG and ICIQ-FLUTS (r = 0.33, p < .001; r = 0.39, p < .001) as well as TUG and overactive bladder scores (r = 0.25, p = .005; r = 0.28, p < .008) were found at baseline and three months, but not six months. Conclusions The association of lower urinary tract symptoms and falls risk in this group of vulnerable community dwelling older women at baseline and three months has potential 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. 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, the Libyan rifting and Maghreb thrusting. Although bearing a relatively slow deformation with regards to the East Africa Rift System, the Nubia plate previously considered as a homogeneous tectonic block appears to be dislocating progressively also forming a system of microplates. A synthesis of earthquake studies and regional deformation exposed in a seismotectonic map hitherto serves as a basis for the seismic hazard evaluations and the reduction of seismic risks. * IGCP/SIDA: International Geoscience Program/Swedish International Cooperation Authority http://www.unesco.org/science/IGCP IGCP-601 Working Group: Paulina Amponsah (Ghana Atomic Energy Commission), Atalay Ayele (Addis Ababa University, Ethiopia), Bekoa Ateba (Inst. of Geol. and Min. Res., Buea, Cameroon), Abdelhakim Ayadi (CRAAG, Algeria), Abdunnur Bensuleman (University of Tripoli, Libya), Damien Delvaux (Royal Museum for Central Africa, Tervuren, Belgium), Mohamed El Gabry (National Research Institute of Geophysics, Cairo, Egypt), Rui-Manuel Fernandes (Universidade da Beira Interior, Portugal), Mustapha Meghraoui (IPG Strasbourg, France), Vunganai Midzi & Magda Roos (Council for Geoscience, Pretoria, South Africa), and Youssef Timoulali (CNRST, Rabat, Morocco).

  18. 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 evident from the task analysis reported here, differences in exposure by sex may be explained by type of welding or by other work practices. A closely comparable cohort of male welders would be necessary to examine this hypothesis more fully. PMID:25359273

  19. Segmental Urethral Dosimetry and Urinary Toxicity in Patients With No Urinary Symptoms Before Permanent Prostate Brachytherapy

    SciTech Connect

    Thomas, Carys; Keyes, Mira Liu, Mitchell; Moravan, Veronika

    2008-10-01

    Purpose: To determine whether segmental urethral dosimetry is predictive for the degree of urinary morbidity after prostate brachytherapy in patients with no urinary symptoms before prostate brachytherapy. Methods and Materials: Between May 2000 and November 2005, 1,107 patients underwent iodine-125 monotherapy with urethral sparing techniques. A total of 166 patients fulfilled the selection criteria: baseline (International Prostate Symptom Score) IPSS {<=}5, no androgen deprivation therapy, and prostate ultrasound planning volumes (PUTV) <45 mL. The median follow-up was 44 months. Urinary morbidity was defined by maximum increase in IPSS, time to IPSS resolution, maximum Radiation Therapy Oncology Group (RTOG) score, time to RTOG resolution, and urinary retention. Surrogate deviated urethra was contoured and doses calculated at the base, mid-prostate, apex, and urogenital diaphragm. Univariate and multivariate analysis was used to evaluate urethral and prostate dosimetry, age, PUTV, and number of needles for their association with urinary morbidity. Results: Urethral dose was fairly constant in all urethra segments except prostate base, where the variation in does was large. On multivariate analysis, higher urethral base D50, V100, and larger PUTV were predictive for higher maximum increase in IPSS. Higher urethral base V100 and larger PUTV predicted for prolonged IPSS resolution. Higher urethral base D50 and larger needle number predicted for longer RTOG resolution. Higher urethral base V100 predicted for RTOG {>=}2 toxicity. Conclusions: Radiation dose to the urethral base, larger PUTV, and needle number, predicted for increased urinary toxicity after prostate brachytherapy. Correlation between urinary morbidity and urethral base dosimetry may reflect a large variation in urethral dose observed at the prostate base.

  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. The sentiment profile for OxyContin changed following reformulation; the post-to-preintroduction change in the ERo indicated reformulated OxyContin was discouraged significantly more than the original formulation (ratio of ERos=0.43, P<.001). A total of 37 recipes for circumventing the abuse-deterrent characteristics of reformulated OxyContin were observed; 32 were deemed feasible (ie, able to abuse). The frequency of posts reporting abuse of reformulated OxyContin via these recipes was low and decreased over time. Among the 5677 posts mentioning reformulated OxyContin, 825 posts discussed recipes and 498 reported abuse of reformulated OxyContin by such recipes (41 reported injecting and 128 reported snorting). Conclusions After introduction of physicochemical properties to deter abuse, changes in discussion of OxyContin on forums occurred reflected by a reduction in discussion levels and endorsing content. Despite discussion of recipes, there is a relatively small proportion of reported abuse of reformulated OxyContin via recipes, particularly by injecting or snorting routes. Analysis of Internet discussion is a valuable tool for monitoring the impact of abuse-deterrent formulations. PMID:24800858

  1. Urinary tract infection caused by Chromobacterium violaceum.

    PubMed

    Pant, Narayan Dutt; Sharma, Manisha

    2015-01-01

    Chromobacterium violaceum, a proteobacterium, is a facultative anaerobe, which is generally present as the normal flora of water and soil in tropical and subtropical regions. The infection due to Chromobacterium violaceum is rare but mostly fatal. It is responsible for causing fatal cases of septicemia, visceral abscesses, skin and soft tissue infections, meningitis, diarrhea, and rarely urinary tract infection. The bacteria has high propensity to spread causing sepsis. Delayed proper treatment due to limited awareness related to the C. violaceum infection is responsible for the high mortality rate. Here, we describe a rare case of urinary tract infection by C. violaceum in a chronic kidney disease patient, which was managed with timely proper antimicrobial therapy as per the culture sensitivity report. PMID:26392784

  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. Urinary tract infection caused by Chromobacterium violaceum

    PubMed Central

    Pant, Narayan Dutt; Sharma, Manisha

    2015-01-01

    Chromobacterium violaceum, a proteobacterium, is a facultative anaerobe, which is generally present as the normal flora of water and soil in tropical and subtropical regions. The infection due to Chromobacterium violaceum is rare but mostly fatal. It is responsible for causing fatal cases of septicemia, visceral abscesses, skin and soft tissue infections, meningitis, diarrhea, and rarely urinary tract infection. The bacteria has high propensity to spread causing sepsis. Delayed proper treatment due to limited awareness related to the C. violaceum infection is responsible for the high mortality rate. Here, we describe a rare case of urinary tract infection by C. violaceum in a chronic kidney disease patient, which was managed with timely proper antimicrobial therapy as per the culture sensitivity report. PMID:26392784

  4. [Women's strategies for coping with urinary incontinence].

    PubMed

    Delarmelindo, Rita de Cássia Altino; Parada, Cristina Maria Garcia de Lima; Rodrigues, Rosalina Aparecida Partezani; Bocchi, Silvia Cristina Mangini

    2013-04-01

    This article is part of a more comprehensive qualitative study which used grounded theory and symbolic interactionism as theoretical and methodological frameworks, resulting in the theoretical model entitled, Between suffering and hope: rehabilitation of urinary incontinence as an intervenient component. In order to communicate all the knowledge produced, part of this model is presented, and it refers to the process of coping with urinary incontinence by women without perspectives of access to surgical treatment after failure of conservative procedures. When interrelating the components (categories and subcategories) of these women's experience in order to compare and analyze them to understand their interaction, moral and psychosocial vulnerability were noticed within the experience of the group, which makes them susceptible to health risks and to compromise of their quality of life, observed in the movement of the group's experience. Research is needed to further understand experiences in which there are barriers to surgical treatment due to physicians' disbelief in its effectiveness. PMID:23743893

  5. 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

  6. Simplification of urinary aldosterone measurement by radioimmunoassay

    PubMed Central

    Cope, C. L.; Loizou, S.

    1973-01-01

    An anti-aldosterone serum has been used to measure urinary aldosterone concentration. A single stage of paper chromatography provides an extract of sufficient purity. Further purification by additional chromatography in a different solvent system only improves the purity by 3% ± 8 (SD). Blanks are negligible and recovery of added aldosterone is 104% ± 10 (SD). A simplified rapid screening assay capable of revealing gross deviations from the normal is also suggested. The diagnostic value of the assay is indicated. PMID:4733866

  7. [Economic importance of postoperative urinary incontinence].

    PubMed

    Lent, V; Schultheis, M

    2015-11-01

    In the 22,160 patients treated in Germany for prostate cancer by prostatectomy, the costs for direct and indirect sequelae as the result of postoperative urinary incontinence are estimated to be 71.8million. This greatly exceeds the costs of 69.8million for the operation itself. This additional economic burden can, however, be decisively influenced by using a surgical technique that preserves the integrity of the urethral sphincter. PMID:26399245

  8. Depressive symptom patterns and urinary MHPG excretion.

    PubMed

    Agren, H

    1982-04-01

    Twenty-four hour urinary excretion of 3-methoxy-4-hydroxyphenyl-glycol (MHPG) was analyzed in 48 unipolar and 19 bipolar depressed patients and 16 healthy controls. All patients were interviewed using the Schedule for Affective Disorders and Schizophrenia. Various symptoms and descriptive variables were correlated univariately with urinary MHPG in two random groups, and those items showing a trend in both splits were further reduced by a multiple regression technique, first on each split separately and finally on the pooled sample. Urinary MHPG correlated significantly both in uni- and multivariate tests with age (positively, but only in females), altered motor activity (summed scores of agitation and retardation during the worst week of present or recent depression), and with existence of at least one suicide attempt before the present depressive episode (last items negatively). There were no differences between unipolar and bipolar patients, or between any patient group and the healthy controls. Males excreted about 25% more MHPG than females. Levels of MHPG in urine and cerebrospinal fluid were highly significantly intercorrelated. PMID:6953458

  9. Pharmacology of the lower urinary tract

    PubMed Central

    Hennenberg, Martin; Stief, Christian G.; Gratzke, Christian

    2014-01-01

    Pharmacology of the lower urinary tract provides the basis for medical treatment of lower urinary tract symptoms (LUTS). Therapy of LUTS addresses obstructive symptoms (frequently explained by increased prostate smooth muscle tone and prostate enlargement) in patients with benign prostate hyperplasia (BPH) and storage symptoms in patients with overactive bladder (OAB). Targets for medical treatment include G protein-coupled receptors (?1-adrenoceptors, muscarinic acetylcholine receptors, ?3-adrenoceptors) or intracellular enzymes (5?-reductase; phosphodiesterase-5, PDE5). Established therapies of obstructive symptoms aim to induce prostate smooth muscle relaxation by ?1-blockers or PDE5 inhibitors, or to reduce prostate growth and volume with 5?-reductase inhibitors. Available options for treatment of OAB comprise anitmuscarinics, ?3-adrenoceptor agonists, and botulinum toxin A, which improve storage symptoms by inhibition of bladder smooth muscle contraction. With the recent approval of ?3-antagonists, PDE inhibitors, and silodosin for therapy of LUTS, progress from basic research of lower urinary tract pharmacology was translated into new clinical applications. Further targets are in preclinical stages of examination, including modulators of the endocannabinoid system and transient receptor potential (TRP) channels. PMID:24744518

  10. 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

  11. [Treatment of uncomplicated lower urinary tract infections].

    PubMed

    Horcajada, Juan Pablo; García-Palomo, Daniel; Fariñas, M Carmen

    2005-12-01

    Empirical antibiotic treatment of lower urinary tract infections should be based on the patient's clinical data and on local sensitivity data. Because of the increase in resistance among uropathogens, recommendations on the empirical treatment of urinary tract infections have been modified. Currently, the empirical use of co-trimoxazole, ampicillin, and first-generation cephalosporins and quinolones is not recommended. Fluoroquinolones have been demonstrated to be highly effective in comparative studies but, because of the increase in resistance, the type of patient who can benefit from these antimicrobial agents must be selected. Second- and third-generation cephalosporins still have high sensitivity rates, although the higher recurrence rates associated with their use and the emergence of extended-spectrum beta-lactamase-producing enterobacterial in the community should be taken into account. Amoxicillin-clavulanate is less effective in eradicating infections than quinolones. Fosfomycin-trometamol has resistance rates of below 2% and single-dose therapy has been demonstrated to be safe and effective. Nitrofurantoin is also currently active, although it must be administered for 7 days and can produce toxicity. Both agents are currently recommended as alternative therapeutic options to fluoroquinolones in uncomplicated infections of the lower urinary tract. PMID:16854355

  12. 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

  13. Control of urinary drainage and voiding.

    PubMed

    Hill, Warren G

    2015-03-01

    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

  14. Urinary tract infection caused by Staphylococcus saprophyticus.

    PubMed

    Jordan, P A; Iravani, A; Richard, G A; Baer, H

    1980-10-01

    This study was designed to determine whether Staphylococcus saprophyticus was an important cause of urinary tract infection (UTI), as has been reported by European, but not by American, investigators, S. saprophyticus was the second most common cause of UTI in young (mean age, 20 years), sexually active female outpatients without known preexisting kidney disease or preceding manipulation of the urinary tract. Most cases presented as acute cystitis, but frank pyelonephritis and UTI in pregnant females were observed. The organism was rarely found as a contaminant in urine cultures. When present in the mucocutaneous flora of the anal-urogenital area, the organism was significantly associated with UTI by the same organism. These results show that S. saprophyticus should be accepted as an important urinary tract pathogen of young female patients in the United States. A simple adequate laboratory identification may be based on resistance to novobiocin (disk diffusion test), absence of hemolysis and coagulase, and intense pigment production (65% of strains yellow, 35% white). PMID:7192302

  15. 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

  16. 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

  17. 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

  18. Biomonitoring Equivalents for interpretation of urinary fluoride.

    PubMed

    Aylward, L L; Hays, S M; Vezina, A; Deveau, M; St-Amand, A; Nong, A

    2015-06-01

    Exposure to fluoride is widespread due to its natural occurrence in the environment and addition to drinking water and dental products for the prevention of dental caries. The potential health risks of excess fluoride exposure include aesthetically unacceptable dental fluorosis (tooth mottling) and increased skeletal fragility. Numerous organizations have conducted risk assessments and set guidance values to represent maximum recommended exposure levels as well as recommended adequate intake levels based on potential public health benefits of fluoride exposure. Biomonitoring Equivalents (BEs) are estimates of the average biomarker concentrations corresponding to such exposure guidance values. The literature on daily urinary fluoride excretion rates as a function of daily fluoride exposure was reviewed and BE values corresponding to the available US and Canadian exposure guidance values were derived for fluoride in urine. The derived BE values range from 1.1 to 2.1mg/L (1.2-2.5μg/g creatinine). Concentrations of fluoride in single urinary spot samples from individuals, even under exposure conditions consistent with the exposure guidance values, may vary from the predicted average concentrations by several-fold due to within- and across-individual variation in urinary flow and creatinine excretion rates and due to the rapid elimination kinetics of fluoride. Thus, the BE values are most appropriately applied to screen population central tendency estimates for biomarker concentrations rather than interpretation of individual spot sample concentrations. PMID:25863192

  19. 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.

  20. 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

  1. 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...

  2. 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 vaginal estrogen therapy effectively reduce symptomatic UTI episodes and should be considered in patients with recurrent UTIs. CONCLUSIONS AND RELEVANCE Establishing a diagnosis of symptomatic UTI in older women requires careful clinical evaluation with possible laboratory assessment using urinalysis and urine culture. Asymptomatic bacteriuria should be differentiated from symptomatic UTI. Asymptomatic bacteriuria in older women should not be treated. PMID:24570248

  3. 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 oestrogen replacement therapy must be borne in mind but remains to be clarified. However, oestriol has less of a uterotrophic effect compared to other oestrogens in standard therapeutic doses and is to be preferred. Side effects are usually dose related and tend not to be a problem with low dose therapy. PMID:3069438

  4. 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/reperfusion injury (p = 0.049). Conclusion: Calprotectin and neutrophil gelatinase—associated lipocalin can be used to monitor clinical and sub-clinical tubular damage after nephron sparing surgery for kidney tumours. Urinary calprotectin concentrations start rising within 2 hours after ischaemia/reperfusion-induced kidney injury. PMID:26745147

  5. 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

  6. 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

  7. Primary amyloidosis of the urinary bladder presenting as painless heamaturia

    PubMed Central

    Altwairgi, Adil

    2011-01-01

    A case of primary amyloidosis of urinary bladder was presented with painless heamaturia and irritative urinary symptoms. Radiological imaging showed multiple small masses within the urinary bladder with suspicion of multiple transitional cell carcinomas within the urinary bladder. Cystoscopy confirmed the multiple masses within the urinary bladder, some showing haemorrhagic papules and papillary projections over the masses. Histopathology of the biopsy material was negative for the malignancy. Immunostaining of the biopsy material with Congo red stain showed the presence of amyloid fibrils within the biopsy material. Further investigations of systemic illness exclude the secondary amyloidosis. Transurethral resection was done. Patient showed improvement after the resection and no recurrence was observed during follow up. The purpose of this case presentation is to create awareness among the urologists to think for the rare entity of urinary amyloidosis especially if the histopathology is negative for the malignant cells. PMID:23267295

  8. 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

  9. 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.

  10. 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.

  11. The Feedback Between Continents and Compositional Anomalies in the Deep Mantle

    NASA Astrophysics Data System (ADS)

    Lowman, J. P.; Trim, S. J.

    2014-12-01

    Findings from global seismic tomography studies suggest that the deep mantle may harbor a pair of broad, steep-sided, relatively dense compositionally anomalous provinces. The longevity and stability of these Large Low Shear-Wave Velocity Provinces (LLSVPs) has received considerable interest but their possible influence on surface motion has drawn lesser attention. Recent work using numerical mantle convection models investigated the feedback between oceanic plate motion and high density compositional anomalies. It was found that surface mobility is affected by the presence of compositional anomalies such that critical density contrasts and volumes of the enriched material produce a transition to stagnant-lid convection. For lesser volumes and density contrast (for example, volumes that are representative of the concentrations in the Earth's mantle) the presence of the compositional anomalies affects mean plate velocity and size when compared to the characteristics of systems in which the enriched material is absent. In addition, numerous studies and lines of evidence in the geologic record suggest that the presence of the density anomalies plays a role in determining the location of mantle upwellings, which in turn influence surface dynamics. In this study, we present the results from a study implementing a two-dimensional mantle convection model featuring an anomalously dense component and distinct continental and oceanic lithosphere. The mass, momentum, and energy conservation equations are solved using a hybrid spectral-finite difference code. Compositional variations are tracked using Lagrangian tracer particles. Mobile tectonic plates are modeled using a force-balance method and plate boundary locations evolve in response to interior stresses, plate velocity, age and lithospheric chemistry (i.e., oceanic versus continental). We examine the influence of continents on compositional anomaly morphology and longevity and the influence of compositional anomalies on continental size, mobility and aggregation. The influence of continents is isolated by comparing our calculations with cases in which continents are absent.

  12. 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: "THE DATA MUST BE GREATLY AMPLIFIED AND STRENGTHENED" (Gutenberg's emphasis). Upcoming generations of seismologists will be well served to heed Gutenberg's advice and follow the example of the designers of USArray.

  13. Antarctic terrestrial life--challenging the history of the frozen continent?

    PubMed

    Convey, Peter; Gibson, John A E; Hillenbrand, Claus-Dieter; Hodgson, Dominic A; Pugh, Philip J A; Smellie, John L; Stevens, Mark I

    2008-05-01

    Antarctica is a continent locked in ice, with almost 99.7% of current terrain covered by permanent ice and snow, and clear evidence that, as recently as the Last Glacial Maximum (LGM), ice sheets were both thicker and much more extensive than they are now. Ice sheet modelling of both the LGM and estimated previous ice maxima across the continent give broad support to the concept that most if not all currently ice-free ground would have been overridden during previous glaciations. This has given rise to a widely held perception that all Mesozoic (pre-glacial) terrestrial life of Antarctica was wiped out by successive and deepening glacial events. The implicit conclusion of such destruction is that most, possibly all, contemporary terrestrial life has colonised the continent during subsequent periods of glacial retreat. However, several recently emerged and complementary strands of biological and geological research cannot be reconciled comfortably with the current reconstruction of Antarctic glacial history, and therefore provide a fundamental challenge to the existing paradigms. Here, we summarise and synthesise evidence across these lines of research. The emerging fundamental insights corroborate substantial elements of the contemporary Antarctic terrestrial biota being continuously isolated in situ on a multi-million year, even pre-Gondwana break-up timescale. This new and complex terrestrial Antarctic biogeography parallels recent work suggesting greater regionalisation and evolutionary isolation than previously suspected in the circum-Antarctic marine fauna. These findings both require the adoption of a new biological paradigm within Antarctica and challenge current understanding of Antarctic glacial history. This has major implications for our understanding of the key role of Antarctica in the Earth System. PMID:18429764

  14. Cost-Effectiveness of Including a Nurse Specialist in the Treatment of Urinary Incontinence in Primary Care in the Netherlands

    PubMed Central

    Holtzer-Goor, K. M.; Gaultney, J. G.; van Houten, P.; Wagg, A. S.; Huygens, S. A.; Nielen, M. M. J.; Albers-Heitner, C. P.; Redekop, W. K.; Rutten-van Mölken, M. P.; Al, M. J.

    2015-01-01

    Objective Incontinence is an important health problem. Effectively treating incontinence could lead to important health gains in patients and caregivers. Management of incontinence is currently suboptimal, especially in elderly patients. To optimise the provision of incontinence care a global optimum continence service specification (OCSS) was developed. The current study evaluates the costs and effects of implementing this OCSS for community-dwelling patients older than 65 years with four or more chronic diseases in the Netherlands. Method A decision analytic model was developed comparing the current care pathway for urinary incontinence in the Netherlands with the pathway as described in the OCSS. The new care strategy was operationalised as the appointment of a continence nurse specialist (NS) located with the general practitioner (GP). This was assumed to increase case detection and to include initial assessment and treatment by the NS. The analysis used a societal perspective, including medical costs, containment products (out-of-pocket and paid by insurer), home care, informal care, and implementation costs. Results With the new care strategy a QALY gain of 0.005 per patient is achieved while saving €402 per patient over a 3 year period from a societal perspective. In interpreting these findings it is important to realise that many patients are undetected, even in the new care situation (36%), or receive care for containment only. In both of these groups no health gains were achieved. Conclusion Implementing the OCSS in the Netherlands by locating a NS in the GP practice is likely to reduce incontinence, improve quality of life, and reduce costs. Furthermore, the study also highlighted that various areas of the continence care process lack data, which would be valuable to collect through the introduction of the NS in a study setting. PMID:26426124

  15. Robot–assisted radical cystectomy and intracorporeal urinary diversion – safe and reproducible?

    PubMed Central

    Sim, Allen; Balbay, Mevlana Derya; Todenhöfer, Tilman; Aufderklamm, Stefan; Halalsheh, Omar; Mischinger, Johannes; Böttge, Johannes; Rausch, Steffen; Bier, Simone; Stenzl, Arnulf; Gakis, Georgios; Canda, Abdullah Erdem

    2014-01-01

    Introduction Robot–assisted radical cystectomy (RARC) plus intracorporeal urinary diversion is feasible. Few centers worldwide demonstrated comparable functional and oncologic outcomes. We reported a large series of RARC and intracorporeal diversion to assess its feasibility and reproducibility. Material and methods We identified 101 RARCs in 82 men and 19 women (mean age 68.3 years) from October 2009 to October 2014. The patients underwent RARC and pelvic lymphadenectomy followed by intracorporeal urinary diversion (ileal conduit/ neobladder). Out of the 101 patients, 28 (27.7%) received intracorporeal ileal conduits and 73 (72.3%) intracorporeal neobladders. Studer pouch was performed in all the patients who underwent intracorporeal neobladder formation. Perioperative, functional and oncologic results including CSS and OS are reported. Results Mean operative time was 402.3 minutes (205–690) and blood loss was 345.3 ml (50–1000). The mean hospital stay was 17.1 days (5–62). All the surgeries were completed with no open conversion. Minor complications (Grade I and II) were reported in 27.7% of patients while major complications (grade III and above) were reported in 36.6% of patients. The mean nodal yield was 20.6 (0–46). Positive ureteric margins were found in 8.9% of patients. The average follow–up was 27.5 months (1–52). Daytime continence could be achieved in 89.2% of patients who underwent intracorporeal neobladder. The 3–year cancer specific survival (CSS) and overall survival (OS) was 80.2% and 69.8% respectively. Conclusions RARC with intracorporeal diversion is safe and reproducible in ‘non–pioneer’ tertiary centers with robotic expertise having acceptable operative time and complications as well as comparable functional and oncologic outcomes. PMID:25914833

  16. [Alpha1 adrenoceptors in human urinary tract:expression, distribution and clinical implications].

    PubMed

    Arrighi, N; Bodei, S; Zani, D; Peroni, A; Simeone, C; Mirabella, G; Sigala, S

    2007-01-01

    Adrenergic receptors (ARs) are a class of proteins belonging to the G proteincoupled receptor family. Pharmacological and molecular studies allowed dividing ARs into three different categories: α1, α2 and β. In this review, we focused on α1 ARs and α1 AR antagonists, since α1 ARs play an important role in the pathophysiology of a number of urinary tract (UT) dysfunctions. α1 ARs are widely expressed in human UT; in particular, the three ureter areas (distal, medial and proximal) show different patterns of receptor expression (i.e. distal > medial = proximal), giving the molecular basis for the use of α1 ARs antagonist in the expulsive therapy of distal ureter calculi. Bladder areas are characterized by important differences among trigone, detrusor and neck, the first showing a different pattern of expression compared to the other parts. Further, there are evidences of both density and subtype gender-dependent expressions. α1 ARs expression in prostate and detrusor is a widely investigated area of research, mainly due to the clinical impact of benign prostatic hyperplasia (BPH). Urethra has not been well studied in human, although it plays a role in the control of continence. Studies carried out on α1 AR subtype expression in the UT indicate that, although the presence of each subtype is observed, α1A firstly and then α1D ARs seem to be more expressed than α1B ARs. Thus, drugs that demonstrate high α1A/D AR selectivity have drawn the researchers' attention. As it relates specifically to the α1 AR antagonists used in the treatment of lower UT symptoms, the concept of uroselectivity has been operationally defined; indeed, in a number of recent publications uroselectivity has been defined as the degree to which a given compound inhibits norepinephrine-induced increase in urinary muscle contractions and/or its propensity to generate unwanted cardiovascular effects, such as decreases in blood pressure. PMID:21086401

  17. 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 mid-Holocene simulations with anomalous onshore flow onto the continent. Conversely, the precipitation is typically more than 10% lower in the late half of the monsoon period (January, February and March-JFM) with anomalous anticyclonic flow over the Australian continent. These anticyclonic anomalies are likely to be caused by reduced convection from the weaker insolation during JFM at 6 ka relative to 0 ka. The increase in OND precipitation and decrease in JFM implies that the monsoon onset and retreat may have been earlier than at present (in response to the insolation forcing), and therefore it is important to assess the changes over the whole monsoon period (October to March) instead of just the summer months (December, January and February).

  18. Lithospheric Structure of the North American Continent Imaged With Earthscope USArray and Global Data

    NASA Astrophysics Data System (ADS)

    Lebedev, S.; Schaeffer, A. J.

    2013-12-01

    The deployment of the Earthscope USArray during the last decade has produced an unprecedentedly dense sampling of the central part of the North American continent (within the United States) with broadband seismic data. Regional tomography is now mapping the deep structure of the continent in great detail, in particular beneath the western US where the USArray deployment began. At the scale of the entire continent, however, the resolution of seismic imaging remains uneven, with much poorer coverage away from the footprint of the array than beneath it. Important questions regarding the deep structure, lateral extent and evolution of the North American Craton, most of it not covered by USArray, thus remain difficult to answer. We present a new model of the upper mantle beneath the entire North America computed by inversion of multimode waveform fits of 3/4 of a million vertical-component, broadband seismograms. Of these, almost 230 thousand are from the Transportable Array component of USArray, several tens of thousands from other USArray-affiliated stations, and the rest from global networks and other arrays. Automated multimode waveform inversion was used to extract accurate structural information from surface and S wave forms, yielding resolving power from the crust down to the transition zone. Our unprecedentedly large waveform dataset, with highly complementary USArray and global-network sub-sets within it, produces improved resolution for a variety of features in North American upper mantle, compared to other available models. The internal structure and boundaries of the North American Craton are resolved in more detail than previously. Sharp northern boundaries of the cratonic lithosphere are observed to closely follow the coastline, with North America's and Greenland's lithospheric roots clearly separated. The boundary of the craton in western Canada closely follows the Rocky Mountain Front, whereas in eastern North America, where multiple episodes of continental rifting are superimposed, the boundary largely coincides with the western extent of the Appalachian orogenic front. Within the continent, relatively low-velocity lithosphere is found beneath the failed Mid-Continental Rift. High velocities at depth between the Great Bear Arc and Beaufort Sea provide convincing new evidence for the enigmatic, recently proposed ``MacKenzie Craton'', not exposed anywhere at the surface.

  19. 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

  20. 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-D effects in some data. However, an overall regional 2-D strike direction is defined that is parallel to the coastline of Taiwan. Regularized 2-D inversions of these transects image conductive sedimentary rocks in the western foreland basin and an east dipping mid-crustal conductor beneath the fold-and-thrust belt. A sharp boundary is observed between the western sedimentary rocks and the more resistive slates and metamorphic rocks to the east in the Central Range. This boundary coincides with a conductor rising from the mid-crust that may be related to interconnected fluids.

  1. 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 those of the Gulf of Cadiz oceanic-continental transition near the Eurasia-African plate boundary (Neves and Neves, 2009), and they contribute to complete the knowledge about seismicity and lithospheric strength in the ocean-continent transition of the Iberian Peninsula. References Neves M.C., Neves, R.G.M., 2009. Flexure and seismicity across the ocean-continent transition in the Gulf of Cadiz. Journal of Geodynamics, 47, 119-129.

  2. [Urinary tract infection in patients with diabetes mellitus].

    PubMed

    Merta, M; Rysavá, R; Tesar, V

    2006-05-01

    Urinary tract infection is an important infection in patients with diabetes mellitus. Asymptomatic and symptomatic infections of urinary tract, and also some rarer serious complications of urinary tract infections (papillary necrosis, renal and perirenal abscess, emphysematous and xantogranulomatous pyelonephritis and s.o.). Incidence, outcome and treatment in patients with diabetes, which deserve special clinical attention, are commonly viewed by prism of personal opinion, and should be based on clinical studies, focused on this topic. PMID:16771081

  3. 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 recently published literature.

  4. 21 CFR 862.1560 - Urinary phenylketones (nonquantitative) test system.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems § 862.1560 Urinary phenylketones (nonquantitative) test system. (a) Identification....

  5. 21 CFR 862.1340 - Urinary glucose (nonquantitative) test system.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...). Urinary glucose (nonquantitative) measurements are used in the diagnosis and treatment of carbohydrate metabolism disorders including diabetes mellitus, hypoglycemia, and hyperglycemia. (b) Classification....

  6. Diagnosis and treatment of urinary tract infections in children.

    PubMed

    White, Brett

    2011-02-15

    Acute urinary tract infections are relatively common in children, with 8 percent of girls and 2 percent of boys having at least one episode by seven years of age. The most common pathogen is Escherichia coli, accounting for approximately 85 percent of urinary tract infections in children. Renal parenchymal defects are present in 3 to 15 percent of children within one to two years of their first diagnosed urinary tract infection. Clinical signs and symptoms of a urinary tract infection depend on the age of the child, but all febrile children two to 24 months of age with no obvious cause of infection should be evaluated for urinary tract infection (with the exception of circumcised boys older than 12 months). Evaluation of older children may depend on the clinical presentation and symptoms that point toward a urinary source (e.g., leukocyte esterase or nitrite present on dipstick testing; pyuria of at least 10 white blood cells per high-power field and bacteriuria on microscopy). Increased rates of E. coli resistance have made amoxicillin a less acceptable choice for treatment, and studies have found higher cure rates with trimethoprim/sulfamethoxazole. Other treatment options include amoxicillin/clavulanate and cephalosporins. Prophylactic antibiotics do not reduce the risk of subsequent urinary tract infections, even in children with mild to moderate vesicoureteral reflux. Constipation should be avoided to help prevent urinary tract infections. Ultrasonography, cystography, and a renal cortical scan should be considered in children with urinary tract infections. PMID:21322515

  7. 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.

  8. The Prevalence of Lower Urinary Tract Symptoms in Korean Men Aged 40 Years or Older: A Population-Based Survey

    PubMed Central

    Kim, Tae Heon; Han, Deok Hyun

    2014-01-01

    Purpose The aim of this study was to evaluate the prevalence of lower urinary tract symptoms (LUTS) among Korean men aged ?40 years. Methods We performed a population-based, cross-sectional door-to-door survey on a geographically stratified random sample of men aged ?40 years. All respondents were asked about the presence of individual LUTS using a questionnaire based on 2002 International Continence Society definitions. For comparison, we also defined nocturia as two or more nocturnal micturitions per night. The International Prostate Symptom Score (IPSS) questionnaire was used to assess LUTS severity. Results Responses from 1,842 subjects were analyzed. The overall prevalence of LUTS was 83.4%. Storage LUTS (70.1%) were more prevalent than voiding (60.4%) or postmicturition LUTS (38.3%). When nocturia was defined as two or more nocturnal micturitions per night, voiding symptoms became most prevalent (storage, 39.7%; voiding, 60.4%; and postmicturition, 38.3%). More than 90% of our population described the severity of their urinary symptoms as moderate (8-19) or severe (20-35). The prevalence and severity of LUTS increased with age. Conclusions LUTS are highly prevalent among Korean men, and its prevalence increases with age. Increased public awareness and a larger number of treatment options are needed to appropriately manage symptoms and their consequences. PMID:25279239

  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. Magnetotelluric imaging beneath the Taiwan orogen: An arc-continent collision

    NASA Astrophysics Data System (ADS)

    Bertrand, Edward A.; Unsworth, Martyn J.; Chiang, Chih-Wen; Chen, Chow-Son; Chen, Chien-Chih; Wu, Francis T.; TürkoǧLu, Ersan; Hsu, Han-Lun; Hill, Graham J.

    2012-01-01

    The Taiwan orogen has formed since the late Miocene by oblique collision between the Luzon Volcanic Arc on the Philippine Sea Plate, and the Eurasian continental margin. This oblique collision has produced an orogen that decreases in age from north to south, and permits study of the temporal evolution of an arc-continent collision. These factors make Taiwan a favorable location to study the process of arc-continent collision. The first long-period magnetotelluric (MT) measurements were recorded in Taiwan as part of the Taiwan Integrated Geodynamics Research (TAIGER) project in 2006-7. Measurements were made at 82 sites on three transects across south, central and north Taiwan, that span the breadth of the orogen and cross all major tectonic boundaries. Robust, remote reference processing of the MT time series data resulted in high-quality soundings that were modeled in both 2 and 3-dimensions. These MT models support predictions of lithospheric deformation (i.e., thick-skinned tectonics) beneath the Central Ranges in south and central Taiwan, but are inconsistent with predictions of orogen-scale thin-skinned models. The MT resistivity model for northern Taiwan is consistent with dewatering of the subducting Philippine slab, and with deformation described by the subducting-indenter tectonic model. Modeling the TAIGER MT data has definitively shown that conductive, and seismically active crustal structures, exist to 30+ km beneath the orogen. These conductive regions, interpreted as interconnected fluid, map pervasive zones of collisional deformation that are lithospheric in scale.

  11. 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.

  12. Two years long field campaign YMC - A challenge to the complicated Maritime Continent weather and climate

    NASA Astrophysics Data System (ADS)

    Yoneyama, Kunio; Zhang, Chidong; Hayati, Noer; Katsumata, Masaki

    2015-04-01

    The Maritime Continent (MC), which spans from the eastern Indian Ocean to the western Pacific via the complicated land topography, hosts various weather and climate phenomena and plays a role of the heat engine for the global atmospheric circulation. However, most of our knowledge on them are qualitative and result in unrealistic simulation by numerical models. For example, most climate models are suffering from the systematic errors of precipitation with overestimate/underestimate over the land/ocean. Interaction between the local circulation due to the heating diurnal cycle and large-scale phenomena might be a key to understand them quantitatively. To cover the entire monsoon cycle, two-year long field campaign, Years of the Maritime Continent or YMC, is proposed. While long-term atmospheric and oceanic monitoring is done by or through the collaboration with the MC countries, several coordinated intensive observations using ship, aircraft, mooring, float, land-based are planned. Their main targets include convective diurnal cycle, aerosol-cloud interaction, the Madden-Julian oscillation, equatorially trapped waves, troposphere-stratosphere interaction, Indonesian through flow, coastal upwelling, and so on. In this presentation, current status will be reviewed.

  13. 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.

  14. 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

  15. Does Structural Complexity Determine the Morphology of Assemblages? An Experimental Test on Three Continents

    PubMed Central

    Gibb, Heloise; Parr, Catherine L.

    2013-01-01

    Understanding how species will respond to global change depends on our ability to distinguish generalities from idiosyncrasies. For diverse, but poorly known taxa, such as insects, species traits may provide a short-cut to predicting species turnover. We tested whether ant traits respond consistently to habitat complexity across geographically independent ant assemblages, using an experimental approach and baits. We repeated our study in six paired simple and complex habitats on three continents with distinct ant faunas. We also compared traits amongst ants with different foraging strategies. We hypothesised that ants would be larger, broader, have longer legs and more dorsally positioned eyes in simpler habitats. In agreement with predictions, ants had longer femurs and dorsally positioned eyes in simple habitats. This pattern was most pronounced for ants that discovered resources. Body size and pronotum width responded as predicted for experimental treatments, but were inconsistent across continents. Monopolising ants were smaller, with shorter femurs than those that occupied or discovered resources. Consistent responses for several traits suggest that many, but not all, aspects of morphology respond predictably to habitat complexity, and that foraging strategy is linked with morphology. Some traits thus have the potential to be used to predict the direction of species turnover, changes in foraging strategy and, potentially, evolution in response to changes in habitat structure. PMID:23691137

  16. Development of the continent-ocean transform boundary of the southern Exmouth Plateau

    NASA Astrophysics Data System (ADS)

    Lorenzo, Juan M.; Mutter, John C.; Larson, Roger L.

    1991-08-01

    A two-stage model is proposed to explain the principal tectonic and magmatic features observed in multichannel seismic reflection and refraction data across the southern transform margin of the Exmouth Plateau (northwestern Australia): (1) The rifting stage, in which detachment surfaces developed under conditions of extension at a high angle to the future transform and were later sheared by right-lateral strike-slip faulting. Final transform rupture was attended by large fault-block rotation and mafic intrusions in conditions of pure shear. (2) In the drifting stage, as the oceanic ridge abutted the continent, the continental rim was underplated (at this location, resulting in a 10-km-thick, 7.3 km/s, 3 g/cm3 layer), resulting in a permanent isostatic uplift of the crust and tilting of synrift sedimentary deposits. This wedge extends laterally, forming a thickened oceanic layer 3. Transient heating of the continental lithosphere induced thermal uplift and erosion of up to 3.5 km of sedimentary units over a 50-km distance from the continent-ocean contact.

  17. 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.

  18. 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

  19. The Effect of Continental Rifting on Lithospheric Fabric: Evidence From the Mid-Continent Rift

    NASA Astrophysics Data System (ADS)

    Ola, O. B.; Frederiksen, A. W.

    2013-12-01

    The Mid-Continent Rift (MCR) is a major feature of the North American continent: a 1.1 Ga rift that failed to develop into an ocean basin. Though the crustal expression of the rift is preserved, it is impossible to determine from crustal evidence the nature of the lithospheric contribution to the rifting process. The installation of teleseismic instrumentation through the Superior Province Rifting Earthscope Experiment (SPREE) is allowing investigation of the lithosphere beneath the MCR, which will help in addressing questions about the initiation, propagation, and failure of the rift structure. We focus on observing the strength and orientation of lithospheric fabric through measurements of the splitting of teleseismic SK(K)S waves at instruments in and near the rift axis, using the method of Silver and Chan (1991) to find the set of parameters that optimally restores linear particle motion. Our results show that the fast direction varies only subtly across the study area, with the exception of localized outliers. The fast direction is close to the direction of absolute plate motion, but shows greater scatter within the MCR itself. Split times show strong variations (from near-zero to 1.5 s), with lower values within the rift; the Nipigon Embayment stands out as a particularly low-anisotropy region. These measurements suggest that the rifting process thinned the lithosphere or reset its fabric, indicating significant lithospheric participation in the rifting process.

  20. 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.

  1. 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.

  2. Microtomographic analysis of lower urinary tract obstruction.

    PubMed

    Siebert, Joseph R; Smith, Kenneth J; Cox, Liza L; Glass, Ian A; Cox, Timothy C

    2013-01-01

    Prenatal obstruction of the lower urinary tract may result in megacystis, with subsequent development of hydroureter, hydronephrosis, and renal damage. Oligo- or anhydramnios, pulmonary hypoplasia, and prune belly syndrome are lethal consequences. Causes and mechanisms responsible for obstruction remain unclear but might be clarified by anatomic study at autopsy. To this end, we employed 2 methods of tomographic imaging-optical projection tomography and contrast-enhanced microCT scanning-to elucidate the anatomy of the intact urinary bladder and urethra in 10 male fetuses with lower urinary tract obstruction. Images were compared with those from 9 age-matched controls. Three-dimensional images, rotated and sectioned digitally in multiple planes, permitted thorough examination while preserving specimens for later study. Both external and internal features of the bladder and urethra were demonstrated; small structures (ie, urethral crest, verumontanum, prostatic utricle, ejaculatory ducts) were seen in detail. Types of obstruction consisted of urethral atresia (n  =  5), severe urethral stenosis (n  =  2), urethral diaphragm (n  =  2), or physical kinking (n  =  1); classic (Young type I) posterior urethral valves were not encountered. Traditional light microscopy was then used to verify tomographic findings. The prostate gland was hypoplastic or absent in all cases; in 1, prostatic tissue was displaced inferior to the verumontanum. Findings support previous views that dissection may produce valve-like artifacts (eg, bisection of an obstructing diaphragm) and that deformation of an otherwise normal urethra may result in megacystis. The designation "posterior urethral valves" should not be used as a generic expression of urethral obstruction unless actual valves are demonstrated. PMID:23977847

  3. Prevention of recurrent urinary tract infections.

    PubMed

    Wagenlehner, F M E; Vahlensieck, W; Bauer, H W; Weidner, W; Piechota, H J; Naber, K G

    2013-03-01

    Urinary tract infections (UTI) are among the most frequent bacterial infections in the community and health care setting. Mostly young and, to some extent, postmenopausal women are affected by recurrent UTI (rUTI) defined as ≥3 UTI/year or ≥2 UTI/half year. In contrast, rUTI is rare in healthy men. On the other hand, rUTI are frequently found in female and male patients with complicating urological factors, e.g. urinary catheters, infection stones. Remediable predisposing factors in uncomplicated rUTI in women are rare. In complicated rUTI the success depends mainly on the possibility to eliminate or at leastimprove the complicating risk factors. Continuous antibiotic prophylaxis or postcoital prophylaxis, if there is close correlation with sexual intercourse, are most effective to prevent rUTI. Nitrofurantoin, trimethoprim (or cotrimoxazole), and fosfomycin trometamol are available as first-line drugs. Oral cephalosporins and quinolones should be restricted to specific indications. Antibiotic prophylaxis reduces the number of uropathogens in the gut and/or vaginal flora and reduces bacterial "fitness". Given the correct indication, the recurrence rate of rUTI can be reduced by about 90%. Due to possible adverse events and the concern of selecting resistant pathogens, according to the guidelines of the European Association of Urology antimicrobial prophylaxis should be considered only after counselling, behavioural modification and non-antimicrobial measures have been attempted. In postmenopausal patients vaginal substitution of oestriol should be started first. Oral or parenteral immunoprophylaxis is another option in patients with rUTI. Other possibilities with varying scientific evidence are prophylaxis with cranberry products, specific plant combinations or probiotics. The prophylaxis of catheter-associated UTI should employ strategies which result in a reduction of frequency and duration of catheter drainage of the urinary tract. The currently available catheter materials have only little influence on reducing catheter-associated rUTI. PMID:23538307

  4. Vancomycin-resistant enterococcal urinary tract infections.

    PubMed

    Heintz, Brett H; Halilovic, Jenana; Christensen, Cinda L

    2010-11-01

    Enterococci are a common cause of urinary tract infections (UTIs) among hospitalized patients. The rising prevalence of vancomycin-resistant enterococci (VRE) is of particular concern within many institutions because of its association with increased mortality and health care costs, as well as limited treatment options. Clinicians need to differentiate between VRE-associated urinary colonization, asymptomatic bacteriuria, and UTIs in order to determine the need for treatment, optimal therapeutic options, and length of therapy. Unnecessary use of antibiotics in patients simply colonized and not infected with VRE in the urine has become a large problem in both hospitals and long-term care facilities. A PubMed-MEDLINE search was conducted to identify all English-language literature published between January 1975 and March 2010 in order to summarize diagnostic criteria and treatment options for VRE UTIs. Several antimicrobials are discussed, with the specific focus on those with the potential to treat VRE UTIs and susceptibility patterns of VRE from urinary sources: ampicillin, amoxicillin, daptomycin, doxycycline, fosfomycin, imipenem-cilastatin, linezolid, nitrofurantoin, penicillin, piperacillin, quinupristin-dalfopristin, tetracycline, and tigecycline. Recommendations for empiric treatment of enterococcal UTIs and definitive treatment of VRE UTIs, including an evidence-based treatment algorithm, are proposed. Ampicillin generally is considered the drug of choice for ampicillin-susceptible enterococcal UTIs, including VRE. Nitrofurantoin, fosfomycin, and doxycycline have intrinsic activity against enterococci, including VRE, and are possible oral options for VRE cystitis. Linezolid and daptomycin should be reserved for confirmed or suspected upper and/or bacteremic VRE UTIs among ampicillin-resistant strains. Use of other antimicrobials, such as quinupristin-dalfopristin and tigecycline, should be evaluated on a case-by-case basis due to concerns of toxicity, resistance, and insufficient supportive data. Additional clinical data are needed to determine the optimal management and duration of therapy for VRE UTIs. PMID:20973687

  5. Microtomographic Analysis of Lower Urinary Tract Obstruction

    PubMed Central

    Siebert, Joseph R.; Smith, Kenneth J.; Cox, Liza L.; Glass, Ian A.; Cox, Timothy C.

    2014-01-01

    Prenatal obstruction of the lower urinary tract may result in megacystis, with subsequent development of hydro-ureter, hydronephrosis, and renal damage. Oligo- or anhydramnios, pulmonary hypoplasia, and prune belly syndrome are lethal consequences. Causes and mechanisms responsible for obstruction remain unclear but might be clarified by anatomic study at autopsy. To this end, we employed 2 methods of tomographic imaging—optical projection tomography and contrast-enhanced microCT scanning—to elucidate the anatomy of the intact urinary bladder and urethra in 10 male fetuses with lower urinary tract obstruction. Images were compared with those from 9 age-matched controls. Three-dimensional images, rotated and sectioned digitally in multiple planes, permitted thorough examination while preserving specimens for later study. Both external and internal features of the bladder and urethra were demonstrated; small structures (ie, urethral crest, verumontanum, prostatic utricle, ejaculatory ducts) were seen in detail. Types of obstruction consisted of urethral atresia (n = 5), severe urethral stenosis (n = 2), urethral diaphragm (n = 2), or physical kinking (n = 1); classic (Young type I) posterior urethral valves were not encountered. Traditional light microscopy was then used to verify tomographic findings. The prostate gland was hypoplastic or absent in all cases; in 1, prostatic tissue was displaced inferior to the verumontanum. Findings support previous views that dissection may produce valve-like artifacts (eg, bisection of an obstructing diaphragm) and that deformation of an otherwise normal urethra may result in megacystis. The designation “posterior urethral valves” should not be used as a generic expression of urethral obstruction unless actual valves are demonstrated. PMID:23977847

  6. [Development of invasive urinary bladder carcinomas].

    PubMed

    Fukushima, Shoji; Wanibuchi, Hideki; Wei, Min; Morimura, Keiichirou

    2006-06-01

    In this paper, we report on invasive urinary bladder carcinomas as follows, (1) p53 mutations have an important role in promotion and progression stages of carcinogenesis, (2) invasive bladder carcinomas occur multi-centrically in the bladder, (3) an organic arsenic, dimethylarsinic acid exerts carcinogenicity in the bladder of rats, (4) p53 mutations in carcinomas are caused by different carcinogens, and (5) bladder urothelium of people living in 137Cs-contaminated areas of Ukraine showed chronic proliferative atypical cystitis (so-called Chernobyl cystitis). PMID:16848359

  7. Treatment of Fungal Urinary Tract Infection.

    PubMed

    Thomas, Lewis; Tracy, Chad R

    2015-11-01

    Funguria, and particularly candiduria, is an increasingly common problem encountered by the practicing urologist and is associated with high-acuity care, indwelling catheters, diabetes mellitus, antibiotic and steroid use, and urinary tract disease. In most cases, candiduria is asymptomatic and follows a benign clinical course with antifungal therapy only required in symptomatic or high-risk cases, because spontaneous resolution is common in patients with asymptomatic colonization. Rarely, invasive infections can occur (such as fungus balls or renal abscesses) and may require percutaneous and endoscopic interventions. This article highlights the workup and treatment of funguria and its related urologic manifestations. PMID:26475944

  8. 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 in multivariate models. In summary, among this population of custodians, we identified both occupational and nonoccupational predictors of phthalate exposures. Identification of phthalates as ingredients in cleaning chemicals and consumer products would allow workers and consumers to avoid phthalate exposure. PMID:26240196

  9. 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

  10. Upper urinary tract lipoma: A case report

    PubMed Central

    Lmezguidi, Khalid; Hajji, Fouad; Sinaa, Mohamed; Janane, Abdellatif; Ghadouane, Mohamed; Ameur, Ahmed; Albouzidi, Abderrahmane; Abbar, Mohamed

    2015-01-01

    Upper urinary tract (UUT) benign tumours are rare. We present a case of UUT lipoma in a 41-year-old man with left flank pain. A computed tomographic urography scan revealed an irregular thickening of the left renal collecting system wall extending from the upper calices to the renal pelvis. The diagnosis of UUT was made and the patient underwent a nephroureterectomy with bladder cuff excision, as standard treatment. However, macroscopic and histological examination revealed a lipomatous tumour with no sign of malignancy. To our knowledge this is the first reported case of its kind of a UUT managed first with a minimally invasive approach. PMID:26425240

  11. Bone and metabolic complications of urinary diversions.

    PubMed

    Cano Megías, Marta; Muñoz Delgado, Eva Golmayo

    2015-02-01

    Hyperchloremic metabolic acidosis is a complication of urinary diversion using ileum or colon. Its prevalence ranges from 25% and 46% depending on the procedure used and renal function of the patient. It is a consequence of intestinal fluid and electrolyte exchange between intestinal mucosa and urine. The main mechanism is absorption of ammonium and chloride from urine. Long-term chronic metabolic acidosis in these patients may lead to impaired bone metabolism and osteomalacia. Regular monitoring of pH, chlorine, bicarbonate, and calcium-phosphorus metabolism is therefore essential for early diagnosis and treatment. PMID:25481805

  12. 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

  13. Urinary Biomarkers at Early ADPKD Disease Stage

    PubMed Central

    Petzold, Katja; Poster, Diane; Krauer, Fabienne; Spanaus, Katharina; Andreisek, Gustav; Nguyen-Kim, Thi Dan Linh; Pavik, Ivana; Ho, Thien Anh; Serra, Andreas L.; Rotar, Laura

    2015-01-01

    Background Autosomal dominant polycystic kidney disease (ADPKD) is characterized by a decline in renal function at late disease stage when the majority of functional renal parenchyma is replaced by cystic tissue. Thus, kidney function, assessed by estimated glomerular filtration rate (eGFR) does not well represent disease burden in early disease. Here, we investigated various urinary markers for tubular injury and their association with disease burden in ADPKD patients at early disease course. Methods ADPKD patients between 18 and 40 years with an eGFR greater or equal to 70 ml per min per 1.73m2 were eligible for this cross-sectional study. Urinary Neutrophil Gelatinase-Associated Lipocalin (NGAL), Kidney Injury Molecule-1 (KIM-1), and Uromodulin (UMOD) were investigated by Enzyme-Linked Immunosorbent Assay. Clara Cell Protein 16 (CC16) was investigated by Latex Immuno Assay. Cryoscopy was performed to assess urine osmolality and Urinary Albumin-to-Creatinine Ratio (UACR) was calculated. The association and the predictive properties of the markers on eGFR and height adjusted total kidney volume (htTKV) was evaluated using multiple regression analysis, incorporating different control variables for adjustment. Internal bootstrapping validated the obtained results. Results In 139 ADPKD patients (age 31 ±7 years, mean eGFR of 93 ± 19 ml per min per 1.73 m2) the total kidney volume was negatively correlated with eGFR and UMOD and positive associated with age, UACR, KIM-1 and urine osmolality after adjustment for possible confounders. Urine osmolality and htTKV were also associated with eGFR, whereas no association of CC16, NGAL and UMOD with eGFR or htTKV was found. Conclusion UACR and urinary KIM-1 are independently associated with kidney size but not with renal function in our study population. Urine osmolality was associated with eGFR and kidney volume following adjustment for multiple confounders. Despite statistical significance, the clinical value of our results is not yet conceivable. Further studies are needed to evaluate the property of the aforementioned biomarkers to assess disease state at early ADPKD stage. PMID:25875363

  14. Obesity and Urinary Incontinence: Epidemiology and Clinical Research Update

    PubMed Central

    Subak, Leslee L.; Richter, Holly E.; Hunskaar, Steinar

    2010-01-01

    Purpose We reviewed the epidemiological literature on the association of obesity and urinary incontinence, and summarized clinical trial data on the effect of weight loss on urinary incontinence. Materials and Methods We systematically searched for published community based prevalence studies with bivariate or multivariate analysis of the association of urinary incontinence and overweight/obesity in women. Case series and randomized controlled trials of the effect of surgical, behavioral and pharmacological weight loss on urinary incontinence are summarized. Results Epidemiological studies showed that obesity is a strong independent risk factor for prevalent and incident urinary incontinence. There was a clear dose-response effect of weight on urinary incontinence with each 5-unit increase in body mass index associated with about a 20% to 70% increase in the urinary incontinence risk, and the maximum effect of weight rarely exceeded an OR of greater than 4 to 5 on well controlled analyses. The odds of incident urinary incontinence during 5 to 10 years increased by approximately 30% to 60% for each 5-unit increase in body mass index. There may be a stronger association of increasing weight with prevalent and incident stress incontinence, including mixed incontinence, than with urge incontinence and overactive bladder syndrome. Weight loss studies indicated that surgical and nonsurgical weight loss led to significant improvements in urinary incontinence symptoms. Conclusions Epidemiological studies document overweight and obesity as important risk factors for urinary incontinence. Weight loss by surgical and more conservative approaches is effective to decrease urinary incontinence symptoms and should be strongly considered a first line treatment in this patient population. PMID:19846133

  15. Urinary Incontinence in the CKiD Cohort and Health Related Quality of Life

    PubMed Central

    Dodson, Jennifer L.; Cohn, Silvia E.; Cox, Christopher; Hmiel, Paul S.; Wood, Ellen; Mattoo, Tej K.; Warady, Bradley A.; Furth, Susan L.

    2010-01-01

    Purpose Many children with chronic kidney disease have urinary incontinence due to urological disorders and/or a urine concentrating defect. We determined the prevalence and impact of incontinence on health related quality of life in children with chronic kidney disease. Materials and Methods The Chronic Kidney Disease in Children study is a prospective, observational cohort of children recruited from 47 sites in the United States and Canada. Eligibility requirements are age 1 to 16 years and an estimated glomerular filtration rate of 30 to 90 ml per minute per 1.73 m2. Demographics, continence status, glomerular filtration rate and physical examination were assessed at study entry. Health related quality of life was measured using the parent and child versions of PedsQL™. PedsQL scores in participants 5 years old or older were compared among children who were toilet trained and not bed-wetting, bed-wetting or not toilet trained using multivariate linear regression. Results Overall median age of the 329 participants was 12.5 years,