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1

Percutaneous fetal cystoscopy and endoscopic fulguration of posterior urethral valves  

Microsoft Academic Search

Percutaneous fetal cystoscopy was performed in a male fetus with ultrasonographic evidence of lower urinary tract obstruction at 19 weeks of gestation. The diagnosis of posterior urethral valves was confirmed. Percutaneous endoscopic fulguration of the valves was successfully performed at 22 weeks of gestation, and urethral patency was established. This case illustrates the feasibility of performing diagnostic and therapeutic endoscopic

Rubén A. Quintero; Roderick Hume; Craig Msith; Mark P. Johnson; David B. Cotton; Roberto Romero; Mark I. Evans

1995-01-01

2

Posterior Urethral Valves; A single Center Experience  

PubMed Central

Objective Posterior urethral valves (PUV) are the most common cause of bladder outlet obstruction in infancy that impair renal and bladder function. This study was planned to evaluate and record the various clinical presentations and management, complications, and surgical management and long-term outcome of PUV. Methods In a retrospective study, 98 patients who have been treated for PUV are evaluated in Mofid Children's Hospital from January 2007 to December 2012. Detailed history taken and paraclinical examinations were performed in each patient and diagnosis was confirmed by voiding-cysto-urethrography (VCUG). PUV had been ablated in 62 patients by electric hook, and diversion was performed in 42 (42.85%) cases. Data were analyzed by SPSS software version18. Findings Totally 98 patients with mean age at diagnosis 62 (±13) days were included in this study. Fifty seven cases had been catheterized within one to 6 days of life (mean age one day), PUV was ablated in 62 patients by electric hook, and diversion was performed in 42 cases. The most common symptom in our group was dribbling poor stream 51% and urinary tract infection (UTI) 40.8%. There was vesico-ureteral-reflux (VUR) in 61.2%, and hydronephrosis in 82.6%. Most common associated anomaly was kidney anomalies (multicystic kidney disease and renal agenesis/dysplasia) in 8 (8.2%) patients. Twenty patients had prenatal diagnosis of PUV. Complication occurred in three (3.1%) patients. Mortality occurred in 5 (5.1%) patients. Mean follow-up period was 3.4±1.2 years (1.5 months to 5 years). Conclusion Urinary drainage by feeding tube in early days of infancy, followed by valve ablation is the best treatment in PUV, and urinary diversion improves the outcome. VCUG is still the gold-standard imaging modality for documenting PUVs. The factors like renal dysplasia and UTI have their role in final outcome. PMID:24800012

Mirshemirani, Alireza; Khaleghnejad, Ahmad; Rouzrokh, Mohsen; Sadeghi, Afsaneh; Mohajerzadeh, Leila; Sharifian, Mustafa

2013-01-01

3

Transpubic Urethroplasty for Complex Posterior Urethral Strictures: A Single Center Experience  

Microsoft Academic Search

Aim: To review our experience and outcome of transpubic urethroplasty for complex posterior urethral strictures. Patients and Methods: 19 patients, mean age 17.8 (6–35) years, were treated with transpubic urethroplasty over the last 6 years. All had traumatic etiology (15 due to road traffic accidents and 4 due to falls from height). Mean stricture length was 4.4 (3.0–6.0) cm. All

N. P. Gupta; S. Mishra; P. N. Dogra; R. Yadav; A. Seth; R. Kumar

2009-01-01

4

Bilateral epididymitis in a child with undiagnosed posterior urethral valves.  

PubMed

Posterior urethral valves are most commonly detected in the early neonatal period, the diagnosis often antenatally suspected from ultrasound findings. Nevertheless, some cases might go undetected and become manifest later in life with lower urinary tract symptoms. We describe the unusual case of a 5-year-old boy with a 2-month history of bladder distension, urinary dribbling, and epididymitis. Cystourethrography revealed posterior urethral valves with reflux into the seminal vesicles, vas deferens, and epididymis, bilaterally. A review of the published data is provided in the context of this unusual presentation pattern. PMID:23477755

Kwong, Justin; Lorenzo, Armando J; DeMaria, Jorge; Braga, Luis H P

2013-07-01

5

Posterior Urethral Valves: Renal Failure and Prenatal Treatment  

PubMed Central

Posterior urethral valves occur in 1?:?5000 live births. Despite the high prevalence, the few children that survive do poorly, with over 50% progressing to ESRD in 10 years. The gold standard for post-natal diagnosis is voiding cystourethrography, while pre-natal diagnosis is dependent on routine screening ultrasonography. Despite the ability to identify features of bladder outlet obstruction early in fetal development, there is no consensus on how to incorporate early detection into current screening protocols. There has yet to be a marker that allows prediction of obstruction in the absence of or prior to radiographic evidence of obstruction. With our current screening strategy, the majority of interventions are performed well after irreversible damage has occurred. Improved mortality and long term morbidity from posterior urethral valves and congenital bladder outlet obstruction will likely remain unchanged until it is possible to intervene prior to the onset of irreversible renal damage. New biologic markers and improved instrumentation will allow for more effective diagnosis and intervention at earlier stages of fetal development. PMID:21860792

Casella, Daniel P.; Tomaszewski, Jeffrey J.; Ost, Michael C.

2012-01-01

6

SIU/ICUD Consultation on Urethral Strictures: Posterior urethral stenosis after treatment of prostate cancer.  

PubMed

Posterior urethral stenosis can result from radical prostatectomy in approximately 5%-10% of patients (range 1.4%-29%). Similarly, 4%-9% of men after brachytherapy and 1%-13% after external beam radiotherapy will develop stenosis. The rate will be greater after combination therapy and can exceed 40% after salvage radical prostatectomy. Although postradical prostatectomy stenoses mostly develop within 2 years, postradiotherapy stenoses take longer to appear. Many result in storage and voiding symptoms and can be associated with incontinence. The evaluation consists of a workup similar to that for lower urinary tract symptoms, with additional testing to rule out recurrent or persistent prostate cancer. Treatment is usually initiated with an endoscopic approach commonly involving dilation, visual urethrotomy with or without laser treatment, and, possibly, UroLume stent placement. Open surgical urethroplasty has been reported, as well as urinary diversion for recalcitrant stenosis. A proposed algorithm illustrating a graded approach has been provided. PMID:24361008

Herschorn, Sender; Elliott, Sean; Coburn, Michael; Wessells, Hunter; Zinman, Leonard

2014-03-01

7

Etiopathogenesis and management of bladder dysfunction in patients with posterior urethral valves  

PubMed Central

Posterior urethral valves are the commonest cause of urethral obstruction in a male child. It has significant effects on the development of upper urinary tracts and in the evolution of urinary bladder function. The effect on the kidneys and the urinary bladder persists even after the successful management of the obstructing valves. A detailed evaluation of the associated bladder dysfunction will help in planning management protocols that will improve the long-term outcome of these patients. PMID:21369376

Thomas, Joseph

2010-01-01

8

Urethritis  

MedlinePLUS

... or foams Risks for urethritis include: Being a female in the reproductive years Being male, ages 20 to 35 Having many sexual partners High-risk sexual behavior (such as anal sex without a condom) History of sexually transmitted diseases

9

Prenatal resolution of megacystis possibly caused by spontaneous rupture of posterior urethral valves.  

PubMed

We report herein a case of resolution of severe megacystis, possibly caused by spontaneous rupture of posterior urethral valves during follow-up on a prenatal ultrasound. A 32-year-old woman presented at gestational week 15 for evaluation of fetal bladder enlargement. Prenatal ultrasonography revealed megacystis and posterior urethral dilatation. The longitudinal diameter of the bladder was 25 mm. Megacystis spontaneously resolved at gestational week 16. No association with urinary ascites was observed, and amniotic fluid volume remained normal throughout gestation. A boy was delivered vaginally at week 37. Apgar scores were 8 at 1 minute and 9 at 5 minutes. The neonate voided smoothly. Ultrasonography revealed a thickened bladder wall and normal kidneys and upper urinary tracts. Voiding cystourethrography showed dilatation of the posterior urethra but confirmed normal bladder capacity with smooth voiding and no vesicoureteral reflux. On day 57, remnant valves were incised. Postoperatively, filling cystometry showed a compliant bladder with no involuntary phasic contraction. At 7 months follow-up, the infant was asymptomatic, and ultrasonography showed some improvement of bladder wall thickness. Resolution of megacystis in utero appears to have resulted from spontaneous rupture of the posterior urethral valves. To the best of our knowledge, no similar cases have been previously reported. PMID:19040955

Matsui, Futoshi; Shimada, Kenji; Matsumoto, Fumi; Obara, Takashi

2008-12-01

10

[Significance of early diagnosis of posterior urethral valves in fetus for further development - own experience].  

PubMed

The incidence of posterior urethral valves is estimated to be from 3:1000 to 8:1000 and this is one of the most common causes of obstruction of urinary tract in boys. About 13-17% of children with posterior urethral valves develop end stage renal failure. We present a  6-month-old boy with late diagnosis of posterior urtehral valves. Antenatal ultrasound investigation of the urinary tract was normal. A small degree of oligohydramnios was found during delivery. At the age of six months the boy was admitted to hospital because of urinary tract infection, hypertension (130/90 mmHg) and acute kidney injury (urea - 46 mg/dL, creatinine - 1.1 mg/dL, GFR - 35.5 mL/min/1.73 m2 ). Bilateral hydronephrosis and megaureters, low-capacity bladder with hypertrophied wall were seen on ultrasound examination. Voiding cystourethrograhy revealed vesicoureteral refluxes (III/V), hypertrophy of the bladder wall with numerous diverticula and dilated posterior urethra. During urethroscopy urethral valves were resected. Increased intravesical pressure (leak point up to 305 cm H2 O) was found on urodynamic test. Renal scintigraphy (99mTc-EC) revealed decreased intake of isotope in the left kidney (5%), and the right kidney intake was 95% ERPF. The patient was qualified for left-sided nephrectomy, which was postponed because of high leak point and high risk of worsening of vesicoureteral reflux to right kidney after nephrectomy. Anticholinergic and ?-blocker treatment was started. At the age of 11 months left-side nephrectomy was performed because of recurrent urinary tract infections. After 3.5-year follow-up blood pressure, physical development, kidney function tests, and urinalysis are normal. Additionally to this investigation the significance of early diagnosis including prenatal (PUV) for further development as well as further therapeutic procedure is discussed. PMID:24519771

Krzemie?, Gra?yna; Szmigielska, Agnieszka; Wawer, Zofia; Roszkowska-Blaim, Maria

2013-01-01

11

Delayed repair is the ideal management for posterior urethral injuries- FOR the motion  

PubMed Central

Posterior urethral injuries are seen in trauma cases with pelvic fracture. The time-tested and honored method of management is immediate supra-pubic diversion followed by delayed repair. Immediate alignment as a management option is not new. It was abandoned 30 years ago due to high incidence of incontinence and impotence. However, of late there is a tendency towards immediate management of these injuries with various endoscopic maneuvers. Unfortunately, there is little evidence supporting this. Even these evidences are of limited in number and of limited duration of follow-up. PMID:20877619

Philipraj, S. Joseph

2010-01-01

12

Clinical Factors That Predict Successful Posterior Urethral Anastomosis With a Gracilis Muscle Flap  

PubMed Central

Purpose We evaluated the preoperative clinical factors that affect the surgical outcome of posterior urethral anastomosis (PUA) with a gracilis muscle flap (GMF) to determine which factors predict benefit from the use of the GMF. Materials and Methods This was a retrospective analysis of 49 patients who underwent a delayed PUA with a GMF. A successful clinical outcome was defined as achieving a peak urinary flow rate greater than 15 mL/s at 3 and 12 months postoperatively without evidence of stricture recurrence on a retrograde urethrogram or cystourethroscopy at 3 months postoperatively. Multiple clinical factors were evaluated by use of univariate and multivariate analyses. Results The outcome of 21 of 49 patients (42.9%) was deemed successful. The mean age of the 49 patients was 37.2±13.5 years and the mean follow-up duration was 43.4±28.0 months. The length of the urethral defect was significantly shorter in patients with a successful outcome than in patients with an unsuccessful outcome (p=0.010). The outcome differed significantly depending on whether the patients had a previously successful urethroplasty (p=0.036) or whether they had suffered a pelvic bone injury (p=0.012). Multivariate logistic regression analyses revealed that a previous urethroplasty was the only preoperative clinical factor that significantly affected the surgical outcome in PUA with a GMF (odds ratio, 0.218; 95% confidence interval, 0.050 to 0.947; p=0.042). Conclusions A history of previous urethroplasty is a preoperative clinical factor that significantly affects the surgical outcome in PUA with a GMF; the procedure is more likely to be successful in patients who have not previously undergone urethroplasty. PMID:24175047

Hwang, Jin Ho; Kang, Moon Hyung; Lee, Young Tae; Park, Dong Soo

2013-01-01

13

Traumatic bilateral posterior hip dislocation in 10 year old male child  

PubMed Central

Traumatic bilateral posterior hip dislocation in skeletally immature patient is reported very less in literature. We report a 10 yr old boy presented to us following farmyard injury with bilateral posterior hip dislocation, which was reduced manually under sedation with uneventful follow-up and complete hip range of motion at 2 year.

Garg, Vipul; Singh, Ajay Pal; Singh, Arun Pal; Bajaj, P.S.

2014-01-01

14

Aneurysm of the posterior inferior cerebellar artery caused by a traumatic perforating artery tear-out mechanism in a child  

Microsoft Academic Search

Traumatic posterior circulation aneurysms in the absence of fractures and penetrating wounds are extremely uncommon, especially\\u000a in children. To our knowledge this is the first traumatic posterior inferior cerebellar artery(PICA) aneurysm reported that\\u000a cannot be related to a skull fracture or a trauma caused by the edge of a rigid meningeal structure. In the present case,\\u000a the initial subarachnoid hemorrhage

U. Sure; Ralf Becker; Michael Petermeyer; Helmut Bertalanffy

1999-01-01

15

Judo-related traumatic posterior sternoclavicular joint dislocation in a child.  

PubMed

Judo is a combat sport with high risk of injury. We present a rare case of traumatic left posterior sternoclavicular (SC) joint dislocation, inflicted to a 12-year-old boy during a judo contest. An extensive literature review did not reveal any case of posterior SC joint dislocation in judo. The patient was treated with closed reduction under general anesthesia. At 2-year follow-up, his left upper extremity had full range of motion, and he did not complain of any residual symptoms. He decided to discontinue judo training; however, he participates in other physically demanding sports. Although not often encountered, posterior SC joint dislocation is a challenging and critical medical problem that can be fatal if not promptly diagnosed and treated on time and should be considered in the differential diagnosis of trauma-related anterior chest pain. PMID:24172655

Galanis, Nikiforos; Anastasiadis, Prodromos; Grigoropoulou, Foteini; Kirkos, John; Kapetanos, George

2014-05-01

16

Allograft reconstruction of the anterior and posterior cruciate ligaments after traumatic knee dislocation.  

PubMed

Seven patients (average age, 26.3 years) with traumatic knee dislocations were retrospectively evaluated more than 2 years (average, 51 months) after having fresh-frozen allograft anterior and posterior cruciate ligament reconstructions. All patients were treated consecutively at an average of 9.6 days after injury. Two patients had arterial injuries and three patients had or developed common peroneal nerve palsy. Five patients had 20 additional injuries. All patients were enlisted in an early, aggressive physical therapy regimen with early protected weightbearing. Four patients required a manipulation under anesthesia for arthrofibrosis at an average of 16.8 weeks postoperatively (range, 6 to 33 weeks). At followup, only one patient had significant pain, three patients had rare or occasional giving way, and all seven were able to return to school or to the workplace. The functional grading was excellent in three patients, good in three patients, and fair in one patient. No patient had a significant flexion contracture; the average flexion arc was 118 degrees (range, 105 degrees to 135 degrees). Knee dislocation is a very traumatic injury, often resulting in a painful, dysfunctional knee. Anterior and posterior cruciate ligament reconstructions in young, active patients can minimize pain and optimize functional outcome. Arthrofibrosis is a common occurrence in these patients, and manipulation under anesthesia is frequently required. PMID:8526274

Shapiro, M S; Freedman, E L

1995-01-01

17

Fatal traumatic aneurysm of the posterior inferior cerebellar artery with delayed rupture.  

PubMed

Traumatic aneurysms of intracranial arteries are rare, forming less than 1% of all intracranial arteries. They may be associated with penetrating and non-penetrating trauma. Most cases are associated with fracturing of the skull. Rupture of traumatic aneurysms occur in up to 50% of cases and are typically delayed from days to weeks following the initiating trauma. We report a case of a 22-year-old man who was punched to the head. He was rendered unconscious but recovered and had a GCS of 14 on admission. CT scans showed subarachnoid hemorrhage. An initial angiogram was negative but on day 7 following the incident he was noted to have a 1mm aneurysm of the posterior inferior cerebellar artery on CT angiogram. On day 9 he collapsed and was found to have new subarachnoid hemorrhage and to have a 4.0mm×3.7mm. He did not recover and was declared brain dead on day 12. At autopsy, there was a 4.0mm aneurysm of the left PICA just after the origin of the artery. Histological examination confirmed the presence of a traumatic false aneurysm in the left PICA. This case study shows sequential radiological imaging with pathologiocal correlation. PMID:25549847

Purgina, Bibianna; Milroy, Christopher Mark

2015-02-01

18

Posterior circulation infarction in patients with traumatic cervical spinal cord injury and its relationship to vertebral artery injury.  

PubMed

Study design:Prospective study.Objective:To ascertain the prevalence of posterior circulation stroke in traumatic chronic spinal cord injured (SCI) patients and associated traumatic vertebral artery injuries (VAI).Methods:All adult patients with cervical SCI and American Spinal Injury Association Impairment Scale (AIS) grade A or B referred for follow-up magnetic resonance imaging of their spinal cord were invited to take part in the study between January 2010 and December 2012 at the National Spinal Injury Centre. Two additional sequences were added to the existing imaging protocol to evaluate the brain and vertebral arteries.Results:Ninety-eight patients were recruited. All imaging were analysed independently by three consultant radiologists. Posterior circulation infarcts were noted in seven (7%) patients. Significant VAI was noted in 13 patients (13%) with 10 occlusions and 3 with high-grade stenosis. However, only one patient had co-existent posterior circulation infarct and significant VAI.Conclusion:There is an increased prevalence of posterior circulation infarction in SCI patients. The relationship with associated traumatic VAI requires further investigation.Spinal Cord advance online publication, 2 September 2014; doi:10.1038/sc.2014.145. PMID:25179661

de Heredia, L L; Belci, M; Briley, D; Hughes, R J; McNeillis, B; Meagher, T M; Yanny, S; McKean, D

2014-09-01

19

Maximizing the visual outcome in traumatic cataract cases: The value of a primary posterior capsulotomy and anterior vitrectomy.  

PubMed

Objective: The objective was to provide evidence-based care for patients with traumatic cataracts, we assessed whether a posterior capsulotomy and anterior vitrectomy, as part of the primary surgical procedure, could be a positive predictor of final visual outcome. Materials and Methods: This is a prospective randomized control trial. Patients presenting at our hospital between January 2010 and December 2012 having ocular trauma and traumatic cataracts were enrolled, according to the inclusion criteria. We enrolled two groups: Those with and without primary posterior capsulotomy and vitrectomy. Information regarding demographic and ocular trauma were collected using the World Eye Trauma Registry form at the first visit and follow-up, and specific information was collected for both the group who underwent posterior capsulectomies and vitrectomies as a part of the primary procedure, and the control group. Data were analyzed to evaluate the predictive value of primary posterior capsulectomy and anterior vitrectomy. Results: We enrolled 120 cases, 60 in each group, comprising 31 females and 89 males. When all other variables were controlled for, the visual outcome (best corrected visual acuity) differed significantly (P < 0.001) between the groups. Conclusion: Performance of posterior capsulectomy and anterior vitrectomy as part of the primary procedure improves the final visual outcome. PMID:25494250

Shah, Mehul A; Shah, Shreya M; Patel, Krunal D; Shah, Ashit H; Pandya, Jaimini S

2014-11-01

20

Maximizing the visual outcome in traumatic cataract cases: The value of a primary posterior capsulotomy and anterior vitrectomy  

PubMed Central

Objective: The objective was to provide evidence-based care for patients with traumatic cataracts, we assessed whether a posterior capsulotomy and anterior vitrectomy, as part of the primary surgical procedure, could be a positive predictor of final visual outcome. Materials and Methods: This is a prospective randomized control trial. Patients presenting at our hospital between January 2010 and December 2012 having ocular trauma and traumatic cataracts were enrolled, according to the inclusion criteria. We enrolled two groups: Those with and without primary posterior capsulotomy and vitrectomy. Information regarding demographic and ocular trauma were collected using the World Eye Trauma Registry form at the first visit and follow-up, and specific information was collected for both the group who underwent posterior capsulectomies and vitrectomies as a part of the primary procedure, and the control group. Data were analyzed to evaluate the predictive value of primary posterior capsulectomy and anterior vitrectomy. Results: We enrolled 120 cases, 60 in each group, comprising 31 females and 89 males. When all other variables were controlled for, the visual outcome (best corrected visual acuity) differed significantly (P < 0.001) between the groups. Conclusion: Performance of posterior capsulectomy and anterior vitrectomy as part of the primary procedure improves the final visual outcome. PMID:25494250

Shah, Mehul A; Shah, Shreya M; Patel, Krunal D; Shah, Ashit H; Pandya, Jaimini S

2014-01-01

21

Candida albicans Fungaemia following Traumatic Urethral Catheterisation in a Paraplegic Patient with Diabetes Mellitus and Candiduria Treated by Caspofungin  

PubMed Central

A 58-year-old paraplegic male, with long-term indwelling urethral catheter, developed catheter block. The catheter was changed, but blood-stained urine was drained intermittently. A long segment of the catheter was seen lying outside his penis, which indicated that the balloon of Foley catheter had been inflated in urethra. The misplaced catheter was removed and a new catheter was inserted correctly. Gentamicin 160?mg was given intravenously; meropenem 1 gram every eight hours was prescribed; antifungals were not given. Twenty hours later, this patient developed distension of abdomen, tachycardia, and hypotension; he was not arousable. Computed tomography of abdomen revealed inflamed uroepithelium of right renal pelvis and ureter, 4?mm lower ureteric calculus with gas in right ureter proximally, and vesical calculus containing gas in its matrix. Urine and blood culture yielded Candida albicans. Identical sensitivity pattern of both isolates suggested that the source of the bloodstream infection was most likely urine. Both isolates formed consistently high levels of biofilm formation in vitro as assessed using a biofilm biomass stain, and high levels of resistance to voriconazole were observed. Both amphotericin B and caspofungin showed good activity against the biofilms. HbA1c was 111?mmol/mol. This patient was prescribed human soluble insulin and caspofungin 70?mg followed by 50?mg daily intravenously. He recovered fully from candidemia. PMID:24223316

Vaidyanathan, Subramanian; Soni, Bakul; Hughes, Peter; Singh, Gurpreet

2013-01-01

22

Congenital urethral polyps in the pediatric population.  

PubMed

Congenital urethral polyps are a rare entity. Most commonly, they present as benign posterior urethral growths in the pediatric male patient. However, reports of urethral polyps in female patients or even those with an anterior urethral location can also be found in the literature. Patients can present with a spectrum of symptoms including dysuria, hematuria, and obstructive type urinary complaints. Diagnosis in these cases includes a combination of medical imaging (e.g. ultrasound, fluoroscopic, CT or MRI), direct endoscopic visualization, and final surgical pathology. Treatment involves surgical removal either via an endoscopic or open approach. PMID:24128844

Liu, Xiaolong S; Kreiger, Portia A; Gould, Sharon W; Hagerty, Jennifer A

2013-10-01

23

A Case of Post-radiotherapy Urethral Stricture with Spontaneous Bladder Rupture, Mimicking Obstructive Uropathy due to Cancer Metastasis.  

PubMed

Non-traumatic, spontaneous urinary bladder rupture is a rare complication of urethral stricture. Furthermore, its symptoms are often nonspecific, and misdiagnosis is common. The authors experienced a case of urethral stricture with spontaneous bladder rupture and bilateral hydronephrosis, mimicking obstructive uropathy attributed to cancer metastasis. A 55-year-old woman was admitted with abdominal pain and distension, oliguria, and an elevated serum creatinine level. She had undergone radical hysterectomy for uterine cervical cancer and received post-operative concurrent chemoradiation therapy 13 years previously. Non-contrast enhanced computed tomography showed massive ascites and bilateral hydronephrosis. The initial diagnosis was acute kidney injury due to obstructive uropathy caused by malignant disease. After improvement of her renal function by bilateral percutaneous nephrostomy catheterization, contrast-enhanced computed tomography and a cytologic examination of ascites showed no evidence of malignancy. However, during retrograde pyelography, a severe urethral stricture was found, and subsequent cystography showed leakage of contrast into the peritoneal cavity and cystoscopy revealed a defect of the posterior bladder wall. After urethral dilatation and primary closure of the bladder wall, acute kidney injury and ascites were resolved. PMID:25061470

Shin, Jun Young; Yoon, Sang Min; Choi, Hyuck Jae; Lee, Si Nae; Kim, Hai Bong; Joo, Woo Chul; Song, Joon Ho; Kim, Moon-Jae; Lee, Seoung Woo

2014-06-01

24

A Case of Post-radiotherapy Urethral Stricture with Spontaneous Bladder Rupture, Mimicking Obstructive Uropathy due to Cancer Metastasis  

PubMed Central

Non-traumatic, spontaneous urinary bladder rupture is a rare complication of urethral stricture. Furthermore, its symptoms are often nonspecific, and misdiagnosis is common. The authors experienced a case of urethral stricture with spontaneous bladder rupture and bilateral hydronephrosis, mimicking obstructive uropathy attributed to cancer metastasis. A 55-year-old woman was admitted with abdominal pain and distension, oliguria, and an elevated serum creatinine level. She had undergone radical hysterectomy for uterine cervical cancer and received post-operative concurrent chemoradiation therapy 13 years previously. Non-contrast enhanced computed tomography showed massive ascites and bilateral hydronephrosis. The initial diagnosis was acute kidney injury due to obstructive uropathy caused by malignant disease. After improvement of her renal function by bilateral percutaneous nephrostomy catheterization, contrast-enhanced computed tomography and a cytologic examination of ascites showed no evidence of malignancy. However, during retrograde pyelography, a severe urethral stricture was found, and subsequent cystography showed leakage of contrast into the peritoneal cavity and cystoscopy revealed a defect of the posterior bladder wall. After urethral dilatation and primary closure of the bladder wall, acute kidney injury and ascites were resolved. PMID:25061470

Shin, Jun Young; Yoon, Sang Min; Choi, Hyuck Jae; Lee, Si Nae; Kim, Hai Bong; Joo, Woo Chul; Song, Joon Ho; Kim, Moon-Jae

2014-01-01

25

Nonspecific Urethritis in Females  

PubMed Central

The possibility of nonspecific urethritis must be considered in females with persistent irritative symptoms of the lower urinary tract despite “negative” urine cultures. The diagnosis can be made only by the proper collections of urine specimens from both the urethra and the bladder. These specimens will reveal the presence of white blood cells in the urethral washings, while the midstream (bladder) specimen will be free of cells. PMID:5429140

Marshall, Sumner; Lyon, Richards P.; Schieble, Jack

1970-01-01

26

Nonspecific urethritis in females.  

PubMed

The possibility of nonspecific urethritis must be considered in females with persistent irritative symptoms of the lower urinary tract despite "negative" urine cultures. The diagnosis can be made only by the proper collections of urine specimens from both the urethra and the bladder. These specimens will reveal the presence of white blood cells in the urethral washings, while the midstream (bladder) specimen will be free of cells. PMID:5429140

Marshall, S; Lyon, R P; Schieble, J

1970-06-01

27

Micturitional urethral pressure profilometry.  

PubMed

The technique of micturitional urethral pressure profilometry using a trilumen catheter provides a method of assessing the dynamic behavior of the lower urinary tract during voiding. This method of evaluation is simple to perform, highly reproducible, accurate, and clinically useful not only in diagnosing the presence of outlet obstruction, but also in identifying its location and assessing its severity. The rationale for the use of this technique, the interpretation of the results, and various pressure profile configurations are discussed. PMID:8659026

Sullivan, M P; Comiter, C V; Yalla, S V

1996-05-01

28

Current Management of Urethral Stricture  

PubMed Central

The surgical treatment of urethral stricture diseases is continually evolving. Although various surgical techniques are available for the treatment of anterior urethral stricture, no one technique has been identified as the method of choice. This article provides a brief updated review of the surgical options for the management of different sites and different types of anterior urethral stricture. This review also covers present controversies in urethral reconstruction. Among the various procedures available for treating urethral stricture, one-stage buccal mucosal graft urethroplasty is currently widely used. The choice of technique for urethroplasty for an individual case largely depends on the expertise of the surgeon. Therefore, urologists working in this field should keep themselves updated on the numerous surgical techniques to deal with any condition of the urethra that might surface at the time of surgery. PMID:24044088

Lee, Young Ju

2013-01-01

29

Gram stain of urethral discharge  

MedlinePLUS

Urethral discharge Gram stain ... microscope slide. A series of stains called a gram stain is applied to the specimen. The stained ... culture ) should be performed in addition to the gram stain. More sophisticated diagnostic tests (such as PCR ...

30

Anterior Urethral Valves: Not Such a Benign Condition…  

PubMed Central

Purpose: Anterior urethral valves (AUVs) is an unusual cause of congenital obstruction of the male urethra, being 15–30 times less common than posterior urethral valves (PUVs). It has been suggested that patients with congenital anterior urethral obstruction have a better prognosis than those with PUV, with less hydronephrosis, and a lower incidence of chronic renal insufficiency (5 vs. 30%). The long-term prognosis of AUVs is not clear in the literature. In this report we describe our experience and long-term follow up of patients with anterior urethral valve. Materials and Methods: We retrospectively identified 13 patients who presented with the diagnosis of AUVs in our institutions between January 1994 and June 2012. Two patients were excluded: one patient had no follow up after intervention; the other had a follow up <1?year. From the 11 patients included, we evaluated the gestational age, prenatal and postnatal ultrasound findings, voiding cystourethrogram findings, age upon valve ablation, micturition pattern, creatinine, and clinical follow up. Results: Between 1994 and 2012 we evaluated 150 patients with the diagnosis of urethral valves. Of this group, 11 patients (7.3%) had AUVs and an adequate follow up. Mean follow up is 6.3?years (2.5–12?years). Five (45.4%) patients had prenatal diagnosis of AUV. The most common prenatal ultrasonographic finding was bilateral hydronephrosis and distended bladder. One patient showed a large perineal cystic mass, which was confirmed to be a dilated anterior urethra. The mean gestational age was 37.6?weeks (27–40 WGA). Postnatally, 90% had trabeculated bladder, 80% hydronephrosis, and 40% renal dysplasia. The most common clinical presentation was urinary tract infection in five patients (45.4%), followed by weak urinary stream found in four patients (36.3%). The age at initial surgical intervention ranged between 7?days and 13?years. Seven (63.6%) patients had primary transurethral valve resection or laser ablation and three patients (27.2%) had primary vesicostomies. One boy (9.1%) had penile urethrostomy with excision of urethral diverticulum. Two (18.2%) patients developed end-stage renal disease. Conclusion: Anterior urethral valve is a rare congenital entity affecting the genitourinary system in males. Early urinary tract obstruction resulted in end-stage renal disease in 18% of our patient population. In our series, the complication rate and the evolution to renal failure are high and similar to patients with PUV. In patients with AUVs we recommend long-term follow up and close evaluation of patient’s bladder and renal function. PMID:24400281

Cruz-Diaz, Omar; Salomon, Anahi; Rosenberg, Eran; Moldes, Juan Manuel; de Badiola, Francisco; Labbie, Andrew Scott; Gosalbez, Rafael; Castellan, Miguel Alfredo

2013-01-01

31

Buccal mucosa urethroplasty for adult urethral strictures  

PubMed Central

Urethral strictures are difficult to manage. Some treatment modalities for urethral strictures are fraught with high patient morbidity and stricture recurrence rates; however, an extremely useful tool in the armamentarium of the Reconstructive Urologist is buccal mucosal urethroplasty. We like buccal mucosa grafts because of its excellent short and long-term results, low post-operative complication rate, and relative ease of use. We utilize it for most our bulbar urethral stricture repairs and some pendulous urethral stricture repairs, usually in conjunction with a first-stage Johanson repair. In this report, we discuss multiple surgical techniques for repair of urethral stricture disease. Diagnosis, evaluation of candidacy, surgical techniques, post-operative care, and complications are included. The goal is to raise awareness of buccal mucosa grafting for the management urethral stricture disease. PMID:22022061

Zimmerman, W. Britt; Santucci, Richard A.

2011-01-01

32

Female Urethral Condyloma Causing Bladder Outlet Obstruction  

PubMed Central

In women, urethral condyloma rarely leads to a bladder outlet obstruction. A 39-year-old woman who presented with frequency, urgency, and residual urine sensation was found to have a condyloma in her urethral meatus. Urodynamic study indicated bladder outlet obstruction. After condyloma excision, she returned to normal voiding, and the free maximum flow rate improved. In women, excision of urethral condylomas that cause obstruction can be an effective treatment with early recovery of voiding function. PMID:24729927

Chae, Ji Yun; Bae, Jae Hyun; Yoon, Cheol Yong; Park, Hong Seok; Moon, Du Geon; Lee, Jeong Gu

2014-01-01

33

Graft surgery in extensive urethral stricture disease.  

PubMed

Surgical treatment of long urethral stricture disease remains one of the most challenging problems in urology. In recent years there has been continuous discussion with regard to the etiology, location, length, and management of extensive urethral stricture disease. Various tissues such as genital and extragenital skin, buccal mucosa, lingual mucosa, small intestinal submucosa, and bladder mucosa have been proposed for urethral reconstruction. The most frequent questions pertain to the optimal technique for urethroplasty and the optimal graft for substitution urethroplasty, as judged by both patient satisfaction and outcome success. We review the recent literature with respect to any new information on graft urethroplasty for extensive urethral stricture. PMID:24935160

Djordjevic, Miroslav L

2014-08-01

34

Male Urethral Diverticulum Having Multiple Stones  

PubMed Central

Congenital diverticulum of male urethra is an uncommon entity. Neglected management complicates the process in the form of calculi formation and recurrent urinary infection. A 10-year-old boy presented with urinary voiding disturbances and development of a painless hard lump at the penoscrotal junction. Imaging demonstrated presence of anterior urethral diverticulum with contained calculi in it. Open urethral diverticulectomy, extraction of multiple calculi, and primary urethral reconstruction over a Foley catheter was carried out. Early diagnosis and individualized surgical management of congenital male urethral diverticulum is the key to a successful outcome. PMID:25031909

Mohanty, D; Garg, PK; Jain, BK; Bhatt, S

2014-01-01

35

[Urethral stenosis in children. Apropos of 33 pediatric cases].  

PubMed

Urethral stenosis in children is rare. Between 1961 and 1993, only five specific retrospective studies were published. Between January 1987 and December 1992, thirty-three children, i.e. thirty boys and three girls, were observed in our institution for urethral stenosis. Their ages ranged from two and half months to seventeen years. Etiology was congenital in six, traumatic in two, inflammatory in two and iatrogenic in thirteen patients. In additions, ten stenoses were consecutive with hypospadias repair. Seventeen patients underwent first-line endoscopic internal urethrotomy. Success rate was ninety-one percent. Two patients underwent a successful second similar procedure. Repeating this procedure more than twice and second-line urethrotomy doesn't improve success rate. It appeared that internal urethrotomy proved to be more effective in short and recent stenosis. Fourteen patients underwent urethroplasty by using various techniques, of whom only five first-line urethroplasty. Its indication in case of multioperated or complicated stenoses may explain the poor global success rate of about fifty percent. PMID:7976856

Tombal, B; Abi Aad, A; Opsomer, R; van Cangh, P; Clapuyt, P; Lorge, F; Veyckemans, F; Wese, F X

1994-09-01

36

The urethral smear as a tool in diagnosing adenovirus-induced urethritis.  

PubMed

Adenovirus is a recognised cause of non-gonococcal urethritis, and is not uncommonly associated with extragenital signs and symptoms. This case report describes a patient with symptoms of conjunctivitis, meatitis and urethritis. The urethral smear revealed almost exclusively monocytes microscopically, raising the suspicion of a viral aetiology. Results confirmed the presence of adenovirus in both the eyes and urethra. Despite waning reliance on the urethral smear in sexual health clinics, it can still be an important diagnostic tool in assessing the aetiology of non-specific urethritis. Finding an obvious monocytic cell response in the urethral smear can indicate a viral cause and allow the clinician to optimise management, counsel appropriately, and potentially reduce unnecessary antibiotic use. PMID:24737883

Tønsberg, E; Hartgill, U

2014-12-01

37

Multiple Urethral Stones Causing Penile Gangrene  

PubMed Central

Penile urethral stones are a rare occurrence resulting from a number of causes including migration of stones within the urinary tract, urethral strictures, meatal stenosis, and obstructing tumours such as adenomatous metaplasia of the uroepithelium, hypospadias, urethral diverticulum, and very rarely primary fossa navicularis calculi. We report the case of a 54-year-old male presenting with penile gangrene and sepsis resulting from impaction of multiple stones within the penile urethra. This paper summarises the topic and discusses the pathophysiology of this unusual condition. PMID:24963438

Ramdass, Michael J.

2014-01-01

38

Nephrogenic adenoma in a urethral diverticulum.  

PubMed

Nephrogenic adenoma (NA) is a rare finding that represents metaplasia of the urothelium. We present a case of a 46-year-old woman who presented with a symptomatic anterior vaginal wall cyst that was found to be an NA within a urethral diverticulum. Although this remains an infrequently reported entity in the literature, prevalence has been shown to be higher in consecutive case series than what may be presumed by the rarity of case reports in clinical literature. Nephrogenic adenoma within a urethral diverticulum may represent an under-recognized entity which needs to be carefully distinguished from clear cell adenocarcinoma occurring within urethral diverticula. We discuss salient clinical features of NA occurring within a urethral diverticulum and describe a review of literature of published cases to date. PMID:25185615

Gujral, Harneet; Chen, Haiyang; Ferzandi, Tanaz R

2014-01-01

39

Traumatic Grief  

MedlinePLUS

... Learn more about traumatic grief in the NCTSN Learning Center for Child and Adolescent Trauma . The Child Traumatic Grief Speaker Series features experts from the Network. Free CEs are available. Table of Contents

40

Lower Urinary Tract Pain and Anterior Urethral Stricture Disease: Prevalence and Effects of Urethral Reconstruction  

PubMed Central

Purpose Anterior urethral stricture disease most commonly presents as urinary obstruction. Lower urinary tract pain is not commonly reported as a presenting symptom. We prospectively characterized lower urinary tract pain in association with urethral stricture disease and assessed the effects of urethroplasty on this pain. Materials and Methods Men (18 years old or older) with anterior urethral stricture disease were prospectively enrolled in a longitudinal, multi-institutional, urethral reconstruction outcomes study from June 2010 to January 2013 as part of TURNS (Trauma and Urologic Reconstruction Network of Surgeons). Preoperative and postoperative lower urinary tract pain was assessed by the validated CLSS. Voiding and sexual function was assessed using validated patient-reported measures, including I-PSS. Results Preoperatively 118 of 167 men (71%) reported urethral pain and 68 (41%) reported bladder pain. Age was the only predictor of urethral pain with men 40 years or younger reporting more pain than those 60 years old or older (81% vs 58%, p = 0.0104). Lower urinary tract pain was associated with worse quality of life and overall voiding symptoms on CLSS and I-PSS (each p <0.01). Postoperatively lower urinary tract pain completely resolved in 64% of men with urethral pain and in 73.5% with bladder pain. There were no predictive factors for changes in lower urinary tract pain after urethral reconstruction. Conclusions Lower urinary tract pain is common in urethral stricture disease, especially in younger men. It is associated with worse quality of life and voiding function. In most men lower urinary tract pain resolves after urethral reconstruction. PMID:25046621

Bertrand, Laura A.; Warren, Gareth J.; Voelzke, Bryan B.; Elliott, Sean P.; Myers, Jeremy B.; McClung, Christopher D.; Oleson, Jacob J.; Erickson, Bradley A.

2015-01-01

41

[Traumatic anosmia].  

PubMed

Traumatic anosmy can be found after any traumatism of the skull, whatever its impact and intensity. A long loss of consciousness or a heavy post-commotionnal syndrom can increase a traumatic anosmy. The best way to really assess a traumatic loss of smell is to use of olfacto-breathing reflex and possibility for confirmation, the olfactive electroencephalography. The suppression of a traumatic anosmy can happen, but the published statistics on this matter seem a little too optimistic. With regard to stimulators, the rate is far too high than it is usually accepted. PMID:1233865

Rasquin, P

1975-01-01

42

Strain-Dependent Urethral Response  

PubMed Central

Aims The Sprague–Dawley (SD) rat, an out-bred, all-purpose strain, has served well for lower urinary tract research. However, to test new cellular therapies for conditions such as stress urinary incontinence, an in-bred rat strain with immune tolerance, such as the Lewis rat, may be more useful. The objective of this study was to reveal any differences in lower urinary tract continence mechanisms between the Lewis and SD rat. Methods The contribution of (1) the striated and smooth muscle to the mechanical and functional properties of the urethra in vitro, and (2) the striated sphincter to leak point pressure (LPP) and reflex continence mechanisms in vivo were assessed in normal (control) Lewis and SD rats and in a model of stress urinary incontinence produced by bilateral pudendal nerve transection. Results Control, Lewis rats had significantly lower LPP, significantly less fast-twitch skeletal muscle and relied less on the striated sphincter for continence than control, SD rats, as indicated by the failure of neuromuscular blockade with alpha-bungarotoxin to reduce LPP. Nerve transection significantly decreased LPP in the SD rat, but not in the Lewis rat. Although the Lewis urethra contained more smooth muscle than the SD rat, it was less active in vitro as indicated by a low urethral baseline pressure and lack of response to phenylephrine. Conclusions We have observed distinct differences in functional and mechanical properties of the SD and Lewis urethra and have shown that the Lewis rat may not be suitable as a chronic model of SUI via nerve transection. PMID:21826722

Haworth, Donna J.; Kitta, Takeya; Morelli, Brian; Chew, Douglas W.; Yoshimura, Naoki; de Groat, William C.; Vorp, David A.

2015-01-01

43

Spontaneous ventral urethral fistula in a young healty man and a modified surgical technique of urethral fistula repair  

PubMed Central

Urethral fistula is rare and is usually a complication of penile and urethral surgery. A few congenital cases have been reported. Also, one acquired spontaneous case in a diabetic man has been reported. We present the first case in the literature of a healthy man with a spontaneous ventral urethral fistula, with unknown etiology. We performed a modified technique of urethral fistula repair (four-layer technique). PMID:23283105

Akkoc, Ali; Metin, Ahmet

2012-01-01

44

Spontaneous ventral urethral fistula in a young healty man and a modified surgical technique of urethral fistula repair.  

PubMed

Urethral fistula is rare and is usually a complication of penile and urethral surgery. A few congenital cases have been reported. Also, one acquired spontaneous case in a diabetic man has been reported. We present the first case in the literature of a healthy man with a spontaneous ventral urethral fistula, with unknown etiology. We performed a modified technique of urethral fistula repair (four-layer technique). PMID:23283105

Akkoc, Ali; Metin, Ahmet

2012-12-01

45

Urethral duplication: Experience of four cases  

PubMed Central

Aim: Our experience of 4 cases of urethral duplication is reported here. Materials and Methods: A retrospective chart review. Results: The age at presentation varied from newborn to 10 years. The clinical presentation ranged from prepubic sinus to diphallus urethra. There were 2 each incomplete duplication with only external openings (Type IA) and complete duplication of Effmann Type IIA2. All underwent complete excision of accessory urethra and corrections of associated anomalies. Conclusions: Urethral duplications have a varied presentation. At follow up, all are asymptomatic with good cosmetic result. PMID:22869976

Ramareddy, Raghu S.; Alladi, Anand; Siddappa, O. S.

2012-01-01

46

Selective control by posterior spinal nerve roots of micturition and erection in rats?  

PubMed Central

The posterior rootlets in L6 and S1 spinal cord of adult male Sprague-Dawley rats underwent electrostimulation. The bladder pressure, urethral perfusion pressure and intracavernous pressure were recorded. When some posterior rootlets of L6 and S1 were electrostimulated, the intracavernous pressure peaked rapidly, but the bladder pressure and the urethral perfusion pressure curve did not show great change. When other rootlets were stimulated, the bladder pressure changed greatly, but the urethral perfusion pressure and the intracavernous pressure did not show great change. When different rootlets were stimulated, the urethral perfusion pressure changed maximally, but there were no great changes in bladder pressure or intracavernous pressure. Furthermore, stimulation of some rootlets produced simultaneous changes in two or three different pressure measures mentioned above. The results demonstrate that regulation by L6 and S1 posterior rootlets of the rat bladder detrusor, external urethral sphincter and penis cavernous body are significantly distinct. Different rootlets can be distinguished by electrostimulation. PMID:25317123

Wang, Wenting; Zhou, Mouwang; Zhu, Genying; Li, Tao; Liu, Nan

2012-01-01

47

An Unexpected Course after Simultaneous Urethral Repair and Reimplantation of Penile Prosthesis in a Patient with a Urethral Stricture  

PubMed Central

We experienced the growth of urethral hair along the urethral stricture six years after simultaneous urethral repair and reimplantation of penile prosthesis (RPP) in a patient with a urethral stricture. We detected hair in the urethra with a stricture on the bulbous urethra. Further, we performed hair removal by using a pair of cystoscopic forceps and internal urethrotomy. Then, we performed RPP, and the patient voided well; the prosthesis worked very well and without any complications. One-stage urethroplasty with a pedicle island of the penile skin and RPP in a simultaneous stage may be an option for treating the long-segment urethral stricture in the penile prosthesis patient. However, we should pay attention to the urethral hair growth that can occur after urethral repair performed using a skin graft. PMID:25606569

Shin, Yu Seob; Ko, Oh Seok; Zhang, Li Tao; Zhao, Chen

2014-01-01

48

Spontaneous Postmenopausal Urethral Prolapse Treated Surgically and Successfully  

PubMed Central

Urethral prolapse (UP) is a circular complete eversion of the distal urethral mucosa through the external meatus. It is a rare condition seen mostly in African-American premenarcheal girls. Both a medical and a surgical approach to this condition have been described. We present a case of a spontaneous urethral prolapse in a 60-year-old postmenopausal Caucasian woman, who failed medical management and underwent successful surgical management. The patient is asymptomatic 18 months following the procedure. PMID:25140273

Klein, I.; Dekel, Y.; Stein, A.

2014-01-01

49

Female urethral syndrome. A female prostatitis?  

PubMed Central

The cause of the female urethral syndrome has previously been obscure, as it has been associated by definition with a lack of objective findings but a plethora of subjective complaints of retropubic pressure, dyspareunia, urinary frequency, and dysuria. There is now strong evidence that the microscopic paraurethral glands connected to the distal third of the urethra in the prevaginal space are homologous to the prostate. They stain histologically for prostate-specific antigen and, like the prostate, are subject to both infection and cancer. The most important aspect of recognizing this microscopic "female prostate" as an anatomic feature is that its infections may completely explain many cases of the urethral syndrome. Further, the diagnosis is not elusive if trained clinicians palpate for localized and objective paraurethral tenderness through the anterior vagina wall to one or both sides of the urethra. Treatment parallel to that for male prostatitis is usually rewarded by the elimination of symptoms and the objective finding of the loss of tenderness of the paraurethral glands. As with prostatitis, the localized problem often recurs. It is time to alert primary care physicians to this disorder and to eliminate the widespread practice of treating affected women with either invasive urethral dilation or tranquilizers. Images Figure 1. Figure 3. PMID:8686301

Gittes, R F; Nakamura, R M

1996-01-01

50

Clinical and Functional Anatomy of the Urethral Sphincter  

PubMed Central

Continence and micturition involve urethral closure. Especially, insufficient strength of the pelvic floor muscles including the urethral sphincter muscles causes urinary incontinence (UI). Thus, it is most important to understand the main mechanism causing UI and the relationship of UI with the urethral sphincter. Functionally and anatomically, the urethral sphincter is made up of the internal and the external sphincter. We highlight the basic and clinical anatomy of the internal and the external sphincter and their clinical meaning. Understanding these relationships may provide a novel view in identifying the main mechanism causing UI and surgical techniques for UI. PMID:23094214

Ahn, Hyo Kwang; Huh, Youngbuhm

2012-01-01

51

Vascularisation of Urethral Repairs with the Gracilis Muscle Flap  

PubMed Central

Background The ability to achieve a long-term, stricture-free urethral repair is one of the ongoing challenges of reconstructive urologic surgery. A successful initial repair is critical, as repeat procedures are difficult, owing to distortion, scarring, and short urethral stumps. Methods We describe a technique in which the gracilis muscle flap is laid on or wrapped around the urethral repair site to provide a well-vascularised soft tissue reinforcement for urethral repair. This technique promotes vascular induction, whereby a new blood supply is introduced to the repair site to improve the outcome of urethral repair or anastomotic urethroplasty. The surface contact between the muscle flap and the repair site is enhanced by the use of fibrin glue to improve adherence and promote inosculation and healing. We employed this technique in 4 patients with different urethral defects. Results After a follow-up period of 32 to 108 months, all of the urethral repairs were successful without complications. Conclusions Our results suggest that the use of a gracilis muscle flap to vascularise urethral repairs can improve the outcome of challenging urethral repairs. PMID:24086814

Kua, Ee Hsiang Jonah; Leo, Kah Woon; Ong, Yee Siang; Cheng, Christopher

2013-01-01

52

Traumatic rectourethral fistula repair: A potential application of porcine small intestinal submucosa  

PubMed Central

Rectourethral fistula is an uncommon but devastating condition. Traumatic rectourethral fistula is still uncommon and repair of traumatic rectourethral fistula involves a complex procedure. Most of the urologists would prefer to repair the fistula through perineal route especially when urethral reconstruction is also required. The repaired ends of the fistula are separated with various interposition flaps and grafts in order to prevent recurrence. Gracilis interposition muscle flap is commonly used. We describe the first case of traumatic rectourethral fistula repair in a 45-year-old man using interposition of a porcine small intestinal submucosal (Biodesign™ (Surgisis®) graft. PMID:23956521

Rajaian, Shanmugasundaram; Rajadoss, Muthukrishna Pandian; Nayak, Sukriya; Kekre, Nitin S.

2013-01-01

53

[Catheter measurements of the urethral pressure].  

PubMed

The outflow of viscous incompressible fluid from catheter holes into a small gap between the catheter and surrounding elastic tube is considered. Initially, the catheter is inserted into the tube lumen in such a manner that a considerable tube wall prestress exists. An additional longitudinally non-uniform external load is applied to the outer tube surface. The procedure of measuring the urethral "pressure profile" is discussed. It is shown that there is no easy way for extracting the external load (muscle forces in reality) from the measured pressure. PMID:15612559

Bykova, A A; Regirer, S A

2004-01-01

54

Uncommon causes of anterior urethral diverticula in children: Two cases and review of literature  

PubMed Central

Anterior urethral diverticula are rare in children. Anterior urethral valves and associated diverticulum is the commonly discussed pathological entity in children. There is a lack of awareness among clinicians regarding less common presentations of anterior urethral diverticula in children; which can have a diverse involvement of the urinary tract. This report describes two uncommon presentations of anterior urethral diverticula in children, their diagnoses and management. A systematic differential diagnosis and review of anterior urethral diverticula in children is also presented. PMID:24669129

Smith, Grahame H. H.; Deshpande, Aniruddh V.; Tang, Robert W. K.

2014-01-01

55

Urethral Recurrence in Patients with Orthotopic Ileal Neobladders  

Microsoft Academic Search

PurposeWe identified the risk of urethral recurrence following cystectomy for transitional cell bladder carcinoma, stratified by pathological characteristics of the bladder tumor and type of urinary diversion.

John A. Freeman; Thomas A. Tarter; David Esrig; John P. Stein; Donald A. Elmajian; Su-Chiu Chen; Susan Groshen; Gary Lieskovsky; Donald G. Skinner

1996-01-01

56

Non-surgical treatment of primary female urethral cancer  

PubMed Central

Primary carcinomas of the female urethra are extremely rare, with an annual incidence of less than ten in one million. Currently, there is no consensus regarding management of this malignancy. However, there have been several case reports demonstrating the efficacy of chemoradiation in the treatment of female urethral cancer. In this report we present two cases of female primary urethral adenocarcinoma that were treated by concomitant chemotherapy and external beam radiotherapy, followed by interstitial brachytherapy. PMID:21139970

Libby, Bruce; Chao, David; Schneider, Bernard F

2010-01-01

57

The morbidity of urethral stricture disease among male Medicare beneficiaries  

PubMed Central

Background To date, the morbidity of urethral stricture disease among American men has not been analyzed using national datasets. We sought to analyze the morbidity of urethral stricture disease by measuring the rates of urinary tract infections and urinary incontinence among men with a diagnosis of urethral stricture. Methods We analyzed Medicare claims data for 1992, 1995, 1998, and 2001 to estimate the rate of dual diagnoses of urethral stricture with urinary tract infection and with urinary incontinence occurring in the same year among a 5% sample of beneficiaries. Male Medicare beneficiaries receiving co-incident ICD-9 codes indicating diagnoses of urethral stricture and either urinary tract infection or urinary incontinence within the same year were counted. Results The percentage of male patients with a diagnosis of urethral stricture who also were diagnosed with a urinary tract infection was 42% in 2001, an increase from 35% in 1992. Eleven percent of male Medicare beneficiaries with urethral stricture disease in 2001 were diagnosed with urinary incontinence in the same year. This represents an increase from 8% in 1992. Conclusions Among male Medicare beneficiaries diagnosed with urethral stricture disease in 2001, 42% were also diagnosed with a urinary tract infection, and 11% with incontinence. Although the overall incidence of stricture disease decreased over this time period, these rates of dual diagnoses increased from 1992 to 2001. Our findings shed light into the health burden of stricture disease on American men. In order to decrease the morbidity of stricture disease, early definitive management of strictures is warranted. PMID:20167087

2010-01-01

58

The overlooked cause of benign prostatic hyperplasia: prostatic urethral angulation.  

PubMed

Benign prostatic hyperplasia (BPH) is one of the most common problems faced by aging men and can be associated with bothersome lower urinary tract symptoms that affect quality of life by interfering with normal daily activities and sleep patterns. Despite the clinical importance of BPH, its pathogenesis is still poorly understood. Previously, our understanding of BPH was centered on bladder outlet obstruction being secondary to benign prostatic enlargement. However, prostate size itself is not correlated with the urine flow rate and symptomatology. The prostatic urethra is a bend tube and the increased prostatic urethral angulation shows a higher bladder neck on cystoscopic examination. Although some urologists suspected that the higher bladder neck might be a causal factor for BPH, the clinical significance of prostatic urethral angulation was previously underestimated. In this study, we propose a new hypothesis that prostatic urethral angulation is a causal factor for BPH. By applying the concept of fluid dynamics to the process of urination in the prostatic urethra, we show that the energy loss in this bending tube (the prostatic urethra) can occur during micturition and it increases proportionally to prostatic urethral angulation; this energy loss results in a decrease of the urine velocity and accordingly, the urine flow rate is inversely associated with prostatic urethral angulation. We also propose that BPH involves prostatic urethral angulation as well as the classical BPH triad of prostatic enlargement, bladder outlet obstruction, and symptomatology. Our hypothesis suggests that prostatic urethral angulation is an overlooked cause of bladder outlet obstruction and is a causal factor of BPH, and provides novel insight into the pathogenesis of BPH. Ultimately, the relationship between prostatic urethral angulation and urine flow rate, and other clinical factors including urodynamic parameters, the symptomatology, the response to treatment, and disease progression, need to be investigated in a clinical setting. PMID:17761390

Cho, Kang Su; Kim, Joohan; Choi, Young Deuk; Kim, Jang Hwan; Hong, Sung Joon

2008-01-01

59

A Balloon-Tipped Catheter for Measuring Urethral Pressures  

PubMed Central

Background: Better methods are needed for recording urethral function for complex urologic problems involving the bladder, urethra, and pelvic floor. Objective: To evaluate a balloon catheter for recording urethral pressure and function using bench-top testing and evaluation in an animal model. Methods: Balloon pressure–recording methods included slightly inflating the balloon with water and placing the pressure transducer on the distal end of the catheter. For bench-top testing, manual procedures and a silastic tube with a restriction were used. In 3 anesthetized dogs, pressure recorded from the skeletal urethral sphincter was induced with electrical stimulation of the sphincter. Anal sphincter pressure was also recorded. Results: Bench-top testing showed good pressure recordings, including a confined peak at the tube restriction. Animal tests showed urethral pressure records with rapid responses when electrical stimulation was applied. Peak pressure at the urethral skeletal sphincter was 55.7 ± 15 cmH2O, which was significantly higher than the peak pressure recorded 2 cm distally in the proximal urethra (3.3 ± 2.3 cmH2O). Peak anal pressures were smaller and unchanged for the 2 stimulations. Conclusions: Balloon-pressure recordings showed rapid responses that were adequate for the tests conducted. In the animal model, high-pressure contractions specific to the skeletal urethral sphincter were shown. Balloon-tipped catheters warrant further investigation and may have applications for the evaluation of detrusor-sphincter dyssynergia after spinal cord injury or for stress urinary incontinence. PMID:20025155

Walter, James S; Wheeler, John S; Wang, Xiaoli; Wurster, Robert D

2009-01-01

60

Posterior fossa malformations.  

PubMed

Understanding embryologic development of the cerebellum and the 4th ventricle is essential for understanding posterior fossa malformations. Posterior fossa malformations can be conveniently classified into those that have a large posterior fossa and those with normal or small posterior fossa. Disorders associated with a large posterior fossa include classic Dandy-Walker malformation, Blake's pouch cyst, mega cisterna magna, and posterior fossa arachnoid cyst. Disorders associated with normal or small posterior fossa include Dandy-Walker variant, Joubert syndrome, tecto-cerebellar dysraphia, rhombencephalosynapsis, the neocerebellar hypoplasias, and cerebellar atrophy. Neuro-imaging features should enable the imager to provide the referring physician a logical approach to these complex posterior fossa malformations. PMID:21596278

Shekdar, Karuna

2011-06-01

61

Female urethral diverticulum: cases report and literature  

PubMed Central

Introduction A female urethral diverticulum is an uncommon pathologic entity. It can manifest with a variety of symptoms involving the lower urinary tract. Our objective is to describe the various aspects of the diverticulum of the female urethra such as etiology, diagnosis and treatment. Cases presentation We report five female patients, without prior medical history. They had different symptoms: dysuria in four cases, recurrent urinary tract infection in three cases, stress incontinence in two cases and hematuria in two cases. All patients had dyspareunia. The physical exams found renitent mass located in the endovaginal side of urethra which drained pus in two cases. Urethrocystography found a diverticulum of urethra in all cases. Our five patients underwent diverticulotomy by endovaginal approach. The course after surgical treatment was favorable. The urinary catheter was withdrawn after ten days. Some recurrent symptoms were reported. Conclusion Evaluation of recurrent urinary complaints in young women can lead to the finding of a diverticulum of urethra. Urethrocystography can reveal this entity. Diverticulectomy by endovaginal approach is the best choice for treatment. PMID:24528809

2014-01-01

62

Urethral stromal tumor with pacemaker cell phenotype.  

PubMed

Penile malignancies are rare in developed countries. The authors present a case of a penile urethral mesenchymal tumor occurring in a 51-year-old Caucasian male and displaying light microscopic, immunohistochemical, and ultrastructural features suggestive of a pacemaker cell type, combined with a lack of diagnostic features of any other established tumor category. The immunohistochemical profile was intensely positive for vimentin, PKC theta, and NSE and weakly positive to nonreactive for CD34 and smooth muscle actin, and entirely negative for CD117 (c-kit), S-100, and other markers. C-kit and PDGFRA gene analysis showed no mutations. Electron microscopy revealed tumor cells with plentiful cytoplasm and cytoplasmic processes/filopodia, both filled with intermediate filaments and occasional solitary focal densities. There were also prominent smooth endoplasmic reticulum cisternae, caveolae, neurosecretory granules, particularly concentrated in cytoplasmic processes, and synaptic-type structures. Poorly formed basal lamina, gap junctions, and intercellular collagen aggregates, consistent with skeinoid-type fibers, were also noted. Interstitial cells with potential pacemaker function have been recently described in the lower urinary tract, including the urethra, and this tumor may be related to this cellular phenotype. PMID:17455099

Kanner, William A; Drachenberg, Cinthia B; Papadimitriou, John C; Wang, Suna; Meltzer, Stephen J; Sklar, Geoffrey N

2007-01-01

63

Bougie urethral dilators: revival or survival?  

PubMed Central

Objectives To present our center's experience in managing bladder outlet obstruction (BOO) conditions using bougie dilators. We described the dilation technique methodically for teaching purpose. Patients and method Retrospectively, a total of 196 medical records over the last four years denoting BOO conditions in men, women, and children were retrieved for analysis. Data reviewed for common complications was namely: perforation, recurrence, urinary tract obstruction (UTI) and inability to overcome the obstruction. Results Among the 196 analyzed cases, 24 (12.2%) cases were cured, whereas 172 (87.8%) cases reported complications. Within the complicated cases analyzed, 134 (68.4%) cases had recurrent obstructions, 13 (6.6%) cases had perforations, 6 (3.0%) cases developed UTI, while in 19 (9.7%) cases, we failed to pass the obstruction. Conclusions In our center where urethral dilation technique has revived four years ago, it turned back to be the standard choice in managing BOO cases. We propose the technique to Urology training program directors, all over the world, to teach it as a compulsory skill for junior urologists to master. PMID:24757552

Al–Adawi, Mohammad Ahmad

2013-01-01

64

Transurethral holmium laser vaporization to the urethral tumour through a ureteroscope  

PubMed Central

We present 2 cases of urethral cancers: one is recurrent bladder transitional cell carcinoma accompanied by urethral metastatic carcinoma located on the right side of verumontanum, and the other is primary bladder and metastatic urethral adenocarcinoma. The urethral tumour was treated by transurethral holmium laser vaporization to the urethral tumour through a ureteroscope and the bladder tumour was treated with transurethral resection and degeneration of the bladder tumour (TURD-Bt). After the second or third therapy, patients were free of urethral or bladder tumour recurrence; they also did not experience urethral stricture or urinary incontinence during the 24- to 36-month follow-up. Transurethral holmium laser vaporization and TURD-Bt could be performed to treat non-invasive urethral cancer accompanied with bladder cancer and preserve the urethra and bladder. PMID:25553166

Li, Aihua; Fang, Wei; Zuo, Xiaoming; Zhang, Feng; Li, Weiwu; Lu, Honghai; Liu, Sikuan; Wang, Hui; Zhang, Binghui

2014-01-01

65

Sonic hedgehog Signaling from the Urethral Epithelium Controls External Genital Development  

E-print Network

Sonic hedgehog Signaling from the Urethral Epithelium Controls External Genital Development Claire tubercle outgrowth, urethral plate epithelium expresses Sonic hedgehog (Shh). In mice with a targeted: external genitalia; urethra; polarizing activity; mouse embryo; Sonic hedgehog; Hox gene; apoptosis

Cohn, Martin

66

Anterior Urethral Strictures: A Brief Review of the Current Surgical Treatment  

Microsoft Academic Search

A review of the recent literature on the surgical management of anterior urethral stricture was performed. The literature was searched via PubMed using the search terms ‘urethral stricture’ and ‘urethroplasty’ from 1996 to 2009. The management of anterior urethral strictures is changing rapidly in the sense that the reconstructive procedures have evolved greatly. Penile skin, because of its location and

Onkar Singh; Shilpi Singh Gupta; Nand Kishore Arvind

2011-01-01

67

[Non-gonococcal infectious urethritis : Pathogen spectrum and management].  

PubMed

For many years an increase in cases of urethritis has been observed in western Europe. In order to be able to combat this continuous rise, the perception of sexually transmitted diseases must be promoted, the clarification and screening must be intensified and therapy must be rapidly and correctly carried out. In addition to the commonest pathogens causing urethritis, namely chlamydia and gonococci, many other pathogenic microbes must be taken into consideration in the diagnostics. With respect to therapy, apart from the increasing resistance formation of Mycoplasma genitalium, the decreasing effectiveness of standard forms of treatment of other microbes must be emphasized. For chronic and recurrent urethritis in particular a broad clarification of the pathogen should be carried out to enable targeted treatment and also partner treatment. Priority must again be given to primary prevention. PMID:25410827

Lautenschlager, S

2015-01-01

68

Where Do Patients Go for Treatment of Urethritis?  

PubMed Central

Background: Urethritis is characterized by urethral inflammation, and it can result from both infectious and noninfectious conditions. Physicians and other health care providers play a critical role in preventing and treating urethritis. Objectives: The aim of this study was to describe and identify predictors of health care seeking behavior among men with urethritis. Patients and Methods: In total, 98 male patients aged between 16 to 52 years-of-age (mean 30.9 ± 8.0 years), who attended our clinic with symptoms of urethritis, were included in the study. We conducted face-to-face interviews with the patients using a 9-item survey questionnaire. Patients were divided into three groups according to their level of education as follows: group I (n = 44), elementary school; group II (n = 38), high school; and group III (n = 16), university. Results: Among the 98 patients evaluated, the source of treatment was physicians in 44 patients (44.9%), drugstores in 38 cases (38.77%), and friends in 16 patients (16.32%). There was a statistically significant difference found between the groups according to the source of treatment (P < 0.001). The most common factors associated with seeking care from other sources, rather than physicians, were economic reasons in 19 patients (35.18%), confidentiality concerns in 24 (44.4%), and ease of access in 11 patients (20.37%). Conclusions: A substantial proportion of patients with urethritis sought help from other sources, rather than physicians. The results of our study show that the patients with higher levels of education were more likely to seek help from health care services. It is important to promote the public’s knowledge through informative studies and educational materials in order to encourage patients to seek rapid and effective treatment from proper sources. PMID:25032138

Hoscan, Mustafa Burak; Tunckiran, Ahmet; Oksay, Taylan; Ozorak, Alper; Ozkardes, Hakan

2014-01-01

69

Ureteral Cannulation as a Complication of Urethral Catheterization  

PubMed Central

Urinary catheterization is a common procedure, particularly among patients with neurogenic bladder secondary to spinal cord injury. Urethral catheterization is associated with the well-recognized complications of catheter-associated urinary tract infections and limited genitourinary trauma. Unintentional ureteral cannulation represents a rare complication of urethral catheterization and has been previously described in only eight cases within the literature. We describe two cases of aberrant ureteral cannulation involving two patients with quadriplegia. These cases along with prior reports identify the spastic, insensate bladder and altered pelvic sensorium found in upper motor neuron syndromes as major risk factors for ureteral cannulation with a urinary catheter. PMID:25405021

Greenlund, Andrew C.

2014-01-01

70

Tissue engineering in urethral reconstruction—an update  

PubMed Central

The field of tissue engineering is rapidly progressing. Much work has gone into developing a tissue engineered urethral graft. Current grafts, when long, can create initial donor site morbidity. In this article, we evaluate the progress made in finding a tissue engineered substitute for the human urethra. Researchers have investigated cell-free and cell-seeded grafts. We discuss different approaches to developing these grafts and review their reported successes in human studies. With further work, tissue engineered grafts may facilitate the management of lengthy urethral strictures requiring oral mucosa substitution urethroplasty. PMID:23042444

Mangera, Altaf; Chapple, Christopher R

2013-01-01

71

Congenital urethral stenosis in a male miniature piglet  

PubMed Central

A 2-month-old male miniature pig showed progressive abdominal pain, pollakiuria, and stranguria that progressed to complete urinary obstruction. Postmortem examination revealed idiopathic urethral stenosis at the level of the recess, of probable congenital origin. Urinary tract malformations should be included in the differential diagnosis of miniature piglets with urinary disorders. PMID:24891635

Pouleur-Larrat, Bénédicte; Maccolini, Edouard; Carmel, Eric Norman; Hélie, Pierre

2014-01-01

72

Urethral pseudodiverticulum secondary to penile fracture and complete urethra dissection.  

PubMed

A 22-year-old man reported cracking sound and acute pain during sexual intercourse followed by rapid penile detumescence and ecchymosis. He experienced more pain because he could not urinate and had a palpably full bladder. Moreover, his urethra was bleeding. Physical examination revealed swollen, ecchymotic and deviated penis and penis ultrasonography showed an injury of the tunica albuginea and Buck's fascia with an expanding hematoma. Suprapubic catheter was positioned. Surgical exploration revealed a tear of tunica albuginea of both corpora cavernosa and complete urethral dissection. End-to-end urethral anastomosis and suture of corpora cavernosa lesion were performed. Vescical catheter was mantained for 6 days and suprapubic catheter for 3 months to allow a complete urethral healing. A pseudodiverticulum was found at anastomosis level on the urethrocistography 1 month after surgery. It disappeared by allowing micturition via the suprapubic catheter. The patient presented regular urinary flow and physiological erections 30 days later. In our experience, prompt surgical repair preserved erectile function and keeping the suprapubic catheter protected the urethra; this was the correct management for repairing the urethral lesion. PMID:23766837

Di Pierro, Giovanni B; Iannotta, Luca; Innocenzi, Michele; Caterina, Gulia; Grande, Pietro; Cristini, Cristiano; Gentile, Vincenzo

2013-01-01

73

Treatment of female incontinence with or without urethral instability  

Microsoft Academic Search

A group of 75 non-neuropathic female patients with persisting complaints (71 incontinent and 4 urge patients) had been selected earlier for extensive urodynamic study. Based on an objectified history and urodynamic results, 28 patients were diagnosed as genuine stress incontinent (12 of whom showed urethral instability as well), 19 as motor urge incontinent (16 unstable urethras) and 18 as sensory

Pieter L. Venema; August E. J. L. Kramer

1986-01-01

74

Eosinophilic cystitis associated with urethral stricture disease from pelvic trauma. Case report and literature review.  

PubMed

We report a case of eosinophilic cystitis (EC) in a 65-year-old man with urethral stricture disease from blunt pelvic traumatic event. EC is a rare condition characterized by eosinophilic infiltration of the bladder wall, that usually presents with irritative voiding symptoms, suprapubic pain and hematuria. Etiology is still not clear although a review of the literature suggests that pathogenetic mechanisms probably engage an altered immune response in the bladder, with the inflammatory reaction caused by factors such as exogenous allergens and previous bladder injury or surgery to the bladder or the prostate. The diagnosis of EC has to be confirmed by biopsy, since in some cases it may manifest as other inflammatory and malignant bladder disorders. A conservative medical management is indicated initially, since this disease may be self-limited, with a benign course especially in children and young patients. In adults EC is more often a chronic recurrent condition that requires close follow-up since it may lead to serious progressive bladder and/or upper urinary tract disease. More invasive therapies (including transurethral resection, partial or total cystectomy) may also be required when conservative therapy fails. PMID:16472421

Martino, G; Torcasio, A; Iavarone, C; Cardarelli, A; Monti, M

2005-01-01

75

Management of recurrent bulbar urethral stricture-a 54 patients study with Allium bulbar urethral stent (BUS)  

PubMed Central

The Allium Bulbar Urethral Stent (BUS) is a fully covered, self-expandable, large caliber metal stent specially designed for the treatment of bulbar urethra strictures. The stent is intended for a long term use for the purpose of opening the occluded urethral passage and to allow spontaneous urination. This study objective was to evaluate the clinical efficacy of temporary placement of the Allium BUS stent. This was a prospective study in 54 men with recurrent benign urethral stricture conducted during 2009 to 2012. All men underwent an internal urethrotomy or dilatation procedure followed by an endoscopic stent placement. Clinical success was achieved in 44 (81.4%) of the 54 patients. No patient reported discomfort at the stent site. 2 stents migrated distally. 1 stent was occluded. All stents were removed in a mean time of 8.8 (range 3-18) months following implantation. This experience with the Allium BUS for treating urethral strictures suggests that it is safe and reliable treatment modality. PMID:25419377

Culha, Melih; Ozkuvanci, Unsal; Ciftci, Seyfettin; Saribacak, Ali; Ustuner, Murat; Yavuz, Ufuk; Yilmaz, Hasan; Ozkan, Levend

2014-01-01

76

Urethral closure mechanisms during sneezing-induced stress in anesthetized female cats.  

PubMed

During stress-induced increase in abdominal pressure, urinary continence is maintained by urethral closure mechanisms. Active urethral response has been studied in dogs and rats. Such an active urethral response is also believed to occur in humans during stress events. We aimed to investigate urethral closure mechanisms during sneezing in cats. Urethral pressures along the urethra (UP1-UP4), with microtip transducer catheters with UP4 positioned in the distal urethra where the external urethral sphincter (EUS) is located, and intravesical pressure were measured, and abdominal wall, anal sphincter (AS), levator ani (LA), and EUS electromyograms (EMGs) were recorded during sneezing under closed-abdomen and open-abdomen conditions in eight anesthetized adult female cats. Proximal and middle urethral response induced by sneezing was not different from bladder response. Distal urethral response was greater compared with proximal and middle urethral and bladder response. In the open-abdomen bladder, proximal and middle urethral responses were similarly decreased and distal urethral response was unchanged compared with the closed-abdomen bladder. Bladder and urethral responses were positively correlated to sneeze strength. EUS, LA, and AS EMGs increased during sneezing. No urine leakage was observed, regardless of the strength of sneeze. In cats urethral closure mechanisms are partly passive in the proximal and middle urethra and involve an active component in the distal urethra that is believed to result from EUS and possibly LA contractions. Because central serotonin exerts similar effects on the lower urinary tract in cats and humans, the cat may represent a relevant model for pharmacological studies on continence mechanisms. PMID:17626129

Julia-Guilloteau, V; Denys, P; Bernabé, J; Mevel, K; Chartier-Kastler, E; Alexandre, L; Giuliano, F

2007-09-01

77

Reversible posterior leukoencephalopathy syndrome  

Microsoft Academic Search

Reversible posterior leukoencephalopathy syndrome (RPLS) is characterized by subacute onset of headache, decreased alertness,\\u000a vomiting, seizures, visuoperceptual disturbances, together with bilateral white matter lesions in posterior brain regions\\u000a on brain imaging. The most frequently associated conditions related to RPLS are arterial hypertension and the use of immunosuppressive\\u000a or cytotoxic treatment. T2-, Fluid Attenuation Inversion Recovery (FLAIR), and Apparent Diffusion Coefficient

Dimitri Renard; Pierre Labauge; Rik Vandenberghe

2010-01-01

78

Horizontal posterior hamstring harvest.  

PubMed

Harvesting of the gracilis and semi-tendinosus (ST) hamstring tendons is usually performed by anteromedial approach. Harvesting by a horizontal posterior approach is possible. Based on a series of 90 patients, this technical note describes the perioperative difficulties and the characteristics of the harvested tendon(s) as well as any complications. Only one unsuccessful harvest was reported. Posterior harvesting of the gracilis and ST hamstring tendons is a reliable, reproducible surgical technique with a low rate of complications. PMID:25453925

Letartre, R; Isida, R; Pommepuy, T; Miletic, B

2014-12-01

79

Acquired urethral diverticulum in a man with paraplegia presenting with a scrotal mass: a case report  

PubMed Central

Introduction Male urethral diverticula are rare. Patients with paraplegia may present with acquired diverticula as a result of prolonged catheterization. Diverticula may be asymptomatic or lead to lower urinary tract symptoms. Rarely, the diverticulum may initially present as a scrotal mass. Case presentation We report the case of a male 45-year-old Arab with paraplegia who presented with a mass in the peno-scrotal junction. He had in his medical history iterative prolonged urethral catheterizations associated with urine leakage through the urethral meatus upon applying compression. Diagnosis confirmation of urethral diverticula is obtained by retrograde urethrography. The patient underwent a diverticulectomy with urethroplasty. Conclusion Male acquired urethral diverticula can be found in patients who have a spinal cord injury because of prolonged urethral catheterization. Clinical presentations are different and sometimes can be misleading. Retrograde urethrography is the key to diagnosis and open surgery is the treatment of reference. PMID:23171575

2012-01-01

80

[Traumatic lung hernia].  

PubMed

Traumatic lung herniation is an unusual clinical problem. We present a case of a large left post-traumatic lung hernia on the left, anterior, second intercostal space following blunt chest trauma. An important factor in the etiology of these lesions is the relative lack of muscular support of the anterior part of the chest. This report describes the diagnosis and management of a post-traumatic lung hernia. PMID:21537748

Marsico, Giovanni Antonio; Boasquevisque, Carlos Henrique Ribeiro; Loureiro, Gustavo Lucas; Marques, Rodrigo Felipe; Clemente, Antonio Miraldi

2011-01-01

81

Somatomotor and sensory urethral control of micturition in female rats.  

PubMed

In rats, axons of external urethral sphincter (EUS) motoneurons travel through the anastomotic branch of the pudendal nerve (ABPD) and anastomotic branch of the lumbosacral trunk (ABLT) and converge in the motor branch of the sacral plexus (MBSP). The aim of the present study was to determine in female rats the contribution of these somatomotor pathways and urethral sensory innervation from the dorsal nerve of the clitoris on urinary continence and voiding. EUS electromyographic (EMG) activity during cystometry, leak point pressure (LPP), and voiding efficiency (VE) were assessed in anesthetized virgin Sprague-Dawley female rats before and after transection of the above nerve branches. Transection of the MBSP eliminated EUS EMG, decreased LPP by 50%, and significantly reduced bladder contraction duration, peak pressure, intercontraction interval, and VE. Transection of the ABPD or ABLT decreased EUS EMG discharge and LPP by 25% but did not affect VE. Transection of the dorsal nerve of the clitoris did not affect LPP but reduced contraction duration, peak pressure, intercontraction interval, and VE. We conclude that somatomotor control of micturition is provided by the MBSP with axons travelling through the ABPD and ABLT. Partial somatomotor urethral denervation induces mild urinary incontinence, whereas partial afferent denervation induces voiding dysfunction. ABPD and ABLT pathways could represent a safeguard ensuring innervation to the EUS in case of upper nerve damage. Detailed knowledge of neuroanatomy and functional innervation of the urethra will enable more accurate animal models of neural development, disease, and dysfunction in the future. PMID:25339694

Cruz, Yolanda; Pastelín, César; Balog, Brian M; Zaszczurynski, Paul J; Damaser, Margot S

2014-12-01

82

Acute urinary retention in women due to urethral calculi: A rare case  

PubMed Central

We present a case of a 51-year-old woman with acute urinary retention caused by a urethral calculus. Urethral calculi in women are extremely rare and are usually formed in association with underlying genitourinary pathology. In this case, however, no pathology was detected via thorough urological evaluation. We discuss the pathogenesis, clinical presentation and treatment of urethral calculi. To our knowledge, this is the second reported case of a primary urethral calculus in a female with an anatomically normal urinary tract and the first in a middle-aged Caucasian female. PMID:24554984

Turo, Rafal; Smolski, Michal; Kujawa, Magda; Brown, Stephen C.W.; Brough, Richard; Collins, Gerald N.

2014-01-01

83

Traumatic Brain Injury  

NSDL National Science Digital Library

Very concise description of what constitutes a traumatic brain injury and the cost to society in hospitalizations, injuries and deaths resulting from traumatic brain injury. It also looks very concisely at new understandings of the nature of TBIs and the research being done to find better treatments.

Dr. Leslie Nader (MSMR)

2000-02-01

84

Hypnotherapy with Traumatized Children  

Microsoft Academic Search

The psychological impact of trauma can include cognitive, affective, and behavioral components. The degree to which a child is either overwhelmed by or unable to access the traumatic event can make the working through of the event in therapy difficult. Hypnotherapy is a useful modality not only for alleviating symptoms but also for uncovering the traumatic event(s) with associated affects,

William N. Friedrich

1991-01-01

85

Vicarious traumatization and secondary traumatic stress: A research synthesis  

Microsoft Academic Search

Vicarious traumatization (VT) refers to harmful changes that occur in professionals’ views of themselves, others, and the world, as a result of exposure to the graphic and\\/or traumatic material of their clients. Secondary traumatic stress (STS) refers to a set of psychological symptoms that mimic post-traumatic stress disorder, but is acquired through exposure to persons suffering the effects of trauma.

Katie Baird; Amanda C. Kracen

2006-01-01

86

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

SciTech Connect

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.

Thomas, Carys [Department of Radiation Oncology, Vancouver Cancer Centre, Vancouver, BC (Canada); Keyes, Mira [Department of Radiation Oncology, Vancouver Cancer Centre, Vancouver, BC (Canada)], E-mail: mkeyes@bccancer.bc.ca; Liu, Mitchell [Radiation Oncology, Fraser Valley Cancer Centre, Surrey, BC (Canada); Moravan, Veronika [Surveillance and Outcomes Unit, British Columbia Cancer Agency, Vancouver, BC (Canada)

2008-10-01

87

SIU/ICUD Consultation on Urethral Strictures: The management of anterior urethral stricture disease using substitution urethroplasty.  

PubMed

In this systematic review of the literature, a search of the PubMed database was conducted to identify articles dealing with augmentation/substitution urethral reconstruction of the anterior urethral stricture. The evidence was categorized by stricture site, surgical technique, and the type of tissue used. The committee appointed by the International Consultation on Urological Disease reviewed this data and produced a consensus statement relating to the augmentation and substitution of the anterior urethra. In this review article, the background pathophysiology is discussed. Most cases of urethral stricture disease in the anterior urethra are consequent on an ischemic spongiofibrosis. The choice of technique and the surgical approach are discussed along with the potential pros and cons of the use of a graft vs a flap. There is research potential for tissue engineering. The efficacy of the surgical approach to the urethra is reviewed. Whenever possible, a 1-stage approach is preferable from the patient's perspective. In some cases, with complex penile urethral strictures, a 2-stage procedure might be appropriate, and there is an important potential role for the use of a perineal urethrostomy in cases where there is an extensive anterior urethral stricture or where the patient does not wish to undergo complex surgery, or medical contraindications make this hazardous. It is important to have accurate outcome measures for the follow-up of patients, and in this context, a full account needs to be taken of patients' perspectives by the use of appropriate patient-reported outcome measures. The use of symptoms and a flow rate can be misleading. It is well established that with a normally functioning bladder, the flow rate does not diminish until the caliber of the urethra falls below 10F. The most accurate means of following up patients after stricture surgery are by the use of endoscopy or visualization by urethrography. Careful consideration needs to be made of the outcomes reported in the world literature, bearing in mind these aforementioned points. The article concludes with an overview of the key recommendations provided by the committee. PMID:24411214

Chapple, Christopher; Andrich, Daniela; Atala, Anthony; Barbagli, Guido; Cavalcanti, André; Kulkarni, Sanjay; Mangera, Altaf; Nakajima, Yosuke

2014-03-01

88

Bilateral Asymmetrical Traumatic Sternoclavicular Joint Dislocations  

PubMed Central

Unilateral and bilateral sternoclavicular joint (SCJ) dislocations are rare injuries. The difficulty in assessing this condition often leads to delay in diagnosis and treatment. We report a rare case of bilateral asymmetrical traumatic SCJ dislocations in a 45-year-old male. The right anterior SCJ dislocation was reduced in the emergency room (ER) and resulted in residual instability. The left posterior SCJ dislocation was asymptomatic and unnoticed for six months. It is important for ER physicians and orthopaedic surgeons to be able identify and treat this condition. All suspected SCJ dislocations should be evaluated by computed tomography (CT) scan for confirmation of the diagnosis and evaluation of both SCJs. Posterior SCJ dislocation is a potentially fatal injury and should not be overlooked due to the presence of other injuries. Surgical intervention is often necessary in acute and old cases. PMID:23275851

Albarrag, Mohammed K.

2012-01-01

89

Traumatic Brain Injuries. Guidelines Paper.  

ERIC Educational Resources Information Center

This paper on traumatic brain injuries begins with statistics on the incidence of the disorder, especially as they relate to Colorado. Traumatic brain injury is then defined, and problems caused by traumatic brain injury are discussed. The components of effective programming for students with traumatic brain injuries are described, followed by the…

Colorado State Dept. of Education, Denver. Special Education Services Unit.

90

Post-traumatic stress disorder  

Microsoft Academic Search

Post-traumatic stress disorder (PTSD) is an increasingly recognized and potentially preventable condition. Certain factors, especially the severity of the trauma, perceived lack of social support and peri-traumatic dissociation have been associated with its development. In recent years, a more robust evidence base regarding the management of individuals involved in traumatic events has emerged. Immediately after a traumatic event, simple practical,

Jonathan I. Bisson

2007-01-01

91

Healing of the Urethral Plate after Deep Incision: Does Catheterization Change the Course of This Process?  

Microsoft Academic Search

Background: We aimed to evaluate the sequence of healing process as well as possible effects of stent placement on the healing process after deep urethral plate incision. Methods: A deep urethral plate incision was done at the 12 o’clock position. After that, in the first group (n = 14) the anterior urethra was stented with a silicon catheter. Animals in

Kaya Horasanli; Cem Perk; Tahsin Yesildere; Eyup Gumus; Cengiz Miroglu

2007-01-01

92

Urethral closure pressure with stress--a comparison between stress-incontinent and continent women.  

PubMed

Stress incontinence has been said to occur as a consequence of a low urethral pressure and defective pressure transmission from the abdomen to the urethra due to descent of the bladder neck area. Equipment suitable for dynamic pressure measurements has been used to analyse the losses of urethral pressure that lead to incontinence. The pressure transmission from abdomen to urethra was found to be incomplete in both continent and stress-incontinent women. There was also significant loss of smooth muscle tone in the urethral wall after repeated straining, leading to a still narrower margin between the urethral pressure and the leakage treshold in both continent and stress-incontinent women. The main factor determining the degree of continence or incontinence seemed to be the urethral closure pressure at rest . As long as this pressure is sufficiently high, leakage during sudden stress will not occur. PMID:568337

Bunne, G; Obrink, A

1978-01-01

93

Urethral advancement technique for repair of distal hypospadias.  

PubMed

Eighty children with distal hypospadias were operated upon by this technique. It is a modification from the old Beck technique and is applicable only for distal types (coronal and subcoronal) with minimal chordae and rotation. The urethral meatus could be placed to the tip of the glans penis by mobilizing and advancing the urethra without constructing a neourethra. Children did not need catheterization or diversion. The average hospital stay was 2 days. Success rate was 98%. Children who developed fistulae were treated by simple closure of the defect. PMID:2318238

Wishahi, M M; Wishahy, M K; Kaddah, N

1990-01-01

94

One-stage dorsal inlay oral mucosa graft urethroplasty for anterior urethral stricture  

PubMed Central

Background Anterior urethral stricture remains a great challenge. We reported our clinical technique and results by using inlay dorsal buccal mucosal graft urethroplasty for repair of anterior urethral stricture. Methods From January 2005 to July 2008, 87 male patients (range from 9 to 72 years old) with anterior urethral stricture have been treated by one-stage dorsal inlay oral mucosal graft (OMG) urethroplasty. All patients gave written informed consent for their participation. All patients showed that urethral plate had been either scarred or removed previously. In our surgery, the urethra was dissected dorsally and scar of the urethral plate was removed. The remnant urethral plate was split at midline and a buccal mucosa patch was inserted between the two parts. Neourethra was tubularized and covered with dartos flap. The pre-operative assessments included clinical data, urine analysis, uroflowmetry, retrograde and voiding cystogram, urethral ultrasonography and endoscopy. Postoperatively, the flow rate and void residual volume were analyzed by uroflowmetry and sonography. Any further instrumentation to assist voiding was considered as failure. Results After 12 to 48 months (mean: 25.8 months), 78 patients (89.66%) have shown good results by the one-stage urethroplasty. However, 9 patients (10.3%) required further treatment due to recurrence, while 6 patients (6.9%) had fistula. Conclusions This one-stage dorsal inlay approach using dorsal oral mucosal grafts is a reliable method to create a substitute urethral plate for tubularization. This approach represents a safe option for anterior urethral stricture patients especially with grossly scarred urethral plate. PMID:24885070

2014-01-01

95

Role of the urethral plate characters in the success of tubularized incised plate urethroplasty  

PubMed Central

Background: Today, tubularized incised plate (TIP) urethroplasty is the most commonly performed operation for distal and mid-penile hypospadias. Reports from different centers worldwide confirm its nearly universal applicability and low complications rate. Aim: Evaluation of the urethral plate characters and its effect on the outcome of TIP urethroplasty. Materials and Methods: Between 2010 and 2013, 100 children with primary distal penile hypospadias underwent TIP urethroplasty. Urethral plates were categorized as flat, cleft, and deeply grooved. Postoperatively, patients were followed-up for evaluation of meatal stenosis, fistula formation, and glandular dehiscence at 1st, 3rd and 6th months. Patients were followed-up for urethral calibration by urethral sound 8 Fr at 3rd and 6 months follow-up. Data were statistically analysed using Epi info program to correlate between the width, plate shape, and complications. Results: Mean age at surgery was 4.3 years. Patients were followed-up for an average period of 6.4 months. Pre-operative location of the meatus was reported as coronal in 46, subcoronal in 50 and anterior penile in 4 cases. Urethral plate characters were flat in 26 cases, cleft in 52, and deeply grooved in 22. Urethral plate width was >8 mm in 74 cases and <8 mm in 26. Patients with urethral plate <8 mm had a statistically significant higher fistula rate (P = 0.004) and failed 8 Fr calibrations in 26.9% (P = 0.01) compared with the patients with urethral plate >8 mm. In addition, we also founds higher fistula rate and failed 8 Fr calibrations in flat urethral plate. Conclusions: An adequate urethral plate width (>8 mm) is essential for successful TIP repair. Lower success rates with flat plates may need buccal mucosal augmentation to improve the results. PMID:25190919

Aboutaleb, Hamdy

2014-01-01

96

Spinal osteotomies to treat post-traumatic thoracolumbar deformity.  

PubMed

Fractures of the thoracolumbar junction can lead to regional kyphosis, this being a significant cause of pain and disability for the patients. After a traumatic fracture of the thoracolumbar spine, early or late regional kyphosis can be observed. This post-traumatic deformity can, however, be corrected with appropriate surgical methods. Posterior tricolumnar osteotomies are some of the most powerful methods of correction and are particularly indicated when sagittal and coronal deformities have to be simultaneously corrected or when anterior surgery is not possible. Anterior corpectomy and lengthening with posterior instrumentation are, however, an alternative technique to restore the anterior column support and to correct the regional kyphotic deformity and an option for appropriate sagittal balance restoration and control of symptoms. Proper surgical technique, evaluation of the bone quality and identification of eventual extension of the deformity to the thoracic spine are key aspects in prevention of failures. PMID:24770652

Cecchinato, R; Berjano, P; Damilano, M; Lamartina, C

2014-07-01

97

[Locked posterior shoulder dislocation].  

PubMed

Posterior shoulder dislocations are diagnosed rarely in every-day practice. Although the methods of radiological imaging have been developing and becoming commonly available, the cases of late diagnosis are still happening. Proper clinical examination and properly conducted and interpretated radiographs allow for identification and implementation of appropriate medical procedures. In spite of fact that such cases are identified expectionally rarely, a few types of procedural have been analised and numerous therapeutic methods have been described. The choice of an appropriate treatment is complicated and requires in-depth theoretical knowledge as well as the knowledge of specific conditions within the shoulder surgery. Based on an algorithm, proposed by Griggs, between 2000-2006 seven patients with locked posterior instability were treated, for all of them defect of the proximal humerus did not exceed 30%. In all these cases the goals of improving stability and range of motion were obtained. PMID:18853661

Gadek, Artur; Slusarski, Jakub; Kasprzyk, Marcin; Ciszek, Elzbieta

2008-01-01

98

Posterior calf injury.  

PubMed

Acute injuries of the Achilles tendon are common among athletes and non-athletes alike. Injuries of other posterior calf muscles are far less common but should be considered in the differential, to ensure proper diagnosis and treatment of patients with calf injuries. This article focuses on these calf injuries, including injuries of the gastrocnemius, plantaris, soleus, and flexor hallucis longus, which may occasionally be mistaken for Achilles tendon disorders. PMID:19857847

Campbell, John T

2009-12-01

99

Coping with Traumatic Events  

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... the areas of traumatic stress reactions, specifically mental health issues among U.S. service members. What we learn from the military experience can help us understand stress risk predictions for the entire population.   Read transcript. &# ...

100

Understanding Child Traumatic Stress  

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101

Traumatic Brain Injury  

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... Resilience, Mental Health Resources The Center for the Study of Traumatic Stress at the Uniformed Services University ... on PTSD, TBI DOD Establishes Tissue Bank to Study Brain Injuries Defense Brain Injury Center, Two Decades ...

102

Traumatic Brain Injury (TBI)  

MedlinePLUS

... appointed director of NICHD’s National Center for Medical Rehabilitation Research NICHD Co-Sponsors White House Disability Summit NICHD Funds Research on Traumatic Brain Injury (TBI) All related news Home Accessibility Contact Disclaimer ...

103

Treatment of urethral strictures with the KTP 532 laser  

NASA Astrophysics Data System (ADS)

The objective of this study was to evaluate and compare the safety and efficacy of the KTP 532 laser to direct vision internal urethrotomy (DVIU) in the management of urethral strictures. A total of 32 patients were randomized prospectively in this study, 14 DVIU and 18 KTP 532 laser. Patients were evaluated postoperatively with flowmetry and in the case of recurrence with cystourethrography at 3, 12, 24 weeks. With the KTP 532 laser complete symptomatic and urodynamic success was achieved in 15 (83%) patients at 12 and 24 weeks. Success rate was lower in the DVIU group with 9 (64%) patients at 12 weeks and 8 (57%) patients at 24 weeks. With the KTP mean preoperative peak-flow was improved from 6 cc/s to 20 cc/s at 3, 12 and 24 weeks. With DVIU mean preoperative peak-flow was improved from 5.5 cc/s to 20 cc/s at 3 weeks followed by a steady decrease to 13 cc/s at 12 weeks and to 12 cc/s 24 weeks. No complications were observed in either group of patients. Our results confirm that stricture vaporization with the KTP 532 laser is a safe and efficient procedure. It thus represents a valuable alternative in the endoscopic treatment of urethral strictures.

Schmidlin, Franz R.; Oswald, Michael; Iselin, Christoph E.; Jichlinski, Patrice; Delacretaz, Guy P.; Leisinger, Hans-Juerg; Graber, Peter

1997-05-01

104

Trans-vastus Intermedius Transfer of the Pedicled Anterolateral Thigh Flap for Posterior Thigh Reconstruction  

PubMed Central

Summary: Proximal, posterior thigh wounds from oncologic or traumatic defects can be difficult wounds to reconstruct if local flap options have been sacrificed during the trauma or oncologic resection. Free flap options to cover these defects are also difficult because of the lack of convenient recipient vessels in the region. The authors present 2 cases (oncologic and traumatic) wherein a myocutaneous anterolateral thigh (ALT) flap was harvested and tunneled from the anterior muscle compartment to the posterior muscle compartment of the thigh through a medially based transmuscular tunnel, decreasing the required pedicle distance to the wound. This technique of transmuscular tunneling of the ALT flap expands the indications and utility of the ALT flap to cover posterior thigh wounds. PMID:25289275

Batdorf, Niles J.; Lettieri, Salvatore C.

2013-01-01

105

Acquired urinary incontinence in the bitch: update and perspectives from human medicine. Part 2: The urethral component, pathophysiology and medical treatment.  

PubMed

Various pathologies can affect the bladder and/or urethral contractility causing signs of urinary incontinence. In this second part of a three-part review, the pathophysiology of impaired urethral contractility (including urethral hyper- and hypotonicity) in the bitch and in women is discussed. Urethral sphincter mechanism incompetence (USMI) is the most common form of acquired urinary incontinence in bitches and is characterized by a decreased urethral tone. The pathophysiology and current recommended medical treatment options for USMI and cases of modified urethral tonicity due to a neurological disorder or functional outlet obstruction are discussed. Treatment options in human medicine in cases of impaired urethral contractility are described. PMID:20655776

Noël, Stéphanie; Claeys, Stéphanie; Hamaide, Annick

2010-10-01

106

Traumatic Alterations in Consciousness: Traumatic Brain Injury  

PubMed Central

Mild traumatic brain injury (mTBI) refers to the clinical condition of transient alteration of consciousness as a result of traumatic injury to the brain. The priority of emergency care is to identify and facilitate the treatment of rare but potentially life threatening intra-cranial injuries associated with mTBI through the judicious application of appropriate imaging studies and neurosurgical consultation. Although post-mTBI symptoms quickly and completely resolve in the vast majority of cases, a significant number of patients will complain of lasting problems that may cause significant disability. Simple and early interventions such as patient education and appropriate referral can reduce the likelihood of chronic symptoms. Although definitive evidence is lacking, mTBI is likely to be related to significant long-term sequelae such as Alzheimer's disease and other neurodegenerative processes. PMID:20709244

Blyth, Brian J.; Bazarian, Jeffrey J.

2010-01-01

107

Delayed post-traumatic saccular aneurysm of PICA in an adolescent  

Microsoft Academic Search

Delayed traumatic intracranial aneurysms of the posterior circulation caused by nonpenetrating head injury are rare, especially\\u000a in pediatric patients. The true incidence and natural history of these aneurysms are poorly understood. We report a case of\\u000a a 15-year-old boy who initially presented with subarachnoid hemorrhage of the posterior fossa without any evidence of associated\\u000a aneurysm. On a routine computed tomography

Mandy J. Binning; Tricia B. Hauschild; Amin Amini; Joel D. MacDonald

2009-01-01

108

Suprapubic Cystostomy for the Management of Urethral Injuries During Penile Prosthesis Implantation  

PubMed Central

Introduction Urethral injury is an uncommon surgical complication of penile prosthesis (PP) surgery. Conventional dogma requires abortion of the procedure if the adjacent corporal body is involved or delayed implantation to avert device infection associated with urinary extravasation. Besides the setback of the aborted surgery, this management approach also presents the possible difficulty of encountering corporal fibrosis at the time of reoperation. Aim We report an approach using primary urethral repair and temporary suprapubic cystostomy for the management of incidental urethral injuries in a cohort of patients allowing for successful completion of unaborted PP implantation. Materials and Methods We performed a retrospective analysis of all patients receiving PPs from 1990 to 2014 in which incidental urethral injuries were repaired and PP implantation was completed with suprapubic cystostomy (suprapubic tube [SPT] insertion). After allowing for urethral healing and urinary diversion via SPT for 4–8 weeks, the PP was activated. Main Outcome Measures Successful management was determined by the absence of perioperative complications within 6 months of implantation. Results We identified four cases, all receiving inflatable PPs, managed with temporary suprapubic cystostomy. These patients sustained urethral injuries during corporal dissection (one patient), corporal dilation (one patient), and penile straightening (two patients). All patients were managed safely and successfully. Conclusion Primary urethral repair followed by temporary suprapubic cystostomy offers a surgical approach to complete PP implantation successfully in patients who sustain urethral injury complications, particularly for complex PP surgeries. Anele UA, Le BV, and Burnett AL. Suprapubic cystostomy for the management of urethral injuries during penile prosthesis implantation. PMID:25548649

Anele, Uzoma A; Le, Brian V; Burnett, Arthur L

2014-01-01

109

Docetaxel Inhibits Urethral Stricture Formation, an Initial Study in Rabbit Model  

PubMed Central

Introduction Urethral stricture, a frequent source of lower urinary tract disorders in men, is still a difficult problem for urologists. Based the anti-restenosis effect of paclitaxel on coronary artery, the role of docetaxel, a semi-synthetic analogue of paclitaxel, in limiting urethral stricture formation was studied. Methods Forty adult New Zealand male rabbits were involved in this study, which were randomly assigned into 3 groups, namely a high dose docetaxel (DH, 0.1 mg/d), a low dose docetaxel (DL, 0.01 mg/d) and a control (C) group, with 16, 16, 8 rabbits in each group, respectively. All animals underwent a 10 mm-long circumferential electrocoagulation of the bulbar urethra with a 13Fr pediatric resectoscope. Drugs were given by urethral irrigation daily and continuous for 28 days. Stricture formation was assessed by retrograde urethrography and videourethroscopy. Urethra pathology was evaluated by hematoxylin and eosin staining and Sirius red staining. Results At the end of this study, 15, 14 and 7 rabbits remained for evaluation in DH, DL and C group, respectively. Urethral diameters in DH, DL and C group were (7.17±1.63) mm, (6.55±0.62) mm, (3.23±1.36) mm, with a normal urethral diameter of (9.08±1.29) mm. Lumen reduction in DH, DL and C group were (36.93±11.58)%, (48.03±7.89)% and (84.66±14.95)%, respectively. Statistically difference could be found between every two groups (p<0.05) both in urethral diameters and in lumen reduction, except for compare of urethral diameters between DH and DL group. Histological examination confirmed mass fibrous tissue and collagen content at the stricture sit in C group, whereas less in docetaxel treated rabbits. Conclusions Docetaxel could limit urethral stricture formation, which may be due to inhibition of fibrous tissue and collagen expression. Docetaxel may become a new choice in the prevention of urethral stricture formation. PMID:25375859

Fu, Delai; Chong, Tie; Li, Hecheng; Zhang, Huibo; Wang, Ziming

2014-01-01

110

A novel radiographic technique to asses grafts in the female pelvis: a comparison of the Inside-Out and the Outside-In transobturator mid urethral sling positioning  

PubMed Central

The three-dimensional configuration of mid-urethral sling tapes is difficult to demonstrate in traditional anatomical dissections or imaging studies. The aim of this study was to test the utility of a novel technique using mesh tapes to assess spatial differences between the in-out and out-in transobturator mid-urethral slings. Two independent surgeons performed their usual transobturator mid-urethral sling placement on 10 fresh thawed cadavers, alternating sides in the consecutive cadavers. Tantalum wires threaded through the polypropylene-tapes rendered them radio-opaque. Following placement, CT scans were obtained to generate 3-D and MIPS images for analysis. Results showed that the mean angle formed by the in-out sling measured 122º (95%CI: 107º-136º); versus 144º (95%CI: 131º-151º) for the out-in sling (p?=?0.02). The paired differences between the tapes’ inner angles were significantly different; with a mean difference of 20º (median 19.0º), (p?=?0.008). There was no significant correlation between either approach and BMI or angle of the pubic arch. The images revealed that the tapes lie as a band posterior/dorsal to the urethra rather than inferior. In conclusion: marking mesh with Tantalum wire, in combination with 3-D and MIPS CT-scan reconstruction images, provided a unique method to visualize the entire sling trajectory. The clinical implications of the more horizontal positioning after the out-in approach remain to be determined. PMID:24753952

Hinoul, P.; Elzevier, H.W.; Kirkemo, A.; Patel, B.G.; Flynn, B.J.; Walters, M.D.

2013-01-01

111

Use of an Aortic Stent Graft Extension for the Treatment of Urethral Stricture in a Dog  

PubMed Central

ABSTRACT A 2-year-old male mixed dog was referred to us for further evaluation and treatment of a 4-week-history of oliguria and abdominal distension after a surgical repair of urethral injury. To relieve the urethral stricture, we placed a self-expanding aortic stent graft extension with a partial coverage with an expanded polytetrafluoroethylene (ePTFE). After the placement of the stent, the dog presented with a normal urinary voiding, despite the presence of urinary incontinence. The current case indicates that the ePTFE-covered, self-expanding ASGE is an effective intervention for the treatment of severe urethral stricture in the dog. PMID:23676211

BAE, Jae Hyun; KWON, Yong Hwan; JUNG, Ye Chan; JUNG, Ji Mo; LEE, Hae Beom; LEE, Ki Chang; KIM, Nam Soo; KIM, Min-Su

2013-01-01

112

Use of Cutting Balloon in the Treatment of Urethral Stricture: A Novel Technique  

SciTech Connect

The peripheral cutting balloon has been used to treat various nonvascular strictures as well as vascular stenosis. In this article, we describe for the first time the use of the cutting balloon in the treatment of patients with urethral stricture. Four patients with bulbar urethral stricture were included in the study. All strictures were successfully dilated with the cutting balloon, and patients were free of symptoms at 6-month follow-up. Cutting-balloon dilatation is a safe, easy-to-perform, and effective treatment for patients with tight urethral strictures.

Yildirim, Erkan, E-mail: drerkany@yahoo.co [Baskent University Medical School Ankara, Department of Radiology (Turkey); Cicek, Tufan; Istanbulluoglu, Okan; Ozturk, Bulent [Baskent University Medical School Ankara, Department of Urology (Turkey)

2009-05-15

113

Post-traumatic stress disorder  

MedlinePLUS

PTSD ... Doctors do not know why traumatic events cause PTSD in some people, but not in others. Your ... Past emotional trauma may increase your risk of PTSD after a recent traumatic event. With PTSD, the ...

114

TRAUMATIC BRAIN INJURY (TBI) DATABASE  

EPA Science Inventory

The Traumatic Brain Injury National Data Center (TBINDC) at Kessler Medical Rehabilitation Research and Education Center is the coordinating center for the research and dissemination efforts of the Traumatic Brain Injury Model Systems (TBIMS) program funded by the National Instit...

115

Urethral masturbation and sexual disinhibition in dementia: a case report.  

PubMed

Urethral masturbation and sexual disinhibition as manifestations of behavioral and psychological symptoms of dementia (BPSD) are described in a 90-year-old patient who repeatedly self-inserted foreign bodies into his urethra. A diagnosis was made of late onset sexual disinhibition and hypersexuality in a patient with Dementia of the Alzheimer Type. Significant reduction of his sexual behavior was achieved with low doses of haloperidol. Similar symptoms are noted in Pick's disease, other fronto-temporal lesions, mania and following a seizure or treatment of Parkinson's disease, and have been described as Kluver-Busy-type. Clinicians should consider this diagnosis when investigating dysuria, cystitis, haematuria and urinary tract infections even in the very old. PMID:12817671

Rosenthal, Michal; Berkman, Pinhas; Shapira, Adi; Gil, Israel; Abramovitz, Jancu

2003-01-01

116

A man with urethral polyembolokoilamania successfully treated with electroconvulsive therapy.  

PubMed

Polyembolokoilamania is the act of inserting foreign objects into bodily orifices and can be classified as a paraphilia if done for sexual pleasure. Although problematic sexual behaviors are common in dementia, the majority of case reports of urethral polyembolokoilamania in the elderly have occurred in the absence of dementia or cognitive impairment. Little empirical evidence exists for managing problematic sexual behaviors in the elderly and in dementia. Most evidence in the form of case reports demonstrates that behavioral, environmental, and pharmacological interventions can be effective. In this case report, we describe the management of sexually disinhibited behavior in the form of polyembolokoilamania in a 67-year-old man suffering from treatment-resistant depression, obsessive compulsive disorder, and early signs of frontotemporal dementia. The successful treatment included a course of electroconvulsive therapy. PMID:24569921

Ingves, Matthew V; Lau, Timothy; Fedoroff, J Paul; Levine, Sharon

2014-08-01

117

Detrusor urethral sphincter dyssynergia: micturitional vesicourethral pressure profile patterns.  

PubMed

Vesicourethral static pressure recordings were attempted in patients with detrusor urethral sphincter dyssynergia. The technique consisted of recording vesicourethral pressures at successive points, commencing in the lower segment of the bladder during micturition. A small catheter with side holes was used for this purpose and static (lateral) pressure profile recordings were attempted during voiding. Successful static pressure recordings were obtained only in those patients who could expel urine as uninterrupted stream. Patients who could not void or those who could void only with interrupted stream have demonstrated profile patterns that required careful interpretation. The accuracy of urodynamic interpretation also depended upon careful clinical evaluation and awareness of the built-in artifacts of the technique. PMID:7176062

Yalla, S V; Yap, W; Fam, B A

1982-11-01

118

Post-Traumatic Stress Disorder  

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... our disclaimer about external links Menu Post-Traumatic Stress Disorder Post-traumatic stress disorder (PTSD) is an anxiety disorder that can ... military combat. For Consumers General Information Post-Traumatic Stress Disorder ( NIMH ) Anxiety Information Stress Information Depression Information ...

119

Vicarious traumatization: concept analysis.  

PubMed

There is growing knowledge of the effects of stress on professionals, including various negative symptoms that may mirror the biopsychosocial effects exhibited by the victims of trauma. Multiple concepts including burn out, compassion fatigue, post-traumatic stress disorder (PTSD), and secondary traumatic stress, are terms that have been incorrectly interchanged with the term vicarious traumatization (VT). Clarity of vicarious victimization and understanding contributing factors is imperative in order to facilitate future research and implement timely and effective interventions, as well as sculpt evidence based practice. This concept anaylsis, complete with a concept map, discusses VT; related terminology; symptomology; prevention and relevant interventions; and discusses opportunities for personal/professional growth for nurses and especially forensic nurses working with victims of violence. PMID:22123041

Tabor, Pamela Diane

2011-12-01

120

Remote discovery of an asymptomatic bowel perforation by a mid-urethral sling.  

PubMed

Bowel perforation is a rare complication of mid-urethral sling procedures and is usually reported shortly after the surgery. We report a remotely discovered asymptomatic bowel injury found at the time of subsequent surgery. The patient with a history of several prior pelvic surgeries underwent an uneventful retropubic mid-urethral sling placement. Five years later, during an abdominal sacrocolpopexy procedure, mesh from the mid-urethral sling was found perforating the wall of the cecum and fixating it to the right pelvic sidewall. Cecal wedge resection was performed to excise the sling mesh. Asymptomatic bowel perforation by mid-urethral sling mesh has not been previously reported. Pelvic and abdominal surgeons should be aware of the possibility of finding this injury in patients with prior sling surgeries. PMID:22052439

Elliott, Jason E; Maslow, Ken D

2012-02-01

121

Severe Traumatic Injury  

PubMed Central

Objectives The public health implications of regional variation in incidence and outcome of severe traumatic injury remain to be analyzed. The objective of this study was to determine whether the incidence and outcome associated with severe traumatic injury differs across geographic regions of North America. Methods A prospective, observational study was conducted of the Resuscitation Outcomes Consortium of all patients in 9 North American sites (6 US and 3 Canadian) sustaining severe traumatic injury from April 1, 2006 to March 31, 2007 followed to hospital discharge. Eligible patients were assessed by organized emergency medical services, and had field-based physiologic criteria including systolic blood pressure ?90 mm Hg, Glasgow Coma Scale score ?12, respiratory rate <10 or >29 per minute, advanced airway procedure, or traumatic death in the field. Census data were used to determine rates adjusted for age and sex. The main outcome measures were incidence rate, mortality rate, case fatality rate, and survival to discharge for patients sustaining severe traumatic injury assessed by EMS. Results The total catchment population of 20.5 million yielded 7080 cases of severe traumatic injury. Median age was 36 years and 67% were male. The median incidence of EMS-assessed severe traumatic injury per 100,000 population across sites was 37.4 (interquartile range [IQR] = 24.6 – 69.6); survival ranged from 39.8% to 80.8%, with a median of 64.5% (IQR = 55.5–78.4). About 942 cases were pronounced dead at the scene and 5857 patients were transported to hospital; 4477 (63.2%) were discharged alive. The median incidence of severe trauma due to a blunt mechanism, transported to hospital, was 25.8 (IQR = 13.1–44.3); survival ranged from 52.6% to 87.3%, with a median of 78.0% (IQR = 68.4–83.5). The median incidence of severe penetrating trauma, transported to hospital, was 2.6 (IQR = 1.5–10.4); survival ranged from 37.5% to 84.7%, with a median of 67.5% (IQR = 54.1–75.9). All P values for differences across sites for incidence and survival were <0.001. Conclusions In this study involving 9 geographic regions in North America, there were significant and important regional differences in severe traumatic injury, incidence, and outcome. These differences were sustained for patients with either isolated blunt or penetrating injury mechanisms. PMID:20531005

Minei, Joseph P.; Schmicker, Robert H.; Kerby, Jeffrey D.; Stiell, Ian G.; Schreiber, Martin A.; Bulger, Eileen; Tisherman, Samuel; Hoyt, David B.; Nichol, Graham

2014-01-01

122

Palliative Surgery for Rare Cases of Anterior Urethral Metastasis in Prostate Cancer  

PubMed Central

Penis metastasis from prostate cancer is very rare, and its management varies from case to case as there are very few cases reported in the literature. We describe a patient with prostate cancer treated with radiotherapy and androgen deprivation therapy who presented with urethral bleeding as a symptom of anterior urethral metastasis during followup. We propose a way to manage this and review the literature. PMID:25161796

Gómez Gómez, Enrique; Carrasco Aznar, Jose Carlos; Moreno Rodríguez, Maria del Mar; Valero Rosa, José; Requena Tapia, Maria José

2014-01-01

123

Comparative efficacy of piperacillin and penicillin G in treatment of gonococcal urethritis.  

PubMed Central

The comparative efficacy of 2 g of piperacillin and 4.8 X 10(6) U of penicillin G in the treatment of uncomplicated gonococcal urethritis was assessed in a randomized prospective study. Sixty-five evaluable patients received piperacillin, and 55 received penicillin G. All patients received either therapy were cured of gonorrhea. We conclude that piperacillin is as efficacious as aqueous procaine penicillin G in the therapy of uncomplicated gonococcal urethritis. PMID:6459764

Landis, S J; Ramphal, R; Mansheim, B J; Rand, K H; Shands, J W

1981-01-01

124

Comparative efficacy of piperacillin and penicillin G in treatment of gonococcal urethritis.  

PubMed

The comparative efficacy of 2 g of piperacillin and 4.8 X 10(6) U of penicillin G in the treatment of uncomplicated gonococcal urethritis was assessed in a randomized prospective study. Sixty-five evaluable patients received piperacillin, and 55 received penicillin G. All patients received either therapy were cured of gonorrhea. We conclude that piperacillin is as efficacious as aqueous procaine penicillin G in the therapy of uncomplicated gonococcal urethritis. PMID:6459764

Landis, S J; Ramphal, R; Mansheim, B J; Rand, K H; Shands, J W

1981-11-01

125

Suprapubic Bladder Aspiration or Urethral Catheterization: Which is More Painful in Uncircumcised Male Newborns?  

PubMed Central

Background: The aim was to compare the intensity of pain caused by suprapubic aspiration (SPA) and urethral catheterization for urine sampling in premature infants. Methods: A prospective randomized controlled design with 80 premature infants in Alzahra University Hospital, Isfahan, Iran was conducted. Premature newborns who needed urine samples for microbiologic analysis were randomly assigned into two groups: SPA group and urethral catheterization group. Newborn faces and upper parts of the body were videotaped during the study and the pain was assessed during urine collection using Premature Infant Pain Profile (PIPP) score. Furthermore, crying time compared between groups. Results: The mean crying time was significantly higher in SPA than urethral catheterization group (77 vs. 34.4 s) (P < 0.001). The PIPP score was significantly lower in urethral catheterization group (13.4) than SPA group (11.5) P < 0.001. The success rate of SPA was 53% compared with 71% success rate of urethral catheterization. Conclusions: SPA is more painful than urethral catheterization in premature male infants as assessed by PIPP score and is more likely leads to procedure failure. PMID:25317295

Badiee, Zohreh; Sadeghnia, Alireza; Zarean, Noushin

2014-01-01

126

Post-traumatic amnesia and the nature of post-traumatic stress disorder after mild traumatic brain injury  

Microsoft Academic Search

The prevalence and nature of post-traumatic stress disorder (PTSD) following mild traumatic brain injury (MTBI) is controversial because of the apparent paradox of suffering PTSD with impaired memory for the traumatic event. In this study, 1167 survivors of traumatic injury (MTBI: 459, No TBI: 708) were assessed for PTSD symptoms and post-traumatic amnesia during hospitalization, and were subsequently assessed for

RICHARD A. BRYANT; MARK CREAMER; MEAGHAN O’DONNELL; DERRICK SILOVE; C. RICHARD CLARK; ALEXANDER C. MCFARLANE

2009-01-01

127

Traumatic Brain Injury  

Microsoft Academic Search

Approximately 250 per 100,000 of the population sustain traumatic brain injury (TBI) annually (Cassidy et al., 2004), making it the most commonly occurring neurological condition. Of these 102 per 100,000 are hospitalised (Chesnut, Carney, Maynard, Patterson, Mann, & Helfand, 1998). Because of advances in trauma care these individuals are surviving injuries that would previously have been fatal (Klimczak, Donovick, &

Janet M. Leathem; Muriel Christianson

128

Detailed urethral dosimetry in the evaluation of prostate brachytherapy-related urinary morbidity  

SciTech Connect

Purpose: To evaluate the relationship between urinary morbidity after prostate brachytherapy and urethral doses calculated at the base, midprostate, apex, and urogenital diaphragm. Methods and Materials: From February 1998 through July 2002, 186 consecutive patients without a prior history of a transurethral resection underwent monotherapeutic brachytherapy (no supplemental external beam radiation therapy or androgen deprivation therapy) with urethral-sparing techniques (average urethral dose 100%-140% minimum peripheral dose) for clinical T1c-T2b (2002 AJCC) prostate cancer. The median follow-up was 45.5 months. Urinary morbidity was defined by time to International Prostate Symptom Score (IPSS) resolution, maximum increase in IPSS, catheter dependency, and the need for postimplant surgical intervention. An alpha blocker was initiated approximately 2 weeks before implantation and continued at least until the IPSS returned to baseline. Evaluated parameters included overall urethral dose (average and maximum), doses to the base, midprostate, apex, and urogenital diaphragm, patient age, clinical T stage, preimplant IPSS, ultrasound volume, isotope, and D90 and V100/150/200. Results: Of the 186 patients, 176 (94.6%) had the urinary catheter permanently removed on the day of implantation with only 1 patient requiring a urinary catheter >5 days. No patient had a urethral stricture and only 2 patients (1.1%) required a postbrachytherapy transurethral resection of the prostate (TURP). For the entire cohort, IPSS on average peaked 2 weeks after implantation with a mean and median time to IPSS resolution of 14 and 3 weeks, respectively. For the entire cohort, only isotope predicted for IPSS resolution, while neither overall average prostatic urethra nor segmental urethral dose predicted for IPSS resolution. The maximum postimplant IPSS increase was best predicted by preimplant IPSS and the maximum apical urethral dose. Conclusions: With the routine use of prophylactic alpha blockers and strict adherence to urethral-sparing techniques, detailed urethral dosimetry did not substantially improve the ability to predict urinary morbidity. Neither the average dose to the prostatic urethra nor urethral doses stratified into base, midprostate, apex, or urogenital diaphragm segments predicted for IPSS normalization. Radiation doses of 100%-140% minimum peripheral dose are well tolerated by all segments of the prostatic urethra with resultant tumorcidal doses to foci of periurethral cancer.

Allen, Zachariah A. [Schiffler Cancer Center, Wheeling, WV (United States); Merrick, Gregory S. [Schiffler Cancer Center, Wheeling, WV (United States) and Wheeling Jesuit University, Wheeling, WV (United States)]. E-mail: gmerrick@wheelinghospital.com; Butler, Wayne M. [Schiffler Cancer Center, Wheeling, WV (United States); Wheeling Jesuit University, Wheeling, WV (United States); Wallner, Kent E. [Puget Sound Healthcare Corporation, Group Health Cooperative, and University of Washington, Seattle, WA (United States); Kurko, Brian [Schiffler Cancer Center, Wheeling, WV (United States); Anderson, Richard L. [Schiffler Cancer Center, Wheeling, WV (United States); Murray, Brian C. [Schiffler Cancer Center, Wheeling, WV (United States); Galbreath, Robert W. [Schiffler Cancer Center, Wheeling, WV (United States); Wheeling Jesuit University, Wheeling, WV (United States); Ohio University Eastern, St. Clairsville, OH (United States)

2005-07-15

129

How common is self-treatment in non gonococcal urethritis?  

PubMed Central

OBJECTIVE--To assess the prevalence of self-treatment in men with new episode non gonococcal urethritis (NGU). METHOD--Three hundred consecutive men with new episode NGU attending an open access genitourinary medicine clinic were interviewed using a semi-structured questionnaire. Details of treatment used before attending the clinic were obtained. RESULTS--Thirty (10%) men had used treatment, for an average of 7 days, prior to the clinic attendance. Agents used included antibiotics (11), savion or iodine (4), vitamin tablets (4), cisapride (2), local anaesthetic gel (2), antiseptic cream (2), cod liver oil (1), ferrous sulphate (1), naproxen (1), clotrimazole cream (1) and a poultice (1). Over 70% of the men reporting antibiotic use had self-medicated and in one case a fixed drug eruption had ensued. CONCLUSION--A significant number of men with NGU self-treat. In addition to the adverse effects of such treatment and the potential effect on culture tests, clinic attendance may be postponed, the use of appropriate therapy delayed, and sexual contacts will remain at risk. Early attendance for treatment and contact tracing is essential and should be actively promoted. PMID:8566983

Carlin, E M; Barton, S E

1995-01-01

130

Mid-urethral slings in female incontinence: Current status  

PubMed Central

The advent of the mid-urethral sling (MUS) 15 years ago has drastically changed the surgical management of stress urinary incontinence (SUI). Both retropubic and transobturator MUS can be placed in the ambulatory setting with excellent results. The tension-free vaginal tape (TVT) sling has the most robust and long-term data, but more recent literature suggests that the transobturator tape sling may offer comparable efficacy in appropriately selected patients. Single incision sling (SIS) is the newest addition to the MUS group and was developed in an attempt to minimize morbidity and create an anti-incontinence procedure that could be performed in the office. The efficacy of SIS remains unknown as the current literature regarding SIS lacks long-term results and comparative trials. The suprapubic arc sling appears to have equally effective outcomes in at least the short-term when compared with TVT. Although evolution of the SIS has led to a less invasive procedure with decreased post-op pain and reduced recovery time, durability of efficacy could be the endpoint we are sacrificing. Until longer-term data and more quality comparison trials are available, tailoring one's choice of MUS to the individual patient and her unique clinical parameters remains the best option. PMID:22022053

Krlin, Ryan M.; Murphy, Alana M.; Ingber, Michael S.; Vasavada, Sandip P.

2011-01-01

131

Modified posterior musculofascial plate reconstruction decreases the posterior vesicourethral angle and improves urinary continence recovery in patients undergoing laparoscopic radical prostatectomy  

PubMed Central

The aim of this study was to evaluate the efficacy of our modified posterior musculofascial plate reconstruction (PMPR) procedure in laparoscopic radical prostatectomy (LRP). Prior to 2010, four operative procedures were used to expedite continence recovery: preserving the fascia covering the levator ani muscle, preserving the bladder neck, securing a functional urethral length by using a lateral-view dissection technique and suspending the vesicourethral anastomosis from the puboprostatic ligaments. Since February, 2010, a running suture between Denonvilliers' fascia (DF) and the median fibrous raphe (MFR, the fibrous tissue that lies immediately underneath the urethra) has also been used. In vesicourethral anastomosis, a double-armed running suture was performed. At the beginning of the anastomosis, the first stitches (at 1 and 11 o'clock positions on the bladder neck) were placed 1–2 cm dorsocephalad to the bladder neck (first through the seromuscular layer and then through the full thickness of the bladder neck). At the 5 and 7 o'clock positions of the urethra, the stitches were placed through the urethral mucosa as well as the the reconstructed musculofascial plate. The bladder shape was evaluated by postoperative cystography and the clinical results were compared between patients undergoing LRP without PMPR (group A) and those undergoing LRP with PMPR (group B). The cystograms demonstrated that the PMPR significantly shortened the vertical length of the bladder and significantly decreased the posterior vesicourethral angle. At 1, 3 and 6 months after LRP, the number of daily used pads was significantly lower in group B compared to that in group A and the time to achieve a pad-free status was significantly shorter in group B. Our modified PMPR procedure significantly improved the recovery of urinary continence following LRP and this improvement may be due in part to changes of the bladder shape. PMID:24649279

ITO, KEIICHI; KENJI, SEGUCHI; YOSHII, HIDEHIKO; HAMADA, SHINSUKE; ASAKUMA, JUNICHI; TASAKI, SHINSUKE; KURODA, KENJI; SATO, AKINORI; HORIGUCHI, AKIO; ASANO, TOMOHIKO

2013-01-01

132

Posterior sampling with improved efficiency  

SciTech Connect

The Markov Chain Monte Carlo (MCMC) technique provides a means to generate a random sequence of model realizations that sample the posterior probability distribution of a Bayesian analysis. That sequence may be used to make inferences about the model uncertainties that derive from measurement uncertainties. This paper presents an approach to improving the efficiency of the Metropolis approach to MCMC by incorporating an approximation to the covariance matrix of the posterior distribution. The covariance matrix is approximated using the update formula from the BFGS quasi-Newton optimization algorithm. Examples are given for uncorrelated and correlated multidimensional Gaussian posterior distributions.

Hanson, K.M.; Cunningham, G.S.

1998-12-01

133

Two-stage posterior cross-labial transposition flap: a novel technique for labium minus reconstruction.  

PubMed

Distinctive asymmetry of the labia minora is an underestimated complication that can be congenital, post-traumatic, or occur after oncological intervention or aesthetic labioplasty. Affected women can be restricted functionally and in their sense of self-worth, aesthetic appearance and sexual life. In presenting this case of post-oncological labia minora asymmetry, we demonstrate our method of the two-stage posterior cross-labial transposition flap as a reliable technique for unilateral labium minus reconstruction. PMID:25192748

Zeplin, Philip H; Nuwayhid, Rima; Nuwayhid, Marwan

2014-10-01

134

Traumatic Head Injuries  

Microsoft Academic Search

\\u000a Head injuries are common among children, and they result in a significant number of visits to emergency departments and physicians’\\u000a offices each year. In children 15yr old and under, the estimated incidence of traumatic brain injury is 180 per 100,000 children\\u000a per year, totaling more than 1 million injuries annually in the United States and accounting for more than 10%

Laura Purcell

135

Traumatic Brain Injury  

Microsoft Academic Search

Patients with traumatic brain injury (TBI) pose an enormous clinical, emotional, and intellectual challenge to rehabilitation\\u000a professionals. For public policymakers, the cost of care for approximately 6 million survivors of TBI is measured in the billions\\u000a of dollars. In addition to the motor, sensory, and language deficits commonly seen in nontraumatic etiologies, the patient\\u000a with TBI often experiences cognitive and\\/or

Ramnik Singh; Michael W. O’Dell

136

Bacterial Vaginosis–Associated Bacteria in Men: Association of Leptotrichia/Sneathia spp. With Nongonococcal Urethritis  

PubMed Central

Background Approximately 45% of nongonococcal urethritis cases have no identified etiology. Novel bacteria recently associated with bacterial vaginosis (BV) in women may be involved. We evaluated the association of idiopathic nongonococcal urethritis and 5 newly described BV-associated bacteria (BVAB). Methods Heterosexual men 16 years or older attending a sexually transmitted disease clinic in Seattle, Washington, from May 2007 to July 2011 and negative for Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Mycoplasma genitalium, and Ureaplasma urealyticum–biovar2 were eligible. Cases had urethral discharge or 5 or more polymorphonuclear leukocytes per high-power field in urethral exudates. Controls had no urethral discharge and less than 5 polymorphonuclear leukocytes per high-power field. Urine was tested for Atopobium spp., BVAB-2, BVAB-3, Megasphaera spp., and Leptotrichia/Sneathia spp. using quantitative taxon-directed polymerase chain reaction. Results Cases (n = 157) and controls (n = 102) were of similar age, education, and income, and most were white. Leptotrichia/Sneathia spp. was significantly associated with urethritis (24/157 [15.3%] vs. 6/102 [5.9%], P = 0.03). BVAB-2 was more common in cases than in controls (7/157 [4.5%] vs. 1/102 [1.0%], P = 0.15), and BVAB-3 (n = 2) and Megasphaera spp. (n = 1) were only detected in men with urethritis, but these bacteria were found only in men who also had Leptotrichia/Sneathia spp. Atopobium spp. was not associated with urethritis. The quantity of bacteria did not differ between cases and controls. Among treated cases, doxycycline was more effective than azithromycin for clinical cure of men with Leptotrichia/Sneathia spp. (9/10 vs. 7/12, P = 0.16) and BVAB-2 (3/3 vs. 0/3, P = 0.10). Conclusions Leptotrichia/Sneathia spp. may be urethral pathogens or contribute to a pathogenic microbiota that can also include BVAB-2, BVAB-3, and Megasphaera spp. Doxycycline may be more effective than azithromycin against these newly identified bacteria. PMID:24220356

Manhart, Lisa E.; Khosropour, Christine M.; Liu, Congzhu; Gillespie, Catherine W.; Depner, Kevin; Fiedler, Tina; Marrazzo, Jeanne M.; Fredricks, David N.

2014-01-01

137

Effect of therapy on susceptibility to urinary tract infection in male cats with indwelling urethral catheters.  

PubMed

Indwelling urinary catheters with a closed urine collection system were maintained in 30 male cats for 3 days after induction of irritant cystitis. All cats received subcutaneous fluids during the 3 days the catheters were in place. The effects of four different treatment regimens on urinary tract infection rates, incidence of urethral obstruction, and development of urinary tract lesions over a 10-day period were compared with results in a nontreated group. Treatments were 1) amoxicillin for 5 days PO; 2) prednisolone for 5 days PO; 3) both amoxicillin and prednisolone for 5 days PO; and 4) dimethylsulfoxide (DMSO) for 3 days intravesicularly. Euthanasia was done before the end of the 10-day experimental period if the cats had two bouts of urethral obstruction or if the cats became uremic for causes unrelated to urethral obstruction. Seven cats were euthanatized before the conclusion of the experiment. These cats had been treated with prednisolone, prednisolone and amoxicillin, or DMSO. All cats that received amoxicillin alone or no therapy survived the 10-day period. Mortality was due to repeated urethral obstruction or to uremia associated with pyelonephritis or papillitis. Urinary tract infection rate was similar in all groups. The group treated with prednisolone alone had the highest incidence of renal infection. Inflammatory lesions in the lower urinary tract were similar in all groups. In conclusion, persistent urinary tract infection often develops in cats with cystitis after indwelling urethral catheterization even when closed systems of urine drainage are used.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1588543

Barsanti, J A; Shotts, E B; Crowell, W A; Finco, D R; Brown, J

1992-01-01

138

Spontaneus resolution of a traumatic vertebral artery pseudoaneurysm.  

PubMed

Injuries of the vertebral artery are rare and are usually seen after penetrating or blunt cervical trauma. Vertebral artery injuries (VAI) have been reported in 0.5% of blunt trauma cases. These injuries can lead to hemorrhage, thrombosis, arteriovenous fistula or traumatic pseudoaneurysm in the early or late period. They must be treated carefully due to their increased risk of morbidity and mortality. In this case report, we present a case of asymptomatic traumatic vertebral artery pseudoaneurysm(TVAP) seen after cervical spinal trauma with C5-C6 listhesis developing afterwards, treated with anterior-posterior stabilization and fusion. Spontaneous resolution of the pseudoaneurysm is demonstrated by vertebral arter angiogrphy. PMID:21294098

Tekiner, Ayhan; Gokcek, Cevdet; Bayar, Mehmet Akif; Erdem, Yavuz; Kilic, Celal

2011-01-01

139

Posterior Tibial Tendon Dysfunction (PTTD)  

MedlinePLUS

... ACFAS | Información en Español Advanced Search Home » Foot & Ankle Conditions » Posterior Tibial Tendon Dysfunction (PTTD) Text Size ... the arch, and an inward rolling of the ankle. As the condition progresses, the symptoms will change. ...

140

Posttraumatic persistent shoulder pain: Superior labrum anterior-posterior (SLAP) lesions  

PubMed Central

Patient: Male, 57 Final Diagnosis: Typ 2 Superior labrum anterior-posterior lesion Symptoms: Shoulder pain after trauma Medication: — Clinical Procedure: — Specialty: Orthopedics and Traumatology • Emergency Medicine Objective: Rare disease Background: Due to the anatomical and biomechanical characteristics of the shoulder, traumatic soft-tissue lesions are more common than osseous lesions. Superior labrum anterior-posterior (SLAP) lesions are an uncommon a cause of shoulder pain. SLAP is injury or separation of the glenoid labrum superior where the long head of biceps adheres. SLAP lesions are usually not seen on plain direct radiographs. Shoulder MRI and magnetic resonance arthrography are useful for diagnosis. Case Report: A 57-year-old man was admitted to the emergency department due to a low fall on his shoulder. In physical examination, active and passive shoulder motion was normal except for painful extension. Anterior-posterior shoulder x-ray imaging was normal. The patient required orthopedics consultation in the emergency observation unit due to persistent shoulder pain. In shoulder MRI, performed for diagnosis, type II lesion SLAP was detected. The patient was referred to a tertiary hospital due to lack of arthroscopy in our hospital. Conclusions: Shoulder traumas are usually soft-tissue injuries with no findings in x-rays. SLAP lesion is an uncommon cause of traumatic shoulder pain. For this reason, we recommend orthopedic consultation in post-traumatic persistent shoulder pain. PMID:23961305

Gulacti, Umut; Can, Cagdas; Erdogan, Mehmet Ozgur; Lok, Ugur; Buyukaslan, Hasan

2013-01-01

141

Posterior skull surgery in craniosynostosis  

Microsoft Academic Search

In 1984, two young infants with unusual “clover-leaf” patterns of skull deformity were treated by posterior skull-releasing surgery that dramatically improved their overall skull shape, to the extent that further operative intervention was not required. This focused our attention on the posterior skull and its role in craniosynostosis. In cases of multi-suture craniosynostosis and craniofacial syndromes severely raised intracranial pressure

S. Sgouros; J. H. Goldin; A. D. Hockley; M. J. C. Wake

1996-01-01

142

Changes in plasma gonadotropin concentrations and urethral closure pressure in the bitch during the 12 months following ovariectomy  

Microsoft Academic Search

Urinary incontinence due to acquired urethral sphincter incompetence is a common side effect of spaying, for which the underlying cause remains unknown. Spaying not only results in a significant reduction in the urethral closure pressure within 1 year but also in an increase in the plasma gonadotropin concentrations.To investigate the possible link between the post-ovariectomy changes in plasma gonadotropins and

Iris Margaret Reichler; Esther Pfeiffer; Claude A. Piché; Wolfgang Jöchle; Malgorzata Roos; Madeleine Hubler; Susi Arnold

2004-01-01

143

[Urethral meatus buried and urethra hypospadias in women: Prevalence, problems and definitions. Study of 12,739 patients.  

PubMed

The difficulty to access to the urethral meatus is found in women in relation to morphological abnormalities of urogenital or ectopic locations meatus, whether acquired (urethral meatus buried [UMB]) or congenital reality (urethra hypospadias [UH]). The pathophysiology is not unequivocal with lack of clear and specific studies. PMID:25458739

Salga, M; Guinet-Lacoste, A; Demans-Blum, C; Thomas-Pohl, M; Weglinski, L; Amarenco, G

2014-11-13

144

Spontaneous ventral urethral fistula in a young diabetic man: a case report  

PubMed Central

We present the first case reported in the medical literature of a patient with a spontaneous ventral urethral fistula accompanied by severe infection due to diabetes mellitus. A 34-year-old man with poor controlled adult-onset diabetes mellitus was admitted to our hospital with a large subcutaneous abscess involving the complete penis, scrotum and perineum. The patient did not report any history of any penile trauma or local infection but has experienced transient swelling of the perineal region following urination. Initial surgical treatment consisted of surgical debridement of necrotic tissue. At this time reconstructive surgery was impossible and a suprapubic cystostomy was performed. After 4 months of suprapubic urinary diversion the urethral fistula resolved and function of external genitalia was reestablished. In a follow-up period of 40 months no recurrence occurred. Spontaneous diabetes-associated ventral urethral fistulas are extremely rare and we are not aware of any other published case report. PMID:17803821

Denzinger, Stefan; Wieland, Wolf F; Burger, Maximilian; Otto, Wolfgang

2007-01-01

145

Clinical evaluation of Apamarga-Ksharataila Uttarabasti in the management of urethral stricture  

PubMed Central

Stricture urethra, though a rare condition, still is a rational and troublesome problem in the international society. Major complications caused by this disease are obstructed urine flow, urine stasis leading to urinary tract infection, calculi formation, etc. This condition can be correlated with Mutramarga Sankocha in Ayurveda. Modern medical science suggests urethral dilatation, which may cause bleeding, false passage and fistula formation in few cases. Surgical procedures have their own complications and limitations. Uttarabasti, a para-surgical procedure is the most effective available treatment in Ayurveda for the diseases of Mutravaha Strotas. In the present study, total 60 patients of urethral stricture were divided into two groups and treated with Uttarabasti (Group A) and urethral dilatation (Group B). The symptoms like obstructed urine flow, straining, dribbling and prolongation of micturation were assessed before and after treatment. The results of the study were significant on all the parameters. PMID:24250127

Reddy, K. Rajeshwar

2013-01-01

146

Isolated urethral tuberculosis in a middle-aged man: a case report  

PubMed Central

Introduction Urogenital tuberculosis is a frequent disease in endemic countries. It is characterized by clinical polymorphism. The isolated urethral form is exceptional, even in countries with endemic tuberculosis. We present a rare case of urogenital tuberculosis in a man revealed by urethral narrowing and multiple urethro-scrotal fistulas. Case presentation The patient, a Moroccan man, was 40 years old. He visited our hospital for a urology consultation and presented with dysuria, purulent discharge and a meatic penoscrotal fistula. A retrograde and voiding urethrocystography was performed and revealed an extended narrowing of the whole anterior urethra associated with multiple fistulous portions toward the scrotum and perineum. At this stage, we reached a diagnosis of nonspecific sclero-inflammatory urethral stricture with complicating fistulas. We decided to perform a urethroplasty enlargement to clear the narrowing urethral sinus tracts. The evolution was marked by delayed wound healing associated with the persistence of fistulas extending into the corpus cavernosum with purulent discharge. It was at this point in the treatment that we suspected tuberculosis. Multiple biopsies were then performed on the periurethral tissue and fistula tracts. The histological examination confirmed urethral tuberculosis and showed the presence of giant cell epithelial lesions with caseous necrosis characteristic of tuberculosis. The treatment for tuberculosis was immediately established and the evolution was marked by a localized, rapid and significant improvement. A second-stage urethroplasty was scheduled for two months after the start of his antituberculous treatment. Conclusions Urogenital tuberculosis is common, but isolated urethral involvement is very rare even in countries with endemic tuberculosis. We urge practitioners, and especially urologists, to consider the disease in their investigation whenever given clinical signs are declared. PMID:23566379

2013-01-01

147

Urodynamic measure of urethral cross-sectional area: application for obstructive uropathy.  

PubMed

A conductance formula was developed based on pressure (P) and flow (Q) data collected from rigid tubes with a cross-sectional area in the range of the flow controlling zone of the urethra. Curve fitting of data resulted in an exponential formula and a simple proportionality constant related tube of differing cross-sectional area. The resulting formula estimates cross-sectional area based on P and Q data and is in the form of a conductance ratio because Q is in the numerator and P is in the denominator. The formula is AEFm = 3.5 Q/P0.58, where AEFm is the area equivalent factor-male and Q is measured in ml/sec and P is cm H2O. To further introduce the estimate of cross-sectional area, urodynamics were retrospectively reviewed from 19 males over the age of 50 with complaints of prostatism. The AEFm was plotted on standard urodynamic records much like P and Q data. The onset of voiding was characterized by a rapid increase in urethral area. Maximal cross-sectional area obtained at maximal flow was 2.9 +/- 1.4 mm2. The maximal urethral area per unit of applied detrusor pressure, an estimate of urethral compliance, was 0.06 +/- 0.6 mm2/cm H2O. This latter measure may help to compare patients with widely different detrusor pressures. The urodynamic data from two young adult males is also presented for comparison. Their average maximal urethral cross-sectional area was 7.1 mm2. Their average area per unit of applied detrusor pressure was 0.15 mm2/cm H2O. These larger values contrast sharply with the BPH group. The AEFm clearly shows urethral function in terms of the principal factor regulating the urine flow rate, the urethral cross-sectional area. PMID:7530555

Walter, J S; Wheeler, J S; Zaszczurynski, P; Plishka, M

1994-01-01

148

Diagnosis of common bacterial causes of urethritis in men by Gram stain, culture and multiplex PCR.  

PubMed

Urethritis is one of the most important causes of morbidity and mortality in developing countries. The aim of this study was to detect common bacterial causes of urethritis in men by Gram stain, culture and multiplex PCR.185 male patients who presented at the Skin and venereal clinic of the Dhaka Medical College, Bangladesh with clinical symptoms suggestive of urethritis were enrolled in this study. Urethral discharges were tested for detection of Neisseria gonorrhoeae by Gram stain, culture and PCR. Multiplex PCR assay was done to detect DNA of Chlamydia trachomatis, Ureaplasma urealyticum and Mycoplasma genitalium. Out of 185 participants, 30.27% and 14.6% were infected by Neisseria gonorrhoeae and Chlamydia trachomatis respectively. None of the individuals was found positive for either Ureaplasma urealyticum or Mycoplasma genitalium. Among the Neisseria gonorrhoeae positive patients 27.57% were positive from Gram stain, 26.49% were culture positive, 30.27% were positive by PCR (p<0.001). 32.65% of the Neisseria gonorrhoeae isolates were penicillinase producers and 83.67% were susceptible to ceftriaxone. Considering culture as the gold standard, the sensitivity and specificity of PCR for the detection of Neisseria gonorrhoeae was 100%, and 94.85% respectively with an accuracy of 96.22%. 3.73% of the 134 smear negative and 5.15% of the 136 culture negative samples were positive by PCR. PCR was the most sensitive and rapid method for the diagnosis of urethritis. Multiplex PCR may be a useful approach to laboratory diagnosis of urethritis in men for its high sensitivity and specificity. PMID:25500516

Jahan, F; Shamsuzzaman, S M; Akter, S

2014-12-01

149

Photodynamic therapy of urethral condylomata acuminata using topically 5-aminolevulinic acid  

NASA Astrophysics Data System (ADS)

Background Electrocoagulation and laser evaporation for urethral condylomata acuminata have high recurrence rates and can be associated with urethral malformations. Objective To investigate the effect of photodynamic therapy (PDT) with topical 5-aminolevulinic acid (ALA) on urethral condylomata acuminata and to examine the histological changes in lesions of condylomata acuminata after ALA-PDT. Methods One hundred and sixty-four urethral condylomata patients were given topical ALA followed by intraurethral PDT through a cylindrical fiber. Among the cases, 16 penile and vulval condylomatous lesions in 11 patients were treated with topical ALA-PDT at same time. After the treatment, biopsy specimens were collected from the 16 penile and vulval lesions. The histological changes were then evaluated by light microscope and electron microscope. Results The complete response rate for urethral condylomata by topical ALA-PDT was 95.12% and the recurrence rate was 5.13% after 6 to 24 months follow-up. Keratinocytes in middle and upper layers of the epidermis with marked vacuolation and some necrocytosis were detected one and three hours after PDT. Necrosis in all layers of the epidermis was noted five hours after PDT by microscopy. In electron microscopy of kerationcytes, distinct ultrastructural abnormalities of mitochondrion, endoplasmic reticulum and membrane damage were observed. Apoptotic bodies were detected three hours after PDT and a large number of the keratinocytes exhibited necrosis five hours after PDT by electron microscope. Conclusions Results suggests that topical ALA-PDT is a simple, effective, relatively safe, less recurrent and comparatively well tolerated treatment for urethral condylomata acuminata. The mechanisms might be that ALA-PDT could trigger apoptotic process and necrosis in the HPV infected keratinocytes. Key words:

Wang, Xiuli; Wang, Hongwei; Wang, Haishan; Xu, Shizheng; Liao, Kanghuang; Hillemanns, Peter

2005-07-01

150

Post-Traumatic Stress Disorder  

E-print Network

-Traumatic Stress Disorder What is post-traumatic stress disorder, or PTSD? PTSD is a real illness. You can get PTSD after living through or seeing a dangerous event, such as war, a hurricane, or bad accident. PTSD makes. If you have PTSD, you can get treatment and feel better. Who gets PTSD? PTSD can happen to anyone at any

Bandettini, Peter A.

151

Post-Traumatic Stress Disorder  

E-print Network

-traumatic stress disorder. #12;· · · · · · What is post-traumatic stress disorder, or PTSD? PTSD is a real illness.You can get PTSD after living through or seeing a dangerous event, such as war, a hurricane, or bad accident. PTSD makes you feel stressed and afraid after the danger is over. It affects your life

Bandettini, Peter A.

152

Post-Traumatic Stress Disorder  

MedlinePLUS

Post-traumatic stress disorder (PTSD) is a real illness. You can get PTSD after living through or seeing a traumatic event, such as war, a ... sexual assault, physical abuse, or a bad accident. PTSD makes you feel stressed and afraid after the ...

153

Cognitive Attributions and Traumatic Experiences  

Microsoft Academic Search

The hypotheses that explanatory style moderates current PTSD, depression and alcohol consumption in students who have experienced potentially traumatic events, such as child physical abuse, child emotional abuse, and child sexual abuse, was examined. Participants were 127 graduate students (aged 18-65 yrs) from a private university in Oregon. It was found that the experience of general traumatic events and child

Olivia McElderry

2007-01-01

154

Cognitive Attributions and Traumatic Events  

Microsoft Academic Search

The hypotheses that explanatory style moderates current PTSD, depression and alcohol consumption in students who have experienced potentially traumatic events, such as child physical abuse, child emotional abuse, and child sexual abuse, was examined. Participants were 144 clients (aged 18-61) receiving outpatient mental health services for addictions. It was found that the experience of generally traumatic events significantly predicted depressive

Olivia McElderry

2009-01-01

155

Hypopituitarism after traumatic brain injury  

Microsoft Academic Search

Traumatic brain injury (TBI) is one of the main causes of death and disability in young adults, with consequences ranging from physical disabilities to long-term cognitive, behavioural, psychological and social defects. Post-traumatic hypopituitarism (PTHP) was recognized more than 80 years ago, but it was thought to be a rare occurrence. Recently, clinical evidence has demonstrated that TBI may frequently cause

Marta Bondanelli; Maria Rosaria Ambrosio; Maria Chiara Zatelli; Laura De Marinis

2005-01-01

156

Fournier's Gangrene in a Heterosexual Man: A Complication of Neisseria meningitidis Urethritis  

PubMed Central

A 55-year-old heterosexual male presented to the emergency department with a symptomatology consistent with urethritis and Fournier's gangrene. Urethral swab and operative tissue cultures were positive for coagulase-negative Staphylococcus and an intracellular Gram-negative diplococcus. The latter was initially thought to be Neisseria gonorrhea; however, DNA sequencing technique confirmed it to be Neisseria meningitidis. The patient required three separate surgical debridements to control widespread necrotizing infection. Following documentation of sterile wound healing with appropriate antibiotics, four reconstructive surgeries were necessary to manage the resultant wound defects. To our knowledge, Neisseria meningitidis as a causative organism in Fournier's gangrene has not been reported in the literature. PMID:23304623

Porshinsky, Brian S.; Patel, Abhishek P.; McClung, Christopher D.

2012-01-01

157

Location of bladder and urethral sphincter motoneurons in the male guinea pig (Cavia porcellus).  

PubMed

Although the guinea pig is used widely in experimental medical research, including in studies on micturition control, the spinal origin of preganglionic parasympathetic bladder and somatic external urethral sphincter motoneurons is not known. In the male guinea pig using wheat germ agglutinin-conjugated horseradish peroxidase and dextran Alexa Fluor 488/568 tracers, preganglionic parasympathetic bladder motoneurons were observed in the ventrolateral part of the intermediolateral cell group of the first sacral segment. The external urethral sphincter motoneurons were found to be located in the ventral horn of the first sacral segment, in a cell group corresponding with the nucleus of Onuf in cat and human. PMID:15147780

Kuipers, Rutger; Izhar, Zofiet; Gerrits, Peter O; Miner, Wesley; Holstege, Gert

2004-05-13

158

Radical Chemoradiotherapy for Urethral Squamous Cell Carcinoma: Two Case Reports and a Review of the Literature  

PubMed Central

Primary urethral squamous cell carcinoma is rare. Its management is particularly challenging owing to the paucity of evidence from randomised trials to inform practice. We report two male and female cases of squamous cell carcinoma of the urethra, which were treated with concomitant cisplatin and radiotherapy. These cases add to the body of case reports that have shown benefit for concomitant chemoradiotherapy in urethral squamous cell carcinoma. They also illustrate that single agent chemotherapy, namely, cisplatin, may be used successfully with limited toxicities. PMID:23738187

Coop, H.; Pettit, L.; Boon, C.; Ramachandra, P.

2013-01-01

159

Imaging Diagnosis of Urethral Leiomyoma, usual Tumour at an Unusual Location  

PubMed Central

Leiomyomas are benign tumours of smooth muscle origin and are the most common uterine masses in females of reproductive age group. Extrauterine leiomyomas are also encountered occassionally and most commonly they involve the genitourinary tract. Leiomyomas arising from urethral smooth muscle are exceptionally unusual which can pose a diagnostic dilemma. Patients usually present with urinary complaints and an intraluminal soft tissue mass bulging from urethral meatus. We are presenting the imaging findings of leiomyoma of distal urethra presenting as a perineal mass with histopathological correlation.

Mehra, Shibani; Garga, U.C.; Jain, Nishchint; Bhardwaj, Krishna

2014-01-01

160

[Traumatic duodenal rupture].  

PubMed

Traumatic duodenal perforation has an incidence of 1%-17% (blunt injury) or 1.7%-5% (penetrating injury). Its prognosis correlates to the kind of injury, associated injuries, size of perforation and delayed diagnosis. Mortality in cases of delayed repair is 65% compared with 5% mortality in early repaired perforation. In cases of delayed diagnosis, we recommend drainage of the perforation, naso-duodenal suction tube, parenteral alimentation. 5 patients where diagnosis was delayed for 8 days or longer were treated in this way and the duodenal wound healed completely without any complications within 22-44 days. PMID:4072459

Kupczyk-Joeris, D; Raguse, T

1985-01-01

161

Mild traumatic brain injury.  

PubMed

Mild traumatic brain injury (mTBI) can have a profoundly negative effect on the injured person's quality of life, producing cognitive, physical, and psychological symptoms; impeding postinjury family reintegration; creating psychological distress among family members; and often having deleterious effects on spousal and parental relationships. This article reviews the most commonly reported signs and symptoms of mTBI, explores the condition's effects on both patient and family, and provides direction for developing nursing interventions that promote patient and family adjustment. PMID:25319524

Hyatt, Kyong S

2014-11-01

162

Posterior polar cataract: A review.  

PubMed

Posterior polar cataract is a rare form of congenital cataract. It is usually inherited as an autosomal dominant disease, yet it can be sporadic. Five genes have been attributed to the formation of this disease. It is highly associated with complications during surgery, such as posterior capsule rupture and nucleus drop. The reason for this high complication rate is the strong adherence of the opacity to the weak posterior capsule. Different surgical strategies were described for the handling of this challenging entity, most of which emphasized the need for gentle maneuvering in dealing with these cases. It has a unique clinical appearance that should not be missed in order to anticipate, avoid, and minimize the impact of the complications associated with it. PMID:23960967

Kalantan, Hatem

2012-01-01

163

[Treatment of posterior positional plagiocephaly].  

PubMed

In 1992, the American academy of paediatrics has recommended that infants be placed on their backs to sleep, because prone sleeping has been correlated with sudden infant death syndrome. Following this article, medical paediatric community has documented an exponential increase in the diagnosis of posterior cranial deformities, which were considered as the consequence of unrelieved pressure onto the occiput during infant sleep. These last 15 years, management of posterior positional plagiocephaly has evolved but is still not standardized; it varies according to local specificities, and medical or parental preferences. Treatment of deformational plagiocephaly includes preventive counseling, repositioning adjustments and exercises, physiotherapy, osteopathy, treatment by dynamic cranial orthosis. On extremely rare occasions, corrective surgery is proposed. This article aims at reviewing the epidemiologic, diagnostic, and various therapeutic options of posterior positional plagiocephaly. PMID:18952411

Vernet, O; de Ribaupierre, S; Cavin, B; Rilliet, B

2008-12-01

164

Modeling acute traumatic injury.  

PubMed

Acute traumatic injury is a complex disease that has remained a leading cause of death, which affects all ages in our society. Direct mechanical insult to tissues may result in physiological and immunologic disturbances brought about by blood loss, coagulopathy, as well as ischemia and reperfusion insults. This inappropriate response leads to an abnormal release of endogenous mediators of inflammation that synergistically contribute to the incidence of morbidity and mortality. This aberrant activation and suppression of the immune system follows a bimodal pattern, wherein activation of the innate immune responses is followed by an anti-inflammatory response with suppression of the adaptive immunity, which can subsequently lead secondary insults and multiple organ dysfunction. Traumatic injury rodent and swine models have been used to describe many of the underlying pathologic mechanisms, which have led to an improved understanding of the morbidity and mortality associated with critically ill trauma patients. The enigmatic immunopathology of the human immunologic response after severe trauma, however, has never more been apparent and there grows a need for a clinically relevant animal model, which mimics this immune physiology to enhance the care of the most severely injured. This has necessitated preclinical studies in a more closely related model system, the nonhuman primate. In this review article, we summarize animal models of trauma that have provided insight into the clinical response and understanding of cellular mechanisms involved in the onset and progression of ischemia-reperfusion injury as well as describe future treatment options using immunomodulation-based strategies. PMID:25481528

Valparaiso, Apple P; Vicente, Diego A; Bograd, Benjamin A; Elster, Eric A; Davis, Thomas A

2014-10-22

165

Decreased posterior tibial slope increases strain in the posterior cruciate ligament following total knee arthroplasty  

Microsoft Academic Search

The purpose of this study was to measure the strain in the posterior cruciate ligament as a function of knee flexion angle and posterior tibial slope following total knee arthroplasty with a posterior cruciate ligament-retaining design. Posterior cruciate ligament strain was measured in seven fresh-frozen cadavers for posterior tibial slopes of 10°, 8°, and 5°. For all three levels of

Robert Singerman; John C. Dean; Hector D. Pagan; Victor M. Goldberg

1996-01-01

166

Urethro-urethral fistula: A rare cause of post-TURP incontinence  

PubMed Central

Prostatic abscess rarely follows acute prostatitis and can sometimes lead to a fistula by breaking into the prostatic urethra, peri-rectal tissues, the perineum, or the rectum. We report a case of a prostatic abscess tracking into the bulbar urethra after a transurethral resection of the prostate. This created a fistula, mimicking a urethral duplication and leading to urinary incontinence. PMID:25553167

Moorthy, H. Krishna; Pillai, Biju S.

2014-01-01

167

An endothelialized urothelial cell-seeded tubular graft for urethral replacement  

PubMed Central

Introduction Many efforts are used to improve surgical techniques and graft materials for urethral reconstruction. We developed an endothelialized tubular structure for urethral reconstruction. Methods: Two tubular models were created in vitro. Human fibroblasts were cultured for 4 weeks to form fibroblast sheets. Then, endothelial cells (ECs) were seeded on the fibroblast sheets and wrapped around a tubular support to form a cylinder for the endothelialized tubular urethral model (ET). No ECs were added in the standard tubular model (T). After 21 days of maturation, urothelial cells were seeded into the lumen of both models. Constructs were placed under perfusion in a bioreactor for 1 week. At several times, histology and immunohistochemistry were performed on grafted nude mice to evaluate the impact of ECs on vascularization. Results: Both models produced an extracellular matrix, without exogenous material, and developed a pseudostratified urothelium. Seven days after the graft, mouse red blood cells were present only in the outer layers in T model, but in the full thickness of ET model. After 14 days, erythrocytes were present in both models, but in a greater proportion in ET model. At day 28, both models were well-vascularized, with capillary-like structures in the whole thickness of the tubes. Conclusion: Incorporating endothelial cells was associated with an earlier vascularization of the grafts, which could decrease the necrosis of the transplanted tissue. As those models can be elaborated with the patient’s cells, this tubular urethral graft would be unique in its autologous property. PMID:23401738

Imbeault, Annie; Bernard, Geneviève; Rousseau, Alexandre; Morissette, Amélie; Chabaud, Stéphane; Bouhout, Sara; Bolduc, Stéphane

2013-01-01

168

Age effects on urethral striated muscle II. Anatomic location of muscle loss  

Microsoft Academic Search

OBJECTIVE: The purpose of the study was to measure the thickness and cross-sectional area of urethral muscle layers to identify localized striated muscle loss. STUDY DESIGN: The urethra and surrounding tissues from 25 female cadavers (mean age, 52 ± 18 [SD] years; range, 15-80 years) were used for this study. Axial and median sagittal histologic sections were prepared. Median sagittal

Daniele Perucchini; John O. L. DeLancey; James A. Ashton-Miller; Andrzej Galecki; Gabriel N. Schaer

2002-01-01

169

Enigma of urethral pain syndrome: why are there so many ascribed etiologies and therapeutic approaches?  

PubMed

Urethral pain syndrome has had several sobriquets, which have led to much confusion over the existence of this pathological condition and the useful options in the care of the afflicted patient. Our aim was to explore the proposed etiologies of this syndrome, and to provide a critical analysis of each proposed etiology and present a balanced argument on the plausibility of the proposed etiology and therapeutic approaches. We carried out an English language electronic search in the following databases: Medline, Embase, Amed, Cinahl, Pubmed, Cochrane Library, Trip Database and SUMSearch using the following search terms: urethral syndrome, urethral diseases, urethra, urologic diseases etiology/etiology, presentation, treatment, outcome, therapeutics and treatment from 1951 to 2011. In excess of 200 articles were recovered. With the clearly defined objectives of analyzing the proposed etiologies and therapeutic regimes, two author(s) (HP and IO) perused the abstracts of all the recovered articles, selecting those that addressed the etiologies and therapeutic approaches to treating the urethral pain syndrome. The number of articles was reduced to 25. The full text of all 25 articles were retrieved and reviewed. Through the present article, we hope to elucidate the most probable etiology of this condition whilst simultaneously, advance a logical explanation for the apparent success in the treatment of this condition using a range of different therapeutic modalities. We have carried out a narrative review, which we hope will reduce some of the confusion around this clinical entity by combining the known facts about the disease. PMID:24447292

Phillip, Harris; Okewole, Idris; Chilaka, Victor

2014-06-01

170

Abnormal electromyographic activity of the urethral sphincter, voiding dysfunction, and polycystic ovaries: a new syndrome?  

Microsoft Academic Search

A potential association between abnormal electromyographic activity--that is, decelerating bursts and complex repetitive discharges--of the urethral sphincter and difficulty in voiding was examined in 57 women with urinary retention. Abnormal electromyographic activity was found in 33. Ultrasonography of the ovaries in 22 of the 33 women showed that 14 had polycystic ovaries. Of the other eight women, two had had

C. J. Fowler; T. J. Christmas; C. R. Chapple; H. F. Parkhouse; R. S. Kirby; H. S. Jacobs

1988-01-01

171

Dynamic urethral pressure measurements in the diagnosis of incontinence in women  

Microsoft Academic Search

A group of 72 female patients whose incontinence had persisted despite various therapies was selected for an extensive urodynamic study. Overt neuropathy was absent in the patient group. An objectified history was taken and the patients were categorized accordingly. Filling cystometry and flow studies were performed in supine and standing positions, combined with continuous measurement of urethral pressure from three

August E. J. L. Kramer; Pieter L. Venema

1984-01-01

172

What is the place of internal urethrotomy in the treatment of urethral stricture disease?  

Microsoft Academic Search

As a treatment for male urethral stricture, internal urethrotomy (IU) has the advantages of ease, simplicity, speed and short convalescence. Various modifications of the single cold-knife incision in the 12 o'clock position have been proposed, but there are no prospective, randomized studies to prove their claims of greater efficacy. IU can be performed as an outpatient procedure using local anesthesia,

André M Naudé; Chris F Heyns

2005-01-01

173

Neuroscience Letters 244 (1998) 137-140 Urethral pudendal afferent-evoked bladder and sphincter reflexes  

E-print Network

reflexes in decerebrate and acute spinal cats Susan J. Shefchyk*, R.R. Buss Department of Physiology of the urethral sensory pudendal nerve in decerebrate or acute spinal cats was used to evoke micturition reflexes sphincter activity and contribute to both guarding-like reflexes as well as suppression of sphincter

Manitoba, University of

174

Stereolithography for Posterior Fossa Cranioplasty  

PubMed Central

Posterior fossa cranioplasty has been suggested for improvement of neurological symptoms following craniectomy. However, there is no particular recommendation in the literature about techniques for prosthesis manufacture and implantation. We report our experience using rapid prototyping technology and stereolithography for pre-surgical implant design and production of cranioplasties. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5 PMID:17171056

Agner, Celso; Dujovny, Manuel; Evenhouse, Raymond; Charbel, Fady T.; Sadler, Lewis

1998-01-01

175

Attentional functioning in children with and without post-traumatic stress symptoms post traumatic brain injury .  

E-print Network

??Attentional deficits are common following childhood traumatic brain injury (TBI). There is also evidence of attentional impairments in individuals with post-traumatic stress disorder (PTSD), however… (more)

Eren, Senem

2010-01-01

176

Traumatic tympanic bulla fracture.  

PubMed

A Pekingese dog was presented for evaluation of head trauma with ventral head and neck swelling, puncture wounds, palpable mandibular fractures, and loss of menace, severe miosis, and loss of palpebral reflex of the right eye. Computed tomography confirmed multiple mandibular and zygomatic fractures, a right ear canal avulsion, and a complete right tympanic bulla fracture with ventral displacement. The tympanic bulla fracture was managed conservatively. Topical lubrication and antibiotic ointment was prescribed for the right eye. A subtotal hemimandibulectomy was performed to address the mandibular fractures. A temporary oesophagostomy feeding tube was placed. No short-term complications developed as a result of the fractured bulla and avulsed ear canal being left in situ, and no complications were reported 18 months after the injury. To the authors' knowledge this is the first report of a traumatic tympanic bulla fracture in the dog. PMID:23889756

Rubin, J A; Kim, S E; Bacon, N J

2013-11-01

177

Nucleus caudalis lesioning: Case report of chronic traumatic headache relief  

PubMed Central

Background: The nucleus caudalis dorsal root entry zone (DREZ) surgery is used to treat intractable central craniofacial pain. This is the first journal publication of DREZ lesioning used for the long-term relief of an intractable chronic traumatic headache. Case Description: A 40-year-old female experienced new-onset bi-temporal headaches following a traumatic head injury. Despite medical treatment, her pain was severe on over 20 days per month, 3 years after the injury. The patient underwent trigeminal nucleus caudalis DREZ lesioning. Bilateral single-row lesions were made at 1-mm interval between the level of the obex and the C2 dorsal nerve roots, using angled radiofrequency electrodes, brought to 80°C for 15 seconds each, along a path 1 to 1.2 mm posterior to the accessory nerve rootlets. The headache improved, but gradually returned. Five years later, her headaches were severe on over 24 days per month. The DREZ surgery was then repeated. Her headaches improved and the relief has continued for 5 additional years. She has remained functional, with no limitation in instrumental activities of daily living. Conclusions: The nucleus caudalis DREZ surgery brought long-term relief to a patient suffering from chronic traumatic headache. PMID:22059123

Sandwell, Stephen E.; El-Naggar, Amr O.

2011-01-01

178

Body's Response to Traumatic Injury  

MedlinePLUS

... what happens to the body after a serious physical injury. Your browser does not support iframes. Share Print E-mail Related Links Inside Life Science Article: Life After Traumatic Injury: How the Body ...

179

Post-Traumatic Stress Disorder  

MedlinePLUS

... examples of traumatic events are a natural disaster, rape, severe car crash or fighting in a war. ... or victims of war or combat Survivors of rape, domestic violence, physical assault such as a mugging ...

180

Post Traumatic Stress Disorder Research  

MedlinePLUS

... fact sheet. Research on Possible Risk Factors for PTSD Currently, many scientists are focusing on genes that ... PTSD following a traumatic event. Research on Treating PTSD Currently, people with PTSD may be treated with ...

181

Post-reduction stress urinary incontinence rates in posterior versus anterior pelvic organ prolapse: a secondary analysis  

PubMed Central

Introduction/hypothesis Stress incontinence with vaginal prolapse reduction is less common in women with posterior-predominant prolapse (rectocele) compared with those with anterior-predominant prolapse (cystocele). Methods This was a secondary analysis of a cohort of prospectively enrolled women with symptomatic pelvic organ prolapse at or beyond the hymen and prolapse-reduced stress urinary incontinence (SUI) testing. Subjects were included if they had anterior- or posterior-predominant prolapse with at least a 1 cm difference in pelvic organ prolapse quantification (POP-Q) points Ba and Bp (N=214). We evaluated the prevalence and risk factors of post-reduction SUI between the two groups. Results Comparing posterior (n=45) and anterior (n=169) prolapse groups, we identified similar rates of post-reduction SUI (posterior: 6/45, 13.3 %; anterior: 18/169, 10.7 %; p= 0.52) and SUI without reduction (posterior: 4.4 %; anterior: 11.2 %; p=0.26). Maximum prolapse size was slightly larger in anterior than in posterior patients (+3.1 vs +2.0 cm beyond the hymen, p=0.001), while a higher proportion of posterior subjects reported a prior hysterectomy (p=0.04). Among posterior subjects, lower maximum urethral closure pressure values (MUCP; p=0.02) were associated with post-reduction SUI. In contrast, among anterior-predominant prolapse, larger prolapse measured at POP-Q point Ba (p=0.003) and maximum POP-Q measurement (p=0.006) were each associated with higher rates of post-reduction SUI and were highly correlated with each other (R=0.90). Conclusions We observed similar rates of post-reduction SUI in women with anterior- and posterior-predominant pelvic organ prolapse. Factors affecting the anterior and posterior prolapse groups differed, suggesting different mechanisms of continence protection. These findings suggest that reduction incontinence testing for operative planning would be as relevant to posterior-predominant prolapses as it is to anterior prolapse. PMID:23306769

DeLancey, John O. L.; Fenner, Dee E.

2014-01-01

182

Posterior cruciate ligament of the knee (image)  

MedlinePLUS

The posterior cruciate ligament (PCL) is a powerful ligament extending from the top-rear surface of the tibia to the bottom-front surface of the femur. The ligament prevents the knee joint from posterior instability.

183

Porcine small intestinal submucosa augmentation urethroplasty and balloon dilatation of a urethral stricture secondary to inadvertent prostatectomy in a dog.  

PubMed

A 10-month-old, male German shepherd dog experienced inadvertent prostatectomy during cryptorchidectomy. Cystourethral anastomosis was performed 1 day later. The dog developed stranguria and incontinence. A proximal urethral stricture was diagnosed with a contrast urethrogram 5 weeks later. Urethral augmentation with an onlay graft of porcine small intestinal submucosa was performed. Urinary diversion was accomplished with a urethral catheter followed by a cystostomy tube. The stricture recurred over the next 6 weeks. Three urethral balloon dilatations were performed 3 days apart, with the third attempt resulting in expansion of the stricture. Twenty-two months postdilatation, the dog intermittently urinated with a steady stream and had mild to moderate urinary incontinence. PMID:20810558

Powers, Michelle Y; Campbell, Bonnie G; Weisse, Chick

2010-01-01

184

[A new generation of urethral stents--Allium in the therapy of symptomatic prostatic enlargement of various etiology].  

PubMed

A number of urethral stents made of different materials, with different time of indwelling and different designs, primarily based on the vascular stent concept, have been applied in the clinical practice so far. According to the published studies, urethral stents have justified their clinical application, however with certain limitations. Within an attempt to overcome the limitations, a covered, temporary urethral stent was initially designed by Daniel Yachie and Ijko Markovi in Allium corporation from Israel. With its triangular shape, the stent is a replica of the obstructive prostatic urethral lumen. In has been applied in a series of 14 patients with lower urinary tract symptoms caused by the obstruction at the level of the prostatic urethra. The subjects were averagely aged 77.4 +/- 5.1 years. Allium prostatic stent remained in place in the patients for 4.93 +/- 3.17 months, at the average. PMID:17988035

Markovi?, B B; Markovi?, Z; Yachia, D; Hadzi, Djoki? J

2007-01-01

185

Ventral inlay buccal mucosal graft urethroplasty: A novel surgical technique for the management of urethral stricture disease  

PubMed Central

To describe the novel technique of ventral inlay substitution urethroplasty for the management of male anterior urethral stricture disease. A 58-year-old gentleman with multifocal bulbar stricture disease measuring 7 cm in length was treated using a ventral inlay substitution urethroplasty. A dorsal urethrotomy was created, and the ventral urethral plated was incised. The edges of the urethral plate were mobilized without violation of the ventral corpus spongiosum. A buccal mucosa graft was harvested and affixed as a ventral inlay to augment the caliber of the urethra. The dorsal urethrotomy was closed over a foley catheter. No intraoperative or postoperative complications occurred. Postoperative imaging demonstrated a widely patent urethra. After three years of follow-up, the patient continues to do well with no voiding complaints and low postvoid residuals. Ventral inlay substitution urethroplasty appears to be a safe and feasible technique for the management of bulbar urethral strictures. PMID:25685305

Terlecki, Ryan Patrick

2015-01-01

186

Nanotherapy for posterior eye diseases.  

PubMed

It is assumed that more than 50% of the most enfeebling ocular diseases have their origin in the posterior segment. Furthermore, most of these diseases lead to partial or complete blindness, if left untreated. After cancer, blindness is the second most dreaded disease world over. However, treatment of posterior eye diseases is more challenging than the anterior segment ailments due to a series of anatomical barriers and physiological constraints confronted for delivery to this segment. In this regard, nanostructured drug delivery systems are proposed to defy ocular barriers, target retina, and act as permeation enhancers in addition to providing a controlled release. Since an important step towards developing effective treatment strategies is to understand the course or a route a drug molecule needs to follow to reach the target site, the first part of the present review discusses various pathways available for effective delivery to and clearance from the posterior eye. Promise held by nanocarrier systems, viz. liposomes, nanoparticles, and nanoemulsion, for effective delivery and selective targeting is also discussed with illustrative examples, tables, and flowcharts. However, the applicability of these nanocarrier systems as self-administration ocular drops is still an unrealized dream which is in itself a huge technological challenge. PMID:24862316

Kaur, Indu Pal; Kakkar, Shilpa

2014-11-10

187

Traumatic intracerebellar haematoma: To operate or not to operate?  

PubMed

Background. Pure cerebellar haematoma of traumatic etiology, without associated posterior fossa sub- or epi-dural haematomas is a rare entity and has been reported to have a poor outcome. We report 23 patients with traumatic intracerebellar haematoma. We sought to study the pattern of such presentations and assess the factors which could be associated with their outcome. Methods. A retrospective review of prospectively collected data for all patients who were admitted for the management of traumatic intracerebellar haematoma at Rajendra Institute of Medical Sciences, Ranchi, India provided data for the 23 consecutive patients admitted for aforesaid over a seven-year study period. Medical records, diagnostic imaging and operative notes were reviewed for all patients. We divided the patient pool in to two groups based on their GCS score at the time of presentation - Group A (GCS > 7) and Group B (GCS ? 7). The association of different allied factors was studied and statistically analyzed. The relevant medical literature was also reviewed. Results. Most Group B patients were found to be associated with poor outcome at hospital discharge. The overall incidence of poor outcome in our study was 69.56%. GCS score at time of admission, allied supratentorial lesions, advanced age, condition of fourth ventricle and chest infection were found to be important factors which could be associated with poor outcome. Conclusion. Surgery in patients with the mentioned risk factors remains debatable and should be approached cautiously. Larger multi-institutional and meta-analytic studies are required to study and statistically establish the factors which might be associated with poor outcome in these patients. An algorithm which may be used in the management of traumatic intracerebellar haematoma patients is proposed. PMID:25488388

Harsh, Viraat; Prakash, Anand; Barry, James Marcellus; Kumar, Anil

2014-12-01

188

Cell-Seeded Tubularized Scaffolds for Reconstruction of Long Urethral Defects: A Preclinical Study  

PubMed Central

Background The treatment options for patients requiring repair of a long segment of the urethra are limited by the availability of autologous tissues. We previously reported that acellular collagen-based tubularized constructs seeded with cells are able to repair small urethral defects in a rabbit model. Objective We explored the feasibility of engineering clinically relevant long urethras for surgical reconstruction in a canine preclinical model. Design, setting, and participants Autologous bladder epithelial and smooth muscle cells from 15 male dogs were grown and seeded onto preconfigured collagen-based tubular matrices (6 cm in length). The perineal urethral segment was removed in 21 male dogs. Urethroplasties were performed with tubularized collagen scaffolds seeded with cells in 15 animals. Tubularized constructs without cells were implanted in six animals. Serial urethrography and three-dimensional computed tomography (CT) scans were performed pre- and postoperatively at 1, 3, 6, and 12 mo. The animals were euthanized at their predetermined time points (three animals at 1 mo, and four at 3, 6, and 12 mo) for analyses. Outcome measurements and statistical analysis Statistical analysis of CT imaging and histology was not needed. Results and limitations CT urethrograms showed wide-caliber urethras without strictures in animals implanted with cell-seeded matrices. The urethral segments replaced with acellular scaffolds collapsed. Gross examination of the urethral implants seeded with cells showed normal-appearing tissue without evidence of fibrosis. Histologically, an epithelial cell layer surrounded by muscle fiber bundles was observed on the cell-seeded constructs, and cellular organization increased over time. The epithelial and smooth muscle phenotypes were confirmed using antibodies to pancytokeratins AE1/AE3 and smooth muscle–specific desmin. Formation of an epithelial cell layer occurred in the unseeded constructs, but few muscle fibers formed. Conclusions Cell-seeded tubularized collagen scaffolds can be used to repair long urethral defects, whereas scaffolds without cells lead to poor tissue development and strictures. This study demonstrates that long tissue-engineered tubularized urethral segments may be used for urethroplasty in patients. PMID:22877501

Orabi, Hazem; AbouShwareb, Tamer; Zhang, Yuanyuan; Yoo, James J.; Atala, Anthony

2012-01-01

189

Azithromycin for Empirical Treatment of the Nongonococcal Urethritis Syndrome in Men A Randomized Double-blind Study  

Microsoft Academic Search

States. Patients.\\\\p=m-\\\\Atotal of 452 men aged 18 years or older with symptomatic nongonococcal urethritis of less than 14 days' duration. Intervention.\\\\p=m-\\\\Patientswere treated with either 1.0 g of azithromycin as a single oral dose or 100 mg of doxycycline taken orally twice daily for 7 days. Main Outcome Measures.\\\\p=m-\\\\Clinicalresolution of symptoms and signs of non- gonococcal urethritis, microbiological cure of C

Walter E. Stamm; Charles B. Hicks; David H. Martin; Peter Leone; Edward W. Hook III; Ronald H. Cooper; Myron S. Cohen; Byron E. Batteiger; Kimberly Workowski; William M. McCormack; Gail Bolan; John M. Douglas; Edward S. Wong; Peter G. Pappas; Raymond B. Johnson

2010-01-01

190

Detrusor internal and external work in relation to passive urethral resistance in a canine model of the lower urinary tract.  

PubMed

This study was conducted to evaluate whether passive urethral resistance, detrusor internal work, and detrusor external work are independent measures of the voiding process. Passive urethral resistance, detrusor internal work, detrusor external work, and detrusor total work of 5 canines were determined under nonobstructive and obstructive outlet conditions. All urodynamic analyses were performed on a surgically exposed urinary tract. Solid-state pressure transducers were used to measure the intravesical and distal urethral pressures, while an ultrasonic flow meter was used to obtain a simultaneous measure of urinary flow rate. Detrusor contractions were induced using bilateral electrical stimulation of the pelvic nerves. Varying degrees of outlet obstruction were created using an inflatable sphincter cuff secured around the proximal urethra. Urethral resistance, internal work, and total work increased with increasing obstruction, while external work decreased with increasing obstruction. Internal work was linearly and negatively correlated to external work. At low degrees of obstruction, internal and external work changed more rapidly than passive urethral resistance per unit change in obstruction. As obstruction was increased, the change in work parameters per unit change in obstruction decreased, while the change in passive urethral resistance per unit change in obstruction increased. Our results indicate that at low degrees of outlet obstruction (cuff volume < 60% of isometric cuff volume), detrusor internal and external work are more sensitive to changes in obstruction than passive urethral resistance. It therefore appears prudent to use these work parameters with a passive urethral resistance relation (PURR) when evaluating early BPH and also when monitoring its progression. The data also show that a detrusor will acutely respond to a change in outlet obstruction by modulating its total work output. The mechanisms responsible for this response are presently under investigation. PMID:8857620

Lecamwasam, H S; Sullivan, M P; Cravalho, E G; Yalla, S V

1996-01-01

191

Prune belly syndrome with urethral hypoplasia and vesico-cutaneous fistula: A case report and review of literature.  

PubMed

Association between Prune belly syndrome (PBS) and urethral hypoplasia is an unusual condition. It is usually fatal unless there is a communication between the fetal bladder and the amniotic sac. We report a case of PBS with urethral hypoplasia and congenital vesico-cutaneous fistula in a male neonate. Patient underwent cutaneous vesicostomy and was discharged for close follow up of his renal function and for future reconstruction. PMID:24311916

Sarhan, Osama M; Al-Ghanbar, Mustafa S; Nakshabandi, Ziad M

2013-10-01

192

Prune belly syndrome with urethral hypoplasia and vesico-cutaneous fistula: A case report and review of literature  

PubMed Central

Association between Prune belly syndrome (PBS) and urethral hypoplasia is an unusual condition. It is usually fatal unless there is a communication between the fetal bladder and the amniotic sac. We report a case of PBS with urethral hypoplasia and congenital vesico-cutaneous fistula in a male neonate. Patient underwent cutaneous vesicostomy and was discharged for close follow up of his renal function and for future reconstruction. PMID:24311916

Sarhan, Osama M.; Al-Ghanbar, Mustafa S.; Nakshabandi, Ziad M.

2013-01-01

193

The joint-contact area of the ankle. The contribution of the posterior malleolus.  

PubMed

Eight ankles from fresh cadavera were tested under simulated clinical conditions to determine the effect of increasing the size of the posterior malleolar fracture on the contact area of the ankle joint and on the distribution of joint pressure. The surface area of contact decreased with increased size of the posterior malleolar fragment. However, the documented changes were smaller than expected on the basis of the findings of Ramsey and Hamilton; they reported a 42 per cent reduction in contact area with only a one-millimeter lateral shift of the talus, which clinically would be associated with a similar one-millimeter shift of the distal tibial fragment. In addition, clinical experience has shown a high rate of post-traumatic degenerative arthritis associated with an inadequately reduced one-half-size posterior fragment. There were considerable changes in the load-distribution patterns, with increased confluence and concentration of loads as the size of the fragment was increased. In plantar flexion, many specimens had three separate areas of contact between the tibia and the talus. With increased size of the posterior fragment, the three areas of contact always joined to become one. Similarly, for all positions of the ankle, increased size of the posterior fragment caused decreases in the contact area. The maximum loss of contact area was 35 per cent for specimens with one-half-size fractures that were tested in the neutral position. PMID:2002072

Macko, V W; Matthews, L S; Zwirkoski, P; Goldstein, S A

1991-03-01

194

Delayed traumatic intracerebral haemorrhage  

PubMed Central

Twenty-one out of 7,866 head injuries were complicated by the development of delayed intracerebral haematomata. The age distribution of patients with this condition closely resembled that of patients with subdural haematomata and differed sharply from patients with extradural haemorrhage. This finding, combined with the fact that the two conditions often coexisted, suggests the possibility of similar aetiological factors operating in their production. The injury producing the lesion was often minor and the larger haematomata appeared to be associated with longer `asymptomatic' intervals. The neurological deterioration was in most instances clearly the result of an increase in intracranial pressure. When possible, angiography followed by definitive craniotomy was the most satisfactory method of management and multiple burr holes even when combined with needling of the hemisphere yielded unsatisfactory results. The distribution of lesions tended to confirm their traumatic origin. On no occasion was there a vascular abnormality to account for the haemorrhage and, despite the fact that the ages of most patients were in the seventh and eighth decades, the incidence of degenerative vascular disease was small. Contusional injury causes a local failure of the mechanisms that regulate cerebral blood flow. Hypoxia, hypercapnia, and venous congestion produce cerebral hyperaemia which encourages gradual haematoma formation particularly at the sites of injury. This explains not only the situation of the lesions but also the latency between the trauma and their development. PMID:5084138

Baratham, Gopal; Dennyson, William G.

1972-01-01

195

Traumatic ventricular septal defect.  

PubMed Central

A 26 year old man was admitted to hospital following a traffic accident. He had been sitting in the back of a car without wearing a seat belt. He suffered crush injuries on the anterior chest wall, trunk, and legs. On admission he was awake and cooperative, but restless, and obviously in severe pain. Radiography of the skull, facial bones, chest, spine, pelvis, and legs revealed a shaft fracture of the left femur and tibia and fracture of the 7th and 8th right ribs. The patient was transferred to the University Hospital of Zurich for further assessment and surgical repair of the lower limb fractures three days later. Because of worsening clinical condition with onset of partial respiratory insufficiency and new loud systolic murmur at the left sternal edge, a transthoracic echocardiography was performed, which showed an apical ventricular septal defect. Surgery was performed immediately. The ventricular septal defect was successfully repaired using a Teflon felt patch and interrupted sutures with pledgets, and sealed with glue. At six months' follow up the patient was doing well. Ventricular septal defects after blunt chest trauma occur either because of heart compression between sternum and the spine or because of myocardial infarction. In the present case the ventricular septal defect appeared three days after the accident, probably secondary to a post-traumatic myocardial infarction. Patients with blunt chest trauma and suspicion of cardiac contusion should be monitored carefully. Images PMID:9391298

Genoni, M.; Jenni, R.; Turina, M.

1997-01-01

196

Postpartum Post-Traumatic Stress Disorder  

MedlinePLUS

... simply adjusting to life with a baby. Postpartum Post-Traumatic Stress Disorder Approximately 1-6% of women experience postpartum post-traumatic stress disorder (PTSD) following childbirth. Most often, this illness is ...

197

Post-traumatic stress disorder vs traumatic brain injury  

PubMed Central

Post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) often coexist because brain injuries are often sustained in traumatic experiences. This review outlines the significant overlap between PTSD and TBI by commencing with a critical outline of the overlapping symptoms and problems of differential diagnosis. The impact of TBI on PTSD is then described, with increasing evidence suggesting that mild TBI can increase risk for PTSD. Several explanations are offered for this enhanced risk. Recent evidence suggests that impairment secondary to mild TBI is largely attributable to stress reactions after TBI, which challenges the long-held belief that postconcussive symptoms are a function of neurological insult This recent evidence is pointing to new directions for treatment of postconcussive symptoms that acknowledge that treating stress factors following TBI may be the optimal means to manage the effects of many TBIs, PMID:22034252

Bryant, Richard

2011-01-01

198

Approaches to a posterior polar cataract  

PubMed Central

Posterior polar cataracts present special challenges to the cataract surgeon. These are often associated with weakness/dehiscence of the posterior capsule and thus have a higher rate of intraoperative posterior capsule rupture. The surgeon needs to adhere to special surgical strategies to minimize the risk of a posterior capsule rupture. These include, adhering to the principles of closed chamber technique, avoiding hydrodissection – instead performing ‘inside-out’ hydrodelineation and using modest to low phaco parameters and reducing these stepwise. This article provides important pearls on how to approach a posterior polar cataract. PMID:23960968

Vasavada, Abhay R.; Vasavada, Viraj A.; Raj, Shetal M.

2011-01-01

199

Correlations between urethral elastance and histological architecture in patients with benign prostatic hyperplasia.  

PubMed

To investigate whether the properties of the flow-controlling zone (FCZ) in obstructive benign prostatic hyperplasia (BPH) would be affected by differences in the histological architecture of the prostate, we evaluated relationships between morphometric and urodynamic data. BPH specimens from 14 patients undergoing transurethral surgery were analysed by quantitative morphometry. The cross-sectional area and mean elastance of FCZ, together with other parameters, were calculated on a preoperative pressure-flow study. Correlations between these parameters and tissue composition were determined. Our study group comprised men with clinical and urodynamic evidence of infravesical obstruction secondary to BPH. No correlations were found between the area density or total volume of each histological element and the cross-sectional area of FCZ at peak flow rate. Neither area density nor total volume of each element correlated with the mean urethral elastance. Our results indicate that the histological architecture of the prostate in patients with obstructive BPH cannot predict the urethral elastance. PMID:9689702

Ichiyanagi, O; Sasagawa, I; Aoyama, N; Ishigooka, M; Kubota, Y; Nakada, T

1998-05-01

200

Methotrexate elimination in a patient with an orthotopic neobladder with and without a urethral catheter.  

PubMed

Placement of a urethral catheter has been recommended to ensure adequate methotrexate elimination in patients with a neobladder; however, the need for this and its impact on methotrexate elimination have not been determined. A 53-year-old man with a cecal continent urinary diversion received intravenous methotrexate 30 mg/m2 on two occasions, with and without urethral catheter drainage of the neobladder. Serum methotrexate concentrations declined at a rate that resulted in 24- and 48-hour values falling below the accepted toxic concentration threshold of 5-50 mumol/L, and 0.05 mumol/L, respectively. In this man, who received low-dose methotrexate, catheterization of the neobladder did not alter methotrexate elimination sufficiently to justify its cost, risk, and inconvenience. PMID:8888094

Wire, P D; Dupuis, R E; Mohler, J L; Bernard, S A; Lindley, C M

1996-01-01

201

[Precautions regarding prevent acute urethritis caused by Neisseria meningitidis in Japan].  

PubMed

In Japan, Neisseria meningitidis is not sufficiently recognized as the primary causative bacteria of sexually transmitted diseases (STDs) as the number of reported cases is small. Here, we summarize reports from 3 medical institutions, present clinical courses for each case, as well recommending precautions to prevent infection with this bacterium. Fourteen cases of N. meningitidis urethritis (MU) were admitted between April 2001 and June 2006. All patients were male, consulted a doctor after experiencing subjective symptoms, such as micturition pain and pus discharge, and were diagnosed as having urethritis using isolation culture methods. In 8 of the 14 cases, history of sexual contact in the preclinical stage was confirmed, and contact was with a commercial sex worker (CSW) in 6 of these cases. Many of these patients recalled oral contact. All strains indicated susceptibility to many drugs, and there were no problems with treatment. With regard to serotype, there were 10 cases of type Y, 1 case of type B, and 3 cases that were not classifiable or unidentified. In addition, among the 9 strains that were subjected to genotype identification, 7 strains were ST-23. The recent increase in availability of nucleic acid amplification methods has facilitated simultaneous detection of Neisseria gonorrhoeae and Chlamydia trachomatis. However, we fear that MU will become latent. For screening of urethritis, Gram staining and culture of urethral material must be performed to detect this disease. The relationship of the detected strain and its role in the pathogenesis of meningitis are uncertain, but its serotype and genotype are common in cases of meningitis. Thus, precautions are required to prevent spread of this bacterium. PMID:18318230

Oishi, Tsuyoshi; Ishikawa, Keiko; Tamura, Takashi; Tsukahara, Miyuki; Goto, Mieko; Kawahata, Daisuke; Yamamoto, Masae; Okuzumi, Katsuko; Fukutake, Katsuyuki

2008-01-01

202

Surgical views: Surgical treatment of urethral sphincter mechanism incompetence in dogs.  

PubMed

Urinary incontinence--loss of voluntary control over the retention and expulsion of urine--is a common medical problem in small animal patients. Incontinence occur when pressure within the bladder exceeds urethral pressure. Incontinence may result from a variety of etiologies, including congenital anatomic abnormalities of the lower urinary and reproductive systems (ureter, bladder, bladder neck, urethra, vagina,vestibule) as well as neurologic, neoplastic, infectious, and inflammatory disease. PMID:19866443

McLoughlin, Mary A; Chew, Dennis J

2009-08-01

203

Extraperitoneal Pelvic laparoscopic disconnection of accessory urethra from normal urethra in a case of urethral duplication  

PubMed Central

We report an extraperitoneal pelvic laparoscopic approach to disconnect accessory urethra from normal urethra in complete urethral duplication. First stage consisted of chordee correction, partial excision of the accessory urethra and glansplasty. In the second stage the remaining accessory urethra was disconnected from the normal urethra through a pre-peritoneal minimal access approach to the retropubic space. The remaining distal mucosa was ablated using monopolar cautery. PMID:24741219

Pant, Nitin; Aggarwal, Satish Kumar

2014-01-01

204

Adenovirus urethritis and concurrent conjunctivitis: a case series and review of the literature.  

PubMed

We present eight cases and review the literature of concurrent urethritis and conjunctivitis where adenovirus was identified as the causative pathogen. The focus of this review concerns the identification of specific sexual practices, symptoms, signs and any serotypes that seem more commonly associated with such adenovirus infections. We discuss the seasonality of adenovirus infection and provide practical advice for clinicians to give to the patient. PMID:25433050

Liddle, Olivia Louise; Samuel, Mannampallil Itty; Sudhanva, Malur; Ellis, Joanna; Taylor, Chris

2014-11-28

205

Traumatic Loss in Children and Adolescents  

Microsoft Academic Search

Although different types of childhood trauma have many common characteristics and mental health outcomes, traumatic loss in children and adolescents has a number of distinctive features. Most importantly, youth who experience a traumatic loss may develop childhood traumatic grief (CTG), which is the encroachment of trauma symptoms on the grieving process and prevents the child from negotiating the typical steps

Anthony P. Mannarino; Judith A. Cohen

2011-01-01

206

Memory for Traumatic Experiences in Early Childhood  

ERIC Educational Resources Information Center

Traumatic experiences in early childhood raise important questions about memory development in general and about the durability and accessibility of memories for traumatic events in particular. We discuss memory for early childhood traumatic events, from a developmental perspective, focusing on those factors that may equally influence memories for…

Cordon, Ingrid M.; Pipe, Margaret-Ellen; Sayfan, Liat; Melinder, Annika; Goodman, Gail S.

2004-01-01

207

Secondary Traumatic Stress and Oncology Social Work  

Microsoft Academic Search

Secondary traumatic stress (STS) represents a disorder that has the same symptoms as post traumatic stress disorder, but results from vicariously experiencing trauma through association with those directly encountering the traumatic event(s). This exploratory study examined STS in 21 oncology social workers who were members of the Association of Oncology Social Workers. The results of this study revealed that oncology

Cassandra E. Simon; Josephine G. Pryce; Lucinda L. Roff; David Klemmack

2006-01-01

208

Sexually dimorphic expression of Mafb regulates masculinization of the embryonic urethral formation  

PubMed Central

Masculinization of external genitalia is an essential process in the formation of the male reproductive system. Prominent characteristics of this masculinization are the organ size and the sexual differentiation of the urethra. Although androgen is a pivotal inducer of the masculinization, the regulatory mechanism under the control of androgen is still unknown. Here, we address this longstanding question about how androgen induces masculinization of the embryonic external genitalia through the identification of the v-maf avian musculoaponeurotic fibrosarcoma oncogene homolog B (Mafb) gene. Mafb is expressed prominently in the mesenchyme of male genital tubercle (GT), the anlage of external genitalia. MAFB expression is rarely detected in the mesenchyme of female GTs. However, exposure to exogenous androgen induces its mesenchymal expression in female GTs. Furthermore, MAFB expression is prominently down-regulated in male GTs of androgen receptor (Ar) KO mice, indicating that AR signaling is necessary for its expression. It is revealed that Mafb KO male GTs exhibit defective embryonic urethral formation, giving insight into the common human congenital anomaly hypospadias. However, the size of Mafb KO male GTs is similar with that of wild-type males. Moreover, androgen treatment fails to induce urethral masculinization of the GTs in Mafb KO mice. The current results provide evidence that Mafb is an androgen-inducible, sexually dimorphic regulator of embryonic urethral masculinization. PMID:25362053

Suzuki, Kentaro; Numata, Tomokazu; Suzuki, Hiroko; Raga, Dennis Diana; Ipulan, Lerrie Ann; Yokoyama, Chikako; Matsushita, Shoko; Hamada, Michito; Nakagata, Naomi; Nishinakamura, Ryuichi; Kume, Shoen; Takahashi, Satoru; Yamada, Gen

2014-01-01

209

Preliminary experimental study of urethral reconstruction with tissue engineering and RNA interference techniques  

PubMed Central

This study investigated the feasibility of replacing urinary epithelial cells with oral keratinocytes and transforming growth factor-?1 (TGF-?1) small interfering RNA (siRNA)-transfected fibroblasts seeded on bladder acellular matrix graft (BAMG) in order to reconstruct tissue-engineered urethra. Constructed siRNAs, which expressed plasmids targeting TGF-?1, were transfected into rabbit fibroblasts. The effective siRNA was screened out by RT-PCR and was transfected into rabbit fibroblasts again. Synthesis of type I collagen in culture medium was measured by enzyme-linked immuno sorbent assay (ELISA). Autologous oral keratinocytes and TGF-?1 siRNA-transfected fibroblasts were seeded onto BAMGs to obtain a tissue-engineered mucosa. The tissue-engineered mucosa was assessed morphologically and with the help of scanning electron microscopy. The TGF-?1 siRNA decreased the expression of fibroblasts synthesis type I collagen. Oral keratinocytes and TGF-?1 siRNA-transfected fibroblasts were seeded onto sterilized BAMG to obtain a tissue-engineered mucosa for urethral reconstruction. The compound graft was assessed using scanning electron microscope. Oral keratinocytes and TGF-?1 siRNA-transfected fibroblasts had a good compatibility with BAMG. The downregulation of fibroblasts synthesis type I collagen expression by constructed siRNA interfering TGF-?1 provided a potential basis for genetic therapy of urethral scar. Oral keratinocytes and TGF-?1 siRNA-transfected fibroblasts had good compatibility with BAMG and the compound graft could be a new choice for urethral reconstruction. PMID:23542139

Li, Chao; Xu, Yue-Min; Li, Hong-Bin

2013-01-01

210

Traumatic brain injury and diet.  

PubMed

Increasing attention is being paid to nutritional and metabolic management of traumatic brain injury patients. The gross metabolic changes that occur after injury have been found to be influenced by both macronutrients, that is, dietary ratios of fat, carbohydrates, and protein, and micronutrients, for example, vitamins and minerals. Alterations in diet and nutritional strategies have been shown to decrease both morbidity and mortality after injury. Despite this knowledge, defining optimal nutritional support following traumatic brain injury continues to be an ongoing challenge. PMID:23670252

Greco, Tiffany; Prins, Mayumi L

2013-08-01

211

Effects of Concomitant Surgeries during Mid-Urethral Slings (MUS) on Post-operative Complications, Voiding Dysfunction, Continence Outcomes, and Urodynamic Variables  

PubMed Central

Objectives To determine whether concomitant surgeries affected outcomes in a randomized trial comparing retropubic (RMUS) versus transobturator midurethral slings (TOMUS). Methods Subjects (n=597) were stratified into 4 groups based on type of concomitant surgeries: Group I had anterior/apical with or without posterior repairs (n=79, 13%), Group II had posterior repairs or perineorrhaphy only (n=38, 6%), Group III had non-prolapse procedures (n=34, 6%) and Group IV had no concomitant surgeries (n=446, 75%). Complication rates, voiding dysfunction, objective and subjective surgical failure rates and changes in urodynamic (UDS) values (post-op minus pre-op) were assessed and compared in these 4 groups. Results There were no differences in complications, voiding dysfunction and subjective failure outcomes between these 4 groups. Group I had lower odds ratio (OR) of objective surgical failure compared to Group IV (OR 0.38, 95% CI 0.18–0.81, p=0.05). The OR of failure of all undergoing concomitant surgeries (Groups I–III) was lower than Group IV (OR 0.57, 95% CI 0.35–0.95, p=0.03). The change in Pdet@Qmax (from pressure-flow) was significantly higher in Group III versus IV (p=0.01). The change in Qmax (from uroflowmetry) was significantly less in Group I and II versus Group IV (p=0.046 and 0.04, respectively). Conclusions Concomitant surgeries did not increase complications. Subjects who underwent certain concomitant surgeries had lower failure rates than those undergoing slings only. These data support safety and efficacy of performing concomitant surgery at the time of mid-urethral slings. PMID:22542356

Chai, Toby C.; Kenton, Kimberly; Xu, Yan; Sirls, Larry; Zyczynski, Halina; Wilson, Tracey S.; Rahn, David D.; Whitcomb, Emily L.; Hsu, Yvonne; Gormley, Elizabeth A.

2012-01-01

212

Posterior Epidural Migration of Sequestrated Cervical Disc Fragment: Case Series  

PubMed Central

Study Design A retrospective study was undertaken to delineate the characteristics of non-traumatic sequestrated epidurally migrated cervical disc prolapse. Purpose To present first case series of eight such cases diagnosed preoperatively and to discuss their magnetic resonance imaging (MRI) characteristics and their management. Overview of Literature Non-traumatic spontaneous migration of the sequestrated disc fragment epidurally behind cervical vertebral body is rare. Only ten cases have been reported in literature. Methods Detailed clinico-radiological profiles of these 8 cases are presented. In six cases their clinical picture was suggestive of cervical myelopathy. MRI scan showed single level epidural migrated disc behind body of C4, C6, and C7 in six patients and two cases with multiple levels (C5-C6). In six cases, anterior corpectomy with excision of the disc was performed and the seventh patient underwent dorsal laminectomy. The eighth patient chose not to undergo surgery. Results T1 images of the MRI scan showed an isointense signal in all the 8 cases. T2 images revealed a varying intensity. In six cases who underwent anterior corpectomy, there was a rent in the posterior longitudinal ligament. Among those in two cases multiple disc fragments were seen. In the rest four cases, a single large fragment was observed. These patients improved after anterior corpectomy and disc excision. There was no improvement in the patient who had undergone dorsal laminectomy. The eighth patient who refused surgery progressively deteriorated. Conclusions We opine that MRI scan especially T1 images are useful in these cases. We prefer to treat these cases through anterior corpectomy with excision of the sequestrated disc which proved to result in excellent outcome. PMID:22164316

Kumar, Gopalan Senthil; Mahesha, Kanthila Bhat

2011-01-01

213

Post-Traumatic Stress Disorder  

E-print Network

Post-Traumatic Stress Disorder (PTSD) National Institute of Mental Health U.S. Department of Healt, or PTSD? 1 Who gets PTSD? 1 What are the symptoms of PTSD? 1 Do children react differently than adults? 3 How is PTSD detected? 3 Why do some people get PTSD and other people do not? 4 How is PTSD

Bandettini, Peter A.

214

Evaluation after Traumatic Brain Injury  

ERIC Educational Resources Information Center

It is important to determine if a traumatic brain injury (TBI) has occurred when an individual is assessed in a hospital emergency room after a car accident, fall, or other injury that affects the head. This determination influences decisions about treatment. It is essential to screen for the injury, because the sooner they begin appropriate…

Trudel, Tina M.; Halper, James; Pines, Hayley; Cancro, Lorraine

2010-01-01

215

NATIONAL TRAUMATIC OCCUPATIONAL FATALITIES (NTOF)  

EPA Science Inventory

The National Traumatic Occupational Fatalities (NTOF) surveillance system is a death certificate-based census of occupational injury deaths. Death certificates are obtained from the 50 States, New York City, and the District of Columbia for decedent's ages 16 years or older with ...

216

Post-traumatic stress disorder  

Microsoft Academic Search

Exposure to trauma can result in immune dysregulation, and increasing evidence suggests that there are immune alterations associated with post- traumatic stress disorder (PTSD). However, the exact nature of these immune findings in PTSD has not been defined. The study of psychoneuro- immunology in PTSD is relevant not only for understanding the biological underpinnings of this disorder but also for

Cheryl M. Wong

2002-01-01

217

Reconsidering Post-Traumatic Stress  

ERIC Educational Resources Information Center

This article serves to challenge the prevailing wisdom that suggests that most trauma is followed by post-traumatic stress disorder (PTSD), and is best treated with critical incident stress debriefing (CISD). Instead, recent evidence suggests that many individuals exposed to stress do not experience stress responses. Even those who do, however,…

Berman, Dene S.; Davis-Berman, Jennifer

2005-01-01

218

Cultural Factors in Traumatic Stress  

Microsoft Academic Search

Posttraumatic stress disorder (PTSD) as a diagnosis was first recognized in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) (APA, 1980). In this chapter, we highlight the relevance of and need for a better elucidation of the prevalence of PTSD in diverse settings and discuss its utility as a way of conceptualizing traumatic stress. Next

Peter D. Yeomans; Evan M. Forman

2008-01-01

219

Traumatic Brain Injury Inpatient Rehabilitation  

ERIC Educational Resources Information Center

Traumatic brain injuries (TBI) can cause multiple medical and functional problems. As the brain is involved in regulating nearly every bodily function, a TBI can affect any part of the body and aspect of cognitive, behavioral, and physical functioning. However, TBI affects each individual differently. Optimal management requires understanding the…

Im, Brian; Schrer, Marcia J.; Gaeta, Raphael; Elias, Eileen

2010-01-01

220

Posterior Lamellar Keratoplasty in Perspective  

Microsoft Academic Search

\\u000a \\u000a \\u000a \\u000a \\u000a \\u000a • \\u000a \\u000a \\u000a Posterior lamellar keratoplasty (PLK) offers many substantial benefits compared to penetrating keratoplasty (PK) including:\\u000a closed eye surgery elimination of both regular and irregular postoperative astigmatism leading to full visual rehabilitation\\u000a with spectacles within 3–6 months, elimination of postoperative corneal anaesthesia, and a reduced risk of postoperative globe\\u000a rupture.\\u000a \\u000a \\u000a \\u000a \\u000a • \\u000a \\u000a \\u000a Disadvantages of PLK compared to PK include: corneal stromal scarring

F Arnalich-Montiel; JKG Dart

221

Minimally Invasive Posterior Hamstring Harvest  

PubMed Central

Autogenous hamstring harvesting for knee ligament reconstruction is a well-established standard. Minimally invasive posterior hamstring harvest is a simple, efficient, reproducible technique for harvest of the semitendinosus or gracilis tendon or both medial hamstring tendons. A 2- to 3-cm longitudinal incision from the popliteal crease proximally, in line with the semitendinosus tendon, is sufficient. The deep fascia is bluntly penetrated, and the tendon or tendons are identified. Adhesions are dissected. Then, an open tendon stripper is used to release the tendon or tendons proximally; a closed, sharp tendon stripper is used to release the tendon or tendons from the pes. Layered, absorbable skin closure is performed, and the skin is covered with a skin sealant, bolster dressing, and plastic adhesive bandage for 2 weeks. PMID:24266003

Wilson, Trent J.; Lubowitz, James H.

2013-01-01

222

Traumatic stress in acute leukemia  

PubMed Central

Objective Acute leukemia is a condition with an acute onset that is associated with considerable morbidity and mortality. However, the psychological impact of this life-threatening condition and its intensive treatment has not been systematically examined. In the present study, we investigate the prevalence and correlates of post-traumatic stress symptoms in this population. Methods Patients with acute myeloid, lymphocytic, and promyelocytic leukemia who were newly diagnosed, recently relapsed, or treatment failures were recruited at a comprehensive cancer center in Toronto, Canada. Participants completed the Stanford Acute Stress Reaction Questionnaire, Memorial Symptom Assessment Scale, CARES Medical Interaction Subscale, and other psychosocial measures. A multivariate regression analysis was used to assess independent predictors of post-traumatic stress symptoms. Results Of the 205 participants, 58% were male, mean age was 50.1 ± 15.4 years, 86% were recently diagnosed, and 94% were receiving active treatment. The mean Stanford Acute Stress Reaction Questionnaire score was 30.2 ± 22.5, with 27 of 200 (14%) patients meeting criteria for acute stress disorder and 36 (18%) for subsyndromal acute stress disorder. Post-traumatic stress symptoms were associated with more physical symptoms, physical symptom distress, attachment anxiety, and perceived difficulty communicating with health-care providers, and poorer spiritual well-being (all p <0.05). Conclusions The present study demonstrates that clinically significant symptoms of traumatic stress are common in acute leukemia and are linked to the degree of physical suffering, to satisfaction with relationships with health-care providers, and with individual psychological characteristics. Longitudinal study is needed to determine the natural history, but these findings suggest that intervention may be indicated to alleviate or prevent traumatic stress in this population. PMID:22081505

Rodin, Gary; Yuen, Dora; Mischitelle, Ashley; Minden, Mark D; Brandwein, Joseph; Schimmer, Aaron; Marmar, Charles; Gagliese, Lucia; Lo, Christopher; Rydall, Anne; Zimmermann, Camilla

2013-01-01

223

Traumatic Subscapularis Tendon Tear in an Adolescent American Football Player  

PubMed Central

Isolated traumatic subscapularis tendon tears are uncommon at any age. In adolescent patients, this type of injury is even more infrequent and usually presents as a bony avulsion of the lesser tuberosity. This report reviews a case of an adolescent American football player sustaining a posterior impact to an abducted, extended arm that resulted in an isolated subscapularis tendon tear. Magnetic resonance imaging of the shoulder revealed an isolated subscapularis tear retracted 1.6 cm without bony avulsion from the lesser tuberosity. Surgical repair was performed with 2 biocomposite absorbable anchors in the lesser tuberosity. The patient returned to basketball 12 weeks after surgery. This case illustrates that a high index of suspicion is required for an appropriate diagnosis in young athletes. PMID:24427400

Gibson, Margaret E.; Gurley, Daniel; Trenhaile, Scott

2013-01-01

224

Bony wall damage in the region of the middle and posterior cranial fossa observed during otosurgery  

PubMed Central

Summary Background Bony wall damages in the region of the middle and posterior cranial fossa are usually observed in cases of chronic otitis media. These defects can also be congenital, post-traumatic, iatrogenic or due to tumors. They can potentially lead to the development of intracranial complications. Material/Methods We analyzed patients who were diagnosed as having bony wall damage in the region of the middle and/or posterior cranial fossa. We also discuss methods of reconstruction during otosurgery. The analysis involves patients who underwent middle ear operations in the Department of Otolaryngology at the Jagiellonian University of Krakow between 2004 and 2008; 495 otosurgeries were performed during this period of time. Results In 70% of patients the reason for otosurgery was chronic otitis media. In 20%, bone defects occurred simultaneously with otosclerosis. Less than 10% underwent otosurgery for other reasons. Bony wall damage in the region of the middle and posterior cranial fossa were diagnosed in 46 patients who underwent surgery. In patients with bony wall damage, otogenic intracranial complications were described in 14 cases. Conclusions The performed reconstruction methods for bony wall damage, which used the fascia, strengthened with the pedicle muscle flap for larger defects and with either bone lamella or cartilage in specific cases, proved successful. Nearly 80% of bony wall damages in the region of the middle and posterior cranial fossa remain asymptomatic and are discovered incidentally during middle ear surgery. The above observations emphasize the significant role of pre-operative imaging diagnostics. PMID:22648242

Wiatr, Maciej; Sk?adzie?, Jacek; Tomik, Jerzy; Str?k, Pawe?; Przeklasa-Muszy?ska, Anna

2012-01-01

225

Longitudinal changes of structural connectivity in traumatic axonal injury  

E-print Network

during the first 6 months after traumatic brain injury and to evaluate the utility of diffusion tensor changes occurring between the acute and chronic stages of traumatic brain injury and for predicting of interest; TAI traumatic axonal injury; TBI traumatic brain injury; UF uncinate fasciculus. Traumatic axonal

Abdi, Hervé

226

[Surgical correction of post-traumatic kyphosis: a thoracoscopic approach].  

PubMed

Conservative treatment of an unstable spinal fracture can give lead to post-traumatic kyphosis, and may give rise to serious back pain. Surgical correction can alleviate the problem in patients with this deformity. Operative correction of kyphotic deformities of the thoracic spine and deformities at the level of the thoracolumbar junction are often performed via a thoracotomy or a thoraco-phrenico-laparotomy, respectively. There are also some correction techniques that are only performed via a posterior approach. In accordance with general surgical trends, spinal surgery tries to use minimally invasive intervention in order to reduce operative trauma, postoperative pain and complications. In the authors' hospital, patients with unstable spinal fractures have been undergoing surgery using a thoracoscopic approach for the past few years; now patients with post-traumatic kyphosis are also being treated using a minimally invasive approach. The thoracoscopic approach has been used in major centres abroad for some time, but has not previously been described in the Netherlands. PMID:23464583

Noor, Arwin; Bloemers, Frank W; Bakker, Fred C

2013-01-01

227

Clinical evaluation of a single daily dose of phenylpropanolamine in the treatment of urethral sphincter mechanism incompetence in the bitch  

PubMed Central

The objective of this retrospective study was to determine the efficacy of a single daily oral dose of phenylpropanolamine (PPA) in the treatment of urethral sphincter mechanism incompetence (USMI) in bitches. Nine bitches diagnosed with USMI were treated with a single daily dose [1.5 mg/kg body weight (BW)] of PPA for at least 1 month. Urethral pressure profiles (UPP) were performed in 7 dogs before treatment and repeated in 4 of them after treatment. Treatment with PPA resulted in long-term continence in 8/9 bitches. One dog did not respond to PPA and was treated surgically later. Recheck UPPs showed a significant increase in maximal urethral closure pressure in the 4 bitches after treatment with PPA compared to before treatment. In conclusion, long-term continence can be achieved in bitches affected with USMI after administration of a single daily dose of PPA (1.5 mg/kg BW). PMID:22043069

Claeys, Stéphanie; Rustichelli, Frederico; Noël, Stéphanie; Hamaide, Annick

2011-01-01

228

Decelerating burst and complex repetitive discharges in the striated muscle of the urethral sphincter, associated with urinary retention in women.  

PubMed Central

A type of electromyographic activity, formerly referred to as "pseudomyotonia", can be recorded from the striated muscle of the urethral sphincter using a concentric needle electrode. There are two components to this activity, complex repetitive discharges and decelerating bursts. The latter usually dominate recordings and sound very like myotonic discharges. Analysis of these discharges indicates that they are a form of "bizarre repetitive discharge", and as such, result from ephaptic spread of excitation between muscle fibres rather than from excitation arising in the terminal branches of the motor axon. Profuse activity of this type has been found in 15 women with symptoms of urethral dysfunction, including 11 with urinary retention. It is suggested that this activity is associated with a failure of urethral sphincter relaxation. Images PMID:4056803

Fowler, C J; Kirby, R S; Harrison, M J

1985-01-01

229

Effect of dilution rate on feline urethral sperm motility, viability, and DNA integrity.  

PubMed

This study was designed to investigate if the characteristics of feline urethral sperm can be affected by high dilution in an artificial medium. The semen collected by urethral catheterization from eight male cats was evaluated for sperm concentration and motility and subsequently diluted with a TRIS-based extender to the concentration of spermatozoa 10 × 10(6)/mL, 5 × 10(6)/mL, and 1 × 10(6)/mL. Immediately after the extension samples were assessed for motility, cell viability using SYBR-14 and propidium iodide, acrosome integrity using lectin from Arachis hypogaea Alexa Fluor 488 Conjugate, and propidium iodide and chromatin status by acridine orange. Compared with 10 × 10(6)/mL dilution rate, spermatozoa diluted to 1 × 10(6) sperm/mL had a significantly lower proportion of motile (31.1% ± 19.8 and 0.7% ± 1.6, respectively, P < 0.05) and viable spermatozoa (88.3% ± 3.1 and 69.1% ± 12.8, respectively, P < 0.01). There was no dilution-related difference in the acrosome integrity (76.7% ± 11.9 vs. 75.9% ± 10.6) and chromatin status (defragmentation index, 3.3% ± 0.97 vs. 3.4% ± 1.7). These results indicate that feline urethral semen is susceptible to high dilution rate, and some sperm characteristics can be artifactually changed by semen dilution. It also suggests the potential role of seminal plasma in maintaining sperm motility and viability in high dilution rates. PMID:25262548

Prochowska, Sylwia; Ni?a?ski, Wojciech; Ochota, Ma?gorzata; Partyka, Agnieszka

2014-12-01

230

Early Experience with Hyaluronic Acid Instillation to Assist with Visual Internal Urethrotomy for Urethral Stricture  

PubMed Central

Purpose The clinical usefulness of hyaluronic acid (HA) instillation during visual internal urethrotomy (VIU) for decreasing the incidence of recurrent urethral stricture was assessed. Materials and Methods Twenty-eight patients were treated by VIU with HA instillation between May 2007 and June 2009. After insertion of a Foley catheter following urethrotomy, HA was instilled via an 18-gauge tube catheter between the urethral lumen and Foley catheter. Seventeen cases were analyzed retrospectively 12 months postoperatively. We evaluated the success rate of this procedure by comparing retrograde urethrography (RGU) results, maximum flow rates, and postvoid residual urine volumes preoperatively and 3 and 12 months postoperatively. Success was defined as either a maximum flow rate of at least 15 ml/s or no visible urethral stricture on RGU at 12 months postoperatively. Results Total success rates were 76.5% (13/17) and 52.9% (9/17) at 3 and 12 months postoperatively, respectively. By etiology, success rates at 3 and 12 months postoperatively, respectively, were 66.7% and 33.3% for inflammation, 66.7% and 50.0% for trauma, and 83.3% and 66.7% for unknown causes. Success rates were 63.6% for strictures less than 10 mm in length and 33.3% for strictures of 10 mm or more in length at 12 months postoperatively. Success rates were 61.5% for single strictures and 25% for multiple strictures at 12 months postoperatively. Conclusions The success rate of VIU with HA instillation was not better than that observed in the literature for conventional VIU. PMID:21221206

Kim, Hak Min; Kang, Dong Il; Shim, Bong Suk

2010-01-01

231

Posterior acceleration as a mechanism of blunt traumatic injury of the aorta  

Microsoft Academic Search

Rupture of the thoracic aorta is a leading cause of rapid fatality in automobile crashes, but the exact mechanisms of this injury remain unidentified. One commonly postulated mechanism is a differential motion of the aortic arch relative to the heart and its neighboring vessels caused by high-magnitude acceleration of the thorax. This paper investigates acceleration as an aortic injury mechanism

Jason Forman; Stephen Stacey; Jay Evans; Richard Kent

2008-01-01

232

Traumatic brain injury with particular reference to diffuse traumatic axonal injury subpopulations   

E-print Network

Traumatic brain injury (TBI) remains an important cause of morbidity and mortality within society. TBI may result in both focal and diffuse brain injury. Diffuse traumatic axonal injury (TAI) is an important pathological substrate of TBI, and can...

Al-Hasani, Omer Hussain

2011-07-05

233

Cerebral Palsy Spasticity. Selective Posterior Rhizotomy  

Microsoft Academic Search

We have performed selective posterior rhizotomies on 60 children with cerebral palsy. The procedure involves lumbar laminectomy with stimulation of the rootlets (fascicles) of the second lumbar to the first sacral posterior roots bilaterally; those rootlets associated with an abnormal motor response, as evidenced by sustained or diffused muscular contraction, are divided leaving intact rootlets associated with a brief localized

Warwick J. Peacock; Leila J. Arens; Barbara Berman

1987-01-01

234

Squamous cell carcinoma of suprapubic cystostomy tract in a male with locally advanced primary urethral malignancy  

PubMed Central

A 65-year-old man with stricture urethra underwent drainage of periurethral abscess and suprapubic cystostomy (SPC) placement. He presented to us 3 months later with a fungating ulcer at the site of perineal incision, the biopsy of which revealed squamous cell carcinoma (SCC). He underwent a total penile amputation, wide local excision scrotum, radical urethrocystoprostatectomy, ileal conduit with the en-bloc excision of the SPC tract. Histopathological examination of the suprapubic tract also revealed SCC. This is the first documented case of SCC of a suprapubic tract in the presence of primary urethral SCC.

Boaz, Ranil Johann; John, Nirmal Thampi; Kekre, Nitin

2015-01-01

235

Perspectives by patients and physicians on outcomes of mid-urethral sling surgery  

Microsoft Academic Search

Introduction and hypothesis  The aim of this study is to determine patient expectations regarding wanted and unwanted sequels of mid-urethral sling (MUS)\\u000a procedures and to identify mismatches during the physician–patient information exchange prior to MUS procedures.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A patient preference study (40 patients) and a questionnaire study with 20 experts as control group were conducted. Seventeen\\u000a different sequels, defined by an expert

R. Marijn Houwert; Daphne N. van Munster; Jan Paul W. R. Roovers; Pieter L. Venema; Marcel G. W. Dijkgraaf; Hein W. Bruinse; Harry A. M. Vervest

2010-01-01

236

[Necrotizing fasciitis and double bowel perforation after retropubic sub-urethral sling].  

PubMed

A 60-year-old woman without medical history developed after a Tension-free Vaginal Tape (TVT) procedure a necrotizing fasciitis and an abscess. After unadapted initial treatment, surgical procedure revealed 2 bowel perforations caused by the sling. Treatment was achieved by total mesh removal, bowel repair, necrosis excision and vacuum-assisted closure system. This is the first case report about the association of necrotizing fasciitis and double bowel perforations after TVT procedure. Any critical sepsis or with unsatisfactory evolution after retropubic sub-urethral sling has to make look for a digestive wound. PMID:24332737

Carassou-Maillan, A; Savary, D; Jacquetin, B

2014-10-01

237

Traumatic brain injury among Indiana state prisoners.  

PubMed

Research on traumatic brain injury among inmates has focused on comparing the rate of traumatic brain injury among offenders to the general population, but also how best to screen for traumatic brain injury among this population. This study administered the short version of the Ohio State University Traumatic Brain Injury Identification Method to all male inmates admitted into Indiana state prisons were screened for a month (N = 831). Results indicate that 35.7% of the inmates reported experiencing a traumatic brain injury during their lifetime and that these inmates were more likely to have a psychiatric disorder and a prior period of incarceration than those without. Logistic regression analysis finds that a traumatic brain injury predicts the likelihood of prior incarceration net of age, race, education, and psychiatric disorder. This study suggests that brief instruments can be successfully implemented into prison screenings to help divert inmates into needed treatment. PMID:24588316

Ray, Bradley; Sapp, Dona; Kincaid, Ashley

2014-09-01

238

45 CFR 1308.16 - Eligibility criteria: Traumatic brain injury.  

... false Eligibility criteria: Traumatic brain injury. 1308.16 Section 1308.16...1308.16 Eligibility criteria: Traumatic brain injury. A child is classified as having traumatic brain injury whose brain injuries are...

2014-10-01

239

Posterior Instrumentation for Occipitocervical Fusion  

PubMed Central

Since 1995, 29 consecutive patients with craniocervical spine instability due to several pathologies were managed with posterior occipitocervical instrumentation and fusion. Laminectomy was additionally performed in nineteen patients. The patients were divided in two groups: Group A which included patients managed with screw-rod instrumentation, and Group B which included patients managed with hook-and-screw-rod instrumentation. The patients were evaluated clinically and radiographically using the following parameters: spine anatomy and reconstruction, sagittal profile, neurologic status, functional level, pain relief, complications and status of arthrodesis. The follow-up was performed immediately postoperatively and at 2, 6, 12 months after surgery, and thereafter once a year. Fusion was achieved in all but one patient. One case of infection was the only surgery related complication. Neurological improvement and considerable pain relief occurred in the majority of patients postoperatively. There were neither intraoperative complications nor surgery related deaths. However, the overall death rate was 37.5% in group A, and 7.7% in group B. There were no instrument related failures. The reduction level was acceptable and was maintained until the latest follow-up in all of the patients. No statistical difference between the outcomes of screw-rod and hook-and-screw-rod instrumentation was detected. Laminectomy did not influence the outcome in either group. Screw-rod and hook-and-screw-rod occipitocervical fusion instrumentations are both considered as safe and effective methods of treatment of craniocervical instability. PMID:21772931

Sapkas, George; Papadakis, Stamatios A; Segkos, Dimitrios; Kateros, Konstantinos; Tsakotos, George; Katonis, Pavlos

2011-01-01

240

Penile necrosis requiring penectomy complicating recto-urethral fistula post prostate cancer external beam radiation and brachytherapy  

PubMed Central

Radiation therapy is a well-recognized treatment for unfavourable risk localized prostate cancer. Radiation induced recto-urethral fistulae are known rare complications particularly from brachytherapy. We report a case of a recto-urethral fistula 7 years post-external beam radiation and I-125 brachytherapy, which was complicated by a severe polymicrobial soft tissue infection. This infection required penectomy and pelvic exenteration with diverting colostomy, Indiana pouch urinary diversion and gracilis myo-cutaneuos flap closure of the perineum. PMID:24454604

Kinahan, John; Pai, Howard; Martens, Mildred; Gray, Jason; Biberdorf, Darren; Mihailovic, Alex; McAuley, Iain

2014-01-01

241

Sleep of chronic post-traumatic patients  

Microsoft Academic Search

The purpose of the present study was to investigate the sleep of people diagnosed as suffering from chronic Post-Traumatic Stress Disorder (PTSD). The sleep of seven chronic post-traumatic patients with no known physical injuries was compared with that of seven matched control subjects. The post-traumatic patients had poorer sleep: decreased sleep efficiency, increase in number of awakenings, and decreased SWS,

Hananyah Glaubman; Mario Mikulincer; Anat Porat; Orna Wasserman; Moshe Birger

1990-01-01

242

HIV infection associated post-traumatic stress disorder and post-traumatic growth – A systematic review  

Microsoft Academic Search

The phenomenon of post-traumatic stress has been well documented in the literature as a lasting mental health condition associated with exposure to traumatic life events. The diagnosis and experience of human immunodeficiency virus (HIV) disease may be such a trauma. On the other hand, the phenomenon of post-traumatic growth (PTG) has been described, whereby people show positive mental health growth

Lorraine Sherr; Navneet Nagra; Grace Kulubya; Jose Catalan; Claudine Clucas; Richard Harding

2011-01-01

243

Traumatic injuries in revue dancers.  

PubMed

Revue productions are a combination of dancing and singing, musical and spoken sequences, and acrobatics, performed with or without a story line, and characterized by a versatility of dance styles and a high number of performances (over 250 in a 10-month season). The aim of this quantitative single cohort study is to evaluate work-related traumatic injuries in this dance genre. Data were obtained from work accident reports of the German Social Accident Insurance Institution for the public sector in Berlin (UKB) involving 440 revue dancers (183 males and 257 females). Analysis was conducted with Excel 2007 and PASW Statistics 18. One out of three female dancers and one out of two male dancers sustained an acute injury in the course of a theatrical season (0.22 injuries per 1,000 hours). The incidence rate was 0.44 for males and 0.31 for females, with the lower extremity as the most commonly injured body region, followed by the spine. Of all occupational accidents, 75.1% happened on stage, with 69% during performances. The dance partner and dance floor were the most common exogenous factors resulting in a traumatic injury. Of all traumatic injuries, 81.7% occurred in the first 3 hours after starting work. Gender specific differences could be observed. Due to the limited availability of comparable studies of other forms of professional dance, in this study revue dance is largely considered as an independent genre. PMID:24568800

Wanke, Eileen M; Arendt, Michael; Mill, Helmgard; Koch, Franziska; Wanke, Alice; Groneberg, David A

2014-03-01

244

Is traumatic amnesia nothing but psychiatric folklore?  

PubMed

Some psychotherapists believe that certain experiences are so overwhelmingly traumatic that some victims become incapable of remembering their worst trauma except under special circumstances (e.g. therapy) many years later. Unfortunately, clinicians who endorse this concept of traumatic amnesia often misinterpret the very studies they adduce in support of it. More specifically, they misinterpret other, unrelated memory phenomena as evidence for traumatic amnesia, such as ordinary forgetfulness, psychogenic amnesia, organic amnesia, incomplete encoding of traumatic experiences, non-disclosure of remembered trauma, and simply not thinking about something for a long time. The purpose of this article is to dispel confusions rampant in this literature. PMID:15279316

McNally, Richard J

2004-01-01

245

[Asymmetric bilateral traumatic dislocation of the hip joint: a case report].  

PubMed

Bilateral traumatic dislocation of the hip is a rare condition. Simultaneous asymmetric traumatic dislocation of the hip, one hip anterior and the other posterior, is even more unusual. This article reports a 21-year-old male patient with asymmetric bilateral dislocation of the hip joint, injured due to a landslide during a canal excavation. The patient was treated conservatively and evaluated according to Thompson and Epstein clinical and radiographic criteria after a follow-up period of 10 years and six months. The clinical result was perfect and radiographical result was good. We determined that our case had occurred as a result of a mechanism that has not been previously published in the literature and evaluated it from this point of view. PMID:20632930

Azar, Nikola; Yalçinkaya, Merter; Akman, Yunus Emre; Uzümcügil, Onat; Kabukçuo?lu, Yavuz S

2010-08-01

246

Traumatic Experiences and Post-traumatic Stress Symptoms in Kurdish Children in their Native Country and in Exile  

Microsoft Academic Search

Background: Traumatic experiences and post-traumatic stress symptoms were assessed in Kurdish children in their native country and in exile. Method: 312 randomly selected school-age children at two sites completed assessments of traumatic experiences and post-traumatic symptoms. Results: Although traumatic experiences showed more similarities than differences between the two samples, the PTSD frequencies and post-traumatic stress symptom scores were higher in

Abdulbaghi Ahmad; Anne-Liis von Knorring; Viveka Sundelin-Wahlsten

2008-01-01

247

The urethral rhabdosphincter, levator ani muscle, and perineal membrane: a review.  

PubMed

Detailed knowledge of the anatomy of the rhabdosphincter and adjacent tissues is mandatory during urologic surgery to ensure reliable oncologic and functional outcomes. To characterize the levator ani (LA) function for the urethral sphincter, we described connective tissue morphology between the LA and urethral rhabdosphincter. The interface tissue between the LA and rhabdosphincter area in males contained abundant irregularly arrayed elastic fibers and smooth muscles. The male rhabdosphincter was positioned alongside the LA to divide the elevation force and not in-series along the axis of LA contraction. The male perineal membrane was thin but solid and extends along the inferior margin or bottom of the rhabdosphincter area. In contrast, the female rhabdosphincter, including the compressor urethrae and urethrovaginal sphincter muscles, was embedded in the elastic fiber mesh that is continuous with the thick, multilaminar perineal membrane. The inferomedial edge of the female LA was attached to the upper surface of the perineal membrane and not directly attached to the rhabdosphincter. We presented new diagrams showing the gender differences in topographical anatomy of the LA and rhabdosphincter. PMID:24877147

Hinata, Nobuyuki; Murakami, Gen

2014-01-01

248

Congenital duplication of the urethra with urethral diverticulum: a case report  

PubMed Central

Duplication of the urethra is a rare congenital anomaly. Urethral duplication with the presence of diverticulum is a rare combination and to the best of our knowledge has  not been previously reported. We report a case of a 16 month old male child with duplication of the urethra and diverticulum arising from the ventral urethra. We also cover the intricacies and challenges in the management of such a case. The opening of the narrowed accessory dorsal urethra at the verumontanum was cauterized and gradually the dorsal urethra became atrophied. The ventral urethral diverticulum was excised. This case is unique due to: The unusual presentation of swelling over the dorsum of the penis, together with duplication of the urethra with diverticulum.The use of cauterization as a treatment modality. Cauterization of the ventral urethra with a Bugbee electrode and diverticulectomy was performed. A glidewire helped in identifying the small opening of the dorsal urethra at the level of the verumontanum. The case also highlights the importance of endoscopic management of this clinical entity. PMID:25254101

Shah, Darshan H; Ganpule, Arvind P; Sabnis, Ravindra B; Desai, Mahesh R

2014-01-01

249

The Urethral Rhabdosphincter, Levator Ani Muscle, and Perineal Membrane: A Review  

PubMed Central

Detailed knowledge of the anatomy of the rhabdosphincter and adjacent tissues is mandatory during urologic surgery to ensure reliable oncologic and functional outcomes. To characterize the levator ani (LA) function for the urethral sphincter, we described connective tissue morphology between the LA and urethral rhabdosphincter. The interface tissue between the LA and rhabdosphincter area in males contained abundant irregularly arrayed elastic fibers and smooth muscles. The male rhabdosphincter was positioned alongside the LA to divide the elevation force and not in-series along the axis of LA contraction. The male perineal membrane was thin but solid and extends along the inferior margin or bottom of the rhabdosphincter area. In contrast, the female rhabdosphincter, including the compressor urethrae and urethrovaginal sphincter muscles, was embedded in the elastic fiber mesh that is continuous with the thick, multilaminar perineal membrane. The inferomedial edge of the female LA was attached to the upper surface of the perineal membrane and not directly attached to the rhabdosphincter. We presented new diagrams showing the gender differences in topographical anatomy of the LA and rhabdosphincter. PMID:24877147

Hinata, Nobuyuki; Murakami, Gen

2014-01-01

250

Initial experience with lingual mucosal graft urethroplasty for anterior urethral strictures  

PubMed Central

Background To present the feasibility of lingual mucosal graft urethroplasty in anterior urethral strictures and appraisal of donor site morbidity. Methods From November 2007 to December 2010, 14 patients underwent dorsal onlay lingual mucosal graft urethroplasty for anterior urethral strictures. Lingual mucosal graft was harvested from the lateral and undersurface of the tongue. Check micturating cystourethrograms were done 2 weeks after catheter removal and uroflowmetry after 3 months. Success was defined as normal uroflowmetry rates at 3 months in the absence of any postoperative instrumentation. Tongue was assessed for any residual pain, taste disturbances or restricted movement at 3 months. Results Four patients had submucosal fibrosis of the oral cavity and their buccal mucosa was unfit for grafting. Mean (range) stricture length was 5 (3–16) cm and the operation time 170 (140–210) min. Graft width averaged 1.6 cm. Average length of harvested graft was 6.5 cm. Mean duration of follow-up was 12.8 months. Two patients developed stricture at the proximal anastomotic site. There were no donor site complications. Conclusions Lingual mucosal graft harvesting is simple, gives graft lengths comparable to buccal mucosa and is associated with negligible donor site morbidity. PMID:24532928

Srivastava, Anand; Dutta, A.; Jain, D.K.

2012-01-01

251

Bitter triggers acetylcholine release from polymodal urethral chemosensory cells and bladder reflexes.  

PubMed

Chemosensory cells in the mucosal surface of the respiratory tract ("brush cells") use the canonical taste transduction cascade to detect potentially hazardous content and trigger local protective and aversive respiratory reflexes on stimulation. So far, the urogenital tract has been considered to lack this cell type. Here we report the presence of a previously unidentified cholinergic, polymodal chemosensory cell in the mammalian urethra, the potential portal of entry for bacteria and harmful substances into the urogenital system, but not in further centrally located parts of the urinary tract, such as the bladder, ureter, and renal pelvis. Urethral brush cells express bitter and umami taste receptors and downstream components of the taste transduction cascade; respond to stimulation with bitter (denatonium), umami (monosodium glutamate), and uropathogenic Escherichia coli; and release acetylcholine to communicate with other cells. They are approached by sensory nerve fibers expressing nicotinic acetylcholine receptors, and intraurethral application of denatonium reflexively increases activity of the bladder detrusor muscle in anesthetized rats. We propose a concept of urinary bladder control involving a previously unidentified cholinergic chemosensory cell monitoring the chemical composition of the urethral luminal microenvironment for potential hazardous content. PMID:24843119

Deckmann, Klaus; Filipski, Katharina; Krasteva-Christ, Gabriela; Fronius, Martin; Althaus, Mike; Rafiq, Amir; Papadakis, Tamara; Renno, Liane; Jurastow, Innokentij; Wessels, Lars; Wolff, Miriam; Schütz, Burkhard; Weihe, Eberhard; Chubanov, Vladimir; Gudermann, Thomas; Klein, Jochen; Bschleipfer, Thomas; Kummer, Wolfgang

2014-06-01

252

Neural control of the female urethral and anal rhabdosphincters and pelvic floor muscles  

PubMed Central

The urethral rhabdosphincter and pelvic floor muscles are important in maintenance of urinary continence and in preventing descent of pelvic organs [i.e., pelvic organ prolapse (POP)]. Despite its clinical importance and complexity, a comprehensive review of neural control of the rhabdosphincter and pelvic floor muscles is lacking. The present review places historical and recent basic science findings on neural control into the context of functional anatomy of the pelvic muscles and their coordination with visceral function and correlates basic science findings with clinical findings when possible. This review briefly describes the striated muscles of the pelvis and then provides details on the peripheral innervation and, in particular, the contributions of the pudendal and levator ani nerves to the function of the various pelvic muscles. The locations and unique phenotypic characteristics of rhabdosphincter motor neurons located in Onuf's nucleus, and levator ani motor neurons located diffusely in the sacral ventral horn, are provided along with the locations and phenotypes of primary afferent neurons that convey sensory information from these muscles. Spinal and supraspinal pathways mediating excitatory and inhibitory inputs to the motor neurons are described; the relative contributions of the nerves to urethral function and their involvement in POP and incontinence are discussed. Finally, a detailed summary of the neurochemical anatomy of Onuf's nucleus and the pharmacological control of the rhabdosphincter are provided. PMID:20484700

de Groat, William C.

2010-01-01

253

Bitter triggers acetylcholine release from polymodal urethral chemosensory cells and bladder reflexes  

PubMed Central

Chemosensory cells in the mucosal surface of the respiratory tract (“brush cells”) use the canonical taste transduction cascade to detect potentially hazardous content and trigger local protective and aversive respiratory reflexes on stimulation. So far, the urogenital tract has been considered to lack this cell type. Here we report the presence of a previously unidentified cholinergic, polymodal chemosensory cell in the mammalian urethra, the potential portal of entry for bacteria and harmful substances into the urogenital system, but not in further centrally located parts of the urinary tract, such as the bladder, ureter, and renal pelvis. Urethral brush cells express bitter and umami taste receptors and downstream components of the taste transduction cascade; respond to stimulation with bitter (denatonium), umami (monosodium glutamate), and uropathogenic Escherichia coli; and release acetylcholine to communicate with other cells. They are approached by sensory nerve fibers expressing nicotinic acetylcholine receptors, and intraurethral application of denatonium reflexively increases activity of the bladder detrusor muscle in anesthetized rats. We propose a concept of urinary bladder control involving a previously unidentified cholinergic chemosensory cell monitoring the chemical composition of the urethral luminal microenvironment for potential hazardous content. PMID:24843119

Deckmann, Klaus; Filipski, Katharina; Krasteva-Christ, Gabriela; Fronius, Martin; Althaus, Mike; Rafiq, Amir; Papadakis, Tamara; Renno, Liane; Jurastow, Innokentij; Wessels, Lars; Wolff, Miriam; Schütz, Burkhard; Weihe, Eberhard; Chubanov, Vladimir; Gudermann, Thomas; Klein, Jochen; Bschleipfer, Thomas; Kummer, Wolfgang

2014-01-01

254

Mobile-bearing total knee arthroplasty: a full traumatic rotation of 180°.  

PubMed

From February 2008 to September 2012 we implanted 204 mobile-bearing knee prostheses in 192 patients. All the prostheses were cemented (both femoral and tibial components), and the patella was not replaced. Only one early complication of the implants (1/204 = 0.004%) occurred after a traumatic event as a full 180° rotation of the mobile-bearing polyethylene insert. A 78-year-old woman presented with swelling and severe pain at her right knee. This traumatic event was the only case among our mobile-bearing insert patients. ?The failed polyethylene inserts were retrieved and studied using a scanning electron microscope (SEM, ZEISS EVO 50 EP, Cambridge, UK) operating at 20 kV. ?Scratching and pitting were found on the UHMWPE insert perpendicular to the machining tracks for the concave surface. SEM micrographs of the insert showed burnishing on the concave surfaces and longitudinal scratches were clearly detectable and well-marked on the analyzed surfaces. ?A traumatic, fully rotating, polyethylene insert is rare and our case is the first report describing a traumatic event with a complete 180 degree rotation mobile-bearing in a total knee prosthesis. ?In the literature few reports discuss clinical outcomes after total knee arthroplasty in patients with Parkinson's disease and they cite mixed results. However, some authors suggest that posterior-stabilized and cruciate-retaining TKA should work well while others prefer cruciate-retaining, condylar constrained kinetics, or hinged devices. Although we did not implant a posterior-stabilized mobile-bearing total knee prosthesis or a constrained prosthesis, we obtained good clinical and radiological results at the 2-year followup. PMID:23653296

Sudanese, Alessandra; Castiello, Emanuela; Affatato, Saverio

2013-06-25

255

High posterior density ellipsoids of quantum states  

NASA Astrophysics Data System (ADS)

Regions of quantum states generalize the classical notion of error bars. High posterior density (HPD) credible regions are the most powerful of region estimators. However, they are intractably hard to construct in general. This paper reports on a numerical approximation to HPD regions for the purpose of testing a much more computationally and conceptually convenient class of regions: posterior covariance ellipsoids (PCEs). The PCEs are defined via the covariance matrix of the posterior probability distribution of states. Here it is shown that PCEs are near optimal for the example of Pauli measurements on multiple qubits. Moreover, the algorithm is capable of producing accurate PCE regions even when there is uncertainty in the model.

Ferrie, Christopher

2014-02-01

256

Acute tibialis posterior tendon rupture associated with a distal tibial fracture.  

PubMed

Tibialis posterior tendon ruptures associated with closed medial malleolar fractures are rare. This article describes the association of tibialis posterior tendon ruptures with closed, high-energy, distal tibia fractures. Tendon ruptures are likely to be identified intraoperatively or missed if clinical evaluation at acute injury is limited. A high index of suspicion is required to diagnose this injury. The consequences of an unrecognized tibialis posterior tendon rupture include progressive, painful pes planus deformities due to the unopposed action of the peroneus brevis muscle and lack of support of the medial longitudinal arch. Secondary operative intervention may be required. This article describes an intraoperative tenodesis technique between the tibialis posterior and flexor digitorum longus tendons when direct repair is not possible.A 48-year-old woman sustained a closed AO/Orthopaedic Trauma Association type 43A right lower-extremity distal tibia fracture and a traumatic left knee arthrotomy. Temporary stabilization with an external fixator was performed, followed by open reduction and internal fixation of the distal tibial fracture 6 days later. A periarticular nonlocking medial plate was applied, and the tibialis posterior tendon was shortened. We performed a direct tenodesis to the flexor digitorum longus tendon. At 1-year follow-up, the patient had made excellent progress, with no detectable muscle weakness, and was able to perform a single-leg toe raise.A review of the literature suggested which features of radiological evidence of tendon rupture should be examined, which may be useful in the current era considering most high-energy distal tibia or pilon fractures undergo examination with computed tomography. PMID:22495868

Jarvis, Hannah C; Cannada, Lisa K

2012-04-01

257

Prevention of urethral blockage following semen collection in two species of lemur, Varecia variegata variegata and Lemur catta.  

PubMed

Lemurs are a diverse group of primates comprised of five families, all of which are found only on Madagascar and the Comoro Islands. Of the 60 known species, 17 are endangered and 5 of these are considered critically endangered. The effects of inbreeding on population health and viability have been well described; though negative inbreeding effects can be ameliorated through the introduction of new genetic material. Introduction of new individuals into a population can be extremely challenging because of the highly social nature of lemurs. Semen collection in lemur species is notoriously challenging, as the ejaculate forms a coagulum. During normal breeding, the coagulum forms a copulatory plug in the female. However, this coagulum can present a life-threatening situation when retained in the urethra abnormally following electroejaculation. This study investigates the use of ascorbic acid in preventing urethral blockage in two lemur species during semen collection, demonstrates successful collection of semen by electroejaculation from two species of lemur during the breeding season, and discusses removal of urethral plugs subsequent to semen collection. Semen was collected successfully from all animals. Urethral plugs formed during each collection and were abnormally retained in 2/11 collections. Both plugs were successfully and immediately removed with the use of retropulsion through a urethral catheter. Although the results of this study are encouraging, more investigation is required to establish whether or not this procedure can be safely performed in the field. PMID:17679512

Chatfield, Jenifer; Penfold, Linda

2007-06-01

258

Damage to histaminergic tuberomammillary neurons and other hypothalamic neurons with traumatic brain injury.  

PubMed

The need for increased sleep after traumatic brain injury is a common and disabling complaint, yet its etiology is unknown. Previous studies have demonstrated diffuse damage to various hypothalamic systems, but the integrity of the histaminergic tuberomammillary nucleus, a major arousal-promoting system located in the posterior hypothalamus, has never been examined in head trauma patients. Here, we demonstrate that severe head trauma is associated with a marked loss (41%) of histaminergic neurons. Reduced histamine signaling may contribute to increased sleep need, and therapies that enhance histaminergic tone may improve arousal after head trauma or other conditions. ANN NEUROL 2015;77:177-182. PMID:25363332

Valko, Philipp O; Gavrilov, Yury V; Yamamoto, Mihoko; Finn, Kristen; Reddy, Hasini; Haybaeck, Johannes; Weis, Serge; Scammell, Thomas E; Baumann, Christian R

2015-01-01

259

Acute traumatic stroke: a case of bow hunter's stroke in a child.  

PubMed

Acute traumatic stroke of the cerebellum is rarely seen in children. In adults, chiropractical manipulation, yoga exercises, bow hunting and cervical trauma have all been associated with vertebrobasillar damage and subsequent stroke due to cerebellar infarction. We present a case of bow hunter's stroke in a child. An 11-year-old boy developed deep coma one day after minor occipital head injury due to an infarct in the left cerebellum and ipsilateral medulla oblongata. Magnetic resonance angiography (MRA) showed hypoperfusion of the left vertebral artery and occlusion of the posterior and anterior inferior cerebellar arteries (PICA and AICA respectively). PMID:9846257

Duval, E L; Van Coster, R; Verstraeten, K

1998-06-01

260

Arthroscopic Repair of Inferior Labrum From Anterior to Posterior Lesions Associated With Multidirectional Instability of the Shoulder  

PubMed Central

Multidirectional instability (MDI) of the shoulder may arise spontaneously; however, recent evidence suggests that traumatic events may play a role in this syndrome. Variable degrees of injury around the circumference of the glenoid have been reported, ranging from Bankart and Kim lesions to 270° of injury and even 360° of injury. Hyperabduction injury may cause inferior subluxation of the shoulder and result in traumatic isolated injury to the inferior labrum from anterior to posterior. This particular lesion spans approximately 180° of the inferior hemisphere and may lead to symptomatic MDI. In contrast to open or arthroscopic plication procedures for atraumatic MDI without labral injury, the goal in these cases is anatomic arthroscopic repair of the inferior labrum tear without the need for capsular plication, volume reduction, or rotator interval closure.

Burt, David M.

2014-01-01

261

Unilateral posterior arch fractures of the atlas.  

PubMed

Unilateral posterior arch fractures of the atlas are discussed with two clinical examples and an experimental study of their mechanism. Laboratory fracturing of posterior arches of atlas specimens with a specially adapted universal testing machine produced nonsimultaneous fractures of the two sides in four of six specimens. In three of these specimens, a complete fracture on one side was temporarily displaced because the orientation of the leverage acting on the other side changed from sagittal to oblique. The consequent increase in the effective length of the lever arm reduced the angular deformation and strain on the second side. The second fracture occurred only after additional deflection of the posterior tubercle by up to 3 mm reproduced on the second side about the same angle of deformation that had caused the first fracture. A posterior arch fracture occurring by this mechanism will remain unilateral if the deflection is arrested before failure of the second side. PMID:6437181

Suss, R A; Bundy, K J

1984-01-01

262

Meibomian Gland Dysfunction and Treatment (Posterior Blepharitis)  

MedlinePLUS

... Meibomian Gland Dysfunction and Treatment What are Meibomian (Oil) Glands? Meibomian glands are glands that are arranged ... lashes. The force of an eyelid blink causes oil to be excreted onto the posterior lid margin. ...

263

Posterior Hip Pain in an Athletic Population  

PubMed Central

Context: Posterior hip pain is a relatively uncommon but increasingly recognized complaint in the orthopaedic community. Patient complaints and presentations are often vague or nonspecific, making diagnosis and subsequent treatment decisions difficult. The purposes of this article are to review the anatomy and pathophysiology related to posterior hip pain in the athletic patient population. Evidence Acquisition: Data were collected through a thorough review of the literature via a MEDLINE search of all relevant articles between 1980 and 2010. Results: Many patients who complain of posterior hip pain actually have pain referred from another part of the body—notably, the lumbar spine or sacroiliac joint. Treatment options for posterior hip pain are typically nonoperative; however, surgery is warranted in some cases. Conclusions: Recent advancements in the understanding of hip anatomy, pathophysiology, and treatment options have enabled physicians to better diagnosis athletic hip injuries and select patients for appropriate treatment. PMID:23015944

Frank, Rachel M.; Slabaugh, Mark A.; Grumet, Robert C.; Virkus, Walter W.; Bush-Joseph, Charles A.; Nho, Shane J.

2010-01-01

264

Traumatic Brain Injury: A Challenge for Educators  

Microsoft Academic Search

In this article, the authors provide information designed to enhance the knowledge and understanding of school personnel about traumatic brain injury (TBI). The authors specifically define TBI and enumerate common characteristics associated with traumatic brain injury, discuss briefly the growth and type of services provided, and offer some thoughts on ways to help ensure quality services for these students once

Lyndal M. Bullock; Robert A. Gable; J. Darrell Mohr

2005-01-01

265

Seizures Following Traumatic Brain Injury in Childhood.  

ERIC Educational Resources Information Center

This guide provides information on seizures in students with traumatic brain injury (TBI) and offers guidelines for classroom management. First, a classification system for seizures is presented with specific types of seizures explained. Post-traumatic seizures are specifically addressed as is the importance of seizure prevention when possible.…

Williams, Dennis

266

Family Burden Following Traumatic Brain Injury  

Microsoft Academic Search

This study investigated burden experienced by 60 spouses and 71 parents who served as primary caregivers to individuals with traumatic brain injury. Burden levels, as assessed by the Questionnaire on Resources and Stress (QRS-SF), were compared for spouses and parents. Overall, both parents and spouses of individuals with traumatic brain injury exhibited high levels of burden. Relative to spouses, parents

Karen Allen; Richard T. Linn; Horacio Gutierrez; Barry S. Willer

1994-01-01

267

TRAUMATIC BRAIN INJURY (TBI): INFORMATION FOR PARENTS  

Microsoft Academic Search

Each year, as many as 4 out of 100 people experience a traumatic brain injury, resulting in approximately 100,000 hospitalizations. Traumatic brain injury (TBI) is defined as either a physical blow or an acceleration\\/deceleration (rapid moving and a sudden stopping) injury severe enough to require medical attention. It is more common in children than adults, and more common in males

Robert Diamond

268

Traumatic Brain Injury: A Challenge for Educators  

ERIC Educational Resources Information Center

In this article, the authors provide information designed to enhance the knowledge and understanding of school personnel about traumatic brain injury (TBI). The authors specifically define TBI and enumerate common characteristics associated with traumatic brain injury, discuss briefly the growth and type of services provided, and offer some…

Bullock, Lyndal M.; Gable, Robert A.; Mohr, J. Darrell

2005-01-01

269

Traumatic Memories, Eye Movements, Phobia, and Panic  

Microsoft Academic Search

In the past years, Eye Movement Desensitization and Reprocessing (EMDR) has become increasingly popular as a treatment method for Posttraumatic Stress Disorder (PTSD). The current article critically evaluates three recurring assumptions in EMDR literature: (a) the notion that traumatic memories are fixed and stable and that flashbacks are accurate reproductions of the traumatic incident; (b) the idea that eye movements,

Peter Muris; Harald Merckelbach

1999-01-01

270

Secondary Traumatic Stress in Substance Abuse Treatment  

ERIC Educational Resources Information Center

The terms secondary traumatic stress (STS), vicarious traumatization (VT), and compassion fatigue (CF) have all been used, sometimes interchangeably, to refer to the observation that those who provide clinical services to trauma survivors may themselves experience considerable emotional disruption, becoming indirect victims of the trauma.…

Bride, Brian E.; Walls, Erin

2006-01-01

271

Post-Traumatic Stress Disorder and Violence.  

ERIC Educational Resources Information Center

This paper is a clinical discussion of post-traumatic stress disorder and violence, particularly as it applies to the Vietnam Post-Traumatic Stress Syndrome. In the first section, the syndrome is described as the sudden onset of explosive rage and unprovoked violence with little or no warning, accompanied by a drastic change in personality. It is…

French, Laurence

272

Incidence and risk factors for urethral and anal gonorrhoea and chlamydia in a cohort of HIV?negative homosexual men: the Health in Men Study  

PubMed Central

Background Early detection and treatment of bacterial sexually transmitted infections has been advocated as an HIV prevention strategy. Aim To inform screening guidelines, the incidence and risk factors for urethral and anal gonorrhoea and chlamydia were studied in a prospective cohort of community?based HIV negative homosexual men in Sydney, New South Wales, Australia. Methods All participants were offered annual screening for gonorrhoea and chlamydia (study?visit diagnoses) on urine and anal swabs using nucleic acid amplification. Participants also reported diagnoses of gonorrhoea and chlamydia made elsewhere between interviews (interval diagnoses). All diagnoses were summed to create a combined incidence rate, and detailed data on specific sexual practices with casual and regular partners were collected. Results Among 1427 men enrolled, the combined incidence rates were 3.49 and 2.96 per 100?person?years for urethral and anal gonorrhoea, respectively; and 7.43 and 4.98 per 100?person?years for urethral and anal chlamydia, respectively. Urethral infections were associated with unprotected anal intercourse (UAI) with HIV?positive partners (hazard ratio (HR)?=?2.58, 95% CI 1.10 to 6.05 for urethral gonorrhoea) and with frequent insertive oral sex (p for trend 0.007 for urethral chlamydia). Anal infections were associated with receptive UAI (p for trend 0.001 for both anal gonorrhoea and chlamydia) and other receptive anal sexual practices. Stratified analyses showed the independence of the associations of insertive oral sex with urethral infections and of non?intercourse receptive anal practices with anal infections. Conclusion Incident gonorrhoea and chlamydia were common. Risk behaviours for both urethral and anal infections were not restricted to UAI. Screening that includes tests for anal and urethral infections should be considered for all sexually active homosexual men, not just for those who report UAI. PMID:17005541

Jin, F; Prestage, G P; Mao, L; Kippax, S C; Pell, C M; Donovan, B; Cunningham, P H; Templeton, D J; Kaldor, J M; Grulich, A E

2007-01-01

273

Posterior odds ratios for selected regression hypotheses  

Microsoft Academic Search

Summary  Bayesian posterior odds ratios for frequently encountered hypotheses about parameters of the normal linear multiple regression\\u000a model are derived and discussed. For the particular prior distributions utilized, it is found that the posterior odds ratios\\u000a can be well approximated by functions that are monotonic in usual sampling theoryF statistics. Some implications of this finding and the relation of our work

A. Zellner; A. Siow

1980-01-01

274

Post-traumatic Stress Disorder.  

PubMed

Unexpected extreme sudden traumatic stressor may cause post-traumatic stress disorder (PTSD). Important traumatic events include war, violent personal assault (e.g., sexual assault, and physical attack), being taken hostage or kidnapped, confinement as a prisoner of war, torture, terrorist attack, severe car accidents, and natural disasters. In childhood age sexual abuse or witnessing serious injuries or unexpected death of a beloved one are among important traumatic events.PTSD can be categorized into two types of acute and chronic PTSD: if symptoms persist for less than three months, it is termed "acute PTSD," otherwise, it is called "chronic PTSD." 60.7% of men and 51.2% of women would experience at least one potentially traumatic event in their lifetime. The lifetime prevalence of PTSD is significantly higher in women than men. Lifetime prevalence of PTSD varies from 0.3% in China to 6.1% in New Zealand. The prevalence of PTSD in crime victims are between 19% and 75%; rates as high as 80% have been reported following rape. The prevalence of PTSD among direct victims of disasters was reported to be 30%-40%; the rate in rescue workers was 10%-20%. The prevalence of PTSD among police, fire, and emergency service workers ranged from 6%-32%. An overall prevalence rate of 4% for the general population, the rate in rescue/recovery occupations ranged from 5% to 32%, with the highest rate reported in search and rescue personnel (25%), firefighters (21%), and workers with no prior training for facing disaster. War is one of the most intense stressors known to man. Armed forces have a higher prevalence of depression, anxiety disorders, alcohol abuse and PTSD. High-risk children who have been abused or experienced natural disasters may have an even higher prevalence of PTSD than adults.Female gender, previous psychiatric problem, intensity and nature of exposure to the traumatic event, and lack of social support are known risk factors for work-related PTSD. Working with severely ill patients, journalists and their families, and audiences who witness serious trauma and war at higher risk of PTSD.The intensity of trauma, pre-trauma demographic variables, neuroticism and temperament traits are the best predictors of the severity of PTSD symptoms. About 84% of those suffering from PTSD may have comorbid conditions including alcohol or drug abuse; feeling shame, despair and hopeless; physical symptoms; employment problems; divorce; and violence which make life harder. PTSD may contribute to the development of many other disorders such as anxiety disorders, major depressive disorder, substance abuse/dependency disorders, alcohol abuse/dependence, conduct disorder, and mania. It causes serious problems, thus its early diagnosis and appropriate treatment are of paramount importance. PMID:23022845

Javidi, H; Yadollahie, M

2012-01-01

275

Posterior tibial tendon dysfunction: a review.  

PubMed

Posterior tibial tendon dysfunction is a progressive deformity that can result in the development of a pathologic flatfoot deformity. Numerous publications have studied the effects of clinical interventions at specific stages of progression of posterior tibial tendon dysfunction, but there is still uncertainty regarding the clinical identification of the condition. It is clear that more information regarding the etiology, progression, and risk factors of posterior tibial tendon dysfunction is required. Clear evidence exists that suggests that the quality of life for patients with posterior tibial tendon dysfunction is significantly affected. Furthermore, evidence suggests that early conservative intervention can significantly improve quality of life regarding disability, function, and pain. This would suggest that significant cost burden reductions could be made by improving awareness of the condition, which would improve early diagnosis. Early conservative intervention may help reduce the number of patients requiring surgery. This review focuses on the etiologic factors, epidemiologic features, and pathogenesis of posterior tibial tendon dysfunction. It aims to analyze, discuss, and debate the current understanding of this condition using the available literature. In addition, there is a discussion of the evidence base surrounding disease characteristics associated with the different clinical stages of posterior tibial tendon dysfunction. PMID:21406702

Durrant, Beverley; Chockalingam, Nachiappan; Hashmi, Farina

2011-01-01

276

Post-traumatic stress disorder in children.  

PubMed

In the past ten years, there has been increasing recognition that children who have been exposed to traumatic events can, like traumaexposed adults, develop post-traumatic stress disorder (PTSD). Practitioners therefore need to be able to recognise and treat post-traumatic stress reactions in children. However, the direct application of adult diagnostic criteria for PTSD can result in the misdiagnosis of post-traumatic stress reactions in children, while research has only recently begun to investigate the effectiveness of different treatments for children with PTSD. This article discusses issues regarding the assessment and diagnosis of post-traumatic stress reactions in children at different developmental stages, considers neurobiological, cognitive and other factors that are theorized to increase the risk of PTSD in trauma-exposed children, and evaluates current psychotherapeutic and pharmacotherapeutic treatments for childhood PTSD. The need for more systematic research on the management of PTSD in children is noted. PMID:16633528

Kaminer, Debra; Seedat, Soraya; Stein, Dan J

2005-06-01

277

Early traumatic events in psychopaths.  

PubMed

The relationship between diverse early traumatic events and psychopathy was studied in 194 male inmates. Criminal history transcripts were revised, and clinical interviews were conducted to determine the level of psychopathy using the Psychopathy Checklist-Revised (PCL-R) Form, and the Early Trauma Inventory was applied to assess the incidence of abuse before 18 years of age. Psychopathic inmates presented a higher victimization level and were more exposed to certain types of intended abuse than sociopathic inmates, while the sum of events and emotional abuse were associated with the PCL-R score. Our studies support the influence of early adverse events in the development of psychopathic offenders. PMID:23550705

Borja, Karina; Ostrosky, Feggy

2013-07-01

278

Traumatic subarachnoid-pleural fistula  

SciTech Connect

Traumatic subarachnoid-pleural fistulas are rare. The authors found nine cases reported since 1959. Seven have been secondary to trauma and two following thoracotomy. One patient's death is thought to be directly related to the fistula. The diagnosis should be suspected in patients with a pleural effusion and associated vertebral trauma. The diagnosis can usually be confirmed with contrast or radioisotopic myelography. Successful closure of the fistula will usually occur spontaneously with closed tube drainage and antibiotics; occasionally, thoracotomy is necessary to close the rent in the dura.

Brown, W.H.; Stothert, J.C. Jr.

1985-11-01

279

[Urethral recurrence of invasive carcinoma following BCG treatment for bladder Ca in situ].  

PubMed

CIS is a flat, high-grade, non-invasive microscopic urothelial carcinoma. It is considered a precursor of invasive bladder cancer. CIS is classified as primary, secondary or concurrent, when occurred as isolated CIS without cuncurrent papillary tumors, or detected during the follow-up of patients with a previous papillary tumor, or finally in the presence of bladder neoplasm. BCG is widely established as the treatment of choice for CIS with a success rate of approximately 70%. BCG reduces the risk of progression of CIS into invasive carcinoma in 30 to 50% of cases. Direct and prolonged contact between the urothelium and BCG is a prerequisite for successful therapy. Discovery of CIS in the prostatic or membranous urethra represents an ominous sign. CIS may be present only in the epithelial lining of the prostatic urethra or in the ducts, or in the worst case it may be found in the prostatic tissue stroma. Urethral involvement by CIS is at high risk of tumor progression and development of metastases due to reduced thickness of lamina propria and absence of muscolaris mucosa. 83 patients, enrolled from 1/1996 to 12/2005 at our urological department with CIS: primary (focal and multifocal) in 25, secondary in 7 and cuncurrent in 51 (associated with T1bG3 cancer in 37 cases), and urethral CIS in 5 and conservatively treated by TUR and intravescical instillations of BCG, 4 developed afterwords only invasive cancer of the urethra in the absence of bladder involvement. In 2 cases cancer arised from the prostatic fossa after TURP, in 1 from membranous urethra and in the last from prostatic ducts. Among the 4 patients, 3 were treated by cystoprostatourethrectomy and Platinum-based chemotherapy, 1 refused surgical treatment. Two patients died for disseminated disease. 1 patient is alive at 60-month's follow-up. In the last patient cancer relapsed at 36-month's follow-up. We conclude that prostatic/urethral involvement during follow-up after successful intravesical treatment with BCG in CIS represents a high risk of developing invasive and incontrolled cancer. A careful watch is recommended in these patients. PMID:21308679

Ruoppolo, M; Gozo, M; Milesi, R; Spina, R; Fragapane, G

2010-01-01

280

Urethral stricture  

MedlinePLUS

... the groin (inguinal) area Enlarged or tender prostate Hardness (induration) on the under surface of the penis ... to stretch the urethra while you are under local anesthesia. You may be able to treat your ...

281

Urethral Diverticulum  

MedlinePLUS

... the Ureter F no topics for this letter G no topics for this letter H Hematuria Horseshoe ... medical history, and analyzing any tests performed (e.g., blood tets, urine tests, brain scans, etc.). distal: ...

282

A Conceptual Framework for the Impact of Traumatic Experiences  

Microsoft Academic Search

This conceptual framework for the effects of traumatic experiences addresses what makes an experience traumatic, what psychological responses are expected follow- ing such events, and why symptoms persist after the traumatic experience is over. Three elements are considered necessary for an event to be traumatizing: The event must be experienced as extremely negative, uncontrollable, and sudden. The initial core responses

EVE B. CARLSON; CONSTANCE DALENBERG

2000-01-01

283

The Spectrum of Disease in Chronic Traumatic Encephalopathy  

ERIC Educational Resources Information Center

Chronic traumatic encephalopathy is a progressive tauopathy that occurs as a consequence of repetitive mild traumatic brain injury. We analysed post-mortem brains obtained from a cohort of 85 subjects with histories of repetitive mild traumatic brain injury and found evidence of chronic traumatic encephalopathy in 68 subjects: all males, ranging…

McKee, Ann C.; Stein, Thor D.; Nowinski, Christopher J.; Stern, Robert A.; Daneshvar, Daniel H.; Alvarez, Victor E.; Lee, Hyo-Soon; Hall, Garth; Wojtowicz, Sydney M.; Baugh, Christine M.; Riley, David O.; Kubilus, Caroline A.; Cormier, Kerry A.; Jacobs, Matthew A.; Martin, Brett R.; Abraham, Carmela R.; Ikezu, Tsuneya; Reichard, Robert Ross; Wolozin, Benjamin L.; Budson, Andrew E.; Goldstein, Lee E.; Kowall, Neil W.; Cantu, Robert C.

2013-01-01

284

Traumatic hemipelvectomy in children: report on 2 survivors with urological involvement.  

PubMed

Traumatic hemipelvectomy through the sacroiliac joint is a devastating injury, mainly because of motor vehicle accidents. Recent improvements in prehospital trauma care have increased the chances of survival for victims. Besides amputation of the lower limb, associated complications usually involve digestive and urological systems. We report on 2 pediatric patients from 2 different European countries. PATIENT 1: A 9-year-old boy suffered uprooting of his left lower limb, laceration of the rectum and anal sphincter, as well as an injury to distal urethra with partial loss of cavernous bodies. Initial management included a colostomy and an essay of contention by means of a polypropylene prosthesis that had to be removed in the following months. After several attempts at urethral reconstruction, he underwent a Mitrofanoff derivation. PATIENT 2: An 18-month-old girl lost her left lower limb and suffered severe lacerations of bladder and rectum. Among other measures, management included a colostomy, a skin graft, and 2 attempts at reconstruction of her bladder neck, including a modified Casale procedure (cecum and ileocecal appendix were in a high position that made a Mitrofanoff derivation impossible) and a Malone procedure. To the authors' knowledge, she would be the youngest reported survivor of this kind of injury. PMID:21034958

Calonge, Wenceslao M; Alova, Ilona; Ramos, Manuel R; Martínez, Leopoldo; Lortat-Jacob, Stéphan; Ochoa de Castro, Antonio; Lottmann, Henri

2010-11-01

285

Pediatric minor traumatic brain injury.  

PubMed

The literature surrounding minor traumatic brain injury is complex, methodologically challenging, and controversial. Although we lack a consistent standardized definition, the annual rate is likely in excess of 200 per 100,000 children. The proportion of children with minor traumatic brain injury who will require neurosurgery is certainly <1%. Several studies are underway that have the potential to significantly advance our understanding of the specific risk factors for intracranial injury and more specifically neurosurgical injury. The mortality within children is very low, with estimates of 0% to 0.25%. Virtually all studies of the prognosis of minor brain injury in children have reported no long-term behavioral or cognitive sequelae as a specific result of the brain injury. Symptoms fall in 4 domains: somatic, cognitive, sleep/fatigue, and affective. Limited pediatric studies are available to assist clinicians in the prognosis or in optimizing recovery. Until further studies are available, a conservative approach is recommended. Children with suspected concussions should be removed from activity and observed. Children with symptomatic concussions must be limited to no physical activity. Adolescents and families need to self-monitor symptoms and limit environments or circumstances that exacerbate any symptoms. When symptoms resolve, a gradual progressive return to play is currently recommended. The recurrence risk for subsequent concussions is elevated, but there is limited documentation of the effectiveness of preventative efforts. Much remains to be learned. PMID:17178354

Gordon, Kevin E

2006-12-01

286

The pathogenesis of traumatic coagulopathy.  

PubMed

Over the last 10 years, the management of major haemorrhage in trauma patients has changed radically. This is mainly due to the recognition that many patients who are bleeding when they come in to the emergency department have an established coagulopathy before the haemodilution effects of fluid resuscitation. This has led to the use of new terminology: acute traumatic coagulopathy, acute coagulopathy of trauma shock or trauma-induced coagulopathy. The recognition of acute traumatic coagulopathy is important, because we now understand that its presence is a prognostic indicator, as it is associated with poor clinical outcome. This has driven a change in clinical management, so that the previous approach of maintaining an adequate circulating volume and oxygen carrying capacity before, as a secondary event, dealing with coagulopathy, has changed to haemostatic resuscitation as early as possible. While there is as yet no universally accepted assay or definition, many experts use prolongation of the prothrombin time to indicate that there is, indeed, a coagulopathy. Hypoxia, acidosis and hypothermia and hormonal, immunological and cytokine production, alongside consumption and blood loss, and the dilutional effects of resuscitation may occur to varying extents depending on the type of tissue damaged, the type and extent of injury, predisposing to, or amplifying, activation of coagulation, platelets, fibrinolysis. These are discussed in detail within the article. PMID:25440402

Cap, A; Hunt, B J

2015-01-01

287

Individual motor unit analysis in the diagnosis of disorders of urethral sphincter innervation.  

PubMed Central

A technique is described for recording the electromyographic activity of striated muscle in the urethral sphincter. Using a concentric needle electrode and an oscilloscope with a delay line and trigger, individual motor units were isolated and measured. To validate the method as a means of detecting pathology, the results are presented of analysis of the motor units of a group of patients with disturbances of micturition, known to have either cauda equina lesions or pelvic nerve injury. These results are compared with those from a group of controls. In the control group 93% of the motor units were less than 6 ms in duration and 2.0 mv in amplitude. Of motor units recorded from patients with cauda equina or pelvic nerve injury 59% exceeded the control ranges for amplitude or duration. It is concluded that quantitative analysis of individual motor units may be a helpful technique in the investigation of patients with disorders of micturition. PMID:6736998

Fowler, C J; Kirby, R S; Harrison, M J; Milroy, E J; Turner-Warwick, R

1984-01-01

288

An unusual side effect of isotretinoin: retinoid dermatitis affecting external urethral meatus.  

PubMed

Abstract Isotretinoin (Iso) is the most effective drug against severe nodulocystic acne. As a synthetic oral retinoid, Iso exerts its actions by modulating cell growth and differentiation. Targeting all the pathophysiologic processes in acne development, Iso has been considered to be an unique drug, however it has several side effects. While chelitis, xerosis, ocular sicca, arthralgia, myalgia, headache, hyperlipidemia are the most common side effects, teratogenicity and depressive symptoms are the most concerning ones. In addition, Iso has unusual side effects which have been described for the first time in the literature. Here, we report a remarkable side effect of Iso in a 23-years-old male patient with retinoid dermatitis affecting the external uretral meatus. To our knowledge, only few cases of retinoid dermatitis in the urethral mucosa due to Iso have been reported in the literature so far. PMID:24964168

Alli, Nuran; Yorulmaz, Ahu

2014-06-25

289

Assessing Traumatic Event Exposure: Comparing the Traumatic Life Events Questionnaire to the Structured Clinical Interview for "DSM-IV"  

ERIC Educational Resources Information Center

Post-traumatic stress disorder (PTSD) diagnosis requires first identifying a traumatic event, but very few studies have evaluated methods of potential traumatic event assessment and their impact on PTSD diagnosis. The authors compared a behaviorally specific comprehensive multiple-item traumatic event measure with a single-item measure to…

Peirce, Jessica M.; Burke, Christopher K.; Stoller, Kenneth B.; Neufeld, Karin J.; Brooner, Robert K.

2009-01-01

290

Recombinant insulin-like growth factor-1 activates satellite cells in the mouse urethral rhabdosphincter  

PubMed Central

Background The goal of this study is to demonstrate the efficacy of a new method for the treatment of urinary incontinence by stimulation of urethral rhabdosphincter satellite cells. We show that satellite cells do exist in the sphincter muscle of retired male mice breeders by staining for c-Met, a satellite cell specific protein. Once activated by recombinant mouse Insulin-like Growth Factor-1(rIgf-1), the satellite cells develop into muscle cells within the rhabdosphincter thereby potentially strengthening it. Methods 20 ?l (1 ?g/?l) of rIgf-1 was surgically injected directly into the urethral wall of retired male mouse breeders. Mice injected with phosphate buffered saline (PBS) were used as controls. 4 weeks later, urethras were harvested and serially-sectioned through the sphincter for routine hematoxylin-eosin staining as well as immunohistochemical staining with satellite cell specific anti-c-Met antibody and proliferation specific anti-Ki-67 antibody. Results Anti-c-Met antibody positive cells (c-Met+) were identified in the rhabdosphincter. c-Met+ cells increased by 161.8% relative to controls four weeks after rIGF-1 injection. Anti- Ki-67 antibody positive cells were identified and characterized as cells with centrally located nuclei in striated muscle bundles of rIGF-1 treated animals. Conclusions Satellite cells in the mouse rhabdosphincter can be activated by rIGF-1 treatment, which subsequently are incorporated into existing skeletal muscle bundles. Using this approach, the rhabdosphincter can be induced to regenerate and potentially strengthen via satellite cell activation and likely improve urinary continence. PMID:24279352

2013-01-01

291

Biomechanical study on the bladder neck and urethral positions: Simulation of impairment of the pelvic ligaments.  

PubMed

Excessive mobility of the bladder neck and urethra are common features in stress urinary incontinence. We aimed at assessing, through computational modelling, the bladder neck position taking into account progressive impairment of the pelvic ligaments. Magnetic resonance images of a young healthy female were used to build a computational model of the pelvic cavity. Appropriate material properties and constitutive models were defined. The impairment of the ligaments was simulated by mimicking a reduction in their stiffness. For healthy ligaments, valsalva maneuver led to an increase in the ? angle (between the bladder neck-symphysis pubis and the main of the symphysis) from 91.8° (at rest) to 105.7°, and 5.7mm of bladder neck dislocation, which was similar to dynamic imaging of the same woman (? angle from 80° to 103.3°, and 5mm of bladder neck movement). For 95% impairment, they enlarged to 124.28° and 12mm. Impairment to the pubourethral ligaments had higher effect than that of vaginal support (115° vs. 108°, and 9.1 vs. 7.3mm). Numerical simulation could predict urethral motion during valsalva maneuver, for both healthy and impaired ligaments. Results were similar to those of continent women and women with stress urinary incontinence published in the literature. Biomechanical analysis of the pubourethral ligaments complements the biomechanical study of the pelvic cavity in urinary incontinence. It may be useful in young women presenting stress urinary incontinence without imaging evidence of urethral and muscle lesions or organ descend during valsalva, and for whom fascial damage are not expected. PMID:25527889

Brandão, Sofia; Parente, Marco; Mascarenhas, Teresa; da Silva, Ana Rita Gomes; Ramos, Isabel; Jorge, Renato Natal

2015-01-21

292

Correlation among maximal urethral closure pressure, retrograde leak point pressure, and abdominal leak point pressure in men with postprostatectomy stress incontinence  

Microsoft Academic Search

ObjectivesTo assess the correlation among abdominal leak point pressure (ALPP), maximal urethral closure pressure (MUCP), and retrograde leak point pressure (RLPP) in the evaluation of men with stress urinary incontinence (SUI) after radical prostatectomy.

Craig V. Comiter; Maryrose P. Sullivan; Subbarao V. Yalla

2003-01-01

293

Minor traumatic injuries to the permanent dentition.  

PubMed

Treatment of traumatized teeth generally occurs in two phases: short-term emergency treatment and stabilization followed by endodontic management and review. These authors recently reviewed the endodontic considerations in the treatment of traumatized permanent anterior teeth, and in this article review the early management of traumatized permanent teeth. Preoperative assessment and emergency management are emphasized, as is the treatment of immature teeth for which continued development of the root system must be encouraged. Factors influencing long-term prognosis are discussed and the influence of various management strategies evaluated. PMID:19958903

Moule, Alex J; Moule, Christopher A

2009-10-01

294

Traumatic Stressors and Post-Traumatic Stress Disorder Symptoms in Headache Patients  

Microsoft Academic Search

Objective.—The aim of this study was to assess the prevalence of significant traumatic stressors and post-traumatic stress disorder (PTSD) symptoms in a headache population.\\u000aBackground.—Several recent publications have emphasized the relationship between life stressors and\\/or daily hassles and recurrent headaches. However, little is known about the prevalence and impact of major traumatic stressors in patients with recurrent headaches.\\u000aMethods.—Eighty patients

Reny deLeeuw; John E. Schmidt; Charles R. Carlson

2005-01-01

295

Giant epidermoid cyst of the posterior neck.  

PubMed

A 49-year-old man was presented for evaluation of a painless mass on his right posterior neck. The mass had gradually enlarged for a 25-year period without inflammation or rupture. On physical examination, a round, nontender, soft-tissue mass, 8 cm in diameter, was noted on the right posterior neck. The neck is a common site of epidermoid cysts, but a mass more than 5 cm in diameter is rare. A contrast-enhanced neck computed tomographic (CT) scan revealed a 7.6 × 6.5 × 5.7 cm unilocular hypodense mass adjacent to the posterior neck muscles.The mass was completely excised under general anesthesia. A histopathologic examination of the excised specimen resulted in a diagnosis of an epidermoid cyst. The patient was discharged from the hospital on the third postoperative day. There were no recurrences in a 2-year follow-up period. PMID:21586972

Kim, Cheesun; Park, Myong Chul; Seo, Seung Jo; Yoo, Young Moon; Jang, Yu Jin; Lee, Il Jae

2011-05-01

296

Epidemiology of traumatic dental injuries.  

PubMed

The oral region comprises 1% of the total body area, yet it accounts for 5% of all bodily injuries. In preschool children, oral injuries make up as much as 17% of all bodily injuries. The incidence of traumatic dental injuries is 1%-3%, and the prevalence is steady at 20%-30%. The annual cost of treatment is US $2-$5 million per 1 million inhabitants. Etiologic factors vary between countries and with age groups. Important public health implications such as how to best organize emergency dental care and how to prevent dental injuries, decrease cost, and increase lay knowledge are important factors needed to change epidemiologic data toward more favorable figures in the future. PMID:23635975

Andersson, Lars

2013-01-01

297

Epidemiology of traumatic dental injuries.  

PubMed

The oral region comprises 1% of the total body area, yet it accounts for 5% of all bodily injuries. In preschool children, oral injuries make up as much as 17% of all bodily injuries. The incidence of traumatic dental injuries is 1%-3%, and the prevalence is steady at 20%-30%. The annual cost of treatment is US $2-$5 million per 1 million inhabitants. Etiologic factors vary between countries and with age groups. Important public health implications such as how to best organize emergency dental care and how to prevent dental injuries, decrease cost, and increase lay knowledge are important factors needed to change epidemiologic data toward more favorable figures in the future. PMID:23439040

Andersson, Lars

2013-03-01

298

A patient with traumatic chylothorax  

PubMed Central

Chylothorax refers to the accumulation of chyle in the pleural cavity. Although rare, it is the most frequent cause of pleural effusion in the neonatal period. Its incidence is estimated at one in 15,000 neonates. The causes of chylothorax are multiple, and there are several major types of chylothorax defined by origin, ie, traumatic (and iatrogenic) chylothorax, medical (spontaneous) chylothorax, and congenital chylothorax. A case of neonatal chylothorax following surgery for esophageal atresia and our therapeutic approach to this entity are presented. Conservative therapy with total enteral nutrition and drainage were sufficient. Treatment for chylothorax is essentially medical, ie, pleural drainage, removal of dietary fats, treatment of any medical cause, and use of drugs to reduce production of chyle. In the event of failure or reappearance of a large effusion, surgical treatment is needed. PMID:23049269

Barkat, Amina; Benbouchta, Ilham; Karboubi, Lamia; Ghanimi, Zineb; Kabiri, Meryem

2012-01-01

299

[Surgery of traumatic aortic rupture].  

PubMed

This report describes the clinical presentation, diagnosis, surgery and results of patients with acute traumatic rupture of the aorta in a series of 21 consecutive patients. Direct cross-clamping without additional methods of spinal cord protection was used in 18/21 patients (86%). Direct suture was possible in 12/21 patients (60%). In the remaining patients, the repair was carried out by interposition of a Dacron graft. Overall mortality was 7/21 patients (33%). However, in 3 patients with severe polytrauma irreversible brain damage was the cause of death whereas 2 patients died from septicemia and myocardial infarction, respectively. No paraplegia nor paraparesis occurred in the surviving patients which were operated by direct cross-clamping of the aorta and rapid reanastomosis without additional methods of spinal cord protection. PMID:2777620

von Segesser, L; Schneider, K; Siebenmann, R; Glinz, W; Turina, M

1989-06-01

300

A preliminary study of neuroSPECT evaluation of patients with post-traumatic smell impairment  

PubMed Central

Background Most olfactory testings are subjective and since they depend upon the patients' response, they are prone to false positive results. The aim of this study was to use quantitative brain perfusion SPECT in order to detect possible areas of brain activation in response to odorant stimulation in patients with post-traumatic impaired smell in comparison to a group of normal subjects. Methods Fourteen patients with post-traumatic impaired smell and ten healthy controls were entered in this prospective study. All subjects underwent brain SPECT after intravenous injection of 740-MBq 99mTc-ECD and 48 hours later, the same procedure was repeated following olfactory stimulus (vanilla powder). Results In most of seven regions of interest (Orbital Frontal Cortex, Inferior Frontal Pole, Superior Frontal Pole, Posterior Superior Frontal Lobe, Parasagittal Area, Occipital Pole, and Cerebellar area) the post-stimulation quantitative values show increased cortical perfusion being more pronounced in normal volunteers than the anosmic patients (except cerebellar areas and the right occipital pole). Maximal activation was observed in orbitofrontal regions (right+ 25.45% and left +25.47%). Conclusion Brain SPECT is a valuable imaging technique in the assessment of post-traumatic anosmia and could be competitive as an alternative to other imaging techniques, especially when functional MRI is unavailable or unsuitable. However, this procedure may benefit from complementary MRI or CT anatomical imaging. PMID:16313675

Eftekhari, Mohammad; Assadi, Majid; Kazemi, Majid; Saghari, Mohsen; Esfahani, Armaghan Fard; Sichani, Babak Fallahi; Gholamrezanezhad, Ali; Beiki, Davood

2005-01-01

301

Post-Traumatic Stress Disorder (PDQ)  

MedlinePLUS

... Risk Factors, Protective Factors, and the Development of PTSD Assessment Treatment Current Clinical Trials Changes to This ... threatening events. This group of symptoms is called post-traumatic stress disorder (PTSD) and includes avoiding situations related to the ...

302

TRAUMATIC BRAIN INJURY SURVEILLANCE SYSTEM (TBISS)  

EPA Science Inventory

The National Center for Injury Prevention and Control (NCIPC), Centers for Disease Control and Prevention (CDC) had developed and maintains a surveillance system to understand the magnitude and characteristics of hospitalized and fatal traumatic brain injuries in the United State...

303

Traumatic injury among females: does gender matter?  

PubMed Central

Background Trauma remains one of the leading causes of morbidity and mortality worldwide. Generally, the incidence of traumatic injuries is disproportionately high in males. However, trauma in females is underreported. Aim To study the epidemiology and outcome of different mechanisms and types of traumatic injuries in women. Methods We conducted a traditional narrative review using PubMed, MEDLINE and EMBASE, searching for English-language publications for gender-specific trauma between January 1993 and January 2013 using key words “trauma”, “gender”, “female” and “women”. Results Among 1150 retrieved articles, 71 articles were relevant over 20 years. Although it is an important public health problem, traumatic injuries among females remain under-reported. Conclusion There is a need for further research and evaluation of the exact burden of traumatic injuries among females together with the implementation of effective community based preventive programs. PMID:25089153

2014-01-01

304

International Society for Traumatic Stress Studies  

MedlinePLUS

... in the definition of traumatic stressors (Caspi, Ghafoori, Smith, & Contractor, 2013) and in the understanding of their short and long-term impact (Ghafoori, Caspi, Contractor, & Smith, 2014), is further accentuated in the cross-cultural ...

305

Cerebral Blood Flow and Autoregulation after Pediatric Traumatic Brain Injury  

PubMed Central

Traumatic brain injury is a global health concern and is the leading cause of traumatic morbidity and mortality in children. Despite a lower overall mortality than in adult traumatic brain injury, the cost to society from the sequelae of pediatric traumatic brain injury is very high. Predictors of poor outcome after traumatic brain injury include altered systemic and cerebral physiology, including altered cerebral hemodynamics. Cerebral autoregulation is often impaired following traumatic brain injury and may adversely impact poor outcome. Although altered cerebrovascular hemodynamics early after traumatic brain injury may contribute to disability in children, there is a paucity of information regarding changes in cerebral blood flow and cerebral autoregulation after pediatric traumatic brain injury. In this article, we discuss normal pediatric cerebral physiology and cerebrovascular pathophysiology following pediatric traumatic brain injury. PMID:18358399

Udomphorn, Yuthana; Armstead, William M.; Vavilala, Monica S.

2008-01-01

306

[Proximal urethra portion perforation during TVT-O in a patient with urethral deviation secondary to previous failed Burch surgery].  

PubMed

A 59 years old woman with laparoscopic Burch made during 2003 in another hospital. During 2006, the patient is evaluating in our center for a persistent urinary incontinence, the urodynamic study demonstrated stress urinary incontinence type II and overactive bladder without obstruction evidences. A TVT-O (tension-free vaginal tape obturador in-out route) was made, nevertheless when the right branch was passed blood was observed in the Foley catheter. A cystoscopy showed an important deviation of urethra and the tape through urethra in the proximal portion. The right branch went again inserted taking the necessary precautions. Two days after surgery the Foley catheter was removed and the stress urinary incontinence symptoms disappeared. The urge incontinence symptoms disappeared with the pharmacalogical treatment (Tolterodine 2 mg/day). We believe that the urethral deviation caused by a technically deficient laparoscopic Burch was the reason for the urethral perforation during the TVT-O. PMID:19537071

Ricci Arriola, Paolo; Solà Dalenz, Vicente; Pardo Schanz, Jack

2009-03-01

307

Refractoriness of urethral striated sphincter during voiding: studies with afferent pudendal reflex arc stimulation in male subjects.  

PubMed

To assess the excitability of the striated sphincter under normal and abnormal conditions, electrostimulation of the periurethral striated sphincter via the dorsal nerve of the penis was done with the patient at rest and during voiding. Monitoring of simultaneous intravesical and intramembranous urethral pressures, and electromyographic responses of the striated sphincter was performed under fluoroscopic guidance in 14 male subjects. The urethral striated sphincter attained a state of relative refractoriness during detrusor contraction (voiding phase) and greater amounts of afferent stimulation were required to elicit sphincter contractile activity compared to the amounts required during resting states. Under conditions of a hyperactive detrusor with synergic voiding, the amounts of stimulation required to elicit striated sphincter responses were higher than those required in normal subjects. On the other hand, under conditions of striated sphincter dyssynergia, minute amounts of afferent stimulation were enough to produce sphincter contraction during voiding. PMID:3959194

Dyro, F M; Yalla, S V

1986-04-01

308

Staged male urethroplasty transferring megalourethra tissue as free graft dorsal inlay to proximal urethral atresia in VACTERL association.  

PubMed

Megalourethra is a rare spectrum of urologic malformations of penile corporal structures frequently associated with multiple congenital anomalies, such as prune belly syndrome or vertebral, anorectal, cardiac, trachea-esophageal, renal, and limb (VACTERL association) defects. A 6-year-old boy with VACTERL association and proximal urethral atresia with distal fusiform megalourethra underwent staged reconstruction, including appendicovesicostomy, perineal urethrostomy, and first-stage urethroplasty with a dorsal inlay free graft of megalourethra tissue to the proximal urethral atretic region, followed by second-stage urethroplasty. At 2.6 years of follow-up, he was continent, voids per urethra without postvoid residual urine volume, and no longer performs clean intermittent catheterization by way of the appendicovesicostomy. PMID:21601242

Bagrodia, Aditya; Yucel, Selcuk; Baker, Linda A

2011-12-01

309

New mechanics of traumatic brain injury  

Microsoft Academic Search

The prediction and prevention of traumatic brain injury is a very important aspect of preventive medical science. This paper\\u000a proposes a new coupled loading-rate hypothesis for the traumatic brain injury (TBI), which states that the main cause of the TBI is an external Euclidean jolt, or SE(3)-jolt, an impulsive loading that strikes the head in several coupled degrees-of-freedom simultaneously. To

Vladimir G. Ivancevic

2009-01-01

310

Functions, diversity, and evolution of traumatic mating.  

PubMed

Copulation can involve the wounding of the mating partner by specialised devices. This type of mating, which we term traumatic mating, has been regarded as exceptional. Its prevalence, however, has not been compared across taxa, nor have its functions and putative evolutionary pathways. A categorisation has been lacking to date. We here show that traumatic mating is a widespread and diverse phenomenon that likely evolved via several pathways. Its putative functions include: (i) anchorage during mating; (ii) stimulation of short-term female reproductive investment; (iii) male paternity advantages; and (iv) enhanced fertilisation efficiency in transitions to internal fertilisation. Both natural and sexual selection have likely contributed to the parallel evolution of traumatic intromittent organs in phylogenetically distant taxa. These organs are sometimes remarkably similar in shape and often, but not always, inject sperm. The target sites of trauma infliction and the nature of secretions delivered alongside sperm are thus far poorly studied, but data on both are needed to elucidate the function of traumatic mating. The few existing studies that explicitly quantify fitness impacts of traumatic mating indicate that this strategy may often be costly to the party being wounded. However, a comprehensive approach to assess overall investments and returns for both sexes is a major target for future work. Finally, for the first time, we corroborate quantitatively the hypothesis that traumatic mating evolved relatively more often among hermaphroditic than among gonochoric taxa. PMID:23347274

Lange, Rolanda; Reinhardt, Klaus; Michiels, Nico K; Anthes, Nils

2013-08-01

311

Women with occult stress incontinence should not routinely have a mid-urethral sling with prolapse surgery.  

PubMed

The risk of postoperative stress incontinence (SI) is increased in women with occult stress incontinence (OSI) but the majority of patients will not develop troublesome SI postoperatively or need further SI surgery. This risk reported in current studies does not warrant a mid-urethral sling at the time of surgery for pelvic organ prolapse in women with OSI. However, if performed, the risks as well as the benefits need to be discussed with the patient. PMID:22415701

Dwyer, Peter L

2012-07-01

312

Posterior arch defects of the cervical spine  

SciTech Connect

Spondylolysis and absence of the pedicle are congenital anomalies of the posterior cervical spine. Their roentgenographic changes may be confused with other more serious entities which may necessitate either emergent therapy or require extensive diagnostic testing and treatment. Four cases are present and the literature is reviewed. A hypothesis for the embryologic etiology of these entities is proposed.

Schwartz, A.M.; Wechsler, R.J.; Landy, M.D.; Wetzner, S.M.; Goldstein, S.A.

1982-05-01

313

Posterior predictive Bayesian phylogenetic model selection.  

PubMed

We present two distinctly different posterior predictive approaches to Bayesian phylogenetic model selection and illustrate these methods using examples from green algal protein-coding cpDNA sequences and flowering plant rDNA sequences. The Gelfand-Ghosh (GG) approach allows dissection of an overall measure of model fit into components due to posterior predictive variance (GGp) and goodness-of-fit (GGg), which distinguishes this method from the posterior predictive P-value approach. The conditional predictive ordinate (CPO) method provides a site-specific measure of model fit useful for exploratory analyses and can be combined over sites yielding the log pseudomarginal likelihood (LPML) which is useful as an overall measure of model fit. CPO provides a useful cross-validation approach that is computationally efficient, requiring only a sample from the posterior distribution (no additional simulation is required). Both GG and CPO add new perspectives to Bayesian phylogenetic model selection based on the predictive abilities of models and complement the perspective provided by the marginal likelihood (including Bayes Factor comparisons) based solely on the fit of competing models to observed data. PMID:24193892

Lewis, Paul O; Xie, Wangang; Chen, Ming-Hui; Fan, Yu; Kuo, Lynn

2014-05-01

314

Posterior plagiocephaly: craniosynostosis or skull molding?  

Microsoft Academic Search

The surgical indication in posterior plagiocephaly has been and still is a subject of discussion. Unlike other types of craniosynostosis, this particular type of cranial deformity does not show the typical radiological findings that are encountered in cases of prematurely fused cranial sutures. Furthermore, in most cases even the inspective evaluation during the surgical operation fails to demonstrate the actual

Concezio Di Rocco; Antonio Scogna; Franceso Velardi; Helder J. L. Zambelli

1998-01-01

315

Subspecialization in the human posterior medial cortex.  

PubMed

The posterior medial cortex (PMC) is particularly poorly understood. Its neural activity changes have been related to highly disparate mental processes. We therefore investigated PMC properties with a data-driven exploratory approach. First, we subdivided the PMC by whole-brain coactivation profiles. Second, functional connectivity of the ensuing PMC regions was compared by task-constrained meta-analytic coactivation mapping (MACM) and task-unconstrained resting-state correlations (RSFC). Third, PMC regions were functionally described by forward/reverse functional inference. A precuneal cluster was mostly connected to the intraparietal sulcus, frontal eye fields, and right temporo-parietal junction; associated with attention and motor tasks. A ventral posterior cingulate cortex (PCC) cluster was mostly connected to the ventromedial prefrontal cortex and middle left inferior parietal cortex (IPC); associated with facial appraisal and language tasks. A dorsal PCC cluster was mostly connected to the dorsomedial prefrontal cortex, anterior/posterior IPC, posterior midcingulate cortex, and left dorsolateral prefrontal cortex; associated with delay discounting. A cluster in the retrosplenial cortex was mostly connected to the anterior thalamus and hippocampus. Furthermore, all PMC clusters were congruently coupled with the default mode network according to task-unconstrained but not task-constrained connectivity. We thus identified distinct regions in the PMC and characterized their neural networks and functional implications. PMID:25462801

Bzdok, Danilo; Heeger, Adrian; Langner, Robert; Laird, Angela R; Fox, Peter T; Palomero-Gallagher, Nicola; Vogt, Brent A; Zilles, Karl; Eickhoff, Simon B

2015-02-01

316

Congenital orbital teratoma up to posterior fossa  

PubMed Central

Congenital orbital teratoma is a rare condition which presents as marked proptosis of eyeball in a newborn. It is rapidly progressive with secondary damage to eyeball due to pressure effect. This case presented by us is of interest due to radiological features and rarity of this tumor extending into posterior fossa. PMID:25250083

Kharosekar, Hrushikesh U.; Jasmit, S.; Velho, V.; Palande, D. A.

2014-01-01

317

UNIFORM STABILITY OF POSTERIORS Sanjib Basu  

E-print Network

UNIFORM STABILITY OF POSTERIORS by Sanjib Basu Northern Illinois University DeKalb, IL 60115, USA E M of probability measures. Stability then amounts to checking if these functions satisfy Lipschitz condition of order 1. For parametric prior families, an intuitive criterion of p--stability is proposed

Basu, Sanjib

318

Resilience and vulnerability among refugee children of traumatized and non-traumatized parents  

Microsoft Academic Search

BACKGROUND: The aim of the study was to explore resilience among refugee children whose parents had been traumatized and were suffering from Post-Traumatic Stress Disorder (PTSD). METHODS: The study comprised 80 refugee children (40 boys and 40 girls, age range 6–17 yrs), divided into two groups. The test group consisted of 40 refugee children whose parents had been tortured in

Atia Daud; Britt af Klinteberg; Per-Anders Rydelius

2008-01-01

319

Stress and Traumatic Stress: How Do Past Events Influence Current Traumatic Stress among Mothers Experiencing Homelessness?  

ERIC Educational Resources Information Center

The purpose of this research was to evaluate the relationship between past traumatic events and the level of current traumatic stress among mothers experiencing homelessness. The data for this study were gathered from 75 homeless mothers between May 2006 and October 2006 using a cross-sectional survey design with purposive sampling. All mothers…

Williams, Julie K.; Hall, James A.

2009-01-01

320

Classroom Strategies for Teaching Veterans with Post-Traumatic Stress Disorder and Traumatic Brain Injury  

ERIC Educational Resources Information Center

Postsecondary institutions currently face the largest influx of veteran students since World War II. As the number of veteran students who may experience learning problems caused by Post-Traumatic Stress Disorder and/or Traumatic Brain Injury continues to rise, the need for instructional strategies that address their needs increases. Educators may…

Sinski, Jennifer Blevins

2012-01-01

321

Gender Differences in Traumatic Events and Rates of Post-Traumatic Stress Disorder among Homeless Youth  

ERIC Educational Resources Information Center

In the present report we describe patterns of traumatic events and Post-traumatic Stress Disorder (PTSD), both partial and full, among homeless youth and those at risk for homelessness, with an emphasis on gender differences. Participants were 85 homeless and at-risk youth (49% female) recruited from a drop-in center in New York City in 2000.…

Gwadz, Marya Viorst; Nish, David; Leonard, Noelle R.; Strauss, Shiela M.

2007-01-01

322

Unrecognized pediatric partial achilles tendon injury followed by traumatic completion: a case report and literature review.  

PubMed

Achilles tendon ruptures are a relatively common athletic injury but are exceedingly rare in the pediatric population. We describe the case of a 10-year-old ice hockey player who experienced an Achilles tendon injury from a laceration to the posterior leg from a skate blade that led to a partial tendon laceration. This tendon injury was initially unrecognized despite an emergency department evaluation. The patient continued to complain of weakness and paresthesia after the skin laceration had healed. A traumatic dorsiflexion injury while running several weeks later led to a traumatic complete tendon rupture. The clinical, operative, and physical therapy records were reviewed to complete the history, treatment, and rehabilitation progress. The initial laceration injury had occurred 6 weeks before presentation, and the traumatic dorsiflexion injury had occurred 2 days before referral to an acute orthopedics clinic. Open repair was performed several days after the traumatic completion of the laceration, and the patient was immobilized in a cast for 5 weeks. The patient had weaned off crutches by 10 weeks postoperatively and had returned to some activities and light skating at 5.5 months. A full return to running and ice hockey had been achieved by 8 months postoperatively. The optimal repair for this injury has not been well established in published studies. We have concluded that laceration injuries have the potential to mask tendon injuries and that prolonged symptoms after a laceration should suggest occult pathologic features. Open tendon repair is a viable treatment option in the pediatric patient with Achilles tendon ruptures. A return to activities within a reasonable period can be expected with robust physical therapy. PMID:24713492

Vasileff, William Kelton; Moutzouros, Vasilios

2014-01-01

323

Neurological outcome in a series of 58 patients operated for traumatic thoracolumbar spinal cord injuries  

PubMed Central

Background: Traumatic thoracolumbar spinal fractures represent approximately 65% of all traumatic spinal fractures and are frequently associated to permanent disability with significant social and economic impact. These injuries create severe physical limitations depending on neurological status, level of fracture, severity of injury, patient age and comorbidities. Predicting neurological improvement in patients with traumatic spinal cord injuries (SCIs) is very difficult because it is related to different preoperative prognostic factors. We evaluated the neurological improvement related to the preoperative neurological conditions and the anatomic level of spinal cord injury. Methods: From January 2004 to June 2010, we operated 207 patients for unstable thoracolumbar spinal fractures. We carried out a retrospective analysis of 69 patients with traumatic SCIs operated on by a posterior fixation performed within 24 hours from the trauma. The preoperative neurological conditions (ASIA grade), the type of the fracture, the anatomic level of spinal cord injury and the postoperative neurological improvement were evaluated for each patient. Results: The ASIA grade at admission (P = 0,0005), the fracture type according to the AO spine classification (P = 0,0002), and the anatomic location of the injury (P = 0,0213) represented predictive factors of neurological improvement at univariate analysis. The preoperative neurological status (P = 0,0491) and the fracture type (P = 0,049) confirmed a positive predictive value also in the multivariate analysis. Conclusions: Our study confirms that the preoperative neurological status, the fracture type and the anatomic location of the fracture are predictive factors of the neurological outcome in patients with spinal cord injury. PMID:25289154

Dobran, Mauro; Iacoangeli, Maurizio; Di Somma, Lucia Giovanna Maria; Di Rienzo, A.; Colasanti, Roberto; Nocchi, Niccolò; Alvaro, Lorenzo; Moriconi, Elisa; Nasi, Davide; Scerrati, Massimo

2014-01-01

324

Posterior cruciate ligament-retaining and posterior-stabilized total knee arthroplasty: differences in surgical technique  

PubMed Central

Summary The debate over the relative merits of substituting or retaining the posterior cruciate ligament in total knee arthroplasty is still ongoing. This article discusses the differences between the two procedures, considering the biomechanics and the surgical techniques involved.

D’Anchise, Roberto; Andreata, Mauro; Balbino, Cristiana; Manta, Nicola

2013-01-01

325

Post-traumatic stress disorder: a right temporal lobe syndrome?  

NASA Astrophysics Data System (ADS)

In a recent paper (Georgopoulos et al 2010 J. Neural Eng. 7 016011) we reported on the power of the magnetoencephalography (MEG)-based synchronous neural interactions (SNI) test to differentiate post-traumatic stress disorder (PTSD) subjects from healthy control subjects and to classify them with a high degree of accuracy. Here we show that the main differences in cortical communication circuitry between these two groups lie in the miscommunication of temporal and parietal and/or parieto-occipital right hemispheric areas with other brain areas. This lateralized temporal-posterior pattern of miscommunication was very similar but was attenuated in patients with PTSD in remission. These findings are consistent with observations (Penfield 1958 Proc. Natl Acad. Sci. USA 44 51-66, Penfield and Perot 1963 Brain 86 595-696, Gloor 1990 Brain 113 1673-94, Banceaud et al 1994 Brain 117 71-90, Fried 1997 J. Neuropsychiatry Clin. Neurosci. 9 420-8) that electrical stimulation of the temporal cortex in awake human subjects, mostly in the right hemisphere, can elicit the re-enactment and re-living of past experiences. Based on these facts, we attribute our findings to the re-experiencing component of PTSD and hypothesize that it reflects an involuntarily persistent activation of interacting neural networks involved in experiential consolidation.

Engdahl, B.; Leuthold, A. C.; Tan, H.-R. M.; Lewis, S. M.; Winskowski, A. M.; Dikel, T. N.; Georgopoulos, A. P.

2010-12-01

326

Posterior Pole Sparing Laser Photocoagulation Combined with Intravitreal Bevacizumab Injection in Posterior Retinopathy of Prematurity  

PubMed Central

Purpose. To report the results of the posterior pole sparing laser photocoagulation combined with intravitreal bevacizumab injection (IVB) in retinopathy of prematurity (ROP). Methods. A retrospective chart review of premature babies with ROP, all of whom received laser photocoagulation with IVB. Eleven eyes of 6 infants with advanced zone I ROP underwent laser ablation sparing posterior pole with concurrent IVB. The results were compared with those of full-laser treatment combined with IVB to 8 eyes of 5 infants with advanced ROP without involvement of the posterior pole. Results. The posterior pole sparing laser with IVB was performed with zone I, stage 3+ ROP at the mean postmenstrual age of 36 weeks and 5 days. The plus sign decreased significantly at postoperative day 1, the neovascular proliferation regressed by postoperative week 1, and the normal vascularization started at postoperative day 32 on the average. Two months after treatment, vascularization of the spared avascular area was completed. There was no macular dragging, tractional retinal detachment, foveal destruction by laser scars, or any other adverse event. No significant anatomical differences were identified from those of full-laser ablation combined with IVB. Conclusions. Posterior pole sparing laser with IVB can give favorable results without destruction of posterior pole retina. PMID:25614828

Kim, Rebecca; Kim, Yu Cheol

2014-01-01

327

Determining injuries from posterior and flank stab wounds using computed tomography tractography.  

PubMed

Unlike anterior stab wounds (SW), in which local exploration may direct management, posterior SW can be challenging to evaluate. Traditional triple contrast computed tomography (CT) imaging is cumbersome and technician-dependent. The present study examines the role of CT tractography as a strategy to manage select patients with back and flank SW. Hemodynamically stable patients with back and flank SW were studied. After resuscitation, Betadine- or Visipaque®-soaked sterile sponges were inserted into each SW for the estimated depth of the wound. Patients underwent abdominal helical CT scanning, including intravenous contrast, as the sole abdominal imaging study. Images were reviewed by an attending radiologist and trauma surgeon. The tractogram was evaluated to determine SW trajectory and injury to intra- or retroperitoneal organs, vascular structures, the diaphragm, and the urinary tract. Complete patient demographics including operative management and injuries were collected. Forty-one patients underwent CT tractography. In 11 patients, tractography detected violation of the intra- or retroperitoneal cavity leading to operative exploration. Injuries detected included: the spleen (two), colon (one), colonic mesentery (one), kidney (kidney), diaphragm (kidney), pneumothorax (seven), hemothorax (two), iliac artery (one), and traumatic abdominal wall hernia (two). In all patients, none had negative CT findings that failed observation. In this series, CT tractography is a safe and effective imaging strategy to evaluate posterior torso SW. It is unknown whether CT tractography is superior to traditional imaging modalities. Other uses for CT tractography may include determining trajectory from missile wounds and tangential penetrating injuries. PMID:24887674

Bansal, Vishal; Reid, Chris M; Fortlage, Dale; Lee, Jeanne; Kobayashi, Leslie; Doucet, Jay; Coimbra, Raul

2014-04-01

328

Idiopathic detrusor-urethral dyssynergia in dogs: a retrospective analysis of 22 cases.  

PubMed

Results of a retrospective study of 22 dogs with signs of dysuria and/or stranguria in which a diagnosis of idiopathic detrusor-urethral dyssynergia was made are presented. The diagnosis was based on the exclusion of detectable pathological conditions which could also cause urine outflow obstruction. The affected cases were 22 middle-aged male dogs (mean age 4.9 years) of large and giant breeds (mean bodyweight 36.7 kg). Nine dogs had had periodic clinical signs for longer than one year, one for seven months and eight for two to five weeks, while in four dogs signs had begun four to five days before referral. All dogs received the alpha-sympatholytic agent prazosin as an initial treatment and in 11 it remained the only therapy. There was a good effect in seven and a moderate response in the other four dogs. In one dog, prazosin was ineffective and was replaced by diazepam, which markedly reduced the signs. Three other dogs required frequent catheterisation and antibiotics were administered. These dogs responded favourably. Another three dogs with evidence of impaired bladder contractility were also treated with the parasympathomimetic agent carbachol. One did not improve and was euthanased. Four dogs developed bladder paralysis and severe infectious cystitis. Only one of these could be managed satisfactorily by long-term administration of prazosin, carbachol and antibiotics, and the others had to be euthanased. PMID:9673901

Díaz Espiñeira, M M; Viehoff, F W; Nickel, R F

1998-06-01

329

Experimental epididymitis and urethritis in grivet monkeys provoked by Chlamydia trachomatis.  

PubMed

Recently Chlamydia trachomatis has been indicated as a common cause of acute epididymitis in young men. In the present study, the grivet monkey was established as an experimental model for such infection. A yolk sac suspension of C. trachomatis, immunotype K, was inoculated into the left spermatic cords of two monkeys. On days 7 and 14 postinoculation (pi), the left testis of each monkey was enlarged to twice its normal size. The epididymis and the spermatic cord on the same side were swollen and reddened. All layers of spermatic cord were infiltrated with lymphocytes and polymorphonuclear leukocytes, and the lumen, which was filled with an exudate, was reduced in diameter. The luminar epithelium was destroyed. The ducts of the left epididymis were filled with an inflammatory exudate. The epithelium was flattened, but there were no lesions. The seminiferous tubules of the left testis were normal, but edema and hyperemia were observed in the interstitial tissue. The right spermatic cord was inoculated with noninfected yolk sac suspension. On the right side, no inflammatory reactions were seen in the testis, the epididymis, or the spermatic cord. The monkeys had a yellowish discharge 7 to 14 days pi. Urethral smears revealed an preincubation values were found. PMID:7409251

Møller, B R; Märdh, P A

1980-09-01

330

Clinical Trials of a Urethral Dose Measurement System in Brachytherapy Using Scintillation Detectors  

SciTech Connect

Purpose: To report on the clinical feasibility of a novel scintillation detector system with fiberoptic readout that measures the urethral dose during high-dose-rate brachytherapy treatment of the prostate. Methods and Materials: The clinical trial enrolled 24 patients receiving high-dose-rate brachytherapy treatment to the prostate. After the first 14 patients, three improvements were made to the dosimeter system design to improve clinical reliability: a dosimeter self-checking facility; a radiopaque marker to determine the position of the dosimeter, and a more robust optical extension fiber. Results: Improvements to the system design allowed for accurate dose measurements to be made in vivo. A maximum measured dose departure of 9% from the calculated dose was observed after dosimeter design improvements. Conclusions: Departures of the measured from the calculated dose, after improvements to the dosimetry system, arise primarily from small changes in patient anatomy. Therefore, we recommend that patient response be correlated with the measured in vivo dose rather than with the calculated dose.

Suchowerska, Natalka, E-mail: natalka@email.cs.nsw.gov.a [Radiation Oncology, Royal Prince Alfred Hospital, New South Wales (Australia); School of Physics, University of Sydney, New South Wales (Australia); Jackson, Michael [Radiation Oncology, Prince of Wales Hospital, New South Wales (Australia); Department of Medicine, University of Sydney, New South Wales (Australia); Lambert, Jamil; Yin, Yong Bai [School of Physics, University of Sydney, New South Wales (Australia); Hruby, George [Radiation Oncology, Royal Prince Alfred Hospital, New South Wales (Australia); Department of Medicine, University of Sydney, New South Wales (Australia); McKenzie, David R. [School of Physics, University of Sydney, New South Wales (Australia)

2011-02-01

331

Therapeutic designing for urethral obstruction by virtual urethra and flow dynamics simulation.  

PubMed

Abstract Introduction: Transurethral surgery is widely accepted as standard therapy for male urethral obstruction. The present study was undertaken to identify and select lesions to be managed by processing endoscopic images of the urethra for assisting less invasive therapy in patients with voiding dysfunction. Material and methods: Cystourethroscopic video files of 25 patients with lower urinary tract symptoms were recorded before and after administration of alpha-1 adrenoceptor antagonists. Each video frame was restored and tagged with information indicating the position in the panoramic image of the urethra. A three-dimensional virtual urethra was created to indicate critical lesions for voiding dysfunction, together with fluid dynamics simulation of urine flow. Results: The urine stream was depicted in the virtual urethras in 19 patients. Before therapy, 17 patients showed vortex formation that was diminished after therapy in nine patients with a significant relationship in improvement of relative energy loss of flow (p=0.025). The narrowing points proximal to the vortex, candidate of lesions, were identified in the panoramic image and linked to the endoscopic image. Discussion: Therapeutic designing for endoscopic management was possible in patients with voiding dysfunction based on computational fluid dynamics, and would be promising as "focal" therapy for aging males. PMID:25273605

Ishii, Takuro; Nakamura, Kazuyoshi; Naya, Yukio; Igarashi, Tatsuo

2014-10-01

332

[Novelties and new possibilities in radiological diagnostics of kidney and urethral tumors].  

PubMed

The author analyses the opportunities granted by diagnostic imaging for the early perception of kidney and urethral tumors and exact tumor staging. The wide-scale application of non-invasive ultrasound scans has lead to an increase in incidentalomas. Volumetric (multidetector or dual source) CT scans, the various MR techniques and, more recently, PET/CT scans have largely contributed to the exact preoperative staging of tumorous diseases, and help characterize the tumors found. In the case of small kidney tumors, attempts are made to decide which masses require operation and which do not, based on the tumor's absorption of the contrast agent and its wash-out intensity as observed by dynamic contrast-enhanced scans. The author points out that despite the achieved development, especially in terms of small tumors, image-guided biopsies still play a significant role. Medical imaging techniques are also indispensable for post-therapy follow-up of patients (PET/CT, CT and MR perfusion imaging). PMID:25517446

Baranyai, Tibor

2014-12-01

333

A simplified protocol for evaluating and monitoring urethral stricture patients minimizes cost without compromising patient outcome.  

PubMed

Uroflowmetry, urethrocystoscopy and urethrography are either not readily available or the cost is prohibitive for many patients in low-resource countries. This paper examines the use of clinical history in post-urethroplasty follow-up. We retrospectively reviewed the outcome of 54 post-urethroplasty patients. Preoperative diagnostic work-up included simple blood tests and a retrograde urethrography, and postoperatively we did not perform any immediate diagnostic work-up. Follow-up of these patients was done through mobile phone calls and personal contacts. Eighty-nine per cent of our patients reported acceptable voiding over a mean follow-up period of 48.4 months - 79.6% were followed using mobile phone contact. In the majority of the urethral strictures cases, diagnostic work up can be kept to a minimum, thereby reducing cost. Follow-up can be done via phone calls and personal contact in many African countries where compliance is frequently less than encouraging. The spread of mobile phone networks across the continent has been remarkable. PMID:20413547

Okorie, Chukwudi O; Pisters, Louis L; Ndasi, Henry T; Fekadu, Arega

2010-07-01

334

Neurostimulation for traumatic brain injury.  

PubMed

Traumatic brain injury (TBI) remains a significant public health problem and is a leading cause of death and disability in many countries. Durable treatments for neurological function deficits following TBI have been elusive, as there are currently no FDA-approved therapeutic modalities for mitigating the consequences of TBI. Neurostimulation strategies using various forms of electrical stimulation have recently been applied to treat functional deficits in animal models and clinical stroke trials. The results from these studies suggest that neurostimulation may augment improvements in both motor and cognitive deficits after brain injury. Several studies have taken this approach in animal models of TBI, showing both behavioral enhancement and biological evidence of recovery. There have been only a few studies using deep brain stimulation (DBS) in human TBI patients, and future studies are warranted to validate the feasibility of this technique in the clinical treatment of TBI. In this review, the authors summarize insights from studies employing neurostimulation techniques in the setting of brain injury. Moreover, they relate these findings to the future prospect of using DBS to ameliorate motor and cognitive deficits following TBI. PMID:25170668

Shin, Samuel S; Dixon, C Edward; Okonkwo, David O; Richardson, R Mark

2014-11-01

335

Medical interventions for traumatic hyphema  

PubMed Central

Background Traumatic hyphema is the entry of blood into the anterior chamber (the space between the cornea and iris) subsequent to a blow or a projectile striking the eye. Hyphema uncommonly causes permanent loss of vision. Associated trauma (e.g. corneal staining, traumatic cataract, angle recession glaucoma, optic atrophy, etc.) may seriously affect vision. Such complications may lead to permanent impairment of vision. Patients with sickle cell trait/disease may be particularly susceptible to increases of elevated intraocular pressure. If rebleeding occurs, the rates and severity of complications increase. Objectives To assess the effectiveness of various medical interventions in the management of traumatic hyphema. Search methods We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2013, Issue 8), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMED-LINE (January 1946 to August 2013), EMBASE (January 1980 to August 2013), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 30 August 2013. Selection criteria Two authors independently assessed the titles and abstracts of all reports identified by the electronic and manual searches. In this review, we included randomized and quasi-randomized trials that compared various medical interventions versus other medical interventions or control groups for the treatment of traumatic hyphema following closed globe trauma. We applied no restrictions regarding age, gender, severity of the closed globe trauma, or level of visual acuity at the time of enrolment. Data collection and analysis Two authors independently extracted the data for the primary and secondary outcomes. We entered and analyzed data using Review Manager 5. We performed meta-analyses using a fixed-effect model and reported dichotomous outcomes as odds ratios and continuous outcomes as mean differences. Main results We included 20 randomized and seven quasi-randomized studies with 2643 participants in this review. Interventions included antifibrinolytic agents (oral and systemic aminocaproic acid, tranexamic acid, and aminomethylbenzoic acid), corticosteroids (systemic and topical), cycloplegics, miotics, aspirin, conjugated estrogens, traditional Chinese medicine, monocular versus bilateral patching, elevation of the head, and bed rest. No intervention had a significant effect on visual acuity whether measured at two weeks or less after the trauma or at longer time periods. The number of days for the primary hyphema to resolve appeared to be longer with the use of aminocaproic acid compared with no use, but was not altered by any other intervention. Systemic aminocaproic acid reduced the rate of recurrent hemorrhage (odds ratio (OR) 0.25, 95% confidence interval (CI) 0.11 to 0.57), but a sensitivity analysis omitting studies not using an intention-to-treat (ITT) analysis reduced the strength of the evidence (OR 0.41, 95% CI 0.16 to 1.09). We obtained similar results for topical aminocaproic acid (OR 0.42, 95% CI 0.16 to 1.10). We found tranexamic acid had a significant effect in reducing the rate of secondary hemorrhage (OR 0.25, 95% CI 0.13 to 0.49), as did aminomethylbenzoic acid as reported in one study (OR 0.07, 95% CI 0.01 to 0.32). The evidence to support an associated reduction in the risk of complications from secondary hemorrhage (i.e. corneal blood staining, peripheral anterior synechiae, elevated intraocular pressure, and development of optic atrophy) by antifibrinolytics was limited by the small number of these events. Use of aminocaproic acid was associated with increased nausea, vomiting, and other adverse events compared with placebo. We found no difference in the number of adverse events with the use of

Gharaibeh, Almutez; Savage, Howard I; Scherer, Roberta W; Goldberg, Morton F; Lindsley, Kristina

2014-01-01

336

Choroid plexus papilloma in the posterior fossa.  

PubMed

Choroid plexus papillomas in the posterior fossa can present with different clinical signs and symptoms. The tumors in the patients we discuss in this article originated from different sites of the choroid plexus. One patient, who had a fourth ventricle papilloma, experienced unsteady gait and episodes of dizziness over many years. The tumor was cystic an calcified, and adherent to the brain-stem. The second patient had only signs of increased intracranial pressure. A soft tumor was located in the cerebellomedullary cistern. The third patient, with a papilloma in the cerebellopontine angle, complained of hearing loss. This tumor was firmly adherent to the dura mater and looked exactly like a meningioma. The appearance on computed tomography scan, the macroscopic aspect, and the vascular supply of a papilloma in the posterior fossa can vary considerably. PMID:3496674

van Swieten, J C; Thomeer, R T; Vielvoye, G J; Bots, G T

1987-08-01

337

Pseudoexfoliation material on posterior chamber intraocular lenses  

PubMed Central

The presence of pseudoexfoliation material on the surface of an intraocular lens (IOL) is a rare finding. We report a series of seven cases with different patterns of pseudoexfoliation material deposition on the posterior chamber IOLs, recognized 2–20 years after cataract surgery. Six patients had an IOL implanted in the capsular bag and one in the ciliary sulcus. Two patients had undergone posterior capsulotomy. Although the pathophysiological mechanisms and clinical significance of this finding remain unknown, the careful follow-up of pseudophakic patients with known or suspected pseudoexfoliation syndrome is essential to monitor the development or progression of glaucoma, since deposition of pseudoexfoliation material continues even after cataract surgery. PMID:25143707

da Rocha-Bastos, Ricardo António; Silva, Sérgio Estrela; Prézia, Flávio; Falcão-Reis, Fernando; Melo, António B

2014-01-01

338

Material Properties of the Posterior Human Sclera?  

PubMed Central

To characterize the material properties of posterior and peripapillary sclera from human donors, and to investigate the macro- and micro-scale strains as potential control mechanisms governing mechanical homeostasis. Posterior scleral shells from 9 human donors aged 57–90 years were subjected to IOP elevations from 5 to 45 mmHg and the resulting full-field displacements were recorded using laser speckle interferometry. Eye-specific finite element models were generated based on experimentally measured scleral shell surface geometry and thickness. Inverse numerical analyses were performed to identify material parameters for each eye by matching experimental deformation measurements to model predictions using a microstructure-based constitutive formulation that incorporates the crimp response and anisotropic architecture of scleral collagen fibrils. The material property fitting produced models that fit both the overall and local deformation responses of posterior scleral shells very well. The nonlinear stiffening of the sclera with increasing IOP was well reproduced by the uncrimping of scleral collagen fibrils, and a circumferentially-aligned ring of collagen fibrils around the scleral canal was predicted in all eyes. Macroscopic in-plane strains were significantly higher in peripapillary region then in the mid-periphery. In contrast, the meso- and micro-scale strains at the collagen network and collagen fibril level were not significantly different between regions. The elastic response of the posterior human sclera can be characterized by the anisotropic architecture and crimp response of scleral collagen fibrils. The similar collagen fibril strains in the peripapillary and mid-peripheral regions support the notion that the scleral collagen architecture including the circumpapillary ring of collagen fibrils evolved to establish optimal load bearing conditions at the collagen fibril level. PMID:23684352

Grytz, Rafael; Fazio, Massimo A.; Girard, Michael J.A.; Libertiaux, Vincent; Bruno, Luigi; Gardiner, Stuart; Girkin, Christopher A.; Downs, J. Crawford

2013-01-01

339

Material properties of the posterior human sclera.  

PubMed

To characterize the material properties of posterior and peripapillary sclera from human donors, and to investigate the macro- and micro-scale strains as potential control mechanisms governing mechanical homeostasis. Posterior scleral shells from 9 human donors aged 57-90 years were subjected to IOP elevations from 5 to 45mmHg and the resulting full-field displacements were recorded using laser speckle interferometry. Eye-specific finite element models were generated based on experimentally measured scleral shell surface geometry and thickness. Inverse numerical analyses were performed to identify material parameters for each eye by matching experimental deformation measurements to model predictions using a microstructure-based constitutive formulation that incorporates the crimp response and anisotropic architecture of scleral collagen fibrils. The material property fitting produced models that fit both the overall and local deformation responses of posterior scleral shells very well. The nonlinear stiffening of the sclera with increasing IOP was well reproduced by the uncrimping of scleral collagen fibrils, and a circumferentially aligned ring of collagen fibrils around the scleral canal was predicted in all eyes. Macroscopic in-plane strains were significantly higher in peripapillary region then in the mid-periphery. In contrast, the meso- and micro-scale strains at the collagen network and collagen fibril level were not significantly different between regions. The elastic response of the posterior human sclera can be characterized by the anisotropic architecture and crimp response of scleral collagen fibrils. The similar collagen fibril strains in the peripapillary and mid-peripheral regions support the notion that the scleral collagen architecture including the circumpapillary ring of collagen fibrils evolved to establish optimal load bearing conditions at the collagen fibril level. PMID:23684352

Grytz, Rafael; Fazio, Massimo A; Girard, Michaël J A; Libertiaux, Vincent; Bruno, Luigi; Gardiner, Stuart; Girkin, Christopher A; Downs, J Crawford

2014-01-01

340

Blast-related traumatic brain injury.  

PubMed

A bomb blast may cause the full severity range of traumatic brain injury (TBI), from mild concussion to severe, penetrating injury. The pathophysiology of blast-related TBI is distinctive, with injury magnitude dependent on several factors, including blast energy and distance from the blast epicentre. The prevalence of blast-related mild TBI in modern war zones has varied widely, but detection is optimised by battlefield assessment of concussion and follow-up screening of all personnel with potential concussive events. There is substantial overlap between post-concussive syndrome and post-traumatic stress disorder, and blast-related mild TBI seems to increase the risk of post-traumatic stress disorder. Post-concussive syndrome, post-traumatic stress disorder, and chronic pain are a clinical triad in this patient group. Persistent impairment after blast-related mild TBI might be largely attributable to psychological factors, although a causative link between repeated mild TBIs caused by blasts and chronic traumatic encephalopathy has not been established. The application of advanced neuroimaging and the identification of specific molecular biomarkers in serum for diagnosis and prognosis are rapidly advancing, and might help to further categorise these injuries. PMID:23884075

Rosenfeld, Jeffrey V; McFarlane, Alexander C; Bragge, Peter; Armonda, Rocco A; Grimes, Jamie B; Ling, Geoffrey S

2013-09-01

341

Sleep–wake disturbances 3 years after traumatic brain injury  

Microsoft Academic Search

Background6 months after traumatic brain injury (TBI), almost three out of four patients suffer from sleep–wake disturbances (SWD) such as post-traumatic hypersomnia (increased sleep need of ?2 h compared with before injury), excessive daytime sleepiness (EDS), fatigue and insomnia. The long-term course of post-traumatic SWD, however, is unknown.ObjectivesTo assess the prevalence and characteristics of post-traumatic SWD 3 years after trauma.DesignProspective

Julia Kempf; Esther Werth; Philippe R Kaiser; Claudio L Bassetti; Christian R Baumann

2010-01-01

342

Indocyanine green angiography in posterior uveitis  

PubMed Central

Literature review for indocyanine green angiography and evaluate the role of indocyanine green angiogram (ICGA) in patients with posterior uveitis seen at a tertiary referral eye care centre. Detailed review of the literature on ICGA was performed. Retrospective review of medical records of patients with posterior uveitis and dual fundus and ICGA was done after institutional board approval. Eighteen patients (26 eyes) had serpiginous choroiditis out of which 12 patients had active choroiditis and six patients had healed choroiditis, six patients (12 eyes) had ampiginous choroiditis, six patients (12 eyes) had acute multifocal posterior placoid pigment epitheliopathy, eight patients (10 eyes) had multifocal choroiditis, four patients (eight eyes) had presumed ocular histoplasmosis syndrome, four patients (eight eyes) had presumed tuberculous choroiditis, two patients (four eyes) had multiple evanescent white dot syndrome and two patients (four eyes) had Vogt Koyanagi Harada (VKH) syndrome. The most characteristic feature noted on ICGA was the presence of different patterns of hypofluorescent dark spots, which were present at different stages of the angiogram. ICGA provides the clinician with a powerful adjunctive tool in choroidal inflammatory disorders. It is not meant to replace already proven modalities such as the fluorescein angiography, but it can provide additional information that is useful in establishing a more definitive diagnosis in inflammatory chorioretinal diseases associated with multiple spots. It still needs to be determined if ICGA can prove to be a follow up parameter to evaluate disease progression. PMID:23685486

Agrawal, Rupesh V; Biswas, Jyotirmay; Gunasekaran, Dinesh

2013-01-01

343

Posterior mini-incision hamstring harvest.  

PubMed

Many orthopedists looking for alternatives to autograft bone-patellar-tendon-bone grafts are uncertain of their ability to harvest a hamstring graft of adequate length. They may use an allograft instead for this reason despite recent reports of high failure rates. This article presents step-by-step instructions for a posterior mini-incision hamstring harvest that offers a safe and simple method of reliably harvesting sufficient hamstring for 4 or 6 strand repair, while using tiny incisions for excellent cosmesis and minimal pain. Access from the posterior mini-incision allows easy identification and differentiation of the semitendinosus and gracilis (Gr) tendons, as well as precise placement of the anterior mini-incision for tibial tunnel drilling and fixation. Most importantly sectioning of the intertendinous cross-connections is performed under easy direct vision posteriorly, instead of at a distance from the typical anterior incision under retractors. This prevents the tendons from being cut too short by the tendon stripper and is particularly useful in large patients. In addition to the surgical procedure, details on the required equipment are presented. PMID:20160624

Prodromos, Chadwick C

2010-03-01

344

Charcot Spine Treated Using a Single Staged Posterolateral Costotransversectomy Approach in a Patient with Traumatic Spinal Cord Injury  

PubMed Central

Charcot spine is a progressive and destructive process that affects the vertebral bodies, intervertebral discs, and posterior facets. It is the result from repetitive microtrauma in patients who have decreased joint protective mechanisms due to loss of deep pain and proprioceptive sensation, typically because of spinal cord injury. The objective of the study is to report an unusual case of Charcot spine, as a late complication of traumatic spinal cord injury, treated by a circumferential arthrodesis performed with a single staged posterolateral costotransversectomy approach. PMID:24527201

Kim, Tae-Woo; Hwang, Jung-Taek; Kwak, Byung-Chan

2013-01-01

345

Association of Antidepressant Medication Therapy With Inpatient Rehabilitation Outcomes for Stroke, Traumatic Brain Injury, or Traumatic Spinal Cord Injury  

Microsoft Academic Search

Weeks DL, Greer CL, Bray BS, Schwartz CR, White JR Jr. Association of antidepressant medication therapy with inpatient rehabilitation outcomes for stroke, traumatic brain injury, or traumatic spinal cord injury.

Christopher L. Greer; Brenda S. Bray; Catrina R. Schwartz; John R. White

2011-01-01

346

Comparison of plasmakinetic transurethral resection of the prostate with monopolar transurethral resection of the prostate in terms of urethral stricture rates in patients with comorbidities  

PubMed Central

Purpose To compare urethral stricture rates in comorbid patients undergoing plasmakinetic transurethral resection of the prostate (PK-TURP) and monopolar transurethral resection of the prostate (M-TURP) for benign prostatic hyperplasia. Methods The data of 317 patients with comorbidities undergoing either PK-TURP or M-TURP from September 2008 to December 2012 were retrospectively evaluated. Preoperative and postoperative 12-month International Prostate Symptom Score, maximal flow rate, postoperative International Index of Erectile Function scores, and urethral stricture rates were evaluated. Results A total of 154 patients underwent M-TURP and 163 patients underwent PK-TURP. Urethral stricture rates were 6/154 in the M-TURP treatment arm and 17/163 in the PK-TURP treatment arm (P=0.000). In the presence of hypertension and/or coronary artery disease and/or diabetes mellitus, the risk of urethral stricture complication was significantly higher in the PK-TURP group than in the M-TURP group (P=0.000). Conclusions The risk of urethral stricture increases with PK-TURP in elderly patients with a large prostate and concomitant hypertension and/or coronary artery disease and/or diabetes mellitus. Therefore, PK-TURP should be performed cautiously in this group of benign prostatic hyperplasia patients. PMID:25325023

Sinanoglu, Orhun; Ekici, Sinan; Balci, MB Can; Hazar, A Ismet; Nuhoglu, Baris

2014-01-01

347

Assessing Child and Adolescent Complex Traumatic Stress Reactions  

Microsoft Academic Search

Children and adolescents exposed to traumatic stressors may develop severe and persistent complex traumatic stress reactions. A framework for conceptualizing and assessing children's and adolescents' complex traumatic stress reactions as forms of impaired self-regulation is described. Psychometric measures for the assessment of posttraumatic dysregulation of emotion, cognition, behavior, and bodily functioning are also described. The question of whether children and

Julian D. Ford

2011-01-01

348

Resolving Child and Adolescent Traumatic Grief: Creative Techniques and Interventions  

Microsoft Academic Search

This article presents a review of creative interventions that can be helpful in facilitating the resolution of traumatic grief in children and adolescents. Traumatic grief is conceptualized as a condition in which a person loses a close loved one (e.g., a parent or a sibling) in a traumatic manner, and ensuing trauma-related symptoms disrupt the normal grieving process. The presented

Meredith Edgar-Bailey; Victoria E. Kress

2010-01-01

349

Abuse, Post-Traumatic Stress Disorder and Migraine  

MedlinePLUS

... Traumatic Stress Disorder and Migraine Print Email Abuse, Post Traumatic Stress Disorder and Migraine ACHE Newsletter Sign up for our ... by entering your e-mail address below. Abuse, Post-Traumatic Stress Disorder and Migraine Gretchen E. Tietjen, MD and Dawn ...

350

Automated Prediction of Glasgow Outcome Scale for Traumatic Brain Injury  

E-print Network

Automated Prediction of Glasgow Outcome Scale for Traumatic Brain Injury Bolan Su, Thien Anh Dinh}@nni.com.sg Abstract--Clinical features found in brain CT scan images are widely used in traumatic brain injury (TBI of the system has shown promising results in prediction of GOS of traumatic brain injury cases. Index Terms--Brain

Tan, Chew Lim

351

Systems Biology Approaches for Discovering Biomarkers for Traumatic Brain Injury  

E-print Network

Review Systems Biology Approaches for Discovering Biomarkers for Traumatic Brain Injury Jacob D Jitendra Dave,2 Frank Tortella,2 and Jaques Reifman1 Abstract The rate of traumatic brain injury (TBI words: biomarker; pathway analysis; protein-protein interaction; systems biology; traumatic brain injury

352

The role of the posterior cingulate cortex in cognition and disease  

PubMed Central

The posterior cingulate cortex is a highly connected and metabolically active brain region. Recent studies suggest it has an important cognitive role, although there is no consensus about what this is. The region is typically discussed as having a unitary function because of a common pattern of relative deactivation observed during attentionally demanding tasks. One influential hypothesis is that the posterior cingulate cortex has a central role in supporting internally-directed cognition. It is a key node in the default mode network and shows increased activity when individuals retrieve autobiographical memories or plan for the future, as well as during unconstrained ‘rest’ when activity in the brain is ‘free-wheeling’. However, other evidence suggests that the region is highly heterogeneous and may play a direct role in regulating the focus of attention. In addition, its activity varies with arousal state and its interactions with other brain networks may be important for conscious awareness. Understanding posterior cingulate cortex function is likely to be of clinical importance. It is well protected against ischaemic stroke, and so there is relatively little neuropsychological data about the consequences of focal lesions. However, in other conditions abnormalities in the region are clearly linked to disease. For example, amyloid deposition and reduced metabolism is seen early in Alzheimer’s disease. Functional neuroimaging studies show abnormalities in a range of neurological and psychiatric disorders including Alzheimer’s disease, schizophrenia, autism, depression and attention deficit hyperactivity disorder, as well as ageing. Our own work has consistently shown abnormal posterior cingulate cortex function following traumatic brain injury, which predicts attentional impairments. Here we review the anatomy and physiology of the region and how it is affected in a range of clinical conditions, before discussing its proposed functions. We synthesize key findings into a novel model of the region’s function (the ‘Arousal, Balance and Breadth of Attention’ model). Dorsal and ventral subcomponents are functionally separated and differences in regional activity are explained by considering: (i) arousal state; (ii) whether attention is focused internally or externally; and (iii) the breadth of attentional focus. The predictions of the model can be tested within the framework of complex dynamic systems theory, and we propose that the dorsal posterior cingulate cortex influences attentional focus by ‘tuning’ whole-brain metastability and so adjusts how stable brain network activity is over time. PMID:23869106

Sharp, David J.

2014-01-01

353

Posterior semicircular canal dehiscence following endolymphatic sac surgery.  

PubMed

Posterior semicircular canal dehiscence is a rare otologic entity that presents with third window signs and symptoms. Petrous apex cholesteatoma, fibrous dysplasia, high riding jugular bulb, and eosinophilic granuloma have been reported to be associated with posterior semicircular canal dehiscence. Here we report a case of development of posterior semicircular canal dehiscence following an endolymphatic sac surgery for the first time. PMID:22689472

Kiumehr, Saman; Mahboubi, Hossein; Djalilian, Hamid R

2012-09-01

354

Bayesian Posterior Comprehension via Message from Monte Carlo  

E-print Network

Bayesian Posterior Comprehension via Message from Monte Carlo Leigh J. Fitzgibbon, David L. Dowe Markov Chain Monte Carlo methods. The Message from Monte Carlo methodology is illustrated for binary Length, MML, MCMC, RJMCMC, Message from Monte Carlo, MMC, posterior summary, epitome, Bayesian Posterior

Allison, Lloyd

355

Posterior Semicircular Canal Dehiscence Following Endolymphatic Sac Surgery  

PubMed Central

Posterior semicircular canal dehiscence is a rare otologic entity which presents with third window signs and symptoms. Petrous apex cholesteatoma, fibrous dysplasia, high riding jugular bulb, and eosinophilic granuloma have been reported to be associated with posterior semicircular canal dehiscence. Here we report a case of development of posterior semicircular canal dehiscence following an endolymaphatic sac surgery for the first time. PMID:22689472

Kiumehr, Saman; Mahboubi, Hossein; Djalilian, Hamid R.

2012-01-01

356

Controversies in posterior composite resin restorations.  

PubMed

The use of posterior composites is riddled with so many controversies that the puzzled practitioner must step warily among them. This modality is a minefield, where one careless movement can bring disaster. All composite restorations are subject to three big destructive forces--moisture, polymerization shrinkage, and clinical wear--forces that can eventually produce both microleakage and deterioration of the silane coupling agent linking filler particles to resin matrix. Despite the extreme technique sensitivity of posterior composite resins, knowledge of resin technology, sound operative dentistry principles and foresight in case selection can be effective in producing durable cosmetic restorations. Posterior composite resin restorations bonded to enamel and dentin reputedly strengthen teeth in both conventional and adhesive types of preparations provided polymerization shrinkage can be controlled. It is imperative that a knowledge of occlusal contacts be used to influence cavity outline, confining the trauma or occlusal forces away from the tooth-resin interface and helping to minimize occlusal wear. With the increased use of posterior resins, the trend in cavity preparations should break away from the traditional Black preparation toward the adhesive type preparation. If the Black Class II preparation is used, it is suggested that bevels be confined to the facial and lingual margins of the proximal box. Prewedging helps to maintain a conservative Class II preparation. Shade selection must be made prior to rubber dam isolation for greater accuracy and to help prevent postinsertion discoloration. The enamel should be pumiced to present a clean substrate for acid etching. The smear layer should be removed. The type of pulp protection applied before acid etching is dependent on the material used. After etching, the enamel should be washed with a 1 per cent potassium chloride solution. It is a more universally chemically stable solution than additive-laden local water supplies. The potassium chloride solution lowers the electrostatic forces on the enamel that would interfere with the flow of enamel bonding agents. Furthermore, tests have shown that the use of potassium chloride washes increase the strength of the enamel body by 40 per cent. Because of the depth of most posterior cavities, an incremental filling technique must be used to ensure a thorough polymerization of the resin and to forestall a massive polymerization shrinkage. When finished and contoured, the margins of the restoration should be re-etched, washed, and dried and then covered with an application of unfilled resin to discourage microleakage. Traditional operative dentistry technique must become flexible enough to meet the new demands of resin technology.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:2403943

Wilson, E G; Mandradjieff, M; Brindock, T

1990-01-01

357

[Traumatic shock--physiopathologic aspects].  

PubMed

Traumatic shock is a complex phenomenon that represents the culminating element of a series of events. It is, in fact, the outcome of an imbalance-decompensation of the organism's defence mechanisms, in which the oxygen supply to the mitochondria is hampered by a macro and/or microcirculation failure. Basically, it is a form of hypovolemic shock in which further factors have a role, including the activation of inflammation mediators. It should also be stressed that part of the cellular damage is caused by tissue reperfusion. Good hemodynamic compensation is maintained with loss of up to 30% of the circulation mass but, beyond this amount, a fall of the cardiac index, peripheral pO2, and an increase of blood lactates will ensue. Hypoxia causes capillary injury and increased permeability, resulting in the formation of edema and finally in loss of the self-regulating power of the microcirculation. Moreover, it strongly stimulates pro-inflammatory activation of the macrophages and the release of vasoactive substances, such as prostaglandins and thromboxanes. The inflammatory response is triggered by cascade systems (such as the complement, coagulation, kinins, fibrinolysis), cell elements (endothelium, leukocytes, macrophages, monocytes, mast cells) and the release of mediators (cytokines, proteolytic enzymes, histamine, etc.) and others interacting factors. In severe trauma, the inflammatory process extends beyond the local limits, maintaining and aggravating the state of shock and causing a Systemic Inflammatory Response Syndrome (SIRS), with involvement and injury of healthy organs and tissues even at a distance from the site of trauma, raising a risk of onset of ARDS (Acute Respiratory Distress Syndrome), sepsis, MODS (Multiple Organ Dysfunction Syndrome). Tissue reperfusion (reoxygenation) also induces the production of toxic metabolites, such as hydroxylated anions, superoxide, hydrogen peroxide: peroxidation of the phospholipid cell membranes alters the barrier functions, permitting entry of substances such as calcium, which interfere with the intracellular enzymatic systems. PMID:18252151

Fabiano, G; Pezzolla, A; Filograna, M A; Ferrarese, F

2008-01-01

358

Treating traumatic injuries of the diaphragm  

PubMed Central

Traumatic diaphragmatic injury (DI) is a unique clinical entity that is usually occult and can easily be missed. Their delayed presentation can be due to the delayed rupture of the diaphragm or delayed detection of diaphragmatic rupture, making the accurate diagnosis of DI challenging to the trauma surgeons. An emergency laparotomy and thorough exploration followed by the repair of the defect is the gold standard for the management of these cases. We report a case of blunt DI in an elderly gentleman and present a comprehensive overview for the management of traumatic injuries of the diaphragm. PMID:20606795

Dwivedi, Sankalp; Banode, Pankaj; Gharde, Pankaj; Bhatt, Manisha; Ratanlal Johrapurkar, Sudhakar

2010-01-01

359

[Traumatic lumbosacral dislocation - an underrated injury].  

PubMed

Traumatic lumbosacral dislocations are rare. We report two cases with initially missed posttraumatic lumbosacral dislocations. The reported cases and the review of the literature show that, especially, accident victims with multiple fractures of the lumbar transverses processes may require a CT scan to confirm fractures or dislocations of L5/S1. Follow-up examinations due to persisting pain after physiotherapy should include lateral X-rays of the lumbar spine of the patient standing. According to the literature and our experience, the treatment of traumatic lumbosacral dislocation usually consists of open reduction and postero-lateral or dorso-ventral fusion of the unstable segments. PMID:19358081

Schroeter, S; Weise, K; Badke, A

2009-01-01

360

Traumatic Endophthalmitis due to Cellulosimicrobium cellulans  

PubMed Central

Purpose. To report a case of traumatic endophthalmitis due to Cellulosimicrobium cellulans. Design. Case report. Methods. Retrospective chart review. Results. To our knowledge, this is the first report of traumatic endophthalmitis due to C. cellulans, which did not respond to intravitreal antibiotics or repeat vitrectomy and ultimately led to the discovery of an occult intraocular foreign body. Conclusions. C. cellulans is a rare cause of endophthalmitis. Greater awareness of this bacterium in the ophthalmic literature as a cause of endophthalmitis and its association with foreign bodies may allow earlier and more purposeful intervention in future cases. PMID:22606461

Jaru-ampornpan, Pimkwan; Agarwal, Anita; Midha, Narinder K.; Kim, Stephen J.

2011-01-01

361

Traumatic Endophthalmitis due to Cellulosimicrobium cellulans.  

PubMed

Purpose. To report a case of traumatic endophthalmitis due to Cellulosimicrobium cellulans. Design. Case report. Methods. Retrospective chart review. Results. To our knowledge, this is the first report of traumatic endophthalmitis due to C. cellulans, which did not respond to intravitreal antibiotics or repeat vitrectomy and ultimately led to the discovery of an occult intraocular foreign body. Conclusions. C. cellulans is a rare cause of endophthalmitis. Greater awareness of this bacterium in the ophthalmic literature as a cause of endophthalmitis and its association with foreign bodies may allow earlier and more purposeful intervention in future cases. PMID:22606461

Jaru-Ampornpan, Pimkwan; Agarwal, Anita; Midha, Narinder K; Kim, Stephen J

2011-01-01

362

Vision disturbances following traumatic brain injury  

Microsoft Academic Search

Opinion statement  \\u000a \\u000a \\u000a \\u000a \\u000a – \\u000a \\u000a Vision disturbances following traumatic brain injury (TBI) include anomalies of accommodation, version, vergence (nonstrabismic,\\u000a as well as strabismic), photosensitivity, visual field integrity, and ocular health.\\u000a \\u000a \\u000a \\u000a \\u000a – \\u000a \\u000a Traumatic brain injury patients with complex diplopia patterns, noncomitant strabismic anomalies, and advanced ocular health\\u000a anomalies are either monitored by or referred to neuro-ophthalmologists and ophthalmologists for evaluation and possible surgical

Neera Kapoor; Kenneth J. Ciuffreda

2002-01-01

363

Clinical tetrad of arthritis, urethritis, conjunctivitis, and mucocutaneous lesions (HLA-B27-associated spondyloarthropathy, Reiter syndrome): report of a case.  

PubMed

A 21-year-old male patient with the clinical tetrad of arthritis, urethritis, conjunctivitis, and mucocutaneous lesions, commonly known as Reiter syndrome was presented. He was hospitalized in poor condition, with fever, bilateral conjunctivitis, swollen and painful knee and tarsal joints, low back pain, Achilles tendonitis, dactilitis, keratoderma blenorrhagica, purulent urethritis, circinate balanitis, and oral erosive lesions. Radiography and Computerized Axial Tomography (CAT) showed sacroileitis, spondilosis thoracalis, and arthritis of the feet. The laboratory studies revealed anemia, neutrophilic leukocytosis, elevated erythrocyte sedimentation rate (ESR), hypoalbuminemia, negative rheumatoid factor, pyuria, proteinuria, and the presence of HLA-B27. The microbiological examinations of samples from pustular lesions, throat, eyes, urethra, stool, and blood were sterile. Urethral smear was positive for Chlamydia trachomatis (PCR). The histopathological picture of skin lesions was consistent with pustular psoriasis. Systemic treatment with antibiotics, corticosteroids, and non-steroidal anti-inflammatory drugs produced clinical improvement. This clinical syndrome requires comprehensive evaluation and multidisciplinary management. PMID:19265617

Chudomirova, K; Abadjieva, Ts; Yankova, R

2008-01-01

364

Incidence of Female Urethral Diverticulum: A Population-Based Analysis and Literature Review  

PubMed Central

Introduction and Hypothesis Urethral diverticulum (UD) is a protrusion of the urethra through the periurethral fascia. We aimed to determine the population-based incidence of female UD. Methods Using the records-linkage system of the Rochester Epidemiology Project (REP), we identified women 18 years and older with a new diagnosis of UD in Olmsted County, Minnesota, from January 1, 1980, through December 31, 2011. We also identified cases meeting the same criteria diagnosed at Mayo Clinic, regardless of county of residency. Incidence rates were calculated and trends for changes in incidence over time were tested. We conducted a systematic search of the MEDLINE, EMBASE, Cochrane Systematic Reviews, CENTRAL, Web of Science, and Scopus databases from inception through March 30, 2013, to identify published reports of UD incidence or prevalence. Results We identified 164 incidence cases, including 26 women residing in Olmsted County. Age-adjusted annual incidence of UD in Olmsted County was 17.9 per 1,000,000 women (<0.02%) per year (95% CI, 10.9–24.9). We observed a trend for increased incidence during the past 3 decades (P=.03). In our literature review, only 7 studies included an estimate of incidence or prevalence of UD; these estimates ranged from 6.4 per 1,000,000 per year (<0.01%) having surgical intervention related to UD to a 4.7% rate of UD diagnosed in asymptomatic women admitted for gynecologic or obstetric issues. Conclusion In this population-based study, female UD was a rare disease, affecting fewer than 20 per 1,000,000 women (<0.02%) per year. PMID:23857063

El-Nashar, Sherif A.; Bacon, Melissa M.; Kim-Fine, Shunaha; Weaver, Amy L.; Gebhart, John B.; Klingele, Christopher J.

2015-01-01

365

Urethral sphincter EMG-controlled dorsal penile/clitoral nerve stimulation to treat neurogenic detrusor overactivity  

NASA Astrophysics Data System (ADS)

The goal of this study was to investigate whether real-time external urethral sphincter (EUS) EMG-controlled dorsal genital nerve (DGN) stimulation can suppress undesired detrusor bladder contractions in patients with both neurogenic detrusor overactivity (NDO) and detrusor sphincter dyssynergia (DSD). Detrusor pressure (Pdet) and EUS EMG were recorded in 12 neurogenic patients who underwent two filling cystometries. The first one was without stimulation and was intended to confirm the NDO and DSD and to set the EMG detection threshold. The second one was with real-time EMG-controlled stimulation of DGNs. Two detection methods were analyzed to detect bladder contractions. The first method was a Kurtosis-scaled root mean square (RMS) detector and was used on-line. The second was a simple RMS detector and was used off-line. Of 12 patients included, 10 patients showed both NDO and DSD. In nine of these ten patients relevant EMG concomitant to detrusor activity was detected and stimulation could suppress at least one detrusor contraction. The second filling compared to the first one showed an increase of 84% in bladder capacity (p = 0.002) and a decrease of 106% in Pdet (p = 0.002). Nine false-positive detections occurred during the ten fillings with electrical stimulation. The mean increases of both time and Pdet between stimulation and bladder contraction onsets for method 1 were 1.8 s and 4 cmH2O and for method 2 were 0.9 s and 2 cmH2O, respectively. This study shows that EUS EMG can be used in real time to detect the onset of a bladder contraction. In combination with DGN stimulation has been shown to be feasible to suppress undesired bladder contractions and in turn to increase bladder capacity in subjects with both NDO and DSD.

Opisso, E.; Borau, A.; Rijkhoff, N. J. M.

2011-06-01

366

Long-term recording of external urethral sphincter EMG activity in unanesthetized, unrestrained rats.  

PubMed

The external urethral sphincter muscle (EUS) plays an important role in urinary function and often contributes to urinary dysfunction. EUS study would benefit from methodology for longitudinal recording of electromyographic activity (EMG) in unanesthetized animals, but this muscle is a poor substrate for chronic intramuscular electrodes, and thus the required methodology has not been available. We describe a method for long-term recording of EUS EMG by implantation of fine wires adjacent to the EUS that are secured to the pubic bone. Wires pass subcutaneously to a skull-mounted plug and connect to the recording apparatus by a flexible cable attached to a commutator. A force transducer-mounted cup under a metabolic cage collected urine, allowing recording of EUS EMG and voided urine weight without anesthesia or restraint. Implant durability permitted EUS EMG recording during repeated (up to 3 times weekly) 24-h sessions for more than 8 wk. EMG and voiding properties were stable over weeks 2-8. The degree of EUS phasic activity (bursting) during voiding was highly variable, with an average of 25% of voids not exhibiting bursting. Electrode implantation adjacent to the EUS yielded stable EMG recordings over extended periods and eliminated the confounding effects of anesthesia, physical restraint, and the potential for dislodgment of the chronically implanted intramuscular electrodes. These results show that micturition in unanesthetized, unrestrained rats is usually, but not always, associated with EUS bursting. This methodology is applicable to studying EUS behavior during progression of gradually evolving disease and injury models and in response to therapeutic interventions. PMID:24990895

LaPallo, Brandon K; Wolpaw, Jonathan R; Chen, Xiang Yang; Carp, Jonathan S

2014-08-15

367

Are Ureaplasma spp. a Cause of Nongonococcal Urethritis? A Systematic Review and Meta-Analysis  

PubMed Central

Background Nongonococcal urethritis (NGU) is the most common male reproductive tract syndrome. Ureaplasmas spp. including U. urealyticum and U. parvum, have been increasingly reported to be implicated in NGU. However, there are still many contradictions about their pathogenic role in NGU. Aims The goals of this study were to evaluate the association of Ureaplasmas spp. with NGU, and to compare the prevalence of Ureaplasmas spp. infection in China relative to the world average. Methods A systematic review and meta-analysis was conducted following standard guidelines for meta-analysis. The quality of included studies was assessed by Newcastle-Ottawa scale. Results A total of seven studies involving 1,507 NGU patients and 1,223 controls were eligible for meta-analysis. There was no significant difference in the Ureaplasma spp. positive rate between the NGU and control groups. However, the U. urealyticum positive rate was significantly higher in NGU patients compared to controls; the U. parvum positive rate was significantly higher in controls compared to NGU patients. Furthermore, within the NGU patient group, the positive rate of U. urealyticum was significantly higher than that of U. parvum, whereas within the control group, the opposite trend was observed. Compared to the world average, a significantly higher positive rate of Ureaplasma spp. was observed in both the NGU and control groups in China. Conclusions Our analysis supports that U. urealyticum, but not U. parvum, is an etiological agent in NGU. More detailed studies of these two species in China and the world could contribute to a better understanding of the epidemiology and pathogenesis, and facilitate the development of better strategies for treatment and prevention of NGU. PMID:25463970

Zhang, Nan; Wang, Rong; Li, Xue; Liu, Xu; Tang, Zhaobing; Liu, Yunde

2014-01-01

368

YouTube as an educational tool regarding male urethral catheterization.  

PubMed

Abstract Objective. Urethral catheterization (UC) is a common procedure carried out on a daily basis. The aims of this study were to assess the quality of YouTube as an educational tool regarding male UC and to assess the experience of newly qualified doctors regarding UC. Materials and methods. YouTube was searched for videos containing relevant information about male UC. A checklist for evaluating content for male UC was devised. The top-ranked video was shown to interns and they were questioned regarding their experience of UC and the usefulness of the video. Results. A total of 100 videos was screened and 49 unique videos were identified. The median length of video was 7?min 15?s (range 1?min 44?s to 26?min 44?s). Regarding the Safe Catheter Insertion Score, the mean score was 5.18 ± 1.64. 9 (18.4%) deemed useful, 24 (49%) somewhat useful and 16 (32.7%) not useful. There was no difference in the number of views (p = 0.487), duration of video (p = 0.364) or number of days online (p = 0.123) between those categorized as useful, somewhat useful and not useful. Twenty-six interns (89.7%) attended the UC teaching session. All reported the video to be a useful educational adjunct. Nine of the respondents (42.9%) had independently inserted a urinary catheter before the educational session. Conclusions. The quality of videos on YouTube regarding male UC is widely variable. Preselected videos are deemed useful by junior doctors regarding male UC and can be used as an educational adjunct before performing hands-on tasks. PMID:25363608

Nason, Gregory J; Kelly, Padraig; Kelly, Michael E; Burke, Matthew J; Aslam, Asadullah; Giri, Subhasis K; Flood, Hugh D

2014-11-01

369

Outcomes following vaginal Prolapse repair and mid Urethral Sling (OPUS) trial  

PubMed Central

Background Many women without preexisting stress urinary incontinence (SUI) who undergo vaginal surgery to correct pelvic organ prolapse will develop symptoms of SUI. A concomitant prophylactic anti-incontinence procedure may prevent SUI symptom development in women undergoing vaginal prolapse surgery. Purpose To present the rationale, design and methodology of a randomized controlled surgical trial (RCT), the Outcomes Following Vaginal Prolapse Repair and Mid Urethral Sling (OPUS) Trial. The primary aims of this RCT are to determine (1) whether the prevalence of post-operative urinary incontinence (UI) differs between stress continent women receiving vaginal prolapse repair with concomitant tension-free vaginal tape (TVT®; a sling procedure commonly used to treat SUI) and those with only sham incisions at 3 months post surgery (2) whether it is more cost-effective to place a TVT prophylactically than to treat the SUI symptoms postoperatively as they occur over a 12 month period after the index surgery.. The study also incorporates a patient preference trial (PPT). Methods Primary outcome, defined as signs (positive cough stress test), symptoms (per validated questionnaire) and/or need for treatment of SUI and its associated cost, at 3 and 12 months post-operatively. Secondary outcomes consist of group differences in lower urinary tract and prolapse symptoms, health related quality of life, measures of vaginal anatomy, and surgical complications. Limitations Given the invasive nature of surgical intervention trials, some individuals may be reluctant to agree with random assignment, potentially impacting result generalizability. To evaluate the magnitude and direction of non-participation bias, the PPT will enroll a sample of those who decline participation in the RCT but are otherwise eligible. Conclusion This sham-controlled RCT will provide important information for patients and surgeons regarding both the short- and long-term optimal treatment approach for stress continent women undergoing a vaginal surgery for prolapse. Non-participation bias will be estimated. PMID:19342469

Wei, John T.; Nygaard, Ingrid; Richter, Holly E.; Brown, Morton B; Barber, Matthew D.; Xu, Xiao; Kenton, Kim; Nager, Charles W.; Schaffer, Joseph; Visco, Anthony; Weber, Anne

2010-01-01

370

Changes in Uroflowmetry Maximum Flow Rates After Urethral Reconstructive Surgery as a Means to Predict for Stricture Recurrence  

PubMed Central

Purpose A reliable, noninvasive screening method for urethral stricture recurrence after urethroplasty is needed. We hypothesized that changes in flow rates on uroflowmetry relative to preoperative values might help predict stricture recurrence. Materials and Methods All men who underwent urethral reconstructive surgery from 2000 to 2009 with adequate preoperative and postoperative uroflowmetry studies were included in the study. Preoperative and postoperative maximum flow rates were compared. The absolute change in maximum flow rate was compared between patients with and those without recurrence as determined by retrograde urethrogram. Results A total of 125 patients treated with urethroplasty were included in the study. Mean ± SD preoperative maximum flow rate was 11.8 ± 9.1 ml per second, which did not vary by stricture length (p = 0.11), patient age (p = 0.46) or stricture location (p = 0.58). The change in maximum flow rate in men without recurrence was 19.2 ± 11.7 vs 0.2 ± 6.4 ml per second (p <0.001) in failed repairs. Setting a change in maximum flow rate of less than 10 ml per second as a screen for stricture recurrence would have resulted in a test sensitivity and specificity of 92% and 78%, respectively. There were 85 men without stricture recurrence who underwent more than 1 postoperative uroflowmetry study. Repeated maximum flow rate values achieved reasonable test reproducibility (r = 0.52), further supporting the use of uroflowmetry. Conclusions Change in flow rate after urethral reconstruction represents a promising metric to screen for stricture recurrence that is noninvasive and has a high sensitivity. PMID:21944128

Erickson, Bradley A.; Breyer, Benjamin N.; McAninch, Jack W.

2013-01-01

371

Post-traumatic catamenial sciatica.  

PubMed

This article presents a unique case of posttraumatic extrapelvic endometriosis presenting as a gluteal mass causing cyclic sciatica. A 38-year-old woman presented with an enlarging right buttock mass over the previous 6 years. She also had symptoms of radicular pain referred to the right leg and foot with sitting and daily activity. Four years prior to noticing the mass, she sustained a gunshot wound through the lower abdomen while 5 months pregnant. Excisional biopsy of the gluteal mass revealed endometrioma. Sciatica is a common and painful disorder that is believed to have an incidence of 40% in the adult population. Sciatica is most often due to intraspinal pathology affecting the lumbar nerve roots. There are many recognized extraspinal etiologies for sciatica in the literature including aneurysms, sciatic hernia, abcess, neoplasm, trochanteric wire, piriformis syndrome, ischial fracture, a posteriorly flexed uterus, and even an intrauterine device following uterine perforation. Similarly, endometriosis is a gynecologic condition that represents a significant health problem for women of reproductive age as it occurs in up to 50% of premenopausal women and 71% to 87% in women with chronic pelvic pain. Although rare, endometriosis has a well known ability to migrate outside of the abdominal cavity and proliferate ectopically under the control of systemic estrogen. PMID:19292268

Hughes, Michael S; Burd, Timothy A; Allen, William C

2008-04-01

372

Diagnostic imaging of posterior fossa anomalies in the fetus and neonate: part 2, posterior fossa disorders.  

PubMed

This second portion of a two-part review illustrates examples of posterior fossa disorders detectable on prenatal ultrasound and MRI, with postnatal or pathology correlation where available. These disorders are discussed in the context of an anatomic classification scheme described in Part 1 of this posterior fossa anomaly review. Assessment of the size and formation of the cerebellar hemispheres and vermis is critical. Diagnoses discussed here include arachnoid cyst, Blake's pouch cyst, Dandy-Walker malformation, vermian agenesis, Joubert syndrome, rhombencephalosynapsis, Chiari II malformation, ischemia, and tumors. PMID:25457569

Chapman, Teresa; Mahalingam, Sowmya; Ishak, Gisele E; Nixon, Jason N; Siebert, Joseph; Dighe, Manjiri K

2014-10-22

373

Association of Baseline Urodynamic Measures of Urethral Function With Clinical, Demographic and Other Urodynamic Variables in Women Prior to Undergoing Midurethral Sling Surgery  

PubMed Central

Aims To explore how baseline demographic, clinical and urodynamic variables correlate with measures of urethral function in women planning midurethral sling surgery. Methods Women with predominant stress urinary incontinence (SUI) as part of the Trial of Mid-Urethral Slings (TOMUS) were characterized preoperatively including: demographics, body mass index (BMI), responses to the Medical and Epidemiologic Social Aspects of Aging (MESA) and Urogenital Distress Inventory (UDI) questionnaires, pad weight (PW), incontinence duration, prior SUI surgery, prolapse, strength of pelvic contraction, Q-tip test, uroflow, cystometrogram and detrusor pressures at maximum flow (Pdet at Qmax). Multivariate regression analysis and modeling confirmed variables with significant correlations with maximal urethral closure pressure (MUCP), functional urethral length (FUL) and Valsalva leak point pressure (VLPP). Results Five-hundred thirty nine women were included in the analysis. In multivariable analyses, PW (p=0.045) and age (p<0.0001) were negatively correlated with MUCP (as PW and age increased, MUCP decreased); BMI (p=0.02) and Pdet at Qmax (p<0.0001) were positively correlated with MUCP (as BMI and Pdet at Qmax increased, MUCP increased). Age (p=0.002) was negatively correlated with FUL; Qtip delta (p=0.006), POPQ stage (p=0.002) and strength of pelvic contraction (p=0.03) were positively correlated with FUL. Duration of incontinence (p=0.01) was negatively correlated with VLPP; Qtip delta (p=0.02), BMI (p=0.0005) and Pdet at Qmax (p=0.0005) were positively correlated with VLPP. Conclusions Age, BMI, Qtip delta and Pdet at Qmax were variables that correlated with two or more measures of urethral function. These correlations may help direct future research in female urethral function. PMID:22378483

Chai, Toby C.; Huang, Liyuan; Kenton, Kim; Richter, Holly E.; Baker, Jan; Kraus, Stephen; Litman, Heather

2011-01-01

374

Trigeminal neuralgia secondary to posterior fossa tumor  

PubMed Central

Trigeminal neuralgia (TN) is by no means an uncommon entity presenting as typical or atypical pain syndrome with a standard treatment protocol consisting of medical and surgical therapies. The diagnosis of TN is mainly dependent on the characteristics of symptoms conveyed by the patient and the clinical presentation. Careful history taking, proper interpretation of the signs and symptoms and cranial nerve assessment are necessary for proper diagnosis. Here, we report a case of TN, treated for dental problems and then for neuralgia with only short-term relief. Subsequently, the patient underwent neuroimaging and was found to be having an uncommon space-occupying lesion in the posterior cranial fossa. PMID:22442556

Agrawal, Mamta; Agrawal, Vikrant; Agrawal, Rajiv; Pramod, D.S.R.

2010-01-01

375

Complications of posterior cruciate ligament surgery.  

PubMed

In addition to standard risks associated with all orthopedic surgical procedures, posterior cruciate ligament (PCL) reconstruction poses some relatively unique potential complications. These complications arise from a combination of several factors: the relative infrequency of PCL injuries, the lack of knowledge and experience in treating them, the proximity of neurovascular structures to the PCL, and the technically demanding nature of reconstructive procedures. This article discusses the anatomy, pathogenesis, and prevention of intraoperative and postoperative complications of PCL surgery including neurovascular injury, osteonecrosis, fracture, motion loss, and persistent laxity. PMID:21079507

Zawodny, Sarah R; Miller, Mark D

2010-12-01

376

Complications and urologic risks of neurogenic bladder in veterans with traumatic spinal cord injury.  

PubMed

Objectives:This observational study aimed to determine the types of urological lesion encountered in veterans with traumatic spinal cord injury (SCI) with neurogenic bladder (NGB), and the usage of bladder management programs to deal with NGB.Setting:NGB (detrusor muscle and urethral sphincter dysfunction with loss of bladder sensation to void) is common in daily practice; however, information on types of urological lesions encountered in these veterans with NGB and how best to manage their NGB is limited.Methods:We retrospectively reviewed the electronic charts of veterans with SCI enrolled in our program and regularly followed in our SCI clinic. Demographic data collected included: age, gender, ethnicity and age, level, severity and cause of spinal injury. Also noted was presence of NGB, episodes of urinary tract infection (UTI), bladder program followed and urological lesions found on renal nuclear scans, renal ultrasounds and cystoscopies.Results:Of the 161 veterans with SCI, symptoms of NGB was present in 133 (82.6%). Veterans with NGB had more severe spinal injury and more frequent UTI (P<0.05). Renal atrophy and hydronephrosis were the most common urological lesions seen in patients with UTI. Clean intermittent catheterization (CIC) was the most frequently used bladder program resulting in less frequent occurrence of UTI.Conclusion:Renal atrophy and hydronephrosis were the most common urological lesions encountered in veterans with NGB especially in those with UTI. CIC was the most frequently used bladder management program with the least risk for UTI.Spinal Cord advance online publication, 18 November 2014; doi:10.1038/sc.2014.205. PMID:25403501

Rabadi, M H; Aston, C

2014-11-18

377

Substance P Mediates Reduced Pneumonia Rates After Traumatic Brain Injury  

PubMed Central

Objectives Traumatic brain injury results in significant morbidity and mortality and is associated with infectious complications, particularly pneumonia. However, whether traumatic brain injury directly impacts the host response to pneumonia is unknown. The objective of this study was to determine the nature of the relationship between traumatic brain injury and the prevalence of pneumonia in trauma patients and investigate the mechanism of this relationship using a murine model of traumatic brain injury with pneumonia. Design Data from the National Trauma Data Bank and a murine model of traumatic brain injury with postinjury pneumonia. Setting Academic medical centers in Cincinnati, OH, and Boston, MA. Patients/Subjects Trauma patients in the National Trauma Data Bank with a hospital length of stay greater than 2 days, age of at least 18 years at admission, and a blunt mechanism of injury. Subjects were female ICR mice 8–10 weeks old. Interventions Administration of a substance P receptor antagonist in mice. Measurements and Main Results Pneumonia rates were measured in trauma patients before and after risk adjustment using propensity scoring. In addition, survival and pulmonary inflammation were measured in mice undergoing traumatic brain injury with or without pneumonia. After risk adjustment, we found that traumatic brain injury patients had significantly lower rates of pneumonia compared to blunt trauma patients without traumatic brain injury. A murine model of traumatic brain injury reproduced these clinical findings with mice subjected to traumatic brain injury demonstrating increased bacterial clearance and survival after induction of pneumonia. To determine the mechanisms responsible for this improvement, the substance P receptor was blocked in mice after traumatic brain injury. This treatment abrogated the traumatic brain injury–associated increases in bacterial clearance and survival. Conclusions The data demonstrate that patients with traumatic brain injury have lower rates of pneumonia compared to non–head-injured trauma patients and suggest that the mechanism of this effect occurs through traumatic brain injury–induced release of substance P, which improves innate immunity to decrease pneumonia. PMID:25014065

Yang, Sung; Stepien, David; Hanseman, Dennis; Robinson, Bryce; Goodman, Michael D.; Pritts, Timothy A.; Caldwell, Charles C.; Remick, Daniel G.; Lentsch, Alex B.

2014-01-01

378

Behavioral Considerations Associated with Traumatic Brain Injury  

ERIC Educational Resources Information Center

Children who sustain traumatic brain injury (TBI) can experience significant cognitive deficits. These deficits may significantly impair their functioning in the classroom, resulting in the need for academic and behavioral modifications. Behavior and social problems can be the direct or indirect result of brain injury. Difficulties in paying…

Mayfield, Joan; Homack, Susan

2005-01-01

379

Traumatic Brain Injury: A Guidebook for Educators.  

ERIC Educational Resources Information Center

This guidebook is designed to help New York school staff better understand the specialized needs of students with traumatic brain injury (TBI) and appropriately apply educational interventions to improve special and general education services for these students. It provides information on the following areas: (1) the causes, incidence, and…

New York State Education Dept., Albany. Office for Special Education Services.

380

Traumatic Brain Injury: Perspectives From Educational Professionals  

Microsoft Academic Search

This article reports the outcomes from 2 focus groups conducted to ascertain professional educators' perceptions regarding their (a) level of preparedness for working with students with traumatic brain injury (TBI), (b) ideas regarding ways to improve support to students and families, and (c) concerns about meeting the diverse needs of children with TBI.

J. Darrell Mohr; Lyndal M. Bullock

2005-01-01

381

Academic Placement after Traumatic Brain Injury.  

ERIC Educational Resources Information Center

Determined academic placement of 87 students with traumatic brain injuries within 1 year after injury: 45 children had returned to regular programs; 42 received some special education support. Verbal intelligence quotient at initial postinjury assessment appeared to be most important factor with regard to school placement. (Author/NB)

Donders, Jacques

1994-01-01

382

Mild Traumatic Brain Injury: Educational Techniques  

Microsoft Academic Search

The awareness of mild traumatic brain injury as a health concern has increased across a multitude of athletic settings due to a plethora of research and clinical findings that indicate the serious threat concussions pose, particularly to young athletes. The need to provide risk reduction and health promotion education to athletes and parents necessitates an innovative approach. This study explores

Katherine R Racanelli; Folse

2012-01-01

383

School Reentry Following Traumatic Brain Injury  

ERIC Educational Resources Information Center

Successful school reentry following traumatic brain injury (TBI) is critical to recovery. Physical, cognitive, behavioral, academic, and social problems can affect a child's school performance after a TBI. However, early intervention has the potential to improve child academic outcomes and promote effective coping with any persistent changes in…

Deidrick, Kathleen K. M.; Farmer, Janet E.

2005-01-01

384

Reality Lessons in Traumatic Brain Injury  

Microsoft Academic Search

This article goes beyond the typical guidance on how to address the educational needs of students with traumatic brain injury (TBI). A survivor of TBI and his parent advocate describe real-life encounters in the education arena and offer ways to respond to the problems depicted in the situations. Their candor enhances educator awareness of the users’ perspective. Ten topical incidents

Elaine Parker Adams; Adams Albert A. Jr

2008-01-01

385

Procedural discourse following traumatic brain injury  

Microsoft Academic Search

Procedural discourse is a monologue discourse task concerned with explaining to a listener how a particular activity is carried out. The study reported here is part of a series of investigations into discourse abilities following severe traumatic brain injury (TBI). The aim of this study was to compare the procedural discourse skills of a group of 26 TBI speakers, with

Pamela Snow; Jacinta Douglas; Jennie Ponsford

1997-01-01

386

Adult Outcomes of Pediatric Traumatic Brain Injury  

Microsoft Academic Search

Traumatic brain injury (TBI) is one of the most common causes of acquired disability during childhood. While the majority of such injuries are mild, and result in few, if any, functional sequelae, children sustaining more significant insults may experience permanent cognitive and behavioral deficits. Clinical reports indicate residual impairments in a range of skills, particularly information-processing, attention, memory, learning, social

Miriam Beauchamp; Julian Dooley; Vicki Anderson

2010-01-01

387

Behavioral Considerations Associated With Traumatic Brain Injury  

Microsoft Academic Search

Children who sustain traumatic brain injury (TBI) can experience significant cognitive deficits. These deficits may significantly impair their functioning in the classroom, resulting in the need for academic and behavioral modifications. Behavior and social problems can be the direct or indirect result of brain injury. Difficulties in paying attention, staying on task, and predicting the consequences of actions may be

JOAN Mayfield; Susan Homack

2005-01-01

388

Post-traumatic intradiploic pseudomeningocele in children  

Microsoft Academic Search

Summary Eight children with post-traumatic pseudomeningocele are reported. In this paper the mean age at the time of injury was one year and ten months. All of them gave a history of a fall from a height. In six patients the meningocele was located in the parietooccipital region. The frontal bone was involved in one and the roof of the

A. K. Mahapatra; P. N. Tandon

1989-01-01

389

Reality Lessons in Traumatic Brain Injury  

ERIC Educational Resources Information Center

This article goes beyond the typical guidance on how to address the educational needs of students with traumatic brain injury (TBI). A survivor of TBI and his parent advocate describe real-life encounters in the education arena and offer ways to respond to the problems depicted in the situations. Their candor enhances educator awareness of the…

Adams, Elaine Parker; Adams, Albert A., Jr.

2008-01-01

390

Traumatic Brain Injury and Personality Change  

ERIC Educational Resources Information Center

Traumatic brain injury (TBI) is the leading cause of death and lifelong disability in the United States for individuals below the age of 45. Current estimates from the Center for Disease Control (CDC) indicate that at least 1.4 million Americans sustain a TBI annually. TBI affects 475,000 children under age 14 each year in the United States alone.…

Fowler, Marc; McCabe, Paul C.

2011-01-01

391

Resource Guide on Traumatic Brain Injury  

ERIC Educational Resources Information Center

The purpose of this resource guide on traumatic brain injury (TBI) is to provide assistance to educators, families, and professionals who may be striving to increase their knowledge and understanding of brain injury. This guide will hopefully become an initial resource. It provides: a glossary of TBI Terms; contact information for and brief…

Monfore, Dorothea

2005-01-01

392

Post-traumatic stress reactions in children  

Microsoft Academic Search

Surprisingly, far less is known of the manifestations of post-traumatic stress reactions in children than in adults. Research over the past 10 years has begun to describe phenomena very similar to PTSD in adults, particularly among young adolescents. This paper will briefly review recent research and will describe our own experiences working with children who survived the Herald of Free

William Yule; Ruth M. Williams

1990-01-01

393

Traumatic phacocele: Review of eight cases  

PubMed Central

Blunt trauma can result in indirect scleral rupture with subsequent dislocation of the crystalline lens in the subconjunctival or subtenon space. This retrospective review of eight patients with traumatic phacocele highlights the clinical presentation, management and visual outcome. This study provides evidence that timely and effective intervention can ensure good visual recovery. PMID:17951909

Bhattacharjee, Harsha; Deka, Amarendra; Bhattacharyya, Pankaj

2007-01-01

394

Physiatric Management of Mild Traumatic Brain Injury  

Microsoft Academic Search

Mild traumatic brain injury (MTBI) is a common condition, afflicting as many as 1.5 million Americans yearly. Most individuals sustain MTBI as a result of motor vehicle collisions, but it may also occur as a result of falls, physical assault or sporting accidents. Problems related to MTBI include various pain syndromes, cognitive impairments, disorders of affect, cranial nerve dysfunction, and

STEVEN FLANAGAN

1999-01-01

395

Pediatric Traumatic Brain Injury: Quo Vadis?  

Microsoft Academic Search

In this review, five questions serve as the framework to discuss the importance of age-related differences in the pathophysiology and therapy of traumatic brain injury (TBI). The following questions are included: (1) Is diffuse cerebral swelling an important feature of pediatric TBI and what is its etiology? (2) Is the developing brain more vulnerable than the adult brain to apoptotic

Patrick M. Kochanek

2006-01-01

396

Traumatic Brain Injury: Looking Back, Looking Forward  

ERIC Educational Resources Information Center

This article is the eighth of a multi-part series on traumatic brain injury (TBI). Historically, TBI has received limited national attention and support. However, since it is the signature injury of the military conflicts in Iraq and Afghanistan, TBI has gained attention of elected officials, military leaders, policymakers, and the public. The…

Bartlett, Sue; Lorenz, Laura; Rankin, Theresa; Elias, Eileen; Weider, Katie

2011-01-01

397

Working with Students with Traumatic Brain Injury  

ERIC Educational Resources Information Center

The participation of a student with Traumatic Brain Injury (TBI) in general physical education can often be challenging and rewarding for the student and physical education teacher. This article addresses common characteristics of students with TBI and presents basic solutions to improve the education of students with TBI in the general physical…

Lucas, Matthew D.

2010-01-01

398

Understanding Traumatic Brain Injury: An Introduction  

ERIC Educational Resources Information Center

This article is the first of a multi-part series on traumatic brain injury (TBI). Historically, TBI has received very limited national public policy attention and support. However since it has become the signature injury of the military conflicts in Iraq and Afghanistan, TBI has gained the attention of elected officials, military leaders,…

Trudel, Tina M.; Scherer, Marcia J.; Elias, Eileen

2009-01-01

399

Prevention of post-traumatic stress disorders  

Microsoft Academic Search

This article deals with issues which are helpful in designing preventive outreach programs for victims of traumatic stress. The first part outlines a theoretical approach to the process of coping with serious life events. The second part analyzes the various aspect of mental assistance after such events. Aims of psychological intervention and different components of intervention programs are discussed. Finally

D. Brom; R. J. Kleber

1989-01-01

400

Atypical Traumatic Pneumorrhachis Accompanied by Paraparesis  

PubMed Central

Pneumorrhachis, caused by intraspinal air, is an exceptional but important radiographic finding that is accompanied by different etiologies. Pneumorrhachis, by itself, is usually asymptomatic and gets reabsorbed spontaneously. Therefore, the patients with pneumorrhachis are mostly managed conservatively. We encountered a unique case of atypical traumatic pneumorrhachis accompanied by paraparesis. PMID:25024968

Kim, Kweon Young; Kang, Jung Hun; Lee, Min Hong; Han, Yong

2014-01-01

401

Traumatic Brain Injury. Fact Sheet Number 18.  

ERIC Educational Resources Information Center

This fact sheet describes traumatic brain injury (TBI), an injury of the brain caused by the head being hit by something or being shaken violently. It discusses the incidence of TBI, and describes its symptoms as changes in thinking and reasoning, understanding words, remembering things, paying attention, solving problems, thinking abstractly,…

National Information Center for Children and Youth with Disabilities, Washington, DC.

402

Clinimetric measurement in traumatic brain injuries.  

PubMed

Traumatic brain injury is a leading cause of death and disability worldwide. Every year, about 1.5 million affected people die and several millions receive emergency treatment. Most of the burden (90%) is in low and middle-income countries. The costs of care depend on the level of disability. The burden of care after traumatic brain injury is caused by disability as well as by psychosocial and emotional sequelae of injury. The final consequence of brain injury is the reduction of quality of life. It is very difficult to predict the outcome after traumatic brain injury. The basic clinical model included four predictors: age, score in Glasgow coma scale, pupil reactivity, and the presence of major extracranial injury. These are the neuroradiological markers of recovery after TBI (CT, MRI and PET) and biomarkers: genetic markers of ApoE Gene, ectoenzyme CD 38 (cluster of differentiation 38), serum S100B, myelin basic protein (MBP), neuron specific endolase (NSE), and glial fibrillary acidic protein (GPAP). These are many clinimetric scales which are helpful in prognosing after head injury. In this review paper, the most commonly used scales evaluating the level of consciousness after traumatic brain injury have been presented. PMID:25408714

Opara, J A; Ma?ecka, E; Szczygiel, J

2014-06-15

403

Post-traumatic stress disorder and vision  

Microsoft Academic Search

Post-traumatic stress disorder (PTSD) can be defined as a memory linked with an unpleasant emotion that results in a spectrum of psychological and physical signs and symptoms. With the expectation of at least 300,000 postdeployment veterans from Iraq and Afghanistan having PTSD, optometrists will be faced with these patients' vision problems. Complicating the diagnosis of PTSD is some overlap with

Joseph N. Trachtman

2010-01-01

404

Coagulation Factors in Controlling Traumatic Bleeds  

E-print Network

. Hemorrhagic shock2,3 (SEE APPENDIX A) a. Precipitated by traumatic event, resulting in acute blood loss b administration COAGULOPATHY AFTER TRAUMA III. Coagulopathy1,4 a. Definition: a defect in the body's mechanism plug c. Hemostasis4 i. Definition: a complex process that limits blood loss following vascular injury 1

Pillow, Jonathan

405

Psychiatric disorders and traumatic brain injury  

PubMed Central

Psychiatric disorders after traumatic brain injury (TBI) are frequent. Researches in this area are important for the patients’ care and they may provide hints for the comprehension of primary psychiatric disorders. Here we approach epidemiology, diagnosis, associated factors and treatment of the main psychiatric disorders after TBI. Finally, the present situation of the knowledge in this field is discussed. PMID:19043523

Schwarzbold, Marcelo; Diaz, Alexandre; Martins, Evandro Tostes; Rufino, Armanda; Amante, Lúcia Nazareth; Thais, Maria Emília; Quevedo, João; Hohl, Alexandre; Linhares, Marcelo Neves; Walz, Roger

2008-01-01

406

Adolescent Post-Traumatic Stress Disorder  

ERIC Educational Resources Information Center

Based on over a decade of work in the area of PTSD, including a longitudinal study of PTSD among adolescents, Dr. Yule provides an introduction to post-traumatic stress disorder as it occurs in youth. This includes a look at the manifestations of stress reactions, the incidence and prevalence of PTSD, and the relationship between levels of…

Yule, William

2003-01-01

407

Narrative Language in Traumatic Brain Injury  

ERIC Educational Resources Information Center

Persons with traumatic brain injury (TBI) often show impaired linguistic and/or narrative abilities. The present study aimed to document the features of narrative discourse impairment in a group of adults with TBI. 14 severe TBI non-aphasic speakers (GCS less than 8) in the phase of neurological stability and 14 neurologically intact participants…

Marini, Andrea; Galetto, Valentina; Zampieri, Elisa; Vorano, Lorenza; Zettin, Marina; Carlomagno, Sergio

2011-01-01

408

Post-traumatic psychosis among Cambodian refugees  

Microsoft Academic Search

Of 100 consecutive Cambodian patients with post-traumatic stress disorder (PTSD), seven had severe persistent psychotic symptoms. Those with psychosis did not differ demographically or in severity of trauma from those without psychosis. The behavior of these seven patients was disruptive to their families; all required hospitalizations and were difficult to treat. This report as well as other clinical literature indicate

J. David Kinzie; James J. Boehnlein

1989-01-01

409

Traumatic Brain Injured Families: Therapeutic Considerations.  

ERIC Educational Resources Information Center

Defines traumatic brain injury (TBI) as an acquired injury to the head that results in long-term and often permanent physical and emotional disturbances that often has catastrophic impacts on families. Reviews six research articles regarding implications for both therapists and researchers working with TBI families. (Author/MKA)

Christensen, Teresa M.; Skaggs, Jobie L.; Kleist, David M.

1997-01-01

410

Cognitive sequelae of traumatic brain injury.  

PubMed

Cognitive dysfunction is the leading cause of disability following traumatic brain injury (TBI). This article provides a review of the cognitive sequelae of TBI, with a focus on deficits of executive functioning and everyday thinking skills. The pathophysiology, assessment, and treatment of TBI-related cognitive problems are also discussed. PMID:24529420

Rabinowitz, Amanda R; Levin, Harvey S

2014-03-01

411

Traumatic brain injury and posttraumatic stress disorder.  

PubMed

Given the upsurge of research in posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI), much of which has focused on military samples who served in Iraq and Afghanistan, the purpose of this article is to review the literature published after September 11th, 2001 that addresses the epidemiology, pathophysiology, evaluation, and treatment of PTSD in the context of TBI. PMID:24529423

Bahraini, Nazanin H; Breshears, Ryan E; Hernández, Theresa D; Schneider, Alexandra L; Forster, Jeri E; Brenner, Lisa A

2014-03-01

412

Endocrine Consequences of Adult Traumatic Brain Injury  

Microsoft Academic Search

Background: Traumatic brain injury (TBI) is the most common cause of death and disability in young adults living in industrialised countries. Over the last few years, there has been an increasing awareness that hypopituitarism can complicate TBI in a significant proportion of survivors: at least 25% of TBI survivors develop one or more pituitary hormone deficiencies. This remarkably high frequency

Lucy Ann Behan; Amar Agha

2007-01-01

413

4: Rehabilitation after traumatic brain injury  

Microsoft Academic Search

Traumatic brain injury (TBI) commonly affects younger people and causes life-long impairments in physical, cognitive, behavioural and social function. The cognitive, behavioural and personality deficits are usually more disabling than the residual physical deficits. Recovery from TBI can continue for at least 5 years after injury. ? Rehabilitation is effective using an interdisciplinary approach, and close liaison with the patient,

Fary Khan; Ian J Baguley; Ian D Cameron

2003-01-01

414

Partial posterior hyaloidectomy for macular disorders  

PubMed Central

Purpose To evaluate the effect of partial posterior hyaloidectomy (PPH) in preventing iatrogenic retinal breaks related to the induction of a posterior vitreous detachment (IPVD) Methods Fifty-nine patients who necessitated IPVD for an epiretinal membrane or macular hole were included in this prospective, interventional case series. Extensive removal of vitreous gel, close to the retina, was conducted before IPVD under 23?G (gauge)-vitrectomy system. The PPH involved the limited extent of IPVD and limited removal of the outermost vitreous cortex to an area slightly beyond the margin of the temporal major vascular arcade. The incidence of retinal breaks related to the surgery was compared with 57 eyes that had undergone conventional 23-G total vitrectomy accompanied by extensive IPVD using ?2-test. Results Patients were followed-up for a mean of 14.3 months (6–30 months) after the surgery. The incidence of peripheral retinal breaks after the PPH was 3.4% (2/59 eyes), which was significantly lower than that in the eyes that underwent conventional 23?G vitrectomy (15.8%, 9/57 eyes, P=0.023) for the same disorders that required an IPVD. No patient complained of postoperative floaters, postoperatively. Conclusions PPH would be an efficient procedure to prevent iatrogenic peripheral retinal breaks related to an IPVD. PMID:23743531

Kim, J H; Kang, S W; Kim, Y T; Kim, S J; Chung, S E

2013-01-01

415

Sampling Networks from Their Posterior Predictive Distribution  

PubMed Central

Recent research indicates that knowledge about social networks can be leveraged to increase efficiency of interventions (Valente, 2012). However, in many settings, there exists considerable uncertainty regarding the structure of the network. This can render the estimation of potential effects of network-based interventions difficult, as providing appropriate guidance to select interventions often requires a representation of the whole network. In order to make use of the network property estimates to simulate the effect of interventions, it may be beneficial to sample networks from an estimated posterior predictive distribution, which can be specified using a wide range of models. Sampling networks from a posterior predictive distribution of network properties ensures that the uncertainty about network property parameters is adequately captured. The tendency for relationships among network properties to exhibit sharp thresholds has important implications for understanding global network topology in the presence of uncertainty; therefore, it is essential to account for uncertainty. We provide detail needed to sample networks for the specific network properties of degree distribution, mixing frequency, and clustering. Our methods to generate networks are demonstrated using simulated data and data from the National Longitudinal Study of Adolescent Health. PMID:25339990

Goyal, Ravi; De Gruttola, Victor; Blitzstein, Joseph

2014-01-01

416

Posterior consistency in conditional distribution estimation  

PubMed Central

A wide variety of priors have been proposed for nonparametric Bayesian estimation of conditional distributions, and there is a clear need for theorems providing conditions on the prior for large support, as well as posterior consistency. Estimation of an uncountable collection of conditional distributions across different regions of the predictor space is a challenging problem, which differs in some important ways from density and mean regression estimation problems. Defining various topologies on the space of conditional distributions, we provide sufficient conditions for posterior consistency focusing on a broad class of priors formulated as predictor-dependent mixtures of Gaussian kernels. This theory is illustrated by showing that the conditions are satisfied for a class of generalized stick-breaking process mixtures in which the stick-breaking lengths are monotone, differentiable functions of a continuous stochastic process. We also provide a set of sufficient conditions for the case where stick-breaking lengths are predictor independent, such as those arising from a fixed Dirichlet process prior. PMID:25067858

Pati, Debdeep; Dunson, David B.; Tokdar, Surya T.

2014-01-01

417

Posterior Interosseous Nerve Syndrome from Thermal Injury  

PubMed Central

Background. Due to anatomical proximity to bone, the radial nerve is the most frequently injured major nerve of the upper extremity, frequently secondary to fractures (Li et al. (2013)). We describe an incidence when a branch of the radial nerve is injured as a result of a thermal injury. Observation. Radial nerve injury can occur anywhere along the anatomical course with varied etiologies, but commonly related to trauma. The most frequent site is in the proximal forearm involving the posterior interosseous branch. However, problems can occur at the junction of the middle and proximal thirds of the humerus and wrist radially. When the radial nerve is injured by a burn, a new rehabilitation dynamic arises. Not only does one agonize about the return of nerve function but also fret about the skin grafts that replaced the devitalized tissue housing that compartment. Discussion. Although posterior interosseous nerve syndrome has been described in the context of many different etiologies, it has not previously been discussed in relation to burn injuries. In this case, not only did the patient's rehabilitation involve aggressive therapy for return of sensation and function of the arm, but also prevention of contracture normally seen in replacement of full thickness burns. PMID:24707432

Singh, Vijay A.; Michael, Rami E.; Dinh, Duy-Bao P.; Bloom, Scott; Cooper, Michael

2014-01-01

418

Percutaneous minimally invasive instrumentation for traumatic thoracic and lumbar fractures: a prospective analysis.  

PubMed

Open posterior instrumentation is still the standard procedure for unstable traumatic thoracic and lumbar fractures. There is a general tendency towards minimally invasive approaches in various surgical disciplines. The Sextant II Rod Insertion system is one of these. The authors prospectively studied this system in 51 patients with thoracic and lumbar fractures, between October 2007 and January 2011. Most fractures (31/51) were situated at the lumbar level. In 7 older patients the technique was combined with kyphoplasty and/or cement augmentation of the pedicle screws. The median operative time was 61 minutes (range: 26-130). The median fluoroscopy time was 132 seconds (range: 24-414). Most pedicle screws were correctly placed: 197 out of 204 screws. All fractures showed bony union after 6 weeks, but the multiaxial pedicle screws were not able to conserve the slight correction obtained peroperatively via positioning and longitudinal traction. Percutaneous minimally invasive stabilization of the spine needs further improvement. PMID:22822580

Krüger, Antonio; Rammler, Katharina; Ziring, Ewgeni; Zettl, Ralph; Ruchholtz, Steffen; Frangen, Thomas M

2012-06-01

419

Descemet's Stripping-Automated Endothelial Keratoplasty for Traumatic Aniridia and Aphakia  

PubMed Central

This Interventional case reports a challenging case of descemet's stripping-automated endothelial keratoplasty (DSAEK) in a young male patient with traumatic aniridia, aphakia, and corneal edema. Surgery was planned in two stages; first was implantation of aniridia intraocular lens (AIOL), few months later, DSAEK procedure was performed. Successful outcome of both procedures was achieved as measured by the stability of the AIOL, clarity of the cornea, attachment of the lenticule, and improvement in vision. Aniridia implant supports a sufficient amount of air in the anterior chamber especially if the posterior segment is well formed, while providing the required lens power to improve vision. DSAEK procedure challenges that include iris defects and aphakia may be overcome by stepwise planning of the procedure. PMID:22606506

Jastaneiah, Sabah S.

2012-01-01

420

Chlamydia trachomatis serovar distribution and other concurrent sexually transmitted infections in heterosexual men with urethritis in Italy.  

PubMed

The distribution of Chlamydia trachomatis serovars among 157 heterosexual male patients with urethritis and the presence of coinfections with other sexually transmitted infections were studied. One hundred seventeen (74.5%) patients, with a mean age of 33.7 years, were Italians, whereas 40 (25.5%) were immigrants coming from eastern European countries, Africa, and South America. All the immigrants and 82 (70.0%) Italian patients reported sex with prostitutes. Out of 157 patients, 73 (46.5%) were found positive for C. trachomatis in urethral secretions and eight different C. trachomatis serovars were identified. The most common serovars were E (n = 18; 24.7%), D (n = 15; 20.5%), G (n = 14;19.2%), and F (n = 12; 16.4%). The sequencing data showed a high degree of conservation of the omp1 gene. Thirty-six (46.7%) out of the 73 C. trachomatis-positive patients were coinfected with another sexually transmitted infection. The most common coinfection was gonorrhoea detected in 22 (30.1%) patients, followed by condyloma in eight (8.2%) patients, syphilis in five (6.8%), and HIV in three (4.1%). PMID:18958506

Donati, M; Di Francesco, A; D'Antuono, A; Pignanelli, S; Shurdhi, A; Moroni, A; Baldelli, R; Cevenini, R

2009-05-01

421

Acquired urinary incontinence in the bitch: update and perspectives from human medicine. Part 3: The urethral component and surgical treatment.  

PubMed

Urethral sphincter mechanism incompetence (USMI) is the most common cause of urinary incontinence in dogs. Surgery may be recommended if the animal does not respond to medical treatment or becomes refractory. In this third part of a three-part review, surgical options for the treatment of USMI are described. Colposuspension is the most frequently described procedure and offers a fair prognosis, with about 50% of the dogs being continent after surgery and most of the reminder being improved or more responsive to medical treatment. Urethropexy offers a similar success rate, but with a higher rate of complications. Endoscopic injection of collagen is an attractive technique due to its minimally invasive nature and low risk of adverse effects. Initial results may however deteriorate with time. Other procedures have been reported, but involve a low number of cases and have resulted in variable success rates. In women, stress urinary incontinence is mainly treated by minimally invasive procedures involving vaginal placement of sub-urethral slings. PMID:19926505

Claeys, Stéphanie; Noël, Stéphanie; Hamaide, Annick

2010-10-01

422

Study of Vertebral Body Replacement with Reconstruction Spinal Cages in Dorsolumbar Traumatic and Koch's Spine  

PubMed Central

Study Design Retrospective and prospective case series. Purpose The aim of this study was to assess the results of reconstruction of anterior column, fusion and complications related to cages. Overview of Literature Literature shows that corpectomy has become a common surgical procedure for spinal infection, trauma, deformity, instability and metastasis. Also the use of reconstructive spinal cages is common after corpectomy. Methods Study was carried out in patients with dorsolumbar traumatic and Koch's spine. We assessed 25 patients (13 traumatic/12 tuberculous) who were treated with cages with/without any other instrumentation. Radiographs were obtained before and after the surgery. A preoperative magnetic resonance imaging was obtained in every patient. Results Fourteen patients underwent 1 level of corpectomy, 9 patients underwent 2 levels and 2 patients underwent 3 levels of corpectomy. Anterior reconstruction alone was performed in 8 patients; 360° reconstruction was performed in 17 patients and 2 of them underwent reconstruction through single posterior approach only. The mean kyphotic angulation improved from 21.2° preoperatively to 9.3° postoperatively and to 12° at final follow up. 8 patients with neurological deficits had improvement by at least one or more Frankel grade. No migration/displacement of cage was seen in any patients. Conclusions The present study demonstrates that the vertebral body replacement after corpectomy by reconstructive cages provides a reconstruction of the anterior column, good correction of the mean kyphotic angle, and a correction maintained with cage without any cage related complication at long term follow up. The fusion can be achieved with reconstructive cage plus bone graft with or without posterior instrumentation. PMID:25558321

Gautam, Vinod K

2014-01-01

423

Traumatic rupture of the neurocentral synchondrosis of the axis in a child.  

PubMed

The authors report the first case of unilateral traumatic rupture of the C-2 neurocentral synchondrosis. A 26-month-old child was in a vehicular collision that caused his head to be rotated sharply to the left with the neck flexed. He had severe neck pain but was neurologically normal. Computerized tomography scanning showed rupture of the left C-2 neurocentral synchondrosis, a right C-2 pars interarticularis fracture, and anterior angulation of C-2 on C-3. The neck injury was unrecognized until postinjury Day 9 when an MRI study showed a tear of the posterior longitudinal ligament at C2-3 and separation of the C-2 body from the inferior anular epiphysis. A second CT showed widening of the synchondrosis fracture, increased angulation of C-2 on C-3, and distraction of the right C-2 pars fracture. The mechanism of the neurocentral synchondrosis fracture is thought to be hyperflexion-axial loading combined with leftward rotation, which provided the lateral force that overcame the cartilaginous synchondrosis and extruded the lateral mass. The patient underwent open reduction and posterior fusion of C1-3, and was maintained in a halo jacket for 4 months, when CT scans demonstrated solid C1-C3 fusion and ossification of the injured synchondrosis. Unilateral traumatic rupture of the C-2 neurocentral synchondrosis is one component of several injuries involving C-2 sustained before synchondrosis closure. The resulting C2-3 relationship is highly unstable. Reduction and C1-C3 fusion are necessary in patients with significant displacement of the adjacent bony units. PMID:24628510

Wong, Sui-To; Zovickian, John; Hou, Yongjin; Sonne, Chris; Pang, Dachling

2014-05-01

424

Percutaneous Vertebral Augmentation with Polyethylene Mesh and Allograft Bone for Traumatic Thoracolumbar Fractures  

PubMed Central

Purpose. In cases of traumatic thoracolumbar fractures, percutaneous vertebral augmentation can be used in addition to posterior stabilisation. The use of an augmentation technique with a bone-filled polyethylene mesh as a stand-alone treatment for traumatic vertebral fractures has not yet been investigated. Methods. In this retrospective study, 17 patients with acute type A3.1 fractures of the thoracic or lumbar spine underwent stand-alone augmentation with mesh and allograft bone and were followed up for one year using pain scales and sagittal endplate angles. Results. From before surgery to 12 months after surgery, pain and physical function improved significantly, as indicated by an improvement in the median VAS score and in the median pain and work scale scores. From before to immediately after surgery, all patients showed a significant improvement in mean mono- and bisegmental kyphoses. During the one-year period, there was a significant loss of correction. Conclusions. Based on this data a stand-alone approach with vertebral augmentation with polyethylene mesh and allograft bone is not a suitable therapy option for incomplete burst fractures for a young patient collective.

Schulz, C.; Kunz, U.; Mauer, U. M.; Mathieu, R.

2015-01-01

425

Multi-modal MRI of mild traumatic brain injury  

PubMed Central

Multi-modal magnetic resonance imaging (MRI) that included high resolution structural imaging, diffusion tensor imaging (DTI), magnetization transfer ratio (MTR) imaging, and magnetic resonance spectroscopic imaging (MRSI) were performed in mild traumatic brain injury (mTBI) patients with negative computed tomographic scans and in an orthopedic-injured (OI) group without concomitant injury to the brain. The OI group served as a comparison group for mTBI. MRI scans were performed both in the acute phase of injury (~24 h) and at follow-up (~90 days). DTI data was analyzed using tract based spatial statistics (TBSS). Global and regional atrophies were calculated using tensor-based morphometry (TBM). MTR values were calculated using the standard method. MRSI was analyzed using LC Model. At the initial scan, the mean diffusivity (MD) was significantly higher in the mTBI cohort relative to the comparison group in several white matter (WM) regions that included internal capsule, external capsule, superior corona radiata, anterior corona radiata, posterior corona radiata, inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, forceps major and forceps minor of the corpus callosum, superior longitudinal fasciculus, and corticospinal tract in the right hemisphere. TBSS analysis failed to detect significant differences in any DTI measures between the initial and follow-up scans either in the mTBI or OI group. No significant differences were found in MRSI, MTR or morphometry between the mTBI and OI cohorts either at the initial or follow-up scans with or without family wise error (FWE) correction. Our study suggests that a number of WM tracts are affected in mTBI in the acute phase of injury and that these changes disappear by 90 days. This study also suggests that none of the MRI-modalities used in this study, with the exception of DTI, is sensitive in detecting changes in the acute phase of mTBI. PMID:25610770

Narayana, Ponnada A.; Yu, Xintian; Hasan, Khader M.; Wilde, Elisabeth A.; Levin, Harvey S.; Hunter, Jill V.; Miller, Emmy R.; Patel, Vipul Kumar S.; Robertson, Claudia S.; McCarthy, James J.

2014-01-01

426

Multi-modal MRI of mild traumatic brain injury.  

PubMed

Multi-modal magnetic resonance imaging (MRI) that included high resolution structural imaging, diffusion tensor imaging (DTI), magnetization transfer ratio (MTR) imaging, and magnetic resonance spectroscopic imaging (MRSI) were performed in mild traumatic brain injury (mTBI) patients with negative computed tomographic scans and in an orthopedic-injured (OI) group without concomitant injury to the brain. The OI group served as a comparison group for mTBI. MRI scans were performed both in the acute phase of injury (~24 h) and at follow-up (~90 days). DTI data was analyzed using tract based spatial statistics (TBSS). Global and regional atrophies were calculated using tensor-based morphometry (TBM). MTR values were calculated using the standard method. MRSI was analyzed using LC Model. At the initial scan, the mean diffusivity (MD) was significantly higher in the mTBI cohort relative to the comparison group in several white matter (WM) regions that included internal capsule, external capsule, superior corona radiata, anterior corona radiata, posterior corona radiata, inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, forceps major and forceps minor of the corpus callosum, superior longitudinal fasciculus, and corticospinal tract in the right hemisphere. TBSS analysis failed to detect significant differences in any DTI measures between the initial and follow-up scans either in the mTBI or OI group. No significant differences were found in MRSI, MTR or morphometry between the mTBI and OI cohorts either at the initial or follow-up scans with or without family wise error (FWE) correction. Our study suggests that a number of WM tracts are affected in mTBI in the acute phase of injury and that these changes disappear by 90 days. This study also suggests that none of the MRI-modalities used in this study, with the exception of DTI, is sensitive in detecting changes in the acute phase of mTBI. PMID:25610770

Narayana, Ponnada A; Yu, Xintian; Hasan, Khader M; Wilde, Elisabeth A; Levin, Harvey S; Hunter, Jill V; Miller, Emmy R; Patel, Vipul Kumar S; Robertson, Claudia S; McCarthy, James J

2015-01-01

427

[Biomechanical correlations of lesions associated with traumatic diseases of the anterior cruciate ligament. Analysis with magnetic resonance].  

PubMed

To investigate the correlations between traumatic injuries of the anterior cruciate ligament and other ligamentous, meniscal and bone traumatic injuries, a series of 193 patients with anterior cruciate ligament injuries studied with MRI between January 1992 and December 1994, was retrospectively reviewed. MR results were compared with arthroscopic and/or surgical findings in most (181) patients; in the remaining 12 patients, clinical follow-up was performed. We used two 0.5 superconductive MR units, with dedicated coils and T1-weighted spin-echo and T2*-weighted gradient-echo sequences on the axial, sagittal and coronal planes. Anterior cruciate ligament injuries were associated with other ligamentous, meniscal and bone injuries in 78% of patients. The patients were classified in 5 groups depending on biomechanics and the association of injuries: -group I: isolated injury of the anterior cruciate ligament (41 patients), most frequently caused by forced extension stress associated with "kissing contusions" of the anterior portion of the lateral femoral condyle and of the lateral tibial plateau; this type of injury is less frequently caused by forced flexion stress associated with avulsion fracture of the tibial eminence; -group II: associated injury of the anterior cruciate ligament and medial compartment (62 patients), caused by forced flexion-external rotation stress (abduction, valgism and external rotation). The classic association of this mechanism was the injury of the anterior cruciate ligament, medial collateral ligament and medial meniscus (O'Donoghue triad) (9 patients). Valgus stress and the pivot-shift phenomenon can impact the tibial and femoral articular surfaces, with consequent osteochondral contusion; -group III: associated injury of the anterior cruciate ligament and lateral compartment (26 patients), caused by forced flexion-internal rotation stress (adduction, varism and internal rotation). This mechanism can cause, as a typical bone lesion, Segond fractures; -group IV: associated injury of the anterior cruciate ligament, lateral and medial compartments observed in 52 patients with different associations of varus-valgus and rotatory stress; -group V: in 5 patients, anterior cruciate ligament injury was associated with traumatic injury of the posterior cruciate ligament; in this case, posterior displacement of the tibia and knee hyperextension were the most common mechanisms of injury. In conclusion, our results demonstrate that anterior cruciate ligament injuries due to traumatic sprains of the knee are rarely isolated (21%). Thus, it is important to know the biomechanics of knee trauma to read MR images in order to detect possibly associated injuries. The final goal is to assess the actual extent of the traumatic damage for best subsequent clinical-therapeutic management. PMID:8830351

De Maria, M; Barbiera, F; Lo Casto, A; Iovane, A; Rossello, M; Sparacia, G; Lagalla, R

1996-06-01

428

Short-Term Results of Total Knee Arthroplasty with Anterior-Posterior Glide LCS Mobile-Bearing System  

PubMed Central

Purpose To evaluate the clinical and radiological results of total knee arthroplasty (TKA) using the anterior-posterior glide (APG) low contact stress (LCS) mobile-bearing system. Materials and Methods We evaluated 130 knees in 117 patients who had undergone TKA with APG LCS mobile-bearing system between September 2005 and July 2007 and could be followed over 5 years. The mean follow-up period was 68 months. The clinical and radiological results were evaluated using the American Knee Society Scoring System, Oxford knee score and the American Knee Society Roentgenographic Evaluation and Scoring System. And we analyzed short-term postoperative complications. Results The average range of motion of the knee joint was 107.9° (range, 70° to 135°) preoperatively and 125.2° (range, 90° to 135°) at the last follow-up. The average knee and functional scores were improved from 39.1 and 42.0 to 71.2 and 75.6, respectively, between the preoperative and last follow-up evaluation. The Oxford knee score was decreased from 42.9 preoperatively to 23.1 at the last follow-up. The femoro-tibial angle (anatomical axis) changed from 10.1° varus preoperatively to 3.3° valgus at the last follow-up. Radiolucency was observed in 14% of all cases. There were 1 case of traumatic dislocation of the polyethylene liner, 1 case of aseptic loosening and 6 cases of posterior instability because of posterior cruciate ligament (PCL) insufficiency. Conclusions TKA with APG LCS mobile-bearing system demonstrated relatively good short-term clinical and radiological results. However, further considerations for posterior instability associated with PCL insufficiency are needed. PMID:25229046

Kim, Kyung Taek; Kang, Min Soo; Lim, Young Hoon; Park, Jin Woo

2014-01-01

429

Isolated posterior femoral cutaneous neuropathy following intragluteal injection.  

PubMed

Isolated posterior femoral cutaneous nerve lesions are rarely encountered. Electrophysiological documentation has only been made in a few cases. In this study we evaluated a 22-year-old woman with sensory loss and pain in the lower buttock and posterior thigh after left gluteal intramuscular injection. We assessed the posterior femoral cutaneous nerve using an accepted conduction technique. The results showed a normal response on the asymptomatic side, but no response on the symptomatic side. PMID:19623639

Kim, Jee-Eun; Kang, Ji-Hoon; Choi, Jay Chol; Lee, Jung Seok; Kang, Sa-Yoon

2009-11-01

430

Late posterior failure after mitral valve repair in degenerative disease  

Microsoft Academic Search

Objectives: Little is known regarding the mechanisms, the feasibility and the long-term results of re-repair in 'posterior failure' of a previous mitral valve repair performed for severe degenerative mitral regurgitation. We report our 16-year experience in redo surgery for late posterior failureofmitralvalverepairindegenerativedisease.Methods:From1991to2004,13consecutivepatients(10males;medianage:65years)were reoperated for late posterior failure of mitral valve repair. All patients had grade 3+ mitral regurgitation. Repair was

Rachid Zegdi; Ghassan Sleilaty; Ziad Khabbaz; Milena Noghin; Christian Latremouille; Alain Carpentier; Alain Deloche; Jean-Noel Fabiani

431

Stage IV posterior tibial tendon rupture.  

PubMed

Adult acquired flatfoot deformity progresses through well defined stages as set out by Johnson and Strom. Myerson modified this classification system with the addition of a fourth, more advanced stage of the disease. This stage describes the involvement of the tibiotalar joint in addition to the hindfoot malalignment seen in stages II and III. This most advanced stage is comprised of a hindfoot valgus deformity, resulting from degeneration of the posterior tibial tendon, with associated valgus tilting of the talus within the mortise. The deformity at the tibiotalar joint may or may not be rigid. Although rigid deformities are still best treated with fusions of the ankle and hindfoot, supple tibiotalar deformity may be treated with joint sparing procedures involving reconstructive procedures of the foot and deltoid ligaments. PMID:17561206

Bluman, Eric M; Myerson, Mark S

2007-06-01

432

Ectomesenchymal chondromyxoid tumour of the posterior tongue.  

PubMed

Ectomesenchymal chondromyxoid tumor (ECMT) is a rare benign neoplasm arising in the tongue. With only 45 cases reported in the literature, there are several unique features defining this lesion. Firstly, almost all patients present with an asymptomatic slow growing mass on the anterior dorsum of the tongue. At the microscopic level, it is recognizable as a well-circumscribed unencapsulated proliferation of uniform round to fusiform cells embedded in a chondromyxoid matrix. Lastly, the immunohistochemistry profile is characterised by positivity for glial fibrillary acidic protein and frequent positivity for S-100 and cytokeratins. We report a case of a mass located on the posterior dorsum of the tongue and meeting the aforementioned morphological and immunohistochemical criteria of ECMT. PMID:24288100

Cardin, Marie-Josée; Fiset, Pierre Olivier; Zeitouni, Anthony G; Caglar, Derin

2014-09-01

433

[Epidural hematomas in the posterior cranial fossa].  

PubMed

In the course of twenty years 92 patients with intracranial epidural haematomas (EH) were operated. In five these patients, i.e. 5.4%, the EH was in the posterior cranial fossa (EHPF). Focal symptoms of compression of the cerebellum and the lower cranial nerves developed only in subacute EHPF. In acute EHPF it was masked by manifestations of an affection of the brain stem. Direct evidence of EHPF was produced by AG. The best diagnostic method is computed tomography. Attention to EHPF can be however, drawn also clinical sings of injury of the bask of the skull or the finding of a fracture of the occipital bone on an X-ray picture of the skull. Evacuation of the EHPF provides favourable perspectives of a normal future life even on patients who are in a poor condition incl. signs of and impaired respiration. PMID:2237649

Steno, J; Fröhlich, J; Bízik, I

1990-06-01

434

Posterior Cruciate Ligament: Focus on Conflicting Issues  

PubMed Central

There is little consensus on how to optimally reconstruct the posterior cruciate ligament (PCL) and the natural history of injured PCL is also unclear. The graft material (autograft vs. allograft), the type of tibial fixation (tibial inlay vs. transtibial tunnel), the femoral tunnel position within the femoral footprint (isometric, central, or eccentric), and the number of bundles in the reconstruction (1 bundle vs. 2 bundles) are among the many decisions that a surgeon must make in a PCL reconstruction. In addition, there is a paucity of information on rehabilitation after reconstruction of the PCL and posterolateral structures. This article focused on the conflicting issues regarding the PCL, and the scientific rationales behind some critical points are discussed. PMID:24340144

Lee, Yong Seuk

2013-01-01

435

Allocentric spatial neglect with posterior cortical atrophy.  

PubMed

Patients with posterior cortical atrophy (PCA) have been reported to have neglect in the egocentric/ body-centered reference frame. This report describes a woman with PCA who had a right-sided stimulus-based form of allocentric visual neglect on cancellation, reading, and drawing tests. Her brain imaging revealed left parietal atrophy. The pathophysiology of this disorder may be related to an impairment of the ventral "what" stream's ability to interact with the dorsal "where" stream that mediates the allocation of spatial attention, or a deficit in the systems that allocate contralateral focal attention. Further research is needed to better understand the mechanisms of this disorder and to optimally treat it. PMID:24679168

Zilli, Eduardo M; Heilman, Kenneth M

2015-04-01

436

The Neuropsychiatric Profile of Posterior Cortical Atrophy.  

PubMed

We analyzed scores obtained at the Neuropsychiatric Inventory (NPI) by 20 patients with posterior cortical atrophy (PCA) and contrasted it with 20 patients having Alzheimer disease (AD). Patients with hallucinations and delusions were not included due to the high probability of a diagnosis of Lewy body disease. Prevalence of behavioral and psychological symptoms (BPSD) was 95% in the PCA group, the most frequent being apathy and anxiety. Cluster analysis on NPI subscales highlighted a behavioral subsyndrome characterized by agitated temper and irritability. Depression, anxiety, and apathy did not cluster with any other BPSD nor with each other. The PCA group showed a significantly higher proportion of anxious patients and worse anxiety score than patients with AD. No correlation was found between NPI data and demographic, clinical, or neuropsychological features nor were there significant differences for the same variables between anxious and nonanxious cases with PCA. In agreement with anecdotal reports, anxiety seems particularly relevant in PCA. PMID:25330926

Isella, Valeria; Villa, Giulia; Mapelli, Cristina; Ferri, Francesca; Appollonio, Ildebrando Marco; Ferrarese, Carlo

2014-10-20

437

77 FR 32397 - Servicemembers' Group Life Insurance Traumatic Injury Protection Program-Genitourinary Losses  

Federal Register 2010, 2011, 2012, 2013

...RIN 2900-AO20 Servicemembers' Group Life Insurance Traumatic Injury Protection Program...regulations governing the Servicemembers' Group Life Insurance Traumatic Injury Protection...that expanded the Servicemembers' Group Life Insurance Traumatic Injury...

2012-06-01

438

DOPAMINE AND CAMP REGULATED PHOSPHOPROTEIN, 32 KDA: A NOVEL THERAPEUTIC TARGET IN TRAUMATIC BRAIN INJURY.  

E-print Network

REGULATED PHOSPHOPROTEIN, 32 KDA: A NOVEL THERAPEUTIC TARGET IN TRAUMATIC BRAIN INJURY. James William Bales, B.S. University of Pittsburgh, 2010 Traumatic brain injury (TBI) represents a significant cause ..................................................................................................................... 1 1.1 TRAUMATIC BRAIN INJURY

Sibille, Etienne

439

Traumatic Brain Injury (TBI) Documentation Head injury or traumatic brain injury is considered a medical or clinical diagnosis. Individuals qualified to  

E-print Network

Traumatic Brain Injury (TBI) Documentation Head injury or traumatic brain injury is considered are practitioners who have been trained in the assessment of head injury or traumatic brain injury. Recommended of the student's condition. Please have your medical professional complete the Traumatic Brain Injury (TBI

Delgado, Mauricio

440

A scheme for categorizing traumatic military events.  

PubMed

A common assumption among clinicians and researchers is that war trauma primarily involves fear-based reactions to life-threatening situations. However, the authors believe that there are multiple types of trauma in the military context, each with unique perievent and postevent response patterns. To test this hypothesis, they reviewed structured clinical interviews of 122 active duty service members and assigned the reported index (principal, most currently distressing) events to one or more of the following categories: Life Threat to Self, Life Threat to Others, Aftermath of Violence, Traumatic Loss, Moral Injury by Self, and Moral Injury by Others. They found high interrater reliability for the coding scheme and support for the construct validity of the categorizations. In addition, they discovered that certain categories were related to psychiatric symptoms (e.g., reexperiencing of the traumatic event, guilt, anger) and negative thoughts about the world. Their study provides tentative support for use of these event categories. PMID:22679239

Stein, Nathan R; Mills, Mary Alice; Arditte, Kimberly; Mendoza, Crystal; Borah, Adam M; Resick, Patricia A; Litz, Brett T

2012-11-01

441

Protesi di ginocchio a stabilizzazione posteriore e a conservazione del legamento crociato posteriore. Esame comparativo  

Microsoft Academic Search

L’artroprotesi totale di ginocchio si è oramai dimostrata un presidio efficace nel ridurre l’entità del dolore ed incrementare\\u000a le capacità funzionali. Dati ottenuti da studi eseguiti sia su artroprotesi postero-stabilizzate (PS) che su quelle a conservazione\\u000a del crociato posteriore (PCR) hanno messo in evidenza risultati rilevanti anche a lungo termine. Ancora oggi esiste, tuttavia,\\u000a notevole controversia su quale sia il

G. Cerulli; A. Caraffa; P. Antinolfi; G. Zamarra

442

The hidden price of repeated traumatic exposure.  

PubMed

Neuroimaging studies have demonstrated reduced hippocampal volume in trauma-exposed individuals without posttraumatic stress disorder (PTSD). However, the implications of such a deficit in this non-clinical population are still unclear. Animal and human models of PTSD suggest that hippocampal deficit may result in impaired learning and use of associations between contextual information and aversive events. Previous study has shown that individuals with PTSD have a selective impairment in reversing the negative outcome of context-related information. The aim of this study was to test whether non-PTSD individuals who are repeatedly exposed to traumatic events display similar impairment. To that end, we compared the performance of active-duty firefighters who are frequently exposed to traumatic events as part of their occupational routine and civilian matched-controls with no history of trauma-exposure. We used a novel cue-context reversal paradigm, which separately evaluates reversal of negative and positive outcomes of cue and context-related information. As predicted, we found that while both trauma-exposed firefighters and unexposed matched-controls were able to acquire and retain stimulus-outcome associations, firefighters struggled to learn that a previously negative context is later associated with a positive outcome. This impairment did not correlate with levels of PTSD, anxiety or depressive symptoms. The results suggest that similar to individuals with PTSD, highly exposed individuals fail to associate traumatic outcomes with their appropriate context. This impairment may reflect a possible hidden price of repeated traumatic exposure, which is not necessarily associated with PTSD diagnosis, and may affect the way highly exposed individuals interpret and react to their environment. PMID:24810272

Levy-Gigi, Einat; Richter-Levin, Gal

2014-07-01

443

Neuropsychiatry of pediatric traumatic brain injury.  

PubMed

Pediatric traumatic brain injury (TBI) is a major public health problem. Psychiatric disorders with onset before the injury are more common than population base rates. Novel (postinjury onset) psychiatric disorders (NPD) are also common and complicate child function after injury. Novel disorders include personality change due to TBI, secondary attention-deficit/hyperactivity disorder, other disruptive behavior disorders, and internalizing disorders. This article reviews preinjury psychiatric disorders as well as biopsychosocial risk factors and treatments for NPD. PMID:24529428

Max, Jeffrey E

2014-03-01

444

Traumatic Events and Posttraumatic Stress in Childhood  

Microsoft Academic Search

Results: More than two thirds of children reported at least 1 traumatic event by 16 years of age, with 13.4% of thosechildrendevelopingsomePTSsymptoms.FewPTS symptoms or psychiatric disorders were observed for in- dividuals experiencing their first event, and any effects were short-lived. Less than 0.5% of children met the cri- teria for full-blown DSM-IV PTSD. Violent or sexual trauma were associated with

William E. Copeland; Gordon Keeler; Adrian Angold; E. Jane Costello

2007-01-01

445

Post-traumatic stress disorder in veterans.  

PubMed

Over 2000 general practice encounters per year (2.3%) in BEACH are with repatriation health card holders, referred to here as veterans. The patients are veterans of Australia's defence force or war widows, widowers or dependent children. We compared the rate at which post-traumatic stress disorder (PTSD) was managed among veterans and non-veterans from April 2009 to June 2014. PMID:25393458

Charles, Janice; Harrison, Christopher; Britt, Helena

2014-11-01

446

Predicting traumatic stress using emotional intelligence  

Microsoft Academic Search

The study investigated whether emotional intelligence (EI) can predict how individuals respond to traumatic experiences. A random sample of 414 participants (181 male, 233 female) were administered a measure of EI along with the Impact of Event Scale—revised [IES-R; Weiss, D. S. & Marmar, C. R. (1997). The Impact of Events Scale—revised. In J.P. Wilson & T.M. Keane (Eds.), Assessing

Nigel Hunt; Dee Evans

2004-01-01

447

Treatment of traumatic brain injury in pediatrics  

Microsoft Academic Search

Opinion statement  The primary goal in treating any pediatric patient with severe traumatic brain injury (TBI) is the prevention of secondary\\u000a insults such as hypotension, hypoxia, and cerebral edema. Despite the publication of guidelines, significant variations in\\u000a the treatment of severe TBI continue to exist, especially in regards to intracranial pressure (ICP)-guided therapy. This variability\\u000a in treatment results mainly from a

Andranik Madikians; Christopher C. Giza

2009-01-01

448

Managing traumatic brain injury secondary to explosions  

PubMed Central

Explosions and bombings are the most common deliberate cause of disasters with large numbers of casualties. Despite this fact, disaster medical response training has traditionally focused on the management of injuries following natural disasters and terrorist attacks with biological, chemical, and nuclear agents. The following article is a clinical primer for physicians regarding traumatic brain injury (TBI) caused by explosions and bombings. The history, physics, and treatment of TBI are outlined. PMID:20606794

Burgess, Paula; E Sullivent, Ernest; M Sasser, Scott; M Wald, Marlena; Ossmann, Eric; Kapil, Vikas

2010-01-01

449

Acute Traumatic Injuries in Rural Populations  

PubMed Central

In the United States, injuries are the leading cause of death among individuals aged 1 to 45 years and the fourth leading cause of death overall. Rural populations exhibit disproportionately high injury mortality rates. Deaths resulting from motor vehicle crashes, traumatic occupational injuries, drowning, residential fires, and suicide all increase with increasing rurality. We describe differences in rates and patterns of injury among rural and urban populations and discuss factors that contribute to these differences. PMID:15451733

Peek-Asa, Corinne; Zwerling, Craig; Stallones, Lorann

2004-01-01

450

Post-traumatic headache: facts and doubts  

Microsoft Academic Search

The International Classification of Headache Disorders does not separate the moderate from severe\\/very severe traumatic brain\\u000a injury (TBI), since they are all defined by Glasgow coma scale (GCS) < 13. The distinction between the severe and very severe\\u000a TBI (GCS < 8) should be made upon coma duration that in the latter may be longer than 15 days up to months in the case of

Rita Formisano; Umberto Bivona; Sheila Catani; Mariagrazia D’Ippolito; M. Gabriella Buzzi

2009-01-01

451

Traumatic hemipelvectomy: case report and literature review.  

PubMed

A case of traumatic hemipelvectomy with survival is presented, apparently the sixth reported case in the literature. Following complete left hemipelvectomy and fracture of the right acetabulum, the patient recovered, demonstrated voluntary bowel and urinary control, was full weight bearing on crutches (against advice), and refused a bucket seat or prosthesis, as well as neurosurgical consultation. The patient was then unfortunately lost to followup. PMID:1127788

Meester, G L; Myerley, W H

1975-06-01

452

Spatial cytokine distribution following traumatic injury.  

PubMed

Temporal changes in cytokine concentrations following traumatic injuries have been extensively studied. Less is known regarding spatial differences in cytokine concentrations following traumatic injury. The primary aim of this study was to determine the spatial relationship between cytokines and the zone of injury (ZOI). Muscle and vessel tissues obtained from rats subjected to an open femoral fracture were analyzed to determine if spatial cytokine gradients exist that could potentially be used as biomarkers of the ZOI. Samples were collected at 4 time points following fracture from 3 distinct locations: at the fracture site, 1-cm away from the fracture, and from the opposite leg. The concentrations of IL-6, IL-1?, IL-1ß, IL-2, GM-CSF, TNF-?, and MIP-1? were quantified in each sample. Temporally and spatially regulated variations in cytokine concentrations were found. IL-6 showed the most promise as a ZOI biomarker with statistically different spatial concentrations that were inversely proportional to the distance from the fracture in both tissues. IL-1ß and IL-2 also showed spatial differences in concentration in both tissues, while GM-CSF, MIP-1?, and TNF-? showed spatial differences in vessel samples. These results demonstrate that spatial cytokine gradients exist following traumatic injury, representing potential biomarkers that may be used to define the ZOI. PMID:24461742

Currie, Holly N; Loos, Matthew S; Vrana, Julie A; Dragan, Kristen; Boyd, Jonathan W

2014-04-01

453

Client-centred therapy, post-traumatic stress disorder and post-traumatic growth: theoretical perspectives and practical implications.  

PubMed

In practice it is not unusual for client-centred therapists to work with people who have experienced traumatic events. However, client-centred therapy is not usually considered within texts on traumatic stress and questions have been raised over the appropriateness of client-centred therapy with trauma survivors. The present study shows how, although he was writing well before the introduction of the term 'post-traumatic stress disorder', Carl Rogers provided a theory of therapy and personality that contains an account of threat-related psychological processes largely consistent with contemporary trauma theory. Rogers' theory provides the conceptual underpinnings to the client-centred and experiential ways of working with traumatized people. Furthermore, Rogers' theory provides an understanding of post-traumatic growth processes, and encourages therapists to adopt a more positive psychological perspective to their understanding of how people adjust to traumatic events. PMID:15025907

Joseph, Stephen

2004-03-01

454

[Diagnostic and treatment patterns in management of male patients with nongonococcal urethritis: results of Russian multicentral cross-sectional study].  

PubMed

The aim of the study was to estimate the diagnostic and treatment patterns in the management of acute nongonococcal urethritis (NGU) in males in some cities of Russia. Retrospective cross-sectional study was conducted in 2009 in 5 centers of 4 cities in the Central Part of Russia (Kaluga, Pskov, Smolensk - 2 centres and Tula). The data on the diagnostic and treatment approaches to the management of NGU in male subjects >16 years old were collected and analyzed with the use of specially designed case report forms. 556 cases of acute urethritis were analyzed during the study. The diagnosis of NGU was confirmed in 401 cases. The average age of the patients was 29.8 years (16-68 years). The following diagnostic methods were used in 95% of the cases: urethral smear microscopy (314/82.4%), C. trachomatis - PCR (113/29.7%), ELISA (155/40.7%); T. vaginalis - PCR (106/27.8%); U. urealyricum and M. hominis, respectively - bacteriology (140/36.7% and 126/33.1%), PCR (110/28.9% and 108/28.3%); M. genitalium - PCR (110/28.9%). The treatment patterns included antimicrobials AMs alone in 60.3, and AMs + non-AMs in 37.8% of the cases. The most frequently prescribed AMs were azithromycin (27.5%), fluconazole (16.4%), doxycycline (13.6%), metronidazole (11.2%), ofloxacine (7.3%), ceftriaxone (4.4%), josamycin (4.2). According to the results use of the standard methods for NGU diagnosis was rather rare. The use of PCR for atypical pathogens was the following: C. trachomatis 29.7%, U. urealyticum 36.7%, M. hominis 28.9%, M. genitalium 28.3%. Doubtful culture methods were used for detection of U. urealyticum and M. hominis (36.7% and 33.1%). The AMs treatment in some cases was not in compliance with the up-to-date practical guidelines for STD and NGU. PMID:23156042

Andreeva, I V; Kozlov, S N; Korolev, S V; Belikov, A N; Grinev, A V; Evstaf'ev, V V; Kirpicheva, N N; Serdiutskaia, M V; Stetsiuk, O U; Fokin, A A; Khrianin, A A

2012-01-01

455

Evidence-Based Medicine of Traumatic Thoracolumbar Burst Fractures: A Systematic Review of Operative Management across 20 Years.  

PubMed

Study Design?Systematic literature review. Objective?The management of traumatic thoracolumbar burst fractures (TLBF) remains challenging, and analyzing the levels of evidence (LOEs) for treatment practices can reform the decision-making process. However, no review has yet evaluated the operative management of traumatic thoracolumbar burst fractures with particular attention placed on LOE from an established methodology. The objective of the present study was to characterize the literature evidence for TLBF, specifically for operative management. Methods?A comprehensive search of the English literature over the past 20 years was conducted using PubMed (MEDLINE). The inclusion criteria consisted of (1) traumatic burst fractures (2) in the thoracic or lumbar spine. Exclusion criteria included (1) osteoporotic burst fractures, (2) pathologic burst fractures, (3) cervical fractures, (4) biomechanical studies or those involving cadavers, and (5) computer-based studies. Studies were assigned an LOE and those meeting level 1 or 2 were included. Results?From 1,138 abstracts, 272 studies met the criteria. Twenty-three studies (8.5%) met level 1 (n?=?4, 1.5%) or 2 (n?=?19, 7.0%) criteria. All 23 studies were reported. Conclusions?The literature contains a high LOE to support the operative management of traumatic thoracolumbar burst fractures. For patients who are neurologically intact, a high LOE demonstrated similar functional outcomes, lower complication rates, and less costs with conservative management when compared with surgical management. There is a high LOE for short- or long-segment pedicle instrumentation without fusion and less invasive (percutaneous and paraspinal) approaches. Furthermore, the posterior approaches are associated with lower complications as opposed to the anterior or combined approaches. PMID:25648401

Scheer, Justin K; Bakhsheshian, Joshua; Fakurnejad, Shayan; Oh, Taemin; Dahdaleh, Nader S; Smith, Zachary A

2015-02-01

456

The effect of the homoeopathic similimum in post traumatic stress disorder .  

E-print Network

??This research involved the holistic, individualized treatment of patients with post traumatic stress disorder (PTSD), employing homoeopathic medicine. Post traumatic stress disorder can lead to… (more)

Lankesar, Yasmeen

2008-01-01

457

78 FR 13600 - Proposed Priority-National Institute on Disability and Rehabilitation Research-Traumatic Brain...  

Federal Register 2010, 2011, 2012, 2013

...rehabilitation therapy for traumatic brain injury: Evaluating the evidence...Cognitive-Rehabilitation-Therapy-for-Traumatic-Brain-Injury-Evaluating-the-Evidence...war on terror. Archives of Physical Medicine and...

2013-02-28

458

Predictors of post-traumatic stress symptoms in oklahoma city: Exposure, social support, peri-traumatic responses  

Microsoft Academic Search

Eighty-five adults seeking mental health assistance six months after the Oklahoma City bombing were assessed to determine which of three groups of variables (exposure, peri-traumatic responses, and social support) predicted development of post-traumatic stress disorder (PTSD) symptoms. Variables most highly associated with subsequent PTSD symptoms included having been injured (among exposure variables), feeling nervous or afraid (peri-traumatic responses), and responding

Phebe Tucker; Betty Pfefferbaum; Sara Jo Nixon; Warren Dickson

2000-01-01

459

Posterior regeneration in Isodiametra pulchra (Acoela, Acoelomorpha)  

PubMed Central

Introduction Regeneration is a widespread phenomenon in the animal kingdom, but the capacity to restore damaged or missing tissue varies greatly between different phyla and even within the same phylum. However, the distantly related Acoelomorpha and Platyhelminthes share a strikingly similar stem-cell system and regenerative capacity. Therefore, comparing the underlying mechanisms in these two phyla paves the way for an increased understanding of the evolution of this developmental process. To date, Isodiametra pulchra is the most promising candidate as a model for the Acoelomorpha, as it reproduces steadily under laboratory conditions and is amenable to various techniques, including the silencing of gene expression by RNAi. In order to provide an essential framework for future studies, we report the succession of regeneration events via the use of cytochemical, histological and microscopy techniques, and specify the total number of cells in adult individuals. Results Isodiametra pulchra is not capable of regenerating a new head, but completely restores all posterior structures within 10 days. Following amputation, the wound closes via the contraction of local muscle fibres and an extension of the dorsal epidermis. Subsequently, stem cells and differentiating cells invade the wound area and form a loosely delimited blastema. After two days, the posterior end is re-patterned with the male (and occasionally the female) genital primordium being apparent. Successively, these primordia differentiate into complete copulatory organs. The size of the body and also of the male and female copulatory organs, as well as the distance between the copulatory organs, progressively increase and by nine days copulation is possible. Adult individuals with an average length of 670 ?m consist of approximately 8100 cells. Conclusion Isodiametra pulchra regenerates through a combination of morphallactic and epimorphic processes. Existing structures are “re-modelled” and provide a framework onto which newly differentiating cells are added. Growth proceeds through the intercalary addition of structures, mirroring the embryonic and post-embryonic development of various organ systems. The suitability of Isodiametra pulchra for laboratory techniques, the fact that its transcriptome and genome data will soon be available, as well as its small size and low number of cells, make it a prime candidate subject for research into the cellular mechanisms that underlie regeneration in acoelomorphs. PMID:24160844

2013-01-01

460

LOCAL SENSITIVITY, FUNCTIONAL DERIVATIVES AND NONLINEAR POSTERIOR QUANTITIES  

E-print Network

LOCAL SENSITIVITY, FUNCTIONAL DERIVATIVES AND NONLINEAR POSTERIOR QUANTITIES by Sanjib Basu 1 University of Arkansas, Fayetteville, AR 72701 February, 1994 Abstract The local sensitivity of a posterior quantities are established under these definitions. Local sensitivity is measured by maxi­ mizing

Basu, Sanjib