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Sample records for achieving urinary continence

  1. Achieving urinary continence in children.

    PubMed

    Wu, Hsi-Yang

    2010-07-01

    Achievement of urinary continence is an important developmental step that most children attain with the assistance of their parents and caregivers. Debate continues as to the best time to toilet train; in some Asian and African cultures children are trained as infants, while training at age 2-3 years is more typical in Western cultures. Infant voiding is not merely a spinal reflex, as the sensation of bladder filling is relayed to the brain. However, the ability of the brain to inhibit bladder contractions, and to achieve coordinated bladder contraction with sphincter relaxation, matures over time. While there is a concern that later toilet training may be responsible for an increase in urinary incontinence in children, no controlled studies on early versus late toilet training exist to evaluate this hypothesis. A number of medical conditions such as spina bifida, posterior urethral valves, cerebral palsy and autism can cause incontinence and difficulties in toilet training. The decision to start toilet training a child should take into account both the parents' expectation of how independent the child will be in terms of toileting, and the child's developmental readiness, so that a realistic time course for toilet training can be implemented.

  2. Evolution of the Indiana continent urinary reservoir.

    PubMed

    Rowland, R G; Kropp, B P

    1994-12-01

    The Indiana continent urinary diversion evolved from the Gilchrist procedure. Full detubularization of the reservoir segment, tapering of the efferent limb with staples, plication of the ileocecal valve, and tunneled tenial implants have resulted in a reliable and reproducible continent cutaneous urinary reservoir. In this report the first 69 patients treated with these techniques are reviewed after a minimum 2-year followup. Overall day and night continence rates were 97% by 1 year after surgery. More than 80% of all patients are able to sleep a normal nighttime interval without catheterizing or leaking. Early plus late reoperation rates for problems related to the pouch were 17%. This rate compares favorably to other series of continent cutaneous reservoirs and even to series of ileal conduits. PMID:7966719

  3. 21 CFR 876.5280 - Implanted mechanical/hydraulic urinary continence device.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  4. 21 CFR 876.5280 - Implanted mechanical/hydraulic urinary continence device.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

  5. 21 CFR 876.5280 - Implanted mechanical/hydraulic urinary continence device.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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

  6. 21 CFR 876.5280 - Implanted mechanical/hydraulic urinary continence device.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Implanted mechanical/hydraulic urinary continence....5280 Implanted mechanical/hydraulic urinary continence device. (a) Identification. An implanted mechanical/hydraulic urinary continence device is a device used to treat urinary incontinence by...

  7. 21 CFR 876.5280 - Implanted mechanical/hydraulic urinary continence device.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Implanted mechanical/hydraulic urinary continence....5280 Implanted mechanical/hydraulic urinary continence device. (a) Identification. An implanted mechanical/hydraulic urinary continence device is a device used to treat urinary incontinence by...

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

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Implanted electrical urinary continence device. 876.5270 Section 876.5270 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices §...

  9. 21 CFR 876.5270 - Implanted electrical urinary continence device.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Implanted electrical urinary continence device. 876.5270 Section 876.5270 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices §...

  10. 21 CFR 876.5270 - Implanted electrical urinary continence device.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

  11. 21 CFR 876.5270 - Implanted electrical urinary continence device.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Implanted electrical urinary continence device. 876.5270 Section 876.5270 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices §...

  12. 21 CFR 876.5270 - Implanted electrical urinary continence device.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Implanted electrical urinary continence device. 876.5270 Section 876.5270 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices §...

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

    PubMed Central

    2016-01-01

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

  14. Does menopausal status impact urinary continence outcomes following abdominal sacrocolpopexy without anti-incontinence procedures in continent women?

    PubMed Central

    Inan, Abdurrahman Hamdi; Toz, Emrah; Beyan, Emrah; Gurbuz, Tutku; Ozcan, Aykut; Oner, Oznur

    2016-01-01

    Objective: We investigated the impact of menopausal status on urinary continence following abdominal sacrocolpopexy (ASC) without an anti-incontinence procedure in continent women. Methods: We conducted a clinical follow-up study of 137 patients diagnosed with stage 3 or higher pelvic organ prolapse (POP) without urinary incontinence between January 2012 and December 2014. Patients were provided with detailed a priori information pertaining to the abdominal sacrocolpopexy procedure and were invited to attend follow-up visits at 1, 3, 12, and 24 months. Follow-up visits included a gynecological examination, cough test, and validated Urinary Distress Inventory-6 (UDI-6) and Incontinence Impact Questionnaire-7 (IIQ-7) questionnaires. Results: The mean follow-up time for the cohort was 16.5±3.45 months. The study group was divided according to menopausal status: premenopausal (Group-1) and postmenopausal women (Group-II). Anatomical recurrence was not detected during the follow-up period in either group, but de novo stress urinary incontinence was seen in 15 of 53 (28.3%) Group-I patients and in 6 of 84 (7.1%; p < 0.01) Group-II patients. Conclusions: The risk of de novo stress urinary incontinence in postmenopausal women after ASC is low. However, premenopausal patients have a higher incidence of de novo stress incontinence which affect quality of life. PMID:27648027

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

    2014-01-01

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

  17. The integrated continence system: a manual therapy approach to the treatment of stress urinary incontinence.

    PubMed

    Grewar, Heather; McLean, Linda

    2008-10-01

    Stress urinary incontinence (SUI) constitutes a large-scale public health concern. The integrated continence system (ICS) developed by the authors is an evidence-based model that demonstrates how urinary incontinence is maintained through the interaction of three structural systems (intrinsic urethral closure, urethral support and lumbopelvic stability) and three modifiable factors (motor control, musculoskeletal and behavioural). The purpose of the ICS is first, to demonstrate the important role that manual physiotherapists can play in the treatment of SUI and second, to guide clinical practice decisions in order to improve clinical outcomes among women with SUI.

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

    SciTech Connect

    Brand, E. )

    1991-09-01

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

  19. The association between urinary continence and quality of life in paediatric patients with spina bifida and tethered cord

    PubMed Central

    Olesen, Jamie D; Kiddoo, Darcie A; Metcalfe, Peter D

    2013-01-01

    OBJECTIVE: To determine the association between urinary continence and quality of life (QoL) in a paediatric spina bifida population. METHODS: After appropriate ethics approval, a prospective study was initiated using multiple validated QoL instruments that were distributed to patients as they presented for their annual appointment at the Northern Alberta Spina Bifida Clinic (Edmonton, Alberta). General demographic information was collected and validated questionnaires were used. The survey package included two instruments to assess overall QoL: Global Pediatric QoL (PedsQL 4.0) and Health Specific QoL-Spina Bifida (HRQoL-SB). Two instruments were also included to quantify urinary symptoms and assess urinary specific QoL: the Urinary Incontinence Severity Index – Pediatric (ISI-P) and Urinary Specific QoL (PinQ). RESULTS: A total of 71 patients were enrolled in the study. The general QoL (PedsQL 4.0) and health-specific QoL (HRQoL-SB) scores for the population indicated an overall QoL of 66% (n=69) and 83% (n=67), respectively. Approximately 46% (33 of 71) reported >1 episode of urinary incontinence per week. Urinary continence was associated with a significantly higher urinary-specific QoL (PinQ; P<0.001), general QoL (PedsQL 4.0; P<0.05) and health-specific QoL (HRQoL-SB; P<0.05). Furthermore, urinary incontinence and its effect on QoL was not influenced by the presence of a shunt, level of the lesion or manner of dysraphism. CONCLUSION: These data suggest that QoL in patients with spina bifida is related to urinary continence. This effect appears to be independent of the type and level of the spinal dysraphism and the presence or absence of a shunt. PMID:24421717

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

    Kaggwa, S.; Galukande, M.

    2014-01-01

    Background. Open retropubic radical prostatectomy is a commonly performed procedure for clinically localized prostate cancer. The demand for high level functional outcomes after therapy is increasing especially for young age patients; in this regard refinements in the surgical technique have been made. There is limited data to show the success of some of these refinements in resource limited settings. Methods. A retrospective clinical study was performed over a 2-year period at Mengo Hospital, Urology Unit. Men with clinically localized prostate cancer and who consented to the procedure were eligible and were recruited. Consequently excluded were those that turned out to have advanced disease and those with severe comorbidities. Patients were followed up for 3 months after surgery. Data was entered using SPSS version 17 and analyzed. Results. A total of 24 men with clinically localized prostate cancer underwent open retropubic puboprostatic ligament preserving radical prostatectomy technique. Mean age was 66, range 54–75 years. Outcome. Two patients had stress incontinence and three were incontinent at 3 months. The urinary continence recovery rate was 19/24 (79%) at 3 months. Conclusion. Preservation of the puboprostatic ligament in open retropubic radical prostatectomy was associated with rapid and a high rate of return to urinary continence among men with clinically localized disease. PMID:27382635

  5. Urinary Continence after Robot-Assisted Laparoscopic Radical Prostatectomy: The Impact of Intravesical Prostatic Protrusion

    PubMed Central

    Jo, Jung Ki; Hong, Sung Kyu; Byun, Seok-Soo; Zargar, Homayoun; Autorino, Riccardo

    2016-01-01

    Purpose To assess the impact of intravesical prostatic protrusion (IPP) on the outcomes of robot-assisted laparoscopic prostatectomy (RALP). Materials and Methods The medical records of 1094 men who underwent RALP from January 2007 to March 2013 were analyzed using our database to identify 641 additional men without IPP (non-IPP group). We excluded 259 patients who presented insufficient data and 14 patients who did not have an MRI image. We compared the following parameters: preoperative transrectal ultrasound, prostate specific antigen (PSA), clinicopathologic characteristics, intraoperative characteristics, postoperative oncologic characteristics, minor and major postoperative complications, and continence until postoperative 1 year. IPP grade was stratified by grade into three groups: Grade 1 (IPP≤5 mm), Grade 2 (5 mm10 mm). Results Of the 821 patients who underwent RALP, 557 (67.8%) experienced continence at postoperative 3 months, 681 (82.9%) at 6 months, and 757 (92.2%) at 12 months. According to IPP grade, there were significant differences in recovering full continence at postoperative 3 months, 6 months, and 12 months (p<0.001). On multivariate analysis, IPP was the most powerful predictor of postoperative continence in patients who underwent RALP (p<0.001). Using a generalized estimating equation model, IPP also was shown to be the most powerful independent variable for postoperative continence in patients who underwent RALP (p<0.001). Conclusion Patients with low-grade IPP have significantly higher chances of recovering full continence. Therefore, the known IPP grade will be helpful during consultations with patients before RALP. PMID:27401645

  6. The role of interventional radiology in the management of intra-and extra-Peritoneal leakage in patients who have undergone continent urinary diversion

    SciTech Connect

    Bodner, Leonard; Nosher, John L.; Siegel, Randall; Russer, Tadeus; Cummings, Kenneth; Kraus, Stephen

    1997-07-15

    Purpose. To assess how radiologic intervention altered the hospital course of patients undergoing continent urinary diversion. Methods. Thirty-seven consecutive patients with bladder cancer invading the muscular layer were treated with total cystectomy and construction of a continent urinary reservoir. Eleven of 37 patients suffered early and late anastomotic leakage; six had prolonged extraperitoneal leakage at the urethroenteric anastomosis, three had prolonged intraperitoneal pouch leaks, and two had delayed ureteroenteric leaks. Seven of these patients required radiologic intervention.Results. Intervention in the form of drainage catheter manipulation (n=4), percutaneous nephrostomy (n=4), or ureteral stent placement (n=2) resulted in cessation of leakage without surgical intervention in all seven patients. Intraperitoneal pouch leaks were more difficult to control than extraperitoneal leakage and required longer drainage intervals.Conclusion. Interventional radiologic procedures played a key role in the management of continent urinary diversion complications obviating the need for repeat surgical intervention in all instances.

  7. A novel method of bladder neck imbrication to improve early urinary continence following robotic-assisted radical prostatectomy.

    PubMed

    Beattie, K; Symons, J; Chopra, S; Yuen, C; Savdie, R; Thanigasalam, R; Haynes, A M; Matthews, J; Brenner, P C; Rasiah, K; Sutherland, R L; Stricker, P D

    2013-06-01

    Early return of continence forms an important component of quality of life for patients after robotic-assisted radical prostatectomy (RALP). Here we describe the steps of bladder neck imbrication and vesico-urethral anastomosis improving early continence after RALP. Between April 2008 and July 2009, 202 consecutive patients underwent RALP for clinically localised prostate cancer in a tertiary referral centre by a single surgeon. One hundred and thirty-two (65 %) of these patients agreed to participate in the study. Prior to November 2008, 51 patients underwent standard RALP as described by Patel et al. From November 2008, 81 patients underwent a novel method of bladder neck imbrication. The robotic urethro-vesical anastomosis commences on the posterior wall of the urethra and proceeds anteriorly. In our technique the anastomosis is halted with the suture arms fixed to the anterior abdominal wall. A new suture is used to perform a two-layer repair, anchoring proximally then continuing anteriorly to the level of the urethral stump, where it returns upon itself. The aim is to narrow the urethra to 16 Fr and tighten the second layer to create an imbrication effect. Posterior reconstruction was performed in all patients. Outcome measures were recorded prospectively using the Expanded Prostate Cancer Index Composite tool. Our technique shows significant improvement at all stages of follow-up in urinary summary and incontinence scores. Absolute continence rates increased from 8.2 to 20.5 %, 26.7 to 44.3 %, and 47.7 to 62.3 % at 1.5, 3 and 6 months, respectively. These results support the use of our technique in patients undergoing RALP. PMID:27000912

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

    PubMed Central

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

    2015-01-01

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

  9. A new theory of micturition and urinary continence based on histomorphological studies. 3. The two parts of the musculus sphincter urethrae: physiological importance for continence in rest and stress.

    PubMed

    Dorschner, W; Stolzenburg, J U

    1994-01-01

    The urethral component of continence is the object of a lively discussion. A large number of the examiners interpret the external striated urethral muscle as part of the muscular pelvic diaphragm, formed partially or completely by the so-called musculus transversus perinei profundus. About 30,000 histological sections have been examined by light microscopy in a systematical manner. In contrast to numerous suggestions in the literature the musculus sphincter urethrae has been found to be an independent morphological unit in our investigation. It is separated from the surroundings by a segment of connective tissue. Furthermore, with the help of transversal, sagittal and frontal serial sections it was possible to show that the musculus transversus perinei profundus does not exist. In the female as well as in the male in the direction of the urethra the outer sphincter always borders on a layer of smooth muscle cells. In order to distinguish both parts the terms musculus sphincter urethrae transversostriatus and musculus sphincter urethrae glaber are introduced. In the context of a new continence theory three structures capable of occluding the urinary bladder will be discussed. It should be emphasized that the musculus sphincter urethrae glaber makes long-term continence possible.

  10. Quality of life after radical cystectomy for bladder cancer in men with an ileal conduit or continent urinary diversion: A comparative study

    PubMed Central

    Asgari, M. A.; Safarinejad, M. R.; Shakhssalim, N.; Soleimani, M.; Shahabi, A.; Amini, E.

    2013-01-01

    Aim: To investigate quality of life (QoL) domains with three forms of urinary diversions, including ileal conduit, MAINZ pouch, and orthotopic ileal neobladder after radical cystectomy in men with muscle-invasive bladder cancer. Materials and Methods: In a prospective study, 149 men underwent radical cystectomy and urinary diversion (70 ileal conduit, 16 MAINZ pouch, and 63 orthotopic ileal neobladder). Different domains of QoL, including general and physical conditions, psychological status, social status, sexual life, diversion-related symptoms, and satisfaction with the treatment were assessed using an author constructed questionnaire. Assessment was performed at three months postoperatively. Results: In questions addressing psychological status, social status, and sexual life, patients with continent diversion had a more favorable outcome (P = 0.002, P = 0.01, and P = 0.002, respectively). The rate of erectile dysfunction did not differ significantly between the three groups (P = 0.21). The rate and global satisfaction was higher with the MAINZ pouch (68.7%) and ileal neobladder (76.2%) as compared with the ileal conduit group (52.8%) (P = 0.002). Conclusion: Continent urinary diversion after radical cystectomy provides better results in terms of QoL as compared with ileal conduit diversion. PMID:24049384

  11. Preserving continence during robotic prostatectomy.

    PubMed

    Ahlering, Thomas E; Gordon, Adam; Morales, Blanca; Skarecky, Douglas W

    2013-02-01

    Preservation of postoperative urinary continence remains the primary concern of all men and their surgeons following robot-assisted radical prostatectomy (RARP). Without doubt, continence is the most important quality of life issue following radical prostatectomy. Identification of difficulties and lessons learned over time has helped focus efforts in order to improve urinary quality of life and continence. This review will examine definitions of continence and urinary quality of life evaluation, technical aspects and the impact of patient-related factors affecting time to and overall continence.

  12. Continent vesicovaginal fistula

    PubMed Central

    de Toledo, Luís Gustavo Morato; Santos, Victor Espinheira; Maron, Paulo Eduardo Gourlat; Vedovato, Bruno César; Fucs, Moacyr; Perez, Marjo Deninson Cardenuto

    2013-01-01

    ABSTRACT Vesicovaginal fistula is an abnormal communication between the bladder and vagina and represents the most frequent type of fistula in the urinary tract. The most common cause in Brazil is iatrogenic fistula, secondary to histerectomia. Classically these women present continuous urinary leakage from the vagina and absence of micturition, with strong negative impact on their quality of life. We present a case of totally continent vesicovaginal fistula, with a follow-up of 11 years with no complications. PMID:23579756

  13. The mechanism of continence after posterior urethroplasty

    PubMed Central

    Bagga, Herman S.; Angermeier, Kenneth W.

    2015-01-01

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

  14. 21 CFR 876.5320 - Nonimplanted electrical continence device.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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

  15. 21 CFR 876.5320 - Nonimplanted electrical continence device.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

  16. 21 CFR 876.5320 - Nonimplanted electrical continence device.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  17. 21 CFR 876.5320 - Nonimplanted electrical continence device.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

  18. 21 CFR 876.5320 - Nonimplanted electrical continence device.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

  19. MONTI as continent catheterized stoma using serosal-lined trough “Ghoneim Abolenin” technique in ileocystoplasty

    PubMed Central

    Sammour, Mohammed T.; Ajjaj, Abdulbari Bin

    2011-01-01

    It is a great challenge to select and perform continent mechanism in a stoma for urinary reservoir. A new technique by combining MONTI ileal conduit with the serosal lined trough in order to achieve continent catheterizable stoma to the umbilicus as a part of augmentation ileocystoplasty. We applied serosal-lined trough as a continent mechanism with MONTI ileal tube in 12 years smart girl underwent ileocystoplasty for neuropathic bladder due to meylomeningocele in whom continence failed to be achieved by using Mitrofanoff with submucosal tunnel of the bladder as continent mechanism before, also the previous operation included left to right transuretero-ureterostomy, ureterocystoplasty and reimplantation of the right ureter. The patient became completely continent; she was able to do self-catheterization easily through the umbilical stoma using 16-French catheter and was able to wash the mucous easily. The capacity of the augmented bladder was 300ccs. She became independent from her mother and stopped using diapers, anticholinergic and antibiotics. Combining MONTI conduit with serosal-lined extramural valve trough (The Ghoneim technique) is an effective continent technique and gives wider channel for catheterization and washing out the mucous. PMID:21346831

  20. Anatomy and histology of the lower urinary tract.

    PubMed

    Pradidarcheep, Wisuit; Wallner, Christian; Dabhoiwala, Noshir F; Lamers, Wouter H

    2011-01-01

    The function of the lower urinary tract is basically storage of urine in the bladder and the at-will periodic evacuation of the stored urine. Urinary incontinence is one of the most common lower urinary tract disorders in adults, but especially in the elderly female. The urethra, its sphincters, and the pelvic floor are key structures in the achievement of continence, but their basic anatomy is little known and, to some extent, still incompletely understood. Because questions with respect to continence arise from human morbidity, but are often investigated in rodent animal models, we present findings in human and rodent anatomy and histology. Differences between males and females in the role that the pelvic floor plays in the maintenance of continence are described. Furthermore, we briefly describe the embryologic origin of ureters, bladder, and urethra, because the developmental origin of structures such as the vesicoureteral junction, the bladder trigone, and the penile urethra are often invoked to explain (clinical) observations. As the human pelvic floor has acquired features in evolution that are typical for a species with bipedal movement, we also compare the pelvic floor of humans with that of rodents to better understand the rodent (or any other quadruped, for that matter) as an experimental model species. The general conclusion is that the "Bauplan" is well conserved, even though its common features are sometimes difficult to discern.

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

    PubMed Central

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

    2015-01-01

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

  2. Our changing continent

    USGS Publications Warehouse

    ,

    1969-01-01

    Where were the land areas and oceans of the North American Continent one million years ago, compared to our present geography? Was North America always about the same size and shape as it is today? To answer these questions, we must construct maps of the lands and sea that existed during the past ages. This process of reconstructing ancient geography is called paleogeography (from the Greek word "palaios," meaning ancient).

  3. [Continence in low resections].

    PubMed

    Rosa, G; Girardi, S; Lolli, P; Ferrara, R; Fasoli, G L

    1994-01-01

    Anorectal function is an important problem after low anterior resection procedure. This paper reports the results from 14 patients undergoing to low resection at Surgical Pathology Institute of the University of Verona. In 12 cases the restoration of the bowel continuity has been obtained by colon-anal anastomosis (Parks Operation) and in 3 cases by colo-rectal anastomosis at the anorectal ring level. The patients have been examined in the preoperative and in the postoperative period by clinical and manometric study. The results confirm that low resection does not involve faecal continence.

  4. Percutaneous tibial nerve stimulation for the treatment of urinary frequency, urinary urgency, and urge incontinence: results from a community-based clinic.

    PubMed

    Wooldridge, Leslie Saltzstein

    2009-01-01

    Overactive bladder affects 16% of the adult population. This retrospective analysis evaluated the application of percutaneous tibial nerve stimulation (PTNS), a minimally invasive neuromodulation therapy, in a population of patients who failed to achieve adequate control of symptoms of urinary urgency, urinary frequency, and urinary incontinence with conservative treatments. A course of 12 PTNS sessions was prescribed and administered in the context of an independent community-based, nurse practitioner-led continence practice. The results of this analysis indicated that patients treated with PTNS therapy experienced statistically significant decreases in both day and night voids, and in episodes of urge incontinence. This study confirmed the results of previous studies indicating that PTNS therapy is a safe and effective treatment that can be successfully incorporated in a community-based setting.

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

    PubMed Central

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

    2015-01-01

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

  6. Effectiveness of continence promotion for older women via community organisations: a cluster randomised trial

    PubMed Central

    Tannenbaum, Cara; Agnew, Rona; Benedetti, Andrea; Thomas, Doneal; van den Heuvel, Eleanor

    2013-01-01

    Objectives The primary objective of this cluster randomised controlled trial was to compare the effectiveness of the three experimental continence promotion interventions against a control intervention on urinary symptom improvement in older women with untreated incontinence recruited from community organisations. A second objective was to determine whether changes in incontinence-related knowledge and new uptake of risk-modifying behaviours explain these improvements. Setting 71 community organisations across the UK. Participants 259 women aged 60 years and older with untreated incontinence entered the trial; 88% completed the 3-month follow-up. Interventions The three active interventions consisted of a single 60 min group workshop on (1) continence education (20 clusters, 64 women); (2) evidence-based self-management (17 clusters, 70 women); or (3) combined continence education and self-management (17 clusters, 61 women). The control intervention was a single 60 min educational group workshop on memory loss, polypharmacy and osteoporosis (17 clusters, 64 women). Primary and secondary outcome measures The primary outcome was self-reported improvement in incontinence 3 months postintervention at the level of the individual. The secondary outcome was change in the International Consultation on Incontinence Questionnaire (ICIQ) from baseline to 3-month follow-up. Changes in incontinence-related knowledge and behaviours were also assessed. Results The highest rate of urinary symptom improvement occurred in the combined intervention group (66% vs 11% of the control group, prevalence difference 55%, 95% CI 43% to 67%, intracluster correlation 0). 30% versus 6% of participants reported significant improvement respectively (prevalence difference 23%, 95% CI 10% to 36%, intracluster correlation 0). The number-needed-to-treat was 2 to achieve any improvement in incontinence symptoms, and 5 to attain significant improvement. Compared to controls, participants in the

  7. Do continence management strategies reduce falls? a systematic review.

    PubMed

    Batchelor, Frances A; Dow, Briony; Low, May-Ann

    2013-12-01

    Urinary incontinence is associated with increased fall risk, and fall prevention programs include recommendations to manage continence as one component of fall reduction. However, the evidence to support this recommendation is unclear. The aim of this study was to identify continence management interventions that are effective in decreasing falls. A systematic review of the literature was conducted. Studies were included if they evaluated the effect of any type of continence management strategy on falls in older adults. The included studies were assessed for quality, and data relating to participants, interventions and outcomes were extracted by two independent reviewers. Four articles met the inclusion criteria. Two studies were randomised controlled trials, one a retrospective cohort study and one an uncontrolled intervention study. Interventions included pharmacological agents, a toileting regime combined with physical activity and an individualised continence program. Only the study evaluating the combination of physical activity and prompted voiding found an effect on falls. It is surprising that there has been so little research into continence management interventions that include fall outcomes. A toileting regime combined with physical activity may reduce falls in residential care. There is a need for further studies investigating the impact of continence management on falls.

  8. Urinary Dysfunction

    MedlinePlus

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

  9. [Principles and indications of electrostimulation of the urinary bladder].

    PubMed

    Tanagho, E A

    1990-07-01

    Neurostimulation to restore the essential elements of lower urinary tract function is a very promising approach in the management of the neuropathic bladder. The goal of neurostimulation is to restore the three main functions of the lower urinary tract: the reservior capacity of the bladder, the sphincteric activity of the continence mechanism, and the ability of the bladder to evacuate completely. In extensive experimental studies conducted over the past 18 years, the physiological foundations of micturition and sphincteric control were investigated, which made the clinical application of neurostimulation in the management of the neurogenic bladder possible. In human studies, the essential experimental model of ventral root stimulation after dorsal rhizotomy and selective peripheral neurotomy proved to be the most successful. To date, over 220 patients have been treated, of whom 35 have spinal cord injury or severe neuropathy and received multiple sacral root implants. 25 of the 35 patients are evaluable, 15 (60%) of these achieved the three goals of the study: complete continence, restoration of reservoir function with adequate capacity, and voiding to neurostimulation with minimal residual urine or none. The remaining 185 patients with a variety of voiding dysfunctions classified under four main headings: 1) urge incontinence; 2) post-prostatectomy incontinence; 3) pelvic dysfunction syndrome in the male; 4) pelvic dysfunction syndrome in the female were treated by single electrode implantation in order to modulate spastic voiding dysfunction and pelvic floor activity. Success rates (improvement of 50% or more) were 72%, 38%, 46%, and 47% in the four groups, respectively.

  10. [Ultrasound of the urinary system].

    PubMed

    Segura-Grau, A; Herzog, R; Díaz-Rodriguez, N; Segura-Cabral, J M

    2016-09-01

    Ultrasound techniques are able to provide a fairly complete examination of the urinary system, achieving a high sensitivity in relevant-pathology detection, especially in the kidney, bladder and prostate. Early detection of pathologies such as tumors or urinary tract obstructions, sometimes even before their clinical manifestation, has improved their management and prognosis in many cases. This, added to its low cost and harmlessness, makes ultrasound ideal for early approaches and follow-up of a wide number of urinary system pathologies. In this article, the ultrasound characteristics of the main urinary system pathologies that can be diagnosed by this technique, are reviewed.

  11. [Ultrasound of the urinary system].

    PubMed

    Segura-Grau, A; Herzog, R; Díaz-Rodriguez, N; Segura-Cabral, J M

    2016-09-01

    Ultrasound techniques are able to provide a fairly complete examination of the urinary system, achieving a high sensitivity in relevant-pathology detection, especially in the kidney, bladder and prostate. Early detection of pathologies such as tumors or urinary tract obstructions, sometimes even before their clinical manifestation, has improved their management and prognosis in many cases. This, added to its low cost and harmlessness, makes ultrasound ideal for early approaches and follow-up of a wide number of urinary system pathologies. In this article, the ultrasound characteristics of the main urinary system pathologies that can be diagnosed by this technique, are reviewed. PMID:25982474

  12. Improving service provision for patients who are prescribed continence products.

    PubMed

    Mangnall, Joanne; Midgley, Kate; Lakin, Stuart; Beckitt, Liz; Shepherd, Laura

    2010-04-01

    It is estimated that 14 million people experience problems with bladder control and 6.5 million people have a bowel control problem (Bladder and Bowel Foundation, 2008). Many will rely on continence products to manage their problem and as such require products which ensure user dignity and discretion is maintained. Locally, an ever-increasing spend on prescribed continence products promoted a review of current service delivery. The combined results of a clinical audit and patient satisfaction survey highlighted areas in which service delivery needed immediate improvement. Significant service re-design has been undertaken with prescribing responsibility for continence-related products being transferred from GP practices to specialist nurses working within the continence service. Improvements in clinical care have been achieved and cost savings have been re-invested in the service. PMID:20559160

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

    PubMed

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

    2015-07-01

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

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

    ERIC Educational Resources Information Center

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

    2004-01-01

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

  15. Urinary Incontinence

    MedlinePlus

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

  16. Continence after posterior sagittal anorectoplasty.

    PubMed

    Langemeijer, R A; Molenaar, J C

    1991-05-01

    Posterior sagittal anorectoplasty (PSARP) was introduced in 1982 by Peña and De Vries as a new operation for patients with a high anorectal malformation. The degree of postoperative continence is reported to be high. During the past decade, too, new insights have been gained into the embryology of anorectal malformations. Evaluation of PSARP in relation to current understanding of the development and anatomy of the anorectum and the pelvic floor has led us to conclude that optimal continence cannot be expected. Fifty patients with a high anorectal malformation underwent PSARP between June 1983 and May 1990. Postoperative follow-up consisted of anamnesis (subjective) and electrostimulation, defecography, and anorectal manometry (objective). All patients are alive, and all but one are being evaluated regularly. Subjectively, the majority of patients were more or less incontinent, with soiling of pants at least once a day. On the basis of objective criteria, virtually all patients appeared to be incontinent, and in only one patient was the mechanism of defecation almost unimpaired after PSARP. From this study, we conclude that although PSARP provides a good aesthetic result, patients will never acquire normal continence.

  17. Urinary incontinence, catheters, and urinary tract infections: an overview of CMS tag F 315.

    PubMed

    Newman, Diane K

    2006-12-01

    The majority of nursing home residents experience some type of urinary incontinence. Other bladder-related disorders (eg, urinary retention and urinary tract infection) also are common in long-term care facilities. Efforts to manage urological conditions such as the use of indwelling catheters and absorbent products, perineal hygiene and care, toileting, and bladder rehabilitation are areas of concern and have become the subject of revised regulations. The intent of recent changes to the Centers for Medicare and Medicaid Services surveyor guidance for incontinence and urinary catheters is to ensure that: 1) incontinent residents are identified, assessed, and provided appropriate treatment, 2) indwelling catheters are not used without medical justification and removed as soon as clinically warranted, and 3) residents receive appropriate care to prevent urinary tract infections. Nursing homes must implement policies, procedures, and programs to help restore bladder function and continence in order to improve quality-of-life for nursing home residents.

  18. Improving continence services--a case study in policy influence.

    PubMed

    Thomas, Sue; Billington, Angela; Getliffe, Kathryn

    2004-07-01

    This article presents a case history of the process followed by a group of nurses who used their power and influence to improve the provision of continence services within the National Health Service in England. The process and outcomes demonstrate how nurses can achieve change using their political influence combined with a planned or evolving strategy. PMID:15209570

  19. Improving continence services--a case study in policy influence.

    PubMed

    Thomas, Sue; Billington, Angela; Getliffe, Kathryn

    2004-07-01

    This article presents a case history of the process followed by a group of nurses who used their power and influence to improve the provision of continence services within the National Health Service in England. The process and outcomes demonstrate how nurses can achieve change using their political influence combined with a planned or evolving strategy.

  20. Does previous transurethral prostate surgery affect oncologic and continence outcomes after RARP?

    PubMed

    Su, Yu-Kai; Katz, Benjamin F; Sehgal, Shailen S; Yu, Sue-Jean S; Su, Yu-Chen; Lightfoot, Andrew; Lee, Ziho; Llukani, Elton; Monahan, Kelly; Lee, David I

    2015-12-01

    We examined the effect of previous transurethral resection of the prostate (TURP) on multiple oncologic and continence outcomes after robotic-assisted radical prostatectomy (RARP). We performed a retrospective cohort study of a total of 2693 patients from 2007 to 2014 who underwent RARP. Patients were stratified into 49 patients who had previous TURP prior to RARP (group 1) and 2644 patients who had no TURP prior to RARP (group 2). We collected operative variables including estimated blood loss, operative time, and positive surgical margin (PSM) rates. Urinary continence, defined as 0 pads per day (PPD), and social continence, defined as 1-PPD, were also assessed. American Urological Association Symptoms Score (AUASS), overall ability to function sexually, and Expanded Prostate Cancer Index Composite (EPIC) questionnaire were evaluated at 3 and 12 months after RARP. Weakness of urinary stream (EPIC #4d) at 12 months imposed a greater problem for group 1 patients with prior TURP compared to group 2 patients without prior TURP (p = 0.012). PSM was not statistically significant between the two groups (p = 0.110). Group 1 patients had a greater PSM rate (30.61 %) as compared to group 2 (20.95 %). PSM locations in group 1 patients showed the most common locations at the posterior and apex. The difference between the two groups for AUASS, overall sexual function, estimated blood loss, operative time, urinary continence, and social continence was not statistically significant. We examined the effect of previous TURP on postoperative RARP continence and oncologic outcomes. This data can be used to counsel those with prior TURP before RARP. PMID:26530840

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

    PubMed Central

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

    2013-01-01

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

  2. Review of current technologies for urinary incontinence: strengths and limitations.

    PubMed

    Fader, M

    2003-01-01

    A wide range of continence products is available, and this paper focuses on products to prevent incontinence (such as urinals and commodes) and to contain or manage urinary incontinence (such as absorbent pads, penile sheaths and urethral catheters). Drawing on results from published clinical evaluations at the Continence Product Evaluation Network at UCL and at other centres, the strengths and limitations of the major categories of incontinence products currently on the market are reviewed. It is concluded that, although products for continence have improved considerably over the last 20 years, there is considerable scope for the designer and engineer to improve on current products. PMID:12885193

  3. [Urinary bilharziasis].

    PubMed

    Gigase, P L

    1992-01-01

    A short account is given of present views on urinary schistosomiasis or bilharziasis. The incidence of infections is increasing in endemic areas of Africa and the near east, as a consequence of irrigation programs and hydroelectric power development. Urinary schistosomiasis is a disease of children and young adults. The serious consequences, obstructive uropathy due to more or less irreversible ureteral lesions, and cancer of the bladder, less directly related to the infection, appear but later in life. Diagnosis is still based on parasitology and serology but ultrasonography has proven to be an important means to evaluate the extent of lesions of the urinary tract, especially in developing countries. Praziquantel was a major development in the medical treatment and cures easily the infection. Some irreversible consequences have however to be treated surgically. Schistosomiasis is still an important cause of morbidity and mortality in medically backward endemic countries. The control of the disease aims at reducing morbidity and mortality, consequences of the infection, rather than to avoid infection itself. It is based on mass treatment of school age children, together with focal molluscacides at places where people have contacts with water. Vaccination will be available in the near future and will be a welcome addition to other control measures, but will not be able to interrupt transmission on its own. Only economic development will solve in the long term this social African problem. PMID:1492630

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

  6. Female stress and urge incontinence in family practice: insight into the lower urinary tract.

    PubMed

    Viktrup, L

    2002-11-01

    As many as 25% of all women are affected by urinary incontinence, but only a few are treated. This frequent, often medically unrecognised, condition occurs in women of all ages. The continence mechanism is based on bladder detrusor control, intact anatomical structures in and around the urethra, correct positioning of the bladder neck and a comprehensive innervation of the lower urinary tract. Age and childbearing are established risk factors for the development of urinary incontinence, but other factors are currently suggested. The evaluation of urinary incontinence should include history, gynaecological examination, urine test, frequency-volume diary and a pad-weighing test. Female urinary incontinence can be treated in general practice by simple means, e.g. pelvic floor muscle training, bladder training, electrostimulation, drug therapy, or a combination of these approaches. This review updates the knowledge of the continence mechanism and summarises the epidemiology, risk factors, assessment and treatment of urinary incontinence in general practice.

  7. [Urinary calculi and infection].

    PubMed

    Trinchieri, Alberto

    2014-01-01

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

  8. Urinary catheter - infants

    MedlinePlus

    Bladder catheter - infants; Foley catheter - infants; Urinary catheter - neonatal ... A urinary catheter is a small, soft tube placed in the bladder. This article addresses urinary catheters in babies. WHY IS ...

  9. [The 4-stage continence-micturition cycle. The presentation of a urodynamic, diagnostic and therapeutic abacus].

    PubMed

    Lardennois, B; Clément, T; Coulon, J M; Brandt, B

    1990-01-01

    The complexity of the mode of operation of the bladder and urinary sphincter has led to the development of a number of temporospatial physiologic models that divide the process of micturition into several stages in order to facilitate investigations. Ten years ago, the authors described a two-stage continence-micturition model intended to improve the accuracy of studies of urodynamic disorders and thus contribute to the development of more effective and more rational therapeutic solutions. A large number of diseases can affect the distal urinary tract and recent advances in neurophysiology [10] have made the selection of the appropriate therapy extremely complex. Consequently, the authors have developed a decision analysis system that simultaneously confronts diseases, urodynamic manifestations, risks for the patient, and the main therapeutic approaches available. In 1985, they increased the number of stages in their continence-micturition model from two the four. This four-stage model has provided satisfactory result when used with an abacus for modeling observed biologic phenomena. In addition to offering simulation exercises for teaching purposes, this abacus provides the means for studying the instantaneous urodynamic situation (correspondences between cycle time points, symptoms, and effects of treatments) and determining the effect of various medicosocial events on the course of the bladder and sphincter dysfunction. The authors hope this abacus will be an attractive aide to the understanding of the complex function of the distal urinary tract.

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

    PubMed Central

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

    2015-01-01

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

  11. Urinary incontinence - injectable implant

    MedlinePlus

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

  12. The Kock continent ileostomy: a preliminary report.

    PubMed

    Failes, D

    1976-05-01

    A review is presented of seven patients who have undergone a continent type of ileostomy, as described by Professor Kock. There has been no mortality. Two of the early patients had considerable difficulty with the functioning of the valve and required re-operation. No patient in the series now wears an external appliance. Six of the seven are fully continent; the seventh reports occasional leakage, but is satisfied with the operation. The operation is considered to be still under trial, but is regarded as having great potential and likely to be much more widely practised in the future. PMID:1067068

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

    PubMed Central

    Harrison, G L; Memel, D S

    1994-01-01

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

  14. Vas deferens urethral support improves early post-prostatectomy urine continence.

    PubMed

    van der Poel, H G; De Blok, W; Van Muilekom, H A M

    2012-12-01

    Urine continence is often impaired after radical prostatectomy. Few randomized studies prove the efficacy of novel surgical approaches. Vas deferens urethral support (VDUS) during robot-assisted laparoscopic prostatectomy (RALP) was studied for improvement of early postoperative urine continence in a single-centre prospective double-blind randomized study with a power of 90% to detect a 30% decrease in early incontinence. 112 men were randomized, and 108 could be analyzed (VDUS n = 54, noVDUS n = 54). VDUS improved early continence by 40% at 1 month (59% vs. 35%, P = 0.02); 6 months postoperatively this was 72% vs. 62%, P = 0.41. A 24-h pad test at 1 day, 3 days, and 1 week showed decreased amounts of urine loss in the VDUS group. The ICIQ-SF score was significantly lower for the VDUS group within the first month after surgery. VDUS had no impact upon quality of life questionnaire analyses for overall and lower urinary tract symptom-related quality of life but showed a significant improvement in the social domain of the EORTC-QLQ-C30 questionnaire. VDUS moderately improved early urine continence within 1 month after RALP. PMID:27628467

  15. [Infection and urinary lithiasis].

    PubMed

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

    2008-12-01

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

  16. Stem cell therapy: a future treatment of stress urinary incontinence.

    PubMed

    Nikolavasky, Dmitriy; Stangel-Wójcikiewicz, Klaudia; Stec, Malgorzata; Chancellor, Michael B

    2011-01-01

    The main urinary continence mechanism in human is the striated muscle rhabdosphincter that forms a ring around the mid-urethra. Cellular therapy and the use of stem cells transplanted into the site of the rhabdosphincter in a setting of stress urinary incontinence (SUI) may augment sphincter regeneration. Implanted cells may also release trophic factors promoting muscle and nerve integration into this muscle. We review the use of cellular therapy for SUI and our experience with the development of muscle-derived stem cells.

  17. Understanding Barriers to Continence Care in Institutions

    ERIC Educational Resources Information Center

    Tannenbaum, Cara; Labrecque, Danielle; Lepage, Christiane

    2005-01-01

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

  18. African Universities Tackle the Continent's Agricultural Crisis

    ERIC Educational Resources Information Center

    Lindow, Megan

    2009-01-01

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

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

    PubMed

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

    2014-01-01

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

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

    PubMed Central

    Bakuła, Stanisław

    2014-01-01

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

  1. Spreading continents kick-started plate tectonics.

    PubMed

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

    2014-09-18

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

  2. Spreading continents kick-started plate tectonics.

    PubMed

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

    2014-09-18

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

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

    PubMed Central

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

    2011-01-01

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

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

    PubMed

    Roosen, Kerri; Fulbrook, Paul; Nowicki, Tracy

    2010-08-10

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

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

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Nonimplanted, peripheral electrical continence....5310 Nonimplanted, peripheral electrical continence device. (a) Identification. A nonimplanted, peripheral electrical continence device is a device that consists of an electrode that is connected by...

  6. 21 CFR 876.5030 - Continent ileostomy catheter.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Continent ileostomy catheter. 876.5030 Section 876...) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5030 Continent ileostomy catheter. (a) Identification. A continent ileostomy catheter is a flexible tubular device used as a...

  7. 21 CFR 876.5030 - Continent ileostomy catheter.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Continent ileostomy catheter. 876.5030 Section 876...) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5030 Continent ileostomy catheter. (a) Identification. A continent ileostomy catheter is a flexible tubular device used as a...

  8. 21 CFR 876.5030 - Continent ileostomy catheter.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Continent ileostomy catheter. 876.5030 Section 876...) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5030 Continent ileostomy catheter. (a) Identification. A continent ileostomy catheter is a flexible tubular device used as a...

  9. 21 CFR 876.5030 - Continent ileostomy catheter.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Continent ileostomy catheter. 876.5030 Section 876...) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5030 Continent ileostomy catheter. (a) Identification. A continent ileostomy catheter is a flexible tubular device used as a...

  10. Continence pads: have we got it right?

    PubMed

    Uchil, Dhiraj; Thakar, Ranee; Sultan, Abdul H; Seymour, Joy; Addison, Ray

    2006-05-01

    Women listed in the Croydon Community Continence database were contacted with a self-assessment questionnaire regarding continence pad usage and quality of life. Completed questionnaires were received from 763 of 1509 (51%) participants. Pads were used for bladder dysfunction (88.1%) and bowel dysfunction (44%). The majority (82.5%) had concurrent medical disorders and problems with mobility with 77.5% being on one or more types of medication. Nearly 39% of women claimed that they would be happy to continue pad use indefinitely and only 28% expressed interest in seeking further help. Compared to bowel dysfunction, bladder dysfunction appeared to have a greater impact on women's quality of life (P < 0.001). Containment products make a substantial contribution in improving the quality of lives of women with bowel and bladder dysfunction. The financial burden of containment products has a major impact on the health budget and therefore, comprehensive clinical evaluation should be mandatory before relegating women to pads as a final resort. PMID:15999216

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

    ERIC Educational Resources Information Center

    Simon, Jennifer L.; Thompson, Rachel H.

    2006-01-01

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

  12. Is osteitis pubis associated with the use of bone anchors in urinary continence operations?

    PubMed

    Chung, T; Slippe-Quartey, J; Beacon, J; Kane, L

    2000-11-01

    We studied 130 patients who underwent either a vaginal needle suspension procedure or a pubofascial sling procedure with Mitek titanium bone anchors to determine the association of osteitis pubis with bone anchoring in these procedures. Fifteen patients complained of postoperative suprapubic pain; five cases were due to wound infections and another five were associated with tying the suspension sutures too tightly. We suggest the use of the term 'periostitis pubis' to describe the remaining five patients who suffered suprapubic pain. We found no radiological evidence of osteitis pubis in any patients.

  13. Imaging Lithospheric Structure beneath the Indian continent

    NASA Astrophysics Data System (ADS)

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

    2015-12-01

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

  14. The ribbon continent of northwestern South America

    NASA Astrophysics Data System (ADS)

    Altamira-Areyan, Armando

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

  15. Young Africans Tackle Their Continent's Environmental Issues

    NASA Astrophysics Data System (ADS)

    Olwoch, Jane Mukarugwiza

    2008-11-01

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

  16. Dynamic Topography of Oceans and Continents

    NASA Astrophysics Data System (ADS)

    Lithgow-Bertelloni, C.; Conrad, C. P.

    2004-05-01

    The large contrasts in surface topography are one of the most striking features of our planet. Contributions to topography range from short-wavelength uncompensated features due to tectonic activity, to variations in crustal thickness and density structure and long-wavelength deflections of the lithosphere caused by mantle dynamics. Upwelling or downwelling flow in Earth's mantle can elevate or depress the earth's surface even if the sources of buoyancy are deep in the mantle. However, direct observation of this ``dynamic topography'' has been elusive, because it is obscured by the isostatic contribution due to crustal and lithospheric structure. Any potential confirmation of the role of dynamic topography, sheds light not only on the impact of mantle dynamics on surface processes, but also on the nature of mantle dynamics itself. For example, we expect dramatically different topographic signals from layered vs. whole mantle convection. We have learned a great deal about the consequences of dynamic topography for continental flooding and the formation of large sedimentary basins since the pioneering work of Mitrovica et al. [1989] and Gurnis [1990]. Recently, unequivocal signals of dynamically supported topography have been found in both continents (Africa [Lithgow-Bertelloni and Silver, 1998] and Arabia [Daradich et al., 2004]) and oceanic basins (North-Atlantic [Conrad et al., 2004]). In all three cases, the identifiable dynamic topography signal results from upwelling mantle. In regions associated with downwellings considerable controversy remains [e.g. Wheeler and White, 2002]. There is a hint in this result that relates to the ability of slabs to penetrate into the lower mantle and of upwellings to reach the surface from great depth. We review in this talk the evidence for dynamic topography in continents and oceans, and present some speculations related to the nature of layering in mantle convection.

  17. [The dilemma of metaphylaxis of urinary calculi].

    PubMed

    Zechner, O

    1995-01-01

    Drug therapy in terms of prophylaxis of recurrent urolithiasis is known to be successful in inborn metabolic disturbances as cystinuria, primary hyperoxaluria, inborn errors of purine metabolism and calculi due to urinary infection. At the time efficient regimes for the large group of idiopathic urolithiasis are not available. The reason is that pathophysiology of urinary stone formation is still not fully understood. As a consequence of changing therapy in terms of extracorporal shockwave therapy and endourological lithotripsy, intensity of basic research in this field has markedly decreased. Optimizing prophylactic therapy of urolithiasis could only be achieved by development of completely new strategies from basic research.

  18. Percutaneous urinary procedures

    MedlinePlus

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

  19. Stability, continence and breathing: the role of fascia following pregnancy and delivery.

    PubMed

    Lee, D G; Lee, L J; McLaughlin, L

    2008-10-01

    Pregnancy-related pelvic girdle pain (PRPGP) has a prevalence of approximately 45% during pregnancy and 20-25% in the early postpartum period. Most women become pain free in the first 12 weeks after delivery, however, 5-7% do not. In a large postpartum study of prevalence for urinary incontinence (UI) [Wilson, P.D., Herbison, P., Glazener, C., McGee, M., MacArthur, C., 2002. Obstetric practice and urinary incontinence 5-7 years after delivery. ICS Proceedings of the Neurourology and Urodynamics, vol. 21(4), pp. 284-300] found that 45% of women experienced UI at 7 years postpartum and that 27% who were initially incontinent in the early postpartum period regained continence, while 31% who were continent became incontinent. It is apparent that for some women, something happens during pregnancy and delivery that impacts the function of the abdominal canister either immediately, or over time. Current evidence suggests that the muscles and fascia of the lumbopelvic region play a significant role in musculoskeletal function as well as continence and respiration. The combined prevalence of lumbopelvic pain, incontinence and breathing disorders is slowly being understood. It is also clear that synergistic function of all trunk muscles is required for loads to be transferred effectively through the lumbopelvic region during multiple tasks of varying load, predictability and perceived threat. Optimal strategies for transferring loads will balance control of movement while maintaining optimal joint axes, maintain sufficient intra-abdominal pressure without compromising the organs (preserve continence, prevent prolapse or herniation) and support efficient respiration. Non-optimal strategies for posture, movement and/or breathing create failed load transfer which can lead to pain, incontinence and/or breathing disorders. Individual or combined impairments in multiple systems including the articular, neural, myofascial and/or visceral can lead to non-optimal strategies during

  20. Intestinal reconstruction of the lower urinary tract as a prerequisite for renal transplantation.

    PubMed

    Djakovic, Nenad; Wagener, Nina; Adams, Judith; Gilfrich, Christian; Haferkamp, Axel; Pfitzenmaier, Jesco; Toenshoff, Burkhard; Schmidt, Jan; Hohenfellner, Markus

    2009-06-01

    OBJECTIVE To report a two-stage protocol for children in whom bladder reconstruction was followed by kidney transplantation, as about a quarter of children requiring a kidney transplantation show significant lower urinary tract dysfunction, and consequently their bladder is unsuitable for a kidney transplant. PATIENTS AND METHODS Twelve children (median age 9.5 years, range 4.2-16.8) with end-stage renal disease had a lower urinary tract reconstruction before kidney transplantation. The cause of bladder dysfunction and renal failure included posterior urethral valves in five, neuropathic bladder in two, prune-belly syndrome in two, anal-rectum and urethral atresia syndrome in one, primary obstructive uropathy in one and caudal regression syndrome in one. Two children were diverted with an ileal conduit; four had a bladder augmentation, and four had a bladder augmentation with additional continent cutaneous stoma. A continent urinary reservoir was constructed in one boy, and one boy had a Mitrofanoff-only procedure. Subsequently, 11 children were transplanted. RESULTS The graft survival rate was 11 of 12 at 1 year and eight of 12 at 5 years. No patient lost the graft related to the reconstructed lower urinary tract. During the median (range) follow-up of 5.4 (1.6-12.5) years all but one child had free drainage of the upper urinary tract. All 10 children who did not have an ileal conduit are continent. CONCLUSION Reconstruction of the lower urinary tract followed by renal transplantation is a safe and efficient approach. It has the advantage of restoring the lower urinary tract before immunosuppressive therapy, and supplies the best possible reservoir for a transplanted kidney. PMID:19076129

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

    PubMed

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

    2014-01-01

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

  2. [Electrostimulation in therapy of postoperative urinary incontinence. Therapeutic value for quality of life].

    PubMed

    Hoffmann, W; Liedke, S; Dombo, O; Otto, U

    2005-01-01

    Worldwide use of electrical stimulation for therapy of postoperative incontinence is based on a few prospective randomized controlled studies. We present a three-arm prospective randomized study evaluating physiotherapeutic pelvic floor training alone and in combination with transanal or perineal electrical stimulation. The study compared specific continence training (CT) and a combination of CT with transanal or perineal electrostimulation. The groups included 60 patients each and were analyzed with regard to self-assessment, objective characteristics of incontinence, standard quality of life questionnaire (QLQ-C 30), and recorded data of the stimulation device. The patients participated in a specific inpatient rehabilitation program and were assessed at the time of admittance, upon discharge, and again after 3 months. Significant improvement could be achieved in every group concerning urinary incontinence and quality of life. Additional use of electrical stimulation was significantly superior to physiotherapeutic training alone. However, these results could only be detected in a highly compliant subgroup. Analysis of device data indicated a high score of errors and lack of patient compliance. Perineal electrical stimulation was better accepted than transanal and showed less side effects and better outcome in the characteristics of incontinence. Improvement in the quality of life was mostly achieved during the weeks of inpatient rehabilitation. Electrical stimulation could not improve quality of life items. Electrical stimulation is an efficient instrument for treatment of postoperative high-grade incontinence, however, only with sufficient patient compliance.

  3. Urinary incontinence: a vibration alert system for detecting pad overflow.

    PubMed

    Fernandes, Bosco; Gaydecki, Patrick; Jowitt, Felicity; van den Heuvel, Eleanor

    2011-01-01

    A sensor and electronics system is described that monitors the leakage of urine from continence pads into surrounding underwear. Urinary incontinence is involuntary loss of urine and occurs when the bladder muscles contract without warning or the sphincter muscles surrounding the urethra are too weak to prevent leakage. The system comprises a wetness sensor and electronics unit. The sensor is stitched into the underwear and detects overspills of urine from the pad. The electronics unit is attached to the underwear and responds by vibrating, signaling to the wearer that pad has failed. This system has application for individuals who use continence pads in the community, but it could also be used in care homes.

  4. OxyContin: Prescription Drug Abuse. CSAT Advisory.

    ERIC Educational Resources Information Center

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

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

  5. 21 CFR 876.5030 - Continent ileostomy catheter.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  6. Developing a tool to assess person-centred continence care.

    PubMed

    Wright, Jayne

    2006-07-01

    This article presents an overview of the first phase of a study to determine the contextual indicators that enable or hinder evidence-based continence care and management. The main focus of the article is to provide an insight into the value of understanding practice 'context' and its impact on the provision of person-centred continence care.

  7. Upper and Lower Urinary Tract Outcomes in Adult Myelomeningocele Patients: A Systematic Review

    PubMed Central

    Veenboer, Paul W.; Bosch, J. L. H. Ruud; van Asbeck, Floris W. A.; de Kort, Laetitia M. O.

    2012-01-01

    Background The introduction of sophisticated treatment of bladder dysfunction and hydrocephalus allows the majority of SB patients to survive into adulthood. However, no systematic review on urological outcome in adult SB patients is available and no follow-up schemes exist. Objectives To systematically summarize the evidence on outcome of urinary tract functioning in adult SB patients. Methods A literature search in PubMed and Embase databases was done. Only papers published in the last 25 years describing patients with open SB with a mean age >18 years were included. We focused on finding differences in the treatment strategies, e.g., clean intermittent catheterization and antimuscarinic drugs versus early urinary diversion, with regard to long-term renal and bladder outcomes. Results A total of 13 articles and 5 meeting abstracts on urinary tract status of adult SB patients were found describing a total of 1564 patients with a mean age of 26.1 years (range 3–74 years, with a few patients <18 years). All were retrospective cohort studies with relatively small and heterogeneous samples with inconsistent reporting of outcome; this precluded the pooling of data and meta-analysis. Total continence was achieved in 449/1192 (37.7%; range 8–85%) patients. Neurological level of the lesion and hydrocephalus were associated with incontinence. Renal function was studied in 1128 adult patients. In 290/1128 (25.7%; range 3–81.8%) patients some degree of renal damage was found and end-stage renal disease was seen in 12/958 (1.3%) patients. Detrusor-sphincter dyssynergy and detrusor-overactivity acted as adverse prognostic factors for the development of renal damage. Conclusions These findings should outline follow-up schedules for SB patients, which do not yet exist. Since renal and bladder deterioration continues beyond adolescence, follow-up of these individuals is needed. We recommend standardization in reporting the outcome of urinary tract function in adult SB

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

    NASA Astrophysics Data System (ADS)

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

    2015-01-01

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

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

    PubMed

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

    2007-01-01

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

  10. Urinary Adiponectin Excretion

    PubMed Central

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

    2009-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2002-12-01

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

  12. Urinary tract infections in adults

    PubMed Central

    Wei Tan, Chee; Chlebicki, Maciej Piotr

    2016-01-01

    A urinary tract infection (UTI) is a collective term for infections that involve any part of the urinary tract. It is one of the most common infections in local primary care. The incidence of UTIs in adult males aged under 50 years is low, with adult women being 30 times more likely than men to develop a UTI. Appropriate classification of UTI into simple or complicated forms guides its management and the ORENUC classification can be used. Diagnosis of a UTI is based on a focused history, with appropriate investigations depending on individual risk factors. Simple uncomplicated cystitis responds very well to oral antibiotics, but complicated UTIs may require early imaging, and referral to the emergency department or hospitalisation to prevent urosepsis may be warranted. Escherichia coli remains the predominant uropathogen in acute community-acquired uncomplicated UTIs and amoxicillin-clavulanate is useful as a first-line antibiotic. Family physicians are capable of managing most UTIs if guided by appropriate history, investigations and appropriate antibiotics to achieve good outcomes and minimise antibiotic resistance. PMID:27662890

  13. Urinary tract infections in adults.

    PubMed

    Tan, Chee Wei; Chlebicki, Maciej Piotr

    2016-09-01

    A urinary tract infection (UTI) is a collective term for infections that involve any part of the urinary tract. It is one of the most common infections in local primary care. The incidence of UTIs in adult males aged under 50 years is low, with adult women being 30 times more likely than men to develop a UTI. Appropriate classification of UTI into simple or complicated forms guides its management and the ORENUC classification can be used. Diagnosis of a UTI is based on a focused history, with appropriate investigations depending on individual risk factors. Simple uncomplicated cystitis responds very well to oral antibiotics, but complicated UTIs may require early imaging, and referral to the emergency department or hospitalisation to prevent urosepsis may be warranted. Escherichia coli remains the predominant uropathogen in acute community-acquired uncomplicated UTIs and amoxicillin-clavulanate is useful as a first-line antibiotic. Family physicians are capable of managing most UTIs if guided by appropriate history, investigations and appropriate antibiotics to achieve good outcomes and minimise antibiotic resistance. PMID:27662890

  14. Surgery for Stress Urinary Incontinence

    MedlinePlus

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

  15. Feline Lower Urinary Tract Disease

    MedlinePlus

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

  16. Urinary tract endometriosis.

    PubMed

    Koszczuk, J C; Foglietti, M; Perez, J F; Dono, F V; Thomas, R J

    1989-01-01

    Although endometriosis is a common gynecologic pathologic phenomenon, involvement of the urinary tract is relatively rare. The clinical presentation and course of urinary system disease is extremely variable, as illustrated by the seven cases presented in this report. Therapy primarily is surgical, but a thorough understanding of the disease process and a complete knowledge of the patient's history and desires for fertility conservation are necessary to plot the most appropriate treatment course. Bladder involvement is more common, and usually less devastating, than either ureteral or kidney involvement. No signs, symptoms, or physical findings are pathognomonic, and the clinician must maintain a high index of suspicion in all cases of advanced pelvic endometriosis.

  17. Urinary albumin in space missions.

    PubMed

    Cirillo, Massimo; De Santo, Natale G; Heer, Martina; Norsk, Peter; Elmann-Larsen, Benny; Bellini, Luigi; Stellato, Davide; Drummer, Christian

    2002-07-01

    Proteinuria was hypothesized for space mission but research data are missing. Urinary albumin, as index of proteinuria, was analyzed in frozen urine samples collected by astronauts during space missions onboard MIR station and on ground (control). Urinary albumin was measured by a double antibody radioimmunoassay. On average, 24h urinary albumin was 27.4% lower in space than on ground; the difference was statistically significant. Low urinary albumin excretion could be another effect of exposure to weightlessness (microgravity).

  18. Urinary Tract Infections (For Kids)

    MedlinePlus

    ... time. And when you do, phew! Your pee smells bad. These changes occur because bacteria have caused an infection somewhere in your urinary tract. Let's find out more. What Exactly Is a Urinary Tract? Your urinary tract is actually a system made up of these main parts: two kidneys ...

  19. Tablet-based screening improves continence management in multiple sclerosis

    PubMed Central

    Beadnall, Heidi N; Kuppanda, Kushi E; O’Connell, Annmaree; Hardy, Todd A; Reddel, Stephen W; Barnett, Michael H

    2015-01-01

    Objective To investigate whether electronic continence questionnaires aid early identification and optimizes management of sphincter dysfunction in a multiple sclerosis clinic. Methods A custom designed, tablet-based cross-platform software tool was designed to capture validated multiple sclerosis (MS) patient-reported outcomes. An unselected cohort of MS patients from a tertiary referral clinic completed electronic tablet-based versions of the Bladder Control Scale (BLCS) and the Bowel Control Scale in the waiting room. Data were captured wirelessly “on-the-fly” and stored in a deidentified, secure database; and individual questionnaire results were immediately available to the treating neurologist in the electronic medical record. Scores of ≥2 on either questionnaire generated an automated electronic referral to the clinic MS continence nurse (MS CN). Results One hundred and fifty-seven MS patients completed a total of 184 electronic continence test sets and on two occasions only the BLCS was completed. An automatic electronic referral for formal continence review was generated 128 times in 108 patients. Fifty-seven formal continence assessments were undertaken by the MS CN following automated referral. All reviews resulted in at least one clinical intervention being made. Interpretation Tablet-based data capture and automated continence referral using this software tool is an efficient, sensitive, and feasible method of screening MS patients for bladder and bowel dysfunction. Concordance with the results of formal continence assessment in this pilot study validates the use of this technology as a screening tool. PMID:26125042

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

    SciTech Connect

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

    1981-12-10

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

  1. Urinary Tract Infections

    MedlinePlus

    ... body's drainage system for removing wastes and extra water. It includes two kidneys, two ureters, a bladder, and a urethra. Urinary tract infections (UTIs) are the second most common type of infection in the body. You may have a UTI if you notice ...

  2. [Urinary catheter biofilm infections].

    PubMed

    Holá, V; Růzicka, F

    2008-04-01

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

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

    PubMed Central

    2011-01-01

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

  4. Development of cellular therapy for the treatment of stress urinary incontinence.

    PubMed

    Wang, Hung-Jen; Chuang, Yao-Chi; Chancellor, Michael B

    2011-09-01

    Stress urinary incontinence (SUI) is highly prevalent and associated with a reduced quality of life. An intact rhabdosphincter at the mid-urethra is mandatory to maintain urinary continence. Adult stem cell injection therapy for the regenerative repair of an impaired sphincter is currently at the forefront of incontinence research. The implanted cells will fuse with muscle and release trophic factors promoting nerve and muscle integration. Hereby, we review the use of mesenchymal stem cell therapy for SUI and the experience with the development of muscle-derived stem cells.

  5. Changing our view of older people's continence care.

    PubMed

    Dennis, Jacqueline

    An assumption is often made that incontinence is inevitable in older people, or those with dementia or other long-term conditions. However, research has highlighted strategies that can help them to remain continent. A working group was established to develop a resource to promote continence for people with dementia and long-term conditions. This article explores the resource's key messages, as well as the importance of changing how incontinence is viewed, and what health professionals and the public expect of continence services. PMID:27386706

  6. The effect of urinary incontinence status during pregnancy and delivery mode on incontinence postpartum. A cohort study*

    PubMed Central

    Wesnes, SL; Hunskaar, S; Bo, K; Rortveit, G

    2009-01-01

    Objective The objectives of this study were to investigate prevalence of urinary incontinence at 6 months postpartum and to study how continence status during pregnancy and mode of delivery influence urinary incontinence at 6 months postpartum in primiparous women. Design Cohort study. Setting Pregnant women attending routine ultrasound examination were recruited to the Norwegian Mother and Child Cohort Study (MoBa). Population A total of 12 679 primigravidas who were continent before pregnancy. Methods Data are from MoBa, conducted by the Norwegian Institute of Public Health. Data are based on questionnaires answered at week 15 and 30 of pregnancy and 6 months postpartum. Main outcome measures Urinary incontinence 6 months postpartum is presented as proportions, odds ratios and relative risks (RRs). Results Urinary incontinence was reported by 31% of the women 6 months after delivery. Compared with women who were continent during pregnancy, incontinence was more prevalent 6 months after delivery among women who experienced incontinence during pregnancy (adjusted RR 2.3, 95% CI 2.2–2.4). Adjusted RR for incontinence after spontaneous vaginal delivery compared with elective caesarean section was 3.2 (95% CI 2.2–4.7) among women who were continent and 2.9 (95% CI 2.3–3.4) among women who were incontinent in pregnancy. Conclusion Urinary incontinence was prevalent 6 months postpartum. The association between incontinence postpartum and mode of delivery was not substantially influenced by incontinence status in pregnancy. Prediction of a group with high risk of incontinence according to mode of delivery cannot be based on continence status in pregnancy. PMID:19220234

  7. Equatorial Electrojet Observations in the African Continent

    NASA Astrophysics Data System (ADS)

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

    2008-12-01

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

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

    EPA Science Inventory

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

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

    PubMed Central

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

    1990-01-01

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

  10. Immediate Continence Rates in RALRP: A Comparison of Three Techniques

    PubMed Central

    Tugcu, Volkan; Sahin, Selcuk; Sevinc, Cuneyd; Eksi, Mithat; Yavuzsan, Abdullah Hizir; Tasci, Ali Ihsan

    2016-01-01

    Background and Objectives: Robot-assisted laparoscopic radical prostatectomy (RALRP) is said to provide excellent long-term continence. In this study, we compared the early incontinence outcomes of our patients, who had undergone no reconstruction, posterior reconstruction only, or total anatomic restoration and posterior reconstruction. Methods: We retrospectively analyzed the patients who underwent RALRP for localized prostate cancer by a single surgeon in our clinic from January 1, 2009–February 1, 2016. Continence was defined as no leakage or use of a safety pad for minimal leakage. The main outcome measure was continence at postoperative week 1 and months 1, 6, and 12. Results: Between 2009 and 2016, 239 patients underwent RALRP for localized prostate disease. Seventy-four patients underwent a standard approach (group 1), 88 had posterior reconstruction (group 2), and 77 had posterior reconstruction with total anatomic restoration (group 3). After 1 week, 24.3% of the patients in group 1 (18/74), 31.8% in group 2 (28/88), and 45.8% in group 3 (33/72) were continent (P = .02). One month after the surgery, continence rates for groups 1, 2, and 3 were 56.7, 67, and 75%, respectively (0.065). After 6 and 12 months, continence rates for groups 1, 2, and 3 were 72.9 and 87.8%, 81.8 and 89.7%, and 84.7 and 91.6%, respectively (P = .178 and .7484). Conclusion: Anatomic restoration improves continence rates in the early period after RALRP. Even though other parameters were higher in the total restoration group, immediate continence (at 1 week) was significantly better. PMID:27777500

  11. The controversy surrounding OxyContin abuse: issues and solutions

    PubMed Central

    Jayawant, Sujata S; Balkrishnan, Rajesh

    2005-01-01

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

  12. Postcircumcision urinary tract infection.

    PubMed

    Cohen, H A; Drucker, M M; Vainer, S; Ashkenasi, A; Amir, J; Frydman, M; Varsano, I

    1992-06-01

    The possible association of urinary tract infection (UTI) with ritual circumcision on the eighth day of life was studied by analyzing the epidemiology of urinary tract infections during the first year of life in 169 children with UTI (56 males and 113 females) born in Israel from 1979 to 1984. Forty-eight percent of the episodes of UTI occurring in males appeared during the 12 days following circumcision, and the increased incidence during that period was highly significant. The median age of the males at the time of the UTI was 16 days, compared with seven months in females. Ritual Jewish circumcision as practiced in Israel may be a predisposing factor for UTI during the 12-day period following that procedure.

  13. Urinary Tract Endometriosis.

    PubMed

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

    2015-01-01

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

  14. Endoscopic management of upper urinary tract stones.

    PubMed Central

    Tolley, D. A.; Buist, T. A.

    1986-01-01

    In a two year period from March 1983, 157 patients with upper urinary tract stones were managed primarily by endoscopy. Of 90 patients with renal stones, extraction was achieved in 91% of patients with complete extraction in 76%. Of the remaining patients with ureteric stones, successful extraction was achieved in 75%. Ten patients required open surgery which was for failed extraction in 9. Morbidity is low with a mean hospital stay of 4.7 days for patients with kidney stones, and of 3.7 days for patients undergoing extraction of ureteric stones. Images Fig. 2 PMID:3954313

  15. Geriatric urinary incontinence.

    PubMed

    Ouslander, J G

    1992-02-01

    Urinary incontinence (UI) is now recognized as a prevalent, physically and emotionally disruptive, and costly health problem in the geriatric population. Because incontinence may be a manifestation of a subacute or reversible process within or outside of the lower urinary tract, and because effective treatment is available, it is important for primary care physicians to identify and appropriately assess incontinence in their geriatric patients. The initial evaluation of an incontinent geriatric patients. The initial evaluation of an incontinent geriatric patient includes a targeted history and physical examination, urinalysis, and simple tests of lower urinary tract function. Potentially reversible conditions that may be causing or contributing to the incontinence, such as delirium and urinary tract infection (UTI), should be identified and managed. Patients who may benefit from further testing, including urologic or gynecologic examination and/or complex urodynamic tests, should be identified and referred. Several therapeutic modalities can be used to treat geriatric UI. Behavioral therapies are noninvasive and effective, both in functional community-dwelling geriatric patients and in functionally impaired nursing home residents. Behavioral therapies include bladder training, pelvic muscle exercises, biofeedback, scheduled toileting, habit training, and prompted voiding. Pharmacologic therapy is often used in conjunction with behavioral therapy. For stress incontinence, alpha-adrenergic drugs are used and can be combined with topical or oral estrogen therapy in women. For urge incontinence, pharmacologic treatment involves drugs with anticholinergic and direct bladder muscle relaxant properties. Pharmacologic therapy for overflow incontinence is generally not effective on a long-term basis. Surgical treatment is indicated when a pathologic lesion such as a tumor is diagnosed, or when anatomic obstruction is believed to be the cause of the patient's symptoms

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

    Purpose To evaluate the effects of phosphodiesterase type 5 inhibitor (PDE5i) on urinary continence recovery after bilateral nerve-sparing radical prostatectomy (BNSRP). Materials and Methods Between 2002 and 2012, 137 of 154 consecutive patients who underwent BNSRP in our institution retrospectively divided into 3 groups that included patients taking PDE5i immediately after surgery (immediate PDE5i group, n=41), patients starting PDE5i at an outpatient clinic after discharge (PDE5i group, n=56), and patients taking no medication (non-PDE5i group, n=40). Using self-administered questionnaires, the proportion of patients who did not require incontinence pads (pad-free patients) was calculated preoperatively and at 1, 3, 6, 12, 18, and 24 months after BNSRP. Severity of incontinence was determined based on the pad numbers and then compared among the 3 groups. Results Proportions of pad-free patients and severity of incontinence initially deteriorated in all of the groups to the lowest values soon after undergoing BNSRP, with gradual improvement noted thereafter. The deterioration was most prominent in the immediate PDE5i group. As compared to the non-PDE5i group, both the PDE5i and immediate PDE5i groups exhibited a better final continence status. Conclusions PDE5i improves final continence status. However, administration of PDE5i immediately after surgery causes a distinct temporary deterioration in urinary incontinence. PMID:27617318

  18. Neonatal Staphylococcus lugdunensis urinary tract infection.

    PubMed

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

    2015-08-01

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

  19. [Urinary complications after anorectal surgery].

    PubMed

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

    2000-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2010-12-01

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

  1. Middle Archean continent formation by crustal delamination

    NASA Astrophysics Data System (ADS)

    Zegers, Tanja E.; van Keken, Peter E.

    2001-12-01

    The processes that created the first large cratonic areas such as the Pilbara and the Kaapvaal remain poorly understood. Models based on the uniformitarian extrapolation of present-day arc volcanic processes to a hotter early Earth have not adequately explained the observations in these terranes. Here we propose an alternative mechanism for the formation of the earliest continental crust. The formation of continental crust may be achieved by delamination of the lower eclogitic part of an oceanic plateau like protocrust. Such delamination results in uplift, extension, and the production of tonalite, trondhjemite, and granodiorite (TTG) suites as recorded in Middle Archean cratons. The available geologic and geophysical observations in combination with model calculations permit this scenario as an alternative to subduction-based hypotheses.

  2. Prosthetic urinary sphincter

    NASA Technical Reports Server (NTRS)

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

    1981-01-01

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

  3. Urinary tract infections.

    PubMed

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

    2013-09-01

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

  4. Postcollision extension in arc-continent collision zones, eastern Indonesia

    NASA Astrophysics Data System (ADS)

    Charlton, T. R.

    1991-01-01

    Postcollisional extension superimposed on arc-continent collision complexes is a common feature in the orogenic belts of eastern Indonesia. In the southern Banda arc, the arc-continent collision event is essentially a Pliocene and younger feature, but already an element of extension is being superimposed on the compressional structures of the collision complex. It is thus likely that the extension commences within a very short period (<5 m.y.) after the initiation of collision-related compressional deformation. A similar history of fold-belt development immediately followed by extension can be inferred for the Lengguru fold belt and the adjacent Wandamen-Wondiwoi terranes of Irian Jaya and for the Gulf of Bone in Sulawesi. It is suggested that the extension results from decoupling of the subducting oceanic lithosphere from the unsubductable continental lithosphere and that the superimposition of extension is a virtually unavoidable consequence of the arc-continent collision.

  5. Endoscopic treatment for pill bezoars after continent ileostomy.

    PubMed

    Lian, L; Fazio, V; Shen, B

    2009-07-01

    Difficulty intubation is the most common long-term complication after continent ileostomy, which can be associated with nipple valve slippage, parastomal hernia, stenosis. Diagnosis and management of a patient with nipple valve stricture and partial bowel obstruction associated with dietary supplement retention in the pouch reservoir is described. A 50-year-old female patient with ulcerative colitis and a 15-year history of continent ileostomy after total proctocolectomy reported 5-week symptoms of abdominal pain and difficulty in intubating the pouch. Pill bezoar composed of dietary supplement was found in diagnostic pouch endoscopy. Therapeutic pouch endoscopy was performed with balloon dilation of a nipple valve stenosis and retrieval of 224 dietary supplement tablets. Pill bezoar in the pouch is rare. However, patients with continent ileostomy should be advised to avoid taking hard-to-dissolve foods and medications. PMID:18619932

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

    NASA Astrophysics Data System (ADS)

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

    2013-12-01

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

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

    PubMed Central

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

    2016-01-01

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

  8. Bridging the Gap: Fraction Understanding Is Central to Mathematics Achievement in Students from Three Different Continents

    ERIC Educational Resources Information Center

    Torbeyns, Joke; Schneider, Michael; Xin, Ziqiang; Siegler, Robert S.

    2015-01-01

    Numerical understanding and arithmetic skills are easier to acquire for whole numbers than fractions. The "integrated theory of numerical development" posits that, in addition to these differences, whole numbers and fractions also have important commonalities. In both, students need to learn how to interpret number symbols in terms of…

  9. Improving time to continence after robot-assisted laparoscopic prostatectomy: augmentation of the total anatomic reconstruction technique by adding dynamic detrusor cuff trigonoplasty and suprapubic tube placement.

    PubMed

    Tewari, Ashutosh K; Ali, Adnan; Ghareeb, George; Ludwig, Wesley; Metgud, Sheela; Theckumparampil, Nithin; Takenaka, Atsushi; Chugtai, Bilal; Shrivastava, Abhishek; Kaplan, Steve A; Leung, Robert; Paryani, Rahul; Grushow, Siobhan; Durand, Matthieu; Peyser, Alexandra; Chopra, Sameer; Harneja, Niyati; Lee, Richard K; Herman, Michael; Robinson, Brian; Shevchuck, Maria M

    2012-12-01

    After robot-assisted laparoscopic prostatectomy, total anatomic reconstruction (TR) with the additions of a circumapical urethral dissection, a dynamic detrusor cuff trigonoplasty, and placement of a suprapubic catheter was performed in 49 patients from June to July 2012. Continence at 6 weeks after catheter removal was assessed for an initial group of 23 patients, and also at 2 weeks in an additional 26 patients who most recently had undergone surgery. Follow-up appointments and telephone interviews were used to assess pad use and continence. Of the initial 23 patients receiving the modified TR, 60.9% had 0 pad use at 6 weeks. By 2 weeks, 65.4% of the most recent 26 patients operated on achieved continence with 0-1 pad use. Preservation and reconstruction of the pelvic floor and supporting bladder structures leads to an earlier return of continence. These key steps need to be validated and confirmed in larger and randomized trials. PMID:23230868

  10. Urinary Bladder Dysfunction in Transgenic Sickle Cell Disease Mice

    PubMed Central

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

    2015-01-01

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

  11. Urinary incontinence: the basics.

    PubMed

    Kennedy, K L; Steidle, C P; Letizia, T M

    1995-08-01

    Urinary incontinence (UI) is a widely prevalent problem that affects people of all ages and levels of physical health, both in healthcare settings and in the community. Contributing to the problem are that many practitioners remain uneducated about this condition, individuals are often too ashamed or embarrassed to seek professional help, and there are significant variations in diagnostic and treatment practices. Five types of UI are stress, urge, overflow, functional and manufactured incontinence. Stress, urge and overflow are caused by factors within the urinary tract and will be concentrated on in this article. To diagnose UI a three-part assessment should be conducted, including the patient history, physical examination, and urinalysis. A behavioral program should be designed which incorporates identification and education for both patient and clinician. Treatment options include pelvic floor exercises (Kegel), vaginal cones, bladder training (retraining), habit training (timed voiding), electrostimulation and biofeedback, clean intermittent catheterization, indwelling catheters, medications, collagen injections, surgery, and absorption products. Most patients can be helped dramatically or cured with the appropriate treatment.

  12. Family Planning in Five Continents: Africa, America, Asia, Europe, Oceania.

    ERIC Educational Resources Information Center

    International Planned Parenthood Federation, London (England).

    Population growth trends and family planning activities in Africa, America, Asia, Europe, and Oceania are summarized in this booklet developed by the International Planned Parenthood Federation. Narrative information for each continent gives a resume of population growth trends, reasons for the trends, population problems, policy formation, family…

  13. Regulating continent growth and composition by chemical weathering

    USGS Publications Warehouse

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

    2008-01-01

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

  14. Regulating continent growth and composition by chemical weathering.

    PubMed

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

    2008-04-01

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

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

    SciTech Connect

    Lyle, D.

    1995-10-01

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

  16. Choosing and using disposable body-worn continence pads.

    PubMed

    Gilbert, Rachel

    Disposable, body-worn pads are the product most commonly chosen to contain and absorb urine and faeces (Pomfret, 2000). The cost to the NHS of supplying continence pads has been estimated at 80 million pounds per annum (Euromonitor, 1999) and is a huge financial burden on local services. PMID:16052946

  17. 21 CFR 876.5310 - Nonimplanted, peripheral electrical continence device.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Nonimplanted, peripheral electrical continence device. 876.5310 Section 876.5310 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices §...

  18. 21 CFR 876.5310 - Nonimplanted, peripheral electrical continence device.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Nonimplanted, peripheral electrical continence device. 876.5310 Section 876.5310 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices §...

  19. 21 CFR 876.5310 - Nonimplanted, peripheral electrical continence device.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Nonimplanted, peripheral electrical continence device. 876.5310 Section 876.5310 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices §...

  20. 21 CFR 876.5310 - Nonimplanted, peripheral electrical continence device.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

  1. Regulating continent growth and composition by chemical weathering

    PubMed Central

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

    2008-01-01

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

  2. Treatment of stress urinary incontinence.

    PubMed

    Fischer-Rasmussen, W

    1990-12-01

    This review presents reported cure and improvement rates of stress urinary incontinence in women obtained by different treatment modalities. Apart from the urodynamic findings, histological and histochemical changes of the pelvic floor may be clinically relevant to treatment in the future. Long-term cure and improvement rates achieved by non-surgical treatment (physiotherapy, biofeedback, bladder training, electrostimulation) are commented on. These rates range from 40-60% for physiotherapy and electrostimulation but are considerably less after biofeedback and bladder training. Pharmacotherapy is unlikely to offer more than a placebo effect. Studies of a single surgical procedure usually report high cure rates. In making the appropriate choice of operation the best guidelines are the cure rates from comparative or prospective randomized reports. From such studies an abdominal retropubic suspension operation (cure rates after five years 57-78 %) is more likely to help the patient than an anterior colporrhaphy (cure rates 31-70 %) or a transvaginal needle bladder neck suspension (cure rates 39-61 %). In selected patients sling procedures or the use of artificial sphincters may produce excellent results (70-80 %). To estimate the results of different treatments urine loss should be assessed objectively and physical restrictions and hygienic and social implications taken into account. A method of pre- and post-treatment "performance scores" should be developed.

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

    SciTech Connect

    Nur, A.; Ben-Avraham, Z.

    1982-05-10

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

  4. [Nosocomial urinary infections].

    PubMed

    Butreau-Lemaire, M; Botto, H

    1997-09-01

    The concept of nosocomial urinary tract infection now corresponds to a precise definition. It is generally related to bladder catheterization, constitutes the most frequent form of nosocomial infection (30 to 50% of infections), and represents the third most frequent portal of entry of bacteraemia. The organism most frequently isolated is Escherichia coli; but the flora is changing and the ecological distribution is continually modified. Despite their usually benign nature, these nosocomial infections can nevertheless influence hospital mortality; they increase the hospital stay by an average of 2.5 days and their treatment represents a large share of the antibiotic budget. Prevention of these infections is therefore essential, with particular emphasis on simple and universally accessible measures: very precise indications for vesical catheterization, use of closed circuit drainage, maximal asepsis when handling catheters, after washing the hands.

  5. [Female urinary incontinence].

    PubMed

    Jundt, K; Friese, K

    2005-06-01

    Several million women suffer from urinary incontinence in Germany. Stress and urge incontinence are especially clinically relevant. Training of the pelvic floor muscles (vaginal cones, electrical stimulation, biofeedback, and so forth) plays a central role in the conservative therapy of stress incontinence. The use of devices such as incontinence tampons and urethral pessaries is also common. A medication for the therapy of stress incontinence, which improves the closure of the urethral sphincter, has been on the market since 2004. In the operative area,the insertion of a tension-free vaginal tape (TVT) has gained acceptance in recent years. Anticholinergics are the primary medication used in the treatment of urge incontinence. Local estrogens, low frequency electrical stimulation, phytotherapeutics and the like have supportive effects.

  6. Drugs for treating urinary schistosomiasis

    PubMed Central

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

    2014-01-01

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

  7. Urinary Tract Infections (For Teens)

    MedlinePlus

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

  8. Urinary incontinence - vaginal sling procedures

    MedlinePlus

    ... help control stress urinary incontinence . This is urine leakage that happens when you laugh, cough, sneeze, lift ... these and are still having problems with urine leakage, surgery may be your best option.

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

    NASA Astrophysics Data System (ADS)

    de Wit, Maarten J.

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

  10. Commissioning continence services--turning policy into action.

    PubMed

    Thomas, Sue

    2004-05-18

    Incontinence of urine and faeces is a major issue in health care today. The financial cost is enormous with the NHS purchasing an annual 80 m Pounds worth of absorbent products alone (Euromonitor, 1999). But the financial cost is only part of the equation. Incontinence also has a considerable impact on the quality of life of those who experience it. The nature and impact on quality of life varies among individuals. However, where expert services are available cure rates can exceed 50 per cent (Royal College of Physicians, 1995). This suggests that specialist continence services have a vital role to play in helping patients improve their incontinence or manage their continence problems more effectively. PMID:15176280

  11. Mid-continent natural gas reservoirs and plays

    SciTech Connect

    Bebout, D.G. )

    1993-09-01

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

  12. Durability of the Malone antegrade continence enema in pregnancy.

    PubMed

    Wren, Francis J; Reese, Carl T; Decter, Ross M

    2003-03-01

    The Malone antegrade continence enema (MACE) is a therapeutic option to treat chronic constipation and fecal incontinence in patients with neurogenic bowel. Previous reports have described the short-term success of this procedure, but no report has described the durability of the procedure during pregnancy. We present the case of a spinal cord injury patient who underwent an uncomplicated pregnancy after a MACE procedure with no stomal catheterization difficulties or leakage during or after the pregnancy.

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

    SciTech Connect

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

    1983-08-01

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

  14. Observational Evidence of Changes in Soil Temperatures across Eurasian Continent

    NASA Astrophysics Data System (ADS)

    Zhang, T.

    2015-12-01

    Soil temperature is one of the key climate change indicators and plays an important role in plant growth, agriculture, carbon cycle and ecosystems as a whole. In this study, variability and changes in ground surface and soil temperatures up to 3.20 m were investigated based on data and information obtained from hydrometeorological stations across Eurasian continent since the early 1950s. Ground surface and soil temperatures were measured daily by using the same standard method and by the trained professionals across Eurasian continent, which makes the dataset unique and comparable over a large study region. Using the daily soil temperature profiles, soil seasonal freeze depth was also obtained through linear interpolation. Preliminary results show that soil temperatures at various depths have increased dramatically, almost twice as much as air temperature increase over the same period. Regionally, soil temperature increase was more dramatically in high northern latitudes than mid/lower latitude regions. Air temperature changes alone may not be able to fully explain the magnitude of changes in soil temperatures. Further study indicates that snow cover establishment started later in autumn and snow cover disappearance occurred earlier in spring, while winter snow depth became thicker with a decreasing trend of snow density. Changes in snow cover conditions may play an important role in changes of soil temperatures over the Eurasian continent.

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

    SciTech Connect

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

    1984-04-01

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

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

    SciTech Connect

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

    1984-04-01

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

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

    SciTech Connect

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

    1980-12-01

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

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

    ERIC Educational Resources Information Center

    CSTA Journal, 1995

    1995-01-01

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

  19. Outcomes of Pregnancy Following Surgery for Stress Urinary Incontinence: A Systematic Review

    PubMed Central

    Pollard, Matthew E.; Morrisroe, Shelby; Anger, Jennifer T.

    2016-01-01

    Purpose Although few data have been published on the safety of childbearing after surgery for stress urinary incontinence, a large proportion of physicians recommend that women wait to complete childbearing before pursuing surgical treatment for stress urinary incontinence. We systematically reviewed the available literature to examine the safety of pregnancy after stress urinary incontinence surgery, and to measure the effect of such pregnancy on continence outcomes. Materials and Methods The review was conducted according to the recommendations of the MOOSE (Meta-Analysis of Observational Studies in Epidemiology) group. We performed a systematic review to identify articles published before January 2011 on pregnancy after incontinence surgery. Databases searched include PubMed®, EMBASE® and the Cochrane Review. Our literature search identified 592 titles, of which 20 articles were ultimately included in the review. Results Data were tabulated from case reports, case series and physician surveys. The final analysis in each category included 32, 19 and 67 patients, respectively. Urinary retention developed during pregnancy in 2 women, 1 of whom was treated with a sling takedown and the other with intermittent catheterization. Of these 2 women 1 also had an episode of pyelonephritis during pregnancy, possibly related to the intermittent catheterization. The incidence of postpartum stress urinary incontinence ranged from 5% to 18% after cesarean delivery and from 20% to 30% after vaginal delivery. Conclusions Although the data on outcomes in the literature are limited and further studies need to be performed on the subject, the current data suggests that any increase in risks for pregnancy after surgery for stress incontinence may be small. A low risk of urinary retention during pregnancy may exist. Although some data suggest that cesarean deliveries may result in a lower rate of recurrent stress urinary incontinence than vaginal deliveries, a formal analysis could

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

    NASA Astrophysics Data System (ADS)

    Dickerson, Patricia Wood

    2003-04-01

    The intraplate Ancestral Rocky Mountains of western North America extend from British Columbia, Canada, to Chihuahua, Mexico, and formed during Early Carboniferous through Early Permian time in response to continent-continent collision of Laurentia with Gondwana—the conjoined masses of Africa and South America, including Yucatán and Florida. Uplifts and flanking basins also formed within the Laurentian Midcontinent. On the Gondwanan continent, well inboard from the marginal fold belts, a counterpart structural array developed during the same period. Intraplate deformation began when full collisional plate coupling had been achieved along the continental margin; the intervening ocean had been closed and subduction had ceased—that is, the distinction between upper versus lower plates became moot. Ancestral Rockies deformation was not accompanied by volcanism. Basement shear zones that formed during Mesoproterozoic rifting of Laurentia were reactivated and exerted significant control on the locations, orientations, and modes of displacement on late Paleozoic faults. Ancestral Rocky Mountain uplifts extend as far south as Chihuahua and west Texas (28° to 33°N, 102° to 109°W) and include the Florida-Moyotes, Placer de Guadalupe-Carrizalillo, Ojinaga-Tascotal and Hueco Mountain blocks, as well as the Diablo and Central Basin Platforms. All are cored with Laurentian Proterozoic crystalline basement rocks and host correlative Paleozoic stratigraphic successions. Pre-late Paleozoic deformational, thermal, and metamorphic histories are similar as well. Southern Ancestral Rocky Mountain structures terminate along a line that trends approximately N 40°E (present coordinates), a common orientation for Mesoproterozoic extensional structures throughout southern to central North America. Continuing Tien Shan intraplate deformation (Central Asia) has created an analogous array of uplifts and basins in response to the collision of India with Eurasia, beginning in late

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

    PubMed

    Pfeifer, J; Berger, A; Uranüs, S

    1994-07-01

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

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

    ERIC Educational Resources Information Center

    Lyons, Stacie Salsbury

    2010-01-01

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

  3. Building Mathematics Achievement Models in Four Countries Using TIMSS 2003

    ERIC Educational Resources Information Center

    Wang, Ze; Osterlind, Steven J.; Bergin, David A.

    2012-01-01

    Using the Trends in International Mathematics and Science Study 2003 data, this study built mathematics achievement models of 8th graders in four countries: the USA, Russia, Singapore and South Africa. These 4 countries represent the full spectrum of mathematics achievement. In addition, they represent 4 continents, and they include 2 countries…

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

    PubMed

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

    2015-01-01

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

  5. [Extracorporeal shock wave lithotripsy of urolithiasis in patients with urinary diversion].

    PubMed

    Vega Vega, A; García Alonso, D; Parra Muntaner, L; Sánchez Merino, J M; García Alonso, J

    2004-05-01

    We evaluate the efficacy of ESWL in the management of calculi in patients with urinary diversion. We treated 5 patients who suffered from urinary lithiasis after urinary diversion post cistectomy. We managed the patients with extracorporeal shock wave lithotripsy in monotherapy with a Siemens Lithostar Modularis device. Mean stone size (long axis) was 1.95 cm (range 1 to 3.5 cm). The mean shockwave number per session was 2.6 per patient. Stone free result was 100%. We conclude that ESWL technique can provide acceptable results in patients with urinary diversion and can be used as first choice treatment in these type of patients due to its minimal morbidity and excellent results, equivalent to those achieved in patients without urinary diversion.

  6. Urinary Biomarkers of Oxidative Status

    PubMed Central

    Il’yasova, Dora; Scarbrough, Peter; Spasojevic, Ivan

    2012-01-01

    Oxidative damage produced by reactive oxygen species (ROS) has been implicated in the etiology and pathology of many health conditions, including a large number of chronic diseases. Urinary biomarkers of oxidative status present a great opportunity to study redox balance in human populations. With urinary biomarkers, specimen collection is non-invasive and the organic/metal content is low, which minimizes the artifactual formation of oxidative damage to molecules in specimens. Also, urinary levels of the biomarkers present intergraded indices of redox balance over a longer period of time compared to blood levels. This review summarizes the criteria for evaluation of biomarkers applicable to epidemiological studies and evaluation of several classes of biomarkers that are formed non-enzymatically: oxidative damage to lipids, proteins, DNA, and allantoin, an oxidative product of uric acid. The review considers formation, metabolism, and exertion of each biomarker, available data on validation in animal and clinical models of oxidative stress, analytical approaches, and their intra- and inter-individual variation. The recommended biomarkers for monitoring oxidative status over time are F2-isoprostanes and 8-oxodG. For inter-individual comparisons, F2-isoprostanes are recommended, whereas urinary 8-oxodG levels may be confounded by differences in the DNA repair capacity. Promising urinary biomarkers include allantoin, acrolein-lysine, and dityrosine. PMID:22683781

  7. Urothelial Bladder Cancer Urinary Biomarkers

    PubMed Central

    Noon, Aidan P

    2014-01-01

    Abstract Urothelial bladder cancer is the fourth most prevalent male malignancy in the United States and also one of the ten most lethal. Superficial or non-muscle-invasive bladder cancer has a high rate of recurrence and can progress to muscle invasive disease. Conventional surveillance requires regular cystoscopy and is used often with urinary cytology. Unfortunately, the cystoscopy procedure is invasive for patients and costly for health care providers. Urinary biomarkers have the potential to improve bladder cancer diagnosis, the efficiency and also the cost-effectiveness of follow up. It may also be possible for urinary biomarkers to help prognosticate particularly for patients with high-grade bladder cancer who may want enhanced assessment of their risk of disease progression. In this review the important historical urinary biomarkers and the newly emerging biomarkers are discussed. As will be presented, although many of the tests have good performance characteristics, unfortunately no single test can fulfill all the roles currently provided by cystoscopy and cytology. It is likely that in the future, urinary biomarker testing will be used selectively in a personalized manner to try and improve prognostication or reduce the necessity for invasive cystoscopy in patients understanding the limits of the test.

  8. [Infection-induced urinary stones].

    PubMed

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

    2003-01-01

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

  9. A knowledge-based reactive-transport approach for the modeling of biogeochemical cycles at the continent-ocean interface

    NASA Astrophysics Data System (ADS)

    Regnier, P.; Aguilera, D.; Jourabchi, P.; Meile, C.; van Cappellen, P.; Vanderborght, J.-P.

    2003-04-01

    Reactive-transport models (RTMs) are traditionally developed and used to investigate the fate and transport of a selected set of chemical constituents within a given compartment of the earth, mainly at the local or subregional scale. As a result, existing RTMs tend to be environment and application specific. For instance, at the continent-ocean interface, RTMs have been used to simulate, among others, biogeochemical dynamics in rivers, estuaries, coastal areas, aquifers, and sediments. The development of upscaling protocols, where RTMs of interconnected environments are progressively aggregated into larger system units is critical for merging marine and continental approaches to biogeochemical cycles. However, one of the major challenges to achieve this goal is in the realistic and consistent representation of highly complex reaction networks that characterize the chemical dynamics of the natural environments present along the continent-ocean continuum (rivers, estuaries, coastal areas, sediments). The expanding knowledge about (bio)geochemical transformation processes achieved via field- and laboratory-based experiments needs also to be made available and integrated consistently (i.e. with comparable level of complexities) across traditional disciplinary barriers, by utilizing the unifying conceptual and mathematical principles underlying all RTMs. Our modeling approach, based on a modular concept, offers the necessary flexibility for the implementation of new theoretical and experimental information on the rates and pathways of biogeochemical reactions. A key component of our reaction network simulator is the "Knowledge Base", which acts as a single evolving repository of up-to-date information on biogeochemical processes. The development of self-consistent, "Knowledge-Based" biogeochemical reaction network modules, which can be merged with existing transport models of the various compartments of the hydrosphere along the continent-ocean continuum, creates a

  10. Study on the location and fit of continents in western central Pangea with a focus on the Mediterranean and North Atlantic Ocean

    NASA Astrophysics Data System (ADS)

    Kwon, Ohyeok; Cheong, Hyeong-Bin

    2015-04-01

    Since Alfred Wegener proposed the theory of continental drift more than a century ago, continuous effort to reconstruct the super continent Pangea has been carried out paleo-geographically during past several decades. Although a remarkable success has been achieved, there remains still a great uncertainty on the precise location and fits of the continents that constitute the Pangea. While the fits are recognized as quite complete for Gondwana, the northern part of Pangea, the fits for Laurasia which contains North Ameraica and Eurasia, are left with a lot of improvement. What the two giant continents look like when they were fitted to form the Pangea is also a unsolved question. Several hypothesis for the fits of Laurasia and Gondwana have been raised, and the scenarios of Pangea A1, Pangea A2, Pangea B, and Pangea C were proposed hitherto. Recently, an updated version very close to Pangea A2 was suggested by authors including Van der Voo, Trond H. Torsvik, which have improved several deficiencies of the Pangea A2. However, it was found that the new scenario cannot be fully supported by the paleomagnetism data. Furthermore, it is not in complete agreement with previous paleogeological surveys on major geological features such as Variscan and Caledonian orogenic belt, indicating that a more sophisticated scenario is needed still for the Pangea. The purpose of this study is to reconstruct the continents in western central Pangea with a focus on the Mediterranean and North Atlantic Ocean. A new fit of continents to form the Pangea is proposed, where the continents are fitted with enhanced accuracy compared to other models of Pangea particularly for the Mediterranean Sea, central America, Iran Plateau etc.. The results suggest that the continents were not distorted significantly on the process of drifting and merging during the past 200 million years.

  11. Drug-Induced Urinary Calculi

    PubMed Central

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

    2003-01-01

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

  12. Effective management of urinary discomfort.

    PubMed

    Hassay, K A

    1995-02-01

    Urinary discomfort is the second most common physical complaint affecting women. Although urinary discomfort is commonly a result of inflammation due to bacterial invasion, there are also nonbacterial causes. The development of antimicrobial resistance to bacteria is frequent and costs the patient and the medical community unnecessary time and money. Antimicrobial intervention should be instituted only after the uropathogen is identified through a urine culture. While awaiting the results of the urine culture or other laboratory or radiological tests, the patient's symptoms can be relieved with the use of urinary analgesics or antispasmodics. This conservative approach meets the immediate concern of the patient and better ensures a proper diagnostic workup and successful cure. Along with a conservative diagnostic approach, the patient should be included in all aspects of health care management.

  13. Currents in the mantle and the geology of continents

    NASA Astrophysics Data System (ADS)

    Wilson, J. Tuzo

    1991-02-01

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

  14. International Continence Society guidelines on urodynamic equipment performance.

    PubMed

    Gammie, Andrew; Clarkson, Becky; Constantinou, Chris; Damaser, Margot; Drinnan, Michael; Geleijnse, Geert; Griffiths, Derek; Rosier, Peter; Schäfer, Werner; Van Mastrigt, Ron

    2014-04-01

    These guidelines provide benchmarks for the performance of urodynamic equipment, and have been developed by the International Continence Society to assist purchasing decisions, design requirements, and performance checks. The guidelines suggest ranges of specification for uroflowmetry, volume, pressure, and EMG measurement, along with recommendations for user interfaces and performance tests. Factors affecting measurement relating to the different technologies used are also described. Summary tables of essential and desirable features are included for ease of reference. It is emphasized that these guidelines can only contribute to good urodynamics if equipment is used properly, in accordance with good practice.

  15. MAGSAT and aeromagnetic data in the North American continent

    NASA Technical Reports Server (NTRS)

    1981-01-01

    Problems were encountered in deriving a proper reference field to be subtracted from the aeromagnetic data obtained from Project MAGNET. Field models tried thus far do not seem to eliminate properly the main field. The MAGSAT data in the North American continent for the period November 1 to December 22, 1979 are being compiled and compared with MAGNET data. Efforts are being made to eliminate the orbital bias errors. A computer program was developed and successfully tested which computes a topographic profile of the Curie depth isotherm which fits best to the observed vector or scalar field magnetic data.

  16. Savanna vegetation-fire-climate relationships differ among continents.

    PubMed

    Lehmann, Caroline E R; Anderson, T Michael; Sankaran, Mahesh; Higgins, Steven I; Archibald, Sally; Hoffmann, William A; Hanan, Niall P; Williams, Richard J; Fensham, Roderick J; Felfili, Jeanine; Hutley, Lindsay B; Ratnam, Jayashree; San Jose, Jose; Montes, Ruben; Franklin, Don; Russell-Smith, Jeremy; Ryan, Casey M; Durigan, Giselda; Hiernaux, Pierre; Haidar, Ricardo; Bowman, David M J S; Bond, William J

    2014-01-31

    Ecologists have long sought to understand the factors controlling the structure of savanna vegetation. Using data from 2154 sites in savannas across Africa, Australia, and South America, we found that increasing moisture availability drives increases in fire and tree basal area, whereas fire reduces tree basal area. However, among continents, the magnitude of these effects varied substantially, so that a single model cannot adequately represent savanna woody biomass across these regions. Historical and environmental differences drive the regional variation in the functional relationships between woody vegetation, fire, and climate. These same differences will determine the regional responses of vegetation to future climates, with implications for global carbon stocks.

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

    PubMed Central

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

    2015-01-01

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

  18. Acute Urinary Retention: Risks and Management

    PubMed Central

    Roehrborn, Claus G

    2005-01-01

    Acute urinary retention (AUR) secondary to benign prostatic hyperplasia has in the past represented an immediate indication for surgery, and today most patients failing to void after an attempt at catheter removal still undergo surgery. The concept that this disease is in fact progressive in nature is slowly being accepted. Descriptive and analytical epidemiological data have shown that the incidence rate per 1000 person-years is less variable in the community than previously assumed; however, the risk is cumulative and increases with advancing age. The risk for patients diagnosed with benign prostatic hyperplasia is naturally higher, and analytical epidemiology has identified several strong risk factors, the most important one being serum prostate-specific antigen (PSA). In addition, prostate volume, maximum flow rate, and symptom severity should be considered when counseling patients presenting with lower urinary tract symptoms and clinical benign prostatic hyperplasia who are considering a course of watchful waiting. Efforts toward primary prevention of AUR should be directed to patients at increased risk, ie, those who are older and have more severe symptoms, larger glands, and higher PSA values. Risk reduction with finasteride has been demonstrated, and α-blockers have been shown to aid patients in achieving spontaneous voiding after an episode of AUR. PMID:16986053

  19. Laparoscopic implantation of an artificial urinary sphincter around the prostatic urethra

    PubMed Central

    Chłosta, Piotr; Aboumarzouk, Omar; Bondad, Jasper; Szopiński, Tomasz; Korzelik, Ignacy; Borówka, Andrzej

    2015-01-01

    Objective To report the first laparoscopic periprostatic implantation of an artificial urinary sphincter (AUS) after a transurethral resection of the prostate. Background The implantation of an AUS is a standard procedure for severe urinary incontinence. In men it is usually implanted through a perineal approach, with the cuff placed around the bulbous urethra, bladder neck, or even around the prostate. Method We report a laparoscopic periprostatic implantation of an AUS after a transurethral resection of a prostate in a 72-year-old-man with incontinence. Results The operative duration was 180 min and the blood loss was 150 mL. There were no complications. After activating the AUS the patient was totally continent. Conclusion The laparoscopic periprostatic implantation of an AUS is a safe, effective and considerably less invasive procedure. PMID:26413345

  20. Urinary catheters - what to ask your doctor

    MedlinePlus

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

  1. Urinary markers for bladder cancer

    PubMed Central

    Smith, Zachary L.

    2013-01-01

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

  2. Does Urinary Bladder Shape Affect Urinary Flow Rate in Men with Lower Urinary Tract Symptoms?

    PubMed Central

    Ateşçi, Yusuf Ziya; Aydoğdu, Özgü; Karaköse, Ayhan; Karal, Ömer; Şentürk, Utku

    2014-01-01

    We aimed to investigate the role of urinary bladder shape which may potentially change with advancing age, increased waist circumference, pelvic ischemia, and loosening of the urachus on bladder emptying and UFR. We retrospectively investigated the medical records of 76 men. The patients were divided into two groups according to bladder shapes in MRI scan (cone and spheric shapes). There was a significant difference between the two groups in terms of IPSS, Qmax, Qave, and waist circumference. A positive correlation has been demonstrated between mean peak urinary flow rate measured with UFM and mean flow rate calculated using the CP. There was a significant difference between mean urinary flow rates calculated with CP of cone and sphere bladder shapes. The change in the bladder shape might be a possible factor for LUTS in men and LUTS may be improved if modifiable factors including increased waist circumference and loosening of the urachus are corrected. PMID:24511301

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

    PubMed

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

    2014-07-15

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

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

    SciTech Connect

    Rascoe, B.; Adler, F.J.

    1983-06-01

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

  5. Pregnancy and delivery in patients with a continent ileostomy.

    PubMed

    Ojerskog, B; Kock, N G; Philipson, B M; Philipson, M

    1988-07-01

    Patients undergoing surgical treatment for inflammatory disease of the intestine are often in their reproductive years. Therefore, it is highly relevant to study the influence of surgical treatment on later pregnancy and delivery. Reported herein are 28 patients with continent ileostomies who have carried 37 pregnancies to term. An increased urge to empty the ileostomy reservoir, especially in the late period of pregnancy, was noted by the majority of patients. About one-third of the patients reported some difficulties with intubation of the reservoir in late pregnancy but in only a few patients did these disturbances result in a revisional operation after delivery. Pregnancy was normal in most instances and only four premature childbirths occurred. All pregnancies resulted in live birth. Vaginal delivery was successful in the majority of the patients, cesarean section being chosen for obstetric reasons in nine instances. From this study, it is concluded that, in patients with a continent ileostomy, normal pregnancy and delivery can be expected. However, in a few instances, the ileostomy function may be disturbed, necessitating later revisional operations.

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

    PubMed Central

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

    2014-01-01

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

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

    USGS Publications Warehouse

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

    1997-01-01

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

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

    PubMed

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

    2014-07-15

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

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

    SciTech Connect

    Ricciuto, Daniel M; Gu, Lianhong

    2010-07-01

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

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

    NASA Astrophysics Data System (ADS)

    Massonne, Hans-Joachim

    2016-05-01

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

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

    PubMed

    Koech, D K

    2001-01-01

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

  12. [Conservative treatment of urinary incontinence].

    PubMed

    Soljanik, I; Schorsch, I; Stanislaus, P; Bauer, R; Mayer, M; Hocaoglu, Y; Becker, A; May, F

    2007-09-20

    Urinary incontinence can be treated with medicinal products in addition to active pelvic floor muscle training and electrostimulation. A local hormone therapy should be first discussed with the gynaecologist. The active substance duloxetine has been used for a few years for treating stress incontinence. Several older and newer active substances are available for treating irritable bladder and stress incontinence.

  13. Transcorporal artificial urinary sphincter in radiated and non - radiated compromised urethra. Assessment with a minimum 2 year follow-up

    PubMed Central

    Long, Erwann Le; Rebibo, John David; Nouhaud, Francois Xavier; Grise, Philippe

    2016-01-01

    ABSTRACT Purpose to assess the efficacy of transcorporal artificial urinary sphincter (AUS) implantation on continence for male stress urinary incontinence in cases of prior surgical treatment or/and radiation failure, and as a first option in radiation patients. Materials and Methods From March 2007 to August 2012, 37 male patients were treated with transcorporal AUS AMS™ 800. Twelve patients had primary placement of transcorporal cuff, a surgical option due to a previous history of radiation and 25 patients had secondary procedure after failure of AUS or urinary incontinence surgery. Functional urinary outcomes were assessed by daily pad use, 24-hour Pad-test and ICIQ-SF questionnaire. Quality of life and satisfaction were assessed based on I-QoL and PGI-I questionnaires. Results After a median of 32 months, the continence rate (0 to 1 pad) was 69.7%. Median pad test was 17.5g (0-159), mean ICIQ-SF score was 7.3/21 (±5.4) and mean I-QoL score was 93.9/110. A total of 88% of the patients reported satisfaction with the AUS. The 5-year actuarial revision-free for AUS total device was 51%. Patients for primary implant for radiation were not more likely to experience revision than non-radiation patients. Preservation of erections was reported in half of the potent patients. Conclusions Transcorporal AUS cuff placement is a useful alternative procedure option for severe male UI treatment, especially in patients with a compromised urethra after prior surgery or radiation. A high continence rate was reported and implantation as first option in radiation patients should be considered. PMID:27286112

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

    USGS Publications Warehouse

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

    2006-01-01

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

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

    PubMed

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

    2012-05-01

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

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

    PubMed Central

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

    2012-01-01

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

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

    PubMed

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

    2012-05-01

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

  18. [Urinary acidification by furosemide test].

    PubMed

    Alvarado, L C; Voyer, L E; Bortolazzo, G; Costa, M A

    1991-01-01

    The aim of this study was to investigate the effect of furosemide on urinary acidification in 7 healthy children (aged 7 to 9 years) 5 patients with normokalemic distal renal tubular acidosis (RTA) (aged 4 to 13 years) and in 1 patient with proximal RTA (aged 20 months). Furosemide was given (2 mg/kg orally) as a tool to stimulate H+ and K+ secretion by enhancing Na delivery and transport in distal tubular segments. Patients with distal RTA were diagnosed by means of the ammonium chloride test and the alkaline overload and the one with proximal RTA by the ammonium chloride test only. Urinary acidification was evaluated 1 hour before and until 4 hours after furosemide administration. Healthy children (Fig. 1) showed a significant fall in urinary pH, 5.8 +/- 0.27 to 4.88 +/- 0.18 (p less than 0.02) and increase of NH3 excretion from 38.58 +/- 10.33 to 79.09 +/- 10.38 microEq/min/1.73 m2 (p less than 0.05). There was a direct correlation between urinary pH and urinary flow: r = 0.62 p less than 0.01 (Fig. 3). In patients with distal RTA (Fig. 5) furosemide failed to lower urine pH below 6 and net acid excretion persisted low: 47.9 +/- 6.1 microEq/min/1.73 m2. In the patient with proximal RTA (Fig. 4) furosemide produced the same effect as in healthy children with a fall in urine pH to 4.4 and an increase in net acid excretion to 118 microEq/min/1.73 m2. Furosemide proved to be effective to differentiate the type of RTA.(ABSTRACT TRUNCATED AT 250 WORDS)

  19. Correlates of urinary symptom scores in men.

    PubMed Central

    Klein, B E; Klein, R; Lee, K E; Bruskewitz, R C

    1999-01-01

    OBJECTIVES: This study determined the prevalence of urinary symptoms and their relationship to characteristics of a cohort of men in Beaver Dam, Wis, from 1993 to 1995. METHODS: A standardized questionnaire concerning urinary symptoms (the American Urological Association Urinary Symptom Questionnaire) was administered. RESULTS: All outcomes were associated with age and history of enlarged prostate. Urinary frequency (57%) and nocturia (65%) were the most common individual symptoms. Diuretic usage, diabetes, history of cardiovascular disease, and smoking were related to specific symptoms. CONCLUSIONS: While urinary symptoms are associated with age and history of enlarged prostate, symptoms may also be attributable to other diseases and exposures. PMID:10553401

  20. Inflammatory pseudotumor of the urinary bladder.

    PubMed

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

    2015-01-01

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

  1. Inflammatory Pseudotumor of the Urinary Bladder

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2013-05-01

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

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

    PubMed

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

    2013-05-01

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

  4. Comparison of different evaporation estimates over the African continent

    NASA Astrophysics Data System (ADS)

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

    2014-01-01

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

  5. Comparison of different evaporation estimates over the African continent

    NASA Astrophysics Data System (ADS)

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

    2013-07-01

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

  6. Assessing the causes of late Pleistocene extinctions on the continents.

    PubMed

    Barnosky, Anthony D; Koch, Paul L; Feranec, Robert S; Wing, Scott L; Shabel, Alan B

    2004-10-01

    One of the great debates about extinction is whether humans or climatic change caused the demise of the Pleistocene megafauna. Evidence from paleontology, climatology, archaeology, and ecology now supports the idea that humans contributed to extinction on some continents, but human hunting was not solely responsible for the pattern of extinction everywhere. Instead, evidence suggests that the intersection of human impacts with pronounced climatic change drove the precise timing and geography of extinction in the Northern Hemisphere. The story from the Southern Hemisphere is still unfolding. New evidence from Australia supports the view that humans helped cause extinctions there, but the correlation with climate is weak or contested. Firmer chronologies, more realistic ecological models, and regional paleoecological insights still are needed to understand details of the worldwide extinction pattern and the population dynamics of the species involved.

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

    PubMed Central

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

    2005-01-01

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

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

    PubMed

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

    2005-08-16

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

  9. Convergent structure of multitrophic communities over three continents.

    PubMed

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

    2013-12-01

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

  10. Clustered and transient earthquake sequences in mid-continents

    NASA Astrophysics Data System (ADS)

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

    2012-12-01

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

  11. Plasmodium vivax Diversity and Population Structure across Four Continents

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2015-07-01

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

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

    PubMed

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

    2015-07-01

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

  16. Towards a vaccine against Escherichia coli-associated urinary tract infections.

    PubMed

    Serino, Laura; Moriel, Danilo Gomes; Rappuoli, Rino; Pizza, Mariagrazia

    2010-03-01

    Evaluation of: Alteri CJ, Hagan EC, Sivick KE, Smith SN, Mobley HLT: Mucosal immunization with iron receptor antigens protects against urinary tract infections. PLoS Pathog. 5(9), E1000586 (2009). Urinary tract infection is one of the most common infections in humans. The eradication of uropathogenic Escherichia coli-mediated urinary tract infections has still not been achieved and no effective licensed vaccines are currently available. To overcome the limitations of previous approaches in developing an efficacious vaccine, Alteri et al., through a functional genomic approach, identified six novel vaccine candidates shown to be protective against urinary tract infection in a mouse model. The six proteins all belong to the class of outer membrane iron receptors, are upregulated in iron-restricted conditions and were demonstrated to induce, upon mucosal vaccination, antigen-specific antibodies and cytokine responses, which correlated with protection in a mouse model of urinary tract infection. Therefore, for the first time, antigens that were previously recognized as necessary for bacterial pathogenesis, being involved in iron acquisition in an iron-limited environment such as the urinary tract, are now proposed as potential candidates for the development of a vaccine against uropathogenic strain-associated urinary tract infections.

  17. Drugs for treating urinary schistosomiasis

    PubMed Central

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

    2014-01-01

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

  18. Studies on human urinary arylamidases

    NASA Technical Reports Server (NTRS)

    Raina, P. N.; Ellis, S.

    1975-01-01

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

  19. MODERN USE OF URINARY ANTISEPTICS

    PubMed Central

    Hinman, Frank

    1952-01-01

    It is not necessary to resort to complete study in most cases of urinary tract infection. However, if the lesion is chronic or recurrent, associated with mixed organisms, complicated by lower tract involvement, accompanied by low total renal function, with or without abnormalities in a kidney-ureter-bladder x-ray film or in an intravenous urogram, then complete retrograde study should be carried out. A Gram stain will substitute for culture in most simple urinary tract infections and a trial of the agent of choice will act as a test of bacterial sensitivity. If the infection persists, however, more adequate bacteriologic studies are required. For good chemotherapeutic practice, it is important to: (1) Withhold the drug until it has been determined that obstruction, stone or other such lesion is not present; (2) watch for side effects and toxicity; and (3) give the best drug in large enough dosage for an adequate period of time. PMID:14886751

  20. Tissue-engineered urinary conduits.

    PubMed

    Kates, Max; Singh, Anirudha; Matsui, Hotaka; Steinberg, Gary D; Smith, Norm D; Schoenberg, Mark P; Bivalacqua, Trinity J

    2015-03-01

    The role of tissue engineering in the cystectomy population rests on the principle of sparing healthy intestinal tissue while replacing diseased bladder. Over the last 25 years advances in cell biology and material science have improved the quality and durability of bladder replacement in animals. The neo-urinary conduit ([NUC]-Tengion) employs autologous fat smooth muscle cells which are seeded onto synthetic, biodegradable scaffolds. This seeded construct is then implanted in the patient and purportedly regenerates native urinary tissue to serve as a passive channel connecting the ureters to the skin surface. Preclinical animal studies as well as the first phase I human trial implanting the NUC are reviewed. While the ultimate goal of creating a durable, effective, tissue-engineered conduit is still in its infancy, important technical and experimental strides have been made. PMID:25677229

  1. Simple cyst of urinary bladder.

    PubMed

    Bo, Yang

    2014-07-01

    Simple cysts are rare in the urinary bladder and can pose a diagnostic dilemma to both the urologist and the histopathologist. No case study was found in the database of Elsevier Science Direct, Spring-Link, or PubMed. We present two cases of subserous cyst in the bladder and discuss the diagnosis and treatment of the condition. The cystic lesion at bladder dome was detected by radiologic examination and confirmed by cystoscopy. In case 1, transurethral resection was first performed which was followed by partial cystectomy; In case 2, the cyst was removed with the urachus using laparoscopic surgery. The patients recovered uneventfully and the histopathology showed cysts in subserous layer of urinary bladder. The bladder cyst should be distinguished from urachal tumor, and laparoscopic partial cystectomy is the preferred operative procedure.

  2. Urinary tract infections and Candida albicans

    PubMed Central

    Behzadi, Payam; Behzadi, Elham

    2015-01-01

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

  3. [Melanosis of the urinary bladder].

    PubMed

    Wöllner, J; Janzen, J; Pannek, J

    2016-01-01

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

  4. Paraganglioma of the urinary bladder.

    PubMed

    Adraktas, Dionesia; Caserta, Melanie; Tchelepi, Hisham

    2014-09-01

    Extra-adrenal paragangliomas of the urinary bladder are rare. Typically, patients present with symptoms related to catecholamine hypersecretion or mass effect, but these tumors can also be encountered incidentally on imaging studies obtained for a different purpose. It is important to recognize the key imaging features of this entity so that it may be suggested as a possible differential diagnosis in the setting of a newly identified bladder mass.

  5. Acute urinary retention among astronauts.

    PubMed

    Stepaniak, Philip C; Ramchandani, Suneil R; Jones, Jeffrey A

    2007-04-01

    Although acute urinary retention (AUR) is not commonly thought of as a life-threatening condition, its presentation in orbit can lead to a number of medical complications that could compromise a space mission. We report on a middle-aged astronaut who developed urinary retention during two spaceflights. On the first mission of note, the astronaut initially took standard doses of promethazine and scopolamine before launch, and developed AUR immediately after entering orbit. For the first 3 d, the astronaut underwent intermittent catheterizations with a single balloon-tipped catheter. Due to the lack of iodine solution on board and the need for the astronaut to complete certain duties without interruption, the catheter was left in place for a total of 4 d. Although the ability to void returned after day 7, a bout of AUR reemerged on day 10, 1 d before landing. On return to Earth, a cystometrogram was unremarkable. During the astronaut's next mission, AUR again recurred for the first 24 h of microgravity exposure, and the astronaut was subsequently able to void spontaneously while in space. This report details the presentation of this astronaut, the precautions that were taken for space travel subsequent to the initial episode of AUR, and the possible reasons why space travel can predispose astronauts to urinary retention while in orbit. The four major causes of AUR--obstructive, pharmacologic, psychogenic, and neurogenic-are discussed, with an emphasis on how these may have played a role in this case.

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

    NASA Astrophysics Data System (ADS)

    Braitenberg, Carla

    2014-05-01

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

  7. Recent Aeromagnetic Anomaly views of the Antarctic continent

    NASA Astrophysics Data System (ADS)

    Ferraccioli, F.

    2012-04-01

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

  8. A model of weathering intensity for the Australian continent

    NASA Astrophysics Data System (ADS)

    Wilford, J.

    2013-12-01

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

  9. Treatment of urinary incontinence in women in general practice: observational study.

    PubMed Central

    Seim, A.; Sivertsen, B.; Eriksen, B. C.; Hunskaar, S.

    1996-01-01

    OBJECTIVE--To examine what is attainable when treating urinary incontinence in women in general practice. DESIGN--Observational study with 12 months' follow up. Interview and clinical examination before, during, and after treatment of women seeking help for urinary incontinence in general practice. SETTING--General practice in the rural district of Rissa, Norway. SUBJECTS--105 women aged 20 or more with urinary incontinence. INTERVENTIONS--Treatment with pelvic floor exercises, electrostimulation, oestrogen, anticholinergic drugs, bladder training, and protective pads. MAIN OUTCOME MEASURES--Subjective and objective measures of urinary incontinence; number of patients referred to a specialist. RESULTS--After 12 months' follow up 70% (69/99) of the women were cured or much better; the mean score on a 100 mm visual analogue scale decreased from 37 to 20 mm; and the proportion of women who were greatly bothered by their incontinence decreased by 62%. 20% (20/98) of women became continent, and the percentage of women with severe incontinence decreased from 64% (63/99) to 28% (27/98). Mean leakage per 24 hours measured by a pad test decreased from 28 g at the start of treatment to 13 g after 12 months. The number of light weight pads or sanitary towels decreased from 1.6 to 0.6 a day. In all, 17/105 (16%) patients were referred to a specialist. CONCLUSIONS--Urinary incontinence in women can be effectively managed in general practice with fairly simple treatment. Most women will be satisfied with the results. PMID:8664627

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

    PubMed

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

    2016-03-01

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

  11. Application of a new method in the study of pelvic floor muscle passive properties in continent women.

    PubMed

    Morin, Mélanie; Gravel, Denis; Bourbonnais, Daniel; Dumoulin, Chantale; Ouellet, Stéphane; Pilon, Jean-François

    2010-10-01

    The aim of this study was to present a new methodology for evaluating the pelvic floor muscle (PFM) passive properties. The properties were assessed in 13 continent women using an intra-vaginal dynamometric speculum and EMG (to ensure the subjects were relaxed) in four different conditions: (1) forces recorded at minimal aperture (initial passive resistance); (2) passive resistance at maximal aperture; (3) forces and passive elastic stiffness (PES) evaluated during five lengthening and shortening cycles; and (4) percentage loss of resistance after 1min of sustained stretch. The PFMs and surrounding tissues were stretched, at constant speed, by increasing the vaginal antero-posterior diameter; different apertures were considered. Hysteresis was also calculated. The procedure was deemed acceptable by all participants. The median passive forces recorded ranged from 0.54N (interquartile range 1.52) for minimal aperture to 8.45N (interquartile range 7.10) for maximal aperture while the corresponding median PES values were 0.17N/mm (interquartile range 0.28) and 0.67N/mm (interquartile range 0.60). Median hysteresis was 17.24N *mm (interquartile range 35.60) and the median percentage of force losses was 11.17% (interquartile range 13.33). This original approach to evaluating the PFM passive properties is very promising for providing better insight into the patho-physiology of stress urinary incontinence and pinpointing conservative treatment mechanisms.

  12. Cranberries and lower urinary tract infection prevention.

    PubMed

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

    2012-01-01

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

  13. Female urinary incontinence: effective treatment strategies.

    PubMed

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

    2015-04-01

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

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

    PubMed Central

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

    2015-01-01

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

  15. Convective Transport of Trace Gases in the Maritime Continent

    NASA Astrophysics Data System (ADS)

    Harris, Neil

    2015-04-01

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

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

    PubMed

    Jackwood, Daral J; Sommer-Wagner, Susan

    2007-09-01

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

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

    PubMed

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

    2015-10-07

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

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

    PubMed

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

    2015-01-01

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

  19. The antegrade continence enema procedure and total anorectal reconstruction

    PubMed Central

    Zbar, Andrew P.

    2014-01-01

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

  20. The ocean-continent transition of western Iberia

    SciTech Connect

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

    1991-08-01

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

  1. NASA Astronaut Urinary Conditions Associated with Spaceflight

    NASA Technical Reports Server (NTRS)

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

    2016-01-01

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

  2. Quantification of neurological and other contributors to continence in female rats

    PubMed Central

    Jiang, Hai-Hong; Salcedo, Levilester B.; Damaser, Margot S.

    2011-01-01

    Smooth muscle, striated muscle, their central and peripheral innervations and control, and mucosal coaptation contribute to maintenance of continence. We used manual leak point pressure (mLPP) testing and electrical stimulation LPP (eLPP) testing in female rats to quantify the contribution of these factors to urethral resistance, a measure of continence. Abdominal muscles were electrically stimulated to induce leakage for eLPP. A Crede maneuver was applied for mLPP. These were repeated after complete T8 spinal cord injury (SCI) and/or bilateral pudendal nerve transection (PNT). After euthanasia, mLPP was repeated. MLPP was not significantly affected by opening the abdomen, suggesting that intra-abdominal pressure transmission contributes little to continence during slow pressure changes. ELPP was significantly higher than mLPP in intact rats, after PNT, and after SCI+PNT, suggesting that abdominal pressure transmission contributes to continence during rapid increases in intra-abdominal pressure. MLPP decreased significantly after PNT, indicating that urethral striated muscles contribute significantly to continence. ELPP decreased significantly after PNT with and without SCI, suggesting that supraspinal control significantly affects continence during rapid pressure changes, but not during slow pressure changes. MLPP after euthanasia was significantly decreased compared to mLPP after SCI+PNT, suggesting that urethral mucosal seal coaptation and tissue elasticity also contribute to continence. The urethra is a complex organ that maintains continence via a highly organized and hierarchical system involving both the central and peripheral nervous systems. PMID:21295013

  3. A harbinger of plate tectonics: a commentary on Bullard, Everett and Smith (1965) 'The fit of the continents around the Atlantic'.

    PubMed

    Dewey, John F

    2015-04-13

    In the 1960s, geology was transformed by the paradigm of plate tectonics. The 1965 paper of Bullard, Everett and Smith was a linking transition between the theories of continental drift and plate tectonics. They showed, conclusively, that the continents around the Atlantic were once contiguous and that the Atlantic Ocean had grown at rates of a few centimetres per year since the Early Jurassic, about 160 Ma. They achieved fits of the continental margins at the 500 fathom line (approx. 900 m), not the shorelines, by minimizing misfits between conjugate margins and finding axes, poles and angles of rotation, using Euler's theorem, that defined the unique single finite difference rotation that carried congruent continents from contiguity to their present positions, recognizing that the real motion may have been more complex around a number of finite motion poles. Critically, they were concerned only with kinematic reality and were not restricted by considerations of the mechanism by which continents split and oceans grow. Many of the defining features of plate tectonics were explicit or implicit in their reconstructions, such as the torsional rigidity of continents, Euler's theorem, closure of the Tethyan ocean(s), major continental margin shear zones, the rapid rotation of small continental blocks (Iberia) around nearby poles, the consequent opening of small wedge-shaped oceans (Bay of Biscay), and misfit overlaps (deltas and volcanic piles) and underlaps (stretched continental edges). This commentary was written to celebrate the 350th anniversary of the journal Philosophical Transactions of the Royal Society.

  4. Thermomechanical consequences of Cretaceous continent-continent collision in the eastern Alps (Austria): Insights from two-dimensional modeling

    NASA Astrophysics Data System (ADS)

    Willingshofer, Ernst; van Wees, J. D.; Cloetingh, S. A. P. L.; Neubauer, F.

    1999-10-01

    We use two-dimensional numerical modeling techniques to investigate the thermomechanical consequences of closure of the Meliata-Hallstatt ocean and consequent Cretaceous continent-continent collision in the eastern Alps (Austria). In the modeling a lower plate position of the Austro-Alpine (AA) continental block is adopted during collision with the Upper Juvavic-Silice block. The thermal structure of the lithosphere was calculated for major AA tectonic units (Upper, Middle, and Lower Austro-Alpine) by integration of the transient heat flow equation along an approximately NW-SE cross section east of the Tauern Window. Indications of the rheological evolution of the AA were determined by calculating strength profiles at key stages of the Cretaceous orogeny, making use of the thermal modeling predictions combined with rock mechanics data. Cooling in the upper plate and lower greenschist facies metamorphism within footwall parts of the lower Upper Austro-Alpine (UA) plate, related to SE directed underthrusting of the UA beneath the Upper Juvavic-Silice block at circa 100 Ma, were predicted by the numerical model. The observed pressure-temperature path for deeply buried Middle Austro-Alpine (MA) upper crustal units and their subsequent isothermal exhumation are best reproduced assuming a pressure peak at 95 Ma and exhumation rates ranging between 4 and 7.5 mm yr-1. From the modeling results, we deduce that the temperature evolution during eclogite exhumation is primarily dependent on rates of tectonic movements and largely independent of the mode of exhumation (thrusting versus erosion). Furthermore, very rapid postmetamorphic exhumation of southern Lower Austro-Alpine (LA) units is predicted in order to account for subsequent cooling. This is constrained by 40Ar/39Ar data. The cooling paths of MA and LA rocks appear to be primarily controlled by their near-surface positions at the end of the Cretaceous rather than by other processes such as concurrent underthrusting

  5. Approach to urinary tract infections

    PubMed Central

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

    2009-01-01

    Urinary tract infection (UTI) is the most common infection experienced by humans after respiratory and gastro-intestinal infections, and also the most common cause of both community-acquired and nosocomial infections for patients admitted to hospitals. For better management and prognosis, it is mandatory to know the possible site of infection, whether the infection is uncomplicated or complicated, re-infection or relapse, or treatment failure and its pathogenesis and risk factors. Asymptomatic bacteriuria is common in certain age groups and has different connotations. It needs to be treated and completely cured in pregnant women and preschool children. Reflux nephropathy in children could result in chronic kidney disease; otherwise, urinary tract infections do not play a major role in the pathogenesis of end-stage renal disease. Symptomatic urinary tract infections occur most commonly in women of child-bearing age. Cystitis predominates, but needs to be distinguished from acute urethral syndrome that affects both sexes and has a different management plan than UTIs. The prostatitis symptoms are much more common than bacterial prostatic infections. The treatment needs to be prolonged in bacterial prostatitis and as cure rates are not very high and relapses are common, the classification of prostatitis needs to be understood. The consensus conference convened by National Institute of Health added two more groups of patients, namely, chronic prostatitis/chronic pelvic pain syndrome and asymptomatic inflammatory prostatitis, in addition to acute and chronic bacterial prostatitis. Although white blood cells in urine signify inflammation, they do not always signify UTI. Quantitative cultures of urine provide definitive evidence of UTI. Imaging studies should be done 3-6 weeks after cure of acute infection to identify abnormalities predisposing to infection or renal damage or which may affect management. Treatment of cystitis in women should be a three-day course and if

  6. Advances in Urinary Tract Endoscopy.

    PubMed

    Berent, Allyson C

    2016-01-01

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

  7. URINARY INCONTINENCE IN ACUTE PSYCHOSIS

    PubMed Central

    Choudhury, S.; Augustine, M.

    1993-01-01

    SUMMARY A prospective two year study of consecutive admissions (n=984) to a psychiatry ward revealed that the incidence of temporary urinary incontinence in psychiatric patients without delirium or dementia was 1.63% (n=l6). When compared with controls (n=64) the incontinent patients were more often psychotic, gave a history of childhood enuresis and a past history of temporary incontinence during psychosis. Compared with psychotic controls (n=26), incontinent patients (n=16) had been exposed to a greater variety of treatments and were hospitalized for longer periods. PMID:21743617

  8. URINARY CALCULI IN GERMFREE RATS

    PubMed Central

    Gustafsson, Bengt E.; Norman, Arne

    1962-01-01

    In a colony of germfree rats 50 per cent of the males had urinary calculi composed of calcium citrate and calcium oxalate. Genetically closely related conventional animals on the same sterilized diet did not present a single case of stone formation. The tendency to calculus formation disappeared when germfree animals were contaminated with the intestinal flora from conventional rats. The calculus formation can readily be explained by the high calcium, high citrate, and high pH of the urine. This pattern was changed to that of conventional rats when the germfree rats were infected with intestinal microorganisms. PMID:13903130

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

    PubMed Central

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

    1994-01-01

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

  10. Wetland dynamics influence mid-continent duck recruitment

    USGS Publications Warehouse

    Anteau, Michael J.; Pearse, Aaron T.; Szymankski, Michael L.

    2013-01-01

    Recruitment is a key factor influencing duck population dynamics. Understanding what regulates recruitment of ducks is a prerequisite to informed habitat and harvest management. Quantity of May ponds (MP) has been linked to recruitment and population size (Kaminski and Gluesing 1987, Raveling and Heitmeyer 1989). However, wetland productivity (quality) is driven by inter-annual hydrological fluctuations. Periodic drying of wetlands due to wet-dry climate cycles releases nutrients and increases invertebrate populations when wet conditions return (Euliss et al. 1999). Wetlands may also become wet or dry within a breeding season. Accordingly, inter-annual and intra-seasonal hydrologic variation potentially influence duck recruitment. Here, we examined influences of wetland quantity, quality, and intra-seasonal dynamics on recruitment of ducks. We indexed duck recruitment by vulnerability-corrected age ratios (juveniles/adult females) for mid-continent Gadwall (Anas strepera). We chose Gadwall because the majority of the continental population breeds in the Prairie Pothole Region (PPR), where annual estimates of MP exist since 1974. We indexed wetland quality by calculating change in MP (?MP) over the past two years (?MP = 0.6[MPt – MPt-1] + 0.4[MPt – MPt-2]). We indexed intra-seasonal change in number of ponds by dividing the PPR mean standardized precipitation index for July by MP (hereafter summer index). MP and ?MP were positively correlated (r = 0.65); therefore, we calculated residual ?MP (?MPr) with a simple linear regression using MP, creating orthogonal variables. Finally, we conducted a multiple regression to examine how MP, ?MPr, and summer index explained variation in recruitment of Gadwall from 1976–2010. Our model explained 67% of the variation in mid-continent Gadwall recruitment and all three hydrologic indices were positively correlated with recruitment (Figure 1). Type II semi-partial R2 estimates indicated that MP accounted for 41%, ?MPr

  11. Urothelial cancer of the urinary bladder: can lessons learned be applied to the upper urinary tract?

    PubMed

    Krabbe, Laura M; Hutchinson, Ryan C; Margulis, Vitaly

    2016-08-01

    Even though urothelial cancer may occur anywhere in the urinary tract, it is most commonly found in the urinary bladder. Due to its higher incidence, this disease is studied in the bladder much more frequently than in the upper urinary tract. The question that arises is, to what extent can concepts and treatment paradigms derived from lower tract disease be applied to urothelial carcinoma of the upper urinary tract? This review aims at providing an overview of established care concepts in urothelial carcinoma of the bladder and applicability of these findings to tumors of the upper urinary tract.

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

    SciTech Connect

    Wickstrom, L.H. )

    1992-01-01

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

  13. Intraplate termination of transform faulting within the Antarctic continent

    NASA Astrophysics Data System (ADS)

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

    2007-08-01

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

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

    SciTech Connect

    Egorov, A.Yu. )

    1993-09-01

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

  15. Drifting continents and endemic goitre in northern Pakistan.

    PubMed Central

    Stewart, A G

    1990-01-01

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

  16. Antarctica and IGY: New Frontiers in "A Continent for Science"

    NASA Astrophysics Data System (ADS)

    Wilson, T.; Anandakrishnan, S.; Deconto, R.; Finn, C.; Harwood, D.; Leventer, A.; Ritzwoller, M.; Tulaczyk, S.

    2002-12-01

    Antarctica was established as a laboratory for cooperative international science during the last IGY, and remains an unparalleled model of successful international research. The scientific foundations established in the IGY have led to significant advances in understanding processes in the solid earth, the atmosphere, the oceans, the cryosphere and the global climate system. It is increasingly clear that deciphering the feedbacks and interactions between these spheres is required to comprehend the earth system as a whole, hence understanding the unique Antarctic geodynamic environment is imperative. Yet, in many respects, Antarctica remains an unexplored frontier of the earth system. The Antarctic geoscience community has begun planning a new era of earth science exploration projected to reach fruition at the time of the IGY golden jubilee (see: http://www.geology.ohio-state.edu/agg-group/). International cooperation will be organized through SCAR (Scientific Committee on Antarctic Research). An `Antarctic Geophysical Decade' will include experiments at unprecedented scales across the continent, enabled by new technologies. Coordinated airborne and marine geophysical surveys, drilling (offshore and through the ice sheet to bedrock), deployment of GPS and seismic arrays, topical geological studies, and modeling studies, integrated with the wealth of new and upcoming satellite-derived data, will allow us to make the next leaps forward in understanding questions such as: 1) how changing ice mass loads influence lithospheric stress/strain regimes; 2) how glacial isostatic adjustment and the tectono-thermal structure of the lithosphere control modern ice sheet dynamics; 3) inception, growth and fluctuations of Antarctic ice sheets and interhemispheric a/synchroneity; 4) climate sensitivity to forcing factors such as continental-scale paleogeography, volcanism, erosion/sedimentation; 5) the origin and evolution of subglacial lakes and their life forms; and 6) the mode

  17. Smoke aerosol transport patterns over the Maritime Continent

    NASA Astrophysics Data System (ADS)

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

    2013-03-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2002-12-01

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

  19. Preparation of northern mid-continent petroleum atlas

    SciTech Connect

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

    1997-02-13

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

  20. Organic geochemistry of mid-continent Ordovician oils

    SciTech Connect

    Palmer, S.E.

    1985-01-01

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

  1. Single-Incision Slings (SIS) – a New Option for the Surgical Treatment of Female Stress Urinary Incontinence

    PubMed Central

    Naumann, G.; Albrich, S.; Skala, C.; Laterza, R.; Kölbl, H.

    2012-01-01

    The new development of single-incision slings (SIS) for the treatment of female stress urinary incontinence offers comparable results with only minimal side effects and will find wide acceptance in modern incontinence surgery. This mini-sling is inserted over a single vaginal incision and fixed on both sides to the pelvic wall tissue with special anchors, without passing through the groin and avoiding a blind tape passage. Compared with the established sub-urethral tapes, there are comparable success rates with fewer complications. Randomised prospective studies are needed to evaluate whether, in the long run, the benefits of the single incision technique can be correlated with satisfying continence results. PMID:25284829

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

    PubMed

    van Houten, Paul

    2015-01-01

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

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

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test...) test system is a device intended for the analysis of urinary calculi. Analysis of urinary calculi...

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

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test...) test system is a device intended for the analysis of urinary calculi. Analysis of urinary calculi...

  5. Urinary Incontinence: Management and Treatment Options

    ERIC Educational Resources Information Center

    Griebling, Tomas L.

    2009-01-01

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

  6. URINARY MUTAGENICITY AND COLORECTAL ADENOMA RISK

    EPA Science Inventory

    Abstract

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

  7. Urinary glucose and vitamin C.

    PubMed

    Brandt, R; Guyer, K E; Banks, W L

    1977-11-01

    The recent popularization of self-prescribed large doses of vitamin C has increased the possibility for erroneous conclusions to be drawn from standard clinical methods used in urinary glucose monitoring, due to interference with these methods by the greatly elevated excretion of vitamin C. The coupled-enzyme-chromogen strip tests showed erroneously negative glucose levels in urines of both a diabetic individual and a subject with a genetic low renal threshold for glucose when they were supplementing their normal diets with 1-2 g vitamin C per day. With this regimen, their urinary vitamin C levels reached 200 mg/dl (11.4 mmol/l). For normal urine with vitamin C added, false-positive tests for glucose were found using Benedict's reagent when vitamin C was present at 250 mg/dl (14.3 mmol/l) or higher concentrations. In diabetic individuals consuming large quantities of vitamin C, this interference with standard coupled-enzyme-chromogen strip tests or Benedict's test could present a significant problem in diagnosis and clinical management of the disease. A simple anion exchange method of treating the urine was used to correct the false results. PMID:920657

  8. Isoelectric focusing of urinary metallothionein.

    PubMed

    Felley-Bosco, E; Hunziker, P E; Savolainen, H

    1990-05-01

    Isoelectric focusing of human urinary metallothionein at a pH range of 4.8 to 7.0 yielded a single protein band with a pI of 5.57 which co-migrated with authentic purified metallothionein I from human liver. Minimum pretreatment of the urine samples (160 ml) was needed. The preparatory steps included sample concentration with the original protein, enriched from 69 +/- 23 micrograms/ml to 2.0 +/- 1.4 mg/ml (+/- SD; n = 9), followed by heat treatment at 80 degrees C for 5 min (2.4 +/- 1.7 mg protein/ml). After focusing, the gels were stained with silver and the lanes were scanned with a laser scanner. Peak areas were used for quantitation with commercial beta 2-microglobulin as a standard. The urinary metallothionein ranged from 1.0 to 2.6 nmol/mmol creatinine, which is comparable with values reached by radio-immunoassay.

  9. Urinary Kallikrein Excretion in Essential and Mineralocorticoid Hypertension

    PubMed Central

    Holland, O. Bryan; Chud, James M.; Braunstein, Helen

    1980-01-01

    excretion by Florinef was equal in black and white normal subjects vs. hypertensive patients (black normals = 12.3±2.7 [n = 9], NREH = 11.7±1.8 [n = 10], LREH = 10.9±1.5 [n = 12]; white normals = 21.2±2.9 [n = 11], essential hypertension = 20.9±3.2 [10 NREH, 5 LREH]). Stimulation of urinary kallikrein excretion with low sodium diet was decreased (P < 0.05) only in black LREH (black normals = 11.2±2.4 [n = 10], NREH = 10.1±2.7 [n = 10], LREH = 7.4±1.1 [n = 13]; white normals = 19.1±2.7 [n = 13], essential hypertension = 17.5±2.3 [nine NREH, four LREH]). However, during low sodium diet, black patients with LREH had evidence for less sodium depletion as manifested by a decreased rise in urinary aldosterone excretion (16.3±2.7 vs. 33.3±6.4 μg/24 h for black normals) and a failure to achieve metabolic balance in 11/13 patients. Thus, the lesser kallikrein stimulation appeared to result from these two factors. Black and white hypertensives with creatinine clearance <80 ml/min had little increase in urinary kallikrein excretion with Florinef or low sodium diet. 5 of 12 patients with primary aldosteronism or 17α-hydroxylase deficiency did not have an elevated urinary kallikrein excretion rate. Mild renal insufficiency may have contributed to this finding in two of these five patients. Nevertheless, this finding illustrates a limitation to the use of urinary kallikrein excretion rate as an index of mineralocorticoid activity. However, it appears that the majority of patients with LREH have no evidence for excess production of an unknown mineralocorticoid. The failure to find a decrease in urinary kallikrein excretion in racially matched patients with essentil hypertension and normal renal function questions the postulate of a role of the kallikrein-kinin system in the initiation of essential hypertension. PMID:7356684

  10. Spinal morphine anesthesia and urinary retention.

    PubMed

    Mahan, K T; Wang, J

    1993-11-01

    Spinal anesthetic is a common form of surgical anesthetic used in foot and ankle surgery. Spinal morphine anesthetic is less common, but has the advantage of providing postoperative analgesia for 12 to 24 hr. A number of complications can occur with spinal anesthesia, including urinary retention that may be a source of severe and often prolonged discomfort and pain for the patient. Management of this problem may require repeated bladder catheterization, which may lead to urinary tract infections or impairment of urethrovesicular function. This study reviews the incidence of urinary retention in 80 patients (40 after general anesthesia and 40 after spinal anesthesia) who underwent foot and ankle surgery at Saint Joseph's Hospital, Philadelphia, PA. Twenty-five percent of the patients who had spinal anesthesia experienced urinary retention, while only 7 1/2% of the group who had general anesthesia had this complication. Predisposing factors, treatment regimen, and recommendations for the prevention and management of urinary retention are presented.

  11. The newfoundland basin - Ocean-continent boundary and Mesozoic seafloor spreading history

    NASA Technical Reports Server (NTRS)

    Sullivan, K. D.

    1983-01-01

    It is pointed out that over the past 15 years there has been considerable progress in the refinement of predrift fits and seafloor spreading models of the North Atlantic. With the widespread acceptance of these basic models has come increasing interest in resolution of specific paleogeographic and kinematic problems. Two such problems are the initial position of Iberia with respect to North America and the geometry and chronology of early (pre-80 m.y.) relative motions between these two plates. The present investigation is concerned with geophysical data from numerous Bedford Institute/Dalhousie University cruises to the Newfoundland Basin which were undrtaken to determine the location of the ocean-continent boundary (OCB) and the Mesozoic spreading history on the western side. From the examination of magnetic data in the Newfoundland Basin, the OCB east of the Grand Banks is defined as the seaward limit of the 'smooth' magnetic domain which characterizes the surrounding continental shelves. A substantial improvement in Iberia-North America paleographic reconstructions is achieved.

  12. [Elution of urinary proteins preserved on nitrocellulose membrane with heating].

    PubMed

    Qin, Weiwei; Gao, Youhe

    2015-09-01

    The preservation of urinary proteins on a membrane plays a vital role in biomarker research, and the efficient elution of proteins preserved on nitrocellulose membrane (NC membrane) determines the application of this method. During the heating elution procedure, we raised the temperature to reduce the intense vortexing time, and kept gentle rotating while precipitation to prevent nitrocellulose reformation. We also used SDS-PAGE and LC-MS/MS to analyze the urinary proteins prepared by heating elution procedure, intense vortexing elution procedure and acetone precipitation method. There was no degradation of proteins prepared by heating elution procedure. Compared with proteins prepared by heating elution method and acetone precipitation method, the overlapping rates of the proteins was almost the same (92.6% versus 96.8%) and the ratios of CV values (< 20%) of the proteins were both high (85.2% and 94.4%). The heating elution procedure achieved good technical reproducibility, and was much simpler and more efficient than the previous one. It can facilitate the application of the preservation of urinary proteins on membrane.

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

    NASA Astrophysics Data System (ADS)

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

    2012-12-01

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

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

    NASA Technical Reports Server (NTRS)

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

    1981-01-01

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

  15. THE TREATMENT OF URINARY TRACT CALCULI

    PubMed Central

    Leadbetter, Wyland F.

    1958-01-01

    From review of recent information relative to calculus formation in the kidney, the conclusion reached that we do not yet understand, despite much effort, the basic physicochemical mechanisms involved. Since this is so, it has seemed best to the author for the present to rely, in treating patients with renal stones, on simple therapeutic concepts, which, if carefully and conscientiously applied, produce good results. The concepts are the elimination of known causes such as parathyroid adenomas and obstructive lesions, elimination or at least treatment of infections, diminution of urinary components which form the basis of calculi by limiting the oral intake or absorption from the gastrointestinal tract and maintenance of a dilute urine of desired pH. A plan for preoperative study is suggested to allow planned therapy. Indications for operative removal of calculi as well as some points of technique are discussed. It is emphasized that surgical removal of a calculus is but an incident in the care of patients with calculi and that treatment during the postoperative period and followup therapy is most important if success is to be achieved. Reports of cases to illustrate the application of these concepts are presented. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6Figure 7Figure 8Figure 9Figure 10Figure 11Figure 12Figure 13Figure 14Figure 15Figure 16 PMID:13523394

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

    PubMed

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

    2016-04-01

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

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

    PubMed Central

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

    2016-01-01

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

  18. Forty years continous monitoring for bluetongue virus at an Australian site of high arbovirus activity. What have we achieved?

    PubMed

    Melville, Lorna; Weir, Richard; Hunt, Neville; Davis, Steven; Walsh, Susan

    2015-01-01

    Beatrice Hill Farm (BHF) near Darwin, Australia was identified in the early 1970's as a site of high arbovirus activity. The first isolation of Bluetongue virus (BTV) in Australia was made on BHF in 1975. Since then, there has been continuous monitoring for BTV at BHF, the virus has been isolated on a yearly basis, with the only exception of 1990. All 10 serotypes known in Australia have been isolated at this site and an assessment of their biological behaviour made. Over the years, the methods and intensity of monitoring have been changed. In recent years molecular techniques have permitted more detailed examination of the origins of the viruses and their natural behaviour in field situations. Data collected at BHF have allowed modelling to detect likely origins of the BTVs that regularly enter Australia through wind borne infected Culicoides from South East Asia. Concurrent vector monitoring led to assess the Culicoides species more likely to be involved with transmission of these viruses. PMID:26741242

  19. Specific pharmacokinetic aspects of the urinary tract.

    PubMed

    Korstanje, Cees; Krauwinkel, Walter

    2011-01-01

    This chapter reviews the evidence for "specific" pharmacokinetics playing a role in currently marketed drugs intended to treat lower urinary tract (LUT) symptoms. Principles of drug targeting include intrinsic properties of drugs or organs as well as drug formulations to modify drug release or to create confinement of drug presence. Prodrugs and specific formulations to deliver high drug concentrations at the site(s) of action as well as other ways to manipulate drug distribution to achieve enrichment in target tissues are considered. In overactive bladder (OAB), specific formulations for oxybutynin have been introduced to reduce the level of side effects of the active drug. Extended release tablet formulations and a topical gel formulation have been introduced, with efficacy similar to immediate release (IR) tablets, but with a reduction in anticholinergic adverse effects. However, these modifications have not led to outstanding performance parameters compared to other anticholinergic drugs marketed as IR formulations. Urinary excretion is discussed as potential mechanism for targeting LUT symptoms, but no strong indications appear to exist that this mechanism would contribute for currently available drugs. Intravesical administration of drugs is not a preferred option and only considered for drugs like botulinum toxin, where the inconvenient application compensates for a reasonable degree of long-term efficacy in severe refractory OAB. Alpha acid glycoprotein binding is discussed as a potential factor to influence drug tissue distribution, and it is concluded that there is reasonable evidence that for tamsulosin this mechanism is responsible for the difference in free fraction of the drug observed in plasma and prostate, which could contribute to its relative absence of blood pressure effects in patients with LUT symptoms related to benign prostate hyperplasia (LUTS-BPH). The principle of irreversible inhibition of type II 5α-reductase as a tool to develop drugs

  20. Urinary Biomarkers of Brain Diseases

    PubMed Central

    An, Manxia; Gao, Youhe

    2016-01-01

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

  1. Urinary Bladder Cancer in Yemen

    PubMed Central

    Al-Samawi, Abdullah Saleh; Aulaqi, Saleh Mansoor

    2013-01-01

    Objectives The aims of this study are to highlight the clinicopathological features of urinary bladder cancer in Yemen, and to describe the histological grading of urothelial neoplasms according to the World Health Organization and International Society of Urologic pathology (WHO/ISUP 1998) classification. Methods This is a descriptive record-based study of 316 cases of bladder cancer diagnosed by two pathologists at the Department of pathology, Sana'a University from 1st January 2005 to 30th April 2009. The diagnoses were made on hematoxylin and eosin stained sections and categorized according to WHO/ISUP 1998 classification. Results Out of 316 urinary bladder cancers, 248 (78%) were urothelial neoplasms, 53 (17%) were squamous cell carcinoma, 7 (2%) were adenocarcinoma, and 3 (1%) were rhabdomyosarcoma. The remaining cases were metastatic carcinomas (n=3), small cell carcinoma (n=1), and non-Hodgkin's lymphoma (n=1). The urothelial neoplasms observed were carcinoma in situ 4 (2%), papilloma 7 (3%), papillary urothelial neoplasm of low malignant potential 26 (11%), papillary urothelial carcinoma of low grade 107 (43%), papillary urothelial carcinoma of high grade 18 (7%), and non-papillary urothelial carcinoma of high grade 85 (34%), with 60 years mean age for males and 58 years for females; along with a male to female ratio of 4:1. The peak incidence was observed in the 61-70 years age group. Conclusion This study documents a high frequency of urothelial neoplasms, mostly papillary urothelial carcinoma of low grade and non-papillary urothelial carcinoma of high grade with male preponderance and peak incidence in 6th decade of age. PMID:24044060

  2. Association of urinary cadmium and myocardial infarction

    SciTech Connect

    Everett, Charles J. Frithsen, Ivar L.

    2008-02-15

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

  3. Urinary arsenic concentration adjustment factors and malnutrition.

    PubMed

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

    2008-02-01

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

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

    NASA Astrophysics Data System (ADS)

    Osmaston, Miles F.

    2014-05-01

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

  5. Fighting urinary tract infections with antibiotic and non-antibiotic therapies.

    PubMed

    Peri, Lluis

    2016-06-25

    Urinary tract infections (UTIs) place a considerable burden on the patient and are associated with substantial economic cost. Treatment of UTIs is mainly achieved using antibiotics, however, the rise in antibiotic resistance is concerning and the use of non-antimicrobial prophylaxis offers alternative treatment methods.

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

    NASA Astrophysics Data System (ADS)

    Jain, Charitra; Rozel, Antoine; Tackley, Paul

    2016-04-01

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

  7. Radical urethrectomy with bladder preservation and continent catheterizable stoma (Yang-Monti tecnique)

    PubMed Central

    Maestro, Mario Alvarez; Martinez-Piñeiro, Luis; Gonzalez, Emilio Rios

    2012-01-01

    Malignant melanoma originating in the urethra is considered extremely rare and has a very poor prognosis. Consequently, therapeutic reviews are retrospective describing assorted treatments. We report how to perform a radical urethrectomy with bladder preservation and a continent catheterizable stoma (Yang-Monti technique) Radical urethrectomy with bladder preservation and a continent catheterizable stoma may be appropriate in selected patients with tumours that do not invade the bladder neck. PMID:22557732

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

    NASA Astrophysics Data System (ADS)

    Bilham, R. G.

    2012-12-01

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

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

    PubMed

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

    2013-03-01

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

  10. Treatment of upper urinary lithiasis in patients who have undergone urinary diversion.

    PubMed

    Badalato, Gina M; Cortes, Janice A Santos; Gupta, Mantu

    2011-04-01

    Patients undergoing urinary diversion are at high risk for developing stone disease due to the metabolic and structural features intrinsic to the creation of a urinary reservoir. The utilization of shockwave lithotripsy as well as antegrade and retrograde endoscopic techniques in appropriately selected patients affords a relatively safe and effective means of stone removal. This review focuses on the etiology of stone formation in patients with urinary diversion and examines the most relevant and current reports on expulsive techniques and their associated outcomes for patients within this population who develop upper urinary tract calculi.

  11. Development of a Prosthesis for Urinary Control

    NASA Technical Reports Server (NTRS)

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

    1986-01-01

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

  12. Conservative Management of Urinary Incontinence in Women

    PubMed Central

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

    2015-01-01

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

  13. [Conservative treatment in male urinary incontinence].

    PubMed

    Kirschner-Hermanns, R; Anding, R

    2014-03-01

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

  14. Urinary incontinence - what to ask your doctor

    MedlinePlus

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

  15. Urinary incontinence - tension-free vaginal tape

    MedlinePlus

    ... help control stress urinary incontinence . This is urine leakage that happens when you laugh, cough, sneeze, lift ... these and are still having problems with urine leakage, surgery may be your best option.

  16. Urinary tract complications with rectal surgery.

    PubMed Central

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

    1978-01-01

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

  17. Urinary diversion after cystectomy: An Indian perspective

    PubMed Central

    Jain, Deepak; Raghunath, S. K.; Khanna, Samir; Kumar, Prem; Rawal, Sudhir

    2008-01-01

    Radical cystectomy remains the standard treatment for muscle-invasive carcinoma bladder. Various methods have been described for the urinary diversion. In the last 150 years urinary diversion has evolved from cutaneous ureterostomy to the orthotopic neobladder. Especially during the last 20 years, much advancement has been made. We hereby have reviewed the current approaches being used at different centers in India. We have also analyzed the evolution of diversion from conduit to the orthotopic substitution at our center. PMID:19468368

  18. Nosocomial urinary tract infections: A review.

    PubMed

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

    2014-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2010-12-01

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

  20. A unified model of avian species richness on islands and continents.

    PubMed

    Kalmar, Attila; Currie, David J

    2007-05-01

    How many species in a given taxon should be found in a delimited area in a specified place in the world? Some recent literature suggests that the answer to this question depends strongly on the geographical, evolutionary, and ecological context. For example, current theory suggests that species accumulate as a function of area differently on continents and islands. Species richness-climate relationships have been examined separately on continents and on islands. This study tests the hypotheses that (1) the functional relationship between richness and climate is the same on continents and islands; (2) the species-area slope depends on distance-based isolation; (3) species-area relationships differ among land bridge islands, oceanic islands, and continents; (4) richness differs among biogeographic regions independently of climate and isolation. We related bird species numbers in a worldwide sample of 240 continental parcels and 346 islands to several environmental variables. We found that breeding bird richness varies similarly on islands and on continents as a function of mean annual temperature, an area x precipitation interaction, and the distance separating insular samples from the nearest continent (R2 = 0.86). Most studies to date have postulated that the slope of the species-area relationship depends upon isolation. In contrast, we found no such interaction. A richness-environment relationship derived using Old World sites accurately predicts patterns of richness in the New World and vice versa (R2 = 0.85). Our results suggest that most of the global variation in richness is not strongly context-specific; rather, it reflects a small number of general environmental constraints operating on both continents and islands.

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

    NASA Astrophysics Data System (ADS)

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

    2014-12-01

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

  2. Sustaining Rocky Mountain landscapes: Science, policy and management for the Crown of the Continent ecosystem

    USGS Publications Warehouse

    Prato, Tony; Fagre, Daniel B.

    2007-01-01

    Prato and Fagre offer the first systematic, multi-disciplinary assessment of the challenges involved in managing the Crown of the Continent Ecosystem ( CCE), an area of the Rocky Mountains that includes northwestern Montana, southwestern Alberta, and southeastern British Columbia. The spectacular landscapes, extensive recreational options, and broad employment opportunities of the CCE have made it one of the fastest growing regions in the United States and Canada, and have lead to a shift in its economic base from extractive resource industries to service-oriented recreation and tourism industries. In the process, however, the amenities and attributes that draw people to this “New West” are under threat. Pastoral scenes are disappearing as agricultural lands and other open spaces are converted to residential uses, biodiversity is endangered by the fragmentation of fish and wildlife habitats, and many areas are experiencing a decline in air and water quality. Sustaining Rocky Mountain Landscapes provides a scientific basis for communities to develop policies for managing the growth and economic transformation of the CCE without sacrificing the quality of life and environment for which the land is renowned. This forthcoming edited volume focuses on five aspects of sustaining mountain landscapes in the CCE and similar regions in the Rocky Mountains. The five aspects are: 1) how social, economic, demo graphic and environmental forces are transforming ecosystem structure and function, 2) trends in use and conditions for human and environmental resources, 3) activating science, policy and education to enhance sustainable landscape management, 4) challenges to sustainable management of public and private lands, and 5) future prospects for achieving sustainable landscapes.

  3. Reconstructed and simulated temperature asymmetry between continents in both hemispheres over the last centuries

    NASA Astrophysics Data System (ADS)

    Goosse, Hugues

    2016-05-01

    Available proxy-based temperature reconstructions covering the past millennium display contrasted evolutions between the continents. The difference is particularly large between the two hemispheres. When driven by realistic natural and anthropogenic forcings, climate models tend to simulate a more spatially homogenous temperature response. This is associated with a relatively good agreement between model results and reconstructions in the Northern Hemisphere but a low consistency in the Southern Hemisphere. Here, simulations with data assimilations are performed to analyse the causes of this apparent disagreement. It shows that, when the uncertainties are taken into account, states of the climate system compatible with the forcing estimates, the reconstructions and the model physics can be obtained over the past millennium, except for the twentieth century in Antarctica where the simulated warming is always much larger than in the reconstructions. Such states consistent with all sources of information can be achieved even if the uncertainties of the reconstructions are underestimated. Although, well within the range of the proxy-based reconstructions, the temperatures obtained after data assimilation display more similar developments between the hemispheres than in those reconstructions. Ensuring the compatibility does not require to systematically reduce the model response to the forcing or to strongly enhance the model internal variability. From those results, there is thus no reason to suspect that the model is strongly biased in one aspect or another. The constraint imposed by the data assimilation is too low to unambiguously identify the origin of each feature displayed in the reconstructions but, as expected, changes in atmospheric circulation likely played a role in many of them. Furthermore, ocean heat uptake and release as well as oceanic heat transport are key elements to understand the delayed response of the Southern Hemisphere compared to the northern

  4. Electromagnetic Subsurface Soundings at HF frequencies and Antenna Impedance Measurements on the Antarctic Continent

    NASA Astrophysics Data System (ADS)

    Valerie, C.; Jean-Jacques, B.; Richard, N.; Michel, H.; Sebastien, B.; Francois, D.; Alain, R.

    2004-05-01

    In the frame of the NETLANDER project, a ground penetrating radar (GPR) dedicated to the exploration of the Martian subsurface has been developed. This GPR is designed for deep sounding down to a depth which is sufficient to allow possible detection of liquid water and thus operates mainly at a frequency of 2 MHz. Contrary to the normal mode of operation of subsurface radars which can be moved over the soil to be explored, the GPR of NETLANDER aims at performing 3D imaging of the underground reflecting structures even if it operates in a fixed position. This is achieved by retrieving not only the distance of the reflectors but also the direction of the backscattered waves by measuring the 2 horizontal electric components and the 3 magnetic components of the reflected waves. Two perpendicular dipoles each consisting in two 35-meters electric monopoles are used for both transmission and reception, while the receiving magnetic antenna can be successively directed along 3 mutually orthogonal directions. In addition, the perfect stability of the environment allows a very large number of coherent integrations to be performed, which provide a satisfactory sensitivity Ground tests were recently carried out on the Antarctic continent in 2004. Soundings at frequencies in the range 2-5 MHz have been performed with the NETLANDER monostatic GPR prototype and with the updated version of this instrument, which operates in a real bistatic mode. As expected the echoes due to interaction with the bedrock are detected and the magnetic component measurements provide information linked to the orientation of the reflecting structures. The first experimental results will be reported. We will present results on the electric antenna impedance measurements, which give information on the permittivity of the upper subsurface layer. We will also focus on the analysis of the backscattered signals using both electric and magnetic components of the received field. Comparisons with numerical

  5. Management of urinary tract calculi by extracorporeal shock wave lithotripsy.

    PubMed

    Wadhwa, S N; Seth, A; Sood, R; Gupta, N P; Dogra, P N; Hemal, A K

    1994-02-01

    From July 1989 to April 1993, Extracorporeal Shockwave Lithotripsy (ESWL) was performed on 642 patients, of which 21 were from the pediatric age group. All treatments were done on a second generation lithotriptor-Siemens Lithostar, which does not require any modification for positioning of children. Fragmentation was achieved in all the patients (100%). A complete stone free rate was achieved in 17/21 patients (80.9%). Three (14.3%) patients had insignificant residual fragments whereas 1 (4.8%) had a residual fragment approximately 4 mm in size. 5640 shocks were required on an average. We have used low energy shockwaves with good results. General anesthesia was required for lithotripsy in only one child. The average fluoro exposure time was 1.6 minutes. We conclude that ESWL is a safe and effective method for treating urinary tract calculi in children.

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

    PubMed

    Swaffield, J

    1995-09-01

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

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

    NASA Astrophysics Data System (ADS)

    Flatau, M. K.

    2015-12-01

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

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

    PubMed Central

    Lyons, Stacie Salsbury

    2010-01-01

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

  9. A harbinger of plate tectonics: a commentary on Bullard, Everett and Smith (1965) 'The fit of the continents around the Atlantic'.

    PubMed

    Dewey, John F

    2015-04-13

    In the 1960s, geology was transformed by the paradigm of plate tectonics. The 1965 paper of Bullard, Everett and Smith was a linking transition between the theories of continental drift and plate tectonics. They showed, conclusively, that the continents around the Atlantic were once contiguous and that the Atlantic Ocean had grown at rates of a few centimetres per year since the Early Jurassic, about 160 Ma. They achieved fits of the continental margins at the 500 fathom line (approx. 900 m), not the shorelines, by minimizing misfits between conjugate margins and finding axes, poles and angles of rotation, using Euler's theorem, that defined the unique single finite difference rotation that carried congruent continents from contiguity to their present positions, recognizing that the real motion may have been more complex around a number of finite motion poles. Critically, they were concerned only with kinematic reality and were not restricted by considerations of the mechanism by which continents split and oceans grow. Many of the defining features of plate tectonics were explicit or implicit in their reconstructions, such as the torsional rigidity of continents, Euler's theorem, closure of the Tethyan ocean(s), major continental margin shear zones, the rapid rotation of small continental blocks (Iberia) around nearby poles, the consequent opening of small wedge-shaped oceans (Bay of Biscay), and misfit overlaps (deltas and volcanic piles) and underlaps (stretched continental edges). This commentary was written to celebrate the 350th anniversary of the journal Philosophical Transactions of the Royal Society. PMID:25750142

  10. A harbinger of plate tectonics: a commentary on Bullard, Everett and Smith (1965) ‘The fit of the continents around the Atlantic’

    PubMed Central

    Dewey, John F.

    2015-01-01

    In the 1960s, geology was transformed by the paradigm of plate tectonics. The 1965 paper of Bullard, Everett and Smith was a linking transition between the theories of continental drift and plate tectonics. They showed, conclusively, that the continents around the Atlantic were once contiguous and that the Atlantic Ocean had grown at rates of a few centimetres per year since the Early Jurassic, about 160 Ma. They achieved fits of the continental margins at the 500 fathom line (approx. 900 m), not the shorelines, by minimizing misfits between conjugate margins and finding axes, poles and angles of rotation, using Euler's theorem, that defined the unique single finite difference rotation that carried congruent continents from contiguity to their present positions, recognizing that the real motion may have been more complex around a number of finite motion poles. Critically, they were concerned only with kinematic reality and were not restricted by considerations of the mechanism by which continents split and oceans grow. Many of the defining features of plate tectonics were explicit or implicit in their reconstructions, such as the torsional rigidity of continents, Euler's theorem, closure of the Tethyan ocean(s), major continental margin shear zones, the rapid rotation of small continental blocks (Iberia) around nearby poles, the consequent opening of small wedge-shaped oceans (Bay of Biscay), and misfit overlaps (deltas and volcanic piles) and underlaps (stretched continental edges). This commentary was written to celebrate the 350th anniversary of the journal Philosophical Transactions of the Royal Society. PMID:25750142

  11. General practitioners and women with urinary incontinence.

    PubMed Central

    Grealish, M; O'Dowd, T C

    1998-01-01

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

  12. Elemental distribution analysis of urinary crystals.

    PubMed

    Fazil Marickar, Y M; Lekshmi, P R; Varma, Luxmi; Koshy, Peter

    2009-10-01

    Various crystals are seen in human urine. Some of them, particularly calcium oxalate dihydrate, are seen normally. Pathological crystals indicate crystal formation initiating urinary stones. Unfortunately, many of the relevant crystals are not recognized in light microscopic analysis of the urinary deposit performed in most of the clinical laboratories. Many crystals are not clearly identifiable under the ordinary light microscopy. The objective of the present study was to perform scanning electron microscopic (SEM) assessment of various urinary deposits and confirm the identity by elemental distribution analysis (EDAX). 50 samples of urinary deposits were collected from urinary stone clinic. Deposits containing significant crystalluria (more than 10 per HPF) were collected under liquid paraffin in special containers and taken up for SEM studies. The deposited crystals were retrieved with appropriate Pasteur pipettes, and placed on micropore filter paper discs. The fluid was absorbed by thicker layers of filter paper underneath and discs were fixed to brass studs. They were then gold sputtered to 100 A and examined under SEM (Jeol JSM 35C microscope). When crystals were seen, their morphology was recorded by taking photographs at different angles. At appropriate magnification, EDAX probe was pointed to the crystals under study and the wave patterns analyzed. Components of the crystals were recognized by utilizing the data. All the samples analyzed contained significant number of crystals. All samples contained more than one type of crystal. The commonest crystals encountered included calcium oxalate monohydrate (whewellite 22%), calcium oxalate dihydrate (weddellite 32%), uric acid (10%), calcium phosphates, namely, apatite (4%), brushite (6%), struvite (6%) and octocalcium phosphate (2%). The morphological appearances of urinary crystals described were correlated with the wavelengths obtained through elemental distribution analysis. Various urinary crystals that

  13. Graded Achievement, Tested Achievement, and Validity

    ERIC Educational Resources Information Center

    Brookhart, Susan M.

    2015-01-01

    Twenty-eight studies of grades, over a century, were reviewed using the argument-based approach to validity suggested by Kane as a theoretical framework. The review draws conclusions about the meaning of graded achievement, its relation to tested achievement, and changes in the construct of graded achievement over time. "Graded…

  14. [Urinary urgency and reflex incontinence].

    PubMed

    Madersbacher, H

    1991-07-01

    Urge and reflex incontinence are caused by detrusor dysfunction:urgency may be due to hyperactivity or hypersensitivity of the bladder. Neurogenic hyperactivity of the detrusor is called detrusor hyperreflexia: the neurogenic uninhibited bladder is caused by incomplete, and the so-called reflex bladder by complete, suprasacral lesions. The pathophysiology of symptomatic and idiopathic detrusor hyperactivity and the therapeutic armentarium are described. Bladder drill together with biofeedback and pharmacotherapy with spasmolytic drugs - several potent spasmolytic drugs with different modes of action are available - are the basis of treatment for hyperactivity and hypersensitivity of the detrusor. An alternative is electrostimulation: stimulation of the afferents of the pudendal nerve, via the pelvic floor (anal, vaginal), percutaneously (dorsal nerve of the penis, clitoric nerve) or by the implantation of electrodes results in inhibition of the detrusor. Most (80-90%) patients can be treated successfully by conservative means. Operative measurements comprise bladder denervation and bladder augmentation. The results of bladder denervation by transtrigonal phenolization of the pelvic plexus are highly controversial. In patients with uncontrollable hyperactivity of the detrusor, augmentation of the bladder (e.g. clam ileocystoplasty) is the method of choice, while for those with uncontrollable hypersensitivity of the detrusor, cystectomy followed by bladder substitution should be performed as a last resort. Treatment for urinary incontinence due to detrusor hyperreflexia must be selected bearing in mind that bladder emptying is inadequate, in most cases because of dyssynergia between detrusor and external sphincter. Therapy is basically aimed at transforming hyperreflexia of the detrusor into hyporeflexia, primarily by potent spasmolytic drugs.(ABSTRACT TRUNCATED AT 250 WORDS)

  15. A clinical experience with dantrolene sodium for external urinary sphincter hypertonicity in spinal cord injured patients.

    PubMed

    Hackler, R H; Broecker, B H; Klein, F A; Brady, S M

    1980-07-01

    Significant bladder residual urine is secondary to pelvic floor skeletal muscle hypertonicity in some spinal cord injury patients with suprasacral or mixed lesions. Fifteen patients with residual urine volumes greater than 150 cc were treated with dantrolene sodium because of its ability to decrease skeletal muscle contractibility. All of the patients had urethral closure pressures greater than 100 cm. water. Of the 15 patients 8 benefited from dantrolene sodium therapy and were maintained on external condom urinary drainage. Five of these 8 patients required up to 600 mg. dantrolene sodium daily to affect this result. The residual urine volume decreased to less than 100 cc and the post-therapy decrease in urethral pressure averaged 77 cm. water (49 per cent). The patients in the failure group (residual urine greater than 150 cc) had an average decrease in urethral pressure of 21 cm. water (16 per cent). Detrusor hyporeflexia possibly contributed to the failure rate. In summary, dantrolene sodium seems to be beneficial in some patients with external urinary sphincter hypertonicity. However, it will not supplant external sphincterotomy in the more complete male spinal cord injury patient in whom reflex incontinence is of minimal concern. Dantrolene sodium could be an ideal treatment of patients with incomplete neurologic lesions in whom continence might be preserved. The drug will have to be effective at low doses to obviate the major side effect of over-all muscle weakness.

  16. An integral theory of female urinary incontinence. Experimental and clinical considerations.

    PubMed

    Petros, P E; Ulmsten, U I

    1990-01-01

    In this Theory paper, the complex interplay of the specific structures involved in female urinary continence are analyzed. In addition the effects of age, hormones, and iatrogenically induced scar tissue on these structures, are discussed specifically with regard to understanding the proper basis for treatment of urinary incontinence. According to the Theory stress and urge symptoms may both derive, for different reasons from the same anatomical defect, a lax vagina. This laxity may be caused by defects within the vaginal wall itself, or its supporting structures i.e. ligaments, muscles, and their connective tissue insertions. The vagina has a dual function. It mediates (transmits) the various muscle movements involved in bladder neck opening and closure through three separate closure mechanisms. It also has a structural function, and prevents urgency by supporting the hypothesized stretch receptors at the proximal urethra and bladder neck. Altered collagen/elastin in the vaginal connective tissue and/or its ligamentous supports may cause laxity. This dissipates the muscle contraction, causing stress incontinence, and/or activation of an inappropriate micturition reflex, ("bladder instability") by stimulation of bladder base stretch receptors. The latter is manifested by symptoms of frequency, urgency, nocturia with or without urine loss.

  17. Thermal models of dyke intrusion during development of continent-ocean transition

    NASA Astrophysics Data System (ADS)

    Daniels, K. A.; Bastow, I. D.; Keir, D.; Sparks, R. S. J.; Menand, T.

    2014-01-01

    A consensus has emerged in recent years from a variety of geoscientific disciplines that extension during continental rifting is achieved only partly by plate stretching: dyke intrusion also plays an important role. Magma intrusion can accommodate extension at lower yield stresses than are required to extend thick, strong, unmodified continental lithosphere mechanically, thereby aiding the breakup process. Dyke intrusion is also expected to heat and thereby weaken the plate, but the spatial extent of heating and the effect of different rates of magmatic extension on the timescales over which heating occurs are poorly understood. To address this issue, a numerical solution to the heat-flow equation is developed here to quantify the thermal effects of dyke intrusion on the continental crust during rifting. The thermal models are benchmarked against a priori constraints on crustal structure and dyke intrusion episodes in Ethiopia. Finite difference models demonstrate that magmatic extension rate exerts a first-order control on the crustal thermal structure. Once dyke intrusion supersedes faulting and stretching as the principal extensional mechanism the crust will heat and weaken rapidly (less than 1 Ma). In the Main Ethiopian Rift (MER), the majority of present-day extension is focused on ∼20 km-wide Quaternary-Recent axial magmatic segments that are mostly seismogenic to mid-crustal depths and show P-wave seismic velocities characteristic of heavily intruded continental crust. When reviewed in light of our models, these observations require that no more than half of the MER's extension since ∼2 Ma has been achieved by dyke intrusion. Magmatic heating and weakening of the crust would have rendered it aseismic if dyke intrusion accounted for the entire 6 mm/yr extension rate. In the older, faster extending (16 mm/yr) Red Sea rift (RSR) in Afar, dyke intrusion is expected to have had a more dramatic impact on crustal rheology. Accordingly, effective elastic plate

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

    NASA Astrophysics Data System (ADS)

    Sun, Lantao; Perlwitz, Judith; Hoerling, Martin

    2016-05-01

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

  19. Lower urinary tract development and disease

    PubMed Central

    Rasouly, Hila Milo; Lu, Weining

    2013-01-01

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

  20. Serum and Urinary NGAL in Septic Newborns

    PubMed Central

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

    2014-01-01

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

  1. Growth of the Maritime Continent and its possible contribution to recurring Ice Ages

    NASA Astrophysics Data System (ADS)

    Molnar, Peter; Cronin, Timothy W.

    2015-03-01

    The areal extent of the Maritime Continent (the islands of Indonesia and surrounding region) has grown larger by ~60% since 5 Ma. We argue that this growth might have altered global climate in two ways that would have contributed to making recurring Ice Ages possible. First, because rainfall over the islands of the Maritime Continent not only is heavier than that over the adjacent ocean but also correlates with the strength of the Walker Circulation, the growth of the Maritime Continent since 5 Ma may have contributed to the cooling of the eastern tropical Pacific since that time. Scaling relationships between the strength of the Walker Circulation and rainfall over the islands of the Maritime Continent and between sea surface temperature (SST) of the eastern tropical Pacific and the strength of easterly wind stress suggest that the increase in areal extent of islands would lead to a drop in that SST of 0.75°C. Although only a fraction of the 3-4°C decrease in SSTs between the eastern and western tropical Pacific, the growth of the Maritime Continent may have strengthened the Walker Circulation, increased the east-west temperature gradient across the Pacific and thereby enabled ice sheets to wax and wane over Canada since 3 Ma. Second, because the weathering of basaltic rock under warm, moist conditions extracts CO2 from the atmosphere more rapidly than weathering of other rock or of basalt under cooler or drier conditions, the increase in weathering due to increasing area of basalt in the Maritime Continent may have drawn down enough CO2 from the atmosphere to affect global temperatures. Simple calculations suggest that increased weathering of basalt might have lowered global temperatures by 0.25°C, possibly important for the overall cooling.

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

    NASA Astrophysics Data System (ADS)

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

    2015-12-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2011-12-01

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

  4. Association of overactive bladder and stress urinary incontinence in rats with pudendal nerve ligation injury.

    PubMed

    Furuta, Akira; Kita, Masafumi; Suzuki, Yasuyuki; Egawa, Shin; Chancellor, Michael B; de Groat, William C; Yoshimura, Naoki

    2008-05-01

    Approximately one-third of patients with stress urinary incontinence (SUI) also suffer from urgency incontinence, which is one of the major symptoms of overactive bladder (OAB) syndrome. Pudendal nerve injury has been recognized as a possible cause for both SUI and OAB. Therefore, we investigated the effects of pudendal nerve ligation (PNL) on bladder function and urinary continence in female Sprague-Dawley rats. Conscious cystometry with or without capsaicin pretreatment (125 mg/kg sc), leak point pressures (LPPs), contractile responses of bladder muscle strips to carbachol or phenylephrine, and levels of nerve growth factor (NGF) protein and mRNA in the bladder were compared in sham and PNL rats 4 wk after the injury. Urinary frequency detected by a reduction in intercontraction intervals and voided volume was observed in PNL rats compared with sham rats, but it was not seen in PNL rats with capsaicin pretreatment that desensitizes C-fiber-afferent pathways. LPPs in PNL rats were significantly decreased compared with sham rats. The contractile responses of detrusor muscle strips to phenylephrine, but not to carbachol, were significantly increased in PNL rats. The levels of NGF protein and mRNA in the bladder of PNL rats were significantly increased compared with sham rats. These results suggest that pudendal nerve neuropathy induced by PNL may be one of the potential risk factors for OAB, as well as SUI. Somato-visceral cross sensitization between somatic (pudendal) and visceral (bladder) sensory pathways that increases NGF expression and alpha(1)-adrenoceptor-mediated contractility in the bladder may be involved in this pathophysiological mechanism.

  5. [Stress urinary incontinence. Its surgical management].

    PubMed

    Neri Ruz, E S; Azcona Arteaga, F J

    1991-10-01

    Ninety eight patients with stress urinary incontinence treated surgically at Central Military Hospital, were studied. We analyzed the risk factors as age, weight, height, parity, menopause age, and previous medical and surgical procedures. They were divided in two groups. The Group I, vaginal approach, with 35 patients and Group II, retropubic surgery, with 63 patients. There were no differences both groups regarding age, weight, height, parity and menopausal age. The most frequent illness associated with stress urinary incontinence, was pelvic floor relaxation. The complications were 17.1% and 33.3%, respectively. The efficacy of Burch is procedure for the management of stress urinary incontinence, with a success rate of 84.1% versus 62.1% in the vaginal approach, was confirmed.

  6. [Ultrasound diagnostics of upper urinary tract calculi].

    PubMed

    Belyĭ, L E

    2006-01-01

    The review is dedicated to ultrasonography of the upper urinary tract in patients with nephrolithiasis. Ultrasonographic semiotics of urolithiasis, the ability of unlrasonography to detect nephrolithiasis, and methods of the optimization of these diagnostic techniques in patients with upper urinary tract calculi are covered. The author discusses difficulties that may be faced while differentiating between nephrolithiasis and such conditions as spongious kidney, nephrocalcinosis, calcification of renal papillae, cysts, tumors, and vascular walls, as well as other kinds of renal calcification, associated with ultrasonographic acoustic path phenomenon. The advantages and disadvantages of ultrasonography in cases of X-ray urolithiasis are evaluated in the paper. The article describes hardships in ultrasound visualization of ureteral calculi causing acute upper urinary tract obstruction, and the ways of getting over them.

  7. Assessing adrenocortical activity by determining levels of urinary free cortisol and urinary 6 beta-hydroxycortisol.

    PubMed

    Nakamura, J; Yakata, M

    1989-03-01

    A comparative study of urinary free cortisol and urinary 6 beta-hydroxycortisol levels as a diagnostic test for hypercortisolemic states was carried out by measuring the excretion in 24-h specimens from 289 apparently healthy subjects and 10 Cushing patients. The diurnal variations of both variables were examined in normal subjects and subjects with altered adrenal activities. Two of the 289 apparently normal subjects had high values of urinary free cortisol; one had a high, the other a normal 6 beta-hydroxycortisol level; they were later diagnosed as having Cushing's syndrome and infertility, respectively. Three other subjects had high values of the urinary variables, but during 5 years of follow-up did not show any clinical evidence of hypercortisolism. The two urinary variables gave no false-negative results in the Cushing patients. The diurnal variation revealed that levels of 6 beta-hydroxycortisol change in parallel with those of free cortisol in normal subjects and in subjects with altered adrenal activities. However, the ratio of 6 beta-hydroxycortisol to free cortisol during the diurnal variation varied from low values when free cortisol levels were high to high values when free cortisol levels were low. In normal subjects, 1 mg of dexamethasone taken orally at 23.00 h completely suppressed the levels of both variables on the following day. It is concluded that urinary 6 beta-hydroxycortisol is correlated to urinary free cortisol so that measurement of urinary 6 beta-hydroxycortisol levels can be used as a diagnostic test for hypercortisolism in a way comparable to the method using urinary free cortisol.

  8. Calcifying nanoparticles associated encrusted urinary bladder cystitis

    PubMed Central

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

    2008-01-01

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

  9. Urinary Tract Infection and Neurogenic Bladder.

    PubMed

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

    2015-11-01

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

  10. Botulinum toxin for the lower urinary tract.

    PubMed

    Chuang, Yao-Chi; Kuo, Hann-Chorng; Chancellor, Michael B

    2010-04-01

    Botulinum toxins (BoNTs) are known for their ability to potently and selectively modulate neurotransmission for successful long-term treatment of muscle hypercontractility. Recent studies suggest that BoNT has effects on modulation of sensory processing, inflammation and glandular function. Urologists and urogynaecologists have become interested in the potential application of BoNTs in patients with lower urinary tract symptoms, including detrusor and sphincter overactivity, bladder hypersensitivity, interstitial cystitis/painful bladder symptoms and benign prostatic hyperplasia. We review the biological action of BoNT in bladder and prostate, and present the techniques and results of the clinical studies with BoNT in the lower urinary tract.

  11. Urinary capillariosis in six dogs from Italy

    PubMed Central

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

    2016-01-01

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

  12. Urinary tract infections: treatment/comparative therapeutics.

    PubMed

    Olin, Shelly J; Bartges, Joseph W

    2015-07-01

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

  13. Calcifying nanoparticles associated encrusted urinary bladder cystitis.

    PubMed

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

    2008-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-09-01

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

  16. Application of Analyte Harvesting Nanoparticle Technology to the Measurement of Urinary HGH in Healthy Individuals.

    PubMed

    Luchini, Alessandra; Tamburro, Davide; Magni, Ruben; Fredolini, Claudia; Espina, Virginia; Bosch, Jaume; Garaci, Enrico; Petricoin, Emanuel F; Liotta, Lance A

    2012-01-01

    Urine represents a valuable biofluid for noninvasive measurement of Human Growth Hormone (HGH) secretion. Unfortunately, currently available commercial HGH immunoassays do not achieve the sensitivity needed for urinary HGH measurement in the low picogram per milliliter range, the expected normal concentration range of HGH in urine. A nanotechnology based sample preprocessing step was used to extract and concentrate HGH in urine so that urinary HGH could be measured with a clinical grade standard immunoassay designed for serum (Immulite 1000, Siemens). We applied the nanoparticle enhanced immunoassay to evaluate the baseline value of urinary HGH in a population of healthy young adults (age 18-30, N=33, median 21, M: F=39%:61%, with no reported medical therapies). Nanoparticle sample preprocessing effectively improved the lower limit of detection of the Immulite HGH assay by more than 50 fold, shifting the linear range of the assay to encompass the expected value of urinary HGH. The full process between run and within run CV% was 7.9 and 9.0%, respectively. On 33 healthy volunteers, the 95% reference values for hGH in spot urine normalized to specific gravity were 0.64 - 16.85 pg/mL (0.05-5.82 ng/g creatinine). Nanoparticle preprocessing constitutes a reliable means of measuring urinary HGH with a clinical grade immunoassay, now establishing a normal baseline value for HGH in urine. Nanoparticles can be used to study the kinetics of HGH excretion in urine, and the factors that influence urinary HGH secretion and HGH isoform proportions.

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

    NASA Technical Reports Server (NTRS)

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

    1974-01-01

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

  18. Rotational Inerfia of Continents: A Proposed Link between Polar Wandering and Plate Tectonics.

    PubMed

    Kane, M F

    1972-03-24

    A mechanism is proposed whereby displacement between continents and the earth's pole of rotation (polar wandering) gives rise to latitudinal transport of continental plates (continental drift) because of their relatively greater rotational inertia. When extended to short-term polar wobble, the hypothesis predicts an energy change nearly equivalent to the seismic energy rate. PMID:17813830

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

    NASA Astrophysics Data System (ADS)

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

    2011-01-01

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

  20. Family Planning Services Available to Migratory Farm Workers in the Mid-Continent Streams.

    ERIC Educational Resources Information Center

    Planned Parenthood--World Population, Austin, TX. Southwest Region.

    The information in this directory is designed to promote continuity in family planning services for migrant families in mid-continent streams. It provides professional personnel with a new tool to help meet the distinctive needs of individual migrants. Names, addresses, schedules, methods, and fee information of service agencies (health…

  1. Family Planning in Five Continents: Africa, America, Asia, Europe, Oceania. October 1973 Update.

    ERIC Educational Resources Information Center

    International Planned Parenthood Federation, London (England).

    Population growth trends and family planning activities in Africa, America, Asia, Europe, and Oceania are summarized in this booklet developed by the International Planned Parenthood Federation. Narrative information for each continent gives a resume of population growth trends, reasons for the trends, population problems, policy formation, family…

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

    PubMed

    Forbat, Liz

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

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

    PubMed

    Boisclair-Fahey, Anne

    2009-10-01

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

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

    ERIC Educational Resources Information Center

    Boisclair-Fahey, Anne

    2009-01-01

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

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

    USGS Publications Warehouse

    Kane, M.F.

    1972-01-01

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

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

    ERIC Educational Resources Information Center

    Eggemeyer, Valerie

    2004-01-01

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

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

    ERIC Educational Resources Information Center

    Barley, Zoe

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

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

    EPA Science Inventory

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

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

    ERIC Educational Resources Information Center

    Wiegand, Patrick; Stiell, Bernadette

    1996-01-01

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

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

    NASA Technical Reports Server (NTRS)

    1985-01-01

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

  11. Rotational Inerfia of Continents: A Proposed Link between Polar Wandering and Plate Tectonics.

    PubMed

    Kane, M F

    1972-03-24

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

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

    USGS Publications Warehouse

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

    1991-01-01

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

  13. Multiscale Interactions over the Maritime Continent: Feedbacks between Atmospheric Convectively Coupled Kelvin Waves and Diurnal Cycle

    NASA Astrophysics Data System (ADS)

    Baranowski, D.

    2015-12-01

    Interactions between atmospheric convectively coupled Kelvin waves (CCKW), initiated over the Indian Ocean, and the diurnally varying convection over the Maritime Continent are primary interest of this presentation. Mutliscale interactions between local and propagating convection lead to substantial enhancement of the local diurnal cycle over that region. CCKW activity strongly modulates magnitude of the diurnal cycle of precipitation over the Maritime Continent, but not its temporal evolution, which maintains characteristics of a diurnal cycle. The impact is such that precipitation is highly increased during convective part of the CCKW and little suppressed during its non-convective part. Timing of the increase in diurnal cycle magnitude strongly depends on the time of the day of the CCKW approach to the Maritime Continent. It is shown that precipitation anomaly associated with CCKW is phase locked with local diurnal cycle of precipitation over the Maritime Continent and that has implications for CCKW ability to propagate across that region. The composite daily-zonal evolution of the precipitation anomaly associated with CCKW is such that it is "in-phase" with local diurnal cycle over Sumatra, Borneo and surrounding seas. This presentation is based on analysis of TRMM precipitation data and newly developed CCKW trajectories database.

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

    EPA Science Inventory

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

  15. Developing Your Own Continent--A Teaching Unit for World Geography.

    ERIC Educational Resources Information Center

    Richburg, Robert W.; Dornan, David Lynn

    1980-01-01

    Describes a six-week seventh-grade project in which students create their own continent. The project helps students learn about weather and climatic patterns, use map scales and legends, describe relationships between natural resources and human activities, solve problems, and work effectively in groups. (Author/KC)

  16. Moving Target: ENSO and Seasonal Forecasting for the Winter Monsoon over the Western Maritime Continent

    NASA Astrophysics Data System (ADS)

    Lee, S. Y.

    2014-12-01

    The El Niño-Southern Oscillation (ENSO) is the dominant mode of interannual variability over most of the tropics, and the performance of seasonal forecast models over such region is often related to how well they capture the regional teleconnection with ENSO. During the boreal winter monsoon, mean precipitation over much of the Maritime Continent is strongly correlated with ENSO phase. Over these regions, the prospect of accurate seasonal precipitation forecast is optimistic. Unfortunately, the ENSO signal in precipitation is known to be much weaker over the western Maritime Continent, which covers the Malay Peninsula, Borneo, Sumatra, and west Java. We investigate the ENSO teleconnection with mean precipitation using simple statistics on merged observation-remote sensing and model hindcast products. These diagnostics suggest an additional reason for why the winter monsoon mean precipitation over the western Maritime Continent is poorly correlated with the ENSO phase, and why some forecast models may not reflect this observed situation. We make recommendations for some process-based forecast products that are desirable for the Western Maritime Continent.

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

    ERIC Educational Resources Information Center

    Samuel, Francis A.

    2011-01-01

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

  18. 21 CFR 862.1377 - Urinary homocystine (nonquantitative) test system.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Urinary homocystine (nonquantitative) test system... Test Systems § 862.1377 Urinary homocystine (nonquantitative) test system. (a) Identification. A urinary homocystine (nonquantitative) test system is a device intended to identify homocystine...

  19. 21 CFR 862.1377 - Urinary homocystine (nonquantitative) test system.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Urinary homocystine (nonquantitative) test system... Test Systems § 862.1377 Urinary homocystine (nonquantitative) test system. (a) Identification. A urinary homocystine (nonquantitative) test system is a device intended to identify homocystine...

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

    NASA Astrophysics Data System (ADS)

    Osmaston, Miles F.

    2014-05-01

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

  1. NorthAm Fest : fostering a North American continent approach to countering terrorism.

    SciTech Connect

    Gerdes, Dick; Moore, Judy Hennessey; Whitley, John B.; Turnley, Jessica Glicken; Oborotova, Marina

    2004-12-01

    On September 14-16, 2004, the Advanced Concepts Group of Sandia National Laboratories in conjunction with the University of Texas at El Paso and the North American Institute hosted a workshop (fest) designed to explore the concept of a North American continental approach to countering terrorism. The fest began with the basic premise that the successful defense of North America against the threat of terrorism will require close collaboration among the North American allies--Canada, Mexico and the U.S.--as well as a powerful set of information collection and analysis tools and deterrence strategies. The NorthAm Fest recast the notion of ''homeland defense'' as a tri-national effort to protect the North American continent against an evolving threat that respects no borders. This is a report of the event summarizing the ideas explored. The fest examined the uniqueness of dealing with terrorism from a tri-national North American viewpoint, the role and possible features of joint security systems, concepts for ideal continental security systems for North America, and the challenges and opportunities for such systems to become reality. The following issues were identified as most important for the advancement of this concept. (1) The three countries share a set of core values--democracy, prosperity and security--which form the basis for joint interactions and allow for the development of a culture of cooperation without affecting the sovereignty of the members. (2) The creation of a continental defensive strategy will require a set of strategic guidelines and that smart secure borders play a pivotal role. (3) Joint security systems will need to operate from a set of complementary but not identical policies and procedures. (4) There is a value in joint task forces for response and shared information systems for the prevention of attacks. (5) The private sector must play a critical role in cross-border interactions. Finally, participants envisioned a ''Tri-National Security

  2. Clinical usefulness of the transobturator sub-urethral tape in the treatment of stress urinary incontinence in female patients with spinal cord lesion

    PubMed Central

    Pannek, Juergen; Bartel, Peter; Gocking, Konrad

    2012-01-01

    Objectives To evaluate the clinical usefulness of transobturator sub-urethral tapes for the treatment of stress urinary incontinence in women with spinal cord injury. Method and subjects Chart review for all female patients with spinal cord injury who underwent implantation of a transobturator sub-urethral tape for treatment of stress urinary incontinence at our institution. Results Nine women, median age 45.1 years, received a sub-urethral transobturator tape in the period November 2007 to September 2010. Four patients had paraplegia and five had tetraplegia. Seven women performed intermittent catheterization. At follow up, three of the nine patients were either cured or vastly improved. One major late complication (urethral erosion) occurred. Five of the six patients without treatment success underwent second-line treatment (artificial sphincter or urinary diversion). Conclusion In our case series, implantation of transobturator sub-urethral tapes in women with stress urinary continence due to intrinsic sphincter deficiency and a low leak point pressure led to unfavorable results. PMID:22525323

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

    NASA Astrophysics Data System (ADS)

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

    2015-12-01

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

  4. Neural Control of the Lower Urinary Tract

    PubMed Central

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

    2015-01-01

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

  5. Recurrent urinary tract infections in children.

    PubMed Central

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

    1993-01-01

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

  6. Urinary Incontinence: Causes and Methods of Evaluation

    ERIC Educational Resources Information Center

    Griebling, Tomas L.

    2008-01-01

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

  7. Antimicrobial Stewardship and Urinary Tract Infections

    PubMed Central

    Abbo, Lilian M.; Hooton, Thomas M.

    2014-01-01

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

  8. Effects of microgravity on urinary osteopontin

    NASA Technical Reports Server (NTRS)

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

    1999-01-01

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

  9. Urinary excretion of Iopamidol following intrathecal administration.

    PubMed

    Pitrè, D; Zingales, M F; Trevisan, C

    1983-01-01

    No iodinated compound other than Iopamidol was found in the urine of subjects who received intrathecal injection of 10 ml of Iopamiro "300". The compound was neither metabolized nor altered in its optical configuration and urinary iodide content was always in the normal range. Between 72 and 85% of injected Iopamidol was excreted within 72 h of injection.

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

    PubMed

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

    2005-02-01

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

  11. Stem Cells for the Treatment of Urinary Incontinence

    PubMed Central

    Staack, Andrea

    2010-01-01

    Stress urinary incontinence (SUI) is highly prevalent. As of now, there is no minimally invasive long-term treatment available. Adult stem cells are nonimmunogenic and have the ability to self-renew and to differentiate into multiple cell types. Over the past decade, in vivo studies have described periurethral injections of adult-derived stem cells for the treatment of SUI. The ultimate goal has been to achieve a permanent cure for SUI by restoration of the intrinsic and extrinsic urethral sphincter and the surrounding connective tissue, including peripheral nerves and blood vessels. For this purpose, future studies need to focus on delivery systems, cell survival, and functional improvement of the urethral closure mechanism, including improvement of innervation and vascularization. PMID:21113694

  12. Prevalence of asymptomatic urinary abnormalities among adolescents.

    PubMed

    Fouad, Mohamed; Boraie, Maher

    2016-05-01

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

  13. Profile of urinary arsenic metabolites during pregnancy.

    PubMed

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

    2003-12-01

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

  14. Acetylcysteine for urinary tract mucolysis.

    PubMed

    Benderev, T V

    1988-02-01

    The use of acetylcysteine is described for the relief of mucinous obstruction of the distal ureter after a mid ureteral replacement with ileum. Acetylcysteine (300 cc of 1 per cent) was instilled at low pressure via a nephrostomy tube following documentation of the obstruction with a nephrostogram. Patency of the ureter was achieved within 5 minutes. Re-obstruction ensued but it resolved with repeat percutaneous instillation of acetylcysteine. Patency, confirmed by a followup nuclear renogram at 4 months, has been maintained with 700 mg. acetylcysteine orally 4 times a day.

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

    PubMed Central

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

    2016-01-01

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

  16. Penicillin combinations against multi-resistant urinary pathogens as an alternative to gentamycin treatment.

    PubMed

    Gnarpe, H; Alfredsson, H; Börstad, B

    1976-01-01

    A total of 42 multi-resistant urinary pathogens, sensitive to gentamycin only, were investigated with regard to the effects of dicloxacillin and ampicillin or cloxacillin/flucloxacillin and amoxycillin in combination. A synergistic antibiotic effect with resulting low MIC levels was demonstrated for 81% of the strains. It was also found that a further increase in sensitivity might be achieved by adjustment of the pH level.

  17. [Treatment of genito-urinary prolapses by spinuos fixation with a polypropylene prosthesis].

    PubMed

    Montête, Philippe; Gilbon, François; Borgogno, Claude; Coloby, Patrick

    2002-06-01

    This article describes an original technique for transvaginal repair of prolapses concerning the anterior and middle stages of the pelvis. This operative technique uses a polypropylene prosthesis binding the pelvic structures of the anterior and middle stages to the small sacro-sciatic ligaments. The very satisfactory results achieved let us think that this technique will take a great place in the treatment of the genito-urinary prolapses.

  18. Pulmonary tumor thrombotic microangiopathy associated with urothelial carcinoma of the urinary bladder: antemortem diagnosis by pulmonary microvascular cytology.

    PubMed

    Yamakawa, Hideaki; Yoshida, Masahiro; Yamada, Masami; Ishikawa, Takeo; Takagi, Masamichi; Katagi, Hiroaki; Yoshida, Jun; Kosuga, Tsuneharu; Kuwano, Kazuyoshi

    2015-09-01

    PTTM (Pulmonary tumor thrombotic microangiopathy) is very difficult to diagnose before death. We report a case of urothelial carcinoma of the urinary bladder associated with PTTM in which an antemortem diagnosis by PMC (pulmonary microvascular cytology). PMC may represent the only chance for diagnosis and achievement of remission in PTTM. PMID:26401277

  19. Soft Robotic Concepts in Catheter Design: an On-demand Fouling-release Urinary Catheter

    PubMed Central

    Leveri, Vrad; Wang, Qiming; Shivapooja, Phanindhar; Zhao, Xuanhe; L00F3;pez, Gabriel P.

    2014-01-01

    Infectious biofilms are problematic in many healthcare-related devices, and are especially challenging and ubiquitous in urinary catheters. This report presents an on-demand fouling-release methodology to mechanically disrupt and remove biofilms, and proposes this method for the active removal of infectious biofilms from the previously-inaccessible main drainage lumen of urinary catheters. Mature Proteus mirabilis crystalline biofilms detach from silicone elastomer substrates upon application of strain to the substrate, and increasing the strain rate increases biofilm detachment. The study presents a quantitative relationship between applied strain rate and biofilm debonding through an analysis of biofilm segment length and the driving force for debonding. Based on this mechanism, hydraulic and pneumatic elastomer actuation was used to achieve surface strain selectively within the lumen of prototypes of sections of a fouling-release urinary catheter. Proof-of-concept prototypes of sections of active, fouling-release catheters were constructed using techniques typical to soft robotics including 3D printing and replica molding, and those prototypes demonstrate release of mature P. mirabilis crystalline biofilms (e.g., ≈90%) from strained surfaces. These results provide a basis for the development of a new urinary catheter technology in which infectious biofilms are effectively managed through new methods that are entirely complementary to existing approaches. PMID:24668920

  20. Urinary bladder carcinoma with divergent differentiation featuring small cell carcinoma, sarcomatoid carcinoma, and liposarcomatous component.

    PubMed

    Yasui, Mariko; Morikawa, Teppei; Nakagawa, Tohru; Miyakawa, Jimpei; Maeda, Daichi; Homma, Yukio; Fukayama, Masashi

    2016-09-01

    Both small cell carcinoma and sarcomatoid carcinoma of the urinary bladder are highly aggressive tumors, and a concurrence of these tumors is extremely rare. We report a case of urinary bladder cancer with small cell carcinoma as a predominant component, accompanied by sarcomatoid carcinoma and conventional urothelial carcinoma (UC). Although the small cell carcinoma component had resolved on receiving chemoradiotherapy, rapid growth of the residual tumor led to a fatal outcome. A 47-year-old man presented with occasional bladder irritation and had a 2-year history of asymptomatic hematuria. Cystoscopy revealed a huge mass in the urinary bladder, and transurethral resection was performed. Microscopically, small cell carcinoma was detected as the major tumor component. Spindle-shaped sarcomatoid cells were also observed that were intermingled with small cell carcinoma and conventional UC. In addition, a sheet-like growth of the lipoblast-like neoplastic cells was observed focally. Initially, by providing chemoradiotherapy, we achieved a marked tumor regression; however, the tumor rapidly regrew after the completion of chemoradiotherapy, and the patient underwent radical cystectomy. Only conventional UC and sarcomatoid carcinoma were identified in the cystectomy specimen. The patient died of the disease 4 months after cystectomy. Urinary bladder cancer may include a combination of multiple aggressive histologies as in the present case. Because the variation in the tumor components may affect the efficacy of therapy, a correct diagnosis of every tumor component is necessary.

  1. Urinary catheter blockage depends on urine pH, calcium and rate of flow.

    PubMed

    Burr, R G; Nuseibeh, I M

    1997-08-01

    Urinary catheters tend to block when biofilm from urease-producing organisms build up on the catheter surface. This is a locally-occurring process that influences and influenced by the composition of the urine. In this work we relate urine pH and calcium to catheter blockage and suggest how to reduce the rate of encrustation. Sixty patients with indwelling urinary catheters were studied, 26 of them being troubled by frequent blockage of their catheters, 34 of them not. A series of small urine samples were collected during a 24 h period. Urinary pH and calcium concentration were combined into discriminant functions designed to separate Blockers from Non-blockers and achieved a 95% correct classification. The results indicate that a high and uniform rate of fluid intake is mandatory for the patient with a tendency for catheter blockage. Excessive total fluid intake may be avoided by attention to uniformity. Other avoidable risk factors include: excess dietary calcium from certain protein supplements and antacids; excess dietary magnesium from certain beverages and antacids; alkali from effervescent tablets; excess dietary citrate from some fruit juices and cordials; intermittent dehydration from alcohol ingestion. Less tractable risk factors include infection of the urinary tract with urease-positive organisms, hypercalciuria of immobilisation, hyperhydrosis and postural oliguria. The processes involved in catheter encrustation and blockage provide a model for the formation of calculi in spinal cord injured patients. Therefore the above considerations may also be relevant to the management of stone disease in paraplegic and tetraplegic patients.

  2. Soft robotic concepts in catheter design: an on-demand fouling-release urinary catheter.

    PubMed

    Levering, Vrad; Wang, Qiming; Shivapooja, Phanindhar; Zhao, Xuanhe; López, Gabriel P

    2014-10-01

    Infectious biofilms are problematic in many healthcare-related devices and are especially challenging and ubiquitous in urinary catheters. This report presents an on-demand fouling-release methodology to mechanically disrupt and remove biofilms, and proposes this method for the active removal of infectious biofilms from the previously inaccessible main drainage lumen of urinary catheters. Mature Proteus mirabilis crystalline biofilms detach from silicone elastomer substrates upon application of strain to the substrate, and increasing the strain rate increases biofilm detachment. The study presents a quantitative relationship between applied strain rate and biofilm debonding through an analysis of biofilm segment length and the driving force for debonding. Based on this mechanism, hydraulic and pneumatic elastomer actuation is used to achieve surface strain selectively within the lumen of prototypes of sections of a fouling-release urinary catheter. Proof-of-concept prototypes of sections of active, fouling-release catheters are constructed using techniques typical to soft robotics including 3D printing and replica molding, and those prototypes demonstrate release of mature P. mirabilis crystalline biofilms (e.g., ≈90%) from strained surfaces. These results provide a basis for the development of a new urinary catheter technology in which infectious biofilms are effectively managed through new methods that are entirely complementary to existing approaches. PMID:24668920

  3. Urinary bladder carcinoma with divergent differentiation featuring small cell carcinoma, sarcomatoid carcinoma, and liposarcomatous component.

    PubMed

    Yasui, Mariko; Morikawa, Teppei; Nakagawa, Tohru; Miyakawa, Jimpei; Maeda, Daichi; Homma, Yukio; Fukayama, Masashi

    2016-09-01

    Both small cell carcinoma and sarcomatoid carcinoma of the urinary bladder are highly aggressive tumors, and a concurrence of these tumors is extremely rare. We report a case of urinary bladder cancer with small cell carcinoma as a predominant component, accompanied by sarcomatoid carcinoma and conventional urothelial carcinoma (UC). Although the small cell carcinoma component had resolved on receiving chemoradiotherapy, rapid growth of the residual tumor led to a fatal outcome. A 47-year-old man presented with occasional bladder irritation and had a 2-year history of asymptomatic hematuria. Cystoscopy revealed a huge mass in the urinary bladder, and transurethral resection was performed. Microscopically, small cell carcinoma was detected as the major tumor component. Spindle-shaped sarcomatoid cells were also observed that were intermingled with small cell carcinoma and conventional UC. In addition, a sheet-like growth of the lipoblast-like neoplastic cells was observed focally. Initially, by providing chemoradiotherapy, we achieved a marked tumor regression; however, the tumor rapidly regrew after the completion of chemoradiotherapy, and the patient underwent radical cystectomy. Only conventional UC and sarcomatoid carcinoma were identified in the cystectomy specimen. The patient died of the disease 4 months after cystectomy. Urinary bladder cancer may include a combination of multiple aggressive histologies as in the present case. Because the variation in the tumor components may affect the efficacy of therapy, a correct diagnosis of every tumor component is necessary. PMID:27461832

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

    PubMed

    Buckley, Catherine; Clements, Charlotte; Hopper, Adrian

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

  5. Clinical study of urinary excretion of Ga-67

    SciTech Connect

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

    1990-04-01

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

  6. Urinary metal concentrations among female welders.

    PubMed

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

    2015-01-01

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

  7. Urinary metal concentrations among female welders.

    PubMed

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

    2015-01-01

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

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

    SciTech Connect

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

    2008-10-01

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

  9. [Morphologic and functional heterogeneous changes of the urinary bladder different parts at rats with infravesical obstruction of the urinary tracts].

    PubMed

    Kudriavtsev, Iu V; Kirpatovskiĭ, V I; Mudraia, I S; Khromov, R A; Kudriavtseva, L V

    2012-01-01

    Infravesical obstruction of the lower urinary tracts of 30 rats was carried out by the measured constriction of the urethral prevesical parts. Morphologic and functional changes of the urinary bladder different parts were studied in 1 week and in 3 months. Compensatory hypertrophy of the detrusor was accompanied increasing of hypertrophied, atrophic and native forms of leiomyocytes, as so their transformation into myofibroblasts with connective tissue formation between the muscle fibers mainly in the neck of urinary bladder Contractility of the detrusor decreased with their tonus increasing mainly in the neck of urinary bladder too. Weakening effect of adrenalin in 3 month after obstruction significantly decreased, while in the body and neck of urinary bladder it virtually disappeared. Blockade of alpha-adrenoreceptors after noradrenalin stimulation resulted in enchancement of the hypertrophic detrusor contraction when tonus of the urinary neck decreased. On the contrary, in the intact urinary bladder the similarly influence resulted in weakening of contraction.

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

    NASA Technical Reports Server (NTRS)

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

    1990-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Bernoulli, Daniel; Jenkyns, Hugh C.

    2009-05-01

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

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

    SciTech Connect

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

    1992-03-01

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

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

    PubMed

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

    2012-01-01

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

  14. High-dose OxyContin to treat pain associated with bone metastasis in patients with small-cell lung cancer: a case study report.

    PubMed

    Zhou, Tao; Zhang, Xia; Dong, Yan; Zhuang, Feifei; Jiang, Fengquan; Yu, Jinming; Zhang, Bin

    2016-01-01

    Pain management is an important topic that has received extensive attention from clinical practitioners. Nearly all patients with malignant tumors suffer pain at the advanced stage of their disease. Oxycodone is a first-line choice for treating moderate-to-severe cancer-related pain, and OxyContin, a controlled-release oxycodone hydrochloride tablet, is internationally recognized as a safe and effective opioid analgesic. OxyContin has the characteristics of both immediate release and sustained release, with a time to onset and peak similar to those of immediate-release morphine. It acts on both μ and κ receptors and has been shown to be effective in treating different types of pain, especially neuropathic pain, theoretically without a dose cap. However, the dose is limited in clinical applications due to various factors that are likely to affect its analgesic effect and reduce patient quality of life. Cooperation with a patient's family members is required during the treatment of cancer pain. Chronic cancer pain has a long disease course, which could easily cause complex psychological symptoms due to their important role in the pain experience. Pain is controllable, and patients have a right to not experience pain. An optimal living state can be achieved through collaboration between physicians and patients. Rational personalized treatment of cancer pain can improve patient quality of life, relieve pain, and help prolong patient survival. This article reports the treatment procedure and adverse reactions in a patient who was treated with high-dose OxyContin, with the aim of providing a reference for other clinical practitioners. PMID:26855563

  15. Comparing Science Achievement Constructs: Targeted and Achieved

    ERIC Educational Resources Information Center

    Ferrara, Steve; Duncan, Teresa

    2011-01-01

    This article illustrates how test specifications based solely on academic content standards, without attention to other cognitive skills and item response demands, can fall short of their targeted constructs. First, the authors inductively describe the science achievement construct represented by a statewide sixth-grade science proficiency test.…

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

    USGS Publications Warehouse

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

    2003-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2014-12-01

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

  18. Redi award lecture: clinical studies of snake-bite in four tropical continents.

    PubMed

    Warrell, David A

    2013-07-01

    Research is discussed in the areas of venomous snake taxonomy, epidemiology, species diagnosis, defining the clinical phenotype of human envenoming, pathophysiological mechanisms of envenoming, clinical testing of antivenoms and prevention of snake-bite through community education. This work was carried out over the past 40 years in many countries in four tropical continents. The help and friendship of a large number of collaborators is gratefully acknowledged.

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

    PubMed

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

    1998-01-01

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

  20. [Conservative treatment of female urinary incontinence].

    PubMed

    Kerdraon, Jacques; Denys, Pierre; Amarenco, Gérard

    2011-09-01

    Female urinary incontinence can be improved by nonsurgical pharmacologic as well as non-pharmacologic treatments. Hygiene and dietary rules apply to all forms of incontinence. If overweight, weight loss improves stress urinary incontinence. There are levels of evidence to show that pelvic floor muscle training and behavioral therapy improve incontinence. Duloxetine is better than placebo for improvement of quality of life and for the impression of an improvement, but its place is still not determined in the algorithm of conservative treatments. The effects of vaginal electrostimulation and oestrogen are inconsistent or inhomogeneous. In case of urgency incontinence, anticholinergics remain the first line treatment and the place of stimulation of posterieur tibial nerve is still to be defined.

  1. Cell-Based Therapy for Urinary Incontinence

    PubMed Central

    Bae, Jae Hyun

    2010-01-01

    Urinary incontinence has become a societal problem that affects millions of people worldwide. Although numerous therapeutic modalities are available, none has been shown to be entirely satisfactory. Consequently, cell-based approaches using regenerative medicine technology have emerged as a potential solution that would provide a means of correcting anatomical deficiencies and restoring normal function. As such, numerous cell-based investigations have been performed to develop systems that are focused on addressing clinical needs. While most of these attempts remain in the experimental stages, several clinical trials are being designed or are in progress. This article provides an overview of the cell-based approaches that utilize various cell sources to develop effective treatment modalities for urinary incontinence. PMID:20414402

  2. Management of urinary incontinence in women.

    PubMed Central

    O'Dowd, T C

    1993-01-01

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

  3. [Drug therapy of female urinary incontinence].

    PubMed

    Hampel, C; Gillitzer, R; Pahernik, S; Melchior, S W; Thüroff, J W

    2005-03-01

    Drug treatment for female urinary incontinence requires a thorough knowledge of the differential diagnosis and pathophysiology of incontinence as well as of the pharmacological agents employed. Pharmacotherapy has to be tailored to suit the incontinence subtype and should be carefully balanced according to efficacy and side effects of the drug. Women with urge incontinence require treatment that relaxes or desensitizes the bladder (antimuscarinics, estrogens, alpha-blockers, beta-mimetics, botulinum toxin A, resiniferatoxin, vinpocetine), whereas patients with stress incontinence need stimulation and strengthening of the pelvic floor and external sphincter (alpha-mimetics, estrogens, duloxetine). Females with overflow incontinence need reduction of outflow resistance (baclofen, alpha-blockers, intrasphincteric botulinum toxin A) and/or improvement of bladder contractility (parasympathomimetics). If nocturia or nocturnal incontinence are the major complaints, control of diuresis is obtained by administration of the ADH analogue desmopressin. Future developments will help to further optimize the pharmacological therapy for female urinary incontinence.

  4. Urinary Drainage Procedures in Interventional Radiology.

    PubMed

    Thornton, Raymond H; Covey, Anne M

    2016-09-01

    Urinary drainage procedures are used to treat a wide range of clinical situations including pyonephrosis, preservation of renal function in patients with ureteral obstruction, as a means to access the collecting system for stone retrieval or lithotripsy and to divert urine from a distal leak or fistula. Several different drainage devices are available and include those that provide obligatory external drainage (nephrostomy), both internal and external drainage (nephroureteral stent) and internal drainage (double-J stent). Each device requires some maintenance and effort on the patient's part-from having to undergo routine exchange of double-J stents every 3-6 months to the daily management of an external catheter and drainage bag. Ideally, the desired outcome can be attained with minimal effect on patient lifestyle. In this article, we present our approach to patients who require urinary drainage, with a focus on choosing and placing the most appropriate device in a variety of clinical scenarios. PMID:27641451

  5. Mobility and Reading Achievement.

    ERIC Educational Resources Information Center

    Waters, Theresa Z.

    A study examined the effect of geographic mobility on elementary school students' achievement. Although such mobility, which requires students to make multiple moves among schools, can have a negative impact on academic achievement, the hypothesis for the study was that it was not a determining factor in reading achievement test scores. Subjects…

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

    NASA Astrophysics Data System (ADS)

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

    2016-06-01

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

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

    NASA Astrophysics Data System (ADS)

    Lee, H. H.; Wang, C.

    2014-12-01

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

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

    PubMed Central

    Lee, Byung Jin; Kim, Tae Young

    2016-01-01

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

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

    SciTech Connect

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

    2011-04-01

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

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

    SciTech Connect

    Brian McPherson

    2010-08-31

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

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

    PubMed

    Lee, Byung Jin; Kim, Tae Young

    2016-02-01

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

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

    PubMed

    Lee, Byung Jin; Kim, Tae Young

    2016-02-01

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

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

    PubMed

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

    2012-03-01

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

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

    PubMed

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

    2016-05-01

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

  15. Can Urinary Nitrite Results Be Used to Conduct Antimicrobial Option for Urinary Tract Infection in Children?

    PubMed Central

    Mahyar, Abolfazl; Ayazi, Parviz; Froozesh, Mahta; Daneshi-Kohan, Mohammad-Mahdi; Barikani, Ameneh

    2012-01-01

    Objective This study was performed to determine the relationship between urinary nitrite results and bacterial resistance to antimicrobial drugs in urinary tract infection of children. Methods In a cross-section study 119 children younger than 12 years with urinary tract infection were evaluated in Qazvin children's hospital. Patients were divided into negative and positive nitrite groups depending on urinary nitrite test result. Rates of antibiotic resistance in the two groups were compared. Findings Sixty seven patients were in the negative nitrite group and 52 in the positive nitrite group. Resistance rates to ceftriaxone, trimethoprim sulfamethoxazole, ampicillin, gentamicin, amikacin, nalidixic acid, cephalothin and nitrofurantoin in the nitrite negative group were 7.5%, 31.3%, 50.7%, 11.9%, 9%, 3%, 14.9% and 11.9%, respectively. These values in the nitrite positive group were 21.2%, 28.8%, 63.5%, 7.7%, 5.8%, 1.9%, 9.6%, and 3.8%, respectively (P>0.05). Conclusion This study showed that there is no correlation between urinary nitrite results and bacterial resistance to antimicrobial drugs. Therefore, it seems that physicians should not adjust antibiotic therapy for UTI based on nitrite results. PMID:23056892

  16. Managing lower urinary tract symptoms in men.

    PubMed

    MacKenzie, Kenneth R; Aning, Jonathan J

    2016-04-01

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

  17. Urinary Ascites - A Consequence of Intraoperative Injury.

    PubMed

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

    2015-09-01

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

  18. Iatrogenic foreign body in the urinary bladder.

    PubMed

    Shah, Safdar; Qureshi, Farhan; Rakhio, Sain

    2015-04-01

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

  19. Urinary polypeptides related to collagen synthesis

    PubMed Central

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

    1970-01-01

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

  20. Proteus mirabilis and Urinary Tract Infections

    PubMed Central

    Schaffer, Jessica N.; Pearson, Melanie M.

    2015-01-01

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

  1. The relationship between kidney and urinary kininogenase

    PubMed Central

    Nustad, K.

    1970-01-01

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

  2. Pharmacology of the lower urinary tract

    PubMed Central

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

    2014-01-01

    Pharmacology of the lower urinary tract provides the basis for medical treatment of lower urinary tract symptoms (LUTS). Therapy of LUTS addresses obstructive symptoms (frequently explained by increased prostate smooth muscle tone and prostate enlargement) in patients with benign prostate hyperplasia (BPH) and storage symptoms in patients with overactive bladder (OAB). Targets for medical treatment include G protein-coupled receptors (α1-adrenoceptors, muscarinic acetylcholine receptors, β3-adrenoceptors) or intracellular enzymes (5α-reductase; phosphodiesterase-5, PDE5). Established therapies of obstructive symptoms aim to induce prostate smooth muscle relaxation by α1-blockers or PDE5 inhibitors, or to reduce prostate growth and volume with 5α-reductase inhibitors. Available options for treatment of OAB comprise anitmuscarinics, β3-adrenoceptor agonists, and botulinum toxin A, which improve storage symptoms by inhibition of bladder smooth muscle contraction. With the recent approval of β3-antagonists, PDE inhibitors, and silodosin for therapy of LUTS, progress from basic research of lower urinary tract pharmacology was translated into new clinical applications. Further targets are in preclinical stages of examination, including modulators of the endocannabinoid system and transient receptor potential (TRP) channels. PMID:24744518

  3. [Tumor markers of urinary tract carcinoma].

    PubMed

    Kikuchi, Haruhito

    2004-04-01

    The tumor markers for malignant tumors arisen from urinary system including prostate cancer were reviewed. As for renal cell carcinoma there was no good marker used in routine test level at present. In the diagnosis of urothelial (transitional cell) carcinoma, mainly bladder cancer, 3 methods (urinary BTA, NMP22 and BFP) are used now in Japan. They all seem to be not fully sufficient in respect of the specificity. In foreign countries, new tests such as urinary telomerase and BLCA-4 are used and have been evaluated. On the diagnosis of prostate cancer, serum total PSA is well established and used. Various PSA relation markers have been advocated for the differentiation between benign prostate hypertrophy and carcinoma in so called "gray zone" level of total PSA. In methods based on the molecular forms of PSA, the ratio of free PSA to total PSA (f/T) is widely use, and proPSA is a test that is expected. Other approaches such as volume of index PSA, age specific PSA reference range and PSA velocity are also in practical application. Human glandular kallikrein 2, which belong to the human kallikrein family as well as PSA, is expected as a tumor specific marker.

  4. [Urinary tumor marker for urothelial cancer].

    PubMed

    Ohtani, M; Iwasaki, A; Shiraiwa, H

    2001-11-01

    The urinary tumor markers BTA, BFP and NMP22 used for urothelial cancer in Japan are reviewed briefly. We also evaluate and compare the sensitivity and specificity of BTA, BFP and NMP22 with urine cytology in detecting bladder cancer in 24 of our patients. The results showed that the sensitivity with urine cytology, BTA, BFP and NMP22 was 37, 54, 66 and 62% respectively. The specificity of BTA, BFP and NMP22 with urine cytology was 100, 65, 60 and 70% respectively. The sensitivity with BTA, BFP and NMP22 for urothelial cancer was higher than that with urine cytology. However, all except for urine cytology showed high false positive rates (83-90%) for urinary tract infection. These markers may thus complement urine cytology, which has a low sensitivity for urothelial cancer. Quite possibly they could act as low-cost and useful tumor markers, which could in turn reduce the number of invasive cystoscopic examinations. However, considering their high false positive rates for benign disease such as urinary tract infection, we must acknowledge that an ideal urothelial tumor marker, which is simple, non-invasive, inexpensive and accurate with high sensitivity and specificity has yet to be developed.

  5. [Use of bulking agents in urinary incontinece].

    PubMed

    Angioli, R; Muzii, L; Zullo, M A; Battista, C; Ruggiero, A; Montera, R; Guzzo, F; Montone, E; Musella, A; Di Donato, V; Benedetti Panici, P

    2008-12-01

    Urinary incontinence consist in voluntary urine leakage. Female affected in the world are about 200 thousand. Urinary incontinence affect severely women quality of life. There are different kinds of urinary incontinence that can be treated in different ways. We can use pelvic floor rehabilitation, drug therapy, invasive and non-invasive surgical treatment. Different treatments are used for different incontinence types. Periurethral injection is the most common procedure between non-invasive surgery. The most recent bulking agents occasionally determine severe adverse reaction or complication. Frequently we can have just pain during injection and a temporary urine retention. During the latest years we used a lot of bulking agents: bovine collagen, autologous fat, carbon particles, macroplastique, calcium hydroxylapatite, ethylene vinyl alcohol copolymer, dextranomer. Urethral injection have success in 40-90%. We can assert that macroplastique is the most efficacy and safe on the basis of literature data and of our experience data. This surgical procedure, in fact, has good percentage of success in accurately selected patients. In our experience Macroplastique can also be used in oncological patients, in elderly women, in patients with important comorbidity and with high surgical risk with good objective and subjective results.

  6. Lower urinary tract symptoms in men

    PubMed Central

    Hollingsworth, John M

    2014-01-01

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

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

    SciTech Connect

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

    2011-05-15

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

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

    NASA Astrophysics Data System (ADS)

    Meghraoui, Mustapha

    2014-05-01

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

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

    PubMed

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

    1997-01-01

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

  10. Dynamics of Urinary Calprotectin after Renal Ischaemia

    PubMed Central

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

    2016-01-01

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

  11. Occurrence of trivalent monomethyl arsenic and other urinary arsenic species in a highly exposed juvenile population in Bangladesh.

    PubMed

    Kalman, David A; Dills, Russell L; Steinmaus, Craig; Yunus, Md; Khan, Al Fazal; Prodhan, Md Mofijuddin; Yuan, Yan; Smith, Allan H

    2014-01-01

    Following reports of high cytotoxicity and mutagenicity of monomethyl arsonous acid (MMA(III)) and early reports of urinary MMA(III) in arsenic-exposed individuals, MMA(III) has often been included in population studies. Use of urinary MMA(III) as an indicator of exposure and/or health risk is challenged by inconsistent results from field studies and stability studies, which indicate potential artifacts. We measured urinary arsenic species in children chronically exposed to arsenic in drinking water, using collection, storage, and analysis methods shown to conserve MMA(III). MMA(III) was easily oxidized in sample storage and processing, but recoveries of 80% or better in spiked urine samples were achieved. Attempts to preserve the distribution of MMA between trivalent and pentavalent forms using complexing agents were unsuccessful and MMA(III) spiked into treated urine samples actually showed lower stability than in untreated samples. In 643 urine samples from a highly exposed population from the Matlab district in Bangladesh stored for 3-6 months at ≤-70 °C, MMA(III) was detected in 41 samples, with an estimated median value of 0.3 μg/l, and levels of MMA(III) above 1 μg/l in only two samples. The low urinary concentrations in highly exposed individuals and known difficulties in preserving sample oxidation state indicate that urinary MMA(III) is not suitable for use as an epidemiological biomarker.

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

    Takeuchi, K; Kogo, H; Aizawa, Y

    1981-04-01

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

  14. Human Urinary Composition Controls Antibacterial Activity of Siderocalin* ♦

    PubMed Central

    Shields-Cutler, Robin R.; Crowley, Jan R.; Hung, Chia S.; Stapleton, Ann E.; Aldrich, Courtney C.; Marschall, Jonas; Henderson, Jeffrey P.

    2015-01-01

    During Escherichia coli urinary tract infections, cells in the human urinary tract release the antimicrobial protein siderocalin (SCN; also known as lipocalin 2, neutrophil gelatinase-associated lipocalin/NGAL, or 24p3). SCN can interfere with E. coli iron acquisition by sequestering ferric iron complexes with enterobactin, the conserved E. coli siderophore. Here, we find that human urinary constituents can reverse this relationship, instead making enterobactin critical for overcoming SCN-mediated growth restriction. Urinary control of SCN activity exhibits wide ranging individual differences. We used these differences to identify elevated urinary pH and aryl metabolites as key biochemical host factors controlling urinary SCN activity. These aryl metabolites are well known products of intestinal microbial metabolism. Together, these results identify an innate antibacterial immune interaction that is critically dependent upon individualistic chemical features of human urine. PMID:25861985

  15. Evaluation of a behavioral treatment for female urinary incontinence

    PubMed Central

    Santacreu, Marta; Fernández-Ballesteros, Rocío

    2011-01-01

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

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

    PubMed

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

    2016-03-01

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

  17. Management of urolithiasis in patients after urinary diversions.

    PubMed

    Okhunov, Zhamshid; Duty, Brian; Smith, Arthur D; Okeke, Zeph

    2011-08-01

    After urinary diversion patients are at increased risk of long-term complications, including stones of the upper urinary tract and reservoir or conduit. Advances in instrumentation and techniques have expanded treatment options, while minimizing morbidity. Minimally invasive treatment methods include shockwave lithotripsy, antegrade and retrograde ureteroscopic lithotripsy and percutaneous nephrolithotomy. Percutaneous and laparoscopic techniques are applicable to stones within urinary diversions. Medical management is crucial for avoiding recurrent stones in these patients.

  18. [Use of LKhM-80 chromatograph in the analysis of urinary steroids].

    PubMed

    Orlov, E N; Antipov, E M

    1995-01-01

    The paper describes a simple way of updating a Russian production-type LKaM-80 chromatograph in order to make a gas chromatographic analysis of urinary steroids for separation by using high performance capillary columns. To connect capillary columns, the units consisting of a gas heaving T-joint, a stream separating chamber, and a releasing restrictor were applied. To achieve satisfactory results, it is necessary to place a column through the tube connecting the union for attachment of the column and the flame-ionization detector so that the end of a capillary should be located at the detector as soon as closer. The updated chromatograph has been successfully used to obtain urinary steroidal profiles which are essential for the differential diagnosis of causes of hyperandrogyny in females, including pregnants.

  19. The use of urinary bladder matrix in the treatment of trauma and combat casualty wound care.

    PubMed

    Valerio, Ian L; Campbell, Paul; Sabino, Jennifer; Dearth, Christopher L; Fleming, Mark

    2015-01-01

    Treatment of combat injuries and resulting wounds can be difficult to treat due to compromised and evolving tissue necrosis, environmental contaminants, multidrug resistant microbacterial and/or fungal infections, coupled with microvascular damage and/or hypovascularized exposed vital structures. Our group has developed surgical care algorithms with identifiable salvage techniques to achieve stable, definitive wound coverage often with the aid of certain regenerative medicine biologic scaffold materials and advanced wound care to facilitate tissue coverage and healing. This case series reports on the role of urinary bladder matrix scaffolds in the wound care and reconstruction of traumatic and combat wounds. Urinary bladder matrix was found to facilitate definitive soft tissue reconstruction by establishing a neovascularized soft tissue base acceptable for second stage wound and skin coverage options within traumatic and combat-related wounds. PMID:26237704

  20. Urinary tract disease in dogs: US findings. A mini-pictorial essay.

    PubMed

    Robotti, G; Lanfranchi, D

    2013-01-01

    Ultrasound (US) is the most commonly used imaging method for studying urinary tract disorders in dogs, as it is easy to perform, inexpensive and provides excellent contrast resolution in real-time. However, US examination of dogs presents a series of technical difficulties, and the US operator must therefore have a longstanding experience and access to high-quality equipment including a range of different probes to achieve a correct diagnosis. The aim of this mini-pictorial essay is to describe US findings and patterns which permit identification of the most common pathologies of the urinary tract in dogs. The technical difficulties that may be encountered are also evaluated as well as integration with other imaging modalities (traditional X-ray, computed tomography, magnetic resonance imaging).

  1. The use of urinary bladder matrix in the treatment of trauma and combat casualty wound care.

    PubMed

    Valerio, Ian L; Campbell, Paul; Sabino, Jennifer; Dearth, Christopher L; Fleming, Mark

    2015-01-01

    Treatment of combat injuries and resulting wounds can be difficult to treat due to compromised and evolving tissue necrosis, environmental contaminants, multidrug resistant microbacterial and/or fungal infections, coupled with microvascular damage and/or hypovascularized exposed vital structures. Our group has developed surgical care algorithms with identifiable salvage techniques to achieve stable, definitive wound coverage often with the aid of certain regenerative medicine biologic scaffold materials and advanced wound care to facilitate tissue coverage and healing. This case series reports on the role of urinary bladder matrix scaffolds in the wound care and reconstruction of traumatic and combat wounds. Urinary bladder matrix was found to facilitate definitive soft tissue reconstruction by establishing a neovascularized soft tissue base acceptable for second stage wound and skin coverage options within traumatic and combat-related wounds.

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

    EPA Science Inventory

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

  3. Enzymatic synthesis of hyaluronan hybrid urinary trypsin inhibitor.

    PubMed

    Kakizaki, Ikuko; Takahashi, Ryoki; Yanagisawa, Miho; Yoshida, Futaba; Takagaki, Keiichi

    2015-09-01

    Human urinary trypsin inhibitor is a proteoglycan that has a single low-sulfated chondroitin 4-sulfate chain at the seryl residue in position 10 of the core protein as a glycosaminoglycan moiety, and is used as an anti-inflammatory medicine based on the protease inhibitory activity of the core protein. However, the functions of the glycosaminoglycan moiety have not yet been elucidated in detail. In the present study, the glycosaminoglycan chains of a native urinary trypsin inhibitor were remodeled to hyaluronan chains, with no changes to the core protein, using transglycosylation as a reverse reaction of the hydrolysis of bovine testicular hyaluronidase, and the properties of the hybrid urinary trypsin inhibitor were then analyzed. The trypsin inhibitory activitiy of the hyaluronan hybrid urinary trypsin inhibitor was similar to that of the native type; however, its inhibitory effect on the hydrolysis of hyaluronidase were not as strong as that of the native type. This result demonstrated that the native urinary trypsin inhibitor possessed hyaluronidase inhibitory activity on its chondroitin sulfate chain. The hyaluronan hybrid urinary trypsin inhibitors obtained affinity to a hyaluronan-binding protein not exhibited by the native type. The interactions between the hyaluronan hybrid urinary trypsin inhibitors and phosphatidylcholine (abundant in the outer layer of plasma membrane) were stronger than that of the native type. Hyaluronan hybrid urinary trypsin inhibitors may be useful for investigating the functions of the glycosaminoglycan chains of urinary trypsin inhibitors and hyaluronan, and our hybrid synthesizing method may be used widely in research for future medical applications.

  4. [Urinary stress incontinence: rehabilitation treatment of the pelvic floor].

    PubMed

    Braccini, S; Toniazzi, P

    1995-11-01

    The authors inspected 112 patients with diagnostic urogynecologic and urodynamic criteria. They suffered from urinary stress incontinence. Forty patients effected rehabilitative therapy of the pelvic floor with visits twice weekly with a method which included: pelvic muscle exercises, biofeedback and functional electrostimulation. The patients were divided into two groups in accordance with the kind of urinary stress incontinence: in the first group there were patients with genuine urinary stress incontinence, in the second group patients with mixed urinary stress incontinence. The results at the end of treatment reported a proportion of success of 66% in the first group and of 54% in the second group.

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

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

  6. Postoperative Morganella morganii endophthalmitis associated with subclinical urinary tract infection.

    PubMed

    Tsanaktsidis, Gina; Agarwal, Smita A; Maloof, Anthony J; Chandra, Jay; Mitchell, Paul

    2003-05-01

    We report a case of Morganella morganii acute endophthalmitis following clear corneal phacoemulsification cataract surgery in which a coincident asymptomatic chronic urinary tract infection was detected postoperatively. Morganella morganii is a gram-negative bacillus that inhabits the gastrointestinal tract and is part of the normal fecal flora. It is an opportunistic pathogen usually encountered in postoperative and nosocomial settings, causing urinary tract and wound infections. Chronic urinary tract infection may be a risk factor for postoperative endophthalmitis. A dipstick urinalysis before elective cataract surgery in elderly patients with a history of recurrent urinary tract infections may be considered.

  7. Urinary tract infection in individuals with spinal cord lesion.

    PubMed

    Biering-Sørensen, Fin

    2002-01-01

    Urinary tract infection is the most frequently reported secondary impairment in individuals with spinal cord lesion. The most prevalent risk indicator is an indwelling catheter. Hydrophilic catheters for clean intermittent catheterization may induce lower rates of bacteriuria and long-term urethral complications. Due to chronic bacterial infection within biofilms, an antibacterial treatment based on a urinary culture of bacteria in the urine and its antimicrobial susceptibility may fail to eradicate catheter-associated urinary tract infection. No commercially available drugs are sufficiently active against the bacteria in a mature biofilm. Biomaterials may be modified to decrease the formation of a biofilm. Silver alloy catheters are effective in preventing urinary tract infection when indwelling urinary catheterization is necessary. The risk of systemic argyria in long-term use needs to be evaluated. Suprapubic cystostomy drainage in patients with neurogenic bladder is preferred to an indwelling urethral catheter. In cases of recurring urinary tract infection in patients with a permanent urinary catheter, it may be beneficial to change the catheter every 1 or 2 weeks. There is some evidence that cranberry products may prevent urinary tract infection. In the future, bacterial interference and vaccination may be a possibility for prevention of urinary tract infection.

  8. 21 CFR 862.1340 - Urinary glucose (nonquantitative) test system.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

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

    PubMed

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

    2016-03-01

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

  10. Non-invasive diagnosis of stress urinary incontinence sub types using wavelet analysis, shannon entropy and principal component analysis.

    PubMed

    Tufan, Kadir; Kara, Sadık; Latifoğlu, Fatma; Aydın, Sinem; Kırış, Adem; Ozkuvancı, Unsal

    2012-08-01

    Urinary incontinence is a common female disorder. Although generally not a serious condition, it negatively affects the lifestyle and daily activity of subjects. Stress urinary incontinence (SUI) is the most versatile of several incontinence types and is distinguished by physical degeneration of the continence-providing mechanism. Some surgical treatment methods exist, but the success of the surgery mainly depends upon a correct diagnosis. Diagnosis has two major steps: subjects who are suffering from true SUI must be identified, and the SUI sub-type must be determined, because each sub-type is treated with a different surgery. The first step is straightforward and uses standard identification methods. The second step, however, requires invasive, uncomfortable urodynamic studies that are difficult to apply. Many subjects try to cope with the disorder rather than seek treatment from health care providers, in part because of the invasive diagnostic methods. In this study, a diagnostic method with a success rate comparable to that of urodynamic studies is presented. This new method has some advantages over the current one. First, it is noninvasive; data are collected using Doppler ultrasound recording. Second, it requires no special tools and is easy to apply, relatively inexpensive, faster and more hygienic.

  11. General Achievement Trends: Oklahoma

    ERIC Educational Resources Information Center

    Center on Education Policy, 2009

    2009-01-01

    This general achievement trends profile includes information that the Center on Education Policy (CEP) and the Human Resources Research Organization (HumRRO) obtained from states from fall 2008 through April 2009. Included herein are: (1) Bullet points summarizing key findings about achievement trends in that state at three performance…

  12. General Achievement Trends: Georgia

    ERIC Educational Resources Information Center

    Center on Education Policy, 2009

    2009-01-01

    This general achievement trends profile includes information that the Center on Education Policy (CEP) and the Human Resources Research Organization (HumRRO) obtained from states from fall 2008 through April 2009. Included herein are: (1) Bullet points summarizing key findings about achievement trends in that state at three performance…

  13. General Achievement Trends: Nebraska

    ERIC Educational Resources Information Center

    Center on Education Policy, 2009

    2009-01-01

    This general achievement trends profile includes information that the Center on Education Policy (CEP) and the Human Resources Research Organization (HumRRO) obtained from states from fall 2008 through April 2009. Included herein are: (1) Bullet points summarizing key findings about achievement trends in that state at three performance…

  14. General Achievement Trends: Arkansas

    ERIC Educational Resources Information Center

    Center on Education Policy, 2009

    2009-01-01

    This general achievement trends profile includes information that the Center on Education Policy (CEP) and the Human Resources Research Organization (HumRRO) obtained from states from fall 2008 through April 2009. Included herein are: (1) Bullet points summarizing key findings about achievement trends in that state at three performance…

  15. General Achievement Trends: Maryland

    ERIC Educational Resources Information Center

    Center on Education Policy, 2009

    2009-01-01

    This general achievement trends profile includes information that the Center on Education Policy (CEP) and the Human Resources Research Organization (HumRRO) obtained from states from fall 2008 through April 2009. Included herein are: (1) Bullet points summarizing key findings about achievement trends in that state at three performance…

  16. General Achievement Trends: Maine

    ERIC Educational Resources Information Center

    Center on Education Policy, 2009

    2009-01-01

    This general achievement trends profile includes information that the Center on Education Policy (CEP) and the Human Resources Research Organization (HumRRO) obtained from states from fall 2008 through April 2009. Included herein are: (1) Bullet points summarizing key findings about achievement trends in that state at three performance…

  17. General Achievement Trends: Iowa

    ERIC Educational Resources Information Center

    Center on Education Policy, 2009

    2009-01-01

    This general achievement trends profile includes information that the Center on Education Policy (CEP) and the Human Resources Research Organization (HumRRO) obtained from states from fall 2008 through April 2009. Included herein are: (1) Bullet points summarizing key findings about achievement trends in that state at three performance…

  18. General Achievement Trends: Texas

    ERIC Educational Resources Information Center

    Center on Education Policy, 2009

    2009-01-01

    This general achievement trends profile includes information that the Center on Education Policy (CEP) and the Human Resources Research Organization (HumRRO) obtained from states from fall 2008 through April 2009. Included herein are: (1) Bullet points summarizing key findings about achievement trends in that state at three performance…

  19. General Achievement Trends: Hawaii

    ERIC Educational Resources Information Center

    Center on Education Policy, 2009

    2009-01-01

    This general achievement trends profile includes information that the Center on Education Policy (CEP) and the Human Resources Research Organization (HumRRO) obtained from states from fall 2008 through April 2009. Included herein are: (1) Bullet points summarizing key findings about achievement trends in that state at three performance…

  20. General Achievement Trends: Kansas

    ERIC Educational Resources Information Center

    Center on Education Policy, 2009

    2009-01-01

    This general achievement trends profile includes information that the Center on Education Policy (CEP) and the Human Resources Research Organization (HumRRO) obtained from states from fall 2008 through April 2009. Included herein are: (1) Bullet points summarizing key findings about achievement trends in that state at three performance…

  1. General Achievement Trends: Florida

    ERIC Educational Resources Information Center

    Center on Education Policy, 2009

    2009-01-01

    This general achievement trends profile includes information that the Center on Education Policy (CEP) and the Human Resources Research Organization (HumRRO) obtained from states from fall 2008 through April 2009. Included herein are: (1) Bullet points summarizing key findings about achievement trends in that state at three performance…

  2. General Achievement Trends: Massachusetts

    ERIC Educational Resources Information Center

    Center on Education Policy, 2009

    2009-01-01

    This general achievement trends profile includes information that the Center on Education Policy (CEP) and the Human Resources Research Organization (HumRRO) obtained from states from fall 2008 through April 2009. Included herein are: (1) Bullet points summarizing key findings about achievement trends in that state at three performance…

  3. General Achievement Trends: Tennessee

    ERIC Educational Resources Information Center

    Center on Education Policy, 2009

    2009-01-01

    This general achievement trends profile includes information that the Center on Education Policy (CEP) and the Human Resources Research Organization (HumRRO) obtained from states from fall 2008 through April 2009. Included herein are: (1) Bullet points summarizing key findings about achievement trends in that state at three performance…

  4. General Achievement Trends: Alabama

    ERIC Educational Resources Information Center

    Center on Education Policy, 2009

    2009-01-01

    This general achievement trends profile includes information that the Center on Education Policy (CEP) and the Human Resources Research Organization (HumRRO) obtained from states from fall 2008 through April 2009. Included herein are: (1) Bullet points summarizing key findings about achievement trends in that state at three performance…

  5. General Achievement Trends: Virginia

    ERIC Educational Resources Information Center

    Center on Education Policy, 2009

    2009-01-01

    This general achievement trends profile includes information that the Center on Education Policy (CEP) and the Human Resources Research Organization (HumRRO) obtained from states from fall 2008 through April 2009. Included herein are: (1) Bullet points summarizing key findings about achievement trends in that state at three performance…

  6. General Achievement Trends: Michigan

    ERIC Educational Resources Information Center

    Center on Education Policy, 2009

    2009-01-01

    This general achievement trends profile includes information that the Center on Education Policy (CEP) and the Human Resources Research Organization (HumRRO) obtained from states from fall 2008 through April 2009. Included herein are: (1) Bullet points summarizing key findings about achievement trends in that state at three performance…

  7. General Achievement Trends: Colorado

    ERIC Educational Resources Information Center

    Center on Education Policy, 2009

    2009-01-01

    This general achievement trends profile includes information that the Center on Education Policy (CEP) and the Human Resources Research Organization (HumRRO) obtained from states from fall 2008 through April 2009. Included herein are: (1) Bullet points summarizing key findings about achievement trends in that state at three performance…

  8. Inverting the Achievement Pyramid

    ERIC Educational Resources Information Center

    White-Hood, Marian; Shindel, Melissa

    2006-01-01

    Attempting to invert the pyramid to improve student achievement and increase all students' chances for success is not a new endeavor. For decades, educators have strategized, formed think tanks, and developed school improvement teams to find better ways to improve the achievement of all students. Currently, the No Child Left Behind Act (NCLB) is…

  9. Achievement Test Program.

    ERIC Educational Resources Information Center

    Ohio State Dept. of Education, Columbus. Trade and Industrial Education Service.

    The Ohio Trade and Industrial Education Achievement Test battery is comprised of seven basic achievement tests: Machine Trades, Automotive Mechanics, Basic Electricity, Basic Electronics, Mechanical Drafting, Printing, and Sheet Metal. The tests were developed by subject matter committees and specialists in testing and research. The Ohio Trade and…

  10. School Effects on Achievement.

    ERIC Educational Resources Information Center

    Nichols, Robert C.

    The New York State Education Department conducts a Pupil Evaluation Program (PEP) in which each year all third, sixth, and ninth grade students in the state are given a series of achievement tests in reading and mathematics. The data accumulated by the department includes achievement test scores, teacher characteristics, building and curriculum…

  11. Heritability of Creative Achievement

    ERIC Educational Resources Information Center

    Piffer, Davide; Hur, Yoon-Mi

    2014-01-01

    Although creative achievement is a subject of much attention to lay people, the origin of individual differences in creative accomplishments remain poorly understood. This study examined genetic and environmental influences on creative achievement in an adult sample of 338 twins (mean age = 26.3 years; SD = 6.6 years). Twins completed the Creative…

  12. Confronting the Achievement Gap

    ERIC Educational Resources Information Center

    Gardner, David

    2007-01-01

    This article talks about the large achievement gap between children of color and their white peers. The reasons for the achievement gap are varied. First, many urban minorities come from a background of poverty. One of the detrimental effects of growing up in poverty is receiving inadequate nourishment at a time when bodies and brains are rapidly…

  13. Achieving Public Schools

    ERIC Educational Resources Information Center

    Abowitz, Kathleen Knight

    2011-01-01

    Public schools are functionally provided through structural arrangements such as government funding, but public schools are achieved in substance, in part, through local governance. In this essay, Kathleen Knight Abowitz explains the bifocal nature of achieving public schools; that is, that schools are both subject to the unitary Public compact of…

  14. The progression of the boreal winter monsoon through the western Maritime Continent as differentiated by ENSO phase

    NASA Astrophysics Data System (ADS)

    Lee, Shao-Yi; McBride, John L.

    2016-08-01

    The impact of global ENSO on the regional monsoon onset over the Maritime Continent is examined, using satellite-derived scatterometer surface winds over the sea channel from the South China Sea, through the Karimata Strait into the Java Sea. An index of monsoon onset, fracsign, is defined based on a positive dot-product between the monthly wind at each gridpoint and the "basis-wind" or climatological wind at the peak of the relevant monsoon season.Rather than being delayed throughout the Maritime Continent during El Niño years, the monsoon is seen to arrive faster at and remain longer over the western Maritime Continent, and therefore delayed for the eastern Maritime Continent. The wind-based diagnostic can be further decomposed into two components that reflect the monsoon wind strength and the location of the wind convergence zone, respectively. During El Niño years, the monsoon strength post-onset is weaker than normal over the eastern maritime continent. However, there is no ENSO-related differentiation in monsoon strength post-onset over the western Maritime Continent.

  15. Regional climate projection of the Maritime Continent using the MIT Regional Climate Model

    NASA Astrophysics Data System (ADS)

    IM, E. S.; Eltahir, E. A. B.

    2014-12-01

    Given that warming of the climate system is unequivocal (IPCC AR5), accurate assessment of future climate is essential to understand the impact of climate change due to global warming. Modelling the climate change of the Maritime Continent is particularly challenge, showing a high degree of uncertainty. Compared to other regions, model agreement of future projections in response to anthropogenic emission forcings is much less. Furthermore, the spatial and temporal behaviors of climate projections seem to vary significantly due to a complex geographical condition and a wide range of scale interactions. For the fine-scale climate information (27 km) suitable for representing the complexity of climate change over the Maritime Continent, dynamical downscaling is performed using the MIT regional climate model (MRCM) during two thirty-year period for reference (1970-1999) and future (2070-2099) climate. Initial and boundary conditions are provided by Community Earth System Model (CESM) simulations under the emission scenarios projected by MIT Integrated Global System Model (IGSM). Changes in mean climate as well as the frequency and intensity of extreme climate events are investigated at various temporal and spatial scales. Our analysis is primarily centered on the different behavior of changes in convective and large-scale precipitation over land vs. ocean during dry vs. wet season. In addition, we attempt to find the added value to downscaled results over the Maritime Continent through the comparison between MRCM and CESM projection. Acknowledgements.This research was supported by the National Research Foundation Singapore through the Singapore MIT Alliance for Research and Technology's Center for Environmental Sensing and Modeling interdisciplinary research program.

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

    NASA Astrophysics Data System (ADS)

    Ritzwoller, M. H.

    2013-12-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2005-12-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2014-12-01

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

  19. Continent-wide distribution in mycorrhizal fungi: implications for the biogeography of specialized orchids

    PubMed Central

    Davis, Belinda J.; Phillips, Ryan D.; Wright, Magali; Linde, Celeste C.; Dixon, Kingsley W.

    2015-01-01

    Background and Aims Although mycorrhizal associations are predominantly generalist, specialized mycorrhizal interactions have repeatedly evolved in Orchidaceae, suggesting a potential role in limiting the geographical range of orchid species. In particular, the Australian orchid flora is characterized by high mycorrhizal specialization and short-range endemism. This study investigates the mycorrhizae used by Pheladenia deformis, one of the few orchid species to occur across the Australian continent. Specifically, it examines whether P. deformis is widely distributed through using multiple fungi or a single widespread fungus, and if the fungi used by Australian orchids are widespread at the continental scale. Methods Mycorrhizal fungi were isolated from P. deformis populations in eastern and western Australia. Germination trials using seed from western Australian populations were conducted to test if these fungi supported germination, regardless of the region in which they occurred. A phylogenetic analysis was undertaken using isolates from P. deformis and other Australian orchids that use the genus Sebacina to test for the occurrence of operational taxonomic units (OTUs) in eastern and western Australia. Key Results With the exception of one isolate, all fungi used by P. deformis belonged to a single fungal OTU of Sebacina. Fungal isolates from eastern and western Australia supported germination of P. deformis. A phylogenetic analysis of Australian Sebacina revealed that all of the OTUs that had been well sampled occurred on both sides of the continent. Conclusions The use of a widespread fungal OTU in P. deformis enables a broad distribution despite high mycorrhizal specificity. The Sebacina OTUs that are used by a range of Australian orchids occur on both sides of the continent, demonstrating that the short-range endemism prevalent in the orchids is not driven by fungal species with narrow distributions. Alternatively, a combination of specific edaphic

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

    NASA Astrophysics Data System (ADS)

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

    2016-07-01

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