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  1. Renal transplantation using external continent urinary diversion.

    PubMed

    Lucon, A M; Sabbaga, E; Ianhez, L E; Chocair, P R; Pestana, J O; Arap, S

    1994-02-01

    A 29-year-old man born with bladder exstrophy presented with end stage renal failure many years after ileal conduit diversion. Bilateral nephrectomy and continent external urinary diversion were performed, and 1.5 months later a cadaveric kidney was grafted into the right iliac fossa. The patient was well at 18 months with a serum creatinine level of 1.2 mg./dl. and he was completely dry with 4 or 5 daily catheterizations. Although followup is still short, renal transplantation with drainage into an external continent urinary diversion permits excellent quality of life and good renal function. Therefore, this alternative is worth consideration whenever other reconstructive alternatives are not possible in candidates for renal transplantation.

  2. 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... Implanted electrical urinary continence device. (a) Identification. An implanted electrical urinary device is a device intended for treatment of urinary incontinence that consists of a receiver implanted...

  3. 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...

  4. 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...

  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, 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...

  8. 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... the pelvic floor, and a battery-powered transmitter outside the body. (b) Classification. Class...

  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... the pelvic floor, and a battery-powered transmitter outside the body. (b) Classification. Class...

  10. 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... the pelvic floor, and a battery-powered transmitter outside the body. (b) Classification. Class...

  11. 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

  12. 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

  13. 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

  14. Controversies in female urethral anatomy and their significance for understanding urinary continence: observations and literature review.

    PubMed

    Haderer, J M; Pannu, H K; Genadry, R; Hutchins, G M

    2002-01-01

    To re-examine the anatomy of the female urethra and related structures, three female pelves serially sectioned in sagittal, coronal or transverse planes, and four sets of transverse histological slides of female urethras, were studied. The observations were assembled, rendered as illustrations, and correlated with published works to present an overall explanation of the gross and histological anatomy of the female pelvis and perineum as related to continence. The figures accompanying the text present the anatomy in a series of views in the three anatomical planes. The anatomical relationships of the paraurethral and paravaginal tissues are examined in relation to the conflicting nomenclature applied to these structures. The figures show the spatial relationships within the pelves and perineum that explain their effective function in urinary continence.

  15. Promoting social continence: products and devices in the management of urinary incontinence.

    PubMed

    Lekan-Rutledge, Deborah; Doughty, Dorothy; Moore, Katherine N; Wooldridge, Leslie

    2003-12-01

    Urinary incontinence (UI) is a prevalent problem occurring in men and women across the lifespan. Technologic innovations have provided individuals with incontinence and caregivers with an array of options for achieving social continence. Even when UI cannot be completely cured, it can always be managed with products, skin care regimens, occlusive or drainage devices and toileting equipment to ensure optimal skin integrity, odorless urine containment, social independence, comfort, and freedom of movement. Various products, devices, and equipment available to help incontinent individuals preserve independence and quality of life and manage incontinence are described.

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

    PubMed Central

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

    2015-01-01

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

  17. 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

  18. 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

  19. Evaluation of pelvic floor muscle strength before and after robotic-assisted radical prostatectomy and early outcomes on urinary continence.

    PubMed

    Manley, Lauren; Gibson, Luke; Papa, Nathan; Beharry, Bhawanie Koonj; Johnson, Liana; Lawrentschuk, Nathan; Bolton, Damien M

    2016-12-01

    The aim of the study was to evaluate the effect of pelvic floor muscle (PFM) assessment and training before and after robot-assisted laparoscopic radical prostatectomy (RARP) in improving PFM strength and urinary continence. We performed an analysis of a database of patients who underwent robot-assisted laparoscopic radical prostatectomy (RARP) performed by two urologists from 2011 to 2013. Pelvic floor muscle (PFM) activation and strength were graded by a trained pelvic floor physiotherapist. Patients were given an exercise program, grouped according to the strength of their pelvic floor as graded by assessment, to complete before and after surgery. PFM strength was recorded preoperatively, 4 days post-catheter removal and 4 weeks post-catheter removal. Continence was recorded at 4 weeks postop and was defined as the requirement of no continence aids. A total of 98 patients had RARP and a preoperative physiotherapy assessment plus postoperative appointments at around 1 and 4 weeks post-RARP. The majority of men improved their PFM strength regardless of preoperative strength with no significant predictors of postoperative strength found. Age was the only significant predictor of postoperative incontinence. In this pilot study, a majority of patients increased their pelvic floor strength with time. Pelvic floor physiotherapy is an important modifiable patient factor, which does have an impact in improving patients' urinary continence by strengthening the pelvic floor muscles. Patient age influences response to pelvic floor physiotherapy.

  20. “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

  1. Effect of Bladder Neck Preservation and Posterior Urethral Reconstruction during Robot-Assisted Laparoscopic Radical Prostatectomy for Urinary Continence

    PubMed Central

    You, Youn Chul; Kim, Tae Hyo

    2012-01-01

    Purpose To report our results on urinary continence after bladder neck preservation (BNP) and posterior urethral reconstruction (PUR) during robot-assisted laparoscopic radical prostatectomy (RALP). Materials and Methods Data from 107 patients who underwent RALP were compared on the basis of whether the patients underwent BNP and PUR, BNP only, or the standard technique (ST). In group A (n=31 patients), ST was performed by using Ven velthoven continuous suturing for urethrovesical anastomosis. In group B (n=28 patients), ST with only PUR was performed. In group C (n=48 patients), both the BNP and PUR techniques were used. "Recovery of continence" was defined as the use of 1 pad (50 ml) or less within 24 hours. Results The three groups were comparable in terms of patient demographics. The mean operative time and the mean blood loss decreased significantly from group A to group C (p=0.021 for mean operative time and p=0.004 for the mean blood loss). Mean catheterization time was 8.9, 7.8, and 7.1 days in each group (p=0.047). Early return of urinary continence at 3 months was observed in group B (89.2%) and group C (90.6%) compared with group A (71%). However, continence at 6 months was comparable in the 3 groups (87.5% in group A, 92.8% in group B, and 92.3% in group C). Rates of positive surgical margins decreased from 30.2% in group A to 20% in group B and 12% in group C. Conclusions BNP and PUR during RALP showed a favorable impact on the early postoperative recovery of continence while not affecting positive surgical margins. PMID:22323971

  2. 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

  3. Impact of preoperative and postoperative membranous urethral length measured by 3 Tesla magnetic resonance imaging on urinary continence recovery after robotic-assisted radical prostatectomy

    PubMed Central

    Song, Wan; Kim, Chan Kyo; Park, Byung Kwan; Jeon, Hwang Gyun; Jeong, Byong Chang; Seo, Seong Il; Jeon, Seong Soo; Choi, Han Yong; Lee, Hyun Moo

    2017-01-01

    Introduction We sought to investigate the impact of preoperative and postoperative membranous urethral length (MUL) on urinary continence using 3 Tesla (3T) magnetic resonance imaging (MRI) after robotic-assisted radical prostatectomy (RARP). Methods Between 2008 and 2013, 190 men with RARP underwent preoperative and postoperative MRI. Patients who received adjuvant radiotherapy or who were lost to followup were excluded, leaving 186 patients eligible for analysis. Preoperative MUL was estimated from the prostate apex to the penile bulb, while postoperative MUL was estimated from the bladder neck to penile bulb. Patients with no pads or protection were considered to have complete continence. Logistic regression analysis was used to identify predictors associated with urinary incontinence at six and 12 months. Results Age was commonly associated with urinary incontinence at six and 12 months. In addition, diabetes mellitus (DM) was another factor associated with urinary incontinence at 12 months. When adjusting these variables, preoperative MUL ≤16 mm (95% confidence interval [CI] 1.01–1.14; p=0.022), postoperative MUL ≤14 mm (95% CI 1.16–9.80; p=0.025) and percent change of MUL >18% (95% CI 1.17–7.23; p=0.021) were significantly associated with urinary incontinence at six months. However, at 12 months, preoperative MUL ≤13.5 mm (95% CI 1.85–19.21; p=0.003) and postoperative MUL ≤13 mm (95% CI 1.24–13.84; p=0.021) had impacts on urinary incontinence, but not percent change of MUL. Conclusions Preoperative and postoperative MUL were significantly associated with urinary continence recovery after RARP. Therefore, efforts to preserve MUL are highly recommended during surgery for optimal continence outcomes after RARP. PMID:28360954

  4. The role of pubococcygeus muscle in urinary continence in the male rat.

    PubMed

    Manzo, J; Esquivel, A; Hernández, M E; Carrillo, P; Martínez-Gómez, M; Pacheco, P

    1997-06-01

    The role of the male rat pubococcygeus muscle (Pcm) in the micturition reflex was analyzed. Anatomical features of Pcm, electrical stimulation of its nerve, electrical recording and stimulation of the muscle and cystometrograms were carried out. Results showed that Pcm has fibers attached to the ventrolateral part of the external urethral sphincter, and that its activity contributes to hold the tail in the midline. Pcm shows activity during fluid expulsion in cystometrograms and spontaneous micturitions. This activity produced reflex inhibition of detrusor contraction and was not the cause of intravesical high frequency oscillations. Thus, it is proposed that Pcm activity produces the discharge of its afferents which in turn activates a spinal reflex to promote continence.

  5. Systematic review of the management of incontinence and promotion of continence in older people in care homes: descriptive studies with urinary incontinence as primary focus

    PubMed Central

    Roe, Brenda; Flanagan, Lisa; Jack, Barbara; Barrett, James; Chung, Alan; Shaw, Christine; Williams, Kate

    2011-01-01

    Aim This is a review of descriptive studies with incontinence as the primary focus in older people in care homes. Background Incontinence is prevalent among residents of care home populations. Data sources MEDLINE and CINAHL were searched from 1996 to 2007 using the highly sensitive search strings of the Cochrane Incontinence Review Group for urinary and faecal incontinence including all research designs. Search strings were modified to enhance selectiveness for care homes and older people and exclude studies involving surgical or pharmacological interventions. Searching of reference sections from identified studies was also used to supplement electronic searches. The Cochrane Library was searched for relevant systematic reviews to locate relevant studies from those included or excluded from reviews. The search was limited to English-language publications. Methods A systematic review of studies on the management of incontinence, promotion of continence or maintenance of continence in care homes was conducted in 2007–2009. This is a report of descriptive studies. Results Ten studies were identified that reported on prevalence and incidence of incontinence (urinary with or without faecal), policies, assessment, documentation, management or economic evaluation of its management. Use of incontinence pads and toileting programmes comprised the most common management approaches used. No studies were identified that attempted to maintain continence of residents in care homes. Conclusions Studies on maintaining continence and identifying components of toileting programmes that are successful in managing or preventing incontinence and promoting continence in residents of care home populations along with their economic evaluation are warranted. PMID:21105895

  6. 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

  7. Anatomy of female continence.

    PubMed

    Sampselle, C M; DeLancey, J O

    1998-03-01

    Various muscle, connective tissue, and neurologic structures within the pelvic floor play critical roles in the maintenance of both urinary and fecal continence. Recent advances in technology, combined with greater precision during anatomic study, have expanded our understanding of the role played by the pelvic floor in maintaining continence. The goal of this article is to summarize recent research on female pelvic anatomy, with a particular emphasis on the evidence base related to urinary incontinence. The content is organized to accomplish three aims: (1) identify, within the context of pelvic floor anatomy, the structures that comprise the urinary continence system, (2) Describe the functional dynamics of urinary continence, including factors in resting urethral pressure and pressure transmission, and (3) Present the rationale, technique, and interpretation of various methods of measuring pelvic floor function.

  8. The Long-Term Effect of Radical Prostatectomy on Erectile Function, Urinary Continence, and Lower Urinary Tract Symptoms: A Comparison to Age-Matched Healthy Controls

    PubMed Central

    Ponholzer, Anton; Augustin, Herbert; Madersbacher, Stephan; Pummer, Karl

    2017-01-01

    Introduction. To analyze the impact of radical prostatectomy (RPE) on erectile function and lower urinary tract function in comparison to age-matched healthy men. Materials and Methods. Patients who underwent radical retropubic prostatectomy completed questionnaires containing the IIEF-5, the Bristol female LUTS questionnaire, and the International Prostate Symptom Score (IPSS). Results. Patients after RPE were included (n = 363). Age-matched healthy men (n = 363) were included. The mean IIEF-5 of patients aged 61–70 yrs after RPE was 10.4 ± 6.6 versus 18.8 ± 5.3 in the control cohort; the respective values for men aged 71–80 yrs after RPE were 7.2 ± 6.5 versus 13.6 ± 7.7 in the control cohort. Urinary incontinence after RPE was reported in 41.9% (61–70 years) and 37.7% (71–80) versus 7.5% and 15.1% in the control cohort. The mean IPSS of patients after RPE aged 61–70 yrs was 5.0 ± 4.4 versus 5.5 ± 4.9 in the control cohort; the respective values for men aged 71–80 yrs were 6.0 ± 4.9 versus 7.5 ± 5.7 in the healthy cohort. Conclusions. The negative effect of radical prostatectomy on erectile and urinary incontinence remains substantial. The physiologically declining erectile and lower urinary tract function with ageing reduces the difference between healthy men and those after surgery. Healthy men have a higher IPSS presumably due to the presence of bladder outlet obstruction. PMID:28261619

  9. 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

  10. [A case of acquired immunodeficiency syndrome with ileocecal ulcer].

    PubMed

    Iwasaki, Tetsuyoshi; Saruta, Masayuki; Sawada, Ryoichi; Ide, Daisuke; Arihiro, Seiji; Matsuoka, Mika; Katoh, Tomohiro; Tajiri, Hisao

    2015-10-01

    We report a case of a patient with acquired immunodeficiency syndrome (AIDS) and ileocecal ulcer. A 31-year-old man was admitted with chief complaints of decreased body weight and abdominal pain. Colonoscopy revealed a round punched-out ulcer on the ileocecal valve. Initially, we suspected entero-Behçet's disease and simple ulcer as the cause of the ileocecal ulcer. However, after histologic examination of tissue biopsies obtained during colonoscopy, we diagnosed the patient as having cytomegalovirus (CMV) enteritis. Based on the patient's white blood cell depletion and CMV enteritis, we performed a human immunodeficiency virus (HIV) antibody test. The test was positive, and the diagnosis of AIDS was established. The number of patients with AIDS has been increasing in Japan; thus, we should consider the possibility of CMV enteritis and AIDS in young adult patients affected by ileocecal ulcer with no notable history.

  11. 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 (§...

  12. 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 (§...

  13. 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 (§...

  14. Partial urethral resection in the surgical treatment of vulvar cancer does not have a significant impact on urinary continence. A confirmation of an authority-based opinion.

    PubMed

    de Mooij, Y; Burger, M P M; Schilthuis, M S; Buist, M; van der Velden, J

    2007-01-01

    Partial resection of the urethra is sometimes necessary in the surgical treatment of locally advanced vulvar cancer. In this study, the frequency of urinary incontinence after partial urethral resection was compared with that of patients who were treated without partial resection of the urethra. Eighteen patients with vulvar cancer encroaching or infiltrating the urethra, treated by a radical vulvectomy and partial urethrectomy, were compared with 17 patients treated by vulvectomy without partial removal of the urethra. Data on urinary incontinence pre- and postoperatively from both groups were retrospectively collected from the patient files. A questionnaire on urinary incontinence was sent to a subset of patients from both groups in order to get information on the current micturation pattern. In four out of 18 patients (22%) with a partial urethrectomy, incontinence was reported, versus two out of 17 patients (12%) in the control group (P= 0.860). Eight patients in the study group and 12 in the control group are currently alive, and all responded to the questionnaire. Two (25%) in the study group and three (25%) in the control group reported to have current symptoms of urinary incontinence. This retrospective study shows that partial resection of 1-1.5 cm of the distal urethra in addition to a radical local excision for vulvar cancer does not result in a significant increase in the frequency of urinary incontinence, compared with vulvar cancer patients without partial urethrectomy.

  15. Childhood continence.

    PubMed

    Dean, Erin

    2017-03-15

    Essential facts An estimated one in 12 (900,000) children aged 5-19 in the UK experience bowel and bladder conditions. The impact of continence conditions can be profound on a child's or teenager's life and can continue into adulthood. Those affected can have a lower quality of life than their peers, miss out on education and social activities, and are more likely to be bullied. Most bowel and bladder problems are avoidable and treatable, yet it's estimated that only 11% of those affected ask for help.

  16. [A case of extramammary Paget's disease with urethral invasion treated by construction of continent urinary diversion based on the Monti principle using the sigmoid colon].

    PubMed

    Hakariya, Tomoaki; Nakanishi, Hiromi; Asai, Akihiro; Kanokoki, Katsura; Kihara, Toshiharu; Takehara, Kosuke; Igawa, Tsukasa; Sakai, Hideki; Tou, Kazuo; Takeshita, Hiroaki; Miura, Kiyonori; Tanaka, Katsumi; Kashima, Shiro; Matsuo, Manabu

    2015-02-01

    Extramammary Paget's disease occurring in the female vulva is occasionally associated with invasive disease to urethra and bladder mucosa. For such cases, ensuring adequate surgical margin is essential. Not only adequate removal of tumor, but also urinary diversion is important for patient's quality of life. A 77- year-old woman was treated with excision of vulvar tumor, urethra, vagina, rectum and anus. The determination of excision area was decided according to the result of mapping biopsy including urethra and bladder. Then she received reconstruction of vulva using the gracilis muscle skin flap. We applied a technique of channel formation for intermittent catheterization using the retubularized sigmoid colon based on the Monti principle. The tube was implanted submucosally into the bladder to prevent the reflux of urine. Fifteen days after operation, self-intermittent catheterization was started successfully. Surgical margins were negative in urethra, skin, vagina and rectum. There are no obvious recurrence or metastasis 1 year after surgery.

  17. Promoting social continence using incontinence management products.

    PubMed

    Dingwall, Lindsay

    Urinary incontinence (UI) is a common problem which affects men and women for a variety of reasons. For some people with UI cure is not achievable. For others, time is required to accurately diagnose and treat their urinary symptoms. In order to improve quality of life for people with UI, health professionals require awareness of the products available to achieve social continence. Continence products and devices fall into three categories: collective devices, containment products and occlusive devices. This article provides a brief overview of the more common products available and discusses some of the common benefits and drawbacks to their use.

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

    PubMed Central

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

    2013-01-01

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

  19. Sympathetic innervation of the ileocecal junction in horses.

    PubMed

    Russo, D; Bombardi, C; Grandis, A; Furness, J B; Spadari, A; Bernardini, C; Chiocchetti, R

    2010-10-01

    The distribution and chemical phenotypes of sympathetic and dorsal root ganglion (DRG) neurons innervating the equine ileocecal junction (ICJ) were studied by combining retrograde tracing and immunohistochemistry. Immunoreactivity (IR) for tyrosine hydroxylase (TH), dopamine beta-hydroxylase (DBH), neuronal nitric oxide synthase (nNOS), calcitonin gene-related peptide (CGRP), substance P (SP), and neuropeptide Y (NPY) was investigated. Sympathetic neurons projecting to the ICJ were distributed within the celiac (CG), cranial mesenteric (CranMG), and caudal mesenteric (CaudMG) ganglia, as well as in the last ganglia of the thoracic sympathetic chain and in the splanchnic ganglia. In the CG and CranMG 91 +/- 8% and 93 +/- 12% of the neurons innervating the ICJ expressed TH- and DBH-IR, respectively. In the CaudMG 90 +/- 15% and 94 +/- 5% of ICJ innervating neurons were TH- and DBH-IR, respectively. Sympathetic (TH-IR) fibers innervated the myenteric and submucosal ganglia, ileal blood vessels, and the muscle layers. They were more concentrated at the ICJ level and were also seen encircling myenteric plexus (MP) and submucosal plexus (SMP) descending neurons that were retrogradely labeled from the ICJ. Among the few retrogradely labeled DRG neurons, nNOS-, CGRP-, and SP-IR nerve cells were observed. Dense networks of CGRP-, nNOS-, and SP-IR varicosities were seen around retrogradely labeled prevertebral ganglia neurons. The CGRP-IR fibers are probably the endings of neurons projecting from the intestine to the prevertebral ganglia. These findings indicate that this crucial region of the intestinal tract is strongly influenced by the sympathetic system and that sensory information of visceral origin influences the sympathetic control of the ICJ.

  20. Ileocecal Valve as Substitute for the Missing Pyloric Sphincter After Partial Distal Gastrectomy

    PubMed Central

    Metzger, Jürg; Degen, Lukas P.; Beglinger, Christoph; Siegemund, Martin; Studer, Wolfgang; Heberer, Michael; Harder, Felix; von Flüe, Markus O.

    2002-01-01

    Objectives Accelerated gastric emptying (including dumping syndrome) occurs frequently after gastric resections, largely resulting from rapid entry of meal contents into the small intestine. The authors hypothesized that an ileocecal segment used as an interpositional graft placed between the remaining part of the stomach and the small intestine would slow down food transit and thus replace pyloric function. Methods Thirty Göttingen minipigs were randomized into three groups. Group 1: partial gastrectomy and Roux-en-Y reconstruction; Group 2: partial gastrectomy and ileocecal interpositional graft; and Group 3: sham laparotomy. Gastric emptying in the nonsedated animals was quantified using radioscintigraphy at 3 and 6 months postoperatively. The animals ingested 300 grams of soft food containing 99mTc labeled resin- pellets using a technique previously described. Data were analyzed using ANOVA. Results Three months postoperatively, the ileocecal group had a significantly prolonged gastric emptying time compared with the Roux-en-Y group, but gastric emptying time was also significantly faster compared to the control group (sham laparotomy). After 6 months no significant difference was seen between the ileocecal group and the controls, while emptying rates were still significantly faster in the Roux-en-Y group. Conclusions Reconstruction of the gastric reservoir with an ileocecal segment largely restores gastric emptying patterns of food in minipigs. Six months postoperatively, gastric emptying time is similar to that of controls, and significantly slower when compared with the group with Roux-en-Y reconstruction. These results suggest that the ileocecal interposition graft could offer specific advantages over current reconstruction procedures. PMID:12131082

  1. Literature review of factors affecting continence after radical prostatectomy

    PubMed Central

    Pacik, Dalibor; Fedorko, Michal

    2017-01-01

    Radical prostatectomy (RP) is the most common cause of stress urinary incontinence (UI) in men. Several anatomic structures affect or may affect urinary continence - urethral sphincter, levator ani muscle, puboprostatic ligaments, bladder neck, endopelvic fascia, neurovascular bundle - and understanding of the anatomy of pelvic floor and urethra is crucial for satisfactory functional outcome of the procedure. Surgical techniques implemented to improve continence rates include nerve-sparing procedure, bladder neck preservation/plication, urethral length preservation, musculofascial reconstruction, puboprostatic ligaments preservation or seminal vesicle preservation. Perioperative (preoperative and postoperative) pelvic floor muscle training (PFMT) aims to shorten the duration of postoperative UI and thus, improve early continence rates postoperatively. In the review, complex information regarding anatomical, intra- and perioperative factors affecting urinary continence after RP is provided, including description of important anatomical structures, possible implications for surgical technique and evaluation of different PFMT strategies in perioperative period. PMID:28042624

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  4. Rectus sheath tunnels for continent stomas.

    PubMed

    Dickson, Alan P; Khalil, Basem A; Cervellione, Raimondo M

    2008-03-01

    Continent stoma rectus sheath tunnel (CSRST) has been used in antegrade colonic enema (ACE) and urinary continent cutaneous diversion (UCCD) stomas to reduce leakage and to support a straight track for the continent conduit. All patients that underwent CSRST between 1995 and 2005 were identified and their case notes retrospectively reviewed. Patients were divided into two groups: the ACE group and the UCCD group. Demographic data, age at surgery and complications including stenosis and leakage were recorded. Forty patients underwent CSRST between 1995 and 2005. The mean age and standard deviation (SD) at surgery was 6.8 (2.1) years. Eighteen patients underwent ACE with a mean (SD) follow-up of 7.6 (3.1) years. No patient has faecal leakage. No patient had stomal revision, but one patient (5.5%) required an indwelling gastrostomy button to maintain patency. Twenty-two patients underwent UCCD with a mean (SD) follow-up of 8.1 (2.8) years. No patient developed urinary leakage. Two patients (9%) required revision of the stoma and one (4.5%) required an indwelling catheter because of recurring stomal stenosis. CSRST prevents stoma leakage. Revision surgery rate after CSRST is low, particularly after ACE reconstruction.

  5. Visceral pain triggered by traction on the ileocecal ligament with ileitis

    PubMed Central

    Janyaro, Habibullah; Wan, Juan; Tahir, Adnan H; Shah, Manoj K; Li, Xiao-Jing; Ding, Ming-Xing

    2016-01-01

    Background Visceral pain is a common symptom of several gastrointestinal disorders. Despite tremendous progress in understanding its basic mechanisms, it remains a significant health challenge for clinicians. The present study quantified the intensity of visceral pain using ileocecal ligament traction on an inflamed ileum in goats. Materials and methods A total of 36 male goats weighing 20.05±2.1 kg were randomly allocated equally into a 2,4,6-trinitrobenzenesulfonic acid (TNBS) group (n=18) and a saline group (n=18). Ileitis was induced via the injection of 30 mg TNBS dissolved in 30% ethanol into the ileal wall through a laparotomy. An equal volume of normal saline was injected into the ileal wall of the saline goats. Behavioral responses to traction (2, 4, and 6 N) on the ileocecal ligament were observed on days 3, 7, and 14. Six goats from each group received a laparotomy and partial intestinal resection for ileal sample collection immediately after behavioral testing on days 3, 7, and 14. Ileal histopathological changes were assessed and concentrations of myeloperoxidase, IL-1β, IL-6, and TNFα investigated using enzyme-linked immunosorbent assay. Results The TNBS-treated goats exhibited remarkably increased macroscopic scores, mast-cell counts, myeloperoxidase, and TNFα concentrations on days 3 and 7 compared to the saline group, and increased microscopic scores and IL-1β and IL-6 concentrations on days 3–14. The TNBS-treated goats exhibited behavioral changes in response to traction in the same pattern as their microscopic changes and cytokine levels. The traction force correlated positively with pain-behavior responses. Conclusion Traction on the ileocecal ligament of goats with ileitis provoked an apparent, stable, and reproducible ileum-derived pain. The current model may be helpful in evaluating the efficacy of new drugs for the management of visceral pain and in investigating its underlying mechanisms. PMID:27757049

  6. Technical Note: Improved technique for fitting pigs with steered ileocecal valve cannulas.

    PubMed

    Radcliffe, J S; Rice, J P; Pleasant, R S; Apgar, G A

    2005-07-01

    Collection of ileal digesta to evaluate AA digestibilities has become increasingly important in swine nutrition research. Steered ileocecal valve cannulation of pigs permits total collection of ileal digesta, while still allowing normal digesta flow during noncollection periods. This technique was modified and used with 64 crossbred barrows in five trials. Our procedural changes included preoperative i.v. administration of a broad-spectrum antibiotic and nonsteroidal antiinflammatory drug, sharp incision through the muscle layers of the laparotomy wound, use of a heparinized saline lavage solution, replacement of the guide ring with a stylette, and fixing the outer cannula barrel in place with a hose clamp. The current technique involves a right flank laparotomy, parallel and distal to the last rib, with the pig under general anesthesia. A stainless-steel ring (inner ring = 2.0 mm thick, 35.0 mm i.d.) is introduced into the ileal lumen through an enterotomy proximal to the origin of the ileocecal fold. A nylon string attached to this ring is threaded through the ileum and ileocecal valve into the cecum using a silastic stylette, which encases the string. A second stainless-steel ring (outer ring = 2.0 mm thick, 34 mm o.d.) is fixed in place around the ileum, distal to the inner ring and just proximal to the ileocecal valve. A polyurethane cannula barrel (barrel = 100 mm long, 26 mm i.d., 32 mm o.d.; flange = 70 mm o.d.) is introduced into the cecal lumen via an enterotomy through the lateral cecal band and secured in place with two purse-string sutures. The cannula is exteriorized through an incision caudal and proximal to the intial laparotomy site, where it is plugged using a cylindrical stopper (26 mm o.d., 55 mm long) and held in place by a second cannula barrel (barrel = 43 mm length, 33 mm i.d., 41 mm o.d.; flange = 80 mm o.d.). Procedural changes decreased postsurgical complications, as evidenced by decreased seepage around the cannula and fewer and less

  7. [Evolution of urinary bladder substitution].

    PubMed

    Kock, N G

    1992-11-01

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

  8. Where the continent ends

    NASA Astrophysics Data System (ADS)

    Paris, Paul J.; Walsh, J. P.; Corbett, D. Reide

    2016-12-01

    The Earth's continents and islands are bordered by shallow ocean plains that are arguably the most environmentally, economically, and politically important parts of the sea. Yet in spite of this, they remain poorly defined and understood. A quantitative approach is employed here to map and analyze these plains, or shelves. The Earth's ocean bathymetry was used to determine the continent-ocean basin transition at 1200 m and then parsed with a novel geospatial terrain classification concept/method borrowed from the field of image analysis: the geomorphic phonotype, or geomorphon. The technique is less subjective than visual interpretation and digitization and here illustrates that the ocean coastal plains are deeper, wider, and more steeply sloped than previously recognized. Their variable form is related to tectonics and latitude and ultimately affects function and habitat.

  9. 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).

  10. The effect of Protexin on prevention of ileocecal infection by Mycobacterium avium subspecies paratuberculosis in dairy calves.

    PubMed

    Badiei, A; Moosakhani, F; Hamidi, A; Sami, M

    2013-10-01

    The objective of this study was to evaluate the effect of Protexin (Probiotics International Ltd., South Petherton, UK) in the prevention of ileocecal infection by Mycobacterium avium ssp. paratuberculosis (MAP) in dairy calves in the field situation. Forty Holstein bull calves whose dams were paratuberculosis negative (confirmed by serum ELISA test and fecal nested PCR) were randomly selected in 2 groups. All calves were fed raw milk collected from the bulk tank in a paratuberculosis-infected dairy farm, which was confirmed by PCR. The treatment group (20 calves) was given 2 g of Protexin from birth until weaning (90 d). The control group (20 calves) did not consume Protexin. The calves were culled at 12 mo of age and the ileocecal lymph nodes were sampled. The lymph nodes were tested by nested PCR to evaluate MAP infection. In the treatment group, 2 out of 20 calf (10%) ileoceca were infected by MAP, whereas in the control group, 8 out of 20 calf (40%) ileoceca were infected by MAP. A significant difference existed between ileocecal infection by MAP in treatment and control groups. Thus, Protexin showed a significant effect in decreasing the ileocecal infection by MAP.

  11. Urinary Incontinence

    MedlinePlus

    ... It may begin around the time of menopause. Urgency urinary incontinence happens when people have a sudden need ... urinary incontinence is a mix of stress and urgency urinary incontinence. You may leak urine with a laugh ...

  12. 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.

  13. Selecting appropriate absorbent products to treat urinary incontinence.

    PubMed

    Payne, Drew

    2015-11-01

    Urinary incontinence can have a significant negative effect on a person's life, especially if left unmanaged and untreated. Continence assessment, often carried out by community nurses, is an important element in the management of a person's urinary incontinence, and so is the selection of appropriate absorbent incontinence pads. This article reviews: the causes and effects of urinary incontinence; how to derive the most appropriate information from a continence assessment; strategies for selecting incontinence pads for a person, on the basis of the results of the continence assessment; and some of the problems and risks associated with the use of incontinence pads.

  14. Factors associated with variations in older people's use of community-based continence services.

    PubMed

    Peters, Tim J; Horrocks, Sue; Stoddart, Helen; Somerset, Maggie

    2004-01-01

    Many people who have urinary incontinence and who may benefit from healthcare and professional advice do not currently access UK National Health Service services, even though effective treatments are available in the community. Older people have an increased prevalence of incontinence and a correspondingly increased need for continence services. Therefore, increasing older people's access to continence services has the potential to reduce inequalities and improve quality of life. The present study aimed to identify older people with urinary incontinence living in the community, to describe and compare the characteristics of users and non-users of continence services, and to identify factors which prevent older people seeking help. A cross-sectional postal survey of patients aged over 65 years registered with four general practices in an urban area found an overall prevalence of 39% of older people with urinary incontinence, only 15% of whom had accessed services. Two-thirds of respondents who reported that they experienced urinary leakage several times per week to all the time, and up to two-thirds of those reporting leakage of moderate or large volumes of leakage had not accessed services. The majority of older people are in regular contact with health professionals, and the greatest single influence on use of services was that of being asked whether there were continence problems by a health professional. Being married or having a partner, experiencing less pain generally, and suffering relatively high frequency and volumes of urinary leakage also appeared to be associated independently with continence service use. In conclusion, there appears to be considerable unmet need for continence services. Health professionals should be aware that incontinence is an important health problem for older people, and by asking older people specifically about urinary leakage, they could reduce inequalities in use of services.

  15. [Non continent urinary transcutaneous derivation to cure recurrent vesicostomy prolapse].

    PubMed

    Stainier, A; Di Gregorio, M; Tombal, B

    2009-12-01

    Vesicostomy prolapse is a frequent complication of an unusual surgical technique in adult patients. We have described a surgical technique to repair a vesicostomy prolapse using subcutaneous tubulisation of thick cutaneous flap taken off the abdominal wall. This technique could help surgeons to cure prolapse of vesicostomy in case of impossible intraperitoneal approach.

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

    PubMed Central

    Hempel, Randy J.; Bannantine, John P.

    2016-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  18. Urinary Incontinence

    MedlinePlus

    ... urinary incontinence. Initial pilot studies have shown that acupuncture can provide some short-term benefit, but more ... Urology. 2013;190:113. Wang Y, et al. Acupuncture for stress urinary incontinence in adults. Cochrane Database ...

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

    PubMed Central

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

    2015-01-01

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

  20. [Treatment of urinary incontinence in epispadias at the beginning of the third millenium].

    PubMed

    Touili, Y; Chebil, M; Bacha, K; Hajri, M; Hassine, B; Ayed, M

    2002-01-01

    The treatment of urinary incontinence in epispadias is delicate. Urinary continence is generally obtained after onerous and repetitive surgery. Different publications show a variable results. After the study of the results of our series (nine cases) and the results published in the literature, we propose a clarification on the therapeutic modalities of urinary incontinence associated to this malformation.

  1. 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…

  2. Surgical management of pediatric urinary incontinence.

    PubMed

    Dave, Sumit; Salle, Joao Luiz Pippi

    2013-08-01

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

  3. Independent Predictors of Recovery of Continence 3 Months After Robot-Assisted Laparoscopic Radical Prostatectomy

    PubMed Central

    Kim, Jung Jun; Ha, Yun-Sok; Kim, Jeong Hyun; Jeon, Seong Soo; Lee, Dong-Hyeon; Kim, Wun-Jae

    2012-01-01

    Abstract Purpose To investigate the factors that predict recovery of continence within 3 months after robot-assisted radical prostatectomy (RARP). Patients and Methods The charts of 452 patients who underwent RARP with a minimum follow-up period of 3 months were collected prospectively and reviewed retrospectively. Urinary continence was determined using the self-administered validated Expanded Prostate Cancer Index Composite questionnaire during the routine follow-up visits. Results The overall continence rate 3 months after RARP was 79.9%. In an univariate logistic regression test, age<70 years, higher preoperative Sexual Health Inventory for Men (SHIM) score, lower clinical T1 stage, lower biopsy and pathologic Gleason score, shorter operative time, lower estimated blood loss, smaller prostate volume (<40 cc) were associated with recovery of urinary continence within 3 months after RARP (P<0.05). In multivariate logistic regression analysis, younger age, higher SHIM score, lower clinical T1 stage, lower body mass index (BMI), and smaller prostate volume were independent factors that predicted return of continence within 3 months after RARP (P<0.05). Conclusions Younger age (<70 years), higher preoperative SHIM score, clinical T1 stage, lower BMI, and smaller prostate volume (<40 cc) independently predicted recovery of continence within 3 months after RARP. PMID:22651546

  4. Ileocecal valve dysfunction in small intestinal bacterial overgrowth: A pilot study

    PubMed Central

    Miller, Larry S; Vegesna, Anil K; Sampath, Aiswerya Madanam; Prabhu, Shital; Kotapati, Sesha Krishna; Makipour, Kian

    2012-01-01

    AIM: To explore whether patients with a defective ileocecal valve (ICV)/cecal distension reflex have small intestinal bacterial overgrowth. METHODS: Using a colonoscope, under conscious sedation, the ICV was intubated and the colonoscope was placed within the terminal ileum (TI). A manometry catheter with 4 pressure channels, spaced 1 cm apart, was passed through the biopsy channel of the colonoscope into the TI. The colonoscope was slowly withdrawn from the TI while the manometry catheter was advanced. The catheter was placed across the ICV so that at least one pressure port was within the TI, ICV and the cecum respectively. Pressures were continuously measured during air insufflation into the cecum, under direct endoscopic visualization, in 19 volunteers. Air was insufflated to a maximum of 40 mmHg to prevent barotrauma. All subjects underwent lactulose breath testing one month after the colonoscopy. The results of the breath tests were compared with the results of the pressures within the ICV during air insufflation. RESULTS: Nineteen subjects underwent colonoscopy with measurements of the ICV pressures after intubation of the ICV with a colonoscope. Initial baseline readings showed no statistical difference in the pressures of the TI and ICV, between subjects with positive lactulose breath tests and normal lactulose breath tests. The average peak ICV pressure during air insufflation into the cecum in subjects with normal lactulose breath tests was significantly higher than cecal pressures during air insufflation (49.33 ± 7.99 mmHg vs 16.40 ± 2.14 mmHg, P = 0.0011). The average percentage difference of the area under the pressure curve of the ICV from the cecum during air insufflations in subjects with normal lactulose breath tests was significantly higher (280.72% ± 43.29% vs 100% ± 0%, P = 0.0006). The average peak ICV pressure during air insufflation into the cecum in subjects with positive lactulose breath tests was not significantly different than cecal

  5. Ancient suture zones within continents.

    PubMed

    Moores, E M

    1981-07-03

    Ancient suture belts within continents are deformed regions which contain the remnants of former ocean basins. They form when two continents or island arcs that earlier were separated by an ocean basin converge and collide during plate tectonic activity. These belts provide the only record we have of deep oceanic crust and of ancient sea-floor processes for the first 94 percent of the earth's history, that is, prior to the oldest preserved crust in the oceans. Ten criteria for the recognition and interpretation of these ancient belts are discussed. A comprehensive program for the study of these belts should have great scientific and economic benefit for the United States and would be relatively cheap compared to other large national scientific efforts.

  6. Severe stomatitis and ileocecal perforation developed after all-trans retinoic acid monotherapy in an HLA-B51-positive patient with acute promyelocytic leukemia.

    PubMed

    Kimura, Kenji; Takeuchi, Masahiro; Hasegawa, Nagisa; Togasaki, Emi; Shimizu, Ryoh; Kawajiri, Chika; Muto, Tomoya; Tsukamoto, Shokichi; Takeda, Yusuke; Ohwada, Chikako; Sakaida, Emiko; Sakai, Shio; Mimura, Naoya; Ota, Satoshi; Iseki, Tohru; Nakaseko, Chiaki

    2016-06-01

    A 34-year-old man who had been referred to our hospital was diagnosed with acute promyelocytic leukemia (APL). All-trans retinoic acid (ATRA), oral administration, was initiated. On day 25, he developed fever and respiratory distress with bilateral pulmonary infiltrates, suggesting differentiation syndrome (DS) caused by ATRA. These symptoms showed amelioration after discontinuing ATRA and initiating methylprednisolone. ATRA was re-started on day 29 at half the original dose because of residual APL blasts. The patient subsequently developed fever, severe stomatitis, and oropharyngeal ulcers, which persisted even after discontinuing ATRA. On day 48, he suddenly developed severe abdominal pain with free air, observable on an abdominal X-ray, and underwent emergency ileocecal resection. Pathological examination of the resected ileocecal intestines revealed multiple ulcers and perforations. No leukemic cell infiltration was observed. In this case, only ATRA was administered for APL treatment. These findings suggest that ileocecal ulcerations and perforations, as well as oropharyngeal ulcers, might have been caused by DS or ATRA. Furthermore, DNA typing of the HLA-B locus revealed that the patient had HLA-B51 associated with Behçet's disease. Therefore, hypercytokinemia with DS might have induced Behçet's disease-like symptoms, including stomatitis and ileocecal perforation, complications that are particularly observed in patients with HLA-B51.

  7. Traveling the Continents and Cruising the Oceans.

    ERIC Educational Resources Information Center

    Slack, Glenda

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

  8. Laparoscopic ileocecal resection in acute and chronic presentations of Crohn’s disease. A single center experience

    PubMed Central

    COCORULLO, G.; TUTINO, R.; FALCO, N.; SALAMONE, G.; FONTANA, T.; LICARI, L.; GULOTTA, G.

    2016-01-01

    Introduction The terminal ileum is the most involved tract in Crohn’s disease. The obstruction in this location is the most frequent complication. Acute or chronic presentations can occur. Surgery finds a role in the management of chronic strictures and in acute clinical presentations with complications not improving with conservative therapy. Patients and methods We investigate the outcome of patients with obstruction of the ileo-cecal bowel tract laparoscopically managed. It was analyzed the average operative time (OT), the conversion rate and the occurrence of re-operation due to surgical complications. Results 21 patients underwent an ileocecal resection for complicated Crohn’s disease between January 2013 and December 2014. The admissions were performed in emergency in 42% of patients. The pre-intervention hospital stay was 5.8 (Sd 6.23). The mean operative time was 154 min (Sd 41). 28% of the procedures were converted to open surgery. The average hospital stay was 10 days (Sd 5) in uncomplicated patients. The morbidity rate was 28%. In 19% of cases a re-intervention was needed due to anastomotic leakage (3pts) and one hemoperitoneum for bleeding from the suture line. Discussion Laparoscopy seems an affordable technique in the management of obstructive pattern of Crohn’s disease. It should be the preferable approach in young patients that probably will be submitted to subsequent surgery for the same disease; in fact, the reduced adhesions formation provided by the less bowel manipulation make easy the subsequent access. Older patients had usually more post-operative morbidity and mortality mostly due to pre-existing conditions; if possible in these patients the treatment should be medical. PMID:28098059

  9. The Functional Anatomy of the Female Pelvic Floor and Stress Continence Control System

    PubMed Central

    Ashton-Miller, James A.; Howard, Denise; DeLancey, John O. L.

    2005-01-01

    This paper provides an overview of the functional anatomy of the structures responsible for controlling urinary continence under stress. The stress continence control system can be divided into two parts: the system responsible for bladder neck support, and the system responsible for sphincteric closure. Age- and injury-related changes in each of these systems are discussed. Understanding the pathophysiology of incontinence on the anatomical level will help to lead to identification of specific defects, thereby allowing better individualized treatment for the incontinent patient. PMID:11409608

  10. The functional anatomy of the female pelvic floor and stress continence control system.

    PubMed

    Ashton-Miller, J A; Howard, D; DeLancey, J O

    2001-01-01

    This paper provides an overview of the functional anatomy of the structures responsible for controlling urinary continence under stress. The stress continence control system can be divided into two parts: the system responsible for bladder neck support, and the system responsible for sphincteric closure. Age- and injury-related changes in each of these systems are discussed. Understanding the pathophysiology of incontinence on the anatomical level will help to lead to identification of specific defects, thereby allowing better individualized treatment for the incontinent patient.

  11. Extended diaper wearing: effects on continence in and out of the diaper.

    PubMed

    Tarbox, Rachel S; 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 study, we used a withdrawal design to evaluate the effect of wearing diapers on daily urinary accidents and successful voids for an adult who had been diagnosed with mental retardation. Results indicated that wearing diapers increased the rate of accidents and decreased the rate of successful voids. Clinical implications of these results are discussed.

  12. [Anatomic principles of urinary incontinence].

    PubMed

    Dorschner, W; Stolzenburg, J U; Neuhaus, J

    2001-05-01

    The morphological fundamentals of urinary continence are still subject to controversy. This was the reason for a renewed examination of the sphincter musculature of the lower urinary tract. This study included 50 male and 15 female autopsy specimens. The organs of the lower urinary tract including the neighboring organs had been removed in their entirety and histologically reprocessed en bloc as a complete series of sections. We were able to demonstrate that the internal sphincter or m. sphincter vesicae is represented as a circular, distinct structure which elliptically embraces the internal urethral orifice. Lamellas of the detrusor are not involved in the formation of the internal sphincter. In females and males, the external sphincter consists of a striated and a smooth muscular part (m. sphincter urethrae transversostriatus et glaber). In transverse sections, the muscle has a horseshoe shape. It is completely separated by connective tissue from the musculature of the pelvic floor. A deep transverse perineal muscle does not exist. The histological findings were used for the construction of a digital three-dimensional model of the anatomy of the lower urinary tract. Computer animations of the model with integrated original histologies were generated and stored as a computer video on a CD-ROM attached to this journal.

  13. [Physiology of continence and micturition].

    PubMed

    Buzelin, J M

    1995-02-01

    Continence and micturition result from an inversely related evolution of urethra and bladder pressures. On filling, the bladder pressure remains low and the urethral pressure is high: filling bladder pressure mainly depends on its visco-elastic property while urethral pressure is actively kept high by the tonic activity of smooth and striated urethral sphincters, respectively maintained by sympathetic and somatic spinal reflexes. It is the other way round when the bladder empties: bladder pressure rises and urethral pressure lower, because the parasympathetic impulses brings about a massive contraction of the detrusor musculature, and a reflex relaxation of both sympathetic and somatic systems. In the adult, the reflex loop passes through the pontine center. The volitional control of this micturitional reflex, which is not only the privilege of human beings, implies an ability to recognize a specific feeling: the desire to urinate. It involves brain centers located in the inner aspect of the frontal lobe and in the underlying structures of the archaic cortex (limbic system).

  14. Antipodal location of continents and oceans.

    PubMed

    Harrison, C G

    1966-09-09

    The percentage of continent antipodal to ocean on the earth is compared with a distribution obtained by a Monte Carlo method. It is concluded that the present antipodal arrangement of continents and oceans has less than 1 chance in 14 of being caused by a random process.

  15. Urinary Retention

    MedlinePlus

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

  16. 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.

  17. Bladder neck preservation improves time to continence after radical prostatectomy: a systematic review and meta-analysis

    PubMed Central

    Yang, Chunguang; Wu, Guanqing; Xu, Nan; Wang, Meng; Zeng, Xing; Hu, Zhiquan; Song, Ranran; Yuh, Bertram; Wang, Zhihua; Ye, Zhangqun

    2016-01-01

    Bladder neck preservation (BNP) during radical prostatectomy (RP) may improve postoperative urinary continence, although its overall effectiveness remains controversial. We systematically searched PubMed, Ovid Medline, Embase, CBM and the Cochrane Library to identify studies published before February 2016 that assessed associations between BNP and post-RP urinary continence. Thirteen trials (1130 cases and 1154 controls) assessing BNP versus noBNP (or with bladder neck reconstruction, BNR) were considered suitable for meta-analysis, including two randomized controlled trials (RCT), six prospective and five retrospective studies. Meta-analysis demonstrated that BNP improved early urinary continence rates (6 mo, OR = 1.66; 95% CI, 1.21–2.27; P = 0.001) and long-term urinary continence outcomes (>12 mo, OR = 3.99; 95% CI, 1.94–8.21; P = 0.0002). Patients with BNP also had lower bladder neck stricture frequencies (OR = 0.49; 95% CI, 0.29–0.81; P = 0.006). Anastomotic leak rates, positive surgical margins and biochemical failure rates were comparable between the two groups (P>0.05). There were no differences in baseline characteristics except for a smaller average prostate volume (WMD = −2.24 ml; 95% CI, -4.27 to -0.22; P = 0.03) in BNP patients. Our analyses indicated that BNP during RP improved early recovery and overall long-term (1 year) urinary continence and decreased bladder neck stricture rates without compromising oncologic control. PMID:27634899

  18. [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.

  19. Teaching strategies for assessing and managing urinary incontinence in older adults.

    PubMed

    Bradway, Christine; Cacchione, Pamela

    2010-07-01

    Urinary incontinence is common and affects many aspects of older adults' lives; therefore, it is essential that nursing faculty include this content in classroom and clinical teaching situations. This article describes innovative strategies for teaching upper-level nursing students (e.g., junior and senior undergraduates) about urinary incontinence in older adults, specifically, the relevant anatomy and physiology of continence and associated pathophysiology of urinary incontinence, risk factors and consequences, definitions and types, and effective nursing assessment and management strategies.

  20. Continence care is every nurse's business.

    PubMed

    Booth, Joanne

    Maintaining continence lies at the heart of a sense of adulthood and is essential to preserving dignity, a core and universal nursing value. This article explores the reasons why poor continence care was found at Mid Staffordshire Foundation Trust, the changes to the culture of the health service that led to it, and why it is so important for nurses to maintain patients' dignity. Recommendations for changing this culture in the future are discussed.

  1. Artificial urinary sphincter for post-prostatectomy incontinence: a review.

    PubMed

    James, Mary H; McCammon, Kurt A

    2014-06-01

    The artificial urinary sphincter remains the gold standard for treatment of post-prostatectomy urinary incontinence. The AMS 800 (American Medical Systems, Minnetonka, MN, USA) is the most commonly implanted artificial urinary sphincter. Having been on the market for almost 40 years, there is an abundance of literature regarding its use, but no recent review has been published. We reviewed the current literature regarding the indications, surgical principles, outcomes and complications of artificial urinary sphincter implantation for stress urinary incontinence after prostatectomy. A PubMed search was carried out for articles on the artificial urinary sphincter from 1995 to present. The review was centered on articles related to the use of the AMS 800 for stress urinary incontinence in males after prostatectomy. Relevant articles were reviewed. The majority of patients will achieve social continence (1 pad per day) after artificial urinary sphincter implantation; however, rates of total continence (no pad usage) are significantly lower. Patient satisfaction outcomes average greater than 80% in most series. Potential complications requiring reoperation include infection (0.5-10.6%) and urethral erosion (2.9-12%). Revision surgeries are most commonly as a result of urethral atrophy, which ranges from 1.6 to 11.4%. The 5-year Kaplan-Meier freedom from reoperation ranges from 50 to 79%, while the 10-year Kaplan-Meier freedom from mechanical failure is 64%. The artificial urinary sphincter is a reliable device with good outcomes. As expected with any prosthetic device, complications including mechanical failure, infection, erosion and recurrent incontinence remain significant concerns. Despite known complications, the patient satisfaction rates after artificial urinary sphincter implantation remain high. Appropriate patient counseling and adherence to surgical principles are imperative.

  2. Global mantle convection models with mobile continents

    NASA Astrophysics Data System (ADS)

    Phillips, Benjamin R.

    Continental motions are fundamental in shaping the Earth's surface. Features attributable to continental drift, such as orogenies and rifts, dominate subaerial geography. On an even grander scale, paleomagnetism suggests global continental reorganizations over time scales of hundreds of millions of years (Myr). In fact, supercontinental aggregations such as Pangea, Rodinia, and Columbia appear in the geologic record with a period of a few hundred Myr, suggestive of a cycle. These surface motions are likely coupled to mantle convection. Continents cluster over cold downwellings, as in the closing of the Tethys Ocean. Supercontinents apparently warm the mantle, as suggested by the African superplume, which lingers beneath the former site of Pangea. A number of geodynamic modelers have investigated the nature of this coupling, often generating results reminiscent of observations. Still, many such studies were limited by the use of Cartesian geometries that do not accurately represent the Earth. In this thesis I address the feedback between continents and the mantle using a high resolution, spherical, finite element (FEM) mantle convection code. I integrate a lithospheric model into the code, prescribing rigid, buoyant, mobile continents that serve as boundary conditions for the mantle. In a series of simulations with individual continents, I investigate the system's sensitivity to variations in fundamental mantle parameters and continent size. Continents covering 30%, 10%, and 3% of Earth's surface (representative of Pangea, Asia, and Antarctica, respectively) are introduced into mantle models characterized by pure core or radiogenic heating, and uniform or layered viscosity. Supercontinents are found effective in promoting the development of global thermal heterogeneities in an internally heated, layered viscosity mantle. Smaller continents behave passively and exhibit more time dependent behavior. Next, I introduce models incorporating three to six continents in

  3. Long-term Continence Outcomes in Men Undergoing Radical Prostatectomy for Clinically Localized Prostate Cancer

    PubMed Central

    Prabhu, Vinay; Sivarajan, Ganesh; Glen, B; Taksler, Juliana Laze; Lepor, Herbert

    2014-01-01

    Background Urinary incontinence is a common short-term complication of radical prostatectomy (RP). Little is known about the long-term impact of RP on continence. Objective To elucidate the long-term progression of continence after RP. Design, setting, and participants From October 2000 through September 2012, 1788 men undergoing open RP for clinically localized prostate cancer by a single surgeon at an urban tertiary care center prospectively signed consent to be followed before RP and at 3, 6, 12, 24, 96, and 120 mo after RP. A consecutive sampling method was used and all men were included in this study. Intervention Men underwent open RP Outcome measurements and statistical analysis Regression models controlled for preoperative University of California, Los Angeles–Prostate Cancer Index urinary function score (UCLA-PCI-UFS), age, prostate-specific antigen level, Gleason score, stage, nerve-sparing status, race, and marital status were used to evaluate the association of time since RP with two dependent variables: UCLA-PCI-UFS and continence status. Results and limitation The mean UCLA-PCI-UFS declined between 2 yr and 8 yr (83.8 vs 81.8; p = 0.007) and marginally between 8 yr and 10 yr (81.8 vs 79.6; p = 0.036) after RP, whereas continence rate did not significantly change during these intervals. Men ≥60 yr old experienced a decline in mean UCLA-PCI-UFS between 2 yr and 8 yr (p = 0.002) and a marginal decline in continence rate between 2 yr and 10 yr (p = 0.047), whereas these variables did not change significantly in men <60 yr old. These outcomes are for an experienced surgeon, so caution should be exercised in generalizing these results. Conclusions Between 2 yr and 10 yr after RP, there were slight decreases in mean UCLA-PCIUFS and continence rates in this study. Men aged <60 yr had better long-term outcomes. These results provide realistic long-term continence expectations for men undergoing RP. PMID:23957946

  4. The development of a physiotherapy continence promotion program using a customer focus.

    PubMed

    Chiarelli, Pauline; Cockburn, Jill

    1999-01-01

    Health promotion programs provide information, education for health and opportunity for the development of the skills that people need to make healthy choices. The current climate of health care practice also directs its focus to the needs and wants of the health care consumers. This entails active input from the target group. The present study used focus groups in an attempt to ensure input from women in early postpartum into the development of a postpartum continence promotion program. The focus groups revealed anomalies in women's perceived susceptibility to, and knowledge about, urinary incontinence and pelvic floor exercises, while highlighting other areas of need. Focus groups proved an invaluable tool in the development of a more effective physiotherapy continence promotion program.

  5. 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…

  6. 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…

  7. 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.

  8. Global anisotropy and the thickness of continents.

    PubMed

    Gung, Yuancheng; Panning, Mark; Romanowicz, Barbara

    2003-04-17

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

  9. Kidneys and Urinary Tract

    MedlinePlus

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Kidneys and Urinary Tract KidsHealth > For Teens > Kidneys and ... be a sign of diabetes . continue What the Kidneys and Urinary Tract Do Although the two kidneys ...

  10. [Surgical management of urinary and fecal incontinence in neurological sphincter disorders of children and adolescents].

    PubMed

    Lemelle, J L; Barthelme, H; Schmitt, M

    1999-01-01

    The management of urinary and fecal incontinence in children and adolescents with neurogenic disorders related to congenital or acquired conditions was frequently considered to be of secondary importance compared with orthopaedic complications. The improvement of artificial urinary sphincter and continent urinary diversion techniques allowed to establish for each case an individual plan considering overall, abilities and voiding dysfunction as well as renal complications. Antegrade colonic enema has greatly improved the quality of life of children with fecal incontinence or intractable constipation. Surgical management requires a large contribution by the patients and their closest relatives and complete information about goals, advantages and obligations of surgical management. Surgical principles for bladder augmentation, bladder neck reconstruction and continent urinary diversion are presented and discussed according to data in the recent literature and the author's clinical experience.

  11. Self-esteem disturbance in patients with urinary diversions: assessing the void.

    PubMed

    Salloum, Mona

    2005-12-01

    Self-esteem can be affected by any change in health, appearance, or emotional status--change that can affect quality of life. A decrease in self-esteem is especially evident in people with urinary diversions. A review of the literature, conducted to demonstrate self-esteem problems related to this population, revealed that body image and sexuality changes related to urinary diversions are frequently discussed in the current literature but studies that focus directly on self-esteem in the urinary diversion population have not been published. However, self-esteem may be compromised in people with urinary diversions more frequently than the literature reflects. Patients with urinary diversions, whether continent or incontinent, may be at risk for self-esteem problems. Future research and exploration are needed to expand knowledge of self-esteem with regard to urinary diversions in order to further understand the issue.

  12. [The continent colon-conduit stoma].

    PubMed

    Jonas, U; Wetzel, W; Hohenfellner, R

    1978-07-01

    A conduit occlusor is presented consisting of a tube surrounded by foam rubber and covered by a latex membrane, with a polyurethane cap attached to the other end. A valve imbedded in the cap allows voluntary urine drainage. This atraumatic, pneumatic, non-invasive occlusor device was used quite succesfully in 3 volunteers who had had a colon conduit urinary diversion. The device was well-tolerated, leakage was effectively prevented. Further experience, however, will be necessary for final evaluation.

  13. 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.

  14. 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

  15. The female urinary microbiota, urinary health and common urinary disorders

    PubMed Central

    Wolfe, Alan J.

    2017-01-01

    This review provides the clinical context and updated information regarding the female urinary microbiota (FUM), a resident microbial community within the female bladder of many adult women. Microbial communities have variability and distinct characteristics in health, as well as during community disruption (dysbiosis). Information concerning characteristics of the FUM in health and disease is emerging. Sufficient data confirms that the microbes that compose the FUM are not contaminants and are cultivatable under appropriate conditions. Common clinical conditions, including urinary tract infection (UTI) and urgency urinary incontinence (UUI), a common form of urinary incontinence (UI), may be usefully reconsidered to determine the role of the FUM. Knowledge of FUM characteristics may help advance prevention, diagnosis and treatment of these conditions and other common lower urinary disorders in women. The FUM appears related to UTI and UUI in adult women. The specific role of the FUM remains to be clarified and requires significant additional work in describing FUM variability and resilience in health. Unique aspects of the FUM prompt re-evaluation of existing nomenclature to more appropriately define health and disease; the concept of dysbiosis may be useful for understanding the interaction of the FUM with other aspects of lower urinary tract physiology, including urothelial signaling. Clinicians, through their clinical laboratories, can adopt enhanced urine culture techniques that more fully describe the living microbes within the FUM. This additional information may provide clinicians and their patients an opportunity to impact clinical care without antibiotic use, if the FUM can be appropriately modified to improve treatment precision for UTI and UUI. PMID:28217699

  16. Urinary incontinence in women.

    PubMed

    Norton, Peggy; Brubaker, Linda

    2006-01-07

    Urinary incontinence is common in women, but is under-reported and under-treated. Urine storage and emptying is a complex coordination between the bladder and urethra, and disturbances in the system due to childbirth, aging, or other medical conditions can lead to urinary incontinence. The two main types of incontinence in women, stress urinary incontinence and urge urinary incontinence, can be evaluated by history and simple clinical assessment available to most primary care physicians. There is a wide range of therapeutic options, but the recent proliferation of new drug treatments and surgical devices for urinary incontinence have had mixed results; direct-to-consumer advertising has increased public awareness of the problem of urinary incontinence, but many new products are being introduced without long-term assessment of their safety and efficacy.

  17. 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

  18. Urinary catheter - infants

    MedlinePlus

    Bladder catheter - infants; Foley catheter - infants; Urinary catheter - neonatal ... Fanaroff AA, Walsh MC, eds. Fanaroff and Martin's Neonatal-Perinatal Medicine . 10th ed. Philadelphia, PA: Elsevier Saunders; ...

  19. A "Stratospheric Drain" over the Maritime Continent

    NASA Technical Reports Server (NTRS)

    Sherwood, Steve

    1999-01-01

    Evidence is presented from operational rawinsonde data surrounding the maritime continent that the net mass flux near the tropopause is downward over this region, contrary to the behavior of current numerical models. The air is descending year-round, despite mean upward motion below and above the descending layer. This sinking implies the existence of a significant energy-removing process, which is argued to be the injection of cold air by overshooting convective clouds. The mass, energy, and horizontal momentum budgets are examined in reaching these conclusions. The implied cooling effect of convective overshoots can be simulated with a simple, parcel-sorting convective mixing model. The findings contradict the common view that the mean flow enters the stratosphere in this strongly-convecting region, and have important implications for transport of water vapor and other gases into the stratosphere.

  20. 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).

  1. A review: the application of minimally invasive surgery to pediatric urology: lower urinary tract reconstructive procedures.

    PubMed

    Traxel, Erica J; Minevich, Eugene A; Noh, Paul H

    2010-07-01

    This paper is one-half of a 2 part review on minimally-invasive procedures in pediatric urology. This article focuses on lower tract procedures, including ureteroureterostomy, anti-reflux surgeries, creation of continent catheterizable channels, and augmentation cystoplasty. We note important articles on pure laparoscopic as well as robotic-assisted laparoscopic lower urinary tract surgeries, concentrating on their techniques and outcomes.

  2. A Short Bowel (Small Intestine = 40 cm), No Ileocecal Valve, and Colonic Inertia Patient Works Well with Oral Intake Alone without Parenteral Nutrition

    PubMed Central

    Tang, Hsiu-Chih; Yang, Hui-Lan

    2014-01-01

    We present a 50-year-old male who suffered from ischemic bowel disease, having undergone massive resection of small intestine and ileocecal valve. He had to cope with 40 cm proximal jejunum and 70 cm distal colon remaining. In the postoperative period parenteral nutrition (PN) was used immediately for nutrition support and electrolyte imbalance correction. We gave him home PN as regular recommendation for the short bowel status after discharge from hospital. This patient has tolerated regular oral intake 2 months later and did not develop significant short bowel syndrome. There were several episodes of venous access infection which troubled this patient and admitted him for treatment during home PN. Therefore, we changed home PN to cyclic tapering pattern. The patient could maintain his nutrition and hydration with oral intake alone after tapering home PN 15 months later. He has survived more than one year without PN support and still maintained 80% ideal body weight with average albumin of 3.5 ± 0.2 mg/dL. Although patient was hospitalized every two months to supplement nutrients, however, this has greatly improved the quality of life. PMID:25018889

  3. Surgery for Stress Urinary Incontinence

    MedlinePlus

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

  4. 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…

  5. Continents, Super-Continents, Mantle Thermal Mixing, and Mantle Thermal Isolation

    NASA Astrophysics Data System (ADS)

    Lenardic, A.; Jellinek, M.; O'Neill, C.; Cooper, C. M.; Moresi, L.; Lee, C.

    2010-12-01

    Super-continental insulation refers to an increase in the temperature of the mantle below a super-continent due to the heat transfer inefficiency of thick, stagnant continental lithosphere relative to thinner, subducting oceanic lithosphere. Recent studies have reached different conclusions as to the physical viability of this hypothesized effect with some groups arguing for a large heat up (100 degrees) and others arguing that any local heating is so small as to be insignificant. We start with the position that both groups are correct, in different limits, and use a combination of thermal network theory, numerical simulations, and laboratory experiments to provide tighter physical insight into the thermal link between continents and the mantle. We isolate two end-member dynamic regimes. In the thermally well mixed regime the insulating effect of continental lithosphere can not cause a localized increase in mantle temperature due to the efficiency of lateral mixing in the mantle. In this regime the potential temperature of the entire mantle is higher than it would be without continents (the magnitude depending on the specific properties of continental and oceanic lithosphere). Thermal mixing can be short circuited if, for example, subduction zones surround a super-coninent or if the convective flow pattern of the mantle becomes spatially fixed relative to a stationary super-continent. This causes a transition to the thermal isolation regime: The potential temperature increases below a super-coninent while the potential temperature below oceanic domains drops such that the volume averaged temperature of the whole mantle remains constant. Transition out of this regime would thus involve the unleashing of a potentially large lateral temperature gradient that would enhance global convective motions. The connection to sub-oceanic domains provides a larger set of predictions that can be compared to the post pangea geologic record to help determine if a hypothesized super

  6. Space science education in the african continent

    NASA Astrophysics Data System (ADS)

    Aseno, J. O.

    Through measurement and interpretation of the spectral, spatial and temporal variations in electromagnetic emissions and reflections from the Earth's surface, important information related to natural resources can be acquired. Furthermore, satellite technology has greatly improved the communication and positioning techniques world-wide. Consequently, space science now provides valuable and timely information about natural resources, which has become a major factor in sustainable development. The realization of the full potential of space science in the context of development in Africa requires adequate education and training in order to facilitate project formulation, planning, management and implementation. This, in turn, would lead to the formulation and adoption of national space science policies based on user needs and addressing both the short and long-term needs of a particular country. Space science education in Africa needs to address issues like (i) provision of programme, (ii) integration of the proposed techniques within the existing infrastructure, and (iii) training in Remote Sensing, Global Positioning System, Geographic Information System and other space science techniques, in order to ensure the successful implementation of space science projects within the continent. In this context, African universities ought to play a major role in space science training, research, consultancy and publication. Through international co-operation, it is possible to develop and support national, regional and international training programmes and international scientific exchange in Africa.

  7. 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…

  8. Mountain ranges and the deformation of continents

    NASA Astrophysics Data System (ADS)

    Avouac, J.

    2007-12-01

    Mountain ranges are the most spectacular manifestation of continental dynamics and a primary locus of geo- hazards. Their geological imprint is ubiquitous since all continents consist of cratonic cores that grew with time through collisions with accreting terrains. Understanding how mountain range form and evolve as a result of the interaction between deep seated tectonic processes, and climate driven surface processes is thus a major issue in earth science. The Himalaya is probably the best place on earth where orogenic processes can be observed at work today and where the geological history of a mountain belt can be compared with its current tectonic processes. We now have a reasonably solid understanding of the structure of the range, of its petro-metamorphic history, and of the kinematics of its active deformation and seismicity. The long-term geological history of the range - from several millions to a few tens of millions of years - has been documented by structural, thermobarometric and thermochronological studies. Morphotectonic investigations have revealed its evolution over the past several thousands or tens of thousands of years. And, finally, geodetic measurements and seismological monitoring have revealed the pattern of strain and stress build-up over several years, or due to single large earthquakes. The presentation will show how the results of these investigations can be assembled into a simple, coherent picture of the structure and evolution of the range. The Himalayan model will be compared to other case examples of active orogeny and some implications regarding continental deformation and the influence of surface processes will be drawn.

  9. 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- ...

  10. [Nocosomial urinary tract infections].

    PubMed

    Pigrau, Carlos

    2013-11-01

    Nosocomial urinary tract infections (UTI) are mainly related to urinary catheterisation. In this paper we review the pathogenic mechanisms, particularly the route by which the microorganisms colonise the urinary tract, their adhesion ability, and their capacity to form biofilms, and are related not only to the microorganism but also to the type of urinary catheter. The aetiology of catheter related UTI is variable, and multiresistant microorganisms are often isolated, making empirical antibiotic therapy complex. Clinical findings are frequently atypical, and its diagnosis is difficult. The therapeutic management of catheter-related UTI should be stratified according to the type of UTI: asymptomatic bacteriuria should not be habitually treated, but patients with septic shock should receive a broad spectrum antibiotic. In this review, the value of the different preventive measures are discussed.

  11. Urinary Incontinence in Women.

    PubMed

    Jay, J; Staskin, D

    1998-10-01

    Despite the prevalence of urinary incontinence, most affected women don't seek help, primarily because of embarrassment or because they are not aware that effective treatment is available. Failure to store urine may be caused by an abnormality in any component of the lower urinary tract. Common abnormalities are poor bladder compliance and bladder outlet failure. Patients who experience failure to empty can present with recurrent urinary tract infections, retention or incontinence. Using a symptom-based classification of incontinence, this would be referred to as overflow incontinence. Other possible categories of urinary incontinence are failure to store and empty and functional incontinence. A combination of a failure to store and empty is difficult to diagnose and treat clinically. Treatments are directed at the particular cause of incontinence and can include medical or surgical therapies.

  12. Urinary incontinence - injectable implant

    MedlinePlus

    Intrinsic sphincter deficiency repair; ISD repair; Injectable bulking agents for stress urinary incontinence ... Urine leakage that gets worse Pain where the injection was done Allergic reaction to the material Implant ...

  13. 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.

  14. [Urinary tract infections].

    PubMed

    Hörl, W H

    2011-09-01

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

  15. 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

  16. 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 ...

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

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  18. Preferential rifting of continents - A source of displaced terranes

    NASA Technical Reports Server (NTRS)

    Vink, G. E.; Morgan, W. J.; Zhao, W.-L.

    1984-01-01

    Lithospheric rifting, while prevalent in the continents, rarely occurs in oceanic regions. To explain this preferential rifting of continents, the total strength of different lithospheres is compared by integrating the limits of lithospheric stress with depth. Comparisons of total strength indicate that continental lithosphere is weaker than oceanic lithosphere by about a factor of three. Also, a thickened crust can halve the total strength of normal continental lithosphere. Because the weakest area acts as a stress guide, any rifting close to an ocean-continent boundary would prefer a continental pathway. This results in the formation of small continental fragments or microplates that, once accreted back to a continent during subduction, are seen as displaced terranes. In addition, the large crustal thicknesses associated with suture zones would make such areas likely locations for future rifting episodes. This results in the tendency of new oceans to open along the suture where a former ocean had closed.

  19. Mantle dynamics of continent-wide tilting of Australia

    NASA Astrophysics Data System (ADS)

    Dicaprio, L.; Gurnis, M.; Muller, R. D.

    2009-12-01

    Australia is distinctive in that during the Cenozoic it experienced first order, broad-scale vertical motions unrelated to normal orogenic processes. The progressive continent-wide tilting down to the northeast is attributed to the horizontal motion of the continent over subducted slabs. We use plate tectonic reconstructions and a model of mantle convection to quantitatively link the geological evolution of the continent to mantle convection. The passage of slabs beneath the Southwest Pacific since 50 Ma is modeled numerically, and the results are compared to geologic observations of anomalous topography. Models show that Australia undergoes a 300 m northeast downward tilt as it approaches and overrides subducted slabs between Melanesia and the active margin along the Loyalty and proto-Tonga Kermadec subduction systems. This pattern of dynamic subsidence is consistent with observations of continent wide tilting and may indicate that during the Cenozoic Australia moved northward away from a relatively hot mantle anomaly presently located beneath Antarctica.

  20. 21 CFR 876.5320 - Nonimplanted electrical continence device.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... cable to a battery-powered pulse source. The plug or pessary is inserted into the rectum or into the... nonimplanted electrical continence device and the powered vaginal muscle stimulator for therapeutic use (§...

  1. 21 CFR 876.5320 - Nonimplanted electrical continence device.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... cable to a battery-powered pulse source. The plug or pessary is inserted into the rectum or into the... nonimplanted electrical continence device and the powered vaginal muscle stimulator for therapeutic use (§...

  2. Estimating equivalency values of microbial phytase for amino acids in growing and finishing pigs fitted with steered ileo-cecal valve cannulas.

    PubMed

    Radcliffe, J S; Pleasant, R S; Kornegay, E T

    2006-05-01

    Ten crossbred barrows (48.3 +/- 2.3 kg of initial BW) fitted with steered ileo-cecal valve cannulas were used to investigate the effects of supplemental microbial phytase on the apparent ileal digestibilities (AID) of AA, Ca, P, N, and DM, and the apparent total tract digestibilities of Ca, P, N, and DM. All diets were corn-soybean meal-based, and contained 0.44% Ca and 0.40% total P. Diets 1, 2, and 3 contained 12.0, 11.1, and 10.2% CP, respectively. Diets 4 and 5 had the same ingredient composition as diet 3, plus 250 and 500 U/kg phytase (Natuphos), respectively. Pigs were randomly allotted to 1 of 5 dietary treatments in a paired 5 x 5 Latin square with an extra period to test for carryover effects. Each 14-d period consisted of a 7-d adjustment followed by a 3-d total collection, a 12-h ileal digesta collection, a 3-d readjustment, and a second 12-h ileal digesta collection. Pigs were housed individually in metabolism pens (1.2 x 1.2 m). Water was supplied ad libitum, and feed was supplied at a level of 9% of the metabolic BW (BW(0.75)) per day in 2 equal daily feedings. As the dietary CP concentration increased, the AID of CP and all AA measured increased linearly (P < 0.05) with the exception of proline. In addition, the apparent total tract digestibilities (grams per day) and retention of N (grams per day) increased linearly (P < 0.01) with increasing CP levels. Supplementing diets with phytase increased the AID of Ca (P < 0.01), P (P < 0.001), CP (P = 0.07), and the AA (P < 0.10) Gly, Ala, Val, Ile, Thr, TSAA, Asp, Glu, Phe, Lys, and Arg. Protein and phytase response equations were generated for those AA affected (P < 0.10) by both CP level and phytase supplementation. Based on these equations, 500 U/kg of phytase can replace 0.52 percentage units of the dietary CP, which includes a 0.03 percentage unit improvement in Lys AID. The results of this study show that supplementing pig diets with microbial phytase improves CP and AA digestibilities in addition

  3. [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.

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

    PubMed

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

    2014-10-01

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

  5. The controversy surrounding OxyContin abuse: issues and solutions.

    PubMed

    Jayawant, Sujata S; Balkrishnan, Rajesh

    2005-06-01

    This paper overviews the controversies surrounding the abuse of prescription analgesic OxyContin((R)) (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.

  6. Predictors of female urinary incontinence at midlife and beyond.

    PubMed

    Menezes, M; Pereira, M; Hextall, A

    2010-02-01

    Urinary incontinence (UI) is an important middle age health issue and approximately 20% of women over 40 years of age have problems with continence. Urinary incontinence poses a significant negative impact on social functioning and quality of life to many individuals. It is estimated that around three million people are regularly incontinent in the UK with a prevalence of about 40 per 1000 adults. There are various factors which can cause incontinence such as pregnancy, childbirth, obesity, menopause, or just inherent connective-tissue weakness. All of these factors can cause pathophysiology changes in the muscular and fascial structures of the pelvic floor and lead to pelvic support defects and possibly pelvic floor dysfunction. We aim with this review article to highlight predictors or predisposing factors of incontinence; in order to help clinicians during their decisions and put in place a policy of a preventive strategy to decrease the incontinence rate in the general population.

  7. Female urinary incontinence and sexuality.

    PubMed

    Mota, Renato Lains

    2017-01-01

    Urinary incontinence is a common problem among women and it is estimated that between 15 and 55% of them complain of lower urinary symptoms. The most prevalent form of urinary incontinence is associated with stress, followed by mixed urinary incontinence and urge urinary incontinence. It is a symptom with several effects on quality of life of women mainly in their social, familiar and sexual domains. Female reproductive and urinary systems share anatomical structures, which promotes that urinary problems interfere with sexual function in females. This article is a review of both the concepts of female urinary incontinence and its impact on global and sexual quality of life. Nowadays, it is assumed that urinary incontinence, especially urge urinary incontinence, promotes anxiety and several self-esteem damages in women. The odour and the fear of incontinence during sexual intercourse affect female sexual function and this is related with the unpredictability and the chronicity of incontinence, namely urge urinary incontinence. Female urinary incontinence management involves conservative (pelvic floor muscle training), surgical and pharmacological treatment. Both conservative and surgical treatments have been studied about its benefit in urinary incontinence and also the impact among female sexual function. Unfortunately, there are sparse articles that evaluate the benefits of female sexual function with drug management of incontinence.

  8. Female urinary incontinence and sexuality

    PubMed Central

    Mota, Renato Lains

    2017-01-01

    ABSTRACT Urinary incontinence is a common problem among women and it is estimated that between 15 and 55% of them complain of lower urinary symptoms. The most prevalent form of urinary incontinence is associated with stress, followed by mixed urinary incontinence and urge urinary incontinence. It is a symptom with several effects on quality of life of women mainly in their social, familiar and sexual domains. Female reproductive and urinary systems share anatomical structures, which promotes that urinary problems interfere with sexual function in females. This article is a review of both the concepts of female urinary incontinence and its impact on global and sexual quality of life. Nowadays, it is assumed that urinary incontinence, especially urge urinary incontinence, promotes anxiety and several self-esteem damages in women. The odour and the fear of incontinence during sexual intercourse affect female sexual function and this is related with the unpredictability and the chronicity of incontinence, namely urge urinary incontinence. Female urinary incontinence management involves conservative (pelvic floor muscle training), surgical and pharmacological treatment. Both conservative and surgical treatments have been studied about its benefit in urinary incontinence and also the impact among female sexual function. Unfortunately, there are sparse articles that evaluate the benefits of female sexual function with drug management of incontinence. PMID:28124522

  9. Making and Breaking of a Continent: Following the Scent of Geodynamic Imprints on the African Continent Using Electromagnetics

    NASA Astrophysics Data System (ADS)

    Weckmann, Ute

    2012-01-01

    The African continent inherits a long history of continental accretion and breakup. The stage of "making" a continent goes back to the Archean, when the first continental masses formed cratons which mostly remained stable ever since. Subsequent collision of weaker continental masses was followed by several extension and compression episodes that resulted in the formation of super-continents. After the assemblage of Gondwana, a period of predominantly "breaking" , i.e., the breakup of super-continents, took over. The modern-day African continent exhibits different types of margins; continental rifting occurs side by side with recent collision. Since the late 1960s, magnetotelluric (MT) experiments have played an important role in studies of the electrical conductivity structure of Africa. The early results significantly shaped the MT community's understanding of continental-scale conductivity belts and basic characteristics of cratons and mobile belts on both crustal and lithospheric mantle scales for some decades. Modern MT studies in Africa have generally supported earlier results with high resistivities observed on cratons and low resistivities observed across mobile belts. Advances in instrumentation, data processing and interpretation resulted in higher-resolution images of the lithosphere, which in consequence induce an improved understanding of tectonic processes and geological prerequisites for the occurrence of natural resources. The high electrical conductivity of mobile belts and their relation to reactivated fault and detachment zones were often interpreted to characterize mobile belts as tectonic weak zones, which can accommodate stress and constitute zones along which continents can break. Recent breaking of the African continent can be studied on land across the East African rift; however, the lack of amphibian MT experiments across today's margins does not allow for good resolution of remnants of continental breakup processes. Naturally, the regions

  10. Knowledge and understanding of urinary incontinence

    PubMed Central

    Nguyen, Katherina; Hunter, Kathleen F.; Wagg, Adrian

    2013-01-01

    Abstract Objective To investigate family physicians’ knowledge of, attitudes toward, and understanding of urinary incontinence (UI), as well as their perceptions of barriers to continence care, as a foundation for designing interventions to improve service provision for those in northern Alberta who suffer from UI. Design Descriptive survey using a standardized instrument. The survey instrument was completed either by telephone interview or on paper copy faxed back to the researchers, depending on participant preference. Setting Northern Alberta. Participants Random sample of family physicians (N = 158). Main outcome measures Physician knowledge of and attitudes toward UI, UI management practices, and barriers to providing UI care. Results Survey response rate was 10.6% (158 of 1488); 84.2% (133 of 158) of respondents practised in urban settings, 44.9% (71 of 158) had been in practice for fewer than 15 years, 24.1% (38 of 158) reported having no training in UI management since graduation, and 53.8% (85 of 158) reported that they proactively discussed UI with their patients. Overall, 70.0% of respondents felt fairly confident in managing UI. Most family physicians referred patients for specialist care, with few referrals to community services. Respondents thought that continence services were scarce, with long waiting times, and that such services were generally overstretched; they believed that although high-quality continence care was a personal priority, it was not a priority focus for their practice partnerships or networks. In terms of the highest ranked areas for improvement in UI management, increased awareness and understanding among physicians (ranked first by 28.5% of respondents), followed by dedicated incontinence clinics or nurses for referral (17.7%) and improving patient awareness and understanding (12.0%). Conclusion There continues to be considerable variation in knowledge about UI management and a relative overreliance on specialist care, despite

  11. Urinary incontinence surgery - female - discharge

    MedlinePlus

    ... gov/ency/patientinstructions/000134.htm Urinary incontinence surgery - female - discharge To use the sharing features on this ... Dmochowski RR, Blaivas JM, Gormley EA, et al; Female Stress Urinary Incontinence Update Panel of the American ...

  12. Feline Lower Urinary Tract Disease

    MedlinePlus

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

  13. Role of pelvic floor in lower urinary tract function.

    PubMed

    Chermansky, Christopher J; Moalli, Pamela A

    2016-10-01

    The pelvic floor plays an integral part in lower urinary tract storage and evacuation. Normal urine storage necessitates that continence be maintained with normal urethral closure and urethral support. The endopelvic fascia of the anterior vaginal wall, its connections to the arcus tendineous fascia pelvis (ATFP), and the medial portion of the levator ani muscles must remain intact to provide normal urethral support. Thus, normal pelvic floor function is required for urine storage. Normal urine evacuation involves a series of coordinated events, the first of which involves complete relaxation of the external urethral sphincter and levator ani muscles. Acquired dysfunction of these muscles will initially result in sensory urgency and detrusor overactivity; however, with time the acquired voiding dysfunction can result in intermittent urine flow and incomplete bladder emptying, progressing to urinary retention in severe cases. This review will start with a discussion of normal pelvic floor anatomy and function. Next various injuries to the pelvic floor will be reviewed. The dysfunctional pelvic floor will be covered subsequently, with a focus on levator ani spasticity and stress urinary incontinence (SUI). Finally, future research directions of the interaction between the pelvic floor and lower urinary tract function will be discussed.

  14. 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

  15. [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.

  16. Urinary bladder xanthomatous cystitis

    PubMed Central

    Shah, Shrenik J.; Ajitsaria, Vineet; Singh, Vineet

    2017-01-01

    Xanthoma cystitis of urinary bladder is a rare entity and may present as an intravesical mass. A 38-year-old female presented with abdominal pain and imaging was done which was suggestive of a malignant mass with surrounding tissue infiltration. Partial cystectomy was performed, and histological examination of the mass showed xanthomatous cystitis. PMID:28197037

  17. Urinary Tract Infections.

    ERIC Educational Resources Information Center

    Plummer, Nancy; Michael, Nancy, Ed.

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

  18. Seismic evidence for very deep roots of continents

    NASA Astrophysics Data System (ADS)

    Gossler, Jürgen; Kind, Rainer

    1996-02-01

    A major problem in geodynamics with seismic data is discussed: How deeply do the continents penetrate into the mantle? Differential travel times of underside reflections from mantle discontinuities that appear as precursors to SS, in large parts of the globe, show a clear correlation with oceans and continents. They are significantly larger beneath the Asian and North American continents than underneath the neighbouring Pacific. From this observation we conclude that the Asian and North American continents affect the mantle well below 410 km. Changes in the thickness of the transition zone can explain our observations, which are in agreement with the hypothesis of petrological phase changes causing the 410 km and 660 km seismic discontinuities. Average thickness of the transition zone underneath continents is about 14 kim thicker than beneath oceans. Moreover, our findings imply temperature variations about 100-200 K in the mantle transition zone. Weak reflections from 520 km depth corresponding to an impedance contrast of about 2% can be observed only in some areas of the Earth, while observations from other locations definitively show no signal from this depth. Therefore, we propose that the 520 km reflector is only a regional feature.

  19. 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

  20. Continent-scale linearity of kimberlite-carbonatite magmatism, mid-continent North America

    NASA Astrophysics Data System (ADS)

    Duke, Genet Ide; Carlson, Richard W.; Frost, Carol D.; Hearn, B. C.; Eby, G. Nelson

    2014-10-01

    Cretaceous-Tertiary kimberlite-carbonatite magmatism in mid-continent North America extends along a N40°W linear trend from Louisiana to Alberta, and occurs in at least four different pulses (∼109-85, 67-64, 55-52, and less than 50 Ma). The lack of spatial age progressions of magmatism consistent with motion of North America over a fixed hot spot, the presence of Sr-Nd-Hf-Pb isotopic and trace-element compositions that show a temporal evolution from lithospheric to asthenospheric melt-sources, and the orientation of the magmatic belt parallel to the western subduction margin of the North American plate, suggest that this linear zone is the surface expression of mantle melting related to the subduction system. We propose that fragmentation of Farallon and Kula plates opened slab windows perpendicular to their convergence direction. In this model, sheet-like mantle upwellings were induced along slab-window margins, and these upwellings underwent low-degree partial melting to produce highly alkalic magmas along the trend parallel to, but ∼2000 km east of, the convergent margin. The N40°W trend may reflect melting associated with penetration of the mantle transition-zone by the downgoing oceanic plate(s).

  1. 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

  2. Anatomy of North America: thematic geologic portrayals of the continent

    NASA Astrophysics Data System (ADS)

    Williams, Harold; Hoffman, Paul F.; Lewry, John F.; Monger, James W. H.; Rivers, Toby

    1991-02-01

    Six thematic tectonic maps are used to analyse the makeup of the North American continent. Themes are: (1) major tectonic elements of the continent (2) time of last major deformation (3) time of first major deformation (4) miogeoclines and terranes by kindred (5) suture zones and terrane boundaries by age, and (6) time of accretion. Features illustrated include distribution of orogenic belts and their extensions beneath cover sequences to the continental edge, contrast between juvenile and reworked crust in orogenic belts, geometry of ancient continental margins, distribution and classification of accreted terranes, geometry of suture zones and courses of ancient oceans, and how the continent evolved from an assemblage of Archean minicontinents to its present configuration. It is suggested that essentially similar plate tectonic processes controlled continental breakup and assembly from the Archean onwards, albeit with gradual increase in size of continental lithospheric plates and quantitative change in other parameters such as heatflow and character of the mantle.

  3. Mean Elevation of Continents and Survival of Islands

    NASA Astrophysics Data System (ADS)

    Zhang, Y.

    2009-12-01

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

  4. Overactive Bladder and Continence Guidelines: implementation, inaction or frustration?

    PubMed

    Wagg, A; Cardozo, L; Chapple, C; Diaz, D C; de Ridder, D; Espuna-Pons, M; Haab, F; Kelleher, C; Kolbl, H; Milsom, I; Van Kerrebroeck, P; Vierhout, M; Kirby, M

    2008-10-01

    Guidelines for the management of continence and overactive bladder are generally available across Europe. For a majority of countries, these have been adopted by professional societies in either urology or gynaecology for local use. There has, however, been little monitoring of formal implementation of these guidelines and seldom any attempt to audit their operation. The state of continence care therefore remains largely unknown. This article reviews current guidelines and their status across Europe and examines what might be relevant from other disease areas to promote successful implementation.

  5. Urinary p75ECD

    PubMed Central

    Shepheard, Stephanie R.; Wuu, Joanne; Cardoso, Michell; Wiklendt, Luke; Dinning, Phil G.; Chataway, Tim; Schultz, David

    2017-01-01

    Objective: To evaluate urinary neurotrophin receptor p75 extracellular domain (p75ECD) levels as disease progression and prognostic biomarkers in amyotrophic lateral sclerosis (ALS). Methods: The population in this study comprised 45 healthy controls and 54 people with ALS, 31 of whom were sampled longitudinally. Urinary p75ECD was measured using an enzyme-linked immunoassay and validation included intra-assay and inter-assay coefficients of variation, effect of circadian rhythm, and stability over time at room temperature, 4°C, and repeated freeze-thaw cycles. Longitudinal changes in urinary p75ECD were examined by mixed model analysis, and the prognostic value of baseline p75ECD was explored by survival analysis. Results: Confirming our previous findings, p75ECD was higher in patients with ALS (5.6 ± 2.2 ng/mg creatinine) compared to controls (3.6 ± 1.4 ng/mg creatinine, p < 0.0001). Assay reproducibility was high, with p75ECD showing stability across repeated freeze-thaw cycles, at room temperature and 4°C for 2 days, and no diurnal variation. Urinary p75ECD correlated with the revised ALS Functional Rating Scale at first evaluation (r = −0.44, p = 0.008) and across all study visits (r = −0.36, p < 0.0001). p75ECD also increased as disease progressed at an average rate of 0.19 ng/mg creatinine per month (p < 0.0001). In multivariate prognostic analysis, bulbar onset (hazard ratio [HR] 3.0, p = 0.0035), rate of disease progression from onset to baseline (HR 4.4, p < 0.0001), and baseline p75ECD (HR 1.3, p = 0.0004) were predictors of survival. Conclusions: The assay for urinary p75ECD is analytically robust and shows promise as an ALS biomarker with prognostic, disease progression, and potential pharmacodynamic application. Baseline urinary p75ECD provides prognostic information and is currently the only biological fluid–based biomarker of disease progression. PMID:28228570

  6. Psychogenic urinary retention.

    PubMed

    Bird, J R

    1980-01-01

    The literature on psychogenic urinary retention is reviewed. 2 cases treated by analytical psychotherapy are reported, in which significant demand for physical punishment was revealed and seen as linked to unacceptable, unconscious sadistic and aggressive feelings. Some psychodynamic aspects of what is considered to be "a disturbance of internal body space' are discussed. Psychogenic urinary retention has received little attention in the literature. It may represent the uneasy position this disorder of bodily function occupies in clinical practice, with clear physical symptoms and associated psychological factors. The condition is more frequent in females, usually young adults. Case histories regularly record the placid, passive presentation of these patients, childhood enuresis and disturbed backgrounds. The diagnosis, "hysteric', is frequent and most psychodynamic evaluations suggest the symptom represents a displacement of unacceptable sexual wishes and impulse. 2 patients treated by analytical psychotherapy are reported who, whilst fulfilling many of the criteria already noted, additionally revealed an intense desire for physical punishment. This punitive demand had less to do with unacceptable sexual wishes, than guilt at repressed aggressive drives of considerable magnitude. The role of aggression in the genesis of psychogenic urinary retention has so far been little studied.

  7. Urinary tract infections.

    PubMed

    Chenoweth, Carol E; Saint, Sanjay

    2011-03-01

    Catheter-associated urinary tract infections (CAUTIs) account for approximately 40% of all health care-associated infections. Despite studies showing benefit of interventions for prevention of CAUTI, adoption of these practices has not occurred in many healthcare facilities in the United States. As urinary catheters account for the majority of healthcare-associated UTIs, the most important interventions are directed at avoiding placement of urinary catheters and promoting early removal when appropriate. Alternatives to indwelling catheters such as intermittent catheterization and condom catheters should be considered. If indwelling catheterization is appropriate, proper aseptic practices for catheter insertion and maintenance and use of a closed catheter collection system are essential for preventing CAUTI. The use of antimicrobial catheters also may be considered when the rates of CAUTI remain persistently high despite adherence to other evidence-based practices, or in patients deemed to be at high risk for CAUTI or its complications. Attention toward prevention of CAUTI will likely increase as Center for Medicare and Medicaid Services and other third-party payers no longer reimburse for hospital-acquired UTI.

  8. 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.

  9. 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

  10. 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…

  11. 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.

  12. [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

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

    NASA Astrophysics Data System (ADS)

    Nur, Amos; Ben-Avraham, Zvi

    1982-05-01

    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 allochthonous 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 not 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 affinities 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.

  14. 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.

  15. 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.

  16. [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.

  17. 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.

  18. Urinary tract infections.

    PubMed

    Litza, Janice A; Brill, John R

    2010-09-01

    Urinary tract infection (UTI) is the most common urologic disorder and one of the most common conditions for which physicians are consulted. Patients at increased risk for UTI include women; diabetics; the immunocompromised; and those with anatomic abnormalities, impaired mobility, incontinence, advanced age, and instrumentation. Antibiotic therapy aims to relieve symptoms and prevent complications such as pyelonephritis and renal scarring. Distinguishing asymptomatic bacteriuria from a UTI can be difficult, especially in those with comorbidities. Most experts do not recommend screening for UTI, except in the first trimester of pregnancy.

  19. Ileocolic neobladder post-cystectomy: continence and potency.

    PubMed

    Marshall, F F; Mostwin, J L; Radebaugh, L C; Walsh, P C; Brendler, C B

    1991-03-01

    Incontinence and impotence are 2 of the primary complications associated with total bladder reconstruction after cystectomy for carcinoma. These and other features are addressed in 25 patients who underwent total neobladder reconstruction following cystectomy for transitional cell carcinoma. Of these patients 20 had a urethral anastomosis. No patient had to wear a pad or device. Enuresis was rare. When the radical cystoprostatectomy population was contrasted with a radical prostatectomy patient population, continence was achieved more rapidly in the neobladder group. Potency was maintained in 15 of 21 (71%) evaluable patients. This ileocolic neobladder produces a large volume and low pressure, and provides excellent day and night continence. With preservation of the neurovascular bundle potency can be maintained in the majority of patients.

  20. Tectonically buried continent/ocean boundary, Ouachita Mountains, Arkansas

    NASA Astrophysics Data System (ADS)

    Lillie, Robert J.

    1985-01-01

    A seismic-reflection sequence observed at depth beneath the south flank of the Benton Uplift in Arkansas is interpreted to mark the early Paleozoic continent/ocean boundary. The sequence is similar in both external and internal geometry to wedge-shaped features commonly observed in the narrow zone separating continental from oceanic basement on modern passive margins and interpreted as layered volcanic sequences. It is suggested that slope and rise sediments now exposed in the Benton Uplift were thrust in a “thin-skinned” fashion over the edge of the North American continent during initial stages of the Carboniferous Ouachita orogeny, but that later uplift and slight northward translation of the continental margin basement occurred in a more “thick-skinned” fashion, preserving the boundary wedge intact beneath the earlier thrust sheets. *Present address: Department of Geology, Oregon State University, Corvallis, Oregon 97331

  1. 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.

  2. [Urinary tract infections in adults].

    PubMed

    Emonet, Stéphane; Harbarth, Stephan; van Delden, Christian

    2011-04-27

    Urinary tract infections are commonly seen by general practitioners. Quinolones are frequently prescribed in this setting. The emergence of resistance to these antibiotics has led to new guidelines for the management of uncomplicated UTI, based on the use of fosfomycin and furadantine. This article reviews the epidemiology, pathogenesis, diagnostic and treatment of urinary tract infections in adults.

  3. [Recurrent urinary tract infections].

    PubMed

    Pigrau-Serrallach, Carlos

    2005-12-01

    Recurrent urinary tract infections (RUTI) are a frequent clinical problem in sexually active young women, pregnant or postmenopausal women and in patients with underlying urological abnormalities. The present chapter reviews RUTI based on their classification: relapses, which usually occur early (< 1 month), are caused by the same microorganism and are associated with underlying urological abnormalities, and reinfections, which usually occur later and are caused by a new distinct microorganism (or by the same microorganism usually located in the rectum or uroepithelial cells). The pathogenesis of RUTI is reviewed and the risk factors associated with RUTI in premenopausal women (usually related to sexual activity), postmenopausal women (in whom estrogen deficiency has a significant effect on the vaginal Lactobacillus flora), and in pregnant women are discussed. Likewise, an extensive review of the distinct therapeutic strategies to prevent RUTI is provided: self-treatment of cystitis, continuous antibiotic prophylaxis, postcoital antibiotic prophylaxis, topical vaginal estrogens, Lactobacillus, cranberry juice, intravesical administration of non-virulent E. coli strains and vaccines, among others. Several diagnostic-therapeutic algorithms are included. These algorithms are based on the type of urinary infection (relapse-reinfection), on the type of patient (young, postmenopausal, or pregnant women) and on the number of episodes of RUTI.

  4. Smart wireless continence management system for persons with dementia.

    PubMed

    Wai, Aung Aung Phyo; Fook, Victor Foo Siang; Jayachandran, Maniyeri; Biswas, Jit; Nugent, Chris; Mulvenna, Maurice; Lee, Jer-En; Kiat, Philp Yap Lian

    2008-10-01

    Incontinence is highly prevalent in the elderly population, especially in nursing home residents with dementia. It is a distressing and costly health problem that affects not only the patients but also the caregivers. Effective continence management is required to provide quality care, and to eliminate high labor costs and annoyances to the caregivers resulting from episodes of incontinence. This paper presents the design, development, and preliminary deployment of a smart wireless continence management system for dementia-impaired elderly or patients in institutional care settings such as nursing homes and hospitals. Specifically, the mote wireless platform was used to support the deployment of potentially large quantities of wetness sensors with wider coverage and with dramatically less complexity and cost. It consists of an intelligent signal relay mechanism so that the residents are free to move about in the nursing home or hospital and allows personalized continence management service. Preliminary results from a trial in a local nursing home are promising and can significantly improve the quality of care for patients.

  5. Diurnal Variability and Kelvin Wave Propagation Through Maritime Continent

    NASA Astrophysics Data System (ADS)

    Flatau, M. K.; Baranowski, D. B.; Flatau, P. J.; Matthews, A. J.

    2014-12-01

    The 10 year series of the equatorial Kelvin waves obtained from the analysis of TRMM precipitation were examined to evaluate the impact of the diurnal variability of convection on the wave propagation through Maritime Continent. The convection in the Kelvin waves appears to be strongly phase locked in the area of the Maritime continent with the pronounced afternoon maximum. The diurnal phase locking is also evident as Kelvin waves propagate trough the Indian Ocean basin, suggesting that at least some Kelvin waves in this area are forced by the diurnally varying heat source related either to the convection over the land such as Eastern Africa or Madagascar, or over ocean areas with the high SST variability. We examine the hypothesis that the "matching" of the convective phase of the waves with the afternoon maximum of convection over Sumatra influences the wave strength after it crosses the Maritime Continent and can contribute to MJO propagation. The observational results based on observed Kelvin waves are supported by the results of the shallow water model of the interaction of the dry Kelvin wave with the diurnally oscillating heat source.

  6. 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.

  7. New Caledonia a classic example of an arc continent collision

    NASA Astrophysics Data System (ADS)

    Aitchison, J.

    2011-12-01

    The SW Pacific island of New Caledonia presents a classic example of an arc-continent collision. This event occurred in the Late Eocene when elements of an intra-oceanic island arc system, the Loyalty-D'Entrecasteaux arc, which stretched SSE from near Papua New Guinea east of New Caledonia to offshore New Zealand, collided with micro-continental fragments that had rifted off eastern Gondwana (Australia) in the late Cretaceous. Intervening Late Cretaceous to Paleogene oceanic crust of the South Loyalty Basin was eliminated through eastward subduction beneath this west-facing intra-oceanic island arc. As with many arc-continent collisions elsewhere collision was accompanied by ophiolite emplacement. The erosional remnants of which are extensive in New Caledonia. Collision led to subduction flip, followed by extensive rollback in front of the newly established east-facing Vitiaz arc. Post-collisional magmatism occurred after slab break-off and is represented by small-scale granitoid intrusions. Additional important features of New Caledonia include the presence of a regionally extensive UHP metamorphic terrain consisting of blueschists and eclogites that formed during the subduction process and were rapidly exhumed as a result of the collision Not only was collision and associated orogeny short-lived this collision system has not been overprinted by any major subsequent collision. New Caledonia thus provides an exceptional location for the study of processes related to arc-continent collision in general.

  8. Post-operative urinary retention.

    PubMed

    Steggall, Martin; Treacy, Colm; Jones, Mark

    Urinary retention is a common complication of surgery and anaesthesia. The risk of post-operative urinary retention is increased following certain surgical procedures and anaesthetic modalities, and with patients' advancing age. Patients at increased risk of post-operative urinary retention should be identified before surgery or the condition should be identified and treated in a timely manner following surgery. If conservative measures do not help the patient to pass urine, the bladder will need to be drained using either an intermittent catheter or an indwelling urethral catheter, which can result in catheter-associated urinary tract infections. This article provides an overview of normal bladder function, risk factors for developing post-operative urinary retention, and treatment options. Guidance drawn from the literature aims to assist nurses in identifying at-risk patients and inform patient care.

  9. 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)

  10. [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.

  11. 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…

  12. Are natural and unnatural appetites equally controllable? A response to Jensen's "Is continence enough?".

    PubMed

    Smith, Janet E

    2004-01-01

    This response challenges Jensen's analysis in no substantial way. Rather, it explains more fully some of the moral character categories that Aristotle provides. It argues that Aristotle understood there to be two forms of continence: the continence that enables us to control natural appetites and"some form"of continence directed towards unnatural appetites, generally engendered by some pathology or abuse.

  13. Managing urinary tract infections.

    PubMed

    Saadeh, Sermin A; Mattoo, Tej K

    2011-11-01

    Urinary tract infections (UTI) are common in childhood. Presence of pyuria and bacteriuria in an appropriately collected urine sample are diagnostic of UTI. The risk of UTI is increased with an underlying urological abnormality such as vesicoureteral reflux, constipation, and voiding dysfunction. Patients with acute pyelonephritis are at risk of renal scarring and subsequent complications such as hypertension, proteinuria with and without FSGS, pregnancy-related complications and even end-stage renal failure. The relevance and the sequence of the renal imaging following initial UTI, and the role of antimicrobial prophylaxis and surgical intervention are currently undergoing an intense debate. Prompt treatment of UTI and appropriate follow-up of those at increased risk of recurrence and/or renal scarring are important.

  14. [Treatment of urinary incontinence of neurologic origin in children and adolescents].

    PubMed

    Mollard, P; Meunier, P; Berard, C; Henriet, M

    1984-01-01

    Recent advances in the treatment of urinary incontinence of neurological origin in children are discussed. The etiology of the neurological changes is mainly congenital (myelomeningocele, sacral agenesis and hidden dysraphism) other causes such as myelitis, radiculitis or cord injuries being very rarely observed. Two fundamental elements can be evaluated by radiologic and urodynamic investigations of the lower urinary tract: the capacity for compliance of the detrusor muscle and the degree of cervico-urethral resistance. The presence of a cervico-urethral obstruction is no longer an indication for its removal but, on the contrary, a factor that can be retained to assist continence. Intermittent use of self-catheterization enables the obstruction to be used to obtain continence (dryness) and makes the obstruction innocuous, since it enables emptying of the bladder. Of 50 patients (26 girls and 24 boys) treated in this way, 11 were not seen again, but the other 39 are still being followed up after an average of 50 months. This method of bladder emptying maintains the integrity of the upper urinary tract when this was normal previously and improves uretero-pyelo-caliceal distension. Uretero-vesical reimplantation can prevent reflux. Of these 39 children, 23 are continent during the day and 13 among them during the night also. A colocystoplasty was performed in 3 cases to enlarge the bladder capacity. The use of a catheter is well accepted by the girls and young boys but less so by the male adolescents. In the absence of a cervico-urethral obstruction it is impossible to relieve incontinence by re-education, and only three solutions exist: high cutaneous diversion continent cystostomy and artificial sphincter. The high diversion operation should be used as a last resort only. The continent cystostomy uses an appendix isolated on its mesothelium an opening on the abdominal wall and into the bladder in a long anti-reflux tunnel. Catheterization is by a catheter which

  15. Role of spinal serotonergic pathways in sneeze-induced urethral continence reflex in rats.

    PubMed

    Miyazato, Minoru; Kaiho, Yasuhiro; Kamo, Izumi; Kitta, Takeya; Chancellor, Michael B; Sugaya, Kimio; Arai, Yoichi; de Groat, William C; Yoshimura, Naoki

    2009-10-01

    To clarify the role of spinal serotonergic mechanisms in preventing stress urinary incontinence (SUI) during sneezing, we investigated the effect of intrathecal (it) application of 8-OH-DPAT (a 5-HT(1A) agonist), mCPP (a 5-HT(2B/2C) agonist), and fluoxetine (a serotonin reuptake inhibitor) using a rat model that can examine the neurally evoked continence reflex during sneezing. Amplitudes of urethral pressure responses during sneezing (A-URS), urethral baseline pressure (UBP) at the midurethra, and sneeze-induced leak point pressure (S-LPP) were measured in normal female adult rats and rats with SUI induced by vaginal distention (VD). In normal rats, 8-OH-DPAT decreased A-URS by 48.9%, whereas mCPP increased A-URS by 33.6%. However, A-URS was not changed after fluoxetine. 8-OH-DPAT, mCPP, or fluoxetine did not alter UBP. The effect of 8-OH-DPAT and mCPP was antagonized by WAY-100635 (it), a selective 5-HT(1A) antagonist, and RS-102221 (it), a selective 5-HT(2C) antagonist, respectively. Fluoxetine in the presence of WAY-100635 did not change either A-URS or UBP, but fluoxetine in the presence of RS-102221 decreased A-URS. In VD rats, S-LPP was decreased by 14.6 cmH2O after 8-OH-DPAT, whereas it was increased by 12.8 cmH2O after mCPP. However, S-LPP was not changed after fluoxetine. These results indicate that activation of 5-HT(2C) receptors enhances the active urethral closure reflex during sneezing at the spinal level, whereas 5-HT(1A) inhibits it and that no apparent changes in the sneeze-induced continence reflex after fluoxetine treatment are due to coactivation of excitatory 5-HT(2C) receptors and inhibitory 5-HT receptors other than the 5-HT(1A) subtype. Thus, activation of excitatory 5-HT receptor subtypes such as 5-HT(2C) could be effective for the treatment of SUI.

  16. Urinary incontinence and risk of functional decline in older women: data from the Norwegian HUNT-study

    PubMed Central

    2013-01-01

    Background The main objective of the present study was to determine whether UI is an independent predictor of ADL decline and IADL decline in elderly women. We also aimed to find out whether incontinent subjects were at higher risk of needing help from formal home care or home nursing care during 11 year follow-up. Methods A prospective cohort study conducted as part of the North-Trøndelag Health Study 2 and 3. Women aged 70–80 years when participating in the HUNT 2 study, who also participated in the HUNT 3 study, were included in this study. Analyses on self-reported urinary incontinence at baseline and functional decline during a11-year period were performed for incontinent and continent subjects. Results Baseline prevalence of urinary incontinence was 24%. At on average eleven year follow up, logistic regression analysis showed a significant association between incontinence and decline in activities of daily living (ADL) (OR =2.37, 95% CI =1.01-5.58) (P=0.04). No association between urinary incontinence and instrumental activities of daily living (IADL) in incontinent women compared with continent women was found (OR=1.18, CI=.75-1.86) (P=.46). Data were adjusted for ADL, IADL and co morbid conditions at baseline. No significant differences in need of more help from formal home care and home nursing care between continent and incontinent women were found after 11 years of follow-up. Conclusions Urinary incontinence is an important factor associated with functional decline in women aged 70–80 years living in their own homes. At eleven years of follow up, no significant differences in need of more help from formal home care and home nursing care between continent and incontinent women were found. PMID:23678851

  17. Fission track thermotectonic imaging of the Australian continent

    NASA Astrophysics Data System (ADS)

    Gleadow, A. J. W.; Kohn, B. P.; Brown, R. W.; O'Sullivan, P. B.; Raza, A.

    2002-05-01

    Fission track analyses of apatites from a very large data set across Australia provide a first look at the patterns of low-temperature thermochronology over an entire continent. The rock samples are mostly of granitic rocks, or their metamorphic equivalents, of Palaeozoic or older age from the exposed basement regions. Sample chemical analyses indicate that the apatite suite is overwhelmingly of fluorapatite composition. Approximately 2750 fission track analyses have been completed, of which >1700 are of sufficient quality to form a coherent data set that can be interpolated to show the variation of central fission track age and mean confined track length on a continental scale. The resulting images exhibit some features which are well known, such as the trend towards young apatite ages along the eastern and southeastern rifted continental margins, but others that are more surprising, such as the lack of clear differentiation, in terms of the range of ages and lengths, between the older Precambrian cratonic areas in the west, and younger Phanerozoic mobile belts to the east. The Precambrian rocks from the western two-thirds of the continent do, however, show distinctly different cooling histories to those in the eastern Phanerozoic mobile belts when the relationships between track lengths and fission track ages are considered. The western craton everywhere shows patterns of prolonged slow cooling, whereas all major regions of the eastern part of the continent show discrete episodes of rapid cooling, mostly from the Jurassic to the Palaeogene. Significant areas of unusually young apatite ages (<50 Ma) are found in Tasmania and in Precambrian rocks from the northern Gawler Block in South Australia. The most obvious regional cause of the overall fission track patterns across Australia is variation in surface denudation over time scales of hundreds of Ma. However, in some areas, such as the northern Gawler Block, other mechanisms such as the movement of hydrothermal

  18. Urinary Incontinence and Levels of Regular Physical Exercise in Young Women.

    PubMed

    Da Roza, T; Brandão, S; Mascarenhas, T; Jorge, R N; Duarte, J A

    2015-08-01

    The purpose of this study was to determine the influence of different levels of regular physical exercise on the frequency of urinary incontinence in young nulliparous women from the northern region of Portugal. Participants (n=386) self-reported demographic variables, frequency, and time spent practicing organized exercise per week, as well as completed the International Consultation on Incontinence Questionnaire-Short Form. The level of exercise was calculated based on the time (in minutes) usually spent per week in organized exercise. 19.9% of Portuguese nulliparous women reported incontinence symptoms. Considering the distribution of urinary incontinence among the different quartiles of organized exercise, women from the 4(th)quartile (those who train for competitive purposes) demonstrated highest relative frequency (p=0.000) and a 2.53 greater relative risk to develop (95% CIs,1.3-2.7) incontinence compared to women from the 1(st) quartile (inactive). Women who practice exercise for recreational purposes (2(nd) and 3(rd) quartiles) did not show significant differences in the urinary incontinence prevalence and relative risk of developing it compared to women from the 1(st) quartile. The results showed that women participating in organized exercise involving high volume training for competition are potentially at risk of developing urinary incontinence, although organized exercise undertaken without the intent to compete seems to be safe for maintaining urinary continence.

  19. 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.

  20. 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.

  1. The continent ileal reservoir--an experimental study.

    PubMed

    Meijer, D W

    1992-01-01

    This thesis describes new concepts pertaining to the continent ileostomy. The aim of the study was twofold: to counter valve desinvagination and to simplify pouch construction. In Chapter 1 a survey is given of the history, the present situation of the technique and the complications of the continent ileostomy. It appears that on the one hand the operation improves the quality of the patient's life, but on the other hand the operation gives rise to many complications. The number of complications quoted in the literature varies and has been reported to be as high as 43%. Most of the time this led to repeat surgery, with equally uncertain results. This is the reason why the operation is not very frequently performed. Most of the time the complications concern the valve system and to a lesser degree the reservoir. In order to obtain a better insight into the origin of and possible gain better control over these complications an investigation was carried out on laboratory animals. This investigation involved: the complications of the valve system, the effect of the suturing method on the function of the reservoir and the simplification of the construction of the reservoir. In Chapter 2 the aim of the investigation was formulated in three questions. 1. Is it possible to diminish the chance of complications of the valve system of the continent ileostomy? 2. Does the method of suturing influence the function of the reservoir? 3. Is it possible to simplify the construction of the reservoir, so that the duration of the operation can be shortened? Chapter 3 is the general materials and methods section. Chapter 4 is about the research on the valve system. Up to now, no method of suturing the valve has consistently produced results good enough to make subsequent re-operations unnecessary. In this study two types of valve experiments have been carried out. First the feasibility of circumventing the problems of the nonpermanent form of the valve was investigated combining a

  2. 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.

  3. Assessment of voluntary pelvic floor muscle contraction in continent and incontinent women using transperineal ultrasound, manual muscle testing and vaginal squeeze pressure measurements.

    PubMed

    Thompson, Judith A; O'Sullivan, Peter B; Briffa, N Kathryn; Neumann, Patricia

    2006-11-01

    The aims of the study were: (1) to assess women performing voluntary pelvic floor muscle (PFM) contractions, on initial instruction without biofeedback teaching, using transperineal ultrasound, manual muscle testing, and perineometry and (2) to assess for associations between the different measurements of PFM function. Sixty continent (30 nulliparous and 30 parous) and 60 incontinent (30 stress urinary incontinence (SUI) and 30 urge urinary incontinence (UUI)) women were assessed. Bladder neck depression during attempts to perform an elevating pelvic floor muscle (PFM) contraction occurred in 17% of continent and 30% of incontinent women. The UUI group had the highest proportion of women who depressed the bladder neck (40%), although this was not statistically significant (p=0.060). The continent women were stronger on manual muscle testing (p=0.001) and perineometry (p=0.019) and had greater PFM endurance (p<0.001) than the incontinent women. There was a strong tendency for the continent women to have a greater degree of bladder neck elevation than the incontinent women (p=0.051). There was a moderate correlation between bladder neck movement during PFM contraction measured by ultrasound and PFM strength assessed by manual muscle testing (r=0.58, p=0.01) and perineometry (r=0.43, p=0.01). The observation that many women were performing PFM exercises incorrectly reinforces the need for individual PFM assessment with a skilled practitioner. The significant correlation between the measurements of bladder neck elevation during PFM contraction and PFM strength measured using MMT and perineometry supports the use of ultrasound in the assessment of PFM function; however, the correlation was only moderate and, therefore, indicates that the different measurement tools assess different aspects of PFM function. It is recommended that physiotherapists use a combination of assessment tools to evaluate the different aspects of PFM function that are important for continence

  4. Functional imaging of structures involved in neural control of the lower urinary tract.

    PubMed

    Griffiths, Derek

    2015-01-01

    Recent functional brain imaging studies, building on earlier observations, suggest a working model of brain control of the lower urinary tract. It comprises a few cerebral neural circuits that, during the storage phase, act on the midbrain periaqueductal gray to inhibit the long-loop, spinobulbospinal voiding reflex, thus promoting continence. Circuit 1, centered on the medial prefrontal cortex, appears to be concerned with conscious control of both continence and voiding. Circuit 2, centered on the dorsal anterior cingulate (midcingulate) and supplementary motor area, is concerned with emotional aspects of bladder control: desire to void or urgency with concomitant urethral sphincter activation to delay leakage. A subcortical circuit 3 has been less well studied. Circuit 1 is bilateral with a right-sided preference. Scattered studies of the connectivity of the control network suggest that white-matter damage may contribute to urinary incontinence. A few studies confirm that isolated cerebral lesions, if in the medial prefrontal cortex or its connecting pathways, may lead to incontinence. Lower urinary tract dysfunction in other neurologic diseases (normal-pressure hydrocephalus, Parkinson's disease, and multiple systems atrophy) appears consistent with the working model, and even spinal or peripheral lesions have central effects. However, this model omits the contributions of brain regions already observed in some imaging studies and therefore is certainly oversimplified.

  5. 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 ...

  6. Hyperammonemia in Urinary Tract Infections

    PubMed Central

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

    2015-01-01

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

  7. Urinary tract infections in adults.

    PubMed

    Cohn, Evan B; Schaeffer, Anthony J

    2004-06-07

    Urinary tract infection (UTI) is an exceedingly common problem prompting seven million office visits and one million hospitalizations in the United States each year. Advances in the understanding of both host and bacterial factors involved in UTI have led to many improvements in therapy. While there have also been advances in the realm of antimicrobials, there have been numerous problems with multiple drug resistant organisms. Providing economical care while minimizing drug resistance requires appropriate diagnosis, evaluation, and treatment of urinary tract infections.

  8. Role of noradrenergic pathways in sneeze-induced urethral continence reflex in rats.

    PubMed

    Kaiho, Yasuhiro; Kamo, Izumi; Chancellor, Michael B; Arai, Yoichi; de Groat, William C; Yoshimura, Naoki

    2007-02-01

    To clarify the role of noradrenergic pathways in preventing stress urinary incontinence (SUI) during sneezing, we investigated the effect of the norepinephrine reuptake inhibitor nisoxetine and alpha-adrenoceptor antagonists phentolamine (nonspecific blocker) and prazosin (alpha(1)-receptor-selective blocker) on the neurally evoked urethral continence reflex induced by sneezing in rats. The amplitude of urethral pressure responses during sneezing (A-URS), urethral baseline pressure (UBP) at the midurethra, and sneeze-induced leak point pressure (S-LPP) were measured in normal female adult rats and rats with SUI induced by vaginal distention (VD). In normal rats, intrathecal (it) phentolamine (0.02 nmol) and prazosin (0.02 nmol) decreased A-URS by 11.9 and 15.7%, respectively, without affecting UBP. In both normal and VD rats, intravenous (iv) application of nisoxetine (1 mg/kg) increased A-URS by 17.2 and 18.3% and UBP by 23.7 and 32.7%, respectively. Phentolamine or prazosin (both it) eliminated nisoxetine-induced increases in A-URS, but not the increases in UBP, which were, however, suppressed by iv phentolamine (5 mg/kg) or prazosin (1 mg/kg). Sneezing induced fluid leakage from the urethral orifice in VD rats, but not in normal rats. In VD rats, S-LPP was increased by 30.2% by iv nisoxetine. Application of phentolamine and prazosin (both it) decreased S-LPP by 15.7 and 20.6%, respectively, and nisoxetine induced increases in S-LPP to 13.2 and 12.3%, respectively. These results indicate that activation of the noradrenergic system by a norepinephrine reuptake inhibitor can prevent SUI via alpha(1-)adrenoceptors by enhancing the sneeze-induced active urethral closure mechanism at the spinal level and augmenting UBP at the periphery.

  9. 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.

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

    USGS Publications Warehouse

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

    1997-01-01

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

  11. Riverine nitrogen export from the continents to the coasts

    NASA Astrophysics Data System (ADS)

    Boyer, Elizabeth W.; Howarth, Robert W.; Galloway, James N.; Dentener, Frank J.; Green, Pamela A.; VöRöSmarty, Charles J.

    2006-03-01

    We present an overview of riverine nitrogen flux calculations that were prepared for the International Nitrogen Initiative's current global assessment of nitrogen cycles: past, present, and future (Galloway et al., 2004). We quantified anthropogenic and natural inputs of reactive nitrogen (N) to terrestrial landscapes and the associated riverine N fluxes. Anthropogenic inputs include fossil-fuel derived atmospheric deposition, fixation in cultivated croplands, fertilizer use, and the net import in human food and animal feedstuffs. Natural inputs include natural biological N fixation in forests and other noncultivated vegetated lands, and fixation by lightning. We use an empirical model relating total N inputs per landscape area to the total flux of N discharged in rivers based on watershed data from contrasting ecosystems spanning multiple spatial scales. With this approach, we simulate riverine N loads to the coastal zone and to inland waters from the continents. Globally, rivers exported about 59 Tg N yr-1, with 11 Tg N yr-1 transported to dry lands and inland receiving waters, and 48 Tg N yr-1 transported to the coastal zone. Rates of riverine N loss vary greatly among the continents, reflecting the regional differences in population and the associated anthropogenic N inputs. We compare our estimates to other approaches that have been reported in the literature. Our work provides an understanding of the sources of N to landscapes and the associated N fluxes in rivers, and highlights how anthropogenic activities impact N cycling around the world.

  12. 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.

  13. 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

  14. 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.

  15. [Urinary albumin fragmentation and immunoreactivity].

    PubMed

    Kurihara, Yuriko; Nishimaki, Junichi; Nakajima, Toshie; Ida, Takashi; Shiba, Kiyoko

    2009-02-01

    Urinary albumin (ALB) has been measured as a marker for the early detection of diabetic nephropathy. In 2004, Comper et al. developed a gel-filtration high-performance liquid chromatography (HPLC) procedure for the determination of urinary ALB. They demonstrated the presence in its albumin fraction of non immunoreactive ALB with the total molecular weight of a monomeric ALB that was non-reactive with the existing anti-ALB antibody, and reported that the level of urinary non-immunoreactive ALB was higher in diabetic patients than in normal subjects. In this study, we isolated urinary ALB from diabetic patients using an anti-ALB antibody-coupled affinity column to test its immunoreactivity. In some diabetic patients, the results of HPLC and turbidimetric immunoassay for urinary ALB were discrepant. Western blot analysis showed that ALB samples from such patients were contaminated with proteins other than ALB, and contained ALB, whose molecular weight became lower using a reductive procedure. In addition, the reactivity of ALB with anti-ALB antibody differed depending on whether it was in a reduced or non-reduced state. These results indicate that ALB in such patients is susceptible to structural changes due to disease-induced urinary factors and, thus, their urine contains ALB with an altered reactivity to antibody.

  16. 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.

  17. Self-consistent formation of continents on early Earth

    NASA Astrophysics Data System (ADS)

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

    2013-04-01

    In our study we want to understand how Earth evolved with time and examine the initiation of plate tectonics and the possible formation of continents on Earth. Plate tectonics and continents seem to influence the likelihood of a planet to harbour life [1], and both are strongly influenced by the planetary interior (e.g. mantle temperature and rheology) and surface conditions (e.g. stabilizing effect of continents, atmospheric temperature), and may also depend on the biosphere. Earth is the only terrestrial planet (i.e. with a rocky mantle and iron core) in the solar system where long-term plate tectonics evolved. Knowing the factors that have a strong influence on the occurrence of plate tectonics allows for prognoses about plate tectonics on terrestrial exoplanets that have been detected in the past decade, and about the likelihood of these planets to harbour Earth-like life. For this purpose, planetary interior and surface processes are coupled via 'particles' as computational tracers in the 3D code GAIA [2,3]. These particles are dispersed in the mantle and crust of the modelled planet and can track the relevant rock properties (e.g. density or water content) over time. During the thermal evolution of the planet, the particles are advected due to mantle convection and along melt paths towards the surface and help to gain information about the thermo-chemical system. This way basaltic crust that is subducted into the silicate mantle is traced in our model. It is treated differently than mantle silicates when re-molten, such that granitic (felsic) crust is produced (similar to the evolution of continental crust on early Earth [4]), which is stored in the particle properties. We apply a pseudo-plastic rheology and use small friction coefficients (since an increased reference viscosity is used in our model). We obtain initiation of plate tectonics and self-consistent formation of pre-continents after a few Myr up to several Gyr - depending on the initial conditions

  18. [Urinary incontinence and obesity].

    PubMed

    Legendre, G; Fritel, X; Capmas, P; Pourcelot, A-G; Fernandez, H

    2012-06-01

    Obesity, defined as a body mass index (BMI) more than or equal to 30kg/m(2), promotes pelvic floor disorders such as urinary incontinence (UI) and genital prolapse. Datas from cohort studies found an association between high BMI and the onset of UI. This association seems to be predominant with for mixed UI and stress UI. For the urge UI and overactive bladder syndrome, the analysis of the literature found a weaker association. The weight is therefore the only modifiable risk factor. Thus, the weight loss by a hypocaloric diet associated with pelvic floor muscle training should be the front line treatment in the obese patient suffering from UI. Bariatric surgery can be discussed in the most obese patient, even if the risk/benefit balance should be weighed because of significant morbidity of this surgery. The results of sub urethral sling (by retropubic tension-free vaginal tape or transobturator sling) in obese patients appear to be equivalent to those obtained in patients of normal weight. Datas on per- and postoperative complications for suburethral slings are reassuring.

  19. Urinary β-trace protein

    PubMed Central

    Donadio, Carlo; Bozzoli, Laura

    2016-01-01

    Abstract The screening for chronic kidney disease (CKD) patients needs the measurement of serum markers like creatinine. Our previous results indicated that urinary excretion of β-trace protein (BTP), a low-molecular-weight protein (23–29 kDa), is increased in CKD patients from stage 2. The aim of this study was to assess the major determinants of urinary excretion of BTP and to evaluate its feasibility as noninvasive marker of glomerular filtration rate (GFR) impairment. We studied 355 CKD patients (198 males), aged 15 to 83 years, in stable clinical conditions, classified in the different stages of CKD on the basis of GFR (renal clearance of 99mTc-diethylenetriamine penta-acetic acid). At the same time, we measured serum and urinary creatinine and BTP, and urinary albumin. Urinary excretion of BTP and albumin was expressed as mg/g urinary creatinine. Fractional clearance of BTP was calculated as the ratio of BTP clearance to creatinine clearance (%). Urinary excretion of BTP is mainly determined by its serum concentration and by the level of GFR, and to a lower extent by urinary albumin excretion. In fact, urinary BTP (U-BTP) and fractional clearance of BTP progressively and significantly increased along with the reduction of GFR and the concurrent rise in serum BTP (S-BTP). The relationship of U-BTP with GFR was very similar to that of S-BTP with GFR: U-BTP mirrors S-BTP. The accuracy of U-BTP to screen patients with GFR <90 mL/min/1.73 m2 was good (area under the curve 0.833), its sensitivity was 76.9%, specificity 80%, and positive predictive value 84.9%. Sensitivity of U-BTP was quite similar to that of S-BTP and serum creatinine. The major determinants of urinary excretion of BTP are S-BTP and GFR. U-BTP may be a suitable noninvasive marker to screen the general population for detection of GFR <90 mL/min/1.73 m2. PMID:27930558

  20. 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

  1. 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.

  2. Urinary proteins in children with urinary tract infection.

    PubMed

    Andersson, Lena; Preda, Iulian; Hahn-Zoric, Mirjana; Hanson, Lars A; Jodal, Ulf; Sixt, Rune; Barregard, Lars; Hansson, Sverker

    2009-08-01

    The aim of this study was to test our hypothesis that the urinary excretion of C-reactive protein (CRP), alpha 1-microglobulin (A1M), retinol-binding protein (RBP) and Clara cell protein (CC16) is increased in children with urinary tract infection (UTI) and relates to renal damage as measured by acute dimercaptosuccinic acid (DMSA) scintigraphy. Fifty-two children <2 years of age with UTI were enrolled in the study, 44 of whom were febrile. The control group consisted of 23 patients with non-UTI infection and elevated serum CRP (s-CRP) levels. Thirty-six patients had abnormal DMSA uptake, classified as mild, moderate or severe damage (DMSA class 1, 2, 3, respectively). There was a significant association between DMSA class and the excretion of urinary RBP (u-RBP) and u-CC16. There was also a significant difference in u-CRP levels between children with UTI and control children with non-UTI infections, although u-CRP excretion was not significantly correlated to DMSA class. In conclusion, the urinary excretion of the low-molecular-weight proteins RBP and CC16 showed a strong association with uptake defects on renal DMSA scans. The urinary level of CRP seems to distinguish between children with UTI and other febrile conditions. A combination of these biomarkers may be useful in the clinical assessment of children with UTI.

  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. 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.

  5. 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.

  6. 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

  7. 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.

  8. Continent-Ocean Interactions Within East Asian Marginal Seas

    NASA Astrophysics Data System (ADS)

    Clift, Peter; Kuhnt, Wolfgang; Wang, Pinxian; Hayes, Dennis

    The study of the complex interactions between continents and oceans has become a leading area for 21st century earth cience. In this volume, continent—ocean interactions in tectonics, arc-continent collision, sedimentology, and climatic volution within the East Asian Marginal Seas take precedence. Links between oceanic and continental climate, the sedimentology of coastal and shelf areas, and the links between deformation of continental and oceanic lithosphere are also discussed. As an introduction to the science presented throughout the volume, Wang discusses many of the possible interactions between the tectonic evolution of Asia and both regional and global climate. He speculates that uplift of central Asia in the Pliocene may have triggered the formation of many of the major rivers that drain north through Siberia into the Arctic Ocean. He also argues that it is the delivery of this fresh water that allows the formation of sea ice in that area and triggered the start of Northern Hemispheric glaciation. This may be one of the most dramatic ways in which Asia has shaped the Earth's climate and represents an alternative to the other competing models that have previously emphasized the role of oceanic gateway closure in Central America. Moreover, his proposal for major uplift of at least part of Tibet and Mongolia as late as the Pliocene, based on the history of drainage evolution in Siberia, supports recent data from the southern Tarim Basin and from the Qilian Shan and Qaidam and Jiuxi Basins in northeast Tibet that indicate surface uplift at that time. Constraining the timing and patterns of Tibetan surface uplift is crucial to testing competing models for strain accommodation in Asia following India—Asia collision.

  9. Earth's first stable continents did not form by subduction.

    PubMed

    Johnson, Tim E; Brown, Michael; Gardiner, Nicholas J; Kirkland, Christopher L; Smithies, R Hugh

    2017-03-09

    The geodynamic environment in which Earth's first continents formed and were stabilized remains controversial. Most exposed continental crust that can be dated back to the Archaean eon (4 billion to 2.5 billion years ago) comprises tonalite-trondhjemite-granodiorite rocks (TTGs) that were formed through partial melting of hydrated low-magnesium basaltic rocks; notably, these TTGs have 'arc-like' signatures of trace elements and thus resemble the continental crust produced in modern subduction settings. In the East Pilbara Terrane, Western Australia, low-magnesium basalts of the Coucal Formation at the base of the Pilbara Supergroup have trace-element compositions that are consistent with these being source rocks for TTGs. These basalts may be the remnants of a thick (more than 35 kilometres thick), ancient (more than 3.5 billion years old) basaltic crust that is predicted to have existed if Archaean mantle temperatures were much hotter than today's. Here, using phase equilibria modelling of the Coucal basalts, we confirm their suitability as TTG 'parents', and suggest that TTGs were produced by around 20 per cent to 30 per cent melting of the Coucal basalts along high geothermal gradients (of more than 700 degrees Celsius per gigapascal). We also analyse the trace-element composition of the Coucal basalts, and propose that these rocks were themselves derived from an earlier generation of high-magnesium basaltic rocks, suggesting that the arc-like signature in Archaean TTGs was inherited from an ancestral source lineage. This protracted, multistage process for the production and stabilization of the first continents-coupled with the high geothermal gradients-is incompatible with modern-style plate tectonics, and favours instead the formation of TTGs near the base of thick, plateau-like basaltic crust. Thus subduction was not required to produce TTGs in the early Archaean eon.

  10. 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

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

    NASA Astrophysics Data System (ADS)

    Kusznir, N. J.; Tymms, V.

    2009-04-01

    Satellite gravity anomaly inversion incorporating a lithosphere thermal gravity anomaly correction has been used to determine Moho depth, crustal thickness and lithosphere thinning factor for the NW Indian Ocean and to map ocean-continent transition location (OCT) and micro-continent distribution. Input data is satellite gravity (Sandwell & Smith 1997) and digital bathymetry (Gebco 2003). Crustal thicknesses predicted by gravity inversion under the Seychelles and Mascarenes are in excess of 30 km and form a single micro-continent extending southwards towards Mauritius. Thick crust (> 25 km) offshore SW India is predicted to extend oceanwards under the Lacadive and Maldive Islands and southwards under the Chagos Archipelago. Superposition of illuminated satellite gravity data onto crustal thickness maps from gravity inversion clearly shows pre-separation conjugacy of the thick crust underlying the Chagos and Mascarene Islands. Maps of crustal thickness from gravity inversion show a pronounced discontinuity in crustal thickness between Mauritius-Reunion and the Mascarene Basin which is of Late Cretaceous age and pre-dates recent plume volcanism. Gravity inversion to determine Moho depth and crustal thickness variation is carried out in the 3D spectral domain and incorporates a lithosphere thermal gravity anomaly correction for both oceanic and continental margin lithosphere (Chappell & Kusznir 2008). Failure to incorporate a lithosphere thermal gravity anomaly correction gives a substantial over-estimate of crustal thickness predicted by gravity inversion. The lithosphere thermal model used to predict the lithosphere thermal gravity anomaly correction may be conditioned using magnetic isochron data to provide the age of oceanic lithosphere (Mueller et al. 1997). The resulting crustal thickness determination and the location of the OCT are sensitive to errors in the magnetic isochron data. An alternative method of inverting satellite gravity to give crustal thickness

  12. Cure of urinary bladder functions in severe (95%) motoric complete cervical spinal cord injury in human.

    PubMed

    Schalow, G

    2010-01-01

    Severe cervical Spinal Cord Injury (SCI) leads to quadriplegia, and autonomic dysfunctions. Bladder/bowel continence, cardiovascular performance, and breathing are impaired besides movements. Even though there are no fully restorative treatments for SCI, I report about a patient, who suffered a severe cervical, motoric complete SCI, in whom urinary bladder functions were fully repaired by functional and structural repair (limited regeneration of the cord) upon 2.5 years of Coordination Dynamics Therapy (CDT). On the repair of the blood circulation (no occurrence of pressure ulcers any more), breathing and motor functions was reported earlier. The mechanism that underlies this important repair of urinary bladder functions is the learning transfer from movements to bladder functions. The human bladder repair is analyzed at the neuron level, the collective variable level (System Theory of Pattern Formation), the movement, and the clinical diagnostic level.

  13. [Proteomic analysis of urinary exosomes].

    PubMed

    Nakayama, Aki

    2014-07-01

    Exosomes are 40-100-nm membrane vesicles secreted into the extracellular space by various types of cell in many biological fluids, including serum, saliva, breast milk, amniotic fluid, and urine. Exosomes, which contain several key proteins, lipids, mRNAs, and microRNAs, were considered as an alternative secretion pathway. In addition, recent findings suggest that the exosome itself is a functional biomolecule involved in intracellular communication; thus, its components can be transferred to recipient cells by fusion, changing the function of the target cell. Recently, urinary exosomes have attracted much attention because some of their proteins have been identified as biomarkers related to certain physiological events and disease-related metabolism of the kidney. This review provides an overview of urinary exosomes, including methods of isolation and associated problems, and focuses on urinary exosomes as protein biomarker sources involved in numerous physiological and pathophysiological processes.

  14. Drug-induced urinary calculi.

    PubMed

    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.

  15. Urinary tract infection in older adults

    PubMed Central

    Rowe, Theresa A; Juthani-Mehta, Manisha

    2013-01-01

    Urinary tract infection and asymptomatic bacteriuria are common in older adults. Unlike in younger adults, distinguishing symptomatic urinary tract infection from asymptomatic bacteriuria is problematic, as older adults, particularly those living in long-term care facilities, are less likely to present with localized genitourinary symptoms. Consensus guidelines have been published to assist clinicians with diagnosis and treatment of urinary tract infection; however, a single evidence-based approach to diagnosis of urinary tract infection does not exist. In the absence of a gold standard definition of urinary tract infection that clinicians agree upon, overtreatment with antibiotics for suspected urinary tract infection remains a significant problem, and leads to a variety of negative consequences including the development of multidrug-resistant organisms. Future studies improving the diagnostic accuracy of urinary tract infections are needed. This review will cover the prevalence, diagnosis and diagnostic challenges, management, and prevention of urinary tract infection and asymptomatic bacteriuria in older adults. PMID:24391677

  16. Urinary tract infection in older adults.

    PubMed

    Rowe, Theresa A; Juthani-Mehta, Manisha

    2013-10-01

    Urinary tract infection and asymptomatic bacteriuria are common in older adults. Unlike in younger adults, distinguishing symptomatic urinary tract infection from asymptomatic bacteriuria is problematic, as older adults, particularly those living in long-term care facilities, are less likely to present with localized genitourinary symptoms. Consensus guidelines have been published to assist clinicians with diagnosis and treatment of urinary tract infection; however, a single evidence-based approach to diagnosis of urinary tract infection does not exist. In the absence of a gold standard definition of urinary tract infection that clinicians agree upon, overtreatment with antibiotics for suspected urinary tract infection remains a significant problem, and leads to a variety of negative consequences including the development of multidrug-resistant organisms. Future studies improving the diagnostic accuracy of urinary tract infections are needed. This review will cover the prevalence, diagnosis and diagnostic challenges, management, and prevention of urinary tract infection and asymptomatic bacteriuria in older adults.

  17. Urinary incontinence - what to ask your doctor

    MedlinePlus

    ... to help with my urinary incontinence? What are Kegel exercises? What can I do when I want ... tape Urinary incontinence - vaginal sling procedures Patient Instructions Kegel exercises - self-care Self catheterization - female Self catheterization - ...

  18. 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

  19. 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

  20. [Urinary tract infections in the elderly].

    PubMed

    Naline, Charlotte; Cudennec, Tristan; Teillet, Laurent

    2014-01-01

    In the elderly, urinary tract infections are frequent. Diagnosis is not always evident because symptoms are often absent. In doubt, a urinary strip evaluation must be performed. Prevention begins with simple lifestyle and dietary rules, such as good voiding and adequate fluid intake. Asymptomatic bacteriuria is treated only in certain cases. Other urinary tract infections require antibiotics, which must be adapted to renal function.

  1. 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

  2. [Urinary tract infections in adults].

    PubMed

    Ali, Adel Ben; Bagnis, Corinne Isnard

    2014-09-01

    Urinary tract infections in adults are frequent and can induce several septic situations. Their economic cost (drugs, microbiologic samples, consultations and/or hospitalizations and stop working) and ecologic cost (second reasons of antibiotic prescription in winter and first in the rest of the year) are important. A better respect of recommendations can improve the outcome of this different infections and decrease their cost.

  3. Candida urinary tract infection: pathogenesis.

    PubMed

    Fisher, John F; Kavanagh, Kevin; Sobel, Jack D; Kauffman, Carol A; Newman, Cheryl A

    2011-05-01

    Candida species are unusual causes of urinary tract infection (UTI) in healthy individuals, but common in the hospital setting or among patients with predisposing diseases and structural abnormalities of the kidney and collecting system. The urinary tract may be invaded in either an antegrade fashion from the bloodstream or retrograde via the urethra and bladder. Candida species employ a repertoire of virulence factors, including phenotypic switching, dimorphism, galvano - and thigmotropism, and hydrolytic enzymes, to colonize and then invade the urinary tract. Antegrade infection occurs primarily among patients predisposed to candidemia. The process of adherence to and invasion of the glomerulus, renal blood vessels, and renal tubules by Candida species was elegantly described in early histopathologic studies. Armed with modern molecular biologic techniques, the various virulence factors involved in bloodborne infection of the kidney are gradually being elucidated. Disturbances of urine flow, whether congenital or acquired, instrumentation of the urinary tract, diabetes mellitus, antimicrobial therapy, and immunosuppression underlie most instances of retrograde Candida UTI. In addition, bacterial UTIs caused by Enterobacteriaceae may facilitate the initial step in the process. Ascending infections generally do not result in candidemia in the absence of obstruction.

  4. [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.

  5. Surgical management of stress urinary incontinence: Burch colposuspension, modified Pereyra and Stamey bladder neck suspension, and collagen injection--Toa Payoh Hospital experience.

    PubMed

    Tay, K P; Lim, P H; Chng, H C

    1995-12-01

    A retrospective analysis was performed on 34 female patients who underwent corrective surgery for stress urinary incontinence over a 4-year period at the Toa Payoh Hospital. These patients were offered surgery only after an adequate trial of medical therapy, pelvic floor exercises and weight reduction. Bladder neck suspension operations were performed via the Burch, Stamey and modified Pereyra techniques. Towards the later part of this study, endoscopic injection of Collagen was performed as a salvage procedure in 2 patients. The Burch colposuspension gave uniformly good results, with all patients being completely dry. Seventy percent and sixty percent complete continence were achieved via the modified Pereyra and Stamey techniques respectively. Three patients required additional surgical procedures. Using these techniques, the overall results showed that 27 patients (79.4%) had complete urinary continence following surgery, while the remaining 7 patients (20.6%) experienced significant improvement of symptoms.

  6. 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

  7. 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.

  8. 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

  9. "Broken heart syndrome" after separation (from OxyContin).

    PubMed

    Rivera, Juanita M; Locketz, Adam J; Fritz, Kevin D; Horlocker, Terese T; Lewallen, David G; Prasad, Abhiram; Bresnahan, John F; Kinney, Michelle O

    2006-06-01

    We describe a 61-year-old woman with "broken heart syndrome" (Takotsubo-like cardiomyopathy) after abrupt postsurgical withdrawal of OxyContin. Her medical history was remarkable for long-term opiold dependence associated with the treatment of multi-Joint degenerative osteoarthritis. The patient presented to the emergency department 1 day after discharge from the hospital following total knee arthroplasty revision with acute-onset dyspnea and mild chest pain. She had precordial ST-segment elevation characteristic of acute myocardial infarction and elevated cardiac biomarkers. Emergency coronary angiography revealed no major coronary atherosclerosis. However, the left ventricular ejection fraction was severely decreased (26%), and new regional wall motion abnormalities typical of broken heart syndrome were noted. In addition to resuming her opioid therapy, she was treated supportively with bilevel positive airway pressure, diuretic therapy, morphine, aspirin, metoprolol, enalaprilat, intravenous heparin, nitroglycerin infusion, and dopamine infusion. Ventricular systolic function recovered completely by the fourth hospital day. To our knowledge, broken heart syndrome after opioid withdrawal has not been reported previously in an adult. Our case illustrates the importance of continuing adequate opiate therapy perioperatively in the increasing number of opioid-dependent patients to prevent potentially life-threatening complications such as broken heart syndrome.

  10. 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.

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

    PubMed

    Pacheco, Maria de Lourdes; Havel, Josef

    2002-01-01

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

  12. 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.

  13. Urinary zinc excretion in infancy.

    PubMed

    Sievers, E; Oldigs, H D; Dörner, K; Schaub, J

    1990-03-01

    In view of the conflicting data on urinary Zn excretion in infancy we investigated the possible influence of contamination, collecting methods, nutrition (human milk versus formula) and longitudinal changes during the first 16 weeks of life. Methodical investigation showed that special attention is necessary to avoid contamination due to the use of Zn-containing baby creams in the genital region. The sampling device for collection should include the smallest area of skin possible and the use of Zn-containing baby creams has to be avoided both during the collection and at least 24 hours prior to urine collection. Previous fractional urine sampling of the collecting method to be evaluated proves that erroneously high values are not obtained at the beginning of collection. Midstream urinary samples reduce the possibility of contamination. Increased urinary excretion was shown in pre-term infants under theophylline or coffeine medication. The median daily urinary Zn excretion in healthy breast-fed term infants declined significantly from 0.063 (0.027-0.111) mg per kg body weight at the age of 2 weeks to 0.018 (0.004-0.059) mg per kg body weight at the age of 16 weeks. Comparable values for formula-fed term infants were 0.029 (0.025-0.063) mg per kg body weight initially and 0.025 (0.007-0.059) mg per kg body weight at the end of the study. These values can be used as reference values for the urinary Zn excretion of healthy infants.

  14. Cold Stress and Urinary Frequency.

    PubMed

    Ishizuka, Osamu; Imamura, Tetsuya; Nishizawa, Osamu

    2012-03-01

    There have been few studies regarding the onset of urinary sensations and frequent urination induced by sudden whole-body cooling. In this article, we review the relationship between cold stress and urinary frequency based mainly on our previous studies. A recent study showed that cold stress induces bladder overactivity in conscious rats, and these effects were mediated, at least in part, by α1A -adrenergic receptor (AR) and α1D -AR. Another study suggested that the resiniferatoxin-sensitive nerves present in the urinary bladder may also be involved in the regulation of detrusor activity associated with cold stress. The mammalian transient receptor potential (TRP) channel family consists of 28 channels subdivided into five different classes: TRPV (vanilloid), TRPC (canonical), TRPM (melastatin), TRPML (mucolipin), and TRPA (ankyrin). TRP channels function as multifunctional sensors at the cellular level. They can be activated by physical (voltage, heat, cold, mechanical stress) or chemical stimuli and binding of specific ligands. In 2002, it was reported that a nonselective cation channel, TRPM8, could be activated by both menthol and thermal stimuli (8-28 °C). We demonstrated the presence of TRPM8 in the skin from the legs and back of rats by immunofluorescence staining and that stimulation of this receptor by menthol causes urinary frequency. There have been other reports demonstrating roles of TRPM8 not related to its thermosensory function. Further studies are needed to clarify the mechanism of cold stress-induced urinary frequency, and the roles of TRPM8 in the micturition control system.

  15. 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

  16. [Urinary tract dysfunction in older patients].

    PubMed

    Verdejo, Carlos; Méndez, Santiago; Salinas, Jesús

    2016-11-18

    Urinary tract dysfunction in older patients has a multifactorial aetiology and is not a uniform clinical condition. Changes due to physiological ageing as well as comorbidity and polypharmacy, can produce several dynamic conditions such as urinary incontinence and urinary retention. Lower urinary tract symptoms increase with age in both sexes and are a major problem in older patients due to their medical and psychosocial consequences. For these reasons, in assessing urinary dysfunction in older patients, we should consider external circumstances such as polypharmacy, poor mobility, affective and cognitive disorders and also accessibility to housing.

  17. What is the best surgical intervention for stress urinary incontinence in the very young and very old? An International Consultation on Incontinence Research Society update.

    PubMed

    Robinson, Dudley; Castro-Diaz, David; Giarenis, Ilias; Toozs-Hobson, Philip; Anding, Ralf; Burton, Claire; Cardozo, Linda

    2015-11-01

    An increasing number of continence procedures are being performed in women of all ages. An overview of the existing literature and consensus regarding surgery for stress urinary incontinence (SUI) in the young and the old was presented and discussed at the International Consultation on Incontinence Research Society Think Tank. This manuscript reflects the Think Tank's summary and opinion. Despite the increasing number of continence procedures, there are relatively few data to guide management in the very young and the very old. When considering continence surgery in the young, long-term efficacy and safety are paramount, and the future effects of pregnancy and childbirth need to be carefully considered. Conversely, in the elderly, minimally invasive procedures with low morbidity are important, especially in the frail elderly who may have significant co-morbidities. Further research including prospective randomised trials, cohort studies and national registries, should help guide our management in these two challenging groups of patients.

  18. Two-Year Outcomes After Sacrocolpopexy With and Without Burch to Prevent Stress Urinary Incontinence

    PubMed Central

    Brubaker, Linda; Nygaard, Ingrid; Richter, Holly E.; Visco, Anthony; Weber, Anne M.; Cundiff, Geoffrey W.; Fine, Paul; Ghetti, Chiara; Brown, Morton B.

    2008-01-01

    OBJECTIVES To report anatomic and functional outcomes 2 years after sacrocolpopexy in stress-continent women with or without prophylactic Burch colposuspension. METHODS In the Colpopexy and Urinary Reduction Efforts (CARE) trial, stress-continent women undergoing sacrocolpopexy were randomized to receive or not receive a Burch colposuspension. Outcomes included urinary symptoms, other pelvic symptoms, and pelvic support. Standardized pelvic organ prolapse quantification examinations and validated outcome measures including the Pelvic Floor Distress Inventory and the Pelvic Floor Impact Questionnaire were completed before surgery and at several postoperative intervals, including at 2 years. RESULTS This analysis is based on 302 of 322 randomized participants. Most were Caucasian (94%), with a mean age of 62±10 years (mean±standard deviation). Two years after surgery, 32.0% and 45.2% of women in the Burch and control groups, respectively, met the stress incontinence endpoint (presence of symptoms or positive cough stress test or interval treatment for stress incontinence, P=.026). The apex was well supported (point C within 2 cm of total vaginal length) in 95% of women, and this was not affected by concomitant Burch (P=.18). There was a trend toward fewer urgency symptoms in the Burch group (32.0% versus 44.5% no Burch, P=.085). Twenty participants experienced mesh or suture erosions. CONCLUSION The early advantage of prophylactic Burch colposuspension for stress incontinence that was seen at 3 months remains at 2 years. Apical anatomic success rates are high and not affected by concomitant Burch. PMID:18591307

  19. 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

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

    PubMed

    Walsh, Colin A

    2011-09-01

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

  1. The Rise of Continents and the Transition Archean to Proterozoic

    NASA Astrophysics Data System (ADS)

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

    2011-12-01

    Terrestrial planets evolve in part via partial melting and gravitational differentiation, and in part via fluid/rock interactions at the surface. Mass and energy transfers across their various envelopes depend on the mode of convective motion, which may involve stagnant or mobile lid systems, for which plate tectonics is a possible mode; one promoting the coupling between exogenic and endogenic envelopes. In the other hand, fluid/rock interaction at the surface depends on the planet hypsometry and availability of weathering agents such as liquid water. It also depends on fluid/rock interaction at mid-oceanic ridge and therefore on the mode of convection. Hence, from 4.54 to 2.5 Ga the interplay between deep and surface processes under the forcing of secular cooling was such that the Earth differentiation was non-linear with sudden crises that punctuated periods of relative quietness. The Earth secular cooling impacted on deep and surface processes through the modulation of the Earth's hypsometry. This modulation occurred via cooling and strengthening of the lithosphere (Rey and Coltice, Geology, 2008), and via the deepening of oceanic basin, which lowered the mean sea level forcing the continents to emerge (Flament et al., EPSL, 2008). Stronger lithospheres are able to sustain higher orogenic belts and orogenic plateaux, the erosion of which lead to stronger fluxes towards the ocean. Secular strengthening and emergence conspired to enhance weathering and erosion of the continents and therefore to enhance the geochemical coupling between the endogenic and exogenic Earth's envelopes (Rey and Coltice, Geology, 2008). The shift to the aerobic world, at the Archean to Proterozic transition, took place at a time when exogenic envelopes recorded major shifts in composition (eg. Taylor and McLennan, Rev. of Geophys., 1995; Veizer and Compston, Geochem. Cosmochem Acta, 1976; Valley et al., Contrib. to Mineral. Petrol., 2005) that are consistent with the progressive exposure

  2. 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

  3. 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

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

    NASA Astrophysics Data System (ADS)

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

    2003-12-01

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

  5. 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.

  6. Drifting continents and endemic goitre in northern Pakistan.

    PubMed

    Stewart, A G

    1990-06-09

    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.

  7. Jurassic paleopole controversy: Contributions from the Atlantic-bordering continents

    NASA Astrophysics Data System (ADS)

    van der Voo, Rob

    1992-11-01

    The Early-early Middle Jurassic and Early Cretaceous mean paleopoles for North America, Europe, South America, and Africa are very well grouped in appropriate continental reconstructions, but the intervening late Middle and Late Jurassic segment of the apparent polar wander path (APWP) is poorly defined and controversial. The available paleopoles, reconstructed for the partial opening of the central Atlantic Ocean, form a scattered grouping with no coherent age patterns, illustrating that they do not constitute a robust data set. Uncertainties in the reconstruction parameters between North America and Europe also play a role. However, excellent paleomagnetic results exist for tectonic elements near the margin of west Gondwana that are unlikely to have been significantly displaced with respect to cratonic Africa and South America. These results have not previously been used for APWP reconstructions, because local rotations are thought to have deflected the paleopoles in many cases. The inclinations of such results, however, can be used to determine a locus of paleopole positions. Paleopole loci for about 150 and 170 Ma were determined from results from Spain, Italy, Lebanon, and the Chilean Andes, and these were rotated with appropriate parameters to give locus intersections in North American coordinates. A late Middle Jurassic (early Callovian) best estimate of the paleopole in North American coordinates is located at about lat 70°N, long 135°E, and a Late Jurassic (Kimmeridgian) best estimate is located at about 70°N, 155°E. The resulting Jurassic-Early Cretaceous APWP follows roughly the 70th parallel, passing through the middle of the scattered individual paleopoles from the cratonic parts of the Atlantic-bordering continents.

  8. Single mode continous wave GaAs quantum cascade lasers

    NASA Astrophysics Data System (ADS)

    Strasser, Gottfried

    2001-03-01

    Quantum cascade lasers (QCLs) are powerful light emitters in the mid infrared. We fabricated GaAs-based first order and second order distributed feedback lasers to achieve single mode emission. The emission wavelength is continuously tunable according to the temperature dependence of the effective refractive index, which shifts the Bragg wavelength. For the continous-wave operation achieved from first order DFB structures the active material consists of 40 periods of an AlAs/GaAs chirped superlattice, grown by solid source molecular beam epitaxy. A double plasmon enhanced waveguide is used for vertical optical confinement, lateral electrical and optical confinement is achieved by deep etched ridges. The Bragg grating is defined by contact lithography and etched into the surface of the top cladding layer, thus avoiding the need of regrowth. Single mode emission at 11.8 microns is observed for pulsed mode operation and for continuous-wave operation. The emission wavelength depends on the laser current, because of the electrical heating in the active material. We derive the effective temperature in the laser cavity from the emission wavelength. We use the measured dependence of the emission wavelength from the heat sink temperature in pulsed-mode operation, where the effective temperature change within a pulse can be neglected and the average heat load is low. Additionally, single mode emission from electrically pumped QCL micro-cavities (circular and deformed cross sections) and monolithic GaAs/AlGaAs QCLs with self-aligned Focused Ion Beam cut coupled cavities are demonstrated. Deep FIB etched Bragg reflectors can be used to increase the reflectivity. This work is supported by the European Project SUPERSMILE.

  9. 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.

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

    NASA Astrophysics Data System (ADS)

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

    2014-12-01

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

  11. 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.

  12. 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.

  13. 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.

  14. [Urinary tract infections in children].

    PubMed

    Lellig, E; Apfelbeck, M; Straub, J; Karl, A; Tritschler, S; Stief, C G; Riccabona, M

    2017-02-01

    Urinary tract infections (UTI) are the most common bacterial infections in children. The symptoms are not very specific and range from abdominal pain, poor feeding to nocturnal urinary incontinence. The technique of collecting urine plays an important role for securing the diagnosis. The best way to obtain urine in non-toilet-trained children is catheterization or suprapubic bladder aspiration. In toilet-trained children midstream urine is an acceptable alternative after cleaning the foreskin or labia. In the case of an infection a prompt empirical antibiotic therapy is necessary to reduce the risk of parenchymal scarring of the kidneys. There are different approaches to diagnose vesicoureteral reflux in different countries. The commonly used standard approach in Germany is voiding cystourethrography. In the case of reflux dimercaptosuccinic acid (DMSA) scintigraphy should be performed additionally to exclude renal scarring (bottom-up approach).

  15. 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.

  16. Urinary Incontinence in the Elderly

    PubMed Central

    Ouslander, Joseph G.

    1981-01-01

    Urinary incontinence is a common and distressing problem for elderly patients, their families and friends, and the health professionals who care for them. It is a heterogeneous condition, and appropriate management depends on a thorough evaluation and understanding of the multiple factors that can play a role in its cause and perpetuation. Identifying reversible causes of transient incontinence, and appropriate management of incontinence that is associated with acute illness, can be important in preventing the problem from becoming established. A thorough diagnostic evaluation of urinary incontinence in the elderly, and appropriate use of the different types of therapy, will greatly improve the management in these cases. The need and opportunities for research to improve the management of incontinent elderly persons should be considered by all those involved in caring for this population. PMID:7039134

  17. Fetal lower urinary tract obstruction.

    PubMed

    Lissauer, David; Morris, Rachel K; Kilby, Mark D

    2007-12-01

    Fetal lower urinary tract obstruction affects 2.2 per 10,000 births. It is a consequence of a range of pathological processes, most commonly posterior urethral valves (64%) or urethral atresia (39%). It is a condition of high mortality and morbidity associated with progressive renal dysfunction and oligohydramnios, and hence fetal pulmonary hypoplasia. Accurate detection is possible via ultrasound, but the underlying pathology is often unknown. In future, magnetic resonance imaging (MRI) may be increasingly used alongside ultrasound in the diagnosis and assessment of fetuses with lower urinary tract obstruction. Fetal urine analysis may provide improvements in prenatal determination of renal prognosis, but the optimum criteria to be used remain unclear. It is now possible to decompress the obstruction in utero via percutaneous vesico-amniotic shunting or cystoscopic techniques. In appropriately selected fetuses intervention may improve perinatal survival, but long-term renal morbidity amongst survivors remains problematic.

  18. [Urinary tract infection in pregnancy].

    PubMed

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

    2005-12-01

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

  19. Sexual function before and after non-surgical treatment for stress urinary incontinence

    PubMed Central

    Handa, Victoria L.; Whitcomb, Emily; Weidner, Alison C.; Nygaard, Ingrid; Brubaker, Linda; Bradley, Catherine S.; Paraiso, Marie Fidela R.; Schaffer, Joseph; Zyczynski, Halina M.; Zhang, Min; Richter, Holly E.

    2011-01-01

    Objectives (1) to describe sexual function in women seeking treatment of stress urinary incontinence (SUI); (2) to compare the impact on sexual function of three SUI treatments; and (3) to investigate whether non-surgical treatment of SUI is associated with improved sexual function. Methods Women with SUI were randomized to continence pessary, behavioral therapy (pelvic floor muscle training and continence strategies), or combination therapy. Sexual function was assessed at baseline and 3-months using short forms of the Pelvic Organ Prolapse-Urinary Incontinence Sexual Function Questionnaire (PISQ-12) and the Personal Experiences Questionnaire (SPEQ). Successful treatment of SUI was assessed with a patient global impression of improvement. ANOVA was used to compare scores between groups. Results At baseline, sexual function was worse among women with mixed incontinence compared to those with pure SUI. After therapy, successful treatment of SUI was associated with greater improvement in PISQ-12 score (2.26 ± 3.24 versus 0.48 ± 3.76, p=0.0007), greater improvement in incontinence with sexual activity (0.45 ± 0.84 versus 0.01 ± 0.71, p=0.0002), and greater reduction in restriction in sexual activity related to fear of incontinence (0.32 ± 0.76 versus −0.06 ± 0.78, p=0.0008). Among those successfully treated for SUI, improvement in continence during sexual activity was greater in both the combined therapy group (p=0.019) and the behavioral group (p=0.02) compared to the pessary group. Conclusions Successful non-surgical treatment of SUI is associated with improvements in incontinence-specific measures of sexual function. Behavioral therapy may be preferred to pessary for treatment of SUI among women whose incontinence interferes with sexual function. PMID:21572534

  20. 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

  1. The association between bacteria and urinary stones

    PubMed Central

    Wolfe, Alan J.

    2017-01-01

    Urinary stone disease (USD) is an increasing clinical problem in both children and adults. One in ten individuals will experience a urinary stone, yet the mechanisms responsible for urinary stones remain largely unknown. Bacteria have long been recognized to contribute to struvite urinary stones; however, the role of bacteria in the development of the more common calcium oxalate (CaOx) and calcium phosphate (CaPhos) stones has not been extensively investigated. However, several findings do indicate a possible association between urinary stones and bacteria, including the high rate of urinary tract infections (UTI) in urinary stone patients and multiple case series of culture-positive urinary stones, including stones composed of CaOx or CaPhos. New technology, such as next generation sequencing, may be used to lend additional insight regarding the association between urinary stones and bacteria. In 2015, we published the initial bacterial sequencing results from five urinary stones, from which we sequenced multiple types of bacterial DNA. Whether these bacteria are causal, disease modifying or passively present remains to be determined. However, initial exploration of underlying mechanisms for this association indicate that bacteria aggregate selectively to crystals, that their presence is associated with increased clumping of crystals, and that they stimulate incorporation of proteins into the stone matrix. PMID:28217697

  2. 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.

  3. A history of urinary stone.

    PubMed

    Modlin, M

    1980-10-18

    Urinary stone was well known to the ancient Greeks, as the reference to it in the Oath of Hippocrates shows. The oldest renal stone on record actually comes from an Egyptian mummy. For obvious reasons our forefathers were better acquainted with bladder stones than renal stones until the advent of radiography. Interesting aspects of the story are the gradual decline in the incidence of bladder stones and their apparent replacement by renal stones.

  4. Urinary incontinence. Noninvasive treatment options.

    PubMed

    Maloney, C; Cafiero, M R

    1999-06-01

    One in six women older than 45 experiences incontinence, but 31% of them never discuss their condition with anyone. A proactive approach on the part of all health care providers is needed to break this silence, particularly among clinicians who care for women. Urinary incontinence is classified as stress, urge, mixed, overflow or functional incontinence. Differential diagnosis of incontinence is essential to choosing appropriate treatment options. This article outlines noninvasive treatment options that are specific to diagnosis.

  5. Diagnosing resolution sensitivity over the Maritime Continent in the MetUM

    NASA Astrophysics Data System (ADS)

    Woolnough, S. J.; Bush, S. J.; Schiemann, R.; Turner, A. G.; Martin, G.

    2014-12-01

    The Maritime Continent, with over 25,000 islands ranging from hundreds to 780,000 square kilometers, is a key challenge for cumulus-convection and coastal parameterizations in climate resolution GCMs. We studied the resolution sensitivity of precipitation over the Maritime Continent in the MetUM AGCM at horizontal resolutions ranging from approximately 200 to 40 km. We found robust increases in summer precipitation over the Maritime Continent Islands and decreases in summer precipitation over the northern Maritime Continent seas, similar to the resolution sensitivity seen in other studies. These precipitation changes near the Maritime Continent can be large, exceeding 5 mm/day, and are the largest changes in tropical precipitation as resolution is increased. To explore the source of these changes, we present novel experiments to diagnose the role of increased resolution of different components of the AGCM, such as the orography, coastlines and atmospheric dynamics, in the Maritime Continent domain. Our results suggest that total orographic precipitation in the Maritime Continent domain is resolution dependent at these scales. While increased precipitation associated with the higher resolution of the mean orography (see Figure 1) is compensated for by decreasing precipitation associated with changes in the subgrid orography and its effect on parameterized drag, the total orographic precipitation is not equal across resolutions. Changes in moisture convergence, precipitation and circulation due to improved resolution of the orography then affect precipitation in the wider Indo-Pacific region.

  6. 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

  7. Urinary tract infections in adults.

    PubMed

    Orenstein, R; Wong, E S

    1999-03-01

    Urinary tract infections remain a significant cause of morbidity in all age groups. Recent studies have helped to better define the population groups at risk for these infections, as well as the most cost-effective management strategies. Initially, a urinary tract infection should be categorized as complicated or uncomplicated. Further categorization of the infection by clinical syndrome and by host (i.e., acute cystitis in young women, acute pyelonephritis, catheter-related infection, infection in men, asymptomatic bacteriuria in the elderly) helps the physician determine the appropriate diagnostic and management strategies. Uncomplicated urinary tract infections are caused by a predictable group of susceptible organisms. These infections can be empirically treated without the need for urine cultures. The most effective therapy for an uncomplicated infection is a three-day course of trimethoprim-sulfamethoxazole. Complicated infections are diagnosed by quantitative urine cultures and require a more prolonged course of therapy. Asymptomatic bacteriuria rarely requires treatment and is not associated with increased morbidity in elderly patients.

  8. 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.

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

    PubMed Central

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

    2012-01-01

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

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

    PubMed

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

    1995-04-21

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

  11. 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.

  12. New Zealand phylogeography: evolution on a small continent.

    PubMed

    Wallis, Graham P; Trewick, Steven A

    2009-09-01

    New Zealand has long been a conundrum to biogeographers, possessing as it does geophysical and biotic features characteristic of both an island and a continent. This schism is reflected in provocative debate among dispersalist, vicariance biogeographic and panbiogeographic schools. A strong history in biogeography has spawned many hypotheses, which have begun to be addressed by a flood of molecular analyses. The time is now ripe to synthesize these findings on a background of geological and ecological knowledge. It has become increasingly apparent that most of the biota of New Zealand has links with other southern lands (particularly Australia) that are much more recent than the breakup of Gondwana. A compilation of molecular phylogenetic analyses of ca 100 plant and animal groups reveals that only 10% of these are even plausibly of archaic origin dating to the vicariant splitting of Zealandia from Gondwana. Effects of lineage extinction and lack of good calibrations in many cases strongly suggest that the actual proportion is even lower, in keeping with extensive Oligocene inundation of Zealandia. A wide compilation of papers covering phylogeographic structuring of terrestrial, freshwater and marine species shows some patterns emerging. These include: east-west splits across the Southern Alps, east-west splits across North Island, north-south splits across South Island, star phylogenies of southern mountain isolates, spread from northern, central and southern areas of high endemism, and recent recolonization (postvolcanic and anthropogenic). Excepting the last of these, most of these patterns seem to date to late Pliocene, coinciding with the rapid uplift of the Southern Alps. The diversity of New Zealand geological processes (sinking, uplift, tilting, sea level change, erosion, volcanism, glaciation) has produced numerous patterns, making generalizations difficult. Many species maintain pre-Pleistocene lineages, with phylogeographic structuring more similar to

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

    NASA Astrophysics Data System (ADS)

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

    2012-12-01

    The surface topography of Europe shows important variations, most of which are relatively well explained by isostatic compensation of density contrasts within the crust and lithosphere. However, not all of the density contrasts leading to topography reside within the lithosphere. The crucial problem is how to detect the extra topography signal, in addition to that associated with both crustal and lithospheric anomalies. Forte and Perry, 2000 estimate the amplitude of the dynamic topography by removal of the crustal isostatic topography signal from the surface of the Earth. Faccenna and Becker, 2010 infer the equivalent dynamic topography from the normal stress generated at the surface by mantle viscous flow driven by thermal anomalies. Here we consider the correlation between residual topography and mantle residual gravity anomalies. As shown by Pekeris, 1935 and Hager et al., 1985, the viscous mantle flow that is driven by the thermal density contrasts is responsible for the long-wavelength gravity anomalies observed at the surface. They have demonstrated that the gravitational effects of surface deformation caused by the flow is opposite in sign and comparable in magnitude to that of the driving density contrast. The 1°x1° recently assembled European crustal model, EPCrust (Molinari and Morelli, 2011) is used to estimate the effects of the isostatic crust and the mantle residual gravity anomalies. We calculate the correlation matrix between the residual topography and the mantle residual gravity anomalies and we define the regions where the sublithospheric mantle density, below the European continent, contributes to surface topography. To recover the residual topography, the effects of the isostatic crust is estimated with the Panasyuk and Hager (2000) algorithm and subtracted from the observed elevation (ETOPO-1). The mantle residual gravity anomalies are estimated as the differences between the produced gravity field of EPCrust and the observations. 3-D

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

    NASA Astrophysics Data System (ADS)

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

    2013-12-01

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

  15. Regenerative medicine based applications to combat stress urinary incontinence

    PubMed Central

    Thaker, Hatim; Sharma, Arun K

    2013-01-01

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

  16. Systemic implications of urinary stone disease

    PubMed Central

    Kovshilovskaya, Bogdana; Miller, Joe; Stoller, Marshall L.

    2012-01-01

    Urinary stone disease is the third most common condition affecting the urinary tract. It contributes to a great deal of morbidity for both men and women, and cost the United States (US) over 5.3 billion dollars in 2000 alone. Moreover, it is associated with systemic diseases such as hypertension, diabetes, and other components of the metabolic syndrome. Reciprocally, these systemic diseases may be contributing to the rising incidence in urinary stone disease. Previously described mechanisms of stone formation attribute stone development and growth to the urinary milieu. While this may partly influence the process, it cannot account for the associations between systemic diseases and stones observed in large community-based studies. Here we present a review of the evidence demonstrating a link between urinary stone disease and components of the metabolic syndrome. We believe a vascular etiology for the initiation of urinary stones may tie these processes together. PMID:26816692

  17. 21 CFR 862.1780 - Urinary calculi (stones) test system.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Urinary calculi (stones) test system. 862.1780... Systems § 862.1780 Urinary calculi (stones) test system. (a) Identification. A urinary calculi (stones) test system is a device intended for the analysis of urinary calculi. Analysis of urinary calculi...

  18. 21 CFR 862.1780 - Urinary calculi (stones) test system.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Urinary calculi (stones) test system. 862.1780... Systems § 862.1780 Urinary calculi (stones) test system. (a) Identification. A urinary calculi (stones) test system is a device intended for the analysis of urinary calculi. Analysis of urinary calculi...

  19. 21 CFR 862.1780 - Urinary calculi (stones) test system.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

  20. 21 CFR 862.1780 - Urinary calculi (stones) test system.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

  1. 21 CFR 862.1780 - Urinary calculi (stones) test system.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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

  2. 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.

  3. Cranberries and lower urinary tract infection prevention

    PubMed Central

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

    2012-01-01

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

  4. [Nosocomial urinary tract infection in adults].

    PubMed

    Hug, B L; Flückiger, U; Widmer, A F

    2006-11-01

    Urinary tract infection (UTI) is the most common infection in hospitalized adults. Nosocomial UTIs are mainly associated with the use of urinary catheters. Thus, the decision for catheterization should be made carefully and catheters removed in time. In order to prevent unnecessary antibiotic use in patients with urinary catheters correct diagnosis is crucial. Chinolones, broad-spectrum penicillins and third-generation cephalosporins are the mainstay of therapy. Comorbidities should be considered and potential obstructions of urinary flow removed. Economically important are the normally higher prices of i.v. antibiotics compared to oral use.

  5. 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

  6. Discreet products for women with urinary incontinence.

    PubMed

    Evans, Debra

    It is estimated that 10 million women in the UK suffer with urinary incontinence (Hunskarr et al, 2004). Many women consider bladder weakness to be an inevitable consequence of childbirth or the menopause. Haslam (2004) reported on a telephone survey that examined whether women were aware of stress urinary incontinence, their attitude to it and the impact it had on their daily lives. In the UK, 505 women were interviewed, 206 of whom responded positively to a question about symptoms of stress urinary incontinence, giving a prevalence rate of 41 per cent. There is also evidence that most patients with urinary incontinence do not present to their doctors

  7. [Hospital-acquired urinary tract infections].

    PubMed

    Adukauskiene, Dalia; Cicinskaite, Ilona; Vitkauskiene, Astra; Macas, Andrius; Tamosiūnas, Ramūnas; Kinderyte, Aida

    2006-01-01

    Urinary tract infections are responsible for 40-60% of all hospital-acquired infections. Increased age of patients and comorbid diseases render hospitalized patients more susceptible to infection. Almost 80% of hospital-acquired urinary tract infections are associated with urinary catheters, and only 5-10% of urinary infections are caused by invasive manipulations in the urogenital tract. Pathogens of hospital-acquired urinary tract infections are frequently multi-resistant, and antibiotic therapy can only be successful when the complicating factors are eliminated or urodynamic function is restored. For treatment of complicated hospital-acquired urinary tract infections, the antibiotics must exhibit adequate pharmacodynamic and pharmacokinetic properties: high renal clearance of unmetabolized form with good antimicrobial activity in both acidic and alkaline urine. For selection of empirical treatment of hospital-acquired urinary tract infections, it is necessary to evaluate localization of infection, its severity, possible isolates, and the most frequent pathogens in the department where patient is treated. The best choice for the starting the antimicrobial therapy is the cheapest narrow-spectrum effective antibiotic in the treatment of urinary tract infection until microbiological evaluation of pathogens will be received. Adequate management of urinary tract infections lowers the rate of complications, requirements for antibacterial treatment, selection of multi-resistant isolates and is cost effective.

  8. Treatment of Stress Urinary Incontinence in Neurological Patients With an Injectable Elastomer Prosthesis: Preliminary Results

    PubMed Central

    Citeri, Marco; Zanollo, Lucia; Guerrer, Chiara; Rizzato, Luigi; Frediani, Luca; Iselin, Christophe; Spinelli, Michele

    2017-01-01

    Many treatment options for stress urinary incontinence are difficult to apply to neurological patients. Urolastic is a new agent that is primarily indicated for women with mild stress urinary incontinence or men after prostate surgery. In this report, we present a series of 5 cases describing the first use of Urolastic to treat neurological patients. All patients were evaluated with a voiding diary and the use of auxiliary devices as the main indicators of continence. The median operative time was 30.8 minutes, and no complications were observed. Of the 5 patients, 4 reported improved incontinence: 2 switched from diapers to small pads, while the other 2 patients were able to discontinue urinary condom use. The only instance of treatment failure occurred in a patient with a low-compliance bladder. The advantages of this procedure appear to include a soft-cuff effect, reversibility, and minimal invasiveness. However, a future randomized study would be necessary to validate this treatment option. PMID:28361514

  9. Muscle-Derived Cells for Treatment of Iatrogenic Sphincter Damage and Urinary Incontinence in Men

    PubMed Central

    Gerullis, H.; Eimer, C.; Georgas, E.; Homburger, M.; El-Baz, A. G.; Wishahi, M.; Borós, M.; Ecke, T. H.; Otto, T.

    2012-01-01

    Introduction. Aim of this study was to assess the safety and efficacy of injection of autologous muscle-derived cells into the urinary sphincter for treatment of postprostatectomy urinary incontinence in men and to characterize the injected cells prior to transplantation. Methods. 222 male patients with stress urinary incontinence and sphincter damage after uroloical procedures were treated with transurethral injection of autologous muscle-derived cells. The transplanted cells were investigated after cultivation and prior to application by immunocytochemistry using different markers of myogenic differentiation. Feasibility and functionality assessment was achieved with a follow-up of at least 12 months. Results. Follow-up was at least 12 months. Of the 222 treated patients, 120 responded to therapy of whom 26 patients (12%) were continent, and 94 patients (42%) showed improvement. In 102 (46%) patients, the therapy was ineffective. Clinical improvement was observed on average 4.7 months after transplantation and continued in all improved patients. The cells injected into the sphincter were at least ~50% of myogenic origin and representative for early stages of muscle cell differentiation. Conclusions. Transurethral injection of muscle-derived cells into the damaged urethral sphincter of male patients is a safe procedure. Transplanted cells represent different phases of myogenic differentiation. PMID:22919359

  10. 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

  11. LINET Lightning Characteristics Observed on 4 Different Continents

    NASA Astrophysics Data System (ADS)

    Hoeller, H.; Betz, H.-D.; Schmidt, K.; Calheiros, R. V.; May, P.; Houngninou, E.; Scialom, G.

    2009-04-01

    During recent field campaigns DLR operated its six-station VLF/LF lightning detection network LINET in co-operation with the University of Munich and nowcast GmbH as well as local partners in 4 different continents. For TROCCINOX (Tropical convection, cirrus and nitrogen oxides experiment) the network was set in Sao Paulo state in Brazil during Jan/Feb 05, for the tropical EU SCOUT-O3 (Stratospheric-Climate Links with Emphasis on the Upper Troposphere and Lower Stratosphere) and TWP-ICE (Tropical Warm Pool - International Cloud Experiment) campaigns during Nov/Dec 2005 and Jan/Feb 2006, respectively, in the Darwin area in N-Australia, for AMMA (African Monsoon Multidisciplinary Analyses) in Benin/W-Africa during June-Nov 2006 and for measurements in Southern Germany during June-August 2005. Using the same experimental set up in all areas it became possible to compare the lightning characteristics for the different climatic regions and also to assess the relative significance for lightning NOx production. Regional and temporal characteristics of lightning are found to be dependent on orographic effects (e.g. S-Germany, Brazil, Benin), land-sea breeze circulations (N-Australia) and especially the evolution of the monsoons (Benin, N-Australia). Large intra-seasonal variability in lightning occurrence was found for the Australian monsoon between the strong convection during build-up and break phases and the weak wet monsoon phase with only minor lightning activity. Total daily lightning rates can be of comparable intensity in all regions with the heaviest events found in Germany and N-Australia. The frequency of occurrence of such days was by far the largest in N-Australia. In accordance with radar observed storm structures, the intra-cloud stroke mean emission heights were found distinctly different in Germany (8 km) as compared to the tropics (up to 12 km in N-Australia). The fraction of intra-cloud strokes (compared to all strokes) was found to be relatively high in

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

    NASA Astrophysics Data System (ADS)

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

    2013-12-01

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

  13. 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

  14. [Urinary schistosomiasis in ancient Egypt].

    PubMed

    Ziskind, Bernard

    2009-12-01

    First described by Theodor Bilharz in 1851, Schistosoma haematobium, the worm responsible for urinary schistosomiasis, was a major health problem along the Nile Valley until the present days. Haematuria, the main symptom of this parasitic disease, was known and treated in Egyptian medical papyri since 1550 B.C. A relationship between haematuria and the god Seth was envisaged. Sir Marc Armand Ruffer, pioneer of paleopathology, found (1910) calcified Schistosoma eggs in Egyptian mummies of the xxth dynasty, establishing that bilharzia plagued ancient Egypt people. The ELISA method demonstrated the Schistosoma circulating anodic antigen in 45% of mummies studied.

  15. 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

  16. Approach to urinary tract infections.

    PubMed

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

    2009-10-01

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

  17. Urinary Biomarkers for Prostate Cancer.

    PubMed

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

    2016-02-01

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

  18. 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...

  19. 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…

  20. Urinary tract infection in girls - aftercare

    MedlinePlus

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

  1. Sexually acquired Salmonella Typhi urinary tract infection.

    PubMed

    Wielding, Sally; Scott, Gordon

    2016-05-01

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

  2. Kidneys and Urinary Tract (For Parents)

    MedlinePlus

    ... Old Feeding Your 1- to 2-Year-Old Kidneys and Urinary Tract KidsHealth > For Parents > Kidneys and ... en español Los riñones y las vías urinarias Kidneys and Urinary Tract Basics Our bodies produce several ...

  3. 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.

  4. Management of male urinary incontinence

    PubMed Central

    Moore, Katie C.; Lucas, Malcolm G.

    2010-01-01

    The majority of male urinary incontinence seen is secondary to sphincter weakness following prostatic surgery. As there is a rising elderly population and increasing numbers of surgical interventions for prostate cancer, incidence of male incontinence is increasing. Hence, management of male incontinence has become a subject of increased interest for urologists. Various non-surgical and surgical approaches have been suggested for this devastating condition. Non-invasive therapies are suggested for early postoperative and mild incontinence. For surgical treatment the artificial urinary sphincter is still labeled the gold standard despite the introduction of several more minimally invasive treatments. However, as yet there is no consensus on the optimal timing and best modality for managing these men. Well designed, centrally funded clinical trials are required to establish which treatment modality to offer and when in the broad spectrum of male incontinence. This review focuses mainly on the management of post-prostatectomy incontinence since the management of other types varies little from the modalities of treatment in women. PMID:20877603

  5. Urinary biomarkers after donor nephrectomy.

    PubMed

    Hoogendijk-van den Akker, Judith M; Warlé, Michiel C; van Zuilen, Arjan D; Kloke, Heinrich J; Wever, Kim E; d'Ancona, Frank C H; Ӧzdemir, Denise M D; Wetzels, Jack F M; Hoitsma, Andries J

    2015-05-01

    As the beginning of living-donor kidney transplantation, physicians have expressed concern about the possibility that unilateral nephrectomy can be harmful to a healthy individual. To investigate whether the elevated intra-abdominal pressure (IAP) during laparoscopic donor nephrectomy causes early damage to the remaining kidney, we evaluated urine biomarkers after laparoscopic donor nephrectomy. We measured albumin and alpha-1-microglobulin (α-1-MGB) in urine samples collected during and after open and laparoscopic donor nephrectomy and laparoscopic cholecystectomy and colectomy. Additionally, kidney injury molecule 1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) were measured in urine samples collected during and after laparoscopic donor nephrectomy and colectomy. The same biomarkers were studied in patients randomly assigned to standard or low IAP during laparoscopic donor nephrectomy. We observed a peak in urinary albumin excretion during all procedures. Urine α-1-MGB rose in the postoperative period with a peak on the third postoperative day after donor nephrectomy. Urine α-1-MGB did not increase after laparoscopic cholecystectomy and colectomy. After laparoscopic nephrectomy, we observed slight increases in urine KIM-1 during surgery and in urine NGAL at day 2-3 after the procedure. After laparoscopic colectomy, both KIM-1 and NGAL were increased in the postoperative period. There were no differences between the high- and low-pressure procedure. Elevated urinary α-1-MGB suggests kidney damage after donor nephrectomy, occurring irrespective of IAP during the laparoscopic procedure.

  6. 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

  7. Urinary tract infections. An overview.

    PubMed

    Jepsen, O B

    1987-06-01

    Urinary tract infection remains the most prevalent infection acquired by hospitalized patients. The association with manipulations of the urinary tract is well known and the etiology of these infections is studied in detail. The excess cost of preventable UTI has not been established. It may be negligible for the single case but a high prevalence of nosocomial UTI could add substantially to hospital expenses. Differences in practices of bladder drainage between hospitals and countries have been identified, and educational efforts would seem effective in the management of incontinent patients when hospitalized. Though the infection is often self-limiting, when the catheter is removed, complications are seen. The lower survival with bacteriuria in old age is best explained by the presence of fatal disease in bacteriuric patients. Prevention of the infection with the catheter in situ is discouraging, and measures intended to interfere with the endogenous source of infection have largely failed or postponed infection. A radical approach to the use of indwelling catheters in hospitalized patients may seem the only way out, requiring highly skilled nursing care instead.

  8. Effect of duloxetine, a norepinephrine and serotonin reuptake inhibitor, on sneeze-induced urethral continence reflex in rats.

    PubMed

    Miyazato, Minoru; Kaiho, Yasuhiro; Kamo, Izumi; Chancellor, Michael B; Sugaya, Kimio; de Groat, William C; Yoshimura, Naoki

    2008-07-01

    We investigated the effect of duloxetine, a norepinephrine (NE) and serotonin (5-HT) reuptake inhibitor, on the neurally evoked urethral continence reflex induced by sneezing in rats. To clarify the role of noradrenergic and serotonergic mechanisms in preventing stress urinary incontinence (SUI) during sneezing, we examined the effect of duloxetine followed by intrathecal (it) methiothepin maleate (5-HT receptor and alpha1-adrenoceptor antagonist) or terazosin or idazoxan (selective alpha1- and alpha2-adrenoceptor antagonists, respectively). Amplitude of urethral pressure responses during sneezing (A-URS), urethral baseline pressure (UBP) at the midurethra, and sneeze-induced leak point pressure (S-LPP) were measured in normal adult female rats and rats with SUI induced by vaginal distension (VD). In normal and VD rats, intravenous application of duloxetine (1 mg/kg) increased A-URS by 35% and 34% and UBP by 21% and 34%, respectively. Sneezing-induced fluid leakage from the urethral orifice was observed in VD rats but not in normal rats. S-LPP was increased from 39.1 to 92.2 cmH2O by intravenous duloxetine in incontinent VD rats. Duloxetine-mediated enhancement of A-URS was inhibited by terazosin but not methiothepin maleate (it). In addition, simultaneous intrathecal application of methiothepin and terazosin induced a reduction in A-URS during sneezing, which was not increased by intravenous duloxetine. However, the reduced A-URS after intrathecal application of methiothepin and terazosin returned to the control level when duloxetine (iv) was applied after intrathecal idazoxan administration. These results indicate that duloxetine can prevent SUI by facilitating noradrenergic and serotonergic systems in the spinal cord to enhance the sneeze-induced active urethral closure mechanism.

  9. Effects of diuretics on urinary proteins.

    PubMed

    Li, Xundou

    2015-01-01

    Biomarker is the measurable change associated with a physiological or pathophysiological process. Unlike blood which has mechanisms to keep the internal environment homeostatic, urine is more likely to reflect changes of the body. As a result, urine is likely to be a better biomarker source than blood. However, since the urinary proteome is affected by many factors, including diuretics, careful evaluation of those effects is necessary if urinary proteomics is used for biomarker discovery. The human orthologs of most of these 14 proteins affected are stable in the healthy human urinary proteome, and 10 of them are reported as disease biomarkers. Thus, our results suggest that the effects of diuretics deserve more attention in future urinary protein biomarker studies. Moreover, the distinct effects of diuretics on the urinary proteome may provide clues to the mechanisms of diuretics.

  10. Urinary sodium to potassium ratio and urinary stone disease. The Gubbio Population Study Research Group.

    PubMed

    Cirillo, M; Laurenzi, M; Panarelli, W; Stamler, J

    1994-10-01

    The relation was investigated of urinary sodium to potassium ratio in first morning voided urine (spot urine) to urinary stone disease in 3,625 men and women aged 25 to 74 years participating in the baseline examination of the Gubbio Population Study. History of urinary stone disease (excretion of stone, and/or radiographic or ultrasonic evidence of urinary stone, and/or operation for urinary stone removal) was reported by 127 individuals (3.50%). Prevalence of urinary stone disease was lower in women than in men (2.59 and 4.58%, P < 0.001) and positively related to age (P < 0.001). Compared to nonstone formers, stone formers (N = 127) had higher urinary sodium to potassium ratio (P < 0.01), with similar plasma potassium and sodium concentration. In both sexes, urinary stone disease was positively related (P < 0.001) to sodium to potassium ratio: quartile analysis of this ratio showed that prevalence of stone formers in quartile 4 compared to quartile 1 was 3.33 times higher in women (P < 0.005, 95% confidence interval 1.36/8.60) and 2.71 times higher in men (P < 0.004, 95% confidence interval 1.35/5.93). In multiple logistic regression, urinary stone disease was significantly related to age, sex, and urinary sodium to potassium ratio (P < 0.01), controlled for other possible confounders, with or without exclusion of stone formers with plasma creatinine > 1.20 mg/dl. In an alternative model, with urinary sodium to potassium ratio not included, urinary stone disease was positively related to urinary sodium to creatinine ratio (P < 0.001) and weakly (P = 0.079) related inversely to urinary potassium to creatinine ratio.(ABSTRACT TRUNCATED AT 250 WORDS)

  11. 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

  12. 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.

  13. 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.

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

    PubMed

    Swaffield, J

    1995-09-01

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

  15. 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

  16. [Female urinary incontinence: An update].

    PubMed

    González-Ruiz de León, C; Pérez-Haro, M L; Jalón-Monzón, A; García-Rodríguez, J

    2017-03-16

    The urinary incontinence is a highly prevalent symptom in the adult female population. It has important psychosocial and economic connotations, and affects the quality of life of these patients. As it is an under-diagnosed problem due to patients not always consulting for it, it is very important to keep this in mind and to provide an opportunistic screening from Primary Health Care. It is difficult to determine the costs of this, but it is estimated to be the 2% of the health budget. Because of all of this, it is very important to know how to make a correct diagnose of this condition, to determine the different types of incontinence, possible causes, and treatments available. The purpose of this review is to show the different diagnostic and therapeutic tools available, to show the Primary Health Care role in this condition, and when to refer to specialist care.

  17. [Urinary tract infections and chronic renal failure].

    PubMed

    Sobotová, D

    2011-01-01

    The paper briefly summarizes issues related to urinary tract infections in adults: predispositions and risk factors, classification, assessment of pathogenicity of bacterial agents, the role of bacteriuria and leucocyturia, interpretation of findings, treatment principles and an association with chronic renal failure. Urinary tract infections are the second most frequent infectious disease in the population. They most often affect women of childbearing potential and then seniors of both sexes who have multiple risk factors. Escherichia coli and Staphylococcus saprophyticus are the most pathogenic towards urinary tract; they are responsible for 85% and 10-15% of cases of acute uncomplicated urinary infections, respectively. Chronic pyelonephritis, a chronic interstitial nephritis, is the fourth most frequent cause of chronic renal failure. Chronic renal failure is a risk factor for the development of urinary infections due to metabolic disorders resulting in secondary immunodeficiencywith a disorder of all components of immunity. In patients with chronic renal failure, urinary tract infections occur most frequently after kidney transplantation when graft pyelonephritis is a life-threatening complication. Therefore, urinary tract infection prevention with co-trimoxazole once daily over at least 6 months is recommended in renal allograft recipients.

  18. Probiotics for prevention of urinary stones

    PubMed Central

    2017-01-01

    Background Urinary supersaturation is one key determinant of calcium oxalate (CaOx) urinary stone formation, and urinary excretions of oxalate and citrate are two key determinants. Each is influenced by gastrointestinal processes. Methods Open label and randomized placebo studies have examined the effect of oral probiotic preparations on urinary supersaturation and oxalate excretion. Cross sectional studies in humans have studied the association of Oxalobacter formigenes colonization status and urinary oxalate excretion and prevalence of urinary stones. The intestinal microbiome of representative animals adapted to a high oxalate diet has been defined. Results The fecal content of O. formigenes, the best studied oxalate-degrader, varies depending on stone status. However, trials with probiotics designed to degrade oxalate including those containing O. formigenes, Lactobacillus, and/or Bifidobacterium spp., have been disappointing. Multiple intestinal segments of animals on a high oxalate diet contains diverse communities of microorganisms that can function together to degrade and detoxify a large oxalate load. Conclusions Although the intestinal microbiome seems likely to play a role to modify gastrointestinal absorption of lithogenic substances and hence urinary stone risk, whether we can develop tools to manipulate it and decrease this kidney stone risk remains to be determined. PMID:28217694

  19. Urinary proteomic analysis of chronic allograft nephropathy

    PubMed Central

    O’Riordan, Edmond; Orlova, Tatyana N.; Mendelev, Natalia; Patschan, Daniel; Kemp, Rowena; Chander, Praveen N.; Hu, Rena; Hao, Gang; Gross, Steven S.; Iozzo, Renato V.; Delaney, Veronica; Goligorsky, Michael S.

    2015-01-01

    The pathogenesis of progressive renal allograft injury, which is termed chronic allograft nephropathy (CAN), remains obscure and is currently defined by histology. Prospective protocolbiopsy trials have demonstrated that clinical and standard laboratory tests are insufficiently sensitive indicators of the development and progression of CAN. The study aim was to determine if CAN could be characterized by urinary proteomic data and identify the proteins associated with disease. The urinary proteome of 75 renal transplant recipients and 20 healthy volunteers was analyzed using surface enhanced laser desorption and ionization MS. Patients could be classified into subgroups with normal histology and Banff CAN grades 2-3 with a sensitivity of 86% and a specificity of 92% by applying the classification algorithm Adaboost to urinary proteomic data. Several urinary proteins associated with advanced CAN were identified including α1-micro-globulin, β2-micro-globulin, prealbumin, and endorepellin, the antiangiogenic C-terminal fragment of perlecan. Increased urinary endorepellin was confirmed by ELISA and increased tissue expression of the endorepellin/perlecan ratio by immunofluoresence analysis of renal biopsies. In conclusion, analysis of urinary proteomic data has further characterized the more severe CAN grades and identified urinary endorepellin, as a potential biomarker of advanced CAN. PMID:21136903

  20. Treatment strategy for urinary frequency in women.

    PubMed

    Hsieh, Ching-Hung; Su, Tsung-Hsien

    2017-01-01

    The purpose of this paper is to discuss the differential diagnosis of the underlying etiologies of urinary frequency and the treatment strategies for urinary frequency in women. Urinary frequency is a symptom, a sign, and a condition of uncertainty and of multifactorial cause. Common causes of urinary frequency include psychosocial, medical, sexual, urological, gynecologic, endocrine, and pharmacological in origin. Hence, treatment of symptoms and possible cures need a high-level plan or strategy to overcome the multifactorial etiology. Proper investigation of the chief complaint, history and physical examinations, is needed to evaluate urinary frequency. Pregnancy test, wet smear, urinalysis, midstream urine culture, frequency-volume charts, cystourethroscopy, urodynamics, and genitourinary imaging are the basic routine of office investigations. These tools promote the accuracy of the differential diagnosis of the underlying cause of urinary frequency. It is then often helpful to adopt an algorithmic approach to the management of this complaint. Treatment of urinary frequency might be empirical, and it remains a clinical challenge to gynecologists. To cure the disease, it is important to listen to the patient and consider the condition in all its aspects and use proven techniques.

  1. 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.

  2. Adjustment of urinary concentration to urinary volume in relation to erythrocyte and plasma concentrations: an evaluation of urinary heavy metals and organic substances

    SciTech Connect

    Araki, S.; Aono, H.; Murata, K.

    1986-05-01

    The effects of urinary volume on adjusted and nonadjusted urinary excretion of 11 heavy metals and organic substances were examined in relation to plasma and erythrocyte concentrations in 19 metal workers under conditions of water restriction and loading. Blood lead concentrations in these workers ranged from 25 to 59 micrograms/dl. The results indicated that: urinary volume significantly affects not only nonadjusted urinary concentration for all substances, but also affects timed excretion and concentrations adjusted to urinary specific gravity and to urinary creatinine for most substances; the concentration adjusted to urinary volume is, on the other hand, independent of urinary volume; and urinary excretion of lead and mercury is related more closely to erythrocyte concentration than to plasma concentration. This last finding reflects complex renal excretory mechanisms for these heavy metals.

  3. The female urinary microbiome: a comparison of women with and without urgency urinary incontinence.

    PubMed

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

    2014-07-08

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

  4. Urinary Tract Infections in the Older Adult.

    PubMed

    Nicolle, Lindsay E

    2016-08-01

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

  5. Obesity and female stress urinary incontinence.

    PubMed

    Osborn, David James; Strain, Matthew; Gomelsky, Alex; Rothschild, Jennifer; Dmochowski, Roger

    2013-10-01

    The purpose of this article was to review the epidemiology, pathophysiology, and treatment options for stress urinary incontinence in the obese female patient and draw conclusions regarding the optimal treatment of this condition in this unique patient population. Obesity results in increased intra-abdominal pressure and this leads to weakening of the pelvic floor innervation and musculature. Weight loss through lifestyle modification and bariatric surgery improves stress urinary incontinence. Success of stress urinary incontinence surgery in obese women is similar to nonobese patients. Obese women should not be excluded from potentially curative surgery based on their body mass index (BMI) alone.

  6. 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.

  7. The Questionnaire for Urinary Incontinence Diagnosis (QUID): Validity and Responsiveness to Change in Women Undergoing Non-Surgical Therapies for Treatment of Stress Predominant Urinary Incontinence

    PubMed Central

    Bradley, Catherine S.; Rahn, David D.; Nygaard, Ingrid E.; Barber, Matthew D.; Nager, Charles W.; Kenton, Kimberly S.; Siddiqui, Nazema Y.; Abel, Robert B.; Spino, Cathie; Richter, Holly E.

    2009-01-01

    Aims The Questionnaire for Urinary Incontinence Diagnosis (QUID), a 6-item urinary incontinence (UI) symptom questionnaire, was developed and validated to distinguish stress and urge UI. This study’s objective was to evaluate QUID validity and responsiveness when used as a clinical trial outcome measure. Methods Participants enrolled in a multi-center trial of non-surgical therapy (continence pessary, pelvic floor muscle training or combined) for stress-predominant UI completed baseline and 3-month diaries, the Urinary Distress Inventory (UDI) and QUID. Data from all treatment groups were pooled. QUID internal consistency (Cronbach’s α) and convergent/discriminant validity (Pearson correlations) were evaluated. Responsiveness to change was assessed with 3-month score outcomes and distribution-based measurements. Results 444 women (mean age 50) were enrolled with stress (N=200) and mixed (N=244) UI; 344 had 3-month data. Baseline QUID Stress and Urge scores (both scaled 0-15, larger values indicating worse UI) were 8.4 ± 3.2 and 4.5 ± 3.3, respectively. Internal consistency of QUID Total, Stress and Urge scores was 0.75, 0.64 and 0.87, respectively. QUID Stress scores correlated moderately with UDI-Stress scores (r=0.68, p<0.0001) and diary stress UI episodes (r=0.41, p<0.0001). QUID Urge scores correlated moderately with UDI-Irritative scores (r=0.68, p<0.0001) and diary urge UI episodes (r=0.45, p<0.0001). 3-month QUID Stress and Urge scores improved (4.1 ± 3.4 and 2.2 ± 2.7, both p<0.0001). QUID Stress score Effect Size (1.3) and Standardized Response Mean (1.2) suggested a large change after therapy. Conclusion The QUID has acceptable psychometric characteristics and may be used as a UI outcome measure in clinical trials. PMID:19787711

  8. [Case of urinary mycobacterium fortuitum in a patient with urinary tract tuberculosis posttreatment].

    PubMed

    Maehana, Takeshi; Takahashi, Satoshi; Hirobe, Megumi; Taguchi, Keisuke

    2008-11-01

    A 70-year-old male who complained of urinary frequency and a feeling of incomplete emptying was admitted to our hospital. Imaging findings showed dilation of the left renal pelvis and ureter. He was diagnosed as having urinary tuberculosis because a positive urinary Mycobacterium tuberculosis result was obtained by polymerase chain reaction (PCR). He was treated with a combination of the antituberculosis agents isoniazid, rifampicin, pyrazinamide and ethambutol for six months. The symptoms and pyuria disappeared and M. tuberculosis was negative by PCR; however, Mycobacterium fortuitum was isolated by culture. Due to asymptomatic urinary tract infection by the multidrug resistant M. fortuitum, he was followed up with observation. Currently, he remains unchanged with regard to symptoms and imaging examination. M. fortuitum is a nontubercular mycobacterium, and clinical relevance between urinary tract infection and M. fortuitum has rarely emerged. However, we should be aware that nontubercular mycobacteria such as M. fortuitum can infect the urinary tract, especially in immunocompromised patients.

  9. 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

  10. 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

  11. Uropontin in urinary calcium stone formation.

    PubMed

    Hoyer, J R

    1994-01-01

    Normal urine is frequently supersaturated with respect to calcium oxalate. Thus, urinary inhibitors of crystallization appear to have an important role in preventing urinary stone formation. Uropontin was isolated by monoclonal antibody immunoaffinity chromatography and has the same N-terminal sequence as osteopontin derived from bone. This urinary form of osteopontin is a potent inhibitor of calcium oxalate monohydrate crystal growth at concentrations (approximately 0.1 microM) that normally prevail in human urine. Interaction with calcium oxalate monohydrate in vivo was shown by analysis of EDTA extracts of calcium stones. Uropontin is an abundant component of calcium oxalate monohydrate stones and present in only trace quantities in calcium oxalate dihydrate and hydroxyapatite stones. However, the precise role of uropontin in the pathogenesis of urinary stone formation is not known and is the subject of ongoing investigations.

  12. Escitalopram-associated acute urinary retention.

    PubMed

    Trombetta, Dominick; Garrett, Kathleen; Harrison, Marissa

    2013-10-01

    New-onset urinary retention can typically be explained by the use of the routine normally suspected medications (e.g., anticholinergics, antihistamines). However, selective serotonin-reuptake inhibitors are not typically presumed as the cause of acute urinary retention (AUR). The following case describes the introduction of escitalopram in a patient and the subsequent development of AUR. Medical causes of urinary retention had been ruled out, and ipratropium was initially suspected to be the cause of urinary difficulties and was discontinued. However, the retention persisted four days after suspending the ipratropium. Normal micturition resumed only after stopping the escitalopram without further need for catheterization. Escitalopram may cause rare cases of AUR and may often times be overlooked possibly because of the paucity of reporting.

  13. 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.

  14. Urinary Tract Infections (UTIs) in Children

    MedlinePlus

    ... end of the penis in boys and in front of the vagina in girls. Front view of the urinary tract Side view of ... some children are more prone to getting coughs, colds, or ear infections. Who gets UTIs? Any child ...

  15. Kidneys and Urinary Tract (For Parents)

    MedlinePlus

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

  16. Primary liquid intake and urinary stone disease.

    PubMed

    Shuster, J; Finlayson, B; Scheaffer, R L; Sierakowski, R; Zoltek, J; Dzegede, S

    1985-01-01

    This investigation indicates that there are important associations between urinary stone disease and a person's primary liquid intake. Based on data collected from 2295 caucasian male patients from two geographical regions, the Carolinas (both North and South) and the Rockies (including Colorado, Idaho, Nevada, Montana, Utah and Wyoming) an important (p less than 0.01) positive association was found between urinary stone disease and soda (carbonated beverage) consumption within both geographical regions. It was also found that negative associations exist between urinary stone disease and both beer consumption and coffee consumption in the Rockies and that no important associations exist between urinary stone disease and any of milk, water, or tea, when these beverages represent a person's primary liquid intake. Moreover, soda can be viewed almost synonymously as sugared cola, since few subjects had diet sodas or sugared non-cola soda as primary fluid. No cause/effect relationships are implied in this paper.

  17. Urinary incontinence products - self-care

    MedlinePlus

    ... sores. You have signs of infection (a burning sensation when you urinate, fever, or chills). Alternate Names Adult diapers; Disposable urinary collection devices References Mendez-Probst CE, Razvi H, Denstedt JD. Fundamental ...

  18. Urinary tract infections in surgical patients.

    PubMed

    Ramanathan, Rajesh; Duane, Therese M

    2014-12-01

    Catheter-associated urinary tract infections (CAUTI) are common in surgical patients. CAUTI are associated with adverse patient outcomes, and negatively affects public safety reporting and reimbursement. Inappropriate catheter use and prolonged catheter duration are major risk factors for CAUTI. CAUTI pathogenesis and treatment are complicated by the presence of biofilms. Prevention strategies include accurate identification and tracking of CAUTIs, and the development of institutional guidelines for the appropriate use, duration, alternatives, and removal of indwelling urinary catheters.

  19. [Imaging in urinary tract infections in adults].

    PubMed

    Puech, P; Lagard, D; Leroy, C; Dracon, M; Biserte, J; Lemaître, L

    2004-02-01

    Uncomplicated infection of the urinary tract is frequent and usually resolves rapidly with treatment and imaging is unnecessary. Progression to complex infection often occurs in patients with predisposing factors. Imaging assists in evaluating the extent of disease, plays a role in directing therapy and guides interventional procedures if necessary. This pictorial essay reviews the role of imaging and intervention in infections of the urinary tract.

  20. Chronic epididymitis with scrotal vasocutaneous urinary fistula.

    PubMed

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

    2013-05-01

    Chronic Epididymitis is a relatively rare problem in boys and is often enigmatic in its etiology. It is often associated with urinary tract abnormalities in infants and prepubertal children. This report describes a rare and unusual case of a chronic epididymitis with acquired scrotal vasocutaneous urinary fistula in an 8-mo-old boy who was found to have a large prostatic utricular cyst and ectopic vas insertion. The authors discuss embryology, pathophysiology, diagnostic dilemma and different treatment options.

  1. [Mechanisms of urinary tract sterility maintenance].

    PubMed

    Okrągła, Emilia; Szychowska, Katarzyna; Wolska, Lidia

    2014-06-02

    Physiologically, urine and the urinary tract are maintained sterile because of physical and chemical properties of urine and the innate immune system's action. The urinary tract is constantly exposed to the invasion of microorganisms from the exterior environment, also because of the anatomical placement of the urethra, in the vicinity of the rectum. Particularly vulnerable to urinary tract infections (UTI) are women (an additional risk factor is pregnancy), but also the elderly and children. The main pathogens causing UTI are bacteria; in 70-95% of cases it is the bacterium Escherichia coli. Infections caused by viruses and fungi are less common and are associated with decreased immunity, pharmacotherapy, or some diseases. Bacteria have evolved a number of factors that facilitate the colonization of the urinary tract: the cover and cell membrane antigens O and K1, lipopolysaccharide (LPS), fimbriae, pile and cilia. On the other hand, the human organism has evolved mechanisms to hinder colonization of the urinary tract: mechanisms arising from the anatomical structure of the urinary tract, the physicochemical properties of the urine and the activity of the innate immune system, also known as non-specific, which isolates and destroys pathogens using immunological processes, and the mechanisms for release of antimicrobial substances such as Tamm-Horsfall protein, mucopolysaccharides, immunoglobulins IgA and IgG, lactoferrin, lipocalin, neutrophils, cytokines and antimicrobial peptides. This review aims to analyze the state of knowledge on the mechanisms to maintain the sterility of the urinary tract used by the human organism and bacterial virulence factors to facilitate the colonization of the urinary tract.

  2. Urinary tract infection and hyperbilirubinemia.

    PubMed

    Bilgen, Hülya; Ozek, Eren; Unver, Tamer; Biyikli, Neşe; Alpay, Harika; Cebeci, Dilşat

    2006-01-01

    The aim of this study was to evaluate the incidence of urinary tract infection (UTI) in newborns with asymptomatic, unexplained indirect hyperbilirubinemia in the first two weeks of life. Jaundiced infants, otherwise clinically well, less than two weeks of ages, with a total bilirubin level above 15 mg/dl were eligible for the study. A bilirubin work-up including glucose-6-phosphate dehydrogenase (G-6 PD) level, as well as urinalysis and a urine culture were performed in all patients. Patients with UTI, defined as more than 10,000 colony-forming units per milliliter of a single pathogen obtained by bladder catheterization, were evaluated for sepsis. Renal function tests and renal ultrasound were performed in cases with UTI. During follow-up, voiding cystourethrogram (VCUG) and dimercaptosuccinic acid scintigraphy (DMSA) were performed as well. A total of 102 patients were enrolled. The bilirubin work-up of patients did not demonstrate any significant underlying disorder. None of the infants had a high direct bilirubin level. UTI was diagnosed in eight (8%) cases [Enterobacter aerogenes (3/8:38%), Enterococcus faecalis (2/8:25%), Klebsiella pneumoniae (2/8:25%) and Escherichia coli (1/8:12%)]. Of those eight patients, only four (50%) had pyuria. Bacteriuria was present in seven (88%) patients. The sepsis screen was negative in all but one case with a high C-reactive protein (CRP) level. None of the patients had a positive blood culture. Renal function tests were within normal levels in all patients. Renal ultrasound showed urinary tract abnormalities in three (38%) patients (hydronephrosis, n=1 and pelviectasis, n=2). VCUG was performed in all patients during the study period and one had unilateral grade 3-4 reflux, while only one patient had a diverticulum of the bladder. DMSA was performed in seven patients and none had renal scars. It is of importance that UTI can occur in asymptomatic, jaundiced infants even in the first week of life. Although it is well known

  3. [Urinary tract infection in pregnancy].

    PubMed

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

    2008-02-01

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

  4. High Chance of Late Recovery of Urinary and Erectile Function Beyond 12 Months After Radical Prostatectomy.

    PubMed

    Mandel, Philipp; Preisser, Felix; Graefen, Markus; Steuber, Thomas; Salomon, Georg; Haese, Alexander; Michl, Uwe; Huland, Hartwig; Tilki, Derya

    2016-10-12

    Urinary incontinence (UI) and erectile dysfunction (ED) after radical prostatectomy (RP) can impose a strong burden. While most studies focus on certain time points after RP when analyzing functional outcome, there is paucity of evidence on late functional recovery in patients with UI or ED at 12 mo after RP. Using longitudinal patient data from a large European single-center, we show that the chance of regaining continence among patients (n=974) with UI (≥1 pad/24h) at 12 mo after RP was 38.6% after 24 mo and 49.7% after 36 mo. The corresponding rates for patients (n=1115) with ED (defined as International Index of Erectile Function-5 score <18) at 12 mo after RP were 30.8% at 24 mo and 36.5% at 36 mo after RP. Patients with postoperative UI or ED 12 mo after RP should be counseled about their good chance of achieving continence or potency in the course of time.

  5. Congenital anomalies of the urinary tract.

    PubMed

    Pohl, Hans G; Belman, A Barry

    2014-01-01

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

  6. 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.

  7. An integrative review of standardized clinical evaluation tool utilization in anticholinergic drug trials for neurogenic lower urinary tract dysfunction

    PubMed Central

    Stothers, L; Tsang, B; Nigro, M; Lazare, D; Macnab, A

    2016-01-01

    Study design: To review prospective and randomized trials studying anticholinergic therapy for neurogenic bladder in SCI to identify whether trials included standardized clinical evaluation tools and reporting measures now recognized to enhance clinical trial data. Methods: A systematic search via EMBASE, MEDLINE, CENTRAL, CINAHL (Cumulative Index to Nursing and Allied Health Literature), HTA (Health Technology Assessment), CMR (Comprehensive Microbial Resource), HAPI (Health and Psychosocial Instruments) and PsycINFO using the key term spinal cord injury crossed with oxybutynin, tolterodine, darifenacin, solifenacin, fesoterodine, trospium chloride, propiverine, propantheline and anticholinergic(s) for 1946–2015 inclusive. We then collated whether standardized clinical tools, measures and descriptors were used within each study identified: American Spine Injury Association (ASIA) impairment scale; symptom scores validated in SCI; technical methodology for urodynamics/video urodynamics; urinary diaries; and standardized urologic terminology. Results: A total of 1225 entries with 610 unique articles were identified, 14 randomized and 16 prospective studies. In 6/30 the population comprised SCI patients with neurogenic bladder alone; the remainder included mixed neurogenic etiologies. Classification using the ASIA impairment scale was used in <10% of studies; none used symptom scores validated in SCI; <50% reported urodynamic test methodology fully, incorporated urinary diaries or used International Continence Society Standardization Subcommittee urinary tract terminology. Conclusion: Integrative review of trials from 1946 to 2015 identified infrequent use of standardized clinical evaluation tools and reporting measures. Data from future trials evaluating therapies for neurogenic bladder would likely be more applicable to specific SCI patients if current standardized classification and descriptors now available were used consistently: for example, the ASIA scale

  8. Adenocarcinoma of the urinary bladder.

    PubMed

    Dadhania, Vipulkumar; Czerniak, Bogdan; Guo, Charles C

    2015-01-01

    Adenocarcinoma is an uncommon malignancy in the urinary bladder which may arise primarily in the bladder as well as secondarily from a number of other organs. Our aim is to provide updated information on primary and secondary bladder adenocarcinomas, with focus on pathologic features, differential diagnosis, and clinical relevance. Primary bladder adenocarcinoma exhibits several different growth patterns, including enteric, mucinous, signet-ring cell, not otherwise specified, and mixed patterns. Urachal adenocarcinoma demonstrates similar histologic features but it can be distinguished from bladder adenocarcinoma on careful pathologic examination. Secondary bladder adenocarcinomas may arise from the colorectum, prostate, endometrium, cervix and other sites. Immunohistochemical study is valuable in identifying the origin of secondary adenocarcinomas. Noninvasive neoplastic glandular lesions, adenocarcinoma in situ and villous adenoma, are frequently associated with bladder adenocarcinoma. It is also important to differentiate bladder adenocarcinoma from a number of nonneoplastic lesions in the bladder. Primary bladder adenocarcinoma has a poor prognosis largely because it is usually diagnosed at an advanced stage. Urachal adenocarcinoma shares similar histologic features with bladder adenocarcinoma, but it has a more favorable prognosis than bladder adenocarcinoma, partly due to the relative young age of patients with urachal adenocarcinoma.

  9. Adenocarcinoma of the urinary bladder

    PubMed Central

    Dadhania, Vipulkumar; Czerniak, Bogdan; Guo, Charles C

    2015-01-01

    Adenocarcinoma is an uncommon malignancy in the urinary bladder which may arise primarily in the bladder as well as secondarily from a number of other organs. Our aim is to provide updated information on primary and secondary bladder adenocarcinomas, with focus on pathologic features, differential diagnosis, and clinical relevance. Primary bladder adenocarcinoma exhibits several different growth patterns, including enteric, mucinous, signet-ring cell, not otherwise specified, and mixed patterns. Urachal adenocarcinoma demonstrates similar histologic features but it can be distinguished from bladder adenocarcinoma on careful pathologic examination. Secondary bladder adenocarcinomas may arise from the colorectum, prostate, endometrium, cervix and other sites. Immunohistochemical study is valuable in identifying the origin of secondary adenocarcinomas. Noninvasive neoplastic glandular lesions, adenocarcinoma in situ and villous adenoma, are frequently associated with bladder adenocarcinoma. It is also important to differentiate bladder adenocarcinoma from a number of nonneoplastic lesions in the bladder. Primary bladder adenocarcinoma has a poor prognosis largely because it is usually diagnosed at an advanced stage. Urachal adenocarcinoma shares similar histologic features with bladder adenocarcinoma, but it has a more favorable prognosis than bladder adenocarcinoma, partly due to the relative young age of patients with urachal adenocarcinoma. PMID:26309895

  10. Management of urinary tract infections.

    PubMed

    Nassar, N T

    2000-01-01

    Urinary tract infections (UTIs) are commonly encountered in medical practice and range from asymptomatic bacteruria to acute pyelonephritis. Enterobacteriaceae with E. coli being the most prevalent, are responsible for most commonly acquired uncomplicated UTIs and usually respond promptly to oral antibiotics. In contradistinction, more resistant pathogens cause nosocomially acquired infections which often require parenteral antibiotic therapy. Patients with acute bacterial prostatitis, usually caused by Enterobacteriaceae present with a tender prostate gland and respond promptly to antibiotic therapy. Chronic bacterial prostatitis on the other hand, is a subacute infection characterized by recurrent episodes of bacterial UTI where the patient presents with vague symptoms of pelvic pain and voiding problems. Treatment is protracted and may be frustrating. Nonbacterial prostatitis and chronic pelvic pain syndrome produce symptoms similar to those of chronic bacterial prostatitis. Treatment is not well defined due to their uncertain etiologies. Most episodes of catheter associated bacteruria are asymptomatic, where less than 5% will be complicated by bacteremia. The use of systemic antibiotics for treatment or prevention of bacteruria is not recommended, particularly in the geriatric age group, since it helps select for resistant organisms. Prevention thus remains the best option to control it. Few patients without catheters who have asymptomatic bacteruria develop serious complications and therefore routine antimicrobial therapy is not justified with only two exceptions : before urologic surgery and during pregnancy.

  11. Metabolic Consequences after Urinary Diversion

    PubMed Central

    Stein, Raimund; Rubenwolf, Peter

    2014-01-01

    Metabolic disturbances are well-known, but sometimes neglected immediate consequences or late sequelae following urinary diversion (UD) using bowel segments. Whereas subclinical disturbances appear to be quite common, clinically relevant metabolic complications, however, are rare. Exclusion of bowel segments for UD results in loss of absorptive surface for its physiological function. Previous studies demonstrated that at least some of the absorptive and secreting properties of the bowel are preserved when exposed to urine. For each bowel segment typical consequences and complications have been reported. The use of ileal and/or colonic segments may result in hyperchloremic metabolic acidosis, which can be prevented if prophylactic treatment with alkali supplementation is started early. The resection of ileal segments may be responsible for malabsorption of vitamin B12 and bile acids with subsequent neurological and hematological late sequelae as well as potential worsening of the patient’s bowel habits. Hence, careful patient and procedure selection, meticulous long-term follow-up, and prophylactic treatment of subclinical acidosis is of paramount importance in the prevention of true metabolic complications. PMID:24653981

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

    EPA Science Inventory

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

  13. DMA Support to a Unified Geodetic Datum for the African Continent

    DTIC Science & Technology

    1981-11-01

    The third major geodetic arc is in the northern part of the continent. It joins Marrakech to Alexandria. This North African Arc encompasses the...African geodetic chains. One, in the northwest, extends about 14 degrees between Dakar and Marrakech through Mauritania and Western Sahara. A second

  14. 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)

  15. 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…

  16. 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…

  17. 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.

  18. 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.

  19. 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…

  20. 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…

  1. 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

  2. Continents and Oceans: Determining the Knowledge Level of Selected Preservice Teachers.

    ERIC Educational Resources Information Center

    Roach, Patricia B.; And Others

    This study provides insight into the basic skills level of geographic place of a selected sample of elementary (N=104) and secondary (N=50) preservice teachers. The data indicate a limited ability of the sample to recall correctly the names and identify the location of continents and oceans. Although the scores of secondary and elementary…

  3. 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.

  4. 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)

  5. The North American Cordillera - an Impediment to Growing the Continent-wide Laurentide Ice Sheet

    NASA Astrophysics Data System (ADS)

    Löfverström, M.; Liakka, J.; Kleman, J.

    2015-12-01

    Much effort has been devoted to understanding the climate of the Last Glacial Maximum (LGM) when the continent-wide Laurentide Ice Sheet resided in North America. It has been established, however, that the massive LGM ice sheet was a relatively short lasting (5-15 kyrs) "glacial extreme", and the longer build-up phase (around 75-85 kyrs in length) was dominated by an east-heavy ice configuration and largely ice-free conditions in the interior of the continent. The present study aims to investigate whether first-order (large scale) interactions between the atmosphere and ice sheets can explain the asymmetric ice evolution and the limited glaciation of the continental interior in the larger part of the last glacial cycle. Simulations are conducted using a comprehensive atmospheric circulation model asynchronously coupled to an ice-sheet model. The atmospheric state is updated for every 2×106 km3 increase in ice volume and the coupled model is integrated to steady state. We resort to a simplified model setup, using a triangular representation of North America, with and without the influence of the Cordilleran region, in order to isolate the influence of the mountain range on the ice sheet evolution. In the first experiment we use a flat continent with no background topography. The ice sheet evolves fairly zonally symmetric and the equilibrium ice sheet is continent wide and has the highest point in the center of the continent. In the second experiment we include a simplified representation of the Cordilleran region. The ice sheet's equilibrium state is here structurally different from the flat continent case; the center of mass is strongly shifted to the east and the interior of the continent remains ice-free - an outline resembling the geologically determined pre-LGM state. The ice sheet induces both mechanically and thermally forced stationary waves that result in a reduced cloudiness and hence an increased downwelling of radiation at the surface. This yields

  6. 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.

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

    PubMed

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

    1979-06-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2000-04-01

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

  10. [Persistent urinary infection in children after antireflux ureterovesical reimplantation in primary vesicorenal reflux].

    PubMed

    Viville, C; Lehmann, J M

    1986-01-01

    This study is the outcome of the analysis of 200 cases and concentrates solely on successful antireflux operations (i.e. with neither stenosis nor persistent reflux) performed on primary refluxes, 54 children, all of them being females, have retained refractory postoperative urinary infections. Of these cases, 24 cases (12%) have not been cured yet. In these postoperative infections, some factors play probably no part: the magnitude of the preoperative reflux, the existence of pyelonephritic lesions, the type of germ. However the fact of being female, the age (over 6), the duration of the preoperative infection and, above all, the existence of predominantly vesical symptomatology (frequency, voiding pain, and continence problems such as imperiousness, diurnal incontinence, enuresis) are basic factors. This makes it possible to compose the model of the child that will come up with a rebellious postoperative urinary infection. For these children, suppressing the reflux is only part of the treatment. It will have to be curried on by treating the vesical instability by drugs, vesical reeducation and even psychotherapy. On hand of these observations, one may question the classification of refluxes: do all of them really come under the name of "primary" refluxes?

  11. Cranberry and urinary tract infections.

    PubMed

    Guay, David R P

    2009-01-01

    Urinary tract infection (UTI) refers to the presence of clinical signs and symptoms arising from the genitourinary tract plus the presence of one or more micro-organisms in the urine exceeding a threshold value for significance (ranges from 102 to 103 colony-forming units/mL). Infections are localized to the bladder (cystitis), renal parenchyma (pyelonephritis) or prostate (acute or chronic bacterial prostatitis). Single UTI episodes are very common, especially in adult women where there is a 50-fold predominance compared with adult men. In addition, recurrent UTIs are also common, occurring in up to one-third of women after first-episode UTIs. Recurrences requiring intervention are usually defined as two or more episodes over 6 months or three or more episodes over 1 year (this definition applies only to young women with acute uncomplicated UTIs). A cornerstone of prevention of UTI recurrence has been the use of low-dose once-daily or post-coital antimicrobials; however, much interest has surrounded non-antimicrobial-based approaches undergoing investigation such as use of probiotics, vaccines, oligosaccharide inhibitors of bacterial adherence and colonization, and bacterial interference with immunoreactive extracts of Escherichia coli. Local (intravaginal) estrogen therapy has had mixed results to date. Cranberry products in a variety of formulations have also undergone extensive evaluation over several decades in the management of UTIs. At present, there is no evidence that cranberry can be used to treat UTIs. Hence, the focus has been on its use as a preventative strategy. Cranberry has been effective in vitro and in vivo in animals for the prevention of UTI. Cranberry appears to work by inhibiting the adhesion of type I and P-fimbriated uropathogens (e.g. uropathogenic E. coli) to the uroepithelium, thus impairing colonization and subsequent infection. The isolation of the component(s) of cranberry with this activity has been a daunting task, considering the

  12. A detrital record of continent-continent collision in the Early-Middle Jurassic foreland sequence in the northern Yangtze foreland basin, South China

    NASA Astrophysics Data System (ADS)

    Qian, Tao; Liu, Shaofeng; Wang, Zongxiu; Li, Wangpeng; Chen, Xinlu

    2016-12-01

    The Mesozoic northern Yangtze foreland basin system was formed by continental collision between the North China and South China plates along the Mianlue suture. Synorogenic stratigraphic sequences of Late Triassic to Early-Middle Jurassic age were developed in the northern Yangtze foreland basin. The upper Middle Jurassic Shaximiao Formation consists mainly of thick-bedded terrestrial successions that serve as the main body of the basin-filling sequences, suggesting intense tectonism in the peripheral orogeny of the foreland basin. Laser-ICP-MS U-Pb analysis of 254 detrital zircon grains from sandstone samples and several published Lower-Middle Jurassic samples, detrital compositions, petrofacies, and paleocurrent reconstructions in the northern Yangtze foreland basin indicate that discrete source areas included the Qinling-Dabieshan ranges and the Mianlue suture zone to the north, and the South China plate to the south. The stratigraphic succession and sediment provenance of the foreland basin imply that the early Mianlue oceanic basin, magmatic arc, and nonmarine molasse foreland basin during the period of deposition were modified or buried by the subsequent continent-continent collision between the North China-Qinling-Dabieshan plate and the Yangtze plate during the Jurassic, which followed the oblique amalgamation between these plates during the Middle-Late Triassic.

  13. 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.

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

    PubMed Central

    Michel, Martin C; Vrydag, Wim

    2006-01-01

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

  15. Urinary incontinence: is cesarean delivery protective?

    PubMed

    Nygaard, Ingrid

    2006-10-01

    About half of all women develop transient urinary incontinence during pregnancy. Three months postpartum, the prevalence and incidence rates of urinary incontinence are 9% to 31% and 7% to 15%, respectively. Antenatal incontinence increases the risk of postpartum incontinence, which in turn increases the risk of long-term persistent incontinence. After the first delivery, women delivered vaginally have two-fold more incontinence than those delivered by cesarean. The protective effect of cesarean on urinary incontinence may dissipate after further deliveries, decreases with age, and is not present in older women. Data are mixed about whether cesarean done before labor confers greater protection than cesarean done after labor. To understand the true impact of cesarean delivery on urinary incontinence, future studies must compare incontinence by planned (not actual) delivery modes, consider a woman's entire reproductive career, focus on leakage severe enough to be problematic, consider other bladder symptoms as well as incontinence, and take into account other risk factors, particularly antepartum urinary incontinence.

  16. 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

  17. [Urinary tract infections in the elderly].

    PubMed

    Becher, Klaus Friedrich; Klempien, Ingo; Wiedemann, Andreas

    2015-10-01

    Acute infection of the urinary tract is one of the most commonly encountered bacterial infections in the frail elderly population and is responsible for substantial morbidity and recurrent infections with antibiotic resistance. Although generally considered to be self-limiting without treatment or easily treated with a short antibiotic regime, urinary tract infections (UTIs) often have a dramatic history, associated with incomplete resolution and frequent recurrence. The biological complexity of the infections combined with a dramatic rise in antibiotic-resistant pathogens highlight the need for an anticipating strategy for therapy necessary for a rapid recovery. The first crucial step is the classification in asymptomatic bacteriuria or complicated pyelonephritis, on which the decision for the intensity of treatment and diagnostic effort is based. For the selection of empiric antibiotic therapy, knowledge about the predominant uropathogens as well as local resistance patterns is important. In this manner, most urinary tract infections in the elderly can be treated without greater expense.

  18. Mathematical modelling of the lower urinary tract.

    PubMed

    Paya, Antonio Soriano; Fernandez, Daniel Ruiz; Gil, David; Garcia Chamizo, Juan Manuel; Perez, Francisco Macia

    2013-03-01

    The lower urinary tract is one of the most complex biological systems of the human body as it involved hydrodynamic properties of urine and muscle. Moreover, its complexity is increased to be managed by voluntary and involuntary neural systems. In this paper, a mathematical model of the lower urinary tract it is proposed as a preliminary study to better understand its functioning. Furthermore, another goal of that mathematical model proposal is to provide a basis for developing artificial control systems. Lower urinary tract is comprised of two interacting systems: the mechanical system and the neural regulator. The latter has the function of controlling the mechanical system to perform the voiding process. The results of the tests reproduce experimental data with high degree of accuracy. Also, these results indicate that simulations not only with healthy patients but also of patients with dysfunctions with neurological etiology present urodynamic curves very similar to those obtained in clinical studies.

  19. New drug treatments for urinary incontinence.

    PubMed

    Robinson, Dudley; Cardozo, Linda

    2010-04-01

    Urinary incontinence remains a common and distressing condition affecting many women and is known to have a significant effect on quality of life (QoL). Whilst conservative and behavioural therapy are important in the management of women with both stress incontinence and overactive bladder (OAB) ultimately many may benefit from pharmacological therapy. Antimuscarinic drugs are the commonly used agents in the treatment of OAB although often compliance and persistence are affected by adverse effects. Consequently many newer agents remain under investigation. In addition duloxetine has recently been introduced for the management of women with stress incontinence and may offer an alternative to surgery in selected cases. The aim of this review is to provide an overview of the current and new developments in the management of women with urinary incontinence as well as reviewing the role of oestrogen therapy in relation to lower urinary tract dysfunction.

  20. [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.

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

    PubMed

    Negro, Carlo L A; Muir, Gordon H

    2012-12-01

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

  2. [Therapy for urinary incontinence in general practice].

    PubMed

    Wiedemann, A; Füsgen, I

    2009-08-01

    In national and international guidelines the general practitioner plays an important role in the diagnosis and first-line therapy for urinary incontinence. Nevertheless, there is a lack of data concerning details of the management of incontinence in primary care in Germany. Therefore a series of nationwide educational events for general practitioners and gynaecologists was used to perform a survey dealing with the situation of urinary incontinence in general practice. With 2530 questionnaires filled out and returned, this is the largest European survey on this subject. General practitioners declare in 57.3 % to be often involved with urinary incontinence. They usually question elderly patients about urinary incontinence (73.7 %) or those patients with diseases carrying the risk of developing urinary incontinence (64.9 %). Based on the diagnostic options in primary care, an incontinence anamnesis and urine evaluation are performed. A sonography or micturition diary was more infrequent in primary care in this survey. General practitioners most frequent refer the patient to a specialist (76.6 %) or prescribe the incontinence-type anticholinergic drugs (59.4 %) or absorbent products (45.4 %); duloxetine (27.3 %) is less frequently prescribed. The knowledge about urinary incontinence is gained in educational events (72.2 %); the course of studies was the source of incontinence skills for general practitioners only in 35 %. In conclusion, this survey gives a realistic view on the incontinence management in primary care in Germany. The majority of general practitioners are engaged in incontinence, perform basic diagnostic features and prescribe drugs or absorbent products. The course of (university medical school) studies as a source of skills to diagnose or to treat incontinence should be improved.

  3. Regulation of urinary thromboxane B2 in man: influence of urinary flow rate and tubular transport

    SciTech Connect

    Zipser, R.D.; Smorlesi, C.

    1984-02-01

    Thromboxane B2 (TxB) is excreted in human urine, but the mechanism of renal excretion and the quantitative relationship of urinary TxB to the active parent compound, thromboxane A2, of renal or extrarenal origin is not established. To determine the effects of vasoactive hormones, uricosuric agents and urinary flow rate on TxB excretion, urinary TxB was measured by radioimmunoassay and mass spectrometry, and renal metabolism of blood TxB was determined by radiochromatography of urine after i.v. (3H)-TxB infusions. Basal TxB was 6.7 +/- 1.1 ng/h during an oral water load, and TxB fell with s.g. antidiuretic hormone (to 3.4 +/- 0.4 ng/h, P less than 0.01) and with fluid restriction (to 2.6 +/- 0.5 ng/hr, P . 0.001) in parallel with urinary volume. Urinary excretion of unmetabolized (3H)-TxB also fell (by 56%) with fluid restriction, implicating altered metabolism rather than synthesis as the mechanism of the urinary flow effect. Angiotensin II infusions slightly reduced both TxB and urine volume, consistent with a flow effect. In contrast, probenecid did not alter urine volume, but increased urinary uric acid (by 244%), TxB (from 5.6 +/- 0.9 to 11.1 +/- 2.9 ng/h) and urinary excretion of blood (3H)-TxB (by 243%) by similar amounts (all P less than 0.05), suggesting that TxB is actively reabsorbed in the proximal tubule, similarly to uric acid. Thus, urinary excretion of TxB of renal and extrarenal origin is regulated by proximal and distal tubule factors.

  4. 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

  5. Female Epispadias Presenting as Urinary Incontinence

    PubMed Central

    Popovic, Nusret; Zvizdic, Zlatan; Milišic, Emir; Karavdic, Kenan; Paddy, Dewan

    2017-01-01

    Isolated female epispadias without bladder exstrophy is a rare congenital anomaly affecting 1 in 484,000 females. The presenting features of female epispadias are urinary incontinence and abnormal anatomical features. A 6-year-old girl presented with primary urinary incontinence who on physical examination had a bifid clitoris and labia minora. The vagina and hymen were normal. Voiding cystourethrogram showed no reflux and a funnel shaped proximal urethra. With the diagnosis of isolated female epispadias, one-stage reconstruction of the urethra, bladder neck, labia minora and clitoris was performed.

  6. Female Epispadias Presenting as Urinary Incontinence.

    PubMed

    Jonuzi, Asmir; Popovic, Nusret; Zvizdic, Zlatan; Milišic, Emir; Karavdic, Kenan; Paddy, Dewan

    2017-01-01

    Isolated female epispadias without bladder exstrophy is a rare congenital anomaly affecting 1 in 484,000 females. The presenting features of female epispadias are urinary incontinence and abnormal anatomical features. A 6-year-old girl presented with primary urinary incontinence who on physical examination had a bifid clitoris and labia minora. The vagina and hymen were normal. Voiding cystourethrogram showed no reflux and a funnel shaped proximal urethra. With the diagnosis of isolated female epispadias, one-stage reconstruction of the urethra, bladder neck, labia minora and clitoris was performed.

  7. Ultrasonography of bovine urinary tract disorders.

    PubMed

    Floeck, Martina

    2009-11-01

    Ultrasonography is a helpful diagnostic tool in cattle with urinary tract disorders. It can be used to diagnose pyelonephritis, urolithiasis, hydronephrosis, renal cysts, renal tumors, amyloidosis, cystitis, bladder paralysis, bladder rupture, bladder neoplasms, and, occasionally, nephrosis, glomerulonephritis, and embolic nephritis. This article describes the anatomy, scanning technique, indications, limitations, normal and pathologic sonographic appearance of the bovine urinary tract. References from horses and humans are included, especially when the sonographic findings in these species may complement the understanding of similar diseases reported in cattle.

  8. Urinary tract infection in kidney transplant recipients.

    PubMed

    Chacón-Mora, Natalia; Pachón Díaz, Jerónimo; Cordero Matía, Elisa

    2016-04-21

    Infectious complications remain a major cause of morbidity and mortality among transplant recipients. Urinary tract infection (UTI) is the most common infectious complication in kidney transplant recipients with a reported incidence from 25% to 75%, varies widely likely due to differences in definition, diagnostic criteria, study design, and length of observation. We sought reviews the incidence and importance of urinary tract infection on graft survival, the microbiology with special emphasis on multidrug resistant microorganisms, the therapeutic management of UTI and the prophylaxis of recurrent UTI among solid organ transplant recipients, highlighting the need for prospective clinical trials to unify the clinical management in this population.

  9. Fungal infections of the urinary tract.

    PubMed

    Sobel, J D; Vazquez, J A

    1999-12-01

    Funguria, fungal urinary tract infections, are most commonly caused by Candida species but may also be caused by Cryptococcus neoformans, Aspergillus species, and the endemic mycoses. Candiduria presents as an increasingly common nosocomial infection, which may involve all anatomic levels of the urinary tract, resulting in a spectrum of disease varying from asymptomatic candiduria to clinical sepsis. Although several successful systemic or local therapeutic options exist for the eradication of candiduria, knowledge of the pathogenesis and natural history of candiduria has lagged. This has resulted in confusion among practitioners as to when antifungal therapy is indicated. Treatment guidelines have recently been formulated and are described herein.

  10. 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

  11. 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.

  12. Urinary Tract Infection and Bacteriuria in Pregnancy.

    PubMed

    Glaser, Alexander P; Schaeffer, Anthony J

    2015-11-01

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

  13. Urinary tract infection by chromobacterium violaceum.

    PubMed

    Swain, Bichitrananda; Otta, Sarita; Sahu, Kundan Kumar; Panda, Kirtika; Rout, Subhrajita

    2014-08-01

    Chromobacterium violaceum, a facultative anaerobic proteobacterium, is particularly isolated from water and soil in tropical areas and has been implicated in few infections like septicemia, visceral abscesses, skin and soft tissue infections, meningitis and diarrhea. But urinary tract infection caused by it is very rare. Limited awareness about this pathogen and inappropriate antibiotic therapy contribute to a high mortality rate. Here, we describe an unusual case of urinary tract infection by Chromobacterium violaceum in a young immuno-competent male which was managed aggressively with proper antibiotics as per the culture sensitivity report.

  14. Staying the Course: Vital U.S. Interests on the African Continent

    DTIC Science & Technology

    2012-03-13

    non-governmental organizations focusing on health care , education, and other projects important to local communities and in support of U.S. Embassy...the nations with the weakest governance, struggling 4 economies, the least infrastructure and the poorest ability to care for their population and...continent. They include the very successful 2010 World Cup Soccer competition in South Africa and the fact Ghana is now on track to be the first country in

  15. 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.

  16. [Urodynamics of upper urinary tracts after intestinal plastic surgery on urinary bladder (experimental study)].

    PubMed

    Loran, O B; Mudraia, I S; David'iants, A A; Zaĭtsev, A V

    1999-01-01

    In dog experiments, the urinary bladder was replaced for an isolated intestinal segment to test upper urinary tract function as regards configuration of the established urine reservoir early and late after the surgery. Intestinal plastic surgery of the bladder changes parameters of ureteral function in unchanged potential reserve of ureteral contraction. Postileocystoplasty urodynamics of the upper urinary tracts is characterized by lowering of intraureteral pressure, decreased amplitude of ureteral contractions, enhanced tonicity and motility. Plastic replacement of the bladder with isolated intestinal segment is not contraindicated in the solitary kidney.

  17. 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

  18. 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

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

    NASA Astrophysics Data System (ADS)

    Llovel, W.; Lee, T.

    2014-12-01

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

  20. 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.

  1. Persistent shift of the Arctic polar vortex towards the Eurasian continent in recent decades

    NASA Astrophysics Data System (ADS)

    Zhang, Jiankai; Tian, Wenshou; Chipperfield, Martyn P.; Xie, Fei; Huang, Jinlong

    2016-12-01

    The wintertime Arctic stratospheric polar vortex has weakened over the past three decades, and consequently cold surface air from high latitudes is now more likely to move into the middle latitudes. However, it is not known if the location of the polar vortex has also experienced a persistent change in response to Arctic climate change and whether any changes in the vortex position have implications for the climate system. Here, through the analysis of various data sets and model simulations, we show that the Arctic polar vortex shifted persistently towards the Eurasian continent and away from North America in February over the past three decades. This shift is found to be closely related to the enhanced zonal wavenumber-1 waves in response to Arctic sea-ice loss, particularly over the Barents-Kara seas (BKS). Increased snow cover over the Eurasian continent may also have contributed to the shift. Our analysis reveals that the vortex shift induces cooling over some parts of the Eurasian continent and North America which partly offsets the tropospheric climate warming there in the past three decades. The potential vortex shift in response to persistent sea-ice loss in the future, and its associated climatic impact, deserve attention to better constrain future climate changes.

  2. 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

  3. 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.

  4. 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.

  5. Dimensions of continents and oceans - water has carved a perfect cistern

    NASA Astrophysics Data System (ADS)

    Whitehead, John A.

    2016-11-01

    The ocean basins have almost exactly the correct surface area and average depth to hold Earth's water. Two processes are responsible for this. First, Earth's continental crust is thinned by erosion so that average elevation is a few hundred meters above sea level. Second, the crust is thickened by lateral compression from mountain formation and sediments and water lost in subduction is resupplied at least in part by voclanics. The resulting continents are approximately tabular in cross section, resulting in the well-known double hypsometric curve for Earth's elevation. Therefore, erosion and mountain building have enabled water to carve its own cistern in the form of all the ocean basins. A theoretical fluid model, suggested partly by laboratory experiments, produces such a tabular continent with a surface above sea level. A simple hydrostatic balance gives a first approximation for the average depth and area of oceans and continents for present Earth as a function of material volumes and densities. Using a wide range of possible crust volumes with the present water volume, the average continental crust thickness exceeds 22 km and ocean area exceeds 25% of the globe. Other volumes of water produce a wide range of areas and depths of oceans and crust.

  6. 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.

  7. 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.

  8. Scintigraphic detection of urinary leakage after kidney transplantation.

    PubMed

    DeLange, E E; Pauwels, E K; Lobatto, S; Tjon Pian Gi-van Loon, C E; van Hooff, J P

    1982-01-01

    Urinary leakage after kidney transplantation is a serious complication. In a retrospective study we analyzed 8 relevant cases of 14 patients with urinary leakage. In these eight patients kidney scintigraphy indicated the presence of urinary extravasation. Compared with other imaging modalities such as IV urography, cystography and ultrasound, scintigraphy seems to be an easy and safe method to detect urinary leakage. Moreover scintigraphic examination may suggest leakage, while this may not be clinically evident or suspected.

  9. 21 CFR 862.1340 - Urinary glucose (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 glucose (nonquantitative) test system. 862... Test Systems § 862.1340 Urinary glucose (nonquantitative) test system. (a) Identification. A urinary glucose (nonquantitative) test system is a device intended to measure glucosuria (glucose in...

  10. Draft Genome Sequence of a Urinary Isolate of Lactobacillus crispatus

    PubMed Central

    Price, Travis K.; Shaheen, Majed; Kalesinskas, Laurynas; Malki, Kema; Hilt, Evann E.; Putonti, Catherine

    2016-01-01

    While Lactobacillus crispatus contributes to the stability of normal vaginal microbiota, its role in urinary health remains unclear. As part of an on-going attempt to characterize the female urinary microbiota, we report the genome sequence of an L. crispatus strain isolated from a woman displaying no lower urinary tract symptoms. PMID:27908986

  11. Evolution of the Adria-Europe plate boundary in the northern Dinarides: from continent-continent collision to back-arc extension

    NASA Astrophysics Data System (ADS)

    Ustaszewski, Kamil; Frank, Wolfgang; Fügenschuh, Bernhard; Kounov, Alexandre; Krenn, Erwin; Schaltegger, Urs; Schmid, Stefan M.

    2010-05-01

    The Sava Zone of the northern Dinarides in Former Yugoslavia is part of the Cenozoic Adria-Europe plate boundary. Late Cretaceous subduction of remnants of Meliata-Vardar oceanic lithosphere led to the formation of a suture, across which upper-plate European units were juxtaposed with Adria-derived units of the Dinarides. Late Cretaceous siliciclastic sediments were incorporated into an accretionary wedge that evolved during the initial stages of continent-continent collision. Structurally deeper parts of the exposed accretionary wedge underwent amphibolitegrade metamorphism. Grt-Pl-Ms-Bt thermobarometry and multi-phase equilibria indicate temperatures between 550 and 630°C and pressures between 5 and 7 kbar for this event. Peak-metamorphic conditions were reached at around 65 Ma. Relatively slow cooling from peak-metamorphic conditions throughout most of the Paleogene was possibly induced by hangingwall erosion in conjunction with southwest-directed propagation of thrusting in the Dinarides. Accelerated cooling took place in Miocene times, when the Sava Zone underwent substantial extension that led to the exhumation of the metamorphosed units along a low-angle detachment. 40Ar/39Ar sericite and zircon and apatite fission track ages from the footwall allow bracketing the timing of this extensional unroofing between 25 and 14 Ma. Footwall exhumation started under greenschist-facies conditions and was associated with top-N tectonic transport, indicating exhumation from below European-plate units. Extensional unroofing clearly postdates the emplacement of a 27 Ma old granitoid that also underwent solid-state deformation under greenschistfacies conditions. This extensional phase is hence clearly linked to the Miocene evolution of the Pannonian basin, which represents a back-arc basin formed due to Neogene subduction roll-back in the Carpathians.

  12. 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

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

    PubMed Central

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

    2014-01-01

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

  14. Diagnosis of Urinary Tract Infections in Children.

    PubMed

    Doern, Christopher D; Richardson, Susan E

    2016-09-01

    Urinary tract infections (UTIs) are a common occurrence in children. The management and laboratory diagnosis of these infections pose unique challenges that are not encountered in adults. Important factors, such as specimen collection, urinalysis interpretation, culture thresholds, and antimicrobial susceptibility testing, require special consideration in children and will be discussed in detail in the following review.

  15. 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.

  16. Diagnosis of Urinary Tract Infections in Children

    PubMed Central

    2016-01-01

    Urinary tract infections (UTIs) are a common occurrence in children. The management and laboratory diagnosis of these infections pose unique challenges that are not encountered in adults. Important factors, such as specimen collection, urinalysis interpretation, culture thresholds, and antimicrobial susceptibility testing, require special consideration in children and will be discussed in detail in the following review. PMID:27053673

  17. 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

  18. Human urinary parasites in Nalout popularity, Libya.

    PubMed

    Al Kilani, M K; Dahesh, S M; El Taweel, H A

    2008-08-01

    A total of 2000 fresh urine samples were collected from a central private laboratory in Tigi Conference which served all the popularity. The examination showed motile Trichomonas vaginalis in seven patients (0.35%); five females and two males, and Enterobius vermicularis in two female children (0.1%). None had urinary schistosomiasis. The data were discussed.

  19. 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

  20. The medical management of urinary incontinence.

    PubMed

    Shaban, Ahmed; Drake, Marcus J; Hashim, Hashim

    2010-01-15

    Urinary incontinence is the involuntary leakage of urine; it affects millions of people worldwide, causing significant detrimental effects on their quality of life. Direct expenses, such as containment products, long-term drug prescriptions and surgery, complemented by indirect costs, such as reduced employment productivity, result in overall expenditure running to billions of dollars. Stress urinary incontinence (SUI) occurs on physical exertion, and results from weakness of the bladder outlet. Urgency urinary incontinence (UUI) results from inability to resist a sudden compelling desire to pass urine, arising as a consequence of bladder dysfunction. Clinical evaluation clarifies the underlying mechanisms and excludes diseases causing similar symptoms. Urodynamic studies to measure bladder and abdominal pressures and deduce the bladder and outlet function are undertaken when invasive treatments are being considered or when the nature of the incontinence is not entirely clear. Initial management of SUI involves pelvic floor muscle exercise training; if insufficient symptom improvement results, surgical measures are needed. UUI treatment commences with advice on suitable fluid intake and measures to improve ability to defer voiding, followed by antimuscarinic drugs. Refractory UUI is a difficult problem, currently managed with a range of surgical interventions, including bladder injections of botulinum-A neurotoxin, augmentation cystoplasty and nerve stimulation methods. New treatment options are needed, because of the risk of impeding voiding function, resulting in urinary retention. Persistent leakage is controlled with containment products, such as pads, or collection devices, such as catheters.

  1. 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…

  2. Management of suspected bacterial urinary tract infection.

    PubMed

    Beckford-Ball, Jason

    New guidelines on the management of suspected bacterial urinary tract infection in adults have just been released by the Scottish Intercollegiate Guidelines Network (SIGN). The guidance states that the presence of bacteriuria should lead to antibiotic treatment only when there is definitive evidence that eradicating the bacterial infection will result in a tangible health gain at a reasonable level of risk (SIGN, 2006).

  3. Mechanisms of pain from urinary tract infection.

    PubMed

    Rosen, John M; Klumpp, David J

    2014-04-01

    The pain response to urinary tract infection is largely uncharacterized, but the symptomatic response to urinary tract infection contrasts with the lack of pain response among individuals with asymptomatic bacteriuria. Quantifying pelvic pain in a murine urinary tract infection model, uropathogenic Escerichia coli induces transient pelvic pain, whereas an asymptomatic bacteriuria E. coli isolate causes no pain, thus recapitulating the spectrum of clinical responses to intravesical E. coli. These differential pain responses are not correlated with bladder colonization or inflammation, but instead are intrinsic to E. coli lipopolysaccharide and dependent on the lipopolysaccharide receptor, TLR4. Epidemiological data suggest a link between interstitial cystitis and a history of urinary tract infection, so it was evaluated whether repetitive uropathogenic E. coli instillation would result in chronic pain through central sensitization. Although repeated infection with wild type uropathogenic E. coli results in only transient episodes of acute pain, a uropathogenic E. coli mutant lacking O-antigen causes chronic, post-urinary tract infection pelvic pain. Similarly, a K-12 E. coli strain lacking O-antigen induces chronic pain that persisted long after bacterial clearance, and expressing O-antigen nullified the pain phenotype. Spinal cords isolated from mice with post-urinary tract infection chronic pain showed deficits in short-term depression consistent with central sensitization. Deleting O-antigen gene complex from a uropathogenic E. coli strain and subsequent heterologous expression of O-antigen gene clusters shows that a single bacterial isolate can exhibit pain phenotypes ranging from a null phenotype, an acute pain phenotype, to a chronic pain phenotype. Post-urinary tract infection chronic pain is also associated with voiding dysfunction and anxious/depressive behavior. These effects are also mediated by TRPV1 at the level of pain establishment

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

    PubMed

    Lopez, Julio; Norman, Brian C

    2014-01-01

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

  5. Validity of urinary monoamine assay sales under the "spot baseline urinary neurotransmitter testing marketing model".

    PubMed

    Hinz, Marty; Stein, Alvin; Uncini, Thomas

    2011-01-01

    Spot baseline urinary monoamine assays have been used in medicine for over 50 years as a screening test for monoamine-secreting tumors, such as pheochromocytoma and carcinoid syndrome. In these disease states, when the result of a spot baseline monoamine assay is above the specific value set by the laboratory, it is an indication to obtain a 24-hour urine sample to make a definitive diagnosis. There are no defined applications where spot baseline urinary monoamine assays can be used to diagnose disease or other states directly. No peer-reviewed published original research exists which demonstrates that these assays are valid in the treatment of individual patients in the clinical setting. Since 2001, urinary monoamine assay sales have been promoted for numerous applications under the "spot baseline urinary neurotransmitter testing marketing model". There is no published peer-reviewed original research that defines the scientific foundation upon which the claims for these assays are made. On the contrary, several articles have been published that discredit various aspects of the model. To fill the void, this manuscript is a comprehensive review of the scientific foundation and claims put forth by laboratories selling urinary monoamine assays under the spot baseline urinary neurotransmitter testing marketing model.

  6. Profile of urinary arsenic metabolites during pregnancy.

    PubMed Central

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

    2003-01-01

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

  7. 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.

  8. Cold stress induces lower urinary tract symptoms.

    PubMed

    Imamura, Tetsuya; Ishizuka, Osamu; Nishizawa, Osamu

    2013-07-01

    Cold stress as a result of whole-body cooling at low environmental temperatures exacerbates lower urinary tract symptoms, such as urinary urgency, nocturia and residual urine. We established a model system using healthy conscious rats to explore the mechanisms of cold stress-induced detrusor overactivity. In this review, we summarize the basic findings shown by this model. Rats that were quickly transferred from room temperature (27 ± 2°C) to low temperature (4 ± 2°C) showed detrusor overactivity including increased basal pressure and decreased voiding interval, micturition volume, and bladder capacity. The cold stress-induced detrusor overactivity is mediated through a resiniferatoxin-sensitve C-fiber sensory nerve pathway involving α1-adrenergic receptors. Transient receptor potential melastatin 8 channels, which are sensitive to thermal changes below 25-28°C, also play an important role in mediating the cold stress responses. Additionally, the sympathetic nervous system is associated with transient hypertension and decreases of skin surface temperature that are closely correlated with the detrusor overactivity. With this cold stress model, we showed that α1-adrenergic receptor antagonists have the potential to treat cold stress-exacerbated lower urinary tract symptoms. In addition, we showed that traditional Japanese herbal mixtures composed of Hachimijiogan act, in part, by increasing skin temperature and reducing the number of cold sensitive transient receptor potential melastatin channels in the skin. The effects of herbal mixtures have the potential to treat and/or prevent the exacerbation of lower urinary tract symptoms by providing resistance to the cold stress responses. Our model provides new opportunities for utilizing animal disease models with altered lower urinary tract functions to explore the effects of novel therapeutic drugs.

  9. Effects of morphine in the isolated mouse urinary bladder.

    PubMed

    Acevedo, C G; Tamayo, L; Contreras, E

    1986-01-01

    Acute morphine increased the responses to acetylcholine of the isolated mouse urinary bladder. A chronic morphine treatment did not change the responses of the urinary bladder to acetylcholine or ATP. The acute administration of morphine did not modify the contractile response to ATP in the urinary bladders from untreated or chronically morphine treated mice. Methadone and ketocyclazocine decreased the responses to the electrical stimulation of the urinary bladder. These depressant effects were not modified by naloxone. The results suggest the nonexistence of opiate receptors in the mouse urinary bladder and the lack of direct effects of morphine on the neuroeffector junction.

  10. FOREIGN BODY IN URINARY BLADDER: AN UNUSUAL PRESENTATION.

    PubMed

    Hashmi, Saadat-Hassan; Khan, Ikramullah

    2015-01-01

    Urinary bladder functions for the storage and expulsion of urine. Foreign bodies in male urinary bladder are rare due to lengthy urethra, especially when they are rounded in shape and difficult to be introduced into urinary bladder. This is a case report of a middle age male with thin body habitus and slightly disturbed psychiatric status. He presented with both irritative and obstructive lower urinary tract symptoms (LUTS). He was investigated and found to have an intact bangle in the urinary bladder. The patient was planned for surgery, and the foreign body was removed endoscopically with the help of cystoscope. Later on the patient was referred to a psychiatrist for psychological management.

  11. 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

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

    PubMed

    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

    2014-06-01

    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/m(3).

  13. 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

  14. About the Mid-Continent Ecology Division (MED) of EPA's National Health and Environmental Effects Research Laboratory

    EPA Pesticide Factsheets

    The Mid-Continent Ecology Division (MED) conducts innovative research and predictive modeling to document and forecast the effects of pollutants on the integrity of watersheds and freshwater ecosystems.

  15. 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...

  16. An accreted micro-continent in the north of the Dabie Orogen, East China: Evidence from detrital zircon dating

    NASA Astrophysics Data System (ADS)

    Zhu, Guang; Wang, Yongsheng; Wang, Wei; Zhang, Shuai; Liu, Cheng; Gu, Chengchuan; Li, Yunjian

    2017-02-01

    Continent-continent collision between the North China Block (NCB) and South China Block (SCB) took place along the Qinling-Tongbai-Hong'an-Dabie orogens during the Triassic. A micro-continent with Paleozoic arc magmatism has been recognized in the northern Qinling-Tongbai orogens; however, it remains unclear whether the micro-continent extended to the Dabie Orogen to form a ribbon-shaped micro-continent, due to later burial by the Hefei Basin in the north. To solve this problem, we conducted LA-ICP-MS Usbnd Pb dating of zircons from Silurian to Cretaceous sandstones and volcanic rocks from the southern margin of the basin. The age spectra of detrital zircons suggest that the Dabie Orogen and later basin cover were the sources of the analyzed sandstones. The detrital and inherited zircons indicate Neoproterozoic, early and late Paleozoic magmatism in the Beihuaiyang unit in the north of the Dabie Orogen. The zircon and previous geophysical data show that a micro-continent bounded by the Feizhong Suture in the north and the Xiaotian-Mozitang Suture in the south existed between the NCB and the Triassic Dabie Orogen, and its northern half is buried by the Jurassic-Paleogene Hefei Basin. The Beihuaiyang micro-continent experienced early Paleozoic arc magmatism caused by southward subduction of the Erlangping oceanic crust and late Paleozoic magmatism related to northward subduction of the Paleotethyan oceanic crust. The micro-continent was accreted to the southern edge of the NCB at the end of the Early Devonian (ca. 400 Ma) via arc-continent collision. Similarly to the Qinling-Tongbai orogens, the Dabie Orogen contains a Paleozoic accretionary system in the north and a Triassic collisional system in the south; thus, it is suggested that a ribbon-shaped micro-continent, > 900 km long and 50-100 km wide, was present along the entire Qinling-Tongbai-Hong'an-Dabie orogens prior to the middle Paleozoic. This micro-continent might have originated as a result of middle

  17. 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.

  18. 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.

  19. The Burden of Urinary Incontinence and Urinary Bother Among Elderly Prostate Cancer Survivors

    PubMed Central

    Kopp, Ryan P.; Marshall, Lynn M.; Wang, Patty Y.; Bauer, Douglas C.; Barrett-Connor, Elizabeth; Parsons, J. Kellogg

    2014-01-01

    Background Data describing urinary health in elderly, community-dwelling prostate cancer (PCa) survivors are limited. Objective To elucidate the prevalence of lower urinary tract symptoms, urinary bother, and incontinence in elderly PCa survivors compared with peers without PCa. Design, setting, and participants A cross-sectional analysis of 5990 participants in the Osteoporotic Fractures in Men Research Group, a cohort study of community-dwelling men ≥65 yr. Outcome measurements and statistical analysis We characterized urinary health using self-reported urinary incontinence and the American Urological Association Symptom Index (AUA-SI). We compared urinary health measures according to type of PCa treatment in men with PCa and men without PCa using multivariate log-binomial regression to generate prevalence ratios (PRs). Results and limitations At baseline, 706 men (12%) reported a history of PCa, with a median time since diagnosis of 6.3 yr. Of these men, 426 (60%) reported urinary incontinence. In adjusted analyses, observation (PR: 1.92; 95% confidence interval [CI], 1.15–3.21; p = 0.01), surgery (PR: 4.68; 95% CI, 4.11–5.32; p < 0.0001), radiation therapy (PR: 1.64; 95% CI, 1.20– 2.23; p = 0.002), and androgen-deprivation therapy (ADT) (PR: 2.01; 95% CI, 1.35–2.99; p = 0.0006) were each associated with daily incontinence. Daily incontinence risk increased with time since diagnosis independently of age. Observation (PR: 1.33; 95% CI, 1.00–1.78; p = 0.05), surgery (PR: 1.25; 95% CI, 1.10–1.42; p = 0.0008), and ADT (PR: 1.50; 95% CI, 1.26–1.79; p < 0.0001) were associated with increased AUA-SI bother scores. Cancer stage and use of adjuvant or salvage therapies were not available for analysis. Conclusions Compared with their peers without PCa, elderly PCa survivors had a two-fold to five-fold greater prevalence of urinary incontinence, which rose with increasing survivorship duration. Observation, surgery, and ADT were each associated with

  20. Childbirth-induced trauma to the urethral continence mechanism: review and recommendations.

    PubMed

    Baessler, Kaven; Schuessler, Bernhard

    2003-10-01

    To summarize the literature on immediate pelvic floor damage from childbirth and episiotomy, a MEDLINE search of English language articles published from 1983 to 2001 was performed. Vaginal delivery causes varying degrees of muscular, neuromuscular, and connective tissue damage. This damage may result in urinary and/or fecal incontinence. Routine midline episiotomy increases the risk of third- and fourth-degree perineal lacerations, which may lead to fecal incontinence. Routine use of mediolateral episiotomy does not prevent urinary incontinence (UI) or severe perineal tears. It is possible to reduce the rate of mediolateral episiotomy to as low as 20% in primiparas without increasing the risk of anal sphincter damage. Control of obesity before delivery, as well as pelvic floor exercises and regular physical exercise both before and after delivery, seem to reduce the risk of postpartum UI.

  1. Analysis of positron annihilation lifetime data by numerical laplace inversion with the program CONTIN

    NASA Astrophysics Data System (ADS)

    Gregory, Roger B.; Zhu, Yongkang

    1990-05-01

    The performance of the program CONTIN [Stephen W. Provencher, Comput. Phys. Commun. 27 (1982) 229], modified to solve Fredholm integral equations with convoluted kernels of the type that occur in the deconvolution and analysis of positron annihilation lifetime data, is investigated with computer-simulated test data. The method avoids direct determination of the instrument resolution function by employing the decay curve of a reference material with a well-known single lifetime. CONTIN employs a constrained, regularized least-squares analysis to calculate a continuous annihilation-rate probability density function (pdf) which is the most parsimonious solution that is consistent with the experimental data and prior knowledge. The performance of the algorithm for extracting positron annihilation lifetime information was evaluated by using several measures of the information content of the data described by Schrader and Usmar [in: Positron Annihilation Studies of Fluids, ed. S. Sharma (World Scientific, Singapore, 1988) p. 215]. The quality of the CONTIN reconstruction of the annihilation-rate pdf is strongly dependent on the information content of the data and is greatly improved as the total number of counts in the data set is increased. Nevertheless, the method provides excellent estimates of the intensities and mean lifetimes of peaks in the annihilation-rate pdf, even when the total counts in the data set are relatively low (10 5-10 6). The sensitivity of the algorithm to systematic errors in the data, including errors in the instrument resolution function, shifts in the positron of the zero-time channel of the sample and reference data and contamination of the reference decay by additional lifetime components was also evaluated. Errors in the FWHM of the instrument resolution function and shifts in the zero time channel as small as {1}/{10}to{1}/{5} of the channel width of the instrument generate additional spurious peaks in the annihilation-rate pdf and

  2. 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

  3. The tropical rain belts with an annual cycle and a continent model intercomparison project: TRACMIP: TRACMIP

    SciTech Connect

    Voigt, Aiko; Biasutti, Michela; Scheff, Jacob; Bader, Jürgen; Bordoni, Simona; Codron, Francis; Dixon, Ross D.; Jonas, Jeffrey; Kang, Sarah M.; Klingaman, Nicholas P.; Leung, Ruby; Lu, Jian; Mapes, Brian; Maroon, Elizabeth A.; McDermid, Sonali; Park, Jong-yeon; Roehrig, Romain; Russell, Gary L.; Seo, Jeongbin; Toniazzo, Thomas; Wei, Ho-Hsuan; Yoshimori, Masakazu; Vargas Zeppetello, Lucas R.

    2016-12-02

    This paper introduces the Tropical Rain belts with an Annual cycle and a Continent Model Intercomparison Project (TRACMIP). TRACMIP studies the dynamics of tropical rain belts and their response to past and future radiative forcings through simulations with 13 comprehensive and one simplified atmosphere models coupled to a slab ocean and driven by seasonally-varying insolation. Five idealized experiments, two with an aquaplanet setup and three with a setup with an idealized tropical continent, fill the space between prescribed-SST aquaplanet simulations and realistic simulations provided by CMIP5/6. The simulations reproduce key features of the present-day climate and expected future climate change, including an annual-mean intertropical convergence zone (ITCZ) that is located north of the equator and Hadley cells and eddy-driven jets that are similar to the present-day climate. Quadrupling CO2 leads to a northward ITCZ shift and preferential warming in Northern high-latitudes. The simulations show interesting CO2-induced changes in the seasonal excursion of the ITCZ and indicate a possible state-dependence of climate sensitivity. The inclusion of an idealized continent modulates both the control climate and the response to increased CO2; for example it reduces the northward ITCZ shift associated with warming and, in some models, climate sensitivity. In response to eccentricity-driven seasonal insolation changes, seasonal changes in oceanic rainfall are best characterized as a meridional dipole, while seasonal continental rainfall changes tend to be symmetric about the equator. This survey illustrates TRACMIP’s potential to engender a deeper understanding of global and regional climate phenomena and to address pressing questions on past and future climate change.

  4. 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.

  5. 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

  6. Micro-continents offshore Western Australia: implications for East Gondwana reconstructions

    NASA Astrophysics Data System (ADS)

    Whittaker, Joanne; Williams, Simon; Halpin, Jacqueline; Daczko, Nathan; Gardner, Robyn

    2014-05-01

    The southern part of the Western Australian margin formed at the nexus of rifting and breakup between the East Gondwanan continents India, Australia and Antarctica in the Early Cretaceous. However, understanding the basin evolution along this margin has been hampered by a lack of data from the offshore Perth Abyssal Plain, and from the conjugate Greater Indian margin, which was highly deformed during collision with Eurasia. The Batavia Knoll and Gulden Draak Knoll are two prominent, previously unsampled, bathymetric features located >1600 km offshore Australia that have typically been assumed to be igneous features. In late 2011, successful dredges on the western flanks of both knolls recovered continental basement rocks, revealing that both knolls are micro-continents. Felsic orthogneiss and granite from Gulden Draak and Batavia knolls yield 2.8 Ga, 1.3-1.2 Ga and 540-510 Ma U-Pb zircon ages. The affinity of these geological samples, coupled with existing geological sampling and geophysical data, allow us to test alternative reconstructions for East Gondwana breakup. A number of alternative models have been proposed for the pre-rift configuration of Australia and Antarctica. Competing models make very different predictions for the kinematics of Mesozoic rifting that produced the basins along the Southern Australian margin; the magnitude of extension during rifting; and how mapped Paleozoic and Proterozoic geological terranes and fault zones can be correlated between Australia and Antarctica. We will present reconstructions that reconcile our new samples from Indian Ocean micro-continents with observations from India, Antarctica, Australia, and the evolution of the Indian Ocean.

  7. The tropical rain belts with an annual cycle and a continent model intercomparison project: TRACMIP

    DOE PAGES

    Voigt, Aiko; Biasutti, Michela; Scheff, Jacob; ...

    2016-11-16

    This paper introduces the Tropical Rain belts with an Annual cycle and a Continent Model Intercomparison Project (TRACMIP). TRACMIP studies the dynamics of tropical rain belts and their response to past and future radiative forcings through simulations with 13 comprehensive and one simplified atmosphere models coupled to a slab ocean and driven by seasonally-varying insolation. Five idealized experiments, two with an aquaplanet setup and three with a setup with an idealized tropical continent, fill the space between prescribed-SST aquaplanet simulations and realistic simulations provided by CMIP5/6. The simulations reproduce key features of the present-day climate and expected future climate change,more » including an annual-mean intertropical convergence zone (ITCZ) that is located north of the equator and Hadley cells and eddy-driven jets that are similar to the present-day climate. Quadrupling CO2 leads to a northward ITCZ shift and preferential warming in Northern high-latitudes. The simulations show interesting CO2-induced changes in the seasonal excursion of the ITCZ and indicate a possible state-dependence of climate sensitivity. The inclusion of an idealized continent modulates both the control climate and the response to increased CO2; for example it reduces the northward ITCZ shift associated with warming and, in some models, climate sensitivity. In response to eccentricity-driven seasonal insolation changes, seasonal changes in oceanic rainfall are best characterized as a meridional dipole, while seasonal continental rainfall changes tend to be symmetric about the equator. Finally, this survey illustrates TRACMIP’s potential to engender a deeper understanding of global and regional climate phenomena and to address pressing questions on past and future climate change.« less

  8. The tropical rain belts with an annual cycle and a continent model intercomparison project: TRACMIP

    SciTech Connect

    Voigt, Aiko; Biasutti, Michela; Scheff, Jacob; Bader, Jürgen; Bordoni, Simona; Codron, Francis; Dixon, Ross D.; Jonas, Jeffrey; Kang, Sarah M.; Klingaman, Nicholas P.; Leung, Ruby; Lu, Jian; Mapes, Brian; Maroon, Elizabeth A.; McDermid, Sonali; Park, Jong -yeon; Roehrig, Romain; Rose, Brian E. J.; Russell, Gary L.; Seo, Jeongbin; Toniazzo, Thomas; Wei, Ho -Hsuan; Yoshimori, Masakazu; Vargas Zeppetello, Lucas R.

    2016-11-16

    This paper introduces the Tropical Rain belts with an Annual cycle and a Continent Model Intercomparison Project (TRACMIP). TRACMIP studies the dynamics of tropical rain belts and their response to past and future radiative forcings through simulations with 13 comprehensive and one simplified atmosphere models coupled to a slab ocean and driven by seasonally-varying insolation. Five idealized experiments, two with an aquaplanet setup and three with a setup with an idealized tropical continent, fill the space between prescribed-SST aquaplanet simulations and realistic simulations provided by CMIP5/6. The simulations reproduce key features of the present-day climate and expected future climate change, including an annual-mean intertropical convergence zone (ITCZ) that is located north of the equator and Hadley cells and eddy-driven jets that are similar to the present-day climate. Quadrupling CO2 leads to a northward ITCZ shift and preferential warming in Northern high-latitudes. The simulations show interesting CO2-induced changes in the seasonal excursion of the ITCZ and indicate a possible state-dependence of climate sensitivity. The inclusion of an idealized continent modulates both the control climate and the response to increased CO2; for example it reduces the northward ITCZ shift associated with warming and, in some models, climate sensitivity. In response to eccentricity-driven seasonal insolation changes, seasonal changes in oceanic rainfall are best characterized as a meridional dipole, while seasonal continental rainfall changes tend to be symmetric about the equator. Finally, this survey illustrates TRACMIP’s potential to engender a deeper understanding of global and regional climate phenomena and to address pressing questions on past and future climate change.

  9. 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.

  10. 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.

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

    SciTech Connect

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

    2015-06-21

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

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

    NASA Astrophysics Data System (ADS)

    Ackerley, Duncan; Reeves, Jessica

    2015-04-01

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

  13. Matching patient safety goals to the nursing specialty: using wound, ostomy, continence nursing services.

    PubMed

    Jankowski, Irene M

    2010-01-01

    With increasing nursing specialization, administrators may not have clear guidelines directing which specialists should be targeting specific patient populations and specific patient care issues. Because pressure ulcers are an important indicator of quality of care, this discussion focuses on selecting the appropriate wound, ostomy, continence specialist to develop and support programs that are designed to prevent pressure ulcers, treat patients with pressure ulcers, as well as management of other types of wounds, stomas, fistulas, incontinence, and skin breakdown. Nurse leaders are in a position to ensure that appropriate resources are available to support the development of hospital programs that will promote safe, efficient, and cost-conscious patient care.

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

    NASA Astrophysics Data System (ADS)

    Martín-Velázquez, Silvia; Martín-González, Fidel

    2014-05-01

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

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

    PubMed Central

    Al-Saadi, Wasan Ismail

    2015-01-01

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

  16. Urinary tract infections in adults with diabetes.

    PubMed

    Ronald, A; Ludwig, E

    2001-04-01

    Urinary tract (UTI) is a major disease burden for many patients with diabetes. Asymptomatic bacteriuria is several-fold more common among women and acute plyelonephritis is five to ten times more common in both sexes. The complications of pyelonephritis are also more common in patients with diabetes. These complications include acute papillary necrosis, emphysematous pyelonephritis, and bacteremia with metastatic localization to other sites. The management of urinary infection in patients with diabetes is essentially the same as patients without diabetes. Most infections should be managed as uncomplicated except when they occur in a milieu with obstruction or other factors that merit a diagnosis of complicated UTI. Strategies to prevent these infections and reduce morbidity should be a priority for research.

  17. Improved HPLC determination of urinary neopterin.

    PubMed

    Dewitte, J D; Berthou, F; Dreano, Y; Floch, H H

    1987-01-01

    In order to improve the urinary neopterin measurement, the reversed-phase HPLC method has been reevaluated. The parameters which influence the chromatographic behavior of 12 pteridines were studied: nature of buffer, pH, ionic strength, addition of organic modifier to the mobile phase. Accordingly, an isocratic HPLC method is described which offers a good compromise between specificity and analysis time. This method is well-suited to automation in routine clinical laboratory use. Using this HPLC method, urinary neopterin related to creatinine was determined in lung diseases (neoplasm, sarcoïdosis and bronchial asthma) and in kidney allografts. This method was shown to be useful in the diagnosis and in the monitoring of treatment of rejection episodes.

  18. Urinary tract infection caused by Chromobacterium violaceum.

    PubMed

    Pant, Narayan Dutt; Sharma, Manisha

    2015-01-01

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

  19. 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

  20. [A questionnaire survey on urinary incontinence and urinary disturbances in the institutionalized elderly with senile dementia].

    PubMed

    Otani, N; Kumamoto, Y; Tsukamoto, T; Yokoo, A; Urasawa, K; Kawaharada, M

    1994-09-01

    We carried out a questionnaire survey concerning urinary disturbances, among nursing home patients. The answers were obtained from 1,038 elderly including 355 males and 683 females. Ages, spanned 50-99, with an average age of 79.1. Of the 1,038 respondents which we obtained through our survey for management of urination, 35.8% of the total said that they are able to urinate without incontinence. Those able to urinate with incontinence accounted for 23.6% of the total. However, 40% of all patients required an adult diaper throughout the day to control their urinary functions. Patients suffering from neurological disorders accounted for 70% of respondents, and a correlation was seen between the extent of dementia and ADL, and excretory control. Urinary functioning in both men and women was found to grow increasingly difficult with age, and medical problems involving urinary difficulty appear to increase with the advance of the aging process. The representative groups for this survey were limited to elderly people in nursing homes, many of whom suffer from neurological disorders such as cerebral infarction. It was found that both male and female patients experience a variety of urinary disturbances.

  1. Laparoscopic surgery for intestinal and urinary endometriosis.

    PubMed

    Redwine, D B; Sharpe, D R

    1995-12-01

    Intestinal and urinary tract involvement by endometriosis may be symptomatic, particularly when invasive disease is present. Even in expert hands, complete excision of all invasive disease cannot be accomplished laparoscopically in every case. The practitioner must balance enthusiasm for the advantages of a laparoscopic approach with limitations of time and skill. Laparoscopy should be abandoned in a particular case if a better job can be performed by laparotomy. Hysterectomy with castration may not relieve symptoms due to invasive disease.

  2. 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

  3. Biomonitoring Equivalents for interpretation of urinary fluoride.

    PubMed

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

    2015-06-01

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

  4. Proteus mirabilis and Urinary Tract Infections.

    PubMed

    Schaffer, Jessica N; Pearson, Melanie M

    2015-10-01

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

  5. Genetics of human congenital urinary bladder disease.

    PubMed

    Woolf, Adrian S; Stuart, Helen M; Newman, William G

    2014-03-01

    Lower urinary tract and/or kidney malformations are collectively the most common cause of end-stage renal disease in children, and they are also likely to account for a major subset of young adults requiring renal replacement therapy. Advances have been made regarding the discovery of the genetic causes of human kidney malformations. Indeed, testing for mutations of key nephrogenesis genes is now feasible for patients seen in nephrology clinics. Unfortunately, less is known about defined genetic bases of human lower urinary tract anomalies. The focus of this review is the genetic bases of congenital structural and functional disorders of the urinary bladder. Three are highlighted. First, prune belly syndrome, where mutations of CHRM3, encoding an acetylcholine receptor, HNF1B, encoding a transcription factor, and ACTA2, encoding a cytoskeletal protein, have been reported. Second, the urofacial syndrome, where mutations of LRIG2 and HPSE2, encoding proteins localised in nerves invading the fetal bladder, have been defined. Finally, we review emerging evidence that bladder exstrophy may have genetic bases, including variants in the TP63 promoter. These genetic discoveries provide a new perspective on a group of otherwise poorly understood diseases.

  6. Congenital anomalies of kidney and urinary tract.

    PubMed

    Toka, Hakan R; Toka, Okan; Hariri, Ali; Nguyen, Hiep T

    2010-07-01

    Congenital anomalies of the kidney and urinary tract anatomy (CAKUT) are common in children and represent approximately 30% of all prenatally diagnosed malformations. CAKUT is phenotypically variable and can affect the kidney(s) alone and/or the lower urinary tract. The spectrum includes more common anomalies such as vesicoureteral reflux and, rarely, more severe malformations such as bilateral renal agenesis. In young children, congenital anomalies are the leading cause of kidney failure and for kidney transplantation or dialysis. CAKUT can also lead to significant renal problems in adulthood and may present itself with hypertension and/or proteinuria. Congenital renal anomalies can be sporadic or familial, syndromic (also affecting nonrenal or non-urinary tract tissues), or nonsyndromic. Genetic causes have been identified for the syndromic forms and have shed some light into the molecular mechanisms of kidney development in human beings. The genetic causes for the more common nonsyndromic forms of CAKUT are unknown. The role of prenatal interventions and postnatal therapies as well as the benefits of screening affected individuals and their family members are not clear.

  7. 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

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

    NASA Astrophysics Data System (ADS)

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

    2014-12-01

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

  9. Restoration of fecal continence with chronic electrostimulation of gracilis muscle 17 years after a Pickrell's operation.

    PubMed

    Seccia, M; Banti, P; Zocco, G; Viacava, P

    2001-11-01

    A 27-year-old woman who had undergone a Pickrell's operation at the age of 10 years, was observed for severe incontinence to solid and liquid stools. Physical examination and physiological tests revealed poor resting anal tone but a very good response of the transposed gracilis to percutaneous electrostimulation, which showed that the gracilis ability to contract was maintained in spite of 17 years of only occasional and unplanned muscular activity. Examination also demonstrated that the muscle had followed body growth during the patient's development. Restoration of continence by continuous electrostimulation of the gracilis muscle was then planned. To allow muscular resistance to this stimulation a fast-to-slow twitch fiber conversion was first obtained by low-frequency electrostimulation. A subcutaneous abdominal implant of a pulse generator connected to the gracilis by intramuscular platinum-iridium electrodes was carried out. After a period of muscular training, fiber conversion was achieved, and continuous electrostimulation led to complete restoration of continence with stable results at the 36 month follow-up evaluation. This case demonstrates that even such a long period of muscular inactivity does not affect the possibility of recovering a failed Pickrell's operation using electrostimulation. This easy and safe procedure can be applied to all previously failed graciloplasties provided that muscle contractility is maintained.

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Shah, H. L.; Mishra, V.

    2014-12-01

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

  13. The Contribution of the Mesoscale Convective Complexes (MCCs) to total rainfall over Indonesian Maritime Continent

    NASA Astrophysics Data System (ADS)

    Trismidianto; Yulihastin, E.; Satyawardhana, H.; Nugroho, J. T.; Ishida, S.

    2017-01-01

    The MCCs contribution is expressed as the ratio of MCCs precipitation to the total rainfall at each grid point where MCCs identified by using infrared satellite imagery. The rainfall obtained from the Real-Time Tropical Rainfall Measuring Mission’s (TRMM) data. This study found that MCCs contribute to total rainfall during 15-years over Indonesian Maritime Continent up to 20% where the greatest contribution concentrated over Central Kalimantan, South China Sea, Indian Ocean and Papua Island. The contribution of the MCCs is slightly increased in seasonally and monthly up to 24% and 30%, respectively. The greatest contribution is more existence over continent than the ocean in each season and month, except in July. The greatest contribution of the oceanic MCC concentrated in the Indian Ocean almost in each season and month. The contribution of the MCCs over Java Island is almost small in each season and month, but the contribution a slight increase during JJA. The MCC not only contribute to rainfall in the MCC area but the MCC give a contribution to its surrounding area. The frequency distribution of MCCs contribution to the total rainfall is very similar and consistent with the geographic distribution of the MCCs over the IMC during 15-years.

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

    PubMed Central

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

    2016-01-01

    African elephants (Loxodonta africana) are imperiled by poaching and habitat loss. Despite global attention to the plight of elephants, their population sizes and trends are uncertain or unknown over much of Africa. To conserve this iconic species, conservationists need timely, accurate data on elephant populations. Here, we report the results of the Great Elephant Census (GEC), the first continent-wide, standardized survey of African savannah elephants. We also provide the first quantitative model of elephant population trends across Africa. We estimated a population of 352,271 savannah elephants on study sites in 18 countries, representing approximately 93% of all savannah elephants in those countries. Elephant populations in survey areas with historical data decreased by an estimated 144,000 from 2007 to 2014, and populations are currently shrinking by 8% per year continent-wide, primarily due to poaching. Though 84% of elephants occurred in protected areas, many protected areas had carcass ratios that indicated high levels of elephant mortality. Results of the GEC show the necessity of action to end the African elephants’ downward trajectory by preventing poaching and protecting habitat. PMID:27635327

  15. An evaluation of threatened species categorization systems used on the American continent.

    PubMed

    De Grammont, Paloma C; Cuarón, Alfredo D

    2006-02-01

    Endangered species lists are important tools in conservation. It is essential that these lists be prepared using categorization systems that objectively assess species extinction risk. To determine which threatened species categorization system is the most appropriate and the virtues and limitations of systems used on the American continent, we evaluated 25 categorization systems from 20 countries. These systems included examples of international lists, most national systems used on the American continent, and some systems independently proposed by academics. We based our assessment on 15 characteristics that categorization systems should have, in terms of categories, criteria, and other relevant issues, in order to evaluate species conservation status objectively. Of all evaluated systems, the current World Conservation Union system is the most suitable for assessing species extinction risk. Most categorization systems, but particularly national systems, have serious deficiencies and need to be improved substantially. We recommend governments use three types of lists: (1) threatened species lists constructed following a sound categorization system, (2) lists of species of conservation priority, and (3) lists that serve as normative tools (e.g., Convention on International Trade in Endangered Species of Wild Fauna and Flora). Additionally, the information used to categorize species should be explicit and available to the public. To make the most of threatened species lists in conservation, it is imperative that all countries use the same categorization system.

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

    PubMed

    Rosenfelder, Natalie; Vetter, Walter

    2014-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2012-01-01

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

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

    SciTech Connect

    Teng, L.S. )

    1990-06-01

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

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

    SciTech Connect

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

    1991-03-01

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

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

    SciTech Connect

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

    1987-08-01

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

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

    PubMed Central

    Samalavicius, Narimantas E.

    2016-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Zabanbark, A.; Lobkovsky, L. I.

    2015-09-01

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

  3. 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.

  4. Risk of Urinary Incontinence Following Prostatectomy: The Role of Physical Activity and Obesity

    PubMed Central

    Wolin, Kathleen Y.; Luly, Jason; Sutcliffe, Siobhan; Andriole, Gerald L.; Kibel, Adam S.

    2011-01-01

    Purpose Urinary incontinence is one of the most commonly reported and distressing side effects of radical prostatectomy for prostate carcinoma. Several studies have suggested that symptoms may be worse in obese men but to our knowledge no research has addressed the joint effects of obesity and a sedentary lifestyle. We evaluated the association of obesity and lack of physical activity with urinary incontinence in a sample of men who had undergone radical prostatectomy. Materials and Methods Height and weight were abstracted from charts, and obesity was defined as body mass index 30 kg/m2 or greater. Men completed a questionnaire before surgery that included self-report of vigorous physical activity. Men who reported 1 hour or more per week of vigorous activities were considered physically active. Men reported their incontinence to the surgeon at their urology visits. Information on incontinence was abstracted from charts at 6 and 58 weeks after surgery. Results At 6 weeks after surgery 59% (405) of men were incontinent, defined as any pad use. At 58 weeks after surgery 22% (165) of men were incontinent. At 58 weeks incontinence was more prevalent in men who were obese and physically inactive (59% incontinent). Physical activity may offset some of the negative consequences of being obese because the prevalence of incontinence at 58 weeks was similar in the obese and active (25% incontinent), and nonbese and inactive (24% incontinent) men. The best outcomes were in men who were nonobese and physically active (16% incontinent). Men who were not obese and were active were 26% less likely to be incontinent than men who were obese and inactive (RR 0.74, 95% CI 0.52–1.06). Conclusions Pre-prostatectomy physical activity and obesity may be important factors in post-prostatectomy continence levels. Interventions aimed at increasing physical activity and decreasing weight in patients with prostate cancer may improve quality of life by offsetting the negative side effects

  5. Sex hormones and the female urinary tract.

    PubMed

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

    1988-10-01

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

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

    PubMed

    Johnson, E U; Singh, Gurpreet

    2013-10-01

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

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

    PubMed Central

    Johnson, E. U.; Singh, Gurpreet

    2013-01-01

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

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

    PubMed

    Robinson, Dudley; Giarenis, Ilias; Cardozo, Linda

    2015-07-01

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

  9. 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

  10. [Appropriate and inappropriate use of indwelling urinary catheters].

    PubMed

    Janzen, Jolien; Geerlings, Suzanne E

    2012-01-01

    Many hospitalized patients receive a urinary catheter during their stay. In 21-54% of patients, however, there is no appropriate indication for this. The most significant complication caused by the use of urinary catheters is the development of a urinary tract infection (UTI), one of the most common nosocomial infections. In 71-80% of hospital acquired UTIs a urinary catheter is present. The duration of the presence of a catheter is the major risk factor for catheter-associated UTI. Reducing the number of inappropriate catheterisations is an effective way of preventing catheter-related UTIs. Inappropriate use of indwelling urinary catheters can be reduced by maintaining strict guidelines on justifiable indications for inserting a urinary catheter, verifying daily whether the indication still applies, and by timely removal of the catheter when it is not or no longer needed.

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

    PubMed Central

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

    2015-01-01

    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

  12. The radiological investigation of urinary infections in children

    PubMed Central

    Starer, F.

    1970-01-01

    One hundred children with urinary tract infections were fully investigated radiologically. More than half showed abnormalities of the urinary tract. It is concluded that full investigation of the urinary tract is justifiable at any age; it should be carried out in boys at the first infection, and in girls at the latest after the second infection, or if treatment did not produce the expected cure. ImagesFig. 2Fig. 3Fig. 4Fig. 5Fig. 6Fig. 7Fig. 8 PMID:5412561

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

    SciTech Connect

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

    2011-11-01

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

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

    PubMed

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

    2016-04-01

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

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

    PubMed Central

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

    2016-01-01

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

  16. [Experiences with instrumental methods for urinary calculi analysis].

    PubMed

    Asper, R; Schmucki, O

    1979-08-01

    To reduce the urinary calculi incidence by calculi formers, it is important to know the composition of these stones. Unfortunately the chemical analysis does not give very reliable results. Looking for a better method to analyse urinary calculi, three instrumental methods were tested: infared spectroscopy, thermal analysis and X-ray diffraction. The experimental results and economical considerations show that the X-ray diffraction analysis of urinary calculi would meet the goal of improved care of patients with stones.

  17. Evolutionary conservatism and convergence both lead to striking similarity in ecology, morphology and performance across continents in frogs.

    PubMed

    Moen, Daniel S; Irschick, Duncan J; Wiens, John J

    2013-12-22

    Many clades contain ecologically and phenotypically similar species across continents, yet the processes generating this similarity are largely unstudied, leaving fundamental questions unanswered. Is similarity in morphology and performance across assemblages caused by evolutionary convergence or by biogeographic dispersal of evolutionarily conserved ecotypes? Does convergence to new ecological conditions erase evidence of past adaptation? Here, we analyse ecology, morphology and performance in frog assemblages from three continents (Asia, Australia and South America), assessing the importance of dispersal and convergent evolution in explaining similarity across regions. We find three striking results. First, species using the same microhabitat type are highly similar in morphology and performance across both clades and continents. Second, some species on different continents owe their similarity to dispersal and evolutionary conservatism (rather than evolutionary convergence), even over vast temporal and spatial scales. Third, in one case, an ecologically specialized ancestor radiated into diverse ecotypes that have converged with those on other continents, largely erasing traces of past adaptation to their ancestral ecology. Overall, our study highlights the roles of both evolutionary conservatism and convergence in explaining similarity in species traits over large spatial and temporal scales and demonstrates a statistical framework for addressing these questions in other systems.

  18. Afriflu2--second international workshop on influenza vaccination in the African continent--8 November 2012, Cape Town (South Africa).

    PubMed

    Schoub, Barry D; Gessner, Bradford D; Ampofo, William; Cohen, Adam L; Steffen, Christoph A

    2013-08-02

    The second meeting of the Afriflu conferences took place in Cape Town, South Africa, with over 60 participants from 15 countries in Africa and also outside the continent. Significant progress in surveillance has been made in better understanding the illness burden of influenza on the continent, which limited evidence suggests is greater than that in the developed world. In southern Africa HIV and TB coinfections play a major role in increasing hospitalisation and mortality, while elsewhere in Africa other cofactors still need to be determined. There is currently no indigenous vaccine production in sub-Saharan Africa and only one facility, based in South Africa, capable of filling imported bulk. Innovative vaccine strategies will need to be explored, such as maternal immunisation, and also the possibility of other influenza vaccine options, such as live attenuated influenza vaccine for young children. Sustained indigenous vaccine production is essential for the continent to have vaccine security in the event of a pandemic even though establishing local production faces considerable challenges especially ensuring adequate markets on the continent. There is an urgent need to develop effective communication messages for decision makers as well as healthcare workers addressing the importance of influenza even in the face of the major competing health burdens of the continent.

  19. Evolutionary conservatism and convergence both lead to striking similarity in ecology, morphology and performance across continents in frogs

    PubMed Central

    Moen, Daniel S.; Irschick, Duncan J.; Wiens, John J.

    2013-01-01

    Many clades contain ecologically and phenotypically similar species across continents, yet the processes generating this similarity are largely unstudied, leaving fundamental questions unanswered. Is similarity in morphology and performance across assemblages caused by evolutionary convergence or by biogeographic dispersal of evolutionarily conserved ecotypes? Does convergence to new ecological conditions erase evidence of past adaptation? Here, we analyse ecology, morphology and performance in frog assemblages from three continents (Asia, Australia and South America), assessing the importance of dispersal and convergent evolution in explaining similarity across regions. We find three striking results. First, species using the same microhabitat type are highly similar in morphology and performance across both clades and continents. Second, some species on different continents owe their similarity to dispersal and evolutionary conservatism (rather than evolutionary convergence), even over vast temporal and spatial scales. Third, in one case, an ecologically specialized ancestor radiated into diverse ecotypes that have converged with those on other continents, largely erasing traces of past adaptation to their ancestral ecology. Overall, our study highlights the roles of both evolutionary conservatism and convergence in explaining similarity in species traits over large spatial and temporal scales and demonstrates a statistical framework for addressing these questions in other systems. PMID:24174109

  20. Pandemic Vibrio parahaemolyticus O3:K6 on the American continent

    PubMed Central

    Velazquez-Roman, Jorge; León-Sicairos, Nidia; de Jesus Hernández-Díaz, Lucio; Canizalez-Roman, Adrian

    2014-01-01

    Vibrio parahaemolyticus is one of the most important seafood-borne bacterial in recent years and is the leading causal agent of human acute gastroenteritis, primarily following the consumption of raw, undercooked or mishandled marine products. Until 1996, infections caused by V. parahaemolyticus were generally associated with diverse serovars. However, in February 1996, a unique serovar (O3:K6) of V. parahaemolyticus with specific genetic markers (tdh, toxRS/New and/or orf8) appeared abruptly in Kolkata, India. In subsequent years, O3:K6 isolates similar to those isolated in Kolkata have been reported from food borne outbreaks in Southeast Asia, as well as in the Atlantic and Gulf coasts of the United States (U.S). More recently, there have been reports in Europe, Africa and Central and South America. Specifically, in the American continent, some countries have reported cases of gastroenteritis due to the pandemic O3:K6 strain and its serovariants; the pandemic strain was first detected in Peru (1996, >100 cases), subsequently spreading to Chile in 1998 (>16,804 human cases), to the U.S. in 1998 (>700 cases), to Brazil in 2001 (>18 cases) and to Mexico in 2004 (>1200 cases). The arrival of the pandemic clone on the American continent may have resulted in a significant shift on the epidemic dynamics of V. parahaemolyticus. However, although O3:K6 is the predominant serovar of the recognized clinical strains in some countries in the Americas, a decrease in clinical cases caused by O3:K6 and an increase in cases associated with a new serotype (O3:K59, Chile) have been recently reported. The emergence and worldwide dissemination of O3:K6 and other pandemic strains since 1996 have come to represent a threat to public health and should concern health authorities. This review focuses on the presence, distribution and virulence factors of the V. parahaemolyticus O3:K6 pandemic clone and its serovariants in clinical and environmental strains on the American continent. PMID