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101.
Twenty women diagnosed with functional urinary incoordination were randomly assigned to one of two treatment groups: biofeedback or progressive muscle relaxation. Ten subjects who were placed on a waiting list prior to treatment allocation served as a comparison group. The biofeedback intervention focused specifically on retraining of pelvic floor musculature (PFM). Patients were assessed pretreatment, posttreatment, and at 2-month follow-up. Outcome measures included self-reported symptomatology, psychological functioning, psychophysiological assessment of the PFM, and urologist ratings of problem severity and treatment efficacy. Both treatment approaches proved effective in improving symptomatology and psychological state. Subjects on the waiting list demonstrated no change in urological difficulties. No differences were found between the two treatment groups on any of the outcome measures. Theoretical and practical implications of the results are discussed. 相似文献
102.
G. D'Agostino M. C. Chiari E. Grana 《Naunyn-Schmiedeberg's archives of pharmacology》1989,340(1):76-81
Summary The inhibitory effects of some muscarinic agonists on tritiated acetylcholine release evoked by field stimulation were investigated in the rat urinary bladder strip. The acetylcholine stores of the preparation were labelled with 3H-choline. Electrical field stimulation caused an outflow of tritium, reflecting the release of 3H-acetylcholine. The release of 3H-acetylcholine was decreased in a concentration-dependent manner by all the agonists tested: oxotremorine, muscarone, muscarine, carbachol and methylfurtrethonium. On the contrary, only muscarine and muscarone enhanced the basal efflux of tritium in a concentration-dependent fashion. Concentration-response curves were determined both at 2 Hz and at 1 Hz by using intermittent administration of the drugs. Maximal depression in release (by 78 – 82%) was observed in experiments at 1 Hz. A similar inhibition was obtained at 2 Hz frequency only when a low concentration of calcium (0.6 mM) in the medium was used. Oxotremorine was the most potent among the tested compounds with the same intrinsic activity as the other drugs. In contrast to the other agonists investigated, oxotremorine showed in about 10-fold greater potency at pre- than at postjunctional muscarine receptors in the rat urinary bladder. This difference might depend either on heterogeneity of muscarine receptors or on different mechanism(s) relating to the transducing properties of receptors at the pre- and postjunctional level. A comparison between the relative prejunctional potencies in the rat urinary bladder and in the guinea pig myenteric plexus (data from the literature) suggests that prejunctional muscarine receptors are similar in these tissues. Furthermore, the findings obtained with a low concentration of calcium in the medium may support the view that intraneuronal availability of calcium plays a significant role in modulating the prejunctional negative feed-back mechanism in the rat urinary bladder.Send offprint requests to Dr. G. D'Agostino at the above address 相似文献
103.
J. R. Zahar M. Lecuit E. Carbonnelle F. Ribadeau-Dumas X. Nassif O. Lortholary 《Clinical microbiology and infection》2007,13(3):219-221
Until recently, most reported cases of bacteraemia caused by multidrug-resistant strains of Enterobacteriacae producing an extended-spectrum beta-lactamase (ESBL) in Europe have been nosocomial in origin. However, increasing numbers of reports of community-acquired bacteraemia and urinary tract infection caused by ESBL-producing microorganisms suggest that the geographical origin of patients should be taken into account as a risk-factor for possible ESBL production. Early identification of patients at high-risk of infection with ESBL-producing microorganisms, based on their geographical origin and travel history, should help to optimise initial antibiotic treatment strategies for severe urinary tract infections in Europe. 相似文献
104.
Joao Colaco Vitor Goncalves Catarina Pinto Clara Castro Agueda Vieira Helio Retto 《Gynecological surgery》2007,4(3):223-224
New techniques of sling placement may be associated with infectious complications. Slings through the obturator foramen and
thigh can lead to a significant abscess formation within the thigh adductor muscles. A large thigh abscess associated with
a transobturator sling was diagnosed and treated. The authors report the evaluation and treatment of a unique infectious complication
of transobturator slings. 相似文献
105.
Pat D. O'Donnell 《Neurourology and urodynamics》1989,8(5):505-511
Urinary incontinence is a serious management problem among elderly patients. The care and management of chronic care patients is more difficult in those having urinary incontinence. The level of care required is dependent on both the continence and incontinence behavior of the patient. The continence behavior in this study is presented as the time interval between episodes of involuntary urine loss. The continence interval in elderly inpatient men having severe incontinence was found to be significantly longer in patients having a larger measured cystometric bladder capacity as well as in patients having greater independence in activities of daily living. Significant variability in the continence interval was measured for each patient over a wide range of continence intervals and resulted in an irregular pattern of time between episodes of incontinence. The irregular continence intervals suggest an instability of the central nervous system sensory-motor regulatory mechanism of bladder control in the elderly. 相似文献
106.
107.
108.
The aim of the study was to evaluate the effectiveness of transabdominal wedge colpectomy as surgical treatment for cystocele.
One hundred and sixty-three women with either first or second-degree cystocele (Beecham classification), rectocele and concomitant
stress urinary incontinence or benign pelvic masses were submitted for a combined operation. Transabdominal repair of the
cystocele was performed by wedge colpectomy employing two different absorbable sutures, Vicryl and PDS. The choice of suture
was not random but depended on the period at which surgery was performed. Data obtained were analyzed with Student’st-test and Fisher’s exact test. The cystocele cure rate was 90.2% (110 out of 122) at 3-year follow-up and was significantly
associated with the preoperative degree, being 95.5% and 76.5% in first and in second degree, respectively (P=0.003). At 1-year follow-up the cure rate was significantly associated with the type of the suture employed (P=0.01). At 2-year follow-up rectocele cure rate was 97.2% and vaginal vault prolapse appeared in 3.5% of cases. Stress urinary
incontinence relapsed in 10% of patients after Burch colposuspension. After the operation 94.1% of the women declared normal
coitus. In the present series wedge colpectomy was found to be effective in repairing first-degree cystocele, whereas a high
incidence of relapse was observed when second-degree cystocele was present preoperatively. The suture material employed influenced
the cure rate.
EDITORIAL COMMENT: Wedge colpectomy of the anterior vaginal wall has been described by Weinstein and Roberts (1949), Macer
(1978) and Drutz (1991) as a means of abdominally correcting anterior vaginal wall relaxation. Although the present authors
did not find as high a success rate with the procedure as the previous investigators, they do show that an abdominal approach
to cystocele repair is feasible. There are instances when such an approach would be advantageous to avoid repositioning for
a vaginal anterior wall repair. The danger of abdominal anterior wedge colpectomy lies in the dissection of the bladder base
from the underlying vaginal wall. Dissection in this area must proceed carefully to avoid trauma to the bladder, ureters and,
more distally, to the urethrovesical junction. Performed carefully, with attention directed at avoiding these structures,
the abdominal wedge colpectomy is a potentially useful procedure to add to the armamentarium of the urogynecologic surgeon. 相似文献
109.
Yoshio Takesue Takashi Yokoyama Takashi Kodama Yoshiaki Murakami Yuji Imamura Yuichiro Matsuura 《Surgery today》1997,27(5):392-397
This study was designed to determine the influence of ileal pouch capacity and anal sphincteric function on the clinical outcome
after ileal pouch-anal anastomosis. A total of 24 patients who had undergone ileal pouch-anal anastomosis (J pouch) for ulcerative
colitis were studied. The 24-hour stool frequency was found to be inversely correlated with the sensitivity threshold volume
(STV), maximal tolerance volume (MTV), and distensibility, but was independent of the maximal resting pressure and maximal
squeeze pressure. Patients experiencing nocturnal fecal incontinence had maximal resting pressures that were significantly
lower than those of nocturnally continent patients. Among the patients with fecal incontinence, those with frequent soiling
had lower resting pressures, STV, and distensibility than the patients with intermittent spotting. In addition, the STV in
patients needing nocturnal evacuation were lower than those of patients who did not evacuate after falling asleep. The conclusions
are as follows. Both stool frequency and the need for nocturnal pouch evacuation correlated directly with pouch volume. Anal
incontinence was more common in patients with low internal sphincteric function. In addition, frequent and gross nocturnal
incontinent patients demonstrate a worse function in both the anal sphincter and reservoir than those with intermittent spotting. 相似文献
110.
High-protein Weight-loss Diets: Are They Safe and Do They Work? A Review of the Experimental and Epidemiologic Data 总被引:6,自引:0,他引:6
Julie Eisenstein M.D. Susan B. Roberts Ph.D. Gerard Dallal Ph.D. Edward Saltzman M.D. 《Nutrition reviews》2002,60(7):189-200
Recommendations for increased consumption of protein are among the most common approaches of popular or fad diets. This review summarizes the effects of dietary protein on satiety, energy intake, thermogenesis, and weight loss, as well as its effect on a variety of health outcomes in adults. In short-term studies, dietary protein modulates energy intake via the sensation of satiety and increases total energy expenditure by increasing the thermic effect of feeding. Whereas these effects did not contribute to weight and fat loss in those studies in which energy intake was fixed, one ad libitum study does suggest that a high-protein diet results in a greater decrease in energy intake, and therefore greater weight and fat loss. In terms of safety, there is little long-term information on the health effects of high-protein diets. From the available data, however, it is evident that the consumption of protein greater than two to three times the U.S. Recommended Daily Allowance contributes to urinary calcium loss and may, in the long term, predispose to bone loss. Caution with these diets is recommended in those individuals who may be predisposed to nephrolithiasis or kidney disease, and particularly in those with diabetes mellitus. 相似文献