Effects of Age, Parity, and Adherence on Pelvic Muscle Response to Exercise

OBJECTIVE: To examine factors that affect pelvic muscle response to 12 weeks of pelvic muscle exercise. DESIGN: Repeated measures design in which intravaginal pressures during pelvic muscle contractions were recorded at baseline and after four exercise levels. SETTING: College of Nursing research site in Gainesville, Florida. PARTICIPANTS: Eighty-five parous, community-dwelling women, aged 35-78 years and without incontinence as a primary concern. INTERVENTIONS: A 12-week graded program of regular (three times per week, every other day) pelvic muscle exercise at home. MAIN OUTCOME MEASURES: The hypotheses were that younger age, lower parity, higher baseline intravaginal pressures, and adherence to the pelvic muscle exercise program each would result in significant improvement in maximum intravaginal pressures. RESULTS: The only factor showing significance in predicting a successful outcome was age (t = -2.29, df = 41, one-tail probability = .0136). CONCLUSIONS: Regular, graded exercise over several weeks is needed to build pelvic muscles, and some women who exercise do not improve. Although the reasons for not improving are unclear, age is a significant factor.     

Changes in levels of alcohol consumption: United States, 1983–1988

Using data from the 1983 and 1988 National Health Interview Surveys, this note examines changes both in the prevalence of abstention and the prevalence of heavier drinking among drinkers in the United States. Changes are examined separately by gender and according to other sociodemographic characteristics often associated with different levels of alcohol consumption. Results suggest an increase in abstention and a decrease in heavier drinking between 1983 and 1988. For women, decreases in heavier drinking were found among those 18-44 years of age, among those employed, and among those divorced/separated or never married. For men, decreases in heavier drinking were found among those employed, among those with family income of $25000 or more, and among those married or divorced/separated. Changes both in abstention and heavier drinking were found to vary considerably by geographical region. These findings do not support results from other general population survey studies on alcohol use that suggest a stability in drinking levels, or even a slight increase in heavier drinking among men.     

Gastrointestinal manifestations of type 1 neurofibromatosis (von Recklinghausen''s disease)

Gastrointestinal involvement in von Recklinghausen's disease occurs in three principal forms: hyperplasia of the submucosal and myenteric nerve plexuses and mucosal ganglioneuromatosis which leads to disordered gut motility; gastrointestinal stromal tumours showing varying degrees of neural or smooth muscle differentiation; and a distinctive glandular, somatostatin-rich carcinoid of the periampullary region of the duodenum that contains psammoma bodies and which may be associated with phaeochromocytoma. This review describes the histopathological features of these lesions and discusses potential pitfalls in their differential diagnosis. Their accurate identification has significant implications for clinical management and may even provide the first pointer to the diagnosis of neurofibromatosis.