How Does Participation of Youth With Spina Bifida Vary by Age?

Background  

Youth with disabilities are at risk for decreased participation in community activities. However, little is known about participation at different developmental periods of childhood and adolescence among youth with spina bifida (SB) or whether child, family, and SB-associated factors influence participation.     

Activity Level,Functional Health,and Quality of Life of Children with Myelomeningocele as Perceived by Parents

Background  

To provide the best health care for individuals with myelomeningocele (MM), clinicians and researchers need to understand their health and functional status as well as quality of life. The literature is mixed regarding the relationship between motor level and health-related quality of life (HRQOL) for these individuals.     

Comparison of direct planimetry of mitral valve regurgitation orifice area by three-dimensional transesophageal echocardiography to effective regurgitant orifice area obtained by proximal flow convergence method and vena contracta area determined by color Doppler echocardiography

Direct measurement of anatomic regurgitant orifice area (AROA) by 3-dimensional transesophageal echocardiography was evaluated for analysis of mitral regurgitation (MR) severity. In 72 patients (age 70.6 ± 13.3 years, 37 men) with mild to severe MR, 3-dimensional transesophageal echocardiography and transthoracic color Doppler echocardiography were performed to determine AROA by direct planimetry, effective regurgitant orifice area (EROA) by proximal convergence method, and vena contracta area (VCA) by 2-dimensional color Doppler echocardiography. AROA was measured with commercially available software (QLAB, Philips Medical Systems, Andover, Massachusetts) after adjusting the first and second planes to reveal the smallest orifice in the third plane where planimetry could take place. AROA was classified as circular or noncircular by calculating the ratio of the medial-lateral distance above the anterior-posterior distance (≤1.5 compared to >1.5). AROA determined by direct planimetry was 0.30 ± 0.20 cm2, EROA determined by proximal convergence method was 0.30 ± 0.20 cm2, and VCA was 0.33 ± 0.23 cm2. Correlation between AROA and EROA (r = 0.96, SEE 0.058 cm2) and between AROA and VCA (r = 0.89, SEE 0.105 cm2) was high considering all patients. In patients with a circular regurgitation orifice area (n = 14) the correlation between AROA and EROA was better (r = 0.99, SEE 0.036 cm2) compared to patients with noncircular regurgitation orifice area (n = 58, r = 0.94, SEE 0.061 cm2). Correlation between AROA and EROA was higher in an EROA ≥0.2 cm2 (r = 0.95) than in an EROA <0.2 cm2 (r = 0.60). In conclusion, direct measurement of MR AROA correlates well with EROA by proximal convergence method and VCA. Agreement between methods is better for patients with a circular regurgitation orifice area than in patients with a noncircular regurgitation orifice area.     

Diagnostic problems with parasitic and non-parasitic splenic cysts

Background  

The splenic cysts constitute a very rare clinical entity. They may occur secondary to trauma or even being more seldom due to parasitic infestations, mainly caused by ecchinocccus granulosus. Literature lacks a defined concencus including the treatment plans and follow up strategies, nor long term results of the patients. In the current study, we aimed to evaluate the diagnosis, management of patients with parasitic and non-parasitic splenic cysts together with their long term follow up progresses.     

The Effect of Pelvic Organ Prolapse on Sexual Function in a General Cohort of Women

IntroductionThis is a report about the effects of pelvic organ prolapse on sexual function in women.AimTo determine the effect of pelvic organ prolapse on sexual function in women.MethodsThe study group consisted of 1,267 sexually active women. Baseline characteristics, medical and obstetric history of the patients were recorded. All women underwent vaginal examination to determine the degree of prolapse by pelvic organ prolapse quantification (POPQ) system. Of 1,267 women, 342 (27.0%) had prolapse stage ≥2.Main Outcome Measure(s)The Pelvic Organ Prolapse Urinary Incontinence Sexual Questionnaire short form (PISQ-12) scores of the women were recorded.Result(s)Women with genital prolapse had lower PISQ-12 scores than women without it. The difference resulted mainly from urinary incontinence during sexual activity, fear of incontinence and avoidance of intercourse due to prolapse. Multivariate analyses showed that genital prolapse was one of the confounding factors for sexual function.Conclusion(s)Pelvic floor dysfunction is a multi-faceted problem because it has both anatomical and functional aspects. Although pelvic organ prolapse had an effect on some aspects of sexuality, it has no effect on certain aspects of sexual function such as orgasm and sexual satisfaction. Tok EC, Yasa O, Ertunc D, Savas A, Durukan H, and Kanik A. The effect of pelvic organ prolapse on sexual function in a general cohort of women.     

胰岛素受体底物-1 G972R变异体与妊娠期糖尿病患者基线特性的关系

目的：妊娠期胰岛素受体底物-1（IRS-1）的表达和酪氨酸磷酸化减低。妊娠可能是一个检测与IRS-1多态性有关的任何异常的合适状态。本研究旨在探讨IRS-1G972R多态性在妊娠期糖尿病（GDM）患者中的发生率和对代谢的影响。研究设计：2例根据100g口服葡萄糖耐量试验诊断为GDM妇女的人体测量和代谢变量根据IRS-1多态性进行单变量协方差分析。结果：IRS-1G972R的患者在妊娠开始就出现肥胖及高空腹血胰岛素和血糖水平。两组间在妊娠期间体重增加、胰岛素和葡萄糖水平相似。     

Evaluation of pelvic contractility in ureteropelvic junction obstruction: an experimental study.

BACKGROUND/PURPOSE: Ureteropelvic junction (UPJ) obstruction causes adaptive and/or compensatory alterations in renal pelvic contractility. As these alterations directly affect the outcome after renal damage, definition of these alterations is of the utmost importance from a clinical point of view. Thus, an experimental study was designed to determine the alterations of renal pelvic contractility in response to partial and complete UPJ obstruction. METHODS: Fifteen adult female New Zealand white rabbits were randomly assigned into three groups (each containing 5 rabbits) according to the degree of unilateral UPJ obstruction. Group I: sham operation was performed and served as the control group; group II: partial UPJ obstruction was made; group III: complete UPJ obstruction was made. The animals in groups I and II were sacrificed after three weeks and the rabbits in group III were sacrificed after two weeks. Muscle strips from the renal pelvis were prepared. Spontaneous mechanical activity and contractile responses to phenylephrine (PE), serotonin (5-HT), and KCl were recorded isometrically and compared in all groups. RESULTS: Both the frequency and amplitude of spontaneous mechanical contractions were significantly (p < 0.05) increased in partial (group II) and complete UPJ obstruction (group III) groups. PE and 5-HT-induced tonic contractions, which were more prominent in the complete and partial obstruction groups when compared with the control group (p < 0.05). PE and 5-HT also increased the frequency of spontaneous contractions in both partial and complete obstruction groups. KCl induced long lasting tonic contractions in the control muscles. The duration of contraction to reach the maximum amplitude was shortened in the obstruction groups and the amplitudes of the contractions were significantly augmented when compared to control preparations. CONCLUSION: UPJ obstruction alters the contractile properties of renal pelvis smooth muscle. Increased frequency of spontaneous mechanical activity suggests that pacemaker cells of the renal pelvis change their activities in response to UPJ obstruction. Increase in tonic contraction amplitudes in response to PE and 5-HT suggests an increased sensitivity of smooth muscle cells to these agents. Potentiation of the contractile response to KCl suggests that adaptive changes take place at the level of excitation-contraction coupling in the smooth muscle of the renal pelvis following UPJ obstruction.