Urinary incontinence in the elderly. Bladder-sphincter biofeedback and toileting skills training

Behavioral treatment of urinary incontinence was given to 39 elderly outpatients; 19 had stress incontinence, 12 detrusor motor instability, and 8 urge incontinence without instability. Biofeedback involving the bladder and sphincter was used to teach selective control of sphincter muscles or voluntary inhibition of detrusor contractions. Traditional behavioral methods used included habit training to gradually increase the voiding interval and relaxation training to cope with the urge to void. After an average 3.5 training sessions, patients with stress incontinence reduced the frequency of incontinent episodes an average of 82% (range, 55% to 100%). Patients with detrusor motor instability showed an average 85% improvement (range, 39% to 100%), and patients with urge incontinence reduced incontinence an average of 94% (range, 83% to 100%). Furthermore, 13 of the patients achieved total continence, and 19 had fewer than one accident per week after treatment.     

Angiotensin-converting enzyme and other peptidolytic enzymes in human semen and relations to its spermatologic parameters

Angiotensin-converting enzyme (ACE) and other enzymes of the renin-angiotensin system (RAS) occur in human semen in high activities. In contrast to bull ejaculates, not all zinc-dependent metallopeptidases are found to be in close correlation to the microscopically determined semen parameters; such a relationship was established only partly for the ACE. On the other hand, the RAS-dependent spermatozoa-bound enzymes, inclusive ACE, uniformly show negative correlations to the spermatologic parameters of human semen. These results, for the first time, point to different functions of the sperm-cell-bound (testicular) and of the seminal plasma (pulmonary) ACE activities.     

Vergleichsuntersuchungen über die Spezifisch-Dynamische Wirkung nach Eiweissfrühstück oder Glykokollbelastung

Ohne Zusammenfassung     

Assessing toileting skills and habits in an adult day care center.

In a structured assessment of mobility and toileting skills, all the continent clients but only 46.2% of incontinent clients were able to toilet themselves, even with verbal and physical guidance. Unobtrusive observation of toileting habits indicated that incontinent clients used the toilet less often than continent clients and used more staff assistance to do so. On mental status examination, incontinent clients scored significantly lower than continent clients. Incontinence in this population is a multidimensional disorder in which physical disability is a predominant factor.     

PTCA registry of German community hospitals

BACKGROUND: Percutaneous transluminal coronary angioplasty (PTCA) is widelyused, but no quality control has been systematically performedas yet. METHODS: A registry of all PTCA procedures has been established sinceOctober 1992 for the majority of the German community hospitalsperforming PTCA, representing about one third of all PTCA activityin Germany. Baseline demographic data, indication for PTCA,primary success and in-hospital clinical events were recorded.Each centre was visited at regular intervals to assure completenessand reliability of the data. RESULTS: Of 52 453 procedures performed from October 1992 to December1994 the catheter laboratory and discharge forms were 99·7%and 98·1% complete, respectively. In 85·9% a singlelesion was dilated per procedure, but 48·7% of the patientshad multivessel disease. The success rate was 66·5% incomplete occlusions (residual stenosis<70%) and 91·2%in non-occluded vessels (residual stenosis <50%). Abruptvessel closure occurred in 3·4%, of which 77·5%could be recanalized by repeat intervention. In procedures notdone for acute myocardial infarction, the in-hospital mortalitywas 0·52%, the procedure-related mortality 0·37%.In 3·02% of all patients a severe complication occurred(procedure-related death, myocardial infarction or emergencybypass surgery). CONCLUSION: Complete recording of all PTCA procedures is feasible even ona nationwide basis. This is a pre-requisite for continuous qualitycontrol. The reporting of the procedures by itself very probably,has an impact on the quality which is, however, not measurablequantitatively.     

Synthesis of 14C-anpirtoline

Synthesis of ¹⁴C-Anpirtoline ¹⁴C-labelling of Anpirtoline, a unique centrally acting non-opiate analgesic, is reported.     

Ueber Komplementbindungsversuche mit dem Blute Krebskranker

Ohne Zusammenfassung     

Osteonecrosis in patients with malignant lymphoma. A review of 31 cases

Osteonecrosis of the femoral and humeral heads is a serious complication of therapy for Hodgkin's disease and non-Hodgkin's lymphoma. Twenty-five patients were reassessed 5 years after being initially reported, in order to study the further progress and natural history of this complication. In addition, six recent patients who have also developed this condition are presented. With 5-year additional follow-up, no patient had developed symptoms of osteonecrosis in any bone other than those initially involved. Five patients developed severe complications thought to arise from their therapy suggesting that this group of patients were more sensitive to radiation injury than other patients treated with this modality. During the relatively short follow-up 5-year period, a surprising finding was the fact that 31% of the patients with Hodgkin's disease and 50% with non-Hodgkin's lymphoma had died. It is recommended that patients treated for lymphoma with steroid containing chemotherapy and radiotherapy be observed carefully for the occurrence of joint pain. Early diagnosis should lead to attempts to prevent total joint destruction.     

Zur Bedeutung der linearen Cervixmucuspenetration (CMP) für die Bewertung der Spermatozoenqualität

Linear mucus penetration of spermatozoa from 75 arbitrary selected men was evaluated using a non-commercial bovine cervix mucus preparation in the same way as Penetrak, but using round glass capillary tubes instead of flat plastic tubes. The mean penetration value was 28.7 +/- 7.10 mm in 90 min and the mean sperm density 36.0 +/- 22.79 x 10(6) ml. Mucus penetration was more correlated to sperm density (r = 0.6) than to any other semen parameter. Consequently it seems to be necessary to evaluate a sliding discrimination index for adequate penetration rate depending on sperm density (regression line and confidence interval). Numerical methods for comparison of penetration rates are suggested.