Evaluating the Impact of Overactive Bladder on Sexual Health in Women: What Is Relevant?

IntroductionTo assess sexual health, relevant, valid, and reliable questionnaires need to be used.AimTo assess the relevance and content validity of three sexual health questionnaires in women with overactive bladder (OAB) and urinary incontinence.Main Outcome MeasuresSexual Quality of Life Questionnaire––Female (SQoL‐F), Sexual Function Questionnaire (SFQ), and Pelvic Organ Prolapse–Incontinence Sexual Function Questionnaire (PISQ).MethodsWomen with OAB and urinary incontinence were recruited from five urology clinics in the United States; those who were interested in participating were mailed questionnaire packets with instructions. Each questionnaire item was followed by three questions regarding the understandability, relevance, and impact of bladder condition when responding to the question. Patients returned the completed questionnaires by mail; clinical information was obtained from chart review.ResultsA total of 129 patients (74% response) returned the questionnaires. The mean age was 56 years; 78% were white; 64% were married. In this sample, 64% had urge incontinence; 32% had mixed incontinence; and 4% had stress incontinence. Participants experienced bladder symptoms for a mean of 12.2 years with the following treatments: surgery (43%), bladder training (26%), exercise/biofeedback (42%), and medications (67%). SQoL‐F items were understood by more than 97% of the respondents, more than 89% for SFQ, and more than 82% for PISQ. There were two SQoL‐F items, one SFQ item, and 11 PISQ items that less than 60% of the respondents deemed relevant to their bladder condition. Correlations among questionnaire items and relevance to bladder condition ranged from 0.04 to 0.64 for the SQoL‐F, 0.04 to 0.47 for the SFQ, and 0.01 to 0.58 for the PISQ.ConclusionWomen with OAB found the majority of items on all three questionnaires to be relevant to their bladder condition. Of these questionnaires, the SQoL‐F had the highest understandability, fewest questions considered irrelevant, and correlated well with OAB symptoms. Coyne KS, Margolis MK, Brewster‐Jordan J, Sutherland SE, Bavendam T, and Rogers RG. Evaluating the impact of overactive bladder on sexual health in women: What is relevant? J Sex Med 2007;4:124–136.     

胸腺瘤合并重症肌无力危象30例围手术期的处理

0引言 胸腺切除是治疗重症肌无力(MG)的有效方法,有效率可达80%[1],但胸腺瘤术后常并发MG危象,导致死亡. 1992 02/2003 02我们共手术治疗89例胸腺瘤合并MG患者,术后发生MG 危象 30例,均抢救成功,无围手术期死亡.     

Cloning, expression, and properties of the microtubule-stabilizing protein STOP.

Nerve cells contain abundant subpopulations of cold-stable microtubules. We have previously isolated a calmodulin-regulated brain protein, STOP (stable tubule-only polypeptide), which reconstitutes microtubule cold stability when added to cold-labile microtubules in vitro. We have now cloned cDNA encoding STOP. We find that STOP is a 100.5-kDa protein with no homology to known proteins. The primary structure of STOP includes two distinct domains of repeated motifs. The central region of STOP contains 5 tandem repeats of 46 amino acids, 4 with 98% homology to the consensus sequence. The STOP C terminus contains 28 imperfect repeats of an 11-amino acid motif. STOP also contains a putative SH3-binding motif close to its N terminus. In vitro translated STOP binds to both microtubules and Ca2+-calmodulin. When STOP cDNA is expressed in cells that lack cold-stable microtubules, STOP associates with microtubules at 37 degrees C, and stabilizes microtubule networks, inducing cold stability, nocodazole resistance, and tubulin detyrosination on microtubules in transfected cells. We conclude that STOP must play an important role in the generation of microtubule cold stability and in the control of microtubule dynamics in brain.     

Impact of hepatitis B virus infection on women and children.

HBV infection acquired during infancy and early childhood has a high likelihood of progressing to chronic infection, which can lead to chronic hepatitis, cirrhosis, and primary hepatocellular carcinoma. In areas of the world where HBV infection occurs predominantly in infants and young children, routine infant immunization with hepatitis B vaccine is the most appropriate vaccination strategy. In the United States, the majority of HBV infections occur in adults with behaviors or occupations that put them at risk for HBV infection. Nevertheless, infection acquired during infancy and early childhood contributes significantly to the burden of chronic liver disease in the United States. Until recently, the vaccination strategy in the United States has included HBsAg screening of pregnant women and vaccination of infants born to infected women and vaccination of people in groups at high risk for HBV infection. Because of the difficulties in accessing and vaccinating persons from high-risk groups and the recent findings that HBV infection occurs more commonly among children in some groups in the United States than previously appreciated, the Immunization Practices Advisory Committee of the US Public Health Service and the American Academy of Pediatrics in 1991 endorsed a strategy of universal immunization of infants for hepatitis B. This strategy has the advantages of accessing infants in the United States through preexisting vaccine delivery systems and vaccinating individuals prior to their engaging in high-risk behavior. Continued screening of pregnant women for HBsAg is necessary to prevent perinatal HBV transmission and to identify for vaccination those household and sexual contacts of HBV carriers, a group that is also at high risk of HBV infection.     

Increased circulating CSF-1 (M-CSF) in myeloproliferative disease: association with myeloid metaplasia and peripheral bone marrow extension

Myeloproliferative disease (MPD) is heterogeneous in phenotypic expression and may display features consistent with expansion and activation of the monocyte/macrophage population during its course. The role of colony-stimulating factor-1 (CSF-1) in the pathophysiology of MPD was investigated by measuring circulating CSF-1 levels and examining their relationship to disease phenotype. Serum CSF-1 concentrations, measured by radioimmunoassay, were elevated in all MPD phenotypes. CSF-1 levels differed significantly between groups of patients with essential thrombocythemia, polycythemia vera, and postpolycythemic or agnogenic myeloid metaplasia (in ascending order). CSF-1 serum levels were positively correlated with spleen size and the degree of peripheral bone marrow extension, determined by scintigraphy using a macrophage-seeking isotope. There was no correlation between CSF-1 concentration and circulating levels of erythrocytes, neutrophils or platelets, or the presence of bone marrow fibrosis. Elevated serum CSF-1 levels appear to be associated with an expanded monocyte/macrophage population in MPD. In view of the known cooperativity between CSF-1 and other growth factors in regulating hematopoiesis, the finding of increased serum CSF-1 concentrations and its association with myeloid metaplasia and bone marrow extension may indicate a pathophysiologic role for CSF-1 in determining the phenotypic expression of MPD.     

3T multiparametric MR imaging,PIRADSv2-based detection of index prostate cancer lesions in the transition zone and the peripheral zone using whole mount histopathology as reference standard

Abdominal Radiology - To evaluate 3T mpMRI characteristics of transition zone and peripheral zone index prostate cancer lesions stratified by Gleason Score and PI-RADSv2 with whole mount...     

Extraction Atherectomy for Recently Occluded Saphenous Vein Grafts: A Retrospective Study

BACKGROUND: Over 300,000 coronary artery bypass operations are performed annually in the U.S., in which saphenous vein grafts remain the most often utilized conduit for myocardial revascularization. Still, the relatively short life-span of reverse saphenous vein grafts (SVG) demands that revascularization techniques be developed for SVG occlusions. Extraction atherectomy (EA) as a pre-treatment to percutaneous transluminal coronary angioplasty (PTCA) may offer advantages to PTCA alone in the treatment of these lesions. While a randomized study would best define the potential advantages of this treatment strategy, a retrospective comparison to historical data may provide some practical insights. PATIENTS AND METHODS: One hundred and six patients treated with EA + PTCA (Group 1) were retrospectively compared to a historical subset of 101 patients treated with PTCA alone (Group 2). Both groups presented with similar clinical profiles with respect to gender, age, graft age, percent diameter stenosis, and location of the target lesion. However, Group 1 had a significantly higher incidence of pre-procedure class III-IV angina than did Group 2 (92.4% vs. 70.3%, p < 0.002), and more recent occlusions. Both groups were compared at one year for the presence of angina, myocardial infarction, and death. Chi-square analysis was performed on the categorical variables. RESULTS: At one-year follow-up, 62.1% of the Group 1 patients were free from cardiac events (defined as absence of angina, myocardial infarction or death) and 58.9% of the Group 2 patients were event free (p = 0.78). A total of 27.0% of the Group 1 patients suffered from class I or Il angina compared to 35.9% of the Group 2 patients (p = 0.40). A total of 10.8% of the Group 1 patients had suffered a myocardial infarction compared to 28.2% of the Group 2 patients (p = 0.06). A total of 2.7% of the Group 1 patients had died compared to 10.5% of the Group 2 patients (p = 0.16). CONCLUSIONS: Patients with recently occluded SVGs (within 3 months) and refractory angina (class III or IV) treated with EA + PTCA have a similar clinical outcome at 1 year follow-up to a historical population treated with PTCA alone, despite the higher incidence of class III-IV angina, and more recent occlusions upon presentation. However, 1-year follow-up results reveal a trend towards less frequent myocardial infarctions for patients treated with EA + PTCA than the historical group of patients treated with PTCA alone (p = 0.06).