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61.
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
62.
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
63.
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
64.
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
65.
66.
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
67.
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
68.
体外循环和非体外循环冠脉搭桥术对肾功能的影响 总被引:1,自引:0,他引:1
目的:研究体外循环和非体外循环冠脉搭桥术对肾功能的影响。方法:20例接受选择性冠脉搭桥术的患者随机分为2组,10例(A组)为体外循环下冠脉搭桥组,另10例(B组)为非体外循环下冠脉搭桥组,围术期48h内监测肾小球和肾小管功能的改变。结果:两组无住院死亡,心梗和急性肾功能不全,非体外循环冠脉搭桥组尿白蛋白、α1-微球蛋白和NAG较体外循环组明显降低(P<0.01)。结论:非体外循环冠脉搭桥组较传统体外循环冠脉搭桥组明显减轻对肾功能的损伤。 相似文献
69.
万艾可治疗ED时对BPH引起LUTS改善的研究 总被引:6,自引:3,他引:3
目的 :探索、研究万艾可在治疗阴茎勃起功能障碍 (ED)时对由良性前列腺增生 (BPH)引起的下尿路症状(LUTS)的影响。 方法 :32例ED同时伴有BPH的研究对象 ,采用IIEF 5问卷表和IPSS评分表 ,在服用万艾可前和服药后 6个月分别各填写一次 ,应用单因素方差分析对所得到的前后评分进行统计学分析。结果 :在服药前32例ED中 ,轻、中、重分别为 14、13、5例 ,BPH中轻、中、重分别为 3、15、14例 ;服药后IIEF 5评分平均上升4 2 .36 % ,IPSS评分平均下降 2 0 .14 % ,两者在统计学上都有显著性差异 ,P <0 .0 1。 结论 :在治疗中老年性ED合并BPH中 ,应用万艾可既能治疗ED ,取得完美的性生活 ,又能达到改善由BPH引起的LUTS。万艾可是一治疗ED有效的药物 ,但对于前列腺基质平滑肌亦有辅助性松弛作用 ,因此也有助于BPH时LUTS的缓解。 相似文献
70.
Takashi Ito Ryuji Sakakibara MD Tatsuya Yamamoto Tomoyuki Uchiyama Zhi Liu Masato Asahina Morihiro Higashi Kimihito Arai Shoichi Ito Yusuke Awa Kaori Yamamoto Mika Kinou Tomonori Yamanishi Takamichi Hattori 《Clinical autonomic research》2006,16(1):66-71
Abstract Uro-neurological assessment was performed in four patients with small-fiber neuropathy due to amyloidosis (2 transthyretin-type/2
immunoglobulin light-chain-type). Voiding difficulties were due to detrusor weakness and impaired bladder sensation. In two
patients cholinesterase inhibition treatment caused urge incontinence, indicating detrusor denervation supersensitivity. The
underlying mechanisms of urinary dysfunction seem to involve postganglionic cholinergic and afferent somatic nerves. 相似文献