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Zisis G, Huynh Q, Whitmore K, Lay M, Yang Y, Carrington M, Marwick T. Pre-discharge B-lines at bedside predicts 30-day and multiple 90-day hospital re-admission in patients admitted for acute decompensated heart failure. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Inadequate decongestion at index admission for Acute Decompensation of Heart Failure (ADHF) is a common cause of adverse outcomes. A bedside 9-zone Lung and IVC ultrasound assessment (LUICA) may help to guide decongestion and reduce hospital readmission or mortality.
Purpose
To identify predictors of multiple 90-day hospital representations or mortality based on a bedside handheld 9-zone LUICA volume assessment obtained by HF nurses.
Methods
Patients admitted for ADHF, enrolled in the RISK-HF registry and undergoing pre-discharge LUICA, were assessed for 90-day readmission and/or mortality. The primary outcome of this observational report was prediction of multiple hospital representations based on pre-discharge volume status. The LUICA was performed with a hand-held ultrasound (HHU) device (Lumify, Philips) by trained HF-nurses. Functional capacity was measured with Duke Activity Status Index (DASI). Paired t-tests were used to compare mean differences. Logistic and linear regression were used to study relationships of outcomes with clinical characteristics. Cox regression was used to analyse time to repeated readmission or death. Analysis conducted with SPSS statistics V27 and STATA SE16.
Results
Of 302 ADHF patients, 67 readmitted within 30-days (age 76±8.5; men, 60%; HFrEF; 44%) and 235 did not readmit within 30-days (age 72±14; 57% men; 52% HFrEF). Readmission occurred in older patients (p=0.05), with pre-discharge signs of residual congestion that was based on the number of b-lines (p<0.01) (Table 1). Pre-discharge B-lines were predictive of DAOOH (β −0.41, −0.6, −0.22, p<0.01) and of multiple 90-day hospital readmissions (β 0.03, 0.018, 0.05, p<0.01), independently of 30-day event risk score, number of readmissions the preceding 12 months and age at index admission (Table 2). Number of B-lines at discharge was also associated with repeated readmission or death (HR=1.02 [1.01, 1.04]) in time-to-event analysis, independent of any other factors.
Conclusion
Pre-discharge residual congestion defined by the number B-lines increases the likelihood of multiple 90-day adverse outcomes.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): The University of MelbourneBaker Heart & Diabetes Institute
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Affiliation(s)
- G Zisis
- Baker Heart and Diabetes Institute , Melbourne , Australia
| | - Q Huynh
- Baker Heart and Diabetes Institute , Melbourne , Australia
| | - K Whitmore
- Baker Heart and Diabetes Institute , Melbourne , Australia
| | - M Lay
- Baker Heart and Diabetes Institute , Melbourne , Australia
| | - Y Yang
- Western Health , Melbourne , Australia
| | - M Carrington
- Baker Heart and Diabetes Institute , Melbourne , Australia
| | - T Marwick
- Baker Heart and Diabetes Institute , Melbourne , Australia
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2
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Zisis G, Yang Y, Whitmore K, Lay M, Huynh Q, Neil C, Carrington M, Marwick TH. Association of heart failure readmission with results of lung ultrasound at discharge and follow-up. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Attainment of euvolemia at discharge and maintaining it after discharge are fundamental to avoiding readmission in heart failure (HF). Lung ultrasound (LUS) is potentially of value to detect congestion but the role of sequential LUS is undefined.
Purpose
To determine the predictive value of discharge and follow-up LUS.
Methods
98 pts (mean age 72.8±12.3, mean ejection fraction 41.4%±18.4, gender male 56%) admitted with HF or fluid overload, underwent pre-discharge LUS to evaluate pulmonary (presence of ≥10 B lines) and peripheral (IVC diameter) congestion. LUS was repeated at home follow-up visits at 2 weeks post-discharge. Associations were sought between pre-discharge and follow-up LUS and 90 day outcomes (readmission or mortality).
Results
Overall, there was an increase in the total number of B-lines from baseline to week 2 [mean change in B-lines 3.82 [95% confidence intervals (CI), 0.30, 7.33) p=0.036] followed by a small decrease between scan 2 and scan 3 [mean change in B-lines −0.25 (95% CI, −0.17, 7.68), p=0.94]. Of 73 with <10 B-lines pre-discharge, 26 (36%) had events by 90 days, compared with 14 of the 25 with ≥10 pre-discharge B-lines (56%, p=0.07). However, all of those with ≥10 B lines at 2 weeks had events, compared with 25% of those with <10 B lines (p=0.04).
Conclusions
Attainment and preservation of euvolemia after index hospitalization for HF is challenging and requires appropriate patient support. Detection of residual congestion, as well as detection of early re-congestion after hospital discharge.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): The University of MelbourneBaker Heart & Diabetes Institute Readmission risk ratio
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Affiliation(s)
- G Zisis
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Y Yang
- Western Health, Melbourne, Australia
| | - K Whitmore
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - M Lay
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Q Huynh
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - C Neil
- Western Health, Melbourne, Australia
| | - M Carrington
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - T H Marwick
- Baker Heart and Diabetes Institute, Melbourne, Australia
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3
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Zisis G, Yang Y, Whitmore K, Lay M, Huynh Q, Neil C, Carrington M, Marwick TH. Efficacy and feasibility of heart failure nurses to deliver a lungs and inferior vena cava ultrasound assessment (LUICA) protocol and prediction of outcomes. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background/Introduction
Congestion is the main cause for hospital admission and readmission in heart failure (HF), with almost half being discharged with symptoms that suggest residual congestion. Novel non-invasive assessments (eg. lung ultrasound; [LUS], and Inferior Vena Cava [IVC]) may be used to assess congestion. A LUs and IvC Assessment (LUICA) delivered by HF nurses before discharge, could detect residual congestion, optimise diuresis and guide post discharge treatment.
Purpose
To determine the ability of HF nurses to successfully learn a LUICA protocol, obtain interpretable images, provide diagnostic reports and predict outcomes.
Methods
A teaching program focused on quantification of congestion by counting B-lines and reporting estimated right atrial pressure (e-RAP) from IVC congestion. LUICA readings were dichotomised based on lung congestion (≥10 vs <10 B-lines), the presence of lung pathology (consolidation, atelectasis, effusion) and IVC congestion (e-RAP >3mmHg vs 3mmHg). LUICA (8 lung zones + 2 IVC zones) was added to pre-discharge review (4 days post-admission) by HF nurses in 108 hospitalised pts (72±13 years; 58% male) with acute HF, fluid overload, and a variety of lung pathology. Images were assessed for quality (good, usable, measurable or not measurable) and interpreted by a LUICA expert and HF nurses, blinded to admission diagnosis. The predictive value of LUICA readings for patient outcomes (readmission or mortality) was expressed as risk ratio.
Results
The quality at the majority of the images was assessed as good or usable (expert: 82/107, nurses: 66/107, p=0.02). Readmission was predicted by both experts and nurses (picture 1).
Conclusions
HF nurses can be adequately trained in a 10 Zone LUICA and successfully obtain interpretable images. The predictive power of their interpretation is similar to experts.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): The University of MelbourneBaker Heart & Diabetes Institute Readmission risk ratio based on LUICA
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Affiliation(s)
- G Zisis
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Y Yang
- Western Health, Melbourne, Australia
| | - K Whitmore
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - M Lay
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Q Huynh
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - C Neil
- Western Health, Melbourne, Australia
| | - M Carrington
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - T H Marwick
- Baker Heart and Diabetes Institute, Melbourne, Australia
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4
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Huynh Q, Whitmore K, Negishi K, DePasquale C, Hare J, Leung D, Stanton T, Marwick T. Reducing Readmission in Heart Failure: The Role of Patients’ Cognitive Function. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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5
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Garcia FH, Andreoiu C, Ball GC, Bell A, Garnsworthy AB, Nowacki F, Petrache CM, Poves A, Whitmore K, Ali FA, Bernier N, Bhattacharjee SS, Bowry M, Coleman RJ, Dillmann I, Djianto I, Forney AM, Gascoine M, Hackman G, Leach KG, Murphy AN, Natzke CR, Olaizola B, Ortner K, Peters EE, Rajabali MM, Raymond K, Svensson CE, Umashankar R, Williams J, Yates D. Absence of Low-Energy Shape Coexistence in ^{80}Ge: The Nonobservation of a Proposed Excited 0_{2}^{+} Level at 639 keV. Phys Rev Lett 2020; 125:172501. [PMID: 33156683 DOI: 10.1103/physrevlett.125.172501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 08/19/2020] [Accepted: 09/18/2020] [Indexed: 06/11/2023]
Abstract
The ^{80}Ge structure was investigated in a high-statistics β-decay experiment of ^{80}Ga using the GRIFFIN spectrometer at TRIUMF-ISAC through γ, β-e, e-γ, and γ-γ spectroscopy. No evidence was found for the recently reported 0_{2}^{+} 639-keV level suggested as evidence for low-energy shape coexistence in ^{80}Ge. Large-scale shell model calculations performed in ^{78,80,82}Ge place the 0_{2}^{+} level in ^{80}Ge at 2 MeV. The new experimental evidence combined with shell model predictions indicate that low-energy shape coexistence is not present in ^{80}Ge.
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Affiliation(s)
- F H Garcia
- Department of Chemistry, Simon Fraser University, Burnaby, British Columbia V5A 1S6, Canada
| | - C Andreoiu
- Department of Chemistry, Simon Fraser University, Burnaby, British Columbia V5A 1S6, Canada
| | - G C Ball
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - A Bell
- Department of Chemistry, Simon Fraser University, Burnaby, British Columbia V5A 1S6, Canada
| | - A B Garnsworthy
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - F Nowacki
- Université de Strasbourg, IPHC, 23 rue du Loess 67037 Strasbourg, France
- CNRS, UMR7178, 67037 Strasbourg, France
| | - C M Petrache
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - A Poves
- Departamento de Física Teórica and IFTUAM/CSIC, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - K Whitmore
- Department of Chemistry, Simon Fraser University, Burnaby, British Columbia V5A 1S6, Canada
| | - F A Ali
- Department of Physics, University of Guelph, Guelph, Ontario, N1G 2W1, Canada
- Department of Physics, College of Education, University of Sulaimani, P.O. Box 334, Sulaimani, Kurdistan Region, Iraq
| | - N Bernier
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada
| | - S S Bhattacharjee
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - M Bowry
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - R J Coleman
- Department of Physics, University of Guelph, Guelph, Ontario N1G 2W1, Canada
| | - I Dillmann
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
- Department of Physics and Astronomy, University of Victoria, Victoria, British Columbia V8P 5C2, Canada
| | - I Djianto
- Department of Chemistry, Simon Fraser University, Burnaby, British Columbia V5A 1S6, Canada
| | - A M Forney
- Department of Chemistry and Biochemistry, University of Maryland College Park, College Park, Maryland 20742, USA
| | - M Gascoine
- Department of Chemistry, Simon Fraser University, Burnaby, British Columbia V5A 1S6, Canada
| | - G Hackman
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - K G Leach
- Department of Physics, Colorado School of Mines, Golden, Colorado 80401, USA
| | - A N Murphy
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - C R Natzke
- Department of Physics, Colorado School of Mines, Golden, Colorado 80401, USA
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia, V6T 2A3, Canada
| | - B Olaizola
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia, V6T 2A3, Canada
| | - K Ortner
- Department of Chemistry, Simon Fraser University, Burnaby, British Columbia V5A 1S6, Canada
| | - E E Peters
- Department of Chemistry, University of Kentucky, Lexington, Kentucky 40506-0055, USA
| | - M M Rajabali
- Department of Physics, Tennessee Technological University, Cookeville, Tennessee 38505, USA
| | - K Raymond
- Department of Chemistry, Simon Fraser University, Burnaby, British Columbia V5A 1S6, Canada
| | - C E Svensson
- Department of Physics, University of Guelph, Guelph, Ontario N1G 2W1, Canada
| | - R Umashankar
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia, V6T 2A3, Canada
| | - J Williams
- Department of Chemistry, Simon Fraser University, Burnaby, British Columbia V5A 1S6, Canada
| | - D Yates
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia, V6T 2A3, Canada
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6
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Kolos K, Miller D, Grzywacz R, Iwasaki H, Al-Shudifat M, Bazin D, Bingham CR, Braunroth T, Cerizza G, Gade A, Lemasson A, Liddick SN, Madurga M, Morse C, Portillo M, Rajabali MM, Recchia F, Riedinger LL, Voss P, Walters WB, Weisshaar D, Whitmore K, Wimmer K, Tostevin JA. Publisher's Note: Direct Lifetime Measurements of the Excited States in ^{72}Ni [Phys. Rev. Lett. 116, 122502 (2016)]. Phys Rev Lett 2020; 124:209901. [PMID: 32501080 DOI: 10.1103/physrevlett.124.209901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Indexed: 06/11/2023]
Abstract
This corrects the article DOI: 10.1103/PhysRevLett.116.122502.
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7
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Fall M, Nordling J, Cervigni M, Dinis Oliveira P, Fariello J, Hanno P, Kåbjörn-Gustafsson C, Logadottir Y, Meijlink J, Mishra N, Moldwin R, Nasta L, Quaghebeur J, Ratner V, Sairanen J, Taneja R, Tomoe H, Ueda T, Wennevik G, Whitmore K, Wyndaele JJ, Zaitcev A. Hunner lesion disease differs in diagnosis, treatment and outcome from bladder pain syndrome: an ESSIC working group report. Scand J Urol 2020; 54:91-98. [PMID: 32107957 DOI: 10.1080/21681805.2020.1730948] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objectives: There is confusion about the terms of bladder pain syndrome (BPS) and Interstitial Cystitis (IC). The European Society for the Study of IC (ESSIC) classified these according to objective findings [9]. One phenotype, Hunner lesion disease (HLD or ESSIC 3C) differs markedly from other presentations. Therefore, the question was raised as to whether this is a separate condition or BPS subtype.Methods: An evaluation was made to explore if HLD differs from other BPS presentations regarding symptomatology, physical examination findings, laboratory tests, endoscopy, histopathology, natural history, epidemiology, prognosis and treatment outcomes.Results: Cystoscopy is the method of choice to identify Hunner lesions, histopathology the method to confirm it. You cannot distinguish between main forms of BPS by means of symptoms, physical examination or laboratory tests. Epidemiologic data are incomplete. HLD seems relatively uncommon, although more frequent in older patients than non-HLD. No indication has been presented of BPS and HLD as a continuum of conditions, one developing into the other.Conclusions: A paradigm shift in the understanding of BPS/IC is urgent. A highly topical issue is to separate HLD and BPS: treatment results and prognoses differ substantially. Since historically, IC was tantamount to Hunner lesions and interstitial inflammation in the bladder wall, still, a valid definition, the term IC should preferably be reserved for HLD patients. BPS is a symptom syndrome without specific objective findings and should be used for other patients fulfilling the ESSIC definitions.
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Affiliation(s)
- Magnus Fall
- Department of Urology, Sahlgrenska Academy at the University Gothenburg, Institute of Clinical Sciences, Göteborg, Sweden
| | - Jørgen Nordling
- Department of Urology, Herlev University Hospital, Copenhagen, Denmark
| | - Mauro Cervigni
- Female Pelvic Medicine & Reconstructive Surgery Center, Catholic University, Rome, Italy
| | - Paulo Dinis Oliveira
- Department of Urology, Hospital de Sao Joao, University of Porto Faculty of Medicine, Porto, Portugal
| | - Jennifer Fariello
- The Arthur Smith Institute for Urology, Zucker School of Medicine at Hofstra-Northwell, Hempstead, NY, USA
| | - Philip Hanno
- Department of Urology, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Yr Logadottir
- Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden
| | - Jane Meijlink
- International Painful Bladder Foundation, Naarden, The Netherlands
| | - Nagendra Mishra
- Pramukh Swami Medical College, Shree Krishna Hospital, Karamsad, India
| | - Robert Moldwin
- The Arthur Smith Institute for Urology, Zucker School of Medicine at Hofstra-Northwell, Hempstead, NY, USA
| | | | - Jorgen Quaghebeur
- Department of Urology, Small Pelvis Clinic, University Hospital Antwerpen, Antwerp, Belgium
| | - Vicki Ratner
- Interstitial Cystitis Association of America, San Jose, CA, USA
| | - Jukka Sairanen
- Department of Urology, Helsinki University Central Hospital, Helsinki, Finland
| | - Rajesh Taneja
- Department of Urology and Andrology, Indraprastha Apollo Hospitals, New Delhi, India
| | - Hikaru Tomoe
- Department of Urology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
| | - Tomohiro Ueda
- Comfortable Urology Network, Ueda Clinic, Kyoto, Japan
| | - Gjertrud Wennevik
- Department of Urology, Herlev and Gentofte Hospital, Copenhagen, Denmark
| | - Kristene Whitmore
- Department of Urology, Drexel University College of Medicine, Philadelphia, PA, USA
| | - Jean Jacques Wyndaele
- Department of Urology, University of Antwerp Faculty of Medicine and Health Sciences, Antwerp, Belgium
| | - Andrew Zaitcev
- Department of Urology, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
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8
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Crouss T, Mancenido B, Rana N, Jia X, Whitmore K. Pain control for interstitial cystitis/bladder pain syndrome patients undergoing pelvic reconstructive surgery. Journal of Endometriosis and Pelvic Pain Disorders 2019. [DOI: 10.1177/2284026519869802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: Scant research exists on pain control for interstitial cystitis patients undergoing pelvic reconstructive surgery. Our aim was to compare the perioperative courses in patients with and without interstitial cystitis undergoing pelvic reconstructive surgery performed using primarily monitored anesthesia care with local anesthesia. Methods: A retrospective chart review of surgical cases performed at a single site from November 2015 to July 2018 was performed. Joint non-gynecologic cases were excluded. Data including demographics, intraoperative variables, medication requirements, and postoperative courses were abstracted. Chi-square, independent t, and Mann–Whitney U tests were used to compare interstitial cystitis with non-interstitial cystitis patients. Results: In total, 65 separate cases met inclusion criteria and were analyzed, with 57 individual subjects. Out of the 65 cases, 33 cases were performed on interstitial cystitis patients. Only 2 of the 33 interstitial cystitis patient cases required general anesthesia. Interstitial cystitis patients did not require higher concentrations of 1% lidocaine with epinephrine (average of 3.8 mg/kg) compared to patients without (2.8 mg/kg). There was no difference between groups in perioperative complications, length of recovery, or postoperative narcotic consumption. Conclusion: Perioperative outcomes and pain control do not differ in those with and without interstitial cystitis undergoing pelvic reconstructive surgery. Prolapse surgery can be safely performed on a patient population with a high proportion of chronic pelvic pain using monitored anesthesia care with local anesthesia, without increased morbidity or difficultly with perioperative pain control.
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Affiliation(s)
- Tess Crouss
- Female Pelvic Medicine and Reconstructive Surgery, Drexel University, Philadelphia, PA, USA
| | | | - Neha Rana
- Female Pelvic Medicine and Reconstructive Surgery, Drexel University, Philadelphia, PA, USA
| | - Xibei Jia
- Female Pelvic Medicine and Reconstructive Surgery, Drexel University, Philadelphia, PA, USA
| | - Kristene Whitmore
- Female Pelvic Medicine and Reconstructive Surgery, Drexel University, Philadelphia, PA, USA
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9
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Loelius C, Kobayashi N, Iwasaki H, Bazin D, Belarge J, Bender PC, Brown BA, Elder R, Elman B, Gade A, Grinder M, Heil S, Hufnagel A, Longfellow B, Lunderberg E, Mathy M, Otsuka T, Petri M, Syndikus I, Tsunoda N, Weisshaar D, Whitmore K. Enhanced Electric Dipole Strength for the Weakly Bound States in ^{27}Ne. Phys Rev Lett 2018; 121:262501. [PMID: 30636164 DOI: 10.1103/physrevlett.121.262501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 11/07/2018] [Indexed: 06/09/2023]
Abstract
An enhanced low-energy electric dipole (E1) strength is identified for the weakly bound excited states of the neutron-rich isotope ^{27}Ne. The Doppler-shift lifetime measurements employing a combination of the γ-ray tracking array GRETINA, the plunger device, and the S800 spectrograph determine the lower limit of 0.030 e^{2} fm^{2} or 0.052 W.u. for the 1/2^{+}→3/2^{-} E1 transition in ^{27}Ne, representing one of the strongest E1 strengths observed among the bound discrete states in this mass region. This value is at least 30 times larger than that measured for the 3/2^{-} decay to the 3/2_{gs}^{+} ground state. A comparison of the present results to large-scale shell-model calculations points to an important role of core excitations and deformation in the observed E1 enhancement, suggesting a novel example of the electric dipole modes manifested in weakly bound deformed systems.
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Affiliation(s)
- C Loelius
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - N Kobayashi
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - H Iwasaki
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - D Bazin
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - J Belarge
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - P C Bender
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - B A Brown
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - R Elder
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - B Elman
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - A Gade
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - M Grinder
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - S Heil
- Institut für Kernphysik, Technische Universität Darmstadt, Darmstadt D64289, Germany
| | - A Hufnagel
- Institut für Kernphysik, Technische Universität Darmstadt, Darmstadt D64289, Germany
| | - B Longfellow
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - E Lunderberg
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - M Mathy
- Institut für Kernphysik, Technische Universität Darmstadt, Darmstadt D64289, Germany
| | - T Otsuka
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Center for Nuclear Study, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku Tokyo, Japan
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku Tokyo, Japan
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - M Petri
- Institut für Kernphysik, Technische Universität Darmstadt, Darmstadt D64289, Germany
- Department of Physics, University of York, Heslington, York YO10 5DD, United Kingdom
| | - I Syndikus
- Institut für Kernphysik, Technische Universität Darmstadt, Darmstadt D64289, Germany
| | - N Tsunoda
- Center for Nuclear Study, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku Tokyo, Japan
| | - D Weisshaar
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - K Whitmore
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
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Mijatović T, Kobayashi N, Iwasaki H, Bazin D, Belarge J, Bender PC, Brown BA, Dewald A, Elder R, Elman B, Gade A, Grinder M, Haylett T, Heil S, Loelius C, Longfellow B, Lunderberg E, Mathy M, Whitmore K, Weisshaar D. Lifetime Measurements and Triple Coexisting Band Structure in ^{43}S. Phys Rev Lett 2018; 121:012501. [PMID: 30028163 DOI: 10.1103/physrevlett.121.012501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 05/07/2018] [Indexed: 06/08/2023]
Abstract
Lifetime measurements of excited states in the neutron-rich nucleus ^{43}S were performed by applying the recoil-distance method on fast rare-isotope beams in conjunction with the Gamma-Ray Energy Tracking In-beam Nuclear Array. The new data based on γγ coincidences and lifetime measurements resolve a doublet of (3/2^{-}) and (5/2^{-}) states at low excitation energies. Results were compared to the π(sd)-ν(pf) shell model and antisymmetrized molecular dynamics calculations. The consistency with the theoretical calculations identifies a possible appearance of three coexisting bands near the ground state of ^{43}S: the K^{π}=1/2^{-} band built on a prolate-deformed ground state, a band built on an isomer with a 1f_{7/2}^{-1} character, and a suggested excited band built on a newly discovered doublet state. The latter further confirms the collapse of the N=28 shell closure in the neutron-rich region.
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Affiliation(s)
- T Mijatović
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - N Kobayashi
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - H Iwasaki
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - D Bazin
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - J Belarge
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - P C Bender
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - B A Brown
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - A Dewald
- Institut für Kernphysik der Universität zu Köln, Köln D-50937, Germany
| | - R Elder
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - B Elman
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - A Gade
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - M Grinder
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - T Haylett
- Department of Physics, University of York, Heslington, York YO10 5DD, United Kingdom
| | - S Heil
- Institut für Kernphysik, Technische Universität Darmstadt, Darmstadt 64289, Germany
| | - C Loelius
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - B Longfellow
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - E Lunderberg
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - M Mathy
- Institut für Kernphysik, Technische Universität Darmstadt, Darmstadt 64289, Germany
| | - K Whitmore
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - D Weisshaar
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
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11
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Rogers RG, Pauls RN, Thakar R, Morin M, Kuhn A, Petri E, Fatton B, Whitmore K, Kinsberg S, Lee J. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for the assessment of sexual health of women with pelvic floor dysfunction. Neurourol Urodyn 2018; 37:1220-1240. [PMID: 29441607 DOI: 10.1002/nau.23508] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 12/18/2017] [Indexed: 12/18/2022]
Abstract
AIMS The terminology in current use for sexual function and dysfunction in women with pelvic floor disorders lacks uniformity, which leads to uncertainty, confusion, and unintended ambiguity. The terminology for the sexual health of women with pelvic floor dysfunction needs to be collated in a clinically-based consensus report. METHODS This report combines the input of members of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA), and the International Continence Society (ICS), assisted at intervals by many external referees. Internal and external review was developed to exhaustively examine each definition, with decision-making by collective opinion (consensus). Importantly, this report is not meant to replace, but rather complement current terminology used in other fields for female sexual health and to clarify terms specific to women with pelvic floor dysfunction. RESULTS A clinically based terminology report for sexual health in women with pelvic floor dysfunction encompassing over 100 separate definitions, has been developed. Key aims have been to make the terminology interpretable by practitioners, trainees, and researchers in female pelvic floor dysfunction. Interval review (5-10 years) is anticipated to keep the document updated and as widely acceptable as possible. CONCLUSION A consensus-based terminology report for female sexual health in women with pelvic floor dysfunction has been produced aimed at being a significant aid to clinical practice and a stimulus for research.
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Affiliation(s)
| | | | - Ranee Thakar
- Croydon University Hospital Croydon, London, United Kingdom
| | | | - Annette Kuhn
- University Teaching Hospital Berne (Inselspital), Bern, Switzerland
| | | | - Brigitte Fatton
- University Hospital Nîmes, Nimes, Languedoc-Roussillon, France
| | | | | | - Joseph Lee
- University of New South Wales, St Vincents Hospital, Sydney, New South Wales, Australia
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12
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Garrett P, Bernier N, Dunlop R, MacLean A, Bildstein V, Dillmann I, Jungclaus A, Svensson C, Andreoiu C, Ball G, Bidaman H, Boubel P, Burbadge C, Caballero-Folch R, Dunlop M, Evitts L, Garcia F, Garnsworthy A, Hackman G, Hallam S, Henderson J, Ilyushkin S, Kisliuk D, Krücken R, Lassen J, Li R, MacConnachie E, McGee E, Moukaddam M, Olaizola B, Ortner K, Padilla-Rodal E, Park J, Paetkau O, Petrache C, Pore J, Radich A, Ruotsalainen P, Smallcombe J, Smith J, Tabor S, Teigelhöfer A, Turko J, Whitmore K, Zidar T. Advances at TRIUMF-ISAC and decay of neutron-rich Cd studied with GRIFFIN. EPJ Web Conf 2018. [DOI: 10.1051/epjconf/201819304011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The β-decay half lives of nuclei near the r-process path are critical information required for abundance calculations, especially those near neutron number N = 82. Specifically, the nuclei below doubly-magic 132Sn are key, and play an important role in the formation and shape of the second r-process abundance peak. The half lives in this region are challenging to measure due to the significant β-delayed neutron decay branches and the population of isomeric states with half lives comparable to the ground states. However, by measuring the time distribution of γ rays, these complications can be eliminated. This requires, however, a very effcient γ-ray spectrometer since the production of isotopes in this region is very limited. The new GRIFFIN array at TRIUMF-ISAC provides the high effciency required for these measurements. Recent improvements in the quality of the beams produced at TRIUMF, employing the IG-LIS device, are outlined, as well as the current status of the ARIEL facility. The GRIFFIN spectrometer and its use are briefly described. The experiment to measure the half lives of 128-130Cd is outlined and the results given, and some examples of the power of GRIFFIN to expand decay schemes, specifically for the decay of 128Cd to 128In, are given.
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Rittenberg L, Morrissey D, El-Khawand D, Whitmore K. Kenalog Injection into Hunner's Lesions as a Treatment for Interstitial Cystitis/Bladder Pain Syndrome. Curr Urol 2017; 10:154-156. [PMID: 28878600 DOI: 10.1159/000447171] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 11/29/2016] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION This study aims to evaluate the effectiveness of kenalog injection into Hunner's lesions. MATERIALS AND METHODS All patients had cystoscopy and bladder hydrodistention with corticosteroid injection into Hunner's lesions over a 2.5-year period. Data include patient characteristics and pre- and post-operative validated questionnaires. Spearman Correlation and Wilcoxon t-tests were used for analysis. RESULTS One hundred patients were reviewed retrospectively. There was a 1.1 point decrease in pain at 12 weeks post-operation (p = 0.435). Urinary frequency decreased from a mean of 11.7 to 9.1 daily episodes (p = 0.05), and nocturia from a mean of 3 to 1.6 nightly episodes (p = 0.008). CONCLUSION The use of a corticosteroid may be beneficial to symptom control and improvement in the quality of life of interstitial cystitis/painful bladder syndrome patients. Patients had improved frequency and nocturia 12 weeks post injection.
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Affiliation(s)
- Lauren Rittenberg
- Division of Female Pelvic Medicine and Reconstruction, Drexel University College of Medicine, Philadephia, Pennsylvania, USA
| | - Darlene Morrissey
- Division of Female Pelvic Medicine and Reconstruction, Drexel University College of Medicine, Philadephia, Pennsylvania, USA
| | - Dominique El-Khawand
- Division of Female Pelvic Medicine and Reconstruction, Drexel University College of Medicine, Philadephia, Pennsylvania, USA
| | - Kristene Whitmore
- Division of Female Pelvic Medicine and Reconstruction, Drexel University College of Medicine, Philadephia, Pennsylvania, USA
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Parker JJ, Wiedenhöver I, Cottle PD, Baker J, McPherson D, Riley MA, Santiago-Gonzalez D, Volya A, Bader VM, Baugher T, Bazin D, Gade A, Ginter T, Iwasaki H, Loelius C, Morse C, Recchia F, Smalley D, Stroberg SR, Whitmore K, Weisshaar D, Lemasson A, Crawford HL, Macchiavelli AO, Wimmer K. Isomeric Character of the Lowest Observed 4^{+} State in ^{44}S. Phys Rev Lett 2017; 118:052501. [PMID: 28211717 DOI: 10.1103/physrevlett.118.052501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Indexed: 06/06/2023]
Abstract
Previous experiments observed a 4^{+} state in the N=28 nucleus ^{44}S and suggested that this state may exhibit a hindered E2-decay rate, inconsistent with being a member of the collective ground state band. We populate this state via two-proton knockout from a beam of exotic ^{46}Ar projectiles and measure its lifetime using the recoil distance method with the GRETINA γ-ray spectrometer. The result, 76(14)_{stat}(20)_{syst} ps, implies a hindered transition of B(E2;4^{+}→2_{1}^{+})=0.61(19) single-particle or Weisskopf units strength and supports the interpretation of the 4^{+} state as a K=4 isomer, the first example of a high-K isomer in a nucleus of such low mass.
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Affiliation(s)
- J J Parker
- Department of Physics, Florida State University, Tallahassee, Florida, 32306, USA
| | - I Wiedenhöver
- Department of Physics, Florida State University, Tallahassee, Florida, 32306, USA
| | - P D Cottle
- Department of Physics, Florida State University, Tallahassee, Florida, 32306, USA
| | - J Baker
- Department of Physics, Florida State University, Tallahassee, Florida, 32306, USA
| | - D McPherson
- Department of Physics, Florida State University, Tallahassee, Florida, 32306, USA
| | - M A Riley
- Department of Physics, Florida State University, Tallahassee, Florida, 32306, USA
| | - D Santiago-Gonzalez
- Department of Physics, Florida State University, Tallahassee, Florida, 32306, USA
| | - A Volya
- Department of Physics, Florida State University, Tallahassee, Florida, 32306, USA
| | - V M Bader
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan, 48824, USA
| | - T Baugher
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan, 48824, USA
| | - D Bazin
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - A Gade
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan, 48824, USA
| | - T Ginter
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - H Iwasaki
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan, 48824, USA
| | - C Loelius
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan, 48824, USA
| | - C Morse
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan, 48824, USA
| | - F Recchia
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - D Smalley
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - S R Stroberg
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan, 48824, USA
| | - K Whitmore
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan, 48824, USA
| | - D Weisshaar
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - A Lemasson
- Grand Accélérateur National dIons Lourds (GANIL), CEA/DSM-CNRS/IN2P3 Caen, France
| | - H L Crawford
- Lawrence Berkeley National Laboratory, Nuclear Science Division, 1 Cyclotron Road, Berkeley, California 94720-8153, USA
| | - A O Macchiavelli
- Lawrence Berkeley National Laboratory, Nuclear Science Division, 1 Cyclotron Road, Berkeley, California 94720-8153, USA
| | - K Wimmer
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics, Central Michigan University, Mt. Pleasant, Michigan 48859, USA
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Shah NM, Ginzburg N, Whitmore K. A case of pelvic organ prolapse in the setting of cirrhotic ascites. Rev Urol 2016; 18:178-180. [PMID: 27833470 DOI: 10.3909/riu0702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Ascites is commonly found in patients with liver cirrhosis. Although conservative therapy is often the ideal choice of care with these patients who also have symptomatic pelvic organ prolapse, this may fail and surgical methods may be needed. Literature is limited regarding surgical repair of prolapse in the setting of ascites. The authors present the surgical evaluation and management of a 63-year-old woman with recurrent ascites from liver cirrhosis who failed conservative therapy. With adequate multidisciplinary care and medical optimization, this patient underwent surgical therapy with resolution of her symptomatic prolapse and improved quality of life.
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Affiliation(s)
- Nima M Shah
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Drexel University College of Medicine Philadelphia, PA
| | - Natasha Ginzburg
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Drexel University College of Medicine Philadelphia, PA
| | - Kristene Whitmore
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Drexel University College of Medicine Philadelphia, PA
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16
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Kivlin D, Lim C, Ross C, Whitmore K, Schellato T. The Diagnostic and Treatment Patterns of Urologists in the United States for Interstitial Cystitis/Painful Bladder Syndrome. Urol Pract 2016; 3:309-314. [PMID: 37592494 DOI: 10.1016/j.urpr.2015.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Interstitial cystitis/bladder pain syndrome is not completely understood, making it challenging to diagnose and treat. The current literature elucidating this disease process is inconsistent. Without a clear consensus regarding management it is important to evaluate how urologists are treating these patients. METHODS Urologists across the United States completed a 19-item survey addressing diagnostic and treatment methods for interstitial cystitis. Participation was voluntary and no compensation was provided to complete the survey. RESULTS A total of 95 surveys were completed and returned between December 2012 and January 2013. Of the respondents 92% considered themselves general urologists and most preferred to manage interstitial cystitis/bladder pain syndrome themselves with only 33% referring these patients. Of the respondents 47% believed that the etiology of interstitial cystitis is still unknown. Cystoscopy with hydrodistention was the most common approach to diagnosis (70% of respondents) followed closely by validated symptoms scores (65%). Oral medication was the most commonly used treatment (92% of respondents), of which pentosan polysulfate was the most commonly used agent. Oral medication was followed by intravesical treatment and bladder hydrodistention at 77% and 74% of respondents, respectively. Most urologists ultimately used multimodal therapy. AUA (American Urological Association) guidelines were followed by only 15% of respondent urologists. CONCLUSIONS The treatment of patients with interstitial cystitis/bladder pain syndrome is variable and many urologists use multiple modalities for diagnosis and treatment. This variability in diagnosis and/or treatment reflects the deficiency of our current understanding of this disease process. Until the pathophysiology is better delineated diagnosis and treatment will remain without consensus.
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Affiliation(s)
- Dana Kivlin
- Department of Urology, Einstein Health Care Network, Philadelphia, Pennsylvania
- Department of Urology, Drexel University College of Medicine (KW), Philadelphia, Pennsylvania
| | - Caitlin Lim
- Department of Urology, Einstein Health Care Network, Philadelphia, Pennsylvania
- Department of Urology, Drexel University College of Medicine (KW), Philadelphia, Pennsylvania
| | - Curtis Ross
- Department of Urology, Einstein Health Care Network, Philadelphia, Pennsylvania
- Department of Urology, Drexel University College of Medicine (KW), Philadelphia, Pennsylvania
| | - Kristene Whitmore
- Department of Urology, Einstein Health Care Network, Philadelphia, Pennsylvania
- Department of Urology, Drexel University College of Medicine (KW), Philadelphia, Pennsylvania
| | - Tia Schellato
- Department of Urology, Einstein Health Care Network, Philadelphia, Pennsylvania
- Department of Urology, Drexel University College of Medicine (KW), Philadelphia, Pennsylvania
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Kolos K, Miller D, Grzywacz R, Iwasaki H, Al-Shudifat M, Bazin D, Bingham CR, Braunroth T, Cerizza G, Gade A, Lemasson A, Liddick SN, Madurga M, Morse C, Portillo M, Rajabali MM, Recchia F, Riedinger LL, Voss P, Walters WB, Weisshaar D, Whitmore K, Wimmer K, Tostevin JA. Direct Lifetime Measurements of the Excited States in (72)Ni. Phys Rev Lett 2016; 116:122502. [PMID: 27058074 DOI: 10.1103/physrevlett.116.122502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Indexed: 06/05/2023]
Abstract
The lifetimes of the first excited 2^{+} and 4^{+} states in ^{72}Ni were measured at the National Superconducting Cyclotron Laboratory with the recoil-distance Doppler-shift method, a model-independent probe to obtain the reduced transition probability. Excited states in ^{72}Ni were populated by the one-proton knockout reaction of an intermediate energy ^{73}Cu beam. γ-ray-recoil coincidences were detected with the γ-ray tracking array GRETINA and the S800 spectrograph. Our results provide evidence of enhanced transition probability B(E2;2^{+}→0^{+}) as compared to ^{68}Ni, but do not confirm the trend of large B(E2) values reported in the neighboring isotope ^{70}Ni obtained from Coulomb excitation measurement. The results are compared to shell model calculations. The lifetime obtained for the excited 4_{1}^{+} state is consistent with models showing decay of a seniority ν=4, 4^{+} state, which is consistent with the disappearance of the 8^{+} isomer in ^{72}Ni.
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Affiliation(s)
- K Kolos
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - D Miller
- TRIUMF, 4004 Westbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - R Grzywacz
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831-6371, USA
| | - H Iwasaki
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824-1321, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - M Al-Shudifat
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
| | - D Bazin
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824-1321, USA
| | - C R Bingham
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831-6371, USA
| | - T Braunroth
- Institut für Kernphysik der Universität zu Köln, D-50937 Köln, Germany
| | - G Cerizza
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
| | - A Gade
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824-1321, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - A Lemasson
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824-1321, USA
| | - S N Liddick
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824-1321, USA
- Department of Chemistry, Michigan State University, East Lansing, Michigan 48824, USA
| | - M Madurga
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
| | - C Morse
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824-1321, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - M Portillo
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824-1321, USA
| | - M M Rajabali
- TRIUMF, 4004 Westbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - F Recchia
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824-1321, USA
| | - L L Riedinger
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831-6371, USA
| | - P Voss
- Simon Fraser University, Burnaby, British Columbia, V5A 1S6, Canada
| | - W B Walters
- University of Maryland, College Park, Maryland 20742, USA
| | - D Weisshaar
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824-1321, USA
| | - K Whitmore
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824-1321, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - K Wimmer
- Department of Physics, Central Michigan University, Mount Pleasant, Michigan 48859, USA
| | - J A Tostevin
- Department of Physics, University of Surrey, Guildford, Surrey GU2 7XH, United Kingdom
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19
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Andy U, Malykhina A, Harvie H, Colavita K, Whitmore K, Arya L. Clinical and Biochemical Evidence of Neurogenic Inflammation in Women with Urinary Urgency. J Minim Invasive Gynecol 2015. [DOI: 10.1016/j.jmig.2014.12.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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20
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Iwasaki H, Lemasson A, Morse C, Dewald A, Braunroth T, Bader VM, Baugher T, Bazin D, Berryman JS, Campbell CM, Gade A, Langer C, Lee IY, Loelius C, Lunderberg E, Recchia F, Smalley D, Stroberg SR, Wadsworth R, Walz C, Weisshaar D, Westerberg A, Whitmore K, Wimmer K. Evolution of collectivity in 72Kr: evidence for rapid shape transition. Phys Rev Lett 2014; 112:142502. [PMID: 24765947 DOI: 10.1103/physrevlett.112.142502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Indexed: 06/03/2023]
Abstract
The transition rates from the yrast 2+ and 4+ states in the self-conjugate 72Kr nucleus were studied via lifetime measurements employing the GRETINA array with a novel application of the recoil-distance method. The large collectivity observed for the 4+→2+ transition suggests a prolate character of the excited states. The reduced collectivity previously reported for the 2+→0+ transition was confirmed. The irregular behavior of collectivity points to the occurrence of a rapid oblate-prolate shape transition in 72Kr, providing stringent tests for advanced theories to describe the shape coexistence and its evolution.
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Affiliation(s)
- H Iwasaki
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA and Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - A Lemasson
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - C Morse
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA and Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - A Dewald
- Institut für Kernphysik der Universität zu Köln, D-50937 Köln, Germany
| | - T Braunroth
- Institut für Kernphysik der Universität zu Köln, D-50937 Köln, Germany
| | - V M Bader
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA and Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - T Baugher
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA and Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - D Bazin
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - J S Berryman
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - C M Campbell
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - A Gade
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA and Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - C Langer
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA and Joint Institute for Nuclear Astrophysics, Michigan State University, East Lansing, Michigan 48824, USA
| | - I Y Lee
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - C Loelius
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA and Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - E Lunderberg
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA and Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - F Recchia
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - D Smalley
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - S R Stroberg
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA and Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - R Wadsworth
- Department of Physics, University of York, Heslington, York YO10 5DD, United Kingdom
| | - C Walz
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA and Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - D Weisshaar
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - A Westerberg
- Department of Physics, Central Michigan University, Mount Pleasant, Michigan 48859, USA
| | - K Whitmore
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA and Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - K Wimmer
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA and Department of Physics, Central Michigan University, Mount Pleasant, Michigan 48859, USA
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Magee G, Roy S, Hinoul P, Moretz C, Kozarev R, Waters H, Whitmore K. A real-world comparative assessment of complications following various mid-urethral sling procedures for the treatment of stress urinary incontinence. J Long Term Eff Med Implants 2013; 22:329-40. [PMID: 23662664 DOI: 10.1615/jlongtermeffmedimplants.2013007383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Stress urinary incontinence affects a significant proportion of the adult female population in the United States with prevalence increasing with growing age. Mid-urethral slings are among surgical options offering important improvement in the condition. The aim of this study was to evaluate clinical outcomes of different mid-urethral sling products with respect to postsurgery complications. This retrospective study utilized data from the Premier Perspective Database for mid-urethral sling procedures between 2005 and 2009. Patients were grouped into retropubic or transobturator cohorts, and these cohorts were further divided by the sling utilized during the procedure. Surgical outcomes and 12-month complication rates were assessed. In general, there were fewer complications noted for transobturator procedures than for retropubic procedures. In the retropubic category, Gynecare TVT had significantly lower rates of urinary obstruction/retention than other retropubic procedures. In the transobturator category, lower rates of overall pelvic complications as well as urologic complications, including urgency incontinence and urinary tract infections, were observed in the Gynecare TVTO subgroup than other transobturator procedures. Results of this study confirm the low overall rate of complications for midurethral sling procedures while at the same time suggesting that product choice may also have an impact on complication rates.
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Affiliation(s)
- Glenn Magee
- Premier Research Services, Charlotte, NC, USA
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22
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O'Hare PG, Hoffmann AR, Allen P, Gordon B, Salin L, Whitmore K. Interstitial cystitis patients' use and rating of complementary and alternative medicine therapies. Int Urogynecol J 2012; 24:977-82. [PMID: 23149598 DOI: 10.1007/s00192-012-1966-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2012] [Accepted: 10/03/2012] [Indexed: 10/27/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The purpose of this study was to describe the use of complementary and alternative medicine (CAM) therapies among interstitial cystitis (IC) patients, patients' perception of CAM therapies' effectiveness, and the association of time since diagnosis with perceived effectiveness of these therapies. METHODS In April 2009, the Interstitial Cystitis Association (ICA) initiated an Internet-based survey on CAM. Respondents indicated whether they received an IC diagnosis and how long ago, whether they tried CAM, and who recommended it. On a 5-point scale, respondents rated 49 therapies. For respondents confirming a diagnosis, we used a chi-square goodness-of-fit test to assess which therapies were rated positively or negatively by a majority of patients who tried them. Using separate one-way analyses of variance, we assessed differences in mean perceived effectiveness among groups based on time since diagnosis and conducted post hoc tests, if necessary. Using chi-square tests, we explored the association of time since diagnosis with the use of CAM and the number of therapies tried. RESULTS A total of 2,101 subjects responded to the survey; 1,982 confirmed an IC diagnosis. Most (84.2 %) had tried CAM, and 55 % said physicians had recommended CAM. Of those trying CAM, 82.8 % had tried diet or physical therapy and 69.2 % other therapies. Of the therapies, 22 were rated positively and 20 negatively; 7 were inconclusive. Therapies patients perceived to be helpful included dietary management and pain management adjuncts such as physical therapy, heat and cold, meditation and relaxation, acupuncture, stress reduction, exercise, and sleep hygiene. Many therapies worked better for those diagnosed recently than for those diagnosed long before. CONCLUSIONS Randomized, placebo-controlled studies are needed to demonstrate which therapies may indeed control IC symptoms and help send research in new and productive directions.
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Affiliation(s)
- Peter Gregory O'Hare
- Female Pelvic Medicine and Reconstructive Surgery, Drexel University College of Medicine, 207 N. Broad Street, 4th Floor, Philadelphia, PA, 19107, USA.
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Wehbe S, O'Hare P, El-Khawand D, Whitmore K, Vakili B. Robotic Assisted Laparoscopic Sacrocolpopexy with Uterine Preservation. J Minim Invasive Gynecol 2012. [DOI: 10.1016/j.jmig.2012.08.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Arya LA, Harvie HS, Andy UU, Cory L, Propert KJ, Whitmore K. Construct validity of an instrument to measure neuropathic pain in women with bladder pain syndrome. Neurourol Urodyn 2012; 32:424-7. [PMID: 22972593 DOI: 10.1002/nau.22314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Accepted: 08/21/2012] [Indexed: 11/11/2022]
Abstract
AIMS To determine the construct validity of an instrument to measure neuropathic pain in women with bladder pain syndrome (BPS). Our hypothesis is that neuropathic, bladder, and bowel pain represent different constructs in women with BPS. METHODS Secondary planned analysis of a prospective cross-sectional study of 150 women with BPS. The relationship between neuropathic pain, urinary, and bowel symptoms was assessed. RESULTS The correlation of the total neuropathic pain score with total urinary and bowel symptom scores was low to moderate (r = 0.28-0.49). The correlation of specific neuropathic pain items with bladder and bowel pain was also low to moderate (r = 0.12-0.36). Women with neuropathic pain had significantly higher scores for urinary urgency, bladder pain, abdominal pain, diarrhea, and constipation than women with non-neuropathic pain (all P < 0.0001). CONCLUSION Somatosensory neuropathic pain and "visceral" bladder and bowel pain represent separate but related constructs in women with BPS.
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Affiliation(s)
- Lily A Arya
- Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
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25
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Toozs-Hobson P, Freeman R, Barber M, Maher C, Haylen B, Athanasiou S, Swift S, Whitmore K, Ghoniem G, de Ridder D. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for reporting outcomes of surgical procedures for pelvic organ prolapse. Int Urogynecol J 2012; 23:527-35. [PMID: 22476543 DOI: 10.1007/s00192-012-1726-y] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Standardized terminology has yet to be developed for reporting the outcomes for surgery for pelvic organ prolapse (POP). METHODS This report combines the input of the Terminology and Standardization Committees of the International Urogynecological Association (IUGA) and the International Continence Society (ICS) and a joint Working Group on this topic, as well as expert external referees. The aim was to present a standardized terminology for the definitions of surgery and propose a structure for reporting the outcomes of surgical procedures for POP. An extensive drafting and review process was undertaken, as well as open review on both IUGA and ICS websites. RESULTS A terminology report was developed outlining the recommended structure for reporting outcomes of surgical trials involving POP. This document does not define success and failure. The report includes patient-reported, subjective and objective outcomes to enable researchers to report on their results and compare them with other studies. CONCLUSIONS A consensus-based method for standardizing terminology for reporting outcome measures of POP surgery was developed to aid clinicians working in this area of research.
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Toozs-Hobson P, Freeman R, Barber M, Maher C, Haylen B, Athanasiou S, Swift S, Whitmore K, Ghoniem G, de Ridder D. An international urogynecological association (IUGA)/international continence society (ICS) joint report on the terminology for reporting outcomes of surgical procedures for pelvic organ prolapse. Neurourol Urodyn 2012; 31:415-21. [DOI: 10.1002/nau.22238] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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27
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Rosier PF, de Ridder D, Meijlink J, Webb R, Whitmore K, Drake MJ. Developing evidence-based standards for diagnosis and management of lower urinary tract or pelvic floor dysfunction. Neurourol Urodyn 2012; 31:621-4. [DOI: 10.1002/nau.21253] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2011] [Accepted: 11/21/2011] [Indexed: 01/22/2023]
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28
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Cory L, Harvie HS, Northington G, Malykhina A, Whitmore K, Arya L. Association of neuropathic pain with bladder, bowel and catastrophizing symptoms in women with bladder pain syndrome. J Urol 2011; 187:503-7. [PMID: 22177143 DOI: 10.1016/j.juro.2011.10.036] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Indexed: 12/28/2022]
Abstract
PURPOSE In this study we determined if there is an association of neuropathic pain with urinary, bowel and catastrophizing symptoms in women with bladder pain syndrome. MATERIALS AND METHODS Female patients with a diagnosis of bladder pain syndrome completed validated questionnaires to assess neuropathic pain, urinary and bowel symptoms, quality of life and pain catastrophizing. Women were dichotomized into neuropathic pain and nonneuropathic pain groups. Urinary and bowel symptoms, pain catastrophizing and quality of life scores were compared between the 2 groups using parametric and nonparametric tests. RESULTS Of 150 women with bladder pain syndrome 40 (27%) had features of neuropathic pain while 110 (73%) did not. Women with features of neuropathic pain had significantly worse urinary urgency (mean ± SD 3.1 ± 3.1 vs 2.1 ± 1.7, p <0.001), bladder pain (3.0 ± 1.1 vs 2.0 ± 1.3, p <0.001), bowel pain (8.8 ± 4.0 vs 5.3 ± 3.6, p <0.001), diarrhea (7.8 ± 6.1 vs 4.1 ± 4.3, p <0.001), quality of life (12.2 ± 5.5 vs 9.8 ± 3.8, p <0.001) and higher pain catastrophizing (32.2 ± 12.4 vs 23.1 ± 14.3, p <0.001) scores than those without neuropathic pain. CONCLUSIONS In women with bladder pain syndrome the presence of neuropathic pain is significantly associated with the severity of bladder and bowel pain, urinary urgency and diarrhea. Women with features of neuropathic pain also have worse pain catastrophizing and quality of life than those without features of neuropathic pain.
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Affiliation(s)
- Lori Cory
- University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
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Abstract
INTRODUCTION Female sexual dysfunction (FSD) is common in women with urogenital disorders that occur as a result of pelvic floor muscle and fascial laxity. AIM Provide a comprehensive review of FSD as it relates to common urogenital disorders including pelvic organ prolapse (POP) and stress urinary incontinence (SUI) and to discuss the impact of the surgical repair of these disorders on sexual function. METHODS Systematic search of the medical literature using a number of related terms including FSD, POP, SUI, surgical repair, graft augmentation, complications, and dyspareunia. MAIN OUTCOME MEASURES Review of the medical literature to identify the relation between FSD and common urogenital disorders in women and to describe appropriate treatment strategies to improve quality of life (QOL) and sexual function. RESULTS FSD is common in women with POP and SUI. Treatment options for POP and SUI include behavioral, pharmacological, and surgical methods which can also affect sexual function. CONCLUSIONS Sexual dysfunction is a common, underestimated complaint in women with POP and SUI. Treatment should be tailored toward improving sexual function and QOL. Surgical correction is generally beneficial but occasionally can result in negative alterations in sexual function. Patient selection and methods used for surgical repair are important factors in determining anatomical and functional success.
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Affiliation(s)
- Salim A Wehbe
- Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Drexel University College of Medicine, Philadelphia, PA, USA.
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She Y, Bhattacharya A, Kellogg-Spadt S, O'Hare P, Ekbladh L, Whitmore K. Are there differences? SHBG levels, free testosterone and sexual pain in women using combined hormonal contraception: a retrospective study in vulvodynia patients. Contraception 2010. [DOI: 10.1016/j.contraception.2010.04.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Wehbe SA, Whitmore K, Kellogg-Spadt S. Continuing Medical Education: Urogenital Complaints and Female Sexual Dysfunction (Part 1) (CME). J Sex Med 2010; 7:1704-13; quiz 1703, 1714-5. [DOI: 10.1111/j.1743-6109.2010.01769.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Abstract
INTRODUCTION Sexual pain, or dyspareunia, is a common symptom among women. Dyspareunia presents in many ways, and arises from a range of causes. Interstitial cystitis/painful bladder syndrome (IC/PBS) is one potential cause that may frequently be overlooked by clinicians. Interstitial cystitis is increasingly recognized as more common than was once thought. However, it can be difficult to identify, as the symptoms of IC/PBS (urinary urgency and frequency, dyspareunia, nocturia, and pelvic pain) overlap with other urogynecologic conditions. AIM This article will review the association between dyspareunia and IC/PBS, and will provide an approach to the diagnosis and treatment of IC/PBS in women with sexual pain. METHODS AND MAIN OUTCOME MEASURES Review of the medical literature and expert medical opinion. RESULTS Many women with IC/PBS experience dyspareunia, often in conjunction with chronic pelvic pain. When IC/PBS is suspected, there are simple measures to aid in the diagnosis of this condition, and treatments are readily available. CONCLUSIONS When a woman presents with the symptoms of urinary urgency and frequency, dyspareunia, nocturia, and/or pelvic pain, IC/PBS should be part of the diagnostic evaluation.
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Holzberg A, Kellog-Spadt S, Lukban J, Whitmore K. Evaluation of transvaginal theile massage as a therapeutic intervention for women with interstitial cystitis. Urology 2002; 57:120. [PMID: 11378103 DOI: 10.1016/s0090-4295(01)01071-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- A Holzberg
- Pelvic Floor Institute, Graduate Hospital, Philadelphia, Pennsylvania, USA
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Keay SK, Zhang CO, Shoenfelt J, Erickson DR, Whitmore K, Warren JW, Marvel R, Chai T. Sensitivity and specificity of antiproliferative factor, heparin-binding epidermal growth factor-like growth factor, and epidermal growth factor as urine markers for interstitial cystitis. Urology 2002; 57:9-14. [PMID: 11378043 DOI: 10.1016/s0090-4295(01)01127-x] [Citation(s) in RCA: 88] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We previously determined that the urine of interstitial cystitis (IC) patients specifically contains a factor (antiproliferative factor [APF]) that inhibits primary bladder epithelial cell proliferation, and that it has significantly decreased levels of heparin-binding epidermal growth factor-like growth factor (HB-EGF) and increased levels of epidermal growth factor (EGF) compared with urine from asymptomatic controls and patients with bacterial cystitis. We sought to confirm the specificity of these findings for IC using a larger patient population, including control patients with a variety of urogenital disorders. Clean catch urine specimens were collected from 219 symptomatic IC patients, 113 asymptomatic controls without bladder disease, and 211 patients with various urogenital diseases including acute bacterial cystitis, vulvovaginitis, chronic nonbacterial prostatitis, overactive bladder, hematuria, stress incontinence, neurogenic bladder, benign prostatic hyperplasia, bladder or pelvic pain without voiding symptoms, bladder cancer, prostate cancer, or miscellaneous diagnoses including anatomic disorders. APF activity was determined by (3)H-thymidine incorporation into primary normal adult human bladder epithelial cells. HB-EGF and EGF levels were determined by enzyme-linked immunosorbent assay. APF activity was present significantly more often in IC than control urine specimens (P <0.005 for IC vs any control group; sensitivity = 94%, specificity = 95%, P <10(-82) for IC vs all controls). HB-EGF levels were also significantly lower and EGF levels significantly higher in IC urine than in specimens from controls (P <10(-84) and P <10(-36), respectively). These findings confirm the utility of APF, HB-EGF, and EGF as markers for IC. Understanding the reasons for altered levels of these markers may lead to understanding the pathogenesis of this disorder.
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Affiliation(s)
- S K Keay
- Division of Infectious Diseases, Department of Medicine, University of Maryland, School of Medicine, Baltimore, Maryland, USA
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35
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Lubeck DP, Whitmore K, Sant GR, Alvarez-Horine S, Lai C. Psychometric validation of the O'leary-Sant interstitial cystitis symptom index in a clinical trial of pentosan polysulfate sodium. Urology 2002; 57:62-6. [PMID: 11378052 DOI: 10.1016/s0090-4295(01)01126-8] [Citation(s) in RCA: 104] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The O'Leary-Sant Interstitial Cystitis Symptom Index (ICSI) has been proposed as a treatment outcome measure in interstitial cystitis (IC). The psychometric properties of the ICSI were assessed for reliability and validity in a randomized, double-blind clinical study of 300, 600, and 900 mg daily dose of pentosan polysulfate sodium (PPS) in patients with IC. The ICSI contains 4 items that measure urgency and frequency of urination, nighttime urination, and pain or burning. The ICSI index score is the sum of the item scores (range: 0-20). ICSI scores were obtained at baseline, 4, 8, 12, 16, 24, and 32 weeks of treatment. Patients' overall ratings of improvement of symptoms (PORIS) scores evaluating improvements in pain, urgency, and overall IC symptoms were also collected except at baseline. A total of 376 patients were included in the analysis. Psychometric properties evaluated included variability (range), test-retest reliability (intraclass correlation coefficient [ICC]), internal consistency (the Cronbach alpha), construct validity (convergent, discriminant), responsiveness, and clinically meaningful change. The ICSI items and index score had good variability and test-retest reliability. The ICSI demonstrated internal consistency reliability and was responsive to change. Participants indicating a 75% improvement in PORIS had a 48% mean reduction in the ICSI score, while participants reporting 100% improvement in PORIS had a 77% mean reduction in the ICSI score. The ICSI is a valid, reliable, and responsive measure of change in IC symptoms. This outcome measure should be utilized in future treatment outcomes studies in IC.
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Affiliation(s)
- D P Lubeck
- Department of Urology, University of California, San Francisco, California 94143-1319, USA.
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Gray TA, Azama K, Whitmore K, Min A, Abe S, Nicholls RD. Phylogenetic conservation of the makorin-2 gene, encoding a multiple zinc-finger protein, antisense to the RAF1 proto-oncogene. Genomics 2001; 77:119-26. [PMID: 11597136 DOI: 10.1006/geno.2001.6627] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Natural endogenous antisense RNAs have been reported in multiple loci, with evidence in some cases supporting a regulatory role for the antisense transcript. Here, we describe a novel gene, makorin RING zinc finger-2 (MKRN2), that overlaps and is antisense to the gene RAF1 in mammals. Phylogenetic analysis of the 3' untranslated region of RAF1 orthologues suggests that this relationship may have existed for up to 450 million years. We have also identified MKRN2 orthologues in two species of fish. This places the gene duplication event that created this locus from an ancestral MKRN1 gene early in vertebrate evolution, over 450 million years ago. Northern blot analyses show that human MKRN2 and RAF1 are co-expressed in tissues and cell lines, raising the possibility of mRNA duplex formation. The encoded makorin-2 protein is likely a ribonucleoprotein of unknown function, but its conservation suggests an important cellular role. The data presented here describe a conserved vertebrate MKRN2 gene that is closely associated with the RAF1 locus.
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Affiliation(s)
- T A Gray
- Department of Genetics, Case Western Reserve University, 2109 Adelbert Rd., BRB 739, Cleveland, Ohio 44106, USA.
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Abstract
The goal of this study was to better understand the experience of women suffering from interstitial cystitis (IC), a chronic pain condition that has, as of yet, received little attention from psychosocial investigators. Eighty women with IC participated. The results from this study demonstrate that, in addition to frequency of voiding (the hallmark symptom of the disorder), IC sufferers also endure significant pain and depression. Levels of pain experienced by IC patients during their most painful flares exceed levels of pain experienced by other chronic pain patients. Similarly, levels of depression experienced by IC patients exceed those evidenced by the general population and by other populations of chronic pain patients. Furthermore, the pain and depression experienced by IC patients may be predicted by cognitive factors. Severity of pain is associated with self-efficacy for coping with pain. Severity of depression is associated with pain, self-efficacy for coping with pain, and self-stigmatization.
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Affiliation(s)
- C Rabin
- Department of Psychology, Rutgers University, Piscataway, NJ 08854-8020, USA.
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Lukban J, Whitmore K, Kellogg-Spadt S, Bologna R, Lesher A, Fletcher E. The effect of manual physical therapy in patients diagnosed with interstitial cystitis, high-tone pelvic floor dysfunction, and sacroiliac dysfunction. Urology 2001; 57:121-2. [PMID: 11378106 DOI: 10.1016/s0090-4295(01)01074-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- J Lukban
- The Pelvic Floor Institute, Graduate Hospital, Philadelphia, Pennsylvania, USA
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Keay S, Zhang CO, Hise MK, Hebel JR, Jacobs SC, Gordon D, Whitmore K, Bodison S, Gordon N, Warren JW. A diagnostic in vitro urine assay for interstitial cystitis. Urology 1998; 52:974-8. [PMID: 9836539 DOI: 10.1016/s0090-4295(98)00488-9] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES A low molecular weight urine factor that inhibits the proliferation of normal bladder epithelial cells in vitro was previously shown to be present significantly more often in the urine of patients with interstitial cystitis (IC) than in the urine of asymptomatic age-, race-, and sex-matched control subjects. We sought to determine the specificity of this finding for IC by determining whether the urine of patients with other urogenital inflammatory disorders also contains a factor that inhibits bladder epithelial cell proliferation. METHODS Urine was collected from women with IC, acute bacterial cystitis, or vulvovaginitis, as well as from asymptomatic control women. The proliferation of primary normal adult bladder epithelial cells was determined by measuring 3H-thymidine incorporation in vitro. RESULTS Osmolality- and pH-corrected urine specimens from 50 (86%) of 58 women with IC significantly inhibited human bladder epithelial cell proliferation compared with 3 (8%) of 36 asymptomatic control women, 7 (12%) of 58 women with bacterial cystitis, and 0 (0%) of 12 women with vulvovaginitis (P < 0.001 for the comparison of mean percent change in 3H-thymidine incorporation with IC urine versus urine from each of the control groups). Optimal sensitivity and specificity values of 91.4% and 90.6%, respectively, were achievable at a cutoff of 25% inhibition of 3H-thymidine incorporation, using all three control groups. CONCLUSIONS The measurement of urine antiproliferative activity may be a useful noninvasive means for diagnosing IC in women.
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Affiliation(s)
- S Keay
- Department of Medicine, University of Maryland School of Medicine, Department of Veterans Affairs Medical Center, Baltimore 21201, USA
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Keay S, Zhang CO, Kagen DI, Hise MK, Jacobs SC, Hebel JR, Gordon D, Whitmore K, Bodison S, Warren JW. Concentrations of specific epithelial growth factors in the urine of interstitial cystitis patients and controls. J Urol 1997; 158:1983-8. [PMID: 9334654 DOI: 10.1016/s0022-5347(01)64198-3] [Citation(s) in RCA: 84] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE Interstitial cystitis (IC) is a chronic bladder disease for which the etiology is unknown. Because the bladder epithelium is often abnormal in IC, we determined whether the levels of specific urine growth factors postulated to be important for bladder epithelial proliferation are altered in IC. MATERIALS AND METHODS ELISAs were used to determine levels of epidermal growth factor (EGF), insulin-like growth factor 1 (IGF1), insulin-like growth factor binding protein 3 (IGFBP3), and heparin binding epidermal growth factor-like growth factor (HB-EGF) in urine specimens from women with IC, asymptomatic women without bladder disease, and women with bacterial cystitis. RESULTS Urine HB-EGF levels were specifically and significantly decreased in IC patients as compared to asymptomatic controls or patients with bacterial cystitis, whether expressed as concentration (amount per volume of urine) or the amount relative to urine creatinine in each specimen. In contrast, urine EGF, IGF1, and IGFBP3 levels were all significantly elevated in IC patients compared to asymptomatic controls. Further, the amounts of urine EGF and IGF1 were also elevated in IC patients as compared to patients with bacterial cystitis, and urine IGFBP3 levels were significantly elevated when expressed per milligram of urine creatinine. CONCLUSIONS These findings indicate that complex changes in the levels of urine epithelial cell growth factors (EGF, IGF1, and HB-EGF) and a growth factor binding protein (IGFBP3) are associated with IC. While EGF, IGF1, and IGFBP3 levels are either the same or increased in the urine of IC patients as compared to patients with bacterial cystitis or asymptomatic controls, HB-EGF levels are significantly decreased in the urine of IC patients. Understanding the reasons for these changes may lead to understanding the pathogenesis of this disorder.
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Affiliation(s)
- S Keay
- Department of Medicine, University of Maryland School of Medicine, Baltimore, USA
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Abstract
To evaluate the use of oxygen therapy in the immediate postoperative period, 293 postsurgical patients who had not had thoracic, upper abdominal, or neurologic surgery were randomly assigned upon admission to the postanesthesia care unit (PACU) to receive: 1) 4 L unhumidified O2 via nasal cannula, 2) 40% oxygen by face tent, 3) nurse-coached lung hyperinflations, or 4) no oxygen enhancing regimen. Oxygen saturation was measured on all patients at the time of arrival in the PACU, after 15 min, and after 30 min in the PACU. Only 11 patients in all groups (4%) had their O2 saturation decrease to less than 90% during this time. Ten of these had an initial O2 saturation of 92% or less. Significant differences in O2 saturation were found at 15 min and 30 min between Groups 1 and 2 which received O2 compared to Groups 3 and 4 which did not receive supplemental oxygen. The clinical significance of these differences is open to question. Complaints of dryness were most common in those receiving unhumidified oxygen by nasal cannula. Fourteen percent of patients receiving oxygen by face tent found it uncomfortable and complained of nausea. Supplemental oxygen is not essential in maintaining adequate oxygen saturation in these PACU patients when oxygen saturation levels are more than 92% upon admission to the PACU.
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Affiliation(s)
- A G Gift
- University of Pennsylvania, School of Nursing, Philadelphia 19104-6096
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Abstract
The frequency of inspection of the authors' scheduled maintenance program was reviewed and modified, using the work of Fennigkoh (1989). This work extended to 2,700 devices located at four hospital sites supported by a regional service. These devices included all clinical equipment, including diagnostic imaging and renal dialysis. Review of the inspection frequencies was necessary as part of the quality assurance program and to ensure consistency between similar devices. Equipment was first evaluated according to four criteria to determine if it should be on the scheduled performance assurance program. These criteria included: equipment function, physical risk to patients, maintenance requirements, and incident or related history. The frequency of inspection of included devices was then assessed according to an algorithm that looked at device maintenance requirements and manufacturers' recommendations. Devices were scheduled for inspection once, twice or, in rare cases, four times per year. The quality of the inspection program was enhanced by a systematic review. As an added bonus, the required staffing resources to comply with the scheduled performance assurance declined by 29%.
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Affiliation(s)
- S Moussavi
- Fraser-Burrard Hospital Society, New Westminster, British Columbia
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43
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Abstract
Biomedical engineers have long seen that they have a role in the fields of equipment planning and technology assessment. This role has not been universally understood. Through sustained efforts we have shown that we can contribute to and should be involved in equipment planning. Efforts are now under way to demonstrate the need for and the role that biomedical engineering can play in technology assessment and ultimately in strategic planning. The paper examines the Canadian healthcare scene within the context of the Province of British Columbia, and more specifically the opportunities and challenges in the fields of technology management presented to an in-house biomedical engineering group at a hospital society in Greater Vancouver.
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Affiliation(s)
- K Whitmore
- Fraser-Burrard Hospital Society, University of British Columbia, Vancouver, Canada
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Whitmore K, Moussavi S. A clinical engineering information system incorporating ECRI-HECS, HECSLINK, and dBase. Biomed Instrum Technol 1993; 27:33-41. [PMID: 8418964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- K Whitmore
- Fraser-Burrard Hospital Society, Vancouver, BC, Canada
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46
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Bax M, Whitmore K. School medical. Every child should have one. Health Visit 1991; 64:157-9. [PMID: 2037516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Affiliation(s)
- M C Bax
- Department of Child Health, Westminster Children's Hospital, London
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48
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Abstract
There is increasing evidence that the urothelium of the bladder mucosa prevents the penetration of solutes from the urine into the bladder wall. In the current study, in vivo treatments of rabbit urinary bladder with DMSO, acetone and overdistension resulted in damage to the physical integrity of the bladder mucosa as quantitated by the penetration of the dye indigocarmine (1% in saline) into submucosal tissues. Penetration of the dye can be quantitated, because the dye can be extracted from the tissue and measured spectrophotometrically. Indigocarmine does not penetrate normal, control, bladder mucosae. Bladders treated with gentle 20, 30 and 50% acetone washes for one minute permit dye penetration which is proportional to the acetone concentration utilized. Intravesical 50% DMSO ("RIMSO 50") administration permits modest dye penetration. Distension by slow filling with saline to volumes 90% of capacity and greater causes a marked increase in dye penetration which is proportional to the magnitude of overdistension. Although pretreatment of the bladder with heparin did not reduce the dye penetration following acetone administration, it completely abolished penetration of the dye following overdistension. Indigocarmine is potentially useful as both a quantitative and qualitative indicator of bladder mucosal integrity.
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Affiliation(s)
- F C Monson
- Division of Urology, University of Pennsylvania School of Medicine, Philadelphia 19104
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49
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50
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Affiliation(s)
- K Whitmore
- Department of Child Health, Westminster Children's Hospital, Vincent Square, London
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