bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reliability of dynamometric measurements of the pelvic floor musculature
Authors: Dumoulin Chantale , Gravel D. , Bourbonnais D. , Lemieux M.C. , Morin M. 
Published: February 2004

AbstractAimsThe objective of this study was to evaluate the reliability of strength and endurance dynamometric measurements of the pelvic floor musculature (PFM).Materials and MethodsTwenty‐nine female participants, primipara and multipara, aged between 27 and 42 and presenting different severity levels of stress urinary incontinence (SUI), participated in the study. They were evaluated using a new pelvic floor dynamometer, an instrumented speculum based on strain‐gauged technology. Strength and endurance evaluations were repeated in three successive sessions, each followed by a 4‐week period. Maximal strength values were recorded at three dynamometer openings (5 mm, 1 cm, and 1.5 cm between the two dynamometer branches). The maximal rate of force development (MRFD) and percentage of strength lost after 10 and 60 sec were computed from the endurance trial. The generalizability theory was applied to estimate the reliability of the PFM measurements. The reliability was quantified by the index of dependability and the corresponding standard error of measurement (SEM) for one and the mean of three trials performed in one session for the strength measurements and one trial completed in one session for the MRFD and endurance measurements.ResultsFor the maximal strength measurements, the largest coefficient of dependability was obtained at the 1 cm opening, with a value of 0.88. The corresponding SEM reached 1.49 N. The reliability of the MRFD was also very good with a coefficient of 0.86 and an SEM of 0.056 N/sec. The reliability was minimally affected by the number of trials. The strength loss measurements at 10 and 60 sec were unreliable, with coefficient values of 0.38 and 0.10, respectively.ConclusionsThe results of the present study indicate that the reliability of the strength parameters (maximal strength and MRTD measurements) was high enough for future investigations on pelvic floor rehabilitation programs. Neurourol. Urodynam. 23:134–142, 2004. © 2004 Wiley‐Liss, Inc.
Pubovaginal sling using Duraderm™ graft: Intermediate follow‐up and patient satisfaction
Authors: Owens David C. , Winters J. Christian 
Published: February 2004

AbstractAimTo assess outcome and patient satisfaction utilizing Duraderm™ allograft as sling material.MethodsTwenty five patients undergoing the Duraderm sling procedure were evaluated by pelvic examination, post‐void residual urine, and multi‐channel urodynamics. Follow‐up included repeat examination, stress test, and chart review. Patient satisfaction was assessed by phone interview with an independent examiner. Outcome was defined as dry (no leaking at all and patient perception of satisfaction), improved (minimal leak requiring ≤1 pad daily and patient perception of satisfaction), or failure.ResultsAverage age was 62.0 years (30–83); average daily preoperative pad usage was 3.5 (2–8). Duraderm allograft measuring 2 × 12 cm was used. Mean postoperative catheter time was 7.7 days (3–37 days). At 6 months, 17/25 (68%) were dry, 6 (24%) improved, and 2 (8%) failed. Mean intermediate follow‐up at 14.8 months (8–23 months) revealed 8/25 (32%) patients were dry, 9 (36%) were improved, and 8 (32%) failed Duraderm sling. Mean pad use after surgery was 1.4 (0–6). Of the 25, 19 (76%) were satisfied with the surgical outcome, 17 (68%) noted they would have surgery again, and 17 (68%) would recommend the procedure.ConclusionsInitial results of pubovaginal sling using Duraderm graft are satisfactory; however, longer term follow‐up is disappointing. Graft degeneration previously described after utilization of cadaveric fascia lata may be possible following implantation of cadaveric dermis. Neurourol. Urodynam. 23:115–118, 2004. © 2004 Wiley‐Liss, Inc.
Are fatigue and disturbances in pre‐programmed activity of pelvic floor muscles associated with female stress urinary incontinence?
Authors: Verelst M. , Leivseth G. 
Published: February 2004

AbstractAimsTo investigate whether there is a difference between a continent versus a stress urinary incontinent group of women regarding: (i) fatigue in pelvic floor muscles, and (ii) pre‐activation times between pelvic floor and abdominal muscles during coughing.MethodsTwenty‐six continent and 20 stress urinary incontinent parous women were examined. Fatigue was measured with an intravaginal device. Time to 10% decline of the initial reference force (RF) was defined as time‐to‐fatigue. Simultaneous recordings of force developed in levator ani muscle and electromyographic activity in the external oblique abdominal muscle were performed to determine whether contraction of pelvic floor muscles precedes activity in abdominal muscles during coughing.ResultsTime‐to‐fatigue was identical in the two groups (10.5 sec in the continent and 11.5 sec in the incontinent group, median values). Normalized force was significantly reduced in the incontinent group. The pelvic floor muscles contracted 160 msec before the abdominal muscles in both groups. In 24% of the continent and in 30% of the incontinent women, however, abdominal muscle activity preceded activity of pelvic floor muscles.ConclusionsMuscular fatigue, defined as rate of force loss, does not seem to be associated with urinary stress incontinence. Moreover, muscular activity recruitment patterns were equal in both groups suggesting that other factors than disturbances of ordered muscle recruitment, that is, pelvic floor followed by abdominal muscles, may be responsible for stress urinary incontinence. It is likely that reduced normalized force, as found in the incontinent group, is an important contributing factor. Neurourol. Urodynam. 23:143–147, 2004. © 2004 Wiley‐Liss, Inc.
Mapping of spinal cord circuits controlling the bladder and external urethral sphincter functions in the rabbit
Authors: Pikov Victor , McCreery Douglas B. 
Published: February 2004

AbstractAimsA primary purpose of this study was to evaluate the rabbit as a model for studying the spinal circuitry controlling the bladder emptying. We aimed to map the locations of the neuronal circuitry controlling the external urethral sphincter (EUS) and the detrusor by stimulating at different spinal cord locations with a microelectrode, while recording the responses from these muscles.MethodsSpinal cord microstimulation was performed in the intermediate zone of the gray matter at the L7–S4 spinal cord levels in eight rabbits with empty and full bladders. Bladder activity was measured as intravesical pressure (IVP) changes and EUS activity was measured via electromyographic (EMG) electrodes positioned within the urethra.ResultsUnder both bladder conditions, EUS activation was produced from similar locations in the spinal cord comprising a continuous area in the intermediate zone of the S2–S3 spinal cord. This region extended 25 mm in the rostrocaudal dimension, at least 1 mm lateral to the midline, and 0.5–1 mm in the dorsoventral dimension at a depth of 2–3 mm beneath the dorsal surface. No locations in the intermediate zone produced EUS inhibition. The S2–S3 spinal region, stimulation of which produced the strongest EUS activation, also produced modest bladder contractions.ConclusionsOverall, the results indicate that spinal cord networks controlling bladder and EUS activation in the rabbit are overlapping and clustered into columns extending rostrocaudally. The lack of spinal locations producing EUS inhibition and large bladder contractions make the rabbit an unattractive model for studies of neuroprosthetic spinal control of micturition. Neurourol. Urodynam. 23:172–179, 2004. © 2004 Wiley‐Liss, Inc.
Relationship of urethral retro‐resistance pressure to urodynamic measurements and incontinence severity
Authors: Slack M. , Culligan P. , Tracey M. , Hunsicker K. , Patel B. , Sumeray M. 
Published: February 2004

AbstractAimsThe urethral retro‐resistance pressure (URP) is a retrograde urethral pressure profile measured by a new urodynamic measurement system.1GYNECARE MoniTorr Urodynamic Measurement System (ETHICON, Inc., Somerville, NJ).
URP is the pressure required to achieve and maintain an open sphincter. This clinical investigation focused on a comparison of URP to standard urodynamic measurements and an examination of their relationship to incontinence severity.MethodsTwenty‐two centers enrolled 258 stress incontinent women in a randomized, crossover study of two groups: (1) test procedure followed by multichannel urodynamics, (2) multichannel urodynamics followed by test procedure. We defined incontinence severity categories using 24 hr urine loss and assessed these categories using incontinence quality of life (I‐QOL), urinary incontinence severity score (UISS), incontinence visual analogue score (VAS), URP, maximum urethral closure pressure (MUCP), and leak point pressure (LPP).ResultsThe mean age was 56.2 (±12) years. No order effect was present. The correlation coefficient between URP and MUCP was 0.31 (95% CI 0.19–1, P < 0.0001); between URP and LPP was 0.28 (95% CI 0.12–1, P = 0.003); and between MUCP and LPP was 0.14 (95% CI−0.04–1, P = 0.101). The mean values for URP across symptom severity categories were significantly different (P = 0.028) and decreased with increasing severity. The mean values for MUCP and LPP did not decrease with increasing severity.ConclusionsThe study demonstrated that URP had a consistent relationship with incontinence severity. The data suggested that URP is a physiological measure of urethral function and may have clinical utility as a diagnostic tool. Future outcomes‐based research is necessary to establish the predictive value of URP, MUCP, and LPP measurements in terms of incontinence cure rates and diagnosis of sphincter dysfunction. Neurourol. Urodynam. 23:109–114, 2004. © 2004 Wiley‐Liss, Inc.
Elastolytic activity in women with stress urinary incontinence and pelvic organ prolapse
Authors: Chen Bertha , Wen Yan , Polan Mary Lake 
Published: February 2004

AbstractAimsWeakening of pelvic supportive tissues is thought to be a contributing etiology in female pelvic floor disorders such as stress urinary incontinence and/or pelvic organ prolapse (SUI/POP). Since elastin modulates the mechanical properties of supportive tissues, we examined elastase activity in vaginal tissue from women with pelvic floor dysfunction compared to asymptomatic controls, by comparing overall elastase activity, human neutrophil elastase, cathepsin K, and alpha‐1 antitrypsin (a serine protease inhibitor) mRNA and protein levels.MethodsFull‐thickness peri‐urethral vaginal wall tissues were collected from age and menstrual‐phase matched SUI/POP and control women at the time of pelvic surgery. Elastolytic activity in the homogenized tissue was determined by the generation of amino groups from succinylated elastin. To quantify mRNA levels of each protein, quantitative competitive‐PCR and confirmatory Western blot analyses were performed on the samples for human neutrophil elastase, cathepsin K, and alpha‐1 antitrypsin.ResultsThe mean elastolytic activity in vaginal tissues from the SUI/POP group was similar to that in the control group. With respect to the proteolytic enzymes, neither human neutrophil elastase nor cathepsin K differed between the two groups. However, alpha‐1 antitrypsin mRNA and protein levels were significantly decreased in tissues from affected women.ConclusionsA significant decrease in alpha‐1 antitrypsin expression was seen in tissues from women with SUI/POP compared to controls. This data suggest that altered elastin metabolism may contribute to the connective tissue alterations observed in pelvic floor dysfunction. Future investigations are warranted to help define the role of elastin turnover in pelvic floor dysfunction. Neurourol. Urodynam. 23:119–126, 2004. © 2004 Wiley‐Liss, Inc.
Urinary function in patients with corticobasal degeneration; Comparison with normal subjects
Authors: Sakakibara Ryuji , Uchiyama Tomoyuki , Yamanishi Tomonori , Hattori Takamichi 
Published: February 2004

AbstractAimsCorticobasal degeneration (CBD) is a rare neurodegenerative disorder affecting cerebral cortex and basal ganglia, both of which are crucial for regulating the lower urinary tract function. However, urinary function of this disorder has not been fully delineated. We investigated urinary function in patients with CBD.MethodsA questionnaire for storage and voiding urinary symptoms was performed in all 10 patients with CBD (four men, six women; mean age, 67.3 years; mean duration of disease, 3.9 years) and 11 age‐matched control subjects (four men and seven women; mean age, 73.0 years). Urodynamic studies were performed in six of the patients and all control subjects, including electromyography (EMG)‐cystometry and analysis of motor unit potentials of the external sphincter.ResultsAs compared to the control subjects (27%), patients with CBD had more common urinary symptoms (80%, P < 0.05). The urinary symptoms appeared 1–3 years after the onset of the disease, and were more common in patients with longer disease duration (>5 years) and in patients with forced grasp reflex. Nocturnal frequency was the most common and tended to be the initial urinary symptom (seven), followed by urinary incontinence (six), urinary urgency (six), diurnal frequency (five), and difficulty in voiding (five). None was in a state of urinary retention. While, one asymptomatic patient showed normal urodynamic finding, all five symptomatic patients showed various abnormalities, including decreased bladder capacity (four), detrusor overactivity (DO) (three), which was noted only in one of the control subjects, detrusor hypocontractility on voiding (three), and low compliance detrusor (one). None of the patients had post‐void residuals, detrusor‐sphincter dyssynergia, or neurogenic motor unit potentials of the external sphincter muscles.ConclusionAlthough the number of our patients was small, the present study suggests that urinary dysfunction is a common feature in patients with CBD. Since decreased bladder capacity and DO were common in the symptomatic patients, lesions in the supranuclear parasympathetic system are mainly responsible for their dysfunction. Neurourol. Urodynam. 23:154–158, 2004. © 2004 Wiley‐Liss, Inc.
Functional magnetic stimulation of the spinal cord—a urodynamic study in healthy humans
Authors: Reitz Andre , Knapp Peter A. , Frey Susanne , Schurch Brigitte 
Published: February 2004

AbstractAimsTo study the effects of functional magnetic stimulation of the spinal cord in healthy subjects on somatic and autonomic pathways innervating the anal and the external urethral sphincter, bladder, bladder neck, and rectum.MethodsEight healthy male volunteers gave their written informed consent and underwent functional magnetic stimulation of the thoracolumbar and sacral spinal cord. A two‐channel microtip pressure transducer catheter was placed rectally measuring the abdominal and anal sphincter pressure. A three‐channel microtip pressure transducer catheter was inserted into the urethra measuring the bladder, the bladder neck, and the external urethral sphincter pressure. A comprehensive protocol of single and repetitive magnetic stimulations was performed. Frequency, location, and duration of stimulation were varied while the intensity of stimulation was adapted to the maximum the subjects could tolerate. In four subjects, the degree of bladder filling was changed and the protocol was repeated when the subjects reported a full bladder and desire to void.ResultsContinuous magnetic stimulation of the thoracolumbar spinal cord and the sacral roots applied with different frequencies (5, 15, 30, 60, 100 Hz) and different duration of stimulation (10, 30, 120 sec) evoked sphincter contraction of both anal and urethral sphincters. The stimulation could not evoke contractions of the bladder, the bladder neck, or the rectum. Also with filled bladder and present desire to void, the magnetic stimulation could not activate autonomic pathways innervating these structures.ConclusionsConsidering our results, we suggest that in individuals with preserved sensibility magnetic stimulation of the spinal cord with intensities below the pain threshold is ineffective in activating autonomic nerve fibres innervating bladder, bladder neck, and rectum. Neurourol. Urodynam. 23:148–153, 2004. © 2004 Wiley‐Liss, Inc.
Pressure flow study: A useful diagnostic test of female lower urinary tract symptoms
Authors: Digesu G. Alessandro , Hutchings Anna , Salvatore Stefano , Selvaggi Luigi , Milani R. , Khullar Vik 
Published: February 2004

AbstractAimsTo compare pressure flow parameters in the different urodynamic diagnoses in women with lower urinary tract symptoms (LUTS).Materials and MethodsUrodynamic traces of women with LUTS were prospectively studied. Detrusor pressures at the start of flow (ODP), detrusor pressure at peak flow rate (PdetQmax), peak flow rate (Qmax) and detrusor pressure at the end of flow (CDP) were measured and compared with different urodynamic diagnoses.ResultsSix hundred and twenty one women were prospectively investigated between September 2000 and February 2002. Only 85% (529/621) of women had good quality pressure flow studies and was included in the study. Women with detrusor overactivity have higher ODP, CDP and PdetQmax than women with urethral sphincter incompetence. All these pressure flow parameters are significantly lower in women with urethral sphincter incompetence than continent women (P < 0.05, Bonferroni test). Qmax was significantly greater in women with urodynamic stress incontinence compared to women who had detrusor overactivity (P < 0.05, Bonferroni test). Women with mixed incontinence had pressure flow parameters intermediate between women with detrusor overactivity and those with urodynamic stress incontinence.ConclusionsPressure flow parameters appear to be useful urodynamic tools in the evaluation of women with LUTS as they help the clinician in assessing the urethral and detrusor function. Neurourol. Urodynam. 23:104–108, 2004. © 2004 Wiley‐Liss, Inc.
Degree of bother caused by nocturia in women
Authors: Fiske Joshua , Scarpero Harriette M. , Xue Xiaonan , Nitti Victor W. 
Published: February 2004

AbstractAimsThe prevalence of nocturia in women has been studied, but its severity has not been categorized based on degree of bother. The number of nighttime voids that defines clinically significant nocturia has not been established. The objective of this study was to establish how bothersome nocturia is in women and to determine whether number of nighttime voids correlates with the degree of bother. We also sought to determine if this correlation was affected by age or continence status.Materials and MethodsThe charts of 1,214 neurologically healthy women that presented to a female urology office were reviewed. All women completed the American Urological Association Symptom Index (AUASI) and the symptom problem index (SPI). Question no. 7 of the AUASI assesses the number of voids per night and question no. 3 of the SPI assesses the bother of nighttime voiding. The correlation of these two variables was evaluated using a proportional odds model.ResultsMean age was 54.6 years (18–93). 87.3% complained of waking at least one time per night to void. Bother score increased as the number of nightly voids increased, irrespective of age or continence status. The proportional odds model showed that as the number of voids increases 1 value on AUASI, the odds of having an increase in bother increases 2.7 times (P<0.0001).ConclusionsAs the number of nighttime voiding episodes increases, the bother increases, independent of age or continent status. Based on the degree of bother, we propose that clinically significant nocturia in women be classified as two or more episodes per night. Neurourol. Urodynam. 23:130–133, 2004. © 2004 Wiley‐Liss, Inc.
The role of foundations in informing policymakers
Authors: Jackson‐Elmoore Cynthia 
Published: February 2004

AbstractIn an era when health policymaking is a cacophony of conflicting agendas and the media's focus is constantly
shifting, how does a private foundation that is committed to producing valuable health policy information place that
material into the hands of people most in need of it? And what measures should a foundation employ to
determine whether its communication efforts are achieving this effect? These questions have become more
important for a number of foundations that award most of their grants for health‐related purposes and have
concluded that providing information to health policymakers and the media should be a major priority of their
organization.
Marks & Spencer implements an ethical sourcing program for its global supply chain
Authors: Johnson Muriel 
Published: February 2004

AbstractAs part of its commitment to socially responsible business practices, retailer Marks & Spencer has worked
aggressively with its global supply chain, particularly suppliers in developing countries, to implement more
enlightened employment standards and create better work environments. After significant investments in
processes, training, systems, and people, the company gauges its progress towards a sustainable
solution—empowering suppliers at the local level to improve the lives of their workers. ©
2003 Marks & Spencer
The tough economy prompts companies to shift their approach to sales compensation
Authors: Dorf Paul R. , Masur Lisette F. 
Published: February 2004

AbstractWhen the economy nose‐dived after the boom of the 1990s, some companies modified their sales
compensation plans as a way to reduce costs—in some cases with undesirable results. More progressive
companies modified their sales strategies first and then reshaped compensation to align sales force behavior
with the new business realities. The authors examine four case studies and offer recommendations on how to
reconcile the desire for cost containment with the need to focus the sales force on those customers, products,
and services that can produce profits in even a tight economy. © 2004 Wiley Periodicals,
Inc.
Leadership style and values chart the course for an entrepreneurial journey
Authors: Whalen Matthew , Khin‐Maung‐Gyi Felix , Smithwick David 
Published: February 2004

AbstractThree leaders of a ten‐year‐old start‐up company reveal how they have used transparent
leadership to create employee commitment, inculcated core values to drive organizational behavior, and made
clear communications a competitive advantage. They also share how customer care, continuous learning, and
intentional community have helped nurture their basement business into a nationally recognized success.
© 2004 Wiley Periodicals, Inc.
Sovereign bank develops a methodology for predicting the ROI of training programs
Authors: Engel Sherry , Kapp Karl M. 
Published: February 2004

AbstractTaking a page from the finance function's play book, the Learning and Development Team of Sovereign Bank
crafted a return on investment methodology that predicts the hard‐dollar business impact of proposed
training iniatives. Along the way the team also learned to speak the language of business. © 2004
Wiley Periodicals, Inc.
Ritz‐Carlton and EMC: The gold standards in operational behavioral differentiation
Authors: Bacon Terry R. , Pugh David G. 
Published: February 2004

AbstractThe authors tell the stories of Ritz‐Carlton Hotels and EMC Corporation, two companies whose
customer‐centric behaviors differentiate them from their competitors and have produced extraordinary
levels of business performance and customer satisfaction and loyalty. © 2003 Terry R. Bacon and
David G. Pugh