Bladder outlet obstruction in painful bladder syndrome/interstitial cystitis

Aims Obstructive symptoms such as slow stream, dribbling and straining are often reported by painful bladder syndrome and interstitial cystitis (PBS/IC) patients. Our hypothesis was that some patients with PBS/IC have an associated measurable bladder outlet obstruction (BOO) secondary to dysfunctional voiding and that those patients with more severe PBS/IC are more likely to have BOO. Methods This is a retrospective chart review of female patients diagnosed with PBS/IC based on the NIDDK research definition. Charts were reviewed for clinical symptom severity, ulcer or non-ulcer PBS/IC on cystoscopy, and pressure-flow urodynamics (UDPF). Patients were excluded if they had a urinary infection at the time of urodynamics or did not meet study entry requirements. The cut-off values of ≤12 ml/sec and ≥25 cm of water was used to define BOO. Results Of the 231 women: 38 had ulcer PBS/IC and 193 had non-ulcer PBS/IC. MCC was 269 ml in non-ulcer PBS/IC and 200 ml in ulcer PBS/IC ( P  = 0.006). One hundred eleven women (48%) met criteria for obstruction. MCC was 298 ml in the non-obstructed group and 214 ml in the obstructed group ( P  < 0.0001). The maximum flow with non-ulcer PBS/IC was 11.0 ml/sec and in ulcer PBS/IC 8.9 ml/sec ( P  = 0.04) Detrusor pressure at maximum flow was 33.3 cm H 2 O, in non-ulcer, and 37.4 cm H 2 O in ulcer PBS/IC ( P  = 0.01). Conclusions Forty-eight percent of our PBS/IC patients have BOO, and increasing severity of PBS/IC is associated with higher voiding pressure. Neurourol. Urodynam. 28:944–948, 2009. © 2009 Wiley-Liss, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/64338/1/20729_ftp.pd

Climate Change in the Piscataqua/Great Bay Region: Past, Present, and Future

Earth ’s climate changes. It always has and always will. However, an extensive body of scientific evidence indicates that human activities are now a significant force driving change in the Earth’s climate system. This report describes how the climate of the Piscataqua/Great Bay region of coastal New Hampshire in the United States has changed over the past century and how the future climate of the region will be affected by human activities that are warming the planet. Overall, the region has been getting warmer and wetter over the last century, and the rate of change has increased over the last four decades. To generate future climate projections for the region, simulated temperature and precipitation from four general circulation models were fitted to local, long-term weather observations. Unknowns regarding future fossil fuel consumption were accounted for by using two future emissions scenarios. As greenhouse gases continue to accumulate in the atmosphere, temperatures will rise, extreme heat days are projected to occur more often and will be hotter, extreme cold temperatures are projected to occur less often, and cold days will be warmer.. Annual average precipitation is projected to increase 12 to 17% by end-of-century and the region can expect to see more extreme precipitation events in the future. Tidal gauge data indicates relative sea level at Portsmouth has risen 0.7 inches per decade over the past eight decades. Projected sea level rise of 1.7 to 6.3 feet will result in higher storm surges and more frequent flooding in coastal New Hampshire

Climate Change in Northern New Hampshire: Past, Present and Future

EARTH’S CLIMATE CHANGES. It always has and always will. However, an extensive and growing body of scientific evidence indicates that human activities—including the burning of fossil fuel (coal, oil, and natural gas) for energy, clearing of forested lands for agriculture, and raising livestock—are now the primary force driving change in the Earth’s climate system. This report describes how the climate of northern New Hampshire has changed over the past century and how the future climate of the region will be affected by a warmer planet due to human activities

Climate Change in Southern New Hampshire: Past, Present and Future

EARTH’S CLIMATE CHANGES. It always has and always will. However, an extensive and growing body of scientific evidence indicates that human activities—including the burning of fossil fuel (coal, oil, and natural gas) for energy, clearing of forested lands for agriculture, and raising livestock—are now the primary force driving change in the Earth’s climate system. This report describes how the climate of southern New Hampshire has changed over the past century and how the future climate of the region will be affected by a warmer planet due to human activities

Results of surgical excision of urethral prolapse in symptomatic patients

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/139115/1/nau23232.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/139115/2/nau23232_am.pd

Palaeoecological Implications of Archaeological Seal Bone Assemblages: Case Studies from Labrador and Baffin Island

In recent years, increasing scientific attention has been paid to sea mammals as biological indicators of Arctic environmental change. The usefulness of animals such as ringed seal (Phoca hispida), harp seal (Phoca groenlandica), bearded seal (Erignathus barbatus), and harbour seal (Phoca vitulina) as indicator species is due to the close relationship of their range, reproductive cycles, and life histories to sea ice. The behaviour and distribution of these species correlate with ice conditions in the areas where the animals are encountered. The proportions of seal species represented in archaeological deposits may therefore reflect, at least in part, environmental conditions characterizing past seascapes. This paper examines zooarchaeological data from several Thule and historic Inuit archaeological sites in Baffin Island and Labrador, sites occupied during the last 700 years, to determine whether regional relationships can be demonstrated between subsistence economies, seal populations, and sea ice conditions. Ratios of ringed seal, harbour seal, bearded seal, and walrus (Odobenus rosmarus) bone frequencies from several archaeological sites are analyzed and discussed in light of new high-resolution proxy sea ice and regional palaeoenvironmental data. This exploratory study suggests that characteristics in seal species composition reflected in these assemblages can, in some circumstances, be correlated with recent sea ice reconstructions. However, a regional comparison of a larger number of more precisely dated archaeological sites is required for a full examination of these relationships. Au cours des dernières années, on a porté de plus en plus d'attention scientifique aux mammifères marins en tant qu'indicateurs biologiques du changement global dans l'Arctique. L'utilité d'animaux tels que le phoque annelé (Phoca hispida), le phoque du Groenland (Phoca groenlandica), le phoque barbu (Erignathus barbatus) et le phoque commun (Phoca vitulina) comme espèces indicatrices est due au rapport étroit que leurs aires de distribution, leurs cycles de reproduction et leurs cycles de vie ont avec la glace marine. Le comportement et la distribution de ces espèces sont corrélés avec les conditions de la glace dans les zones où l'on rencontre ces animaux. Les proportions des espèces de phoques qui se trouvent dans les dépôts archéologiques pourraient donc refléter, du moins partiellement, les conditions environnementales qui caractérisaient les paysages marins du passé. Cet article se penche sur les données zooarchéologiques provenant de plusieurs sites archéologiques Thulé et inuits dans l'île Baffin et le Labrador, sites occupés au cours des 700 dernières années, pour déterminer si l'on peut démontrer l'existence de rapports régionaux entre les économies de subsistance, les populations de phoques et les conditions de glace marine. Des taux de fréquence d'os de phoque annelé, de phoque commun, de phoque barbu et de morse provenant de plusieurs sites archéologiques font l'objet d'une analyse et d'une discussion à la lumière de nouvelles données indirectes à haute résolution sur la glace marine et sur le paléoenvironnement régional. Cette étude préliminaire suggère que les caractéristiques présentes dans la composition des espèces de phoques reflétée dans ces assemblages peuvent, dans certaines conditions, être corrélées aux reconstructions récentes de la glace marine. Une comparaison régionale d'un plus grand nombre de sites archéologiques datés de façon plus précise est toutefois nécessaire pour un examen exhaustif de ces rapports.

Palaeoecological Implications of Archaeological Seal Bone Assemblages: Case Studies from Labrador and Baffin Island

In recent years, increasing scientific attention has been paid to sea mammals as biological indicators of Arctic environmental change. The usefulness of animals such as ringed seal (Phoca hispida), harp seal (Phoca groenlandica), bearded seal (Erignathus barbatus), and harbour seal (Phoca vitulina) as indicator species is due to the close relationship of their range, reproductive cycles, and life histories to sea ice. The behaviour and distribution of these species correlate with ice conditions in the areas where the animals are encountered. The proportions of seal species represented in archaeological deposits may therefore reflect, at least in part, environmental conditions characterizing past seascapes. This paper examines zooarchaeological data from several Thule and historic Inuit archaeological sites in Baffin Island and Labrador, sites occupied during the last 700 years, to determine whether regional relationships can be demonstrated between subsistence economies, seal populations, and sea ice conditions. Ratios of ringed seal, harbour seal, bearded seal, and walrus (Odobenus rosmarus) bone frequencies from several archaeological sites are analyzed and discussed in light of new high-resolution proxy sea ice and regional palaeoenvironmental data. This exploratory study suggests that characteristics in seal species composition reflected in these assemblages can, in some circumstances, be correlated with recent sea ice reconstructions. However, a regional comparison of a larger number of more precisely dated archaeological sites is required for a full examination of these relationships. Au cours des dernières années, on a porté de plus en plus d'attention scientifique aux mammifères marins en tant qu'indicateurs biologiques du changement global dans l'Arctique. L'utilité d'animaux tels que le phoque annelé (Phoca hispida), le phoque du Groenland (Phoca groenlandica), le phoque barbu (Erignathus barbatus) et le phoque commun (Phoca vitulina) comme espèces indicatrices est due au rapport étroit que leurs aires de distribution, leurs cycles de reproduction et leurs cycles de vie ont avec la glace marine. Le comportement et la distribution de ces espèces sont corrélés avec les conditions de la glace dans les zones où l'on rencontre ces animaux. Les proportions des espèces de phoques qui se trouvent dans les dépôts archéologiques pourraient donc refléter, du moins partiellement, les conditions environnementales qui caractérisaient les paysages marins du passé. Cet article se penche sur les données zooarchéologiques provenant de plusieurs sites archéologiques Thulé et inuits dans l'île Baffin et le Labrador, sites occupés au cours des 700 dernières années, pour déterminer si l'on peut démontrer l'existence de rapports régionaux entre les économies de subsistance, les populations de phoques et les conditions de glace marine. Des taux de fréquence d'os de phoque annelé, de phoque commun, de phoque barbu et de morse provenant de plusieurs sites archéologiques font l'objet d'une analyse et d'une discussion à la lumière de nouvelles données indirectes à haute résolution sur la glace marine et sur le paléoenvironnement régional. Cette étude préliminaire suggère que les caractéristiques présentes dans la composition des espèces de phoques reflétée dans ces assemblages peuvent, dans certaines conditions, être corrélées aux reconstructions récentes de la glace marine. Une comparaison régionale d'un plus grand nombre de sites archéologiques datés de façon plus précise est toutefois nécessaire pour un examen exhaustif de ces rapports.

Predictors of Implantable Pulse Generator Placement After Sacral Neuromodulation: Who Does Better?

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/107552/1/ner12109.pd

Dynamic MRI evaluation of urethral hypermobility post‐radical prostatectomy

Aims One postulated cause of post‐prostatectomy incontinence is urethral and bladder neck hypermobility. The objective of this study was to determine the magnitude of anatomical differences of urethral and bladder neck position at rest and with valsalva in continent and incontinent men post‐prostatectomy based on dynamic MRI. Methods All subjects underwent a dynamic MRI protocol with valsalva and non‐valsalva images and a standard urodynamic evaluation. MRI measurements were taken at rest and with valsalva, including (1) bladder neck to sacrococcygeal inferior pubic point line (SCIPP), (2) urethra to pubis, and (3) bulbar urethra to SCIPP. Data were analyzed in SAS using two‐tailed t tests. Results A total of 21 subjects (13 incontinent and 8 continent) had complete data and were included in the final analysis. The two groups had similar demographic characteristics. On MRI, there were no statistically significant differences in anatomic position of the bladder neck or urethra either at rest or with valsalva. The amount of hypermobility ranged from 0.8 to 2 mm in all measures. There were also no differences in the amount of hypermobility (position at rest minus position at valsalva) between groups. Conclusions We found no statistically significant differences in bladder neck and urethral position or mobility on dynamic MRI evaluation between continent and incontinent men status post‐radical prostatectomy. A more complex mechanism for post‐prostatectomy incontinence needs to be modeled in order to better understand the continence mechanism in this select group of men. Neurourol. Urodynam. 33:312–315, 2014 . © 2013 Wiley Periodicals, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106760/1/nau22408.pd

Self-report of difficult defecation is associated with overactive bladder symptoms

Aims The association of dysfunctional bowel elimination with lower urinary tract symptoms is well known in children, but not in adults. It was our objective to assess lower urinary tract symptoms (LUTS) in women who report difficult defecation (DD). Methods This is a secondary analysis of 2,812 women, aged 35–64, who participated in a telephone interview. All subjects were asked “When you move your bowels, does the stool come out easily?” DD was considered present in those answering “no.” All subjects were queried regarding LUTS, urinary infections in the past year, self-perceived health status, medical history, and demographics. Symptoms of stress incontinence (five items), urge incontinence (five items), and the impact of these symptoms on their quality of life were solicited from subjects reporting more than 12 episodes of incontinence in 1 year. Results DD was reported by 10.4% (290/2,790) of women. Women with DD had higher LUTS than those who did not: nocturia (mean 1.8 ± 0.1 vs. 1.3 ± 0.0), urgency (47.6% vs. 29.2%), increased daytime frequency (mean 8.2 ± 0.3 vs. 7.2 ± 0.1), dysuria (22.9% vs. 13.7%), and a sensation of incomplete bladder emptying (55.6% vs. 28.2%). DD women were more often menopausal, reported a fair or poor self-reported health status, and had a higher number of comorbidities, less formal education, and lower annual household income. Conclusions Women with symptoms of DD have an increased rate of LUTS, consistent with the diagnosis of overactive bladder without incontinence. The pathophysiology underlying this association is worthy of future research. Neurourol. Urodynam. 29:1290–1294, 2010. © 2009 Wiley-Liss, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/78056/1/20839_ftp.pd