Effects of Age, Parity, and Adherence on Pelvic Muscle Response to Exercise

OBJECTIVE: To examine factors that affect pelvic muscle response to 12 weeks of pelvic muscle exercise. DESIGN: Repeated measures design in which intravaginal pressures during pelvic muscle contractions were recorded at baseline and after four exercise levels. SETTING: College of Nursing research site in Gainesville, Florida. PARTICIPANTS: Eighty-five parous, community-dwelling women, aged 35-78 years and without incontinence as a primary concern. INTERVENTIONS: A 12-week graded program of regular (three times per week, every other day) pelvic muscle exercise at home. MAIN OUTCOME MEASURES: The hypotheses were that younger age, lower parity, higher baseline intravaginal pressures, and adherence to the pelvic muscle exercise program each would result in significant improvement in maximum intravaginal pressures. RESULTS: The only factor showing significance in predicting a successful outcome was age (t = -2.29, df = 41, one-tail probability = .0136). CONCLUSIONS: Regular, graded exercise over several weeks is needed to build pelvic muscles, and some women who exercise do not improve. Although the reasons for not improving are unclear, age is a significant factor.     

An Investigation into the Electrical Ablation Technique and a Method of Electrode Assessment

Ablative techniques, using standard defibrillators and commonly available cardiac catheters, have been applied to the His bundle and bypass tracts for the management of arrhythmias. We have done in vitro studies of the physical effects of these high energy electrical impulses delivered via different pacing electrodes. Unipolar impulses of 10 to 400 joules were delivered via three U.S.C.I. bipolar electrodes and three Vitatron Helifix electrodes immersed in Ringer's solution. The effects were recorded on 35 mm still film, video tape, and high speed cine film. Pressure, voltage, and current were measured. The U.S.C.I. bipolar electrodes and the Vitatron Helifix electrodes safely withstood repeated delivery of 400-joule impulses which produced similar flash shapes. Each took the form of an incandescent, spherical "fire-ball" centered around the exposed electrode surface. The mean diameters of the "fire-ball" for 10 to 400 J using the U.S.C.I. electrodes were 5-24 mm and 3-20 mm for the Helifix catheter electrodes. Peak pressure excursions of over an atmosphere were observed 3 cm from the electrode tips. Higher pressures, lower voltages, and larger currents occurred using the U.S.C.I. pacing lead. The simple, 35 mm time exposure technique showed that at low energies the flashes appeared to emerge in a retrograde manner from the U.S.C.I. catheters and more distally from the Helifix electrode. This suggested that the latter might be more effective with lower energy impulses. It is concluded that lower energies should be used to take full advantage of the active fixation electrode.     

Usefulness of multidetector CT imaging to assess vascular stents in children with congenital heart disease: An in vivo and in vitro study

Objective : To evaluate varying CT settings to visualize pediatric vascular stents in comparison to digital angiography (DA). Background : There is a great clinical interest in substituting noninvasive methods to follow up children with congenital heart disease after interventional treatment. Materials and Methods : CT studies in small children with transcatheter placed stents were reviewed, retrospectively. Furthermore, eight stents were implanted in tubes and partially obstructed. CT exams were performed on varying scanners (4 up to 64 slices) with corresponding tube settings. The effects of dose on image quality were evaluated regarding stent size, strut thickness, and in‐stent stenoses in comparison to DA. Results : Fourteen children with 28 implanted stents were identified. Significant differences between higher and lower radiation settings were not found, corresponding with the phantom, where moderate tube setting showed the best results. In vitro, there was an improvement with increasing number of detector rows, which resulted in a decrease of stent strut overestimation (295% down to 201%; P < 0.0001) and a better agreement with DA measurements for mild (78% up to 91%; P = 0.003) and moderate in‐stent stenoses (80% up to 99%; P = 0.0001). Conclusion : Higher radiation exposure settings did not improve image quality, suggesting that the exams could be performed at a lower radiation dose. © 2008 Wiley‐Liss, Inc.