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Cowen J, Ali M, Dave R, Woodhouse J, Anand R, Repanos C, Brennan PA, Bekker J. Radiologically-guided balloon sialoplasty for benign salivary duct obstruction: a 7-year UK service evaluation. Br J Oral Maxillofac Surg 2023; 61:547-552. [PMID: 37640606 DOI: 10.1016/j.bjoms.2023.07.007] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 07/26/2023] [Accepted: 07/31/2023] [Indexed: 08/31/2023]
Abstract
Obstructive sialadenitis is the most common cause of non-malignant salivary gland disorders, with salivary gland strictures being responsible for approximately 23% of all benign obstructive disease. Significant advances in minimally invasive techniques, including radiologically-guided balloon sialoplasty, offer the potential for successful treatment with reduced complications. At present there is a paucity of follow-up data regarding patient outcomes and repeat interventions in those undergoing the procedure. Patients with parotid or submandibular gland sialadenitis secondary to gland stricture were identified and underwent radiologically-guided balloon sialoplasty at Queen Alexandra Hospital, Portsmouth, UK between 2015 and 2022. Patient outcomes, complications and reintervention rates were recorded prospectively over the seven-year period and analysed retrospectively. A total of 44 patients underwent radiologically-guided balloon sialoplasty. Forty (89%) underwent sialoplasty for parotid gland disease, with a minority (n = 5) receiving an intervention for submandibular gland strictures. A total of 37 (84%) had their obstruction successfully treated (82% of parotid gland obstructions and 100% of submandibular gland obstructions). Five patients (11%) required a repeat intervention. Seventeen successfully treated patients (85%) who attended follow-up clinic appointments described complete resolution of their symptoms, with the remaining three (15%) describing a partial response. Radiologically-guided balloon sialoplasty for the treatment of benign obstructive sialadenitis secondary to a gland stricture is a safe and effective method of eliminating the obstruction and relieving patients' symptoms. Most patients were symptom free at short-term follow up, with a minority requiring a second sialoplastic intervention.
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Affiliation(s)
- Jake Cowen
- Department of Radiology, Queen Alexandra Hospital, Portsmouth, Portsmouth Hospitals University NHS Trust, PO6 3LY, UK.
| | - Muhammad Ali
- Department of Radiology, Queen Alexandra Hospital, Portsmouth, Portsmouth Hospitals University NHS Trust, PO6 3LY, UK
| | - Roma Dave
- Department of Radiology, Queen Alexandra Hospital, Portsmouth, Portsmouth Hospitals University NHS Trust, PO6 3LY, UK
| | - Joe Woodhouse
- Department of Radiology, Queen Alexandra Hospital, Portsmouth, Portsmouth Hospitals University NHS Trust, PO6 3LY, UK
| | - Rajiv Anand
- Department of Oral and Maxillofacial Surgery, Queen Alexandra Hospital, Portsmouth, Portsmouth Hospitals University NHS Trust, PO6 3LY, UK
| | - Costa Repanos
- Department of Ear, Nose and Throat Surgery, Queen Alexandra Hospital, Portsmouth, Portsmouth Hospitals University NHS Trust, PO6 3LY, UK
| | - Peter A Brennan
- Department of Oral and Maxillofacial Surgery, Queen Alexandra Hospital, Portsmouth, Portsmouth Hospitals University NHS Trust, PO6 3LY, UK
| | - Jasper Bekker
- Department of Radiology, Queen Alexandra Hospital, Portsmouth, Portsmouth Hospitals University NHS Trust, PO6 3LY, UK
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Matthews JH, Makin S, Booker RJ, Holland A, K Bhabutta R, Vassallo D, Woodhouse J, Ross D. The History of the Post-Graduate Medical and Nursing Officers (PGMNO) course in the British Army. BMJ Mil Health 2022; 168:e002093. [PMID: 35878969 DOI: 10.1136/military-2022-002093] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 07/03/2022] [Indexed: 11/03/2022]
Abstract
Military medicine has been evolving for over 5000 years of recorded civilisation and conflict. The Army Medical Services performed poorly during the Crimean War and the British Army introduced a professional training course for medical officers in 1860. The Army Medical School and the predecessor of today's Post-Graduate Medical and Nursing Officers (PGMNO) course have had to adapt to changes in British foreign policy and military requirements. The Army Medical School instigated a rigorous scientific medical training which led to major advances in the study of tropical diseases and trauma medicine. These advances were quickly included in the training of future cohorts. Although the Army Medical School has now closed, the PGMNO course thrives at its new location at the Defence Medical Academy, Whittington. Modern general duties medical officers (GDMOs) must be able to provide medical care in a range of austere environments, including humanitarian relief and conflict zones. New clinicians complete their basic military training before completing the PGMNO course and the Diploma in the Medical Care of Catastrophes. This programme ensures that GDMOs and military nurse practitioners gain a wide knowledge of the latest military and humanitarian medicine. The current era will require clinicians who are competent generalists, who can perform in small teams in dispersed locations. This article summarises the development of the British Army's PGMNO course and the evolution of its syllabus as part of the Humanitarian and Disaster Relief Operations special issue of BMJ Military Health.
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Affiliation(s)
| | - S Makin
- Army Medical Services, Robertson House, Camberley, UK
| | - R J Booker
- Research and Clinical Innovation SO1 Implementation and jHub-Med Chief Operating Officer, HQ Defence Medical Services, London, UK
| | | | - R K Bhabutta
- Regional Clinical Director for Central and Wessex, Defence Primary Healthcare, Lichfield, UK
| | - D Vassallo
- Army Medical Services, Robertson House, Camberley, UK
- Chairman, Friends of Millbank, Contactable via Regimental Secretary, Fareham, UK
| | - J Woodhouse
- Regional Clinical Director Overseas, Defence Primary Healthcare, DMS Whittington, Lichfield, UK
| | - D Ross
- Army Medical Services, Robertson House, Camberley, UK
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Cumpsty R, Makin S, Woodhouse J. Can a weight management conditioning course help with armed forces recruitment? BMJ Mil Health 2019; 166:e70-e72. [DOI: 10.1136/jramc-2019-001189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 05/06/2019] [Accepted: 05/08/2019] [Indexed: 11/03/2022]
Abstract
British Armed Forces are facing the most significant recruitment crisis since 2010. An important contributing factor to the recruitment crisis is the rise in obesity of the UK population. At Army Training Centre Pirbright, a weight management programme (WMP) has been established for recruits who have failed their initial medical assessment (IMA). To determine the proportion of recruits who entered the WMP and passed basic and initial trade training, allowing entry into the British Army. Retrospective service evaluation of recruits entering WMP from inception in April 2015 to August 2018. Medical records were used to assess whether recruits completed initial training. 72.3% of recruits included in the WMP who would have previously failed their IMA because of a high body mass index (BMI) passed basic and initial trade training. This evaluation demonstrates potential for candidates otherwise excluded based on BMI. This WMP delivers structured nutritional support and encourages physical training. Once a BMI enters the accepted range, recruits could enter basic training. This WMP would deliver structured nutritional support and encourage physical training, with the aim of promoting healthy lifestyles. Neither the Royal Navy nor the Royal Air Force currently have a WMP. There is potential for WMPs to be introduced to all three services. UK Armed Forces face a recruitment crisis and need to be adaptable with a population where obesity is prevalent. At Pirbright 72.3% of candidates in the WMP passed basic and initial trade training.
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Keoghane SR, Deverill SJ, Woodhouse J, Shennoy V, Johnston T, Osborn P. Combined antegrade and retrograde access to difficult ureters: revisiting the rendezvous technique. Urolithiasis 2018; 47:383-390. [PMID: 29959479 DOI: 10.1007/s00240-018-1070-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 06/25/2018] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Complex ureteric strictures present a significant challenge to the endourologist and uro-radiologist. Multiple separate interventions to try to cross the stricture are often attempted. We describe our experience managing a heterogenous patient group using the 'rendezvous' procedure. METHODS AND MATERIALS 16 patients and 18 ureters (one bilateral procedure, and two separate procedures in one patient) underwent rendezvous procedures. Seven patients had coexisting ureteric calculi treated. Each case was followed up for between 3 months and 5 years. RESULTS In 16/18 ureters there was technical success at time of surgery; successfully crossing the stricture, allowing ureteroscopic access to the ureter, dilating and/or stenting the ureter. 2/18 were unsuccessful; one secondary to advanced malignancy resulting in a uretero-vaginal fistula and the second a failure to remove a retained, displaced ureteric stent. Of the 18 ureteric procedures; 7/18 were stent free at 3 months, improving to 8/18 stent free at 6 months. 4/18 remained nephrostomy dependent (failure of drainage despite stent or failure to stent) at 3 months, increasing to 6/18 being nephrostomy dependent at 6 months. 1/16 remained dialysis dependent with a nephrostomy tube. For those procedures involving ureteric calculi, 6/7 were stone free and 1/5 had a persistent stone fragment requiring further intervention. CONCLUSIONS A combined approach may decrease the number of separate interventions required, with the aim of removing the need for a long-term nephrostomy, as well as providing opportunity to treat ureteric calculi in the context of stricture disease. Our experience has been that where the rendezvous has been required to treat strictures caused by malignant extrinsic compression, stenting has not been successful; this information is key to informed consent in a group of patients who may have a limited life expectancy.
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Affiliation(s)
- S R Keoghane
- Departments of Urology and Radiology, West Suffolk NHS Foundation Trust, Portsmouth and Bury St Edmunds, Suffolk, UK.
| | - S J Deverill
- Departments of Urology and Radiology, Portsmouth NHS Trust, Portsmouth, UK
| | - J Woodhouse
- Departments of Urology and Radiology, Portsmouth NHS Trust, Portsmouth, UK
| | - V Shennoy
- Departments of Urology and Radiology, West Suffolk NHS Foundation Trust, Portsmouth and Bury St Edmunds, Suffolk, UK
| | - T Johnston
- Departments of Urology and Radiology, West Suffolk NHS Foundation Trust, Portsmouth and Bury St Edmunds, Suffolk, UK
| | - P Osborn
- Departments of Urology and Radiology, Portsmouth NHS Trust, Portsmouth, UK
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Butlin T, Woodhouse J, Champneys AR. The landscape of nonlinear structural dynamics: an introduction. Philos Trans A Math Phys Eng Sci 2015; 373:rsta.2014.0400. [PMID: 26303925 PMCID: PMC4549938 DOI: 10.1098/rsta.2014.0400] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/07/2015] [Indexed: 06/04/2023]
Abstract
Nonlinear behaviour is ever-present in vibrations and other dynamical motions of engineering structures. Manifestations of nonlinearity include amplitude-dependent natural frequencies, buzz, squeak and rattle, self-excited oscillation and non-repeatability. This article primarily serves as an extended introduction to a theme issue in which such nonlinear phenomena are highlighted through diverse case studies. More ambitiously though, there is another goal. Both the engineering context and the mathematical techniques that can be used to identify, analyse, control or exploit these phenomena in practice are placed in the context of a mind-map, which has been created through expert elicitation. This map, which is available in software through the electronic supplementary material, attempts to provide a practitioner's guide to what hitherto might seem like a vast and complex research landscape.
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Affiliation(s)
- T Butlin
- Department of Engineering, University of Cambridge, Trumpington Street, Cambridge CB2 1PZ, UK
| | - J Woodhouse
- Department of Engineering, University of Cambridge, Trumpington Street, Cambridge CB2 1PZ, UK
| | - A R Champneys
- Department of Engineering Mathematics, University of Bristol, Queen's Building, Bristol BS8 1TR, UK
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Abstract
Synthesised acoustic guitar sounds based on a detailed physical model are used to provide input for psychoacoustical testing. Thresholds of perception are found for changes in the main parameters of the model. Using a three-alternative forced-choice procedure, just-noticeable diff erences
are presented for changes in frequency and damping of the modes of the guitar body, and also for changes in the tension, bending stiff ness and damping parameters of the strings. These are compared with measured data on the range of variation of these parameters in a selection of guitars.
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Abstract
OBJECTIVE/BACKGROUND Neurogenic reproductive dysfunction in men with spinal cord injury (SCI) is common and the result of a combination of impotence, ejaculatory failure, and abnormal semen characteristics. It is well established that the semen quality of men with SCI is poor and that changes are seen as early as 2 weeks after injury. The distinguishing characters of poor quality are abnormal sperm motility and viability. In the majority of the men with SCI, the sperm count is not abnormal. We elaborate on the effects of the SCI on semen parameters that may contribute to poor motility and poor viability. METHODS Review. DESIGN PubMed and MEDLINE databases were searched using the following key words: spinal cord injuries, fertility, sexual dysfunction, and spermatogenesis. All literature was reviewed by the team of authors according to the various stages of sperm development and transport in the male reproductive cycle. FINDINGS The cause of asthenozoospermia appears to be multifactorial. CONCLUSION Current literature does not support the preeminence of a single factor relating to neurogenic reproductive dysfunction in men with SCI. After SCI, there is ample evidence of disturbance of sperm production, maturation and storage, and transport due to an abnormal neuroendocrine milieu. Semen quality seems to be primarily affected by changes to the seminal plasma constituents, type of bladder management, and the neurogenic impairment to the ejaculatory function. Further focused and structured studies are required.
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Affiliation(s)
- Prasad Patki
- Neurourology Department, London Spinal Cord Injury Centre, Royal National Orthopaedic Hospital, Middlesex, UK.
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Mackenzie I, Woodhouse J. C-reactive protein concentrations during bacteraemia: a comparison between patients with and withour liver dysfunction: reply to Droogh et al. and to Cheng and Currie. Intensive Care Med 2007. [DOI: 10.1007/s00134-006-0525-7] [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: 10/23/2022]
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Woodhouse J, Ferguson MM. Multiple hyperechoic testicular lesions are a common finding on ultrasound in Cowden disease and represent lipomatosis of the testis. Br J Radiol 2006; 79:801-3. [PMID: 16980675 DOI: 10.1259/bjr/50628431] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [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: 11/05/2022] Open
Abstract
Cowden disease (CD) is a genetic disease associated with multiple hamartomas and malignant neoplasms. During investigations for possible subnormal fertility, a series of eight males with CD underwent ultrasound scanning of their testes. Our findings detail the seven adult patients that were found to have multiple and bilateral testicular lesions on ultrasound. These lesions in Cowden's patients represent a newly described testicular pathology - lipomatosis of the testis. Here we detail the radiological findings. Ultrasound findings showed multiple (estimated 40+) discreet lesions randomly scattered thoughout the parenchyma of each affected testis. The lesions themselves had heterogeneous echo texture, but all being hyperechoic and with a variable size from 1 mm to 6 mm. One patient underwent MR examination of the lesions in which a high T(1) signal was seen, but no useful characteristic features were identifiable.
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Affiliation(s)
- J Woodhouse
- Department of Urology, Christchurch Hospital, Christchurch, New Zealand
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Mackenzie I, Woodhouse J. C-reactive protein concentrations during bacteraemia: A comparison between patients with and without liver dysfunction. Intensive Care Med 2006; 32:1344-51. [PMID: 16799774 DOI: 10.1007/s00134-006-0251-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2005] [Accepted: 05/26/2006] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To evaluate the value of serum C-reactive protein (CRP) concentrations as a marker of sepsis in patients with biochemical evidence of liver dysfunction. DESIGN A retrospective case-control comparison of serum CRP concentrations between patients with and those without liver dysfunction (prothrombin time over 18 s and serum bilirubin > or = 20 micromol/l) during their first episode of bacteraemia. SETTING The neurosciences and general adult intensive care units of a university teaching hospital. PATIENTS Any patient from the above settings with a first episode of bacteraemia (first isolate of pathogenic bacteria from blood cultures) over a 3-year period. MEASUREMENTS AND RESULTS After exclusions 126 first episodes of bacteraemia were identified, of which 33 were in patients with liver dysfunction. Serum CRP concentrations were significantly lower in patients with liver dysfunction (median 103 mg/l, IQR 29-204) than in those without (146 mg/l, 74, > 250). CONCLUSIONS Patients with biochemical evidence of liver disease generate significantly lower serum CRP concentrations during bacteraemia than patients without liver dysfunction. Serum CRP concentrations should be interpreted with caution in patients with liver disease to diagnose and monitor bacterial sepsis.
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Affiliation(s)
- Iain Mackenzie
- John Farman Intensive Care Unit, Box 17, Addenbrooke's Hospital, CB2 2QQ, Cambridge, UK.
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Patki P, Woodhouse J, Hamid R, Shah J, Craggs M. Lower urinary tract dysfunction in ambulatory patients with incomplete spinal cord injury. J Urol 2006; 175:1784-7; discussion 1787. [PMID: 16600760 DOI: 10.1016/s0022-5347(05)00979-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2005] [Indexed: 11/30/2022]
Abstract
PURPOSE We evaluated urinary tract dysfunction in individuals with spinal injury who remained able to ambulate. We observed changes with time in urological management. MATERIALS AND METHODS All patients attending outpatient clinics with traumatic, incomplete (American Spinal Injury Association grades D and E) spinal cord injury during a 2-year period were identified. All patients had their hospital notes reviewed retrospectively and salient urological data extracted. RESULTS A total of 43 men and 21 women were identified during this period. Mean age was 46 years (range 18 to 70). Mean followup was 7 years (range 1 to 18). At the time of inpatient discharge 40 of the 64 patients (62.5%) could void spontaneously, 20 required CSIC and 4 had a suprapubic catheter. In 19 of these 40 patients (47.5%) who had been initially assessed as having a bladder that was safe to void spontaneously the condition deteriorated, such that CSIC was required. Conversely 5 of 20 patients (25%) who initially required CSIC improved, such that it became redundant. At last followup 68.7% of the patients had abnormal urodynamics and 24 of the 64 (37.5%) required a change in urological management despite no appreciably detectable neurological change. CONCLUSIONS Despite relatively near total neurological recovery patients with incomplete SCI have neuropathic bladder unless proved otherwise. Salient deterioration in bladder dysfunction is not uncommon. Regular urological monitoring and appropriate treatment changes are required in the long term.
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Affiliation(s)
- Prasad Patki
- Spinal Injuries Unit, Department of Neuro-urology, Royal National Orthopaedic Hospital, Stanmore, United Kingdom.
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Abstract
Plane wave propagation in infinite two-dimensional periodic lattices is investigated using Floquet-Bloch principles. Frequency bandgaps and spatial filtering phenomena are examined in four representative planar lattice topologies: hexagonal honeycomb, Kagomé lattice, triangular honeycomb, and the square honeycomb. These topologies exhibit dramatic differences in their long-wavelength deformation properties. Long-wavelength asymptotes to the dispersion curves based on homogenization theory are in good agreement with the numerical results for each of the four lattices. The slenderness ratio of the constituent beams of the lattice (or relative density) has a significant influence on the band structure. The techniques developed in this work can be used to design lattices with a desired band structure. The observed spatial filtering effects due to anisotropy at high frequencies (short wavelengths) of wave propagation are consistent with the lattice symmetries.
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Affiliation(s)
- A Srikantha Phani
- Department of Engineering, Cambridge University, Trumpington Street, Cambridge CB2 1PZ, United Kingdom
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Patki P, Woodhouse J, Bycroft J, Hamid R, Shah PJR. Stress urinary incontinence: current understanding. Br J Hosp Med (Lond) 2005; 66:335-40. [PMID: 15981341 DOI: 10.12968/hmed.2005.66.6.18400] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 11/11/2022]
Abstract
Many new concepts were introduced in epidemiology, a etiopathology and treatment of stress urinary incontinence. This review gives a short account of these concepts and compares the results of commonly used treatment options with new ones recently introduced.
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Affiliation(s)
- P Patki
- Department of Neurourology, RNOHT, Stanmore
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Patki P, Woodhouse J, Bycroft J, Hamid R, Shah PJR. Stress urinary incontinence: current understanding. Br J Hosp Med (Lond) 2005. [DOI: 10.12968/hmed.2005.66.6.18401] [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: 11/11/2022]
Abstract
Many new concepts were introduced in epidemiology, a etiopathology and treatment of stress urinary incontinence. This review gives a short account of these concepts and compares the results of commonly used treatment options with new ones recently introduced.
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Affiliation(s)
- P Patki
- Department of Neurourology, RNOHT, Stanmore,
| | - J Woodhouse
- Urology, Department of Neurourology, RNOHT, Stanmore and Institute of Urology ' Nephrology, London,
| | - J Bycroft
- Urology, Department of Neurourology, RNOHT, Stanmore and Institute of Urology ' Nephrology, London,
| | - R Hamid
- Urology, Institute of Urology & Nephrology, London and
| | - PJR Shah
- Urologist, Department of Neurourology, RNOHT, Stanmore and Institute of Urology & Nephrology, London
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Abstract
The transition zone of Earth's mantle is delineated by globally observed discontinuities in seismic properties at depths of about 410 and 660 kilometers. Here, we investigate the detailed structure between 410 and 660 kilometers depth, by making use of regional stacks of precursors to the SS phase. The previously observed discontinuity at about 520 kilometers depth is confirmed in many regions, but is found to be absent in others. There are a number of regions in which we find two discontinuities at about 500 and 560 kilometers depth, an effect which can be interpreted as a "splitting" of the 520 kilometer discontinuity. These observations provide seismic constraints on the sharpness and observability of mineralogical phase transitions in the mantle transition zone.
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Affiliation(s)
- A Deuss
- Department of Earth Sciences, University of Oxford, Oxford OX1 3PR, UK.
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Bonthius DJ, Woodhouse J, Bonthius NE, Taggard DA, Lothman EW. Reduced seizure threshold and hippocampal cell loss in rats exposed to alcohol during the brain growth spurt. Alcohol Clin Exp Res 2001; 25:70-82. [PMID: 11198717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
BACKGROUND Epilepsy is a prominent sign of neurologic dysfunction in some children with fetal alcohol syndrome (FAS). However, it is unknown whether the epileptic disorders in these children are directly due to the neuroteratogenic effects of alcohol or to some other factor accompanying maternal alcoholism. The hippocampus is vulnerable to alcohol-induced pathologic changes, and dysfunction of the hippocampus often manifests as epilepsy. We examined the effect of alcohol exposure during development on the seizure threshold and examined the relationship between alteration of seizure threshold and alcohol-induced neuronal loss from the hippocampus. METHODS Rat pups received 0.85, 2.5, or 3.75 g/kg of alcohol via intragastric intubation daily over postnatal days (PD) 4-9. An intubated control and a suckle control group were also included. To assess the effect of a single day of alcohol exposure, an additional group received 3.75 g/kg of alcohol on PD 4 alone. Behavioral seizure thresholds were determined by intravenous infusion of the proconvulsant, pentylenetetrazol (PTZ), on PD 31 or on PD 90. In addition, electrographic seizure thresholds were determined by recording extracellular field potentials from the dentate gyrus. The number of hippocampal CA1 pyramidal cells, CA3 pyramidal cells, and granule cells of the dentate gyrus were determined by stereology. RESULTS Daily exposure to alcohol resulted in a dose-dependent decrease in the seizure threshold and in the selective loss of CA1 pyramidal cells. Reduction in the seizure threshold was significantly correlated with loss of CA1 pyramidal cells. Recordings of extracellular field potentials confirmed the alcohol-induced reduction in seizure threshold, demonstrated that PTZ-induced seizures involve hippocampal-parahippocampal circuitry, and provided evidence that the hippocampal formation is the generator of the PTZ-induced seizures in alcohol-exposed animals. CONCLUSIONS These findings demonstrate that exposure of the developing brain to alcohol can permanently reduce the threshold for both behavioral and electrographic seizures and can selectively kill hippocampal CA1 pyramidal cells. Both the pathologic findings and the physiologic recordings support the concept that the reduced seizure threshold in alcohol-exposed animals is due to hippocampal pathology.
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Affiliation(s)
- D J Bonthius
- Department of Pediatrics, University of Iowa, Iowa City 52242, USA.
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Abstract
A method is presented for reconstructing the friction force and the velocity at the bowing point of a string excited by a rosined bow sliding transverse to the string. Two versions of the method of reconstruction are presented, each approximate in different ways, but both capable of sufficient accuracy to allow useful application to problems of understanding frictional interactions in this dynamical system. The method is illustrated with simulated data to verify its accuracy, and results are shown for two contrasting cases of observed stick-slip string motion. As has been found in other investigations, the friction force during sliding is not determined by the instantaneous sliding speed. The results seem to be compatible with a thermally based model of rosin friction.
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Affiliation(s)
- J Woodhouse
- Department of Engineering, Cambridge University, United Kingdom.
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Woodhouse J. Army general practitioner. West J Med 1999. [DOI: 10.1136/bmj.319.7225.2] [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: 11/03/2022]
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Abstract
This paper reports the findings of an audit of the management of occupational health arrangements in 36 NHS Trusts in the Northern and Yorkshire region of England. A questionnaire was designed based on a national NHS occupational health standard to obtain data on eight categories of occupational health activity: health and safety; pre-employment assessments; Infection Control; health surveillance; sickness absence; ill-health retirement; health promotion and record storage. The management arrangements for occupational health were varied. Assessments of workplace hazards, prevention of HIV-positive workers from performing exposure-prone invasive procedures and the assessment of pregnant workers were identified as issues for further consideration. Provision of competent and effective occupational health services will assist in the management of sickness absence and in the protection and promotion of health of staff. It will also contribute to the health and safety of patients.
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Affiliation(s)
- J Harrison
- Department of Environmental and Occupational Medicine, Medical School, Newcastle-upon-Tyne, UK
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Oliver SE, Woodhouse J, Hollyoak V. Lessons from patient notification exercises following the identification of hepatitis B e antigen positive surgeons in an English health region. Commun Dis Public Health 1999; 2:130-6. [PMID: 10402749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
The results of hepatitis B virus (HBV) serology from notification exercises conducted in cohorts of patients exposed to three surgeons positive for hepatitis B e antigen (HBeAg) identified in one English health region in 1994 and 1995 were reviewed. Of 777 patients notified, serology results at six months or more after exposure were available for 514 individuals who had not received post exposure prophylaxis. In one case DNA analysis confirmed transmission of HBV from surgeon to patient. Pre-existing natural immunity to HBV was found in a further 19 patients, none of whom had evidence of recent infection, and in 13 patients (classified as cases of undetermined origin) transmission during surgery could not be excluded. The overall estimated transmission rate was 0.2% for confirmed cases (95% confidence interval (CI) 0.004-1.1) and 2.7% (95% CI 1.5-4.5) if cases of undetermined origin were included. The management of recall exercises should consider the risks of the operative procedures performed and the time that has elapsed since exposure.
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Affiliation(s)
- S E Oliver
- Department of Social Medicine, University of Bristol.
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Woodhouse J, Gorton R. Why clinical audit doesn't work. Profession must rise to challenge of innovation. BMJ 1998; 316:1906-7. [PMID: 9669861] [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: 02/08/2023]
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Abstract
Theoretical models of the action of a bowed string may be able to shed light on differences of "playability" between different violins. Subjective judgements seem to be concerned, at least in part, with the robustness with which one particular oscillation regime of the string (the "Helmholtz motion") may be obtained under different bowing conditions. In this paper, after a review of bowed-string modelling, systematic simulation is used to obtain plots of the basin of attraction of the Helmholtz motion in a particular subspace of the player's control space. Variations in the size and structure of this basin of attraction are seen when parameters of the problem are varied, and some physical interpretation of these variations is given. Some parallels and contrasts are pointed out between the particular features of the bowed string as a nonlinear system, and the range of more familiar dynamical systems. (c) 1995 American Institute of Physics.
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Affiliation(s)
- R. T. Schumacher
- Department of Physics, Carnegie-Mellon University, Pittsburgh, Pennsylvania 15213Department of Engineering, Cambridge University, Trumpington St., Cambridge CB2 1PZ, United Kingdom
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Dunn CE, Woodhouse J, Bhopal RS, Acquilla SD. Asthma and factory emissions in northern England: addressing public concern by combining geographical and epidemiological methods. J Epidemiol Community Health 1995; 49:395-400. [PMID: 7650463 PMCID: PMC1060128 DOI: 10.1136/jech.49.4.395] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [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: 01/26/2023]
Abstract
STUDY OBJECTIVE The prevalence of asthma was assessed to investigate respiratory health effects of airborne emissions from a factory. A geographical information system allowed flexible definition of study areas in terms of their size, distance, and location in relation to the factory. The value of the approach for this type of investigation is focussed on. SETTING The factory is located in the south western part of a small market town in County Durham. MEASUREMENTS AND MAIN RESULTS A total of 1573 asthma cases were identified from general practitioner computerised repeat prescribing systems. Population denominators were defined from family health services authority patient registers. The area within 1 km and immediately to the north east of the factory had an age and sex standardised asthma prevalence 24% (confidence interval 4, 44%) in excess of the expected rate (p = 0.01). The increased prevalence was confined to middle aged and elderly adults living in the area between 0.5 and 1 km to the north east of the factory. CONCLUSIONS The value of combining the skills of geographers and epidemiologists in addressing public health issues is shown, particularly through the use of geographical information systems which proved powerful and effective.
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Affiliation(s)
- C E Dunn
- Department of Geography, University of Durham
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Woodhouse J. Binocularity at low luminances. Ophthalmic Physiol Opt 1990. [DOI: 10.1016/0275-5408(90)90157-t] [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: 11/27/2022]
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Woodhouse J. Clinical contrast sensitivity evaluation in visually impaired children. Ophthalmic Physiol Opt 1989. [DOI: 10.1016/0275-5408(89)90302-5] [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: 10/26/2022]
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Woodhouse J. Trainee exchanges. J R Coll Gen Pract 1989; 39:430. [PMID: 2560028 PMCID: PMC1712116] [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: 01/01/2023]
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Hall TR, Chadwick A, Woodhouse J, Harvey S. Brain serotonin turnover and plasma prolactin and growth hormone concentrations during changes in osmotic balance in the domestic fowl. J Comp Physiol B 1985. [DOI: 10.1007/bf00692931] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Newman FL, Woodhouse J. Differential eyelid conditioning: establishing differential responding prior to varying the probability of reinforcement. J Exp Psychol 1969; 80:146-9. [PMID: 5787408 DOI: 10.1037/h0027125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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