Applying behavioral research to incontinence

Historically, treatment strategies for urinary incontinence (UI) have not been offered by primary care practitioners. This is despite the fact that prevalence for UI in women of all ages has been reported to be as high as 30 percent and that there are interventions, specifically behavioral treatments, that can be integrated in a primary care practice. However, most practitioners have not been trained in identification of UI, causes and approaches that can be incorporated into a successful treatment program. The authors have implemented a program to address the problem of UI. This article outlines their successful application of a behavioral therapy protocol in two diverse practices: gynecological and internal medicine.     

Schedule induction conditions not only exaggerate intake but also enhance drug solution choice

In previous research, rats exposed to daily, 3 h sessions of schedule-induced polydipsia (SIP) self-administered high doses of cocaine orally. However, a strong and durable preference for cocaine solution to water requires training in addition to mere oral self-administration exposure. If cocaine is dissolved in a preferred vehicle solution, and the vehicle is subsequently faded to water, then a strong preference for cocaine remains. A similar preference can be instituted for lidocaine solution. Such preferences may develop because the gustatory property of a drug becomes associated with the preferred vehicle and remains to function as a durable conditioned reinforcer after vehicle fading. To determine if drug preference is solely a function of this posited conditioning mechanism, or whether it also depends upon the SIP condition, rats were exposed to daily, 3 h sessions of single-ration feeding, rather than the SIP condition. A preferred vehicle (glucose/saccharin solution) was slowly faded from a 0.19 mg/ml lidocaine solution, which was presented concurrently with a choice for water. Although a preference for lidocaine solution to water could be generated, it occurred for only 5 out of 9 rats, and the preference was relatively unstable. By contrast, in two previous studies using SIP, 26 out of 27 rats maintained a preference for lidocaine solution. Thus, SIP not only exaggerates the amount of drug solution ingested but also contributes to the fixation of the associative drug solution choice.     

Xanthogranulomatous pyelonephritis--a rare case of fistula between colon and kidney

A rare case of the Ekman-Westborg-Julin syndrome in a 15-year-old boy is presented. The patient had general macrodontia with gigantic mandibular third molars. Other dental anomalies, such as peak-shaped cuspids, central cusps, dens in dente, multituberculism, and single conical molar roots, were also present.     

Coronary arteries: retrospective cardiac gating technique to reduce cardiac motion artifact at spiral CT

Coronary artery calcification is a marker of atherosclerosis. Detection and quantification has previously been accomplished with electron-beam computed tomography (CT). Use of spiral CT for this application has been limited by cardiac motion. The authors evaluated a retrospective cardiac-gated postprocessing technique that necessitates no modification of scanner hardware or software. At spiral CT in 26 patients, motion artifact was reduced, coronary arteries were consistently visualized, and quantification of calcification could be performed in those patients with prominent deposits. Coronary artery calcification screening can therefore be offered in sites that have access to only spiral CT.     

Aversive stimulation during the stress-hyporesponsive period does not affect the number of corticotroph cells in neonatal male rats

Immunohistochemistry was used to evaluate the effects of neonatal handling and aversive stimulation during the first 10 days of life on the number of corticotrophs in the anterior lobe of the pituitary of 11-day-old male Wistar rats. Since adult rats handled during infancy respond with reduced corticosterone secretion in response to stressors and with less behavior inhibition in novel environments, we assumed that neonatal stimulation could affect pituitary morphology during this critical period of cell differentiation. Three groups of animals were studied: intact (no manipulation, N = 5), handled (N = 5) and stimulated (submitted to 3 different aversive stimuli, N = 5). The percentage of ACTH-immunoreactive cells in the anterior lobe of the pituitary (number of ACTH-stained cells divided by total number of cells) was determined by examining three slices per pituitary in which a minimum of 200 cells were counted by two independent researchers. Although animals during the neonatal period are less reactive to stress-like stimulation in terms of ACTH and corticosterone secretion, results showed that the relative number of ACTH-stained cells of neonatal handled (0.25 +/- 0.01) and aversive stimulated (0.29 +/- 0.03) rats was not significantly different from intact (0.30 +/- 0.03) animals. Neonatal stimulation may have a differential effect on the various subpopulations of corticotroph cells in the anterior pituitary.