Monday, March 31, 2014

Maternal blood pressure and heart rate response to pelvic floor muscle training during pregnancy

Pelvic floor muscle training in nulliparous sedentary pregnant women does not increase BP. It significantly increases HR during the exercise sessions, but only for a limited period of time and with no negative long term effect on BP or HR.

Wednesday, March 26, 2014

Stress urinary incontinence: Usefulness of perineal ultrasound


PURPOSE: Perineal ultrasound provides the most sensitive assessment of the degree of urethral mobility by measuring the pubo-urethral distance and angle.
To evaluate whether these indices may be determinants of success in prosthetic surgery for stress urinary incontinence, we conducted a retrospective study of patients treated with tension-free vaginal tape-obturator (TVT-O) surgery and assessed, by measuring the pubo-urethral distance and angle after TVT-O, whether there was any quantitative difference between the mean values measured in the group of cured patients and uncured patients.
MATERIALS AND METHODS: We selected 51 patients who underwent TVT-O and evaluated the failure rate by means of urogynaecological assessment. We also measured, using perineal ultrasound, the mean values of the pubo-urethral distance and angle between the two groups of patients.
RESULTS: We recorded a difference in the average pubo-urethral distance of 3 mm ± 1.2 at rest and 2.7 mm ± 1.2 under stress and a difference in the average pubo-urethral angle of 13° ± 6.3° at rest and 8° ± 6.3° under stress between the two groups.
CONCLUSIONS: We obtained higher mean values of pubo-urethral distance and angle in uncured patients compared to those found in the group of cured patients.

A Deadly Development of Prostate Cancer (part 1)

Editor's Note: Neuroendocrine prostate cancer (NEPC) is a hormone-refractory late manifestation of prostate cancer and represents about 25% of late-stage disease. NEPC has a poor prognosis, with most patients surviving for less than 1 year after diagnosis.[1] New research on the biology of NEPC has inspired novel approaches to treating this disease. Prostate cancer expert Himisha Beltran, MD, who is leading an ongoing phase 2 study of an aurora kinase inhibitor in NEPC, discussed with Medscape the molecular and genomic advances in NEPC and the challenges that remain for clinicians. Dr. Beltran is Assistant Professor of Medicine at Weill Cornell Medical College and Assistant Attending Physician at New York-Presbyterian Hospital.

Medscape: What are the major challenges for clinicians in diagnosing NEPC?
Dr. Beltran: NEPC is often not recognized because we have not been focused on it. Clinically, NEPC should be suspected in patients who develop rapidly progressive disease or visceral disease such as liver metastases or brain metastases in the setting of low prostate-specific antigen (PSA). In those cases, biopsies should be considered to confirm or rule out NEPC. An important reason to be aware of the possibility of NEPC and to actively look for it is that drugs that target androgen receptor signaling are less likely to be effective in NEPC. That is an important implication for being able to select patients for individualized treatment.

Medscape: Why do some prostate cancers progress or transition to NEPC?
Dr. Beltran: Most prostate cancers are driven by hormonal signaling through the androgen receptor, which is why the mainstays of treatment for prostate cancer patients are drugs that target the androgen signaling pathway. Neuroendocrine prostate tumors often demonstrate low or absent androgen receptor expression and may arise as a mechanism of resistance. NEPC rarely arises de novo, in the absence of prior treatment. Preclinical studies support the concept that if you strongly pressure the androgen receptor you can transform an adenocarcinoma cell into an androgen receptor-negative state.

Monday, March 24, 2014

The prevalence of renal stones in U S


Kidney stones affect approximately 1 in 11 people in the United States. 
The prevalence of kidney stones is 8.8% (95% confidence interval [CI], 8.1–9.5). Among men, the prevalence of stones is 10.6% (95% CI, 9.4–11.9), compared with 7.1% (95% CI, 6.4–7.8) among women. Kidney stones are 
more common among obese than normal-weight individuals (11.2% [95% CI, 10.0–12.3] compared with 6.1% [95% CI, 4.8–7.4], respectively; p < 0.001). Black, non-Hispanic and Hispanic individuals are less likely to report a history of stone disease than are white, non-Hispanic individuals (black, non-Hispanic: odds ratio [OR]: 0.37 [95% CI, 0.28–0.49], p < 0.001; Hispanic: OR: 0.60 [95% CI, 0.49–0.73], p < 0.001).

Obesity and diabetes are strongly associated with a history of kidney stones in multivariable models. The cross-sectional survey design limits causal inference regarding potential risk factors for kidney stones.

(Published by UCLA Department of Urology, University of California, Los Angeles, Los Angeles, CA, USA; bUCLA Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA; cRAND Corporation, Santa Monica, CA, USA)

Sunday, March 23, 2014

How to Boost Your Free Testosterone



As we grow older it can be tougher and tougher to keep up. Maybe you're struggling to add muscle? Perhaps you feel sluggish and slow. Are you seeing progress in the mirror or is your body going downhill?
Your libido and performance may not be as intense as it once was and you—and your partner—want the 'youthful you' to return to the bedroom.
But, how can you improve even as you grow older?
For men, the solution is found in free testosterone.
Your bloodstream contains two types of testosterone: bonded testosterone and free testosterone.
Bonded testosterone attaches to molecules in the body and is mostly ineffective. However, the 'free' testosterone can enter your cells easily and plays a vital role in libido, strength, stamina, and vitality.
In short, free testosterone helps a man…well…be a man!
High free testosterone levels are linked to increased sex drive, a higher libido, and heightened desire. Maintaining an optimal free testosterone level is absolutely vital for men who want to get the most out of their bodies.
High free testosterone levels can help with:
- Maximizing your gains in the gym
- Boosting libido and increasing desire
- Revitalising drive and performance
But how do men raise their free testosterone levels?
This is where it gets a little complicated. Over the years, any number of pills, potions, and gels have claimed to work wonders for men's free testosterone. In reality, few of these options do any good.
It's only been more recently that free testosterone has slipped from being a "dirty word" into something that many men are discussing. As our knowledge of free testosterone has grown, so has the selection of ingredients, products, and compounds available.
One of the most exciting developments in this field has been made by a team of dietary supplement researchers based in Cambridge, Massachusetts. After extensive research, this team has developed a supplement with natural key ingredients, Nugenix, which triggers your body into increasing its levels of free testosterone. GNC stores secured the exclusive rights to Nugenix's US launch and within three months it was one of the top selling vitality supplements in the entire GNC chain.
The key ingredient is Testofen® which is made from the rare Fenugreek plant. Testofen® has been shown in clinical trials to boost free testosterone levels, increase sex drive, and improve libido.
The proprietary Nugenix Testosterone Complex includes five additional ingredients to complement and augment the effectiveness of Testofen®. Nugenix is safe, effective, and can deliver stamina, strength, and libido improvements in as little as a few days. Although most users report seeing the best results after at least one to two weeks of usage.
Studies from Irvine, California and Queensland, Australia have shown strong and even spectacular results with the key ingredient in Nugenix, Testofen®. Benefits include increased sex drive, improved libido, and enhanced muscle mass. These benefits primarily come from safely boosting free testosterone levels.

Thursday, March 20, 2014

ASTRO and AUA Joint Guideline for Radiation Therapy After Prostatectomy Highlighted at ASTRO Annual Meeting (part 8)


“Many thanks to the dedicated efforts of Drs. Valicenti and Thompson for leading the extraordinary effort to issue this important document from both specialty organizations,” said Michael L. Steinberg, MD, FASTRO, chairman of ASTRO’s Board of Directors. “The Adjuvant and Salvage Radiotherapy After Prostatectomy: ASTRO/AUA Guideline is an essential tool for every practice as they determine the best treatment plan for prostate cancer patients after prostatectomy.”
“We are very pleased that ASTRO and AUA came together to create this important document,” said Dr. Wolf, chairman of the AUA’s Practice Guidelines Committee. “By collaborating and cooperating, we have built on the strengths of both specialties to improve patient care.” 
The Adjuvant and Salvage Radiotherapy After Prostatectomy: ASTRO/AUA Guideline will be presented during the ASTRO Guidelines Highlight session at ASTRO’s 55th Annual Meeting at 3:10 p.m. on Monday, September 23, 2013. Dr. Valicenti will present the guideline, and Dr. Hahn will serve as the discussant. The session will be moderated by Lynn D. Wilson, MD, MPH, FASTRO, ASTRO Annual Meeting Scientific Committee chairman and vice-chairman of the department of therapeutic radiology at Yale School of Medicine in New Haven, Conn., and Benjamin Movsas, MD, FASTRO, ASTRO Annual Meeting Scientific Committee vice-chairman and chairman of the department of radiation oncology at Henry Ford Health System in Detroit.
To speak with Dr. Valicenti or ASTRO leadership, please contact Michelle Kirkwood, September 22-25, 2013, in the ASTRO Press Office at the Georgia World Congress Center in Atlanta at 404-222-5303 or 404-222-5304, or email michellek@astro.org. The complete text of the guideline is available with open access in the Red Journal.
ASTRO’s 55th Annual Meeting, held in Atlanta, September 22-25, 2013, is the premier scientific meeting in radiation oncology and brings together more than 11,000 attendees including oncologists from all disciplines, medical physicists, dosimetrists, radiation therapists, radiation oncology nurses and nurse practitioners, biologists, physician assistants, practice administrators, industry representatives and other health care professionals from around the world. The theme of the 2013 meeting is “Patients: Hope • Guide • Heal” and will focus on patient-centered care and the importance of the physician’s role in improving patient-reported outcomes and the quality and safety of patient care. The four-day scientific meeting includes presentation of four plenary papers, 363 oral presentations, 1,460 posters and 144 digital posters in 70 educational sessions and scientific panels for 19 disease sites/tracks. Keynote and featured speakers include: William B. Munier, director of the Center for Quality Improvement and Patient Safety at the Agency for Healthcare Research and Quality; Darrell G. Kirch, MD, president and CEO of the Association of American Medical Colleges; James Cosgrove, PhD, director of the U.S. Government Accountability Office; Otis W. Brawley, MD, chief medical officer of the American Cancer Society; and Peter Friedl, MD, PhD, of St. Radboud University Nijmegen Medical Centre at the University of Nijmegen and MD Anderson Cancer Center.

ASTRO and AUA Joint Guideline for Radiation Therapy After Prostatectomy Highlighted at ASTRO Annual Meeting (part 7)


In addition to Drs. Valicenti and Thompson, authors of theAdjuvant and Salvage Radiotherapy After Prostatectomy: ASTRO/AUA Guideline include Peter C. Albertsen, MD, MS, of the University of Connecticut Health Center; Brian J. Davis, MD, PhD, of the Mayo Clinic; S. Larry Goldenberg, MD, of the Vancouver Prostate Centre at the University of British Columbia; J. Stuart Wolf Jr., MD, of the University of Michigan; Oliver Sartor, MD, of the Tulane University School of Medicine; Eric A. Klein, MD, of the Cleveland Clinic; Carol A. Hahn, MD, of Duke University Medical Center; Jeff M. Michalski, MD, MBA, FASTRO, of the Siteman Cancer Center at the Washington University School of Medicine in St. Louis; Mack Roach, III, MD, of the Helen Diller Family Comprehensive Cancer Center at the University of California, San Francisco; and Martha Faraday, PhD, of Four Oaks Inc.
“This guideline explicitly includes a multitude of significant clinical trial results from more than 20 years of thorough research,” said Dr. Valicenti. “There is a critical need for evidence-based standards, recommendations and options to maximize our ultimate goal of increased patient survival and quality of life. This guideline is a compendium of the vast wealth of research available and provides a thorough treatment template for us to consider for prostate cancer patients after a radical prostatectomy.”
“The work of the AUA and ASTRO staff, as well as our exceptional guideline panelists, was outstanding,” said Dr. Thompson. “This guideline provides a very practical approach for the clinician to help guide in patient decision-making that will result in the very best patient outcomes.”
The Adjuvant and Salvage Radiotherapy After Prostatectomy: ASTRO/AUA Guideline is jointly copyrighted by ASTRO and the AUA. It will serve as a new, living manifesto of both specialties’ dedication to optimal patient care and outcomes and will be updated regularly.

ASTRO and AUA Joint Guideline for Radiation Therapy After Prostatectomy Highlighted at ASTRO Annual Meeting (part 6)


The guideline document provides the following clinical principles, recommendations, standards and options:
1) patients who are being considered for management of localized prostate cancer with radical prostatectomy should be informed of the potential for adverse pathologic findings that portend a higher risk of cancer recurrence;
2) patients with adverse pathologic findings including seminal vesicle invasion, positive surgical margins and extraprostatic extension should be informed that adjuvant radiation therapy, compared to radical prostatectomy only, reduces the risk of biochemical (PSA) recurrence, local recurrence and clinical progression of cancer;
3) physicians should offer adjuvant radiation therapy to patients with adverse pathologic findings at the time of prostatectomy, including seminal vesicle invasion, positive surgical margins or extraprostatic extension because of demonstrated reductions in biochemical recurrence, local recurrence and clinical progression;
4) patients should be informed that the development of a PSA recurrence after surgery is associated with a higher risk of development of metastatic prostate cancer or death from the disease;
5) clinicians should define biochemical recurrence as a detectable or rising PSA value after surgery that is ≥ 0.2 ng/ml with a second confirmatory level ≥ 0.2 ng/ml;
6) a restaging evaluation in the patient with a PSA recurrence may be considered;
7) physicians should offer salvage radiation therapy to patients with PSA or local recurrence after radical prostatectomy in whom there is no evidence of distant metastatic disease;
8) patients should be informed that the effectiveness of radiation therapy for PSA recurrence is greatest when given for lower levels of PSA; and
9) patients should be informed of the possible short-term and long-term urinary, bowel and sexual side effects of radiation therapy, as well as the potential benefits of controlling disease recurrence.

ASTRO and AUA Joint Guideline for Radiation Therapy After Prostatectomy Highlighted at ASTRO Annual Meeting (part 5)


The strategies and approaches recommended were derived from evidence-based and consensus-based processes in the reviewed articles. The systematic review included articles that provided detailed efficacy for patients with detectable and undetectable prostatic specific antigen (PSA) levels, toxicity and quality of life impact, and optimal imaging strategies to determine the appropriateness of radiation therapy use in patients suspected of recurrence. Only studies in which PSA data were provided for 75 percent or more patients were included in the guideline.

ASTRO and AUA Joint Guideline for Radiation Therapy After Prostatectomy Highlighted at ASTRO Annual Meeting (part 4)


The Adjuvant and Salvage Radiotherapy After Prostatectomy: ASTRO/AUA Guideline is a comprehensive review of 324 research articles of English-language publications within the Pubmed, Embase and Cochrane databases, published from January 1, 1990 through December 15, 2012. The guideline is available online free as a PDF document at www.redjournal.org and www.auanet.org, and was published in the August 1, 2013, print issue of the International Journal of Radiation Oncology • Biology • Physics (Red Journal), the official scientific journal of ASTRO, and in the August 2013 print issue of The Journal of Urology, the official journal of the AUA.

ASTRO and AUA Joint Guideline for Radiation Therapy After Prostatectomy Highlighted at ASTRO Annual Meeting (part 3)


News wise — Atlanta, September 22, 2013 – The American Society for Radiation Oncology (ASTRO) will highlight the recently published Adjuvant and Salvage Radiotherapy After Prostatectomy: ASTRO/AUA Guideline during ASTRO’s 55th Annual Meeting, September 22-25, 2013, in Atlanta.
The guideline focuses on radiation therapy after prostatectomy for patients with and without evidence of prostate cancer recurrence, and is a joint effort between ASTRO and the American Urological Association (AUA).
The 81-page document represents an intensive collaboration among experts in the radiation oncology and urology fields, led by Richard K. Valicenti, MD, MBA, professor and chair of the department of radiation oncology at the University of California Davis Comprehensive Cancer Center in Sacramento, on behalf of ASTRO, and Ian M. Thompson Jr., MD, director of the Cancer Therapy and Research Center at the University of Texas Health Science Center at San Antonio and the Glenda and Gary Woods Distinguished Chair in genitourinary oncology, on behalf of the AUA.

ASTRO and AUA Joint Guideline for Radiation Therapy After Prostatectomy Highlighted at ASTRO Annual Meeting (part 2)


ABOUT THE AMERICAN UROLOGICAL ASSOCIATION 
Founded in 1902 and headquartered near Baltimore, Md., the American Urological Association is a leading advocate for the specialty of urology, and has more than 19,000 members throughout the world. The AUA is a premier urologic association, providing invaluable support to the urologic community as it pursues its mission of fostering the highest standards of urologic care through education, research and the formulation of health policy.

ASTRO and AUA Joint Guideline for Radiation Therapy After Prostatectomy Highlighted at ASTRO Annual Meeting (part 1)


Guideline provides detailed direction on treatment options for prostate cancer patients
Released: 9/22/2013 6:15 PM EDT 
Source Newsroom: American Society for Radiation Oncology (ASTRO)


ABOUT ASTRO

ASTRO is the premier radiation oncology society in the world, with more than 10,000 members who are physicians, nurses, biologist, physicists, radiation therapists, dosimetrists and other health care professionals that specialize in treating patients with radiation therapies. As the leading organization in radiation oncology, the Society is dedicated to improving patient care through professional education and training, support for clinical practice and health policy standards, advancement of science and research, and advocacy. ASTRO publishes two medical journals, International Journal of Radiation Oncology, Biology, Physics (www.redjournal.org) and Practical Radiation Oncology (www.practicalradonc.org); developed and maintains an extensive patient website, www.rtanswers.org; and created the Radiation Oncology Institute (www.roinstitute.com), a non-profit foundation to support research and education efforts around the world that enhance and confirm the critical role of radiation therapy in improving cancer treatment. To learn more about ASTRO, visit www.astro.org.



Kidney Stones In Children On The Rise, Expert Says


Modern diet and lifestyle, along with global warming, are contributing to an alarming phenomenon -- kidney stones in children.
Credit: University of Michigan Health System


When Lisa Garnes received a call from her daughter’s daycare saying that 3-year-old Emma was complaining of back pain, she never dreamt the cause would be a condition often associated with middle aged men: kidney stones.

When Lisa Garnes received a call from her daughter’s daycare saying that 3-year-old Emma was complaining of back pain, she never dreamt the cause would be a condition often associated with middle aged men: kidney stones.

They said that Emma was doubled over in pain and saying that her back hurt her,” says Garnes.
Garnes took her to the pediatrician, who suggested it was a urinary tract infection. A half hour later, she called again to tell her doctor that her daughter couldn’t keep anything down. The doctor suggested taking her to the ER.
After a battery of tests, including an ultrasound, the doctor returned with the news: she had kidney stones.
“It was quite hard to believe,” Garnes says.
The growing incidence of kidney stones in children can be linked to the modern diet and lifestyle, says Gary Faerber, MD, a urologist at the University of Michigan Health System.
“I am seeing more and more children who have kidney stones,” says Faerber. “It’s a real phenomenon.”
To treat Emma, urologists performed two lithotripsies to break up the stones and performed surgery on a tough one she couldn’t pass. Doctors said she had high levels of oxalates (found in many fruits and vegetables) in her system, which required putting her on a low oxalate diet. Oxalates can be found in strawberries, blueberries, raspberries, chocolate, peanut butter and nuts. Doctors also suggested she spike up her water intake.
Typically, kidney stones are found in adults between the ages of 35 and 60 but children can get them, too. A family history of kidney stones is also a significant risk factor.
Children today seem to live a lifestyle that puts them at risk of kidney stones, meaning they consume sugar-filled drinks and a fast-food diet that is high in sodium, a known risk factor in the formation of kidney stones, says Faerber.
“The sedentary lifestyle we’re starting to see in the younger age group and the pediatric group is also a risk factor because we know that obesity increases the risk of forming kidney stones,” he adds.
The most common kidney stones in the U.S. are calcium oxalate stones.
Oxalates are found in high concentration in fruits and vegetables such as leafy green vegetables and strawberries.
Recent research has shown a link between global warming and dehydration.
The more dehydrated one becomes, the more concentrated the urine becomes, which forms crystals and crystals form into kidney stones, Faerber adds.
Recent studies in global warming indicate that the number of patients yearly who are treated for kidney stones is going to increase from 1 million to 2 million.
The most common reason people have kidney stones is that the urine becomes super saturated and it doesn’t take much for a small crystal to form in the urine. Crystal can grow into stones and get larger and larger as long as they sit in the super saturated fluid. This is why it’s really important for kidney stone patients to make sure they keep their urine really diluted, Faerber says.
The most common symptoms in children with kidney stones are back and abdominal pain. Parents may often mistake their child's symptoms for appendicitis or gastritis. Kidney stones tend to be way down on the list of possible problems.
Doctors recommend for children between the ages of 5 and 10 who have kidney stones to drink six glasses of water a day and those kids over 10, to drink 10 glasses.
Treatment
·         If stones are small, doctors recommend for the children to pass them on their own.
·         If the stone needs to be treated, shockwave lithotripsy is used. The procedure occurs under an anesthetic. Sound waves are used to break up the stone into small pieces, which the child can then pass.
·         Sometimes doctors perform a ureteroscopy. They pass a very small miniaturized instrument through the urinary system and treat the stone with a laser.
·         In cases where the stone is very large, access to the kidney is made through a very small incision in the back. Using a small scope the urinary system is entered, the stone is broken up and the pieces are then retrieved."
“The main takeaway is to get your child to stay away from sugar filled drinks, sodas, colas and go to something natural like plain old water,” he says.

University of Michigan Health System. "Kidney Stones In Children On The Rise, Expert Says." ScienceDaily. ScienceDaily, 5 May 2009. <www.sciencedaily.com/releases/2009/05/090504211038.htm>.



New lens design drastically improves kidney stone treatment


Engineers have reversed a decades-long trend of decreasing efficiency in lithotripsy machines by designing simple modifications to shock wave lenses. The incidence of kidney stones in the United States has more than doubled during the past two decades, due at least in part to the expanding waistlines of its citizens. The condition has also been linked to hot, humid climates and high levels of stress -- a combination of living environments that seems to have led to a rise in kidney stone rates of veterans returning home from Iraq and Afghanistan.
Modern lithotripsy machines used to break apart kidney stones have been declining in efficiency for decades. Duke engineers have just modified the shock wave lens to improve treatment.
Credit: Image courtesy of Siemens Healthcare


Duke engineers have devised a way to improve the efficiency of lithotripsy -- the demolition of kidney stones using focused shock waves. After decades of research, all it took was cutting a groove near the perimeter of the shock wave-focusing lens and changing its curvature.

"I've spent more than 20 years investigating the physics and engineering aspects of shock wave lithotripsy," said Pei Zhong, the Anderson-Rupp Professor of Mechanical Engineering and Materials Science at Duke University. "And now, thanks to the willingness of Siemens (a leading lithotripter manufacturer) to collaborate, we've developed a solution that is simple, cost-effective and reliable that can be quickly implemented on their machines."

The study appears online the week of March 17, 2014, in the Proceedings of the National Academy of Sciences.

The incidence of kidney stones in the United States has more than doubled during the past two decades, due at least in part to the expanding waistlines السخافات of its citizens. The condition has also been linked to hot, humid climates and high levels of stress -- a combination of living environments that seems to have led to a rise in kidney stone rates of veterans returning home from Iraq and Afghanistan.

During the past two decades, lithotripter manufacturers introduced multiple changes to their machines. Rather than having patients submerged in a bath of lukewarm فاتر water, newer machines feature a water-filled pouch that transfers the shock wave into the flesh.

An electrohydraulic shock wave generator used in the past was replaced by an electromagnetic model that is more powerful, more reliable and more consistent.

The new designs made the devices more convenient and comfortable to use, but reduced the effectiveness of the treatment. After years of research, Zhong and his colleagues have determined why.

The increased power in some third-generation shock wave lithotripters narrowed the wave's focal width to reduce damage to surrounding tissues. But this power jump also shifted the shock wave's focal point as much as 20 millimeters toward the device, ironically contributing to efficiency loss and raising the potential for tissue damage. The new electromagnetic shock wave generators also produced a secondary compressive wave that disrupted one of the primary stone-smashing mechanisms, cavitation bubbles.

"We were presented with the challenge of engineering a design solution that mitigated these drawbacks without being too expensive," said Zhong. "It had to be something that was effective and reliable, but also something that the manufacturer was willing to adopt. So we decided to focus on a new lens design while keeping everything else in their system intact."
The solution was to cut a groove near the perimeter of the backside of the lens and change its geometry. This realigned the device's focal point and optimized the pressure distribution with a broad focal width and lower peak pressure. It also allowed more cavitation bubbles to form around the targeted stone instead of in the surrounding tissue.

In laboratory tests, the researchers sent shock waves through a tank of water and used a fiber optic pressure sensor to ensure the shock wave was focusing on target. They broke apart synthetic stones in a model human kidney and in dead pigs and used a high-speed camera to watch the distribution of cavitation bubbles forming and collapsing -- a process that happens too fast for the human eye to see.
The results showed that while the current commercial version reduced 54 percent of the stones into fragments less than two millimeters in diameter, the new version pulverized 89 percent of the stones while also reducing the amount of damage to surrounding tissue. Smaller fragments are more easily passed out of the body and less likely to recur.

"We feel we have exceeded expectations in our evaluation of this new lens design, which is based on solid physics and engineering principles," said Zhong, who expects the new lens to enter clinical trials in Germany this summer.

"My hope is that this will be a breaking point demonstrating that effective, interactive collaboration between academia and industry can really improve the design of lithotripters that will benefit millions of stone patients worldwide who suffer from this painful disease," Zhong said. "Our design, in principle, can be adapted by other manufacturers to improve their machines as well. I would like to see all lithotripsy machines improved so that urologists can treat stones more effectively and patients can receive better treatment and feel more comfortable with the procedure."
Journal Reference:
1.      A. Neisius, N. B. Smith, G. Sankin, N. J. Kuntz, J. F. Madden, D. E. Fovargue, S. Mitran, M. E. Lipkin, W. N. Simmons, G. M. Preminger, P. Zhong. Improving the lens design and performance of a contemporary electromagnetic shock wave lithotripterProceedings of the National Academy of Sciences, 2014; DOI:10.1073/pnas.1319203111




Friday, March 14, 2014

Clitoris:

·          Sensitive female sex organ, which is visible at the front of the vagina.

Urge:

·        Strong desire to urinate.

Pus:

·        The yellowish or greenish fluid that forms at sites of infection.

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