Evaluating genetic counseling session duration: A scoping review of patient care time, influencing factors, and impact on patient outcomes.

One key element of evaluating the quality of a genetic counseling session is the measurement of its efficiency, yet limited research exists on how the genetic counseling process relates to time and which elements contribute to improved quality of care. A scoping review was undertaken to document studies that have reported genetic counseling patient care time and provide a landscape of the average patient care time, which factors impact patient care time, and how patient care time relates to experiences and outcomes. Twenty-five studies met criteria and were included.

Thermal injury during TUMT.

A 71-year-old man was treated with transurethral microwave thermotherapy because of symptoms of benign prostatic hyperplasia. The treatment session was performed without any abnormal complaints from the patient. Two hours post-treatment the patient felt pain in his penile shaft and noticed a wound.

A personal computer-based system for real-time analysis of surface EMG signals during static and dynamic contractions.

This paper describes a prototype system that uses an advanced data acquisition processor in combination with a personal computer (PC) to analyse surface electromyogram (EMG) signals on-line and in real-time. The system is able to calculate the average power and estimate the mean frequency of the power spectrum of surface EMGs during static and repeated isokinetic contractions with a high degree of standardization. Selection of parameters as well as implementation of future parameters is easy to perform, since the system is software-based.

Ten years of experience with the Swedish bone-anchored hearing system.

In 1977, a new phase began in hearing rehabilitation of patients with chronic middle and external diseases and atresias. Thus far, these patients have had to rely on conventional bone conduction and air conduction devices that for various reasons give poor rehabilitation. The principle of the new treatment, made possible by the Swedish bone-anchored hearing system, is simple: sound vibrations are directly transmitted to the skull bone via a skin-penetrating titanium implant and then are further transmitted to the cochlea, bypassing the middle ear.

Contelle: pelvic floor stimulator for female stress-urge incontinence. A multicenter study.

The clinical efficacy of a new device for treatment of female incontinence was studied in a multicenter trial. The device consists of an inflatable electrode carrier and an external stimulator unit. Forty women were treated: 10 had primary or recurrent genuine stress incontinence, 15 had urge incontinence due to idiopathic detrusor instability, not responding to drug treatment, and 15 had stress incontinence combined with detrusor instability.

Evaluation of history and simple supine cystometry as a preoperative test in stress urinary incontinence.

In a follow-up study the accuracy of a simple preoperative screening including history, Bonney 's test and supine cystometry was evaluated in patients with stress urinary incontinence. Based upon preoperative history alone, the patients were divided into two different groups, pure stress incontinence, and mixed stress and urge incontinence. All patients accepted had a normal supine cystometry at the preoperative work-up.

Rhythmic activity in pelvic efferents to the bladder: an experimental study in the cat with reference to the clinical condition 'unstable bladder'.

Efferent nerve activity was recorded from pelvic nerve filaments to the urinary bladder of the cat. At intravesical pressures below 5-7 cm H2O there was no activity, but at higher pressure levels the parasympathetic neurones discharged in 10- to 15-second-long rhythmic bursts separated by silent periods. The frequency of the burst varied from about 1/min at 5 cm H2O to 6-7/min at 15-20 cm H2O.

The urethral pressure profile during flow. An experimental study.

As part of a project aimed at developing a method for accurate evaluation of the position and significance of infravesical outflow obstructions, a technique for recording urethral pressure profiles during flow in male patients was tested in a rigid bladder-urethral model. The catheter which proved to give the most accurate recording of the static pressure in the urethral model had a measuring eye about 250 mm from the tip. With this arrangement, the tip of the catheter did not leave the bladder until the measuring eye had passed the whole length of the urethra and the effective diameter of the urethra and the flow did not change during the recording.

The micturitional urethral pressure profile.

The micturitional urethral pressure profile (MUPP) was recorded using a measuring catheter with two eyes, 250 mm apart, one for recording the bladder pressure, the other for the urethral pressure during continuous withdrawal during micturition. Fifteen normal male subjects and 48 male patients with infravesical obstruction were studied. By means of the MUPP, it was possible to determine whether the patient had an obstruction or not, to differentiate between various kinds of obstructions and to localise the obstruction in the urethra.

Current leakage in bipolar electrocoagulation.

Bipolar electrocoagulation has previously been shown to give a considerable amount of current leakage to ground from either of the two outputs. This might result in unwanted tissue destruction. Thus far, no standard has been proposed for current leakage to ground from the outputs of bipolar equipment.

The neurophysiological basis of bladder inhibition in response to intravaginal electrical stimulation.

Intravaginal electrical stimulation (IVS) induces a profound bladder inhibition and is successful in the treatment of incontinence due to detrusor instability. In this experimental study in cats, direct recordings of the efferent activity in thin hypogastric and pelvic nerve filaments to the bladder were used to analyze the neuronal mechanisms underlying this bladder inhibition. A longlasting reflex discharge, with a latency of 35 to 50 msec.

Electrical stimulation in interstitial cystitis.

We treated 14 women with chronic interstitial cystitis with long-term intravaginal or transcutaneous nerve stimulation. Clinical and urodynamic evaluations were done after 6 months to 2 years. Improvement was not immediate but required a considerable period of continuous, daily use of electrical stimulation.

Effects of electrical intravaginal stimulation on bladder volume: an experimental and clinical study.

Clinical observations have indicated that not only stress incontinence due to defective urethral closure but also urge incontinence due to bladder hyperactivity can be successfully treated by electrical stimulation of the pelvic floor. Clinical investigations revealed that intravaginal electrical stimulation caused bladder inhibition registered as a volume increase. This inhibition was most marked at a low stimulation frequency (10 Hz).

Long-term intravaginal electrical stimulation in urge and stress incontinence.

Using a new device for intravaginal electrical stimulation (IVS), 24 women with pure stress incontinence, mixed urge and stress incontinence or urge incontinence due to detrusor instability, were treated. To minimize mechanical discomfort, the electrode carrier was made of flexible material and inflatable. Furthermore, this design facilitated fixed, constant positioning of the electrodes at individually tested sites to produce maximum response at voltage well tolerated by the patient.

Mechanisms for closure of the human urethra during intravaginal electrical stimulation.

The effect of intravaginal electrical stimulation (IVS) on the urethral pressure profile (UPP) before and during succinylcholine blockade or spinal anaesthesia was studied in patients with stress incontinence and in patients with clinically normal urethral function. During succinylcholine blockade, the UPP was lowered to 74% and during spinal anaesthesia to 39% of the original maximal UPP. IVS could not influence the UPP during succinylcholine blockade, while the UPP could be restored during spinal anaesthesia when the stimulation strength was increased 3 to 4 times.

Intravaginal electrical stimulation. Clinical experiments on bladder inhibition.

The effect of intravaginal electrical stimulation (IVS) on the bladder in 17 patients with motor detrusor instability was explored. Isotonic volume registrations and cystometries were used for evaluation of volume increase and inhibition of abortive detrusor contractions. With either one or the other method, bladder inhibition was found in all patients, but with both methods only in 6.

Intravaginal electrical stimulation. Clinical experiments of urethral closure.

The effect on the urethra of intravaginal electrical stimulation (IVS) was registered by means of urethral pressure profiles (UPP). With the object of finding the most appropriate electrical parameters and optimal electrode positions within the vagina, 24 patients with stress incontinence, 22 with urgency and 4 continent women were studied. Electrical stimulation was given via an obturator with seven electrodes, which could be connected in different combinations of pairs.

The effect of intravaginal electrical stimulation on the feline urethra and urinary bladder. Electrical parameters.

Intravaginal electrical stimulation (IVS) in cats caused urethral closure and bladder inhibition. The aim was to ascertain the electrical parameters most appropriate for these effects. Minimum voltage was used as main criterion to select an effective, non-destructive stimulation when the shape, frequency and duration of the pulses were systematically varied.