Evaluation of minimally invasive analysis system for cough leak point pressure measurement.

PURPOSE: Leak point pressure (LPP) measurement has become standard in the diagnosis of stress urinary incontinence. Leak point pressure is determined by increasing abdominal pressure, which can be done with a Valsalva maneuver or coughing, that is Valsalva LPP and cough LPP (CLPP). It may be influenced by catheter size, bladder volume and interobserver variability. A new, computerized LPP measuring technique for routine use in daily urodynamic practice was tested at a female unit urodynamic practice to evaluate female urinary incontinence. MATERIALS AND METHODS: A total of 28 female patients with a mean age of 54.07 years (range 23 to 82) and urinary incontinence underwent a new, minimally invasive measurement of the cough leak point. Measurements are made with the patient standing and repeated 3 times per patient. Additionally, parameters of the corresponding leak were recorded simultaneously. All patients underwent new CLPP measurement and a standard, complete urodynamic investigation, including filling cystometry with abdominal LPP and urethral pressure profile at rest. Statistical evaluation was done by linear regression analysis and the correlation coefficients among CLPP, age, standard abdominal LPP and maximum urethral pressure, and among the 3 measurements for each patient. RESULTS: : The assignment of leakage to the pressure signal presented no problem. All CLPP data were reproducible in the 3 repeated measurements per patient. No correlation was seen between CLPP and abdominal LPP or the urethral pressure profile. CONCLUSIONS: The study confirm that the CLPP is a practicable, consistent and minimally invasive method in routine use. Clinical use is easy and reproducible, and only 1 catheter is required for measurement.

[Characteristics of Italian thermal parks and gardens: explorative study; therapeutic possibilities. I]. / Entità e caratteristiche di parchi e giardini termali italiani: censimento esplorativo; possibilità in terapia. Parte I.

There are reported the results of a research about thermal parks and thermal gardens own to 27 italian Spas. The considerable areas of green around Spas, the correct ratio with the number of subjects in thermal treatment and others arguments represent favourable elements for italian Medical Hydrology. The importance of green around Spas in Thermal Medicine and in Ecology il stressed.

[Extension and features of parks and gardens around spas in Italy: explorative census; possible therapeutic usefulness II]. / Entità e caratteristiche di parchi e giardini termali italiani: censimento esplorativo; possibilità in terapia. Parte II.

There are described the results of a census about parks and gardens own to 27 italian Spas. The considerable areas of green around Spas, the correct ratio whith the number of subjects in thermal treatment and other arguments represent favourable elements for italian medical Hydrology. In our census the found plants generally are in conformity with their correct geographical placing. Moreover they are in order to cause favourable effects for environmental Psychology and Therapeutics. The species of recommended plants for the increase and for improvement of green around italian Spas are mentioned. The importance of green around Spas in thermal Medicine and in Ecology is stressed.

[Obstructive azoospermia and malformations of seminal tract]. / Azoospermia ostruttiva e malformazioni della via seminale.

About 10% of the cases of male infertility is represented by the obstruction of the seminal tract, which may be congenital or secondary to inflammatory events or surgery. The most frequent obstructive malformation of the seminal tract is the bilateral agenesia of the vas deferens. Such malformation is typical of the cystic fibrosis (CF), an autosomal recessive disorder determining chronic respiratory infections with bronchiectasia, and pancreatic failure. Recently the defective gene responsible for CF has been identified on the long arm of the chromosome 7. Congenital bilateral absence of the vas deferens (CBAVD) may be present in otherwise healthy males without clinical evidence of CF. Genetics studies demonstrated that most CBAVD display at least one detectable CF mutation, therefore this disease can be considered as an incomplete clinical form of CF. With the realization that a man with CBAVD may have CF, albeit a genital form, considerable care is required not only to document his specific mutations, but also to test his partner for CF mutations to evaluate the risk that their child would have CF. The association of chronic suppurating respiratory disease with obstructive azoospermia characterizes also the Young's syndrome. In this disease the obstruction could possibly be the result of defective epididymal sperm transport, related to an abnormality in the mucus. Despite some clinical common aspects, CF and Young's syndrome are two distinct entity. In fact, no CF mutations have been demonstrated in Young's syndrome. Congenital obstructive abnormalities of the vas deferens and epididymis are often associate to cryptorchidism (36-68% of the cases) and to patent processus vaginalis. The degree of testicular retention and processus vaginalis closure correlates well with the incidence of associated epididymal defects. Rare causes of congenital obstructive azoospermia are represent by the cyst of Müllerian or Wolffian origin. An obstruction to the progression of the sperm along the seminal tract can also be present in complex malformations, such as pseudohermaphroditism in which the infertility has a multifactorial etiology.

[Screening for the early diagnosis of prostatic carcinoma in Ossola: results after 1 year of effort]. / Screening per la diagnosi precoce del carcinoma prostatico nell'Ossola: risultati dopo 1 anno di lavoro.

Data concerning 1 year calls activity in the early diagnosis of the prostate cancer are published. Taking into consideration the results of the screening the Authors wonder whether its costs are justified.

[A case of bladder herniation]. / A proposito di un caso di ernia vescicale.

The Authors examine one patient with hernia of the bladder. The incidence, etiology and clinical picture are discussed.