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Biomedical subjects

T Talseth

Publications and source records attributed to T Talseth.

At least 19 recordsLinked to original sources
PubMed2001

Dynamic MRI of the pelvic floor muscles in an upright sitting position.

Since the pelvic floor muscles are situated inside the pelvis, the actual function is difficult to observe. Magnetic resonance imaging (MRI) is a new method that may prove to give additional information about pelvic floor muscle function during contraction. The purpose of the present study was to assess pelvic floor muscle function during contraction and straining in an upright sitting position by use of MRI. Sixteen women, nine continent and seven with urodynamically and clinically proven genuine stress incontinence participated in the study. MRI was performed in an open-configured GE Signa SP, 0.5 T Tesla magnet. With the participants sitting in an upright position on a pelvic RF-coil, sagittal, coronal and axial T1 weighted spin echo images of the pelvic floor were obtained. During contraction and straining a scan time of 2 seconds per image for 150-250 images, was performed in a mid-sagittal plane. The results showed that the mean inward lift during contraction was 10.8 mm (SD 6.0) for all women. During straining the mean downward movement was 19.1 mm (SD 7.4). The coccyx moved in a ventral, cranial direction during contraction and was pressed in a caudal, dorsal direction during straining. It is concluded that contraction of the pelvic floor muscles is concentric, moving the coccyx in a ventral, cranial direction. The movement measured by MRI in upright sitting position is less than that concluded after clinical observation in supine position. The coccyx is pressed dorsally during straining.

Adult↗
PubMed2001

The clinical value of dynamic magnetic resonance imaging in normal and incontinent women--a preliminary study on micturition.

In this preliminary study in nine volunteers and nine women with genuine stress incontinence (GSI) dynamic magnetic resonance imaging (MRI) was used to study the voiding phase in the sitting position after physiological filling of the bladder by urine. The MRI technique has been documented as being useful for this purpose, but in this small group of women it was not possible to determine any specific difference in the voiding pattern between the volunteers and the G

Female↗
PubMed2000

Randomized controlled trial on the effect of pelvic floor muscle training on quality of life and sexual problems in genuine stress incontinent women.

BACKGROUND: The purpose of the present study was to evaluate the effect of pelvic floor muscle exercise on quality of life, lifestyle and sex-life variables in genuine stress incontinent women. METHODS: Fifty-nine women with clinically and urodynamically proven genuine stress incontinence were randomized to either pelvic floor muscle exercise or an untreated control group. The intervention group was asked to perform 8-12 close to maximum contractions in 3 series per day. In addition they were exercising 45 minutes per week in groups. The intervention period was 6 months, and the women in the exercise group met once a month for individual assessment of pelvic floor muscle strength and motivation. Outcome measures were the Norwegian version of the Quality of Life Scale (QoLS-N) and the Bristol Female Lower Urinary Tract Symptoms (B-FLUTS) questionnaire. RESULTS: The results showed that general quality of life measured by the generic quality of life questionnaire was not much affected by urinary incontinence. However, the disease specific questionnaire demonstrated that ability to participate in physical activity and some sex-life variables were affected by the condition. There was a statistically significant (p<0.01) reduction in number of women having problems with sex-life, social life, and physical activity in the exercise group after six months of pelvic floor muscle exercise. CONCLUSION: Pelvic floor muscle exercise showed some effect on quality of life and sex-life variables.

Adult↗
PubMed1999

Single blind, randomised controlled trial of pelvic floor exercises, electrical stimulation, vaginal cones, and no treatment in management of genuine stress incontinence in women.

OBJECTIVE: To compare the effect of pelvic floor exercises, electrical stimulation, vaginal cones, and no treatment for genuine stress incontinence. DESIGN: Stratified, single blind, randomised controlled trial. SETTING: Multicentre. PARTICIPANTS: 107 women with clinically and urodynamically proved genuine stress incontinence. Mean (range) age was 49.5 (24-70) years, and mean (range) duration of symptoms 10.8 (1-45) years. INTERVENTIONS: Pelvic floor exercise (n=25) comprised 8-12 contractions 3 times a day and exercise in groups with skilled physical therapists once a week. The electrical stimulation group (n=25) used vaginal intermittent stimulation with the MS 106 Twin at 50 Hz 30 minutes a day. The vaginal cones group (n=27) used cones for 20 minutes a day. The untreated control group (n=30) was offered the use of a continence guard. Muscle strength was measured by vaginal squeeze pressure once a month. MAIN OUTCOME MEASURES: Pad test with standardised bladder volume, and self report of severity. RESULTS: Improvement in muscle strength was significantly greater (P=0.03) after pelvic floor exercises (11.0 cm H2O (95% confidence interval 7.7 to 14.3) before v 19.2 cm H2O (15.3 to 23.1) after) than either electrical stimulation (14.8 cm H2O (10. 9 to 18.7) v 18.6 cm H2O (13.3 to 23.9)) or vaginal cones (11.8 cm H2O (8.5 to 15.1) v 15.4 cm H2O (11.1 to 19.7)). Reduction in leakage on pad test was greater in the exercise group (-30.2 g; -43. 3 to 16.9) than in the electrical stimulation group (-7.4 g; -20.9 to 6.1) and the vaginal cones group (-14.7 g; -27.6 to -1.8). On completion of the trial one participant in the control group, 14 in the pelvic floor exercise group, three in the electrical stimulation group, and two in the vaginal cones group no longer considered themselves as having a problem. CONCLUSION: Training of the pelvic floor muscles is superior to electrical stimulation and vaginal cones in the treatment of genuine stress incontinence.

Adult↗
PubMed1997

[Benign prostatic hyperplasia. Shared care between urologists and general practitioners].

Clinical treatment of benign prostatic hyperplasia has been considered to be a task for the urologist alone. The urologist has been the only person capable of providing relief from the urethral obstruction through open and transurethral surgery. In recent years, knowledge about the physiology and pharmacology of the lower urinary tract and about the normal development of the condition has increased considerably. This has led to the development of new pharmacological drugs with positive effects on the symptoms caused by the obstructing hyperplastic prostate gland. The general practitioner now has a means of caring for patients with benign prostatic hyperplasia as long as the obstruction is not too pronounced and the symptoms are mild or moderate. Provided that urinalysis and creatinine level are normal, and there is no suspicion of malignancy, medical treatment can be considered. In cases with mild or moderate symptoms without suspicion of serious obstruction, even expectancy ("watchful waiting") may be preferred. When there is doubt about the diagnosis or when the effect of treatment is not as expected, the patient should be referred to a urologist. Benign prostatic hyperplasia is a condition where the care can suitably be shared between urologist and general practitioner.

Diagnosis, Differential↗
PubMed1997

Change in urethral pressure during voluntary pelvic floor muscle contraction and vaginal electrical stimulation.

The purpose of the study was to compare the effect of voluntary pelvic floor muscle (FFM) contraction and vaginal electrical stimulation on urethral pressure. Twelve women with genuine stress incontinence, mean age 49.4 years (range 33-66) participated in the study. The urethral and bladder pressures were recorded simultaneously through a double-lumen 8 Ch catheter. The patients first performed three voluntary PFM contractions. Then two electrical stimulators, Conmax and Medicon MS 105, 50 Hz, were used in random order. A visual analog scale was used to measure pain and discomfort. Pain was reported to mean 6.8, SEM 0.64 (range 0.7-9.9) and mean 6.1, SEM 0.81 (range 0-9.1) with Conmax and Medicon MS 105, respectively. The mean paired difference in favor of voluntary contraction with Conmax was -8.0, SD 6.7, P = 0.0067, and with Medicon MS 105 it was -12.2, SD 5.9, P = 0.0022. The results demonstrated that voluntary PFM contraction increased urethral pressure significantly more than did vaginal electrical stimulation.

Adult↗
PubMed1996

Long-term effect of pelvic floor muscle exercise 5 years after cessation of organized training.

OBJECTIVE: To evaluate clinically and urodynamically the effect of pelvic floor muscle exercise on genuine stress incontinence 5 years after cessation of a structured training program. METHODS: All 23 women who had participated in a 6-month intensive pelvic floor muscle exercise regimen participated in the follow-up study. Mean age was 50.7 years (range 30-70). The assessment included history by interview, use of subjective rating instruments (leakage index and social activity index), vaginal palpation, measurement of pelvic floor muscle strength by use of vaginal pressure measurement, cystometry, urethral pressure profiles during cough, and pad test with standardized bladder volume. RESULTS: Three of 23 women had been treated surgically. Sixteen (70%) were exercising the pelvic floor muscles once a week or more. This included two of the women treated surgically. Of the 20 women not treated surgically, 70% were satisfied and did not want further treatment. Fifteen of 20 (75%) did not show any visible leakage during cough, and 11 had positive closure pressure during cough. There was a statistically significant increase in the scores of the leakage index and the pad test (P < .05) but not on the social activity index (P = .09). Pelvic floor muscle strength was reduced from a mean of 22 cm H2O (95% confidence interval [CI] 17-26.9) to 19.1 (95% CI 13.2-24.9) (P = .113) during the 5-year period. CONCLUSION: There was a significant increase in incontinence measured by pad test and leakage index 5 years after cessation of organized pelvic floor muscle exercise. However, 75% showed no leakage during stress test, and 70% were satisfied with the condition. Seventy percent were exercising the pelvic floor muscles at least once a week, and pelvic floor muscle strength was maintained.

Adult↗
PubMed1996

Continent urinary diversion in patients with dysfunction of the lower urinary tract. Experience with the detubularized right colonic segment as urinary reservoir.

The experience with a continent urinary diversion in patients with dysfunction of the lower urinary tract is reported. The right detubularized colonic segment was used as urinary reservoir and an intussucepted ileal valve as outlet. Thirty seven patients were studied with a mean followup of 37 months. All patients except one were continent with a well-functioning diversion. The kidney function was not reduced in any of the patients and the acid-base balance was within normal limits. Twelve patients (32%) had had complications resulting in surgical revision. The majority were simple corrections, but 3 patients experienced a spontaneous perforation of the reservoir needing emergency laparotomy.

Adult↗
PubMed1994

Congenital and acquired curvature of the penis treated surgically by plication of the tunica albuginea.

OBJECTIVE: To evaluate the effectiveness of plication surgery for patients with congenital and acquired curvature of the penis. PATIENTS AND METHODS: Forty-eight patients with congenital curvature of the penis and 57 with induratio penis plastica were treated by plication of the tunica albuginea. Their average age was 23 and 56 years, respectively. The operation was performed under local anaesthesia, using 2/0 Prolene and a specially designed suture. The average observation time in the two groups was 24 and 20 months, respectively. RESULTS: Nineteen per cent of patients in the first group and 8% in the second group reported normal intercourse pre-operatively. Post-operatively, the numbers increased to 81% and 82%, respectively, and all were able to perform intercourse. Although 18-19% experienced slight discomfort, mostly related to the cut ends of the suture, this minor problem was accepted by all. Five patients needed more than one operation. No impotence was recorded post-operatively and no patient complained of reduced sensibility of the skin. CONCLUSION: Satisfactory results were obtained with the plication technique in the first 105 patients. Since the follow-up study was completed more than 2 years ago, another 70 patients have been treated by the same procedure.

Adult↗
PubMed1993

Quality of life in Norwegian kidney donors.

The Norwegian kidney transplant programme is based on more extensive use of living donors than in other countries. Re-examination of the physical health of kidney donors has in the majority of studies revealed no long-term medical risk. The quality of life after donation has only been described in very few studies, and with a small number of donors. This report concerns a cross-sectional study of 494 donors with a mean observation time from donation of 6.7 years. A standardized questionnaire containing 19 items related to quality of life was used. The donors were compared to the general adult population in a county in mid-Norway. Out of the 19 quality of life items, the donors scored significantly better in 13. Donors who had experienced that the corresponding recipient had died have been tested separately. The results in this subgroup were equal to the population, but inferior compared to the rest of the donors. We conclude that the quality of life of Norwegian kidney donors is better than the general population. We will continue our policy of an extensive use of living kidney donors.

Adult↗
PubMed1992

Fifteen years' experience with renal transplantation in systemic amyloidosis.

At our center 62 renal transplantations (31 living donor and 31 cadaveric donor grafts) have been performed in 58 patients with amyloid renal disease since 1974. The amyloidosis was secondary to rheumatic disease in 74% of the patients. Predialytic transplantation was performed in 28% of the patients. Mean follow-up time was 5.1 years (0.3-14.5 years). One-year actuarial patient survival was 79%, decreasing to 65% after 5 years. First graft survival was 74% at 1 year and 62% at 5 years. Patient death with a functioning graft caused 16 out of 25 graft losses. Infections caused 11 out of 18 deaths (61%), more than half of them within 3 months. Renal transplant amyloid was diagnosed in about 10% of the cases (6/62); however, only about 3% of the grafts (2/62) were lost. These long-term results encourage transplantation in amyloid renal end-stage disease.

Adolescent↗
PubMed1991

Renal failure in adult patients with hereditary tyrosinaemia type I.

An adult patient with hereditary tyrosinaemia type I who developed renal failure is reported. She received a renal transplant at the age of 23 years. In childhood her kidney disease was dominated by multiple tubular defects with resulting hypophosphataemic rickets. Metabolic acidosis was the most prominent feature in the years preceding the transplantation. Her kidneys were contracted to 40 g. The major morphological finding was that of a tubulointerstitial nephropathy. Liver biopsies taken at the ages of 5.5 and 23 years showed cirrhotic changes. Crystalloid inclusions in the liver mitochondriae were a prominent finding on electron microscopy. Fumarylacetoacetase was deficient in liver, kidneys, fibroblasts and lymphocytes. The typical biochemical parameters of tyrosinaemia, succinylacetone, p-hydroxyphenyllactate, p-hydroxyphenylpyruvate and serum tyrosine were only slightly elevated. A brief history of a second adult tyrosinaemia patient with decreasing renal function is also given.

Adolescent↗
PubMed1991

Doxazosin and atenolol as monotherapy in mild and moderate hypertension: a randomized, parallel study with a three-year follow-up.

The efficacy and safety of doxazosin (n = 83) and atenolol (n = 81) have been compared during a 3-year period. Doxazosin (mean dose at 3 years, 5.2 mg/day) and atenolol (mean dose, 66.4 mg/day) produced a sustained and overall similar reduction in blood pressure, with no evidence of tolerance. Doxazosin decreased mean blood pressure from 158/104 mm Hg to 146/90 mm Hg; with atenolol the decrease was from 160/103 mm Hg to 144/88 mm Hg. Whereas the reduction in blood pressure with atenolol was paralleled by a significant (p less than 0.05) decrease in heart rate (from a mean of 74 to 60 beats/min), doxazosin produced no clinically meaningful changes in heart rate. In contrast to atenolol, doxazosin reduced triglyceride levels by -5.9% (atenolol +22.5%), increased high-density lipoprotein cholesterol levels by +3.7% (atenolol, -11.2%), and increased the high-density lipoprotein/total cholesterol ratio by +5.9% (atenolol, -10.3%); all of these values were significantly (p less than 0.001) different from those of atenolol-treated patients. Doxazosin also reduced the calculated low-density lipoprotein cholesterol levels by -3.3% (atenolol, unchanged). The adverse effect of atenolol on lipid levels apparently negated any beneficial effect of blood pressure reduction, because the calculated coronary heart disease (CHD) risk actually increased significantly. In contrast, the reduction in calculated CHD risk in the doxazosin group was statistically significant at all points during the study. The safety profile of the drugs was similar. With the added potential of the reduction in the calculated risk of CHD among hypertensive patients,doxazosin represents an appropriate first-line drug for the treatment of essential hypertension.

Antihypertensive Agents↗
PubMed1990

[Kidney transplantation in Norway].

Twenty years ago, in 1969, a national kidney transplant program was established, based on uniform indications and preparations for transplantation. Since 1983, all transplants have been performed at one centre. We describe the organization, development, treatment policies and results of the program. The national transplant rate of 42 patients per million population per year (p.m.p.) keeps up with the demand. In contradiction to the international experience of rapidly expanding waiting lists and dialysis populations, a balance has been achieved in Norway, with a high transplant rate, a restricted and stable waiting list (mean 23 p.m.p.), waiting time (mean 5 months) and dialysis population. Approx. 80 per cent of all patients requiring long term renal replacement therapy actually receive a transplant, as against approx. 50% in Western Europe. Seventy-five to 100 per cent of the transplants function for more than a year, and 55-80 per cent for more than five years, depending on the donor and HLA compatibility. Other significant risk factors are age and HLA sensitization. Since 1983, 46 diabetics with renal failure have been treated by combined renal and pancreatic transplantation.

Humans↗