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A placebo controlled double blind study using perioperative prazosin in the prevention of urinary retention following inguinal hernia repair.

Acute urinary retention is a frequent complication following inguinal hernia repair. The smooth muscle of the bladder neck and the prostate have been demonstrated to be rich in alpha-1 adrenergic receptors. It has been postulated that the aetiology of acute urinary retention postoperatively is at least partially due to adrenergic stimulation; blocking these receptors may reduce the incidence of acute urinary retention. We have used prazosin in a double blind, placebo controlled study to establish its efficacy in the prevention of acute urinary retention in patients undergoing elective inguinal hernia repair. A total of 70 male patients were enrolled; 36 patients had been allocated active drug and 34 patients had been allocated placebo. Only two patients developed acute urinary retention. Both patients had been allocated prazosin and had received a general anaesthetic for their hernia surgery. In either arm of the study, a higher number of patients developing urinary retention would have been expected but this may be explained by the greater vigilance on urinary output by nursing staff aware that the trial was being conducted. On the basis of our findings, we do not recommend the routine use of perioperative prazosin with inguinal hernia repair. Further studies in high risk groups would be necessary to assess more fully the efficacy of prazosin in this situation.

Acute Disease↗

Medical treatment for urinary retention in rehabilitating elderly women: is it necessary?

BACKGROUND AND AIMS: It is unclear whether medical treatment of elderly women with acute urinary retention in geriatric rehabilitation centers affects the recovery rate. The aims of the present study were to assess the rate of spontaneous recovery from urinary retention in elderly women in rehabilitation centers and to determine whether medical treatment with a adrenergic receptor blockers (a blockers) is effective in resumption of urination in this population. METHODS: We surveyed 84 elderly women with urinary retention, admitted to a geriatric rehabilitation center between September 1998 and March 2000. Most had undergone orthopedic surgeries. Post-voiding urine residual (PVR) was measured 3 days after an acute episode of urinary retention. PVR of 250 mL and below was the desirable outcome. Patients with PVR over 250 mL were randomly assigned to two groups, placebo vs Doxazosin. Medication doses in both groups were increased every 3 days and catheterization was used until a desirable outcome was achieved. RESULTS: Seventy-eight out of the 84 patients entered the study, of whom 48 (62%) recovered spontaneously prior to initiation of medical treatment. Of the remaining 30, 7 patients dropped out and 23 began medical treatment. Twelve women recovered (a similar rate occurred in the placebo and Doxazosin groups), and 11 did not. The study was terminated due to the high rate of spontaneous recovery and because it became clear from the initial results that Doxazosin had no beneficial effect over placebo in the treatment of urinary retention. Diabetes and poor functional status were found to be prognostic factors for recovery failure. CONCLUSIONS: Most elderly women with urinary retention in geriatric rehabilitation centers will probably recover spontaneously. Alpha blockers appear to have no beneficial effect in this population.

Acute Disease↗

Impaired retention of visual discriminated escape training produced by subseizure amygdala stimulation.

These experiments examined the effects on memory of posttrial, subseizure, electrical stimulation of the amygdala. Rats were trained in a visual discriminated avoidance Y-maze. Each animal received 6 tirals on the training day. Retention, tested the following day, was measured both by the number of correct choices on the first 6 retraining trials and by the number of trials to a criterion of 5 of 6 correct choices. If administered 2 min, 1 h, or 4 h, but not 10 h, after training, bilateral amygdala stimulation significantly impaired retention as measured 24 h after training. In a second experiment, rats received unilateral amygdala stimulation in order to examine better the anatomical localization of effective stimulation sites. The unilateral stimulation was administered either 2 min, 10 min, 1 h, or 4 h after training. The behavioral procedures were the same as those used in the first experiment. For animals stimulated 2 min after training, the optimal stimulation region was one which extended rostrally from the ventrolateral portion of the basomedial nucleus to the dorsomedial region of the amygdala near the stria terminalis and nucleus centralis. For animals stimulated after a 10 min training-treatment interval, this amygdala region was not an effective stimulation site. However, in these animals, stimulation of the basolateral nucleus impaired later retention. Unilateral, posttraining amygdala stimulation administered 1 or 4 h after training did not appear to produce retention deficits. The findings of these experiments thus indicate that posttrial unilateral or bilateral amygdala stimulation impairs retention of discriminated avoidance training. Furthermore, the specific amygdala site at which posttrial stimulation impairs later retention varies with the training-treatment interval.

Amygdala↗

Factors affecting the retention and fit of gold castings.

A study was designed to simulate clinical conditions. Several factors were evaluated for effect on retention and fit (margin adaptation) of gold castings. Twenty-six castings (13 pairs) were made by different investigators using a standard preparation but with varying fabrication techniques. One of each pair of castings was made on a spaced die and one on an unspaced die. A significant difference in the postcementation retention was observed in the varying techniques of each investigator. Retentive values varied from 29 to 129 lbs. Complete seating of the castings during cementation was improved by the use of die spacer. Castings made on the spaced dies had more retention than corresponding unspaced castings. Die spacing has positive benefit when properly used. Moderate roughness of axial surfaces improves retention when zinc phosphate cement is used. Physical properties of restorative materials are important, but the individual technique and care of each investigator has a major effect on the ultimate fit and retention of the cast restoration.

Cementation↗

Retentive properties of attachment sleeves for a new cast-post system.

This study determined the retentive values of various size sleeves and their corresponding post heads when these were cemented with zinc phosphate cement. The experiment was divided into four groups of 10 samples each, except for group 3, which had eight samples. In each instance, the retentive values (measured in pounds) were obtained using a universal testing machine. In all samples studied, the retention of the sleeve was greater than 110 pounds. As the post number increased from 0 to 3, there was a corresponding increase in the retentive force needed to dislodge each sleeve. A maximum of 170.5 pounds was found for the No.3 cast-post sample. Comparison shows that the retention of the sleeve (for this cast-post system) onto the post head is in the same range as crown-to-tooth retention values shown by other investigators.

Cementation↗

Comparison of retentive properties of four post systems.

This study compared the retention of posts in the root for various diameters (1.3 mm and 1.6 mm) of three prefabricated post systems (Unity, Filpost, and Brasseler) with that of the previously reported No. 1 and No. 2 Flexi-Post systems. The experiment was divided into three groups comprising 10 samples for each post system studied. In group 2, the Filpost system was cemented both with a resin cement and zinc phosphate cement. Retention values were obtained with a modified universal testing machine. The retention of 1.3 mm posts from most to least retentive was Flexi-Post (zinc phosphate) greater than Filpost (zinc phosphate) greater than Filpost (resin) greater than Brasseler (zinc phosphate), greater than Unity (resin). The retention of 1.6 mm posts from most to least was Flexi-Post (zinc phosphate) greater than Filpost (zinc phosphate) greater than Brasseler (zinc phosphate), Unity (resin) greater than Filpost (resin). The Filpost system achieved higher retention with zinc phosphate cement than it did with resin cement.

Cementation↗

Retentive strength, disintegration, and marginal quality of luting cements.

This study evaluated the retention of complete crowns by using five different methods of cementation. Complete crowns were prepared with standardized dimensions on extracted human molars. Metal crowns were cast with a high noble gold ceramic alloy and were cemented with zinc phosphate cement, glass ionomer cement, composite resin cement, composite resin cement with a dentinal bonding agent, and adhesive resin cement. The retention was measured by subjecting the specimens to tensile load until fracture occurred. The disintegration was measured according to American Dental Association Specification No. 8, and the condition of the cements at the margins of crowns was analyzed by use of a scanning electron microscope. Kruskal-Wallis one-way analysis of variance revealed statistically significant differences between the mean retentive strengths. The retention of the zinc phosphate and the glass ionomer groups was significantly different from that of the adhesive resin group. The retention of the adhesive resin cement was 65% greater than the retention of the composite resin and the composite resin/dentinal bonding agent group, but the Mann-Whitney Wilcoxon rank sum test did not depict this difference as significant. The mean +/- SD of the disintegration for the zinc phosphate, the glass ionomer cement, and the composite resin cement was 0.025 +/- 0.013, 0.023 +/- 0.011, and 0.017 +/- 0.001, respectively. The scanning electron microscope analysis of the margins revealed that the composite resin cement was almost intact, the zinc phosphate was subjected to limited disintegration, and the glass ionomer displayed the worst marginal integrity.

Adhesives↗

Post-herniorrhaphy urinary retention: a randomized prospective study.

Urinary retention is a known complication of inguinal herniorrhaphy. Bladder distension due to vigorous fluid administration is believed to contribute to this problem. Our hypothesis is that fluid restriction will lower the incidence of urinary retention, post-herniorrhaphy. From January 1989 through March 1991, 113 male patients entered the study. Sixty patients (Group I) received unlimited iv fluids (1294 +/- 58 ml) and 9 patients (15%) developed urinary retention. Fifty-three patients (Group II) received 500 ml or less by protocol (485 +/- 2 ml) and 5 of these patients developed retention (9%). Thus, fluid restriction lowered the incidence of urinary retention post-herniorrhaphy but the difference did not reach statistical significance. In addition age over 60 years approached significance as a risk factor for postoperative urinary retention.

Aged↗

Effect of ovarian steroids on footshock avoidance learning and retention in female mice.

Mice were trained to avoid footshock in a T-maze, with retention tested one week later. Adult male CD-1 mice made their first avoidance during acquisition after fewer trials than random cycling females and with less variability. Female mice in diestrus, when plasma levels of progesterone are low, learned to avoid footshock faster than females in estrus. Ovariectomized (OVX) mice learned in fewer trials than intact random cycling mice. Similar differences, though of a smaller magnitude, were found on the retention tests (i.e. males had better retention than females, mice in diestrus showed better retention 8 days later when in the same part of the estrous cycle than those in estrus, and OVX mice had better retention than cycling females). OVX mice with estrogen implants learned faster than those with progesterone implants or progesterone plus estrogen implants. Hormonal status did not affect sensitivity to acoustic or footshock stimuli as measured by a startle reflex, nor did it affect activity. Pretraining administration of amphetamine, picrotoxin and strychnine attenuated the impairing effect of progesterone on acquisition. The possibility that progesterone may impair learning and to some extent, retention by facilitating the GABAergic activity and thereby reducing arousal level is discussed.

Animals↗

Effects of post-training bicuculline and muscimol on retention: lack of state dependency.

Immediate post-training intraperitoneal injections of the GABA antagonist bicuculline (0.25 or 0.5 mg/kg) or of the GABA agonist muscimol (1.0 or 2.0 mg/kg) improved and impaired, respectively, retention of CD1 mice tested 24 h after training in a one-trial inhibitory avoidance task. Administration of bicuculline or muscimol prior to the retention test did not modify retention latencies of mice that had received either saline or the same drug immediately after training. These findings indicate that the effects of post-training administration of bicuculline and muscimol on retention are not state dependent and, thus, argue against a general state-dependency interpretation of the effects of post-training treatments affecting retention. The findings are consistent with previous evidence indicating that GABAergic drugs affect retention through influences on memory storage processes.

Animals↗

Immediate postoperative retention of visual discriminations following selective cortical lesions in the cat.

Cats were trained preoperatively for brightness discrimination, and 7 pattern and form discriminations, and then retested for preoperative retention on each discrimination. Cortical lesions were then placed in areas 17 and 18 in one group (4 cats), in areas 17, 18 and 19 in another group (3 cats), and in suprasylvian cortex (areas 7, 21, and parts of 19, 5 and the lateral suprasylvian cortex) in a third group (4 cats). Results are also reported for a fourth group with extensive suprasylvian lesions, to which was added an unintended undercutting of areas 17 and 18 (4 cats). While during original preoperative learning the training continued until a fixed, stringent criterion of performance was attained, both preoperative and postoperative retention was tested in short sessions, involving a limited number of trials and a less stringent statistical criterion (significant run). After extensive removal of areas 17 and 18, all cats behaved as though following the cortical lesion they could immediately recognize the discriminative stimuli as efficiently as before, with no need for retraining. On the contrary, the group with areas 17, 18 and 19 lesions showed a substantial postoperative loss of all discriminations, and especially for the more difficult form discriminations, the reattainment of a significant level of performance was hard or impossible within the allotted number of trials. Also in the group with limited suprasylvian lesions, postoperative retention was generally impaired, but the reacquisition of efficient performance was superior to that of the previous group. Finally, large suprasylvian lesions encroaching on the white matter under areas 17, 18 and 19 proved disruptive for all discriminative capacities, both in retention and in relearning. The excellent retention of all discriminations following areas 17 and 18 lesions once again shows that these areas are by no means essential for complex vision in the cat. In addition, the results strongly indicate that the high-level visual capacities of destriate cats are not due to reorganization of readaptation processes occurring in extrastriate areas after a 17/18 removal. The clear-cut retention deficits which were present in cats with cortical lesions more extensive than areas 17 and 18 or outside of the latter areas prove the essential participation of extrastriate cortical areas in visual discrimination including form. However, the distribution of functions among the various visual cortical areas in visual discrimination remains poorly understood.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

Cardiopulmonary resuscitation skills retention in family members of cardiac patients.

The purpose of this study was to determine if the use of a retention strategy would maintain cardiopulmonary resuscitation (CPR) skills in family members of cardiac patients. Thirty-one subjects trained in CPR received retention packets 3 and 6 months after CPR training. Sixteen subjects were tested for CPR retention at 7 months after initial training, and 15 at 12 months. Likelihood chi 2 was used to compare the 7- and 12-month groups. There were no differences between the 7- and 12-month groups, because CPR retention overall was poor. Only 19.4% of subjects reported using the retention packet; therefore, subjects were regrouped into practice and no practice groups for purposes of further statistical analysis. There were significant differences in retention in subjects who practiced compared with subjects who did not. These findings underscore the importance of promoting practice/review after initial CPR training for family members of cardiac patients.

Adult↗

The presence of Fowler's syndrome predicts successful long-term outcome of sacral nerve stimulation in women with urinary retention.

OBJECTIVES: Sacral nerve stimulation (SNS) is an effective treatment for women with urinary retention. Some women present specific electromyography abnormalities of the external urethral sphincter (Fowler's syndrome). The aim of this study was to evaluate whether Fowler's syndrome and psychologic preimplant screening could be predictive factors for long-term success of SNS in women with urinary retention. METHODS: All patients underwent electrophysiologic and urodynamic studies and voiding charts. A validated psychologic screening questionnaire was used. Women with successful temporary stimulation, received a definitive implant (Interstim Medtronic). They were followed prospectively every 6 months. Failure was defined as recurrent retention needing intermittent or permanent catheterisation. RESULTS: Sixty-two women were implanted, 30 with Fowler's syndrome, 32 with idiopathic retention. In those with Fowler's syndrome, 26.6% screened positive for somatisation, as did 43.8% in the idiopathic group (not significant [ns]). Screening for depression was positive in 30% and 18.8%, respectively (ns). There was no correlation with outcome. Twenty-eight patients failed: 9 with Fowler's syndromes, 19 without (p=0.04). Kaplan-Meier analysis showed that patients with Fowler's syndrome benefitted significantly longer from SNS (log-rank test, p=0.005). CONCLUSIONS: The presence of Fowler's syndrome is a positive predictive factor for SNS in female urinary retention. Idiopathic urinary retention patients can benefit as well, but the success might be less predictable. Preimplant psychologic screening, using the Patient Health Questionnaire, does not correlate with long-term outcome of SNS in this population.

Electric Stimulation Therapy↗

Preregistration nursing student attrition and strategies to improve student retention in university; an umbrella review.

BACKGROUND: Attrition among preregistration nursing students remains a persistent international challenge, contributing to nursing workforce shortages. Although extensive research has examined factors influencing student attrition and retention, the evidence is fragmented across review-level literature, limiting clarity regarding priority and evidence-informed retention strategies. AIM: To synthesize review-level evidence on factors associated with preregistration nursing student attrition and to identify strategies that support student retention in university-based nursing programs. METHODS: An umbrella review was conducted in accordance with the Joanna Briggs Institute methodology. Six electronic databases were systematically searched for peer-reviewed literature reviews published in English between January 2016 and October 2025. Eligible reviews focused on undergraduate preregistration nursing students in face-to-face university programs. Methodological quality was appraised using the JBI critical appraisal checklist. Findings were synthesised using narrative and thematic approaches. RESULTS: Seventeen literature reviews were included. Attrition was consistently described as multifactorial, influenced by academic preparedness, psychosocial wellbeing, socio-demographic factors, and institutional support. Retention strategies reported across reviews were predominantly relational, developmental, and sustained over time, including mentoring, tutoring, academic skills development, psychosocial support, and interventions that foster belonging. Faculty engagement and holistic approaches were repeatedly associated with improved student persistence. However, the evidence base was largely descriptive, with limited experimental evaluation of intervention effectiveness. CONCLUSION: Preregistration nursing student retention is best supported through multifaceted, sustained strategies that begin at admission and extend throughout the curriculum. While current evidence highlights consistent patterns of effective support, further rigorous research is required to evaluate retention interventions and extend evidence to flexible nursing education pathways.

Humans↗

Ginkgo biloba promotes short-term retention of spatial memory in rats.

This study examines possible interactions between exposure to Ginkgo biloba extract and enriched environments on the acquisition and retention of spatial learning following massed and spaced trials. After 4 weeks of exposure to either ginkgo or vehicle, 8-week-old rats were tested using a Morris Water Maze in either massed or spaced trials. While ginkgo did not have an effect on maze acquisition or long-term retention, it did promote short-term retention of spatial memory. Following reversal training, ginkgo promoted short-term retention for two groups but impaired retention for a third. These results suggest that ginkgo has powerful effects on short-term retention that vary with training conditions.

Animals↗

Comparative study of the surface characteristics, microstructure, and magnetic retentive forces of laser-welded dowel-keepers and cast dowel-keepers for use with magnetic attachments.

STATEMENT OF PROBLEM: Information regarding the merits and problems associated with connecting a keeper to a dowel and coping using a laser welding technique has not been explored extensively in the dental literature. PURPOSE: This in vitro study compared the surface characteristics, microstructure, and magnetic retentive forces for a dowel and coping-keeper mechanism fabricated using a laser welding process and a cast-to casting technique. MATERIAL AND METHODS: Five cast-to and 6 laser-welded dowel and coping-keeper specimens were tested. Using 5 freestanding keepers as the control group, the surface characteristics and microstructures of the specimens were examined by means of stereomicroscopy, metallographic microscopy, and scanning electron microscopy (SEM). Energy-dispersive spectroscopic (EDS) microanalysis with SEM provided elemental concentration information for the test specimens. The vertical magnetic retentive forces (N) of the 3 groups were measured using a universal testing machine. The results were statistically compared using 1-way analysis of variance and the Newman-Keuls multiple range test (alpha =.05). RESULTS: The laser-welded dowel-keeper generally maintained its original surface smoothness as well as the original microstructure. Elements diffused readily through the fusion zone. The surface of the cast dowel-keeper became rough with the formation of an oxide layer, the microstructure changed, and there was only limited elemental diffusion in the fusion zone. The average vertical magnetic retentive force of the laser-welded group, the cast group, and the control group were 4.2 +/- 0.2 N, 3.8 +/- 0.3 N, and 5.6 +/- 0.3 N, respectively. Statistically significant differences in vertical magnetic retentive force were found between the control group and both the laser-welded and cast groups (P <.01). Compared with the cast dowel-keepers, the average vertical magnetic retentive force of the laser-welded dowel-keepers was significantly higher (P <.05). CONCLUSION: The laser welding technique had less influence on the surface characteristics, the microstructure, and the magnetic retentive forces of keepers relative to techniques that incorporate a keeper at the time of cast dowel and coping fabrication.

Dental Prosthesis Retention↗

Effect of an adhesive resin luting agent on the dowel-head retention of three different core materials.

STATEMENT OF PROBLEM: A dowel-and-core restoration may fail due to failure at either the dowel-tooth or dowel head-core material interface. Long-term clinical success of a dowel-and-core restoration depends on retention of both the dowel to the tooth and the dowel head to the core material. Thus, strengthening of the dowel head-core interface is important. PURPOSE: This study evaluated the retention between a prefabricated dowel and 3 different core materials with or without a dual-polymerized adhesive resin luting agent. MATERIAL AND METHODS: Sixty prefabricated dowels (Gold Plated Anchorage Post) were divided into 3 groups (n=20) consisting of 1 of 3 core materials, amalgam (Standalloy F), light-polymerized resin composite (Clearfil Ray), or glass ionomer (Chelon-Silver). Each core group was divided into 2 subgroups (n=10), and a dual-polymerized adhesive resin luting agent (Panavia F) was applied to the dowel heads of 1 of these subgroups before application of the core material. The manufacturing procedure was standardized by using a plastic index (4.5-mm internal diameter and 5-mm height) and a custom-made dowel holder, which held the dowel head. Prepared specimens were stored in water at room temperature for 3 months and then loaded to fracture in a universal testing machine with a crosshead speed of 0.05 mm/min until failure. Bond strengths were recorded (MPa). Data were analyzed with 2-way analysis of variance (ANOVA) in a 2 x 3 factorial randomized design (alpha=.05). Afterward, core material differences were computed with 1-way ANOVA for both of the bonded and nonbonded groups. Post hoc multiple comparisons were made with the Dunnett C multiple range test. RESULTS: Dowel-head retention values (MPa) of the tested core materials (mean +/- SD) from the highest to the lowest were as follows: bonded amalgam core, 296.1 +/- 108; bonded composite core, 284.3 +/- 38.3; nonbonded composite core, 177.0 +/- 53.7; nonbonded amalgam core, 128.5 +/- 35.0; bonded glass-ionomer core (GIC), 128.0 +/- 24.5; nonbonded GIC, 61.8 +/- 13.3. Two-way ANOVA revealed significant differences between the core material groups and between the bonded and nonbonded groups (P <.001). The interaction between the core material and bond variables was also significant (P =.018). One-way ANOVA revealed statistically significant differences between the bonded (P <.001) and also between the nonbonded core material groups (P <.001). Post hoc multiple comparisons showed that the dowel-head retention of the GIC was significantly weaker than the post-head retention for amalgam and resin composite, whether bonded or not. CONCLUSION: Within the limitations of this study, the adhesive resin luting agent tested appeared to have a significant strengthening effect on the dowel-head retention of the core materials.

Adhesives↗

Comparison of titanium dowel retention using four different luting agents.

STATEMENT OF PROBLEM: Luting material, surface properties, and loading conditions affect the retention of prefabricated dowels to varying degrees. PURPOSE: The purpose of this study was to evaluate the effect of roughening of the dentinal walls and artificial aging on the retention of prefabricated tapered titanium dowels, using 4 different luting materials. MATERIAL AND METHODS: One-hundred twenty-eight single-rooted teeth were selected, the coronal aspect of each tooth was removed, and the remaining root received endodontic therapy. All specimens were divided into 4 groups (n=32). Dowel spaces were prepared to a depth of 10 mm using ISO 90 rotary cutting instruments. Tapered titanium dowels were luted with the following luting materials: zinc-phosphate cement (Harvard cement), glass-ionomer cement (Ketac Cem EasyMix), resin composite luting agent (Panavia 21) with autopolymerizing dentin primer (ED-Primer), or a self-adhesive composite luting agent (RelyX Unicem). Both composite luting agents were used without acid etching of the canal dentin. Each luting agent was used under 2 conditions: in 1 subgroup (n=16) the dentinal walls were not roughened, and in the other subgroup (n=16), walls were roughened with a diamond rotary cutting instrument. Eight specimens from each subgroup were stored in water at 37 degrees C for 3 days; the other 8 specimens were stored for 150 days and subjected to simulated aging conditions using 37,500 thermal cycles (5 degrees C/55 degrees C) and 300,000 mechanical loading cycles with 30 N. Dowel retention (N) was measured using a universal testing machine with a crosshead speed of 2 mm/min. Data were analyzed using 2- and 3-way ANOVAs and the Tukey HSD test (alpha=.05). RESULTS: The dislodged dowels were examined microscopically to evaluate mode of failure. The nonroughened dentinal walls showed no significant differences between the different luting agents. Roughening the dentinal walls increased the retention significantly for all groups. This increase was significantly higher for the resin composite groups (P=.0001). Storage for 150 days with thermal cycling and mechanical loading caused a significant decrease in dowel retention (P=.001). The failure mode was purely adhesive at the luting material-dentin interface for all dowels cemented in nonroughened root canals. A mixed failure mode, adhesive at the luting material-dentin interface and cohesive in the luting material, was observed for dowels cemented in roughened root canals. CONCLUSION: Roughening the dentinal walls and the use of resin luting cements provided statistically significant increases in dowel retention values.

Analysis of Variance↗