Search

Our objective was to investigate the long-term effects of hysterectomy for benign indication on pelvic floor and sexual function. Prospective clinical cohort study, 5-year follow-up. Participants will be followed up to 10 years after surgery. In an academic affiliated district general hospital. 260 patients undergoing hysterectomy on benign indication between 2016 and 2018 at Danderyd Hospital. A comparison of robotic assisted total laparoscopic hysterectomy with traditional techniques of surgery regarding pelvic floor function and sexual function. All women going through hysterectomy filled in validated questionnaires (Pelvic Floor Impact Questionnaire (PFIQ-7), Pelvic Floor Distress Inventory (PFDI-20), Female Sexual Function Index (FSFI)) on pelvic organ and sexual function before surgery, at six months, 1, 3 and 5 years after surgery. Response rate was at the 5-year follow-up was 154/242 (63.6%) for all questionnaires. Data were analyzed using nonparametric statistics and mixed effect models. Symptoms of urinary, bladder and pelvic floor dysfunction were significantly reduced. The improvement of sexual function after six months (mean score of FSFI at baseline 17.9 (SD 11.7), at six months 21.0 (SD 11.7)) (P<0.001) was not persistent after five years 19.0 (SD 11.3)) and there was a decline in sexual function among the sexually active women (mean score of FSFI baseline 25.2 (6.6SD) and at 5 years 21.6 (10.1 SD, p<0.001). Five years after surgery robotic-assisted total laparoscopic hysterectomy, total laparoscopic hysterectomy and total abdominal hysterectomy improve pelvic floor function to the same extent. An overall improvement of sexual function six months after hysterectomy, was not persistent after five years and among the sexually active women there was a decrease in FSFI scores. Correlations between pelvic floor function and sexual function after hysterectomy will be discussed. [ABSTRACT FROM AUTHOR]

Objective: CR4056 is a selective imidazoline-2 (I2) receptor ligand with potent analgesic activity in animal pain models. This proof-of-concept study tested CR4056 efficacy and safety in patients with knee osteoarthritis (OA) and different phenotypes.Design: This is a multicenter, randomized, double-blind, placebo-controlled trial. Knee OA patients with moderate to severe pain received CR4056 (women 100 mg bid; men 200 mg bid) or placebo (both genders) for 14 days. The primary outcome was the change in WOMAC pain score (0-100 scale) compared to placebo, analyzed in the intention-to-treat population and pre-defined OA phenotypes.Results: 213 patients were treated with CR4056 (92 women; 52 men) or placebo (69 overall). After 14 days, median WOMAC pain improvements were 10 points on placebo and 14, 20 and 16 in women, men, and pooled CR4056 groups (P = 0.184, 0.030 and 0.070 vs placebo, respectively). Pre-specified subgroup analysis in the metabolic OA phenotype (BMI ≥ 27.5 kg/m2, N = 156) showed statistically significant differences in all CR4056-treated groups vs placebo of 12-18 points. Conversely, there were too few patients with a neuropathic or inflammatory phenotype for a meaningful analysis. CR4056 was well tolerated; the most common adverse event was mild headache.Conclusions: Although the primary endpoint was met in males only, this exploratory phase 2 trial shows that CR4056 might be an effective analgesic against knee OA pain, especially in overweight patients representing the metabolic OA phenotype. These findings, along with the broad-spectrum analgesic activity of CR4056 in animal models, warrant further clinical investigation in OA and other pain conditions.Clinical Trial Registration Number: EudraCT 2015-001136-37. [ABSTRACT FROM AUTHOR]

• Dietarian Identity is the self-image that individuals have regarding their consumption/avoidance of animal products. • We validated the Italian version of the Dietary Identity Questionnaire (DIQ-I) • Omnivores and flexitarians DIQ-I values were different from vegetarians and vegans. • Differences exist between dietarian categorization and self-categorization. An increasing number of consumers are trying to reduce and control their meat consumption and are shifting toward vegetarian, vegan, or flexitarian diets. While these diet categories are often grouped together, different psychological drivers may lead to the decision to follow a certain dietary pattern. The Dietarian Identity Questionnaire (DIQ) (Rosenfeld & Burrow, 2018) assesses how people think, feel, and behave with respect to consuming or avoiding animal products and allows us to explain the underlying psychological motivations of food choices. Considering that the psychology of eating behavior is strictly connected to the cultural context, this study (N = 678) aimed to (i) evaluate the mismatch between dietarian categorization obtained by food consumption and self-categorization; (ii) validate the Italian version of the DIQ (DIQ-I); and (iii) evaluate whether the results of the DIQ-I dimensions vary with categorization. Mismatches were evaluated using cross-tabulation and χ -square analysis, while DIQ-I was validated using confirmatory factor analysis (CFA). Finally, multiple one-way ANOVAs were conducted on groups of dieters defined by the respondents' self-categorizations and according to self-reported meat consumption. The overall findings suggest that the DIQ-I can satisfactorily depict the ideological significance of following certain diets in the Italian population. Moreover, the self-categorization results revealed that consumers' perceptions of their own diets often differ from scholars' definitions, which might imply a systematic bias in food surveys and consumers' research practices. [ABSTRACT FROM AUTHOR]

Highlights • Atraumatic musculocutaneous neuropathy is a very rare condition. • Differential diagnosis between osteochondroma and bone spur, with absence of the typical cartilage cap. • Multidisciplinary approach is fundamental to make an optimal diagnosis. [ABSTRACT FROM AUTHOR]

Abstract: Background and purpose: To compare the effects of regular cigarettes (RCs) and light cigarettes (LCs) on brachial artery flow-mediated dilation (FMD) and sublingual glyceryl trinitrate-induced dilation (GTN), markers of endothelial dependant and independent function, respectively. Methods: 206 subjects (age 51.5 ± 12.8 yr, 122 men) had their smoking habits recorded and FMD and GTN measured by B-mode ultrasound. Cigarettes were categorized as RCs or LCs according to their content of tar, nicotine and CO. The chronic effect was assessed in current smokers of RCs (n = 85) or LCs (n = 53) and in never smokers (NS; n = 68). The acute effect was assessed in current smokers by measuring FMD before and 10-min after smoking a single regular (n = 29) or light (n = 51) cigarette. Results: FMD was significantly lower in consumers of RCs (6.26%, 95% C.I. 5.58, 6.94) or LCs (5.59%, 95% C.I. 4.74, 6.45) compared to NS (8.68%, 95% C.I. 7.92, 9.44) (both P < 0.0001), but did not differ (P > 0.05) when compared to each other. GTN was similar in the three groups. Analyses adjusted for clinical confounders and for markers involved in oxidative stress, arginine/nitric oxide pathway, and inflammation provided identical results. Smoking a single cigarette, either regular or light, reduced FMD (−0.88% and −1.17%, respectively, both P < 0.05), without significant difference between cigarette type. RCs and LCs produced analogous chronic and acute effects when FMD was calculated with respect to the last 60 s of the low-flow phase (FMD60s). Conclusions: LCs impair endothelial-dependant vasodilation as much as RCs. Thus, smoking LCs cannot be considered an alternative to the only safe choice of a complete and permanent smoking cessation. [Copyright &y& Elsevier]

Summary: Inappropriate hair removal is a risk factor for postoperative surgical site infections (SSIs). A series of obstetric patient awareness interventions were introduced regarding hair self-removal before presentation at hospital. Active inpatient and outpatient surveillance of SSIs following caesarean section was undertaken prospectively. The rate of hair self-removal decreased significantly from 41% (2008) to 27% (2011) after implementation of posters and enhanced prenatal education (P = 0.048). Concurrently, a 51% reduction was seen in the SSI rate following caesarean section. This multi-faceted strategy proved successful in reducing prehospital hair self-removal overall, particularly shaving. Other simultaneous SSI prevention interventions are also likely to have contributed to the reduction in SSI rate. [ABSTRACT FROM AUTHOR]