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Background: Chronic pelvic pain remains challenging for physicians to manage due to central and peripheral sensitization and multiple pain generators including the bladder, pelvic floor, and pudendal nerve. Pain management providers have used nerve blocks for years for diagnosis and treatment. We developed a desensitization algorithm that provides a stepwise approach to improve patients pain scores., Methods: This is a prospective observational cohort study of 182 women aged 15-90 years old with chronic pelvic pain using an algorithm from 2016 to 2018. Treatment started with an Anesthetic Challenge Test of the bladder to guide us through a protocol of intravesical therapy and/or pudendal nerve blocks as a second step., Results: ACT POSITIVE patients, who received intravesical therapy: 84% had a Visual Analog Score pain improvement of at least 50%, 64% improved at least 80% (41% pain-free). Those desiring additional relief that received further Pudendal Blocks: 83% had final improvement of at least 50% (67% pain-free). ACT NEGATIVE patients received Pudendal Blocks with 80% of subjects achieving at least 50% relief, 65% improved at least 80% (35% pain-free). All final groups showed a statistically significance of P  < .05% when compared to their initial pain scores., Conclusion: Management of women with chronic pelvic pain would ideally start with treating a specific diagnosis which, in most cases, is difficult to establish since the majority have more than one pain generator. Our algorithm simplified the approach and reduced the severity of pain scores prior to any further necessary surgical interventions., Competing Interests: Conflict of interests: none., (© 2024 by SLS, Society of Laparoscopic & Robotic Surgeons.)

The aim of this paper is to describe an optimized methodology to study the surface characteristics and internal structure of biopolymer capsules using scanning electron microscopy (SEM) in environmental mode. The main advantage of this methodology is that no preparation is required and, significantly, no metallic coverage is deposited on the surface of the specimen, thus preserving the original capsule shape and its surface morphology. This avoids introducing preparation artefacts which could modify the capsule surface and mask information concerning important feature like porosities or roughness. Using this method gelatin and mainly fatty coatings, difficult to be analyzed by standard SEM technique, unambiguously show fine details of their surface morphology without damage. Furthermore, chemical contrast is preserved in backscattered electron images of unprepared samples, allowing visualizing the internal organization of the capsule, the quality of the envelope, etc... This study provides pointers on how to obtain optimal conditions for the analysis of biological or sensitive material, as this is not always studied using appropriate techniques. A reliable evaluation of the parameters used in capsule elaboration for research and industrial applications, as well as that of capsule functionality is provided by this methodology, which is essential for the technological progress in this domain., (Copyright © 2014 Elsevier B.V. All rights reserved.)

A microsized alpha-tricalcium phosphate (alpha-TCP) powder was calcined at various temperatures (350 degrees C

The sequence of steps of a chemical treatment having as its goal the induce of nucleation and the growth of hydroxyl carbonated apatite (HCA) at the surface of titanium implants was studied by scanning and transmission electron microscopy in cross-section. In the first step, an acid etching forms a rough titanium hydride layer, which remains unchanged after subsequent treatments. In the second step, soaking in an NaOH solution induces the growth of nanobelt tangles of nanocrystallized, monoclinic sodium titanate. In the third step, soaking in simulated body fluid transforms sodium titanate into calcium titanate by ion-exchange in the monoclinic structure. HCA then grows and embodies the tangled structure. The interfaces between the different layers seem to be strong enough to prevent interfacial decohesion. Finally, the role of the titanate structure in the nucleation process of HCA is discussed.

Bioinert titanium (Ti) materials are generally encapsulated by fibrous tissue after implantation into the living body. To improve the bone-bonding ability of Ti implants, we activated commercially pure titanium (cpTi) by a simple chemical pre-treatment in HCl and NaOH. Subsequently, we exposed the treated samples to simulated body fluid (SBF) for 2 (TiCT) and 14 days (TiHCA), respectively, to mimic the early stages of bone bonding and to investigate the in vitro response of osteoblasts on thus altered biomimetic surfaces. Sample surfaces were characterized by scanning electron microscopy, energy-dispersive X-ray analysis, cross-sectional transmission electron microscopy analyses, Fourier transform infrared and Raman spectroscopy. It was shown that the efflorescence consisting of sodium titanate that is present on pre-treated cpTi surfaces transformed to calcium titanate after 2 days in SBF. After 14 days in SBF a homogeneous biomimetic apatite layer precipitated. Human osteoblasts (MG-63) revealed a well spread morphology on both functionalized Ti surfaces. On TiCT, the gene expression of the differentiation proteins alkaline phosphatase (ALP) and bone sialo protein was increased after 2 days. On both TiCT and TiHCA, the collagen I and ALP expression on the protein level was enhanced at 7 and 14 days. The TiCT and the TiHCA surfaces reveal the tendency to increase the differentiated cell function of MG-63 osteoblasts. Thus, chemical pre-treatment of titanium seems to be a promising method to generate osteoconductive surfaces.

The acoustic comfort of classrooms in a Brazilian public school has been evaluated through interviews with 62 teachers and 464 pupils, measurements of background noise, reverberation time, and sound insulation. Acoustic measurements have revealed the poor acoustic quality of the classrooms. Results have shown that teachers and pupils consider the noise generated and the voice of the teacher in neighboring classrooms as the main sources of annoyance inside the classroom. Acoustic simulations resulted in the suggestion of placement of perforated plywood on the ceiling, for reduction in reverberation time and increase in the acoustic comfort of the classrooms.

Objective: To comparatively analyze the perception of daily urban noise between residents of an acoustically and a non-acoustically controlled area., Methods: Two urban areas were selected through objective assessments of equivalent sound levels and defined as a non-acoustically and an acoustically controlled area. A random sample of each area was selected and a questionnaire was applied to its residents. Statistical indicators of urban noise perception were generated through factorial multivariate analysis., Results: The average sound level (Leq) found in the downtown district (a non-acoustically controlled area) was 72.9 dB(A) and in the acoustically controlled area was 53.3 dB(A). Three statistical indicators were generated through factorial multivariate analysis: temporary perception, perception of atypical noises and sources and disturbances., Conclusions: Residents of the acoustically controlled area reported increased noise level. The sound level in the downtown district has remained practically constant and much above the standards established by local law. The generated indicators are useful parameters to characterize the perception to continuous noise exposure in the population.