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Background: Current research pertaining to minimally invasive gynecologic surgical outcomes in the context of diabetes mellitus (DM) is limited. This study seeks to evaluate the association between DM and postoperative complications following laparoscopic hysterectomy for benign indications.Methods: The American College of Surgeons National Surgical Quality Improvement Program database was utilized. We identified laparoscopic hysterectomies completed for benign indications from 2007 to 2016 using current procedural terminology codes. Complications were evaluated by DM status: non-insulin-dependent DM (NIDDM), insulin-dependent DM (IDDM), and non-DM. Postoperative complications were evaluated utilizing univariate and multivariate analyses.Results: We identified 56,640 laparoscopic hysterectomies. Though both the IDDM and NIDDM cohorts had an increased incidence of postoperative complications compared to the non-diabetes cohort. The IDDM group had the highest incidence of all 3 cohorts. Compared to non-DM, the IDDM group had higher odds of reintubation (OR 4.23; 95% CI 1.59-11.19), urinary tract infection (OR 1.45; 95% CI 1.022-2.069), and extended length of stay (OR 1.75; 95% CI 1.36-2.26).Conclusion: Both NIDDM and IDDM were independent risk factors for postoperative complications after laparoscopic hysterectomy. However, the IDDM cohort had the highest odds of complications. Diabetic patients should be carefully counseled regarding their elevated risk of perioperative complications. [ABSTRACT FROM AUTHOR]

Although the use of oral contraceptives among young women is common, there are relatively few data concerning the effect of such medication upon vocal function. This paper investigated differences in objective voice measures in young women taking a triphasic oral contraceptive compared to women not taking any such medication. The results of paired t -tests revealed no significant difference in vocal pitch levels or variability of pitch during a paragraph reading task, indicating that oral contraceptives have a negligible effect upon women's voices, at least during connected speech. [ABSTRACT FROM AUTHOR]

The spinal dorsal horn is a major site for the induction and maintenance of mechanical allodynia, but the circuitry that underlies this clinically important form of pain remains unclear. The studies presented here provide strong evidence that the neural circuits conveying mechanical allodynia in the dorsal horn differ by the nature of the injury. Calretinin (CR) neurons in lamina II inner convey mechanical allodynia induced by inflammatory injuries, while protein kinase C gamma (PKCγ) neurons at the lamina II/III border convey mechanical allodynia induced by neuropathic injuries. Cholecystokinin (CCK) neurons located deeper within the dorsal horn (laminae III–IV) are important for both types of injuries. Interestingly, the Maf + subset of CCK neurons is composed of transient vesicular glutamate transporter 3 (tVGLUT3) neurons, which convey primarily dynamic allodynia. Identification of an etiology-based circuitry for mechanical allodynia in the dorsal horn has important implications for the mechanistic and clinical understanding of this condition. • CR neurons are important for mechanical allodynia in inflammatory injuries • PKCγ neurons are important for mechanical allodynia in neuropathic injuries • CCK and tVGLUT3 neurons in deeper laminae convey both types of injuries • The Maf + subset of CCK neurons encompasses tVGLUT3 and conveys dynamic allodynia Peirs et al. identified distinct spinal cord microcircuits that underlie mechanical allodynia, depending on the injury type. The neurons engaged after neuropathic or inflammatory injuries include populations that express CCK, tVGLUT3, CR, and PKCγ. [ABSTRACT FROM AUTHOR]