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Introduction and hypothesis: The objective was to assess whether midurethral slings (MUS) can improve both stress urinary incontinence (SUI) and cystoceles. MUS with anterior colporrhaphy (AC) as a treatment for SUI with cystocele is more invasive and carries greater risk than MUS alone. Methods: This is a prospective randomized study involving women with stage 1 or 2 cystocele and SUI, who were > 21 years of age, who had had no previous surgery for SUI. Predominant SUI, symptomatic anterior pelvic organ prolapse, and informed consent were mandatory. Patients were randomized as to whether AC had been performed. The sling procedure was left to the surgeon's discretion: pubovaginal sling, tension-free vaginal tape, or trans-obturator tape. Success was defined as a negative stress test and no evidence of cystocele upon local examination. Results: Ninety-eight patients were enrolled, 48 underwent MUS, and 50 underwent MUS and AC. Mean age ± SD was 44.96 ± 8.13 years. Baseline characteristics were similar. Operative time and blood loss were significantly higher in the MUS/AC group (p = 0.01 and 0.02 respectively). At 3 months, success was 79.1% and 77.8% in the MUS and MUS/AC groups respectively. This was maintained until 6 months (79.1% and 77.8% respectively). At 1 year, the results were comparable with success rates of 96.2% and 87.0% in the MUS and MUS and AC groups respectively. Symptom scores were comparable at 6- and 12-month evaluations. Conclusion: Midurethral slings correct symptomatic stage 1 or 2 cystoceles without the need for AC, which carries the risk of a significantly longer procedure and more significant blood loss. [ABSTRACT FROM AUTHOR]

Purpose: Data suggest that the utilization of care in male incontinence surgery (MIS) is insufficient. The aim of this study was to analyse the utilization of care in MIS from 2006 to 2020 in Germany, relate this use to the number of radical prostatectomies (RP) and provide a systematic review of the international literature. Methods: We analysed OPS codes using nationwide German billing data and hospitals' quality reports from 2006 to 2020. A systematic review was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). Results: MIS increased by + 68% from 2006 to 2011 (1843–3125; p = 0.009) but decreased by − 42% from 2011 to 2019 (3104–1799; p < 0.001). In 2020, only 1435 MISs were performed. In contrast, RP increased from 2014 to 2019 by 33% (20,760–27,509; p < 0.001). From 2012 to 2019, the number of artificial urinary sphincters (AUSs) changed minimally (− 12%; 1291–1136; p = 0.02). Sling/sling systems showed a decrease from 2011 to 2019 (− 68% 1632–523; p < 0.001). In 2019, 63% of patients received an AUS, 29% sling/sling systems, 6% paraurethral injections, and 2% other interventions. In 2019, few high-volume clinics [n = 27 (13%)] performed 55% of all AUS implantations, and few high-volume clinics [n = 10 (8%)] implanted 49% of retropubic slings. Conclusion: MIS have exhibited a relevant decrease since 2011 despite the increase in RP numbers in Germany, indicating the insufficient utilization of care in MIS. The systematic review shows also an international deficit in the utilization of care in MIS. [ABSTRACT FROM AUTHOR]

Based on empirical research with parents who carry their children in slings, I propose what I hope will be a new and more progressive way of understanding of parental care relationships, where ideas of dependence/independence are replaced by those of interdependence. Through engagement with feminist literatures which stress relationality between humans and non-humans, I suggest that it may be helpful to broaden our understanding of parental care from an exclusive focus on the mother–child relationship in order to recognise a wider range of actors as participating in this process – including children themselves and the more than human world. Crucially, I also consider the potential for care to flow in multiple directions within these relationships. [ABSTRACT FROM AUTHOR]

ABSTRACT: Stress urinary incontinence (SUI) is a common complication after radical prostatectomy. Placement of artificial urinary sphincter (AUS) is the current gold-standard treatment. Slings are considered as a therapeutic option for stress urinary incontinence, while non-adjustable slings may be considered for mild incontinence. On the other hand, adjustable Transobturator Male System (ATOMS®) consists of a sling that has an adjustable cushion compressing the bulbar urethra ventrally to achieve dryness. ATOMS® achieves continence rates between 64 and 88%, with major complications in only around 3% of the cases. Its market value is around 40% less than AUS.The objective is to show a step-by-step ATOMS® surgery putting forward a standard technique in a challenging preoperative decision-making scenario. For this, we describe a case of a 70-year-old man with right hemiparesis and severe stress incontinence after an open radical prostatectomy, using 6 wet pads per day, who was able to straighten his penis for self-catheterization under supervision while unable to deactivate an AUS pump during a preoperative trial. He underwent an ATOMS® procedure. No intraoperative complications occurred and the patient was discharged 24 h postoperatively. After 3 months, the patient reported using 0 pads per day, and had only occasional small losses of urine with a full bladder. At the 6-month follow-up, he reported being very satisfied with the surgical results, still using 0 pads daily, with no leakages and no storage or voiding symptoms. In conclusion, ATOMS® male adjustable sling may be effective for male stress incontinence, even in severe cases when AUS is not suitable, making it a good alternative in this scenario. Surgical steps shown in this video might be of help to achieve better outcomes.

Copyright of Journal of Physical Medicine & Rehabilitation Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BackgroundThis meta-analysis aimed to compare the efficacy of artificial urinary sphincter (AUS) and slings for the treatment of moderate male stress urinary incontinence (SUI) based on existing data.MethodsThe study was in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. We searched the widely acknowledged database including PubMed, Embase (Ovid version), Medline (Ovid version), and Cochrane Central Register of Controlled Trials (till February 2021). Male patients with moderate SUI who underwent AUS or slings procedure over 18 years old and had been monitored with a mean follow-up time of at least 12 months were included. The primary outcome was success rate defined as daily pad use with 0–1 pad/d postoperatively. Articles with congruent outcomes were suitable for inclusion. The secondary outcome included complication rate of infection, erosion, acute urinary retention, and surgical revision.ResultsFive studies with a total of 509 patients (295 for slings and 214 for AUS) were recruited. The success rate was higher in AUS with an odds ratio (OR) = 0.57 (95% CI: 0.36–0.90). As for the overall complication rate, no significant difference was discovered between slings and AUS groups (OR = 1.06, 95% CI: 0.58–1.92, P = 0.86).ConclusionTo conclude, AUS was better than slings for moderate male SUI treatment according to daily pad use with an acceptable complication rate. The slings also had clinical value and were options when aging male patients were AUS naive and refused inserted mechanical devices. High-quality pieces of evidence are needed to confirm the efficacy of AUS and slings in moderate male SUI.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=271203, identifier: CRD42021271203.

Background and Objective: Stress urinary incontinence (SUI) is the involuntary loss of urine affecting 1-3% of the male population. To manage leakage, patients may try a plethora of penile clamps. and may even consider artificial urinary sphincters (AUS) or sling implantation. We aimed to synthesize the evolution of the modern clamp, AUS, and sling through a comprehensive patent search., Methods: Patents were found through the databases of United States Patent and Trademark Office (USPTO), GooglePatents, and the World Intellectual Property Office Patentscope, covering patents published through January 6, 2024., Key Content and Findings: We found 30 different patents (10 clamps, 13 AUS, and 7 slings), including the patents pertaining to the functionalities and design of five commercially available penile clamps, the American Medical System 800 (AMS 800), the InVance, AdVance, AdVance XP, and Virtue Slings. The clamps, spanning back to 1938 with Bard Cunningham's clamp, have undergone significant refinements. For example, inventors such as Edson S. Outwin and Juan F. V. Wiesner, have modified the location of the primary pressure point. Accessibility has also improved with inventors, such as Gerald French and John W. Timmons, fastening the clamps with Velcro ® , as opposed to the screw and ratchet catch closing mechanism, as in Cunningham's clamp. Similarly, the AUS has greatly evolved since Foley's 1947 "Artificial Sphincter and Method", which was the primary AUS precedent to Mark Polyak's AUS invention, which covered the essential elements and functionalities, such as the incorporation of a balloon reservoir, for the AMS 800. In addressing AUS limitations, inventors such as David W. Anderson and Louisa Thomas have created non-hydraulic AUSs. Likewise, the male sling has seen an evolution in the method of securement, from the use of fixed bone anchors in the InVance sling to the transobturator route used in the AdVance XP, avoiding bone complications. Additionally, innovation in sling adjustment of urethral compression allows for adjustable urethral elevation and distal compression respectively. Recent patents have claimed technological integration for clamps, AUS, and slings, especially concerning automation., Conclusions: Overall, patents have built upon the limitations of previous devices. However, there is still a need to innovate for increased clamp comfort and reduced reoperation rates for the AUS and sling., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tau.amegroups.com/article/view/10.21037/tau-24-115/coif). A.J.C. reports that he supplemented the patent search with one patent filed by him titled “Memory Shape Alloy”. The other authors have no conflicts of interest to declare., (2024 Translational Andrology and Urology. All rights reserved.)

Mobile containers are a keystone human innovation. Ethnographic data indicate that all human groups use containers such as bags, quivers and baskets, ensuring that individuals have important resources at the ready and are prepared for opportunities and threats before they materialize. Although there is speculation surrounding the invention of carrying devices, the current hard archaeological evidence only reaches back some 100,000 years. The dearth of ancient evidence may reflect not only taphonomic processes, but also a lack of attention to these devices. To begin investigating the origins of carrying devices we focus on exploring the basic cognitive processes involved in mobile container use and report an initial study on young children's understanding and deployment of such devices. We gave 3- to 7-year-old children (N = 106) the opportunity to spontaneously identify and use a basket to increase their own carrying capacity and thereby obtain more resources in the future. Performance improved linearly with age, as did the likelihood of recognizing that adults use mobile carrying devices to increase carrying capacity. We argue that the evolutionary and developmental origins of mobile containers reflect foundational cognitive processes that enable humans to think about their own limits and compensate for them.

Aims: The American Urological Association/Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction stress urinary incontinence (SUI) guidelines strongly recommend the midurethral sling (MUS) for the index female patient with SUI. While numerous studies report long‐term outcomes and complications for the retropubic MUS, these are largely absent for the transobturator MUS and are assessed in this study. Methods: This is an Institutional Review Board approved retrospective chart review of all women who underwent a transobturator MUS at a single institution from 2004 to 2010. Pre‐ and postoperative assessment included a cough–stress test, SEAPI assessment, and validated quality‐of‐life (QoL) questionnaires. SUI resolution was defined as no subjective or objective SUI, and no additional surgery to achieve stress continence. Results: Of 437 women, 305 (70%) had a minimum follow‐up of 48 months (mean 88; median 92). SUI was resolved in 69% of the entire cohort and 58% of the 78 women who had MUS only. The median time to SUI recurrence was 38 months in the entire cohort and 18 months in the MUS only group. Perioperative complications were infrequent and typically associated with concomitant surgery. A statistically significant improvement was observed in SEAPI scores and all QoL indices postoperatively. Conclusions: Long‐term resolution of SUI after the transobturator MUS is achieved by 69%, which is commensurate with success rates reported in the literature. Overall, women experience a significant improvement in their QoL after transobturator MUS; however, late recurrences and delayed sequelae may occur. Thus, long‐term follow‐up is warranted in this population. [ABSTRACT FROM AUTHOR]

Mobile carrying devices—slings, bags, boxes, containers, etc.—are a ubiquitous tool form among recent human communities. So ingrained are they to our present lifeways that the fundamental relationship between mobile containers and foresight is easily overlooked, resulting in their significance in the study of human cognitive development being largely unrecognized. Exactly when this game‐changing innovation appeared and became an essential component of the human toolkit is currently unknown. Taphonomic processes are obviously a significant factor in this situation; however, we argue that these devices have also not received the attention that they deserve from human evolution researchers. Here we discuss what the current archeological evidence is for Pleistocene‐aged mobile containers and outline the various lines of evidence that they provide for the origins and development of human cognitive and cultural behavior. [ABSTRACT FROM AUTHOR]

The adaptive immune response involves T cell differentiation and migration to sites of inflammation. T cell trafficking is initiated by rolling on inflamed endothelium. Tethers and slings, discovered in neutrophils, facilitate cell rolling at high shear stress. Here, we demonstrate that the ability to form tethers and slings during rolling is highly inducible in T helper 1 (Th1), Th17, and regulatory T (Treg) cells but less in Th2 cells. In vivo, endogenous Treg cells rolled stably in cremaster venules at physiological shear stress. Quantitative dynamic footprinting nanoscopy of Th1, Th17, and Treg cells uncovered the formation of multiple tethers per cell. Human Th1 cells also showed tethers and slings. RNA sequencing (RNA-seq) revealed the induction of cell migration and cytoskeletal genes in sling-forming cells. We conclude that differentiated CD4 T cells stabilize rolling by inducible tether and sling formation. These phenotypic changes approximate the adhesion phenotype of neutrophils and support CD4 T cell access to sites of inflammation.

Background: Congenital cardiovascular malformations (CCVM) may cause infrequently airway pathologies (AP) in children and are of prognostic and therapeutic relevance. While computed tomography (CT) is considered first-line imaging modality in many centres, we started using magnetic resonance imaging (MRI) more and more in the last years to detect CCVM and AP to avoid radiation in this patient group. Objective: The aim of this retrospective study was to determine and to compare the diagnostic accuracy of CT and MRI when used to detect CCVM and/or AP. Methods: All patients suspected to have CCVM and/or AP and examined either by CT or MRI between 2000 and 2013 in our hospital were included. Extension and type of CCVM, as well as their relationship to esophagus, trachea or bronchi were assessed and related to findings of tracheobronchoscopy, cardiac catheterization or surgery if available. Results: One hundred six patients (median [range] 4 years [2 days to 66 years]) were examined by CT (n = 27) or MRI (n = 79). In 78 patients (74%), CCVM and/or AP were found with either of the imaging methods. CCVM were found in 63 subjects. Forty-six of 63 subjects had both, CCVM and AP. The presence of CCVM was always detected correctly by CT or MRI, although both techniques had a weakness detecting atretic segments directly. AP (n = 61) were correctly diagnosed in all patients not intubated for artificial ventilation by CT (n = 17) and in all but 2 patients by MRI (39 out of 41). Conclusions: MRI is sensitive to detect CCVM associated with AP equally to CT without any radiation exposure. [ABSTRACT FROM AUTHOR]

Stress urinary incontinence is common in adult women. The use of introital or trans-labial ultrasound can help the surgeon (urologist or gynecologist) to better assess the type of incontinence the patient presents in order to guide him in the management of the patient. Often, surgical treatment with a mid-urethral sling (MSU) placement can be chosen in case of failure of non-invasive therapies (such as local estrogen or physical therapy) and if the clinical examination shows an urethral hypermobility. The use of ultrasound can help in this choice. Although rare, complications of MSU can sometimes cause disabling symptoms and be difficult to diagnose. Introital or trans-labial ltrasound can help diagnose them. The objective of this work was to describe the realization of ultrasound of stress urinary incontinence before or after the placement of a MSU, in order to make their realization easier for young surgeons which can use them in current practice., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Purpose: We sought to assess for impact on management trends in new patients presenting to our institution with stress urinary incontinence (SUI) following the release of the FDA Health Notification in July 2011 for vaginal mesh. Materials and methods: Chart analysis was performed on patients assigned a primary International Classification of Diseases (ICD-9) diagnosis code of 625.6 for SUI at initial consultation by two providers at our institution between June 1, 2010 and November 30, 2014. Rates of treatment and types of procedures performed were analyzed: urethral bulking, mesh sling, or pubovaginal sling. Results: A total of 333 new patients were identified with an increasing trend over time. One hundred and twenty-three patients underwent 153 procedures for stress incontinence. The mean proportion that had a procedure per six-month period was 37%, with decreasing proportions over time. Initially all procedures were midurethral mesh slings, with a decline at the time of and after the notification, and a temporary increase in bulking procedures. Subsequently, there was a rise again in sling placement, namely with an increase in pubovaginal slings. Of the 20 pubovaginal slings placed, 13 were placed in patients who had a prior anti-incontinence surgery (eight for sling failure, vaginal mesh, or fixed urethra, and two in patients with mesh extrusion/erosion). Seven were performed in patients who had never had prior surgery (two for very high-grade incontinence, two with urethral diverticulectomy, and three in patients who expressed concern about mesh). Conclusions: Although there were an increasing number of patients seen for management of SUI over time, there was a progressive decrease in the proportion of patients having anti-incontinence procedures after release of the FDA notification. There was an overall decrease in the use of mesh slings and an increase in bulking, and more notably, placement of pubovaginal slings. [ABSTRACT FROM AUTHOR]

Biomaterials integrate with the anatomy and provide support to the weakened area. They are generally synthetic, but natural substances are also used. These substances are being increasingly used in stress urinary incontinence. This article discusses the various biomaterials, minimally invasive techniques, and recent advances for the treatment of female stress urinary incontinence. In addition, their complications and subsequent management are explored.

OBJECTIVE: To evaluate our experience with tension-free transvaginal tape (TVT) placement for the management of stress urinary incontinence (SUI) in women who had previously undergone a failed midurethral synthetic sling (MUS) procedure. MATERIALS AND METHODS: Ten women underwent retropubic TVT insertion for continued or recurrent SUI following a prior MUS procedure. No attempt was made to remove the previously placed sling at the time of surgery. A retrospective chart review was performed to obtain perioperative and follow-up patient information. Post-operatively, each patient completed a mailed incontinence questionnaire to assess self-reported urinary continence outcomes. RESULTS: All 10 women were available for follow-up at a mean period of 16 months (range 6 to 33). Four of the 10 patients achieved complete continence, and another three patients reported significantly improved continence and quality of life. Three women stated that their continence did not improve. CONCLUSIONS: TVT placement may be a viable option for the management of women with persistent or recurrent SUI following an initial MUS procedure.

The surgical treatment of female stress urinary incontinence is a rapidly changing field. This review discusses recent advances in various injectables, minimally invasive techniques and open procedures. It particularly evaluates data from long-term outcome studies and describes peri- and postoperative complications from several procedures, such as bulking agents, tension-free vaginal tape and its modifications (TOT, TVT-O) as well as open and laparoscopic colposuspension.

It is paper has as objective to characterize microstructures the aluminium alloys that are used in the production of cases for slings and obtained by foundry processes. After having lathed and the resistance among the two elements (case-sling) they were pressed with the employment of prints. The magnetic noise Barkhausen allowed to determining the effect of the compression on the cable according to the alloy type. The obtained microstructure is characterized by the size of the grain and their morphology by an orientation of the phase alpha in the alloy Al-Si-Mg, structures dendrites with silicon very fine eutectic in the alloy Al-Si-Cu and it structures polyhydric or acicular for the alloy Al-Si-Mg, this behaviour and a hardness of 224.8 HV, allow to settle down that the alloy of Al-Mg presents better properties to be subjected to compression process. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Male stress urinary incontinence, which has radical prostatectomy as the main aetiology, affects about 39% of the adult male population and is one of the complications of radical prostatectomy with the greatest impact on the quality of life of patients. There are a wide range of treatments for stress urinary incontinence available to the urologist, ranging from conservative treatments to surgical treatments, from minimally invasive procedures to the implant of artificial sphincter prosthesis. The aim of this work is to define the state-of-the-art of surgical treatments for male stress urinary incontinence, analyzing the most recent studies in the literature and evaluating the available scientific evidence. [ABSTRACT FROM AUTHOR]

Tower cranes are popular and one of the predominant methods of material handling in high rise building construction. When there is a collapse of a tower crane in a city like New York, it is very visible, receives intense scrutiny, and becomes potentially political. This paper examines a 250-foot-tall tower crane collapse during the jumping phase of the crane to increase its height in support of a multi-level building construction. The author's investigation examines the "defective sling" claim as the primary cause of the crane collapse along with some key findings and opinions regarding the slings used to rig the collar tie to the tower section of the crane. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: We present our minimum 1-year results with a mesh spiral-sling procedure (MSSP) for managing refractory and disabling stress urinary incontinence (SUI) in women. Methods: Thirty-four women were treated with MSSP between 2007 and 2011. Six had incomplete data and were excluded from analysis. Study cohort comprised 21 women with refractory (mean number of previous surgeries 2.2; range 1-6) and seen with primary disabling SUI. All patients had marked intrinsic sphincter deficiency (ISD) with a Valsalva leak-point pressure (VLPP) <60 cm HO. Preoperative workup included assessing the impact of voiding symptoms using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), estimating the daily number of pads, and urodynamic studies. Preoperative and postoperative findings were compared using the Wilcoxon signed-rank test. Results: Intraoperative unilateral bladder-neck perforation occurred in two women during dorsal urethrolysis. With a mean follow-up of 26 months (range 12-48), SUI was cured in 71.4 % of patients. Distal urethral reconstruction with vaginal mucosal flaps was performed in two patients with short urethral length (<2.5 cm) due to recurrence of SUI 10 months after MSSP. Mean ICIQ-SF score decreased from 19.4 ± 3.6 preoperatively to 7.3 ± 2.8 postoperatively ( p = 0.001). Mean daily pad number decreased from 5.2 preoperatively to 1.2 postoperatively ( p = 0.02). Urethral or vaginal erosion was not observed in any case during follow-up. Conclusion: Using spiral slings may be a viable option in managing refractory and disabling SUI. [ABSTRACT FROM AUTHOR]

With increasing numbers of children participating in sports activities, orthopedic injuries are a very common presenting complaint. Emergency care providers should be familiar with the evaluation and management of common injuries in children and adolescent patients. This article will review the common uses of casts, splints, and braces in the emergency department. Different types of products, indications for their use, and other general considerations like fitting and cleaning will be discussed. [ABSTRACT FROM AUTHOR]

Purpose: The optimal approach for removing surgical materials that have penetrated the bladder is still debatable. We reviewed our initial experience with transvesical (percutaneous intraluminal access) laparoendoscopic single site surgery to treat such complications. We determined the safety, efficacy and morbidity of the procedure. Materials and Methods: In this case series study 9 women 24 to 63 years old were operated on from November 2009 to July 2012 due to bladder tape/mesh or surgical suture extrusion using the transvesical (percutaneous intraluminal access) laparoendoscopic single site surgery approach. We used the TriPort™ or TriPort+ single site access system, and a combination of straight and articulating or only standard laparoscopic instruments. A running V-Loc™ suture was placed as needed. In all cases followup included urine tests, abdominal ultrasound and cystoscopy. Results: Mean operative time was 59 minutes (range 35 to 105). Median postoperative hospital stay was 2.4 days. No blood loss or complications were observed except 1 conversion to open surgery because of a perivesical abscess. No extra port was added. No adverse events related to the method were observed during the mean 19-month followup. In 1 patient mesh extrusion recurred after 12 months of followup. Conclusions: We consider this technique to be an efficient, safe procedure and a valuable minimally invasive treatment option for foreign body removal from the bladder. However, further observations are needed to prove the validity of the method. [ABSTRACT FROM AUTHOR]

Abstract: Neutrophil recruitment to sites of inflammation involves neutrophil rolling along the inflamed endothelium in the presence of shear stress imposed by blood flow. Neutrophil rolling in post-capillary venules in vivo is primarily mediated by P-selectin on the endothelium binding to P-selectin glycoprotein ligand-1 (PSGL-1) constitutively expressed on neutrophils. Blood flow exerts a hydrodynamic drag on the rolling neutrophil which is partially or fully balanced by the adhesive forces generated in the P-selectin–PSGL-1 bonds. Rolling is the result of rapid formation and dissociation of P-selectin–PSGL-1 bonds at the center and rear of the rolling cell, respectively. Neutrophils roll stably on P-selectin in post-capillary venules in vivo and flow chambers in vitro at wall shear stresses greater than 6dyncm−2. However, the mechanisms that enable neutrophils to roll at such high shear stress are not completely understood. In vitro and in vivo studies have led to the discovery of four potential mechanisms, viz. cell flattening, catch bond behavior, membrane tethers, and slings. Rolling neutrophils undergo flattening at high shear stress, which not only increases the size of the cell footprint but also reduces the hydrodynamic drag experienced by the rolling cell. P-selectin–PSGL-1 bonds behave as catch bonds at small detachment forces and thus become stronger with increasing force. Neutrophils rolling at high shear stress form membrane tethers which can be longer than the cell diameter and promote the survival of P-selectin–PSGL-1 bonds. Finally, neutrophils rolling at high shear stress form ‘slings’, which act as cell autonomous adhesive substrates and support step-wise peeling. Tethers and slings act together and contribute to the forces balancing the hydrodynamic drag. How the synergy between the four mechanisms leads to stable rolling at high shear stress is an area that needs further investigation. [Copyright &y& Elsevier]

Abstract: The most commonly performed surgeries for stress urinary incontinence are full-length mesh mid- urethral slings. This chapter will review the indications, contraindications, and complications related to the use of these mesh midurethral slings. Unlike trans- vaginal mesh for prolapse, complications related to mesh midurethral slings are low and less than the complication rates with previous traditional continence surgeries. Given their safety profile and efficacy, full-length mesh midurethral slings have been rapidly adopted and remain the current standard of care for stress urinary incontinence surgical treatment. [ABSTRACT FROM AUTHOR]

Quantitative dynamic footprinting (qDF) allows visualization of the footprints of live leukocytes rolling on a selectin-coated cover glass. qDF works on the principle of total internal reflection fluorescence, which involves fluorescence excitation in a thin slice (∼200 nm) of the cell proximal to the cover glass while the rest of the cell remains dark. Dual color qDF (DqDF) is an advancement of qDF, which enables simultaneous visualization of two fluorochromes in the footprints of rolling leukocytes. When the fluorochrome is localized either in the cell cytoplasm or plasma membrane, the two-dimensional qDF image is used to create a three-dimensional rendition of the footprint topography. DqDF is a useful tool to study leukocyte adhesion under flow, and has recently been used to reveal mechanisms that enable neutrophils to roll at high shear stresses that prevail in venules during inflammation. [ABSTRACT FROM AUTHOR]

Poststroke shoulder pain is a common issue and can be caused by glenohumeral subluxation. This entity hinders function and quality of life and is caused by changes in tone and loss of fi ne control of the shoulder joints' supporting structures after a stroke. Current treatments are limited in number and effectiveness and have significant problems and limitations to their use. Furthermore, prior to percutaneous implantable neuromuscular electrical stimulation, there was no evidence for any treatment to provide relief for chronic hemiplegic shoulder pain from glenohumeral subluxation. This clinical review provides a comprehensive review of the anatomy, pathogenesis, clinical features, management, and clinical efficacy of current treatment modalities. [ABSTRACT FROM AUTHOR]

Copyright of Der Urologe A is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: We examined the clinical effectiveness of a single incision sling in women with stress urinary incontinence and obtained comparative perioperative and postoperative data on retropubic and transobturator slings. Materials and Methods: Women who underwent a cough stress test were treated with surgery using a single incision, retropubic or obturator sling (Gynecare® TVT SECUR™, TVT™ or TVT Obturator System, respectively) with the choice of sling based on surgeon preference. Objective cure was assessed by the standing cough stress test at 1 year. Subjective outcomes were assessed by the Incontinence Quality of Life Questionnaire and EQ-5D™. Perioperative data and return to normal activity were recorded. Results: Of the 1,398 women who underwent surgery there were postoperative data on 1,334, including 32.8%, 17.8% and 49.4% who received a tension free vaginal tape, obturator tension free vaginal tape and SECUR, respectively. After obturator tension free vaginal tape surgery fewer women had a positive cough stress test than after TVT and SECUR surgery (4 of 110 or 3.6% vs 24 of 187 or 12.8% and 59 of 374 or 15.8%, respectively). Incontinence Quality of Life Questionnaire effect size was 1.87, 1.42 and 1.56, respectively, indicating a large treatment effect. Using our Incontinence Quality of Life Questionnaire response definition 85.4%, 79.0% and 85.2% of the TVT, TVT outside-in obturator system and SECUR cohorts, respectively, were treatment responders (p = 0.11).The SECUR cohort had the shortest operative time, the lowest proportion of women who required an overnight stay and the most women who underwent surgery under local anesthesia. Median time to return to employment, housework, sex life and hobbies was most rapid for SECUR. Conclusion: This registry demonstrates the high effectiveness of all 3 approaches. The single incision sling appeared to have objective and subjective efficacy similar to that of the retropubic sling and it can be performed under local anesthesia in an office environment. [ABSTRACT FROM AUTHOR]

Biomaterials integrate with the anatomy and provide support to the weakened area. They are generally synthetic, but natural substances are also used. These substances are being increasingly used in stress urinary incontinence. This article discusses the various biomaterials, minimally invasive techniques, and recent advances for the treatment of female stress urinary incontinence. In addition, their complications and subsequent management are explored. [ABSTRACT FROM AUTHOR]

Abstract: The range of stones cast by slings used in the past is debated. In the Central Andes, slings are asserted to be important weapons of prehispanic war, and have been recovered archaeologically. Rolled river cobbles and stones presumed to be slingstones found at fortified hilltop archaeological sites are presented as evidence that slings were used at these fortifications. Yet sling use has not been adequately tested at hillforts. Experiments conducted in Europe by a novice slinger have attempted to illuminate the range of sling cast stones at ancient hillforts. Data acquired from native slingers is necessary to more accurately assess distances achieved by projectiles launched by slings. We present data from sling experiments carried out in Puno, Perú among Quechua-speaking herders who are experienced slingers. The results demonstrate that a prior model of the maximum theoretical distance of sling cast stones underestimates their range. Results also show significant differences in the use of slings by men and women, and by different age groups. These new data permit a better approximation of warfare that has bearing on our interpretation of fortified sites. [Copyright &y& Elsevier]

Objective: To evaluate the efficacy of white reflecting material (slings) hung from the sides of compact fluorescent lamp (CFL) phototherapy equipment in reducing the duration of phototherapy in healthy term neonates with non-hemolytic jaundice. Design: Randomized controlled trial. Setting: Postnatal ward of a tertiary level neonatal unit. Participants and intervention: Healthy term neonates with non-hemolytic jaundice between 24 hours and 10 days of age were randomly assigned to receive single surface phototherapy with (n=42) or without slings (n=42). Outcome measure: Duration of phototherapy in hours (h) and the requirement of exchange transfusion. Results: Birthweight (2790±352 vs. 2923±330 g), gestation (38±1.3 vs. 37±1.0 wk) and initial serum total bilirubin (STB) (16.6±2.4 vs. 16.1±2.2 mg/dL) were comparable between the two groups. There was no significant difference in the duration of phototherapy (mean±SD) between the Sling (23.3±12.9 h) and No sling (24.9±15.4h) groups (P=0.6). The irradiance of phototherapy equipment (microwatt/cm2, mean±SD) was higher in Sling group compared to No sling group (195.8± 24.2 versus 179.7±27.7, P=0.01). There was a trend towards a higher rate of fall of serum total bilirubin (mg/dL, mean±SD) in the Sling group (0.23±0.49) compared to No sling group (0.03±0.47) (P=0.06). Conclusion: Though hanging of white reflective sling on sides of CFL phototherapy equipment resulted in marginal increase in irradiance, it did not decrease the duration of phototherapy. [ABSTRACT FROM AUTHOR]

OBJECTIVE To report an increase in the referral of patients with disabling complications after the failure of conservative therapy, their presentation, final surgical management and clinical outcome, following the use of non-autologous slings (NAS), currently the primary surgical procedure for managing stress urinary incontinence (SUI) in women. PATIENT AND METHODS Thirty-eight patients (mean age 64 years) required surgical management for disabling complications after placing a NAS for SUI. Sling types were synthetic (25), xenografts (six) and allografts (four). Twenty (53%) patients presented with bladder outlet obstruction, 13 (34%) with sling erosion, three (8%) with worsened SUI, and two (5%) with unobstructive severe urgency and frequency. RESULTS The sling was dissected and incised with no complication in 19 of 20 patients. One had a posterior urethral defect during sling dissection. Twelve patients (60%) acquired normal voiding and were continent. Among the 13 patients who had the sling dismantled and urethrolysis, two had recurrent or persistent SUI, two de-novo urgency/frequency and one developed osteitis pubis. Three patients with disabling SUI received a pubovaginal sling placed proximal to the bladder neck, and had an overall improvement in their urinary control with no retention. Two unobstructed patients with urgency and frequency did not improve with anticholinergic medication and pelvic floor therapy, and are now candidates for botulinum toxin injection or neurostimulation. CONCLUSIONS The complication rate with periurethral NAS for managing SUI in females is substantial. Patients with refractory urgency/frequency after the sling need a complete evaluation with cystoscopy and video-urodynamics. Obstruction and erosion are the commonest problems and require surgical correction. [ABSTRACT FROM AUTHOR]

Therapists may often work with, or provide therapy for clients who are unable to transfer independently Careful assessment of needs, abilities and environment may lead a therapist to advise on using hoisting equipment with these clients. The range of both mobile and ceiling hoist is considerable, as is the choice of slings to use with them. This article will provide a guide to the main types of hoists available and their suitability for different users. Examples of products are given and components and features of note are described. [ABSTRACT FROM AUTHOR]

The regular transfer and rifting of patients can place added stresses on carers. The high incidence of injury among care staff has resulted in an increase in the use of mechanical devices, designed to reduce musculoskeletal strain. This article looks at the various mobility aids, options and hoists available to aid carers involved in the essential task of moving and handling people. Contact details for the manufacturers and suppliers of such mechanical aids will be provided. [ABSTRACT FROM AUTHOR]

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Buying suitable equipment for moving and handling people is essential, as manual rifting can place a severe strain on those assisting and put them at risk of developing a work-related musculoskeletal injury. This article offers information on the different types of mobility aids and hoists available and provides contact details for the manufacturers and suppliers of such equipment. It aims to provide a useful guide for therapists and carers involved in handling people, and for those who are able to independently transfer with the use of the right mechanical aid. [ABSTRACT FROM AUTHOR]