Mid-urethral sling and the mystery of pain Digesu, G. A.; Bhide, Alka A.; Swift, Steven
International Urogynecology Journal,
04/2022, Letnik:
33, Številka:
4
Journal Article
Vasa Praevia: Diagnosis and Management Jauniaux, ERM; Alfirevic, Z; Bhide, AG ...
BJOG,
January 2019, 20190101, Letnik:
126, Številka:
1
Journal Article
Recenzirano
Odprti dostop
This is the fourth edition of this guideline. The first, published in 2001, was entitled Placenta Praevia: Diagnosis and Management; the second, published in 2005, was entitled Placenta Praevia and ...Placenta Praevia Accreta: Diagnosis and Management; and the third, published in 2011, was entitled Placenta Praevia, Placenta Praevia Accreta and Vasa Praevia: Diagnosis and Management.The management and diagnosis of placenta praevia and placenta accreta is addressed in Green‐top Guideline No. 27a.
This is the fourth edition of this guideline. The first, published in 2001, was entitled Placenta Praevia: Diagnosis and Management; the second, published in 2005, was entitled Placenta Praevia and ...Placenta Praevia Accreta: Diagnosis and Management; and the third, published in 2011, was entitled Placenta Praevia, Placenta Praevia Accreta and Vasa Praevia: Diagnosis and Management.The management and diagnosis of vasa praevia is addressed in Green‐top Guideline No. 27b.
To present the ICS Teaching Module on Videourodynamics (VUD) and the information as a best practice report.
This teaching module was developed by the (International Continence Society) ICS ...Urodynamics Committee to assist ICS members in their clinical practice. A detailed literature search on studies and guidelines published on the clinical role of VUD as well as expert opinions have been considered. A slideshow on VUD has been developed and will be presented to the members of the ICS Urodynamics Committee and will be made available to the ICS membership on the ICS website.
The scientific evidence on the indications, recommended techniques and interpretation of VUD in patients presenting with lower urinary tract symptoms has been summarised. Troubleshooting and optimisation of the imaging as also been described to minimise the radiation exposure to both patient and healthcare professionals.
The scientific evidence on the clinical role, techniques and the indications for VUD is sparse with varying clinical expert opinion. The ICS Urodynamics Committee recommends its use as a second line diagnostic tool for a thorough visualisation of the lower urinary tract anatomy and real time function. This manuscript summarises the evidence and provides practice recommendations on VUD for teaching purposes in the framework of an ICS teaching module.
Bladder contractility is altered by high doses of anticholinergics. It is unknown if anticholinergics at doses used for treating overactive bladder alter bladder contractility. This is a randomised, ...double-blind, placebo controlled cross-over multicentre study with two 2-week treatment periods. Patients with a previous diagnosis of detrusor overactivity and reporting urinary frequency of at least seven times a day, one or more episodes of urge urinary incontinence per week and at least seven episodes of urgency per week were included.
After a two-week washout period, subjects were randomised to receive propiverine 20mg od, propiverine 15 mg tds, oxybutynin 5mg tds or placebo for 2 weeks. After a second washout period, they were randomised to receive 2 weeks of another treatment not previously used. Ambulatory urodynamic monitoring was performed according to ICS standards for 4 h, using a standardised protocol before and after treatment. The bladder contractility index (BCI) was given by the formula: BCI = PdetQ max+ 5Qmax. The main outcome measure was the average BCI for the first 2 voids for each of the treatment.
77 participants were recruited. The average BCI for the first two voids was 143 (range 24-314). The BCI was not statistically different before and after antimuscarinic therapy or placebo although there were reductions in urinary frequency and urgency over placebo indicating efficacy over placebo in the treatment of detrusor overactivity.
The bladder contractility index did not change significantly in response to antimuscarinic therapy despite a therapeutic effect. This suggests efficacy is mediated by an effect on another system such as sensory rather than motor function.
Use of tobacco products is injurious to health in men and women. However, tobacco use by pregnant women receives greater scrutiny because it can also compromise the health of future generations. More ...men smoke cigarettes than women. Yet the impact of nicotine use by men upon their descendants has not been as widely scrutinized. We exposed male C57BL/6 mice to nicotine (200 μg/mL in drinking water) for 12 wk and bred the mice with drug-naïve females to produce the F1 generation. Male and female F1 mice were bred with drug-naïve partners to produce the F2 generation. We analyzed spontaneous locomotor activity, working memory, attention, and reversal learning in male and female F1 and F2 mice. Both male and female F1 mice derived from the nicotine-exposed males showed significant increases in spontaneous locomotor activity and significant deficits in reversal learning. The male F1 mice also showed significant deficits in attention, brain monoamine content, and dopamine receptor mRNA expression. Examination of the F2 generation showed that male F2 mice derived from paternally nicotine-exposed female F1 mice had significant deficits in reversal learning. Analysis of epigenetic changes in the spermatozoa of the nicotine-exposed male founders (F0) showed significant changes in global DNA methylation and DNA methylation at promoter regions of the dopamine D2 receptor gene. Our findings show that nicotine exposure of male mice produces behavioral changes in multiple generations of descendants. Nicotine-induced changes in spermatozoal DNA methylation are a plausible mechanism for the transgenerational transmission of the phenotypes. These findings underscore the need to enlarge the current focus of research and public policy targeting nicotine exposure of pregnant mothers by a more equitable focus on nicotine exposure of the mother and the father.
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