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INTRODUCTION: The aim of this systematic review is to compare the vaginal erosion rates in different synthetic materials used in suburethral slings in Tension Free Vaginal Tape (TVT-O /TOT) procedures in management of female stress urinary incontinence. METHODS: PRISMA 2009 framework was adopted for study design. Scholarly literature search was done using MEDLINE, EMBASE, the Cochrane Library and Clinical Trials.gov using selected keywords. Five articles fulfilled the inclusion and exclusion criteria. Our main outcome of interest is to review the ideal properties of the suburethral sling, procedure of insertion and post-surgical complication following the sling insertion primarily vaginal erosion. Results were compared using one way-ANOVA test and independent T- test. RESULTS: Total of 1725 subjects were available for analysis in the five studies. Monofilament polypropylene constituted 92.5% of the total sample size from one study alone. Polyester (n= 16/51) causes higher incidence rate of vaginal erosion compared to monofilament polypropylene (31.4 vs., 4.7; p = 0.01). There was no difference in the vaginal erosion rate between monofilament polypropylene and multifilament polypropylene (4.7 vs, 14.1; p=0.055) as well as between multifilament polypropylene and polyester (14.1 vs, 31.4; p=0.068). Although there was a marginally lower rate of vaginal erosion in TVT-O over TVT, the difference was not significant. (5.6 vs., 6.4, p=0.468). Common presentations of vaginal erosion were vaginal discharge, perineal pain and dyspareunia. CONCLUSION: Given the limited sample size, polyester sling material appears to cause higher rates of vaginal erosion. No difference in erosion rate was seen between TVT and TVT-O.
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Slings Suburetrais/efeitos adversos , Incontinência Urinária por Estresse/cirurgia , Doenças Vaginais/etiologia , Feminino , Humanos , Incidência , Doenças Vaginais/epidemiologiaRESUMO
Objective:To evaluate application value of the dynamic adenoidal/hypertrophy (A/N) ratio in children with OSAHS by analyzing the correlation between the A/N ratio at the different respiratory phases and the index of polysomnography.Method:Fifty-one childrens, with simple hypertrophic adenoids, were diagnosed as OSAHS. Magnetic resonance imaging (MRI) with respiratory gating technology were used to scan the upper airway of children during sleep at the early, middle and end phases of respiratory cycle, and measure adenoidal hypertrophy ratio in different respiratory phases. The correlation analysis was performed between the A/N ratio in different respiratory phases and the index of polysomnography (AHI and LaSO2). Finally, via ROC curve and Kappa analysis, the critical value and diagnosis accordance rate of A/N ratio in illness severity evaluation of children with OSAHS were confirmed.Result:At the 6 respiratory phases, the A/N ratios showed significantly positive correlations with AHI (All P< 0.01). There was a highest coefficient between the end-expiratory A/N ratio and AHI (r= 0.559 4). In addition, the optimal cut-off point of A/N ratio between slight-moderate and severe OSAHS was 0.834. The diagnosis accuracies of the end-expiratory A/N ratio in severe and slight moderate OSAHS were 81% and 84%, respectively.Conclusion:MRI with respiratory gating technology obtaining dynamic A/N ratio might be an important method of imaging diagnosis of children OSAHS, and the end expiratory A/N ratio is expected to become a classification index of slight moderate and severe children OSAHS.
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Tonsila Faríngea/patologia , Apneia Obstrutiva do Sono/patologia , Criança , Humanos , Hipertrofia , Polissonografia , SonoRESUMO
BACKGROUND: Gefitinib was demonstrated to be synergistic with cisplatin and radiotherapy (RT) in in vitro studies. Biomarkers predictive of response to gefitinib in squamous cell head and neck cancer is still lacking. METHODS: Thirty-one patients with locally advanced and easily accessible primary tumor sites for biopsies were recruited. Gefitinib was started 3 weeks before the start of cisplatin/concurrent radiotherapy (CTRT) and continued during the CTRT phase and thereafter for 4 months as consolidation phase. Two baselines and a repeat tumor sample were taken after 2 weeks of gefitinib alone to study its impact on tumor gene expression. Epidermal growth factor receptor (EGFR) protein expression, FISH and mutational status, and matrix metallopeptidase 11 (MMP11) protein expression were correlated with response and survival outcome. RESULTS: The overall response rate to gefitinib alone was 9.7%. The survival outcome is as follows: median disease free 1.3 years, median survival time 2.4 years, 3-year disease free 42.9%, and 3-year overall survival 48.4%. EGFR FISH, protein expression, and mutational status did not predict for response nor survival outcome of patients. Although MMP11 overexpression did not predict for response, it predicted significantly for a poorer survival outcome. CONCLUSIONS: Gefitinib can be combined safely with cisplatin/RT. More studies are needed to uncover predictive biomarkers of benefit to gefitinib.
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Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biomarcadores Tumorais/metabolismo , Quimiorradioterapia , Receptores ErbB/metabolismo , Neoplasias de Cabeça e Pescoço/terapia , Adulto , Idoso , Biomarcadores Tumorais/genética , Cisplatino/administração & dosagem , Análise Mutacional de DNA , Intervalo Livre de Doença , Receptores ErbB/genética , Feminino , Gefitinibe , Expressão Gênica , Perfilação da Expressão Gênica , Neoplasias de Cabeça e Pescoço/metabolismo , Neoplasias de Cabeça e Pescoço/mortalidade , Humanos , Hibridização in Situ Fluorescente , Masculino , Metaloproteinase 11 da Matriz/genética , Metaloproteinase 11 da Matriz/metabolismo , Pessoa de Meia-Idade , Análise de Sequência com Séries de Oligonucleotídeos , Quinazolinas/administração & dosagem , Fatores de Risco , Fumar , Resultado do TratamentoRESUMO
Micro RNAs are small non-coding RNAs, which regulate fundamental cellular and developmental processes at the transcriptional and translational level. In breast cancer, miR-145 expression is downregulated compared with healthy control tissue. As several predicted targets of miR-145 potentially regulate cell motility, we aimed at investigating a potential role for miR-145 in breast cancer cell motility and invasiveness. Assisted by Affymetrix array technology, we demonstrate that overexpression of miR-145 in MDA-MB-231, MCF-7, MDA-MB-468 and SK-BR-3 breast cancer cells and in Ishikawa endometrial carcinoma cells leads to a downregulation of the cell-cell adhesion protein JAM-A and of the actin bundling protein fascin. Moreover, podocalyxin and Serpin E1 mRNA levels were downregulated, and gamma-actin, transgelin and MYL9 were upregulated upon miR-145 overexpression. These miR-145-dependent expression changes drastically decreased cancer cell motility, as revealed by time-lapse video microscopy, scratch wound closure assays and matrigel invasion assays. Immunofluorescence microscopy demonstrated restructuring of the actin cytoskeleton and a change in cell morphology by miR-145 overexpression, resulting in a more cortical actin distribution, and reduced actin stress fiber and filopodia formation. Nuclear rotation was observed in 10% of the pre-miR-145 transfected MDA-MB-231 cells, accompanied by a reduction of perinuclear actin. Luciferase activation assays confirmed direct miR-145-dependent regulation of the 3'UTR of JAM-A, whereas siRNA-mediated knockdown of JAM-A expression resulted in decreased motility and invasiveness of MDA-MB-231 and MCF-7 breast cancer cells. Our data identify JAM-A and fascin as novel targets of miR-145, firmly establishing a role for miR-145 in modulating breast cancer cell motility. Our data provide a rationale for future miR-145-targeted approaches of antimetastatic cancer therapy.
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Neoplasias da Mama/patologia , Proteínas de Transporte/metabolismo , Moléculas de Adesão Celular/metabolismo , Movimento Celular , Imunoglobulinas/metabolismo , MicroRNAs/metabolismo , Proteínas dos Microfilamentos/metabolismo , Actinas/análise , Neoplasias da Mama/metabolismo , Linhagem Celular Tumoral , Citoesqueleto , Regulação para Baixo , Feminino , Humanos , Proteínas dos Microfilamentos/análise , Proteínas Musculares/análise , Invasividade Neoplásica , Inibidor 1 de Ativador de Plasminogênio/análise , Receptores de Superfície Celular , Sialoglicoproteínas/análiseRESUMO
BACKGROUND: Clonidine has been shown to reduce perioperative circulatory instability. This postoperative analgesic effect of clonidine was also known in previous studies. The aim of the study was to investigate the clinical efficiency of oral clonidine premedication in anesthesia and analgesia in patients undergoing laparoscopic cholecystectomy. METHODS: Thirty-two patients scheduled for elective laparoscopic cholecystectomy were recruited for a prospective, randomized, double-blinded comparative study. They were allotted randomly to two groups: placebo or clonidine. Patients in the placebo group (n = 16) were premedicated with oral antacid (alugel hydroxide 300 mg), while those in the clonidine group (n = 16) were premedicated with oral clonidine 150 micro g before anesthesia. Analysis of heart rate variability was used to quantify the control of heart rate at baseline, and during the pneumoperitoneum and recovery periods. Time of the first request for postoperative analgesic and cumulative analgesic requirements in 24 h were recorded. Data are expressed as mean +/- SD. RESULTS: Heart rate variability was reduced in the pneumoperitoneum and postoperative period in the placebo group. Clonidine resulted in a greater perioperative (pneumoperitoneum period) power at all frequency ranges compared with placebo (671.5 +/- 470.5 vs. 55.1 +/- 51.6 ms2/Hz for total power variability, 170.1 +/- 94.4 vs. 16.9 +/- 21.1 ms2/Hz for low-frequency variability and 206.1 +/- 95.7 vs. 16.4 +/- 15.1 ms2/Hz for high-frequency variability, P < 0.05). The postoperative analgesic requirement was less (2.3 +/- 0.8 vs. 3.2 +/- 1.2 dose, P < 0.05) in comparison with the placebo group. CONCLUSION: Clonidine preserves heart rate control in pneumoperitoneum and recovery periods. Oral clonidine premedication also reduces the requirement for postoperative analgesia.
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Agonistas alfa-Adrenérgicos , Anestesia Geral , Colecistectomia Laparoscópica , Clonidina , Frequência Cardíaca/efeitos dos fármacos , Frequência Cardíaca/fisiologia , Medicação Pré-Anestésica , Adulto , Método Duplo-Cego , Eletrocardiografia/efeitos dos fármacos , Feminino , Humanos , Masculino , Medição da Dor , Dor Pós-Operatória/prevenção & controle , Pneumoperitônio ArtificialRESUMO
A photoacoustic spectrum of a smear of whole blood clearly shows all of the details of the haem absorption in an optical spectrum and good optical absorption data without a data extraction procedure. There are three peaks; gamma (420 nm), beta (550 nm), and alpha (585 nm) in the band 350-700 nm. For iron-deficiency anaemia the peak/peak ratios, ratios of the value of peak gamma to that of the peak beta and peak alpha, and the integral/integral ratios, ratios of the value of the integral under the peak gamma to that under the peak beta, peak alpha, peak beta and peak alpha are closely related to the variation of haemoglobin concentration. Linear relationships among the ratios and the Hb concentration are found. These ratios could be a good index of haem synthesis disturbance.