Translabial ultrasound evaluation after tension-free transobturator tape technique: Outcomes based on the tape's position.

OBJECTIVE: The purpose of this study was to evaluate the feasibility and accuracy of postoperative translabial ultrasound to assess the position of the tape implanted with the tension-free transobturator tape technique. METHODS: We enrolled women with clinically and urodynamically proven type I or II stress urinary incontinence who were referred for transobturator tape treatment. RESULTS: A total of 50 women underwent a transobturator tape procedure and were included in the analysis. We divided the patients into two study groups (group A and group B), characterized by normal and obstructed flow at least 30 days after the surgical procedure visit, respectively. We performed a translabial ultrasound evaluation to assess the suburethral localization of the sling. On the longitudinal scan, the distance between the bladder neck and the suburethral sling was >10 mm in all patients in group A (16.7 ± 1.6). On the contrary, the values in group B were ≤10 mm (5.3 ± 4.8). CONCLUSION: Our findings highlight the role of a skilled sonographic operator performing translabial ultrasound as a first-line method for evaluating postoperative transobturator tape procedure and sling positioning. Moreover, translabial ultrasound could be helpful to determine a "cutoff" of the bladder neck to sling distance, as this is related to the onset of the obstruction.

Vitamin D and Male Reproduction: Updated Evidence Based on Literature Review.

The purpose of this study was to clarify the vitamin D (VD) effect on male infertility. Our research was conducted using the following electronic databases: MEDLINE, Embase, Web of Science, Scopus, ClinicalTrials.gov, and Cochrane Library. Selection criteria included all published randomized controlled trials and non-randomized studies, focusing on vitamin D and male reproductive function. The results showed that the effects of VD on male reproduction has been investigated in three different topics: the molecular mechanism underlying VD effects on semen quality (SQ), the relationship between VD levels and SQ, and the effect of VD supplementation on SQ. Results supported the hypothesis of a relevant interrelation between concentrations of male VD and semen parameters, with particular reference to sperm motility; on the contrary, evidence on the effect of VD on male sex steroid hormone levels was inconclusive. The results of this review hold up the thesis that VD plays a role in male reproduction. Most of the data highlighted a positive effect on semen quality, particularly in sperm motility, both in fertile and infertile men. Additional dedicated studies are required to elucidate the still controversial aspects of this topic.

Enabling Robust Radar-Based Localization and Vital Signs Monitoring in Multipath Propagation Environments.

OBJECTIVE: Over the last two decades, radar-based contactless monitoring of vital signs (heartbeat and respiration rate) has raised increasing interest as an emerging and added value to health care. However, until now, the flaws caused by indoor multipath propagation formed a fundamental hurdle for the adoption of such technology in practical healthcare applications where reliability and robustness are crucial. Multipath reflections, originated from one person, combine with the direct signals and multipaths of other people and stationary objects, thus jeopardizing individual vital signs extraction and localization. This work focuses on tackling indoor multipath propagation. METHODS: We describe a methodology, based on accurate models of the indoor multipaths and of the radar signals, that enables separating the undesired multipaths from desired signals of multiple individuals, removing a key obstacle to real-world contactless vital signs monitoring and localization. RESULTS: We also demonstrated it by accurately measure individual heart rates, respiration rates, and absolute distances (range information) of paired volunteers in a challenging real-world office setting. CONCLUSION: The approach, validated using a frequency-modulated continuous wave (FMCW) radar, was shown to function in an indoor environment where radar signals are severely affected by multipath reflections. SIGNIFICANCE: Practical applications arise for health care, assisted living, geriatric and quarantine medicine, rescue and security purposes.

Nightingale V2: Low-power Compact-sized Multi-Sensor Platform for Wearable Health Monitoring.

Nightingale V2, a new wearable multi-sensor platform, is introduced in this paper. It can measure various bio-signals including ECG, BioZ, PPG, motion and heart sounds simultaneously at very low power consumption. Patient safety with optical and electrical sensors were carefully investigated. Preliminary data collection results as well as the sensor characterization results reveal that the Nightingale V2 would be suitable for wearable health monitoring applications.

Is intravesical instillation of hyaluronic acid and chondroitin sulfate useful in preventing recurrent bacterial cystitis? A multicenter case control analysis.

OBJECTIVE: Urinary tract infections (UTIs) are common in the female population and, over a lifetime, about half of women have at least one episode of UTI requiring antibiotic therapy. The aim of the current study was to compare two different strategies for preventing recurrent bacterial cystitis: intravesical instillation of hyaluronic acid (HA) plus chondroitin sulfate (CS), and antibiotic prophylaxis with sulfamethoxazole plus trimethoprim. MATERIALS AND METHODS: This was a retrospective review of two different cohorts of women affected by recurrent bacterial cystitis. Cases (experimental group) were women who received intravesical instillations of a sterile solution of high concentration of HA + CS in 50 mL water with calcium chloride every week during the 1(st) month and then once monthly for 4 months. The control group included women who received traditional therapy for recurrent cystitis based on daily antibiotic prophylaxis using sulfamethoxazole 200 mg plus trimethoprim 40 mg for 6 weeks. RESULTS: Ninety-eight and 76 patients were treated with experimental and control treatments, respectively. At 12 months after treatment, 69 and 109 UTIs were detected in the experimental and control groups, respectively. The proportion of patients free from UTIs was significantly higher in the experimental than in the control group (36.7% vs. 21.0%; p = 0.03). Experimental treatment was well tolerated and none of the patients stopped it. CONCLUSION: The intravesical instillation of HA + CS is more effective than long-term antibiotic prophylaxis for preventing recurrent bacterial cystitis.

Use of trans-labial ultrasound in the diagnosis of female urethral diverticula: A diagnostic option to be strongly considered.

AIM: To demonstrate effectiveness of trans-labial ultrasound (TL-US) in the evaluation of female urethral diverticula (UD). METHODS: In the study period, 20 UD were diagnosed and treated. All data on demographic characteristics, presenting symptoms, physical examination findings, diagnostic and operative procedures, were considered. Patients were referred to TL-US for diverticular evaluation, using a 2D 7.5-MHz endfire probe. For each UD, size, complexity, echogenicity content, and presence of diverticular neck were considered. Follow-up controls were carried out at 1, 6 and 12 months after surgery, to evaluate outcome and need for further intervention. RESULTS: Mean patient age was 46 years (range, 35-55 years) and mean parity was 1 (range, 0-3). The principal symptoms associated with the diverticular mass was dysuria (25%). In all evaluated cases, UD was single (simple in 15 cases and complex in 5). The mean size of the diverticula was 28 mm (range, 8-50 mm). Nineteen diverticula were diagnosed on TL-US, and urethrocystoscopy was carried out for confirmation. Treatment consisted of diverticulectomy. At 1-, 6- and 12-month follow up after surgery, TL-US showed no recurrence of UD in any of the patients. CONCLUSIONS: TL-US is a valid, mini-invasive and reproducible method to diagnose UD.

[Acute abdomen by anisakiasis and globalization]. / Addome acuto da anisakiasi e globalizzazione.

OBJECTIVES: The AA report a case of a patient with acute abdomen caused by intestinal Anisakiasis, a fish-transmitted infection that results from ingestion of raw or improperly cooked fish contaminated by live larvae of Anisakis Simplex, a round worm from the order of Ascaridida. MATERIAL AND METHODS: A 33-year-old man, presented to the emergency room with severe upper abdominal pain, nausea and vomiting, without fever. The patient revealed that he had eaten pickled anchovies a few days before. RESULTS: On the exploratory laparotomy an edematous and stenotic tract of 15 cm of jejunum was found, and a segmental resection was performed. Histologically, the resected jejunum showed a conspicuous and diffuse inflammatory infiltration, predominantly made up of eosinophil granulocytes, numerous mucosal erosions and the presence in the submucosa of sections of parasites which were identified as Anisakis Simplex larvae. DISCUSSION: The ingestion of fish contaminated by Anisakis larva is often followed by the appearance of systemic or gastrointestinal symptoms due respectively to the direct larva localization and the allergic reaction to some parasite components. Diagnosis is made frequently difficult by clinical manifestations that could mimic symptoms of other diseases more common in Italy. CONCLUSIONS: Globalization has made Anisakiasis a more and more frequent disease worldwide, as increased mixture of different cultures and international travelling has allowed the spreading of risky feeding habits. That's why Anisakiasis should be considered in differential diagnosis of intestinal obstruction in patients with positive anamnesis for suspiciously cooked or conserved seafood eating.

[Intestinal occlusion by ileal carcinoid]. / Occlusione intestinale da carcinoide ileale.

OBJECTIVE: Ileal carcinoids diagnosis, generally, is late because patients have aspecific symptoms. MATERIAL OF STUDY: The two cases described presented for a long time peristaltic abdominal pains, vomit episodes and reduction of weight, with negativity of radiologic reports. The first diagnosis was adhesion syndrome produced by previous abdominal surgical operation; just emergency surgical operation executed for intestinal occlusion noticed carcinoids, located into the distal ileum, which infiltrated muscular wall and interested regional lymph nodes. RESULTS: Ileal carcinoids diagnosis, generally, takes place during emergency laparotomy for intestinal occlusion which is the most frequent complication of this tumor. At the moment of diagnosis the tumor presents an advanced stage of evolution. DISCUSSION: Ileal carcinoids behave malignant because of their biologic aggressiveness and because of at the moment of diagnosis they present an advanced stage of evolution. Symptomatology is aspecific, just a carcinoid syndrome could addressed clinical diagnosis, but this is an rare event and however it needs of liver metastases to appear. In case there is an clinical suspect scintigraphy with Octreoscan can locate tumor and metastases. CONCLUSIONS: Surgical treatment of ileal carcinoids is based on large resections en bloc. Ileal carcinoids survival to 5 years is estimated inferior to 60% after surgical treatment.