Antioxidative, Anti-Inflammatory, Anti-Obesogenic, and Antidiabetic Properties of Tea Polyphenols-The Positive Impact of Regular Tea Consumption as an Element of Prophylaxis and Pharmacotherapy Support in Endometrial Cancer.

Endometrial cancer (EC) is second only to cervical carcinoma among the most commonly diagnosed malignant tumours of the female reproductive system. The available literature provides evidence for the involvement of 32 genes in the hereditary incidence of EC. The physiological markers of EC and coexisting diet-dependent maladies include antioxidative system disorders but also progressing inflammation; hence, the main forms of prophylaxis and pharmacotherapy ought to include a diet rich in substances aiding the organism's response to this type of disorder, with a particular focus on ones suitable for lifelong consumption. Tea polyphenols satisfy those requirements due to their proven antioxidative, anti-inflammatory, anti-obesogenic, and antidiabetic properties. Practitioners ought to consider promoting tea consumption among individuals genetically predisposed for EC, particularly given its low cost, accessibility, confirmed health benefits, and above all, suitability for long-term consumption regardless of the patient's age. The aim of this paper is to analyse the potential usability of tea as an element of prophylaxis and pharmacotherapy support in EC patients. The analysis is based on information available from worldwide literature published in the last 15 years.

Predictive value of classification systems and single fistula-related factors in surgical management of vesicovaginal fistula.

AIMS: The aim of this study was to find the most clinically useful vesicovaginal fistula (VVF) classification system or single fistula-related factor, which would be helpful in determining the most proper management leading to successful treatment. METHODS: Between 2018 and 2020, 30 patients were diagnosed with VVF and underwent the Latzko procedure. Nineteen patients, after previously failed surgery, were injected with platelet-rich-plasma (PRP) before a final attempt to close VVF. Patients with primary VVF were included into the surgery only group and patients with secondary VVF were included into PRP and surgery group. Each patient was classified according to 13 different classification systems. RESULTS: Statistical evaluation revealed some significant differences between the patients who required PRP injection and repeated surgery, compared with patients who were successfully treated at first surgery but only with Lawson, Waaldijk, Arrowsmith, and Tafesse classifications. Patients who succeded with the fistula closure after the first surgical procedure had significantly higher body mass index (BMI) when compared with patients who required PRP injection prior surgical procedure (30.9 vs. 25.7, respectively; p < .05). CONCLUSIONS: None of the classification systems allows to precisely predict VVF surgery outcome. There are several factors such as previous surgery, lack of urethral involvement, lack of circumferential defect which might suggest that PRP injection would help to preserve watertightness of the closure. The most important finding is that overweight is the most positive predicting demographic feature of surgical success. Thus we may conclude that Martius flap technique should be taken into consideration in patients with low BMI.

Practical Adaptation of a Low-Cost Voltage Transducer with an Open Feedback Loop for Precise Measurement of Distorted Voltages.

This paper presents the project proposal of a low-cost transducer with a Hall-effect sensor placed in a ferromagnetic core's air gap, which enables the measurement of the distorted voltage instantaneous values without the feedback loop used for measurements in electrical machines. The presented transducer allows for electrical separation between the measured voltage and the voltage at the output. Moreover, the influences of frequency, additional resistance, and the reactance of the winding circuit on the voltage phase shift caused by winding inductance with ferrite core and amplitude are discussed. The result of simulating leakage inductance of measuring winding with ferrite core with an air gap is calculated using finite element analysis. Experimental investigations of the voltage phase shift angle and output voltage amplitude drop for the voltage transducers with an open feedback loop are carried out, taking into account the linear core magnetization characteristic.

Serum paraoxonase 1 activity and protein N-homocysteinylation in primary human endometrial cancer.

Paraoxonase 1 plays an important role in protection from oxidative stress and also decomposes homocysteine thiolactone, the toxic metabolite of homocysteine. A limited number of reports evaluated the role of paraoxonase 1 in women affected by female genital tract neoplasms, including endometrial cancer. This study aimed to analyze the paraoxonase activity in the group of endometrial cancer patients (n = 48) who underwent primary surgery and to compare the data available with a well-matched control group (n = 30). Due to the role of paraoxonase 1 in the metabolism of homocysteine (Hcy) thiolactone, the amount of Hcy-thiolactone as well as total serum Hcy concentrations was also measured. Serum paraoxonase 1 activity toward synthetic substrates, paraoxon and phenyl acetate, in the study group was significantly lower compared to the control one. The mean paraoxonase 1 activity toward homocysteine thiolactone tended to be lower in the endometrial cancer group but this difference was not significant. There was no relationship between endometrial cancer and Q192R polymorphism of PON1 assessed by the dual substrate method. No differences in paraoxonase 1 activity between endometrial cancer subgroups according to clinico-pathological features were detected. Total serum homocysteine and protein-bound homocysteine thiolactone did not differ between control and cancer groups. In conclusion, reduced paraoxonase 1 activity suggests diminished important antioxidant mechanisms during the development of primary endometrial cancers in humans. PON1 Q192R polymorphism is not associated with the risk of endometrial cancer. Despite lower paraoxonase 1 activity, homocysteine concentration, and protein N-homocysteinylation in endometrial cancers do not differ from matched controls.

Use of uroflow parameters in diagnosing an overactive bladder-Back to the drawing board.

AIMS: The aim of our study was to analyze whether uroflowmetry parameters are helpful in diagnosing overactive bladder (OAB). The working hypothesis was that the flow curves of patients with OAB symptoms would appear as a sharp peak flow rate with a short duration and high amplitude, lasting only for a short period during urgency sensation, followed by reduced urine flow. We introduced a new parameter called flow index (FI) defined as an average divided by maximal urine flow rates as a potential marker for diagnosing OAB. METHODS: We conducted a retrospective study analyzing 757 urodynamic studies performed in women with lower urinary tract symptoms between 2007-2014. Based on subjective clinical symptoms patients were divided into four groups (pure OAB, mixed urinary incontinence with predominant OAB [MUI-OAB], mixed urinary incontinence with predominant SUI [MUI-SUI], and pure SUI patients). RESULTS: When comparing FI between pure OAB and pure SUI patients, a strong statistically significant difference was found (mean 0.45 ± 0.08 vs. 0.53 ± 0.09, respectively; P < 0.001). Similar results were found when comparing the patients with pure OAB and MUI-OAB versus patients with pure SUI and MUI-SUI (mean 0.47 ± 0.11 vs. 0.53 ± 0.09, respectively; P < 0.001). On the other hand, we did not find a statistically significant difference in the FI value between mixed urinary incontinence where SUI is the predominant factor and pure SUI groups (median 0.51 ± 0.09 vs. 0.53 ± 0.09, respectively; P > 0.5). CONCLUSIONS: FI may be used as an additional marker for OAB diagnosis. Neurourol. Urodynam. 36:198-202, 2017. © 2015 Wiley Periodicals, Inc.

Prevalence of common comorbidities among urogynaecological patients.

OBJECTIVES: Due to prolonged life expectancy, regardless of the fact that elderly women are more likely to suffer from comorbidities, urogynaecologists worldwide should expect a growing demand for counseling and effective treatment for patients with pelvic floor defects. The aim of the study was to investigate the incidence of popular comorbidities among urogynaecological patients. MATERIAL AND METHODS: The retrospective analysis included clinical data of 4,065 consecutive female patients who under-went surgical treatment in the 2nd Department of Gynaecology at the Medical University of Lublin due to urogynaecological disorders between January 2005 and December 2014. Patients were divided into two groups (< 65 years and ≥ 65 years). The vast majority of patients affected by stress urinary incontinence were treated with mid-urethral slings. Most of patients affected by pelvic organ prolapse underwent reconstructive vaginal surgery with reinforcement using anterior and/or pos-terior meshes. Statistical analysis was performed using STATISTICA 10.0 PL (unpaired Student t-test, U Mann Whitney, χ2 test). RESULTS: In both study groups, overweight and obesity were the most common disorders affecting urogynaecological patients (72.6% overall). Furthermore, the elderly patients suffered more often from the most common comorbidities, such as hypertension (p < 0.01), coronary artery disease (p < 0.001) and diabetes mellitus (p < 0.005). CONCLUSIONS: Common comorbidities such as overweight and obesity, followed by hypertension and coronary heart diseases, are usual among urogynaecological patients. Changes in lifestyle leading to a decrease in obesity should be considered as an important line treatment when counselling urogynaecological patients.

Should we be more aware of endometrial cancer in adolescents?

Although endometrial cancer is generally diagnosed in women after menopause, it may incidentally develop in young women or even in adolescents. Diagnostic tools should be applied in young teenage girls complaining of abnormal genital bleeding, particularly those with hereditary cancer syndromes (such as Cowden or Lynch syndromes). Adolescents affected by polycystic ovary syndrome and obesity may also be at increased risk for the development of atypical endometrial hyperplasia and endometrial cancer, and should be carefully managed when the distressing symptoms occur. In the present article, we briefly summarize the principal clinical correlates associated with endometrial cancer in adolescents.

Laparoscopic mesh procedures for the treatment of pelvic lorgan prolapse--review of the literature.

OBJECTIVES: The main aim of the article was to describe laparoscopic mesh procedures for the treatment of pelvic organ prolapse, as well as evaluate their role, outcomes and limitations. MATERIAL AND METHODS: In February 2014, online search of English-language literature in PubMed was performed. This paper presents the analysis of reports published over the last decade that included at least 50 patients with a minimum of 12 months of follow-up. RESULTS: Numerous laparoscopic techniques to restore proper anatomy in patients with pelvic organ prolapse have been described. Laparoscopy provides a number of important advantages, including enhanced visualization of the pelvic anatomy reduction of adhesion formation, lower morbidity and blood loss, decreased postoperative pain, smaller incision and quicker recovery Nonetheless, this access is technically more difficult than an open or vaginal surgery due to two-dimensional vision and decreased degrees of freedom. It requires high level of laparoscopic suturing skills and longer operative time, especially at the beginning of the learning curve. CONCLUSIONS: Laparoscopic sacrocolpopexy hysteropexy and lateral suspension are interesting and effective options for the treatment of pelvic organ prolapse, providing a number of important advantages characteristic for endoscopic techniques.

[The influence of mesh pelvic floor reconstructive surgery on OAB symptoms]. / Wplyw operacji naprawczych zaburzen statyki narzadu rodnego na redukcje objawów zespolu pecherza nadreaktywnego.

OBJECTIVES: The working hypothesis was that pelvic organs prolapse can induce overactive bladder symptoms. Therefore, restoration of pelvic anatomy with accompanying proper urodynamic parameters (cystometric volume, micturition volume, uroflow) should resolve OAB (Overactive Bladder) symptoms. MATERIALS AND METHODS: Forty eight women, aged 51-77 years (mean 62.4±7.32), with stage II, III or IV prolapse (POP-Q scale) were included into the study. Patients with LUTS (Lower Urinary Tract Symtoms--inflammation, infection, pain) were excluded. Each patient underwent clinical evaluation and full urodynamic examination (cystometry and uroflowmetry MMS Libra +). Depending on the type of the anatomical defect on the POP-Q scale--anterior defect, posterior defect or both anterior and posterior--a repair using polypropylene monofilament mesh was performed (TVM anterior, TVM posterior or TVM Total). Patients were asked to complete King's Health questionnaire before and after the reconstructive surgery. Statistical analysis was performed using Kolmogorov-Smirnov and U Mann-Whitney tests. RESULTS: Overactive bladder symptoms were diagnosed in 27 patients. Detrusor overactivity was found in 10 patients. In 17 patients, out of 27 with OAB before surgery overactivity symptoms completely resolved after the surgery (63%). On the other hand, post-op de novo OAB symptoms appeared in 2 patients (4.1%). Half of the patients with OAB symptoms after surgery had detrusor overactivity before mesh repair while only 30% of patients without OAB symptoms after surgery had DO (Detrusor Overactivity) before the surgical procedure. Micturition volume in group of patients with OAB significantly increased after the surgery (293.78 ml vs. 364.15 ml; p=0.006). Maximal cystometric capacity in patients with overactive bladder also significantly increased after the surgery (318.78 ml vs. 407 ml; p=0.0001). Quality of life measured by King's questionnaire improved in the group of patients with resolution of OAB symptoms in such domains as: Incontinence Impact, Role Limitations and Sleep/emotions, p<0.05. CONCLUSIONS: Correction of pelvic organ prolapse stage II, III and IV in patients with OAB symptoms leads to an improvement in bladder conditions in half of the patients. Such treatment also resulted in symptom resolution of detrusor overactivity ascertained in urodynamic studies. Overactive bladder syndrome with DO was more resistant to surgical treatment as compared to OAB without DO. Quality of life improved in patients who did not present with OAB bladder symptoms after the mesh surgery. Restoration of proper anatomy might also cure or improve bladder symptoms in patients with OAB symptoms, coexisting with advanced pelvic organ prolapse.

[Clinical effectiveness of transobturator midurethral sling (T-sling) with additional 2-point tape fixation performed on an outpatient and inpatient basis]. / Ocena efektywnosci klinicznej operacji typu T-Sling z fiksacja tasmy wykonywanej w ramach procedury jednodniowej i standardowej.

INTRODUCTION: Nowadays, mid-urethral slings are considered the gold standard in surgical treatment of female stress urinary incontinence (SUI). Traditionally this technique has been followed by short inpatient hospitalization and convalescence. From the perspective of both, the patient and the physician, this technique has become increasingly popular due to very high clinical effectiveness and fast recovery ' OBJECTIVES: The aim of the study was to compare the efficacy and safety of transobturator monofilament sling (T-sling-Hernia Mesh, Italy) with additional 2-point tape fixation in the treatment of SUI in women operated on an inpatient and outpatient basis. MATERIAL AND METHODS: A total of 200 women with stress urinary incontinence were included into the study Clinical diagnosis was based on detailed medical history voiding diary gynecological examination, and positive cough test. Exclusion criteria were as follows: previous urogynecologic surgery detrusor overactivity on urodynamics and advanced urogenital prolapse (pelvic organ prolapse-quantification [POP-Q] scale grades--II, III, IV). In both groups the surgery was performed by two (TR; A W) surgeons. Using identical surgical technique, all patients had a monofilament tape inserted at the mid-urethra with 2 absorbable sutures parallel to the urethra in order to fix the tape and prevent its displacement during tape tensioning. Patients were discharged home after the first spontaneous voiding (outpatient group) or 2 days (inpatient group) postoperatively After 12 months, 192 patients (99 in outpatient and 93 in inpatient group) were available for assessment of clinical effectiveness of surgery Success was defined as lack of any leakage during cough stress test. The subjective cure rate was determined by Sandvik scale also after 12 months. Statistical analysis was performed with Statistica 7.1 pl and Mann-Whitney U and Chl tests were used. P-level of < or = 0.05 was considered as statistically significant. RESULTS: There were no differences in demographical data of patients from both groups. The only difference between the two groups concerned the body mass index (mean 26.6 +/- 3.9 vs. 28.67 +/- 3.99; p<0.001) and age (50.48 +/- 9.71 vs. 61.7 +/- 9.2; p<0.001) in the outpatient versus inpatient group, respectively There was no significant difference between the two groups in terms of the overall patients satisfaction and cure rate after the 12-month follow-up (chi2=4.039, p=0.133). CONCLUSIONS: Proper surgical technique but not length of hospitalization is the main factor determining the effectiveness of surgical treatment of SUI. Tape fixation is a simple surgical maneuver that ensures proper sling placement at mid-urethra and does not markedly increase procedure duration or cost of the treatment. Outpatient surgery for SUI using transobturator mid-urethral sling ensures the same cure and satisfaction rates as inpatient orocedure. allowing to reduce the cost of the treatment without compromising clinical effectiveness.

Polyphenols Influence the Development of Endometrial Cancer by Modulating the Gut Microbiota.

Dysbiosis of the microbiota in the gastrointestinal tract can induce the development of gynaecological tumours, particularly in postmenopausal women, by causing DNA damage and alterations in metabolite metabolism. Dysbiosis also complicates cancer treatment by influencing the body's immune response and disrupting the sensitivity to chemotherapy drugs. Therefore, it is crucial to maintain homeostasis in the gut microbiota through the effective use of food components that affect its structure. Recent studies have shown that polyphenols, which are likely to be the most important secondary metabolites produced by plants, exhibit prebiotic properties. They affect the structure of the gut microbiota and the synthesis of metabolites. In this review, we summarise the current state of knowledge, focusing on the impact of polyphenols on the development of gynaecological tumours, particularly endometrial cancer, and emphasising that polyphenol consumption leads to beneficial modifications in the structure of the gut microbiota.

Influence of the Relative Displacements and the Minimum Chip Thickness on the Surface Texture in Shoulder Milling.

The formation of surface texture in milling is a complex process affected by numerous factors. This paper focuses on the surface roughness of X37CrMoV51 steel machined by shoulder milling. The aim of the study was to develop a mathematical model to predict the surface roughness parameter Ra. The proposed model for predicting the surface roughness parameter Ra in shoulder milling takes into account the feed per tooth, fz, the corner radius, rε, and the actual number of inserts involved in the material removal process as well as hmin and D(ξ). The correlation coefficient between the theoretical and experimental data was high (0.96). The milling tests were carried out on a three-axis vertical milling machine using a square shoulder face mill. The geometric analysis of the face mill shows that at a feed rate of 0.04 mm/tooth, cutting was performed by three out of five inserts, and when the feed rate exceeded 0.12 mm/tooth, material was removed by all inserts. The minimum chip thickness parameter and the standard deviation of the relative displacement increased as the feed increased. Over the whole range of feeds per tooth, the displacement increased by 0.63 µm. Higher cutting speeds resulted in lower minimum chip thicknesses and the average standard deviation of the relative displacements for the whole range of cutting speeds was 2 µm.

Analyzing the Potential of Drill Bits 3D Printed Using the Direct Metal Laser Melting (DMLM) Technology to Drill Holes in Polyamide 6 (PA6).

Drilling with standard twist drill bits is the most common method to create cylindrical holes. With the constant development of additive manufacturing technologies and easier access to additive manufacturing equipment, it is now possible to design and fabricate solid tools suitable for various machining applications. Specially designed 3D printed drill bits seem more convenient for standard and nonstandard drilling operations than conventionally made tools. The study described in this article aimed to analyze the performance of a solid twist drill bit made from steel 1.2709 using direct metal laser melting (DMLM), which was compared with that of a drill bit manufactured conventionally. The experiments involved assessing the dimensional and geometric accuracy of the holes made by the two types of drill bits and comparing the forces and torques occurring during the drilling of holes in cast polyamide 6 (PA6).

Effects of topical dehydroepiandrosterone therapy in women after pelvic organ prolapse surgery.

OBJECTIVE: Pelvic organ prolapse (POP) occurs predominantly in postmenopausal women. Restoration of the proper estrogenization of vaginal mucosa is important in preoperative and postoperative treatment, increasing the effectiveness of this approach. The objective of this study was the development of intravaginal vaginal suppositories containing DHEA and comparison of the clinical effects of vaginal topical therapy with DHEA, estradiol, or antibiotic after POP surgery. METHOD: Nine types of vaginal suppositories containing 6.5 mg DHEA in different bases were prepared to find optimal formulation for the vaginal conditions. Ninety women referred for POP surgery were randomly assigned to one of three groups receiving topical treatment in the postoperative period (estradiol, DHEA, or antibiotic). On admission to hospital and during follow-up vaginal pH, vaginal maturation index and vaginal symptoms were assessed. RESULTS: Vaginal suppositories with the base made from polyethylene glycol 1,000 without surfactants characterized the highest percentage of the released DHEA. In women treated with topical estradiol or DHEA a significant decrease in the number of parabasal cells, increase in superficial and intermediate cells in the vaginal smears, decrease in vaginal pH, and reduction of vaginal symptoms were observed. CONCLUSIONS: The use of topical therapy with DHEA or the use of topical therapy with estradiol in the postoperative period were both shown to improve maturation index, vaginal pH, and vaginal symptoms. The benefits of topical therapy with DHEA after pelvic organ prolapse repair brings similar results as estradiol, without potential systemic exposure to increased concentrations of sex steroids above levels observed in postmenopausal women.

[Overactive bladder--a new insight into the pathogenesis of its idiopathic form]. / Pecherz nadreaktywny--nowe spojrzenie na etiopatogeneze idiopatycznej postaci tego schorzenia.

In the last few years cytokines have been shown to be the most important local cell signaling molecules, strongly involved in the pathogenesis of the overactive bladder symptoms. Proper bladder function is dependent on gap junction activity The main gap junction proteins which can be found in bladder smooth muscle are Connexin 43 (Cx43) and Connexin 45 (Cx45). Experimental studies focused on the influence of Basic Fibroblast Growth Factor on Connexin expression in bladder smooth muscle cells have shown an increased expression of Cx43, contrary to Cx45. Elevated level of Connexin 43 leads to overactivity of muscle fibers. It was also proved that expression of these proteins in tissues is modulated by cytokines. Regulation of the Cx43 promoter depends on an activating factor 1 (AP-1), cyclic monophosphate (cAMP) and retinoid concentration as well. AP-1 is induced by extracellular-signal-regulated kinases (ERK 1/2) through the activation of basic fibroblast growth factor (bFGF). Recent studies revealed that cytokine-induced modulation of gap junction plays an important role in the pathogenesis of OAB, whereas activation of sympathetic fibers via beta adrenoreceptors (beta-AR) causes relaxation of the bladder The beta-3 adrenoreceptors are divided into beta-1, beta-2, beta-3 subtypes. beta-3 adrenoreceptors have been found in fat and smooth muscle tissue. Density of beta-3 AR is very high in urinary bladder detrusor Activation of beta-3 AR leads to the relaxation of smooth muscle fibers during the filling phase and is cAMP-dependent. Missense mutation of this receptor subtype in the human bladder leading to the substitution of Tryptophan (Trp) by Arginine (Arg), occurs in about one-third of the world's population. Studies have shown that about 50% of women with Trp 64 Arg polymorphism have OAB symptoms. Higher concentration of beta3-AR with Trp 64 Arg polymorphism in bladders of women with diagnosed OAB is probably associated with a lower level of cAMP and weaker relaxation of the bladder smooth muscle. The role of the muscarinic receptors (M1-M5) in the pathogenesis of OAB has been widely described. Unfortunately due to lack of selective muscarinic ligands, the function of each subtype of the receptor has not been fully elucidated yet. A mouse model lacking one or more muscarinic receptors types has been constructed recently Animals were used to assess the real influence of various muscarinic receptors on bladder function. Studies have confirmed the importance of these receptors in the function of the urinary tract, offering a new insight in their mutual interactions and pathogenesis of OAB. Better understanding of these and new mechanisms may improve the process of diagnosis and treatment of the disease in the near future.

[Nerve growth factor as a biomarker in the diagnosis and treatment of overactive bladder (OAB)]. / Czynnik wzrostu nerwów (NGF) jako biomarker w diagnostyce i terapii peccherza nadreaktywnego (OAB).

Nerve growth factor is a complex regulator of neural plasticity along the micturition pathways. The aim of this review is to summarize the current evidence for a role of NGF in urinary bladder function both in experimental and clinical settings. There is bulk of strong evidence that experimental administration of NGF elicits the symptoms of increased sensation, urgency and bladder hyperreflexia which strongly resemble overactive bladder syndrome (OAB) and interstitial cystitis/painful bladder syndrome (IC/PBS). Therefore in human studies there are attempts to employ urinary NGF levels as a diagnostic marker in various forms of OAB and IC/PBS. It has been shown that urinary NGF levels are correlated with severity of OAB symptoms and in patients successfully treated with antimuscarinics agents or detrusor botulinum toxin injection, urinary NGF levels decrease significantly in association with reduction of urgency severity

Geometry, Structure and Surface Quality of a Maraging Steel Milling Cutter Printed by Direct Metal Laser Melting.

This article considers the use of additive manufacturing to produce cutting tools for various machining operations, especially turning, milling, and drilling. The right geometry and material of the tool as well as coatings applied on cutting edges are crucial as they improve the life and performance of the tool. The study described here focused on a four-flute end mill made of maraging steel 1.2709 using a Concept Laser M2 Cusing Direct Metal Laser Melting (DMLM) machine. Before the printed tool was first used, it was examined to determine its dimensional and geometric accuracy, surface roughness, and surface structure. The measurement data showed that the tool required machining, e.g., grinding, to improve its geometry because the total runout of the shank and the cutting edge radius were too high, amounting to 120 µm and 217 µm, respectively. The cutting edges were sharpened to obtain a fully functional cutting tool ready to perform milling operations. The study aimed to check the dimensional and geometric accuracy of the 3D printed milling cutter and determine the optimal machining allowance for its finishing.