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INTRODUCTION AND HYPOTHESIS: This study was conducted to determine the differences in the inter-observer agreement of the simplified Pelvic Organ Prolapse Quantification (POP-Q) system from center to center in a large international multicenter study. METHODS: This is a secondary analysis of the results of a large prospective single blind multicenter trial studying the inter-observer agreement of a simplified POP-Q exam. Twelve centers from four continents with a total of 511 subjects were included in this study. The number of subjects recruited per center ranged from 20 to 81. Each patient was independently examined by two investigators, with examination order randomly assigned and investigators blinded to each other's result. The weighted kappa statistic was used to evaluate the inter-observer agreement. RESULTS: Good and significant associations were observed on the anterior, posterior, and apical segments. Six out of 11 sites did not provide adequate number of subjects with prior hysterectomy for weighted kappa statistics or achieve significance regarding vaginal cuff measurement. CONCLUSIONS: The simplified POP-Q demonstrated good inter-examiner agreement across multiple centers.
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Prolapso de Órgano Pélvico/diagnóstico , Prolapso de Órgano Pélvico/epidemiología , Examen Físico/métodos , Anciano , Femenino , Humanos , Cooperación Internacional , Persona de Mediana Edad , Variaciones Dependientes del Observador , Prevalencia , Estudios Prospectivos , Reproducibilidad de los Resultados , Método Simple CiegoRESUMEN
OBJECTIVE: The study aimed to investigate the impact of SUI (Stress Urinary Incontinence) on the sexual activity of women, to assess their sexual functioning, and to show the extent of the problem that SUI poses to the quality of life of women. PATIENTS AND METHODS: The study involved 70 women aged 20-48 years. The inclusion criteria included the presence of stress urinary incontinence, the sexual activity of the women, and the history of no urogynecological intervention. The authorial questionnaire and the Polish version of the Female Sexual Function Index (FSFI) were used. RESULTS: SUI contributes to reducing the frequency of intercourse and even complete resignation from sexual intercourse. There is a correlation between the occurrence of urinary leakage during intercourse and the occurrence of sexual dysfunction (p=0.023). The most common factors limiting sexual activity are decreased libido, fatigue, lack of desire, and lack of body acceptance. However, age (p=0.070), marital status (p=0.091), Body Mass Index (BMI) (p=0.436), as well as the duration of stress urinary incontinence (p=0.36) have no effect on women's sexual activity. The most common ways of dealing with the loss of urine during intercourse include micturition before intercourse, intercourse only in safe places, restriction of physical activity during intercourse, and reduction of intercourse frequency and duration. CONCLUSIONS: SUI in women has a significant effect on their sexual activity. The cause of this state of affairs is multifactorial. Some women try to cope with the problem and have developed a number of strategies that allow them to be sexually active without unpleasant surprises.
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Disfunciones Sexuales Fisiológicas/fisiopatología , Incontinencia Urinaria de Esfuerzo/fisiopatología , Adulto , Femenino , Humanos , Persona de Mediana Edad , Polonia , Calidad de Vida , Conducta Sexual , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Lead halides in an asymmetric layered structure form memristive devices which are controlled by the electronic structure of the PbX2|metal interface. In this paper, we explain the mechanism that stands behind the I- V pinched hysteresis loop of the device and shortly present its synaptic-like plasticity (spike-timing-dependent plasticity and spike-rate-dependent plasticity) and nonvolatile memory effects. This memristive element was incorporated into a reservoir system, in particular, the echo-state network with delayed feedback, which exhibits brain-like recurrent behavior and demonstrates metaplasticity as one of the available learning mechanisms. It can serve as a classification system that classifies input signals according to their amplitude.
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The aim of this study was to define referential values of 5 basic bioelements (Ca, Mg, Zn, Cu, Fe) in the hair of Polish young persons aged 10-20 years, based on the research conducted from 1991 to 2004 on a group of over 3420 healthy young persons. Mean concentrations of two toxic metals (Pb and Cd) in over 2000 young men were also investigated. The results of biochemical tests were analyzed with the program STATISTICA 7.0 (StatSoft PL). Significant differences between girls' and boys' hair Ca, Mg and Zn in the same age group were observed (p = 0.0000). It was determined that boys have smaller concentrations of hair Ca, Mg and Zn than girls. No significant differences were observed between concentrations of Cu and Fe in the hair of girls and boys of the same age in the tested period. Significantly greater amounts of Pb and Cd characterize boys. Analyses of correlations confirm significance (p < 0.05000) of synergistic interactions between bioelements: Ca-Mg (r = +0.80), Ca-Zn (r = +0.52), Ca-Cu (r = +0.14), Mg-Zn (r = +0.50), Mg-Cu (r = +0.13), Zn-Cu (r = +0.11), Cu-Fe (r = +0.04). Significance (p < 0.05000) of antagonistic interactions of bioelements with toxic metals: Zn-Pb (r = -0.30), Mg-Pb (r = -0.20), Ca-Pb (r = -0.18) and Zn-Cd (r = -0.07) was confirmed. Significance (p < 0.05000) of synergistic effects with toxic elements: Pb-Cd (r = +0.34), Fe-Pb (r = +0.22), Fe-Cd (r = +0.13) was determined. Compatibility of the statistically mapped basic characteristics of young persons' developmental age with the functions of concentrations in tested hair bioelements was confirmed. Young persons whose concentrations of selected hair bioelements showed values outside the reference ranges and who had higher concentrations of toxic metals should undergo further diagnostic tests since the results of previous tests could be a sign of disturbances leading to various diseases. Analyses of the concentrations of bioelements and toxic metals in humans based on hair analysis can be useful as a convenient, non-invasive and painless method in the diagnosis of pathological states. Combined with other analytical data, this method can be used by practising physicians as a complementary diagnostic procedure.