[Effectiveness of multimodal rehabilitation (biofeedback plus capacitive-resistive radiofrequency) on chronic pelvic pain and dyspareunia: prospective study and literature review]. / Efectividad de la rehabilitación multimodal (biofeedback más radiofrecuencia capacitiva-resistiva) sobre el dolor pélvico crónico y la dispareunia: estudio prospectivo y revisión de la bibliografía.

OBJECTIVE: To determine whether a multimodal rehabilitation protocol (Biofeedback [BFB] plus capacitive-resistive [INDIBA®] radiofrequency [RF]) reduces pain and increases muscular strength in patients with chronic pelvic pain (CPP) and dyspareunia. MATERIAL AND METHODS: We performed a prospective, quasi-experimental, before-after study in 37 patients with CPP and/or dyspareunia referred to the Rehabilitation Department of Hospital Universitario Santa Cristina (January 2016 to December 2018). The protocol consisted of 8 sessions of pelvic floor exercises assisted by manometric BFB (15min of tonic/phasic exercises each) supervised by a physiotherapist, followed by suprapubic and perineovaginal bipolar RF [capacitive(5 min)/resistive(10 min)]. The variables evaluated were pain (VAS 0-10) and strength (mmHg) of the pelvic floor musculature and the start/end of the treatment. RESULTS: The mean age was 41.5±12.65 years. The prevalence was higher among women aged 21-40 years (n=20, 54%) and those aged 41-60 years (n=12; 32.4%). Dyspareunia was present in 34 patients (91.8%), and non-specific CPP in 3 (8.2%). The protocol improved pain (from 7.27±1.34 to 3.75±2.21 points), maximal muscular strength (from 25.56±15.9mmHg to 35.35±20.4mmHg) and mean muscular strength (from 4.86±3.53mmHg to 7.18±4.46mmHg) respectively (p<0.0001). CONCLUSION: CPP and dyspareunia are a diagnostic challenge that requires multidisciplinary management. Treatment should be started early and should consist of distinct therapeutic modalities. The protocol of multimodal rehabilitation including BFB and capacitive-resistive RF reduces pain and improves strength in patients with CPP and dyspareunia.

[Meigs' syndrome caused by bilateral ovarian fibroma mimicking ovarian cancer]. / Síndrome de Meigs por fibroma ovárico bilateral parecido al cáncer de ovario.

CASE REPORT: We report the case of a 55-year-old patient who pre- sented a pelvic mass, ascites and elevated serum CA125. Suspecting a malignant process she underwent surgery and a total hysterectomy with bilateral salpigo-oforectomy was performed. Pathologic report revealed a bilateral ovarian fibroma and non-tumoral ascites. The presence of elevated serum CA125 levels in a postmenopausal woman with a pelvic mass and ascites suggest an ovarian malignant disease. However, in case of Meigs'syndrome, all symptoms will diappear after removal of the pelvic tumor, so a fast surgical management of the patients is mandatory.

Four-electrode impedance spectrometer for investigation of solid ion conductors.

An impedance spectrometer capable of accurately measuring solid ion conducting sample impedance spectra by two- or four-electrode methods in either time or frequency domain has been built. The four-electrode measurement mode is implemented by constructing a differential amplifier with a very high input impedance and common mode rejection ratio over a wide frequency range. All of the measurements can be performed in frequencies ranging from 10 Hz to 2 MHz and sample temperatures up to 800 K. The working principle of the spectrometer as well as its technical parameters and accuracy estimation are presented in this paper. The advantage of four-electrode over two-electrode measurement mode is shown by an example of Ce(0.9)Gd(0.1)O(1.95) solid electrolyte ceramic impedance measurements.

Síndrome de compresión del plexo lumbosacro durante el embarazo / Lumbosacral plexus compression syndrome during pregnancy

Las lesiones del plexo lumbosacro durante el embarazo y el parto son muy poco frecuentes y se han relacionado fundamentalmente con primigestas jóvenes con fetos de gran tamaño. Se suelen presentar en el puerperio inmediato, después de partos prolongados, o bien en partos instrumentales. La forma de aparición más común es como parestesias en miembros inferiores, pérdida de fuerza e incluso como síndrome de pie caído. Presentamos el caso de una paciente con una gestación a término, que acude al servicio de urgencias por síntomas sugestivos de compresión medular a nivel del plexo lumbosacro. Debido al riesgo de isquemia nerviosa se decide la finalización del parto mediante cesárea, que cursó sin incidencias. Tras la cesárea, la paciente empieza a recuperar la función sensitiva y motora con una resolución completa al alta (AU)

Lumbosacral plexus injuries during pregnancy and labor are highly uncommon and have been related to young primiparous women and overweight fetuses. These injuries usually appear during the early puerperium, after a long labor, or after instrumental deliveries. The clinical features are paresthesia in the lower extremities, weakness and drop foot syndrome. We report the case of a woman with term pregnancy who presented to the emergency room with symptoms of lumbosacral plexus compression. Due to the risk of nerve ischemia, a cesarean section was carried out with no adverse events. Immediately after delivery, the patient began to recover sensitivity and mobility, with complete resolution at discharge (AU)

Bioequivalence of two recombinant granulocyte colony-stimulating factor products after subcutaneous injection in healthy volunteers.

OBJECTIVE: The objective of the study was the demonstration of bioequivalence of two recombinant human granulocyte colony-stimulating factor (G-CSF) formulations after subcutaneous administration of 5 microg/kg and 10 microg/kg comparing their pharmacokinetic and pharmacodynamic profiles in healthy subjects. METHODS: This was a randomized, single dose, two-period cross-over, two-arm study with a 14 days wash-out period. In total 56 subjects were included, 28 in each dosage cohort (5 microg/kg and 10 microg/kg). Using a 1 : 1 : 1 : 1 randomization ratio, subjects were randomly assigned to one of four possible treatment-sequence groups. A single dose of test formulation (XM02) and reference product (Neupogen, F. Hoffmann - La Roche, Ltd.) were injected. The serum G-CSF concentrations were measured by enzyme-linked immunosorbent assay (ELISA) during 48 hours after injection. The absolute Neutrophil Count (ANC) was determined by automated hematology analyzer Coulter STKSTM (Beckman Coulter, Inc.) up to 96 hours after injection. The primary pharmacokinetic (AUC0-48, AUC0- yen and Cmax) and pharmacodynamic (ANC AUC0-96, ANC AUC0- yen and ANCmax) variables were considered bioequivalent if the 90% confidence intervals (CI) were in the bioequivalence range of 80 - 125%. RESULTS: 50 subjects completed the study: 24 subjects in 5 microg/kg and 26 in 10 microg/kg dosage groups. The pharmacokinetic and pharmacodynamic parameters in 5 mg/kg and 10 mg/kg group for both formulations were very close to each other. Single doses of test and reference formulations were well tolerated. The most frequent AEs were: headache, erythrocyturia and myalgia. The incidence of AEs was equally distributed across dosage and treatment groups. CONCLUSION: The study results demonstrated the bioequivalence of two body weight-dependent doses of XM02, a new formulation of filgrastim, and the reference product Neupogen after administration of a 5 microg/kg b.w. and 10 microg/kg b.w. with respect to pharmacokinetic, pharmacodynamic and safety profiles.

[Selection of an extraction agent and development of the technology for producing an extract with sedative effects]. / Výber vyluhovadla a vypracování technologie výroby extraktu s uklidnujícím úcinkem.

The drugs Valerinae radix, Crataegi fructus, Leonuri herba and Melissae folium were used to produce a liquid plant extract. The experiment revealed that the extraction with 70% ethanol achieved the highest concentration of extractable active principles. The optimal conditions for obtaining a sedative extract are established when the method of repercolation is used, and in the production itself the batch of the drug is divided into equally large doses and a pre-prepared mixture of plant drugs is extracted. The extract prepared by this manner remains stable for the whole period of storage, i.e., 24 months.