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  • McNeil Pitts posted an update 19 hours, 26 minutes ago

    The study aims to compare the urethral sphincter size and bladder neck position and mobility in women with different parities.

    Women referred to the urodynamics clinic for lower urinary tract and prolapse symptoms were included in the study. A detailed history was taken, and transperineal two- and three-dimensional ultrasound was performed on all the women. The women were divided into four groups according to the vaginal parity. Group 1 had no vaginal childbirths. Group 2 had one, group 3 had two and group 4 had three or more vaginal childbirths. The data was analysed and compared among the groups.

    One hundred fifty women were included in the study. There were 34, 22, 48 and 46 women in groups 1 to 4 respectively. The distribution of different urodynamic diagnoses was similar in all four groups. The urethral sphincter measurements were significantly larger in the vaginally nulliparous group than in all other groups. The measurements were not smaller in multiparous women than in primiparous women. selleck kinase inhibitor The bladder neck was at a lower position at rest in parous women than nulliparous women. The bladder neck movement was not more in groups 2 to 4 than in group 1.

    The urethral sphincter was smaller and the bladder neck position was lower in parous women than nulliparous women. These differences were not progressive with increasing parity. Request for elective caesarean section during the second pregnancy to protect the urethra is not supported by this study.

    The urethral sphincter was smaller and the bladder neck position was lower in parous women than nulliparous women. These differences were not progressive with increasing parity. Request for elective caesarean section during the second pregnancy to protect the urethra is not supported by this study.

    This single-blind, randomised controlled trial was aimed at determining whether peri-operative physiotherapist-supervised pelvic floor muscle (PFM) training was superior to standard care (handout) in terms of improvements in stress urinary incontinence (SUI) symptoms, cure rate, and/or post-operative filling or voiding symptoms among women undergoing surgical mid-urethral sling (MUS) insertion for SUI.

    Women with SUI were recruited from surgical wait lists at four participating urogynecology clinics. Participants were assessed at baseline (V1) then randomised (11 allocation) to receive supervised PFM training or a handout. Immediately following the 12-week intervention period (V2) and at 12weeks following surgery (V3) the groups were compared based on the Female Lower Urinary Tract Symptoms (FLUTS) questionnaire total score and urinary incontinence, filling, and voiding subscale scores as well as on a standardised 30-min pad test administered by a blinded assessor. Intention-to-treat analyses were performunction as measured by a pad test, nor does it lead to fewer post-operative voiding or filling symptoms.

    Physiotherapist-supervised PFM training improves SUI cure rates associated with surgical MUS insertion when considering symptoms of SUI, but does not improve post-operative continence function as measured by a pad test, nor does it lead to fewer post-operative voiding or filling symptoms.

    The objective was to determine whether the rate of adnexal surgery varies by route of hysterectomy in women over the age of 65 undergoing hysterectomy for prolapse. We hypothesized that women undergoing vaginal hysterectomy would be less likely to undergo bilateral salpingo-oophorectomy (BSO) at the time of their hysterectomy for prolapse.

    This was a cross-sectional analysis using the National Inpatient Sample (NIS) database. Our primary outcome was concomitant adnexal surgery performed at the time of hysterectomy, classified into five groups BSO, unilateral salpingo-oophorectomy (USO), bilateral salpingectomy (BS), other adnexal surgery, and no adnexal surgery. The study sample included women aged 65 years and older who underwent hysterectomy between 1 January 2009 and 31 December 2014 and with a diagnosis of genital prolapse.

    Of the 91,292 patients over the age of 65 who underwent a hysterectomy for prolapse, the majority of hysterectomies were vaginal (69%), followed by abdominal (13%), laparoscopic (11%), and robotic (7%). The number of women having a hysterectomy and undergoing a BSO was much lower for vaginal than for other hysterectomy types; 20.3% of women undergoing vaginal hysterectomies had a BSO, compared with 79.2% in abdominal, 81.8% in laparoscopic, and 73.8% in robotic-assisted procedures. Women who received vaginal hysterectomies were five times as likely (RR 5.02, 95% CI 4.70-5.35) to have no concomitant adnexal procedure compared with other routes of hysterectomy.

    Women over the age of 65 undergoing hysterectomy for prolapse are significantly less likely to have adnexal surgery if undergoing hysterectomy via vaginal route compared with the other routes.

    Women over the age of 65 undergoing hysterectomy for prolapse are significantly less likely to have adnexal surgery if undergoing hysterectomy via vaginal route compared with the other routes.

    Lung adenocarcinoma (LUAD), a subtype of non-small cell lung cancer (NSCLC), causes high mortality around the world. Previous studies have suggested that the metabolic pattern of tumor is associated with tumor response to immunotherapy and patient’s survival outcome. Yet, this relationship in LUAD is still unknown.

    Therefore, in this study, we identified the immune landscape in different tumor subtypes classified by metabolism-related genes expression with a large-scale dataset (tumor samples, n = 2181; normal samples, n = 419). We comprehensively correlated metabolism-related phenotypes with diverse clinicopathologic characteristics, genomic features, and immunotherapeutic efficacy in LUAD patients.

    And we confirmed tumors with activated lipid metabolism tend to have higher immunocytes infiltration and better response to checkpoint immunotherapy. This work highlights the connection between the metabolic pattern of tumor and tumor immune infiltration in LUAD. A scoring system based on metabolism-related gene expression is not only able to predict prognosis of patient with LUAD but also applied to pan-cancer. LUAD response to checkpoint immunotherapy can also be predicted by this scoring system.

    This work revealed the significant connection between metabolic pattern of tumor and tumor immune infiltration, regulating LUAD patients’ response to immunotherapy.

    This work revealed the significant connection between metabolic pattern of tumor and tumor immune infiltration, regulating LUAD patients’ response to immunotherapy.

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