Arc-to-arc mini-sling 1999: a critical analysis of concept and technology

PURPOSE: The aim of this study was to critically review the Arc-to-Arc mini-sling (Palma's technique) a less invasive mid-urethral sling using bovine pericardium as the sling material. MATERIALS AND METHODS: The Arc-to-Arc mini-sling, using bovine pericardium, was the first published report of a mini-sling, in 1999. The technique was identical to the tension-free tape operation, midline incision and dissection of the urethra. The ATFP (white line) was identified by blunt dissection, and the mini-sling was sutured to the tendinous arc on both sides with 2 polypropylene 00 sutures. RESULTS: The initial results were encouraging, with 9/10 patients cured at the 6 weeks post-operative visit. However, infection and extrusion of the mini-sling resulted in sling extrusion and removal, with 5 patients remaining cured at 12 months. CONCLUSION: The Arc-to-Arc mini-sling was a good concept, but failed because of the poor technology available at that time. Further research using new materials and better technology has led to new and safer alternatives for the management of stress urinary incontinence.25225

Transurethral radiofrequency collagen denaturation for the treatment of women with urinary incontinence

Peer reviewedPublisher PD

Tomografía de impedancia eléctrica: fundamentos de hardware y aplicaciones médicas

Introduction: The following article shows a systematic review of publications on hardware topologies used to capture and process electrical signals used in Electrical Impedance Tomography (EIT) in medical applications, as well topicality of the EIT in the field of biomedicine. This work is the product of the research project “Electrical impedance tomography based on mixed signal devices”, which took place at the University of Cauca during the period 2017-2019. Objective: This review describes the operation, topicality and clinical use of Electrical Impedance Tomography systems. Methodology: A systematic review was carried out in the IEEE-Xplore, ScienceDirect and Scopus databases. After the classification, 106 relevant articles were obtained on scientific studies of EIT systems; applications dedicated to the analysis of medical images. Conclusions: Impedance-based methods have a variety of medical applications as they allow for the reconstruction of a body region, by estimating the conductivity distribution inside the human body; this is without exposing the patient to the damaging effects of radiation and contrast elements. Impedance-based methods are therefore a very useful and versatile tool in the treatment of diseases such as: monitoring blood pressure, detection of atherosclerosis, localization of intracranial hemorrhages, determining bone density, among others. Originality: It describes the necessary components to design an EIT system, as well as the design characteristics depending on the pathology to be visualized.  Introducción: En el siguiente artículo se muestra una revisión sistemática de publicaciones sobre topologías hardware utilizadas para capturar y procesar señales eléctricas utilizadas en tomografía por impedancia eléctrica (TIE) en aplicaciones médicas, así como la actualidad del TIE en el campo de la biomedicina. Este trabajo es producto del proyecto de investigación “Tomografía de impedancia eléctrica basada en dispositivo de señal mixta”, que tiene lugar en la Universidad del Cauca durante el período 2017-2019.   Objetivo: Esta revisión describe la estructura hardware de los sistemas de TIE, además de sus características, como frecuencia y magnitud de señales de corriente, patrones de inyección y medición de señales y número de electrodos orientado a, uso clínico.   Metodología: Se realizó una revisión sistemática, en las bases de datos IEEE-Xplore, ScienceDirect y Scopus. Tras la clasificación se obtuvo 106 artículos relevantes sobre estudios científicos de sistemas, aplicaciones dedicadas al análisis de imágenes médicas.   Conclusión: Los métodos basados en impedancia, tienen una variedad de aplicaciones médicas, puesto que permite la reconstrucción de una región corporal, mediante la estimación de la distribución de conductividad al interior del cuerpo humano, sin radiación y elementos de contraste, tan perjudiciales para la salud de los pacientes; convirtiéndola en una herramienta muy útil y versátil en el tratamiento de enfermedades como: monitorear la presión arterial, detección de arterosclerosis, localización de hemorragias intracraneales, determinar la densidad ósea, entre otras.     &nbsp

Development of a pad test to assess stress urinary incontinence in young healthy women: a pilot study

Purpose: Current literature reports that between 7 and 14% of young, healthy women have stress urinary incontinence (SUI). No gold standard exists for quantifying urine leakage, although pad tests have been used in older, parous populations. The aim of this study was to determine the reliability and accuracy of a new pad test for young, healthy women with SUI. Methods: The pad test consisted of measuring quantity of leakage after the following activities: stair running, standing up from sitting, curl-ups, running on the spot, jumping jacks, jumping on a mini-trampoline and coughing vigorously. Bladder volume was standardised by having the volunteers drink one litre of water one hour prior to the testing. The volunteers performed the pad test on two consecutive days. Results: Sixteen nulliparous women between the ages of 18 and 30 years (7 controls and 9 with SUI) participated in this study. The mean increase in pad weight was 0.64 g (± 0.50) in the continent group and 11.89 g (± 20.32) in the group with SUI. There was no significant difference in pad weight between the testing sessions (p=0.228), however the test was not able to elicit measureable urine loss in 3 participants with SUI. Pad weights between the two groups of women were significantly different (p=0.023). The test re-test ICC for the continent group was 0.845 (95% CI: 0.139–0.973) and 0.782 (95% CI: -0.040–0.952) for the group with SUI. Significance: The results of this study support the use of this pad test in healthy young women with SUI; it appears to be reliable and challenging enough to cause measureable urine loss in the majority, and it may be useful for diagnosing and quantifying SUI without urodynamic studies