Is there a link between overactive bladder and the metabolic syndrome in women? : A systematic review of observational studies

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.To conduct a systematic review to determine whether there is an association between metabolic syndrome (MetS) and lower urinary tract symptoms (LUTS) or overactive bladder (OAB) in women. We systematically reviewed English language observational studies on the effect of MetS (or component factors) on the presence of OAB or LUTS in women. We searched PubMed, Web of Science and The Cochrane Library with no date restrictions, checked reference lists and undertook citation searches in PubMed and Google Scholar. Studies were assessed for risk of bias. Because of heterogeneity, results were not pooled, but are reported narrativelyPeer reviewe

Substructure in clusters containing wide-angle tailed radio galaxies. I. New redshifts

We present new redshifts and positions for 635 galaxies in nine rich clusters containing Wide-Angle Tailed (WAT) radio galaxies. Combined with existing data, we now have a sample of 18 WAT-containing clusters with more than 10 redshifts. This sample contains a substantial portion of the WAT clusters in the VLA 20 cm survey of Abell clusters, including 75% of WAT clusters in the complete survey (z0.09. It is a representative sample which should not contain biases other than selection by radio morphology. We graphically present the new data using histograms and sky maps. A semi-automated procedure is used to search for emission lines in the spectra in order to add and verify galaxy redshifts. We find that the average apparent fraction of emission line galaxies is about 9% in both the clusters and the field. We investigate the magnitude completeness of our redshift surveys with CCD data for a test case, Abell 690. This case indicates that our galaxy target lists are deeper than the detection limit of a typical MX exposure, and they are 82% complete down to R=19.0. The importance of the uniformity of the placement of fibers on targets is posited, and we evaluate this in our datasets. We find some cases of non-uniformities which may influence dynamical analyses. A second paper will use this database to look for correlations between the WAT radio morphology and the cluster's dynamical state.Comment: 15 pages, 5 figures, 7 tables. To appear in the Astronomical Journa

Delivering successful randomized controlled trials in surgery:methods to optimize collaboration and study design

Randomized controlled trials in surgery are notoriously difficult to design and conduct due to numerous methodological and cultural challenges. Over the last 5 years, several UK-based surgical trial-related initiatives have been funded to address these issues. These include the development of Surgical Trials Centers and Surgical Specialty Leads (individual surgeons responsible for championing randomized controlled trials in their specialist fields), both funded by the Royal College of Surgeons of England; networks of research-active surgeons in training; and investment in methodological research relating to surgical randomized controlled trials (to address issues such as recruitment, blinding, and the selection and standardization of interventions). This article discusses these initiatives more in detail and provides exemplar cases to illustrate how the methodological challenges have been tackled. The initiatives have surpassed expectations, resulting in a renaissance in surgical research throughout the United Kingdom, such that the number of patients entering surgical randomized controlled trials has doubled

The risk of colectomy and colorectal cancer after appendectomy in patients with ulcerative colitis:a systematic review and meta-analysis

Background: Appendectomy decreases the risk of developing ulcerative colitis [UC], and is suggested to have a beneficial effect on the clinical course of established UC. However, recent studies showed no significantly decreased colectomy rate, and moreover an apparently increased risk of colorectal cancer [CRC]. We aimed to investigate the suggested correlation in a meta-analysis and to analyse possible confounding factors. Methods: A systematic review and meta-analysis were performed using MEDLINE, EMBASE, and the Cochrane Library. Data from studies describing the influence of appendectomy on colectomy and CRC were extracted from published reports. Exclusion criteria were patients aged <18 years, non-UC, and animal studies. Results: From 891 studies, 13 studies evaluating 73 323 UC patients [appendectomy n = 2859] were included. All studies, except one, were rated as poor quality. Overall, colectomy rate in appendectomised and non-appendectomised patients was not significantly different (odds ratio [OR] 1.25, 95% confidence interval [CI] 0.88-1.77, I2 = 53%). The proportion of colectomies undertaken for CRC or high-grade dysplasia [HGD] was significantly higher after appendectomy [OR 2.85, 95% CI 1.40-5.78, I2 = 32%], with 50% of the colectomies indicated for CRC/HGD compared with 9.4% in non-appendectomised patients. Possible additional confounding factors were a longer UC disease duration, less medication use, and a higher prevalence of primary sclerosing cholangitis [PSC] in appendectomised patients. Conclusions: Appendectomy in established UC is associated with apparently higher rates of subsequent CRC/HGD, but this appears to be due to inequalities in at-risk exposure between groups, presumably secondary to positive clinical effects of appendectomy on disease symptoms. This finding emphasises the importance of regular endoscopic surveillance in this patient group

Genetic Susceptibility Determines β-Cell Function and Fasting Glycemia Trajectories Throughout Childhood: A 12-Year Cohort Study (EarlyBird 76)

No embargo require

The counterrotating core and the black hole mass of IC1459

The E3 giant elliptical galaxy IC1459 is the prototypical galaxy with a fast counterrotating stellar core. We obtained one HST/STIS long-slit spectrum along the major axis of this galaxy and CTIO spectra along five position angles. We present self-consistent three-integral axisymmetric models of the stellar kinematics, obtained with Schwarzschild's numerical orbit superposition method. We study the dynamics of the kinematically decoupled core (KDC) in IC1459 and we find it consists of stars that are well-separated from the rest of the galaxy in phase space. The stars in the KDC counterrotate in a disk on orbits that are close to circular. We estimate that the KDC mass is ~0.5% of the total galaxy mass or ~3*10^9 Msun. We estimate the central black hole mass M_BH of IC1459 independently from both its stellar and its gaseous kinematics. Some complications probably explain why we find rather discrepant BH masses with the different methods. The stellar kinematics suggest that M_BH = (2.6 +/- 1.1)*10^9 Msun (3 sigma error). The gas kinematics suggests that M_BH ~ 3.5*10^8 Msun if the gas is assumed to rotate at the circular velocity in a thin disk. If the observed velocity dispersion of the gas is assumed to be gravitational, then M_BH could be as high as ~1.0*10^9 Msun. These different estimates bracket the value M_BH = (1.1 +/- 0.3)*10^9 Msun predicted by the M_BH-sigma relation. It will be an important goal for future studies to assess the reliability of black hole mass determinations with either technique. This is essential if one wants to interpret the correlation between the BH mass and other global galaxy parameters (e.g. velocity dispersion) and in particular the scatter in these correlations (believed to be only ~0.3 dex). [Abridged]Comment: 51 pages, LaTeX with 19 PostScript figures. Revised version, with three new figures and data tables. To appear in The Astrophysical Journal, 578, 2002 October 2

An international assessment of the adoption of enhanced recovery after surgery (ERAS (R)) principles across colorectal units in 2019-2020

Aim The Enhanced Recovery After Surgery (ERAS (R)) Society guidelines aim to standardize perioperative care in colorectal surgery via 25 principles. We aimed to assess the variation in uptake of these principles across an international network of colorectal units. Method An online survey was circulated amongst European Society of Coloproctology members in 2019-2020. For each ERAS principle, respondents were asked to score how frequently the principle was implemented in their hospital, from 1 ('rarely') to 4 ('always'). Respondents were also asked to recall whether practice had changed since 2017. Subgroup analyses based on hospital characteristics were conducted. Results Of hospitals approached, 58% responded to the survey (195/335), with 296 individual responses (multiple responses were received from some hospitals). The majority were European (163/195, 83.6%). Overall, respondents indicated they 'most often' or 'always' adhered to most individual ERAS principles (18/25, 72%). Variability in the uptake of principles was reported, with universal uptake of some principles (e.g., prophylactic antibiotics; early mobilization) and inconsistency from 'rarely' to 'always' in others (e.g., no nasogastric intubation; no preoperative fasting and carbohydrate drinks). In alignment with 2018 ERAS guideline updates, adherence to principles for prehabilitation, managing anaemia and postoperative nutrition appears to have increased since 2017. Conclusions Uptake of ERAS principles varied across hospitals, and not all 25 principles were equally adhered to. Whilst some principles exhibited a high level of acceptance, others had a wide variability in uptake indicative of controversy or barriers to uptake. Further research into specific principles is required to improve ERAS implementation