Pelvic organ prolapse and collagen-associated disorders

Contains fulltext : 109010.pdf (publisher's version ) (Open Access)INTRODUCTION AND HYPOTHESIS: Pelvic organ prolapse (POP) and other disorders, such as varicose veins and joint hypermobility, have been associated with changes in collagen strength and metabolism. We hypothesized that these various disorders were more prevalent in both POP patients and their family members. METHODS: In this study, the prevalence of various collagen-associated disorders, including POP, was compared between POP patients (n = 110) and control patients (n = 100) and their first and second degree family members. RESULTS: POP patients reported a higher prevalence of varicose veins, joint hypermobility and rectal prolapse and were more likely to have family members with POP as compared to the control group (p < 0.01). In contrast, the family members of the POP group did not report a higher prevalence of collagen-associated disorders compared to the family members of the control group (p = 0.82). CONCLUSIONS: POP and other collagen-associated disorders may have a common aetiology, originating at the molecular level of the collagens.1 maart 201

Sonographic evaluation of the shoulder in asymptomatic elderly subjects with diabetes

<p>Abstract</p> <p>Background</p> <p>The prevalence of rotator cuff tears increases with age and several studies have shown that diabetes is associated with symptomatic shoulder pathologies. Aim of our research was to evaluate the prevalence of shoulder lesions in a population of asymptomatic elderly subjects, normal and with non insulin - dependent diabetes mellitus.</p> <p>Methods</p> <p>The study was performed on 48 subjects with diabetes and 32 controls (mean age: 71.5 ± 4.8 and 70.7 ± 4.5, respectively), who did not complain shoulder pain or dysfunction. An ultrasound examination was performed on both shoulders according to a standard protocol, utilizing multiplanar scans.</p> <p>Results</p> <p>Tendons thickness was greater in diabetics than in controls (Supraspinatus Tendon: 6.2 ± 0.09 mm <it>vs </it>5.2 ± 0.7 mm, p < 0.001; Biceps Tendon: 4 ± 0.8 mm <it>vs </it>3.2 ± 0.4 mm, p < 0.001). Sonographic appearances of degenerative features in the rotator cuff and biceps were more frequently observed in diabetics (Supraspinatus Tendon: 42.7% <it>vs </it>20.3%, p < 0.003; Biceps Tendon: 27% <it>vs </it>7.8%, p < 0.002).</p> <p>Subjects with diabetes exhibited more tears in the Supraspinatus Tendon (Minor tears: 15 (15.8%) <it>vs </it>2 (3.1%), p < 0.03; Major tears: 15 (15.8%) <it>vs </it>5 (7.8%), p = ns), but not in the long head of Biceps. More effusions in subacromial bursa were observed in diabetics (23.9% <it>vs </it>10.9%, p < 0.03) as well as tenosynovitis in biceps tendon (33.3% <it>vs </it>10.9%, p < 0.001).</p> <p>In both groups, pathological findings were prevalent on the dominant side, but no difference related to duration of diabetes was found.</p> <p>Conclusions</p> <p>Our results suggest that age - related rotator cuff tendon degenerative changes are more common in diabetics.</p> <p>Ultrasound is an useful tool for discovering in pre - symptomatic stages the subjects that may undergo shoulder symptomatic pathologies.</p

Computer work and musculoskeletal disorders of the neck and upper extremity: A systematic review

<p>Abstract</p> <p>Background</p> <p>This review examines the evidence for an association between computer work and neck and upper extremity disorders (except carpal tunnel syndrome).</p> <p>Methods</p> <p>A systematic critical review of studies of computer work and musculoskeletal disorders verified by a physical examination was performed.</p> <p>Results</p> <p>A total of 22 studies (26 articles) fulfilled the inclusion criteria. Results show limited evidence for a causal relationship between computer work per se, computer mouse and keyboard time related to a diagnosis of wrist tendonitis, and for an association between computer mouse time and forearm disorders. Limited evidence was also found for a causal relationship between computer work per se and computer mouse time related to tension neck syndrome, but the evidence for keyboard time was insufficient. Insufficient evidence was found for an association between other musculoskeletal diagnoses of the neck and upper extremities, including shoulder tendonitis and epicondylitis, and any aspect of computer work.</p> <p>Conclusions</p> <p>There is limited epidemiological evidence for an association between aspects of computer work and some of the clinical diagnoses studied. None of the evidence was considered as moderate or strong and there is a need for more and better documentation.</p

Evaluation of a new virtual-reality training simulator for hysteroscopy

BACKGROUND: To determine realism and training capacity of HystSim, a new virtual-reality simulator for the training of hysteroscopic interventions. METHODS: Sixty-two gynaecological surgeons with various levels of expertise were interviewed at the 13(th) Practical Course in Gynaecologic Endoscopy in Davos, Switzerland. All participants received a 20-min hands-on training on the simulator and filled out a four-page questionnaire. Twenty-three questions with respect to the realism of the simulation and the training capacity were answered on a seven-point Likert scale along with 11 agree-disagree statements concerning the HystSim training in general. RESULTS: Twenty-six participants had performed more than 50 hysteroscopies ("experts") and 36 equal to or fewer than 50 ("novices"). Four of 60 (6.6%) responding participants judged the overall impression as "7 - absolutely realistic", 40 (66.6%) as "6 - realistic", and 16 (26.6%) as "5 - somewhat realistic". Novices (6.48; 95% confidence interval [CI] 6.28-6.7) rated the overall training capacity significantly higher than experts (6.08; 95% CI 5.85-6.3), however, high-grade acceptance was found in both groups. In response to the statements, 95.2% believe that HystSim allows procedural training of diagnostic and therapeutic hysteroscopy, and 85.5% suggest that HystSim training should be offered to all novices before performing surgery on real patients. CONCLUSION: Face validity has been established for a new hysteroscopic surgery simulator. Potential trainees and trainers assess it to be a realistic and useful tool for the training of hysteroscopy. Further systematic validation studies are needed to clarify how this system can be optimally integrated into the gynaecological curriculum

The laboratory parameters-derived CoLab score as an indicator of the host response in ICU COVID-19 patients decreases over time: a prospective cohort study

The CoLab score was developed and externally validated to rule out COVID-19 among suspected patients presenting at the emergency department. We hypothesized a within-patient decrease in the CoLab score over time in an intensive care unit (ICU) cohort. Such a decrease would create the opportunity to potentially rule out the need for isolation when the infection is overcome. Using linear mixed-effects models, data from the Maastricht Intensive Care COVID (MaastrICCht) cohort were used to investigate the association between time and the CoLab score. Models were adjusted for sex, APACHE II score, ICU mortality, and daily SOFA score. The CoLab score decreased by 0.30 points per day (95% CI − 0.33 to − 0.27), independent of sex, APACHE II, and Mortality. With increasing SOFA score over time, the CoLab score decreased more strongly (− 0.01 (95% CI − 0.01 to − 0.01) additional decrease per one-point increase in SOFA score.) The CoLab score decreased in ICU patients on mechanical ventilation for COVID-19, with a one-point reduction per three days, independent of sex, APACHE II, and ICU mortality, and somewhat stronger with increasing multi-organ failure over time. This suggests that the CoLab score would decrease below a threshold where COVID-19 can be excluded. Afdeling Klinische Chemie en Laboratoriumgeneeskunde (AKCL

Kabuli Mustafa Efendi ve Kenzü’ l-esrar adlı eseri

ÖZET"Kenzü'l-Esrâr li's-Sâlikîn" adlı eser, 19 yy.'da Edirne'de yaşamış olan Kabûlî Mustafa Efendi tarafından yazılmıştır.Eser müellif tarafından kendisine sorulara cevap verme ve ayrıca tarîkattaki sâliklere bilgi verme amacıyla yazılmıştır. Müellife ifadesine göre kendisine sorulan sorular şunlardır: Tarîkattaki sülûkün hâlinden, ve sülûkle nefsin bilinmesinden ve insan vücûdunun hakîkatinden ve kâmil mürşidlerin sırları.Kenzü'l-Esrâr'da tasavvufî bir çok konu üzerinde durulmuştur. Bu konular: İnsanın hakîkati ve yaratılış, seyr u sülûk, nefsin mertebeleri, kalbin tavırları, ilm-i ledün, zikr-i cehrî(sesli), râbıta, mürşidin bilmesi gereken âdâb, sâlikin bilmesi ve uyması gereken âdâb, tarîkattaki âdâb, tarîkattaki dört kapı kırk makam, ehl-i beyt sevgisi ve on iki imam, tâc, hırka, post ve seccâde.Bu eserde Rifâî tarîkatına mensûb olan müellif tasavvûfî konularda ve tarîkat hakkında bilgi vermektedir. Eser osmanlıca olarak yazılmıştır ve değişik kütüphanelerde nüshaları vardır. Biz çalışmamız esnasında bu nüshalardan iki tanesinden faydalandık.Bu çalışmamızın amacı, 19. yy.'da Edirne'de yaşamış müellifin kaleminden bu döneme ait Rifâî tarîkatının âdâbı ve görüşlerini öğrenmek ve bu konuda çalışanlar için ulaşabilecekleri bir kaynak oluşturmaktır. ABSTRACTKABÛLÎ MUSTAFA AND HİS WORK ENTİTLED "KENZÜ'L- ESRÂR"The work named "Kenzü'l-Esrâr li's-sâlikîn" was written by Kabûlî Mustafa Efendi lived in Edirne in 19th century.The work was written in order to response the questions that was asked to the writer and inform the disciples of the religious way. According to the writer the questions that were asked to himself are these: the state of the following of the religious way and grasping the self with the help of this religious way, the reality of human body and the mysteries of the perfect spritual guides.İn Kenzü'l-Esrâr, many sufic (Islamic mysticism) subjects are mentioned: the reality and the nature of human being, the progress of the following the religious way, levels of the self, manners of the soul, inner science, reciting aloud God's name, devotion, the rules of manner that was necessary for the spritual guide to know, the rules manner that was necessary for disciple to know and obey, the rules of manner in the religious way, four gate fourthy authorities, the love for the family of Prophet Mohammed and twelve imam* crown (tâc), cardigan (hırka), hide (post) and prayer- rug (seccade).In this work, the writer who is a member of Rifâî religious way is giving information about sufic subjects and Rifâî way,. The work was written in Ottoman Turkish and its various capies can be found in different libraries. During our studying process we benefit from two capies.The object of our study is to know about the opinions and the rules of manner of Rifâî way which belongs to the 19th century; and to provide sources for the ones who are studying on this subject. * İmam: Religious leader