Pudendal nerve decompression in perineology : a case series

BACKGROUND: Perineodynia (vulvodynia, perineal pain, proctalgia), anal and urinary incontinence are the main symptoms of the pudendal canal syndrome (PCS) or entrapment of the pudendal nerve. The first aim of this study was to evaluate the effect of bilateral pudendal nerve decompression (PND) on the symptoms of the PCS, on three clinical signs (abnormal sensibility, painful Alcock's canal, painful "skin rolling test") and on two neurophysiological tests: electromyography (EMG) and pudendal nerve terminal motor latencies (PNTML). The second aim was to study the clinical value of the aforementioned clinical signs in the diagnosis of PCS. METHODS: In this retrospective analysis, the studied sample comprised 74 female patients who underwent a bilateral PND between 1995 and 2002. To accomplish the first aim, the patients sample was compared before and at least one year after surgery by means of descriptive statistics and hypothesis testing. The second aim was achieved by means of a statistical comparison between the patient's group before the operation and a control group of 82 women without any of the following signs: prolapse, anal incontinence, perineodynia, dyschesia and history of pelvi-perineal surgery. RESULTS: When bilateral PND was the only procedure done to treat the symptoms, the cure rates of perineodynia, anal incontinence and urinary incontinence were 8/14, 4/5 and 3/5, respectively. The frequency of the three clinical signs was significantly reduced. There was a significant reduction of anal and perineal PNTML and a significant increase of anal richness on EMG. The Odd Ratio of the three clinical signs in the diagnosis of PCS was 16,97 (95% CI = 4,68 – 61,51). CONCLUSION: This study suggests that bilateral PND can treat perineodynia, anal and urinary incontinence. The three clinical signs of PCS seem to be efficient to suspect this diagnosis. There is a need for further studies to confirm these preliminary results

Prescribing practices of primary-care veterinary practitioners in dogs diagnosed with bacterial pyoderma

Concern has been raised regarding the potential contributions of veterinary antimicrobial use to increasing levels of resistance in bacteria critically important to human health. Canine pyoderma is a frequent, often recurrent diagnosis in pet dogs, usually attributable to secondary bacterial infection of the skin. Lesions can range in severity based on the location, total area and depth of tissue affected and antimicrobial therapy is recommended for resolution. This study aimed to describe patient signalment, disease characteristics and treatment prescribed in a large number of UK, primary-care canine pyoderma cases and to estimate pyoderma prevalence in the UK vet-visiting canine population

Establishing a meaningful human rights due diligence process for corporations : learning from experience of human rights impact assessment

The United Nations Special Representative of the Secretary-General on Business and Human Rights, Professor John Ruggie, has constructed a new international framework, which is set to become the cornerstone for all action on human rights and business at the international level. The principle of human rights due diligence (HRDD) is the central component of the corporate duty to respect human rights within that framework. This article argues that Ruggie's HRDD principle contains the majority of the core procedural elements that a reasonable human rights impact assessment (HRIA) process should incorporate. It is likely that the majority of corporations will adopt HRIA as a mechanism for meeting their due diligence responsibilities. However, in the context of the contentious debate around corporate human rights performance, the current state of the art in HRIA gives rise to concerns about the credibility and robustness of likely practice. Additional requirements are therefore essential if HRDD is to have a significant impact on corporate human rights performance – requirements in relation to transparency; external participation and verification; and independent monitoring and review

Resilience factors and coping as predictors of academic performance of the students in private universities

Predecir el rendimiento académico en estudiantes universitarios peruanos es una garantía para cumplir las exigencias de licenciamiento y acreditación. Se realiza un diseño transversal, comparativo y explicativo para establecer los factores de resiliencia y afrontamiento que predicen el rendimiento académico, en dos muestras probabilísticas estratificadas de universidades privadas de Lima. El RESI-, CAE, Smilkstein, CP-LS y estimadores DWLS, GLS, demostraron que el modelo predictivo de resiliencia y promedio ponderado tienen efecto en la percepción de rendimiento académico y un efecto mínimo en el promedio ponderado. Ambos factores predicen de manera directa, indirecta y relacional el rendimiento académico. Destacan los factores confianza en sí mismo, capacidad social, estrategias de autofocalización emocional abierta, exposición emocional abierta y apoyo familiar social como predictores relevantes en expectativa de logro, aprendizaje percibido y satisfacción global. El funcionamiento familiar, es un predictor indirecto a través de la resiliencia del rendimiento académico. Factores de afrontamiento activo, predicen mejor la percepción del rendimiento que factores de protección y riesgo. Muestras homogéneas grandes con valor psicométrico pueden mejorar los modelos predictivos, identificar perfiles, diseñar estudios causales, desarrollar programas de aprendizaje de talento y estrategias activas que mejorarían la calidad del aprendizaje universitario.Predicting academic performance in Peruvian university students is a guarantee to meet licensing and accreditation requirements. A transversal, comparative and explanatory (predictive) design was used to establish the resilience and coping factors that predict academic performance, in two stratified probabilistic samples from private universities in Lima. The RESI-, CAE, Smilkstein, CP-LS and DWLS estimators, GLS, showed that the predictive model of resilience and weighted average have an effect on the perception of academic performance and a minimal effect on the weighted average. Both factors predict academic performance directly, indirectly and relationally. The self-confidence factor, social capacity, open emotional self-targeting strategies, open emotional exposure and social family support are highlighted as relevant predictors in expectation of achievement, perceived learning and overall satisfaction. Family functioning is an indirect predictor through the resilience of academic performance. Factors of active coping better predict the perception of performance than protection and risk factors. Large homogeneous samples with psychometric value can improve predictive models, identify profiles, design causal studies, develop talent learning programs and active strategies that would improve the quality of university learnin

Evaluating synergy between marbofloxacin and gentamicin in Pseudomonas aeruginosa strains isolated from dogs with otitis externa

The aim of this study was to determine antimicrobial susceptibility of Pseudomonas aeruginosa strains to marbofloxacin and gentamicin, and investigate the possible synergistic, additive, indifferent or antagonistic effects between the two agents. P. aeruginosa strains can develop resistance quickly against certain antibiotics if used alone, thus the need emerges to find synergistic combinations. A total of 68 P. aeruginosa strains isolated from dogs were examined. In order to describe interactions between marbofloxacin and gentamicin the checkerboard microdilution method was utilized. The MICs (minimum inhibitory concentrations) for marbofloxacin and gentamicin were in the range 0.25–64 mg/L and 0.25–32 mg/L, respectively. The combination of marbofloxacin and gentamicin was more effective with a MIC range of 0.031–8 mg/L and a MIC90 of 1 mg/L, compared to 16 mg/L for marbofloxacin alone and 8 mg/L for gentamicin alone. The FIC (fractional inhibitory concentration) indices ranged from 0.0945 (pronounced synergy) to 1.0625 (indifference). Synergy between marbofloxacin and gentamicin was found in 33 isolates. The mean FIC index is 0.546, which represents a partial synergistic/additive effect close to the full synergy threshold. In vitro results indicate that marbofloxacin and gentamicin as partially synergistic agents may prove clinically useful in combination therapy against P. aeruginosa infections. Although marbofloxacin is not used in the human practice, the interactions between fluoroquinolones and aminoglycosides may have importance outside the veterinary field

Cloud computing and RESERVOIR project

The support for complex services delivery is becoming a key point in current internet technology. Current trends in internet applications are characterized by on demand delivery of ever growing amounts of content. The future internet of services will have to deliver content intensive applications to users with quality of service and security guarantees. This paper describes the RESERVOIR project and the challenge of a reliable and effective delivery of services as utilities in a commercial scenario. It starts by analyzing the needs of a future infrastructure provider and introducing the key concept of a service oriented architecture that combines virtualisation-aware grid with grid-aware virtualisation, while being driven by business service management. This article will then focus on the benefits and the innovations derived from the RESERVOIR approach. Eventually, a high level view of RESERVOIR general architecture is illustrated