A comparison of sacral neuromodulation vs. transvaginal electrical stimulation for the treatment of refractory overactive bladder: The impact on quality of life, body image, sexual function, and emotional well-being

Overactive bladder syndrome (OAB) is defined by the presence of urinary urgency, with or without urge incontinence, usually accompanied by an increase in urinary frequency and nocturia in the absence of urinary tract infections (UTI) or other diseases. The overall prevalence of OAB symptoms in the female population is reported to be 16.6% and increases with advancing age and menopause. The aetiology of OAB is not fully understood and is likely to affect a heterogeneous population of patients due to changes to their central and peripheral nervous systems. Although OAB is frequently associated with female sexual dysfunction (FSD), its real impact on sexual function in women has been evaluated only in a few studies. The first line of treatment for OAB includes behavioural modification and physical therapy, either as monotherapies or in combination. Many patients who have not had success in managing their symptoms with more conservative therapies may decide to resort to third-line treatments for refractory OAB. These treatments include neuromodulation therapies, particularly transvaginal electrical stimulation (TES) and sacral neuromodulation (SN). The aim of this short commentary is to provide an overview of the effectiveness of these treatments and of their impact on quality of life, body image, sexual function, and emotional well-being

Different patterns of pelvic ureteral endometriosis. What is the best treatment? Results of a retrospective analysis

Objective. Endometriosis is an estrogendependent disease. The incidence of urinary tract endometriosis (UE) increased during the last few years and, nowadays, it ranges from 0.3 to 12% of all women affected by the disease. The ureter is the second most common site affected. The ureteral endometriosis is classified in extrinsic and intrinsic. The aim of this study is to individuate the best treatments for each subset of ureteral endometriosis. Materials and Methods. 32 patients diagnosed with surgically treated UE were retrospectively reviewed. The patients were divided into 3 subsets (intrinsic UE, extrinsic UE with and without obstruction). The patients with intrinsic UE (n = 10) were treated with laser endoureterotomy. The patients with extrinsic UE (n = 22) were divided in two subsets with (n = 16) and without (n = 6) hydronephrosis. All the patients underwent ureteral stenting, and resection and reimplantation was performed in the first group, and when the mass was > 2.5 cm (n = 3) Boari flap was performed. Laparoscopic ureterolysis (shaving) was performed in the second group. Results. In the extrinsic subset of UE, we obtained an high therapeutic success (84%). Conversely, in the intrinsic subset there was a recurrence rate of the disease in 6/10 of the patients (60%). Conclusions. Ureterolysis seems to be a good treatment in extrinsic UE without obstruction. Resection and reimplantation allows excellent results in the extrinsic UE with obstruction. In the intrinsic subset, the endoureterotomy approach is inadequate

Phase I trial combining temozolomide plus lapatinib for the treatment of brain metastases in patients with HER2-positive metastatic breast cancer: the LAPTEM trial

Background Brain metastases (BMs) pose a clinical challenge in breast cancer (BC). Lapatinib or temozolomide showed activity in BM. Our study assessed the combination of both drugs as treatment for patients with HER2-positive BC and BM. Methods Eighteen patients were enrolled, with sixteen of them having recurrent or progressive BM. Any type of previous therapy was allowed, and disease was assessed by gadolinium (Gd)-enhanced magnetic resonance imaging (MRI). The primary end points were the evaluation of the dose-limiting toxicities (DLTs) and the determination of the maximum-tolerated dose (MTD). The secondary end points included objective response rate, clinical benefit and duration of response. Results The lapatinib-temozolomide regimen showed a favorable toxicity profile because the MTD could not be reached. The most common adverse events (AEs) were fatigue, diarrhea and constipation. Disease stabilization was achieved in 10 out of 15 assessable patients. The estimated median survival time for the 16 patients with BM reached 10.94 months (95% CI: 1.09-20.79), whereas the median progression-free survival time was 2.60 months [95% confidence interval (CI): 1.82-3.37]. Conclusions The lapatinib-temozolomide combination is well tolerated. Preliminary evidence of clinical activity was observed in a heavily pretreated population, as indicated by the volumetric reductions occurring in brain lesion

Exploring constituency-level estimates for the 2017 British general election

Most opinion polls conducted during British general election campaigns report on each party’s estimated national vote share. Although of considerable interest, these data do not put the spotlight on the marginal seats, the constituencies targeted by the parties for intensive canvassing; these are where the contest for a majority in the House of Commons is won and lost. There have been some polls covering those constituencies as a whole, but very few of individual constituencies so there was very little reporting of the outcome for each party in those individual constituencies. That changed with the 2017 general election, when three analysts published estimates on the internet of each party’s vote share separately for each constituency and with those data predicted which party would win each seat. This paper explores the veracity of those estimates, finding that although in general terms they accurately represented the relative position of each constituency in the share of each party’s votes, nevertheless their estimates of which marginal seats would be won by each were not as accurate. The implications of such polls, especially as their predictive ability is improved, is discussed

Pilot optical alignment

PILOT (Polarized Instrument for Long wavelength Observations of the Tenuous interstellar medium) is a balloonborne astronomy experiment designed to study the polarization of dust emission in the diffuse interstellar medium in our Galaxy. The PILOT instrument allows observations at wavelengths 240 μm and 550 μm with an angular resolution of about two arcminutes. The observations performed during the two first flights performed from Timmins, Ontario Canada, and from Alice-springs, Australia, respectively in September 2015 and in April 2017 have demonstrated the good performances of the instrument. Pilot optics is composed of an off axis Gregorian type telescope combined with a refractive re-imager system. All optical elements, except the primary mirror, which is at ambient temperature, are inside a cryostat and cooled down to 3K. The whole optical system is aligned on ground at room temperature using dedicated means and procedures in order to keep the tight requirements on the focus position and ensure the instrument optical performances during the various phases of a flight. We’ll present the optical performances and the firsts results obtained during the two first flight campaigns. The talk describes the system analysis, the alignment methods, and finally the inflight performances

Pilot optical alignment

PILOT (Polarized Instrument for Long wavelength Observations of the Tenuous interstellar medium) is a balloonborne astronomy experiment designed to study the polarization of dust emission in the diffuse interstellar medium in our Galaxy. The PILOT instrument allows observations at wavelengths 240 μm (1.2THz) with an angular resolution about two arc-minutes. The observations performed during the first flight in September 2015 at Timmins, Ontario Canada, have demonstrated the optical performances of the instrument

Hydro-mechanical behaviour of a sandy silt from a river embankment

The paper presents the results of an experimental campaign aimed at characterizing the hydro-mechanical behaviour of a sandy silt from a river embankment. Due to continuous river level fluctuations and changing climatic and environmental conditions, flood embankment materials experience frequent variations in degree of saturation and suction values. Such variations strongly impact the earthwork performance both in terms of seepage and stability conditions. For these reasons, a detailed characterization of the material behaviour in unsaturated conditions was carried out. Experiments were designed in order to highlight the response of the involved soil in terms of changes in matric suction and confining stress. All tests were performed on undisturbed samples from the embankment. To cover the suction range, which is expected to be significant for the material and assessed through field monitoring, a combination of several suction-control and suction-measurement techniques was used (e.g. negative water column, axial translation, tensiometers). Obtained results enabled (i) to quantify the evolution of the yield stress with suction, (ii) to assess the collapse upon wetting behaviour, (iii) to get detailed information on the water retention behaviour and (iv) to define the relative permeability of the soil. This extensive characterization work serves as a basis for the analysis of the embankment response following river level variations, the final purpose of the research being to establish a reliable methodology and a feasible procedure for the realistic assessment of the safety margins under transient seepage