Early and late follow-up of untreated traumatic aortic lesion: a support to delayed surgery

Fuente Fuente, Carlos;Montes Gil, Antonio;Periel Piquer, Montserra

An international Urogynecological association (IUGA)/international continence society (ICS) joint report on the terminology for the assessment of sexual health of women with pelvic floor dysfunction.

INTRODUCTION AND HYPOTHESIS: The terminology in current use for sexual function and dysfunction in women with pelvic floor disorders lacks uniformity, which leads to uncertainty, confusion, and unintended ambiguity. The terminology for the sexual health of women with pelvic floor dysfunction needs to be collated in a clinically-based consensus report. METHODS: This report combines the input of members of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA), and the International Continence Society (ICS), assisted at intervals by many external referees. Internal and external review was developed to exhaustively examine each definition, with decision-making by collective opinion (consensus). Importantly, this report is not meant to replace, but rather complement current terminology used in other fields for female sexual health and to clarify terms specific to women with pelvic floor dysfunction. RESULTS: A clinically based terminology report for sexual health in women with pelvic floor dysfunction encompassing over 100 separate definitions, has been developed. Key aims have been to make the terminology interpretable by practitioners, trainees, and researchers in female pelvic floor dysfunction. Interval review (5-10 years) is anticipated to keep the document updated and as widely acceptable as possible. CONCLUSIONS: A consensus-based terminology report for female sexual health in women with pelvic floor dysfunction has been produced aimed at being a significant aid to clinical practice and a stimulus for research

Secondary education reform in Lesotho and Zimbabwe and the needs of rural girls: Pronouncements, policy and practice

Analysis of the educational needs of rural girls in Lesotho and Zimbabwe suggests a number of shortcomings in the current form of secondary education, and ways in which it might be modified so as to serve this sizeable group of students better. Several of the shortcomings, notably in relation to curricular irrelevance and excessive focus on examinations, have long been recognised, including by politicians. Yet political pronouncements are seldom translated into policy, and even where policy is formulated, reforms are seldom implemented in schools. This paper makes use of interviews with educational decision-makers in the two southern African countries and a range of documentary sources to explore why, despite the considerable differences between the two contexts, much needed educational reforms have been implemented in neither

Trocar-guided total tension-free vaginal mesh repair of post-hysterectomy vaginal vault prolapse

Contains fulltext : 81076.pdf (publisher's version ) (Closed access)INTRODUCTION AND HYPOTHESIS: The objective of this study was to report 1 year anatomical and functional outcomes of trocar-guided total tension-free vaginal mesh (Prolift) repair for post-hysterectomy vaginal vault prolapse with one continuous piece of polypropylene mesh. METHODS: We conducted a prospective observational cohort study of 46 patients. A minimum sample size of 35 patients was needed to detect a recurrence rate of less than 20% at 12 months. Instruments of measurement used were pelvic organ prolapse quantification and validated questionnaires. RESULTS: Overall anatomical success was 91% (95% confidence interval 83-99), with significant improvement in experienced bother and quality of life. Mesh exposure occurred in seven patients (15%). No adverse effects on sexual function could be detected. CONCLUSIONS: Trocar-guided total tension-free vaginal mesh (Prolift) repair with one continuous piece of mesh for post-hysterectomy vaginal vault prolapse is well tolerated and anatomically and functionally highly effective. Results of controlled trials will determine its position in the operative armamentarium

La chirurgie vaginale prothétique peut-elle être proposée aux patientes âgées de plus de 75 ans ?

International audiencePrevalence of pelvic organ prolapse will increase with the aging of the population. Concerning the treatment of pelvic organ prolapse, transvaginal route is often preferred for elderly women. However few data are available concerning transvaginal mesh surgery in this population. The aim of this study was to compare efficiency and complications of transvaginal mesh surgery between women aged over 75 and younger women.La chirurgie par voie vaginale est souvent privilégiée pour le traitement du prolapsus chez les patientes âgées. Cependant peu de données existent sur les résultats de la chirurgie prothétique dans cette population. L’objectif de cette étude était donc d’évaluer l’efficacité ainsi que les complications de la chirurgie vaginale prothétique chez les patientes âgées de plus de 75 ans par rapport aux patientes plus jeunes

Évaluation des résidus postmictionnels du postpartum : étude prospective descriptive

International audienceINTRODUCTION:Few studies have evaluated urine postvoid residuals (PVRs) and their risk factors during the post-partum (PP) period. The aim of this prospective study was to screen postvoid residuals in a cohort of patients in PP, and to identify the risk factors.MATERIALS AND METHODS:For three months, patients in PP were given an evaluation of their PVR (ultrasounds method) after a spontaneous urination. Clinical data as regards delivery were collected.RESULTS:One hundred and sixty-eight patients were included. Among them, 61% had a urine volume at the first urination over 500 mL, and 52% presented with a pathological PVR (PVR over 150 mL for a urine volume over 150 mL). The median PVR was 153.50 mL. The median volume of the first spontaneous urination was 400 mL. Among patients with a pathological PVR, the total duration of the labor and the duration of its second phase were significantly longer (P=0.003 and P0.05).CONCLUSION:We were able to identify risk factors for PVR in the PP, such as the duration of labor, instrumental delivery and elevated volume of the first urination after delivery

A paediatric interactive therapy system for arm and hand rehabilitation

Paediatric rehabilitation using virtual reality systems pose unique usability challenges distinct from those in adult rehabilitation. These challenges relate to the different epidemiology and aetiology of children's disorders requiring rehabilitation and the physical design of interactive virtual reality hardware for children of varying sizes. Just as importantly, children need highly entertaining interactive scenarios that suit their differing levels of cognitive development and thus their differing abilities to comprehend gaming scenarios. In this paper we present our virtual reality-based Paediatric Interactive Therapy System (PITS) designed specifically for upper arm rehabilitation in children aged from five years of age upwards. It incorporates a range of interchangeable position sensing devices (compass, bend sensor, pressure sensor and camera tracking) that can be adjusted to a large range of different hand sizes, and interactive gaming scenarios specifically designed for maximum entertainment value for children. We describe the neuroscientific principles behind our system, the technical details of the hardware components and the design of the interactive scenarios. An initial usability and patient acceptance pilot study has been conducted at the Rehabilitation Centre Affoltern of the University Children's Hospital Zurich. To date all patients have accepted the system, and trained in reaching and grasping tasks at a far higher rate than in conventional occupational therapy. The system thus promises to be a valuable complement to conventional therapeutic programs offered in rehabilitation clinics