Post-menopausal vulvovaginal atrophy — an overview of the current treatment options

Sex hormone deficiency in post-menopausal women causes changes in the lower urinary tract. Vulvovaginal atrophy is a pathology resulting from those changes. VVA has a negative effect on the quality of life therefore prompting a search for new therapeutic options. The aim of this article is to summarize the current treatment modalities, both hormonal and non-hormonal for post-menopausal vaginal atrophy. Topical oestrogen therapy remains the “golden standard”. Alternatives, although promising, require well-designed control studies

Pelvic venous insufficiency — an often-forgotten cause of chronic pelvic pain

Chronic pelvic pain is a common health problem that afflicts 39% of women at some time in their life. It is a common challengefor gynecologists, internists, surgeons, gastroenterologists, and pain management physicians. Pelvic venous insufficiency(PVI) accounts for 16–31% of cases of chronic pain but it seems to be often overlooked in differential diagnosis. The aim ofthis article was to summarize current data concerning PVI. The embolization of insufficient ovarian veins remains the goldstandard of therapy but the optimal procedure is yet to be determined. Well-designed randomized trials are required toestablish the best treatment modalities

Multi-proxy inferred hydroclimatic conditions at Bęczkowice fen (central Poland); the influence of fluvial processes and human activity in the stone age

Fens have been forming in the river valleys of central Poland since the Bølling and went through a transformation from fully aquatic to semiterrestrial habitats during the Younger Dryas/Holocene transition. This drove plant and invertebrate communities and left a distinct pattern in chemical sediment composition, which is why river valley peatlands are sensitive palaeo-archives of climatic, hydrological and edaphic changes. Here we reconstruct the Late Weichselian history of the Bęczkowice fen in the upper Luciąża River valley using geochemical, pollen, Cladocera and Chironomidae proxies. Pollen-based age estimation indicates that the analysed peat sequence dates from the Bølling to Early Holocene. The layers 190-170 cm and 125-105 cm of the studied core were reworked by fluvial processes. Chironomidae and Cladocera communities indicate mostly limnetic conditions during the Allerød and early Younger Dryas. Peatland pools were supplied mostly by Luciąża River floods, but also by groundwater. Since the onset of the Holocene, the water level has dropped, eliminating aquatic midges and water fleas, and supporting taxa typical of astatic waters and wet soil.Peer reviewe

Unified time analysis of photon and (nonrelativistic) particle Tunnelling, and the Superluminal group-velocity problem

A unified approach to the time analysis of tunnelling of nonrelativistic particles is presented, in which Time is regarded as a quantum-mechanical observable, canonically conjugated to Energy. The validity of the Hartman effect (independence of the Tunnelling Time of the opaque barrier width, with Superluminal group velocities as a consequence) is verified for ALL the known expressions of the mean tunnelling time. Moreover, the analogy between particle and photon tunnelling is suitably exploited. On the basis of such an analogy, an explanation of some recent microwave and optics experimental results on tunnelling times is proposed. Attention is devoted to some aspects of the causality problem for particle and photon tunnelling.Comment: plain (old) LaTeX; 42 pages; plus figures 1, 2, 3, 4a, 4b, and

Quantum (not frustrated) theory of the total internal reflection as the source of the Goos-Hänchen shift

The frustrated total internal reflection theories (FTIR) from previous century are thoroughly recalculated from the, so called, monodromy operator’s point of view – a theory lunched by Born and Wolf [Principles of Optics (Pergamon Press, 1975), Chap. 1.6] and Arnold [Geometric Methods in the Theory of Ordinary Differential Equations (Springer, 1987)]. Monodromy is a theory of simultaneous solution (for both reflection and transmission amplitudes) of one dimensional Schrödinger equation (for the wavefunction and its derivative) and the Maxwell equation (for electric and magnetic fields). Introducing new quantities: the dwell distance and the phase distance, we get general Goos-Hänchen (G-H) shift formula for optical tunneling for three layer system with refraction indexes n0, n1, n2. This formula reduces itself to expressions known from the scientific literature for infinite air gap (infinite width of second layer). Extension to many layers is possible

Vaginal Aging—What We Know and What We Do Not Know

The aging of the organism is a complex and multifactorial process. It can be viewed in the context of the whole organism, but also of individual tissues and organs. The problem of vaginal aging and the related genitourinary syndrome of menopause significantly reduces the quality of women’s lives. The aging process of the vagina includes estrogen deficiencies, changes in the microbiome, and changes at the genetic level associated with DNA methylation. During the menopause, the number of Lactobacillus colonies decreases, and the number of pathological bacteria colonies increases. The decrease in estrogen levels results in a decrease in vaginal epithelial permeability, perfusion, and elastin levels, resulting in vaginal dryness and atrophy. Changes at the molecular level are the least clear. It can also be assumed that, similarly to the tissues studied so far, there are changes in cytosine methylation and TET (ten-eleven translocation) expression. The interrelationships between DNA methylation, hormonal changes, and the vaginal microbiome have not yet been fully elucidated

Fowler’s Syndrome—The Cause of Urinary Retention in Young Women, Often Forgotten, but Significant and Challenging to Treat

Urinary retention in young women is a relatively rare clinical problem and is often underdiagnosed. In particular, functional causes of urinary retention pose a diagnostic challenge. One of them is Fowler’s syndrome, which is associated with impaired urethral relaxation. Fowler’s syndrome is characterized by a large bladder capacity, reduced sensation, increased maximal urethral closure pressure, and detrusor underactivity. Several hypotheses have arisen to explain the cause of urethral relaxation disorders: hormonal changes characteristic of Polycystic Ovary Syndrome (PCOS), causing abnormal stabilization of the muscle membrane, primary failure of relaxation of the striated muscle of the urethra sphincter, and increased urethral afferent activity, inhibiting the bladder afferent signals from reaching the brain by potentiating a spinal mechanism of urinary continence. Currently, sacral neuromodulation is the only intervention that can restore an atypical voiding pattern in women with Fowler’s syndrome. The therapeutic effectiveness exceeds 70%, although the revision rate is relatively high, exceeding 50%. Well-designed, long-term prospective studies comparing sacral neuromodulation (SNM) with other therapies such as pelvic floor muscle physiotherapy are warranted to offer the best patient-tailored treatment

Unified time analysis of the photon and particle tunnelling

A unified time analysis of photon and nonrelativistic particle tunnellings is presented, in which Time is regardedas a quantum observable, canonically conjugated to Energy. Within this approach, one can introduce self-consistent definitions of the tunnelling times, on the basis of conventional quantum mechanics (or one-dimensional quantum electrodynamics) only. The validity of the Hartman effect [which states the tunnelling duration to be independent of the (opaque) barrier width, with Superluminal group velocities of the tunnelling packet as a consequence] isverified for all the known expressions of the mean tunnelling time. However, some noticeable generalizations of (and deviations from) the Hartman Effect are briefly investigated. Moreover, the analogy between particle and photon tunnelling is suitably exploited; on the basis of such an analogy, an explanation of some recent interesting microwave and optical experimental results on tunnelling times is proposed. Attention is devoted, at last, to someaspects of the causality problem for particle and photon tunnelling

Psychosocial profile and reproductive decisions of women undergoing pregnancy termination for medical reasons : a cross-sectional study

Background: The study aims to define the profile of women who decide to exercise their right to terminate a pregnancy and their future reproductive plans. Methods: Patients found eligible for termination for medical reasons between 2014 and 2016 were asked to complete an anonymous survey consisting of sixty questions examining the determinants of the decision to terminate a pregnancy. In total, 150 completed surveys were returned (62.5%). Results: Environmental factors, such as age, education, place of residence, marital status and financial status did not affect the decision-making process. The majority of the respondents were females under 35 years of age (71.3%). In most cases, the pregnancies had been planned and long-awaited (62.7%). The study also indicated that 22.6% of the patients who had been against abortion changed their mind when they encountered problems themselves. In addition, 20% of them changed their views on the acceptability of abortion. Termination had an impact on the participants future reproductive plans. Eighteen percent of the patients said they were definitely not planning more pregnancies. The majority (84.09%) of these women said that the reason was the traumatic experiences related to their pregnancy. Conclusions: The personal experience of a pregnancy termination procedure changed women’s opinions about pregnancy termination and modified further reproductive plan

Zespół metaboliczny a zespół policystycznych jajników

The consequences of PCOS are the subject of constant research, yet a number of scientific reports underlinethe fact that in women with PCOS, there appear higher risk of glucose intolerance and diabetes type2, hypertension, dislipidemia and atherosclerosis. The effects of PCOS reach beyond women’s reproductiveaxis. Metabolic syndrome occurs in 43-46% of patients with PCOS, which constitutes two times more than inwomen population. Insuline resistance and hyperinsulinemia are key disorders in both syndromes. Obesity,gestational diabetes, positive family history of diabetes type 2 and metabolic syndrome constitute a risk factorfor metabolic disorder development in patients with PCOS. Farmacological treatment of PCO syndrome dependson dominating symptoms and patient’s current needs taking into account her reproductive status. For a longtime, medicines which reduce insuline resistance have been used to treat PCOS, in ovulation stimulation as wellas in improvement of metabolic disorders. Insuline sensitivity improvement via reduction of body weight (diet,physical exercises) and choosing active lifestyle appears to be a standard