Bis(2-ethoxy­carbonyl­ethyl-κ2 C 1,O)(2-thioxo-1,3-dithiole-4,5-dithiol­ato-κ2 S 4,S 5)tin(IV)

In the title compound, [Sn(C5H9O2)2(C3S5)], the immediate environment around the Sn centre is defined by two S and two C atoms that define an approximately tetra­hedral geometry. The close approach of the pendant carbonyl O atoms [Sn—O = 2.577 (3) and 2.573 (3) Å] increases the coordination number to six. Supra­molecular chains are formed along the a axis in the crystal structure owing to the presence of C—H⋯O contacts

2-[(E)-(1H-Pyrrol-2-ylmethyl­idene)hydrazinyl]pyridine monohydrate

The title hydrate, C10H10N4·H2O, shows a small twist in the hydro­zone derivative, the dihedral angle between the pyridine and pyrrole rings being 11.08 (12)°. The pyridine and pyrrole N atoms lie to the same side of the mol­ecule being sustained in place by hydrogen-bonding inter­actions with the water mol­ecule. Further inter­molecular O—H⋯N and N—H⋯O hydrogen bonding leads to the formation of supra­molecular arrays in the ab plane

5-{[(E)-2-(4-Iodo­phen­yl)hydrazinyl­idene]meth­yl}thio­phene-2-carbaldehyde

The title compound, C12H9IN2OS, has an overall U-shape, with a dihedral angle of 21.4 (3)° between the thio­phene and benzene rings. In the crystal, supra­molecular chains mediated by N—H⋯O hydrogen bonds are formed along the b-axis direction

fac-(2-Amido­ethyl-κ2 C 1,O)aqua­tri­chlorido­tin(IV) 1,4,7,10,13,16-hexa­oxacyclo­octa­decane (2/1)

The asymmetric unit of the title compound, [Sn(C3H6NO)Cl3(H2O)]2·C12H24O6, comprises a six-coordinate tin complex and a 18-crown-6 mol­ecule, the latter disposed about a centre of inversion. The tin atom is coordinated by three Cl atoms, that define a facial arrangement, a chelating C-,O- ligand, and a water mol­ecule. The resulting CCl3O2 donor set defines a distorted octa­hedral geometry. The tin-bound aqua ligand forms O—H⋯O hydrogen bonds to the centrosymmetric 18-crown-6 mol­ecule, resulting in a tri-mol­ecular aggregate. These assemble into a supra­molecular chain along the a axis being connected by N—H⋯O hydrogen bonds

(E)-1-Phenyl-2-({5-[(1E)-(2-phenyl­hydrazin-1-yl­idene)meth­yl]-2-thien­yl}methyl­idene)hydrazine

The title mol­ecule, C18H16N4S, adopts a U-shape with the aromatic groups lying syn and orientated in the same direction as the thio­phene S atom. The conformation about each of the C=N bonds is E. Overall, the mol­ecule is curved as seen in the dihedral angle of 30.26 (19)° formed between the terminal benzene rings. In the crystal, supra­molecular chains along the c axis are formed by a combination of N—H⋯N hydrogen bonds and N—H⋯π inter­actions

Stress Urinary Incontinence Correction with Sling: First Results

Purpose: to analyze the surgical results after slings with vaginal wall, performed by the Urogynecology and Vaginal Surgery Sector of UNIFESP/EPM, for the treatment of incontinent women with hypermobility of the bladder neck, who show great risk of surgery failure with other techniques or in those with intrinsic sphincteric deficiency (ISD) and, also, surgery recurrence. Methods: we studied 21 patients submitted to surgery in order to correct urinary incontinence by the vaginal wall sling technique, in the period from December 1997 to February 1999, with postoperative follow-up which varied between 1 and 14 months (average 8.2). The mean age of patients was 56 years (39 to 77 years), 15 (71.4%) were in menopause and 6 (28.6%) in menacme. All patients were evaluated before the surgery through medical interview, physical examination, ultrasound and urodynamic study, the grade of urinary loss being high in 66.7% and moderate in 33.3% of the patients. All patients showed hypermobility of the bladder neck (more than 10 mm) and 12 patients had previous surgery to correct the urinary incontinence. Regarding the urodinamic study, the patients manifested urinary loss with maximum pressure of urethral closure (MPUC) varying from 20 to 124 cmH2O (average 55.2) and Valsalva leak point pressure (VLPP) varying from 18 to 128 cmH2O (average 60.3). The indications of surgery were: ISD (11 patients -- 52.4%), obesity (5 patients -- 23.8%), ISD and obesity (2 patients -- 9.5%), surgery recurrence (2 patients -- 9.5) and ISD and first grade womb prolapse (1 patient -- 4.8%). Results: as complications, 6 patients (28.6%) showed temporary urinary retention after surgery, 1 patient (4.8%) infection in the urinary tract, 1 patient (4.8%) presence of polypropylene suture in the vagina, 1 patient (4.8%) infection of the surgery wound, 4 patients (19%) developed urgency/incontinence, 1 (4.8%) urgency and 1 (4.8%) difficulty in urinating (high postvoiding residue). The grade of the patients' satisfaction was satisfactory, with 15 patients (71.4%) referring cure, 3 patients (14.3%) improvement, in 2 patients (9.5%) the urinary loss remained unchanged and in 1 patient (4.8%) the urinary loss got worse. Conclusions: the vaginal wall sling surgery is efficient for the treatment of specific cases of stress urinary incontinence, emphasizing intrinsic urethral sphincteric incompetence, surgery recurrence and predisposing factors to failure of other techniques.Objetivo: analisar os resultados cirúrgicos após slings com mucosa vaginal, realizados pelo setor de Uroginecologia e Cirurgia Vaginal da UNIFESP/EPM, no tratamento de mulheres incontinentes com hipermobilidade do colo vesical, que apresentam alto risco de falha cirúrgica para outras técnicas ou naquelas com defeito esfincteriano intrínseco e, ainda, recidivas cirúrgicas. Métodos: foram avaliadas 21 pacientes submetidas à cirurgia para correção de incontinência urinária pela técnica de sling vaginal, no período de dezembro de 1997 a fevereiro de 1999, com seguimento pós-operatório que variou de 1 a 14 meses (média de 8,2). A média de idade das pacientes foi de 56 anos (39 a 77 anos), sendo que 15 (71,4%) encontravam-se na menopausa e 6 (28,6%) no menacme. Todas as pacientes foram avaliadas antes da cirurgia por meio de anamnese, exame clínico, estudo ultra-sonográfico e urodinâmico, sendo o grau de perda urinária acentuado em 66,7% e moderado em 33,3% das pacientes. Todas as pacientes apresentavam hipermobilidade da junção uretrovesical (superior a 10 mm) e 12 pacientes apresentavam cirurgia prévia para correção de incontinência urinária. Ao estudo urodinâmico, as pacientes apresentavam perda urinária com pressão máxima de fechamento uretral (PMFU) variando de 20 a 124 cmH2O (média de 55,2) e Valsalva leak point pressure (VLPP) variando de 18 a 128 cmH2O (média de 60,3). As indicações das cirurgias foram: defeito esfincteriano (11 pacientes - 52,4%), obesidade (5 pacientes - 23,8%), defeito esfincteriano e obesidade (2 pacientes - 9,5%), recidiva cirúrgica (2 pacientes - 9,5%) e defeito esfincteriano e prolapso uterino de 1º grau (1 paciente - 4,8%). Resultados: como complicações, 6 pacientes (28,6%) apresentaram retenção urinária temporária no pós-operatório, 1 (4,8%) infecção do trato urinário, 1 (4,8%) presença de fio de polipropileno na vagina, 1 (4,8%) infecção da ferida cirúrgica, 4 pacientes (19%) evoluíram com urgência/incontinência, 1 (4,8%) com urgência miccional e 1 (4,8%) com dificuldade para urinar (elevado resíduo pós-miccional). O grau de satisfação das pacientes foi satisfatório, com 15 pacientes (71,4%) referindo cura, 3 (14,3%) melhora, 2 (9,5%) quadro de perda urinária inalterado e 1 (4,8%) piora da perda urinária. Conclusões: a cirurgia de sling com mucosa vaginal é eficaz para o tratamento de casos específicos de incontinência urinária de esforço, destacando-se defeito esfincteriano, recidivas cirúrgicas e fatores predisponentes para falha de outras técnicas.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de Tocogi-necologiaUNIFESP, EPM, Depto. de Tocogi-necologiaSciEL

Bis(phenyl­sulfin­yl)methane

Two independent mol­ecules comprise the asymmetric unit of the title compound, C13H12O2S2, which differ in terms of minor variations in the relative orientations of the benzene rings [the O–S–C–C torsion angles for the first independent mol­ecule are −6.66 (17) and −12.88 (19)° compared with −21.70 (18) and 4.83 (16)° for the second mol­ecule]. Supra­molecular chains sustained by C—H⋯O contacts and aligned along the a axis are found in the crystal structure. These are held in place in the three dimensional structure by C—H⋯π inter­actions

fac-(2-Amido­ethyl-κ2 C 1,O)trichlorido(urea-κO)tin(IV)

The Sn atom in the title compound, [Sn(C3H6NO)Cl3(CH4N2O)], is octa­hedrally coordinated within a CCl3NO donor set provided by a chelating amido­ethyl ligand (C and O), a urea-O atom and three facially arranged Cl atoms. Systematic variations in the Sn—Cl bond distances are correlated with the relative trans influence exerted by the C and carbonyl-O atoms. The three-dimensional crystal packing is stabilized by N—H⋯O and N—H⋯Cl hydrogen bonds

Postmenopausal Urinary Disorders: Clinical And Urodynamic Evaluation

Purpose: to evaluate the frequency of urinary disorders and variation of the urodynamic parameters according to the time of post-menopause. Method: two hundred forty-two post-menopausal women with urinary complaints were studied at the Division of Gynecology, Escola Paulista de Medicina, UNIFESP. They were grouped according to the time of post-menopause: group A - up to 4 years; group B - 5 to 9 years and group C - more than 10 years. They were submitted to anamnesis, gynecological examination and urodynamic study. The frequency of urinary alterations and the variation of the urodynamic parameters were analyzed, such as voiding volume; flow time; maximum flow rate, average flow rate; residual urine; vesical capacity at the first desire to void; maximum bladder capacity; maximum urethral closure pressure and functional profile length, with full and empty bladder. The data were statistically analyzed. Results: the most common clinical diagnosis was stress urinary incontinence in the three groups, but the longer the time of post-menopause, the more frequently urinary urgency was observed. Regarding urodynamic diagnosis, 93.6%, 84.6% and 90.7% of the patients of the groups A, B and C, respectively, presented stress urinary incontinence, while 4.8%, 13.5% and 6.2% revealed detrusor instability. There was a decrease in the following urodynamic parameters, according to the time of post-menopause: flow time, maximum flow rate and vesical capacity at the first desire to void, and an increase of the residual urine. Conclusion: in spite of the high incidence of urinary symptoms such as urgency incontinence, stress urinary incontinence was the main urinary problem we have found in post-menopause.Objetivos: avaliar a freqüência dos distúrbios urinários e a variação dos parâmetros urodinâmicos segundo o tempo de pós-menopausa. Métodos: foram estudadas 242 mulheres menopausadas atendidas nos Setores de Climatério e de Uroginecologia e Cirurgia Vaginal da Disciplina de Ginecologia da Escola Paulista de Medicina, UNIFESP, que apresentavam queixas urinárias. As pacientes foram agrupadas segundo o tempo de pós-menopausa em: grupo A - até 4 anos; grupo B - de 5 a 9 anos e grupo C - mais de 10 anos. Todas foram submetidas a anamnese, exame ginecológico e estudo urodinâmico. Analisamos a freqüência de alterações urinárias e a variação dos parâmetros urodinâmicos, como volume urinário (VOL); tempo total de micção (TTM); fluxos urinário máximo (FMAX) e médio (FM); resíduo pós-miccional (RES); capacidade vesical no primeiro desejo miccional (CV1D); capacidade vesical máxima (CVM); pressão máxima de fechamento uretral e comprimento funcional da uretra, com bexiga cheia e vazia (PMCH, PMV, CFUCH, CFV). Os dados foram analisados estatisticamente. Resultados: o diagnóstico clínico mais comum foi de incontinência urinária de esforço (IUE) nos três grupos, porém observou-se maior incidência de urgência miccional com o evoluir do tempo de pós-menopausa. Em relação ao diagnóstico urodinâmico, 93,6%, 84,6% e 90,7%, respectivamente, das pacientes dos grupos A, B e C apresentaram IUE, ao passo que 4,8%, 13,5% e 6,2% revelaram instabilidade vesical. Houve diminuição dos seguintes parâmetros urodinâmicos, segundo o tempo de pós-menopausa: TTM, FMAX e CV1D, além de aumento do resíduo pós-miccional. Conclusões: apesar da elevada incidência de sintomas urinários irritativos, como urgência incontinência, a IUE foi a principal afecção urinária nesta faixa etária.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Setor de Uroginecologia e Cirurgia VaginalUNIFESP, EPM, Setor de Uroginecologia e Cirurgia VaginalSciEL

Triclinic form of bis­{di-μ-hydroxidobis[fac-aqua­tribromido­tin(IV)]} hepta­hydrate

The asymmetric unit of the title hydrate, 2[Sn(H2O)2(OH)2Br6]·7H2O, comprises two [Br3(H2O)Sn(μ-OH)2SnBr3(OH2)] units, but three independent mol­ecules as two of these are disposed about inversion centres, and seven water mol­ecules. In common with the monoclinic polymorph [Howie et al. (2005 ▶). Inorg. Chim. Acta, 358, 3283–3286], each of the dinuclear species features a central Sn2O2 core, distorted octa­hedral Sn atom geometries defined by a Br3O3 donor set, and an anti-disposition of the coordinated water mol­ecules. In the crystal, Oh—H⋯Ow, Oa—H⋯Ow, Ow—H⋯Ow, and Ow—H⋯Br (h = hydroxyl, a = aqua, w = water) hydrogen-bonding inter­actions generate a three-dimensional network