What is known from the existing literature about the available interventions for pelvic floor dysfunction among female athletes? A scoping review

Background: Female athletes may be at higher risk of developing pelvic floor dysfunction (PFD). However, despite the great number of epidemiologic studies, the interventions have not been standardized. Aim: The present scoping review aimed to map and summarize the literature to identify the available interventions for PFD among female athletes. Methods: Seven databases were searched up to May 2021. Studies considering female athletes practising sports at any performance level with any type of PFD were eligible for inclusion. Any clinical intervention and any context were considered. No language, study design, and publication type restrictions were applied. Additional studies were identified through gray literature and the reference lists of articles included. The results were presented numerically and thematically. Results: From 2625 initial records, 35 studies met inclusion criteria. The majority of articles were narrative reviews, considering athletes with urinary incontinence practising multiple or high-impact sports. Authors discussed a wide range of interventions: preventive (n = 8); conservative (n = 35), pharmacological (n = 12), and surgical (n = 10). In particular, the Pelvic Floor Muscle Training was considered in 30 studies. Conclusions: This is the first scoping review to provide a comprehensive overview of the topic. Besides the great number of available interventions, specific programs and randomized controlled clinical trials for female athletes are still limited. Findings highlighted evident gaps in the primary research confirming that the current management is based on expert opinion. This review may be useful for the overall management, and it may represent a starting point for future research

Topological First-Order Systems with Landau-Ginzburg Interactions

We consider the realization of N=2 superconformal models in terms of free first-order $(b,c,\beta,\gamma)$-systems, and show that an arbitrary Landau-Ginzburg interaction with quasi-homogeneous potential can be introduced without spoiling the (2,2)-superconformal invariance. We discuss the topological twisting and the renormalization group properties of these theories, and compare them to the conventional topological Landau-Ginzburg models. We show that in our formulation the parameters multiplying deformation terms in the potential are flat coordinates. After properly bosonizing the first-order systems, we are able to make explicit calculations of topological correlation functions as power series in these flat coordinates by using standard Coulomb gas techniques. We retrieve known results for the minimal models and for the torus.Comment: 37 page

Metallic, magnetic and molecular nanocontacts

Scanning tunnelling microscopy and break-junction experiments realize metallic and molecular nanocontacts that act as ideal one-dimensional channels between macroscopic electrodes. Emergent nanoscale phenomena typical of these systems encompass structural, mechanical, electronic, transport, and magnetic properties. This Review focuses on the theoretical explanation of some of these properties obtained with the help of first-principles methods. By tracing parallel theoretical and experimental developments from the discovery of nanowire formation and conductance quantization in gold nanowires to recent observations of emergent magnetism and Kondo correlations, we exemplify the main concepts and ingredients needed to bring together ab initio calculations and physical observations. It can be anticipated that diode, sensor, spin-valve and spin-filter functionalities relevant for spintronics and molecular electronics applications will benefit from the physical understanding thus obtained

Acute Delta Hepatitis in Italy spanning three decades (1991–2019): Evidence for the effectiveness of the hepatitis B vaccination campaign

Updated incidence data of acute Delta virus hepatitis (HDV) are lacking worldwide. Our aim was to evaluate incidence of and risk factors for acute HDV in Italy after the introduction of the compulsory vaccination against hepatitis B virus (HBV) in 1991. Data were obtained from the National Surveillance System of acute viral hepatitis (SEIEVA). Independent predictors of HDV were assessed by logistic-regression analysis. The incidence of acute HDV per 1-million population declined from 3.2 cases in 1987 to 0.04 in 2019, parallel to that of acute HBV per 100,000 from 10.0 to 0.39 cases during the same period. The median age of cases increased from 27 years in the decade 1991-1999 to 44 years in the decade 2010-2019 (p < .001). Over the same period, the male/female ratio decreased from 3.8 to 2.1, the proportion of coinfections increased from 55% to 75% (p = .003) and that of HBsAg positive acute hepatitis tested for by IgM anti-HDV linearly decreased from 50.1% to 34.1% (p < .001). People born abroad accounted for 24.6% of cases in 2004-2010 and 32.1% in 2011-2019. In the period 2010-2019, risky sexual behaviour (O.R. 4.2; 95%CI: 1.4-12.8) was the sole independent predictor of acute HDV; conversely intravenous drug use was no longer associated (O.R. 1.25; 95%CI: 0.15-10.22) with this. In conclusion, HBV vaccination was an effective measure to control acute HDV. Intravenous drug use is no longer an efficient mode of HDV spread. Testing for IgM-anti HDV is a grey area requiring alert. Acute HDV in foreigners should be monitored in the years to come

CARCINOMA METASTATIC TO CERVICAL LYMPH NODES FROM AN OCCULT PRIMARY TUMOR: THE OUTCOME AFTER COMBINED-MODALITY THERAPY

BACKGROUND: The aim of this retrospective analysis was to analyze the results of treatment of patients with cervical node metastases from carcinoma of occult primary with a policy including neck dissection and postoperative comprehensive radiotherapy. METHODS: Ninety patients were treated with curative intent from 1990 to 2002. RESULTS: The actuarial rate of neck disease control was 68.8% at 5 years (95% confidence interval [CI], 58.9%-78.7%). On multivariate analysis, the rate of neck disease control was significantly related to lymph nodal metastatic level (P = .006). The actuarial rate of developing head and neck primary tumors at 5 years was 8.9% (95% CI, 2.6%-15.2%). The 5-year actuarial rate of distant metastases was 19.1% (95% CI, 9.4%-28.9%). In multivariate analysis, a statistically significant difference in the rate of distant metastasis was obtained when patients were stratified according to the level of nodal involvement (P = .01) and the presence of extracapsular extension (P = .013). At the time of analysis, 50 of the 90 patients were alive. A total of 32 (35.6%) had died from causes related to their primary disease. Actuarial disease-specific survival at 2 and 5 years was 73.6% (95% CI, 64.3%-82.9%) and 62.8% (95% CI, 51.9%-73.7%), respectively. In multivariate analysis, a statistically significant difference in disease-specific survival was obtained when patients were stratified according to the level of nodal involvement and the presence of extracapsular extension. CONCLUSIONS: Our study seems to support the use of combined-modality therapy in patients with neck metastases from carcinoma of occult primary. However, in the absence of randomized trials, comprehensive irradiation cannot be routinely advised

Long-Term Quality of Life After Total Laryngectomy and Postoperative Radiotherapy Versus Concurrent Chemoradiotherapy for Laryngeal Preservation.

OBJECTIVE: To compare the quality of life (QoL) of patients who underwent total laryngectomy with voice prosthesis insertion and postoperative radiotherapy (PORT) with those receiving concurrent chemoradiation for laryngeal preservation. STUDY DESIGN: Retrospective, cross-sectional study in a tertiary academic center. METHODS: The European Organization for Research and Treatment of Cancer Quality of Life Questionnaires were used to assess long-term QoL in 67 patients treated for laryngeal cancer. RESULTS: The scores of functional scales for physical (P < .000), social (P = .001), and role functioning (P = .043) were more favorable in the chemoradiation group. The global QoL score was higher in the nonsurgical group (P = .016). Surgical patients reported on sleep disturbance (P < .000), dyspnea (P = .001), and pain (P = .003), with a higher scores and greater difficulties with the senses (P < .000), social contact (P = .002) and speech (P = .010). The chemoradiation group reported greater problems with dry mouth (P < .000) and sticky saliva (P = .005). CONCLUSION: We found better long-term QoL scores in patients undergoing concurrent chemoradiation. This appears to be mainly because of better physical functioning, social functioning, and social contact and smaller problems with pain, respiration, speech, the senses, and sleep disturbances

Long-term quality of life after treatment for locally advanced oropharyngeal carcinoma: surgery and postoperative radiotherapy versus concurrent chemoradiation.

The aim of this study was to evaluate the long-term quality of life (QoL) in survivors with oropharyngeal carcinoma (OC) treated with surgery and postoperative radiotherapy (PORT) versus concurrent chemoradiation (CRT) using the European Organization for Research and Treatment of Cancer QoL Questionnaires. The study group consisted of 57 patients. The scores for physical (P=0.043) and social (P=0.036) functioning were significantly more favorable in the chemoradiation group. Surgical patients showed statistically higher problems with fatigue (P=0.047), pain (P=0.027), swallowing (P=0.042), social eating (P=0.038) and social contact (P=0.002). CRT group reported significantly greater problems with teeth (P=0.049), open mouth (P=0.036), dry mouth (P=0.022) and sticky saliva (P=0.044). The global QoL score was higher in CRT group (P=0.027). These results support an organ preservation approach with CRT in patients with advanced OC. However, considering the absence of randomized trial comparing outcomes after surgical versus nonsurgical approaches, severe xerostomia following CRT, the higher postoperative morbidity in the setting of salvage surgery, future prospective clinical trials on greater samples of patients are needed to confirm our conclusions

Is Neck Dissection Necessary After Induction Plus Concurrent Chemoradiotherapy in Complete Responder Head and Neck Cancer Patients with Pretherapy Advanced Nodal Disease?

Abstract BACKGROUND: The aim of the present study was to assess, in the setting of a single-institution prospective clinical trial, the necessity of planned neck dissection (PND) in physically and radiologically complete responders with pretherapy advanced nodal disease. METHODS: Between January 2000 and July 2007 a total of 139 patients were enrolled to receive a regimen of platinum-based multidrug induction-concurrent chemoradiotherapy (IC/CCRT). A total of 75 of the enrolled patients with advanced nodal disease were included in this retrospective study. Between 8 and 12 weeks from the end of treatment, the response to IC/CCRT was evaluated by fiber-optic endoscopy and head and neck contrast-enhanced computed tomography or magnetic resonance imaging. RESULTS: The complete clinical response (cCR) rate was 68 %. Among the 51 patients who achieved locoregional cCR at the end of CCRT, 8 underwent PND according to the study recommendation. Of the 43 patients with cCR who did not undergo PND, 2 patients (4.7 %) experienced isolated regional recurrences with the 5-year regional control being 82 %. Patients with cCR did not have a significantly lower regional control compared with patients with cCR who underwent ND (P = .962). Pathological evidence of residual disease was found in 81 % of the patients with less than cCR who underwent ND. CONCLUSIONS: In physically and radiologically complete responders to IC/CCRT, a PND appears not justified. Conversely, PND should be performed in patients clinically suspected of having residual disease in the neck, as a significant proportion have viable tumor cell in post CCRT N