Hysteroscopy and pain: what risk factors should we consider in office hysteroscopy? are there really any?

Background: Office hysteroscopy is the gold standard in abnormal uterine bleeding and an indispensable tool in modern gynecology. It is becoming increasingly popular leading to examinations and even operations without anesthesia as it is accurate, cheap and well tolerated. However, pain is still a limitation. The objective of the study was to determine if pain perception is linked to clinical predictors and how well they correlate with pain score.Methods: Prospective observational trial enrolled one hundred and four women; four cases were excluded. One hundred cases were included and analyzed. Selection criteria: patients scheduled for Office Hysteroscopy who accepted to participate and had no contraindication for procedure.Results: A ten centimeter visual analogue scale was used for pain evaluation. Presumed variables such as menopause, pelvic pain, previous cesarean section and cervical surgery, and body mass index were analyzed by ordered regression using standard statistical software tools.Conclusions: Correlation between predictive factors and pain reporting showed no significance (p>0.05) except for body mass index which was found to significantly correlate to discomfort (p<0.05)

Pain, anxiety and patient satisfaction in office hysteroscopy, is there a link? Are patient satisfaction questionnaires reliable?

Background: Office hysteroscopy is becoming increasingly popular leading to examinations and operations without anesthesia.  Anxiety is always present before an aversive medical intervention and may play a role in pain perception. The objectives of the study were to determine if pain perception is linked to anxiety and how well patient satisfaction questionnaires correlate with pain.Methods: Prospective observational study enrolled one hundred and four women. One hundred cases were included and analyzed. Patients scheduled for office hysteroscopy, who accepted to participate and were able to answer questionnaires.Results: A ten centimeter visual analogue scale was used for pain evaluation and the State anxiety-trait inventory for adults questionnaires for anxiety assessment. Three other satisfaction questionnaires, each consisting of three answers, were also administered and investigated. Analysis was performed using SPSS 22.0 IBM for windows software tools.Conclusions: Correlation between anxiety and pain reporting showed no influence with anxiety trait (p value = 0.4170) and a mild correlation with anxiety state (p value = 0.146). Classification of pain into “no pain”, “mild pain”, “moderate pain” and “severe pain”, should be revised in office hysteroscopy: for visual analogue scale, scores of 2.5 to 3 cm correspond to the lower boundary of moderate pain and scores above limit 6.5 cm should define pain as severe. Satisfaction questionnaires significantly correlated to discomfort (p value <0.001) and may be a practical option to assess tolerance of medical procedures with excellent sensibility and specificity

Vivienda progresiva sustentable

El articulo describe el proyecto denominado bicentenario, de una vivienda de dos plantas que reune diversos resultados de investigaciones desarrolladas en CEVE, a partir del concepto del reciclado y la progresividad.Fil: Ferrero, Aurelio Antonio. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnológico Cordoba. Centro Experimental de la Vivienda Economica(i); ArgentinaFil: Pipa, Dante Agustin. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnológico Cordoba. Centro Experimental de la Vivienda Economica(i); ArgentinaFil: Gaggino, Rosana. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnológico Cordoba. Centro Experimental de la Vivienda Economica(i); ArgentinaFil: Gatani, Mariana Pilar. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnológico Cordoba. Centro Experimental de la Vivienda Economica(i); ArgentinaFil: Floreano, Alberto Fabian. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnológico Cordoba. Centro Experimental de la Vivienda Economica(i); ArgentinaFil: Scardino, Lucio. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnológico Cordoba. Centro Experimental de la Vivienda Economica(i); Argentin

Integración tecnológica en una vivienda progresiva sustentable

La vivienda progresiva sustentable integra aspectos relativos a diseño, tecnología, producción, financiamiento, capacitación y sustentabilidad. Es una vivienda social que sintetiza tres conceptos fundamentales: densificación del uso del suelo, modelos de gestión, y tecnologías y componentes constructivos sustentables. En ella convergen desarrollos tecnológicos del Centro Experimental de la Vivienda Económica6 como el sistema constructivo de estructuras metálicas UMA, cerramientos verticales de ladrillos producidos a partir del reciclado de PET (polietileno Tereftalato), cielorrasos termo aislantes elaborados con cáscaras de maní (cacahuete), aberturas modulares de concreto, y artefactos sanitarios economizadores de agua. El diseño propone la progresividad mediante la provisión inicial del volumen habitable total para su completamiento gradual (concepto de vivienda cáscara del arquitecto González Lobo). La densificación de lotes para el aprovechamiento del suelo, el modelo de gestión y producción con emprendimientos concurrentes, y el financiamiento a través de un sistema de microcrédito son otras características diferenciales. The progressive house integrates aspects of sustainable design, technology, production, financing, training and sustainability. It is a social housing unit that synthesizes three key areas: technologies and sustainable building components, densification of land use and management models and production. In it converges technological developments of Experimental Center for Economic Housing, such as the construction system of metal structures UMA, vertical walls of bricks produced from recycled PET (polyethylene terephthalate), thermal insulating ceilings made from peanut shells and windows made in concrete and water-saving fixtures. The design proposes the initial escalation by providing total living volume for gradual completion (shell housing concept architect Gonzalez Lobo). The densification of lots for land use, management model and concurrent production enterprises, and financing through a system of microcredit are other distinguishing features.The progressive house integrates aspects of sustainable design, technology, production, financing, training and sustainability. It is a social housing unit that synthesizes three key areas: technologies and sustainable building components, densification of land use and management models and production. In it converges technological developments of Experimental Center for Economic Housing, such as the construction system of metal structures UMA, vertical walls of bricks produced from recycled PET (polyethylene terephthalate), thermal insulating ceilings made from peanut shells and windows made in concrete and water-saving fixtures. The design proposes the initial escalation by providing total living volume for gradual completion (shell housing concept architect Gonzalez Lobo). The densification of lots for land use, management model and concurrent production enterprises, and financing through a system of microcredit are other distinguishing features.Fil: Ferrero, Aurelio Antonio. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnológico Cordoba. Centro Experimental de la Vivienda Economica(i); ArgentinaFil: Pipa, Dante Agustin. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnológico Cordoba. Centro Experimental de la Vivienda Economica(i); ArgentinaFil: Gaggino, Rosana. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnológico Cordoba. Centro Experimental de la Vivienda Economica(i); ArgentinaFil: Gatani, Mariana Pilar. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnológico Cordoba. Centro Experimental de la Vivienda Economica(i); ArgentinaFil: Floreano, Alberto Fabian. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnológico Cordoba. Centro Experimental de la Vivienda Economica(i); ArgentinaFil: Scardino Lucio. Asoc.vivenda Economica; Argentin

Hysteroscopy and pain: what risk factors should we consider in office hysteroscopy? are there really any?

Background: Office hysteroscopy is the gold standard in abnormal uterine bleeding and an indispensable tool in modern gynecology. It is becoming increasingly popular leading to examinations and even operations without anesthesia as it is accurate, cheap and well tolerated. However, pain is still a limitation. The objective of the study was to determine if pain perception is linked to clinical predictors and how well they correlate with pain score.Methods: Prospective observational trial enrolled one hundred and four women; four cases were excluded. One hundred cases were included and analyzed. Selection criteria: patients scheduled for Office Hysteroscopy who accepted to participate and had no contraindication for procedure.Results: A ten centimeter visual analogue scale was used for pain evaluation. Presumed variables such as menopause, pelvic pain, previous cesarean section and cervical surgery, and body mass index were analyzed by ordered regression using standard statistical software tools.Conclusions: Correlation between predictive factors and pain reporting showed no significance (p&gt;0.05) except for body mass index which was found to significantly correlate to discomfort (p&lt;0.05)

Late-Onset Recurrent Femoral Cyst Formation 10 Years after ACL Reconstruction: A Case Report and Literature Review

Synovial fistula and cyst formation after anterior cruciate ligament (ACL) reconstruction is very unusual and almost always affects the tibia. Only 3 cases originating in the femur have been reported. We present a rare case of late-onset femoral cyst formation related to ACL reconstruction. Ten years after successful ACL reconstruction surgery, effusion and pain at the lateral aspect of the lateral femoral condyle appeared. Symptoms persisted despite initial percutaneous drainage and conservative treatment. Surgery was carried out, with drainage and graft-fixation pin device removal, with recurrent cyst formation after the intervention. Total recovery of the patient was achieved after carrying out revision surgery consisting in bone tunnel filling using autologous bone graft and occlusion of cortical bone defect with local fascial flap. The development of this unusual complication was related to lack of absorption of the fixation device, bone burn due to drilling, and persistent synovial fluid in the femoral bone tunnel, combined with the absence of bone ingrowth

Safety and Performance of Titanium Suture Anchors Used in Knee Ligament Repair Procedures

Injuries to the knee ligaments can be particularly disabling in young patients, given the risk of long-term disability if adequate fixation is not achieved during initial repair. The TWINFIX™ titanium (Ti) suture anchor with ULTRABRAID™ Suture (Smith and Nephew, London, UK) was designed to secure tendon and ligament reconstructions with increased boney ingrowth at the anchor site with minimal invasive technique. This retrospective analysis looked at 33 patients (41 implants) operated with this device between 2015 and 2019 at a single institution. The average age of patients was 33.18 years (standard deviation [SD], 15.26), with an average body mass index of 24.88 (SD, 3.49). The indications were lateral extra-articular tenodesis during anterior cruciate ligament reconstruction, medial patellofemoral ligament reconstruction, quadriceps or patellar tendon repair and medial collateral ligament repair. After an average follow up of 24.3 + 6.53 months, there was no reports of clinical failure or radiographic evidence of implant failure or loosening. One patient experienced a complication unrelated to the study device, requiring manipulation under anesthesia with resolution of symptoms. This case series supports the safety and performance of this implants for the knee procedures in which its use is indicated. Additional follow-up will be required to determine whether these effects are sustained at medium- and long-term durations

Two-Stage Anterior Cruciate Ligament Reconstruction Revision Surgery for Severe Bone Defects With Anterolateral Ligament Reconstruction Technique

Anterior cruciate ligament revision surgery poses a number of specific difficulties. These include the lack of bone mass to enable effective fixation of the reconstruction, morbidity of the donor area when bone autograft is used to fill the tunnels, and absence of the semitendinosus and gracilis homolateral tendons in cases in which they have already been used in the primary surgical procedure. To address all these problems, we describe a 2-stage revision technique that uses bone allograft for tunnel filling and Achilles allograft for ligament reconstruction. In addition, the intervention includes an extra-articular phase in which the anterolateral ligament is reinforced to increase the rotational stability of the knee, thus improving the prognosis of operation