External Genitalia Trauma Following the First Manic Episode in an Elderly Woman With Sexual Disinhibition

Introduction: Late onset bipolar disorder is not common. In addition, bipolar disorder with a dominancy over sexual behaviors is very rare. Hence, traumatic and vigorous sexual behavior, such as masturbation and self-mutilation, are odd and rare occurrences. Case Presentation: An elderly woman in a manic phase of bipolar disorder without a previous history of psychiatric disorders was concomitant with problematic sexual over stimulation in the context of hyper sexuality. She had traumatized her genitals and underwent surgery for their repair. Following her admission and psychopharmacologic therapy, she recovered. Conclusions: The presentation of bipolar disorder in the elderly can be seen in sexual behaviors and self-mutilation that can lead to the need for reparative surgery. In each case with trauma to the external genitalia, psychiatric problems should be considered

Association of interleukin-10 -1082A>G (rs1800896) polymorphism with predisposition to breast cancer: A meta-analysis based on 17 case-control studies

INTRODUCTION: The association between the between IL-10 -1082A>G (rs1800896) polymorphism and breast cancer has been evaluated by several number case-control studies. However, these studies might be underpowered to reveal the true association. OBJECTIVE: We have performed a comprehensive meta-analysis to investigate the association IL-10 -1082A>G polymorphism and breast cancer. MATERIALS AND METHODS: A systematic literature search was conducted using PubMed, Google Scholar, and Web of Science up to September 20, 2017. Data was analysed with CMA software to identify the strength of the association by pooled odds ratios (ORs) with corresponding 95 confidence intervals (CIs). RESULTS: A total of 17 case-control studies involving 3275 cases and 3416 controls obtained from database searches were examined. Overall, there was no significant association between IL-10 -1082A>G polymorphism and breast cancer risk under all genetic models. No significant publication bias was found for the five genetic models (G vs. A: OR = 1.184, 95 CI = 0.895-1.180, p= 0.230; GG vs. AA: OR = 1.430, 95 CI = 0.927-2.204, p= 0.106; GA vs. AA: OR = 0.966, 95 CI = 0.765-1.221, p= 0.774; GG+GA vs. AA: OR = 0.957, 95 CI = 0.697-1.314, p= 0.786; and GG vs. GA+AA: OR = 1.221, 95 CI = 0.981-1.518, p= 0.073). Moreover, there was no significant association between the IL-10 -1082A>G polymorphism and breast cancer risk by ethnicity. CONCLUSION: Our findings indicated that IL-10 -1082A>G (rs1800896) polymorphism might not be a risk factor for the development of breast cancer. © 2018 Associacao Medica Brasileira. All rights reserved

Study design of a phase 4, real-world study (COMPOSUR) to evaluate vibegron in patients with overactive bladder

Abstract Background Overactive bladder (OAB) is defined as urinary urgency accompanied by frequency and nocturia, with or without urge urinary incontinence (UUI). Vibegron, a selective β3-adrenergic receptor agonist approved in the US in December 2020, demonstrated efficacy in reducing symptoms of OAB and was safe and well tolerated in the 12-week EMPOWUR trial and its 40-week, double-blind extension trial. The goal of the COMPOSUR study is to evaluate vibegron in a real-world setting to assess patient treatment satisfaction, tolerability, safety, duration of treatment, and persistence. Methods This is a 12-month, prospective, observational, real-world study, with an optional 12-month extension to 24 months, in the US assessing adults ≥ 18 years old starting a new course of vibegron. Patients must be previously diagnosed with OAB with or without UUI, symptomatic for ≥ 3 months before enrollment, and receive prior treatment with an anticholinergic, with mirabegron, or with a combination of an anticholinergic and mirabegron. Enrollment is performed by the investigator following exclusion and inclusion criteria guided by US product labeling, reinforcing a real-world approach. Patients complete the OAB Satisfaction with Treatment Questionnaire (OAB-SAT-q) monthly and the OAB Questionnaire short form (OAB-q-SF) and Work Productivity and Activity Impairment Questionnaire (WPAI:US) at baseline and monthly for 12 months. Patients are followed up via phone call, in-person visits, or telehealth (ie, virtual) visits. The primary endpoint is patient treatment satisfaction as determined by the OAB-SAT-q satisfaction domain score. Secondary endpoints include percent positive responses to individual OAB-SAT-q questions, additional OAB-SAT-q domain scores, and safety. Exploratory endpoints include adherence and persistence. Discussion OAB leads to a significant decrease in quality of life, as well as impairment of work activities and productivity. Persistence with OAB treatments can be challenging, often due to lack of efficacy and adverse effects. COMPOSUR is the first study to provide long-term, prospective, pragmatic treatment data for vibegron in the US and the resultant effect on quality of life among patients with OAB in a real-world clinical setting. Trial registration ClinicalTrials.gov identifier: NCT05067478; registered: October 5, 2021