Validation of the Polish version of P-QoL questionnaire

Objective: Pelvic organ prolapse (POP) is a common morbidity that affects many women and significantly decreases quality of life. The severity and the impact of the prolapse on the quality of life are important parameters in the management and follow-up of affected patients. The aim of this validation study was to validate the Polish version of the Prolapse Quality of Life questionnaire (P-QoL). Material and methods: The P-QOL questionnaire was translated into Polish and administered to women recruited from two gynecological outpatient clinics (n = 231). Both symptomatic and asymptomatic women were included in the study and examined in supine position using the Pelvic Organ Prolapse Quantification System (POP-Q). The validity was assessed by comparing symptom scores and quality-of-life scores between symptomatic and asymptomatic women. Results: A total number of 154 symptomatic and 77 asymptomatic women were included. There was a strong correlation between severity of the disease based on physical findings (POP-Q scale) and the P-QoL scores in main prolapse quality-of-life domains. The overall scores for each life domain were significantly different between symptomatic and asymptomatic women (p < 0.001). All the questions regarding symptoms showed significant differences (p < 0.001) between both groups. Conclusions: The Polish version of P-QoL is a valid, reliable, and easily comprehensible instrument to assess quality of life and symptoms in Polish-speaking women suffering from urogenital prolapse

Liquid layer envelope for reducing radiative losses in nanofluid-based volumetric receivers

At high flux conditions, surface absorption based solar thermal systems underperform owing to high overheat temperatures of surface (temperature difference between the surface and the working fluid). One of the ways by which this drawback could be addressed is by allowing direct interaction of solar radiation with the working fluid. In this context, nanoparticles (NP) laden fluid (nanofluids) have been shown to be promising candidates as direct absorption volumetric solar energy absorbers owing to their enhanced thermo-physical properties and high solar weighted absorptivity. However, the nanofluids inherently have high emissivity in the mid- infrared region thus not satisfying the conditions of solar selectivity. In this study a layer of liquid (silicone oil) is placed above the nanofluid, which acts as a barrier against the infrared emissions from the nanofluid. Selection criterion for this liquid layer is high transparency in the visible solar spectrum and high absorption in the mid-infrared wavelength range. Thus the two conditions of solar selectively have been met by using two different liquid layers in direct thermal contact. On comparison of two results, it is seen that with silicone oil layer, the temperature rise is about 17% more as compare to without silicone oil layer

The use of laser in urogynaecology

Introduction The use of lasers in urogynaecology has increased in recent years. Their use has been described in pelvic organ prolapse, urinary incontinence and genito-urinary symptoms of menopause. The aim of this study was to review the published literature on CO2 and erbium:YAG laser use in urogynaecological conditions. Methods An extensive search of literature databases (PubMed, EMBASE) was performed for publications (full text and abstracts) written in English up to July 2018. Relevant trials were selected and analysed by an independent reviewer. Twenty-five studies were identified in total. Results All studies were either prospective cohort or case-control studies. The results of individual studies indicate that both CO2 and erbium lasers are effective in treating urogynaecological conditions. Most studies use a vaginal approach with only two investigations of intraurethral application. Conclusion The use of lasers to treat these conditions may seem appealing; however, the lack of good-quality evidence in the form of multi-centre randomised placebo-controlled trials is concerning. The safety and effectiveness of these laser devices have not been established. Use of lasers may lead to serious adverse events such as vaginal burns, scarring, dyspareunia and chronic pain. Randomised placebo-controlled trials in addition to formal evaluation of the laser devices are required before this treatment modality can be recommended

Onset of action of the beta 3-adrenoceptor agonist, mirabegron, in Phase II and III clinical trials in patients with overactive bladder

Purpose Long-term persistence with pharmacotherapy for overactive bladder (OAB) requires a drug with an early onset of action and good efficacy and tolerability profile. Although antimuscarinics improve OAB symptoms within 1–2 weeks of initiating treatment, adherence after 3 months is relatively poor due to bothersome side effects (e.g., dry mouth and constipation). Mirabegron, a b3-adrenoceptor agonist, has demonstrated significant improvements in key symptoms of OAB and good tolerability after 12 weeks in Phase III studies. Methods This was a prespecified pooled analysis of three randomized, double-blind, placebo-controlled, 12-week studies, and a Phase II study, to evaluate efficacy and tolerability of mirabegron 25 and 50 mg versus placebo. The main efficacy endpoints were change from baseline to week 1 (Phase II only), week 4, and final visit in mean number of incontinence episodes/24 h, micturitions/24 h, and mean volume voided/micturition (MVV). Results A significant benefit for mirabegron 25 and 50 mg versus placebo was evident at the first assessment point, 4 weeks after initiation of therapy, in Phase III studies for incontinence, micturitions, and MVV. The earliest measured benefit was after 1 week, in the Phase II study. Quality-of-life parameters also significantly improved with mirabegron 25 and 50 mg as early as week 4. Significant benefits continued throughout the studies. Mirabegron was well tolerated. Conclusions The early onset of action and good overall efficacy and tolerability balance that mirabegron offers may lead to high rates of persistence with mirabegron in the long-term treatment of OAB

Silicone oil envelope for enhancing the performance of nanofluid-based direct absorption solar collectors

IIT Ropar; DST-SERB; Indo-US Science and Technology Forum (IUSSTF); Thapar Institute of Engineering & Technology, Patiala

Survival After Sublobar Resection versus Lobectomy for Clinical Stage IA Lung Cancer An Analysis from the National Cancer Data Base

BackgroundRecent data have suggested possible oncologic equivalence of sublobar resection with lobectomy for early-stage non–smallcell lung cancer (NSCLC). Our aim was to evaluate and compare short-term and long-term survival for these surgical approaches.MethodsThis retrospective cohort study utilized the National Cancer Data Base. Patients undergoing lobectomy, segmentectomy, or wedge resection for preoperative clinical T1A N0 NSCLC from 2003 to 2011 were identified. Overall survival (OS) and 30-day mortality were analyzed using multivariable Cox proportional hazards models, logistic regression models, and propensity score matching. Further analysis of survival stratified by tumor size, facility type, number of lymph nodes (LNs) examined, and surgical margins was performed.ResultsA total of 13,606 patients were identified. After propensity score matching, 987 patients remained in each group. Both segmentectomy and wedge resection were associated with significantly worse OS when compared with lobectomy (hazard ratio: 1.70 and 1.45, respectively, both p < 0.001), with no difference in 30-day mortality. Median OS for lobectomy, segmentectomy, and wedge resection were 100, 74, and 68 months, respectively (p < 0.001). Finally, sublobar resection was associated with increased likelihood of positive surgical margins, lower likelihood of having more than three LNs examined, and significantly lower rates of nodal upstaging.ConclusionIn this large national-level, clinically diverse sample of clinical T1A NSCLC patients, wedge and segmental resections were shown to have significantly worse OS compared with lobectomy. Further patients undergoing sublobar resection were more likely to have inadequate lymphadenectomy and positive margins. Ongoing prospective study taking into account LN upstaging and margin status is still needed

Manual versus automatic bladder wall thickness measurements: a method comparison study

Purpose To compare repeatability and agreement of conventional ultrasound bladder wall thickness (BWT) measurements with automatically obtained BWT measurements by the BVM 6500 device. Methods Adult patients with lower urinary tract symptoms, urinary incontinence, or postvoid residual urine were urodynamically assessed. During two subsequent cystometry sessions the infusion pump was temporarily stopped at 150 and 250 ml bladder filling to measure BWT with conventional ultrasound and the BVM 6500 device. For each method and each bladder filling, repeatability and variation was assessed by the method of Bland and Altman. Results Fifty unselected patients (30 men, 20 women) aged 21–86 years (median 62.5 years) were prospectively evaluated. Invalid BWT measurements were encountered in 2.1–14% of patients when using the BVM 6500 versus 0% with conventional ultrasound (significant only during the second measurement at 150 ml bladder filling). Mean difference in BWT values between the measurements of one technique was -0.1 to +0.01 mm. Measurement variation between replicate measurements was smaller for conventional ultrasound and the smallest for 250 ml bladder filling. Mean difference between the two techniques was 0.11–0.23 mm and did not differ significantly. The BVM 6500 device was not able to correctly measure BWTs above 4 mm. Conclusions Both BWT measurements are repeatable and agree with each other. However, conventional ultrasound measurements have a smaller measurement variance, can measure BWT in all patients, and BWTs above 4 mm

Modeling dose-response relationships of the effects of fesoterodine in patients with overactive bladder

<p>Abstract</p> <p>Background</p> <p>Fesoterodine is an antimuscarinic for the treatment of overactive bladder, a syndrome of urgency, with or without urgency urinary incontinence (UUI), usually with increased daytime frequency and nocturia. Our objective was to develop predictive models to describe the dose response of fesoterodine.</p> <p>Methods</p> <p>Data from subjects enrolled in double-blind, placebo-controlled phase II and III trials were used for developing longitudinal dose-response models.</p> <p>Results</p> <p>The models predicted that clinically significant and near-maximum treatment effects would be seen within 3 to 4 weeks after treatment initiation. For a typical patient with 11 micturitions per 24 hours at baseline, predicted change was -1.2, -1.7, and -2.2 micturitions for placebo and fesoterodine 4 mg and 8 mg, respectively. For a typical patient with 2 UUI episodes per 24 hours at baseline, predicted change was -1.05, -1.26, and -1.43 UUI episodes for placebo and fesoterodine 4 mg and 8 mg, respectively. Increase in mean voided volume was estimated at 9.7 mL for placebo, with an additional 14.2 mL and 28.4 mL for fesoterodine 4 mg and 8 mg, respectively.</p> <p>Conclusions</p> <p>A consistent dose response for fesoterodine was demonstrated for bladder diary endpoints in subjects with overactive bladder, a result that supports the greater efficacy seen with fesoterodine 8 mg in post hoc analyses of clinical trial data. The dose-response models can be used to predict outcomes for doses not studied or for patient subgroups underrepresented in clinical trials.</p> <p>Trial Registration</p> <p>The phase III trials used in this analysis have been registered at ClinicalTrials.gov (NCT00220363 and NCT00138723).</p