Czy założenie taśmy podcewkowej jednoczasowo z korekcją zaburzeń statyki dna miednicy zwiększa częstość występowania de novo OAB? – prospektywne badanie obserwacyjne

Objectives: Approximately 20% of women suffer from pelvic organ prolapse (POP) and stress urinary incontinence (SUI). Furthermore, POP and overactive bladder (OAB) symptoms often coexist. Midurethral slings and mesh surgeries are both considered to be risk factors for de novo OAB symptoms. The aim of our study was to determine whether simultaneous midurethral sling insertion at the time of pelvic organ prolapse mesh surgery further increases the risk of de novo OAB. Materials and methods: The study group consisted of 234 women who underwent surgery in our department between August 2007 and October 2009 (114 patients underwent surgery because of coexisting POP and SUI, and 120 underwent surgery because POP alone). The patients were evaluated at follow-up visits scheduled after 6-8 weeks and after 12 months. All women underwent surgery using the Gynecare Prolift® Pelvic Floor Repair System, whereas in women with additional overt or occult SUI after restoration of the pelvic anatomy, monofilament midurethral slings were simultaneously inserted. The chi-squared test was used to compare the study groups. Results: De novo OAB symptoms were significantly more pronounced among women in the Prolift® only surgery group (23.3%) compared to the Prolift® with IVS04M group (10.5%; p=0.0093). Conclusions: Midurethral sling insertion at the time of pelvic organ prolapse surgery significantly decreases the rate of postoperative de novo OAB symptoms. The lack of anatomical success of the mesh-based reconstructive surgery is a risk factor for the development of de novo OAB symptoms.Cel pracy: Około 20% kobiet uskarża się jednocześnie na zaburzenia statyki dna miednicy i nietrzymanie moczu. Wykazano również, że występowaniu objawów OAB towarzyszą istotne klinicznie zaburzenia statyki. Z drugiej strony zarówno slingi podcewkowe jak też operacje rekonstrukcyjne z użyciem siatek niosą ze sobą ryzyko wystąpienia de novo objawów OAB. Celem naszego badania było ustalenie, czy jednoczasowe zakładanie slingu podcewkowego podczas operacji rekonstrukcyjnej niesie ze sobą podwyższenie ryzyka wystąpienia de novo pooperacyjnych objawów OAB. Materiał i metody: Grupa badana obejmowała 234 pacjentki leczone w klinice pomiędzy sierpniem 2007 a październikiem 2009 (u 114 pacjentek wykonano operację korygującą statykę dna miednicy oraz wysiłkowe nietrzymanie moczu, a u 120 kobiet korygowano jedynie zaburzenia statyki). Pacjentki były oceniane 6-8 tygodni oraz 12 miesięcy po zabiegu. Wszystkie pacjentki operowano z użyciem monofilamentowych siatek polipropylenowych (Gynecare Prolift® Pelvic Floor Repair System), natomiast u pacjentek z objawowym bądź ukrytym nietrzymaniem moczu jednoczasowo zakładano sling podcewkowy. Obie grupy porównano wykorzystując test chi2. Wyniki: De novo objawy OAB wystąpiły częściej u pacjentek, u których korygowano jedynie statykę dna miednicy (23.3%) w porównaniu do pacjentek, u których dodatkowo zakładano sling podcewkowy (10,5%; p=0,0093). Wnioski: Jednoczasowe zakładanie slingu podcewkowego podczas operacji rekonstrukcyjnej dna miednicy nie zwiększa ryzyka wystąpienia pooperacyjnych objawów nadreaktywności mięśnia wypieracza. Jednocześnie niepowodzenie anatomiczne operacji rekonstrukcyjnej jest czynnikiem ryzyka wystąpienia de novo pooperacyjnych objawów OAB

Utraty przytomności spowodowane częstoskurczem z wąskimi zespołami QRS. Czy istnieje jeszcze miejsce dla farmakoterapii w leczeniu częstoskurczu „nadkomorowego”?

W pracy przedstawiono 45-letnią pacjentkę z rodzinnym nawrotnym częstoskurczem węzłowym powodującym utraty przytomności. Zarówno u matki, jak i u jej syna wykonano skuteczną ablację drogi wolnej jako skuteczne i trwałe wyleczenie z arytmii. W czasie 10 miesięcy obserwacji pacjentka jest wolna od arytmii. Opis przypadku odniesiono do standardów Europejskiego i Amerykańskich Towarzystw Kardiologicznych z 2006 roku. Wskazania klasy pierwszej do ablacji (zgoda ekspertów co do preferowania metody) dotyczą pacjentów z arytmią źle tolerowaną, częstą lub szybką, również chorych, którzy nie mogą mieć napadów arytmii (np. pracujący na wysokościach, piloci, kierowcy zawodowi, młode kobiety planujące ciążę). Pacjentów ze sporadycznymi i dobrze tolerowanymi napadami powinno się poinformować o możliwości leczenia ablacją. Jeżeli preferują tę metodę leczenia, zabieg jest wskazany, jeżeli nie - nie należy stosować profilaktycznej farmakoterapii, a jedynie podawać leki celem przerwania napadu. Artykuł przybliża metodę ablacji, jej (niewielkie) ryzyko i korzyści. (Folia Cardiologica Excerpta 2008; 3: 40-45

Utraty przytomności spowodowane częstoskurczem z wąskimi zespołami QRS. Czy istnieje jeszcze miejsce dla farmakoterapii w leczeniu częstoskurczu „nadkomorowego”?

W pracy przedstawiono 45-letnią pacjentkę z rodzinnym nawrotnym częstoskurczem węzłowym powodującym utraty przytomności. Zarówno u matki, jak i u jej syna wykonano skuteczną ablację drogi wolnej jako skuteczne i trwałe wyleczenie z arytmii. W czasie 10 miesięcy obserwacji pacjentka jest wolna od arytmii. Opis przypadku odniesiono do standardów Europejskiego i Amerykańskich Towarzystw Kardiologicznych z 2006 roku. Wskazania klasy pierwszej do ablacji (zgoda ekspertów co do preferowania metody) dotyczą pacjentów z arytmią źle tolerowaną, częstą lub szybką, również chorych, którzy nie mogą mieć napadów arytmii (np. pracujący na wysokościach, piloci, kierowcy zawodowi, młode kobiety planujące ciążę). Pacjentów ze sporadycznymi i dobrze tolerowanymi napadami powinno się poinformować o możliwości leczenia ablacją. Jeżeli preferują tę metodę leczenia, zabieg jest wskazany, jeżeli nie - nie należy stosować profilaktycznej farmakoterapii, a jedynie podawać leki celem przerwania napadu. Artykuł przybliża metodę ablacji, jej (niewielkie) ryzyko i korzyści

A State of Review on Instigating Resources and Technological Sustainable Approaches in Green Construction

Green building is a way to reduce the impact of the building stock on the environment, society, and economy. Despite the significance of a systematic review for the upcoming project, few studies have been conducted. Studies within the eco-friendly construction scope have been boosted in the past few decades. The present review study intends to critically analyse the available literature on green buildings by identifying the prevalent research approaches and themes. Among these recurring issues are the definition and scope of green buildings, the quantification of green buildings' advantages over conventional ones, and several green building production strategies. The study concludes that the available research focuses mainly on the environmental side of green buildings. In contrast, other crucial points of green building sustainability, such as social impacts, are often neglected. Future research objectives include the effects of climate on the effectiveness of green building assessment methods; verification of the actual performance of green buildings; specific demographic requirements; and future-proofing.O

Trzepotanie i migotanie przedsionków - bliscy przyjaciele, a tak bardzo różni

Przedstawiamy opis pacjenta z napadowym migotaniem i trzepotaniem przedsionków. W ramach przyczynowego leczenia trzepotania przedsionków oraz hybrydowego leczenia (w połączeniu z farmakoterapią antyarytmiczną) migotania przedsionków wykonano ablację cieśni dolnej. Dzięki niej pacjent został całkowicie wyleczony z zaburzeń rytmu. Na tej podstawie prezentujemy wskazania do ablacji podłoża trzepotania przedsionków, przybliżamy metody tego leczenia oraz sposób przygotowania pacjenta do tego typu zabiegu. Należy zwrócić uwagę że trzepotanie przedsionków rzadko jest podatne na farmakoterapię, stąd wytyczne europejskiego i amerykańskich towarzystw naukowych jako „złoty standard” sugerują leczenie niefarmakologiczne. Forum Medycyny Rodzinnej 2008, tom 2, nr 2, 112-12

A novel approach to fractional calculus: utilizing fractional integrals and derivatives of the Dirac delta function

While the definition of a fractional integral may be codified by Riemann and Liouville, an agreed-upon fractional derivative has eluded discovery for many years. This is likely a result of integral definitions including numerous constants of integration in their results. An elimination of constants of integration opens the door to an operator that reconciles all known fractional derivatives and shows surprising results in areas unobserved before, including the appearance of the Riemann Zeta Function and fractional Laplace and Fourier Transforms. A new class of functions, known as Zero Functions and closely related to the Dirac Delta Function, are necessary for one to perform elementary operations of functions without using constants. The operator also allows for a generalization of the Volterra integral equation, and provides a method of solving for Riemann's "complimentary" function introduced during his research on fractional derivatives

Epidemiology of taeniosis/cysticercosis in Europe, a systematic review : Western Europe

Background: Taenia solium and Taenia saginata are zoonotic parasites of public health importance. Data on their occurrence in humans and animals in western Europe are incomplete and fragmented. In this study, we aimed to update the current knowledge on the epidemiology of these parasites in this region. Methods: We conducted a systematic review of scientific and grey literature published from 1990 to 2015 on the epidemiology of T. saginata and T. solium in humans and animals. Additionally, data about disease occurrence were actively sought by contacting local experts in the different countries. Results: Taeniosis cases were found in twelve out of eighteen countries in western Europe. No cases were identified in Iceland, Ireland, Luxembourg, Norway, Sweden and Switzerland. For Denmark, Netherlands, Portugal, Slovenia, Spain and the UK, annual taeniosis cases were reported and the number of detected cases per year ranged between 1 and 114. Detected prevalences ranged from 0.05 to 0.27%, whereas estimated prevalences ranged from 0.02 to 0.67%. Most taeniosis cases were reported as Taenia spp. or T. saginata, although T. solium was reported in Denmark, France, Italy, Spain, Slovenia, Portugal and the UK. Human cysticercosis cases were reported in all western European countries except for Iceland, with the highest number originating from Portugal and Spain. Most human cysticercosis cases were suspected to have acquired the infection outside western Europe. Cases of T. solium in pigs were found in Austria and Portugal, but only the two cases from Portugal were confirmed with molecular methods. Germany, Spain and Slovenia reported porcine cysticercosis, but made no Taenia species distinction. Bovine cysticercosis was detected in all countries except for Iceland, with a prevalence based on meat inspection of 0.0002-7.82%. Conclusions: Detection and reporting of taeniosis in western Europe should be improved. The existence of T. solium tapeworm carriers, of suspected autochthonous cases of human cysticercosis and the lack of confirmation of porcine cysticercosis cases deserve further attention. Suspected cases of T. solium in pigs should be confirmed by molecular methods. Both taeniosis and human cysticercosis should be notifiable and surveillance in animals should be improved.Peer reviewe

Inventing a herbal tradition: The complex roots of the current popularity of Epilobium angustifolium in Eastern Europe

Ethnopharmacological relevance: Currently various scientific and popular sources provide a wide spectrum of ethnopharmacological information on many plants, yet the sources of that information, as well as the information itself, are often not clear, potentially resulting in the erroneous use of plants among lay people or even in official medicine. Our field studies in seven countries on the Eastern edge of Europe have revealed an unusual increase in the medicinal use of Epilobium angustifolium L., especially in Estonia, where the majority of uses were specifically related to “men's problems”. The aim of the current work is: to understand the recent and sudden increase in the interest in the use of E. angustifolium in Estonia; to evaluate the extent of documented traditional use of E. angustifolium among sources of knowledge considered traditional; to track different sources describing (or attributed as describing) the benefits of E. angustifolium; and to detect direct and indirect influences of the written sources on the currently documented local uses of E. angustifolium on the Eastern edge of Europe. Materials and methods: In this study we used a variety of methods: semi-structured interviews with 599 people in 7 countries, historical data analysis and historical ethnopharmacological source analysis. We researched historical and archival sources, and academic and popular literature published on the medicinal use of E. angustifolium in the regions of our field sites as well as internationally, paying close attention to the literature that might have directly or indirectly contributed to the popularity of E. angustifolium at different times in history. Results: Our results show that the sudden and recent popularity in the medical use of E. angustifolium in Estonia has been caused by local popular authors with academic medical backgrounds, relying simultaneously on “western” and Russian sources. While Russian sources have propagated (partially unpublished) results from the 1930s, “western” sources are scientific insights derived from the popularization of other Epilobium species by Austrian herbalist Maria Treben. The information Treben disseminated could have been originated from a previous peak in popularity of E. angustifolium in USA in the second half of the 19th century, caused in turn by misinterpretation of ancient herbals. The traditional uses of E. angustifolium were related to wounds and skin diseases, fever, pain (headache, sore throat, childbirth), and abdominal-related problems (constipation, stomach ache) and intestinal bleeding. Few more uses were based on the similarity principle. The main theme, however, is the fragmentation of use and its lack of consistency apart from wounds and skin diseases. Conclusions: Historical ethnobotanical investigations could help to avoid creating repeating waves of popularity of plants that have already been tried for certain diseases and later abandoned as not fully effective. There is, of course, a chance that E. angustifolium could also finally be proven to be clinically safe and cost-effective for treating benign prostatic hyperplasia, but this has not yet happened despite recent intensive research. Documented traditional use would suggest investigating the dermatological, intestinal anti-hemorrhagic and pain inhibiting properties of this plant, if any

Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017 : a systematic analysis for the Global Burden of Disease Study 2017

Background Global development goals increasingly rely on country-specific estimates for benchmarking a nation's progress. To meet this need, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 estimated global, regional, national, and, for selected locations, subnational cause-specific mortality beginning in the year 1980. Here we report an update to that study, making use of newly available data and improved methods. GBD 2017 provides a comprehensive assessment of cause-specific mortality for 282 causes in 195 countries and territories from 1980 to 2017. Methods The causes of death database is composed of vital registration (VR), verbal autopsy (VA), registry, survey, police, and surveillance data. GBD 2017 added ten VA studies, 127 country-years of VR data, 502 cancer-registry country-years, and an additional surveillance country-year. Expansions of the GBD cause of death hierarchy resulted in 18 additional causes estimated for GBD 2017. Newly available data led to subnational estimates for five additional countries Ethiopia, Iran, New Zealand, Norway, and Russia. Deaths assigned International Classification of Diseases (ICD) codes for non-specific, implausible, or intermediate causes of death were reassigned to underlying causes by redistribution algorithms that were incorporated into uncertainty estimation. We used statistical modelling tools developed for GBD, including the Cause of Death Ensemble model (CODErn), to generate cause fractions and cause specific death rates for each location, year, age, and sex. Instead of using UN estimates as in previous versions, GBD 2017 independently estimated population size and fertility rate for all locations. Years of life lost (YLLs) were then calculated as the sum of each death multiplied by the standard life expectancy at each age. All rates reported here are age-standardised. Findings At the broadest grouping of causes of death (Level 1), non-communicable diseases (NC Ds) comprised the greatest fraction of deaths, contributing to 73.4% (95% uncertainty interval [UI] 72.5-74.1) of total deaths in 2017, while communicable, maternal, neonatal, and nutritional (CMNN) causes accounted for 186% (17.9-19.6), and injuries 8.0% (7.7-8.2). Total numbers of deaths from NCD causes increased from 2007 to 2017 by 22.7% (21.5-23.9), representing an additional 7.61 million (7. 20-8.01) deaths estimated in 2017 versus 2007. The death rate from NCDs decreased globally by 7.9% (7.08.8). The number of deaths for CMNN causes decreased by 222% (20.0-24.0) and the death rate by 31.8% (30.1-33.3). Total deaths from injuries increased by 2.3% (0-5-4-0) between 2007 and 2017, and the death rate from injuries decreased by 13.7% (12.2-15.1) to 57.9 deaths (55.9-59.2) per 100 000 in 2017. Deaths from substance use disorders also increased, rising from 284 000 deaths (268 000-289 000) globally in 2007 to 352 000 (334 000-363 000) in 2017. Between 2007 and 2017, total deaths from conflict and terrorism increased by 118.0% (88.8-148.6). A greater reduction in total deaths and death rates was observed for some CMNN causes among children younger than 5 years than for older adults, such as a 36.4% (32.2-40.6) reduction in deaths from lower respiratory infections for children younger than 5 years compared with a 33.6% (31.2-36.1) increase in adults older than 70 years. Globally, the number of deaths was greater for men than for women at most ages in 2017, except at ages older than 85 years. Trends in global YLLs reflect an epidemiological transition, with decreases in total YLLs from enteric infections, respirator}, infections and tuberculosis, and maternal and neonatal disorders between 1990 and 2017; these were generally greater in magnitude at the lowest levels of the Socio-demographic Index (SDI). At the same time, there were large increases in YLLs from neoplasms and cardiovascular diseases. YLL rates decreased across the five leading Level 2 causes in all SDI quintiles. The leading causes of YLLs in 1990 neonatal disorders, lower respiratory infections, and diarrhoeal diseases were ranked second, fourth, and fifth, in 2017. Meanwhile, estimated YLLs increased for ischaemic heart disease (ranked first in 2017) and stroke (ranked third), even though YLL rates decreased. Population growth contributed to increased total deaths across the 20 leading Level 2 causes of mortality between 2007 and 2017. Decreases in the cause-specific mortality rate reduced the effect of population growth for all but three causes: substance use disorders, neurological disorders, and skin and subcutaneous diseases. Interpretation Improvements in global health have been unevenly distributed among populations. Deaths due to injuries, substance use disorders, armed conflict and terrorism, neoplasms, and cardiovascular disease are expanding threats to global health. For causes of death such as lower respiratory and enteric infections, more rapid progress occurred for children than for the oldest adults, and there is continuing disparity in mortality rates by sex across age groups. Reductions in the death rate of some common diseases are themselves slowing or have ceased, primarily for NCDs, and the death rate for selected causes has increased in the past decade. Copyright (C) 2018 The Author(s). Published by Elsevier Ltd.Peer reviewe