Long-term outcome (5-10 years) after non absorbable mesh insertion compared to partially absorbable mesh insertion for anterior vaginal wall prolapse repair

ABSTRACT Objective: To evaluate long-term (5-10 years) outcomes of Minimally Invasive Surgical (MIS) kit insertion with Prolift® (non-absorbable) mesh compared to the use of Prolift M® (partially absorbable), for anterior vaginal wall prolapse repair. Study design: In this retrospective study we compared women undergoing MIS kit Prolift® insertion (n=90) vs. Prolift M® insertion (n=79) for anterior vaginal wall prolapse repair between 2006 and 2012 at our Institution. A number of 169 women fulfilled the inclusion criteria and were included in the study. Results: During the study period 128 women (76%) completed full follow-up; of them 58 (73%) following MIS kit Prolift® insertion, and 70 (88%) following MIS kit ProliftM® insertion. There was no significant difference between the Prolift® and Prolift M® regarding parity (3.04 vs. 2.88, p=0.506), presence of hypertension (24.1% vs. 39.1%, p=0.088), diabetes mellitus (3.4% vs. 11.6%, p=0.109), or urinary stress incontinence (39.7% vs. 47.1%, p=0.475). All participants had been diagnosed with POP grade 3 or 4 before the procedure. No significant complications during the procedure or postoperative period were identified in the study groups. The follow-up period was at least five years in duration for both groups. Both groups were comparable according to questionnaires focused on function and satisfaction. Conclusion: Patients undergoing MIS kit Prolift® and Prolift M® insertion for anterior vaginal wall prolapse repair had comparable early and late postoperative outcomes. No differences in patient's function and satisfaction between the two groups were identified. According to our findings, there is no superiority to either of the two studied mesh devices.

Galectins: Double Edged Swords in the Cross-roads of Pregnancy Complications and Female Reproductive Tract Inflammation and Neoplasia

Galectins are an evolutionarily ancient and widely expressed family of lectins that have unique glycan-binding characteristics. They are pleiotropic regulators of key biological processes, such as cell growth, proliferation, differentiation, apoptosis, signal transduction, and pre-mRNA splicing, as well as homo- and heterotypic cell-cell and cell-extracellular matrix interactions. Galectins are also pivotal in immune responses since they regulate host-pathogen interactions, innate and adaptive immune responses, acute and chronic inflammation, and immune tolerance. Some galectins are also central to the regulation of angiogenesis, cell migration and invasion. Expression and functional data provide convincing evidence that, due to these functions, galectins play key roles in shared and unique pathways of normal embryonic and placental development as well as oncodevelopmental processes in tumorigenesis. Therefore, galectins may sometimes act as double-edged swords since they have beneficial but also harmful effects for the organism. Recent advances facilitate the use of galectins as biomarkers in obstetrical syndromes and in various malignancies, and their therapeutic applications are also under investigation. This review provides a general overview of galectins and a focused review of this lectin subfamily in the context of inflammation, infection and tumors of the female reproductive tract as well as in normal pregnancies and those complicated by the great obstetrical syndromes.

Esclerosis Tuberosa. Su repercusión en la cavidad bucal: presentación de dos casos clínicos / Tuberous Sclerosis: oral manifestations

Se comunican dos casos de Esclerosis Tuberosa asistidos en la Unidad de Salud Bucal del Instituto del Niño y Adolescente del Uruguay (INAU). Se trata de una enfermedad de carácter genético trasmitida de padres a hijos en forma autosómica dominante, aunque un alto porcentaje de casos corresponden a nuevas mutaciones. Actualmente se prefiere denominarla Complejo de Esclerosis Tuberosa por su reperrcusión multisistémica que también incluye a la cavidad bucal. Muchos de los pacientes manifiestan la tríada deiagnóstica de Vogt: epilepsia, retardo mental y angiofibromas faciales. Existen formas leves, moderadas y severas. Las formas leves cursan con inteligencia normal pudiendo pasar desapercibidas. En las formas severas la calidad de vida es mala y raramente llegan a la edad adulta. Las manifestaciones clínicas bucales más frecuentes son loas alteraciones del esmalte dentario y los crecimientos fibromatosos en la mucosa bucal. Los dos casos presentes expresan alguna de estas alteraciones, particularmente se destaca hipoplasia del esmalte e hipomineralización. Esta última alteración no ha sido referida en la bibliografía internacional disponible.