ABSTRACT
BACKGROUND: To describe a new type of incision of the vagina during transobturator sling procedure and to evaluate by ultrasound the tape position at 3, 6 and 12 months after surgery. We conducted a prospective study including 51 patients with urinary stress incontinence who underwent sling procedure using the transversal vaginal incision. Tape position was evaluated by ultrasound at 3, 6 and 12 months after surgery and expressed as a percentage of the urethral length (the proximal third of the urethral length 0-39 %, the middle third 40-60 %, and the distal third 60-100 %). Informed consent was obtained from all patients prior to their inclusion in the study. All procedures have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments and were approved by the Institutional Review Board and Ethical Committee of "Victor Babes" University of Medicine and Pharmacy Timisoara before the beginning of the study (no 7/17.04.2012). RESULTS: At 3 months after surgery, 3.92 % of the slings were located in the proximal third of the urethra, 88.23 % in the middle third of the urethra and 7.84 % in the distal third. At 6 and 12 months after surgery we obtained similar results: 9.81 % of the slings were located in the proximal third of the urethra, 82.35 % in the middle third and 7.84 % in the distal third of the urethra. CONCLUSION: The transversal incision of the vagina offers a minimal dissection along the long axis of the urethra favoring the remaining of the tape in the middle third of the urethra.
Subject(s)
Prosthesis Implantation/methods , Suburethral Slings , Urinary Incontinence, Stress/surgery , Vagina/surgery , Adult , Aged , Aged, 80 and over , Female , Follow-Up Studies , Humans , Middle Aged , Prospective Studies , Prosthesis Implantation/instrumentation , Single-Blind Method , Treatment Outcome , UrethraSubject(s)
Chlamydia Infections , Chlamydia trachomatis/isolation & purification , Fallopian Tubes , Gonadal Dysgenesis , Laparoscopy/methods , Ovary , Pelvic Inflammatory Disease , Adult , Chlamydia Infections/complications , Chlamydia Infections/diagnosis , Chlamydia Infections/physiopathology , Fallopian Tubes/abnormalities , Fallopian Tubes/diagnostic imaging , Female , Gonadal Dysgenesis/complications , Gonadal Dysgenesis/diagnosis , Gonadal Dysgenesis/physiopathology , Humans , Ovary/abnormalities , Ovary/diagnostic imaging , Pelvic Inflammatory Disease/complications , Pelvic Inflammatory Disease/diagnosis , Pelvic Inflammatory Disease/microbiology , Pelvic Inflammatory Disease/physiopathology , Treatment OutcomeABSTRACT
A court-sworn medical expert is sometimes authorized to pass a medical judgement, whether an older, from serious diseases suffering accused is able to take part in the criminal trial proceedings. The court-sworn medical expert is required to consider the accused's fitness, his mental and physical ability to appear in court, to understand the trial, to answer the questions of the judge, to defend himself, to put questions and objections against the witness's testimony, etc. Such medical expert's opinion is usually a task for a psychiatrist. Judgement of the ability of the accused to take part in the main court trial is of another character, especially when the accused is suffering from a serious disease, e.g. cardiovascular, pulmonary, gastrointestinal, haematological, tumorous or other. In this case the medical judgement is usually required from a doctor of internal medicine. Nevertheless, this is not an easy task for him. As far as these problems are concerned, the expert gathers only little experience of his own during his juridical practice. Similar cases have been extremely sporadically published in medical or juridical literature and if, then in common sense only. It is evident that the expert must face any possible aggravation of the accused's difficulties. At the same time the expert ought to take care lest the court trial should be inadequately extended and even should prevent the accused's avoidance in the main court trial. This paper tries to determine the basic rules for the court-sworn experts in the branch of internal medicine and would like to facilitate them to judge under which circumstances a seriously ill accused may appear in trial proceedings without exposing him to a serious damage of his health or even endangerment of his life.
Subject(s)
Crime/psychology , Forensic Psychiatry , Health Status , Stress, Psychological/complications , Expert Testimony , HumansABSTRACT
The newts Triturus vulgaris and Triturus montandoni are sister species that exhibit contrasting levels of intraspecific morphological variation. Triturus vulgaris has a broad Eurasiatic distribution encompassing both formerly glaciated and unglaciated areas and shows substantial morphological differentiation in the southern part of its range, while T. montandoni, confined to the Carpathians, is morphologically uniform. We analysed sequence variation of two mtDNA fragments of the total length of c. 1850 bp in 285 individuals of both species collected from 103 localities. Phylogenetic analysis of 200 unique haplotypes defined 12 major clades, their age estimated at c. 4.5-1.0 million years (Myr). Most of the older clades were found in the southern part of the range, and also in central Europe, mainly in Romania. The distribution of mtDNA clades points to the existence of several glacial refugia, located in the Caucasus region, Anatolia, the Balkan Peninsula, Italy, and more to the north in central Europe. The concordance between mtDNA based phylogeny and the distribution of T. vulgaris subspecies was weak. Triturus montandoni haplotypes did not form a monophyletic group. Instead they were found in six clades, in five of them mixed with T. vulgaris haplotypes, most likely as a result of past or ongoing hybridization and multiple introgression of mtDNA from T. vulgaris to T. montandoni. Patterns of sequence variation within clades suggested long-term demographic stability in the southern groups, moderate and relatively old demographic growth in the populations inhabiting central Europe, and high growth in some of the groups that colonized northern parts of Europe after the last glacial maximum.
Subject(s)
Demography , Genetic Variation , Phylogeny , Salamandridae/genetics , Animals , Base Sequence , Bayes Theorem , DNA Primers , DNA, Mitochondrial/genetics , Europe , Geography , Haplotypes/genetics , Likelihood Functions , Models, Genetic , Molecular Sequence Data , Population Dynamics , Salamandridae/anatomy & histology , Sequence Analysis, DNA , Species SpecificityABSTRACT
Glycosyltransferases mediate changes in glycosylation patterns which, in turn, may affect the function of glycoproteins and/or glycolipids and, further downstream, processes of development, differentiation, transformation and cell-cell recognition. Such enzymes, therefore, represent valid targets for drug discovery. We have developed a solid-phase glycosyltransferase assay for use in a robotic high-throughput format. Carbohydrate acceptors coupled covalently to polyacrylamide are coated onto 96-well plastic plates. The glycosyltransferase reaction is performed with recombinant enzymes and radiolabeled sugar-nucleotide donor at 37 degrees C, followed by washing, addition of scintillation counting fluid, and measurement of radioactivity using a 96-well beta-counter. Glycopolymer construction and coating of the plastic plates, enzyme and substrate concentrations, and linearity with time were optimized using recombinant Core 2 beta1-6-N-acetylglucosaminyltransferase (Core 2 GlcNAc-T). This enzyme catalyzes a rate-limiting reaction for expression of polylactosamine and the selectin ligand sialyl-Lewis(x) in O-glycans. A glycopolymer acceptor for beta1-6-N-acetylglucosaminyltransferase V was also designed and shown to be effective in the solid-phase assay. In a high-throughput screen of a microbial extract library, the coefficient of variance for positive controls was 9.4%, and high concordance for hit validation was observed between the Core 2 GlcNAc-T solid-phase assay and a standard solution-phase assay. The solid-phase assay format, which can be adapted for a variety of glycosyltransferase enzymes, allowed a 5-6 fold increase in throughput compared to the corresponding solution-phase assay.
Subject(s)
Drug Evaluation, Preclinical/methods , Enzyme Inhibitors/analysis , N-Acetylglucosaminyltransferases/metabolism , Acrylic Resins/metabolism , Carbohydrate Sequence , Disaccharides/chemistry , Disaccharides/metabolism , Enzyme Inhibitors/pharmacology , Humans , Isoenzymes/antagonists & inhibitors , Isoenzymes/genetics , Isoenzymes/metabolism , Kinetics , Molecular Sequence Data , N-Acetylglucosaminyltransferases/antagonists & inhibitors , N-Acetylglucosaminyltransferases/genetics , Plastics , Recombinant Proteins/antagonists & inhibitors , Recombinant Proteins/metabolism , Reproducibility of Results , Robotics , Uridine Diphosphate N-Acetylglucosamine/metabolismABSTRACT
As part of a multicenter collaborative study the relative frequency of enteropathogenic agents in children less than 5 years of age with acute diarrhea was determined. Rates of isolation were similar as regards sex, age, and season. The frequency of polymorphonuclear cells (PMN) in the stools was significantly higher among patients requiring admission in comparison with ambulatory patients. Enteropathogenic E. coli (EPEC) was isolated more frequently in that group in comparison with outpatients (p < 0.001), mainly among children less than 5 months of age. The most prevalent agents were EPEC (26.1%), enterotoxigenic E. coli (ETEC) (9.7%), Shigella (8.5%), Rotavirus (5.1%), Giardia (3.6%), Campylobacter (3.2%), and Salmonella (2.4%). The EPEC predominant serogroups were 0 111, 0 55, 0 26, and 0 119. ETEC serotypes 0 153:H45 and 0 128:H21 were more often isolated. The predominant species in the genus Shigella were S. flexneri (80.5%), and S. sonnei (9.5%); in the genus Campylobacter, the species were C. jejuni (81.3%), and C. coli (18.7%). Shigella was clearly related to the presence of PMN in the faeces, in children less than 5 months old. Campylobacter was more frequent in ambulatory patients more than one year of age. Rotavirus was found predominantly in autumn and winter. Salmonella and ETEC were more frequent in summer. Giardia was associated with weight loss. In about 10% of the cases there were simultaneous mixed isolations of two or more agents. Salmonella isolates were sensitive to the majority of antimicrobial agents probed. Many Shigella and E. coli were resistant to sulfamethoxazole-trimethoprim and ampicillin (40-80%). Nearly all enterobacteria were sensitive to gentamicin and norfloxacin.
Subject(s)
Diarrhea/microbiology , Enterobacteriaceae/isolation & purification , Acute Disease , Age Factors , Animals , Argentina/epidemiology , Campylobacter/isolation & purification , Child, Preschool , Diarrhea/epidemiology , Diarrhea/parasitology , Drug Resistance, Microbial , Enterobacteriaceae/drug effects , Female , Giardia/isolation & purification , Humans , Infant , Infant, Newborn , Male , Rotavirus/isolation & purification , SeasonsABSTRACT
Como parte de um estudo multicéntrico nacional se investigaron agentes enteropatógenos em 495 niños menores de 5 años con diarrea aguda, entre agosto de 1985 y diciembre de 1988. La tasa total de aislamiento fue similar en relación a la estación, edad y sexo. Estuvieron significantemente asociados a la condición de hospitalización la desnutrición, deshidratación, fiebre, leucocitos en heces y frecuencia de agentes, en especial Escherichia coli enteropatógeno (ECP) (p < 0,001). Los principales agentes enteropatógenos fueron ECEP (26,5//), E. coli enterotosigénico (ECET) (9,7//), Shigella (8,5//). Rotavirus (5,1//), Giardia (3,6//), Campylobacter (3,2//) y Salmonella (2,4//). Los serotipos de ECET 0 153:H45 y 0 128:H21 fueron los más frecuentes. El aislamiento de Shigella se relacionó claramente con la presencia de leucocitos en heces, predominó en niños internados, febriles y en mayores de 5 meses. Campylobacter se presentó en niños de 1 año y ambulatórios. Rotavirus predominó en otoño e invierno. Giardia predominó en niños internados y denutridos. En 10// de los casos hubo asociación de 2 ó mas agentes. Salmonella resultó multisensible a los antimicrobianos probados pero entre 40 y 80// de las cepas de Shigella y E. coli fueron resistentes a sulfametaxazol-trimetoprima y ampicilina
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Diarrhea/microbiology , Enterobacteriaceae/isolation & purification , Acute Disease , Age Factors , Argentina/epidemiology , Campylobacter/isolation & purification , Diarrhea/epidemiology , Giardia/isolation & purification , Drug Resistance, Microbial , Rotavirus/isolation & purification , SeasonsABSTRACT
As part of a multicenter collaborative study the relative frequency of enteropathogenic agents in children less than 5 years of age with acute diarrhea was determined. Rates of isolation were similar as regards sex, age, and season. The frequency of polymorphonuclear cells (PMN) in the stools was significantly higher among patients requiring admission in comparison with ambulatory patients. Enteropathogenic E. coli (EPEC) was isolated more frequently in that group in comparison with outpatients (p < 0.001), mainly among children less than 5 months of age. The most prevalent agents were EPEC (26.1
), enterotoxigenic E. coli (ETEC) (9.7
), Shigella (8.5
), Rotavirus (5.1
), Giardia (3.6
), Campylobacter (3.2
), and Salmonella (2.4
). The EPEC predominant serogroups were 0 111, 0 55, 0 26, and 0 119. ETEC serotypes 0 153:H45 and 0 128:H21 were more often isolated. The predominant species in the genus Shigella were S. flexneri (80.5
), and S. sonnei (9.5
); in the genus Campylobacter, the species were C. jejuni (81.3
), and C. coli (18.7
). Shigella was clearly related to the presence of PMN in the faeces, in children less than 5 months old. Campylobacter was more frequent in ambulatory patients more than one year of age. Rotavirus was found predominantly in autumn and winter. Salmonella and ETEC were more frequent in summer. Giardia was associated with weight loss. In about 10
of the cases there were simultaneous mixed isolations of two or more agents. Salmonella isolates were sensitive to the majority of antimicrobial agents probed. Many Shigella and E. coli were resistant to sulfamethoxazole-trimethoprim and ampicillin (40-80
). Nearly all enterobacteria were sensitive to gentamicin and norfloxacin.
ABSTRACT
Como parte de um estudo multicéntrico nacional se investigaron agentes enteropatógenos em 495 niños menores de 5 años con diarrea aguda, entre agosto de 1985 y diciembre de 1988. La tasa total de aislamiento fue similar en relación a la estación, edad y sexo. Estuvieron significantemente asociados a la condición de hospitalización la desnutrición, deshidratación, fiebre, leucocitos en heces y frecuencia de agentes, en especial Escherichia coli enteropatógeno (ECP) (p < 0,001). Los principales agentes enteropatógenos fueron ECEP (26,5//), E. coli enterotosigénico (ECET) (9,7//), Shigella (8,5//). Rotavirus (5,1//), Giardia (3,6//), Campylobacter (3,2//) y Salmonella (2,4//). Los serotipos de ECET 0 153:H45 y 0 128:H21 fueron los más frecuentes. El aislamiento de Shigella se relacionó claramente con la presencia de leucocitos en heces, predominó en niños internados, febriles y en mayores de 5 meses. Campylobacter se presentó en niños de 1 año y ambulatórios. Rotavirus predominó en otoño e invierno. Giardia predominó en niños internados y denutridos. En 10// de los casos hubo asociación de 2 ó mas agentes. Salmonella resultó multisensible a los antimicrobianos probados pero entre 40 y 80// de las cepas de Shigella y E. coli fueron resistentes a sulfametaxazol-trimetoprima y ampicilina (AU)
