Prolapse and sexual function 8 years after neovagina according to Shears: a study of 43 cases with Mayer-von Rokitansky-Küster-Hauser syndrome

To investigate sexual and anatomical outcome after Shears neovagina in patients with Mayer-von Rokitansky-Kuster-Hauser syndrome (MRKH).

Bulking agents: an analysis of 500 cases and review of the literature

Stress urinary incontinence (SUI) is common, impacts women's quality of life, and generates high costs. Physiotherapy is the first-line therapy, and if it fails, suburethral slings are the gold standard in SUI surgery. Bulking agents injected periurethrally might be a beneficial alternative, but there is a paucity of data on bulking therapy. The aim of this study was to prospectively analyze the efficacy and safety of bulking agents in the setting of a tertiary referral center.

A comparative study of water perfusion catheters and microtip transducer catheters for urethral pressure measurements

The aim of this study was to compare the maximum urethral closure pressure (MUCP) measures with two different techniques: water perfused catheter and microtip transducer catheters with respect to reproducibility and comparability for urethral pressure measurements. Eighteen women with stress urinary incontinence had repeat static urethral pressure profilometry on a different day using a dual microtip transducer and water perfused catheter (Brown and Wickham). The investigators were blinded to the results of the other. The microtip measurements were taken in the 45 degrees upright sitting position with the patient at rest at a bladder capacity of 250 ml using an 8 Fr Gaeltec(R) double microtip transducer withdrawn at 1 mm/s, and the transducer was orientated in the three o'clock position. Three different measures were taken for each patient. Three water perfusion measurements were performed with the patient at rest in the 45 degrees upright position at a bladder capacity of 250 ml using an 8 Fr BARD dual lumen catheter withdrawn at 1 mm/s. The mean water perfusion MUCP measure was 26.1 cm H(2)0, significantly lower than the mean microtip measure of 35.7 cm H(2)0. The correlation coefficient comparing each water perfusion measurement with the other water perfusion measures in the same patient was excellent, at 0.95 (p = 0.01). Correlation coefficient comparing each microtip measure with the other microtip measure in the same patient was also good, ranging from 0.70 to 0.80. This study confirms that both water perfusion catheters and microtip transducers have excellent or very good reproducibility with an acceptable intraindividual variation for both methods.

Intra-session test-retest reliability of pelvic floor muscle electromyography during running

INTRODUCTION AND HYPOTHESIS The prevalence of female stress urinary incontinence is high, and young adults are also affected, including athletes, especially those involved in "high-impact" sports. To date there have been almost no studies testing pelvic floor muscle (PFM) activity during dynamic functional whole body movements. The aim of this study was the description and reliability test of PFM activity and time variables during running. METHODS A prospective cross-sectional study including ten healthy female subjects was designed with the focus on the intra-session test-retest reliability of PFM activity and time variables during running derived from electromyography (EMG) and accelerometry. RESULTS Thirteen variables were identified based on ten steps of each subject: Six EMG variables showed good reliability (ICC 0.906-0.942) and seven time variables did not show good reliability (ICC 0.113-0.731). Time variables (e.g. time difference between heel strike and maximal acceleration of vaginal accelerator) showed low reliability. However, relevant PFM EMG variables during running (e.g., pre-activation, minimal and maximal activity) could be identified and showed good reliability. CONCLUSION Further adaptations regarding measurement methods should be tested to gain better control of the kinetics and kinematics of the EMG probe and accelerometers. To our knowledge this is the first study to test the reliability of PFM activity and time variables during dynamic functional whole body movements. More knowledge of PFM activity and time variables may help to provide a deeper insight into physical strain with high force impacts and important functional reflexive contraction patterns of PFM to maintain or to restore continence.

Is preoperative chemotherapy followed by surgery the appropriate treatment for signet ring cell containing adenocarcinomas of the esophagogastric junction and stomach?

BACKGROUND Recent data suggest primary resection as the preferable approach in patients with signet ring cell gastric cancer (SRC). The aim of our retrospective exploratory study was to evaluate the influence of SRC on prognosis and response in esophagogastric adenocarcinoma treated with neoadjuvant chemotherapy. METHODS A total of 723 locally advanced esophagogastric adenocarcinomas (cT3/4 N any) documented in a prospective database from two academic centers were classified according to the WHO definition for SRC (more than 50 % SRC) and analyzed for their association with response and prognosis after neoadjuvant treatment. RESULTS A total of 235 tumors (32.5 %) contained SRC. Median survival of SRC was 26.3 compared with 46.6 months (p < 0.001) for non-SRC. SRC were significantly associated with female gender, gastric localization, advanced ypT and R1/2 categories, and lower risk of surgical complications and anastomotic leakage (each p < 0.001). Clinical (21.1 vs. 33.7 %, p = 0.001) and histopathological response (less than 10 % residual tumor: 16.3 vs. 28.9 %, p < 0.001) were significantly less frequent in SRC. Clinical response (p = 0.003) and complete histopathological response (pCR) (3.4 %) (p = 0.003) were associated with improved prognosis in SRC. Clinical response, surgical complications, ypTN categories, but not SRC were independent prognostic factors in forward Cox regression analysis in R0 resected patients. Risk of peritoneal carcinomatosis was increased (p < 0.001), while local (p = 0.015) and distant metastases (p = 0.02) were less frequent than in non-SRC. CONCLUSIONS Prognosis of SRC is unfavorable. Although response to neoadjuvant chemotherapy is rare in SRC, it is associated with improved outcome. Thus, chemotherapy might not generally be abandoned in SRC. A stratification based on SRC should be included in clinical trials.

MYB-FL controls gain and loss of floral UV absorbance, a key trait affecting pollinator preference and reproductive isolation

Adaptations to new pollinators involve multiple floral traits, each requiring coordinated changes in multiple genes. Despite this genetic complexity, shifts in pollination syndromes have happened frequently during angiosperm evolution. Here we study the genetic basis of floral UV absorbance, a key trait for attracting nocturnal pollinators. In Petunia, mutations in a single gene, MYB-FL, explain two transitions in UV absorbance. A gain of UV absorbance in the transition from bee to moth pollination was determined by a cis-regulatory mutation, whereas a frameshift mutation caused subsequent loss of UV absorbance during the transition from moth to hummingbird pollination. The functional differences in MYB-FL provide insight into the process of speciation and clarify phylogenetic relationships between nascent species.

Pelvic floor muscle displacement during voluntary and involuntary activation in continent and incontinent women: a systematic review.

INTRODUCTION Investigations of the dynamic function of female pelvic floor muscles (PFM) help us to understand the pathophysiology of stress urinary incontinence (SUI). Displacement measurements of PFM give insight into muscle activation and thus help to improve rehabilitation strategies. This systematic review (PROSPERO 2013: CRD42013006409) was performed to summarise the current evidence for PFM displacement during voluntary and involuntary activation in continent and incontinent women. METHODS MEDLINE, EMBASE, Cochrane and SPORTDiscus databases were searched using selected terminology reflecting the PICO approach. Screening of Google Scholar and congress abstracts added to further information. Original articles investigating PFM displacement were included if they reported on at least one of the aims of the review, e.g., method, test position, test activity, direction and quantification of displacement, as well as the comparison between continent and incontinent women. Titles and abstracts were screened by two reviewers. The papers included were reviewed by two individuals to ascertain whether they fulfilled the inclusion criteria and data were extracted on outcome parameters. RESULTS Forty-two predominantly observational studies fulfilled the inclusion criteria. A variety of measurement methods and calculations of displacement was presented. The sample was heterogeneous concerning age, parity and continence status. Test positions and test activities varied among the studies. CONCLUSIONS The findings summarise the present knowledge of PFM displacement, but still lack deeper comprehension of the SUI pathomechanism of involuntary, reflexive activation during functional activities. We therefore propose that future investigations focus on PFM dynamics during fast and stressful impact tasks.

Cooperación y conflicto entre empresas, comunidades y gobierno : nuevos movimientos sociales en el caso de Cerro de San Pedro, México

El objetivo de este trabajo es analizar las relaciones de cooperación y conflicto entre una compañía minera y las comunidades, los Nuevos Movimientos Sociales y los tres niveles de gobierno involucrados. La compañía Minera inició operaciones para una mina a cielo abierto de oro y plata con el apoyo de los gobiernos locales, estatales y federal. Los habitantes de estas comunidades apoyados por grupos ambientalistas y Organizaciones No Gubernamentales argumentan que el proyecto contamina las Fuentes de agua fresca además de perturbar el medio ambiente y la ecología de la región. La metodología empleada consistió en un análisis histórico social para determinar, en un estudio exploratorio, las principales variables económicas, políticas, legales, sociales y culturales que inciden en el caso, sobre todo después de la firma del Tratado de Libre Comercio de América del Norte. Los hallazgos de esta investigación contribuyen a explicar las relaciones de cooperación y conflicto entre las empresas multinacionales que operan en las comunidades, a analizar el rol del gobierno en sus tres niveles y de los nuevos movimientos sociales en la conformación de las economías locales bajo procesos de integración económica regional. Los resultados también son de relevancia por sus contribuciones para el entendimiento de procesos de responsabilidad social corporativa de las empresas transnacionales y los procesos de contestación y acción colectiva de los nuevos movimientos sociales en el desarrollo económico y ambiental de las comunidades locales.

Les chaînes de références dans des corpus textuels trilingues : Critères et finalité de la recherche

En la obra Stylistique comparée du français et de l?anglais, Vinay y Darbelnet señalan el valor de la traducción como disciplina auxiliar de la Lingüística (1977: 25). Sin entrar en el debate sobre el alcance de las nociones de traducción y transcodificación, se entiende que en toda situación de lenguas en contactos, como es el caso de la traducción, el universal de interferencia influye sobre los mecanismos discursivos relacionados con la memoria, de manera tal que la producción de un texto traducido sin visibilidad de interferencia supone esfuerzos especiales por parte del traductor (Toury, 2004: 345). En el marco de esta problemática, nuestro estudio respecto de las cadenas referenciales (CR) en corpora trilingües se fundamenta en los trabajos de Ariel (1990) y, especialmente de Schnedecker (1997, 2005), en cuanto a las expresiones referenciales que mantienen la cohesión del texto y sus relaciones con la accesibilidad al referente. Los resultados de este estudio descriptivo y contrastivo a partir de un corpus de textos trilingües podrán contribuir al conocimiento del macroproceso de traducción y, por consiguiente, a la formación de traductores. Asimismo, esta presentación se inscribe en el marco de la Traductología y aspira a ser un aporte a otras disciplinas, especialmente a la Lingüística, en una relación de reciprocidad (García, 2012: 78)