Pudendal Neuromodulation is Feasible and Effective After Pudendal Nerve Entrapment Surgery

BackgroundPatients with intractable pain in the pudendal nerve distribution may benefit from pudendal neuromodulation; however, some may have previously undergone pudendal nerve entrapment surgery (PNES), potentially altering nerve anatomy and function.AimWe examined pudendal neuromodulation outcomes in patients with prior PNES.MethodsPatients with a history of PNES and quadripolar, tined pudendal lead placement for urogenital pain were reviewed. Symptoms and outcomes were collected from existing medical records.OutcomesPatients with pudendal neuromodulation and prior PNES were compared to patients with no prior PNES who had pudendal lead placement.ResultsFifteen patients with a history of 1, 2, or 3 prior PNES (n = 13, 1, and 1, respectively) were evaluated. Most (10; 67%) were female, with bilateral pain (9; 60%), and symptoms of 5–26 years. After trialing the lead, bladder symptoms and pain were improved in 8 of 12 and 9 of 14 patients, respectively, and 80% of patients (12/15) underwent permanent generator implantation. When prior PNES patients were compared to those with no prior PNES (n = 43), gender (67% vs 77% female; P = .50) and age (median 63 vs 58 years; P = .80), were similar; however, BMI differed (mean 24 vs 29; P = .008) and a lower proportion (12/15; 80% vs 42/43; 98%; P = .049) had generator implantation. Importantly, median lead implant time (48 vs 50 minutes; P = .65) did not differ between the 2 groups.Clinical ImplicationsPudendal neuromodulation has the potential to provide pain relief for a very difficult-to-treat population; furthermore, it does not appear that prior PNES surgery made lead placement significantly more challenging.Strengths & LimitationsStudy strengths include being a tertiary referral center for urogenital pain and having a single surgeon perform all procedures in a regimented way. Limitations include the retrospective study design, small sample size and various approaches to PNConclusionChronic pudendal neuromodulation can be a viable option even after prior PNES.Kristen M. Meier, Patrick M. Vecellio, Kim A. Killinger, Judith A. Boura, Kenneth M. Peters. Pudendal Neuromodulation is Feasible and Effective After Pudendal Nerve Entrapment Surgery. J Sex Med 2022;19:995–1001.     

Oxidative stress,endocrine disruption,and malformation of Bufo gargarizans embryo exposed to sub-lethal cadmium concentrations

Thyroid hormone (TH) is critical for vertebrate postembryonic development as well as embryonic development. Chinese toad (Bufo gargarizans) embryos were exposed to different concentrations of cadmium (5, 50, 100, 200 and 500 μg Cd L⁻¹) for 7 days. Malformations were monitored daily, and growth and development of embryos were measured at day 4 and 7, and type 2 and 3 iodothyronine deiodinase (Dio2 and Dio3), thyroid hormone receptors (TRα and TRβ) mRNA levels were also measured to assess disruption of TH synthesis. In addition, superoxide dismutase (SOD), glutathione peroxidase (GPx) and heat shock proteins (HSPs) mRNA expression were examined to evaluate the ability of scavenging ROS. Our results demonstrated a bimodal inhibitory effect of Cd on the embryo growth and development of Bufo gargarizans. Reduced mean stage, total length and weight were observed at 5, 50, 200 and 500, but not at 100 μg Cd L⁻¹. Embryos malformation occurred in all cadmium treatments. Morphological abnormalities of embryos are characterized by axial flexures, abdominal edema, stunted growth and fin flexure. Real-time PCR results show that exposure to cadmium down-regulated TRα and Dio3 mRNA expression and up-regulated Dio2 mRNA level. SOD and GPx mRNA expression was significantly up-regulated after cadmium exposure. We concluded that cadmium could change mRNA expression of TRα, Dio2 and Dio3 leading the inhibition of growth and development of B. gargarizans embryo, which suggests that cadmium might have the endocrine-disrupting effect in embryos. Moreover, the reduced ability of scavenging ROS induced by cadmium might be responsible for the teratogenic effects of cadmium.     

阴道乳杆菌与早产关系的研究进展

阴道乳杆菌为健康育龄女性阴道优势菌。该菌缺乏将导致女性发生一系列不良症状;对妊娠期女性则可能产生不良的妊娠结局,如早产等。本文综述了孕妇阴道乳杆菌与早产关系的研究进展,为降低早产率提供新的研究方向。     

Replacement of in vivo human rabies vaccine potency testing by in vitro glycoprotein quantification using ELISA – Results of an international collaborative study

Three different ELISAs quantifying rabies glycoprotein were evaluated as in vitro alternatives to the National Institutes of Health (NIH) in vivo potency test for batch release of human rabies vaccines. The evaluation was carried out as an international collaborative study supported by the European Partnership for Alternatives to Animal Testing (EPAA). This pre-validation study, the results of which are presented in this paper, compared three different ELISA designs, assessing their within- and between-laboratory precision. One of the ELISA designs was proposed to the European Directorate for the Quality of Medicines & HealthCare (EDQM) and accepted for an international collaborative study under the umbrella of the Biological Standardisation Programme.     

Internet addiction and its facets: The role of genetics and the relation to self-directedness

A growing body of research focuses on problematic behavior patterns related to the use of the Internet to identify contextual as well as individual risk factors of this new phenomenon called Internet addiction (IA). IA can be described as a multidimensional syndrome comprising aspects such as craving, development of tolerance, loss of control and negative consequences. Given that previous research on other addictive behaviors showed substantial heritability, it can be expected that the vulnerability to IA may also be due to a person's genetic predisposition. However, it is questionable whether distinct components of IA have different etiologies. Using data from a sample of adult monozygotic and dizygotic twins and non-twin siblings (N = 784 individuals, N = 355 complete pairs, M = 30.30 years), we investigated the magnitude of genetic and environmental influences on generalized IA as well as on specific facets such as excessive use, self-regulation, preference for online social interaction or negative consequences. To explain the heritability in IA, we further examined the relation to Self-Directedness as potential mediating source. Results showed that relative contributions of genetic influences vary considerable for different components of IA. For generalized IA factors, individual differences could be explained by shared and non-shared environmental influences while genetic influences did not play a role. For specific facets of IA and private Internet use in hours per week, heritability estimates ranged between 21% and 44%. Bivariate analysis indicated that Self-Directedness accounted for 20% to 65% of the genetic variance in specific IA facets through overlapping genetic pathways. Implications for future research are discussed.     

中国基本医疗保险数据在肿瘤研究中的利用情况

目的 掌握中国研究人员利用基本医疗保险数据发表的肿瘤防治领域期刊论文的现状及分布特征,为今后在肿瘤防治中充分、规范和有效地挖掘及使用医疗保险数据库提供依据。方法 检索PubMed、Web of Science、万方数据知识服务平台、中国知网4个数据库建库至2021年利用中国基本医疗保险数据发表的论文,从发文数量、肿瘤类别、主要研究内容和作者机构等维度进行描述性分析。结果 共纳入65篇文献。2016年后,发文量快速增长。研究数量最多的肿瘤是肺癌,最高频的研究内容是肿瘤医疗费用。福建省、北京市、安徽省的基本医疗保险数据库中的肿瘤相关数据被利用较多。新型农村合作医疗保险数据区域限制性强,而城镇基本医疗保险数据共享性高。北京大学、复旦大学利用基本医疗保险数据较多。结论 中国基本医疗保险肿瘤相关数据利用率较低、可及性较差、共享性不足、区域限制性明显,亟须规范数据使用,提高数据可及性及共享水平,促进健康医疗保险大数据的融合与利用。     

Use of the high-dose pulsed hyaluronidase protocol in the management of impending skin necrosis associated with hyaluronic acid fillers: a systematic review

Impending skin necrosis resulting from inadvertent intravascular injection of hyaluronic acid (HA) fillers can lead to tissue loss and significant scarring. In recent years, management trends have shifted from multimodal approaches to the sole use of high doses of hyaluronidase. The aim of this systematic review was to evaluate the effectiveness of the high-dose pulsed hyaluronidase management protocol in preventing skin necrosis and possible subsequent scarring. An online search of the bibliographic databases PubMed and Embase yielded 3039 articles. A total of 72 studies reporting 186 cases were found to be eligible for inclusion. The selection and evaluation process was done according to the PRISMA criteria. Included studies were assessed using the JBI and STROBE critical appraisal tools. The analysis of treatment outcomes was done according to the timing of treatment initiation and the type of intervention used. This review found that an immediate intervention using the high-dose pulsed hyaluronidase management protocol provided predictable and satisfactory outcomes. Initiating the protocol within 24 h of filler injection halted the progression of necrosis and prevented permanent sequelae. The conclusions are limited by the lack of a high level of evidence, since the only available sources of data are case reports and case series.     

A change in surgical margin: do wider surgical margins lead to decreased rates of local recurrence in T1 and T2 oral tongue cancer?

The purpose of this study was to assess the impact of a change in macroscopic/surgical margin width upon histological margins and loco-regional failure in early oral tongue squamous cell carcinoma (OTSCC). In 2009, the surgical margin protocol was increased from 10 mm to 15 mm. A retrospective review was performed of all patients who underwent treatment for early OTSCC between 2009 and 2016 with a 15-mm surgical margin (n = 142), and these patients were compared to those treated between 1999 and 2008 with a 10-mm surgical margin (n = 78). There was a significant increase in the rate of clear histological margins (P < 0.001). The rates of close (P = 0.002) and involved (P < 0.001) histological margins decreased significantly. There were significant reductions in local (P < 0.001) and regional (P < 0.001) recurrence rates. This study demonstrated that a surgical margin of 15 mm delivered significantly lower rates of close/involved histological margins and improved local and regional disease recurrence in early OTSCC when compared with a surgical margin of 10 mm.     

Correction: Interaction of declined handgrip strength and HIV infection on neurocognitive impairment

Journal of NeuroVirology -