The Pelvic Floor Institute

Faecal incontinence (FI) is common, yet clinical guidelines rely on low-quality evidence or expert opinion. A high proportion of research is focused on areas that may not be considered a priority by patients or clinicians. This project aimed to identify the top 10 research priorities for FI in adults in equal collaboration with patients, carers and healthcare professionals in a James Lind Alliance priority setting partnership (PSP). This PSP followed established methodology supported by a multidisciplinary steering group including those with lived experience of FI. Evidence uncertainties were gathered through a survey with free-text responses, summarised in indicative summary questions and prioritised in a second survey. An independently facilitated priority setting workshop used a nominal group technique to reach consensus on the order of research priorities, with a focus on the top 10. At all stages the views of healthcare professionals and individuals with a lived experience of FI were considered equally. After the initial survey, 512 respondents submitted 991 evidence uncertainties. These produced 54 indicative summary questions. In the second survey, 373 respondents generated a shortlist of 26 questions. Finally, the top 10 research priorities were determined by consensus at a face-to-face workshop and include unanswered questions concerning prevention, investigation, education, self-management and treatment of FI. This PSP has identified a comprehensive list of top research priorities, including items of importance to both healthcare professionals and individuals with a lived experience of FI. Researchers and funders should use these priorities to inform future work.

BackgroundThis study aimed to explore the prognostic role of DNA methylation pattern in endometrial cancer (EC) patients.MethodsDifferentially methylated genes (DMGs) of EC patients with distinct survival from The Cancer Genome Atlas (TCGA) database were analyzed to identify methylated genes as biomarkers for EC prognosis. The Least Absolute Shrinkage and Selection Operator (LASSO) analysis was used to construct a risk score model. A nomogram was built based on analysis combining the risk score model with clinicopathological signatures together, and then verified in the validation cohort and patients in our own center.ResultsIn total, 157 DMGs were identified between different prognostic groups. Based on the LASSO analysis, five genes (GBP4, OR8K3, GABRA2, RIPPLY2, and TRBV5‐7) were screened for the establishment of risk score model. The model outperformed in prognostic accuracy at varying follow‐up times (AUC for 3 years: 0.824, 5 years: 0.926, and 7 years: 0.853). Multivariate analysis identified four independent risk factors including menopausal status (HR = 3.006, 95%CI: 1.062–8.511, p = 0.038), recurrence (HR = 2.116, 95%CI: 1.061–4.379, p = 0.046), lymph node metastasis (LNM, HR = 3.465, 95%CI: 1.225–9.807, p = 0.019), and five‐DNA methylation risk model (HR = 3.654, 95%CI: 1.458–9.161, p = 0.006) in training cohort. The performance of the nomogram was good in the training (AUC = 0.828), validation (AUC = 0.866) and the whole cohorts (AUC = 0.843). Furthermore, we verified the nomogram with 24 patients in our center and the Kaplan–Meier survival curve also proved to be significantly different (p < 0.01). The subgroup analysis in different stratifications indicated that the accuracy was high in different subgroups for age, histological type, tumor grade, and clinical stage (all p < 0.01).ConclusionsBriefly, our work established and verified a five‐DNA methylation risk model, and a nomogram merging the model with clinicopathological characteristics to facilitate individual prediction of EC patients for clinicians.

В работе приведены результаты исследований влияния препарата Йоддар на качество мяса МРС. Было установлено, что при применении баранам опытной группы препарата Йоддар мясо по всем показателям качества соответствует нормам, а также по некоторым показателям лучше мяса контрольной группы. Целью исследования стало изучение влияния биологически активной добавки «Йоддар» на основные показатели безопасности и качества мяса овец, полученного от животных, находящихся в условиях биогеохимической по йоду провинции. В ходе эксперимента у животных всех групп учитывался прирост живой массы и затраты корма на 1 кг прироста живой массы. Убой животных для проведения ветеринарно-санитарной экспертизы был проведен на убойном пункте. При этом «Технологическая инструкция по переработке скота на предприятиях мясной промышленности» была соблюдена в полном объёме. Микроскопические и бактериологические показатели мяса баранчиков существенных отличий не имели и соответствовали норме, однако лучшие показатели отмечены у мяса, полученного от опытной группы, что можно объяснить бактерицидными свойствами йода, переходящего в ткани организма. Препарат «Йоддар» можно рекомендовать к широкому использованию для овцеводческих хозяйств РФ, из-за его положительного влияния на обмен веществ, прирост живой массы и отсутствия негативного влияния на безопасность и качество мяса.

The goal of this study was to test the hypothesis that responses to the McGill Pain Questionnaire are predictive of adjunctive neuropathic pain medication use by women with lichen sclerosus (LS). This is a retrospective chart review of 430 women with vulvar LS treated at a tertiary referral vulvar care clinic. Demographics, responses to the McGill Pain Questionnaire, and use of neuropathic pain medications were collected. Bivariate and multivariable logistic regression analyses were performed to identify factors significantly associated with use of neuropathic pain medications. Of the 430 subjects, 119 (27.7%) used neuropathic pain medications for vulvar pain. Factors significantly associated with use of these medications include lower body mass index (odds ratio [OR] = 0.96, p = .02), non-White race (OR = 2.97, p = .05), and total McGill Pain Questionnaire score (OR = 1.05, p < .001). Vulvar pain is a common presenting symptom in women with LS. Responses to the McGill Pain Questionnaire may be helpful in the long-term management of women with LS as a screen to identify those patients who might benefit from adjunctive neuropathic pain medication use.

Journal of Pelvic Medicine and Surgery: March 2005 - Volume 11 - Issue 2 - p 87 doi: 10.1097/01.spv.0000156040.99976.bf

Pelvic floor dysfunction in women with eating disorders is an underexplored area. We present a case of pelvic floor dysfunction in a nulliparous woman with anorexia nervosa.