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INTRODUCTION: Stress urinary incontinence (SUI) is a highly prevalent condition that affects between 20 and 50% of the female population. Pelvic organ prolapse (POP) can coexist with SUI and both can be addressed through a vaginal approach. However, it is unclear whether simultaneous surgery for these two conditions can influence the outcome of incontinence treatment. OBJECTIVE: To evaluate the objective and subjective effectiveness of the transobturator suburethral (TO) band by comparing two groups: group A, of patients undergoing surgery for stress urinary incontinence (SUI) by insertion of TO mesh, and group B, formed for patients requiring simultaneous correction of pelvic organ prolapse (POP) in addition to TO mesh insertion. MATERIALS AND METHODS: This is an observational, descriptive and retrospective study in which 91 patients participated: 33 (group A) underwent surgery for SUI and 58 (group B) underwent corrective surgery for pelvic organ prolapse (POP) and TO band simultaneously. Variables included: total urinary continence, objective urinary continence, subjective urinary continence (satisfaction levels and two validated questionnaires (PGI-1 and ICIQ-SF)) and complications. RESULTS: Regarding total continence, from the seventh to the ninth year, statistically significant differences were observed, with total continence being higher in group A. Objective continence decreased in both groups during the follow-up period. No significant differences were found between the two groups regarding subjective urinary continence (ICIQ-SF) and the degree of improvement after surgical treatment (PGI-1). The level of satisfaction after surgery was high in both groups. Regarding complications, there were no statistically significant differences. CONCLUSIONS: Isolated surgery for SUI could be considered more effective in achieving total and objective continence. However, the insertion of the TO band in both cases improves subjective urinary continence and quality of life with great safety and without differences regarding complications.

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Background: The urgent need for conservation efforts in response to the global biodiversity crisis is exemplified by initiatives, such as the EU LIFE BEETLES project. This project aims to preserve endangered arthropod species that are crucial for ecosystem functionality, with a focus on endemic beetle species in Flores, Pico and Terceira Islands (Azores, Portugal): Tarphiusfloresensis Borges & Serrano, 2017, Pseudanchomenusaptinoides (Tarnier, 1860) and Trechusterrabravensis Borges, Serrano & Amorim, 2004. These species are single island endemics respectively from Flores, Pico and Terceira. They are threatened by environmental degradation, facing the dual challenge of restricted distribution and habitat degradation due to the spread of invasive plants.The project aims to enhance habitat quality and biodiversity conservation through habitat restoration and plant invasive species control measures. These measures are funded by the European Commission and coordinated by the Azorean Environment Directorate-General. The current Data Paper evaluates the effectiveness of the LIFE BEETLES project in improving habitat quality and offers insights into the balance between habitat restoration efforts and endangered species conservation in island ecosystems, utilising as ecological indicator the Index of Biotic Integrity (IBI) framework. New information: This study establishes a comprehensive database derived from a long-term arthropod monitoring survey that used SLAM (Sea, Land and Air Malaise) traps and pitfall traps. Our findings present a proxy for assessing the overall habitat quality for endemic invertebrates, using arthropods as main indicators.From September 2020 to June 2023, a total of 31 SLAM traps were monitored. The traps were set up as follows: seven in Flores (three in mixed forest and four in native forest), 10 in Pico (four in mixed forest and six in native forest) and 14 in Terceira (three in mixed forest and 11 in native forest). Traps were monitored every three months.In addition, we surveyed the epigean fauna in 19 transects with 15 non-attractive pitfall traps per transect. The transects were set up during two weeks at the end of August every year between 2020 and 2023. Eight transects were established in Flores, consisting of one in pasture, four in mixed forest and three in native forest. Six transects were established in Pico, consisting of two in pastures and four in native forest. Five transects were established in Terceira, consisting of two in mixed forest and three in native forest.A total of 243 arthropod taxa were recorded, with 207 identified at the species or subspecies level. These taxa belonged to four classes, 24 orders and 101 families. Out of the 207 identified taxa, 46 were endemic, 60 were native non-endemic, 80 were introduced and 21 were of indeterminate status. Habitat information is also provided, including general habitat and dominant species composition. This publication contributes to the conservation of highly threatened endemic beetles by assessing habitat quality, based on arthropod communities and habitat description (e.g. native or exotic vegetation).Using the Index of Biotic Integrity (IBI) to comparing pre- and post-intervention data, we found no significant change within the epigean community. In contrast, the understorey community sampled with SLAM traps experienced a slight global decrease in biotic integrity over the study period. These findings suggest that the short duration of the study may not be sufficient to detect significant changes, as ecosystem recovery often requires long-term monitoring. The observed changes in the understorey community may be attributed to disturbances from intervention activities, highlighting the need for ongoing monitoring to assess long-term ecological resilience and recovery.

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INTRODUCTION AND HYPOTHESIS: Vaginal mesh has been used for years to try to improve the results of pelvic organ prolapse surgery, but current evidence does not confirm this improvement and instead describes serious and frequent adverse events. CLINICAL CASE: 64-year-old patient with rectal extrusion of posterior vaginal mesh placed 8 years earlier, and persistent left ischiorectal fistula refractory to surgery. She required 5 surgeries, carried out jointly between gynecology and general surgery, to solve, firstly, the bilateral perianal abscess secondary to extrusion of the posterior vaginal mesh into the rectum and then the persistent left ischiorectal fistula, despite the removal of the material prosthetic. Finally, the fistula was solved by injection of platelet-rich plasma. CONCLUSIONS: Vaginal mesh complications often need a multidisciplinary approach, and treatment may require multiple approaches and more than one surgical procedure. In the case of a persistent fistula refractory to surgery, after removing the mesh, non-invasive regenerative therapies that promote vascular growth and tissue regeneration could be considered such as platelet-rich plasma.

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INTRODUCTION AND HYPOTHESIS: Vaginal pessaries are used as a conservative treatment for POP in women who do not want or are not candidates for surgery, or as a preliminary step to surgery. Our goals are: evaluate the evolution of patients with advanced POP and repeated expulsion of the pessary, who underwent perineal suture to try to maintain the device. Describe the epidemiological characteristics of patients treated with pessaries in our environment, with or without perineal closure. METHODS: Observational, descriptive and prospective study (October 2016-March 2021) that includes 352 women with advanced-stage POP treated with a pessary, of which 55, after repeated expulsion of the pessary, were treated with a pessary and perineal suture. RESULTS: After pessary insertion associated with perineal closure, 26 patients (47.2%) expelled the pessary and underwent surgery, and 29 (52.8%) kept the device, avoiding surgery. Regarding the women who required perineal suture: The mean age was higher than in the group of patients who did not need this intervention (75.3 vs. 68.3 years), 94.5% had POP ≥ grade III and 100% had a perineal width > 2.5 cm. CONCLUSIONS: Treatment with pessary and perineal closure avoids surgery in women with advanced age and repeated expulsion. Although age should not be an independent factor that limits surgical treatment or the type of intervention, it would be useful to have scales to quantify the frailty of patients, being able to standardize perineal closure in elderly and/or frail women, and in those who do not want or have contraindications for surgery.

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RESEARCH QUESTION: Hox genes are involved in limb formation during normal embryological development. Their modulation by circulating maternal oestrogens and androgens determines the length of the second and fourth fingers of the adult hand. Do these same intrauterine hormone levels also determine fertility outcomes in the adult? DESIGN: To study the association between the length of the second and fourth fingers of both partners undergoing IVF (as a surrogate of their previous intrauterine exposure to oestrogens and androgens) with treatment outcome after IVF, data corresponding to 256 IVF cycles were analysed. Finger length was normalized to the individual height. RESULTS: In the female partner, a longer normalized second finger length of the left (2DLN) hand, reflecting a high intrauterine exposure to oestrogens, was independently and significantly (P = 0.011) associated with obtaining at least one top-quality embryo in a multivariate model. Conversely, in the male partner a longer normalized fourth finger length of the left hand (4DLN), reflecting a high intrauterine exposure to androgens, was independently and significantly (P = 0.032) associated with obtaining at least one top-quality embryo in the same multivariate model. In the female partner, 2DLN was inversely and significantly (P = 0.01) associated with achievement of pregnancy. CONCLUSIONS: Intrauterine exposure to high levels of oestrogens and androgens in females and males, respectively, predisposes to the production of higher-quality embryos under in-vitro conditions during adulthood. Paradoxically, this also seems to result in a lower pregnancy rate.

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Antecedentes: La relación entre la longitud del segundo y cuarto dedo de las manos (ratio D2:D4) se ha relacionado con la exposición intrauterina a los andrógenos. Se define un patrón androgénico cuando la longitud del cuarto dedo es superior a la del segundo y el cociente es menor de 1. Este ratio se pone en relación con aspectos del desarrollo y la función reproductiva de los individuos, tales como la resistencia al ejercicio físico, el autismo, la concentración de espermatozoides o la esterilidad. Objetivo: Establecer asociación entre la ratio D2:D4 con la edad de la menarquia. Método: Estudio transversal descriptivo sobre una población no seleccionada de 188 mujeres. Se recogen las longitudes de los dedos con un calibre digital, desde una imagen en papel obtenida con un escáner. El análisis estadístico se realizó mediante el test de correlación de Pearson, considerando significativo un valor de p<0,05. Resultados: El análisis de correlación entre los parámetros morfométricos de las manos y la edad de la menarquia, presentó relación estadísticamente significativa y directamente proporcional con la longitud del cuarto dedo en ambos manos. Conclusión: Los resultados obtenidos indican una relación entre el perfil androgénico de la morfometría de las manos y el retraso de la menarquia. Este hecho constituye un inicio en la búsqueda de relaciones entre las características morfométricas de las manos y condiciones clínicas, que podrían estar influenciadas por la exposición androgénica durante el periodo fetal.

Background: The relationship between the length of the second and fourth fingers of the hands (ratio D2:D4) has been associated with intrauterine exposure to androgens. The androgenic pattern is defined when the length of the fourth finger is higher than the second, and the ratio is lower than 1. This ratio is set in relation to aspects of development and reproductive function of individuals, such as resistance to physical exercise, autism, sperm concentration or sterility. Aims: Find relationship between the ratio D2:D4 with age of menarche. Methods: Descriptive cross-sectional study in an unselected population of 188 women. The finger lengths with a digital caliper is collected from a paper image obtained by a scanner. Statistical analysis was perfomed using the Pearson correlation coefficient, with significant value p<0.05. Results: Correlation analysis between the morphometric parameters of the hands and the age of menarche, showed statistically significant and directly proportional to the length of the fourth finger on both hands relationship. Conclusion: The results indicate a relationship between the androgenic pattern morphometry hands and late menarche. This is a start in the search for relationships between the morphometric characteristics of the hands and clinical conditions that might be influenced by androgen exposure during fetal period.

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Los aneurismas de los vasos coriónicos representanuna entidad raramente observada en la patologíadel cordón y la placenta, y excepcionalmentese describen como diagnóstico prenatal porultrasonidos. El alto riesgo que puede suponerpara el feto, la falta de elementos terapéuticos ypronósticos, así como el fatal resultado del casoclínico que presentamos, le confieren un interésobstétrico

Chorionic vessels aneurysms are a rare finding inthe umbilical cord and placental pathology, andits prenatal ultrasound diagnosis is exceptional.This condition means an increased fetal risk, withunknown treatment and prognosis, and it was thecause of the fetal death in the case we present, sowe consider it as obstetric interest

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Hay un riesgo excepcionalmente elevado de cáncer de mama, como segundo tumor, en mujeres que siguen tratamiento para la enfermedad de Hodgkin. Hemos revisado de forma retrospectiva 2 casos de pacientes en remisión completa de su linfoma de Hodgkin, que desarrollaron un cáncer de mama

Women treated for Hodgkin's disease have an exceptionally high risk of breast cancer as a second malignancy. We retrospectively reviewed 2 patients in complete remission from Hodgkin's disease who developed breast cancer

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