In the section "Materials and methods" (second paragraph, fifth sentence), the displacement rate was mistakenly given in millimeters per second instead of millimeters per minute. The correct sentence is: "All the samples were tested with a constant displacement rate of 5 mm/min in a mechanical testing machine specially designed for low-load soft-tissue testing [12]."
The aim of this study was the comparison of the stiffness of different meshes under two types of mechanical tests. Five different mesh types were mechanically tested. The methods used consisted on uniaxial tension test (tensile stiffness) and tape ring tests, experimental continuous compression of the mesh loops (flexural stiffness). The most significant difference of tensile stiffness behaviour appears between Aris and TVTO. From the analysis of the experimental data, we divided the flexural stiffness, in two main groups. The first group includes Auto Suture and Aris meshes. The two meshes seem to have a similar flexural behaviour. The second group includes TVTO, Uretex and Avaulta. The difference between these two groups is clearly evident comparing TVTO and Aris. This study shows that there are significant differences on the mechanical properties between urogynecology meshes.
The role of malformed or dilated branches of iliac vessels in causing pelvic pain is not well understood. Such vessels may entrap nerves of the lumbosacral (LS) plexus against the pelvic sidewalls, producing symptoms not typically encountered in gynecological practice, including sciatica and refractory urinary and/or anorectal dysfunction. We describe cases of sciatica in which laparoscopy revealed compression of the LS plexus by variant superior gluteal veins (SGVs). In demonstrating an improvement in patient symptoms after decompression, we identify this neurovascular conflict as a potential intrapelvic cause of sciatica. This study is a retrospective case series (Canadian Task Force Classification II-3). Nerve decompression laparoscopies were performed in São Paulo, Brazil. Thirteen female patients undergoing laparoscopy for sciatica with no clear spinal or musculoskeletal causes were included in this study. In all cases, we identified LS entrapment by aberrant SGVs, and performed decompression by vessel ligation. The average preoperative visual analog scale score of 9.62 ± 0.77 decreased significantly to 2.54 ± 2.88 post-operatively (P < 0.001). The success rate (defined as ≥ 50% improvement in visual analog scale score) was 92.3%, over a follow-up of 13.2 ± 10.6 months. Our case series demonstrates a high success rate and significant decrease in pain scores after laparoscopic intrapelvic decompression, thereby identifying pelvic nerve entrapment by aberrant SGVs as a potential yet previously unrecognized cause of sciatica. This intrapelvic neurovascular conflict—the SGV syndrome—should be considered in cases of sciatica with no identifiable spinal or musculoskeletal etiology.
Background Red blood cell (RBC) alloimmunization is a complication of patients with sickle cell disease (SCD) and it has a greater impact on pregnancy, leading to a risk of hemolytic disease of the newborn and reducing blood availability for pregnant women. This study proposed to evaluate antigen matching transfusion protocols, aiming to reduce RBC alloimmunization in Brazilian female patients with SCD. Methods Samples from female patients with SCD (153) and self‐declared Afro‐Brazilian donors (307) were genotyped for RBC antigens and RH variants were investigated. The transfusion needs of patients during 1‐year period and the number of compatible donors were assessed using three antigen‐matching transfusion protocols: prophylactic CEK antigen‐matched RBCs, prophylactic extended antigen‐matched RBCs, and extended‐matched red blood cells (RBCs) only for alloimmunized patients. In addition, RH molecular matching has been proposed for patients carrying variant RHCE. Results Provision of CEK antigen‐matched donors would have been possible in 92.4% of transfusion events while provision of prophylactic extended antigen‐matched RBCs would cover 88.7% of the transfusion events. Extended antigen matching for alloimmunized patients would be efficient in 99% of the cases. The presence of partial D in 10 patients increased the need of D‐negative donors. Compatible donors could be enough for four of the five patients with altered RHCE genotypes in both alleles. Conclusion In Brazilians, screening African descent donors allows the implementation of prophylactic CEK and extended antigen‐matching transfusion protocols to female patients with SCD to reduce RBC alloimmunization; however, the supply of compatible blood can be impaired for patients with Rh variants.
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