Introduction and hypothesis The objective was to assess whether telemedicine-based follow-up is equivalent to office-based follow-up in the early postoperative period after routine synthetic midurethral sling placement. Methods This is a prospective, international, multi-institutional, randomized controlled trial. Patients undergoing synthetic midurethral sling placement were randomized to 3-week postoperative telemedicine versus office-based follow-up. The primary outcome was the rate of unplanned events. Secondary outcomes included patient satisfaction, crossover from telemedicine to office-based follow-up, and compliance with 3- to 5-month office follow-up. Results We included 238 patients (telemedicine: 121 vs office: 117). No differences in demographics or medical comorbidities were noted between the study groups ( p = 0.09–1.0). No differences were noted in unplanned events: hospital admission, emergency department visit, or unplanned office visit or call (14% vs 12.9%, p = 0.85) or complications (9.9% vs 8.6%, p = 0.82). Both groups were equally “very satisfied” with their surgical outcomes (71.1% vs 69%, p = 0.2). Telemedicine patients were more compliant with 3- to 5-month office follow-up (90.1% vs 79.3%, p = 0.04). Conclusions After synthetic midurethral sling placement, telemedicine follow-up is a safe patient communication option in the early postoperative period. Telemedicine patients reported no difference in satisfaction compared with office-based follow-up but had greater compliance with 3- to 5-month follow-up.

The copaiba oil decreased significantly the urea serum level at 24 and 48 hours and the creatinine level at 48 hours after kidney ischemia and reperfusion in rats.

Validation survey of the impact of urinary incontinence (IIQ-7) and inventory of distress urogenital (UDI-6) -the short scales -in patients with multiple sclerosisValidação da escala curta do questionário de impacto da incontinência urinária (IIQ-7) e do inventário de angústia urogenital (UDI-6) em pacientes com esclerose múltipla ABSTRACTCross-cultural adaptation and validation of the Impact Questionnaire of Urinary Incontinence (IIQ-7) and Urogenital Distress Inventory (UDI-6) -short scale -in the Brazilian population with multiple sclerosis. The IIQ-7 and UDI-6 were translated into Portuguese, called IIQ-7-BR and UDI-6-BR. The questionnaires were administered in 211 individuals selected randomly. Of these, 140 had MS according to McDonald criteria and 71 were included in the control group. In both questionnaires, the Cronbach's alpha coefficient was above 0.7. The IIQ-7-BR showed 94.31% concordance between the evaluated studies and UDI-6-BR, 93.33%. Thus, the instruments of this study were presented according to the standards proposed by the Instrument Review Criteria, reliability, validity and sensitivity, maintaining the original scales characteristics.Keywords: urinary incontinence, multiple sclerosis, questionnaires. RESUMOAdaptação transcultural e validação da escala curta do Questionário de Impacto de Incontinência Urinária (IIQ-7) e do Inventário da Angústia Urogenital (UDI-6) na população brasileira com esclerose múltipla (EM). O IIQ-7 e o UDI-6 foram traduzidos para a língua portuguesa, obtendo-se IIQ-7-BR e UDI-6-BR. Os questionários foram aplicados em 211 indivíduos selecionados aleatoriamente. Destes, 140 apresentavam EM nos critérios de McDonald, e 71 foram incluídos no grupo controle. Em ambos os questionários aplicados nos grupos, o coeficiente alpha de Cronbach apresentou-se acima de 0,7. O IIQ-7-BR apresentou 94,31% de concordância entre os estudos avaliados e o UDI-6-BR, 93,33%. Sendo assim, os instrumentos desse estudo apresentaram-se, segundo as normas propostas pelo Instrument Review Criteria, confiabilidade, validade e sensibilidade, mantendo as características das escalas originais.Palavras-chave: incontinência urinária, esclerose múltipla, questionários.

No abstract

to evaluate the prevalence of UTIs in women newly diagnosed with GSM versus women without GSM, and 2) to assess the prevalence of UTIs in women treated with prasterone versus untreated women.METHODS: This was a retrospective cohort analysis using data from Integrated Dataverse database from Symphony Health Solutions collected between 02/2015 and 06/2019. Data was analyzed from women at least 45 years old and who have at least one year of clinical data before and after their index dates. For objective 1, index dates were defined as the first observed GSM diagnosis for the GSM cohort and as a randomly selected outpatient visit date for women without a GSM diagnosis. For objective 2, index dates were defined as the first prasterone fill date for treated women and as the initial GSM diagnosis date for untreated women. To ensure women had a balanced UTI risk profile, women treated with prasterone were matched to untreated women based on age, region, diabetes history, and number of UTI episodes in the year prior to the index date. The UTI prevalence was measured over a 1-year period after the index date. The differential prevalence was assessed using risk ratios (RR).RESULTS: The prevalence of UTIs was threefold higher (RR 3.0, 95%CI 2.97-3.04) in women diagnosed with GSM compared to matched controls (N[413,207). Women with untreated GSM (N [5,813) had an increased frequency of UTI episodes in the 12 months following the first observed GSM diagnosis (p<0.05) compared to their baseline. When compared to women with untreated GSM, women treated with prasterone had a significantly lower UTI prevalence within 12 months of the first prescription fill (RR 0.62, 95% CI (0.56 e 0.68), p<0.05).CONCLUSIONS: Women newly diagnosed with GSM have a higher rate of UTIs compared to women without GSM. Results also suggest that the use of prasterone in women diagnosed with GSM may reduce the recurrence of UTIs.