Notes

Electrochemically switchable polymerization from surface-anchored molecular causes.
The treatment strategy for AVM-associated spinal aneurysms should be tailored on the single patient. In presence of large aneurysms that cause mass-effect symptoms, when rupture of the aneurysm is suspected or when treatment of the AVM is not proposable, direct treatment of the aneurysm should be considered. Otherwise, when complete resection of the nidus is performed, the eventually associated unruptured aneurysms located in challenging positions can be safely managed conservatively.
The treatment strategy for AVM-associated spinal aneurysms should be tailored on the single patient. In presence of large aneurysms that cause mass-effect symptoms, when rupture of the aneurysm is suspected or when treatment of the AVM is not proposable, direct treatment of the aneurysm should be considered. Otherwise, when complete resection of the nidus is performed, the eventually associated unruptured aneurysms located in challenging positions can be safely managed conservatively.
Anti-obesity therapy can reduce body weight; however, it is not clear whether it can reduce major adverse cardiovascular events (MACEs). We conducted a systematic review and meta-analysis to assess the effect of long-term anti-obesity drugs on MACEs in individuals with overweight or obesity.

The MEDLINE, Embase, and Cochrane Library databases and clinical trial registries ( https//clinicaltrials.gov ) were searched up to 3 May 2021 for randomized controlled trials (RCT) that compared anti-obesity drugs with controls and reported cardiovascular events in subjects with overweight or obesity. Heterogeneity was described by the I
value. The Mantel-Haenszel randomized effects model was adopted to calculate risk ratios (RR) and weighted mean differences (WMD). mTOR inhibition Sensitivity analysis was used to assess the stability of the effects. Publication bias was assessed by Begg's funnel plot and Egger's test. The Cochrane Collaboration risk-of-bias tool was used to evaluate the bias of each included RCT.

Twelve articles were included; 21,391 and 17,618 subjects were in the anti-obesity drug and placebo groups, respectively. There was no difference in MACEs between the anti-obesity drug and placebo groups (RR 0.99; 95% CI 0.88-1.12). Compared with placebo, anti-obesity interventions reduced body weight (WMD - 3.96kg; 95% CI - 4.89, - 3.03) and improved lipid and blood glucose profiles. The intervention also did not increase the incidence of depression or anxiety or the risk of suicidal ideation.

Long-term anti-obesity drugs did not show a benefit in lowering MACEs in overweight or obese subjects, although the drugs resulted in a decrease in body weight and improved cardiometabolic parameters.
Long-term anti-obesity drugs did not show a benefit in lowering MACEs in overweight or obese subjects, although the drugs resulted in a decrease in body weight and improved cardiometabolic parameters.
To identify preoperative level II/III MRI measures associated with long-term recurrence after native tissue prolapse repair.

Women who previously participated in pelvic floor research involving MRI prior to undergoing primary native tissue prolapse repair were recruited to return for repeat examination and MRI. Recurrence was defined by POP-Q (Ba/Bp > 0 or C > -4), repeat surgery, or pessary use. Preoperative MR images were used to perform five level II/III measurements including a new levator plate (LP) shape analysis at rest and maximal Valsalva. Principal component analysis (PCA) was used to evaluate LP shape variations. Principal component scores calculated for two independent shape variations were noted.

Thirty-five women were included with a mean follow-up of 13.2 ± 3.3years. Nineteen (54%) were in the success group. There were no statistical differences between success versus recurrence groups in demographic, clinical, or surgical characteristics. Women with recurrence had a larger preoperative resting levator hiatus [median 6.4cm (IQR 5.7, 7.1) vs. 5.8cm (IQR 5.3, 6.3), p = 0.03]. This measure was associated with increased odds of recurrence (OR 8.2, CI 1.4-48.9, p = 0.02). Using PCA, preoperative LP shape PC1 scores were different between success and recurrence groups (p = 0.02), with a more dorsally oriented LP shape associated with recurrence.

Larger preoperative levator hiatus at rest and a more dorsally oriented levator plate shape were associated with prolapse recurrence at long-term follow-up. For every 1cm increase in preoperative resting levator hiatus, the odds of long-term prolapse recurrence increases 8-fold.
Larger preoperative levator hiatus at rest and a more dorsally oriented levator plate shape were associated with prolapse recurrence at long-term follow-up. For every 1 cm increase in preoperative resting levator hiatus, the odds of long-term prolapse recurrence increases 8-fold.
The practice of same-day surgery among urogynecologic surgeons is increasing worldwide, but the percentage fluctuates among nations. Our primary aim was to investigate the feasibility of same-day surgery for pelvic organ prolapse (POP) using native tissue repair and the reasons why same-day surgery was not possible. Secondarily, we aimed to investigate the cause of hospital contact within 30days post surgery.

This is a case-control study including 803 women who underwent POP surgery performed by vaginal approach intended as same-day surgery during a 3-year period. No patients were excluded. Patients were divided into two groups successful same-day surgery (SDSS) and same-day surgery failure (SDSF).

Same-day surgery was performed successfully in 90.7% of the cases. Postoperative complications were the main cause of SDSF (76.0%), and most were caused by voiding dysfunction (VD) (42.7%). Patients receiving surgery in the apical compartment and/or surgery involving two compartments, receiving general anesthesia or having comorbidities equivalent to ASA score 3 had a greater tendency not to be able to complete same-day surgery. Regarding telephone contact with the hospital, the SDSS group was significantly less likely to call compared to the SDSF group (11.3% versus 26.7%) (p< 0.01) and the same regarding physical attendance in the department (8.9% and 24.0%) (p < 0.01). Only five patients were re-operated within 30days because of bleeding.

This study demonstrates that same-day surgery for POP has high feasibility and is safe. Complications, hospitalizations and reoperations immediately after surgery and within 30days were found to be minimal.
This study demonstrates that same-day surgery for POP has high feasibility and is safe. Complications, hospitalizations and reoperations immediately after surgery and within 30 days were found to be minimal.
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