Background: Genitourinary syndrome of menopause (GSM) is the new term for vulvovaginal atrophy (VVA). The condition is relevant in more than 50% of women, having an adverse impact on quality of life and sexual relationships. Objective: To assess the efficacy and safety of a new type of non-ablative laser, Solid State Vaginal Laser (SSVL), for vaginal tissue regeneration and rejuvenation. Method: Eighty participants with GSM symptoms were treated with a total of 4 treatments in about two months (every 15 -20 days) of a nonablative SSVL (LASEmaR 1500™-EUFOTON). A cumulative intensity of GSM symptoms using a 10-cm VAS (dryness and/or burning and/or dyspareunia), the vaginal health index (VHI), the Female Sexual Function Index (FSFI) were evaluated. Urinary Incontinence Short Form (ICIQ-UI SF) and vaginal bioptic samples were also collected. Results: Improvement following the SSVL was observed on VHIS, VVA symptoms and sexual female function. This finding was also ratified by the improvement of vaginal histological features. After the SSVL treatment, almost all patients (91%) affected by urinary incontinence obtained the complete remission of symptoms. Conclusion: The objective evaluation of VHIS, FSFI and ICIQ-UI SF scores and the histological results indicates a real favorable effect of SSVL on GSM and on urinary incontinence.
Further large-scale prospective and randomized trials with a long follow-up are needed in order to better clarify the clinical effect of different treatment modalities on the morbidity and mortality of patients on chronic renal replacement therapy. In particular, it must be clarified whether the possible clinical differences in treatment modalities are based on differences in the clearance of middle molecules or on biocompatibility, or, more generally, on the increasingly recognized clinical importance of high-flux treatments, and the possible interaction between membrane flux and biocompatibility.
On-line monitoring of intradialytic sodium removal and the potassium gradient is capable of reducing intradialytic hypotension and the arrhythmogenic effect of haemodialysis, and thus having a considerable clinical impact on acute intradialysis complications. As far as the effects of biocompatibility and/or flux on the incidence of acute intradialytic clinical symptoms are concerned, further trials involving a sicker patient population with higher prevalence of intradialytic hypotension are needed in order to achieve statistical power.
The aim of this study was to investigate the possible influence of arteriovenous fistula (AVF) on nerve conduction velocity in patients on intermittent hemodialysis and its relevance to the pathogenesis of carpal tunnel syndrome (CTS). The data on 22 patients showed no statistically significant differences in the electrographic parameters considered. This suggests that AVF by the end-to-end method plays no significant part in the alteration of nerve conduction. Possibly radial steal phenomena, which occur with other types of AVF, are at least partly responsible for the reported cases of CTS.
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