Bariatric Surgery Reduces Serum Anti-mullerian Hormone Levels in Obese Women With and Without Polycystic Ovarian Syndrome.

Purpose: Obesity in fertile women has negative effect on fertility. Anti-mullerian hormone (AMH) represents a good index of fertility, and it is considered a marker of ovarian reserve and of polycystic ovarian syndrome (PCOS) gravity. Previous studies evaluated the relationship between obesity and AMH with contradictory results.

Spike latency and response properties of an excitable micropillar laser.

We present experimental measurements concerning the response of an excitable micropillar laser with saturable absorber to incoherent as well as coherent perturbations. The excitable response is similar to the behavior of spiking neurons but with much faster time scales. It is accompanied by a subnanosecond nonlinear delay that is measured for different bias pump values.

Large subcapsular hematoma following ureteroscopic laser lithotripsy of renal calculi in a spina bifida patient: lessons we learn.

Introduction: Paraplegic patients are at greater risk of developing complications following ureteroscopic lithotripsy because of urine infection associated with neuropathic bladder, difficulties in access due to altered anatomy of urinary bladder and urethra, spinal curvature, spasticity, and contractures. We report the occurrence of large subcapsular hematoma following ureteroscopy and discuss lessons we learn from this case.

Case Report: A 48-year-old male patient with spina bifida underwent ureteroscopy with laser lithotripsy and ureteric stenting for left ureteric stone and staghorn calculus with hydronephrosis; laser lithotripsy was repeated after 3 months; both procedures were performed by a senior urologist and did not result in any complications.

Spatiotemporal Chaos Induces Extreme Events in an Extended Microcavity Laser.

Extreme events such as rogue waves in optics and fluids are often associated with the merging dynamics of coherent structures. We present experimental and numerical results on the physics of extreme event appearance in a spatially extended semiconductor microcavity laser with an intracavity saturable absorber. This system can display deterministic irregular dynamics only, thanks to spatial coupling through diffraction of light.

Temporal summation in a neuromimetic micropillar laser.

Neuromimetic systems are systems mimicking the functionalities or architecture of biological neurons and may present an alternative path for efficient computing and information processing. We demonstrate here experimentally temporal summation in a neuromimetic micropillar laser with an integrated saturable absorber. Temporal summation is the property of neurons to integrate delayed input stimuli and to respond by an all-or-none kind of response if the inputs arrive in a sufficiently small time window.

Urinary retention and acute kidney injury in a tetraplegic patient using condom catheter after partying: a preventable complication.

Background: Spinal cord injury patients, who manage their bladder using a condom catheter, are at risk of developing urine retention when they consume large volumes of alcoholic drinks within a short period of time.

Case Presentation: A male tetraplegic patient had been managing satisfactorily penile sheath drainage for 8 years. He went out socializing during which he consumed large volumes of alcohol but did not take any recreational drugs.

Complications and salvage options after laser lithotripsy for a vesical calculus in a tetraplegic patient: a case report.

Background: Laser lithotripsy of vesical calculi in tetraplegic subjects with long-term urinary catheters is fraught with complications because of bladder wall oedema, infection, fragile urothelium, bladder spasms, and autonomic dysreflexia. Severe haematuria should be anticipated; failure to institute measures to minimise bleeding and prevent clot retention can be catastrophic. We present an illustrative case.

Weight loss associated with bariatric surgery does not restore short telomere length of severe obese patients after 1 year.

Background: Telomere shortening is physiologically associated with ageing but it may be influenced by oxidative stress and chronic inflammation, linked to obesity. Thus, obesity might represent an additional cause of telomere attrition. We aim to study relative telomere length (RTL) in obese subjects with and without metabolic syndrome and to assess the effect of weight loss induced by bariatric surgery.

Relative refractory period in an excitable semiconductor laser.

We report on experimental evidence of neuronlike excitable behavior in a micropillar laser with saturable absorber. We show that under a single pulsed perturbation the system exhibits subnanosecond response pulses and analyze the role of the laser bias pumping. Under a double pulsed excitation we study the absolute and relative refractory periods, similarly to what can be found in neural excitability, and interpret the results in terms of a dynamical inhibition mediated by the carrier dynamics.

Failure of Urological Implants in Spinal Cord Injury Patients due to Infection, Malfunction, and Implants Becoming Obsolete due to Medical Progress and Age-Related Changes in Human Body Making Implant Futile: Report of Three Cases.

Any new clinical data, whether positive or negative, generated about a medical device should be published because health professionals should know which devices do not work, as well as those which do. We report three spinal cord injury patients in whom urological implants failed to work. In the first, paraplegic, patient, a sacral anterior root stimulator failed to produce erection, and a drug delivery system for intracavernosal administration of vasoactive drugs was therefore implanted; however, this implant never functioned (and, furthermore, such penile drug delivery systems to produce erection had effectively become obsolete following the advent of phosphodiesterase type 5 inhibitors).

Severe diabetic ketoacidosis leading to cardiac failure, pulmonary oedema and spinal cord oedema resulting in tetraplegia.

A 23-year-old man with poorly controlled insulin-dependent diabetes mellitus presented to casualty with community-acquired pneumonia and diabetic ketoacidosis. Shortly after admission he deteriorated and developed cardiac failure, pulmonary oedema and further decreased level of consciousness. He was sedated and ventilated for 3 weeks in the intensive care unit.

Challenges in diagnosis and treatment of a cervical spinal cord injury patient with melanoma, adenocarcinoma, and hepatic and osteolytic metastases: need to implement strategies for prevention and early detection of cancer in spinal cord injury patients.

A male tetraplegic patient with, who had been taking warfarin, developed haematuria. Ultrasound scan revealed no masses, stones, or hydronephrosis. Urinary bladder had normal configuration with no evidence of masses or organised haematoma.

Hydronephrosis and renal failure following inadequate management of neuropathic bladder in a patient with spinal cord injury: Case report of a preventable complication.

Background: Condom catheters are indicated in spinal cord injury patients in whom intravesical pressures during storage and voiding are safe. Unmonitored use of penile sheath drainage can lead to serious complications.

Case Report: A 32-year old, male person, sustained complete paraplegia at T-11 level in 1985.

Pyonephrosis and urosepsis in a 41-year old patient with spina bifida: Case report of a preventable death.

Background: Urological complications are the major cause of ill health in patients with spina bifida. Urinary sepsis accounted for the majority of admissions in patients with spina bifida. As the patient grows older, changes occur in the adult bladder, leading to increases in storage pressure and consequent risk of deterioration of renal function, which may occur insidiously.

Are urological procedures in tetraplegic patients safely performed without anesthesia? a report of three cases.

Background: Some tetraplegic patients may wish to undergo urological procedures without anaesthesia, but these patients can develop autonomic dysreflexia if cystoscopy and vesical lithotripsy are performed without anaesthesia.

Case Presentation: We describe three tetraplegic patients, who developed autonomic dysreflexia when cystoscopy and laser lithotripsy were carried out without anesthesia.In two patients, who declined anaesthesia, blood pressure increased to more than 200/110 mmHg during cystoscopy.

Increased sural nerve epineurial blood flow in human subjects with painful diabetic neuropathy.

Aims/hypothesis: The pathogenesis of painful diabetic neuropathy remains unknown. As a consequence we still do not have any effective, rational treatments and a greater understanding of the mechanisms is urgently required. Previous studies have shown no consistent morphological differences in the nerves of patients with and without painful neuropathy.

Management of degenerative changes and stenosis of the lumbar spinal canal secondary to cervical spinal cord injury.

We describe the case of a 47-year-old female who sustained a C5/6 fracture with C6 complete spinal cord injury 26 years ago. She presented with increased spasticity of the lower extremities, the abdominal wall and episodes of autonomic dysreflexia. Imaging of the spine revealed post-traumatic kyphosis at the level of the injury and degenerative changes of the lumbar spine with marked facet joint hypertrophy at the level of L4/5 causing severe spinal canal stenosis.

Charcot joint of the spine, a cause of autonomic dysreflexia in spinal cord injured patients.

Study Design: Case report of two subjects.

Objective: Charcot joints of the spine as a cause of Autonomic Dysreflexia in spinal cord lesions.

Setting: Stoke Mandeville Hospital, UK.

A new minimally invasive technique to show nerve ischaemia in diabetic neuropathy.

Aims/hypothesis: Experimental studies have shown that abnormalities of nerve microcirculation are important factors in the pathogenesis of diabetic neuropathy but there have been few clinical studies. We have applied microlightguide spectrophotometry to measure intravascular oxygen saturation (HbO2%) and blood flow in human sural nerve.

Methods: We studied ten patients with mild-moderate sensory motor diabetic neuropathy, nine patients without neuropathy and nine control subjects.

Intracerebral haemorrhage due to amphetamine abuse: report of two cases with underlying arteriovenous malformations.

Amphetamine abuse may be complicated by intracerebral, subdural or subarachnoid haemorrhage. The causative mechanism is probably a combination of vasculitis and induced hypertension. Most cases of intracerebral haemorrhage are subcortical.

Type I Chiari deformity presenting with profound sinus bradycardia: case report and literature review.

Type I Chiari deformity presents with diverse symptoms and signs which can be attributed to compression of structures at the foramen magnum. Bradycardia as a result of medullary compression has not been reported previously. A patient is described with type I Chiari deformity who presented with episodic profound sinus bradycardia for which a pacemaker was inserted before the diagnosis of cerebellar ectopia was finally made.

Spinal extradural arteriovenous malformation presenting with recurrent hemorrhage and intermittent paraplegia: case report and review of the literature.

Symptomatic spinal extradural arteriovenous malformations (AVMs) are uncommon. They usually present with slowly progressive myelopathy and/or radiculopathy and only rarely with spinal extradural hemorrhage (SEH). Histopathologic features of a true spinal extradural AVM causing an overt SEH have only previously been described in four cases.

Idiopathic spinal extradural lipomatosis in a non-obese otherwise healthy man.

Spinal extradural lipomatosis is rare and is usually associated with long-term steroid administration or obesity. It is most commonly thoracic in situation. We present a unique case of spinal extradural lipomatosis in a 20-year-old non-obese, clinically normal man.