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Fulltext Predictors and outcomes of Mid-urethral sling continence surgeries for stress urinary incontinence among Taiwanese women: What works best?

Lo TS, Kamarudin M, Sun MJ, Su TH

Taiwan J Obstet Gynecol, 2024 Nov;63(6):826-835.
PMID: 39481988 DOI: 10.1016/j.tjog.2024.07.016

Mid urethral sling (MUS) surgery is a widely accepted and safe procedure performed for stress urinary incontinence (SUI) with excellent cure rate besides its minimal complications. There are various types of MUS which can be offered. In this review we collated published data on MUS surgery performed among Taiwanese women with SUI in search for the best techniques and its outcome. We reviewed 77 articles, searched using PubMed platform related to MUS in USI among Taiwanese women from 1998 to 2023.24 articles, total 2733 participants with at least 12 months follow up after MUS. Objective cure rate for trans-obturator tape (TOT), retropubic sling (TVT, tension vaginal tape), single incision sling (SIS) (Solyx) and SIS (MiniArc) are 80%-92%, 88%-94%, 87%-90% and 87%-91% respectively, while subjective cure is 60%-90% in TOT, 86% in SIS (Solyx) and almost 90% in SIS (MiniArc), Predictors for surgical failure analyzed in 5 papers of 1006 women. Identifiable risk includes low maximal urethral closure pressure, intrinsic sphincter deficiency, previous anti SUI or prolapse surgery, presence of neurogenic disease, constipation, decreased bladder sensation, age >65 years, high pad test, Diabetes, detrusor overactivity, post-menopausal, reduced postoperative urethral mobility and tape percentile. Subsequently we dwell into complications of each type of MUS. This review showed the evolution of MUS and its comparable therapeutic efficacy. However, with certain complication rates and predictors for failure. This will add value in preoperative counselling while taking into accounts patients' factors in choosing the appropriate types of MUS. Future research is needed on long term effectiveness and risk of future recurrence.
Novel effect and the mechanistic insights of fruiting body extract of medicinal fungus Antrodia cinnamomea against T47D breast cancer

Shang KM, Su TH, Lee WL, Hsiao WW, Chiou CY, Ho BY, et al.

Phytomedicine, 2017 Jan 15;24:39-48.
PMID: 28160860 DOI: 10.1016/j.phymed.2016.11.006

INTRODUCTION: Tamoxifen, an anti-oestrogenic drug for estrogen receptor positive (ER+) breast cancer, was observed to stimulate tumor growth or drug resistance in patients. Antrodia cinnamomea (AC), a precious medicinal fungus has been traditionally used as a folk remedy for cancers in Asian countries. The objective of this study was to investigate the bioefficacy and the underlying molecular mechanisms of the AC fruiting bodies extracts (AC-3E) against human ER+ T47D breast cancer cells, and compare the effect with that of tamoxifen.
METHODS: Cell proliferation, migration, TUNEL assay, western blotting, time-lapse confocal microscopy analyses, chorioallantoic membrane assay, and a xenograft BALB/c nude mouse system were used in this study. Chemical fingerprinting of AC-3E was established using LC-MS.
RESULTS: AC-3E attenuated T47D breast cancer cell activity by deregulating the PI3K/Akt/mTOR signaling pathway and key cell-cycle mediators, and inducing apoptosis. AC-3E also effectively inhibited tube-like structures of endothelial cells, blood vessel branching and microvessel formation ex vivo and in vivo. Significant preventive and therapeutic effects against T47D mammary tumor growth of AC-3E was observed comparable or superior to tamoxifen treatment in xenograft BALB/c nude mice. Dehydroeburicoic acid (2) was characterized as the main chemical constituent in AC-3E against breast cancer.
CONCLUSION: This study suggests that AC-3E extracts can be employed as a double-barreled approach to treat human ER+ breast cancer by attacking both cancer cells and tumor-associated blood vessel cells.
Historical epidemiology of hepatitis C virus in select countries-volume 4

Maaroufi A, Vince A, Himatt SM, Mohamed R, Fung J, Opare-Sem O, et al.

J Viral Hepat, 2017 10;24 Suppl 2:8-24.
PMID: 29105285 DOI: 10.1111/jvh.12762

Due to the introduction of newer, more efficacious treatment options, there is a pressing need for policy makers and public health officials to develop or adapt national hepatitis C virus (HCV) control strategies to the changing epidemiological landscape. To do so, detailed, country-specific data are needed to characterize the burden of chronic HCV infection. In this study of 17 countries, a literature review of published and unpublished data on HCV prevalence, viraemia, genotype, age and gender distribution, liver transplants and diagnosis and treatment rates was conducted, and inputs were validated by expert consensus in each country. Viraemic prevalence in this study ranged from 0.2% in Hong Kong to 2.4% in Taiwan, while the largest viraemic populations were in Nigeria (2 597 000 cases) and Taiwan (569 000 cases). Diagnosis, treatment and liver transplant rates varied widely across the countries included in this analysis, as did the availability of reliable data. Addressing data gaps will be critical for the development of future strategies to manage and minimize the disease burden of hepatitis C.
The present and future disease burden of hepatitis C virus infections with today's treatment paradigm: Volume 4

Chan HLY, Chen CJ, Omede O, Al Qamish J, Al Naamani K, Bane A, et al.

J Viral Hepat, 2017 10;24 Suppl 2:25-43.
PMID: 29105283 DOI: 10.1111/jvh.12760

Factors influencing the morbidity and mortality associated with viremic hepatitis C virus (HCV) infection change over time and place, making it difficult to compare reported estimates. Models were developed for 17 countries (Bahrain, Bulgaria, Cameroon, Colombia, Croatia, Dominican Republic, Ethiopia, Ghana, Hong Kong, Jordan, Kazakhstan, Malaysia, Morocco, Nigeria, Qatar and Taiwan) to quantify and characterize the viremic population as well as forecast the changes in the infected population and the corresponding disease burden from 2015 to 2030. Model inputs were agreed upon through expert consensus, and a standardized methodology was followed to allow for comparison across countries. The viremic prevalence is expected to remain constant or decline in all but four countries (Ethiopia, Ghana, Jordan and Oman); however, HCV-related morbidity and mortality will increase in all countries except Qatar and Taiwan. In Qatar, the high-treatment rate will contribute to a reduction in total cases and HCV-related morbidity by 2030. In the remaining countries, however, the current treatment paradigm will be insufficient to achieve large reductions in HCV-related morbidity and mortality.
Strategies to manage hepatitis C virus infection disease burden-Volume 4

Chen DS, Hamoudi W, Mustapha B, Layden J, Nersesov A, Reic T, et al.

J Viral Hepat, 2017 10;24 Suppl 2:44-63.
PMID: 29105286 DOI: 10.1111/jvh.12759

The hepatitis C virus (HCV) epidemic was forecasted through 2030 for 17 countries in Africa, Asia, Europe, Latin America and the Middle East, and interventions for achieving the Global Health Sector Strategy on viral hepatitis targets-"WHO Targets" (65% reduction in HCV-related deaths, 90% reduction in new infections and 90% of infections diagnosed by 2030) were considered. Scaling up treatment and diagnosis rates over time would be required to achieve these targets in all but one country, even with the introduction of high SVR therapies. The scenarios developed to achieve the WHO Targets in all countries studied assumed the implementation of national policies to prevent new infections and to diagnose current infections through screening.