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- Abreu-Mendes, Pedro, et al.
(author)
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Myofascial Pelvic Pain : Best Orientation and Clinical Practice. Position of the European Association of Urology Guidelines Panel on Chronic Pelvic Pain
- 2023
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In: European Urology Focus. - : Elsevier. - 2405-4569. ; 9:1, s. 172-177
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Journal article (peer-reviewed)abstract
- CONTEXT: Despite the high prevalence of a myofascial pain component in chronic pelvic pain (CPP) syndromes, awareness and management of this component are lacking among health care providers.OBJECTIVE: To summarize the current state of the art for the management of myofascial pain in chronic primary pelvic pain syndromes (CPPPS) according to scientific research and input from experts from the European Association of Urology (EAU) guidelines panel on CPP.EVIDENCE ACQUISITION: A narrative review was undertaken using three sources: (1) information in the EAU guidelines on CPP; (2) information retrieved from the literature on research published in the past 3 yr on myofascial pelvic pain; and (3) expert opinion from panel members.EVIDENCE SYNTHESIS: Studies confirm a high prevalence of a myofascial pain component in CPPPS. Examination of the pelvic floor muscles should follow published recommendations to standardize findings and disseminate the procedure. Treatment of pelvic floor muscle dysfunction and pain in the context of CPP was found to contribute to CPP control and is feasible via different physiotherapy techniques. A multidisciplinary approach is the most effective.CONCLUSIONS: Despite its high prevalence, the myofascial component of CPP has been underevaluated and undertreated to date. Myofascial pain must be assessed in all patients with CPPPS. Treatment of the myofascial pain component is relevant for global treatment success. Further studies are imperative to reinforce and better define the role of each physiotherapy technique in CPPPS.PATIENT SUMMARY: Pain and inflammation of the body's muscle and soft tissues (myofascial pain) frequently occurs in pelvic pain syndromes. Its presence must be evaluated to optimize management for each patient. If diagnosed, myofascial pain should be treated.
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| 2. |
- Parsons, Brian A., et al.
(author)
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The Benefits and Harms of Botulinum Toxin-A in the Treatment of Chronic Pelvic Pain Syndromes : A Systematic Review by the European Association of Urology Chronic Pelvic Pain Panel
- 2022
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In: European Urology Focus. - : Elsevier BV. - 2405-4569. ; 8:1, s. 320-338
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Research review (peer-reviewed)abstract
- Chronic pelvic pain (CPP) is chronic or persistent pain perceived in structures related to the pelvis of men and women. Patients with CPP may have pain refractory to conventional management strategies. Botulinum toxin A (BTX-A) injection is a potential therapeutic option in patients with CPP. Beneficial effects of BTX-A on pain, quality of life, and functional symptoms were seen in patients with certain CPP subtypes, but the current evidence level is too weak to allow recommendations about the use of BTX-A for treating CPP. Therefore, larger-scale, multicentre, well-designed, and appropriately powered randomised controlled trials or prospective case-control studies with longer follow-up periods are needed.
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| 3. |
- Pawlak-Kruczek, Halina, et al.
(author)
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Industrial Process Description for the Recovery of Agricultural Water From Digestate
- 2020
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In: Journal of energy resources technology. - : ASME International. - 0195-0738 .- 1528-8994. ; 142:7
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Journal article (peer-reviewed)abstract
- Currently, the reclamation and reuse of water have not reached their full potential, although more energy is needed to obtain and transport freshwater and this solution has a more serious environmental impact. Agricultural irrigation is, by far, the largest application of reclaimed water worldwide, so the proposed concept may result in the production of water that can be used, among others, for crop irrigation. This paper describes a novel installation for the recovery of the agricultural water from the digestate, along with the results of initial experiments. Currently, water is wasted, due to evaporation, in anaerobic digestion plants, as the effluent from dewatering of the digestate is discharged into lagoons. Moreover, water that stays within the interstitial space of the digestate is lost in a similar fashion. With increasing scarcity of water in rural areas, such waste should not be neglected. The study indicates that hydrothermal carbonization (HTC) enhances mechanical dewatering of the agricultural digestate and approximately 900 L of water can be recovered from one ton. Dewatered hydrochars had a lower heating value of almost 10 MJ/kg, indicating the possibility of using it as a fuel for the process. The aim of this Design Innovation Paper is to outline the newly developed concept of an installation that could enable recovery of water from, so far, the neglected resource-i.e., digestate from anaerobic digestion plants.
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| 4. |
- Thompson, J. J.P., et al.
(author)
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Phonon-Bottleneck Enhanced Exciton Emission in 2D Perovskites
- 2024
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In: Advanced Energy Materials. - 1614-6840 .- 1614-6832. ; 14:20
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Journal article (peer-reviewed)abstract
- Layered halide perovskites exhibit remarkable optoelectronic properties and technological promise, driven by strongly bound excitons. The interplay of spin-orbit and exchange coupling creates a rich excitonic landscape, determining their optical signatures and exciton dynamics. Despite the dark excitonic ground state, surprisingly efficient emission from higher-energy bright states has puzzled the scientific community, sparking debates on relaxation mechanisms. Combining low-temperature magneto-optical measurements with sophisticated many-particle theory, the origin of the bright exciton emission in perovskites is elucidated by tracking the thermalization of dark and bright excitons under a magnetic field. The unexpectedly high emission is clearly attributed to a pronounced phonon-bottleneck effect, considerably slowing down the relaxation toward the energetically lowest dark states. It is demonstrated that this bottleneck can be tuned by manipulating the bright-dark energy splitting and optical phonon energies, offering valuable insights and strategies for controlling exciton emission in layered perovskite materials that is crucial for optoelectronics applications.
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| 5. |
- Zumstein, Valentin, et al.
(author)
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The Benefits and Harms of Pharmacological Treatment for Postradiation Pelvic Pain : A Systematic Review by the European Association of Urology Chronic Pelvic Pain Panel with Recommendations for Clinical Practice
- 2023
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In: European Urology Open Science. - 2666-1691. ; 56, s. 29-38
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Research review (peer-reviewed)abstract
- Context: Radiotherapy of the pelvis is a widely used method for the treatment of malignancies, and local complications including pain following pelvic radiation therapy are acknowledged complications. Objective: The primary objective is to assess the clinical effectiveness and safety of pharmacological therapies on postradiation pelvic pain. Evidence acquisition: A systematic review of the use of different pharmacological treatments in the management of post-radiation pelvic pain was conducted (PROSPERO-ID: CRD42021249026). Comprehensive searches of EMBASE, Medline, and Cochrane library were performed for publications between January 1980 and April 2021. The primary outcomes were improvement in pain and adverse events following treatment. The secondary outcomes included quality of life, bowel function, and urinary function. Evidence synthesis: After screening 1514 abstracts, four randomised controlled trials were identified, enrolling 355 patients with bladder and anorectal subtypes of postradiotherapy chronic pelvic pain (CPP). A narrative synthesis was performed as heterogeneity of included studies precluded a meta-analysis. A single study reported a significant reduction in pain after 6 mo in patients with bladder pain syndrome treated with hyaluronic acid or hyperbaric oxygen. Anorectal pain was reported to be reduced by the application of 4% formalin, but the use of hyperbaric oxygen in postradiotherapy anorectal pain remains controversial. Adverse event reporting was generally poor. Studies looking at medications used routinely in guidelines for neuropathic pain, such as gabapentin, pregabalin, amitriptyline, and duloxetine, were absent or of poor quality when it came to postradiation pelvic pain. Conclusions: Beneficial effects of hyperbaric oxygen or formalin on pain, quality of life, and functional symptoms were seen in patients with certain CPP subtypes, but the current evidence level is too weak to allow recommendations about the use of any pharmacological treatment for postradiation pelvic pain. Patient summary: Different pharmacological treatments are used to treat pain after radiotherapy, but current studies are of insufficient quality to determine whether these should be recommended and many chronic pelvic pain subtypes are not covered. Further research is needed.
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