Physiotherapy as a Way to Maintain Vaginal Health during Menopause

The majority of women will experience some or most of the menopause symptoms in their life. Thais time in women’s life is associated with a reduction in estrogen levels which leads to physiological changes that affect different organ systems. In the urogenital tract, these changes usually cause vulvar and vaginal atrophy, affecting a vaginal health of women and decreasing their quality of life. Also, there is a reduction in vaginal moisture and loss of tissue elasticity. Besides, other organ systems are involved and they can also negatively impact normal vaginal physiology. These evolutional changes frequently lead to bothersome symptoms that can negatively impact a woman’s vaginal health and the quality of life. The role of pelvic floor physiotherapy is to improve the tone and strength of the muscle fibres in order to achieve the increase of motor units, improve muscle elasticity and to increase the muscle mass which will help to alleviate menopause symptoms.

Metastatic hormone-sensitive prostate cancer:How should it be treated?

The number of treatment options for metastatic hormone-sensitive prostate cancer has increased substantially in recent years.The classic treatment approach for these patients—androgen-deprivation therapy alone—is now considered suboptimal.Several randomized phase III clinical trials have demonstrated significant clinical benefits—including significantly better overall survival and quality of life—for treatments that combine androgen-deprivation therapy with docetaxel,abiraterone acetate,enzalutamide,apalutamide,and/or radiotherapy to the primary tumour.As a result,these approaches are now included in treatment guidelines and considered standard of care.However,the different treatment strategies have not been directly compared,and thus treatment selection remains at the discretion of the individual physician or,ideally,a multidisciplinary team.Given the range of available treatment approaches with varying toxicity profiles,treatment selection should be individualized based on the patient’s clinical characteristics and preferences,which implies active patient participation in the decision-making process.In the present document,we discuss the changing landscape of the management of patients with metastatic hormonesensitive prostate cancer in the context of several recently-published landmark randomized trials.In addition,we discuss several unresolved issues,including the optimal sequencing of systemic treatments and the incorporation of local treatment of the primary tumour and metastases.

Factors Influencing Serum Amyloid Type A (Saa) Concentrations in Horses

The acute phase response (APR) is the reaction that occurs in animals in response to disturbances in hemostasis following tissue damage. In horses, the APR is manifested in a variety of pathological processes of various origins, such as infections caused by bacteria, viruses, parasites, arthritis, burns, chemicals, trauma surgery and stress. Acute phase proteins (APPs) are considered those proteins that modify its plasma concentration at least 25% in inflammatory and infectious processes. In adult horses, various respiratory inflammatory processes, gastrointestinal tract, reproductive organs and musculoskeletal system are accompanied by increased levels of a specific APP, so-called serum amyloid type A (SAA). SAA is the most important major APP in the horse. This paper provides a review of physiological factors affecting SAA levels and their role in horses in defense of natural mechanisms, the pathways involved and their material components.