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Sexual Health
Published in Carolyn Torkelson, Catherine Marienau, Beyond Menopause, 2023
Carolyn Torkelson, Catherine Marienau
During her reproductive years, Norma’s sexual activity had been limited to solo masturbation. At age 59, Norma began having intercourse with a male partner she met through internet dating. Soon he suggested that they have anal intercourse, which was not something Norma had ever imagined doing. During our visit, Norma was eager to raise questions and concerns about whether anal intercourse was appropriate and safe. At first, I was caught off-guard, but quickly realized that I needed to approach her questions with responsible and respectful answers. I said that while coital intercourse is the most common sexual behavior, anal intercourse also is an expression of human sexuality. I counseled her about the risk of sexually transmitted infections during noncoital sexual activity and encouraged efforts to prevent such infections by using condoms during anal–genital intercourse. I also advised sufficient lubrication to avoid any tearing or discomfort. Then I brought the conversation around to Norma’s own comfort level with having anal intercourse and emphasized her right to choose. I stressed that anal intercourse was not obligatory, and she need not feel coerced into any sexual activity she did not want.
Voice Disorders and Laryngitis
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Management:If nodules are not causing significant problems, they should be left alone.Aggravating factors, such as inadequate lubrication, infections, and reflux, should be treated to reduce their irritant effects.Mainstay for persistent vocal nodules is VT with VH. Not infrequently, the voice and function improve, but the nodules persist.Surgery should be reserved for those who fail voice therapy and remain symptomatic. Surgical aim is precise excision of the nodule alone, with no exposure of the underlying ligament.
Biology of Joints
Published in Verna Wright, Eric L. Radin, Mechanics of Human Joints, 2020
Synovial joints, or diarthroses, are by far the most common form of articulation between adjacent bones (5,6). Within this class of joints, a wide variety of designs accommodate a comparable spectrum of demands. All share, however, the features of a journal bearing: one opposing surface slides across or around its opposing mate. This fundamental feature is well shown in the interphalangeal joint illustrated in Figure 1. Synovial fluid and its requisite supporting synovial tissue are the body’s principal answer to the problem of musculoskeletal friction. Not only in joints, but also in bursae and tendon sheaths, synovial systems serve to enhance stable motion while they minimize friction between adjacent connective tissue components. This highly effective system of lubrication is reviewed in detail in Chapter 5.
Neurotrophic keratopathy: current challenges and future prospects
Published in Annals of Medicine, 2022
Erin NaPier, Matthew Camacho, Timothy F. McDevitt, Adam R. Sweeney
Neurotrophic keratopathy (NK) is a rare, degenerative condition characterized by decreased innervation of the cornea that affects <1.6 per 10,000 people [1,2]. While there is an extensive list of possible causes, prior corneal herpetic infection is the most common aetiology [1]. Notoriously difficult to manage, NK may lead to significant patient morbidity or decreased quality of life. Symptoms are primarily based on stage and severity, ranging from asymptomatic to varying degrees of impaired vision [2]. Appropriate medical and surgical treatment options are based on the severity of the disease. Treatment options range from lubrication alone to multimodality management including aggressive topical and surgical treatments. Recent advances in therapy include strategies aimed at re-innervating the cornea including topical nerve growth factors (NGF) and corneal neurotization. Several novel therapies, such as matrix regenerating therapy, plasma rich in growth factors (PRIGF), Thymosin β4, Substance P/Insulin-like growth factor-1 (IGF-1), and nicergoline are under investigation. The purpose of this article is to provide a review of current literature on neurotrophic keratopathy with a focus on current and novel treatments.
A novel approach of external lubrication in a rotary tablet press using electrostatics
Published in Drug Development and Industrial Pharmacy, 2022
Maren Zimmermann, Felix Michel, Jens Bartsch, Markus Thommes
The aim of this study is the implementation of an external lubrication system based on applying electric charge to the lubricant (magnesium stearate). In contrast to existing systems [16], the use of compressed air is avoided, as it might inhibit the precise application of the lubricant to the relevant surfaces. In the present study, the charging process of well-established lubricants is evaluated with respect to the stability of the accumulated charge and the maximum charge accumulation. An external lubrication device is integrated into a pilot scale rotary tablet press, and the performance of the production process is tested by analyzing critical quality attributes and process parameters. Consequently, this study serves as a proof-of-concept and highlights the feasibility of implementing the modified external lubrication system.
Critical analysis of in vitro stability testing of spinal implants and proposal for standardization
Published in Expert Review of Medical Devices, 2022
Zoltán Csernátony, Sándor Manó, Zsolt Tiba, Géza Husi, Zoltán Jónás, Tímea Váradi, Loránd Csámer, Ágnes Éva Kovács
Lubrication is one of the key aspects of tribology. A lubricant is usually used to keep a distance between two solid materials, consequently preventing direct mechanical contact with each other. The lower the lubricity, the greater the wear of the examined material. The lubricity of a substance cannot be measured directly, moreover it is significantly influenced by other factors such as the shape, microgeometry and extent of the surfaces, viscosity and density of the lubricant, and temperature and pressure [5]. Lubricants can play a key role in the instability of assembled spinal implants in human bodies. Posterior spinal implants are composed of different pedicle screws and hooks, which are connected to two longitudinal rods. Spinal implants mounted on rods are subjected to significant strain after the correction of deformities, and this is compensated by the clamping force of the set screws securing the implant parts together. In the surgical field, both the loosening of the securing set screws and the sliding of the implants on the rods are facilitated by the undesired lubricity of the environment [6] and can be associated with implant failures due to set-screw loosening [7].