Physiotherapy for persistent postnatal stress urinary incontinence : a randomized controlled trial

OBJECTIVE: The aim of this study was to compare the effectiveness of multimodal supervised physiotherapy programs with the absence of treatment among women with persistent postnatal stress urinary incontinence. METHODS: This was a single-blind randomized controlled trial. Sixty-four women with stress urinary incontinence were randomly assigned to 8 weeks of either multimodal pelvic floor rehabilitation (n = 21), multimodal pelvic floor rehabilitation with abdominal muscle training (n = 23), or control non–pelvic floor rehabilitation (n = 20). The primary outcome measure consisted of a modified 20-minute pad test. The secondary outcome measures included a Visual Analog Scale describing the perceived burden of incontinence, the Urogenital Distress Inventory, the Incontinence Impact Questionnaire, and pelvic floor muscle function measurements. RESULTS: Two patients dropped out, leaving 62 for analysis. At follow-up, more than 70% of the women in the treatment groups (14/20 in the pelvic floor and 17/23 in the pelvic floor plus abdominal group) were continent on pad testing compared with 0% of women in the control group. Scores on the pad test, Visual Analog Scale, Urogenital Distress Inventory, and Incontinence Impact Questionnaire improved significantly in both treatment groups (all P < .002), whereas no changes were observed in the control group. Pelvic floor muscle function, however, did not improve significantly in either active group. CONCLUSION: Multimodal supervised pelvic floor physiotherapy is an effective treatment for persistent postnatal stress urinary incontinence.

Physiotherapy for persistent postnatal stress urinary incontinence : a randomized controlled trial

OBJECTIVE: The aim of this study was to compare the effectiveness of multimodal supervised physiotherapy programs with the absence of treatment among women with persistent postnatal stress urinary incontinence. METHODS: This was a single-blind randomized controlled trial. Sixty-four women with stress urinary incontinence were randomly assigned to 8 weeks of either multimodal pelvic floor rehabilitation (n = 21), multimodal pelvic floor rehabilitation with abdominal muscle training (n = 23), or control non–pelvic floor rehabilitation (n = 20). The primary outcome measure consisted of a modified 20-minute pad test. The secondary outcome measures included a Visual Analog Scale describing the perceived burden of incontinence, the Urogenital Distress Inventory, the Incontinence Impact Questionnaire, and pelvic floor muscle function measurements. RESULTS: Two patients dropped out, leaving 62 for analysis. At follow-up, more than 70% of the women in the treatment groups (14/20 in the pelvic floor and 17/23 in the pelvic floor plus abdominal group) were continent on pad testing compared with 0% of women in the control group. Scores on the pad test, Visual Analog Scale, Urogenital Distress Inventory, and Incontinence Impact Questionnaire improved significantly in both treatment groups (all P < .002), whereas no changes were observed in the control group. Pelvic floor muscle function, however, did not improve significantly in either active group. CONCLUSION: Multimodal supervised pelvic floor physiotherapy is an effective treatment for persistent postnatal stress urinary incontinence.

Prevalencia de la ruptura prematura de membranas y la vía de finalización del parto en el Hospital Vicente Corral Moscoso, período 2014

Antecedente. La ruptura prematura de membranas (RPM) es causa importante de morbimortalidad materno fetal por asociarse a complicaciones riesgosas como la corioamnionitis. Objetivo. Establecer la prevalencia de ruptura prematura de membranas y la vía de terminación del parto según la variante de ruptura. Material y métodos. Con un diseño transversal se recopiló información de 360 historias clínicas de maternas atendidas en el Servicio de Obstetricia y Ginecología del hospital Vicente Corral Moscoso de Cuenca, durante el 2014. Resultados. La prevalencia de RPM fue del 8.2% (7.4 – 9.05). La edad promedio fue de 24.0 ± 6.2 años entre un rango de 14 a 44. El 46% cursó la secundaria, el 69% se dedica a actividades domésticas y el 61% reside en zona urbana. La rotura de membranas a término ocurrió en el 66%, la rotura prolongada en el 20% y la rotura pre-término en el 12%. El 71% terminó su parto vía vaginal y el 28% mediante cesárea. El parto vaginal fue más frecuente en rotura de membranas a término (P = 0.0005) y la cesárea en rotura pre-término (P = 0.002). En rotura prolongada, la frecuencia fue similar. Conclusión. La prevalencia de rotura prematura de membranas y la vía de terminación del parto, están dentro de las cifras reportadas por la literatura en estudios similares nacionales y extranjeros. Las variantes de RPM no parecen influenciar sobre la terminación del parto

Study of predictive biomarkers of manganese toxicity : control and prevention of neurotoxicity associated with parenteral nutrition

Tese de doutoramento, Farmácia (Toxicologia), Universidade de Lisboa, Faculdade de Farmácia, 2014

Nutritional Evaluation and Optimisation in Neonates: a randomized, double-blind controlled trial of amino acid regimen and intravenous lipid composition in preterm parenteral nutrition

Background: Parenteral nutrition is central to the care of very immature infants. Current international recommendations favor higher amino acid intakes and fish oil–containing lipid emulsions. Objective: The aim of this trial was to compare 1) the effects of high [immediate recommended daily intake (Imm-RDI)] and low [incremental introduction of amino acids (Inc-AAs)] parenteral amino acid delivery within 24 h of birth on body composition and 2) the effect of a multicomponent lipid emulsion containing 30% soybean oil, 30% medium-chain triglycerides, 25% olive oil, and 15% fish oil (SMOF) with that of soybean oil (SO)-based lipid emulsion on intrahepatocellular lipid (IHCL) content. Design: We conducted a 2-by-2 factorial, double-blind, multicenter randomized controlled trial. Results: We randomly assigned 168 infants born at ,31 wk of gestation. We evaluated outcomes at term in 133 infants. There were no significant differences between Imm-RDI and Inc-AA groups for nonadipose mass [adjusted mean difference: 1.0 g (95% CI: 2108, 111 g; P = 0.98)] or between SMOF and SO groups for IHCL [adjusted mean SMOF:SO ratio: 1.1 (95% CI: 0.8, 1.6; P = 0.58]. SMOF does not affect IHCL content. There was a significant interaction (P = 0.05) between the 2 interventions for nonadipose mass. There were no significant interactions between group differences for either primary outcome measure after adjusting for additional confounders. Imm-RDI infants were more likely than Inc-AA infants to have blood urea nitrogen concentrations .7 mmol/L or .10 mmol/L, respectively (75% compared with 49%, P , 0.01; 49% compared with 18%, P , 0.01). Head circumference at term was smaller in the Imm-RDI group [mean difference: 20.8 cm (95% CI: 21.5, 20.1 cm; P = 0.02)]. There were no significant differences in any prespecified secondary outcomes, including adiposity, liver function tests, incidence of conjugated hyperbilirubinemia, weight, length, mortality, and brain volumes. Conclusion: Imm-RDI of parenteral amino acids does not benefit body composition or growth to term and may be harmful. This trial was registered at www.isrctn.com as ISRCTN29665319 and at eudract.ema.europa.eu as EudraCT 2009-016731-34.

The Role of Plant Primary and Secondary Metabolites in Root-Herbivore Behaviour, Nutrition and Physiology

Many insect herbivores feed on belowground plant tissues. In this chapter, we discuss how they have adapted to deal with root primary and secondary metabolites. It is becoming evident that root herbivores can use root volatiles and exudates for host location and foraging. Their complex sensory apparatus suggests a sophisticated recognition and signal transduction system. Furthermore, endogenous metabolites trigger attractive or repellent responses in root feeders, indicating that they may specifically fine-tune food uptake to meet their dietary needs. Little evidence for direct toxic effects of root secondary metabolites has accumulated so far, indicating high prevalence of tolerance mechanisms. Root herbivores furthermore facilitate the entry of soil microbes into the roots, which may influence root nutritional quality. Investigating the role of plant metabolites in an ecologically and physiologically relevant context will be crucial to refine our current models on root-herbivore physiology and behaviour in the future.

Payment limitation provisions [microform] : hearing before the Subcommittee on Nutrition and Investigations of the Committee on Agriculture, Nutrition, and Forestry, United States Senate, One Hundredth Congress, first session on the administration and enforcement of the $50,000 per person payment limitation for farm programs, July 21, 1987.

CIS Microfiche Accession Numbers: CIS 88 S161-24

Timber harvesting [microform] : hearing before the Subcommittee on Environment, Soil Conservation and Forestry of the Committee on Agriculture, Nutrition, and Forestry, United States Senate, Ninety-sixth Congress, first session, June 22, 1979.

Reuse of record except for individual research requires license from Congressional Information Service, Inc.

Farmland protection act [microform] : hearing before the Subcommittee on Environment, Soil Conservation, and Forestry of the Committee on Agriculture, Nutrition, and Forestry, United States Senate, Ninety-sixth Congress, first session, on S. 795 ... July 10, 1979.

Reuse of record except for individual research requires license from Congressional Information Service, Inc.

Resource conservation and development [microform] : hearing before the Subcommittee on Environment, Soil Conservation, and Forestry of the Committee on Agriculture, Nutrition, and Forestry, United States Senate, Ninety-sixth Congress, first session, March 20, 1979.

Reuse of record except for individual research requires license from Congressional Information Service, Inc.

Oversight on the tobacco price support program [microform] : joint hearing before the Committee on Agriculture, Nutrition, and Forestry, U.S. Senate and Subcommittee on Tobacco and Peanuts, Committee on Agriculture, U.S. House of Representatives (Raleigh, N.C.--Feb. 12, 1982) and : hearing before the Committee on Agriculture, Nutrition, and Forestry, U.S. Senate (Lexington, Ky.--Mar. 15, 1982), Ninety-seventh Congress, second session.

CIS Microfiche Accession Numbers: CIS 82 S161-14

Cultivation of marihuana in national forests [microform] : hearing before the Subcommittee on Forestry, Water Resources, and Environment of the Committee on Agriculture, Nutrition, and Forestry, United States Senate, Ninety-seventh Congress, second session, September 30, 1982.

CIS Microfiche Accession Numbers: CIS 83 S161-5

Soil conservation [microform] : hearings before the Subcommittee on Environment, Soil Conservation, and Forestry of the Committee on Agriculture, Nutrition, and Forestry, United States Senate, Ninety-sixth Congress, second session, August 13, 1980--Waterloo, Iowa, August 14, 1980--Ames, Iowa, August 15, 1980--Fairfield, Iowa.

CIS Microfiche Accession Numbers: CIS 81 S161-7

Impact of geothermal energy exploration on the Targhee National Forest [microform] : hearing before the Subcommittee on Environment, Soil Conservation and Forestry of the Committee on Agriculture, Nutrition, and Forestry, United States Senate, Ninety-sixth Congress, first session, July 16, 1979.

Reuse of record except for individual research requires license from Congressional Information Service, Inc.

Timber contract adjustments [microform] : hearing before the Subcommittee on Forestry, Water Resources, and Environment of the Committee on Agriculture, Nutrition, and Forestry, United States Senate, Ninety-seventh Congress, second session, on S. 2805 ... August 12, 1982.

CIS Microfiche Accession Numbers: CIS 82 S161-30