Adaptação e validação para a cultura portuguesa da Late-Life Function and Disability Instrument (LLFDI)

Introdução:O envelhecimento pressupõe alterações no organismo, sendo fundamental a medição das limitações da funcionalidade e da incapacidade na execução de tarefas individuais e sociais por parte dos idosos. As guidelines da ACSM enfatizam que os idosos obtêm benefícios na saúde com a realização de atividade física regular. Objetivo: Adaptar e validar para a cultura portuguesa a Late-Life Function and Disability Instrument (LLFDI). Material e Métodos: A versão portuguesa foi obtida através de um processo de metodologia sequencial. Para avaliar a validade e fiabilidade, esta versão foi administrada a 619 idosos (72±9). Destes, 77 foram submetidos a uma intervenção de fisioterapia com base em dois programas de exercícios, para determinar o poder de resposta. Resultados: Após obtenção da equivalência semântica e de conteúdo, a versão portuguesa da LLFDI demonstrou valores elevados de reprodutibilidade (CCI_função > 0,8 e CCI_incapacidade > 0,7) e níveis bastantes aceitáveis de consistência interna (α Cronbach > 0,82). As correlações obtidas entre a LLFDI e o MOS SF-36 são moderadas a altas. A análise fatorial confirmatória demonstra um modelo ajustado para a componente função (relações positivas e muito fortes) e incapacidade (relações no limiar da aceitabilidade). O Poder de resposta de 4 semanas, demonstrou valores de ESS <0,30 (função) e <0,28 (incapacidade). Os valores de RMS encontram-se entre 0,40 e 0,72 (função) e entre 0,27 e 0,59 (incapacidade). Conclusões: A versão portuguesa da LLFDI demonstrou valores aceitáveis de validade e fiabilidade, revelando valores baixos de poder de resposta.

Weight loss improves biomarkers endothelial function and systemic inflammation in obese postmenopausal Saudi women.

Background: Although postmenopausal associated disorders are important public health problems worldwide, to date limited studies evaluated the endothelial function and systemic inflammation response to weight loss in obese postmenopausal women. Objective: This study was done to evaluate the endothelial function and systemic inflammation response to weight loss in obese postmenopausal Saudi women. Material and methods: Eighty postmenopausal obese Saudi women (mean age 52.64±6.13 year) participated in two groups: Group (A) received aerobic exercise on treadmill and diet whereas, group (B) received no intervention. Markers of inflammation and endothelial function were measured before and after 3 months at the end of the study. Results: The values of body mass index(BMI), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP), inter-cellular adhesion molecule (ICAM-1), vascular cell adhesion molecule (VCAM-1) and plasminogen activator inhibitor- 1 activity (PAI-1:Ac) were significantly decreased in group (A), while changes were not significant in group (B). Also, there were significant differences between mean levels of the investigated parameters in group (A) and group (B) after treatment. Conclusion: Weight loss ameliorates inflammatory cytokines and markers of endothelial function in obese postmenopausal Saudi women.

Renal effects and vascular reactivity induced by Tityus serrulatus venom

Tityus serrulatus, popularly known as yellow scorpion, is one of the most studied scorpion species in South America and its venom has supplied some highly active molecules. The effects of T. serrulatus venom upon the renal physiology in human showed increased renal parameters, urea and creatinine. However, in perfused rat kidney the effects were not tested until now. Isolated kidneys from Wistar rats, weighing 240-280 g, were perfused with Krebs-Henseleit solution containing 6% (g weight) of previously dialysed bovine serum albumin. The effects of T. serrulatus venom were studied on the perfusion pressure (PP), renal vascular resistance (RVR), urinary flow (UF), glomerular filtration rate (GFR), sodium tubular transport (%TNa+), potassium tubular transport (%TK+) and chloride tubular transport (%TCl-). Tityus serrulatus venom (TsV; 10 mu g/mL) was added to the system 30 min after the beginning of each experiment (n = 6). This 30 min period was used as an internal control. The mesenteric bed was perfused with Krebs solution kept warm at 37 T by a constant flow (4 mL/min), while the variable perfusion pressure was measured by means of a pressure transducer. The direct vascular effects of TsV (10 mu g/mL/min; n=6), infused at a constant rate (0.1 mL/min), were examined and compared to the infusion of the vehicle alone at the same rate. TsV increased PP (PP30'= 127.8 +/- 0.69 vs PP60' = 154.2 +/- 14 mmHg*, *p < 0.05) and RVR (RVR30' = 6.29 +/- 0.25 vs RVR60' = 8.03 +/- 0.82 mmHg/mL g(-1) min(-1)*, *p < 0.05), decreased GFR (GFR(30') =0.58 +/- 0.02 vs GFR(60') = 0.46 +/- 0.01 mL g(-1) min(-1)*, *p < 0.05) and UF (UF30' = 0.135 +/- 0.001 vs UF60' = 0.114 +/- 0.003 mL g(-1)min(-1)*, *p < 0.05). Tubular transport was not affected during the whole experimental period (120 min). on the other hand, the infusion of TsV (10 mu g/mL/min) increased the basal perfusion pressure of isolated arteriolar mesenteric bed (basal pressure: 74.17 +/- 3.42 vs TsV 151.8 +/- 17.82 mmHg*, *p < 0.05). TsV affects renal haemodynamics probably by a direct vasoconstrictor action leading to decreased renal flow. (c) 2005 Elsevier Ltd. All rights reserved.

Exploring the Function and Regulation of Arabidopsis EIN2 in Ethylene Signaling

Ethylene is an essential plant hormone involved in nearly all stages of plant growth and development. EIN2 (ETHYLENE INSENSITIVE2) is a master positive regulator in the ethylene signaling pathway, consisting of an N-terminal domain and a C-terminal domain. The EIN2 N-terminal domain localizes to the endoplasmic reticulum (ER) membrane and shows sequence similarity to Nramp metal ion transporters. The cytosolic C-terminal domain is unique to plants and signals downstream. There have been several major gaps in our knowledge of EIN2 function. It was unknown how the ethylene signal gets relayed from the known upstream component CTR1 (CONSTITUTIVE RESPONSE1) a Ser/Thr kinase at the ER, to EIN2. How the ethylene signal was transduced from EIN2 to the next downstream component transcription factor EIN3 (ETHYLENE INSENSITIVE3) in the nucleus was also unknown. The N-terminal domain of EIN2 shows homology to Nramp metal ion transporters and whether EIN2 can also function as a metal transporter has been a question plaguing the ethylene field for almost two decades. Here, EIN2 was found to interact with the CTR1 protein kinase, leading to the discovery that CTR1 phosphorylates the C-terminal domain of EIN2 in Arabidopsis thaliana. Using tags at the termini of EIN2, it was deduced that in the presence of ethylene, the EIN2 C-terminal domain is cleaved and translocates into the nucleus, where it could somehow activate downstream ethylene responses. The EIN2 C-terminal domain interacts with nuclear proteins, RTE3 and EER5, which are components of the TREX-2 mRNA export complex, although the role of these interactions remains unclear. The EIN2 N-terminal domain was found to be capable of divalent metal transport when expressed in E. coli and S. cerevisiae leading to the hypothesis that metal transport plays a role in ethylene signaling. This hypothesis was tested using a novel missense allele, ein2 G36E, substituting a highly conserved residue that is required for metal transport in Nramp proteins. This G36E substitution did not disrupt metal ion transport of EIN2, but the ethylene insensitive phenotype of this mutant indicates that the EIN2 N-terminal domain is important for positively regulating the C-terminal domain. The defect of the ein2 G36E mutant does not prevent proper expression or subcellular localization, but might affect protein modifications. The ein2 G36E allele is partially dominant, mostly likely displaying haploinsufficiency. Overexpression of the EIN2 N-terminal domain in the ein2 G36E mutant did not rescue ethylene insensitivity, suggesting the N-terminal domain functions in cis to regulate the C-terminal domain. These findings advance our knowledge of EIN2, which is critical to understanding ethylene signaling.

Purification and characterization of the biological effects of phospholipase A(2) from sea anemone Bunodosoma caissarum

Sea anemones contain a variety of biologically active substances. Bunodosoma caissarum is a sea anemone from the Cnidaria phylum, found only in Brazilian coastal waters. The aim of the present work was to study the biological effects of PLA(2) isolated from the sea anemone B. caissarum on the isolated perfused kidney, the arteriolar mesenteric bed and on insulin secretion. Specimens of B. caissarum were collected from the Sao Vicente Channel on the southern coast of the State of São Paulo, Brazil. Reverse phase HPLC analysis of the crude extract of B. caissarum detected three PLA(2) proteins (named BcPLA(2)1, BCPLA(2)2 and BcPLA(2)3) found to be active in B. caissarum extracts. MALDI-TOF mass spectrometry of BcPLA(2)1 showed one main peak at 14.7 kDa. The N-terminal amino acid sequence of BcPLA(2)1 showed high amino acid sequence identity with PLA(2) group III protein isolated from the Mexican lizard (PA23 HELSU, HELSU, PA22 HELSU) and with the honey bee Apis mellifera (PLA(2) and 1POC_A). In addition, BcPLA(2)1 also showed significant overall homology to bee PLA(2). The enzymatic activity induced by native BCPLA(2)1 (20 mu g/well) was reduced by chemical treatment with p-bromophenacyl bromide (p-BPB) and with morin. BcPLA(2)1 strongly induced insulin secretion in presence of high glucose concentration. In isolated kidney, the PLA(2) from B. caissarum increased the perfusion pressure, renal vascular resistance, urinary flow, glomerular filtration rate, and sodium, potassium and chloride levels of excretion. BcPLA(2)1, however, did not increase the perfusion pressure on the mesenteric vascular bed. In conclusion, PLA(2), a group III phospholipase isolated from the sea anemone B. caissarum, exerted effects on renal function and induced insulin secretion in conditions of high glucose concentration. (C) 2009 Elsevier Ltd. All rights reserved.

Does social–behavioral adjustment mediate the relation between executive function and academic readiness?

Research shows that executive function and social–behavioral adjustment during the preschool years are both associated with the successful acquisition of academic readiness abilities. However, studies bringing these constructs together in one investigation are lacking. This study addresses this gap by testing the extent to which social and behavioral adjustment mediated the association between executive function and academic readiness. Sixty-nine 63–76month old children, enrolled in the last semester of the preschool year, participated in the present study. Tasks were administered to measure executive function and preacademic abilities, and teachers rated preschoolers' social–behavioral adjustment. Hierarchical regression analyses revealed that social–behavioral adaptation was a significant mediator of the effect of executive function on academic readiness, even after controlling for maternal education and child verbal ability. These findings extend prior research and suggest that executive function contributes to early academic achievement by influencing preschoolers' opportunities to be engaged in optimal social learning activities.

Reconciling Function- and Affordance-Based Design

Traditional engineering design methods are based on Simon's (1969) use of the concept function, and as such collectively suffer from both theoretical and practical shortcomings. Researchers in the field of affordance-based design have borrowed from ecological psychology in an attempt to address the blind spots of function-based design, developing alternative ontologies and design processes. This dissertation presents function and affordance theory as both compatible and complimentary. We first present a hybrid approach to design for technology change, followed by a reconciliation and integration of function and affordance ontologies for use in design. We explore the integration of a standard function-based design method with an affordance-based design method, and demonstrate how affordance theory can guide the early application of function-based design. Finally, we discuss the practical and philosophical ramifications of embracing affordance theory's roots in ecology and ecological psychology, and explore the insights and opportunities made possible by an ecological approach to engineering design. The primary contribution of this research is the development of an integrated ontology for describing and designing technological systems using both function- and affordance-based methods.

Irrigation with Treated Wastewater: Potential Impacts on Microbial Function and Diversity in Agricultural Soils

The reuse of treated wastewater could be a promising measure to attenuate the water scarcity burden. In agriculture, irrigation with wastewater may contribute to improve production yields, reduce the ecological footprint and promote socioeconomic benefits. However, it cannot be considered exempt of adverse consequences in environmental and human health. Apart from the introduction of some biological and chemical hazardous agents, the disturbance of the indigenous soil microbial communities and, thus, of vital soil functions impacting soil fertility may occur. The consequences of these disturbances are still poorly understood. This chapter summarises the physicochemical and microbiological alterations in soil resultant from irrigation with treated wastewater that are described in scientific literature. These alterations, which involve a high complexity of variables (soil, wastewater, climate, vegetal cover), may have impacts on soil quality and productivity. In addition, possible health risks may arise, in particular through the direct or indirect contamination of the food chain with micropollutants, pathogens or antibiotic resistance determinants. The current state of the art suggests that irrigation with treated wastewater may have a multitude of long-term implications on soil productivity and public health. Although further research is needed, it seems evident that the analysis of risks associated with irrigation with treated wastewater must take into account not only the quality of water, but other aspects as diverse as soil microbiota, soil type or the cultivated plant species.

The relationship between changes in cardiovascular function and changes in VO2peak following SIT

Thesis (Master, Kinesiology & Health Studies) -- Queen's University, 2016-09-27 19:34:16.86

What Does a Domain Analysis Look Like in Form, Function, and Genre?

This article presents an inventory what theorists describe as the definition of domain analysis. Survey writings on and of domain analyses for their distinct attributes and arguments. Compile these components and attributes, linking them to their function, and from there. Describe a proposed ideal form of domain analysis. Evidence that while the debate about the substance and form of the epistemic and ontological character of domain analysis will continue, some might find it useful to give shape to their ideas using a particular form that follows function. If our purpose is to delineate and communicate what it is that we are analyzing when we engage in domain analysis, then I hope this small contribution can be of use.

The role of inflammation in vascular function and pregnancy outcome in the pregnant stroke prone spontaneously hypertensive rat

During pregnancy, the maternal cardiovascular system undergoes major adaptation. One of these changes is a 40-50 % increase in circulating blood volume which requires a systemic remodelling of the vasculature in order to regulate maternal blood pressure and maximise blood supply to the developing placenta and fetus. These changes are broadly conserved between humans and rats making them an appropriate pre-clinical model in which to study the underlying mechanisms of pregnancy-dependent cardiovascular remodelling. Whilst women are normally protected against cardiovascular disease; pregnancy marks a period of time where women are susceptible to cardiovascular complications. Cardiovascular disease is the leading cause of maternal mortality in the United Kingdom; in particular hypertensive conditions are among the most common complications of pregnancy. One of the main underlying pathologies of these pregnancy complications is thought to be a failure of the maternal cardiovascular system to adapt. The remodelling of the uterine arteries, which directly supply the maternal-fetal interface, is paramount to a healthy pregnancy. Failure of the uterine arteries to remodel sufficiently can result in a number of obstetric complications such as preeclampsia, fetal growth restriction and spontaneous pregnancy loss. At present, it is poorly understood whether this deficient vascular response is due to a predisposition from existing maternal cardiovascular risk factors, the physiological changes that occur during pregnancy or a combination of both. Previous work in our group employed the stroke prone spontaneously hypertensive rat (SHRSP) as a model to investigate pregnancy-dependent remodelling of the uterine arteries. The SHRSP develops hypertension from 6 weeks of age and can be contrasted with the control strain, the Wistar Kyoto (WKY) rat. The phenotype of the SHRSP is therefore reflective of the clinical situation of maternal chronic hypertension during pregnancy. We showed that the SHRSP exhibited a deficient uterine artery remodelling response with respect to both structure and function accompanied by a reduction in litter size relative to the WKY at gestational day (GD) 18. A previous intervention study using nifedipine in the SHRSP achieved successful blood pressure reduction from 6 weeks of age and throughout pregnancy; however uterine artery remodelling and litter size at GD18 was not improved. We concluded that the abnormal uterine artery remodelling present in the SHRSP was independent of chronic hypertension. From these findings, we hypothesised that the SHRSP could be a novel model of spontaneously deficient uterine artery remodelling in response to pregnancy which was underpinned by other as yet unidentified cardiovascular risk factors. In Chapter 1 of this thesis, I have characterised the maternal, placental and fetal phenotype in pregnant (GD18) SHRSP and WKY. The pregnant SHRSP exhibit features of left ventricular hypertrophy in response to pregnancy and altered expression of maternal plasma biomarkers which have been previously associated with hypertension in human pregnancy. I developed a protocol for accurate dissection of the rat uteroplacental unit using qPCR probes specific for each layer. This allowed me to make an accurate and specific statement about gene expression in the SHRSP GD18 placenta; where oxidative stress related gene markers were increased in the vascular compartments. The majority of SHRSP placenta presented at GD18 with a blackened ring which encircled the tissue. Further investigation of the placenta using western blot for caspase 3 cleavage determined that this was likely due to increased cell death in the SHRSP placenta. The SHRSP also presented with a loss of one particular placental cell type at GD18: the glycogen cells. These cells could have been the target of cell death in the SHRSP placenta or were utilised early in pregnancy as a source of energy due to the deficient uterine artery blood supply. Blastocyst implantation was not altered but resorption rate was increased between SHRSP and WKY; indicating that the reduction in litter size in the SHRSP was primarily due to late (>GD14) pregnancy loss. Fetal growth was not restricted in SHRSP which led to the conclusion that SHRSP sacrifice part of their litter to deliver a smaller number of healthier pups. Activation of the immune system is a common pathway that has been implicated in the development of both hypertension and adverse pregnancy outcome. In Chapter 2, I proposed that this may be a mechanism of interest in SHRSP pregnancy and measured the pro-inflammatory cytokine, TNFα, as a marker of inflammation in pregnant SHRSP and WKY and in the placentas from these animals. TNFα was up-regulated in maternal plasma and urine from the GD18 SHRSP. In addition, TNFα release was increased from the GD18 SHRSP placenta as was the expression of the pro-inflammatory TNFα receptor 1 (Tnfr1). In order to investigate whether this excess TNFα was detrimental to SHRSP pregnancy, a vehicle-controlled intervention study using etanercept (a monoclonal antibody which works as a TNFα antagonist) was carried out. Etanercept treatment at GD0, 6, 12 and 18 resulted in an improvement in pregnancy outcome in the SHRSP with an increased litter size and reduced resorption rate. Furthermore, there was an improved uterine artery function in GD18 SHRSP treated with etanercept which was associated with an improved uterine artery blood flow over the course of gestation. In Chapter 3, I sought to identify the source of this detrimental excess of TNFα by designing a panel for maternal leukocytes in the blood and placenta at GD18. A population of CD3- CD161+ cells, which are defined as rat natural killer (NK) cells, were increased in number in the SHRSP. Intracellular flow cytometry also identified this cell type as a source of excess TNFα in blood and placenta from pregnant SHRSP. I then went on to evaluate the effects of etanercept treatment on these CD3- CD161+ cells and showed that etanercept reduced the expression of CD161 and the cytotoxic molecule, granzyme B, in the NK cells. Thus, etanercept limits the cytotoxicity and potential damaging effect of these NK cells in the SHRSP placenta. Analysing the urinary peptidome has clinical potential to identify novel pathways involved with disease and/or to develop biomarker panels to aid and stratify diagnosis. In Chapter 4, I utilised the SHRSP as a pre-clinical model to identify novel urinary peptides associated with hypertensive pregnancy. Firstly, a characterisation study was carried out in the kidney of the WKY and SHRSP. Urine samples from WKY and SHRSP taken at pre-pregnancy, mid-pregnancy (GD12) and late pregnancy (GD18) were used in the peptidomic screen. In order to capture peptides which were markers of hypertensive pregnancy from the urinary peptidomic data, I focussed on those that were only changed in a strain dependent manner at GD12 and 18 and not pre-pregnancy. Peptide fragments from the uromodulin protein were identified from this analysis to be increased in pregnant SHRSP relative to pregnant WKY. This increase in uromodulin was validated at the SHRSP kidney level using qPCR. Uromodulin has previously been identified to be a candidate molecule involved in systemic arterial hypertension but not in hypertensive pregnancy thus is a promising target for further study. In summary, we have characterised the SHRSP as the first model of maternal chronic hypertension during pregnancy and identified that inflammation mediated by TNFα and NK cells plays a key role in the pathology. The evidence presented in this thesis establishes the SHRSP as a pre-clinical model for pregnancy research and can be continued into clinical studies in pregnant women with chronic hypertension which remains an area of unmet research need.

On polynomials with given Hilbert function and applications

Using Macaulay's correspondence we study the family of Artinian Gorenstein local algebras with fixed symmetric Hilbert function decomposition. As an application we give a new lower bound for the dimension of cactus varieties of the third Veronese embedding. We discuss the case of cubic surfaces, where interesting phenomena occur.

Occurrence and damage of head blast in barley in Brazil.

2016

OSWALD DE ANDRADE’S THEATER: THE LITERARY FUNCTION AND THE HISTORICAL SERIES

Studies carried out so far allow us to observe important aspects regarding the transformation of the dramatic genre. They show how either traditional or new formal elements are assimilated or reworked by the authors in Modernism and in contemporary productions, with different meanings, transforming the dramatic genre in such a way that typical elements of the ancient tragic genre assume different meanings in the contemporary tragic drama. The same phenomenon can be identified in the elements of metatheater, which undergo displacements in the Vanguard Theater, defining new functions. This approach assumed by most contemporary cultural practices is celebrated as a creative possibility to renew the cultural matrixes; however, such practices are not new, and are found in the production of the poet, playwright and writer Oswald de Andrade. It is important to mention that even Oswald de Andrade revisited traditional sources, as observed by Gilberto Mendonça Teles (2009) when addressing the models of cultural interpretation in the current days. Although there are several studies on Oswald de Andrade’s works, focusing mainly on his prose and poetry, his theatrical texts are still poorly studied. Considering Oswald de Andrade's productions, his theatrical texts present procedures that testify his modernity in the capacity of anticipating changes, which are currently conceived as procedures and trends of contemporary poetics. This reflection is what is intended in the present text.

Excreção urinária de glicosaminoglicanos em crianças com bexiga neurogênica secundária a mielomeningocele

A excreção urinária de glicosaminoglicanos (GAG) está alterada em várias patologias do trato urinário; o padrão de excreção pode estar associado com o estado da doença. A excreção urinária de GAG em crianças com bexiga neurogênica (BN) secundária a mielomeningocele (MMC) pode também estar alterada, mas até a presente data não há detalhamento epidemiológico dos pacientes e não se correlacionou o padrão de excreção com grau de disfunção vesical. Analisamos a excreção urinária de um grupo bem definido de crianças com MMC e correlacionamos os resultados com escore cistométrico. As amostras de urina de 17 pacientes com MMC, 10 meninos e 7 meninas (média de idade DP de 4,6 2,9 anos) foram obtidas durante o exame cistométrico. As amostras do grupo controle foram obtidas de 18 crianças normais, 13 meninos e 5 meninas (6,9 2,2 anos). Todas as crianças não estavam com infecção urinária, tinham função renal normal e não estavam sob tratamento farmacológico. A quantificação do GAG urinário total foi expressa em μg de ácido hexurônico / mg de creatinina e a proporção dos diferentes tipos de GAGs sulfatados foi obtida por eletroforese em gel de agarose. A avaliação cistométrica foi realizada utilizando aparelho de urodinâmica Dynapack modelo MPX816 (Dynamed, São Paulo, Brasil), a partir da qual o escore cistométrico foi calculado de acordo com procedimento recente publicado. [14]. Não observamos diferença significativa na excreção urinária de GAG total entre meninos e meninas tanto no grupo com MMC ( 0,913 0,528 vs 0,867 0,434, p>0,05) como no grupo controle (0,546 0,240 vs 0,699 0,296, p>0,05). Os resultados mostraram também que a excreção de GAG urinário não se correlacionou com a idade tanto no grupo com MMC ( r = -0,28, p> 0,05) como no grupo controle (r = -0,40, p> 0,05). Entretanto, a comparação dos dois grupos mostrou que o grupo com MMC excretava 52% a mais de GAG total que o grupo controle (0,894 0,477 vs 0,588 0,257, p <0,04). Nesses pacientes a excreção de GAG total não se correlacionou com a complacência vesical isoladamente (r = -0,18, p> 0,05) mas foi significativa e negativamente correlacionada ao escore cistométrico (r= -0,56, p<0,05). Em média, os pacientes com piores escores (<9) excretaram 81% a mais de GAG que os pacientes com melhor escore (>9) (1,157 0,467 vs 0,639 0,133, p<0,04). O sulfato de condroitin foi o GAG sulfatado predominante nos grupos neurogênico e controles (92,5 7,6% vs 96,4 4,8%, respectivamente, p> 0,05), enquanto o sulfato do heparan estava presente em quantidades marcadamente menores; o dermatam sulfato não foi detectado. A excreção urinária de GAG em pacientes com MMC é significativamente maior que a excreção das crianças normais e os altos valores encontrados estão correlacionados a um maior compromentimento da função vesical. Evidências em modelos animais com MMC induzida sugerem que alterações no detrusor estão associadas a um elevado turnover da matriz extra celular (MEC) vesical, o que pode explicar a elevada excreção de GAG nos pacientes com MMC. Além disso, esses resultados indicam que a excreção urinária de GAG pode ser usada como fator adjuvante para a caracterização da disfunção vesical em pacientes com MMC.