Treatment of urinary stress incontinence by intravaginal electrical stimulation and pelvic floor physiotherapy

Treatment of urinary stress incontinence (USI) by intravaginal electrical stimulation (IES) and pelvic floor physiotherapy represents an alternative to other therapies. The purpose of this work was to evaluate the effectiveness of this treatment inpatients with urinary incontinence. From January 1998 to May 2000, 30 women (mean age 54 years) were studied. All patients had USI and 70% urge incontinence; average follow-up was 7 months. Selection criteria were based on clinical history, objective evaluation of perineal musculature by perineometry, and urodynamics. The treatment protocol consisted of three sessions of IES per week for 14 weeks using INNOVA equipment. Physiotherapy was initiated in the fifth week of IES. A significant decrease in the number of micturitions and urgency was observed after treatment (P<0.01). The pad test showed a reduction in urinary leakage from 13.9 to 5.9 g after treatment (P<0.01). Objective evaluation of perineal muscle strength showed a significant improvement in all patients after treatment (P<0.01). A positive correlation was observed between maximum flow rate (Q(max)) and all three variables: urethral pressure profile at rest and on straining (stop test), and abdominal leak-point pressure (ALPP). A positive correlation was also observed between ALPP and the stop test. Over 100 different surgical and conservative treatments have been tried to manage USI. The majority of these procedures reveal that despite progress already made in this area, there is no ideal treatment. Satisfactory results can be achieved with this method, especially with patients who are reluctant to undergo surgery because of personal or clinical problems.

CEPALINDEX: resúmenes 1305-1718

Publicado en noviembre de 1980

Elementos para una metodología de medición del sector informal en las cuentas nacionales. Documento de trabajo

Incluye Bibliografía

High-pressure assisted sintering of Ti-20Si-10B and Ti-10Si-5B powders

This work presents the structural characterization of Ti-10Si-5B and Ti-20Si-10B (at-%) alloys produced by high-pressure assisted sintering. Sintering was performed in air at 1100 and 1200°C for 60 s using pressure levels of 5 GPa. Structural evaluation of sintered samples was conducted by means of scanning electron microscopy and energy dispersive spectrometry. Samples were successfully consolidated after sintering, which presented theoretical density values higher than 99%. The microstructures of the sintered Ti-10Si-5B and Ti-20Si-10B alloys revealed the presence of the TiSS, TiB, TiB2, Ti5Si3, Ti5Si4, TiSi, and TiSi2.phases. A small amount of Ti6Si2B was formed after high-pressure assisted sintering of the Ti-20Si-10B alloy (5GPa, 1100°C for 60 s) indicating that equilibrium structures were not achieved during short sintering times. No oxygen and carbon contamination was detected in structures of Ti-Si-B alloys after high-pressure sintering at 1100 and 1200°C without controlled atmosphere. © (2012) Trans Tech Publications, Switzerland.

Análise citogenética comparativa em espécies de morcegos da subfamília phyllostominae (chiroptera-phyllostomidae) por citogenética clássica e hibridização in situ Flourescente (fish)

Os morcegos representam um grupo amplamente distribuído e diversificado. A diversidade de hábitos alimentares faz da ordem Chiroptera uma das mais bem sucedidas entre os mamíferos, desempenhando, em função de seus hábitos, um importante papel no controle de insetos, na polinização e na dispersão de sementes de numerosos vegetais. A família Phyllostomidae constitui a terceira maior família em número de espécies dentro da Ordem Chiroptera. Entre as representantes neotropicais é a mais numerosa, sendo encontrada em florestas tropicais da America do Sul, particularmente, concentrada na Amazônia que é a região com maior diversidade de morcegos do mundo. No presente trabalho foram analisados citogeneticamente exemplares de três espécies da subfamília Phyllostominae: Chrotopterus auritus, Trachops cirrhosus e Vampyrum spectrum coletados no estado do Pará e Amazonas. Os dados cromossômicos obtidos para Chrotopterus auritus (2n = 28 e NF = 52) e Trachops cirrhosus (2n = 30, FN = 56) estão de acordo com os descritos na literatura. Para Vampyrum spectrum (2n=30 NF=56) relatamos os primeiros padrões de bandeamento e FISH (Hibridização in situ Fluorescente). A técnica de bandeamento C demonstrou um padrão pericentromérico de distribuição da heterocromatina constitutiva nas três espécies estudadas. A técnica de FISH com sondas de DNA teloméricas humanas mostrou apenas marcações distais em todos os cromossomos das três espécies e as sondas de rDNA 18S confirmaram a localização das Regiões Organizadoras Nucleares observadas na técnica de Ag-NOR, presentes no braço longo do par 2 de Chrotopterus auritus, no par 11 de Trachops cirrhosus e no braço longo do par 1 de Vampyrum spectrum. A análise comparativa entre elas sugere um extenso grau de diferenciação cromossômica, com poucos cromossomos compartilhados entre os três gêneros. Contudo, cinco pares cromossômicos inteiros se mantiveram conservados sem nenhum tipo de rearranjo após a divergência das três linhagens. A comparação entre as espécies revela que C. auritus e V. spectrum apresentam mais elementos compartilhados entre si do que em relação à T. cirrhosus. Nossos resultados apoiam a proximidade filogenética entre C. auritus e V. spectrum e sugerem a associação de T. cirrhosus com o clado do gênero Phyllostomus.

Urethral striated muscle and extracellular matrix morphological characteristics among mildly diabetic pregnant rats: translational approach

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Gramsci e a Teoria Crítica das Relações Internacionais

This text has the following aims: a) to discuss Gramsci and Horkheimer’s epistemological status, joined authors in an theoretical approach known as Critical Theory of International Relations; b) to draft an analysis in order to show the mentioned and joined authors’ different epistemological statuses in the theoretical approach in discussion; c) to begin a reflection pointing the absence of accuracy in this approach - whose beginning happened with Canadian political scientist Robert W. Cox – due to joining different epistemological statuses and ignoring the theoretical consequences put by respective central Gramsci and Horkheimer’s concepts: hegemony and emancipation.

Stress urinary incontinence in climacteric women in a northeastern Brazilian municipality: a household survey

Low socioeconomic factors may influence the development of stress urinary incontinence (SUI). Thus far, there is little research available on SUI in developing countries. We aimed to determine whether the prevalence of SUI in a northeastern Brazilian municipality was higher or lower than in the general female population. Cross-sectional household cluster study of 1,180 climacteric women in the So Luis municipality (Maranho state, Brazil) was conducted using a standardized questionnaire that was previously tested in a pilot study and administered by interviewers to obtain socioeconomic and cultural information, climacteric aspects, and life habits related to SUI. From this population, 15.34% (n = 181) had SUI; this prevalence did not change with age. More than half (57.92%) of the patients replied that they had not consulted a physician for their SUI. The presence of SUI was not associated with any socioeconomic or gynecological variables after multivariate analysis. The prevalence of SUI in So Luis was similar to the rates observed in the general global female population. Socioeconomic and gynecological variables were not associated with SUI.

Participación ciudadana y vivienda : el programa de autoconstrucción de la Junta de Andalucía, (1988-2007)

Programa de doctorado: Extravíos de la mirada: Crónicas de fin de siglo

Funktionelle Analyse der Plasmamembran-Ca 2+-ATPase 2 -PMCA2- in Modellen der Neurodegeneration

Calcium (Ca2+) ist ein ubiquitär vorkommendes Signalmolekül, das an der Regulation zahlreicher zellulärer Prozesse, von der Proliferation bis zum programmierten Zelltod, beteiligt ist. Daher müssen die intrazellulären Ca2+-Spiegel streng kontrolliert werden. Veränderungen der Ca2+-Homöostase während der altersassoziierten Neurodegeneration können dazu beitragen, dass Neuronen vulnerabler sind. So wurden erhöhte Ca2+-Konzentrationen in gealterten Neuronen, begleitet von einer erhöhten Vulnerabilität, beobachtet (Hajieva et al., 2009a). Weiterhin wird angenommen, dass der selektive Untergang von dopaminergen Neuronen bei der Parkinson Erkrankung auf eine erhöhte Ca2+-Last zurückzuführen sein könnte, da diese Neuronen einem ständigen Ca2+-Influx,rnaufgrund einer besonderen Isoform (CaV 1.3) spannungsgesteuerter Ca2+-Kanäle des L-Typs, ausgesetzt sind (Chan et al., 2007). Bislang wurden die molekularen Mechanismen, die einem Ca2+-Anstieg zu Grunde liegen und dessen Auswirkung jedoch nicht vollständig aufgeklärt und daher in der vorliegenden Arbeit untersucht. Um Veränderungen der Ca2+-Homöostase während der altersassoziiertenrnNeurodegeneration zu analysieren wurden primäre Mittelhirnzellen aus Rattenembryonen und SH-SY5Y-Neuroblastomazellen mit dem Neurotoxin 1-Methyl-4-Phenyl-Pyridin (MPP+), das bei der Etablierung von Modellen der Parkinson-Erkrankung breite Anwendung findet, behandelt. Veränderungen der intrazellulären Ca2+-Konzentration wurden mit einem auf dem grün fluoreszierenden Protein (GFP)-basierten Ca2+-Indikator,rn„Cameleon cpYC 3.6“ (Nagai et al., 2004), ermittelt. Dabei wurde in dieser Arbeit gezeigt, dass MPP+ die Abregulation der neuronenspezifischen ATP-abhängigen Ca2+-Pumpe der Plasmamembran (PMCA2) induziert, die mit der Ca2+-ATPase des endoplasmatischen Retikulums (SERCA) und dem Na+/Ca2+-Austauscher (NCX) das zelluläre Ca2+-Effluxsystem bildet, was zu einer erhöhten zytosolischen Ca2+-Konzentration führt. Die PMCA2-Abnahme wurde sowohl auf Transkriptionsebene als auch auf Proteinebene demonstriert, während keine signifikanten Veränderungen der SERCA- und NCX-Proteinmengen festgestellt wurden. Als Ursache der Reduktion der PMCA2-Expression wurde eine Abnahme des Transkriptionsfaktors Phospho-CREB ermittelt, dessen Phosphorylierungsstatus abhängig von der Proteinkinase A (PKA) war. Dieser Mechanismus wurde einerseits unter MPP+-Einfluss und andererseits vermittelt durch endogene molekulare Modulatoren gezeigt. Interessanterweise konnten die durch MPP+ induzierte PMCA2-Abregulation und der zytosolische Ca2+-Anstieg durch die Aktivierung der PKA verhindert werden. Parallel dazu wurde eine MPP+-abhängige verringerte mitochondriale Ca2+-Konzentration nachgewiesen, welche mit einer Abnahme des mitochondrialen Membranpotentials korrelierte. Darüber hinaus kam es als Folge der PMCA2-Abnahme zu einem verminderten neuronalen Überleben.rnVeränderungen der Ca2+-Homöostase wurden auch während der normalen Alterung inrnprimären Fibroblasten und bei Mäusen nachgewiesen. Dabei wurden verringerte PMCA und SERCA-Proteinmengen in gealterten Fibroblasten, einhergehend mit einem Anstieg der zytosolischen Ca2+-Konzentration demonstriert. Weiterhin wurden verringerte PMCA2-Proteinmengen im Mittelhirn von gealterten Mäusen (C57B/6) detektiert.rnDer zelluläre Ca2+-Efflux ist somit sowohl im Zuge der physiologischen Alterung als auch in einem altersbezogenen Krankheitsmodell beeinträchtigt, was das neuronale Überleben beeinflussen kann. In zukünftige Studien soll aufgeklärt werden, welche Auswirkungen einer PMCA2-Reduktion genau zu dem Verlust von Neuronen führen bzw. ob durch eine PMCA2-Überexpression neurodegenerative Prozesse verhindert werden können.

Carbohydrate counting of food

Carbohydrate counting is a principal strategy in nutritional management of type 1 diabetes. The Nutri-Learn buffet (NLB) is a new computer-based tool for patient instruction in carbohydrate counting. It is based on food dummies made of plastic equipped with a microchip containing relevant food content data. The tool enables the dietician to assess the patient's food counting abilities and the patient to learn in a hands-on interactive manner to estimate food contents such as carbohydrate content.

Injury of the corona mortis during vaginal tape insertion (TVT-Secur™ using the U-Approach)

We report a serious bleeding complication due to injury of the corona mortis following insertion of a transvaginal tape, TVT-Secur™ (Ethicon Women's Health, Sommerville, NJ, USA).

Does bladder wall thickness decrease when obstruction is resolved?

The aim of the current study was to determine if sonographic bladder wall thickness diminishes after symptomatic obstruction is resolved in female patients after stress incontinence surgery.