Prevalence of lower urinary tract symptoms and social determinants in primary care users in Brazil

Introduction and hypothesis

Although lower urinary tract symptoms (LUTS) have considerable clinical relevance, few propose evaluating its association with social conditions. Our study aimed to evaluate LUTS prevalence in primary care and its association with the social determinants of health (SDH).

Methods

This is a cross-sectional study conducted with 322 females in the period of June to October 2016 that carried out consultations and screening to prevent gynecological cancer in a primary care unit.

Results

The ages ranged from 18 to 85 years (M?=?40.53). Storage symptoms had a higher overall prevalence (64.6%), highlighting nocturia (n?=?186, 57.8%) and urinary incontinence (n?=?120, 37.3%). Storage symptoms were associated with three layers of SDH. The voiding and postmicturition symptoms were only related to operative vaginal delivery.

Conclusions

The findings of this study suggest a relationship between SDH and LUTS. It is important to emphasize that the results not only imply a causal relationship, but also point to the social inequalities existing at a population level.

     

TNF-β +252 A>G (rs909253) polymorphism is independently associated with presence of autoantibodies in rheumatoid arthritis patients

Clinical and Experimental Medicine - The TNF-β +252 A>G (rs909253) polymorphism has been associated with a risk of development of rheumatoid arthritis (RA) and could influence plasma...     

TGFB1 (rs1800470 and rs1800469) variants are independently associated with disease activity and autoantibodies in rheumatoid arthritis patients

To evaluate the association between TGFB1?+?869 T?>?C (rs1800470) and TGFB1-509 C?>?T (rs1800469) variants with susceptibility for rheumatoid arthritis (RA), disease activity, presence of rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP) and TGF-β1 plasma levels. A total of 262 patients with RA and 168 control individuals were tested for the TGFB1 variants using a TaqMan genotyping assay. Disease activity score in 28 joints (DAS28) classified RA patients into two groups of disease activity: remission/mild (DAS28?<?3.2) and moderate/severe (DAS28?≥?3.2). TGFB1?+?869 T?>?C and ?509 C?>?T variants, independently or in haplotype combination, were not associated with RA’s susceptibility. Patients with the TGFB1-509 TT genotype had a higher frequency of DAS28?≥?3.2 (OR 2.58, 95% CI 1.04–6.42, p?=?0.041). The TGFB1?+?869 CC genotype in seropositive patients for RF or anti-CCP was associated with decreased TGF-β1 levels (p?=?0.032 and p?=?0.039, respectively). Patients with the TGFB1?+?869 C allele and elevated RF titles demonstrated a higher frequency of DAS28?≥?3.2 (p?=?0.037). The TGFB1?+?869 T?>?C variant was associated with diminished TGF-β1 plasma levels and moderate/severe activity disease only in seropositive RF patients. This is the first study showing that TGF-β1 plasma levels can be modulated by the interaction between the TGFB1?+?869 T?>?C variant and autoantibodies. However, the TGFB1-509 C?>?T variant was associated with moderate/severe activity disease, independently of autoantibodies positivity. Thus, our findings suggest that TGFB1?+?869 T?>?C and ?509 C?>?T variants can predict activity disease in different RA patient subgroups.

     

Acute harmine administration induces antidepressive-like effects and increases BDNF levels in the rat hippocampus

Harmine is a β-carboline alkaloid that inhibits monoamine reuptake systems. Findings point to an antidepressant effect of the compounds that increases the levels of monoamines after monoamine oxidase inhibition. The present study aims to compare the behavioral effects and the BDNF hippocampus levels of acute administration of harmine and imipramine in rats. To this aim, rats were acutely treated with harmine (5, 10 and 15 mg/kg) and imipramine (10, 20 and 30 mg/kg) and animal behavior was assessed in the forced swimming and open-field tests. Afterwards, hippocampal BDNF protein levels were assessed in imipramine- and harmine-treated rats by ELISA-sandwich assay. We observed that harmine at doses of 10 and 15 mg/kg, and imipramine at 20 and 30 mg/kg reduced immobility time, and increased both climbing and swimming time of rats compared to saline group, without affecting locomotor activity. Acute administration of harmine at the higher dose, but not imipramine, increased BDNF protein levels in the rat hippocampus. Finally, these findings further support the hypothesis that harmine could be a new pharmacological target for the treatment of mood disorders.     

Behavior of two Leishmania infantum strains—evaluation of susceptibility to antimonials and expression of microRNAs in experimentally infected J774 macrophages and in BALB/c mice

Parasitology Research - Strains of the same Leishmania parasite species, isolated from different host organisms, may exhibit unique infection profiles and induce a change in the expression of...     

Do smokers have a different gingival crevicular fluid cytokine/chemokine profile than nonsmokers in clinically healthy periodontal sites? A systematic review and meta-analysis

Clinical Oral Investigations - Assessing the evidence and comparing the levels of cytokines in gingival crevicular fluid (GCF) of periodontal healthy sites of smokers and nonsmokers. Seven...     

The phthalimide analogues N-3-hydroxypropylphthalimide and N-carboxymethyl-3-nitrophthalimide exhibit activity in experimental models of inflammatory and neuropathic pain

BackgroundPhthalimide analogues devoid of the glutarimide moiety exhibit multiple biological activities, thus making them candidates for the treatment of patients with different diseases, including those with inflammatory and painful disorders. In the present study, the activities of five phthalimide analogues devoid of the glutarimide moiety (N-hydroxyphthalimide, N-hydroxymethylphthalimide, N-3-hydroxypropylphthalimide, N-carboxy-3-methylphthalimide, N-carboxymethyl-3-nitrophthalimide) were evaluated in experimental models of acute and chronic inflammatory and neuropathic pain.MethodsThe phthalimide analogues were administered per os (po) in Swiss mice or Wistar rats. Nociceptive response induced by formaldehyde and mechanical allodynia induced by chronic constriction injury (CCI) of the sciatic nerve or intraplantar (ipl) injection of complete Freund’s adjuvant (CFA) were used as experimental models of pain.ResultsN-carboxymethyl-3-nitrophthalimide (700 mg/kg, -1 h) inhibited the second phase of the nociceptive response induced by the intraplantar injection of formaldehyde in mice. N-3-hidroxypropylphthalimide (546 mg/kg, -1 h) inhibited both phases of the nociceptive response induced by formaldehyde. Treatment of rats with N-carboxymethyl-3-nitrophthalimide (700 mg/kg) or N-3-hydroxypropylphthalimide (546 mg/kg) inhibited the mechanical allodynia induced by CCI of the sciatic nerve or ipl injection of CFA in rats. Intraperitoneal administration of the opioid antagonist naltrexone (10 mg/kg, -1.5 h) attenuated the antinociceptive activity of N-carboxymethyl-3-nitrophthalimide (700 mg/kg) in the model of nociceptive response induced by formaldehyde.ConclusionsN-3-hydroxypropylphthalimide and N-carboxymethyl-3-nitrophthalimide, two phthalimide analogues devoid of the glutarimide moiety, exhibited activities in different experimental models of pain, including models of chronic inflammatory and neuropathic pain.     

Association of HTRA1 rs11200638 with age-related macular degeneration (AMD) in Brazilian patients

Age-related macular degeneration is a multifactorial disease that can lead to vision impairment in older individuals. Although the etiology of age-related macular degeneration remains unknown, risk factors include age, ethnicity, smoking, hypertension, obesity, and genetic factors. Two main loci have been identified through genome-wide association studies, on chromosomes 1 and 10. Among the variants located at the 10q26 region, rs11200638, located at the HTRA1 gene promoter, has been associated with age-related macular degeneration in several populations and is considered the main polymorphism. We conducted a replication case–control study to analyze the frequency and participation of rs11200638 in the etiology of age-related macular degeneration in a sample of patients and controls from the State of São Paulo, Brazil, through polymerase chain reaction and enzymatic digestion. The frequency of the A allele was 57.60% in patients with age-related macular degeneration and 36.45% in controls (p value < 1e–07), representing a 2.369-fold higher risk factor for the disease. Both the AA and AG genotypes were observed more frequently in the age-related macular degeneration group compared to the control group (p = 1.21^e–07 and 0.0357, respectively). No statistically significant results were observed after stratification in dry versus wet types or advanced versus non-advanced forms. To our knowledge, this is the first time the association between rs11200638 and overall age-related macular degeneration has been reported in South America.     

A Simplified Approach to Select Exercise Endurance Intensity for Interventional Studies in COPD

ABSTRACT

Time to exercise limitation (Tlim) in response to constant work rate (CWR) is sensitive to interventions in chronic obstructive pulmonary disease (COPD). This is particularly true when the pre-intervention test lasts between 3 and 8 min (Tlim_3′–8′). There is, however, no simple method to select a work rate which is consistently associated with Tlim_3′–8′ across the spectrum of COPD severity.

We assessed 59 GOLD stages II–IV patients who initially cycled to Tlim at 75% peak. In case of short (<3 min, low-endurance) or long (>8 min, high-endurance) tests, patients exercised after 60 min at 50% or 90%, respectively (CWR_50%?75%?90%).

Critical mechanical constraints and limiting dyspnea at 75% were reached within the desired timeframe in 27 “mid-endurance” patients (46%). Increasing work rate intensity to 90% hastened the mechanical-ventilatory responses leading to Tlim_3′–8′ in 23/26 (88%) “high-endurance” patients; conversely, decreasing exercise intensity to 50% slowed those responses leading to Tlim_3′–8′ in 5/6 (83%) “high-endurance” patients. Repeating the tests at higher (60%) or lower (80%) intensities fail to consistently produce Tlim_3′–8′ in “low-” and “high-endurance”, respectively (p > 0.05). Compared to a fixed work rate at 75%, CWR_50%?75%?90% significantly decreased Tlim's coefficient of variation; consequently, the required N to detect 100 s or 33% improvement in Tlim decreased from 82 to 26 and 41 to 14, respectively.

This simplified approach to individualized work rate adjustment (CWR_50%?75%?90%) might allow greater sensitivity in evaluating interventional efficacy in improving respiratory mechanics and exercise tolerance while simultaneously reducing sample size requirements in patients with COPD.