Increasing rate of anti-SARS-CoV-2 antibodies between the first and second waves of COVID-19 in São Paulo, Brazil: A cross-sectional blood donors-based study

Background: SARS-CoV-2 infections rapidly spread along with Brazilian territory with heterogeneous transmission and mortality rates, mostly depending on region and period. Investigation of SARS-CoV-2 antibodies is an important tool to understand virus circulation. Given that blood donors are a representative casuistic of a healthy population, the authors evaluated the seroprevalence of IgG and IgM COVID-19 antibodies in 2,806 blood donors from a blood bank located in São Paulo, Brazil. Methods: Aiming to evaluate viral behavior over time, the authors selected samples from blood donors who donated in June and October 2020, and February 2021. To determine whether socio-demographic features affected the seroprevalence, the authors analyzed samples from three different regions from São Paulo (capital, metropolitan and countryside regions) and evaluated predictors as gender, age, educational level, race, and use of public transportation. Results: As expected, the authors observed that seroprevalence increased over time. Seroprevalence was greater in São Paulo city compared to metropolitan and countryside regions, being smallest in the countryside. Characteristics associated with a lower percentage of antibodies were age above 50 years, higher educational level, self-declared Caucasian, and use of individual transportation. Conclusion: In conclusion, blood donors' samples proved to accurately reflect virus circulation in the healthy population

Antibody indexes in COVID-19 convalescent plasma donors: Unanswered questions

OBJECTIVE: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is characterized by high contagiousness, as well as variable clinical manifestations and immune responses. The antibody response to SARS-CoV-2 is directly related to viral clearance and the antibodies’ ability to neutralize the virus and confer long-term immunity. Nevertheless, the response can also be associated with disease severity and evolution. This study correlated the clinical characteristics of convalescent COVID-19 patients with immunoglobulin A (IgA) and IgG anti-SARS-CoV-2 antibodies. METHODS: This study included 51 COVID-19 health care professionals who were candidates for convalescent plasma donation from April to June 2020. The subjects had symptomatic COVID-19 with a polymerase chain reaction-confirmed diagnosis. We measured anti-SARS-CoV-2 IgA and IgG antibodies after symptom recovery, and the subjects were classified as having mild, moderate, or severe symptoms. RESULTS: Anti-SARS-CoV-2 antibodies were positive in most patients (90.2%). The antibody indexes for IgA and IgG did not differ significantly between patients presenting with mild or moderate symptoms. However, they were significantly higher in patients with severe symptoms. CONCLUSIONS: Our study showed an association between higher antibody indexes and severe COVID-19 cases, and several hypotheses regarding the association of the antibody dynamics and severity of the disease in SARSCoV-2 infection have been raised, although many questions remain unanswered

Ultrasound Thickness of Bladder Wall in Continent and Incontinent Women and Its Correlation with Cystometry

Objective. To compare bladder wall thickness in two kinds of urinary incontinent women—stress urinary incontinence (SUI) and overactive bladder (OAB) with urodynamic detrusor overactivity (DO), and to compare them with continent patients by ultrasound, also, correlate with cystometric results in incontinent women. Methods. 91 women were divided into the following groups: continent (n=31), SUI (n=30), and DO (n=30) groups after clinical evaluation and urodynamic test (only in incontinent women). Transvaginal ultrasound was performed to the bladder wall thickness (BWT) measurement. The mean of BWT was calculated and data were analyzed with ANOVA and Turkey’s multiple comparison tests. Pearson’s correlation coefficient (r) was used to compare two variables. Receiver operating characteristic (ROC) curve was performed to study BWT as a diagnostic parameter. Results. BWT in DO group was significantly higher than that in the other groups (P<0.005). A moderate positive correlation was found between BWT and maximum bladder pressure during involuntary bladder contraction. There was no difference in BWT between SUI and continent groups. DO group had lower first desire to void and cystometric capacity. Maximum bladder pressure at detrusor contraction had a moderate positive correlation with BWT. The ROC revealed an area under the curve of 0.962 (95% CI, 0.90–1.01). Conclusions. DO patients have increased bladder wall thickness, lower first desire to void, and lower cystometric capacity. There was a moderate correlation between BWT and maximum bladder pressure during involuntary bladder contraction

Fisioterapia para consciência perineal: uma comparação entre as cinesioterapias com toque digital e com auxílio do biofeedback

INTRODUÇÃO: Grande parte das mulheres (cerca de 30 a 50%) não consegue contrair corretamente seus músculos perineais quando isso lhes é solicitado. Provavelmente, a parte mais importante e também a mais delicada de toda avaliação fisioterapêutica é a conscientização da região perineal das pacientes incontinentes. OBJETIVO: Este trabalho teve como objetivo comparar os efeitos das cinesioterapias com toque digital e com biofeedback para consciência perineal de mulheres com incontinência urinária de esforço. METODOLOGIA: Foi realizado um ensaio clínico randomizado, composto por dois grupos intervencionais, formados por cinco mulheres cada, com incontinência urinária de esforço e com ausência de consciência perineal. RESULTADOS: Inicialmente, o grupo de biofeedback seria composto de seis mulheres e o grupo de cinesioterapia com toque bidigital seria formado por cinco mulheres, porém uma paciente foi excluída do grupo biofeedback no decorrer da pesquisa. Observou-se que houve melhora estatisticamente significativa em ambos os grupos em relação a Power, Endurance, Fast e conhecimentos acerca da região perineal, porém não houve diferença significativa entre os dois grupos, ou seja, ambos os recursos são igualmente eficazes. CONCLUSÃO: Diante dos resultados apresentados, podemos concluir que tanto a cinesioterapia com uso do biofeedback quanto a cinesioterapia com toque digital são excelentes opções de tratamento para ganho de consciência perineal

Treatment of Non-neurogenic Overactive Bladder with OnabotulinumtoxinA: Systematic Review and Meta-analysis of Prospective, Randomized, Placebo-controlled Clinical Trials

<div><p>Abstract We performed a systematic review and meta-analysis of randomized placebo-controlled trials that studied non-neurogenic overactive bladder patients who were treated with 100 units of onabotulinumtoxinA or placebo. The primary purpose of our study was to evaluate the clinical effectiveness with regard to urinary urgency, urinary frequency, nocturia, and incontinence episodes. Our secondary purpose consisted of evaluating the adverse effects. Our initial search yielded 532 entries. Of these, seven studies met all the inclusion criteria (prospective, randomized, placebo-controlled studies, ≥ 3 points on the Jadad scale) and were selected for analysis. For all primary endpoints, the toxin was more effective than placebo (p < 0.0001; 95% confidence interval [95CI]), namely: urgency (mean difference = -2.07; 95CI = [-2.55-1.58]), voiding frequency (mean difference = - 1.64; 95CI = [-2.10-1.18]), nocturia (mean difference = -0.25; 95CI = [-0.39-0.11]) and incontinence episodes (mean difference = -2.06; 95CI= [-2.60-1.52]). The need for intermittent catheterization and the occurrence of urinary tract infection (UTI) were more frequent in patients treated with onabotulinumtoxinA than in patients treated with placebo (p < 0.0001). Compared with placebo, onabotulinumtoxinA had significantly and clinically relevant reductions in overactive bladder symptoms and is associated with higher incidence of intermittent catheterization and UTI.</p></div

Women's Sleep Disorders: Integrative Care

The integrative care model is rooted in a biopsychosocial approach. Integrative is a term which refers to increasing the harmony and coherence of your whole being, and integrative care is therefore focused on the person, not on either the disease or a therapy. It is provided collaboratively by a health team comprising physicians, psychologists, physiotherapists, acupuncturists, and meditation, nutrition, and floral therapy. Previous studies have demonstrated that interventions based on the integrative care model improved womens lifestyle and quality of life. Our aim was to describe the use of complementary and alternative medicine (CAM) alongside traditional medicine among women with sleep conditions in our Womens Sleep Disorders Integrative Treatment Outpatient Clinic. We are sharing our experiences and clinical practice as the model we developed seems to have both physical and psychological benefits for women with sleep problems. We discuss the wide range of benefits that result from this type of complex intervention, and the contextual factors that may influence these benefits. This will inform future practitioners and we hope to contribute to quantitative research in the clinical setting. The study highlights the importance of treating sleep complaints with a caring relationship and a CAM approach, alongside conventional medicine. Exploration of the lived experience of CAM and its meaning enables healthcare professionals to gain insights into the patients needs, preferences, and values. Gynecologists, clinicians, and health care providers should support and guide patients in their decision to use CAM by providing evidence-based and comprehensive advice on the potential benefits, risks and related safety issues of this approach

Fisioterapia para consciência perineal: uma comparação entre cinesioterapia com toque digital e com auxílio do biofeedback

Introdução: Grande parte das mulheres (cerca de 30 a 50%) não consegue contrair corretamente seus músculos perineais quando isso lhes é solicitado. Provavelmente, a parte mais importante e também a mais delicada de toda avaliação fisioterapêutica é a conscientização da região perineal das pacientes incontinentes. Objetivos: Este trabalho teve como objetivo comparar os efeitos da cinesioterapia com toque digital e com biofeedback para consciência perineal de mulheres com incontinência urinária de esforço. Metodologia: Foi realizado um ensaio clínico randomizado, composto por dois grupos intervencionais formados por 5 mulheres cada, com incontinência urinária de esforço e com ausência de consciência perineal. Resultados: Inicialmente, o grupo de biofeedback seria composto de 6 mulheres, enquanto o grupo de cinesioterapia com toque bidigital era formado por 5 mulheres, porém 1 paciente foi excluída do grupo biofeedback no decorrer da pesquisa. Observou-se que houve melhora estatisticamente significativa em ambos os grupos em relação ao Power, Endurance, Fast e conhecimentos acerca da região perineal, porém não houve diferença significativa entre os dois grupos, ou seja, ambos os recursos são igualmente eficazes. Conclusão: Diante dos resultados apresentados, podemos concluir que tanto a cinesioterapia com uso do biofeedback quanto a cinesioterapia com toque digital são excelentes opções de tratamento para ganho de consciência perineal