Prevalence of Urinary Incontinence in a Random Sample of the Urban Population of Pouso Alegre, Minas Gerais, Brazil Prevalencia de la incontinencia urinaria en muestra aleatoria de la población urbana de Pouso Alegre, Minas Gerais, Brasil Prevalência da incontinência urinária em amostra randomizada da população urbana de Pouso Alegre, Minas Gerais, Brasil

This study determines and analyzes the prevalence of Urinary Incontinence (UI) and its demographic and clinical predictors. This epidemiological and cross-sectional study was approved by the Research Ethics Committee of the University of São Paulo, Nursing School. The sample was randomly selected by cluster technique and included 519 individuals aged &#8805;18 years, living in 341 houses in urban areas. Data were analyzed through Chi-Square, Hosmer Lemeshow’s test and multivariate logistic regression (stepwise). Prevalence rates were standardized by gender and age. Of the 519 people composing the sample: 20.1% had UI, 32.9% were women and 6.2% were men. Longer duration of losses (OR = 29.3; p<0.001), diabetes mellitus (OR = 17.7; p<0.001), stroke (OR = 15.9; p<0.001), and cystocele (OR = 12.5; p <0.001) were the factors most strongly associated with UI. This study enabled the identification of UI epidemiology and can contribute to the development of public policies for its primary and secondary prevention and treatment, even if such measures are initially implemented at the city level.<br>El estudio tiene por objetivo conocer la prevalencia de la incontinencia urinaria (IU), de los factores de predicción demográficos y clínicos de la presencia de IU. Se trata de un estudio epidemiológico de corte transversal, aprobado por el Comité de Ética de la Escuela de Enfermería de la Universidad de Sao Paulo. Muestreo estratificado por conglomerado compuesto de 519 individuos con edad &#8805;18 años, residentes en 341 domicilios del área urbana, sorteados aleatoriamente. Las pruebas utilizadas fueron Chi-cuadrado, Hosmer Lemeshow y regresión logística multivariante (stepwise). Las prevalencias de IU fueron estandarizadas por sexo y edad, en una muestra de 519 personas, siendo 20,1 % en la población general - 32,9% eran mujeres y 6,2% hombres. Los factores más fuertemente asociados a la IU fueron: mayor tiempo de pérdidas (OR=29,3; p<0,001), diabetes mellitus (OR=17,7; p<0,001), accidente vascular encefálico (OR=15,9; p<0,001) y cistocele (OR=12,5; p<0,001). El estudio permitió conocer la epidemiologia de la IU y puede contribuir para el desarrollo de políticas públicas para su prevención primaria y secundaria, su tratamiento, inclusive considerando su inicio en el ámbito municipal.<br>Os objetivos deste trabalho foram conhecer a prevalência da incontinência urinária (IU), dos fatores demográficos e clínicos preditores da presença de IU. Estudo epidemiológico, corte transversal, aprovado pelo Comitê de Ética da Escola de Enfermagem da Universidade de São Paulo. A amostragem, estratificada por conglomerado, foi composta por 519 indivíduos com idade &#8805;18 anos, residentes em 341 domicílios da área urbana, sorteados aleatoriamente. Os testes utilizados foram qui-quadrado, Hosmer Lemeshow e regressão logística multivariada (stepwise). As prevalências foram padronizadas por sexo e idade, portanto, das 519 pessoas que compuseram a amostra, 20,1% dessas tinha IU numa população total; 32,9% eram mulheres e 6,2% homens. Maior tempo de perdas (OR=29,3; p<0,001), diabetes mellitus (OR=17,7; p<0,001), acidente vascular encefálico (OR=15,9; p<0,001) e cistocele (OR=12,5; p<0,001) foram os fatores mais fortemente associados à IU. O estudo permitiu conhecer a epidemiologia da IU e pode contribuir para o desenvolvimento de políticas públicas para a sua prevenção primária e secundária, seu tratamento, ainda que inicialmente em nível municipal

A population-based morphometric MRI study in patients with first-episode psychotic bipolar disorder: comparison with geographically matched healthy controls and major depressive disorder subjects

Objectives: Many morphometric magnetic resonance imaging (MRI) studies that have investigated the presence of gray matter (GM) volume abnormalities associated with the diagnosis of bipolar disorder (BD) have reported conflicting findings. None of these studies has compared patients with recent-onset psychotic BD with asymptomatic controls selected from exactly the same environment using epidemiological methods, or has directly contrasted BD patients against subjects with first-onset psychotic major depressive disorder (MDD). We examined structural brain differences between (i) BD (type I) subjects and MDD subjects with psychotic features in their first contact with the healthcare system in Brazil, and (ii) these two mood disorder groups relative to a sample of geographically matched asymptomatic controls. Methods: A total of 26 BD subjects, 20 subjects with MDD, and 94 healthy controls were examined using either of two identical MRI scanners and acquisition protocols. Diagnoses were based on DSM-IV criteria and confirmed one year after brain scanning. Image processing was conducted using voxel-based morphometry. Results: The BD group showed increased volume of the right dorsal anterior cingulate cortex relative to controls, while the MDD subjects exhibited bilateral foci GM deficits in the dorsolateral prefrontal cortex (p < 0.05, corrected for multiple comparisons). Direct comparison between BD and MDD patients showed a focus of GM reduction in the right-sided dorsolateral prefrontal cortex (p < 0.05, corrected for multiple comparisons) and a trend (p < 0.10, corrected) toward left-sided GM deficits in the dorsolateral prefrontal cortex of MDD patients. When analyses were repeated with scanner site as a confounding covariate the finding of increased right anterior cingulate volumes in BD patients relative to controls remained statistically significant (p = 0.01, corrected for multiple comparisons). Conclusions: These findings reinforce the view that there are important pathophysiological distinctions between BD and MDD, and indicate that subtle dorsal anterior cingulate abnormalities may be relevant to the pathophysiology of BD.Wellcome Trust (UK)FAPESP-Brazil[2003/13627-0]CNPq-BrazilCAPES-Brazi