What do Cochrane systematic reviews say about non-surgical interventions for urinary incontinence in women?

BACKGROUND: Urinary incontinence is a highly prevalent condition that impacts self-esteem and overall quality of life. Many non-surgical treatment options are available, ranging from pharmacological approaches to pelvic exercises. We aimed to summarize the available evidence regarding these non-surgical interventions. DESIGN AND SETTING: Review of systematic reviews, conducted in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de Sao Paulo (EPM-UNIFESP). METHODS: A sensitive search was conducted to identify all Cochrane systematic reviews that fulfilled the inclusion criteria. Titles and abstracts were screened by two authors. RESULTS: We included 20 Cochrane systematic reviews: 4 assessing methods of vesical training, 3 evaluating pharmacological interventions, 4 studying pelvic floor muscle training approaches and 9 aimed at other alternatives (such as urethral injections, weighted vaginal cone use, acupuncture, biostimulation and radiofrequency therapy). The reviews found that the evidence regarding the benefits of these diverse interventions ranged in quality from low to high. CONCLUSIONS: This review included 20 Cochrane systematic reviews that provided evidence (of diverse quality) for non-pharmacological interventions for patients with urinary incontinence. Moderate to high quality of evidence was found favoring the use of pelvic floor muscle training among women with urinary incontinence. To establish solid conclusions for all the other comparisons, further studies of good methodological quality are needed.Univ Fed Sao Paulo Unifesp, Escola Paulista Med, Discipline Evidence Based Hlth, Sao Paulo, SP, BrazilUniv Fed Sao Paulo Unifesp, Escola Paulista Med, Sao Paulo, SP, BrazilUniv Fed Sao Paulo Unifesp, Escola Paulista Med, Dept Gynecol, Sao Paulo, SP, BrazilUniv Fed Sao Paulo Unifesp, Escola Paulista Med, Discipline Evidence Based Hlth, Sao Paulo, SP, BrazilUniv Fed Sao Paulo Unifesp, Escola Paulista Med, Sao Paulo, SP, BrazilUniv Fed Sao Paulo Unifesp, Escola Paulista Med, Dept Gynecol, Sao Paulo, SP, BrazilWeb of Scienc

CORRELAÇÃO ENTRE O ÍNDICE PADRONIZADO DE PRECIPITAÇÃO E GERAÇÃO DE CENTRAIS HIDRELÉTRICAS DE PEQUENO PORTE

Períodos de seca influenciam fortemente o Setor Elétrico Brasileiro devido à predominância da hidroeletricidade na matriz elétrica nacional, esse cenário pôde ser vivenciado durante o verão 2013-2014 onde foi constatada a falta de chuvas. Partindo da premissa de que o regime de chuvas pode influenciar a vazão de rios onde estão instaladas centrais hidrelétricas e, consequentemente, na geração desses empreendimentos, foram analisadas as correlações entre o índice padronizado de precipitação, SPI, produzido pelo CPTEC/INPE e o índice de geração, calculado pela razão da energia gerada pela garantia física de 257 centrais hidrelétricas de pequeno porte, até 30 MW. A análise utilizou o coeficiente de correlação de Pearson, a fim de verificar se há uma associação linear entre a precipitação e a geração de energia em aproveitamentos hidrelétricos. Foram observadas correlações com coeficientes altos entre o SPI e o índice de geração. Nos casos em que o SPI indicava seca, muitos empreendimentos apresentaram baixa geração, entretanto, o inverso não foi verificado, o SPI alto não indicou melhor desempenho no índice de geração.Palavras chave: índice padronizado de precipitação, pequenas centrais hidrelétricas, geração de energia elétrica

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

A Relação entre o Regulamento de Uso das Indicações Geográficas e o Conhecimento Tradicional: o caso do guaraná envolvendo os territórios de Maués e da Terra Indígena Andirá-Marau

The cases "Maués" indication of source and "Andirá-Maraú" appellation of origin application related to guarana were analyzed regarding the strategic role of geographical indication regulation governing use in the preservation of productive practices and traditions of the collectivity. Documentary research involving the administrative processes at INPI of these geographical indications was performed. Regulation governing use showed strategic for the collectivity that uses the geographical indication, since it has a direct relation with product identity and typicity, valuing its main characteristics and the close connection with the geographic origin. In the case of “Maués” indication of source, the Sateré-Mawé Producers Consortium verified that regulation governing use would not be adequate in preserving and valuing the traditional forms of production of its collectivity, mainly the agroforestry methods of guaraná production, which motivated an own application of appellation of origin.Analisam-se neste artigo os casos relacionados à indicação de procedência “Maués” e ao pedido de registro da denominação de origem “Terra Indígena Andirá-Maraú”, ambas para guaraná, e discute-se o papel estratégico do regulamento de uso da indicação geográfica na preservação das práticas produtivas e tradições da coletividade. Utilizou-se pesquisa documental envolvendo os processos administrativos dessas indicações geográficas no INPI. Verificou-se que o regulamento de uso é estratégico para a coletividade que utiliza a indicação geográfica, pois tem relação direta com a identidade e tipicidade do produto, valorizando suas principais características e a estreita ligação com a origem geográfica. No caso da indicação de procedência “Maués”, o Consórcio dos Produtores Sateré-Mawé verificou que o regulamento de uso não teria serventia especial para preservar e valorizar as formas de produção tradicional de sua coletividade, principalmente os métodos de produção agroflorestal do guaraná, o que motivou um pedido próprio de registro de denominação de origem

What do Cochrane systematic reviews say about non-surgical interventions for urinary incontinence in women?

ABSTRACT BACKGROUND: Urinary incontinence is a highly prevalent condition that impacts self-esteem and overall quality of life. Many non-surgical treatment options are available, ranging from pharmacological approaches to pelvic exercises. We aimed to summarize the available evidence regarding these non-surgical interventions. DESIGN AND SETTING: Review of systematic reviews, conducted in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-UNIFESP). METHODS: A sensitive search was conducted to identify all Cochrane systematic reviews that fulfilled the inclusion criteria. Titles and abstracts were screened by two authors. RESULTS: We included 20 Cochrane systematic reviews: 4 assessing methods of vesical training, 3 evaluating pharmacological interventions, 4 studying pelvic floor muscle training approaches and 9 aimed at other alternatives (such as urethral injections, weighted vaginal cone use, acupuncture, biostimulation and radiofrequency therapy). The reviews found that the evidence regarding the benefits of these diverse interventions ranged in quality from low to high. CONCLUSIONS: This review included 20 Cochrane systematic reviews that provided evidence (of diverse quality) for non-pharmacological interventions for patients with urinary incontinence. Moderate to high quality of evidence was found favoring the use of pelvic floor muscle training among women with urinary incontinence. To establish solid conclusions for all the other comparisons, further studies of good methodological quality are needed

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans—anteaters, sloths, and armadillos—have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, 10 anteaters, and 6 sloths. Our data set includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the southern United States, Mexico, and Caribbean countries at the northern portion of the Neotropics, to the austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n = 5,941), and Cyclopes sp. have the fewest (n = 240). The armadillo species with the most data is Dasypus novemcinctus (n = 11,588), and the fewest data are recorded for Calyptophractus retusus (n = 33). With regard to sloth species, Bradypus variegatus has the most records (n = 962), and Bradypus pygmaeus has the fewest (n = 12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other data sets of Neotropical Series that will become available very soon (i.e., Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans data set. Please cite this data paper when using its data in publications. We also request that researchers and teachers inform us of how they are using these data