Medicina
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Randomized Controlled Trial Multicenter Study
Low Intensity Extracorporeal Shock Wave Therapy as a Novel Treatment for Stress Urinary Incontinence: A Randomized-Controlled Clinical Study.
Background and Objectives: To evaluate the effects of low intensity extracorporeal shock wave therapy (LiESWT) on stress urinary incontinence (SUI). Materials and Methods: This investigation was a multicenter, single-blind, randomized-controlled trial study. Sixty female SUI patients were randomly assigned to receive LiESWT with 0.25 mJ/mm2 intensity, 3000 pulses, and 3 pulses/s, once weekly for a 4-week (W4) and 8-week (W8) period, or an identical sham LiESWT treatment without energy transmission. ⋯ Furthermore, validated standardized questionnaire scores were significantly improved at W8, F1, F3, and F6 as compared to the baseline (W0). Conclusions: Eight weeks of LiESWT attenuated SUI symptoms upon physical activity, reduced urine leakage, and ameliorated overactive bladder symptoms, which implied that LiESWT significantly improved the quality of life. Our findings suggested that LiESWT could serve as a potentially novel and non-invasive treatment for SUI.
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Background and Objectives: During physical exercise, the electrical signal of the muscle fibers decreases due to repeated muscle contractions held at different intensities. The measured signal is strongly related to the motor unit activation rate, which is dependent on the chemical mediators and the available energy. By reducing the energy availability, adenosine triphosphate (ATP) production will decrease and therefore the muscle fibers activation rate will be negatively affected. ⋯ Yet, with changes in median power output, the power developed in aerobic (p = 0.0087, r = 0.47), mixed (p = 0.0288, r = 0.39), anaerobic (p = 0.0052, r = 0.49) and anaerobic power (p = 0.004, r = 0.50) exercise zones increased. Conclusions: There has been reported a relationship between aerobic/anaerobic ventilatory thresholds (VT1 and VT2) and EMGFT, EMGMRP, respectively. Each change in oxygen uptake increased the power output in EMGFT and EMGMRP, improving performances and therefore overlapping with both ventilatory thresholds.
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Background and Objectives: This retrospective study aimed to identify the main comorbidities found in gynecological patients hospitalized for endometrial lesions and to analyze the relationships between these comorbidities and each type of endometrial lesion. The Charlson comorbidity index (CCI) was calculated, thus assessing the patient's probability of survival in relation to the underlying disease and the existing comorbidities. Materials and Methods: During 2015-2019, 594 cases hospitalized for vaginal bleeding outside of pregnancy were included in the research. ⋯ The lowest chances of survival were calculated for 88 (14.81% of the total) patients over 50 years (the probability of survival in the next 10 years being between 0 and 21%). The chances of survival at 10 years are moderately negatively correlated with age (sample size = 594, r = -0.6706, p < 0.0001, 95% confidence interval (CI) for r having values from -0.7126 to -0.6238) and strongly negatively correlated with the CCI (r = -0.9359, p < 0.0001, 95% CI for r being in the range -0.9452 to -0.9251). Conclusions: Using CCI in endometrial lesions is necessary to compare the estimated risk of EC mortality with other medical conditions.
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Case Reports
Ischemic Nephropaty: The Role of the Renal Artery Stenosis Revascularization on Renal Stem Cells.
We report the case of a 65-year-old man with acute GFR decline to 37 mL/min and uncontrolled high blood pressure. He was suspected for renovascular hypertension and underwent a renal color Doppler ultrasound scan that detected a bilateral atherosclerotic renal artery stenosis. ⋯ These clinical goals were accompanied by a significant increase of circulating renal stem cells (RSC) and a slight increase of resistive index (RI) in both kidneys. This single observation suggests the need for extensive studies aimed at evaluating the predictive power of RI and RSC in detecting post-ischemic renal repair mechanisms.
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Background and objectives: Although the role of insulin in the periphery is well understood, not as much is known about its multifactorial role in the brain. The aim of this study is to determine whether exogenous insulin, evaluated by daily insulin requirement, has an impact on mild cognitive impairment (MCI), and whether this relationship is mediated by insulin doses and other risk factors. Materials and methods: A sample of 100 participants with type 2 diabetes aged 40 and over was divided into case and control groups, according to their insulin requirement. ⋯ Higher insulin dose (>144 IU/d) demonstrated a positive effect on cognitive function, especially in individuals with poorly controlled diabetes (HbA1c ≥ 9%). Finally, the prevalence of MCI in the T2DM population was found to be very high. Future research is needed to determine whether high exogenous insulin doses have a protective effect on MCI.