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Efeitos do Mat Pilates associado a contração voluntária dos músculos do assoalho pélvico em mulheres na pós-menopausa com incontinência urinária de esforço: ensaio clínico randomizado e controlado

Mon, 21 Sep 2026 00:00:00 GMT

Title: Efeitos do Mat Pilates associado a contração voluntária dos músculos do assoalho pélvico em mulheres na pós-menopausa com incontinência urinária de esforço: ensaio clínico randomizado e controlado Abstract: Introduction: Urinary incontinence (UI) affects more than 50% of postmenopausal women. However, it remains unclear whether Mat Pilates provides additional benefits over Pelvic Floor Muscle Training (PFMT) for the treatment of UI. Objective: To evaluate the benefits of Mat Pilates combined with voluntary pelvic floor muscle (PFM) contraction in postmenopausal women with stress urinary incontinence (SUI). Methods: A randomized controlled trial was conducted. Ninety-two women with SUI, PFM strength ≥ 2, and no use of hormone therapy were randomized into an experimental group (57.6 ± 5.2 years, n = 46), which underwent Mat Pilates combined with voluntary PFM contraction (MP + vcPFM), and a control group (57.3 ± 4.4 years, n = 46), which underwent PFMT. Both groups completed 36 sessions, three times per week, for three months, with equalization of the number of PFM contractions and training progression every 12 sessions. Before the intervention, all participants attended three sessions of perineal awareness training. The following outcomes were assessed: the impact of UI using the International Consultation on Incontinence Questionnaire–Short Form (ICIQ-SF), the amount of urinary leakage using the one-hour Pad test, urinary habits using a 3-day bladder diary, and PFM function using digital palpation and vaginal manometry. Statistical analysis was performed using linear mixed models, considering group (PFMT vs. Mat Pilates), time (pre- and post-intervention), and the group × time interaction as fixed effects (α = 5%). Results: Regarding the impact of UI on quality of life, the PFMT group showed a reduction from 11.28 (±4.22) to 5.51 (±4.58), whereas the MP + vcPFM group showed a reduction from 12.17 (±4.56) to 7.45 (±4.16), with a mean difference of 0.96 (95% CI −1.00 to 2.92) and no superiority between interventions (p = 0.334). Regarding urinary habits, urinary frequency decreased from 3.15 (±1.29) to 2.19 (±0.71) in the PFMT group and from 2.82 (±0.93) to 2.64 (±0.92) in the MP + vcPFM group, with a mean difference of 0.80 (95% CI 0.37 to 1.23), demonstrating superiority in favor of PFMT (p < 0.001). Urinary leakage episodes decreased from 1.82 (±2.19) to 0.45 (±0.74) in the PFMT group and from 1.56 (±1.33) to 0.96 (±1.16) in the MP + vcPFM group, with a mean difference of 0.76 (95% CI 0.09 to 1.42), with PFMT demonstrating superiority (p = 0.026). In the PFM assessment, only maximal PFM contractions showed superiority between interventions, in favor of PFMT (p = 0.047). In the PFMT group, maximal PFM contractions increased from 4.24 (±1.86) to 6.19 (±2.11), whereas in the MP + vcPFM group they increased from 4.41 (±1.33) to 5.35 (±1.85), with a mean difference of −0.99 (95% CI −1.97 to −0.01). The cure rate was 70% (32/46) in the PFMT group and 43% (20/46) in the MP + vcPFM group. Conclusion: Both interventions improved the impact of SUI on quality oflife. However, PFMT was superior in relevant urinary and functional outcomes, reinforcing its indication as the first-line conservative treatment for postmenopausal women with SUI.

Identificação da displasia broncopulmonar em recém-nascidos pré-termos de muito baixo peso por meio de biomarcadores urinários: aplicações não-invasivas com plataformas metabolômica e ATR-FTIR

Tue, 25 Aug 2026 00:00:00 GMT

Title: Identificação da displasia broncopulmonar em recém-nascidos pré-termos de muito baixo peso por meio de biomarcadores urinários: aplicações não-invasivas com plataformas metabolômica e ATR-FTIR Abstract: Introduction: Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting preterm infants, characterized by impaired alveolar and vascular development, resulting in compromised gas exchange and prolonged oxygen dependency. The high incidence of prematurity and the morbidity and mortality associated with BPD highlight the limitations of a diagnosis that remains largely based on late clinical outcomes, which fail to reflect the early immunoinflammatory alterations underlying the disease. This limitation hinders risk stratification and timely intervention, underscoring the need for the development of non-invasive biomarkers integrated with artificial intelligence to improve the prediction and management of BPD in very low birth weight preterm infants. Objective: To develop and evaluate non-invasive platforms based on urinary biomarkers integrated with artificial intelligence algorithms for the early prediction of BPD in very low birth weight preterm infants (VLBW-PTIs). Materials and Methods: A longitudinal study was conducted in a neonatal intensive care unit between January 2015 and September 2019, including preterm infants with gestational age <30 weeks and very low birth weight (<1,500 g). Infants were classified into two groups: BPD and non-BPD. Urine samples collected on the second day of life were analyzed using attenuated total reflectance Fourier-transform infrared spectroscopy (ATR-FTIR) and high-resolution mass spectrometry (MS) coupled with high-performance liquid chromatography (HPLC) for metabolite identification. Spectral data generated by both platforms were subsequently analyzed using artificial intelligence algorithms to assess diagnostic predictive performance (accuracy, sensitivity, and specificity). Statistical analyses included parametric and nonparametric tests for group comparisons, principal component analysis (PCA) of spectral data, machine learning-based classification algorithms, metabolomic analysis, univariable and multivariable logistic regression, internal bootstrap validation, receiver operating characteristic (ROC) curve analysis, and decision curve analysis. Results: In the ATR-FTIR analysis of 42 urine samples from very low birth weight (VLBW) preterm infants, including 20 with bronchopulmonary dysplasia (BPD) and 22 without BPD, the AdaBoost algorithm combined with second-derivative preprocessing demonstrated a sensitivity of 73%, a specificity of 81%, and an accuracy of 78% in classifying infants who did or did not develop BPD. The most relevant vibrational markers were associated with lipids, carbohydrates, and proteins. HPLC-MS metabolomic analysis of 88 urine samples from VLBW preterm infants, including 33 with BPD and 55 without BPD, identified two metabolites with significantly different abundances between the groups. The final multivariable model (M2), which combined sex, birth weight, gestational age, mechanical ventilation on the second day of life, and urinary Cys-Ser-Met, showed good discriminatory performance, yielding an AUC of 0.862 (bootstrap 95% CI, 0.775–0.937). At a cutoff of 0.347, the model achieved 80.7% sensitivity, 83.9% specificity, and 81.8% accuracy, with a positive predictive value of 90.2% and a negative predictive value of 70.3%. Conclusions: The results highlight the potential of a portable ATR-FTIR platform combined with artificial intelligence algorithms for the diagnostic screening of BPD using a non-invasive biological matrix such as urine. The urinary metabolomic approach identified Cys-Ser-Met and creatinine as differentially abundant metabolites in preterm infants with BPD, and the incorporation of Cys-Ser-Met into clinical variables improved model discrimination. However, these findings still require external validation in larger, multicenter cohorts. Together with our previous results obtained via ATR-FTIR, these data suggest that spectroscopic and metabolomic platforms can provide complementary biochemical signatures for the early identification of BPD, though their diagnostic and clinical utility must be prospectively confirmed prior to implementation in neonatal practice.

Perfil sorológico e evolução dos neonatos de mães com toxoplasmose aguda na gestação

Fri, 28 Aug 2015 00:00:00 GMT

Title: Perfil sorológico e evolução dos neonatos de mães com toxoplasmose aguda na gestação Abstract: Introduction: Congenital Toxoplasmosis is an infectious disease that resultsfrom transplacental transfer of Toxoplasma gondii to the fetus, resulting from primary infection of the mother during pregnancy. Serological tests are the most widely used and both the diagnosis. However, these antibodies may not be present at birth and there is also the possibility of false positive results in the first days of life. The aim of this study was to evaluate the profile of mothers with serological diagnosis of toxoplasmosis during pregnancy and their children Methods: We evaluated the results of serological tests IgM and IgA of 79 pairs of mothers-infants who were diagnosed with acute toxoplasmosis during pregnancy, and its correlation with congenital toxoplasmosis diagnosis. The medical records were obtained data for clinical symptoms, diagnosis and management. Differences in continuous variables between groups were compared by t test or Mann-Whitney Sudent when appropriate. We calculated sensitivity, specificity, and positive and negative predictive values of serological tests. Data were analyzed using SPSS 20.0 P values <0.05 were considered statistically Results: The diagnosis of congenital toxoplasmosis occurred in 15% of babies, of which 5 (40%) were asymptomatic at birth. The most common symptom was chorioretinitis. The sensitivity and specificity of IgA and IgM collected from newborns were 92/92% 99/96%, respectively. When associated with negative maternal IgA were observed positive or false negative results. Conclusion: The combined detection of IgM or IgA antibodies in the neonate associated with maternal IgA, combined with clinical data, can be useful in identifying newborns with congenital toxoplasmosis

Associação da insegurança alimentar com vitaminas e carotenóides plasmáticos em adultos participantes do National Health and Nutrition Examination Survey (NHANES) 2017-2018

Fri, 29 May 2026 00:00:00 GMT

Title: Associação da insegurança alimentar com vitaminas e carotenóides plasmáticos em adultos participantes do National Health and Nutrition Examination Survey (NHANES) 2017-2018 Abstract: Introduction: In the United States, food insecurity (FI) predisposes vulnerable populations to the paradox of obesity coexisting with “hidden hunger.” Although the literature points to poor diet quality as a mediator of this relationship, the evidence is based primarily on dietary surveys. To overcome the limitations of self-reporting, the use of serum biomarkers is essential for quantifying the impact of this vulnerability on dietary quality. Objective: To evaluate the relationship between Food Insecurity and the serum biochemical profile of vitamins and carotenoids in U.S. adults and older adults, considering effect modification by sex, age group, and race/ethnicity. Material and methods: A cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) 2017-2018, comprising 3,092 adults (≥20 years). Serum levels of vitamins A, C, D, and E, as well as carotenoids, were evaluated. Survey-weighted linear regression models were used to examine the association between FI and these biomarkers. Food Insecurity was assessed using the Household Food Security Survey Module. Confounding variables for the adjusted models were strictly selected using a Directed Acyclic Graph (DAG). Analyses were performed on the total sample and stratified by sex, age, and race/ethnicity. Results: In the total sample, after adjustments, Food Insecurity maintained a significant inverse association with levels of total carotenoids, cis-, and trans-beta-carotene. In stratified analyses, carotenoid depletion persisted among women and young adults. In contrast, men showed an association with reduced vitamin E and lycopene, and older adults with vitamins D and E. Regarding race/ethnicity, the association lost significance among minorities after socioeconomic adjustments, indicating that structural variables such as income and education absorb the isolated impact of Food Insecurity in these groups. Conclusion: Food Insecurity in the U.S. transcends caloric restriction and constitutes a severe state of hidden hunger. The depletion of carotenoids highlights the restricted access to fresh, unprocessed foods (fruits and vegetables). The use of serum biomarkers underscored how social vulnerability can be reflected in measurable nutritional differences.