Trapping of Retrachydes thoracicus thoracicus (Olivier) and Other Neotropical Cerambycid Beetles in Pheromone- and Kairomone-Baited Traps.

The subfamily Cerambycinae, one of the most diverse in longhorn beetles, is well known for its remarkable chemical parsimony in male-emitted pheromones. Conserved shared structural motifs have been reported in numerous species, sometimes working in combination with plant volatile kairomones. Among other compounds, the most ubiquitous male pheromone in cerambycine species is 3-hydroxyhexan-2-one. We conducted field trials using intercept traps baited with 3-hydroxyhexan-2-one and observed abundant captures of several Neotropical cerambycine species. These were Retrachydes thoracicus thoracicus (Olivier), Megacyllene acuta (Germar), Compsocerus violaceus (White), and Cotyclytus curvatus (Germar) in high numbers, as well as Chydarteres striatus striatus (Fabricius) and Odontocroton flavicauda (Bates) in smaller numbers. When ethanol was added to the traps, a remarkable increase in the attractiveness of 3-hydroxyhexan-2-one was observed for R. thoracicus thoracicus and M. acuta. Adding ethanol also resulted in the capture of Chrysoprasis aurigena (Germar). Finally, incidental catches in pheromone-baited traps of Trachelissa maculicollis (Audinet-Serville), Neoclytus pusillus (Laporte & Gory), Achryson unicolor (Bruch, 1908) and Achryson surinamum (Linnaeus), Megacyllene mellyi (Chevrolat) and Thelgetra adustus (Burmeister) were also observed. Pheromone chemistry has been reported for C. curvatus, M. acuta and N. pusillus, all three producing 3-hydroxyhexan-2-one, and for C. aurigena and A. surinamum, which produce other compounds. Our findings suggest that the captured species probably produce 3-hydroxyhexan-2-one for their pheromone communication system. Alternatively, they might be "eavesdropping" on the pheromones of other cerambycine species. The probable synergistic effect of ethanol is likely explained from its kairomonal role as a volatile cue for plant stress or ripeness.

Pheromone Chemistry of the Citrus Borer, Diploschema rotundicolle (Coleoptera: Cerambycidae).

The citrus borer, Diploschema rotundicolle, is a Neotropical longhorn beetle that has become a serious citrus pest in southern South America. Management strategies for this insect rely on trimming off damaged shoots, which is expensive and inefficient. We studied the chemical communication system in D. rotundicolle in search of attractants for monitoring or control. GC-MS and enantioselective GC analyses of volatile extracts from field-collected adults showed that males produce (R)-3-hydroxy-2-hexanone, irregularly accompanied by minor amounts of 2,3-hexanediol (all four stereoisomers) and 2,3-hexanedione. Males emit the compounds only at night, when the adults are active. GC-EAD analyses of natural and synthetic compounds showed that both male and female antennae respond to the natural enantiomer (R)-3-hydroxy-2-hexanone, suggesting that it may function as an aggregation-sex pheromone as seen in many cerambycines. The non-natural (S) enantiomer as well as the minor component 2,3-hexanediol did not trigger antennal responses. Field tests with the racemic 3-hydroxy-2-hexanone, enantiomerically pure (R)-3-hydroxy-2-hexanone, as well as a mixture of racemic 3-hydroxy-2-hexanone and 2,3-hexanediol, showed in all cases low capture levels of D. rotundicolle. However, increasing the elevation of the trap and the emission rate of dispensers enhanced field captures in traps baited with racemic hydroxyketone. Incidental catches of another native cerambycine, Retrachydes thoracicus, in traps baited with 3-hydroxy-2-hexanone are also reported. This is the first report of pheromone chemistry in the genus Diploschema and in the tribe Torneutini, reaffirming the pheromone parsimony well established for the Cerambycinae. Potential factors explaining the weak attraction of D. rotundicolle in the field are discussed.

Phenolic Fingerprinting, Antioxidant, and Deterrent Potentials of Persicaria maculosa Extracts.

Persicaria maculosa (Polygonaceae) (known as lady's thumb) is an annual morphologically variable weed that is widely distributed in Chile. The purpose of this study was to investigate the antifeedant potential of methanolic (MeOH), ethanolic (EtOH), and dichloromethane (DCM) extracts from the aerial parts of this plant collected in the Valparaíso and Curicó provinces (Chile) and relate this activity to the antioxidant capacity and the presence of phenolic compounds in the extracts. A phenolic profile based on HPLC-ESI-MS/MS allowed the identification of 26 phenolic compounds, most of them glycosyl derivatives of isorhamnetin, quercetin, and kaempferol. In addition, the total phenolic content (TP), total flavonoids (TF), and antioxidant activity measured by 2,2-diphenyl-1-picrylhydrazyl (DPPH), superoxide anion scavenging (O2-), ferric-reducing antioxidant power (FRAP), and cupric-reducing antioxidant capacity (CUPRAC) of the extracts are reported. The antifeedant potentials of the plant extracts were tested against Epilachna paenulata, Pseudaletia adultera, Macrosiphum euphorbiae, and Diaphorina citri insects for the first time. The activity against the aphid M. euphorbiae was significant for the DCM extracts of plants from Valparaíso and Curicó (settling % = 23% ± 4% and 23% ± 5%, respectively). The antifeedant activities against the beetle E. paenulata and the lepidoptera P. adultera were significant for Valparaíso extracts, especially when tested against E. Paenulata (IFP = 1.0 ± 0.0). Finally, the MeOH and EtOH extracts from Valparaíso plants reduced the diet consumption of the psilid D. citri (p < 0.05). The results showed that P. maculosa is a good source of flavonoids with some antioxidant capacities and has potential interest as botanical eco-friendly alternative with deterrent activity.

Grado de concordancia interevaluador de la escala «Nursing Activities Score» en cuidados intensivos / Inter-rater concordance of the «Nursing Activities Score» in intensive care

OBJETIVO: Determinar la concordancia entre evaluadores de la escala «Nursing Activities Score». MÉTODO: Estudio descriptivo transversal realizado desde diciembre del 2012 a junio del 2013, en una unidad de cuidados intensivos polivalente de 12 camas. Tres enfermeras evaluadoras con diferentes años de experiencia profesional, de manera simultánea e independiente puntuaron, a través de la gráfica diaria del paciente, el trabajo enfermero utilizando la «Nursing Activities Score» en todos los pacientes ingresados mayores de 18 años. RESULTADOS: Se recogieron un total de 339 registros. El coeficiente de correlación intraclase (CCI) entre los evaluadores fue del 0,92 (0,89-0,94). El 39,1% de los ítems tuvo una concordancia perfecta, el 52,2% alta y el 8,7% baja, correspondiendo a 2 de los ítems con varias opciones de puntuación. Se encontraron diferencias significativas de la puntuación obtenida en 2 de los evaluadores (p = 0,049). CONCLUSIONES: A pesar de que la concordancia interevaluadores de la escala es alta, serían necesarios unos registros enfermeros más precisos para reducir la variabilidad de los ítems con varias opciones de puntuación, y permitir una mayor precisión en la interpretación y medición de los datos sobre la carga de trabajo enfermera

OBJECTIVE: To evaluate inter-rater concordance in the valuation of the «Nursing Activities Score». METHOD: Cross-sectional descriptive study conducted from December 2012 until June 2013 in a general intensive care unit with twelve beds. Three evaluator nurses, simultaneously and independently, through the patient daily charts, scored the nursing workload using Nursing Activities Score scale in all patients admitted over 18 years old. RESULTS: Three hundreds and thirty-nine records were collected. The intra-class correlation coefficient (ICC) between evaluators was 0.92 (0.89-0.94). A perfect concordance was obtained in 39.1% of the items, with 52.2% having a high, and 8.7% having lower concordance, corresponding to two of the items with multiple scoring options. Significant differences between two of the evaluators (P=.049) were found. CONCLUSIONS: Although the inter-rater concordance was high, more accurate records are needed to reduce the variability of the items with multiple options and to allow more accuracy in the interpretation and measurement of the data regarding nursing workload

[Inter-rater concordance of the "Nursing Activities Score" in intensive care]. / Grado de concordancia interevaluador de la escala "Nursing Activities Score" en cuidados intensivos.

OBJECTIVE: To evaluate inter-rater concordance in the valuation of the "Nursing Activities Score". METHOD: Cross-sectional descriptive study conducted from December 2012 until June 2013 in a general intensive care unit with twelve beds. Three evaluator nurses, simultaneously and independently, through the patient daily charts, scored the nursing workload using Nursing Activities Score scale in all patients admitted over 18 years old. RESULTS: Three hundreds and thirty-nine records were collected. The intra-class correlation coefficient (ICC) between evaluators was 0.92 (0.89-0.94). A perfect concordance was obtained in 39.1% of the items, with 52.2% having a high, and 8.7% having lower concordance, corresponding to two of the items with multiple scoring options. Significant differences between two of the evaluators (P=.049) were found. CONCLUSIONS: Although the inter-rater concordance was high, more accurate records are needed to reduce the variability of the items with multiple options and to allow more accuracy in the interpretation and measurement of the data regarding nursing workload.

Disnea y psicopatología en el paciente anciano con enfermedad pulmonar obstructiva crónica / Dyspnoea and psychopathology in the elderly patient with chronic obstructive pulmonary disease

La enfermedad pulmonar obstructiva crónica (EPOC) es una enfermedad progresiva cuyo síntoma principal es la percepción de disnea. En fases avanzadas, esta puede constituir un factor de riesgo de depresión, ansiedad y trastorno por somatización, sobre todo en pacientes mayores. Objetivo. Evaluar la presencia de estas psicopatologías en función de la disnea y del grado de severidad de la enfermedad en pacientes ancianos con EPOC. Materiales y método. Los pacientes (n=51) con una media de edad de fueron evaluados mediante el Hospital Anxiety and Depression Scale, la escala de disnea, el cuestionario de Salud de Goldberg y la espirometría. Resultados. A medida que aumenta el nivel de disnea y avanza la enfermedad, los pacientes presentan progresivamente síntomas ansioso-depresivos y somáticos de mayor relevancia clínica (p<0,05). Aparecen correlaciones significativas entre todos estos parámetros (p<0,05). Conclusiones. La detección y tratamiento precoz de psicopatologías asociadas a la disnea y evolución de la enfermedad debe tenerse en cuenta a la hora de abordar esta compleja patología(AU)

Chronic Obstructive Pulmonary Disease (COPD) is a progressive disease with dyspnoea perception as a main symptom. In severe stages, dyspnoea can constitute a risk factor for depression, anxiety and somatization disorders. Objective. The objective was to evaluate the presence of these psychopathologies based on dyspnoea and severity stages in patients with COPD. Materials and methods. Patients (n=51) were evaluated by means of the Hospital Anxiety and Depression Scale, the dyspnoea scale (MRC), the General Health Questionnaire (GHQ-28) and spirometric criteria. Results. The increase in dyspnoea level and disease severity lead to a progressive worsening of anxiety, depressive and somatic symptoms with clinical relevance (P<0.05). There was a significant correlation between those parameters (P<0.05). Conclusions. The early detection and treatment of these psychopathologies associated with dyspnoea and progression of the disease must be taken into account in this complex pathology(AU)

[Dyspnoea and psychopathology in the elderly patient with chronic obstructive pulmonary disease]. / Disnea y psicopatología en el paciente anciano con enfermedad pulmonar obstructiva crónica.

UNLABELLED: Chronic Obstructive Pulmonary Disease (COPD) is a progressive disease with dyspnoea perception as a main symptom. In severe stages, dyspnoea can constitute a risk factor for depression, anxiety and somatization disorders. OBJECTIVE: The objective was to evaluate the presence of these psychopathologies based on dyspnoea and severity stages in patients with COPD. MATERIALS AND METHODS: Patients (n = 51) were evaluated by means of the Hospital Anxiety and Depression Scale, the dyspnoea scale (MRC), the General Health Questionnaire (GHQ-28) and spirometric criteria. RESULTS: The increase in dyspnoea level and disease severity lead to a progressive worsening of anxiety, depressive and somatic symptoms with clinical relevance (P < 0.05). There was a significant correlation between those parameters (P < 0.05). CONCLUSIONS: The early detection and treatment of these psychopathologies associated with dyspnoea and progression of the disease must be taken into account in this complex pathology.

[Spanish validation of the Epidemiology of Prolapse and Incontinence Questionnaire-EPIQ]. / Validación de la versión en español del cuestionario "Epidemiology of Prolapse and Incontinence Questionnaire-EPIQ".

INTRODUCTION: One out of three women suffers from pelvic floor disorders. Thus, an instrument to evaluate this pathology in common clinical practice would be very useful. In this study the psychometric characteristics of the Spanish version of the US questionnaire "Epidemiology of Prolapse and Incontinence Questionnaire-EPIQ" have been evaluated, in order to test its equivalence to the original and allow for its use in Spain. MATERIAL AND METHODS: 60 women with pelvic floor pathology and 60 control women filled in the Spanish version of the EPIQ. The questionnaire was validated following the statistical procedure used in the validation of the original form. RESULTS: Factibility: 113 women filled in all questionnaire items and 7 leaved some of them blank. VALIDITY: 7 dimensions were indentified: quality of life (QoL), overactive bladder (OAB), anal incontinence (AI), micturition difficulty/pain (MD/P), functional defecation disorders (FDD), stress urinary incontinence (SUI), and pelvic organ prolapse (POP). The validity of contents was proved comparing the mean scores for each dimension in patients and control (T-student test). Positive and negative predictive values were POP=92.3% and 82.52%; SUI= 54.34% and 84.93%; OAB=60.6% and 84.52% and AI=24.32% and 92.68%. Reliability: Global Cronbach's-alfa was 0.94 and for the different dimensions: 0.96 (QoL); 0.91 (OAB); 0.63 (AI); 0.72 (MD/P); 0.75 (FDD) and 0.61 (SUI). DISCUSSION: The Spanish version of the EPIQ questionnaire presents adequate factibility, validity and reliability to evaluate pelvic floor pathology in clinical practice.

Validación de la versión en español del cuestionario “Epidemiology of Prolapse and Incontinence Questionnaire-EPIQ” / Spanish validation of the Epidemiology of Prolapse and Incontinence Questionnaire-EPIQ

Introducción: La patología de suelo pélvico afecta a un tercio de la población femenina adulta, por lo que un instrumento para su cribado en práctica clínica habitual sería de gran utilidad. En este estudio se evaluaron las propiedades psicométricas de la versión española del cuestionario estadounidense “Epidemiology of Prolapse and Incontinence Questionnaire-EPIQ” para comprobar su equivalencia al original y poder recomendar su uso en España. Material y métodos: En el estudio se incluyeron 60 mujeres con problemas de suelo pélvico y 60 pacientes control que respondieron a la versión española del EPIQ. Para validar formalmente el cuestionario se replicó el análisis estadístico utilizado en la validación del original. Resultados: Factibilidad: 113 mujeres respondieron a todos los ítems del cuestionario y 7 dejaron algún ítem sin contestar. Validez: las dimensiones identificadas fueron: calidad de vida (CV), vejiga hiperactiva (VH), incontinencia anal (IA), dolor y dificultad de vaciado (DDV), disfunción defecatoria (DD), incontinencia urinaria de esfuerzo (IUE) y prolapso pélvico (POP).Se comprobó la validez de contenido comparando las puntuaciones medias de las siete dimensiones entre el grupo de pacientes y el control (prueba T de Student). Los valores predictivos positivos y negativos del cuestionario fueron: POP=92,3% y 82,52%; IUE= 54,34% y 84,93%; VH=60,6% y 84,52% y IA=24,32% y 92,68%. Fiabilidad: el coeficiente alfa de Cronbach global fue 0,94 y para las distintas dimensiones: 0,96 (CV); 0,91 (VH); 0,63 (IA); 0,72 (DDV); 0,75 (DD) y 0,61(IUE). Discusión: La versión española del cuestionario EPIQ muestra adecuadas factibilidad, validez y fiabilidad para ser utilizado en la práctica clínica como instrumento de cribado de la patología de suelo pélvico (AU)

Introduction: One out of three women suffers from pelvic floor disorders. Thus, an instrument to evaluate this pathology in common clinical practice would be very useful. In this study the psychometric characteristics of the Spanish version of the US questionnaire “Epidemiology of Prolapse and Incontinence Questionnaire-EPIQ” have been evaluated, in order to test its equivalence to the original and allow for its use in Spain. Material and Methods: 60 women with pelvic floor pathology and 60 control women filled in the Spanish version of the EPIQ. The questionnaire was validated following the statistical procedure used in the validation of the original form. Results: Factibility: 113 women filled in all questionnaire items and 7 leaved some of them blank. Validity: 7 dimensions were indentified: quality of life (QoL), overactive bladder (OAB), anal incontinence (AI), micturition difficulty/pain (MD/P),functional defecation disorders (FDD), stress urinary incontinence (SUI), and pelvic organ prolapse (POP). The validity of contents was proved comparing the mean scores for each dimension in patients and control (T-student test). Positive and negative predictive values were POP=92,3% and 82,52%; SUI= 54,34% and 84,93%; OAB=60,6% and 84,52% and AI=24,32% and 92,68%. Reliability: Global Cronbach´s-alfa was 0,94 and for the different dimensions: 0,96 (QoL); 0,91(OAB); 0,63 (AI); 0,72 (MD/P); 0,75 (FDD) y 0,61 (SUI).Discussion: The Spanish version of the EPIQ questionnaire presents adequate factibility, validity and reliability to evaluate pelvic floor pathology in clinical practice (AU)

[Stress in elderly hospitalized patients with chronic respiratory disease: assessment in a public geriatric hospital]. / Estrés en ancianos hospitalizados con enfermedad respiratoria crónica: valoración en el hospital sociosanitario.

INTRODUCTION: Studies of stress during hospitalization have mainly focused on patients admitted for acute problems. However, stress and its relationship with health-related quality of life (HRQOL) has yet to be described in chronic and elderly patients. The objective of this paper is to study the presence of stress and coping strategies in patients with chronic obstructive pulmonary disease (COPD) in a public geriatric hospital and its relationship with HRQL prior to admission, COPD severity, and dyspnea stage. MATERIAL AND METHODS: Fifty-one patients with a diagnosis of COPD were evaluated in the Joan March Hospital (Balearic Islands, Spain) by means of the Hospital Stress Rating Scale, the Dyspnea Scale, the Nottingham Health Profile, and a list of coping strategies. RESULTS: Low stress levels were found in elderly hospitalized COPD patients. Stress levels were independent of the COPD severity stage. Patients with mild dyspnea had higher stress levels than those with the most severe dyspnea (p<0.05). Patients with poor HRQOL before admission had higher stress levels during hospitalization (p<0.05). The most prevalent coping strategies in these hospitalized patients were related to avoidance. CONCLUSIONS: The stress generated during hospitalization in elderly COPD patients was related to prior psychosocial conditions (HRQOL) and had a greater effect on patients with greater functional independence.

Estrés en ancianos hospitalizados con enfermedad respiratoria crónica: valoración en el hospital sociosanitario / Stress in elderly hospitalized patients with chronic respiratory disease: assessment in a public geriatric hospital

Introducción: El estudio del estrés durante la hospitalización se ha centrado principalmente en los pacientes que ingresan en hospitales de agudos sin que se haya descrito el mismo fenómeno en pacientes crónicos que ingresan en centros sociosanitarios ni se haya relacionado con factores psicosociales, como la calidad de vida relacionada con la salud (CVRS). El objetivo de este estudio es estudiar la presencia de estrés y las estrategias de afrontamiento en pacientes con enfermedad pulmonar obstructiva crónica (EPOC) en el hospital sociosanitario y su relación con la calidad de vida antes del ingreso, el grado de gravedad y el grado de disnea. Material y método: Se evaluó a 51 pacientes con EPOC en el hospital Joan March (Islas Baleares) mediante la escala de estresores hospitalarios, la escala de disnea del Medical Research Council, el perfil de salud de Nottingham y un listado de estrategias de afrontamiento. Resultados: Se han detectado bajos grados de estrés en los pacientes mayores con EPOC hospitalizados en el centro sociosanitario. El grado de estrés no varía en función del grado de gravedad de la EPOC (p>0,05). Los pacientes con disnea leve presentaron más estrés (p<0,05) y los pacientes con una mala calidad de vida antes del ingreso mostraron mayores grados de estrés (p<0,05). Las estrategias de afrontamiento basadas en la evitación son las más prevalentes en el adulto mayor hospitalizado. Conclusiones: El estrés generado en el anciano con EPOC durante la hospitalización se relaciona más con las condiciones psicosociales previas, como la CVRS, y afecta más a los pacientes con mayor independencia funcional (AU)

Introduction: Studies of stress during hospitalization have mainly focused on patients admitted for acute problems. However, stress and its relationship with health-related quality of life (HRQOL) has yet to be described in chronic and elderly patients. The objective of this paper is to study the presence of stress and coping strategies in patients with chronic obstructive pulmonary disease (COPD) in a public geriatric hospital and its relationship with HRQL prior to admission, COPD severity, and dyspnea stage. Material and Methods: Fifty-one patients with a diagnosis of COPD were evaluated in the Joan March Hospital (Balearic Islands, Spain) by means of the Hospital Stress Rating Scale, the Dyspnea Scale, the Nottingham Health Profile, and a list of coping strategies. Results: Low stress levels were found in elderly hospitalized COPD patients. Stress levels were independent of the COPD severity stage. Patients with mild dyspnea had higher stress levels than those with the most severe dyspnea (p<0.05). Patients with poor HRQOL before admission had higher stress levels during hospitalization (p<0.05). The most prevalent coping strategies in these hospitalized patients were related to avoidance. Conclusions: The stress generated during hospitalization in elderly COPD patients was related to prior psychosocial conditions (HRQOL) and had a greater effect on patients with greater functional independence (AU)

Alteration of medial-edge epithelium cell adhesion in two Tgf-beta3 null mouse strains.

Although palatal shelf adhesion is a crucial event during palate development, little work has been carried out to determine which molecules are responsible for this process. Furthermore, whether altered palatal shelf adhesion causes the cleft palate presented by Tgf-beta3 null mutant mice has not yet been clarified. Here, we study the presence/distribution of some extracellular matrix and cell adhesion molecules at the time of the contact of palatal shelves in both wild-type and Tgf-beta3 null mutant palates of two strains of mice (C57/BL/6J (C57), and MF1) that develop cleft palates of different severity. We have performed immunohistochemistry with antibodies against collagens IV and IX, laminin, fibronectin, the alpha5- and beta1-integrins, and ICAM-1; in situ hybridization with a Nectin-1 riboprobe; and palatal shelf cultures treated or untreated with TGF-beta3 or neutralizing antibodies against fibronectin or the alpha5-integrin. Our results show the location of these molecules in the wild-type mouse medial edge epithelium (MEE) of both strains at the time of the contact of palatal shelves; the heavier (C57) and milder (MF1) alteration of their presence in the Tgf-beta3 null mutants; the importance of TGF-beta3 to restore their normal pattern of expression; and the crucial role of fibronectin and the alpha5-integrin in palatal shelf adhesion. We thus provide insight into the molecular bases of this important process and the cleft palate presented by Tgf-beta3 null mutant mice.

In vitro manipulation of cleft palate connective tissue: setting the bases of a proposed new treatment.

BACKGROUND: Palatoplasty has the undesired side effect of impaired mid-facial growth. To avoid this problem, we propose an alternative to palatoplasty. We hypothesize that if BMP-2 is injected together with a carrier into the periosteum of the cleft palate borders, border volume will increase and connective tissue cells will be activated to produce extra bone. Once these borders supported by bone reach the midline, extraction of their covering epithelia with trypsin will permit adhesion of the underlying tissues. We investigated in vitro the ability of cleft palate connective tissue cells to produce extra bone in the presence of BMP-2 and the possibility of using trypsin to remove the epithelium covering the cleft palate borders without impairing the underlying tissues' ability to adhere. MATERIALS AND METHODS: We used the cleft palate presented by tgf-beta(3) null mice and small fragments of human cleft palate mucoperiosteum as models. Immunolabeling BMP-2-treated or untreated cultures with TUNEL and anti-osteocalcin or PCNA antibodies was performed. The epithelium of the cleft palate borders was removed with a trypsin solution, and the de-epithelialized tissues were cultured in apposition. RESULTS: BMP-2 induces differentiation toward bone on cleft palate connective tissue cells without producing cell death or proliferation. Trypsin removal of the cleft palate margins' epithelium does not impair the underlying tissues' adhesion. CONCLUSION: It is possible to generate extra bone at the cleft palate margins and to chemically eliminate their covering epithelia without damaging the underlying tissues, which allows further investigation in vivo of this new approach for cleft palate closure.

Pharmacotherapy for stress urinary incontinence.

PURPOSE OF REVIEW: In the absence of an effective and well tolerated drug for stress urinary incontinence, pharmacological therapy for this condition has remained in the off-label prescription of some products particularly estrogens and alpha-adrenergic agonists. In this review we provide an update of the most recent developments on the pharmacological therapy for stress urinary incontinence. RECENT FINDINGS: In recent years studies have uncovered a role for central neurotransmitters in control of the lower urinary tract and specific targets for pharmacological intervention have been identified. Duloxetine inhibits presynaptic neuron reuptake of serotonin and norepinephrine, in the sacral spinal cord, increasing urethral closure forces and thereby reducing episodes of stress urinary incontinence. In clinical trials in women with stress urinary incontinence, duloxetine has demonstrated efficacy in reducing incontinence episodes and increasing quality of life with no serious adverse effects. Nausea was the most common adverse event, being reported as mild-to moderate in severity and transient in most of patients. SUMMARY: Although estrogens produce some effects on the urethral epithelium and may be useful in patients with atrophic vaginitis, at present, there is no good evidence supporting its use in women with stress urinary incontinence. Alpha-adrenoreceptor agonists have been found to be effective in stress urinary incontinence, but the use of these drugs is limited due to some major safety concerns related to cardiovascular side effects. Duloxetine is a new selective norepinephrine and serotonin reuptake inhibitor that has proven efficacy for the treatment of stress urinary incontinence in women.