Percutaneous electrical stimulation for overactive bladder in children: a pilot study.

PURPOSE: The purpose of this was to evaluate the efficacy (tolerance and safety) of once-a-week parasacral percutaneous electrical nerve stimulation (PENS) to treat overactive bladder (OAB) in children. MATERIALS AND METHODS: This is a prospective case series of children aged 4-14 years who underwent PENS for OAB. Acupuncture needles were used bilaterally and symmetrically at S3 for sacral nerve stimulation (Figure). Eighteen children with pure OAB underwent PENS weekly for 20 weeks. Frequency was 10 Hz. Intensity varied up to a maximum of 10 mA, as tolerated by the participant, but without reaching the motor threshold. Pulse width was 600 µs Patients' voiding history was assessed before treatment using a structured questionnaire. The dysfunctional voiding scoring system (DVSS) was used before and after treatment to quantify symptoms of lower urinary tract dysfunction. A visual analog scale (VAS) was used to evaluate treatment outcome. RESULTS: Seven boys and eleven girls (mean age, 7.82 ± 2.45 years) were included. According to the VAS, symptoms were resolved in 66% of patients. Urinary urgency, present in all children at baseline, was resolved in 84% (P = 0.001). The proportion of patients with involuntary loss of urine without urgency decreased from 77% before treatment to 27% (P = 0.04). Urge incontinence resolved in 13 of 16 patients after treatment (P = 0.001). Only one of the 12 children with frequent urination at baseline reported this complaint after treatment (P = 0.04). All cases of recurrent urinary tract infection were resolved (P = 0.001). Regarding nocturnal enuresis, treatment was successful in 9 of 14 children (P = 0.004). DISCUSSION: The theory behind this new method is that when skin impedance is overcome through the use of acupuncture needles and greater proximity is attained between the tip of the electrode and the sacral nerves, a more effective stimulus is achieved, with enough energy to provide the same benefits as parasacral transcutaneous electrical nerve stimulation with the advantage that treatment can be given only once a week. CONCLUSIONS: Percutaneous electrical nerve stimulation seems to be an effective and safe treatment for OAB over the short term. Furthers studies with a control group are needed.

Degradabilidade ruminal in situ de vagens de faveira (Parkia platycephala Benth.) em diferentes tamanhos de partículas / In situ ruminal degradability of faveira (Parkia platycephala Benth.) pods in different particle sizes

Estimaram-se os parâmetros de degradação ruminal da matéria seca (MS) e da proteína bruta (PB) de vagens de faveira, trituradas em partículas de 2 e 5mm, pelo método do saco de náilon in situ em ovinos, nos tempos de incubação 3, 6, 12, 24, 48, 72 e 96 horas, e determinou-se a degradabilidade efetiva, considerando-se taxas de passagem 2, 5 e 8 por cento/h. A fração a da MS e da PB foram 69,6 e 49,9 por cento, respectivamente, revelando elevada solubilidade da MS; a fração b para MS e PB foi 24,7 e 43,9 por cento, indicando baixa degradação da MS in situ, com estabilização da degradação da MS às 72h e da PB às 48h de incubação. O tanino de vagens de faveira não se mostrou depressor da degradabilidade in situ da PB

Soluble (a) and potentially degradable (b) fractions and degradation rate of b fraction (c) of dry matter (DM) and crude protein (CP) of Parkia platycephala pods in particle sizes 2 and 5mm were estimated by in situ nylon bag method in sheep. The times of incubation were 3, 6, 12, 24, 48, 72 and 96 hours, and the effective degradability (ED) was determined considering passage rates of 2, 5 and 8 percent/h. The a fractions for DM and CP was 69.6 and 49.9 percent, respectively, revealing elevated DM solubility: The b fractions for DM and CP was 24.7 and 43.9 percent, denoting reduced DM in situ degradation. The stabilization of the DM and CP degradation occurred at 72h and 48h after incubation, respectively. In situ degradability of constituents of P. platycephala pods, in special CP, were not depressed for their tannin contents

Body size, diet and endoparasites of the microhylid frog Chiasmocleis capixaba in an Atlantic Forest area of southern Bahia state, Brazil.

We analyzed the diet composition, endoparasites and sexual size dimorphism of the microhylid frog Chiasmocleis capixaba (Microhylidae) from a "mussununga" habitat in the municipality of Nova Viçosa, southern Bahia state, Brazil. All the 119 specimens analyzed were collected in a single night of heavy rainfall. Females (mean snout-vent length = 15.7 + 3.0 mm) were significantly larger than males (mean snout-vent length = 13.2 + 2.1 mm), and specimens of both sexes were smaller than those of a conspecific population previously reported in Aracruz, state of Espírito Santo state. The diet of C. capixaba was dominated by mites, ants and collembolans. Seventy-nine frogs (66.4% of the total) were infected by helminths, all belonging to a single species, Cosmocerca ornata, an intestinal nematode parasite.

Body size, diet and endoparasites of the microhylid frog Chiasmocleis capixaba in an Atlantic Forest area of southern Bahia state, Brazil

Analisamos a composição da dieta, endoparasitas e dimorfismo sexual em tamanho no anuro Chiasmocleis capixaba (Microhylidae) em um habitat de "mussununga" no município de Nova Viçosa, no sul do Estado da Bahia, Brasil. Todos os 119 espécimes analisados foram coletados em uma única noite com chuva intensa. As fêmeas (comprimento rostro-cloacal médio = 15,7 + 3,0 mm) foram significativamente maiores que os machos (comprimento rostro-anal médio = 13,2 + 2,1 mm), e indivíduos de ambos sexos foram menores do que os de uma população coespecífica de Aracruz, no Estado do Espírito Santo. A dieta de C. capixaba estava dominada por ácaros, formigas e colêmbolos. Setenta e nove indivíduos (66.4% do total) estavam infectados por helmintos, todos pertencentes a uma única espécie, Cosmocerca ornata, um nematódeo intestinal.

[Unstable angina: comparison of the effects of diltiazem and propranolol]. / Angina instável: efeito comparativo entre diltiazem e propranolol.

PURPOSE: To evaluate the effects of diltiazem and propranolol in patients with unstable angina. METHODS: Fifty-six patients with unstable angina, mean age of 55.4 +/- 8.5, 41 men and 15 women, were evaluated in a randomized, double-blind study of two groups of patients treated with diltiazem or propranolol at total daily doses of 180 mg and 120 mg respectively during the first 48 hours. After that the total daily doses was adjusted to 240 mg and 160 mg, respectively, until the 7th day. The first 48 hours, four times daily, clinical evaluation, CKMB data, ECG were obtained and two times daily until 7th day. A coronary arteriography was done on study entry. RESULTS: A significative reduction of angina crisis number, duration, intensity and the number of sublingual nitrates doses were observed equally in both groups. The SAP, DAP, HR and RR did not show statistical differences between groups. Individual groups analysis showed significative reductions of SAP, DAP and HR in propranolol group. The CKMB data, ECG alterations and coronary arteriography characteristics were similar. CONCLUSION: Both drugs were effective for the unstable angina treatment.