Quantification of Vitamin D at Different Levels of Clinical Worsening of COVID-19.

INTRODUCTION AND AIM: Vitamin D is the name given to a group of lipid-soluble steroidal substances of physiological importance in the body, especially in bone metabolism. The active form of vitamin D is believed to have immunomodulatory effects on immune system cells, especially T lymphocytes, as well as on the production and action of several cytokines and on the expression of potent antimicrobial peptides in epithelial cells that line the respiratory tract, playing an important role in protecting the lung from infections. The aim of this study was to assess vitamin D levels in patients with COVID-19 in healthcare service and to verify that these levels are adequate to protect the progression of this infection. METHODS: The aim of this observational study was to evaluate the serum concentration of vitamin D in 300 patients suspected of being infected with COVID-19, treated at Basic Health Units (BHUs) and at the Hospital Complex in the municipality of São Bernardo do Campo. RESULTS: 294 patients were included, 195 (66%) of which tested positive for COVID-19 and 99 (34%) negative for COVID-19. Among the patients in the positive group, 163 patients were in the mild group (84%); 22 patients in the moderate group (11%); 8 patients in the severe group (4%), and 2 patients in the deceased group (1%). CONCLUSION: For the patients in this study, no association was observed for the protective factor of vitamin D against COVID-19 infection, and its role in controlling the clinical staging of the disease was not verified.

The prevalence of fecal incontinence and associated risk factors in older adults participating in the SABE study.

AIMS: To assess the prevalence of fecal incontinence (FI) and associated factors in older adults. METHODS: The prevalence and factors associated with FI in older adults were studied by means the SABE study (Health, Well-being, and Aging). A group of 1,345 subjects were interviewed during the third wave of the SABE study performed in Sao Paulo, in 2010. The study included 64.3% females; the mean age of the participants was 70.4 years. The dependent variable was the positive answer for the question "In the last 12 months, have you ever lost control of bowel movements or stools?". Descriptive analysis and hierarchical logistic regression were performed. The independent variables were as follows: (a) demographics: gender, age and (b) clinical characteristics: self-reported chronic diseases, presence of cognitive and/or functional decline, depression and urinary incontinence symptoms, and nutritional status. RESULTS: The overall prevalence of FI was 11,7%, being 8.3% and 13.2% for males and females respectively. Among male subjects, the presence of malnutrition was associated with FI and thus presented a high relative risk index for its occurrence. Among female subjects, age group 70-74 years and some self-reported diseases or conditions such as mild depression, heart disease, urinary incontinence, and polypharmacy were associated with FI. For the first time in literature, polypharmacy appeared as an associated factor for FI for female older adults. CONCLUSIONS: The prevalence of FI in older adults was 11.7% and was mainly associated with advanced age and presence of heart disease, symptoms of depression, polypharmacy and urinary incontinence and malnutrition. Neurourol. Urodynam. 35:959-964, 2016. © 2015 Wiley Periodicals, Inc.

Analysis of glycosaminoglycans in the parametrium and vaginal apex of women with and without uterine prolapse.

BACKGROUND: Pelvic organ prolapse (POP) is a downward descent of pelvic organs that results in protrusions of the vagina, the uterus, or both. The cause of this disorder is likely to be multifactorial, attributable to a combination of risk factors, especially connective tissue disorders. Our objective was to characterize and quantify a component of the extracellular matrix (ECM)-sulfated glycosaminoglycan (GAG)-in the parametrium and vaginal apex of women with and without uterine prolapse. METHODS: Parametrium and vaginal apex tissue was obtained from 42 women who underwent surgery. Patients underwent a physical examination and were divided into groups according to the type of genital prolapse. Standard biopsies were taken during surgery and were assessed by biochemical methods. GAGs were obtained by proteolysis. The relative concentration of GAGs was determined by densitometry. Data were compared using an independent sample t-test or chi(2) test. RESULTS: In both groups (with and without prolapse) and in both types of tissue, dermatan sulfate (DS) was the most predominant glycosaminoglycan, followed by chondroitin sulfate (CS) and heparan sulfate (HS). We did not observe significant differences in the total amounts of GAGs, DS, CS, or HS. CONCLUSIONS: This study did not show altered biochemical characteristics in the ECM of parametrium and vaginal apex tissue of women either with or without uterine prolapse.

Distúrbios urinários em mulheres segundo o grau de cistocele e a paridade / Urinary disorders in women according to the grade of cystocele and parity

Os autores avaliam a influência do grau de cistocele e da paridade nas diversas afecçoes uroginecológicas, em mulheres na menacme e na pós-menopausa. Sao analisadas 101 mulheres, sendo 29 na menacme e 72 na pós-menopausa. Concluem que o número de partos vaginais tem associaçao positiva com o diagnóstico de incontinência urinária verdadeira, mas nao com a incontinência urinária nao verdadeira. Quanto à cistocele, observou-se que a distopia nao auxilia no diagnóstico diferencial.

A ultra-sonografia no câncer de endométrio: estudo prospectivo de 17 casos / The ultrasonography in endometrial cancer: prospective study of 17 cases

Estudaram-se, prospectivamente, 17 mulheres do Setor de Oncocirurgia da Disciplina de Ginecologia da Escola Paulista de Medicina, com queixa de sangramento da pós-menopausa. Realizou-se ultra-sonografia transvaginal e biópsia, de endométrio. Confirmou-se o diagnóstico de carcinoma de endométrio em todas as doentes. Em 14 mulheres foi indicada a cirurgia, correlacionando-se os aspectos anatomopatológicos com as imagens ultra-sonográficas. A espessura média do eco endometrial foi de 27,17mm. Na detecçao das lesoes miometriais profundas, a ultra-sonografia transvaginal apresentou sensibilidade de 83,3 por cento e especificidade de 75 por cento, valor preditivo positivo de 71,4 por cento e valor preditivo negativo de 85,7 por cento. A detecçao do grau de invasao miometrial foi adequada em 78,6 por cento das vezes.

Sarcomas do útero: avaliaçäo clínico-cirúrgia / Uterine sarcoma: clinical and surgical evaluation

Os autores avaliaram 25 mulheres com sarcoma do útero, analisando os tipos histológicos, o tratamento e a evoluçao dos casos. Analisaram-se ll casos de leiomiossarcoma, dez de tumor mülieriano misto, dois de sarcoma indiferenciado, um sarcoma botrióide e um rabdomiossarcoma. O tratamento cirúrgico foi o mais utilizado, associando-se à quimioterapia ou à radioterapia. A sobrevida foi de 42,8 por cento para o leiomiossarcoma e de 70 por cento para o tumor mülleriano misto, em 13,3 meses de seguimento.