The objectives of this study were to verify the occurrence of urinary incontinence (UI) and its characteristics in pre-frail and frail elderly patients of a geriatrics outpatient clinic, compare the presence of frailness criteria among the elderly with and without UI and identify among the frailty criteria the chance of risk for UI among those elderly outpatients. Participants were 100 elderly individuals, with an average age of 76.2 years; 65 participants reported UI, 71.3% of which presented three or more frailness criteria. The occurrence of UI was greater in frail participants (p=0.0011). Multivariate analysis showed that the criteria slowness (OR=4.99) and exhaustion (OR=4.85) has a statistically significant relation with UI. The occurrence of UI was high and participants who presented slowness have a risk almost five times greater to presenting UI while those reporting exhaustion have a risk five times greater for UI compared to those without these criteria.
RESUMOIntrodução: Em 2011, foi introduzido um novo rastreio para a diabetes gestacional que permitiu um diagnóstico mais precoce e de maior número de casos com o intuito de reduzir complicações maternas e perinatais. O objectivo deste estudo foi avaliar a prevalência da diabetes gestacional, comparar resultados obstétricos e perinatais do anterior e presente rastreio e os resultados e realização da prova de reclassificação pós-parto. Material e Métodos: Estudo retrospectivo em gestações simples e diabetes gestacional diagnosticados em 2009 (n = 223) e 2012 (n = 237), vigiadas na Maternidade Dr. Alfredo da Costa, Portugal. Após consulta de processos clínicos procedeu-se à análise de características demográficas, história médica e obstétrica, aumento ponderal durante a gravidez, idade gestacional do diagnóstico, terapêutica utilizada, resultados perinatais e reclassificação pós-parto, seguida de comparação destas variáveis entre os anos de 2009 e 2012. Resultados: Em 2012, houve maior prevalência de diabetes gestacional, ganho ponderal inferior (p < 0,001), maior recurso à terapêutica farmacológica (p < 0,001) e aumento dos casos diagnosticados no primeiro e segundo trimestres (p < 0,001). Relativamente aos resultados neonatais, o peso médio do recém-nascido ao nascer foi significativamente menor (p = 0,001) com diminuição dos recém-nascidos grandes para a idade gestacional (p = 0,002). A taxa de reclassificação pós-parto foi semelhante nos dois anos mas em 2012 houve um aumento dos resultados normais e diminuição das anomalias da glicémia em jejum. Discussão: Critérios mais apertados do actual rastreio permitiram a redução da maioria das complicações da diabetes gestacional levantando novas questões. Conclusão: A introdução do actual rastreio resultou num aumento de prevalência, diagnóstico mais precoce e redução da macrossomia. Palavras-chave: Diabetes Gestacional; Rastreio. Results: In 2012, there was an increased gestational diabetes prevalence, lower weight gain during pregnancy (p < 0.001), more frequent use of pharmacological therapy (p < 0.001) and more diagnosed cases during first and second trimester (p < 0.001). As for neonatal outcomes, in this group, the medium weight at birth was significantly lower (p = 0.001) with a decrease of newborns great for gestational age (p = 0.002). Postpartum screening rate was similar among both groups but in 2012 there was an increase of normal results and a decrease of impaired fasting glucose. Discussion: Tighter criteria of the current screening test resulted in reduction of the majority of gestational diabetes complications but raised new questions. Conclusion:The introduction of the current screening test resulted in an increased prevalence, earlier diagnosis and reduction of macrosomia. Keywords: Gestational Diabetes; Mass Screening. INTRODUÇÃOA diabetes gestacional (DG) é uma das complicações médicas mais frequentes da gravidez, cuja incidência tem vindo a crescer nos últimos anos. Definida como uma intolerância aos hidratos de carbono de intensidade variável que...
The WHO says that annual cases of cancer will increase from 14 million in 2012 to 22 million in the next two decades. Cancer is the second cause of death in the world; in 2015, it caused 8.8 million deaths. On the other hand, it is necessary to consider that 70% of the total deaths due to this disease occur in developing countries, who have the least resources to acquire the drugs of choice for the treatment of this disease. Although there are treatments and these are effective, there are currently cases of resistance to drugs used to treat this disease, which has led to the search for new sources of drugs or compounds effective against the cancer being active; plants are the possible sources to achieve this. Cucurbitaceae is a family of plants widely distributed on the planet which has been used traditionally for the treatment of this disease and from they have been isolated different cucurbitanes. These compounds possess a wide biological activity, antidiabetic, anti-inflammatory, hepatoprotective, or cytotoxic and antitumoral effects. The aim of this review is to present 51 cucurbitacin compounds and 2 with different structures isolated from Cucurbitaceae plants with cytotoxic or antitumoral activity.
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