A disfunção do trato urinário inferior (DTUI) é um quadro comum em crianças, manifestando-se principalmente por incontinência urinária (IU), infecção do trato urinário (ITU), refluxo vesicoureteral (RVU) e constipação. A Sociedade Internacional de Continência (ICS) define a IU como a perda involuntária de urina em maiores ou igual a 5 anos, sendo considerado um sintoma de armazenamento. É uma doença multipatogênica envolvendo o sistema nervoso central, ritmo circadiano (sono/vigília) e alterações funcionais da bexiga. O sexo feminino tem mais propensão a sofrer com IU devido a algumas diferenciações anatômicas em relação ao sexo masculino. Metodologia: Revisão bibliográfica a partir das bases de dados LILACS, MedLine, Scielo e Pubmed, realizada nos meses de julho e agosto de 2018. As palavras-chaves foram urinary incontinency, urology, chil e enuresis e os critérios de inclusão foram idioma espanhol, inglês e português publicados de 2009 a 2018, relacionados com o tema do estudo, e os de exclusão foram artigos anteriores a 2009 e os artigos não relacionados ao tema. Dos 57 artigos selecionados, foram utilizados 17. Discussão: A DTUI pode apresentar-se de diversas formas, com a combinação de múltiplos sinais e sintomas, por vezes acompanhada também de alterações do trato gastrointestinal. Essa apresentação clínica pode alterar de forma importante o convívio social dessas crianças, provocando comorbidades psicológicas, o que afeta diretamente o desenvolvimento desses pacientes. O diagnóstico passa por um olhar atento e uma anamnese adequada, buscando identificar essas alterações miccionais, podendo estar associado a exames complementares. O tratamento deve ser individualizado, iniciando com alterações comportamentais e informações sobre a doença até um tratamento farmacológico quando for adequado. Conclusão: Diante da repercussão clínica e psicológica de tal patologia, faz-se importante um diagnóstico precoce e um tratamento adequado, evitando mais transtornos e melhorando o aspecto social e psicológico do paciente e de seus familiares. Palavras-chave: Trato urinário, Saúde da criança, vesicoureteral, constipação.
Diabetes Mellitus (DM) is a chronic cardio-metabolic disease and plays an important role on cardiovascular outcomes, most importantly when associated with an already established heart disease. Its effects in the body involve both metabolic and structural changes. To avoid such complications, in addition to the strategies already used and known, rises the Empaglifozin, a sodium glucose co-transporter inhibitor 2 (SGLT2). Its benefits and efficacy have been tried and tested in large-scale trials, with multidimensional cardiovascular effects that go beyond the adequate glycemic control. The EMPA-REG Outcome materialize such benefits, especially for people at high cardiovascular risk, when significantly reduced cardiovascular death and death from any cause in this population.
The COVID-19 is pedagogical pandemic. However, the pedagogy is appalling: according to the World Health Organization, every month hundreds of thousands of women seek for health services to take care of incomplete abortions. In Argentina, it is estimated that there are 3.330 women in this situation; 1.522 in Chile; 7.778 in Colombia and 18.285 in Mexico. For each woman who is admitted at a hospital for an incomplete abortion, the same individual may use the services twice: first, for
Background: Heart failure (HF) is a chronic and incapacitant disease with bad prognosis, and it is commonly related to psychosocial comorbidities that difficult treatment adhesion. The prevalence of depression in HF varies from 20 to 40%, occurring 3 to 5 times more frequently in patients with HF than general population. The coexistence of depressive symptoms depreciates heart condition in patients with HF: depressive symptoms predict mortality, re-hospitalization, and an augment of symptoms in those patients. Aiming to clarify certain aspects of this comorbidity, it was performed a systematic review using Scopus and MEDLINE/PubMed databases, correlating HF and depression, from January 1, 2013, to August 20, 2017, by means of the descriptors found in MeSH: “heart failure” and "depression". Methods:Data screening applied combinations, as follows: #1. “Heart Failure” [MeSH Terms]; #2. “Depression” [MeSH Terms]; #3. “Management” [Keyword], using the following research strategy: (#1 AND #2) AND #3. Results:Improvement in depression levels through interventions using telephone is extensively reported in literature, based on providing information about the disease, self-care accompaniment, or cognitive behavioral therapy (CBT). Because of this, it is shown as an effective alternative in depression, improving surviving rates. Equally effective interventions were the empowering of the patient and the familial engagement in caring, palliative care and multidisciplinary participation in construction of caring program. Conclusions: Curiously, physical exercises did not show, statistically, efficiency in depression improvement, and few were the articles approaching antidepressant medications use in this class of patient.
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