Biofeedback (BF) has been widely used in the treatment of pelvic floor dysfunctions, mainly by promoting patient learning about muscle contraction with no side effects. However, its effectiveness remains poorly understood with some studies suggesting that BF offers no advantage over the isolated pelvic floor muscle training (PFMT). The main objective of this study was to systematically review available randomized controlled trials assessing the effectiveness of BF in female pelvic floor dysfunction treatment. Trials were electronically searched and rated for quality by use of the PEDro scale (values of 0-10). Randomized controlled trials assessing the training of pelvic floor muscle (PFM) using BF in women with PFM dysfunction were selected. Outcomes were converted to a scale ranging from 0 to 100. Trials were pooled with software used to prepare and update Cochrane reviews. Results are presented as weighted mean differences with 95 % confidence intervals (CI). Twenty-two trials with 1,469 patients that analyzed BF in the treatment of urinary, anorectal, and/or sexual dysfunctions were included. PFMT alone led to a superior but not significant difference in the function of PFM when compared to PFMT with BF, by using vaginal measurement in the short and intermediate term: 9.89 (95 % CI -5.05 to 24.83) and 15.03 (95 % CI -9.71 to 39.78), respectively. We found a few and nonhomogeneous studies addressing anorectal and sexual function, which do not provide the cure rate calculations. Limitations of this review are the low quality and heterogeneity of the studies, involving the usage of distinct protocols of interventions, and various and different outcome measures. The results of this systematic review suggest that PFMT with BF is not more effective than other conservative treatments for female PFM dysfunction.

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Introduction: Pelvic floor muscle training (PFMT) involves the contraction of the puborectal, anal sphincter and external urethral muscles, inhibiting the detrusor contraction, what justify its use in the treatment of overactive bladder (OAB) symptoms. Objective: To verify the effects of isolated PFMT on the symptoms of OAB. Method: Prospective clinical trial with 27 women with mixed urinary incontinence (MUI), with predominance of OAB symptoms and loss ≥ 2 g in the pad test. It was evaluated: pelvic floor muscles (PFMs) function (digital palpation and manometry); urinary symptoms (nocturia, frequency and urinary loss); degree of discomfort of OAB symptoms; and quality of life (Incontinence Quality-ofLife Questionnaire [I-QoL]). The PFMT program consisted of 24 outpatient sessions (2x/week + home PFMT). The Mann-Whitney and Wilcoxon tests (with a significance level of 5%) were used to analyse the data. Results: There was a significant improvement of the urinary symptoms to the pad test (5.8±9.7, p<0.001), urinary loss (0.7±1.1, p=0.005) and nocturia (0.8±0.9, p=0.011). Reduction in the degree of discomfort of urinary symptoms was observed according to OAB-V8 questionnaire (10.0±7.7, p=0.001). There were also significant results in PFMs function: Oxford (3.6±0.9, p=0.001), endurance (5.2±1.8, p<0.001), fast (8.9±1.5, p<0.001) and manometry (26.6±15.8, p=0.003).In addition, quality of life had a significant improvement in the three domains evaluated by I-QoL. Conclusion: The PFMT without any additional guidelines improves the symptomatology, the function of PFMs and the quality of life of women with OAB symptoms.

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Adjunct BF did not increase the frequency of home exercises performed by SUI patients.

intervals thereafter, where increase represents normal response. Age-and sex-adjusted regression models were used to examine trends in mean number of components across quartiles of area under the curve (AUC) salivary cortisol. Patterns of mean cortisol response were assessed by MetSyn status using repeatedmeasures analysis of covariance. Results The study included 373 officers (74.0% men) with a mean age of 41.0 years. Prevalence of MetSyn was 25.7%. The mean count of MetSyn components decreased (1.89, 1.75, 1.55, 1.37; P < 0.01) across increasing quartiles of AUC salivary cortisol. The pattern of mean salivary cortisol decreased from baseline (5.55, 4.58, 4.47, 4.79, 4.75 nmol/L) in officers with MetSyn and increased (5.08, 5.82, 5.92, 5.82, 5.60 nmol/L) in their counterparts. The test for interaction between MetSyn status and sample timing was statistically significant (P < 0.001). Conclusions A reduced cortisol response to a high-protein challenge may be associated with MetSyn. Future longitudinal studies could provide useful evidence for planning intervention studies on cardiovascular risk among police officers. Objectives A cross-section study design aimed to explain the characteristics of traffic accident cases in northern of Thailand. Method A cross-section study design aimed to explain the characteristics of traffic accident cases in northern of Thailand. The subjects were recruited from 8 hospitals and 7 police stations in the highest case accident areas from hospitals and police stations during 2009-2012. All medical records and police statements were used as the sources of data collection. All research procedures were approved by the committee for the protection of human subjects of Mae Fah Luang University. Results Totally 35 925 cases had been recruited into the study from 8 hospitals during 2009-2011. 66.58% were female, 28.01% aged 16-25 years old, and main vehicle was motorcycle (78.85%). 29.31% of subjects had been admitted at the hospital, 77.06% had a length of admission ≤31 days, 2.39% diability found, 84.81% had medical cost ≥5000 baht. Univariate analysis found alcohol used, types of vehicle, medical cost, and medical surgery were statistical different between sex.In 7 police stationts, 2339 cases had been recruited into the analysis. 71.43% were females, 27.61% were aged 16-25 years old, 60.96% were married, 92.02% were Buddhism. The main type of vehicle was the cars (56.60%), 67.29% had their accident on the highways, and 60.66% had accidents on the day time (06.00 am.-06.00pm.), and those 13.12% drank alcohol. Conclusions Thailand needs the specific study for improving driving safety behaviours and also an effective regulation to control for traffic accident. Objectives The objectives of this study were to assess the importance of the mental suffering of employees in the service sector of a city in western Algeria and to identify risk factors and moderators of this suffering in order to develop a effective prevention. Method Standardised questionnaires were subjected to 753 employees in ...