Background: Pelvic floor muscles (PFM) and rectus abdominis muscles (RAM) of pregnant diabetic rats exhibit atrophy, co-localization of fast and slow fibers and an increased collagen type I/III ratio. However, the role of similar PFM or RAM hyperglycemic-related myopathy in women with gestational diabetes mellitus (GDM) remains poorly investigated. This study aims to assess the frequency of pelvic floor muscle disorders and pregnancy-specific urinary incontinence (PS-UI) 12 months after the Cesarean (C) section in women with GDM. Specifically, differences in PFM/ RAM hyperglycemic myopathy will be evaluated. Methods: The Diamater is an ongoing cohort study of four groups of 59 pregnant women each from the Perinatal Diabetes Research Centre (PDRC), Botucatu Medical School (FMB)-UNESP (São Paulo State University), Brazil. Diagnosis of GDM and PS-UI will be made at 24-26 weeks, with a follow-up at 34-38 weeks of gestation. Inclusion in the study will occur at the time of C-section, and patients will be followed at 24-48 h, 6 weeks and 6 and 12 months postpartum. Study groups will be classified as (1) GDM plus PS-UI; (2) GDM without PS-UI; (3) Non-GDM plus PS-UI; and (4) Non-GDM without PS-UI. We will analyze relationships between GDM, PS-UI and hyperglycemic myopathy at 12 months after C-section. The mediator variables to be evaluated include digital palpation, vaginal squeeze pressure, 3D pelvic floor ultrasound, and 3D RAM ultrasound. RAM samples obtained during C-section will be analyzed for ex-vivo contractility, morphological, molecular and OMICS profiles to further characterize the hyperglycemic myopathy. Additional variables to be evaluated include maternal age, socioeconomic status, educational level, ethnicity, body mass index, weight gain during pregnancy, quality of glycemic control and insulin therapy. Discussion: To our knowledge, this will be the first study to provide data on the prevalence of PS-UI and RAM and PFM physical and biomolecular muscle profiles after C-section in mothers with GDM. The longitudinal design allows for the assessment of cause-effect relationships between GDM, PS-UI, and PFMs and RAMs myopathy. The findings may reveal previously undetermined consequences of GDM.
Estudos com idosos que considerem os diferentes perfis demográfico e socioeconômico são fundamentais para a compreensão da dinâmica da expectativa de vida e formulação de políticas públicas. Objetivo: Avaliar e comparar variáveis demográficas, socioeconômicas, a adesão à Caderneta de Saúde da Pessoa Idosa e a autopercepção de saúde de idosos de Ituiutaba-MG anos anos de 2015 e 2018. Métodos: Trata-se de um estudo transversal que avaliou 304 idosos atendidos nas Unidades Básicas de Saúde utilizando questionário semiestruturado. Estatísticas descritiva e inferencial por meio do teste de Mann-Whitney e qui-quadrado foram utilizadas para comparar as variáveis investigadas no intervalo de três anos. Resultados: Verificou-se transição da faixa etária, de 60-69 anos em 2015 a 70-79 anos em 2018, que vivem com companheiro(a) e não moram sozinhos. A baixa escolaridade foi presente nos anos avaliados e a renda mensal prevalente em 2018 foi menor que no ano de 2015. Além disso, a baixa adesão à Caderneta de Saúde da Pessoa Idosa e a percepção de saúde razoável prevaleceram entre os anos avaliados. Conclusão: Os achados deste estudo reiteram a necessidade de avanço na adesão municipal de políticas públicas de saúde voltadas para o idoso, garantindo melhor acompanhamento em saúde e promoção da qualidade de vida.
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