Ejercicio o prescripción dietética: efectos sobre la salud en mujeres inactivas con malnutrición por exceso / Effects of an exercise program or a dietary prescription in overweight or obese women

Background Physical activity and dietary prescription are the mainstay of overweight and obesity management. Aim To compare the effects of physical activity or dietary management in overweight or obese sedentary women. Material and Methods Thirty-four physically inactive adult women with overweight or obesity, were intentionally divided into three groups: controls (C), exercise (E) and dietary prescription (DP). Women in the E group were trained in a circuit for twelve weeks and a hypocaloric diet was prescribed to those in the DP group. Blood pressure, body composition and phase angle (FA) measured using bioimpedance and dynamometry, were measured at baseline and the end of the intervention. Results Women in the E group had a significant increase in muscle mass and intracellular water and significant decreases in systolic and diastolic blood pressure levels. No significant differences in dynamometry were observed between groups. The DP group had significant decreases in body weight, fat mass, body mass index, waist circumference, systolic and diastolic blood pressure. Conclusions The DP group had a higher weight reduction than the E group. Dietary prescription should be complemented with a physical activity program in the management of overweight or obesity.

Interstitial cystitis/painful bladder syndrome: diagnostic evaluation and therapeutic response in a private urogynecology unit.

BACKGROUND: Interstitial cystitis/painful bladder syndrome (IC/PBS) is a spectrum of pelvic, bladder or urethral pain, as well as irritative voiding symptoms. The term interstitial cystitis (IC) is reserved for patients with typical cystoscopic features. Diagnosis and management of this syndrome may be difficult. The aim of this study was to describe endoscopic features and our experience on the treatment of this syndrome in Urodifem de Occidente S.C., a private urogynecology unit. METHODS: Observational, retrospective analytic study of 25 treated patients from 33 with diagnosis of IC/PBS between January 2001 and March 2015. The diagnosis was done by clinical, cystoscopic and urodynamic approach. Treatment was based on bladder instillation of dymetilsulfoxido (DMSO), dexamethasone and heparin. Oral pentosan polysulphate was prescribed for at least 1 year. RESULTS: Cystoscopic findings showed petechial hemorrhages in 32%, Hunner's lesions in 28%, glomerulations in 28% and bladder pain in absence of lesions in 12%. The basic treatment included one instillation once a week for 6 weeks, twice a month for 2 months and four monthly instillations. Three cases had complete remission of their symptoms, 21 had significant improvement and we have only one failure. CONCLUSIONS: We recommend the combined use of DMSO instillation and pentosan polysulphate (PPS) in cases of IC/PBS.

[Experience in the treatment of interstitial cystitis: review of 17 cases]. / Experiencia en el tratamiento de pacientes con cistitis intersticial: revisión de 17 casos.

BACKGROUND: The Interstitial Cystitis (IC) has been considered in the past an uncommon pathology, however it has received a special attention during the last 20 years, (1678 scientific articles published since 1984 to 2009). There are many therapeutic options not at all satisfactory because there isn't consensus about diagnostic and treatment. OBJECTIVE: To share our experiences in the treatment of interstitial cystitis, additionally, to comment on the therapeutic response of treatment used. MATERIAL AND METHOD: Observational, retrospective an analytic study of 17 treated patients from 22 with diagnosis of IC and Bladder Painful Syndrome (IC/BPS) were managed in Urodifem de Occidente, S.C. a private Urogynecologic unit between January 2001 and April 2010. The diagnosis was done in agreement with the concepts of Interstitial Cystitis group from clinical and cystoscopic characteristics. The treatment was: Dimethyl sulfoxide (DIMSO) and Pentosan Polysulfate. RESULTS: The evaluation was measured by Interstitial Cystitis Symptomatic Index (ICSI) and Interstitial Cystitis Problem Index (ICPI) both validated evaluation instruments, 82% of the patients had a significative improvement of symptomatology and quality of live The ICSI pre and post treatment was of 17.0 and 4.5 and the ICPI was of 14.8 and 4.1 respectively. CONCLUSION: We recommend the use of combine treatment of DIMSO and PPS in cases of I.C.

[Contribution of bladder biopsy to the study of urogynaecological patient]. / Contribución de la biopsia vesical al estudio de la paciente uroginecológica.

BACKGROUND: One of the characteristics of urinary symptoms in women is their lack of specificity. Patients with stress incontinence or urgency, local irritation, infection, distal stenosis or a neoplastic process have very similar symptoms. OBJECTIVE: Determine the frequency of bladder structural lesions detected by urethrocistoscopy in which we performed bladder biopsies. MATERIAL AND METHOD: Descriptive, retrospective, analytical study of files and videos of 331 patients treated in Urodifem de Occidente (private Urogynecology Center). Thirty-five biopsies were taken. The statistical analysis was expressed as means standard deviations, ranges, percentages and Fishers test. RESULTS: Patients ages range 30-90 years average 60+13.76. Predominant symptoms were: irritative vesical syndrome 62.8%; pelvic pain 45.71%; urge incontinence 31.4%; hematuria 31.4%; vesical voiding dysfunction 11.4%. Principal endoscopic findings: Urethrotrigonitis; glomerular lesions or Hunner ulcers; vesical trabeculations; tumor or suspect lesions. Histopathologic findings were: Interstitial Cystitis 42.9%; chronic Cystitis 11.4%; Cystitis glandularis 8.6%; Cystitis follicular 11.4%; bladder cancer 5.7%; Vesical Papilloma 5.7%. CONCLUSIONS: This study supports the practice of vesical biopsy when lesions other than those from chronic infection are observes in the presence of tumors or suspect lesions.

[Clinical and diagnostic evaluation in patients with interstitial cystitis]. / Evaluación clínica y diagnóstica en pacientes con cistitis intersticial.

BACKGROUND: Interstitial cystitis is a disease of unknown origin; in the last twenty years several epidemiological studies reported an increase in frequency. OBJECTIVE: To describe the symptoms, cystoscopic and histologic findings of 18 cases of interstitial cystitis. PATIENTS AND METHOD: A descriptive, retrospective and analytical study of 331 women with lower urinary tract symptoms studied in Urodifem de Occidente, (private Urogynecology Clinic), between January 2001 and April 2008. The diagnostic criterion was in agreement with the NIDDK and the Interstitial Cystitis DataBase Study. The statistical analysis was in interval scale means, standard deviations and ranges. Indeed Spearman's rank correlation coefficient. RESULTS: The most common symptoms were: urinary frequency (100%) nocturia (94.4%), urgency (72%), pain (66.6%), urgency-incontinence (16.7%). Endoscopic lesions were glomerular in 55% and Hunner ulcers in 44.5%. The severity of quality of life resulted in average of 16.7 +/- 2.9 and 15 +/- 2, p < 0.001. CONCLUSIONS: Urogynecologists must considerer interstitial cystitis when patients show symptoms of bladder irritability and associate pain with the bladder filling. The association of hematuria accompanied by long-term irritability and pain associated with the desire of urination suggests this disease. Cystoscopy is sufficient to confirm the diagnosis.

[Prevalence of urinary and anal incontinence in women from metropolitan area of Guadalajara]. / Prevalencia de incontinencia urinaria y anal en mujeres de la zona metropolitana de Guadalajara.

BACKGROUND: Female urinary and anal incontinence are common entities in pelvic floor dysfunction. The most frequently age affected range from 45 to 69 years. Previous studies performed in the United States report a prevalence of 24-62% for urinary incontinence and 3-60% for anal incontinence. OBJECTIVE: To determine the prevalence of these disorders in the Guadalajara metropolitan area because we do not know it. PARTICIPANTS AND METHODS: A transversal and various stage study was performed recollecting blocks first, then houses, finally interviewing women and applying a structured questionnaire with somatometric and social-demographic data and also clinical-pathological antecedents. The data obtained was registered and processed first manually then using Excel and Epi-Info software. RESULTS: The group of women interviewed (n = 352) were between 15-85 years. The majority were married, housewives, 33% with grammar school, 23% finished high school, 25% professionists and 19% did not finish school; with an average of three pregnancies and with a body mass index (BMI) positive for overweight and obesity. The prevalence for urinary incontinence was 27.8% and anal incontinence of 3.4%. These are results compatible with those reported in the United States. CONCLUSIONS: Women living in Guadalajara have the same behavior that European and American women about prevalence of urinary incontinence. We recommend the performance of this type of studies in other states of this country in order to enrich the present information.

[Prevalence and clinical-urodynamic characteristics of vesical voiding dysfunction in two urodynamic centres]. / Prevalencia de disfunción de vaciado vesical y hallazgos clínico-urodinámicos en dos unidades uroginecológicas.

BACKGROUND: It has been estimated in English medical reports, that the frequency of vesical voiding dysfunction in urogynecological patients is around of 22-24%; however in our country it does not have any published epidemiological study about this problem. OBJECTIVE: To detect the prevalence of vesical voiding dysfunction in our urodynamic unities and describe the clinical and urodynamic findings. MATERIAL AND METHODS: This is a descriptive and retrospective study in which were revised the clinical reports of 300 female patients, that were sent to some of our urodynamic units because they were suffering of lower urinary tract symptoms. Assessment variables included: Patient clinical history, physical examination, urinalysis, urine culture, urethral calibration, Q tip test, urethrocistoscopy, uroflowmetry, multichannel cystometry, electromyography and pressure voiding study. The diagnosis criterion was based in the concept that Blaivas established for vesical voiding dysfunction in women. RESULTS: The diagnosis of vesical voiding dysfunction was established in 72 cases of the total 300 patients analyzed. The most frequent symptom was the irritative vesical type (frequency/urgency), following of weak stream. Some grade of pelvic organ prolapse was detected in 84.8% of cases. Uroflowmetry was normal in 50% of the cases; nevertheless in the morphologic aspect were observed profile signs suggestive of distal vesical obstruction in 75%, and detrusor hypoactivity in 25% of the total of the cases. CONCLUSIONS: The frequency of obstruction in our casuistic was similar to the other authors. The obtained results permit us to confirm that the vesical voiding dysfunction in the urogynecological Mexican patients is a frequent problem in the urogynecological patient; however the diagnostic is complex and require a carefully correlation as clinical as urodynamical aspects in addition to endoscopic and image studies.