Transvaginal ultrasonography for trigonitis diagnosis in women.

OBJECTIVE: Chronic trigonitis (CT) is usually diagnosed through cystoscopy which is invasive and expensive. Thus, an accurate non-invasive diagnostic method is necessary. The objective of this study is to determine the efficacy of transvaginal bladder ultrasound (TBU) for CT diagnosis. METHODS: Between 2012 and 2021, 114 women (17-76 years old) with recurrent urinary tract infection (RUTI) and history of antibiotic resistance were evaluated with TBU by a single ultrasonographer. As a control group, TBU was performed in 25 age-matched women with no previous history of UTI, urological or gynecological conditions. All patients with RUTI had undergone a cystoscopy with biopsy for diagnostic confirmation at the time of trigone cauterization. RESULTS: Thickening of trigone mucosa (>3 mm) was detected in all patients with RUTI and represented the most relevant criteria for trigonitis diagnosis on TBU. Other TBU findings in CT are: irregular and interrupted mucosa lining (96.4%), free debris in the urine (85.9%), increased blood flow at doppler (81.5%), mucosa shedding and tissue flaps. Biopsy showed CT with erosive pattern (58%) or non-keratinizing metaplasia (42%). Diagnostic agreement index between TBU and cystoscopy was 100%. In the control group, normal trigone mucosa is ultrasonographically regular, continuous, with thickness ≤3 mm and there is no debris in the urine. CONCLUSIONS: TBU proved to be an efficient, inexpensive and minimally invasive method to diagnose CT. To our knowledge, this is the first article that reports the use of transvaginal ultrasound as an alternative method for diagnosing trigonitis.

Long-term efficacy of complete trigonal electrofulguration for women with recurrent urinary tract infections.

INTRODUCTION AND OBJECTIVE: Recurrent urinary tract infections (R-UTIs) have a negative impact on quality of life and contribute to antimicrobial resistance. Long-term antibiotic therapy is the main treatment alternative but, in some cases, this approach may not be accepted by the patient, is ineffective or poorly tolerated. In selected women, electrofulguration (EF) of trigonal lesions has been shown to reduce urinary tract infection (UTI) episodes. METHODS: Between August 2006 and December 2017, 73 women with R-UTI had their data collected prospectively and analyzed. We evaluated the rate of UTIs during the initial 2 years of follow-up after fulguration based on symptoms and a positive urine culture. All patients failed with multiple antibiotic courses and were offered endoscopic electrofulguration of the entire trigonal and bladder neck mucosa with a rollerball probe. We present our long-term results using a strategy of complete fulguration of the trigone in women with R-UTIs. RESULTS: The median age was 64 years (range: 17-76 years) and the median follow-up time after EF was 4.2 years (range: 2.5-14 years). Overall, 70 patients (96%) remained free of UTI episodes during the first year of follow-up, at 2 years of follow-up, 57, 53% remained infection-free. Currently, UTIs are typically sparse, mild, and caused by multisensitive bacteria. CONCLUSIONS: Complete trigonal and bladder neck mucosal fulguration promoted a significant reduction of UTI episodes during the first 2 years of follow-up. Prospective controlled studies are needed to determine the role of EF in women with R-UTI.

Bioequivalence study of four different trademarks of enalapril maleate in spontaneously hypertensive rats.

INTRODUCTION: High blood pressure is a systemic disease which has major clinical and psycho-social repercussions, involves a high morbidity-mortality rate and generates high costs for the health system. Its treatment involves the use of antihypertensive drugs, which are commercialized as trademark, generic or similar drugs. PURPOSE: To verify the antihypertensive effect produced by a similar dose of different trademarks of enalapril maleate in spontaneously hypertensive rats (SHR). METHODS: Fifteen mg/kg of enalapril maleate were administered by gavage in 50 SHR rats and their blood pressure was verified through tail plethysmography every three days in a period of 16 days. RESULTS: The group treated with reference drug has shown a significant reduction on blood pressure levels when compared to the control group. Thus, treatments with enalapril maleate of generic, similar-A and similar-B brands have also shown significant reduction on animals' blood pressure. CONCLUSION: The use of generic drug and similars (A and B) drugs in the same doses and for the same period of time has not shown significant difference regarding the reference drug, which suggests that the brands tested are bioequivalent.

Bioequivalence study of four different trademarks of enalapril maleate in spontaneously hypertensive rats

INTRODUCTION: High blood pressure is a systemic disease which has major clinical and psycho-social repercussions, involves a high morbidity-mortality rate and generates high costs for the health system. Its treatment involves the use of antihypertensive drugs, which are commercialized as trademark, generic or similar drugs. PURPOSE: To verify the antihypertensive effect produced by a similar dose of different trademarks of enalapril maleate in spontaneously hypertensive rats (SHR). METHODS: Fifteen mg/kg of enalapril maleate were administered by gavage in 50 SHR rats and their blood pressure was verified through tail plethysmography every three days in a period of 16 days. RESULTS: The group treated with reference drug has shown a significant reduction on blood pressure levels when compared to the control group. Thus, treatments with enalapril maleate of generic, similar-A and similar-B brands have also shown significant reduction on animals' blood pressure. CONCLUSION: The use of generic drug and similars (A and B) drugs in the same doses and for the same period of time has not shown significant difference regarding the reference drug, which suggests that the brands tested are bioequivalent.

INTRODUÇÃO: A hipertensão arterial é uma doença sistêmica que traz grandes repercussões clínicas e psico-sociais, cursa com uma elevada morbi-mortalidade e gera elevados gastos para o sistema de saúde. Seu tratamento envolve a utilização de fármacos anti-hipertensivos, os quais são comercializados como remédios de marca, genéricos ou similares. PURPOSE: Verificar o efeito anti-hipertensivo produzido por dose igualitária de diferentes marcas de maleato de enalapril, em ratos naturalmente hipertensos. MÉTODOS: Foram administrados, por meio de gavagem, 15 mg/kg de maleato de enalapril em 50 ratos naturalmente hipertensos e verificada a pressão arterial, através de pletismografia de cauda, a cada três dias, em um período de 16 dias. RESULTADOS: O grupo testado com o fármaco de referência mostrou uma redução significativa dos níveis pressóricos quando comparado ao grupo controle. Da mesma forma, o tratamento com Maleato de Enalapril da marca genérica e das marcas similar-A e similar-B também produziu redução significativa da pressão arterial dos animais. CONCLUSÃO: A utilização do medicamento genérico e os similares A e B nas doses utilizadas e no tempo de experimentação adotado, não indicou diferença significativa em relação ao fármaco de referência, sugerindo que as marcas testadas são bioequivalentes.

O uso de plantas medicinais como tratamento alternativo no bairro Jardim das Colinas, Itajubá – MG, Brasil / The use of medicinal plants as alternative treatment in the Jardim das Colinas district, Itajubá, MG, Brazil

Introdução: várias plantas da flora brasileira e internacional têm sido utilizadas, durante décadas, pela população em geral, com o propósito de se obterem efeitos benéficos à saúde. Objetivos: verificar o uso, a freqüência e a forma de utilização de plantas medicinais, além de identificar a causa do uso pela população do bairro Jardim das Colinas. Material e Métodos: foi aplicada entrevista estruturada a 46 famílias do bairro Jardim das Colinas, Itajubá-MG, escolhidas aleatoriamente por sorteio, num conjunto aproximado de 800 famílias. Resultados: das famílias entrevistadas, 43 (93,47%) confirmaram o uso de plantas medicinais, sendo que 62,79% fazem uso freqüente nas formas de: chá (95,34%) uso tópico (27,90%) e outros tipo de infusão ou métodos diferentes de uso e preparo (76,74%). Verificou-se que 39,55% das famílias fazem uso devido ao melhor resultado em relação aos fármacos convencionais, 37,20% devido ao alto preço destes e 23,25% por outros motivos. Conclusões: os dados obtidos indicam que o uso de plantas medicinais no bairro Jardim das Colinas é prática adotada por grande parte dessa população.