The effect of epidural analgesia on postpartum urinary incontinence: a systematic review.

INTRODUCTION AND HYPOTHESIS: Urinary incontinence (UI) is common during pregnancy and in the postpartum period. Some women appear to recover their usual urinary function but in others UI persists, playing an important role in women's quality of life. Even though postpartum UI seems to have a multifactorial etiology, pregnancy, vaginal delivery, birth weight and parity are recognized as risk factors. This systematic review aims to evaluate the effect of one particular potential risk factor, epidural analgesia, on the development of postpartum UI in women with vaginal delivery. METHODS: PubMed, Cochrane and Scopus were searched for "epidural analgesia," "epidural anesthesia" or "epidural" and "urinary incontinence." All studies published until 31 July 2020 were considered. A total of 393 studies were identified, and 23 studies were included in the systematic review. RESULTS: From the total 23 articles included in this review, 21 showed a non-significant association between epidural analgesia and postpartum UI. One study found that the risk of postpartum SUI and any type of UI was significantly, but only slightly, increased in women with epidural analgesia. Another study showed a protective effect but was lacking control for important confounders. CONCLUSION: There appears to be no association between epidural analgesia and postpartum UI. Therefore, pregnant women should not fear epidural analgesia because of a possible increased risk of UI.

O sismo de 1755: a atuação do enfermeiro na assistência aos feridos de Lisboa / The 1755 Lisbon earthquake: the work of nurses in the care provided to the wounded

Este estudo teve por objetivo analisar o cuidado prestado por enfermeiros aos feridos e enfermos do terramoto de 1755, em Lisboa. Realizou-se uma pesquisa documental das fontes primárias identifi cadas, utilizaram-se as Portarias do Governo sobre o tratamento dos feridos, a assistência aos enfermos e a sua situação após o terramoto. Foi ainda analisado o livro das Enfermarias das Portas de Santo Antão, da Casa dos Almadas no Rossio e em São Bento da Saúde, após o terramoto, em 1755. A análise destes documentos permitiu desvelar várias dimensões da assistência pós-terramoto, nomeadamente no que respeitou à admissão e registo das entradas nas enfermarias provisórias. Conclui-se que houve enfermeiros religiosos e leigos do Hospital Real de Todos os Santos envolvidos na assistência a feridos e enfermos, com a clara indicação de que esses enfermeiros eram treinados

Quantitation of nine organic acids in wild mushrooms.

The organic acids composition of six wild edible mushroom species (Amanita caesarea, Boletus edulis, Gyroporus castaneus, Lactarius deliciosus, Suillus collinitus, and Xerocomus chrysenteron) was determined by an HPLC-UV detector method. The results showed that all of the samples presented a profile composed of at least five organic acids: citric, ketoglutaric, malic, succinic, and fumaric acids. Several samples also contained oxalic, ascorbic, quinic, and shikimic acids. In a general way, the quantitation of the identified compounds indicated that malic acid, followed by the pair citric plus ketoglutaric acids, were the main compounds in the analyzed species, with the exception of A. caesarea, in which malic and ascorbic acids were the most abundant compounds. The relative amounts and the presence/absence of each identified compound may be useful for the differentiation of the species.