ABSTRACT Background: SARS-CoV-2 infections rapidly spread along with Brazilian territory with heterogeneous transmission and mortality rates, mostly depending on region and period. Investigation of SARS-CoV-2 antibodies is an important tool to understand virus circulation. Given that blood donors are a representative casuistic of a healthy population, the authors evaluated the seroprevalence of IgG and IgM COVID-19 antibodies in 2,806 blood donors from a blood bank located in São Paulo, Brazil. Methods: Aiming to evaluate viral behavior over time, the authors selected samples from blood donors who donated in June and October 2020, and February 2021. To determine whether socio-demographic features affected the seroprevalence, the authors analyzed samples from three different regions from São Paulo (capital, metropolitan and countryside regions) and evaluated predictors as gender, age, educational level, race, and use of public transportation. Results: As expected, the authors observed that seroprevalence increased over time. Seroprevalence was greater in São Paulo city compared to metropolitan and countryside regions, being smallest in the countryside. Characteristics associated with a lower percentage of antibodies were age above 50 years, higher educational level, self-declared Caucasian, and use of individual transportation. Conclusion: In conclusion, blood donors' samples proved to accurately reflect virus circulation in the healthy population.

OBJECTIVE: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is characterized by high contagiousness, as well as variable clinical manifestations and immune responses. The antibody response to SARS-CoV-2 is directly related to viral clearance and the antibodies' ability to neutralize the virus and confer long-term immunity. Nevertheless, the response can also be associated with disease severity and evolution. This study correlated the clinical characteristics of convalescent COVID-19 patients with immunoglobulin A (IgA) and IgG anti-SARS-CoV-2 antibodies. METHODS: This study included 51 COVID-19 health care professionals who were candidates for convalescent plasma donation from April to June 2020. The subjects had symptomatic COVID-19 with a polymerase chain reaction-confirmed diagnosis. We measured anti-SARS-CoV-2 IgA and IgG antibodies after symptom recovery, and the subjects were classified as having mild, moderate, or severe symptoms. RESULTS: Anti-SARS-CoV-2 antibodies were positive in most patients (90.2%). The antibody indexes for IgA and IgG did not differ significantly between patients presenting with mild or moderate symptoms. However, they were significantly higher in patients with severe symptoms. CONCLUSIONS: Our study showed an association between higher antibody indexes and severe COVID-19 cases, and several hypotheses regarding the association of the antibody dynamics and severity of the disease in SARS-CoV-2 infection have been raised, although many questions remain unanswered.

Resumo Realizou-se revisão sistemática emetanálise de estudos clínicos prospectivos, randomizados e placebo-controlados que comparavam a toxina botulínica ao placebo no tratamento da bexiga hiperativa. O objetivo primário desta metanálise foi avaliar a eficácia da toxina botulínica em relação à urgência urinária, frequência miccional, noctúria e episódios de incontinência. O objetivo secundário foi avaliar os efeitos adversos. Selecionamos estudos que incluíram somente pacientes com bexiga hiperativa não-neurogênica tratada com 100 unidades de onabotulinum toxina A ou placebo (grupo controle). Foram encontrados 532 estudos após as buscas iniciais, dos quais sete apresentaram todos os critérios de inclusão (estudos prospectivos, randomizados, placebo-controlados, ≥ 3pontosnaescalade Jadad) e fizeram parte desta análise. Para todos os objetivosprimários a toxina foimais eficaz do que o placebo, comp < 0,0001 e intervalo de confiança (IC) de 95%: urgência (diferençamédia = -2,07, IC=[-2,55; -1,58]), freqüênciamiccional (diferençamédia=-1,64, IC=[-2,10; -1,18]), noctúria (diferençamédia=-0,25, IC=[-0,39; -0,11]) e episódios de incontinência (diferença média = -2,06, IC= [-2,60; -1,52]). A necessidade de cateterização intermitente e a ocorrência de infecção urinária (ITU) forammais frequentes no grupo toxina na comparação como grupo placebo (p < 0,0001). A toxina botulínica promoveu melhora significativa dos sintomas de bexiga hiperativa na comparação com o placebo. Entretanto, está associada a uma maior incidência de cateterismo intermitente e infecção do trato urinário.

Abstract We performed a systematic review and meta-analysis of randomized placebo-controlled trials that studied non-neurogenic overactive bladder patients who were treated with 100 units of onabotulinumtoxinA or placebo. The primary purpose of our study was to evaluate the clinical effectiveness with regard to urinary urgency, urinary frequency, nocturia, and incontinence episodes. Our secondary purpose consisted of evaluating the adverse effects. Our initial search yielded 532 entries. Of these, seven studies met all the inclusion criteria (prospective, randomized, placebo-controlled studies, ≥ 3 points on the Jadad scale) and were selected for analysis. For all primary endpoints, the toxin was more effective than placebo (p < 0.0001; 95% confidence interval [95CI]), namely: urgency (mean difference = -2.07; 95CI = [-2.55-1.58]), voiding frequency (mean difference = - 1.64; 95CI = [-2.10-1.18]), nocturia (mean difference = -0.25; 95CI = [-0.39-0.11]) and incontinence episodes (mean difference = -2.06; 95CI= [-2.60-1.52]). The need for intermittent catheterization and the occurrence of urinary tract infection (UTI) were more frequent in patients treated with onabotulinumtoxinA than in patients treated with placebo (p < 0.0001). Compared with placebo, onabotulinumtoxinA had significantly and clinically relevant reductions in overactive bladder symptoms and is associated with higher incidence of intermittent catheterization and UTI.

INTRODUÇÃO: Grande parte das mulheres (cerca de 30 a 50%) não consegue contrair corretamente seus músculos perineais quando isso lhes é solicitado. Provavelmente, a parte mais importante e também a mais delicada de toda avaliação fisioterapêutica é a conscientização da região perineal das pacientes incontinentes. OBJETIVO: Este trabalho teve como objetivo comparar os efeitos das cinesioterapias com toque digital e com biofeedback para consciência perineal de mulheres com incontinência urinária de esforço. METODOLOGIA: Foi realizado um ensaio clínico randomizado, composto por dois grupos intervencionais, formados por cinco mulheres cada, com incontinência urinária de esforço e com ausência de consciência perineal. RESULTADOS: Inicialmente, o grupo de biofeedback seria composto de seis mulheres e o grupo de cinesioterapia com toque bidigital seria formado por cinco mulheres, porém uma paciente foi excluída do grupo biofeedback no decorrer da pesquisa. Observou-se que houve melhora estatisticamente significativa em ambos os grupos em relação a Power, Endurance, Fast e conhecimentos acerca da região perineal, porém não houve diferença significativa entre os dois grupos, ou seja, ambos os recursos são igualmente eficazes. CONCLUSÃO: Diante dos resultados apresentados, podemos concluir que tanto a cinesioterapia com uso do biofeedback quanto a cinesioterapia com toque digital são excelentes opções de tratamento para ganho de consciência perineal.

INTRODUCTION: A significant number of women (around 30 to 50%) are unable to contract correctly their pelvic floor muscles when given a command. OBJECTIVE: This study's objective was to compare pelvic floor muscle training with digital palpation to pelvic floor muscle training with biofeedback for perineal consciousness of women with stress urinary incontinence. METHOD: It was conducted a randomized clinical trial, comprising two groups, each of them formed by five interventional women with stress urinary incontinence and without perineal consciousness. RESULTS: Initially, the biofeedback group was formed by six women and the pelvic floor muscle training group was formed by five women, but one patient was excluded from the biofeedback group during the research. It was observed that there was a statistically significant improvement in both groups for the Power, Endurance, Fast and knowledge of the perineal region, but there was no significant difference between the two groups, i.e., both treatments are equally effective. CONCLUSION: Given the results, we conclude that both pelvic floor training with digital palpation and with biofeedback are excellent treatment options to gain perineal awareness.

OBJETIVO: relacionar as leveduras identificadas aos sinais e sintomas clínicos das pacientes com candidíase vulvovaginal e investigar a importância dos parceiros sexuais na reincidência da infecção. MÉTODOS: foi desenvolvido estudo prospectivo de julho de 2001 a julho de 2003 com uma amostra de mulheres residentes na Grande São Paulo. Foram avaliadas 179 pacientes com suspeita clínica de vaginite fúngica, com idade entre 18 e 65 anos. Os critérios para exclusão foram: gravidez, comprometimento imunológico intrínseco e extrínseco, incluindo AIDS, diabetes, imunossupressão, pacientes em terapia com corticosteróides, antibióticos ou hormônios, em pós-menopausa, em uso de dispositivo intra-uterino e duchas vaginais ou espermicidas. Amostras de secreções vaginais ou da glande dos parceiros sexuais de pacientes com vaginite de repetição foram coletadas para microscopia e cultura de fungos. Colônias fúngicas isoladas em CHROMagar Candida foram identificadas por provas clássicas. O teste exato de Fisher foi usado para correlacionar o quadro clínico com as leveduras isoladas das pacientes. RESULTADOS: os sinais e sintomas clínicos mais relevantes na candidíase vulvovaginal foram prurido e corrimento, seguidos por eritema e edema, estatisticamente independente do agente etiológico. Leveduras foram diagnosticadas por microscopia direta em 77 pacientes com vulvovaginites, sendo obtidos 40 cultivos de Candida spp. Candida albicans (70%), C. glabrata (20%), C. tropicalis (7,5%) e C. guilliermondii (2,5%) foram identificadas. As leveduras prevalentes nos parceiros foram C. albicans e C. glabrata. As mesmas espécies foram detectadas nas companheiras e parceiros em 87% dos casos. CONCLUSÕES: as vulvovaginites fúngicas foram mais freqüentes em mulheres entre 18 e 34 anos de idade. Não foi observada correlação entre as espécies de leveduras detectadas e a sintomatologia clínica. Os parceiros sexuais podem ser importantes reservatórios de Candida spp e estar relacionados à manutenção da candidíase vulvovaginal.

PURPOSE: to relate yeasts identified by laboratory tests to clinical signs and symptoms in patients with vulvovaginal candidiasis, and to investigate the importance of the sexual partners in the recurrence of the infection. METHODS: from July 2001 to July 2003, a sample of 179 patients aged from 18 to 65 years old, with clinical suspicion of fungal vaginitis were analyzed in a prospective study in Great São Paulo. Exclusion criteria included: pregnancy, impaired intrinsic or extrinsic immune response (including Aids), diabetes or immunosuppression; patients undergoing corticosteroid, antibiotic or hormone therapy, in post menopause, with intrauterine device (IUD) or making use of vaginal douches or spemicides. Samples of vaginal and penis secretions from partners of patients with relapse of vaginitis episodes were collected for microscopy and fungal culture. Fungal colonies isolated in CHROMagar Candida were identified by classical methods. Fisher's exact t-test was used to correlate the clinical picture with the yeasts isolated from patients. RESULTS: the most relevant clinical signs and symptoms were pruritus and vaginal discharge followed by erythema and edema, statistically independent from the etiological agent. Direct microscopy revealed yeasts in 77 patients with vulvovaginitis, and 40 Candida spp cultures were obtained. Candida albicans (70%), C. glabrata (20%), C. tropicalis (7,5%) and C. guilliermondii (2,5%) were identified. The yeasts prevalent in partners were C. albicans and C. glabrata. The same species were detected in female and male sex partners in 87% of the cases. CONCLUSIONS: fungal vulvovaginitis was more frequent in women between 18 and 34 years old. No correlation was observed between the species of yeast detected and clinical symptomatology. Sexual partners are important Candida spp reservoirs and may be related to the maintenance of the vulvovaginal candidiasis.