- Factors associated with occasional and recurrent falls in Mexican community-dwelling older people. [Journal Article]
- PlosPLoS One 2018; 13(2):e0192926
- Falls are a frequent event among older adults that can cause wounds, disability, psychological disorders, and premature death. Although the large number of existing studies on the issue, few have bee...
Falls are a frequent event among older adults that can cause wounds, disability, psychological disorders, and premature death. Although the large number of existing studies on the issue, few have been conducted in middle- and low-income countries. The objective of the present study is to identify the sociodemographic, medical, and functional performance factors associated with occasional and recurrent falls in Mexican older adults dwelling in community. Cross-sectional analysis of 9 598 adults ≥60 years old who participated in the fourth round (2015) of the Mexican Health and Aging Study. Bivariate tests were performed to evaluate the differences between covariates by distinct fall groups (no falls, occasional falls, and recurrent falls). Multiple logistic regressions with unadjusted and adjusted models were estimated. Approximately 46% of older adults had had at least one fall during the previous two years (one fall 16% and recurrent falls 30%). Occasional falls were only associated with being a woman; in addition to the sex, recurrent falls were strongly associated with advanced age, rural residence, bad and very bad self-perception of health status, activity-limiting pain, urinary incontinence, depression, arthritis, limitations in basic activities of daily living, and limitations in advanced activities of daily living. Falls, primarily recurrent falls, deserve to be addressed through multifactorial strategies that include different areas of intervention.
- Ureterovaginal fistula: A complication of a vaginal foreign body. [Journal Article]
- TJTaiwan J Obstet Gynecol 2018; 57(1):150-152
- CONCLUSIONS: Ureterovaginal fistula following neglected vaginal foreign body is a serious condition. Early diagnosis, treatment of infection and proper surgical management can improve the outcome and decrease complications.
- The screening process of a patient with low back pain and suspected thoracic myelopathy: a case report. [Journal Article]
- JMJ Man Manip Ther 2018; 26(1):11-17
- Thoracic disc herniations are rare and difficult to diagnose. Myelopathy is a potential consequence that can lead to irreversible neurological impairment if not treated appropriately. It is incumbent...
Thoracic disc herniations are rare and difficult to diagnose. Myelopathy is a potential consequence that can lead to irreversible neurological impairment if not treated appropriately. It is incumbent on all clinicians who see patients with low back pain (LBP) to be aware of such pathologies. This case describes a screening process in the detection of a rare serious spinal pathology and discusses the use of red flags and central nervous system signs and symptoms in the decision leading to immediate referral.
- Extraordinary daytime only urinary frequency in childhood: Prevalence, diagnosis, and management. [Journal Article]
- JPJ Pediatr Urol 2018 Feb 09
- CONCLUSIONS: Childhood EDOUF is rather common and is generally associated with normal non-invasive urodynamic patterns. The PME allows verification of anamnestic data of EDOUF. The sole recommendation to postpone micturition for a maximum of 3 h or until the micturition postponement became stressful could be considered as a possible approach.
- Impact of transvaginal modified sacrospinous ligament fixation with mesh for the treatment of pelvic organ prolapse-before and after studies. [Journal Article]
- IJInt J Surg 2018 Feb 15
- CONCLUSIONS: This study showed that transvaginal modified sacrospinous ligament fixation with mesh might be performed easily and might be a safe surgery for elderly patients whose requirements for sexual life were relatively low. Further researches were required to investigate its long-term efficacy.
- Characterization of the passive and active material parameters of the pubovisceralis muscle using an inverse numerical method. [Journal Article]
- JBJ Biomech 2018 Feb 08
- The mechanical characteristics of the female pelvic floor are relevant to understand pelvic floor dysfunctions (PFD), and how they are related with changes in their biomechanical behavior. Urinary in...
The mechanical characteristics of the female pelvic floor are relevant to understand pelvic floor dysfunctions (PFD), and how they are related with changes in their biomechanical behavior. Urinary incontinence (UI) and pelvic organ prolapse (POP) are the most common pathologies, which can be associated with changes in the mechanical properties of the supportive structures in the female pelvic cavity. PFD have been studied through different methods, from experimental tensile tests using tissues from fresh female cadavers or tissues collected at the time of a transvaginal hysterectomy procedure, or by applying imaging techniques. In this work, an inverse finite element analysis (FEA) was applied to understand the passive and active behavior of the pubovisceralis muscle (PVM) during Valsalva maneuver and muscle active contraction, respectively. Individual numerical models of women without pathology, with stress UI (SUI) and POP were built based on magnetic resonance images, including the PVM and surrounding structures. The passive and active material parameters obtained for a transversely isotropic hyperelastic constitutive model were estimated for the three groups. The values for the material constants were significantly higher for the women with POP when compared with the other two groups. The PVM of women with POP showed the highest stiffness. Additionally, the influence of these parameters was analyzed by evaluating their stress-strain, and force-displacements responses. The force produced by the PVM in women with POP was 47% and 82% higher when compared to women without pathology and with SUI, respectively. The inverse FEA allowed estimating the material parameters of the PVM using input information acquired non-invasively.
- The increasing importance of a continence nurse specialist to improve outcomes and save costs of urinary incontinence care: an analysis of future policy scenarios. [Journal Article]
- BFBMC Fam Pract 2018 Feb 17; 19(1):31
- CONCLUSIONS: Implementation of the OCSS new care strategy for urinary incontinence results in an improvement in the quality of life of community-dwelling elderly, a reduction of the costs for payers and affected elderly, and a reduction in time invested by carers. Various realistic policy scenarios even forecast larger health gains and cost-savings in the future. More importantly, the longer the implementation is postponed the larger the savings foregone. The future organisation of healthcare affects the category in which the greatest savings will be generated.
- Management of female stress urinary incontinence: A care pathway and update. [Review]
- MMaturitas 2018; 109:32-38
- Stress urinary incontinence (SUI) is a condition characterized by an involuntary loss of urine occurring as result of an increase in intra-abdominal pressure due to effort or exertion or on sneezing ...
Stress urinary incontinence (SUI) is a condition characterized by an involuntary loss of urine occurring as result of an increase in intra-abdominal pressure due to effort or exertion or on sneezing or coughing. Estimates of its prevalence in the female population range from 10% to 40%. A literature search of the Medline, Cochrane library, EMBASE, NLH, ClinicalTrials.gov and Google Scholar databases was done up to July 2017, restricted to English-language articles, using terms related to SUI, medical therapy, surgical therapy and treatment options. The search terms included female stress urinary incontinence, mid-urethral sling, tension-free vaginal tape (TVT) and transobturator tape (TOT, TVT-O). Original articles, reviews and meta-analyses were included. Surgical therapy should be considered only after conservative therapies (e.g. an exercise programme or topical estrogens) have failed. Synthetic mid-urethral slings are the gold standard for the surgical treatment of SUI according to the 2016 guidelines of the European Society of Urology (ESU) and the 2017 position statement of the European Urogynaecological Association (EUA). The therapeutic options are numerous but further research into new therapeutic strategies is needed to achieve a better balance between efficacy and adverse events.
- Stigma and self-management: an Interpretative Phenomenological Analysis of the impact of chronic recurrent urinary tract infections after spinal cord injury. [Journal Article]
- SCSpinal Cord Ser Cases 2018; 4:12
- CONCLUSIONS: These results suggest that chronic recurrent UTIs act as major barriers to social participation, with adverse effects on quality of life of people with a neurogenic bladder after SCI. People with SCI would benefit from additional assessment of the impact of recurrent UTIs, so that healthcare professionals can address specific concerns, such as the psychosocial impact of urinary incontinence and stigmatizing views. Additional support to enhance self-management and facilitate social participation should be provided.
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- No. 127-The Evaluation of Stress Incontinence Prior to Primary Surgery. [Journal Article]
- JOJ Obstet Gynaecol Can 2018; 40(2):e45-e50
- CONCLUSIONS: VALIDATION: These guidelines have been approved by the Urogynaecology Committee and the Executive and Council of The Society of Obstetricians and Gynaecologists of Canada.