Study on the prevalence and incidence of urolithiasis in Germany comparing the years 1979 vs. 2000

OBJECTIVES: In 1979, we conducted a representative study to determine the prevalence and incidence of urolithiasis in Germany. Significant progress in stone therapy and changes in nutritional and environmental factors since then consequently led to a second study in 2001 under the same conditions as in 1979. METHODS: A representative sample of 7500 persons from all over Germany was questioned on the occurrence of urinary stones during their lifetimes (prevalence) and on acute urolithiasis in 2000 (incidence). Additionally, data were collected on urinary stone therapy and metaphylaxis. The current data were then compared with those from 1979. RESULTS: Prevalence has risen from 4% to 4.7% from 1979 to 2001. 9.7% of the 50-64 year old males in 2000 had already had urinary stones (females: 5.9%). The current recurrence rate of urinary stones was estimated to be 42%.In the year 2000, the incidence of urolithiasis in Germany was found to be 1.47% (1979: 0.54%). Over 40% of the stones were passed spontaneously. CONCLUSION: There has been a marked increase in the prevalence and incidence of urolithiasis in Germany within the last 22 years. This probably results from improvements in clinical-diagnostic procedures, changes in nutritional and environmental factors and a general apathy towards metabolic clarification and metaphylaxis.     

Incidence,prevalence and mortality of urolithiasis in the German Federal Republic

Summary Two nationwide surveys were conducted in the German Federal Republic. An incidence of 0.54% and a prevalence of 4% were registered. The ratio of men to women for incidence was 2:1 and for prevalence 1:1. Stone prevalence increased from 1.28% to 6.79% with increasing age. The occupational groups mostly affected were pensioners (34.3%), housewives (23.5%) and employees (16.9%). In cities the prevalence rate was higher than in rural areas. In recent years the mortality rate has decreased.     

Infertility among couples in a population-based study in Iran: prevalence and associated risk factors

To explore the prevalence and risk factors of infertility in Iran, a total of 12 285 ever-married women aged 15-50 years old and their husbands (if available) were interviewed by 82 female general practitioners and answered a self-administered questionnaire on several aspects of infertility. They were identified from the national population in 30 counties, and invited to a confidential interview. Data were obtained about their age, education, marital status, toxic habits, medical history, disabilities and illnesses, help-seeking, economy, ethnicity, geographic location, contraceptive use and age at which they had first intercourse. This study used the definition of childlessness proposed by World Health Organization: 'the woman has never conceived despite cohabitation and exposure to pregnancy for a period of 2 years'. The overall prevalence of infertility was 8% (95% CI: 3.2-15.0). The weighted national estimate of primary infertility was 4.6% (95% CI: 3.6-5.2). There was a pronounced regional pattern in the levels of primary infertility. The primary infertility increased significantly from 2.6 to 4.3 to 5.5% for the 1985-1989, 1990-1994 and 1995-2000 marriage cohorts. The prevalence of secondary infertility was 3.4% (95% CI: 2.4-5.1). Overall the prevalence of infertility falls within a relatively wide range being high in the Southern counties, and low in the Northern counties. The probability of first pregnancy at the end of 2 years of marriage was 0.78 for all ever-married women. The prevalence of infertility increased with age (linear chi-square 198.012, 1 d.f., p = 0.01). The age pattern of infertility also varies quite markedly across the counties analysed. No effect of race was detected; neither the intercept (analysis of covariance p = 0.36) nor the slope of the age relationship was influenced by race (analysis of covariance p = 0.41). Infertility were observed as significantly higher in the presence of history of tubo-ovarian surgery [odds ratio (OR): 1.43; 95% CI: 1.28-2.23; p = 0.01], salpingitis (OR: 2.34; 95% CI: 1.31-4.3; p = 0.016), ectopic pregnancy (OR: 2.45; 95% CI: 1.90-3.44; p = 0.04), varicocele (OR: 2.85; 95% CI: 1.61-5.20; p = 0.01) and cryptorchidism (OR: 3.81; 95% CI: 2.51-4.28; p = 0.031). This study provides a quantitative estimate of the prevalence and main risk factors for infertility in Iranian couples. Yet, further studies on the cause of primary and secondary infertility and geographical variations in the incidence and prevalence of infertility in Iran are needed.     

Regional and seasonal variation in the incidence of urolithiasis in Iran: a place for obsession in case finding and statistical approach

The objective of the study is to measure the incidence rate of urolithiasis in a nationwide population-based study by a new methodology. A multi-stage stratified “epsem scheme” sampling was designed among imaging centres in 12 ecologic regions (composed of 30 provinces) while the regions were assumed as independent epidemiologic units. Four temporal phases were determined for sampling to represent four seasons. Imaging-proven positive cases for urinary stones were included and questionnaire filled out by interview. 2,955 new cases of urinary stone were included and the overall pooled yearly incidence rate was 136/100,000 (95% CI, 103–168). The whole positive group had a mean age of 41.5 years (SD = 16.3 years) and composed of 57.9% male. The most common season for presentation of disease was autumn. Geographically, the west and north of Iran, and seasonally, autumn have shown the highest incidence rates for the urinary tract stones. To establish the real burden of urinary stone disease, our study adds a little piece of information to the worldwide epidemiology of urolithiasis.     

Prevalence of the overactive bladder among Iranian women based on the International Continence Society definition: a population-based study

There is a continuing debate on the accurate prevalence estimates of overactive bladder (OAB) among different ethnicities and regions. The aims of our study were to determine the prevalence of OAB, associated risk factors, and the impact of OAB on the quality of life and sexual function of Iranian women. A total of 8748 women between 15 and 55 years of age enrolled in this cross-sectional study. The definition of the 2002 International Continence Society (ICS) was applied to assess the prevalence of OAB. All participants underwent a detailed history and physical examination that included an evaluation of quality of life, coping strategies and treatment-seeking behavior, laboratory tests, urinalysis and current or previous therapy. The degree of bother was quantified using s visual analog scale (VAS). The overall prevalence of OAB was found to be 18.2% and increased with age from 10.9% in adults aged 15–29 years to 26.2% in those aged >50 years old (test for trend, P = 0.001). A negative impact of OAB on sexual function was reported by 72.3% of the women. Frequency was the most commonly reported symptom (67% of women), followed by urgency (54%). Subjects with OAB had a higher prevalence of anxiety (28.2 vs. 8.8%; P = 0.001), depression (38.2 vs. 18.2%; P = 0.02) and tiredness (16.4 vs. 2.7%; P = 0.001), and they reported significant impairment in carrying out household chores (P = 0.01), physical activities (P = 0.01) and work-related activities (P = 0.01) as well as negative effects on education (P = 0.02), sleep (P = 0.001), relationships (P = 0.001) and annual income (P = 0.01). The prevalence of OAB in Iranian women is higher than that reported in many previous studies in developed and developing countries. Our results reveal that OAB is a highly prevalent condition among Iranian women and that is has a serious impact on quality of life and sexual function. Mohammad Reza Safarinejad, Vice-Chancellor for Education and Research, Urology and Nephrology Research Center, Associate Professor of Urology, Director Department of Urology, Associate Editor of Urology Journal.     

Female sexual dysfunction in a population-based study in Iran: prevalence and associated risk factors

To explore the prevalence and risk factors of female sexual dysfunction (FSD) in Iran. A total of 2626 women aged 20-60 years old were interviewed by 41 female general practitioners and answered a self-administered questionnaire on several aspects of FSD including desire, arousal, pain and orgasmic disorders (OD). Criteria of sexual dysfunction followed classification by DSM-IV. The sexual function was evaluated by the Female Sexual Function Index (FSFI). The subjects were randomly identified from 28 counties of Iran. Data on medical history, toxic habits and current use of medication were also obtained. Of the women interviewed, 31.5% (759) reported FSD. The prevalence increased with age, from 26% in women aged 20-39 years to 39% in those >50 years (tested for trend P<0.001). Thirty-seven percent reported OD, 35% desire disorders (DD) and 30% arousal disorders (AD), all of which increased significantly with age. Pain disorders were reported by 26.7%, occurring most frequently in women aged 20-29 years. The educational level (P=0.01) and marriage age (<18 years) (P=0.04) were inversely correlated with the risk of DD, OD and AD. No significant differences were detected in smoking history (P=0.18), the presence of previous pelvic surgery (P=0.08) and contraception methods used (P=0.42). A history of psychological problems (P=0.04), married status (P=0.03), low physical activity (P=0.012), chronic disease (P<0.01), multiparity (P<0.05) menopause status (P相似文献   

The incidence and risk factors of gastrointestinal complications after hepatectomy: a retrospective observational study of 1329 consecutive patients in a single center

Background

Despite of the importance of gastrointestinal (GI) complications in morbidity and mortality after major and moderate surgeries, it is not yet specifically studied in patients undergoing hepatectomy. This study was aimed to investigate the in-hospital incidence and potential risk factors of GI complications after open hepatectomy in our hospital.

Subjects and methods

Prospectively recorded perioperative data from 1329 patients undergoing elective hepatectomy were retrospectively reviewed. The in-hospital incidence of GI complications was investigated, and independent risk factors were analyzed by multiple logistic regression.

Results

GI complications occurrence was 46.4%. Univariate analysis showed that preoperative Child-Pugh score, total bilirubin, aspartate transaminase, anesthesia duration, operation duration, intraoperative blood loss, crystalloid and colloid infusion, blood transfusion, urine output, use of Pringle maneuver were statistically different between patients with and without GI complications (P < 0.05). Moreover, patients with GI complications had a more prolonged postoperative parenteral nutrient supporting time, hospital stay and ICU stay, and higher incidence of other complications than those without GI complications (P < 0.05). Multivariate regression indicated that long duration of anesthesia (odds ratio 2.51, P < 0.001) and use of Pringle maneuver (odds ratio 1.37, P = 0.007) were independent risk factors of GI complications after hepatectomy.

Conclusions

The incidence of GI complications after hepatectomy is high, which is related to an increase of other complications and a prolonged hospital stay. Avoidance of routinely use of Pringle maneuver and shortening the duration of anesthesia are important measures to reduce the postoperative GI complications.     

贵阳市40岁及以上社区居民骨质疏松性骨折的发病率及危险因素调查

目的了解贵阳市40岁及以上社区居民骨质疏松性骨折的发病率及其影响因素,为该地区骨质疏松性骨折的防治提供理论依据。方法 2011年5月至2011年10月随机抽取贵阳市主城区云岩区40~77岁常驻居民8960人。所有调查对象均进行问卷调查、体格检查、超声骨密度测定等。2014年对该人群进行了随访,将排除对象剔除后,入组总人数5697人,随访率为63.58%。骨质疏松性骨折的诊断标准:居民自我报告脆性骨折史或居民提供的影像学骨折的报告。脆性骨折定义为从站立位或低于站立位的高度跌倒在地或相似程度的外伤所致的骨折。结果 1骨质疏松性骨折的发病率为4.86%(277例,男性31例,女性246例)。主要骨折部位是前臂远端、踝部、脊椎。其中女性的发病率(5.94%)较男性发病率(1.99%)明显增高(P0.01)。2女性(odds ratio[OR]=3.427;95%CI:1.98~5.93;P0.001)、骨密度T值-2.5(OR=2.054;95%CI:1.30~3.26;P=0.002)、血脂异常(OR=1.474;95%CI:1.02~2.13;P=0.038)、年龄(OR=1.029;95%CI:1.01~1.05;P=0.002)均是发生骨质疏松性骨折的危险因素。结论骨质疏松性骨折的发病率随年龄的增加而升高,且女性明显高于男性,前臂远端是最常见的发病部位;增龄、女性、血脂异常、骨密度T值-2.5均是其危险因素。     

Rectal bleeding: epidemiology, associated risk factors, and health care seeking behaviour: a population-based study

Purpose Rectal bleeding is considered an important sign of colonic disease, particularly colorectal cancer. The epidemiology of rectal bleeding in the community is poorly understood. Moreover, there is little information as to whether individuals seek health care for this problem. This study aimed to determine the prevalence of rectal bleeding and levels of healthcare seeking amongst an Australian population. Method A community sample of adults aged above 18 years of Penrith (a Sydney suburb representative of the Australian population) selected randomly from the electoral roll. The survey consisted of a self‐administered questionnaire sent out to 440 residents stratified for equal numbers of men and women. Results The response rate was 77% (n = 338; mean age 46 years; SD: 16; range: 18–90; 55% women). Blood in the stools in the previous 12 months was reported by 18% (95% CI: 14–23). Colour of the blood in bowel movements was reported as bright (72%), dark (7%), bright and dark (10%), 11% did not know. Only 31% (n = 21/68) of respondents with rectal bleeding had visited a physician primarily about the presence of blood in the bowel movement within the previous 12 months. The majority (90%) who consulted about the presence of blood were aged between 30 and 60 years. Blood in the stools was independently associated with younger age (OR = 0.97, 95% CI: 0.95–0.99, P = 0.01), feelings of incomplete rectal evacuation (OR = 3.42, 95% CI: 1.66–7.08, P = 0.001), self‐reported injury or tear (OR = 3.45, 95% CI: 1.53–7.69, P = 0.002), and surgery (OR = 2.70, 95% CI: 1.03–7.14, P = 0.04) to the perianal region. Conclusions Rectal bleeding is common in the general population. Only one‐third of those with rectal bleeding consults a physician about their condition. Rectal bleeding occurs in younger individuals, those who suffer from incomplete evacuation and among individuals who have had an injury, tear or surgery to the anus.     

Population-based epidemiology, risk factors and screening of intraductal papillary mucinous neoplasm patients

Intraductal papillary mucinous neoplasm (IPMN) was first recognized in the 1980s with increasing publications over the last decade as the incidence increased sharply, especially at tertiary-care referral centers. Population-based studies have estimated the age and sex-adjusted cumulative incidence of IPMN to be 2.04 per 100 000 person-years (95% confidence interval: 1.28-2.80). It is now understood that IPMN can be classified anywhere along the spectrum of the adenoma to carcinoma sequence and often harbors mutations in genes such as KRAS early in the disease process. Many patients are diagnosed incidentally after imaging of the abdomen for other diagnostic purposes. Patients that present with a history of symptoms such as pancreatitis and abdominal pain are at high risk of harboring a malignancy. Clinicopathologic features such as involvement of the main pancreatic duct, presence of mural nodules, and side branch disease > 3.0 cm in size may indicate that there is an underlying invasive component to the IPMN. In addition, the incidence of extra-pancreatic neoplasms is higher in patients with IPMN, with reported rates of 25% to 50%. There are no current screening recommendations to detect and diagnose IPMN but once the diagnosis is made, screening for extrapancreatic neoplasms such as colon polyps and colorectal cancer should be considered. Surgical resection is the recommend treatment for patients with high-risk features while close observation can be offered to patients without worrisome signs and symptoms of carcinoma.     

Saudi Arabian adult intensive care unit pressure ulcer incidence and risk factors: a prospective cohort study

The purpose of this study was to identify pressure ulcer (PU) incidence and risk factors that are associated with PU development in patients in two adult intensive care units (ICU) in Saudi Arabia. A prospective cohort study design was used. A total of 84 participants were screened second daily basis until discharge or death, over a consecutive 30‐day period, out of which 33 participants with new PUs were identified giving a cumulative hospital‐acquired PU incidence of 39·3% (33/84 participants). The incidence of medical devices‐related PUs was 8·3% (7/84). Age, length of stay in the ICU, history of cardiovascular disease and kidney disease, infrequent repositioning, time of operation, emergency admission, mechanical ventilation and lower Braden Scale scores independently predicted the development of a PU. According to binary logistic regression analyses, age, longer stay in ICU and infrequent repositioning were significant predictors of all stages of PUs, while the length of stay in the ICU and infrequent repositioning were associated with the development of stages II–IV PUs. In conclusion, PU incidence rate was higher than that reported in other international studies. This indicates that urgent attention is required for PU prevention strategies in this setting.     

Occupations associated with a high risk of self-reported back pain: representative outcomes of a back pain prevalence study in the Federal Republic of Germany

Given the increasing medical and economic implications of back pain, occupation-specific prevalence data may provide important pointers for preventive programmes targeted at promoting preventive behaviour and improving conditions. The National German Health Survey is the first study to provide the basis for a representative nationwide analysis of back pain prevalence by occupational category. The net sample comprises a total of 3,488 earners aged 18-69. One in three earners in the Federal Republic of Germany (34%) experienced back pain during the 7 days prior to being interviewed. The 1-year prevalence rate is 60%. Occupational categories associated with a lower-than-average back pain prevalence are highly qualified professionals, senior management, and production occupations associated with a comparatively low degree of manual labour. In contrast, an above-average prevalence was identified for occupations associated with physically strenuous work involving one-sided postures, moving, carrying and holding heavy weights, and work typically performed in poor conditions or bad weather. Our data demonstrates significant inter-occupational differences in terms of self-reported back pain. The results underline the importance of measures to promote preventive behaviour and improve the working conditions of those in low-skill manual labour occupations.     

The effects of the calcium-restricted diet of urolithiasis patients with absorptive hypercalciuria type II on risk factors for kidney stones and osteopenia

The calcium (Ca)-restricted diet of urolithiasis patients with absorptive hypercalciuria type II may decrease Ca excretion but increase biochemical markers of risk for osteopenia. We randomly allocated 25 patients from six hospitals into an experimental group (Ca restriction to 500 mg/day, oxalate-rich products discouraged and normalization of animal protein and sodium) and a control group (no restrictions) for one month. The urinary Ca excretion did not decrease significantly, but the oxalate excretion decreased, although not significantly. The hydroxyproline:creatinine ratio in fasting urine seemed to increase and the calcium:creatinine ratio to decrease. The deoxypyridinoline:creatinine ratio in fasting urine did not change. We conclude that our Ca-restricted diet, which is lower in Ca, animal protein and table salt due to the omission of dairy products, may be of benefit for absorptive hypercalciuria type II patients without enhancing the risk for osteopenia. However, a long-term clinical trial is required. Received: 12 September 1996 / Accepted: 31 July 1997     

Epidemiological aspects and risk factors for low back pain in 38-year-old men and women: a 25-year prospective cohort study of 640 school children

This study is based on data gathered by means of a postal questionnaire from a cohort of 640 38-year-old subjects. At the age of 14 years these subjects had been interviewed by their school doctor to ascertain whether any of them had a history of low back pain (LBP), and X-rays of the thoracic and lumbar spine were taken. The questionnaire contained related groups of questions, with LBP as the main topic. We wanted to identify probable risk factors in developing LBP. The results show a cumulative life-time prevalence of LBP of 70%, a 1-year prevalence of 63% and a point prevalence of 19%, independent of gender. Women reported a higher incidence of LBP than men during the month and week before they filled out the questionnaire, they also reported a higher incidence of sciatica and greater use of the health care system and analgestics over the previous year. Heavy manual work was associated with LBP and sciatica, and smoking (more than 16 cigarettes per day) was more common among unemployed and sick-listed subjects, Severe LBP was associated with increased morbidity, reduced work capacity, deterioration in social life, mental and sexual problems, and increased smoking. A stepwise logistic regression analysis of early independent variables indicated that severe LBP is positively correlated with low social class for men and with menstruation and pregnancy for women.     

Analysis of incidence and risk factors of renal insufficiency in solitary kidney patients

Objective To investigate the incidence of renal insufficiency in solitary kidney patients and analyze the risk factors. Methods Patients with solitary kidney who were admitted to the Second Hospital of Lanzhou University from January 2012 to January 2019 were retrospectively selected as subjects. According to estimated glomerular filtration rate (eGFR) level, the patients were divided into two groups: eGFR＜60 ml?min-1?(1.73 m2)-1 group and eGFR≥60 ml?min-1?(1.73 m2)-1 group. The data of the general information, laboratory examinations and kidney size were collected, and the differences of the above indicators between the two groups were compared. Logistic regression model was used to analyze the related factors of renal function decline. Results (1) A total of 323 solitary kidney patients with age of (53.8±15.8) years and median duration of 10.0 years were enrolled in the study, including 203 males (62.8%). There were 150 cases (46.4%) with hypertension, 136 cases (42.1%) with proteinuria, and 134 cases (41.5%) with renal insufficiency, even 29 cases(9.0%) had developed into end-stage renal disease. (2) Compared with those in eGFR≥60 ml?min-1?(1.73 m2)-1group, patients in eGFR＜60 ml?min-1?(1.73 m2)-1 group had higher age, mean arterial pressure, serum creatinine, serum uric acid, fasting blood glucose, and higher proportion of hypertension and proteinuria, but had lower proportion of congenital solitary kidney, hemoglobin, plasma albumin and residual kidney diameter. The differences of above indicators were statistically significant ( all P＜0.05). (3) Logistic regression analysis showed that increasing age (every ten years, OR=1.752, 95%CI 1.455-2.109, P＜0.001), anemia (OR=2.327, 95%CI 1.356-3.994, P=0.002), hyperuricemia (OR=5.097, 95%CI 2.873-9.042, P＜0.001) and high urine protein level (every 1+, OR=1.515, 95%CI 1.197-1.919, P=0.001) were independent risk factors for renal dysfunction in solitary kidney patients. Conclusions The incidence of renal insufficiency in solitary kidney patients is 41.5%. Patients with solitary kidney may perform varying degrees of kidney damage, such as hypertension, proteinuria and eGFR decline. Increasing age, anemia, hyperuricemia and high urine protein level are independent risk factors for renal insufficiency in solitary kidney patients.     

高龄患者髋关节置换术后谵妄的发生率及危险因素分析

目的 探讨行髋关节置换术的高龄患者术后谵妄的发生率及危险因素.方法 选择2009年9月至2010年2月,择期行髋关节置换术患者120例.术前访视患者,术后当天,术后1、2、3d密切随访患者,用谵妄评定法进行谵妄评估.记录患者一般情况、病史、合并症、手术时间、术中失血量、术中输库存血量、术后疼痛评分及谵妄的发生情况,建立数据库.根据是否发生谵妄分为谵妄组和对照组.结果 术后发生谵妄28例,发生率为23.33%.多因素Logistic逐步回归分析高龄、术前合并肺心病、术前合并肺部感染、全身麻醉、术后低氧血症为谵妄的危险因素(P＜0.05).结论 高龄、术前合并肺心病、术前合并肺部感染、全身麻醉、术后低氧血症是术后谵妄的独立危险因素.