Is there an association between fecal incontinence and lower urinary dysfunction?

BACKGROUND: Urinary and fecal incontinence in females are both common and distressing conditions. Because common pathophysiologic mechanisms have been described, an association between the two would be expected. The aim of this study was to determine whether patients with lower urinary tract dysfunction have concomitant fecal incontinence when compared with age and gender matched community controls and, second, to determine whether they have predisposing factors that have led to lower urinary tract symptoms and concomitant fecal incontinence. METHODS: A case-control study was performed by means of detailed questionnaire and review of investigation results. One thousand consecutive females presenting for urodynamic investigation of lower urinary tract dysfunction, were compared with 148 age and gender matched community controls. RESULTS: Frequent fecal incontinence was significantly more prevalent among all cases than among community controls (5vs. 0.72 percent,P=0.023). Occasional fecal incontinence was also more prevalent (24.6vs. 8.4 percent,P<0.001). Fecal incontinence was not significantly more prevalent among females with genuine stress incontinence (5.1 percent) when compared with females with detrusor instability (3.8 percent) or any other urodynamic diagnosis. Symptoms of fecal urgency and fecal urge incontinence were significantly more prevalent among those with a urodynamic diagnosis of detrusor instability or sensory urgency than among females with other urodynamic diagnoses or community controls. Multivariate analysis comparing cases with fecal incontinence with other cases and also with community controls did not indicate that individual obstetric factors contributed significantly to the occurrence of fecal incontinence in these patients. CONCLUSIONS: There is an association between genuine stress incontinence, lower urinary tract dysfunction, and symptoms of fecal incontinence, but the exact mechanism of injury related to childbirth trauma is questioned.Supported by a research grant from the ANZAC Health and Medical Research Foundation.Presented in part at the Annual Meeting of the Royal Australian College of Surgeons, Sydney, May, 8 to 10, 1997, and the International Urogynaecology Association Meeting, Buenos Aires, September 20 to 24, 1998.     

尿核基质蛋白22在膀胱移行细胞癌诊断中的临床应用

目的评价尿核基质蛋白22(NMP22)对诊断膀胱移行细胞癌的价值。方法选取膀胱占位的患者48例,健康志愿者20例作对照,留取患者术前及对照组人群的晨尿1次,应用免疫酶标记法检测尿中NMP22的数值,并进行分析比较。结果48例膀胱占位患者均经手术治疗,术后病理检查42例为移行细胞癌。42例移行细胞癌患者术前尿NMP22水平为(37.30±7.36)U/ml;而其他6例非膀胱移行细胞癌患者术前尿NMP22水平为(3.85±0.94)U/ml。对照组尿NMP22水平为(1.35±0.59)U/ml,明显低于膀胱移行细胞癌组(P<0.05)。原发性膀胱移行细胞癌患者尿NMP22水平随肿瘤分级、分期的递增而升高。结论尿NMP22对膀胱移行细胞癌具有高灵敏度、高特异度、无创伤性,是检测膀胱移行细胞癌的有效标志物。     

口服不同剂量的碘化油微囊防治地方性甲状腺肿的疗效及有效期观察

本文报告1990～1991年在缺碘性疾病流行区新疆托克逊县观察了一次性口服不同剂量(400、300和200mg)碘化油微囊的防治疗效及尿碘排泄。结果表明,在服药后半年和1年甲状腺肿患病率在不同剂量组均有不同程度的下降,治愈率均有不同程度的提高,但与对照组比较无论患病率还是治愈率均无显著差异(P>0.05)。不同剂量组之间服药后1月内尿碘排泄有随剂量增大相应增高的趋势(P<0.01),但至第三个月时无论是不同剂量组之间还是与对照组之间均未见显著差异(P>0.05)。从而提示,口服碘化油微囊能否作为防治缺碘性疾病的长效补碘方法,很值得商榷。     

Assessment of urinary podocalyxin as an alternative marker for urinary albumin creatinine ratio in early stage of diabetic kidney disease in older patients

This study's objective is to evaluate the correlation relationship between Podocalyxin (PCX), an urinary marker of podocytes, urinary albumin-creatinine ratio (ACR) and the predictive value of PCX in the routine screen of early diabetic kidney disease (DKD) among older people. We also aimed to explore its prediction value despite of other metabolic factor and how PCX alters in the predictive power for early stage of diabetic nephropathy. In retrospective, 320 cases of older patients diagnosed with type 2 diabetes mellitus who met both inclusion and exclusion criteria were collected and divided with levels of urinary albumin, that is, normal albuminuria group, microalbuminuria group and healthy group. The correlation coefficient between PCX and ACR, and the odds ratio of PCX were gauged in the study. Area under the receiver operating characteristic (ROC) curve was also calculated. There were 188 patients in the normal group with urine ACR < 30 mg/g, and 132 patients in the microproteinuria group with urine ACR 30–300 mg/g. 132 cases of DKD diagnosed with ACR, among them, 104 cases of DKD were predicted by PCX. The percentage correction value was 78.8%. The following parameters such as gender, age, course of disease, glycated hemoglobin, triglyceride, total cholesterol, BMI, blood pressure, uric acid, and eGFR were used as variables for adjustment to establish the prediction model of urine PCX and ACR. Multiple logistic regression test was carried out to evaluate against the predictive ability of the model. The area under the ROC curve corresponding to the regression model after adjustment is 0.952. Although factors such as the course of disease, HbA1C, UA, and eGFR could influence on the predictive ability of PCX, PCX still has a good ability to predict early DKD in older patients. Therefore, it could be used as a diagnostic indicator for early-stage DKD in older patients.     

糖尿病肾病脂蛋白(a)质量浓度变化对尿白蛋白排泄率的影响

目的探讨血清脂蛋白(a)[Lp(a)]质量浓度变化与糖尿病肾病(DN)进展之间的关系以及降低血清Lp(a)质量浓度在防治DN进展中的意义。方法对广东省东莞市人民医院2002-04～2004-09门诊及住院270例糖尿病患者分为单纯糖尿病(SDM)组、早期糖尿病肾病(EDN)组和临床糖尿病肾病(CDN)组各90例,比较其与正常对照组的血清Lp(a)水平;两组DN患者在常规治疗基础上每晚服用氟伐他汀40mg。分析血清Lp(a)质量浓度变化与DN进展之间的关系。结果⑴SDM组血清Lp(a)质量浓度与正常对照组比较无显著性差异(P>0.05),EDN、CDN组血清Lp(a)质量浓度明显高于正常对照组和SDM组(P<0.01),CDN组血清Lp(a)质量浓度明显高于EDN组(P<0.01)。血清Lp(a)质量浓度与尿白蛋白排泄率(UAER)呈直线正相关(r=0.396,P<0.01)。⑵两组DN患者血清Lp(a)水平显著降低(P<0.01)。结论血清Lp(a)质量浓度升高与DN进展有关,降低血清Lp(a)质量浓度能有效减轻EDN患者的蛋白尿、改善肾功能,但对CDN患者无效。     

Correlation of urinary cotinine with cardiovascular risk factors in pan masala tobacco users

BackgroundTobacco consumption is considered as one of the major risk factors for cardiovascular (CV) morbidity. However, the effect of paan masala tobacco (PMT) (a type of smokeless tobacco) consumption has not been well studied in our context. Our study is aimed to find an association of CV risk factors between PMT users and nonusers and to correlate those parameters with urinary cotinine level, a degradation product of nicotine occurring in tobacco.MethodsThis comparative cross-sectional study was carried out among 200 participants. The effect of PMT use on CV risk factors such as blood pressure (BP), lipid profile, and body mass index was measured against urine cotinine level. Statistical tests used were χ² test for categorical variable, independent t-test, Mann–Whitney U test, and Spearman's correlation applied for numerical variable, and multivariate regression analysis was performed as required. The level of significance was set at p < 0.05.ResultMean BP, total cholesterol, triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and median cotinine level were found to be significantly higher in PMT users than in controls (p < 0.001). Urinary cotinine level was positively correlated with mean BP, TC, TG, and LDL-C in PMT users (p < 0.001). Similarly, the odds of having hypercholesterolemia and increased diastolic BP was also significantly higher in PMT users (p < 0.001).ConclusionPMT use has an adverse effect on CV risk parameters and there is a rational of cotinine measurement for screening CV risk among PMT users.     

Higher dietary salt and inappropriate proportion of macronutrients consumption among people with diabetes and other co morbid conditions in South India: Estimation of salt intake with a formula

AimThe present study analysed the regular salt and macronutrients consumption of South Indian population with diabetes, hypertension and renal dysfunction.MethodsThe cross sectional study was performed among 200 subjects, divided into four different groups consisted of control, subjects with type 2 diabetes (T2DM) without any other complications, T2DM subjects with chronic kidney disease (CKD) and T2DM subjects with hypertension (HTN). The dietary salt intake was estimated from 24-h urinary sodium excretion and the amount of macronutrients was calculated using 24-h dietary recall method.ResultsOut of 200 study subjects, only 28 (14%) were consuming salt as per the recommended levels by WHO (i.e., 5–6 g/day). Thirty-eight (19%) subjects were consuming more than 18 g of salt per day, 67 (33.5%) were consuming 12–18 g of salt per day and another 67 (33.5%) were found to be consuming salt in a range of 6–12 g/day. Calorie contribution from the carbohydrates was significantly high compared to the calories from the proteins. Fat consumption and its corresponding energy contribution were also high among HTN group subjects.ConclusionObservations of the study point out to the requirement of nationwide intensive and persistent efforts to enhance the public awareness on salt reduction.     

国标法与快速法测定尿碘的对比实验

目的 比较快速法与国标法的测定结果,验证尿碘快速定理检测方法的准确度、精确度、灵敏度。方法 采用快速法和国 法对比测定尿碘标准物质及现场样品。结果 快速法最小检出下限为１．５ｎｇ碘;对碘量为１１９。．１９７μｇ／Ｌ的尿碘标准物质测定的平均相对误差分别为２．３％、１．１％;２４０份现场样品使用国标法和快速法对比测定,测定结果的差异无显著意义（Ｐ〉０．２）,快速法对低、中、高３种浓度４ 尿样进行６批测     

食盐加碘前后缺碘病区儿童生长发育调查

目的 研究碘缺乏病区学龄儿童在全民食盐加碘前后生长发育状况。方法 对该地区７～１４岁儿童（食盐加碘前２４７人,食盐加碘后２１１人）测定身高、下部量、休重,并计算Ｒｏｈｅｒｅｒ指数,测定尿碘。结果 食盐加碘前儿童尿碘中位数平均水平２６．１ｕｇ／Ｌ,其中〉１００ｕｇ／Ｌ者占５．４％;食盐加碘后儿童尿碘中位数平均水平３８４．７ｕｇ／Ｌ,〉１００ｕｇ／Ｌ者占９５．２％。提示碘营养差状态改善（Ｐ〈０．００１