Risk factors for urinary incontinence in Taiwanese women aged 60 or over

To determine risk factors of urinary incontinence (UI) in Taiwanese women aged 60 or over, face-to-face interviews with 1,517 women, selected by a multistage random method, were completed. The prevalence of UI in this age group was 29.8%. Factors and their prevalence associated with UI were age [odds ratio (OR)=1.04 per year], diabetes mellitus (39.8%, p = 0.002), hypertension (39.5%, p = 0.001), abdominal gynecological surgery (41.4%, p = 0.001), hysterectomy (42.4%, p = 0.003), history of drug allergy (41.3%, p = 0.001), smoking (45.5%, p = 0.010), hormone replacement therapy (41.5%, p = 0.026), and high body mass index (OR = 1.05 per unit). Alcohol consumption and marriage did not increase the risk of UI. UI is a common and costly problem in elderly women. It diminishes the quality of life of the affected women. Of the associated factors that are preventable, modifiable, or controllable, smoking, prior hysterectomy, and obesity may have the greatest impact on the prevalence of UI.     

Nocturnal polyuria and nocturia relief in patients treated with solifenacin for overactive bladder symptoms

The objectives of this study are to determine whether patients with overactive bladder (OAB) and nocturia achieved relief of their nighttime voiding symptoms when treated with solifenacin and whether having nocturnal polyuria (NP) affected that response. The patients pooled from four phase III clinical trials were evaluated for reductions in nocturia episodes after treatment with solifenacin (5 or 10 mg) or placebo. A second analysis was performed in patients with and without NP. The patients treated with solifenacin experienced statistically significant reductions in nocturia episodes; median reductions were −35.5% for 5 mg of solifenacin and −36.4% for 10 mg of solifenacin compared with −25.0% for placebo, and significantly more patients treated with solifenacin vs placebo achieved a mean nocturic frequency of ≤1 episode/night. Solifenacin significantly reduced nocturia episodes only in patients without NP (mean change was −0.61 episodes/night for both doses compared with −0.43 episodes for placebo). Solifenacin significantly improved nocturia symptoms only in OAB patients without NP.     

睑袋成形术并发泪囊功能不全

目的 探讨睑袋成形术导致泪囊功能不全的原因和治疗方法。方法 对睑袋成形术后无睑外翻出现溢泪的患者，进行泪道功能检查，功能不全者行下睑睑部眼轮匝肌缩短或断端吻合，下睑眶部眼轮匝肌上移手术。结果 28例患者因睑袋成形术后并发泪囊功能不全，再次手术时均发现有过量切除或未能缩紧（或缩紧不足）睑部眼轮匝肌。经手术加强睑部眼轮匝肌张力后，泪囊“泵”功能恢复，溢泪消失。结论睑袋成形术中，对多余及松弛组织去除量的控制不当，或术中未能有效地恢复下睑各层结构张力的平衡，尤其是下睑睑部眼轮匝肌张力明显减弱时，其泪囊的“泵”作用消失，出现功能性溢泪。通过手术恢复下睑轮匝肌张力的“泪泵”功能，有效地治疗了因睑袋成形术所并发的泪囊功能不全。     

Quantifying work load in neck, shoulders and wrists in female dentists

Objective:?To assess the work load in neck and upper limbs of dentists. Methods:?Twelve right-handed female dentists (six with and six without a history of definite neck/shoulder disorders, pair-wise matched for age) were studied when performing authentic dental work. Electromyography (EMG) was used to quantify the muscular load of the shoulders bilaterally and of the right forearm. Positions and movements of the head and wrists were measured, using inclinometers and electrogoniometers. Results:?During work, the median load for the right upper trapezius muscle was 8.4% of the maximal voluntary EMG activity (MVE); during 90% of the time the load was ?3.3% MVE (“static” load). The figures were somewhat lower on the left side (7.0% and 2.5% MVE, respectively). Subjects with disorders had over all lower load levels for the trapezius muscles, although not statistically significant at <0.05, than those without disorders. During a standardized reference contraction for the trapezius, the load was 17% MVE, and the quotient between MVE and torque [normalized to maximal voluntary torque (MVC)] was 0.5. These figures may be used for transformations. The muscular load on the right forearm was similar to the loads on the trapezius. The head was, on average, forward tilted ?39°, and during 10% of the time ?49°. The left hand was held in more static positions, with palmar flexion and ulnar deviation, also reflected by lower angular velocities and repetitiveness, as compared with the right one, which was dorsiflexed. Conclusions:?Dentists are exposed to high load on the trapezius muscles bilaterally, and steep, prolonged forward bending of the head. Further, for the wrists the postures were constrained, but the dynamic demands were low.     

下胸椎和腰椎椎弓根形态学测量及其临床意义

对15具T_9—L_5段尸体脊椎标本的推弓根进行了实体及X线片形态学测量.测量内容包括:椎弓根高、椎弓根宽、椎弓根后缘皮质与前缘皮质的距离及椎弓根轴线与矢状面夹角.结果提示:临床应用椎弓根螺钉固定时,应选择合适的螺钉,选准进钉点,并注意进钉方向及深度.     

Combined head-up tilt and lower body suction: A test of orthostatic tolerance

Acombined tilt-table and lower body suction chamber to provide a progressive test of orthostatic tolerance which avoided the use of drugs and had a defined end point even in most asymptomatic subjects has been constructed and evaluated. An air-tight cover, sealed to a tilt-table and to the subject at the level of the iliac crest, was used to study the responses to: head-up tilting for 20 min, then tilting plus lower body suction at –20 and –40 mmHg for 10 min at each. Blood pressure, heart rate and cardiac output were measured noninvasively and orthostatic tolerance was assessed as the time to imminent onset of syncope.All subjects tolerated tilt alone but 84% developed signs and symptoms of presyncope during the suction. Younger women had a lower orthostatic tolerance than other groups. Values of the variables measured during tilting alone did not correlate with the measured orthostatic tolerance, but during the suction subjects who developed early syncope showed larger decreases in cardiac output and smaller maximal heart rates than the more resistant subjects. The test is repeatable and is likely to be of value in the assessment of orthostatic tolerance in patients and for evaluating the effects of various interventions.     

碘缺乏地区儿童智力水平的现状调查

应用希内学习能力测试法(简称H-NTLA)对碘缺乏地区189名9～13岁儿童做调查研究,其中男93人,女96人。调查发现智商低于70者57人(30％),其比例明显高于正常人群。相关分析表明,缺碘地区儿童男孩智商高于女孩,父母亲文化程度、职业与儿童智商有关,儿童的智商与学习成绩(包括语文和数学)呈正相关。分析结果还间接说明,希内学习能力测试法是一种能够准确反映儿童智力或学习能力的智力测试法。     

Laser-assisted removal of a foreign body from the colon

Summary An 81-year-old woman underwent a colonoscopy because of a sigmoiditis poorly responding to conservative therapy. A rod-shaped foreign body found in the sigma proved impossible to remove conventionally. Irradiation with a low laser energy caused the foreign body to break apart, after which its extraction was straightforward. The further clinical course was uncomplicated. In this case a partial sigmoidectomy would have been indicated had the laser-supported extraction not been successful. The authors suggest that a similar procedure could be helpful in the management of foreign bodies in the esophagus.     

DIOMED激光治疗下肢静脉曲张的初步报告

目的:初步评价DIOMED激光治疗下肢静脉曲张的临床应用。方法:20例病人共26条患肢均行激光或激光结合手术治疗,主要应用4种手术治疗方式:①单纯激光治疗;②激光治疗加高位大隐静脉结扎术;③激光治疗加合股浅静脉瓣膜包窄术和大隐静脉高位结扎术;④激光治疗加大隐静脉高位结扎和交通支结扎术。结果:经随访2～14个月,所有病人都恢复正常生活自理或工作,无局部复发表现,疗效满意。结论:静脉内激光治疗是一种安全、有效、微创、不遗留手术疤痕、操作简便和疗效好的新治疗方法,还可联合手术治疗。