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Biomedical subjects

G Lose

Publications and source records attributed to G Lose.

At least 19 recordsLinked to original sources
PubMed2006

Validity and reliability of a questionnaire for evaluating nocturia, nocturnal enuresis and sleep-interruptions in an elderly population.

OBJECTIVES: To validate a new questionnaire evaluating nocturia, nocturnal enuresis and sleep-interruptions in an elderly population of men and women in Denmark. METHODS: The Nocturia, Nocturnal Enuresis and Sleep-interruption Questionnaire (NNES-Q) emerged from review of the literature and expert consensus. The questionnaire was a subset of a larger questionnaire comprising several domains on health status and voiding. Convergent and discriminatory validity was assessed in an unselected population of 2000 men and 2000 women 60-80 years old. To test reproducibility, 400 respondents were mailed a separate questionnaire 2 weeks apart. A subgroup of men and women with and without nocturia was used for evaluating reliability of number of nocturia episodes. RESULTS: A total of 2825 (70.6%) filled in the questionnaire. A decrease in health status was correlated with increasing bother (range: -0.25 to -0.36, p<0.001, Spearman's r). These findings indicate acceptable convergent validity. Significant discriminatory validity was proven in separate groups of symptom severity (p<0.0001, Kruskal-Wallis test). Median kappa was 0.70 (range 0.58-0.86) indicating substantial agreement in the retest analysis. Number of nocturia episodes in questionnaires correlated with frequency volume charts (Spearman's rho 0.88; p<0.001). CONCLUSION: These data support that the NNES-Q has a good discriminatory and convergent validity, and is reliable over time. The NNES-Q may be useful in epidemiological studies and may also have a potential in daily clinical work up in patients with nocturia and nocturnal enuresis.

Aged↗
PubMed2006

Bacterial vaginosis in a cohort of Danish pregnant women: prevalence and relationship with preterm delivery, low birthweight and perinatal infections.

OBJECTIVE: To determine the prevalence of bacterial vaginosis (BV) in the second trimester of pregnancy in a Danish population using the Schmidt criteria and to examine whether BV was associated with subsequent preterm delivery, low birthweight or perinatal infections. DESIGN: Prospective cohort study. SETTING: Department of Obstetrics and Gynaecology at a University Hospital, Denmark. POPULATION: Three thousand five hundred and forty pregnant women aged 18 years or more. METHODS: A smear from the vagina was obtained from all women, air-dried and stored for subsequent diagnosis of BV. After rehydration with isotonic saline, the smear was examined in a phase-contrast microscope at 400x, and the numbers of lactobacilli morphotypes and small bacterial morphotypes were counted. A score for BV was calculated according to the method described by Schmidt. The outcome of pregnancy from 20 weeks of gestation was examined in the 3262 singleton pregnant women who were included in this study before 20 weeks of gestation. The relationship between BV and adverse outcome of pregnancy was examined by univariate and multivariate analyses. MAIN OUTCOME MEASURES: Prevalence of BV, preterm delivery (<37 weeks), low birthweight (<2500 g), preterm delivery of a low-birthweight infant and clinical chorioamnionitis. RESULTS: The prevalence of BV was 16%, and the rate of preterm delivery was 5.2% in the study population of 3262 singleton pregnant women who were included before 20 weeks of gestation. Mean birthweight was significantly lower in infants of women with BV than in infants of women without BV (3408 versus 3511 g, P < 0.01). Univariate analyses showed that BV was marginally associated with preterm delivery but significantly associated with low birthweight, preterm delivery of a low birthweight infant, indicated preterm delivery and clinical chorioamnionitis. Multivariate analyses, which adjusted for previous miscarriage, previous preterm delivery, previous conisation, smoking, gestational diabetes, fetal death and preterm premature rupture of membranes, showed that BV was significantly associated with low birthweight (OR 1.95, 95% CI 1.3-2.9), preterm delivery of a low-birthweight infant (OR 2.5, 95% CI 1.6-3.9), indicated preterm delivery (OR 2.4, 95% CI 1.4-4.1) and clinical chorioamnionitis (OR 2.7, 95% CI 1.4-5.1). CONCLUSIONS: The prevalence of BV determined using the Schmidt criteria in the early second trimester of pregnancy was similar to that found in similar studies. The presence of BV before 20 weeks of gestation was an independent risk factor for delivery of an infant with low birthweight, preterm delivery of a low-birthweight infant, indicated preterm delivery and clinical chorioamnionitis.

Cohort Studies↗
PubMed2005

Nocturia: morbidity and management in adults.

Nocturia is an increasingly prevalent and bothersome urinary symptom associated with considerable impact and morbidity in later life. Nocturnal frequency is associated with a number of underlying pathologies, both related and unrelated to the lower urinary tract. Following careful assessment, diagnosis and management, the condition is amenable to amelioration, if not complete cure in the majority of cases. This paper outlines the epidemiology, underlying pathophysiology and diseases associated with nocturia and reviews current treatment strategies.

Adrenergic alpha-Antagonists↗
PubMed2004

Help-seeking behaviour and associated factors among women with urinary incontinence in France, Germany, Spain and the United Kingdom.

OBJECTIVES: To assess the proportion of women who consult their doctor about urinary incontinence (UI), and explore factors associated with help-seeking in France, Germany, Spain and the UK. METHODS: A representative sample of 29,500 women received a 13 item postal questionnaire to identify those with UI. A randomly selected sub-sample of 2953 women with UI received a more detailed follow-up questionnaire. RESULTS: There was a response rate of 58% in the initial survey and 53% in the second. Thirty-one percent of all women had consulted a doctor about their UI symptoms with more women consulting in France and Germany than in the UK and Spain. A number of factors relating to general health care, UI and women's attitudes were found to be associated with help-seeking after adjusting for women's age, UI duration and frequency, and 'bothersomeness' of UI; factors traditionally associated with help-seeking. After adjusting for these factors, willingness to take long-term medication and having spoken to others about UI were found to be strong predictors of help-seeking in all four countries.

Female↗
PubMed2004

Clinical experiences with desmopressin for long-term treatment of nocturia.

PURPOSE: To our knowledge we report the first long-term use of desmopressin for nocturia. Patients previously responding to desmopressin in short-term studies were enrolled in this long-term open label study. MATERIALS AND METHODS: Patients received treatment for 10 or 12 months with the optimal desmopressin dose (0.1, 0.2 or 0.4 mg orally at bedtime). Patients were followed a further month without treatment. Of the patients completing the short-term study 132 males (92%) and 117 females (83%) were recruited, and 95 (72%) and 87 (75%), respectively, completed long-term treatment. RESULTS: The mean number of nocturnal voids was decreased in males and females throughout the study (1.3 to 1.6 and 1.2 to 1.3) compared with baseline (3.1 and 2.9, respectively). After followup the number of voids increased after treatment cessation. From baseline to 12 months the mean duration of the first sleep period gradually increased in males (157 to 288 minutes) and females (142 to 310 minutes). After followup the mean duration of the first sleep period decreased, confirming that it was a treatment related benefit. Desmopressin was well tolerated with few males (14%) or females (10%) withdrawing due to adverse events. Most adverse events were mild (44%) or moderate (44%) in severity. Four males experienced serious drug related adverse events, namely dizziness in 1, cardiac failure, headache and vomiting in 2, and chest pain and hypertension in 1. A female experienced 4 serious drug related adverse events, that is hyponatremia, headache, nausea and vertigo. Two patients had clinically significant hyponatremia. CONCLUSIONS: This long-term study shows that desmopressin is a generally well tolerated and effective treatment for nocturia.

Adult↗
PubMed2004

The prevalence of urinary incontinence in women in four European countries.

OBJECTIVE: To determine the prevalence, type and treatment behaviour of women with urinary incontinence in four European countries. SUBJECTS AND METHODS: Data were collected using a postal survey which was sent to 29,500 community-dwelling women aged > or = 18 years in France, Germany, Spain and the UK. Subjects were asked about the type of urinary incontinence they had experienced and their treatment behaviour. RESULTS: Of the women who responded, 35% reported involuntary loss of urine in the preceding 30 days; stress urinary incontinence was the most prevalent type. The lowest prevalence was in Spain (23%), while the prevalence was 44%, 41% and 42% for France, Germany and the UK, respectively. About a quarter of women with urinary incontinence in Spain (24%) and the UK (25%) had consulted a doctor about it; in France (33%) and Germany (40%) the percentages were higher. Overall, <5% of the women had ever undergone surgery for their condition. While pads were used by half of the women, there were some differences among the countries. CONCLUSIONS: Millions of women in Europe have urinary incontinence; the consultation and treatment rates were low in the European countries included in this study.

Adolescent↗
PubMed2003

Postoperative urinary retention in gynecologic patients.

The aim of this study was to determine the prevalence of postoperative urinary retention (PU) based on preoperative estimation of bladder capacity in gynecologic patients and to evaluate the reliability of clinical examination in diagnosing PU. Over a 3-year period 284 consecutive patients undergoing surgical intervention were included in the study. Bladder capacity was assessed preoperatively. If PU was suspected a clinical examination, bladder scan and catheterization were performed. The prevalence of postoperative urinary retention was 9.2%. There was a significant association between PU and the type of operation, but not with the type or the duration of anesthesia or total blood loss. Clinical examination was reliable, with a positive and negative predictive value of 76.2% and 100%, respectively. In conclusion, PU is a substantial problem after gynecologic surgery. Patients at risk are difficult to predict. The risk is higher after laparotomy than after laparoscopy. The clinical diagnosis is fairly accurate.

Adult↗
PubMed2003

Motor evoked potentials from the pelvic floor in patients with multiple sclerosis.

The use of motor evoked potentials (MEPs) to study the integrity of pelvic floor motor innervation is poorly described in the literature. This study evaluated the clinical use of pelvic floor MEPs in 16 women with multiple sclerosis. Lower urinary tract dysfunction was assessed with urodynamic investigations. Transcutaneous magnetic stimulation was applied over the motor cortex and spinal roots, and MEPs were recorded from the puborectalis, the external urethral sphincter, and the abductor hallucis muscles. In many patients, responses from the pelvic floor muscles could not be evoked, and central motor conduction times for the puborectalis motor pathways could only be calculated in 56%. There was a poor correlation of abnormal conduction to lower urinary tract dysfunction. It is concluded, that unevokable responses from pelvic floor muscles in a patient with multiple sclerosis should be interpreted with care, and that pelvic floor MEPs have a limited clinical value in the investigation of suspected demyelinating disease.

Adult↗
PubMed2002

Urinary incontinence in elite female athletes and dancers.

The aim of this study was, to determine the frequency of urinary loss in elite women athletes and dancers. Elite athletes in eight different sports, including ballet, filled in an evaluated questionnaire about urinary incontinence while participating in their sport/dancing and during daily life activities. A total of 291 women with a mean age of 22.8 years completed the questionnaire, providing a response rate of 73.9%. Overall, 151 women (51.9%) had experienced urine loss, 125 (43%) while participating in their sport and 123 (42%) during daily life. The proportion of urinary leakage in the different sports was: gymnastics 56%, ballet 43%, aerobics 40%, badminton 31%, volleyball 30%, athletics 25%, handball 21% and basketball 17%. During sport 44% had experienced leakage a few times, 46.4% now and then, and 9.6% frequently. During daily life the figures were: 61.7% a few times, 37.4% now and then, and 0.8% frequently. Of those who leaked during sport, 95.2% experienced urine loss while training versus only 51.2% during competition (P<0.001). The activity most likely to provoke leakage was jumping. Sixty per cent (91/151) occasionally wore pads or panty shields because of urine loss. Urinary leakage is common among elite athletes and dancers, particularly during training, but also during daily life activities.

Activities of Daily Living↗
PubMed2002

Repeatability of cystometry and pressure-flow parameters in female patients.

The repeatability of cystometric and pressure-flow data was studied in 31 female patients. The measured parameters had poor correlation coefficients, and logarithmic transforming of the data was generally not warranted. Previous studies and statistical methods of reliability measurement are reviewed. It is suggested as a subject for future studies, that urodynamic measurements are repeated in each patient so that confidence limits can be established within disease entities.

Adolescent↗
PubMed2002

Morbidity of urodynamic investigation in healthy women.

The morbidity of diagnostic catheterization in healthy women has never been described. In order to further elucidate the natural history of postcystometry bacteriuria we studied a group of healthy women without lower urinary tract symptoms. Thirty female volunteers aged 39-72 years underwent urine sampling prior to and at day 3 after invasive urodynamic evaluation. One case of asymptomatic bacteriuria was detected among pretest samples. On post-test sampling 10 of 29 cultures were positive. With a cut-off level of >10(5) CFU/ml only 2 cases could be classified as significant bacteriuria. Only 1 was symptomatic. The remaining 29 women had no symptoms following the examination. Thus the incidence of lower urinary tract infection was 3.3% following repeated diagnostic catheterization. We concluded that although bacteriuria is common after diagnostic catheterization, it is essentially asymptomatic.

Adult↗
PubMed2002

Does the tension-free vaginal tape procedure affect the voiding phase? Pressure-flow studies before and 1 year after surgery.

OBJECTIVE: To evaluate the voiding phase before and 1 year after surgery in women who underwent a tension-free vaginal tape (TVT) procedure for stress incontinence. PATIENTS AND METHODS: The study comprised 45 women with genuine stress urinary incontinence. To assess the voiding phase, patients were asked if their voiding had changed after surgery, and objectively the uroflowmetry, residual urine measurements and pressure-flow data were compared. RESULTS: At 1 year after surgery 39 women (87%) were subjectively cured and six (13%) improved. The objective cure rate was 88%; the pad-test leakage and the number of leakage episodes decreased significantly after surgery. Subjectively, 78% of the patients reported that the voiding phase had become more difficult, and the spontaneous flow curve changed to a more obstructive pattern in 40%, with the mean urinary peak flow rate (Q(max)), the corrected Q(max) and the mean average flow rate decreasing significantly. The residual urine volume increased significantly, although no patient had volumes of > 25% of their bladder capacity. During the pressure-flow study the Q(max) decreased and the urethral resistance factor increased significantly. However, only one patient could be classified as obstructed. Two patients had clinical problems and used self-catheterization once daily 1 year after surgery. CONCLUSION: There were subjective and objective changes in the voiding phase 1 year after the TVT procedure. The significance of these findings remains to be determined. Longitudinal studies are warranted to clarify whether the patients at risk can be characterized from subjective and objective findings.

Female↗
PubMed2001

[Risk factors of lower urinary tract symptoms in women aged 40-60 years].

INTRODUCTION: The study was carried out to determine the relation between lower urinary tract symptoms and possible associated factors in women aged 40-60 years. METHODS: In a normal population study, 502 women with lower urinary tract symptoms and 742 women without symptoms (controls) were asked about possible associated factors. RESULTS: Four hundred and eighty-seven (97.0%) women with symptoms and 564 (76.0%) controls completed the study. Stress incontinence was associated with parity (primipara: OR = 2.2 [95% CI: 1.0; 4.9]; para II: OR = 3.9 [95% CI: 1.9; 8.0]; para III: OR = 4.5 [95% CI: 2.1; 9.5]), the use of diuretics (OR = 2.2 [95% CI: 1.2; 3.9]), hysterectomy (OR = 2.4 [95% CI: 1.6; 3.7]), and increased BMI. Urge incontinence was associated with the use of diuretics (OR = 4.0 [95% CI: 2.2; 7.1]) and increased BMI. Urgency was associated with parity (primipara: OR = 1.9 [95% CI: 0.9; 4.2]; para II: OR = 3.0 [95% CI: 1.5; 5.9]; para III: OR = 3.1 [95% CI: 1.5; 6.5]), the use of diuretics (OR = 2.7 [95% CI: 1.5; 4.7]) and increased BMI. Associations between non-incontinence symptoms (except urgency) and the factors studied were weak and inconsistent. Straining at stool and constipation were inversely associated with lower urinary tract symptoms. Overall, lesion of the anal sphincter, episiotomy, fetal weight, physical activity, and hormonal status had a minor, if any, association with lower urinary tract symptoms. CONCLUSIONS: Lower urinary tract symptoms were associated positively with parity, BMI, prior hysterectomy, use of diuretics, straining at stool, and constipation.

Adult↗
PubMed2001

[Is it possible to optimize the use of economical and professional resources in the diagnosis and treatment of urinary incontinence?].

In 1996, the estimated costs in Sweden, owing to urinary incontinence, increased to $0.5 billion or 2-3% of the health budget. In Denmark, the cost of urinary incontinence is unknown, but probably much the same as that in Sweden. Growth of the elderly population, a rise in the costs of routine incontinence care (mostly pads), and an increasing ability to cure incontinence challenge the existing economic priorities. Economic analysis in this field is sparse. Treatment of urinary incontinence imposes a significant financial burden on society. Based on a review of the literature, the authors recommend increased focus on health economy and preventive possibilities, as well as a change in the diagnostic and treatment algorithm of urinary incontinence.

Aged↗