Nationwide survey of continence status among older adult residents living in long-term care facilities in Japan: The prevalence and associated risk factors of incontinence and effect of comprehensive care on continence status.

日本长期护理机构老年居民节制状况的全国性调查: 失禁的患病率和相关危险因素以及综合护理对节制状况的影响。

  • 影响因子:1.86
  • DOI:10.1111/ggi.13872
  • 作者列表:"Suzuki M","Okochi J","Iijima K","Murata T","Kume H
  • 发表时间:2020-04-01

AIM:This study aimed to identify the prevalence of urinary, fecal and double incontinence among Japanese residents aged ≥65 years living in long-term care facilities. Furthermore, the association between baseline characteristics and changes in toileting activity after a 3-month comprehensive care among older individuals was investigated. METHODS:We examined the prevalence of incontinence and its significant predictors. The association between the Functional Independence Measure score at baseline and each type of incontinence (urinary, fecal or double incontinence) was examined using a logistic regression model. Similarly, the association between the Functional Independence Measure score at baseline and improvement in toileting activity after a 3-month comprehensive care was examined. RESULTS:In total, 2517 residents (670 men and 1847 women) were recruited. The prevalence rates of urinary, fecal and double incontinence were 66.9%, 42.8% and 41.1%, respectively. In multivariate analysis, the sum of the motor subscales after removing four continence items and the sum of the cognitive subscales of the Functional Independence Measure score at baseline were significantly associated with all types of incontinence. The sum of the motor subscales after removing four continence items of the Functional Independence Measure score was associated with improved toileting activity. CONCLUSIONS:This study presented the prevalence of urinary, fecal and double incontinence among residents living in long-term care facilities in Japan. The Functional Independence Measure items at baseline were associated with not only continence status, but also improved toileting activity after 3-month comprehensive care. Geriatr Gerontol Int 2020; 20: 285-290.


目的: 本研究旨在确定居住在长期护理机构中年龄 ≥ 65岁的日本居民的尿失禁、大便失禁和双重尿失禁的患病率。此外,还研究了基线特征与老年人3个月综合护理后如厕活动变化之间的关联。 方法: 我们检查了尿失禁的患病率及其重要的预测因素。使用逻辑回归模型检查基线时的功能独立性测量评分与每种类型的失禁 (尿、粪便或双重失禁) 之间的关联。同样,检查了基线时的功能独立性测量评分与3个月综合护理后如厕活动改善之间的相关性。 结果: 共招募了2517名居民 (670名男性和1847名女性)。尿失禁、大便失禁和双失禁的患病率分别为66.9% 、42.8% 和41.1%。在多变量分析中,去除4个控尿项目后的运动分量表的总和以及基线时功能独立性测量评分的认知分量表的总和与所有类型的失禁显著相关。去除功能独立性测量评分的四个控尿项目后,运动分量表的总和与改善的如厕活动相关。 结论: 本研究显示了日本长期护理机构居民的尿失禁、大便失禁和双重尿失禁的患病率。基线时的功能独立性测量项目不仅与控尿状态相关,而且在3个月的综合护理后改善了如厕活动。Geriatr Gerontol Int 2020; 20: 285-290。



来源期刊:Clinical nephrology
作者列表:["Battaglia Y","Cojocaru E","Fiorini F","Granata A","Esposito P","Russo L","Bortoluzzi A","Storari A","Russo D"]

METHODS::Kidney transplant recipients (KTRs) are susceptible to low levels of vitamin D, which may be responsible for mineral and bone metabolism disorders and play some role in the occurrence of cardiovascular, metabolic, immunologic, neoplastic, and infectious complications after kidney transplant. Kidney Disease Improving Global Outcomes (KDIGO) guidelines of the year 2017 recommended vitamin D supplementation in the first 12 months after transplant using the same treatment strategies for the general population. However, no recommendations are provided after the first 12 months due to a lack of sufficient data. This review analyses some studies that assessed the vitamin D status of KTRs and the effects of nutritional and active vitamin D supplementation on bone mineral density, cardiovascular disease, proteinuria, and graft function in KTRs.

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翻译标题与摘要 下载文献
来源期刊:The Journal of urology
作者列表:["Lee J","Kim HY","Goh HJ","Heo JE","Almujalhem A","Alqahtani AA","Chung DY","Chang K","Choi YD","Rha KH"]

METHODS:PURPOSE:We compared early continence recovery after surgical treatment of prostate cancer with Retzius sparing robot-assisted radical prostatectomy and conventional robot-assisted radical prostatectomy. MATERIALS AND METHODS:Robot-assisted radical prostatectomy was done by a single surgeon in 1,863 cases between October 2005 and May 2018 using the conventional and the Retzius sparing technique in 1,150 and 713, respectively. To compare continence outcomes between the groups propensity score matching was performed using 9 preoperative variables, including age, body mass index, prostate specific antigen, biopsy Gleason Grade Group, clinical T stage, prostate volume on transrectal ultrasound, and the I-PSS (International Prostate Symptom Score), I-PSS quality of life score and International Index of Erectile Function-5 scores. Continence was assessed by the pad count every month postoperatively until month 6 and was converted to a binary outcome. RESULTS:After propensity score matching 609 cases per group were matched with no significant difference in all 9 variables. The Kaplan-Meier curve analysis revealed that Retzius sparing robot-assisted radical prostatectomy was associated with a significantly better continence recovery rate than conventional robot-assisted radical prostatectomy during the 6-month study period (p <0.001). CONCLUSIONS:Based on propensity score matching with multiple variables and a large case series, Retzius sparing robot-assisted radical prostatectomy can be a candidate for future robot-assisted radical prostatectomy. It achieves better early continence recovery, a short operative time and early recovery compared to conventional robot-assisted radical prostatectomy.

翻译标题与摘要 下载文献
来源期刊:The Journal of urology
作者列表:["McCrery R","Lane F","Benson K","Taylor C","Padron O","Blok B","De Wachter S","Pezzella A","Gruenenfelder J","Pakzad M","Perrouin-Verbe MA","Le Normand L","Van Kerrebroeck P","Mangel J","Peters K","Kennelly M","Shapiro A","Lee U","Comiter C","Mueller M","Goldman HB"]

METHODS:PURPOSE:Sacral neuromodulation is a guideline recommended treatment of urinary dysfunction and fecal incontinence in patients in whom conservative treatments have failed. Historically sacral neuromodulation has been delivered using a nonrechargeable device with an average life span of 4.4 years. Surgery is required to replace the implanted neurostimulator due to battery depletion. Implantation of a long-lived implanted neurostimulator can eliminate the need for replacement surgeries, potentially reducing patient surgical risks and health care costs. The Axonics r-SNM System™ is a miniaturized, rechargeable sacral neuromodulation system designed to deliver therapy for at least 15 years. The ARTISAN-SNM (Axonics® Sacral Neuromodulation System for Urinary Urgency Incontinence Treatment) study is a pivotal study using rechargeable sacral neuromodulation therapy to treat urinary urgency incontinence. Six-month results are presented. MATERIALS AND METHODS:A total of 129 eligible patients with urinary urgency incontinence were treated. All participants were implanted with a tined lead and the rechargeable sacral neuromodulation system in a nonstaged procedure. Efficacy data were collected using a 3-day bladder diary, the validated ICIQ-OABqol (International Consultation on Incontinence Questionnaire Overactive Bladder quality of life) questionnaire and a participant satisfaction questionnaire. Therapy responders were identified as participants with a 50% or greater reduction in urinary urgency incontinence episodes compared to baseline. We performed an as-treated analysis in all implanted participants. RESULTS:At 6 months 90% of participants were therapy responders. The mean ± SE number of urinary urgency incontinence episodes per day was reduced from 5.6 ± 0.3 at baseline to 1.3 ± 0.2. Participants experienced a clinically meaningful 34-point improvement on the ICIQ-OABqol questionnaire. There were no serious device related adverse events. CONCLUSIONS:The Axonics r-SNM System is safe and effective with 90% of participants experiencing clinically and statistically significant improvements in urinary urgency incontinence symptoms.