[Frequency of fecal incontinence and its impact on the quality of life of the hospitalized geriatric patient]. / Frecuencia de incontinencia fecal y su impacto en la calidad de vida del paciente geriátrico hospitalizado.

OBJECTIVE: To determine the frequency of fecal incontinence and the impact on the quality of life of hospitalized geriatric patients in a sample from a level two hospital in Monterrey, Nuevo Leon, Mexico. MATERIALS AND METHODS: Hospitalized patients over 60 years of age or their caregivers were questioned about the presence of fecal incontinence. Those who responded affirmatively and could respond were given the following questionnaires and scales: Mini-Mental, Rockwood quality of life for fecal incontinence and Wexner scale modified for severity of incontinence; in addition to clinical data. The frequency was calculated based on a sample and associations were determined between degree of incontinence and quality of life. RESULTS: A total of 234 patients were questioned, of whom 135 (57.69%) were women and 99 (42.31%) men. A total of 34 patients with fecal incontinence were documented, this represents a frequency of 14.53% (95% CI, 10.28-19.71%) in this population. A positive correlation of the severity of incontinence was found with the lifestyle dimension (relation (r) = -0.61, p = 0.04), shame (r = -0.70, p = 0.01), behavior (r = -0.73, p = 0.001) and the average of the four dimensions (r = -0.67, p = 0.02) but not with the depression dimension of the quality of life questionnaire in fecal incontinence. CONCLUSION: When compared with other national and international studies, the frequency of fecal incontinence found was lower than that documented in other series. The quality of life of hospitalized elderly patients with fecal incontinence in this sample was diminished and its impact on quality of life correlated with the severity of fecal incontinence.

Frecuencia de incontinencia fecal y su impacto en la calidad de vida del paciente geriátrico hospitalizado / Frequency of fecal incontinence and its impact on the quality of life of the hospitalized geriatric patient

Objetivo: Determinar la frecuencia de incontinencia fecal y el impacto en la calidad de vida de los pacientes geriátricos hospitalizados en una muestra de un hospital de segundo nivel de Monterrey, Nuevo León, México. Material y métodos: Se interrogó a los pacientes mayores de 60 años hospitalizados o sus cuidadores acerca de incontinencia fecal. A los que respondieran afirmativamente y pudieran responder se les realizaron los siguientes cuestionarios y escalas: Minimental, calidad de vida de Rockwood para incontinencia fecal y escala de Wexner modificada para severidad de incontinencia; además de datos clínicos. Se calculó la frecuencia en base a una muestra y se determinaron asociaciones entre grado de incontinencia y calidad de vida. Resultados: Se interrogaron un total de 234 pacientes, de los cuales 135 (57,69%) eran mujeres y 99 (42,31%) hombres. Se documentó un total de 34 pacientes con incontinencia fecal, esto representa una frecuencia de 14,53% (IC95%, 10,2819,71%) en esta población. Se encontró una correlación positiva de la severidad de la incontinencia con la dimensión de estilo de vida (relación (r) = -0,61, p=0,04), vergüenza (r=-0,70, p=0,01), conducta (r=-0,73, p=0,001) y el promedio de las cuatro dimensiones (r=-0,67, p=0,02) pero no con la dimensión de depresión del cuestionario de calidad de vida en incontinencia fecal. Conclusión: Al comparar con otros estudios nacionales e internacionales, la frecuencia de incontinencia fecal encontrada es menor a lo documentado en otras series. La calidad de vida de los pacientes ancianos hospitalizados con incontinencia fecal en esta muestra se encuentra disminuida y su impacto en la calidad de vida se correlaciona con la severidad de la incontinencia fecal.

Objective: To determine the frequency of fecal incontinence and the impact on the quality of life of hospitalized geriatric patients in a sample from a level two hospital in Monterrey, Nuevo Leon, Mexico. Materials and methods: Hospitalized patients over 60 years of age or their caregivers were questioned about the presence of fecal incontinence. Those who responded affirmatively and could respond were given the following questionnaires and scales: Mini-Mental, Rockwood quality of life for fecal incontinence and Wexner scale modified for severity of incontinence; in addition to clinical data. The frequency was calculated based on a sample and associations were determined between degree of incontinence and quality of life. Results: A total of 234 patients were questioned, of whom 135 (57.69%) were women and 99 (42.31%) men. A total of 34 patients with fecal incontinence were documented, this represents a frequency of 14.53% (95% CI, 10.28-19.71%) in this population. A positive correlation of the severity of incontinence was found with the lifestyle dimension (relation (r) = -0.61, p = 0.04), shame (r = -0.70, p = 0.01), behavior (r = -0.73, p = 0.001) and the average of the four dimensions (r = -0.67, p = 0.02) but not with the depression dimension of the quality of life questionnaire in fecal incontinence. Conclusion: When compared with other national and international studies, the frequency of fecal incontinence found was lower than that documented in other series. The quality of life of hospitalized elderly patients with fecal incontinence in this sample was diminished and its impact on quality of life correlated with the severity of fecal incontinence.

Prevalence of high-grade perineal tear during labor in Mexican adolescents.

INTRODUCTION: There is a high rate of deliveries in adolescents in Mexico. This age group is vulnerable to obstetric complications, including lacerations of the anal sphincter. OBJECTIVE: To determine the prevalence of third and fourth degree perineal tears in adolescents during childbirth, and to evaluate risk factors in comparison with deliveries with lacerations of adult women. METHODS: All obstetric care episodes were reviewed from a public tertiary hospital data in Monterrey, Mexico in 2014. Age, primiparity, delivery instrumentation, episiotomy, body mass index, product weight and tear´s degree were documented at the deliveries with tears of third and fourth degree. RESULTS: The prevalence of third and fourth degree tears of 2.0% was found in the general population, being adolescents the most affected with 2.5%. The unadjusted odds ratio of high-grade tears in adolescent females at delivery, compared to adult females, was 1.36 (95% CI = 0.99-1.86, p= 0.05). No difference was found when comparing risk factors among high-grade tear deliveries in adolescents versus adults. CONCLUSIONS: A higher prevalence than previous reported for high grade tears during delivery was found. The data suggest adolescence as a risk factor for high-grade tears during delivery.

INTRODUCCIÓN: En México hay una elevada tasa de partos en adolescentes. Este grupo es vulnerable para complicaciones obstétricas, entre ellas laceración del esfínter anal. OBJETIVO: Conocer la prevalencia de desgarros perineales de tercer y cuarto grado en adolescentes durante el parto y evaluar factores de riesgo en comparación con partos con laceración de mujeres adultas. MÉTODOS: Se revisaron todas las atenciones obstétricas en un hospital publico de tercer nivel en Monterrey, Nuevo León, México en el año 2014. Se documentó edad, primiparidad, instrumentación del parto, realización de episiotomía, índice de masa corporal, peso del producto y grado del desgarro en los partos que presentaron desgarros de tercer y cuarto grado. RESULTADOS: Se encontró una prevalencia general de 2.0% de desgarros de tercer y cuarto grado y en adolescentes de 2.5%. La razón de momios sin ajustar de desgarros de alto grado en mujeres adolescentes en comparación con mujeres adultas fue de 1.36 (IC 95%= 0.99-1.86, p= 0.05). No se encontró diferencia al comparar factores de riesgo entre los partos con desgarro de alto grado en adolescentes contra adultas. CONCLUSIONES: Se encontró una prevalencia mayor a lo reportado de desgarros de alto grado durante el parto. Los datos sugieren a la adolescencia como factor de riesgo para desgarros de alto grado.

[Correlation between the presence and intensity of symptoms and the results of hydrogen breath tests in the diagnosis of carbohydrate intolerance]. / Correlación entre los síntomas digestivos y los resultados de una prueba de hidrógeno en aliento en el diagnóstico de intolerancia a carbohidratos.

BACKGROUND: Hydrogen breath tests (HBT) are used to confirm the diagnosis of carbohydrate intolerance or small intestinal bacterial overgrowth (SIBO). OBJECTIVE: Determine the existence of a correlation between the presence and intensity of symptoms experimented by the patient after the ingestion of a carbohydrate load and the test result. MATERIALS AND METHODS: This is an observational, retrospective and analytic study, in which all patients' files from year 2008 to 2014 containing a report of a HBT performed at Hospital San José TEC de Monterrey were revised. Using a visual analogue scale (VAS), the patient reported the intensity of gastrointestinal symptoms during the test. Descriptive statistics were obtained, and exclusively for lactose HBTs, Pearson's correlation coefficient (r) between maximum hydrogen concentration in breath and symptom intensity was calculated. RESULTS: A HBT was performed in 33 patients: 23 with lactose, 5 with fructose, and 5 with lactulose as substrate. Of these, 10, 2, and 5 tests were positive, respectively. For lactose HBTs, the symptom with most sensitivity was flatulence (80%), which also had the greatest likelihood ratio for a positive test (1.73). Diarrhea had the greatest specificity (84.6%). A tendency for positivity was observed when patients presented symptoms. A moderately positive correlation between hydrogen ppm and symptom intensity was found (r=0.427, p=0.023). CONCLUSIONS: A correlation between symptom intensity and test positivity was found in patients with lactose intolerance. The presence of flatulence after lactose loading may be indicative of a positive test.