ABSTRACT
Objective:To explore the risk factors of overactive bladder(OAB)syndrome in older women with stress urinary incontinence(SUI).Methods:In this cross-sectional study, 157 elderly women with SUI, aged 60-88(65.6±5.4)years, were recruited from Qingshan District Maternal and Child Health Hospital and areas serviced by Fozuling Community Service Center in Wuhan between October to November 2020.Data collection included a questionnaire covering general information, dietary habits, childbirth history, medical history, the urogenital distress inventory(UDI-6)and the overactive bladder symptom score(OABSS), and physical examinations on curvature of the spine, pelvic floor muscle strength and pelvic floor ultrasound imaging.Results:A total of 157 elderly women with SUI were included in the study and the prevalence of OAB was 17.2%(27 cases). The prevalence of OAB was 17.6%(25 cases)among 142 patients with mild SUI and 13.3%(2 cases)among 15 patients with moderate or severe SUI, but SUI severity was not correlated with the prevalence of OAB( χ2=0.003, P>0.05). The UDI-6 score was 2.39±2.04 and the OABSS score was 3.70±2.48, with a positive correlation between OABSS and UDI-6( r=0.254, P<0.01), suggesting that OAB had a negative effect on the quality of life of patients with SUI.Multivariate Logistic regression analysis on factors with P<0.3 in the univariate analysis showed that number of pregnancies( P<0.01), anterior vaginal wall prolapse( P<0.05), and abnormal inclination of the pelvis( P=0.05)were associated with the prevalence of OAB.Regarding the number of pregnancies, the risk of OAB increased with 2-3 pregnancies( OR=1.46, 95% CI: 0.25-8.56)and with 3 pregnancies or more( OR=4.29, 95% CI: 0.79-23.18), compared with the prevalence at no more than 1 pregnancy.Compared with patients without anterior vaginal wall prolapse, Ⅰ-Ⅱ degree prolapse increased the risk of OAB( OR=4.21, 95% CI: 1.40-12.63), and third-degree prolapse further increased the risk( OR=11.48, 95% CI: 1.37-96.17). Compared with patients with normal inclination of the pelvis, anterior or posterior pelvis inclination promoted the occurrence of OAB( OR=3.46, 95% CI: 1.23-9.73; OR=2.62, 95% CI: 0.54-12.71). Conclusions:OAB has a negative impact on the quality of life of elderly women with SUI.Pregnancy, anterior vaginal prolapse and abnormal inclination of the pelvis promote the occurrence of OAB.
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Objective To characterize the distribution of conjunctival sac flora and antibiotic susceptibility in healthy people of different ages.Methods Totally 1 839 conjunctival sac secretion samples from 1 131 people without infectious eye diseases attending Qingdao Eye Hospital of Shandong First Medical University from 2018 to 2021 were retrospectively analyzed.These people were divided into four groups according to age:children(≤18 years old),young(19-45 years old),middle-aged(46-65 years old),and elderly(＞65 years old).Differences in the distribution of conjunctival sac flo-ra and antibiotic susceptibility among these groups were compared using the chi-square test or Fisher's exact test.The Bonferroni method was used for pairwise comparisons.Results The total bacterial detection rate of the conjunctival sac in the study population aged 1 month to 91 years old(median:11.00 years old;quartiles:5.00 years old,40.00 years old)was 64.93％;the bacterial detection rate in the children group(76.79％)was significantly higher than that in the young,middle-aged and elderly groups(all P＜0.001).Staphylococcus epidermidis(55.97％),Staphylococcus aureus(8.60％)and Streptococcus mitis(7.52％)were the most common bacteria in the conjunctival sacs.Gram-positive bacteria were re-sistant to most penicillins(16.79％-53.47％)and macrolides(17.21％-20.87％)antibiotics,and highly susceptive to van-comycin(99.56％)and gatifloxacin(98.57％).Gram-negative bacteria had low susceptibility rates to cephalosporin(41.38％-80.00％)antibiotics and were susceptive to amikacin(90.48％)and fluoroquinolone(90.91％-97.73％)antibi-otics.Of the common antibiotics used in ophthalmology,the susceptibility rate of fusidic acid was the worst in the children group(54.55％),which was significantly lower than the other three groups(all P＜0.001).Gatifloxacin had a susceptibili-ty rate of more than 90％in different Gram-stained bacteria in all groups,with an overall sensitivity rate of 98.44％.Con-clusion Staphylococcus epidermidis is the most common bacteria in the conjunctival sac in healthy people of all ages.Gatifloxacin is generally susceptive in different Gram-stained bacteria in people at different ages,and may be considered as the first choice for perioperative empiric antibiotics in ophthalmology.
ABSTRACT
Objective To assess the efficacy and feasibility of Wingspan stents for symptomatic atherosclerotic stenosis of the bas-ilar artery.Methods Clinical data of 40 patients with symptomatic atherosclerotic stenoses in the basilar artery were analyzed retro-spectively.The operative successful rate,the degree of stenosis,perioperative complications and the results of clinical and imaging follow-up were analyzed.Results The technical success rate was 95.35%.The rate of procedure-related complications during the perioperative period (30 days)was 20.0% (eight of 40 patients).There were two patients with no permanent neurological sequelae. Ipsilateral stroke or death occurred in six patients(1 5%).Thirty-six patients(92.3%)were available for a clinical follow up.The mean follow-up period was 36.3 months (range 12-75 months).Seventeen patients (47.2%)were available for follow-up imaging with DSA or CTA.The mean imaging follow-up period was 9.4 months (range 4-41 months).Symptomatic in-stent restenosis (ISR)was documented in two (1 1.76%)of these patients.Three ischemic events occurred during the follow-up period in 12 months.The adverse event rate was 8.33% at 1 year.Conclusion Wingspan stents for symptomatic atherosclerotic stenosis of the basilar artery was an effective and feasible technique,but we should carefully grasp the operation indications.