RESUMO
Incontinence is associated with mental illness and neuroleptic medications but diagnosis and treatment is often poor or non-existent. Problems of incontinence are compounded in secure psychiatric services for women by poor health, obesity, and a sedentary lifestyle. Addressing the physical health of this group necessitates a more accurate picture of the nature, incidence, and management of incontinence. A point-in-time survey of 108 women who agreed to be interviewed (93%) covered presence, frequency, and nature of incontinence, and information on management case note data was used to gather demographic and previous medical history, comparisons were made between patients with and without problems of incontinence. Findings indicate a problem of incontinence in 48% of women with a dominance of problems of stress and urge enuresis. Of modifiable factors that contribute to enuresis, the current study highlighted the contribution of obesity, smoking and clozapine medication. A further finding was the preference for managing rather than treating problems of incontinence. Actions to improve the detection and treatment of this problem are described.
Assuntos
Transtornos Mentais/complicações , Incontinência Urinária/diagnóstico , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Encoprese/induzido quimicamente , Encoprese/diagnóstico , Encoprese/etiologia , Feminino , Humanos , Entrevistas como Assunto , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Psicotrópicos/efeitos adversos , Inquéritos e Questionários , Incontinência Urinária/induzido quimicamente , Incontinência Urinária/etiologia , Incontinência Urinária de Urgência/induzido quimicamente , Incontinência Urinária de Urgência/diagnóstico , Incontinência Urinária de Urgência/etiologia , Adulto JovemRESUMO
Six major adverse medical events (AMEs) and 44 minor AMEs were recorded in 6 and 23 patients, respectively, during human growth hormone (GH) treatment of Turner syndrome, equivalent to 118 treatment years. During the first year of GH treatment, there was no change in the SD score (SDS) for systolic or diastolic blood pressure. In a subgroup of 20 patients, there was no change in psychological tests, oral glucose tolerance, glycosylated haemoglobin or serum triglycerides over the first year of GH treatment. The mean total serum cholesterol level fell over this period. The low incidence of adverse medical problems during GH treatment complemented its efficacy. Height velocity in the first year was 7.7 +/- 1.8 cm/year (mean +/- SD) and was correlated with maternal height SDS, though not with paternal height SDS. Some 36% of first-year height velocity SDS could be predicted by the dose of GH and maternal height SDS.