scholarly journals Validity of the International Prostate Symptoms Score in predicting urinary retention after joint replacement

2019 ◽  
Vol 27 (3) ◽  
pp. 230949901986867 ◽  
Author(s):  
Alasdair JA Santini ◽  
Chetan A Jakaraddi ◽  
Fotis Polydoros ◽  
Sree Metikala
Keyword(s):  
Urinary Tract ◽  
Urinary Retention ◽  
Preoperative Evaluation ◽  
Age Groups ◽  
High Specificity ◽  
Logistic Regression Models ◽  
Prosthetic Joints ◽  
Specificity And Sensitivity ◽  
Urinary Tract Symptoms ◽  
Risk Patients

Postoperative urinary retention necessitating catheterization after major lower limb arthroplasty surgery adds to the patients’ postoperative discomfort and increases the risk of urinary tract infection with potential risk of transient bacteraemia and seeding of infection to prosthetic joints. Preoperative evaluation of patients with lower urinary tract symptoms may help to identify at-risk patients and the International Prostate Symptoms Score (IPSS) has been used as a screening tool to quantify the severity of symptoms in males. A prospective cohort of 303 patients undergoing total hip or knee arthroplasty was evaluated using the IPSS. Patients were categorized into three symptom groups (mild, moderate and severe based on scores of 0–7, 8–18 and greater than 18, respectively) and four age groups (<50 years, 51–60 years, 61–70 years and greater than 70 years). Twenty-six patients (8.6%) developed urinary retention and were catheterized postoperatively; of these, 16 were male and 10 were female. Statistical analysis using logistic regression models showed significant association between severe IPSS scores (>18) and urinary retention requiring catheterization in both males and females with both high specificity and sensitivity in the test in predicting postoperative catheterization. Hence, this test is a valid preoperative screen in predicting postoperative catheterization.

scholarly journals A Five-Gene Expression Signature Predicts Clinical Outcome of Ovarian Serous Cystadenocarcinoma

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Li-Wei Liu ◽  
Qiuhao Zhang ◽  
Wenna Guo ◽  
Kun Qian ◽  
Qiang Wang
Keyword(s):  
Gene Expression ◽  
Survival Time ◽  
Proportional Hazards ◽  
Gene Expression Signature ◽  
High Specificity ◽  
Cox Proportional Hazards ◽  
Assessment Model ◽  
Serous Cystadenocarcinoma ◽  
Specificity And Sensitivity ◽  
Risk Patients

Ovarian serous cystadenocarcinoma is a common malignant tumor of female genital organs. Treatment is generally less effective as patients are usually diagnosed in the late stage. Therefore, a well-designed prognostic marker provides valuable data for optimizing therapy. In this study, we analyzed 303 samples of ovarian serous cystadenocarcinoma and the corresponding RNA-seq data. We observed the correlation between gene expression and patients’ survival and eventually established a risk assessment model of five factors using Cox proportional hazards regression analysis. We found that the survival time in high-risk patients was significantly shorter than in low-risk patients in both training and testing sets after Kaplan-Meier analysis. The AUROC value was 0.67 when predicting the survival time in testing set, which indicates a relatively high specificity and sensitivity. The results suggest diagnostic and therapeutic applications of our five-gene model for ovarian serous cystadenocarcinoma.

Everyday Technology Use and Overall Needed Assistance to Function in the Home and Community Among Urban Older Adults

2019 ◽  
Vol 39 (10) ◽  
pp. 1115-1123 ◽  
Author(s):  
Ryan J. Walsh ◽  
Jenica Lee ◽  
Ruxandra M. Drasga ◽  
Caniece S. Leggett ◽  
Holly M. Shapnick ◽  
...  
Keyword(s):  
Older Adults ◽  
Technology Use ◽  
Cognitive Assessment ◽  
High Specificity ◽  
Montreal Cognitive Assessment ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Community Activities ◽  
Specificity And Sensitivity ◽  
The Everyday

Background: Older adults manage increasing numbers of everyday technologies to participate in home and community activities. Purpose: We investigated how assessing use of everyday technologies enhanced predictions of overall needed assistance among urban older adults. Method: We used a cross-sectional design to analyze responses from 114 participants completing the Everyday Technology Use Questionnaire, the Montreal Cognitive Assessment, and a sociodemographic questionnaire. We estimated overall needed assistance based on definitions in the Assessment of Motor and Process Skills. We created logistic regression models and receiver operator characteristic curves to analyze variables predicting overall needed assistance. Findings: With high specificity and sensitivity, the Everyday Technology Use Questionnaire and the Montreal Cognitive Assessment were the strongest predictors of overall needed assistance. Implications: Assessing everyday technology use enhanced predictions of overall needed assistance among urban older adults.

scholarly journals Adult Bilateral Ureteroceles Presenting with Lower Urinary Tract Symptoms and Acute Urinary Retention

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Alexis Rompré-Brodeur ◽  
Sero Andonian
Keyword(s):  
Urinary Tract ◽  
Urinary Retention ◽  
Lower Urinary Tract Symptoms ◽  
Lower Urinary Tract ◽  
Acute Urinary Retention ◽  
Adult Population ◽  
Case Series ◽  
Invasive Approach ◽  
Urinary Tract Symptoms ◽  
Lower Urinary

Ureterocele is a well-known pathologic entity in the pediatric urology population but remains a diagnostic and treatment challenge in the adult population. Adult ureteroceles remain a diagnostic challenge for the adult urologist. Its prevalence is estimated between 1/500 and 1/4000 patients with a wide variety of clinical presentations. We present the case of a 30-year-old female patient who presented with severe lower urinary tract symptoms (LUTS) and acute urinary retention secondary to prolapsing bilateral single-system orthotopic ureteroceles. She was successfully treated with transurethral unroofing of her bilateral ureteroceles and she is currently asymptomatic. This case represents the first reported case of bilateral ureteroceles presenting with severe LUTS and subsequent urinary retention from the prolapse of one of the ureteroceles. We provide a review of the most recent case series of adult ureteroceles and their outcomes. Transurethral unroofing of the ureterocele is a safe and minimally invasive approach for this disease.

scholarly journals Correlation of fine needle aspiration cytology and histopathology of neck swellings

2018 ◽  
Vol 4 (3) ◽  
pp. 648
Author(s):  
C. S. Asha ◽  
B. R. Suchit Roy
Keyword(s):  
Salivary Gland ◽  
Lymph Node ◽  
Predictive Value ◽  
Age Groups ◽  
Invasive Procedure ◽  
High Specificity ◽  
Cost Effective ◽  
Needle Aspiration ◽  
Predictive Values ◽  
Specificity And Sensitivity

<p class="abstract"><strong>Background:</strong> Neck swellings are a common clinical finding affecting all age groups. FNAC is a minimally invasive procedure helpful in the diagnosis of various neck swellings. The purpose of this study is to determine the accuracy of FNAC in the diagnosis of neck swellings by comparing it with the histopathology which is taken as the gold standard.</p><p class="abstract"><strong>Methods:</strong> A prospective study which included 90 patients who attended ENT and surgery departments of Government Medical College, Trivandrum with neck swellings from July 2006-2007. FNAC of the swelling was done and the FNAC results were compared with the histopathology results. The specificity, sensitivity, positive and negative predictive values and accuracy of FNAC were calculated.  </p><p class="abstract"><strong>Results:</strong> Of the 90 patients, thyroid swelling formed the major group followed by lymph node, salivary gland and miscellaneous swellings. Thyroid swellings had a female predominance while the other three groups namely lymph node, salivary gland and miscellaneous groups showed a male preponderance. When the neck swellings namely thyroid, salivary gland, lymph node and miscellaneous group were taken into consideration as a whole, the sensitivity of FNAC for detecting malignancy was 64.3%. The specificity, positive predictive value, negative predictive value and accuracy were 97.4%, 81.8%, 93.7% and 92% respectively.</p><p class="abstract"><strong>Conclusions:</strong> FNAC can be rated as a safe, simple, reliable, cost effective and rapid diagnostic tool with high specificity and sensitivity for the initial evaluation of neck swellings.</p>

scholarly journals The association of depression with lower urinary tract symptoms: data from the National Health and Nutrition Examination Survey, 2005–2008

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e7795
Author(s):  
Jee Soo Park ◽  
Won Sik Ham ◽  
Chang Hee Hong ◽  
Byung Ha Chung ◽  
Kyo Chul Koo
Keyword(s):  
Logistic Regression ◽  
Urinary Tract ◽  
Lower Urinary Tract Symptoms ◽  
National Health ◽  
Lower Urinary Tract ◽  
Nutrition Examination Survey ◽  
Logistic Regression Models ◽  
Health And Nutrition ◽  
Urinary Tract Symptoms ◽  
Lower Urinary

Background To identify the factors associated with lower urinary tract symptoms (LUTS), we investigated associations between psychological factors, including depression and sleep disorders, and LUTS using the National Health and Nutrition Examination Survey (NHANES) database. Materials and Methods The NHANES database was examined for the period of 2005 to 2008. Men older than 40 years, who had completed questionnaires surveying their kidney/urologic, prostate, mental health, and sleep conditions were included in this study. LUTS was defined as the presence of two or more of the following symptoms: incomplete emptying, urinary hesitancy, urinary frequency, and nocturia. Multivariable models using logistic regression were used to compare groups of men with or without LUTS. Results Of 1,820 participants, 110 (6.1%) men reported depression, and 235 (12.9%) presented with LUTS. Men with LUTS were older and had a significantly higher prevalence of depression and unemployment. Sleep disorder was not associated with LUTS. Multivariable logistic regression models demonstrated that men reporting moderate depression had the highest age-adjusted odds (odds ratio = 5.89, 95% CI [3.44–10.11]; p < 0.001) of reporting clinical LUTS. Conclusions A significant association was observed between LUTS and depression, and between LUTS and employment status. Although the pathophysiology of these relationships is unclear, physicians should consider multi-disciplinary evaluation and treatment approaches for LUTS.

scholarly journals Choosing the method of urine derivation in patients with acute urinary retention: current status of the problem

2020 ◽  
Vol 20 (5-6) ◽  
pp. 143-150
Author(s):  
Alexander A. Alexander ◽  
Dmitry S. Vinogradov ◽  
Ivan V. Tarasov ◽  
Denis O. Gusev ◽  
Aleksey S. Pochivalov ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Retention ◽  
Lower Urinary Tract ◽  
Acute Urinary Retention ◽  
Epidemiological Studies ◽  
Current Status ◽  
Urinary Tract Disorders ◽  
Urinary Tract Symptoms ◽  
Emergency Hospitalization ◽  
Lower Urinary

Acute urinary retention (AUR) is an acute inability to empty the bladder, despite its overflow with urine and the urge to urinate. According to the literature data, about 10% of men over 70 years old and about 30% of men over 80 years old suffer this disorder. At the same time, almost 90% of men over 45 years have symptoms of the lower urinary tract disorders and can be included into the risk group for developing of AUR in future. The risk of developing of AUR in middle-aged men is approximately 6.8 cases per 1000 men and increases to 34.7 cases in men over 70 years. Urinary retention remains a common cause of emergency hospitalization of patients to urological departments, as well as the most common complication of benign prostatic hyperplasia (BPH). According to epidemiological studies, 10% of men aged 60-70 years suffer acute urinary retention within 5 years, and their proportion increases up to 30% within 10 years of observation. The main risk factors for the development of AUR in men are old age, the severity of lower urinary tract symptoms (LUTS), and prostate volume.

scholarly journals Medical and non-medical interventions for post-operative urinary retention prevention: network meta-analysis and risk–benefit analysis

2021 ◽  
Vol 13 ◽  
pp. 175628722110222
Author(s):  
Pokket Sirisreetreerux ◽  
Rujira Wattanayingcharoenchai ◽  
Sasivimol Rattanasiri ◽  
Oraluck Pattanaprateep ◽  
Pawin Numthavaj ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Adverse Events ◽  
Urinary Retention ◽  
Meta Analysis ◽  
Opioid Antagonist ◽  
Benefit Analysis ◽  
Early Ambulation ◽  
Urinary Tract Symptoms ◽  
Adrenergic Antagonists ◽  
Risk Benefit Analysis

Aims: To assess the efficacy in lowering post-operative urinary retention, urinary tract infection and lower urinary tract symptoms and the incidence of adverse events among 12 interventions and to perform risk–benefit analysis. Methods: Previous randomized controlled trials were identified from MEDLINE, Scopus and CENTRAL database up to January 2020. The interventions of interest included early ambulation, fluid adjustment, neuromodulation, acupuncture, cholinergic drugs, benzodiazepine, antispasmodic agents, opioid antagonist agents, alpha-adrenergic antagonists, non-steroidal anti-inflammatory drugs (NSAIDs) and combination of any interventions. The comparators were placebo or standard care or any of these interventions. Network meta-analysis was performed. The probability of being the best intervention was estimated and ranked using rankogram and surface under the cumulative ranking curve. Risk–benefit analysis was done. Incremental risk–benefit ratio (IRBR) was calculated and risk–benefit acceptability curve was constructed. Results: A total of 45 randomized controlled trials with 5387 patients was included in the study. Network meta-analysis showed that early ambulation, acupuncture, alpha-blockers and NSAIDs significantly reduced the post-operative urinary retention. Regarding urinary tract infection and lower urinary tract symptoms, no statistical significance was found among interventions. Regarding the side effects, only alpha-adrenergic antagonists significantly increased the adverse events compared with acupuncture and opioid antagonist agents from the indirect comparison. According to the cluster ranking plot, acupuncture and early ambulation were considered high efficacy with low adverse events, corresponding to the IRBR. Conclusion: Early ambulation, acupuncture, opioid antagonist agents, alpha-adrenergic antagonists and NSAIDs significantly reduce the incidence of post-operative urinary retention with no difference in adverse events. Regarding the risk–benefit analysis of the medical treatment, alpha-adrenergic antagonists have the highest probability of net benefit at the acceptable threshold of side effect of 15%, followed by opioid antagonist agents, NSAIDs and cholinergic drugs.

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