Gerald Haidinger

Urinary Incontinence in Both Sexes: Prevalence Rates and Impact on Quality of Life and Sexual Life

The aim of this study was to determine the prevalence of urinary incontinence in both sexes in Austria and to assess its impact on quality of life and sexual function. Voluntary health examinations free of charge are regularly organized in the area of Vienna. From May 1998 to April 1999 we have included in this health examination an incontinence questionnaire containing 37 items, which was largely based on the Bristol female lower urinary tract symptoms (LUTS) questionnaire. This questionnaire asks in detail for various aspects of urinary incontinence/voiding problems, including the impact of urinary incontinence on quality of life and sexual function. In this questionnaire, urinary incontinence was defined as any involuntary loss of urine within the past 4 weeks. The data of 2,498 participants (1,262 women [f]: mean age: 49.7±13.6 years and 1,236 men [m]: 48.6±13.0 years; age range: 20–96 years) were analyzed. Overall, 26.3% of women and 5.0% of men reported on episodes of urinary incontinence during the past 4 weeks. Prevalence rates increased constantly with age in both sexes: 20–29 years: 4.1% (f), 1.7% (m); 30–39 years: 10.8% (f), 2.7% (m); 40–49 years: 22.9% (f); 3.9% (m); 50–59 years: 34.9% (f), 3.7% (m); 60–69 years: 36.9% (f), 7.6% (m); 70 years or older: 36.0%% (f), 11.5% (m). Overall, 65.7% of women and 58.3% of men stated that quality of life was affected by their incontinence status. A moderate or severe impairment was reported by 18.3% of women and 16.6% of men. Impairment of quality of life was related as statistically significant (P < 0.05) to frequency and degree of incontinence (irrespective of the type of incontinence), the impact on sexual function and need for pads or other incontinence devices. Patient gender, age, and the duration of incontinence had no effect (P > 0.05) on quality of life. An impairment of sexual life by urinary incontinence was stated by 25.1% of women and 30.5% of women, respectively. Although only 65.7% of women and 58.3% men with urinary incontinence reported on an impairment of quality of life, these data underline the high prevalence and socioeconomic implications of this disorder. The impact of urinary incontinence on quality of life is significantly higher than on sexual function. Neurourol. Urodynam. 19:259–271, 2000.

Cross-sectional study of nocturia in both sexes: analysis of a voluntary health screening project

OBJECTIVES To assess the prevalence of nocturia and its impact on the quality of life in both sexes by analyzing almost 2500 individuals participating in a health survey. METHODS During a 12-month period, we included an incontinence questionnaire, which was largely based on the Bristol female lower urinary tract symptoms questionnaire, in the voluntary health examinations in the area of Vienna. In parallel, we recorded the medical history, concurrent medical therapy, physical examination findings, sociodemographic parameters, and blood laboratory study results. RESULTS The data of 1247 women (age 49.8 +/- 13.5 years) and 1221 men (age 48.5 +/- 11.9 years) were analyzed. The percentage of individuals with nocturia of two or more times increased constantly with age: less than 30 years, 3.1% of women and 3.4% of men; 30 to 59 years, 7.2% of women and 5. 7% of men; and 60 years old or older, 26.7% of women and 32.4% of men. Age-adjusted extrapolation to the general population (older than 20 years) currently living in Austria yielded that 10.8% of men and 11.8% of women have nocturia of two or more times. Overall, 66. 9% of women and 62.2% of men reported a negative impact of nocturia on their quality of life. The correlation was close between the degree of nocturia with the quality-of-life impairment in both sexes. Several voiding symptoms correlated significantly (P <0.001) with nocturia. CONCLUSIONS Nocturia is almost equally present in both sexes, and the incidence and severity increase constantly from early adolescence to senescence. Approximately 10% of the general population (older than 20 years) have nocturia of two or more times, which impairs the quality of life in two thirds.

Risk Factors for Lower Urinary Tract Symptoms in Elderly Men

Objective: The aim of this study was to confirm previous studies with respect to risk factors for lower urinary tract symptoms (LUTS) as assessed by the International Prostate Symptom Score (IPSS) as well as, for the first time, specifically for storage and voiding symptoms in elderly men.Material and Methods: During a health survey organised in the area of Vienna in 1996, the following parameters were obtained: (1) IPSS including the quality of life question; (2) a detailed medical history; (3) assessment of all concurrent medical therapies; (4) physical examination with assessment of age, weight, height, body mass index, heart rate and blood pressure; (5) sociodemographic parameters, and (6) a blood laboratory study including kidney and liver function tests, low– and high–density lipoproteins, cholesterol and glucose. Only men aged 40 years or older without previous surgery to the prostate and without concurrent medication for LUTS were analysed. The IPSS, its irritative (storage symptoms) and obstructive (voiding symptoms) components were correlated to these parameters by partial correlation analysis which was controlled for age.Results: The data of 1,557 men (mean age: 51.3 years; range: 40–96 years) were analysed. The most important risk factor for the development of LUTS was age, as the IPSS (correlation coefficient r = 0.294), its obstructive (r = 0.248) and irritative (r = 0.261) components all correlated significantly (p<0.0001) with patient age. In all life decades there was no significant difference of the IPSS, its obstructive and irritative components in current smokers and non–smokers. The irritative score, however, correlated significantly (p = 0.001; r = 0.158) with the number of cigarettes smoked per day. In men aged 40–49 years, regular alcohol consumption resulted in a higher total IPSS (p = 0.01) and irritative (p = 0.002) score. This difference was not demonstrable in older age groups. Patient weight and body mass index did not correlate with the IPSS, yet there was a trend for a higher IPSS in men with elevated blood pressure and larger waist size.Conclusions: This large–scale cross–sectional study underlines the importance of age for the development of LUTS. Few avoidable risk factors for the development of LUTS have been identified, such as obesity, cigarette smoking, elevated blood pressure and alcohol consumption. The subcategorization of LUTS into irritative/obstructive symptoms might provide new insights into the assessment of risk factors for LUTS.

Time trends of the prevalence of asthma and allergic disease in Austrian children

After a substantial increase in the prevalence of atopic disease in Europe, recent studies indicate that a plateau has been reached. However, variation across countries and age groups exists. We studied the prevalence and time trends of asthma and allergic disease among schoolchildren in Austria, a country with traditionally low rates of asthma, hay fever, and eczema. As part of the International Study of Asthma and Allergies in Childhood (ISAAC), symptoms and physician diagnoses of asthma and allergic disease of 13,399 Austrian children aged 6–7 yr and 1516 children aged 12–14 yr were surveyed between 1995 and 1997. A similar survey was conducted between 2001 and 2003. Among children aged 6–7 yr, significant increases were seen in the prevalence of physician‐diagnosed asthma (+16%; p = 0.013), hay fever (+22%; p < 0.001), and eczema (+37%; p < 0.001) between 1995 and 2003. These changes were paralleled by an increase in the prevalence of symptoms typical for hay fever (itchy eyes and runny nose), but not by an increase in wheeze. Among children aged 12–14 yr, the lifetime prevalence of diagnosed asthma increased by 32%, of hay fever by 19%, and of eczema by 28% (all, p < 0.001). These changes were paralleled by increases in the prevalence of wheezing as documented by both questions before and after a video showing wheezing children but not by symptoms typical for hay fever such as itchy eyes and runny nose. In conclusion, in Austria, contrary to other European countries, the prevalence of asthma and allergic disease increased among schoolchildren. Additional studies are needed to continue monitoring the dynamics of the prevalence of asthma and allergic disease in Austria and to explore trends in their risk factors.

The prevalence of lower urinary tract symptoms in Austrian males and associations with sociodemographic variables

The aim of our study was to assess the prevalence of lower urinary tract symptoms (LUTS) in Austrian males and to correlate the findings with sociodemographic variables. In a population-based cross-sectional study in Austria in the year 1995, data on voiding symptoms were collected from a representative sample of men by using the International Prostate Symptom Score (IPSS). Only 28.6% of the males aged 15 to 89 years (total n = 939) reported no LUTS at all (IPSS = 0). In the group of males who report symptoms, a positive correlation of the IPSS with age is found. Furthermore IPSS correlates with weekly alcohol and nicotine consumption, but not with the respondents body-mass index (BMI), educational status and monthly household income. The bothersomeness of LUTS increases with age, leaving more than 12% of the males aged 40 to 89 dissatisfied with urinary symptoms. Extrapolated to population numbers, more than 87,000 males in Austria (aged 15 to 89 years) would feel ‘terribly’ if they were to spend the rest of their lives with urinary symptoms as they were at the time of the survey. Due to an estimated future increase of the proportion of older people in Austria, the number of males with LUTS will rise significantly, thereby placing increased burden on medical resources in the future.

Consumption of Brussels sprouts protects peripheral human lymphocytes against 2-amino-1- methyl-6-phenylimidazo(4,5-b)pyridine (PhIP) and oxidative DNA-damage: results of a controlled human intervention trial

To find out if the cancer protective effects of Brussels sprouts seen in epidemiological studies are due to protection against DNA-damage, an intervention trial was conducted in which the impact of vegetable consumption on DNA-stability was monitored in lymphocytes with the comet assay. After consumption of the sprouts (300 g/p/d, n = 8), a reduction of DNA-migration (97%) induced by the heterocyclic aromatic amine 2-amino-1-methyl-6-phenyl-imidazo-[4,5-b]pyridine (PhIP) was observed whereas no effect was seen with 3-amino-1-methyl-5H-pyrido[4,3-b]-indole (Trp-P-2). This effect protection may be due to inhibition of sulfotransferase 1A1, which plays a key role in the activation of PhIP. In addition, a decrease of the endogenous formation of oxidized bases was observed and DNA-damage caused by hydrogen peroxide was significantly (39%) lower after the intervention. These effects could not be explained by induction of antioxidant enzymes glutathione peroxidase and superoxide dismutase, but in vitro experiments indicate that sprouts contain compounds, which act as direct scavengers of reactive oxygen species. Serum vitamin C levels were increased by 37% after sprout consumption but no correlations were seen between prevention of DNA-damage and individual alterations of the vitamin levels. Our study shows for the first time that sprout consumption leads to inhibition of sulfotransferases in humans and to protection against PhIP and oxidative DNA-damage.

Symptoms suggestive of atopic rhinitis in children aged 6–9 years and the indoor environment

Background: We aimed to investigate the influence of indoor factors on the prevalence of symptoms suggestive of atopic rhinitis in children aged 6–9 years in Upper Austria.

Prevalence of persistent vegetative state/apallic syndrome in Vienna

The aim of the project was to survey the hospital prevalence of apallic syndrome in a federal state in Austria at an exact point in time. To achieve this, a point prevalence study was carried out on 28 November 2001 in the Vienna region. The central element was a questionnaire, which provided an exact recording of the patients’ condition. An additional preliminary task was to check all the discharge diagnoses in the hospitals of the Vienna Hospital Association (Wiener Krankenanstalten Verbund) between 1996 and 2000 according to the ICD‐9 diagnoses for apallic syndrome. These data should serve to cross‐check the recorded results. All hospitals (n = 48) and nursing facilities (n = 44) in Vienna were included in this investigation. As the aim of the study was to record the prevalence of apallic syndrome in the population of Vienna, four patients of the group with full‐stage apallic syndrome (n = 36) were excluded as they were from other federal states. In total, 32 hospital patients who met the clinical criteria for apallic syndrome (full‐stage) were recorded. The point prevalence of apallic syndrome was 1.9/100 000 inhabitants. As a result of this study, the exact survey of hospital prevalence of apallic syndrome could be found. As a consequence, the Viennese government has developed a rehabilitation concept for patients with apallic syndrome in Vienna.

Potent protection of gallic acid against DNA oxidation: results of human and animal experiments.

Gallic acid (3,4,5-trihydroxybenzoic acid, GA) is a constituent of plant derived foods, beverages and herbal remedies. We investigated its DNA protective properties in a placebo controlled human intervention trial in single cell gel electrophoresis experiments. Supplementation of drinking water with GA (12.8 mg/person/d) for three days led to a significant reduction of DNA migration attributable to oxidised pyrimidines (endonuclease III sensitive sites) and oxidised purines (formamidopyrimidine glycosylase sensitive sites) in lymphocytes of healthy individuals by 75% and 64% respectively. Also DNA damage caused by treatment of the cells with reactive oxygen species (ROS) was reduced after GA consumption (by 41%). These effects were paralleled by an increase of the activities of antioxidant enzymes (superoxide dismutase, glutathione peroxidase and glutathion-S-transferase-π) and a decrease of intracellular ROS concentrations in lymphocytes, while no alterations of the total antioxidant capacity (TAC), of malondialdehyde levels in serum and of the urinary excretion of isoprostanes were found. Experiments with rats showed that GA reduces oxidatively damaged DNA in lymphocytes, liver, colon and lungs and protects these organs against γ-irradiation-induced strand breaks and formation of oxidatively damaged DNA-bases. Furthermore, the number of radiation-induced preneoplastic hepatic foci was decreased by 43% after oral administration of the phenolic. Since we did not find alterations of the TAC in plasma and lipid peroxidation of cell membranes but intracellular effects it is likely that the antioxidant properties of GA seen in vivo are not due to direct scavenging of radicals but rather to indirect mechanisms (e.g. protection against ROS via activation of transcription factors). As the amount of GA used in the intervention trial is similar to the daily intake in Middle Europe (18 mg/person/day), our findings indicate that it may contribute to prevention of formation of oxidatively damaged DNA in humans.

The prevalence of atopic dermatitis in children is influenced by their parents’ education: results of two cross-sectional studies conducted in Upper Austria

Weber AS, Haidinger G. The prevalence of atopic dermatitis in children is influenced by their parents’ education: results of two cross‐sectional studies conducted in Upper Austria. Pediatr Allergy Immunol 2010: 21: 1028–1035.
© 2010 John Wiley & Sons A/S