J. Svihra

Costs analysis of the treatment of imported malaria

BackgroundTo document the status of imported malaria infections and estimate the costs of treating of patients hospitalized with the diagnosis of imported malaria in the Slovak Republic during 2003 to 2008.Case studyCalculating and comparing the direct and indirect costs of treatment of patients diagnosed with imported malaria (ICD-10: B50 - B54) who used and not used chemoprophylaxis. The target sample included 19 patients diagnosed with imported malaria from 2003 to 2008, with 11 whose treatment did not include chemoprophylaxis and eight whose treatment did.ResultsThe mean direct cost of malaria treatment for patients without chemoprophylaxis was 1,776.0 EUR, and the mean indirect cost 524.2 EUR. In patients with chemoprophylaxis the mean direct cost was 405.6 EUR, and the mean indirect cost 257.4 EUR.ConclusionsThe analysis confirmed statistically-significant differences between the direct and indirect costs of treatment with and without chemoprophylaxis for patients with imported malaria.

Validation of the Slovakian version of the P-QOL questionnaire

Introduction and hypothesisThis study aimed to validate the Slovakian version of the prolapse quality-of-life (P-QOL) questionnaire.MethodsThe P-QOL questionnaire was translated into the Slovakian language and administered to women recruited from a urogynecology outpatient clinic at a tertiary referral teaching hospital. After completing a questionnaire, all women were examined in supine position using the Pelvic Organ Prolapse (POP-Q) Quantification system. The reliability was assessed by using a 2-week test–retest analysis.ResultsFifty symptomatic and 79 asymptomatic women were included. The score of P-QOL was strongly correlated with the vaginal examination findings among the symptomatic group (p < 0.001 in eight domains). P-QOL domain scores were significantly different between symptomatic and asymptomatic women. The test–retest reliability confirmed a highly significant correlation between the total scores for each domain (p < 0.001).ConclusionThe Slovakian version of the P-QOL questionnaire is a valid, reliable, and easily comprehensible instrument to assess quality of life of women with uterovaginal prolapse.

Disability-adjusted life years (DALYs) in general population with pelvic organ prolapse: a study based on the prolapse quality-of-life questionnaire (P-QOL)

OBJECTIVE To evaluate the impact of pelvic organ prolapse (POP) on quality of life in symptomatic and asymptomatic women. STUDY DESIGN This is a cross-sectional study in a general population of adult women. Symptomatic and asymptomatic women with POP were studied. Symptomatic women were defined as those who reported the presence/feeling of lump/bulge/pressure in the vagina and on vaginal examination had the sign of POP defined as the leading edge of the vagina wall/cervix presenting at or beyond the hymeneal remnants. All women were asked to self-complete the Prolapse Quality of life questionnaire (P-QOL) to estimate the disability-adjusted life-years (DALYs) lost due to symptomatic POP. DALYs for a symptomatic POP were calculated as the sum of the years of life lost due to premature mortality (YLL) in the population and the years lost due to disability (YLD). To determinate the optimal threshold of each P-QOL domain in relationship to the symptomatic POP population a receiver operating curve (ROC) and area under curve (AUC) analysis were used. RESULTS A total of 785 were recruited. Only 539 (68.7%) consented to participate in the study. The mean age was 47 years (range 18-82 years). The total scores for each of the P-QOL domains were found to be significantly higher in symptomatic prolapse subjects compared to asymptomatic subjects (p<0.05). Estimated DALY lost per year per 1000 women obtained were 217.0 vs 324.8, lost years of 14.5 vs 10.3 in 50 vs 60-year old women. CONCLUSION In this group of women with POP the quality of life is severely affected. The DALYs revealed lost years due to symptomatic POP.

Gender-specific external barriers to seeking care for urinary incontinence

Background Barriers to seeking care for urinary incontinence are specific, objective, external conditions that prevent incontinence sufferers from seeking treatment. The aim of this study was to compare barriers, gender, and health care disparities in incontinence sufferers. Methods Incontinent patients were recruited into a questionnaire-based cross-sectional study. The 14-item Barriers to Incontinence Care Seeking Questionnaire (BICS-Q) and the three-item International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) were used to evaluate barriers to seeking health care for urinary incontinence. Results The representative sample (n = 1014) finally included 567 adults eligible to participate in this study (response rate 55.9%). Of the 147 incontinent males, 93 (63.3%) did not seek care, and of the 420 incontinent females, 282 (67.1%) did not seek care. Untreated males had significantly higher BICS-Q scores than other patients. Risk factors for barriers were obesity (odds ratio 2.13 for females versus 0.83 for males), stress urinary incontinence (1.57 versus 9.38, respectively), and urgency urinary incontinence (2.40 versus 1.75). Conclusion The barriers to seeking care for urinary incontinence seem to be gender-specific. Obese females with urgency urinary incontinence and males with stress urinary incontinence were least likely to seek treatment.

Prevalence of Urinary Incontinence in Females Performing High-Impact Exercises

The aim of this cross-sectional study was to monitor the prevalence of symptoms of stress (SUI) and mixed urinary incontinence (MUI) in sportswomen performing high-impact exercises. A further objective was to compare the symptoms of urinary incontinence (UI) and quality of life in sportswomen. We used the International Consultation on Incontinence Questionnaire (ICIQ-SF), the Overactive Bladder Questionnaire (OAB-q), the Urinary Incontinence Quality of Life Scale (I-QOL) and the International Physical Activity Questionnaire (IPAQ), short version. The group consisted of 503 sportswomen with a mean age of 21.1±3.6. The response rate was 71.15%. ICIQ-SF results confirmed mild difficulties with urine leakage in 72 (14.3%) sportswomen. Urinary leakage was not noted in 431 (85.7%) sportswomen. The OAB-q and I-QOL showed a significant difference, with pronounced symptoms of UUI and worse QOL in the group of sportswomen with urine leakage (p<0.000). The I-QOL recorded significantly worse parameters in the group of sportswomen with urine leakage (p<0.000). Prevalence of SUI was found in 68 (13.52%), and MUI was found in 4 (0.80%) sportswomen. Every seventh sportswoman (14.3%) in the study group had reported problems with UI when practising high-impact sporting activities, with a negative impact on QOL.

ICS teaching module: Analysis of voiding, pressure flow analysis (basic module)

To present the evidence background for an ICS teaching module for the urodynamic analysis of voiding.

Impact of clean intermittent catheterization on quality adjusted life years (QALYs) in spinal cord injury patients with neurogenic urinary incontinence

The impact of clean intermittent catheterization (CIC) on quality adjusted life years (QALYs) gained in adults’ spinal cord injury population with neurogenic urinary incontinence (UI).

Prevalence and risk of sport types to stress urinary incontinence in sportswomen: A cross-sectional study

The objective of our study was to investigate the prevalence and risk of developing stress urinary incontinence (SUI) in each type of high‐intensity sport, and the associated impact on quality of life in sportswomen.

Involvement of calcium regulating ion channels in contractility of human isolated urinary bladder

This study specified the role of several key calcium-operating ion channels in contraction/relaxation of human detrusor muscle as possible target for overactive bladder (OAB) treatment. Detrusor samples, obtained from 18 males (average age 61.5 ± 5.9 years), were investigated by organ tissue bath method with following agents: diltiazem for L-type voltage-gated calcium channels; 3-fluropyridine-4-carboxylic acid (FPCA) for Orai-STIM channels; SKF 96365-hydrochloride for transient receptor potential (TRP) channels, T-type channels and Orai-STIM channels; 2- aminoethoxydiphenyl borate (2-APB) for inositol-triphosphate receptors (IP3Rs) and Orai-STIM channels. Oxybutynin and mirabegron were tested under the same conditions as controls. Mirabegron, 2-APB and FPCA exhibited the best suppressive effect on carbachol-induced detrusor contractility. As expressed by area under the contractile curve (AUCC), 2-APB, FPCA and mirabegron have similar AUCC: 1.79, 1.73, 1.73. The highest AUCC was 3.64 for diltiazem+SKF, followed by 3.21 for diltiazem, 3.16 for SKF and 2.94 for oxybutynin. The lowest median amplitude and contraction variability is for 2-APB followed by mirabegron and FPCA. There were significant differences between: 2-APB/FPCA vs.: ditiazem, diltiazem+SKF and SKF. Summary of results suggested the principal role of IP3Rs, Orai-STIM coupling and large-conductance calcium-activated potassium channels in detrusor contraction and pointed on Orai-STIM channels as possible targets for OAB pharmacotherapy.

The impact of physical activity measured by the International Physical Activity questionnaire on the prevalence of stress urinary incontinence in young women

OBJECTIVE The aim of this study was to determine the prevalence of SUI symptoms in sportswomen (with a high intensity of physical activity) and non-sportswomen (with a low intensity of physical activity), according to the estimated intensity of physical activity in metabolic equivalents using the IPAQ questionnaire. Another goal was to identify relationships between SUI symptoms, intensity of physical activity, and quality of life. STUDY DESIGN A total of 1005 participants were enrolled into the study. We used the International Consultation on Incontinence Questionnaire (ICIQ-UI SF), the Overactive Bladder Questionnaire (OAB-q), the Urinary Incontinence Quality of Life scale (I-QoL) and the International Physical Activity Questionnaire (IPAQ). RESULTS Out of the 1005 participants, the final sample of 557 women is the result of the adoption of exclusion criteria. The sample consisted of 557 women (270 sportswomen and 287 non-sportswomen) with an average age of 20.9 ± 2.8 years. The ICIQ-UI SF confirmed slight urinary leakage in 33 (6.14%) sportswomen and 11 (2.04%) non-sportswomen. The risk of reporting SUI was higher in the sportswomen group (odds ratio: 3.49; 95% CI: 1.727-7.064, p < 0.001). Significant positive correlation was observed between SUI (assessed by ICIQ-UI SF) and high intensity physical activity (in metabolic equivalents (r = 0.242, p < 0.01). Significant negative correlation was observed between SUI and quality of life (I-QoL) (r = -0.648, p < 0.001). OAB symptoms were not present in the monitored groups. (OAB - q - SS in sportwomen were 4.3 ± 5.4, in non-sportwomen 4.5 ± 4.9, p = 0.265). CONCLUSIONS Sportswomen with high-intensity physical activities in metabolic equivalents measured by the IPAQ have a greater chance of reporting SUI than non-sportswomen, resulting in a negative impact on quality of life.