adolescents and young adults with cancer care in asia the joint esmo siope siop asia survey

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Fecal Incontinence In Postmenopausal Women: Prevalence, Severity And Associated Factors [incontinência Fecal Em Mulheres Na Pós-menopausa: Prevalência, Intensidade E Fatores Associados]

Background - Fecal incontinence occurs more frequently in the female population and it becomes more prevalent with increasing age. There are few studies that have assessed the prevalence and severity of postmenopausal women. Aims - To investigate fecal incontinence. Patients and Methods - A cross-sectional study was performed on 100 postmenopausal women over the age of 45. Sociodemographic and clinical characteristics were evaluated, and a descriptive analysis of these characteristics was carried out. The prevalence of fecal incontinence was estimated. St. Mark's incontinence score was applied to study the severity of symptoms associated with fecal incontinence. The score was then categorized according to the tertile and symptom severity was classified as mild, moderate or severe incontinence. Bivariate and multivariate analyses were used to study the association between fecal incontinence and its likely determinants, employing the prevalence ratio. Confidence interval was set at 95%. Results - The mean age of the patients was 58.9 ± 5.9 years (range, 46-76 years). The prevalence rate was 15% for fecal incontinence. Of incontinent patients, 60% had mild incontinence. After multivariate analysis, factors associated with fecal incontinence was history of forceps delivery (prevalence ratio: 7.80; 95% confidence interval:2.38-25.55). Conclusions - The prevalence of fecal incontinence was high in postmenopausal women. Data suggest that most women presented mild fecal incontinence. The history of forceps delivery was associated with fecal incontinence.432102106Allen, R.E., Hosker, G.L., Smith, A.R.B., Warrell, D.W., Pelvic floor damage and childbirth: A neuropsychological study (1990) Br J Obstet Gynaecol, 97, pp. 770-779Almeida, P.M., Wickerhauser, H., (1991) O Critério ABA/ABIPEME - Em Busca de Uma Atualização, , São Paulo: Associação Brasileira dos Institutos de Pesquisa de MercadoBrambilla, D.J., McKinklay, S.M., Johannes, C.B., Defining the perimenopause for applications in epidemiological investigations (1994) Am J Epidemiol, 140, pp. 1091-1095Buchanan, G.N., Nicholls, T., Solanki, D., Kamm, M.A., Investigation of faecal incontinence (2001) Hosp Med, 62, pp. 533-537Campbell, A.J., Reiken, J., Mc Cosh, L., Incontinence in the elderly: Prevalence and prognosis (1985) Age Ageing, 14, pp. 65-70Chiarelli, P., Murphy, B., Cockburn, J., Fecal incontinence after high-risk delivery (2003) Obstet Gynecol, 102, pp. 1299-1305Curi, L.A., Genoud, M.T., Causas más frecuentes de incontinencia fecal en nuestro medio (2000) Acta Gastroenterol Latinoam, 30, pp. 165-168De Lillo, A.R., Rose, S., Functional bowel disorders in the geriatric patient: Constipation, fecal impaction, and fecal incontinence (2000) Am J Gastroenterol, 95, pp. 901-905Donnelly, V., O'Connell, P.R., O'Herlihy, C., The influence of oestrogen replacement on faecal incontinence in postmenopausal women (1997) Br J Obstet Gynaecol, 104, pp. 311-315Eason, E., Labrecque, M., Marcoux, S., Mondor, M., Anal incontinence after childbirth (2002) CMAJ, 166, pp. 326-330Faltin, D.L., Sangalli, M.R., Curtin, F., Morabia, A., Weil, A., Prevalence of anal incontinence and other anorectal symptoms in women (2001) Int Urogynecol J, 12, pp. 117-121Giebel, G.D., Lefering, R., Tridl, H., Blochi, H., Prevalence of fecal incontinence: What can be expected? (1998) Int J Colorect Dis, 13, pp. 73-77Jackson, S.L., Weber, A.M., Hull, T.L., Mitchinson, A.R., Walters, M.D., Fecal incontinence in women with urinary incontinence and pelvic organ prolapse (1997) Obstet Gynecol, 89, pp. 423-427Kok, A.L.M., Voohorst, F.J., Burger, C.W., Van Houten, P., Kenemans, P., Jansens, J., Urinary and faecal incontinence in community-residing elderly women (1992) Age Ageing, 21, pp. 211-215Lamah, M., Kumar, D., Fecal incontinence (1999) Dig Dis Sci, 44, pp. 2488-2499Madoff, R.D., Williams, J.G., Caushaj, P.F., Fecal incontinence (1992) N Engl J Med, 4, pp. 1002-1007Nelson, R., Norton, N., Cautley, E., Furner, S., Community-based prevalence of anal incontinence (1995) JAMA, 274, pp. 559-561Nelson, R.L., Furner, S., Jesudason, V., Fecal incontinence in Wisconsin nursing homes (1998) Dis Colon Rectum, 41, pp. 1226-1229Nelson, R.L., Epidemiology of fecal incontinence (2004) Gastroenterology, 126, pp. S3-S7Ng, S.C., Chen, Y.C., Lin, L.Y., Chen, G.D., Anorectal dysfunction in women with urinary incontinence or lower urinary tract symptoms (2002) Int J Gynaecol Obstet, 77, pp. 139-145Perry, S., Shaw, C., McGrother, C., Matthews, R.J., Assassa, R.P., Dallosso, H., Williams, K., Castleden, C.M., Prevalence of fecal incontinence in adults aged 40 years or more living in the community (2002) Gut, 50, pp. 480-484Rizk, D.E., Hassan, M.Y., Shaheen, H., Cherian, J.V., Micallef, R., Dunn, E., The prevalence and determinants of health care-seeking behavior for fecal incontinence in multiparous United Arab Emirates females (2001) Dis Colon Rectum, 44, pp. 1850-1856(1999) SAS [Computer Program]. Version 8.2, , Cary: SAS InstituteSchiller, L.R., Constipation and fecal incontinence in the elderly (2001) Gastroenterol Clin N Am, 30, pp. 497-515Shull, B.L., Clinical evaluation of women with pelvic support defects (1993) Clin Obstet Gynecol, 36, pp. 939-951Skov, T., Deddens, J., Petersen, M.R., Endahl, L., Prevalence proportion ratios: Estimation and hypothesis testing (1998) Int J Epidemiol, 27, pp. 91-95Teunissen, T.A.M., Lagro-Janssen, A.L.M., Van Den Bosch, W.J.H.M., Van Den Hoogen, H.J.M., Prevalence of urinary, fecal and double incontinence in the elderly living at home (2004) Int Urogynecol J, 15, pp. 10-13Vaizey, C.J., Carapeti, E., Cahill, J.A., Kamm, M.A., Prospective comparison of faecal incontinence grading systems (1999) Gut, 44, pp. 77-8

Prevalence And Factors Associated With Intestinal Constipation In Postmenopausal Women [prevalência E Fatores Associados à Constipação Intestinal Em Mulheres Na Pós-menopausa]

Background - Constipation occurs more frequently in the female population and it becomes more prevalent with increasing age. There are few studies that have assessed the prevalence of constipation in postmenopausal women. Aim - To investigate the prevalence and factors associated with constipation in postmenopausal women. Patients and Methods - A cross-sectional study of postmenopausal women aged over 45 years was conducted. It included 100 women who sought medical attention at the Menopause Outpatient Facility at the State University of Campinas (UNICAMP), Campinas, SP, Brazil, between March, 2003 and January, 2004. The prevalence of constipation was assessed according to the Rome 11 criteria. Sociodemographic and clinical features of these patients were studied. Physical examinations were performed to evaluate genital dystopias and anal sphincter tone. Statistical analysis was performed by using the mean, standard deviation, median, relative and absolute frequencies and by using the prevalence ratio with a 95% confidence interval and multiple logistic regression. Results - The mean age of the participants was 58.9 ± 5.9 years and the mean age was 47.5 ± 5.4 years at menopause. The prevalence of constipation was 37%, the most common symptom being excessive straining when defecating (91.9%), followed by a feeling of incomplete evacuation (83.8%), hard or lumpy stools (81.1%), less than three bowel movements per week (62.2%), sensation of anorectal obstruction during defecation (62.2%) and digital maneuvers to facilitate defecation (45.9%). Bivariate analysis showed that anal sphincter tone and the history of perianal surgery were factors associated with constipation. After applying multiple regression analysis, the history of perianal surgery was significantly associated with constipation (prevalence ratio: 2.68; 95% confidence interval: 1.18-6.11). Conclusions - The prevalence of constipation in postmenopausal women was high. The history of perianal surgery was significantly associated with constipation, even when the influence of other variables were taken into consideration.4212429Almeida, P.M., Wickerhauser, H., (1991) O Critério ABA/ABIPEME - Em Busca de Uma Atualização, , São Paulo: Associação Brasileira dos Institutos de Pesquisa de MercadoGuidelines on constipation (2000) Gastroenterology, 119, pp. 1761-1778Andre, S.B., Rodriguez, T.N., Moraes Filho, J.P.P., Constipação intestinal (2000) Rev Bras Med, 12, pp. 53-63Chiarelli, P., Brown, W., McElduff, P., Constipation in Australian women: Prevalence and associated factors (2000) Int Urogynecol J, 11, pp. 71-78Delcò, F., Sonnenberg, A., Associations between hemorrhoids and other diagnoses (1998) Dis Colon Rectum, 41, pp. 1534-1541De Lillo, A.R., Rose, S., Functional bowel disorders in the geriatric patient: Constipation, fecal impaction and fecal incontinence (2000) Am J Gastroenterol, 95, pp. 901-905Drossman, D.A., Corazziari, E., Talley, N.J., The Rome II modular questionnaire (2000) Rome II: The Functional Gastrointestinal Disorders: Diagnosis, Pathophysiology, and Treatment: A Multinational Consensus. 2 nd Edition, pp. 670-688. , Drossman DA, editors. McLean, VA: Degnon AssociatesEckardt, V.F., Kanzler, G., How reliable is digital examination for the evaluation of anal sphincter tone? (1993) Int J Colorectal Dis, 8, pp. 95-97Faigel, D.O., A clinical approach to constipation (2002) Clin Cornerstone, 4, pp. 11-21Garrigues, V., Galvez, C., Ortiz, V., Ponce, M., Nos, P., Ponce, J., Prevalence of constipation: Agreement among several criteria and evaluation of the diagnostic accuracy of qualifying symptoms and self-reported definition in a populational-based study survey in Spain (2004) Am J Epidemiol, 159, pp. 520-526Irvine, E.J., Ferrazzi, S., Pare, P., Thompson, W.G., Ranee, L., Health-related quality of life in functional GI disorders: Focus on constipation and resource utilization (2002) Am J Gastroenterol, 97, pp. 1986-1993Johanson, J.F., Sonnenberg, A., The prevalence of hemorrhoids and chronic constipation (1990) Gastroenterology, 98, pp. 380-386Mason, H.J., Serrano-Ikkos, E., Kamm, M.A., Psychological morbidity in women with idiopathic constipation (2000) Am J Gastroenterol, 95, pp. 2852-2857Moore-Gillon, V., Constipation: What does the patient mean? (1984) J R Soc Med, 77, pp. 108-110Ng, S.C., Chen, Y.C., Lin, L.Y., Chen, G.D., Anorectal dysfunction in women with urinary incontinence or lower urinary tract symptoms (2002) Int J Gynaecol Obstet, 77, pp. 139-145Pare, P., Ferrazzi, S., Thompson, W.G., Irvine, E.J., Rance, L., An epidemiological survey of constipation in Canada: Definitions, rates, demographics and predictors of health care seeking (2001) Am J Gastrenterol, 96, pp. 3130-3137Polglase, A.L., Hemorrhoids: A clinical update (1997) Med Aust, 167, pp. 85-88Rekers, H., Drogendjik, A.C., Valkenburg, H.A., Riphagen, F., The menopause, urinary incontinence and others symptoms of the genito-urinary tract (1992) Maturitas, 15, pp. 101-111Sandler, R.S., Jordan, M.C., Shelton, B.J., Demographic and dietary determinants of constipation in the US population (1990) Am J Public Health, 80, pp. 185-189(1999) SAS Software Version 8.2, , Cary, NC: SAS InstituteShull, B.L., Clinical evaluation of women with pelvic support defects (1993) Clin Obstet Gynecol, 36, pp. 939-951Skov, T., Deddens, J., Petersen, M.R., Endahl, L., Prevalence proportion ratios: Estimation and hypothesis testing (1998) Int J Epidemiol, 27, pp. 91-95Soligo, M., Lalia, M., Citterio, S., Scaini, A., Frisco, L.D., Milani, R., Spontaneous reporting of bowel symptoms in women with urinary disorders (2000) Int Urogynecol J Pelvic Floor Dysfunction, 11 (SUPPL. 1), p. 13Stewart, R.B., Moore, M.T., Marks, R.G., Hale, W.E., Correlates of constipation in an ambulatory elderly population (1992) Am J Gastroenterol, 87, pp. 859-864Stewart, W.F., Liberman, J.N., Sandler, R.S., Woods, M.S., Stemhagen, A., Chee, E., Lipton, R.B., Farup, C.E., Epidemiology of constipation (EPOC) in the United States: Relation of clinical subtypes to sociodemographic features (1999) Am J Gastrenterol, 94, pp. 3530-3540Talley, N.J., Weaver, A.L., Zinsmeister, A.R., Melton, L.J., Functional constipation and outlet delay: A population based study (1993) Gastroenterology, 105, pp. 781-790Triadafilopoulos, G., Finlayson, M.A., Grellet, C., Bowel dysfunction in postmenopausal women (1998) Women Health, 27, pp. 55-66Whitehead, W.E., Drinkwater, D., Cheskin, L.J., Heller, B.R., Schuster, M.M., Constipation in the elderly living at home. Definition, prevalence, and relationship to lifestyle and health status (1989) J Am Geriatr Soc, 37, pp. 423-429(1996) Research on the Menopause in the 1990s, , Geneva: WHO. (WHO technical report series, 886

Constipation In Postmenopausal Women [constipação Intestinal Em Mulheres Na Pós-menopausa]

OBJECTIVES. To investigate the prevalence and factors associated with constipation in postmenopausal women and evaluate the level of agreement between different diagnostic criteria. METHODS. A cross-sectional study was conducted with 100 postmenopausal women more than 45 old. The Rome II criteria, stool frequency per week and patient self-evaluation were the diagnostic criteria applied. Social demographic and clinical characteristics with their descriptive analysis were assessed. Subsequently, kappa (ê) statistics was used to assess the level of agreement between diagnostic criteria. The association between constipation and its possible determinants was studied by bivariate and multivariate analyses, using the prevalence ratio (PR). The confidence interval was set at 95% (95% CI). RESULTS. The mean age of participants was 58.9±5.9 years (range, 46-76 years). The prevalence of constipation was 47%, 37% and 26%, according to patient self-evaluation, the Rome II criteria and < 3 bowel movements per week, respectively. The best agreement found was between patient self-evaluation and the Rome II criteria (k: 0.63; 95% CI: 0.48-0.78). After multivariate analysis, the history of perianal surgery (PR: 2.69; 95%CI: 1.03-7.01), according to the Rome II criteria; the presence of hemorrhoids, according to stool frequency (PR: 2.53; 95% CI: 1.16-5.51) and patient self-evaluation (PR: 1.78; 95% CI: 1.01-3.15) were associated with constipation. CONCLUSIONS. Prevalence of constipation in postmenopausal women was high. Agreement between diagnostic criteria ranged from moderate to good. History of perianal surgery and presence of hemorrhoids were associated with constipation.516334341Talley, N.J., Definitions, epidemiology, and impact of chronic constipation (2004) Rev Gastroenterol Disord, 4 (SUPPL. 2), pp. S3-S10Glia, A., Lindberg, G., Quality of life in patients with different types of functional constipation (1997) Scand J Gastroenterol, 32, pp. 1083-1089Johanson, J.F., Geographic distribution of constipation in the United States (1998) Am J Gastroenterol, 93, pp. 188-191Faigel, D.O., A clinical approach to constipation (2002) Clin Cornerstone, 4, pp. 11-21Pare, P., Ferrazzi, S., Thompson, W.G., Irvine, E.J., Rance, L., An epidemiological survey of constipation in Canada: Definitions, rates, demographics and predictors of health care seeking (2001) Am J Gastrenterol, 96, pp. 3130-3137Garrigues, V., Galvez, C., Ortiz, V., Ponce, M., Nos, P., Ponce, J., Prevalence of constipation: Agreement among several criteria and evaluation of the diagnostic accuracy of qualifying symptoms and self-reported definition in a populational-based study survey in Spain (2004) Am J Epidemiol, 159, pp. 520-526Lembo, A., Camilleri, M., Chronic constipation (2003) N Engl J Med, 349, pp. 1360-1368Drossman, D.A., The functional gastrointestinal disorders and the Rome II process (1999) Gut, 45 (SUPPL. 2), pp. II1-II5Thompson, W.G., Creed, F.H., Drossman, D.A., Heaton, K.W., Mazzacca, G., Functional bowel disorders and functional abdominal pain (1992) Gastroenterol Int, 5, pp. 75-91Chiarelli, P., Brown, W., McElduff, P., Constipation in Australian women: Prevalence and associated factors (2000) Int Urogynecol J, 11, pp. 71-78Rekers, H., Drogendjik, A.C., Valkenburg, H.A., Riphagen, F., The menopause, urinary incontinence and others symptoms of the genito-urinary tract (1992) Maturitas, 15, pp. 101-111Triadafilopoulos, G., Finlayson, M.A., Grellet, C., Bowel dysfunction in postmenopausal women (1998) Womens Health, 27, pp. 55-66Almeida, P.M., Wickerhauser, H., (1991) O Critério ABA/ABIPEME: Em Busca de Uma Atualização, , São Paulo: Associação Brasileira dos Institutos de Pesquisa de Mercado;Shull, B.L., Clinical evaluation of women with pelvic support defects (1993) Clin Obstet Gynecol, 36, pp. 939-951(1999) SAS Software Version 8.2, , Cary: SAS Institute IncLandis, J.R., Koch, G.G., The measurement of observer agreement for categorical data (1977) Biometrics, 33, pp. 159-174Skov, T., Deddens, J., Petersen, M.R., Endahl, L., Prevalence proportion ratios: Estimation and hypothesis testing (1998) Int J Epidemiol, 27, pp. 91-95Heaton, K.W., Cripps, H.A., Straining at stool and laxative taking in an English population (1993) Dig Dis Sci, 34, pp. 1004-1008Andre, S.B., Rodriguez, T.N., Moraes Filho, J.P.P., Constipação intestinal (2000) Rev Bras Med, 12, pp. 53-63Stewart, W.F., Liberman, J.N., Sandler, R.S., Woods, M.S., Stemhagen, A., Chee, E., Epidemiology of constipation (EPOC) in the United States: Relation of clinical subtypes to sociodemographic features (1999) Am J Gastrenterol, 94, pp. 3530-3540Snooks, S.J., Barnes, P.R.H., Swash, M., Henry, M.M., Damage to the pelvic floor musculature in chronic constipation (1985) Gastroenterology, 89, pp. 977-981Swash, M., The neurogenic hypothesis of stress incontinence (1990) Ciba Foundation Symposium 151, , Bock G, Whelan J, editors. Neurobiology of incontinence. Chichester: John Wiley and SonsHenry, M.M., Parks, A.G., Swash, M., The pelvic floor musculature in the descending perineum syndrome (1982) Br J Surg, 69, pp. 470-472Spence-Jones, C., Kamm, M.A., Henry, M.M., Hudosn, C.N., Bowel dysfunction: A pathogenic factors in utero-vaginal prolapse and urinary stress incontinence (1994) Br J Obstet Gynaecol, 101, pp. 147-152Sandler, R.S., Jordan, M.C., Shelton, B.J., Demographic and dietary determinants of constipation in the US population (1990) Am J Public Health, 80, pp. 185-189Whitehead, W.E., Drinkwater, D., Cheskin, L.J., Heller, B.R., Schuster, M.M., Constipation in the elderly living at home. Definition, prevalence, and relationship to lifestyle and health status (1989) J Am Geriatr Soc, 37, pp. 423-429Werth, B., Meyer-Wyss, B., Spinas, G.A., Drewe, J., Beglinger, C., Non-invasive assessment of gastrointestinal motility disorders in diabetic patients with and without cardiovascular sings of autonomic neuropathy (1992) Gut, 33, pp. 1199-1203Shafer, R.B., Prentiss, R.A., Bond, J.H., Gastrointestinal transit in tyroid disease (1984) Gastroenterology, 86, pp. 852-855Eckardt, V.F., Kanzler, G., How reliable is digital examination for the evaluation of anal sphincter tone? (1993) Int J Colorectal Dis, 8, pp. 95-97Delcò, F., Sonnenberg, A., Associations between hemorrhoids and other diagnoses (1998) Dis Colon Rectum, 41, pp. 1534-1541Johanson, J.F., Sonnenberg, A., The prevalence of hemorrhoids and chronic constipation (1990) Gastroenterology, 98, pp. 380-386Polglase, A.L., Hemorrhoids: A clinical update (1997) Med Aust, 167, pp. 85-8

Levantamento e patogenicidade de fungos associados às sementes de mangaba (Hancornia speciosa Gomes) no cerrado do Brasil central Survey and pathogenicity of fungi associated with mangaba (Hancornia speciosa Gomes) seeds in the cerrado region of central Brazil

Em 2003 e 2004, os fungos Aspergillus spp., Chaetomium spp., Cladosporium sp., Fusarium spp., Paecilomyces sp., Penicillium spp., Pestalotiopsis sp., Phomopsis sp., Aureobasidium pullulans (de Bary) Arnaud e uma levedura não identificada foram isolados de sementes de mangaba (Hancornia speciosa Gomes) coletadas em três localidades do Cerrado do Brasil. Testes de patogenicidade e o subsequente reisolamento de Fusarium sp. (CPAC-1857), Pestalotiopsis sp (CPAC-1838 e CPAC-1844)., Phomopsis sp. (CPAC-1863) e de A. pullulans (CPAC-1845) de mudas de mangabeira inoculadas artificialmente comprovaram os postulados de Koch.<br>In 2003 and 2004, the following fungi were found in mangaba (Hancornia speciosa Gomes) seeds in the Brazilian Cerrado: Aspergillus spp., Chaetomium spp., Cladosporium sp., Fusarium spp., Paecilomyces sp., Penicillium spp., Pestalotiopsis sp., Phomopsis sp., Aureobasidium pullulans (de Bary) Arnaud and an unidentified yeast. Pathogenicity tests and subsequent reisolations of Fusarium sp. (CPAC-1857), Pestalotiopsis sp. (CPAC-1838 and CPAC-1844)., Phomopsis sp. (CPAC-1863) and A. pullulans (CPAC-CPAC-1845) from artificially inoculated mangabeira seedlings fulfilled the Koch's postulates