Prevalence of urinary stress incontinence in women

三朝分院外来を訪れた女性患者を対象に尿失禁に関する18項目のアンケート調査を行った。その結果，全体の過半数が尿失禁の経験者であった。腹圧性尿失禁が大部分を占め，高齢になるほど　経産回数が多いほど頻度が高くなる傾向がみられた。そのうちの約1割に尿漏れの頻度と程度が重かった。以上より，尿失禁について積極的な啓蒙，診断，治療の必要性が認められた。The prevalence of urinary stress incontinence was investigated in 93 women consulting in our hospital by means of a questionnaire survey. The survey showed that 52.7% of the total cases experienced the loss of urine. 87% of the cases with the loss of urine were the cases with stress incotinence. The prevalence of incontinence increased with age up to 69.2% in the 60's. A positive correlation was found between the number of childbirths and the prevalence of incontinence

A dietary survey in patients with chronic pancreatitis

食事療法は慢性膵炎治療の基本として重要であるが，その具体的な内容についてはあまり明確にされていない。今回，筆者らは慢性膵炎例の食事に関する全国調査の一部を担当したので，その成績を報告し，問題点と対策について考察した。対象は慢性膵炎間欠期の患者56名（男44名，女12名）である。(1)エネルギー摂取量では1日1,400kcal以下が16名（29％）にみられ，肥満度80～90％が7名および80％以下が9名という栄養状態と考え合わせて，食事の回数を増やしてでも摂取エネルギーの改善をはかる必要がある。(2)蛋白質および脂質摂取量についても同様な成績であり，消化酵素剤を投与しながら量的，質的な改善をはかる必要がある。(3)糖質については質的改善をはかる必要がある。(4)ビタミンとミネラルも不足傾向にあった。野菜の摂取不足が顕著であった。(5)診断確定後も禁酒できない患者が男17名(39％)，女1名(8％)にみられ，その指導が重要な課題である。Importance of diet therapy has been emphasized in chronic pancreatitis. However, concrete measures and programs of the diet therapy have remained to be studied. Therefore, Intractable Pancreatic Disease Study Group recently carried out a nation-wide questionnaire survey on the diets in patients with chronic pancreatitis under the auspIces of the Ministry of Health and Welfare. Attendant physicians were requested to report the nutritional states of their patients and the kinds and amounts of foods taken by their patients on three consecutive days. The nutritional state was evaluated by a body weight index calculated by the following formula:Body Weight Index (%) = Present Body Weight / Ideal Body Weight X 100. Daily nutritional intake (calorie, protein, fat, carbohydrate, and others) was calculated by dieticians according to the Food Exchange Table published by the Japanese Association of Diabetes. The present study constitutes a part of the group study. Patients consisted of 44 men and 12 women who fulfilled the diagnostic criteria proposed by the Japanese Society of Gastroenterology;20 men and 3 women had secondary diabetes mellitus. Following results and conclusions were obtained. (1) Average daily calorie intake of the patients was 1,759kcal as compared with 2,057kcal in the general population in Japan. Sixteen patients (28.6%) showed daily calorie intake less than 1,400 kcal and consequently poor nutritional states (6 patients with body weight indices less than 80% and 10 with 80-90%). It is important, therefore, to try to improve the daily calorie intake by increasing the frequency of diets in these patients. (2) Average daily intake of protein was 72.1 g (animal protein 38.1 g), only slightly less than 79.2 g (animal protein 41.7 g) in the general population. However, as many as 16 patients (28.6%) showed daily protein intake of less than 60 g and poor nutritional states as described above. It is important, therfore, to encourage patients to maintain the daily protein intake of more than 60 g by increasing the frequency of diets with oral administration of digestive enzymes. (3) Average daily intake of fat was 39.9 g (animal fat 23.8 g), approximately 20 g less than 58.3 g (animal fat 28.0 g) in the general population. As many as 17 patients (30.4%) showed daily fat intake of less than 30 g , and 16 of the 17 patients showed poor nutritional states as described above. It is important, therefore, to encourage patients to maintain the daily fat intake of more than 30 g (especially by increasing the amounts of vegetable oil) by increasing the frequency of diets with oral administration of digestive enzymes. (4) Average daily intake of carbohydrate was 278 g, almost equal to 289 g in the general population. However, many patients took as much as 48 g of carbohydrate in the from of cakes, plain sugar and alcohol beverages. Seventeen men (39%) and one woman (8%) had continued drinking alcohol beverages even after the diagnosis was made. It is important, therefore, to encourage patients to improve the quality of carbohydrate intake, although it is admittedly difficult to realize the ideal. (5) Intake of vitamins and minerals (especially calcium) also tended to be insufficient. Green vegetables were especially insufficient. (6) In conclusion, it is utmost important in chronic pancreatitis to perform periodical evaluation of nutritional intake and feed back the information to the treatment through a close patient-dietician-doctor relationship