Prevalence of Symptomatic Pelvic Floor Disorders in US Women

Pelvic floor disorders (urinary incontinence, fecal incontinence, and pelvic organ prolapse) affect many women. No national prevalence estimates derived from the same population-based sample exists for multiple pelvic floor disorders in women in the United States

Maternal allergen immunisation to prevent sensitisation in offspring: Th2-polarising adjuvants are more efficient than a Th1-polarising adjuvant in mice

<p>Abstract</p> <p>Background</p> <p>Allergy has been an increasing problem in several parts of the world. Prenatal exposure to allergen and microbial components may affect the development of allergies in childhood, as indicated by epidemiological and experimental studies. We investigated the capacity for allergic sensitisation in offspring after induction of a Th1- or a Th2-polarised immune response to the same allergen in mothers during pregnancy.</p> <p>Results</p> <p>During pregnancy, mice were immunised with ovalbumin (OVA) given with either one of the Th2-adjuvants pertussis toxin (PT) or Al(OH)₃(aluminium hydroxide), or with the Th1 adjuvant CpG. Offspring were immunised with OVA in Al(OH)₃as young adults. Serum and supernatants from <it>ex vivo </it>stimulated or non-stimulated spleen cells from mothers and offspring were analysed for OVA-specific antibodies and cytokines, respectively. Mothers immunised with OVA together with either Al(OH)₃or PT had increased levels of OVA-specific IgE and IgG1 compared to naive mothers, whereas mothers immunised with OVA together with CpG had increased levels of OVA-specific IgG2a compared to naive mothers. In general the highest levels of IL-5, IL-10, and IFNγ were observed in spleen cells from mothers immunised with PT and OVA. Upon immunisation, offspring from mothers immunised with OVA and either PT or Al(OH)₃showed reduced levels of OVA-specific IgE and IgG1 and increased levels of OVA-specific IgG2a antibodies compared to offspring from naive mothers. Maternal immunisation with CpG and OVA did not affect antibody responses in offspring.</p> <p>Conclusion</p> <p>Allergic sensitisation in the offspring was affected by the type of adjuvant used for immunisation of the mothers with the same allergen. Th2 polarisation of the immune response in the mothers was found to give reduced IgE levels upon sensitisation of the offspring, whereas no reduction was achieved with Th1 polarisation in the mothers.</p

The Genomic HyperBrowser: inferential genomics at the sequence level

The immense increase in the generation of genomic scale data poses an unmet analytical challenge, due to a lack of established methodology with the required flexibility and power. We propose a first principled approach to statistical analysis of sequence-level genomic information. We provide a growing collection of generic biological investigations that query pairwise relations between tracks, represented as mathematical objects, along the genome. The Genomic HyperBrowser implements the approach and is available at http://hyperbrowser.uio.no

Trends in the prevalence of breastfeeding up to 6 months of age using structured data from routine child healthcare visits

Aim The Norwegian Action Plan for a Healthier Diet (2017–2021) set the target that 25% of infants should be exclusively breastfed for 6 months by 2022. Our aim was to determine trends in the prevalence and duration of breastfeeding in the municipality of Bergen. Methods Data on breastfeeding status in 2010–2018 were extracted from a standardised electronic medical record kept by public child health centres and recorded as exclusive, partial or none, at 6 weeks and 6 months of age. Results We found that 28,503 and 26,735 infants attended the 6-week and 6-month consultations, respectively. The prevalence of any breastfeeding was 92.0% at 6 weeks and 78.0% at 6 months with no trend over time between 2010 and 2018. The prevalence of exclusive breastfeeding at 6 weeks was 73.9% and stable over time, but it declined at 6 months, from 28.1% in 2010 to 11.1% in 2014 and remained stable thereafter. Conclusion During 2010–2018, the prevalence of any and exclusive breastfeeding at 6 weeks and any breastfeeding at 6 months was stable. Exclusive breastfeeding at 6 months declined halfway through the study period, to a stable, but low, prevalence of 11.1% by 2014.publishedVersio

The Minimum Important Difference for the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form in Women with Stress Urinary Incontinence

INTRODUCTION: Minimum important difference (MID) estimates the minimum degree of change in an instrument\u27s score that correlates with a patient\u27s subjective sense of improvement. We aimed to determine the MID for the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) using both anchor based and distribution based methods derived using data from the Trial of Midurethral Slings (TOMUS). MATERIALS AND METHODS: Instruments for the anchor-based analyses included the urogenital distress inventory (UDI), incontinence impact questionnaire (IIQ), patient global impression of improvement (PGI-I), incontinence episodes (IE) on 7-day bladder diary, and satisfaction with surgical results. After confirming moderate correlation (r ≥ 0.3) of ICIQ-UI SF and each anchor, MIDs were determined by calculating the difference between the mean instrument scores for individuals with the smallest amount of improvement and with no change. The distribution-based method of MID assessment was applied using effect sizes of 0.2 and 0.5 SD (small to medium effects). Triangulation was used to examine these multiple MID values in order to converge on a small range of values. RESULTS: Anchor-based MIDs range from -4.5 to -5.7 at 12 months and from -3.1 to 4.3 at 24 months. Distribution-based MID values were lower. Triangulation analysis supports a MID of -5 at 12 months and -4 at 24 months. CONCLUSION: The recommended MIDs for ICIQ-UI SF are -5 at 12 months and -4 at 24 months. In surgical patients, ICIQ-UI SF score changes that meet these thresholds can be considered clinically meaningful

Technical feed quality influences health, digestion patterns, body mineralization and bone development in farming of the stomachless cleaner fish ballan wrasse (Labrus bergylta)

Farmed ballan wrasse (Labrus bergylta) is an efficient cleaner fish used for non-medicinal delicing of Atlantic salmon in sea cages replacing to an increasing degree wild wrasse due to considerations for biodiversity and risk of overfishing local wrasse populations. Farming of ballan wrasse has been hampered by low growth rates, high prevalence of skeletal deformities and other welfare related pathologies. In this study we investigated how diets identical in composition but differing in their technical characteristics, by being prepared using different feed production technologies, affect fish performance, mineralization, bone development and gut health of the ballan wrasse larvae and juveniles. The different production technologies include the commonly used ‘high temperature’ extrusion, cold extrusion, and agglomeration, resulting in feed pellets with distinctive physicochemical properties. The results revealed that prolonged feeding periods with extruded pellets during ballan wrasse larvae weaning result in low body mineralization and the development of severe skeletal deformities. In juvenile ballan wrasse, the extruded pellet treatment resulted in higher mortality rates, fish with larger livers, indication for increased serum TAG and cholesterol in a similar manner, and increased activity of the digestive enzymes LAP and maltase, most probably as a compensatory mechanism to the assumed reduced availability of protein and carbohydrates of extruded pellets for this fish species. Smaller dietary effects were identified in terms of intestinal morphology and gene transcription rates.publishedVersio

Incontinence pessaries: size, POPQ measures, and successful fitting

The aim of the study was to determine whether successful incontinence pessary fitting or pessary size can be predicted by specific POPQ measurements in women without advanced pelvic organ prolapse. In a multicenter study, women with stress urinary incontinence (SUI) and POPQ stage ≤2 were randomized to three treatment arms: (1) incontinence pessary, (2) behavioral therapy, or (3) both. This study evaluates incontinence pessary size, POPQ measures, and successful fitting in the 266 women assigned to treatment arms 1 and 3. Two hundred thirty-five women (92%) were successfully fitted with an incontinence ring (n = 122) or dish (n = 113). Hysterectomy, genital hiatus (GH), and GH/total vaginal length (TVL) ratios did not predict unsuccessful fitting (p &gt; 0.05). However, mean TVL was greater in women successfully fitted (9.6 vs. 8.8 cm, p &lt; 0.01). Final pessary diameter was not predicted by TVL, point D, or point C (p &gt; 0.05). The vast majority of women with SUI can be successfully fitted with an incontinence pessary, but specific POPQ measures were not helpful in determining incontinence pessary size

Does urethral competence affect urodynamic voiding parameters in women with prolapse?

Aims To (1) compare voiding parameters and (2) correlate symptoms and urodynamic findings in women with pelvic organ prolapse (POP) and varying degrees of urethral competence. Methods We compared three groups of women with stages II–IV POP. Groups 1 and 2 were symptomatically stress continent women participating in the Colpopexy and Urinary Reduction Efforts (CARE) trial; during prolapse reduction before sacrocolpopexy, Group 1 (n = 67) did not have and Group 2 (n = 84) had urodynamic stress incontinence (USI) during prolapse reduction. Group 3 participants (n = 74), recruited specifically for this study, had stress urinary incontinence (SUI) symptoms and planned sacrocolpopexy. Participants completed standardized uroflowmetry, pressure voiding studies, and validated symptom questionnaires. Results Subjects' median age was 61 years, median parity 3 and 87% had stage III or IV POP. Fourteen percent of women in Group 3 demonstrated USI without, and 70% with, prolapse reduction. Women in Groups 2 and 3 had more detrusor overactivity (DO) than Group 1 (17 and 24% vs. 6%, P  = 0.02) and detrusor overactivity incontinence (DOI) (15 and 8% vs. 0%, P  = 0.004). Based on the Blaivis–Groutz nomogram, 60% of all women were obstructed. Post-void residual volume (PVR), peak flow rate, detrusor pressure at peak flow, voiding mechanisms, voiding patterns, obstruction and urinary retention did not differ among groups. Women in Group 3 had higher irritative and obstructive symptom scores than Group 1 or 2; neither score differed by presence of DO nor obstruction, respectively. Conclusion Women with POP have significant rates of urodynamic obstruction and retention, independent of their continence status. Symptoms of obstruction and retention correlate poorly with urodynamic findings. Neurourol. Urodynam. 26:1030–1035, 2007. © 2007 Wiley-Liss, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/57365/1/20436_ftp.pd

Changes in Physical Activity after Sacrocolpopexy for Advanced Pelvic Organ Prolapse

To describe changes in physical activity one year after sacrocolpopexy for pelvic organ prolapse