Objective
The objective was to highlight the epidemiological and clinical profile of urinary incontinence in pregnant women during the first trimester and to determine their knowledge and attitudes ...toward this condition in Kinshasa.
Methods
We carried out a descriptive cross-sectional study among 127 pregnant women who came for prenatal consultations in the first trimester from January to March 2022 at the LISANGA Medical Centre in Kinshasa. A questionnaire was developed containing the Urinary Symptom Profile (USP) scale. Kolmogorov–Smirnov normality tests were used to determine the normality of the distribution of the study variables. Inferential statistics were performed.
The significance level was 0.05.
Results
The mean age was 29.7±5.5 years. Thirty–eight women (29.9%) were primigravida. The median age of pregnancy was 6 weeks of amenorrhoea. The prevalence of urinary incontinence was 73.2%, with 31.2% of urge urinary incontinence and 16.1% of stress incontinence. In 61.4% of cases, overactive bladder was associated with urinary incontinence. Among the incontinent pregnant women, 3.2% had consulted a doctor while accepting that this condition is a health problem, 13.4% knew they had a pelvic floor muscle, 4.7% had knowledge of its rehabilitation, and 8.7% had benefited from gymnastics during pregnancy.
Conclusions
Urinary incontinence was frequent in the first trimester of pregnancy with a predominance of urgency. It was hardly discussed during prenatal consultations and pregnant women were not aware of the pelvic floor muscle, its rehabilitation, and of gymnastics during pregnancy.
L´incontinence urinaire (IU) de la femme est une pathologie très fréquente dans la population. La carence des données épidémio-cliniques dans notre milieu nous a poussés à faire un état de lieu de ...cette affection et de sa prise en charge aux Cliniques Universitaires de Kinshasa. L´objectif de cette étude est de déterminer la prévalence et la prise en charge de l´incontinence urinaire de la femme en milieu clinique. Une étude descriptive a été réalisée aux Cliniques Universitaires de Kinshasa de janvier 2015 à décembre 2016. La fréquence annuelle de l´IU était de 1,3% (soit 23/1813 patientes). Nous n´avons retenu que 15 cas dont les dossiers étaient exploitables, et leur âge moyen était de 49,2±20,5 ans avec des extrêmes de 15 à 98 ans. L´IU a concerné les multipares (53,4%), les paucipares (26,7%), les primipares (6,7%) et les nullipares (13,3%), et la date médiane de survenue de l´IU était de 3 mois. L´IU par urgenturie était présente chez 33,3% des patientes et celle à l´effort chez 13,3%. Parmi les diagnostics associés à l´IU, nous avons plus retrouvé les infections uro-génitales (46,7%), la cystocèle (20%) et les algies pelviennes chroniques (20%). Ces patientes ont bénéficié de l´antibiothérapie (60%), des anticholinergiques (20%), de la rééducation pelvipérinéale (20%) ainsi que du traitement chirurgical. L´IU est sous-évaluée aux Cliniques Universitaires de Kinshasa. Les types d´IU les plus diagnostiqués sont les IU à l´effort et par urgenturie. La prise en charge est pluridisciplinaire.
Female genital mutilation (FGM) can leave a lasting mark on the lives and minds of those affected.
To assess the consequences of FGM on women’s sexual function in women who have undergone FGM ...compared to women who have not undergone FGM.
A systematic review and meta-analysis were conducted from 3 databases; inclusion and exclusion criterions were determined. Studies included adult women having undergone FGM and presenting sexual disorders assessed by the Female Sexual Function Index (FSFI).
Of 129 studies, 5 that met the criteria were selected. The sexual function of mutilated women, based on the FSFI total score and its different domains, was compared to the sexual function of non-mutilated women. There was a significant decrease in the total FSFI scores of mutilated women compared to non-mutilated women. However, the results obtained for the different domains were not the same for all authors. The meta-analysis highlighted a high heterogeneity with inconsistency and true variance in effect size between-studies.
Analysis of studies showed that there is a significant decrease in the total FSFI score, indicating that FGM of any type may cause impaired sexual functioning. But a firm conclusion on this topic is not yet achievable because the results of this analysis do not allow to conclude a cause and effect relationship of FGM on sexual function.
Nzinga A-M, De Andrade Castanheira S, Herklmann J, et al. Consequences of Female Genital Mutilation on Women’s Sexual Health – Systematic Review and Meta-Analysis. J Sex Med 2021;18:750–760.
To assess the prevalence of obstetric and neonatal complications in women with female genital mutilation (FGM) compared to women without FGM.
Literature searches carried out on three scientific ...databases (CINAHL, ScienceDirect, and PubMed).
Selected observational studies published from 2010 to 2021 that assessed prolonged second phase of labor, vaginal outlet obstruction, emergency cesarean birth, perineal tear, instrumental births, episiotomy, and postpartum hemorrhage in women with and without FGM, as well as Apgar score and resuscitation of their newborns.
Nine studies were selected, including case-control, cohort, and cross-sectional studies. There were associations between FGM and vaginal outlet obstruction, emergency cesarean birth, and perineal tears.
For obstetric and neonatal complications other than those listed in the "Results" section, researchers' conclusions remain divided. Still, there is some evidence to support the impact of FGM on obstetric and neonatal harm, particularly in cases of FGM Types II and III.
Urinary Incontinence (UI) in women is a very common disease. Given the shortage of epidemiological and clinical data in our environment, we here provide an update on the status of this disease and ...its management at the University Clinics of Kinshasa. We conducted a descriptive study in the University Clinics of Kinshasa from January 2015 to December 2016. The annual rate of IU was 1.3% (23/1813 patients). We included 15 cases whose medical files were usable and whose average age was 49.2±20.5 years, ranging between 15 and 98 years. IU affected multiparous women (53.4%), pauciparous women (26.7%), primiparous women (6.7%) and nulliparous women (13.3%) and the median date of onset of IU was 3 months. Urge incontinence affected 33.3% of patients and effort incontinence 13.3%. Among diagnoses associated with UI, the most common were urogenital infections (46.7%), cystocele (20%) and chronic pelvic pain (20%). These patients received antibiotic therapy (60%), anticholinergics drugs (20%), and pelviperineal rehabilitation (20%) as well as surgical treatment. UI is underestimated at the University Clinics of Kinshasa. The most commonly diagnosed IUs are effort and urge incontinence. Patient´s management is based on multidisciplinary approach.
State-of-the-art of seizure prediction Lehnertz, Klaus; Mormann, Florian; Osterhage, Hannes ...
Journal of clinical neurophysiology,
2007-April, Letnik:
24, Številka:
2
Journal Article
Recenzirano
Although there are numerous studies exploring basic neuronal mechanisms that are likely to be associated with seizures, to date no definite information is available as to how, when, or why a seizure ...occurs in humans. The fact that seizures occur without warning in the majority of cases is one of the most disabling aspects of epilepsy. If it were possible to identify preictal precursors from the EEG of epilepsy patients, therapeutic possibilities and quality of life could improve dramatically. The last three decades have witnessed a rapid increase in the development of new EEG analysis techniques that appear to be capable of defining seizure precursors. Since the 1970s, studies on seizure prediction have advanced from preliminary descriptions of preictal phenomena and proof of principle studies via controlled studies to studies on continuous multiday recordings. At present, it is unclear whether prospective algorithms can predict seizures. If prediction algorithms are to be used in invasive seizure intervention techniques in humans, they must be proven to perform considerably better than a random predictor. The authors present an overview of the field of seizure prediction, its history, accomplishments, recent controversies, and potential for future development.
We present a client–server application for the distributed multivariate analysis of time series using standard PCs. We here concentrate on analyses of multichannel EEG/MEG data, but our method can ...easily be adapted to other time series. Due to the rapid development of new analysis techniques, the focus in the design of our application was not only on computational performance, but also on high flexibility and expandability of both the client and the server programs. For this purpose, the communication between the server and the clients as well as the building of the computational tasks has been realized via the Extensible Markup Language (XML). Running our newly developed method in an asynchronous distributed environment with random availability of remote and heterogeneous resources, we tested the system's performance for a number of different univariate and bivariate analysis techniques. Results indicate that for most of the currently available analysis techniques, calculations can be performed in real time, which, in principle, allows on-line analyses at relatively low cost.
Les mutilations génitales féminines (MGF) sont définies par l’OMS comme « toute intervention qui modifie ou endommage intentionnellement les organes génitaux externes d’une femme pour des raisons non ...médicales et qui ne présente aucun avantage pour la santé des filles et des femmes » 1. Dans le monde, environ 200 millions de femmes et de filles sont mutilées dans plus de 30 pays. Il existe des lacunes scientifiques concernant l’impact à court et long terme des MGF, selon le type et la gravité de l’acte pratiqué. Les objectifs de ce projet de recherche ont été d’identifier les conséquences des MGF sur les fonctions vésico-sphinctérienne (LUTS), gynécologique, sexuelle et psychologique chez les femmes concernées et les facteurs contextuels les influençant sur la base de 3 revues systématiques mixtes.
Les guidelines Prisma et JBI ont été utilisées. Pour chaque revue, une recherche d’études quantitatives, qualitatives et mixtes a été réalisée à partir des bases de données Pubmed, CINAHL, Embase et PsychINFO.
Au niveau urinaire, la prévalence des LUTS est significativement augmentée chez les femmes ayant subi une MGF avec une majoration du nombre d’incontinence urinaire mixte. La prévalence est d’autant plus élevée que la mutilation est importante 2. Pour la fonction sexuelle, une diminution significative des scores totaux du FSFI chez les femmes mutilées par rapport aux femmes non mutilées a été constatée 3. Au niveau gynécologique, une corrélation entre la présence de MGF et la survenue des troubles obstétriques a été établie. Il a été observé que les femmes mutilées étaient plus exposées à une augmentation de la durée d’expulsion, au risque d’accouchement par césarienne en urgence, à la pratique d’une épisiotomie, à la survenue de déchirures périnéales et à la nécessité de réanimer le nouveau-né 4. Enfin, au niveau psychologique, le PTSD, la dépression, l’anxiété et la somatisation sont les 4 troubles principaux montrant une prévalence significativement plus élevée chez les femmes mutilées versus non-mutilées. Les MGF de type II ou III ont été identifiés comme indices de sévérité des troubles 5.
Les MGF, quel que soit leur type, semblent affecter de manière significative les différentes fonctions pelviennes féminines ainsi que la santé mentale des femmes touchées. Cependant, une conclusion ferme sur la relation cause à effet des MGF sur ce sujet reste difficile à appliquer au vu des biais et limites méthodologiques des études inclues.
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