A review of fuzzy cognitive maps in medicine

The overactive bladder (OAB) picture has dramatically changed in the last 20 years. A quarter century ago, this symptom complex did not even exist. Bladder hyperactivity and urgency incontinence were separate entities poorly understood and treated only with the first-generation anti-muscarinic medications, propantheline and oxybutynin. Only in early 2000 came the concept of this syndrome made of four intimately linked symptoms that we today call OAB. With this concept, new pharmacological agents were launched. These new agents may have not dramatically improved symptoms in comparison with older agents, but undeniably have a more tolerable side effect profile, leading to better compliance and adherence. Neuromodulation was introduced a few years later, giving hope to the worst OAB cases, but with a limited applicability due to its cost. A real revolution occurred around 2010 with the demonstration of onabotulinumtoxinA’s efficacy in controlling the symptoms of OAB. Several years passed before it proved its place in the treatment algorithm for OAB. It is definitely time for the Canadian Urological Association (CUA) to produce guidelines to help Canadian urologists better integrate a sequence of investigation, diagnosis, and treatment, which has become more complex over the years.

To do so, the CUA gave a group of experts, Canadian physicians and nurses, the difficult task of putting together a comprehensive document to guide all interested professionals in the management of this interesting and common syndrome, which has so much impact on our patients’ quality of life.

An executive summary of the CUA guideline on OAB is available as an Appendix at www.cuaj.ca.

/pdf/cua-guideline-on-adult-overactive-bladder-4rjymsgrml.pdf

CUA guideline on adult overactive bladder

Our purpose with this study was to verify the restriction of the urinary incontinence (UI) in a woman's daily life, considering the type of incontinence, and find out how women deal with that. It is a secondary analysis of data taken from a previous study that were obtained using open and closed questions. Interviews were held with 164 incontinent inpatients of gynecological and urological clinics of two hospital schools in the city of Campinas, in the State of Sao Paulo, with ages ranging from 25 to 85 years. Of this universe, 104 (64%) indicated one or more restrictions regarding their daily life activities, such as altered sexual (40.9%), social (33.5%), domestic (18.9%) and occupational activities (15.2%). Mixed urinary incon-tinence and urge incontinence were mentioned as that affected the most women's daily life. The disposable pad system was the most utilized strategy in dealing with UI. It was concluded that UI has a negative impact on the daily life of these women.

/pdf/restricoes-causadas-pela-incontinencia-urinaria-a-vida-da-3q4xegjjhe.pdf

Restrições causadas pela incontinência urinária à vida da mulher

Urinary Incontinence Restrictions In Women's Life [restrições Causadas Pela Incontinência Urinária A Vida Da Mulher.]

Computer-aided diagnosis system based on fuzzy logic for breast cancer categorization

Se trata de un estudio para evaluar la prevalencia de la incontinencia urinaria (IU) y los factores asociados entre mujeres profesionales de enfermeria de un hospital-escuela. De 378 formularios que fueron distribuidos, fueron respondidos 291 (77%) y 80 funcionarias (27,5%) hicieron relato de queja de IU. El analisis multivariado indico una mayor probabilidad de que las mujeres desarrollen IU despues de los 41 anos y cuando relataban alteracion de peso, constipacion intestinal o hipertension arterial. Se concluyo que se hacen necesarias medidas educativas de prevencion y tratamiento para mejorar y prevenir la IU entre profesionales de enfermeria.

/pdf/factores-asociados-con-la-incontinencia-urinaria-en-la-mujer-2ba4qy9uie.pdf

Factores asociados con la incontinencia urinaria en la mujer

PURPOSE

To substantiate the nursing diagnosis of mixed incontinence and demonstrate the need for its acceptance.



METHODS

Interviews with 148 women with complaints of urinary incontinence. Initial diagnoses were identified and these cases later discussed with a specialist in nursing diagnosis in order to reach a consensus.



FINDINGS

Fifty women (34%) had stress urinary incontinence, 13 (9%) had urge incontinence, and 85 (57%) presented with characteristics specific to two types of incontinence (i.e., mixed incontinence). The age range of the women who presented mixed incontinence was 26–85 years (mean age: 49.16 ± 12.02 years); all reported stress urinary loss and a perception of urinary urgency. More than 50% of the women reported nocturia, increased urinary frequency, dribbling with increased abdominal pressure, inability to stop or start miction, inability to reach toilet in time, and inability to completely empty bladder.



DISCUSSION

The high frequency of mixed incontinence (57%) in this study may be a function of the complexity of these cases.



CONCLUSIONS

The evidence found in medical and nursing literature indicates the need to include mixed incontinence as a nursing diagnosis. It is considered to be quite frequent in women with urinary incontinence and is generally more frequent than urge incontinence. Patients may receive inadequate treatment if this diagnosis is not recognized.

Mixed Incontinence in Women: A New Nursing Diagnosis

It was verified the prevalence of urinary incontinence (UI) among the women's nurse staff at a medical school, if the incontinent women seek a doctor for treatment and what was they reasons for not seeking treatment. Among 291 women that answer the survey, 27.5% reported UI and, 79% women didn't seek UI treatment. The most common reasons for not seek treatment were that incontinence was slight degree (28.8%) and the belief that the UI was a common problem for women (22%). The prevalence and the reasons for not seeking treatment for UI were similar the others researches with women in general. It was concluded that the factor at to be health's professional didn't influence their attitudes.

/pdf/why-the-nursing-staff-professionals-with-urinary-2tugtr8fwt.pdf

Why the nursing staff professionals with urinary incontinence do not seek for treatment

The aim was to identify and analyze studies on the quality of life and life experiences of men with urinary incontinence. Through critical review of the literature, data were analyzed using content analysis technique based on psychodynamic references. The results were grouped into two themes: Psychosocial lived experience aspects of men with urinary incontinence; Men's lived experience in the management of urinary incontinence. Men with urinary incontinence experienced a low self-image along with a sense of social stigma associated to the image of a deteriorated body. Seeking treatment when the incontinence is mild and making use of psychological and social mechanisms to adapt to the urinary incontinence. The study shows that incontinent men to have low expectation regarding treatment due to the lack of knowledge about existing therapies and strategies to urinary loss control.

/pdf/male-incontinence-a-critical-review-of-the-literature-4l2cml6y31.pdf

Male incontinence: a critical review of the literature

/pdf/atencion-de-enfermeria-a-mujeres-que-sufren-violencia-sexual-ux4y6fw2xz.pdf

Rosângela Higa

Papers

Factores asociados con la incontinencia urinaria en la mujer

Mixed Incontinence in Women: A New Nursing Diagnosis

Why the nursing staff professionals with urinary incontinence do not seek for treatment

Male incontinence: a critical review of the literature

Atención de enfermería a mujeres que sufren violencia sexual