Prevalence and severity of urinary incontinence and associated factors in Iranian postmenopausal women: a cross-sectional study.

BACKGROUND: Urinary incontinence (UI) is one of the most common symptoms during menopause, leading to a decreased quality of life and limited social activities. This study aimed to determine the prevalence and severity of urinary incontinence and associated risk factors in postmenopausal women. METHODS: It was a cross-sectional study using cluster sampling on 433 postmenopausal women in Tabriz-Iran, 2021-2022. Data were collected using questionnaires of socio-demographic characteristics, Questionnaire for Urinary Incontinence Diagnosis (QUID), and International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UISF). Multivariate logistic regression was used to determine factors related to urinary incontinence. RESULTS: The overall prevalence of urinary incontinence was 39.5%; 20.6% stress urinary incontinence (SUI), 10.4% urgency urinary incontinence (UUI), and 8.5% mixed urinary incontinence (MUI). Multivariate logistic regression analysis showed that the prevalence of SUI (aOR 0.38; 95% CI 0.18-0.77) and UUI (aOR 0.38; 95% CI 0.15-0.94) was significantly lower in women with three childbirths than the ones with fewer childbirths. Also, the odds of UUI increased significantly in women at the 50-55 age range (aOR 3.88; 95% CI 1.16-12.93) than those less than 50 years. CONCLUSION: Due to the high prevalence of urinary incontinence in postmenopausal women, caregivers should screen for early diagnosis and appropriate treatment of urinary incontinence to prevent its destructive impact on the quality of life.

Retinoic acid-inducible gene 1 (RIG-1) and IFN-ß promoter stimulator-1 (IPS-1) significantly down-regulated in the severe coronavirus disease 2019 (COVID-19).

INTRODUCTION: Retinoic acid-inducible gene 1 (RIG-1) and melanoma differentiation-associated protein 5 (MDA5) are the well-known cytoplasmic sensors that recognize microbial DNA or RNA and active down-stream molecules, including IFN-ß promoter stimulator-1 (IPS-1) and receptor interacting protein 1 (RIP1). The roles played by the networked molecules on the infection with SARS-CoV-2 needs more investigations. MATERIAL AND METHOD: In this project MDA5, RIG-1, IPS-1 and RIP1 mRNA levels were evaluated in 45 hospitalized patients suffering from coronavirus disease of 2019 (COVID-19) and 45 healthy subjects using Real Time-qPCR technique. RESULT: The results showed significant decreased RIG-1 and IPS-1 in the SARS-CoV-2 infected patients when compared to healthy cases. MDA5 and RIP1 did not change when compared two groups. Male patients had similar expression of MDA5, RIG-1, IPS-1 and RIP1 when compared to female patients. CONCLUSION: Based on the results, it seems that RIG-1 and its signaling molecule, IPS-1, play key roles in the peripheral blood immune cells against SARS-CoV-2 and, their down-regulation may be induced by the virus to escape from immune responses.

Quality of reporting of literature search strategies in systematic reviews published on the role of telehealth during COVID-19

A comprehensive and reproducible search strategy for systematic reviews especially about COVID-19 plays a pivotal role in conducting a reliable and unbiased review. The primary aim of this study was to investigate the quality of the search strategy reporting in systematic reviews conducted on the role of telehealth during COVID-19. The secondary aim of study was to explore some affecting factor in the quality of search strategy. The study evaluated the quality of the search strategy reporting with PRISMA-S checklist. The search was performed in MEDLINE, Embase, CINAHL, and other related databases. Systematic reviews were included. There was no language restriction. The correlation of the PRISMA-S scores with journal impact factor, CiteScore, and librarians? role were evaluated using Spearman?s rank correlation coefficient. A total of 85 articles were included in the review. The overall mean score of PRISMA-S checklist was 6.12 ± 1.46. PubMed was the most popular database for search. More than half of the studies did not provide a full search strategy. There was a significant positive correlation between PRISMA-S score and the journal impact factor (Spearman?s rho = 0.217;P = 0.46) and CiteScore (Spearman?s rho = 0.235;P = 0.03). The quality of literature search was poor in the included studies. Using the PRISMA-S as a search reporting guideline can be a helpful tool for authors. A professional librarian can be beneficial in improving the quality of the search. It is recommended to use a new pattern in COVID-19-related searches, such as preprint sources.

How accurate are digital symptom assessment apps for suggesting conditions and urgency advice? A clinical vignettes comparison to GPs.

OBJECTIVES: To compare breadth of condition coverage, accuracy of suggested conditions and appropriateness of urgency advice of eight popular symptom assessment apps. DESIGN: Vignettes study. SETTING: 200 primary care vignettes. INTERVENTION/COMPARATOR: For eight apps and seven general practitioners (GPs): breadth of coverage and condition-suggestion and urgency advice accuracy measured against the vignettes' gold-standard. PRIMARY OUTCOME MEASURES: (1) Proportion of conditions 'covered' by an app, that is, not excluded because the user was too young/old or pregnant, or not modelled; (2) proportion of vignettes with the correct primary diagnosis among the top 3 conditions suggested; (3) proportion of 'safe' urgency advice (ie, at gold standard level, more conservative, or no more than one level less conservative). RESULTS: Condition-suggestion coverage was highly variable, with some apps not offering a suggestion for many users: in alphabetical order, Ada: 99.0%; Babylon: 51.5%; Buoy: 88.5%; K Health: 74.5%; Mediktor: 80.5%; Symptomate: 61.5%; Your.MD: 64.5%; WebMD: 93.0%. Top-3 suggestion accuracy was GPs (average): 82.1%±5.2%; Ada: 70.5%; Babylon: 32.0%; Buoy: 43.0%; K Health: 36.0%; Mediktor: 36.0%; Symptomate: 27.5%; WebMD: 35.5%; Your.MD: 23.5%. Some apps excluded certain user demographics or conditions and their performance was generally greater with the exclusion of corresponding vignettes. For safe urgency advice, tested GPs had an average of 97.0%±2.5%. For the vignettes with advice provided, only three apps had safety performance within 1 SD of the GPs-Ada: 97.0%; Babylon: 95.1%; Symptomate: 97.8%. One app had a safety performance within 2 SDs of GPs-Your.MD: 92.6%. Three apps had a safety performance outside 2 SDs of GPs-Buoy: 80.0% (p<0.001); K Health: 81.3% (p<0.001); Mediktor: 87.3% (p=1.3×10-3). CONCLUSIONS: The utility of digital symptom assessment apps relies on coverage, accuracy and safety. While no digital tool outperformed GPs, some came close, and the nature of iterative improvements to software offers scalable improvements to care.