THE RELIABILITY OF URODYNAMIC ASSESSMENT IN CONFIRMATION OF STRESS URINARY INCONTINENCE IN RELATION TO BONNEY TEST.

According to the International Continence Society, stress (static) urinary incontinence is defined as any involuntary loss of urine on effort or physical exertion, due to which intravesical pressure overcomes urethral pressure, with no detrusor activity. Urodynamic testing accurately assesses the function of the bladder and urethra. The urodynamic assessment includes three tests: cystometry, uroflowmetry and profilometry (determination of urethral pressure profile). Prior to urodynamic assessment, it is mandatory to rule out urinary tract infection since it is an invasive test. Urethral profilometry is a technique that measures pressure in the urethra and bladder at rest, during stressful actions, and during the act of miction. Its main purpose is to evaluate the sphincter mechanism. During the examination, a special catheter is used, which is being slowly pulled out from the bladder neck throughout the urethra, with continuous recording of intraurethral pressure. In addition to measuring urethral pressures, stress urinary incontinence is also very successfully proven by the cough test and Bonney test. If, on forced cough, the urine escapes uncontrollably, and continence is restored by finger lifting the neck of the bladder, the diagnosis of static incontinence is confirmed. At our urogynecologic clinic, urodynamic examination is being routinely performed. In the present study, we included patients previously treated for urinary stress incontinence and compared their results of urodynamic assessment to the results of Bonney test. Of the 43 subjects in whom stress incontinence was proven with Bonney test, we recorded an appropriate profilometry result in 13 cases.

Influence of the Cognitive and Emotional Status of Patients with Chronic Pain on Treatment Success (Reduction in Pain Intensity and Adherence to Pharmacotherapy): A Prospective Study.

This prospective study aimed to determine the cognitive and emotional status among patients with chronic pain and to examine the potential influence on the treatment success, measured by the reduction in pain intensity and adherence to pharmacotherapy. A total of seventy patients were followed for two months. The results of the comparison between patients who did and did not follow the physician's instructions regarding adherence to pharmacotherapy showed a significant difference in cognitive status and a reduction in pain intensity. Patients who followed the physician's instructions on taking analgesics had significantly higher scores on the Montreal Cognitive Assessment (MoCA) of cognitive status and a substantially higher reduction in pain intensity. Scores on the MoCA test provide statistically significant indications regarding patients' decision to follow instructions regarding adherence to pharmacotherapy. Scores on the MoCA test, anxiety, age, and pain intensity (measured with a numeric rating scale­NRS) on admission were identified as potential predictors for the reduction in pain intensity. The linear regression model was statistically significant (χ2 = 40.0, p < 0.001), explained between 43.5% and 61.1% of variance regarding the reduction in pain intensity. The findings of this study show that cognitive status, measured with MoCA, and emotional status, measured with the Depression, Anxiety, and Stress Scale (DASS-21), significantly influence the reduction in pain intensity and adherence to pharmacotherapy. The results suggest that cognitive and emotional status may be potential predictors of treatment success. This finding points to the importance of a biopsychosocial approach in the treatment of chronic pain, where an important emphasis can be placed on the psychosocial determinants of pain.

Quality of Life and Mental Distress in Patients with Chronic Low Back Pain: A Cross-Sectional Study.

The aim of this study was to examine the levels of health-related quality of life (HRQoL), pain intensity, and mental distress in participants with chronic low back pain (CLBP), and to examine the differences in the HRQoL of participants with respect to mental distress and the correlations of the examined variables. Data were collected from 148 patients using the SF-36 Health Status Questionnaire (SF-36), the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) questionnaire, and the visual-analog pain scale (VAS). The results indicate poorer self-assessment of physical health (Me = 28.1) compared to mental health (Me = 39.4). Participants with higher levels of mental distress reported significant emotional limitations (p = 0.003), lower energy (p < 0.001), poorer psychological health (p < 0.001) and social functioning (p < 0.001), more pain (p = 0.007), and, ultimately, poorer general health (p < 0.001). The level of mental distress was related to the level of HRQoL, while a correlation with the level of pain of the participants was not found. The study results indicate a connection between the presence of mental distress and almost all aspects of HRQoL in participants with CLBP.

Pre-Vaccination COVID-19 Vaccine Literacy in a Croatian Adult Population: A Cross-Sectional Study.

Despite world-level efforts and the endeavors of scientists and medical professionals in suppressing the COVID-19 pandemic, inadequate levels of vaccine literacy of the general population can represent a grave obstacle. The aim of this study was to evaluate COVID-19 vaccine literacy in the Croatian adult general population before vaccination began. The specific objectives were to test differences regarding socio-demographic characteristics and to examine perceptions and attitudes about vaccination against COVID-19 considering the level of VL against COVID-19. A cross-sectional study with a translated and psychometrically tested questionnaire was conducted in 1227 participants before the start of vaccination, from 15 to 31 January 2021. The results show a medium level of vaccine literacy (M = 2.37, SD = 0.54) and a significant difference between functional and interactive-critical vaccine literacy (p < 0.001). The level of vaccine literacy grew with the level of education (p = 0.031) and reduced with age (p < 0.001). Participants who were employed, had chronic diseases, took medicine, or consumed alcohol daily had a lower level of vaccine literacy. There is room for progress in the COVID-19 VL level for the adult population in Croatia, especially at the interactive-critical VL, which could have an important role in people accepting the vaccine against the COVID-19 disease. A satisfactory level of vaccine literacy in the population is necessary because it can contribute to the fight against the pandemic.

Adenoma Characteristics and the Influence of Alcohol and Cigarette Consumption on the Development of Advanced Colorectal Adenomas.

Background: Colorectal cancer (CRC), one of the leading public health problems worldwide, is a disease that can be prevented when it is detected in time. The objectives of this cross-sectional study were to investigate the characteristics of colorectal adenomas and whether alcohol consumption and cigarette smoking correlated with the development of advanced adenomas in participants in The National Programme for Early Detection of Colorectal Cancer (NP) in Osijek-Baranja County (OBC), Croatia. Methods: The screening methods were the guaiac Faecal Occult Blood Test (gFOBT), colonoscopy, histological analysis, and risk factor questionnaire. Results: The results showed the presence of adenomas in 136 men (57.4%) and 101 women (42.6%), p < 0.001. There was one adenoma in 147 (62%) most commonly located in sigmorect, in 86 (59%) participants, and 44 (18.6%) participants had multiple adenomas, most commonly found in multi loc, p < 0.001. According to size, 118 (49.8%) of all adenomas were between 0.1 and 0.9 cm, while adenomas of 3 cm 19 (8%) were the fewest, p < 0.001. There were 142 (59.9%) advanced adenomas. Conclusions: Adenoma development in the OBC population was correlated with predictors: adenoma size, high-grade dysplasia, smoking and alcohol consumption of 20 g per day. Non-smoking was found to be a health protective behaviour.