Trend and Joinpoint Analysis of Cancer Incidence and 1-Year Mortality in North-East Spain 2005-2020.

Cancer is the second leading cause of death. It is thus essential to examine cancer trends in all regions. In addition, trend data after 2019 and on cancer 1-year mortality are scarce. Our aim was to analyze incidence and 1-year mortality cancer trends in northeastern Spain during 2005-2020. We used the Osona Tumor Registry, which registers cancer incidence and mortality in Osona. The mortality information came from the Spanish Death Index. We analyzed age-standardized incidence rates and 1-year mortality by sex in the population aged > 17 years during 2005-2020. Trends were examined with negative binomial and joinpoint regression. Incidence rates of colorectal, lung and bronchus, and urinary bladder cancer increased annually in females by 2.86%, 4.20%, and 4.56%, respectively. In males, the incidence of stomach and prostate cancer decreased annually by 3.66% and 2.05%, respectively. One-year mortality trends decreased annually for endometrium cancer (-9.0%) and for colorectal cancer in males (-3.1%). From 2019 to 2020, the incidence of cancer decreased, while 1-year mortality increased in both sexes. In a North-Eastern Spanish county, 1-year mortality decreased for endometrium cancer in females and for colorectal cancer in males. Our results suggest a trend of decreasing cancer incidence and increasing cancer mortality as a result of the COVID-19 pandemic.

Endoscopic retrograde cholangiopancreatography for the management of choledocholithiasis in older patients.

BACKGROUND: Older adults are increasing in number and frequently seeking hospital care for acute illness. We aimed to measure the utilization and safety of ERCP in patients aged 85 and older in our hospital. METHODS: This is a single-site, retrospective, observational and descriptive study. We obtained data about admissions and ERCP utilization from our hospital database. We reviewed medical and procedural records of patients aged 85 or older who underwent ERCP for choledocholithiasis between 2013 and 2019. We evaluated technical and medical adverse events after ERCP. RESULTS: 494 ERCP for choledocholithiasis were performed during this period and 154 (31%) were aged 85 or older. We identified 567 (4.8%) admissions for biliary tract diseases in the older population, and 27% of cases had required ERCP. In older patients, the rate of technical adverse events was around 10%. There was no statistical difference between the older and younger groups regarding technical complications (8.8 vs 9.7%; p=0.7). Besides, in 36% of cases, a medical event, decompensated comorbidity or geriatric syndromes appeared after ERCP. The overall mortality for any cause at six months was nearly 20%, and the survival rate was significantly lower in patients who develop adverse events (technical or medical). CONCLUSIONS: Our hospital experiences frequent utilization of ERCP by patients aged 85 and older. Although technical adverse event rates are similar to those of younger adults, medical events appear frequently. We plan to strengthen our care plans for older adults and hope to reduce the medical complications experienced post ERCP.

Aqueous Chemical Solution Deposition of Functional Double Perovskite Epitaxial Thin Films.

Double perovskite structure (A2 BB'O6 ) oxides exhibit a breadth of multifunctional properties with a huge potential range of applications in fields as diverse as spintronics, magneto-optic devices, or catalysis, and most of these applications require the use of thin films and heterostructures. Chemical solution deposition techniques are appearing as a very promising methodology to achieve epitaxial oxide thin films combining high performance with high throughput and low cost. In addition, the physical properties of these materials are strongly dependent on the ordered arrangement of cations in the double perovskite structure. Thus, promoting spontaneous cationic ordering has become a relevant issue. In this work, our recent achievements by using polymer-assisted deposition (PAD) of environmentally friendly, water-based solutions for the growth of epitaxial ferromagnetic insulating double perovskite La2 CoMnO6 and La2 NiMnO6 thin films on SrTiO3 and LaAlO3 single-crystal substrates are presented. It is shown that the particular crystallization and growth process conditions of PAD (very slow rate, close to thermodynamic equilibrium conditions) promote high crystallinity and quality of the films, as well as favors spontaneous B-site cationic ordering.

Infradiagnóstico de enfermedades neuromusculares en ancianos de 80 y más años / Under-diagnosis of neuromuscular diseases in patients of 80 years and older

La miastenia gravis (MG), la esclerosis lateral amiotrófica y el síndrome de Guillain-Barré (SGB) han sido clásicamente considerados como enfermedades excepcionales o inhabituales en las personas de perfil geriátrico. A lo largo de los últimos 25 años se realizaron diversos estudios de base poblacional en la comarca de Osona (Barcelona), que permitieron describir por primera vez en la literatura incidencias globales altas a expensas de los ancianos, especialmente en aquellos de más de 80 años. Los resultados encontrados indican la posibilidad de infradiagnóstico de estas enfermedades neuromusculares en el anciano, hecho que podría resultar especialmente relevante en el caso de la MG y el SGB, dado que son 2entidades potencialmente reversibles y con alta mortalidad en caso de infradiagnóstico y ausencia de tratamiento

Myasthenia gravis (MG), amyotrophic lateral sclerosis and Guillain-Barre syndrome (GBS) have been classically considered as exceptional or unusual diseases in people with a geriatric profile. Over the past 25 years, several population-based studies have been conducted in the Osona area (Barcelona), which, for the first time, has led to describing the high global incidences in the elderly, especially those over 80 years-old. The results suggest the possibility of underdiagnosis of these neuromuscular diseases in the elderly, a fact that could be especially relevant in the case of MG and GBS, since they are 2potentially reversible entities with high mortality in the event of underdiagnosis and absence of treatment

Adverse Events and Acute Chronic Liver Failure in Patients With Cirrhosis Undergoing Endoscopic Retrograde Cholangiopancreatography: A Multicenter Matched-Cohort Study.

BACKGROUND: Data on the outcome of adverse events (AEs) and the risk of developing acute-on-chronic liver failure (ACLF) after ERCP in patients with cirrhosis are unknown. We examined the incidence and risk factors of post-ERCP AEs in patients with cirrhosis and the appearance of ACLF after ERCP. METHODS: In this multicenter, retrospective, matched-cohort study, we evaluated ERCPs performed from January 2002 to 2015. A group of patients with cirrhosis with non-ERCP interventions and one without interventions was also analyzed for the development of ACLF. RESULTS: A total of 441 ERCPs were analyzed; 158 in patients with cirrhosis (cases) and 283 in patients without cirrhosis (controls). The overall rate of AEs after all ERCPs was significantly higher in cases compared to controls (17% vs 9.5, p = 0.02). Cholangitis developed more in cases compared to controls (6.3% vs 1.8%; p = 0.01). In a subanalysis of those with sphincterotomy, the rate of bleeding was higher in those with cirrhosis (9.4% vs 3.4%; p = 0.03). Logistic regression identified cirrhosis (OR, 2.48; 95% CI, 1.36-4.53; p = 0.003) and sphincterotomy (OR, 2.66; 95% CI, 1.23-5.72; p = 0.01) as risk factors of AEs. A total of 18/158 (11.4%) cases developed ACLF after ERCP. ACLF occurred in 7/27 cases with post-ERCP AEs and in 11/131 without post-ERCP AEs (25.9% vs 8.3%; p = 0.01). A total of 3.2% (13/406) patients without interventions developed ACLF compared to 17.5% (102/580) who developed ACLF after non-ERCP interventions. Patients with decompensated cirrhosis at ERCP had a higher risk of developing ACLF (17% vs 6.8%; p = 0.04). Patients with a MELD score ≥ 15 were 3.1 times more likely (95% CI: 1.14-8.6; p = 0.027) to develop ACLF after ERCP. CONCLUSIONS: The rate of AEs after ERCP is higher in patients with cirrhosis compared to the non-cirrhotic population. The incidence of ACLF is higher in those with AEs after ERCP compared to those without AEs, especially cholangitis. The development of ACLF is common after ERCP and other invasive procedures. ACLF can be precipitated by numerous factors which include preceding events before the procedure, including manipulation of the bile duct, and AEs after an ERCP.

[Under-diagnosis of neuromuscular diseases in patients of 80 years and older]. / Infradiagnóstico de enfermedades neuromusculares en ancianos de 80 y más años.

Myasthenia gravis (MG), amyotrophic lateral sclerosis and Guillain-Barre syndrome (GBS) have been classically considered as exceptional or unusual diseases in people with a geriatric profile. Over the past 25 years, several population-based studies have been conducted in the Osona area (Barcelona), which, for the first time, has led to describing the high global incidences in the elderly, especially those over 80 years-old. The results suggest the possibility of underdiagnosis of these neuromuscular diseases in the elderly, a fact that could be especially relevant in the case of MG and GBS, since they are 2potentially reversible entities with high mortality in the event of underdiagnosis and absence of treatment.

Hidrocefalia normotensiva idiopática: alta incidencia en mayores de 80 años / Idiopathic normal pressure hydrocephalus: high incidence in people over 80 years of age

Introducción. La hidrocefalia normotensiva idiopática se da habitualmente en adultos por encima de 60 años. El mayor número de casos se describen entre los 70 y 80 años, aunque pudiera haber un infradiagnóstico por encima de los 80 años. Objetivos. Se describen la incidencia global y por grupos de edad, la demora diagnóstica y el resultado de la cirugía derivativa. Pacientes y método. Se realiza estudio descriptivo de la población censada en la comarca de Osona en el periodo 2010-2015. Resultados. La incidencia global ha sido de 4,43×100.000. La incidencia aumenta con la edad: de 8,09×105 entre 60-69 años pasa a 23,61×105 entre 70-79 años y alcanza 37,02×105 entre 80-89 años. El tiempo transcurrido desde el inicio de los síntomas hasta el diagnóstico de sospecha fue de 15,01±10,35 meses. El pronóstico poscirugía fue favorable en todos los casos a los 3meses y se reducía al 73,3% al año. Conclusiones. La hidrocefalia normotensiva idiopática es una enfermedad relacionada con la edad y está probablemente infradiagnosticada en los más ancianos. Los pacientes más ancianos también se benefician de la cirugía derivativa. Se resalta la necesidad del diagnóstico precoz y de una mayor sospecha en los más ancianos (AU)

Introduction. Idiopathic normal pressure hydrocephalus is usually observed in adults over 60 years of age. The highest incidence of cases is between 70 and 80 years-old, and it could be under-diagnosed in over 80 year-olds. Objective. A description is presented on the overall incidence and age group incidence, the delay in the diagnosis, and main outcomes. Patients and methods. A descriptive study was performed on patients with idiopathic normal pressure hydrocephalus, in the population of Osona County during the years 2010-2015. Results. The annual incidence rate was 4.43 per 100,000 inhabitants. The incidence increased with age; from 8.09 per 100,000 in the 60 to 69 years age group, to 23.61 per 100,000 in the 70-79 years age group of, and to 37.02 per 100,000 in the 80-89 years age. The delay in the diagnosis was 15.01 ± 10.35 months. All the patients improved after surgery, but only 73.3% of the patients maintained the improvement after one year. Conclusions. Idiopathic normal pressure hydrocephalus is an age related disease and probably underdiagnosed in the elderly. An early diagnosis and a clinical suspicion are essential in patients over 80 years old (AU)

[Idiopathic normal pressure hydrocephalus: High incidence in people over 80 years of age]. / Hidrocefalia normotensiva idiopática: alta incidencia en mayores de 80 años.

INTRODUCTION: Idiopathic normal pressure hydrocephalus is usually observed in adults over 60 years of age. The highest incidence of cases is between 70 and 80 years-old, and it could be under-diagnosed in over 80 year-olds. OBJECTIVE: A description is presented on the overall incidence and age group incidence, the delay in the diagnosis, and main outcomes. PATIENTS AND METHODS: A descriptive study was performed on patients with idiopathic normal pressure hydrocephalus, in the population of Osona County during the years 2010-2015. RESULTS: The annual incidence rate was 4.43 per 100,000 inhabitants. The incidence increased with age; from 8.09 per 100,000 in the 60 to 69 years age group, to 23.61 per 100,000 in the 70-79 years age group of, and to 37.02 per 100,000 in the 80-89 years age. The delay in the diagnosis was 15.01 ± 10.35 months. All the patients improved after surgery, but only 73.3% of the patients maintained the improvement after one year. CONCLUSIONS: Idiopathic normal pressure hydrocephalus is an age related disease and probably underdiagnosed in the elderly. An early diagnosis and a clinical suspicion are essential in patients over 80 years old.

Miositis por cuerpos de inclusión: a propósito de un caso / Inclusion-body myositis: presentation of a case

No disponible

Theory of Mind in Euthymic Bipolar Patients and First-Degree Relatives.

The present study analyzed the capacity for mentalization of patients with bipolar disorder (BD) and their first-degree relatives (FDR) and examined the implications of clinical variables and cognitive deficits. The study recruited 31 patients with type I BD, 18 FDR, and 31 paired healthy controls. Their capacity for mentalization was explored by means of first- and second-order false-belief tasks, the hinting task, and the Movie for the Assessment of Social Cognition (MASC). Patients and FDR were found to have a theory of mind (ToM) deficit when they were evaluated with the MASC, which was also related to a worse neurocognitive performance and to being a patient or FDR. The evidence of ToM deficits in FDRs supports the hypothesis that these deficits could be an independent trait marker for cognitive deficit. Further research is needed on FDR of patients with BD, using sensitive ToM assessment instruments such as the MASC.

Knowledge and Attitudes of Nurses in Spain about Inhaled Therapy: Results of a National Survey.

BACKGROUND: The main problem with inhalation therapy is incorrect use of inhalers. Nurses' limited knowledge may contribute to this situation. This study aimed to assess the level of knowledge and attitudes of respiratory nurses about inhaled therapy. METHODS: A 12-item multiple-choice questionnaire was sent to members in the Nursing Area of the Spanish Society of Pneumology and Thorax Surgery and to nurses working with respiratory patients using inhalers devices. The survey was voluntary, self-administered, and anonymous. It collected demographic characteristics, preferences, and knowledge and education about devices and inhalation technique. RESULTS: A total of 1496 nurses completed the questionnaire correctly. Results showed 65.4% preferred dry powder inhalers (DPI), 8.7% were familiar with all 12 devices listed, 59.6% identified "firing the device after beginning inspiration" as the most important step when using the pressurized metered dose inhaler (pMDI), 53.5% identified ''inhale deeply and forcefully'' as the most significant step using DPI, and 20.4% "always checked a patient's inhalation technique when a new inhaler was prescribed." A composite, variable, general inhaled therapy knowledge pooled the correct answers related to knowledge and showed only 14% of nurses had adequate knowledge of inhaled therapy. CONCLUSIONS: In spite of recent training activities, knowledge concerning use of inhaler devices among Spanish nurses managing patients with respiratory diseases continues to be poor. Improvements are also needed in patient education and follow-up of inhalation techniques. Undergraduate and postgraduate educational programs need to be further developed.

Posttraumatic stress disorder comorbidity and clinical implications in patients with severe mental illness.

Traumatic experiences and posttraumatic stress disorder (PTSD) are more frequent in patients with serious mental illness than in the general population. This study included 102 patients with schizophrenia, bipolar disorder, and schizoaffective disorder, according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. Epidemiological and clinical data were collected using the Brief Psychiatric Rating Scale and Traumatic Life Events and Distressing Event questionnaires. We found a high number of traumatic experiences, and 15.1% of the patients met all criteria for PTSD. We found no differences based on diagnosis or sex, although there was a nonsignificant trend toward greater PTSD comorbidity in women. Among patients with serious mental illness and PTSD, 64.3% had made some attempt at suicide at some point in life, compared with 37.4% of patients without PTSD.

Physicians' knowledge of inhaler devices and inhalation techniques remains poor in Spain.

BACKGROUND: Studies in many countries in the 1990s revealed deficiencies in physicians' knowledge about inhalation therapy. In an attempt to remedy this situation, Spanish scientific societies implemented a variety of educational strategies. The objective of the present study was to assess changes in attitudes and knowledge about inhalers and inhalation techniques in a sizable sample of physicians. METHODS: An 11-question multiple choice test was developed and administered throughout Spain to practicing physicians from specialties that frequently prescribe inhaler devices. The survey collected demographic characteristics (four items), preferences (two items), and issues related to knowledge (three items) and education (two items) about devices and inhalation techniques. Completion of the questionnaire was voluntary, individual, and anonymous. RESULTS: A total of 1514 respondents completed the questionnaire. Dry powder inhalers (DPI) were preferred by 61.2% physicians, but only 46.1% identified "inhale deeply and forcefully" as the most significant step in the inhalation maneuver using these devices. Only 27.7% stated that they always checked the patient's inhalation technique when prescribing a new inhaler. A composite variable, general inhaled therapy knowledge, which pooled the correct answers related to knowledge, revealed that only 14.2% physicians had an adequate knowledge of inhaled therapy. Multivariate analysis showed that this knowledge was lowest among internal medicine and primary care physicians. CONCLUSIONS: Prescribers' knowledge of inhalers and inhalation techniques remains poor in Spain. The causes should be identified in further research to allow effective educational strategies to be developed. Specific educational policies should be addressed to general practitioners.

Prevalence and clinical impact of childhood trauma in patients with severe mental disorders.

A high prevalence of childhood abuse has been reported in patients with severe mental illness. We conducted a cross-sectional study of 102 patients with schizophrenia, bipolar disorder, or schizoaffective disorder. Social, demographic, and clinical data were obtained. Patients were evaluated using Brief Psychotic Relative Scale, and Traumatic Life Events and Distressing Event questionnaires. Almost half (47.5%) of these patients had suffered some kind of child abuse, and our results confirmed a relationship between a history of childhood abuse and more severe psychosis. Diagnosis of schizophrenia was determined 4.1 years earlier in victims of childhood abuse. Hospital admissions were twice as high in victims of psychological abuse. Patients with a history of sexual abuse were more than twice as likely to attempt suicide (68% vs. 28.9%).

Ene reactions between two alkynes? Doors open to thermally induced cycloisomerization of macrocyclic triynes and enediynes.

A domino process is described combining an ene reaction between two alkynes and a Diels-Alder cycloaddition of the vinylallene formed. The process accounts for the thermally induced cycloisomerization of macrocyclic triynes and enediynes to give fused tetracycles in a stereoselective manner.

Incontinencia anal postparto y control evolutivo hasta los doce meses / 12 months follow-up of post-partum anal incontinence

Objetivos: Determinar la prevalencia de la incontinencia anal (IA) para heces y gases y los factores asociados propios del parto y de la madre. Diseño: Estudio observacional prospectivo longitudinal con seguimiento a los 2, 6 y 12 meses del parto. Ámbito de estudio: El Hospital General de Vic como hospital general básico de la comarca de Osona (Cataluña central).Sujetos de estudio: Mujeres con un parto a término de recién nacido vivo entre el 1 de Enero de 2001 y el 31 de Marzo de 2002.MetodologíaDurante el ingreso por parto se recogieron datos de 707 madres (edad, paridad, índice masa corporal, síntomas de incontinencia durante el embarazo), del tipo de parto (vaginal, cesárea) y del feto (peso, circunferencia craneal). A los dos meses del parto, fueron visitadas por un ginecólogo para detectar y establecer el diagnóstico clínico de incontinencia anal mediante un protocolo específico. Las mujeres con síntomas de incontinencia anal a los dos meses del parto, eran visitadas a los seis meses y a los 12 meses entrevistadas por teléfono. Se calculó la prevalencia de IA a los dos, seis y doce meses del parto y la asociación de los síntomas de IA con factores maternos, fetales y del parto. Resultados: De las 531 mujeres visitadas a los dos meses del parto, 11 fueron diagnosticadas de incontinencia anal. A los 12 meses, 4 (36,4%) seguían con síntomas de incontinencia. La prevalencia de incontinencia anal a los dos meses del parto fue del 2,1% (IC 0,95: 1,0-3,7) y se asoció a la primiparidad (“odds ratio” [OR]=7,21; p=0,029) y al parto instrumental con fórceps (OR=5,54, p=0,021). Conclusiones: La prevalencia de síntomas de incontinencia anal a los dos meses postparto es baja; en la mitad de las mujeres los síntomas de IA persisten a los 6 y los 12 meses del parto. La primiparidad y el parto instrumental con fórceps, se asociaron a los síntomas de IA a los dos meses del parto (AU)

Objectives: To determine the prevalence of anal incontinence (AI) of faeces and gases, as well as the factors associated with the pregnancy, delivery and postpartum.DesignTwelve-month follow-up study with visits at 2, 6 and 12 months. Settings: Vic General Hospital as a basic general hospital in the Osona region (Central Catalonia, Spain).Subject of the study Women who had a live birth at full-term between the 1st of January 2001 and the 31st of March 2002. Methodology: During admission for childbirth, data were collected on the mother (age, parity, body mass index, symptoms of incontinence during pregnancy), the type of delivery (vaginal, caesarean) and the foetus (weight, cranial circumference). Two months after parturition, the mothers were examined by a gynaecologist to detect and establish the clinical diagnosis of anal incontinence by means of a specific protocol. The women were asked whether they had symptoms of involuntary release of faeces or gases: women with symptoms of AI underwent a pelvic examination before being referred to a specialist in coloproctology for an assessment. Women with symptoms of AI at 2 months postpartum were recalled at 6 months for a new clinical assessment by the gynaecologist, and after 12 months all those who had shown persistence of symptoms at 6 months were contacted by phone. The prevalence of anal incontinence at 2 months postpartum was calculated and also the association of symptoms with maternal, foetal and delivery factors. Results: A total of 531 women were visited at 2 months postpartum. Of these, 11 were diagnosed with anal incontinence. At 12 months post partum, 4 (36.4%) of these 11 women continued to have symptoms of incontinence. The prevalence of anal incontinence at 2 months after delivery was 2.1% (95% CI: 1.0-3.7) and was associated with primiparity (Odds ratio [OR]=7.21, P=0.029) and forceps use (OR=5.54, P=0.021) (AU)

Prevalence of mental disorders in primary care: results from the diagnosis and treatment of mental disorders in primary care study (DASMAP).

OBJECTIVE: Previous epidemiological studies have revealed a high prevalence of mental disorders among primary care (PC) patients. However, most studies have methodological limitations (e.g. absence of structured clinical interviews, two-phase designs) that affect the generalizability of their results. The main objective of the present study was to estimate the lifetime and 12-month prevalence of mental disorders in the PC of Catalonia (Spain), using structured clinical interviews and a one-phase design. METHODS: One-phase cross-sectional survey. A representative probability sample without replacement of individuals aged 18 years or older attending PC for a medical visit were interviewed between October 2005 and March 2006. The interviews included SCID-I for depressive and anxiety disorders and the MINI interview for other mental disorders. A total of 3,815 patients from 77 PC centres were included in the statistical analyses. RESULTS: 45.1% of respondents reported at least one lifetime mental disorder and 30.2% reported at least one mental disorder in the previous 12 months. The most common mental disorders were major depression (9.6%), panic disorder (7.0%), specific phobia (6.6%), and generalized anxiety disorder (3.8%). There was a high comorbidity between mood and anxiety disorders, as well as between mental disorders and some chronic physical conditions. CONCLUSIONS: There is a high prevalence and comorbidity of mental disorders in the PC of Catalonia. Public health policies should reinforce the role of family physicians in the detection and treatment of persons with mental disorders.

Incontinencia urinaria a los 2 meses posparto. Persistencia de los síntomas a los 6 y 12 meses / Post-partum urinary incontinence: prevalence at two months postpartum and symptom persistence at six and twelve months

Objetivos: Determinar la prevalencia de incontinencia urinaria (IU) a los 2 meses del parto, así como los factores asociados del parto y del embarazo. Determinar la persistencia de la IU a los 6 y 12 meses del parto en las mujeres que presentaron IU a los 2 meses del parto. Material y métodos: Estudio observacional, prospectivo, longitudinal, con seguimiento a los 2, 6 y 12 meses desde la inclusión durante el ingreso hospitalario por parto, que se desarrolló en el Hospital General de Vic como hospital general básico de la comarca de Osona (Cataluña central). Se incluyó a mujeres que tuvieron un parto a término con recién nacido vivo entre el 1 de enero de 2001 y el 31 de marzo de 2002. Durante el ingreso por parto se recogieron datos de
707 madres (edad, paridad, índice masa corporal, síntomas de incontinencia durante el embarazo), del tipo de parto (vaginal, cesárea) y del feto (peso, circunferencia craneal). A los 2 meses del parto, 531 mujeres fueron visitadas por un ginecólogo para detectar y establecer el diagnóstico clínico de IU mediante un protocolo específico. Se preguntaba a las mujeres acerca de si tenían síntomas de escapes involuntarios de orina; las pacientes con síntomas de IU eran sometidas a una exploración pélvica y se solicitó una prueba de la compresa. Las mujeres con IU objetivada a los 2 meses posparto fueron citadas a los 6 meses para una nueva valoración clínica. A los 12 meses se realizó un contacto telefónico con todas las mujeres que persistían con síntomas en la visita de los 6 meses. Se calculó la prevalencia de IU a los 2 meses del parto y se determinó la persistencia de los síntomas a los 6 y 12 meses del parto. Se analizó la asociación de los síntomas de IU a los 2 meses del parto, con factores maternos, fetales y del parto con la obtención de las odds ratio (OR) y sus intervalos de confianza (IC). Resultados: De las 531 mujeres visitadas a los 2 meses del parto, 41 fueron diagnosticadas de IU. A los 12 meses posparto, 11 (26,8%) de las 41 mujeres con IU seguían con síntomas. La prevalencia de IU a los 2 meses del parto fue del 7,7% (IC del 95%, 5,6-10,3). De acuerdo con los resultados de un modelo de regresión logística para IU a los 2 meses (variable dependiente) en el que se introdujeron las variables independientes tipo de parto, edad de la madre y peso y circunferencia craneal del recién nacido, la IU se asoció al parto vaginal (OR = 14,4; IC del 95%, 1,9-107,2). Conclusiones: El parto vaginal es un factor de riesgo conocido de incontinencia urinaria y nuestros resultados confirman su impacto en la práctica clínica de un hospital general básico. Pese a que los casos severos persisten, cabe destacar una importante reducción de los síntomas en el transcurso de los 12 primeros meses (AU)

Objectives: To determine the prevalence of urinary incontinence (UI) 2 months after delivery as well as the factors associated with delivery and pregnancy. To determine the persistence of UI at 6 and 12 months after delivery among women with UI at 2 months after delivery. Material and methods: We performed an observational, prospective, longitudinal study with follow-up at 2, 6 and 12 months after inclusion in the study during hospital admission for delivery in the Vic General Hospital, the basic general hospital in the region of Osona (central Catalonia). Women who delivered live newborns at term between 1 January, 2001 and 31 March, 2002 were included. During admission for delivery, data were gathered on 707 women (age, parity, body mass index, symptoms of incontinence during pregnancy), type of delivery (vaginal, cesarean) and fetuses (weight, head circumference). At 2 months after delivery, 531 women were seen by a gynecologists to detect and establish a clinical diagnosis of UI through a specific protocol. Women were asked whether they had involuntary leaks of urine. Women with UI symptoms underwent a pelvic examination and a pad test was requested. Women with UI at 2 months after delivery were called for further clinical evaluation at 6 months. All women with persistent symptoms at the 6-month visit were contacted by telephone at 12 months. The prevalence of UI at 2 months after delivery was calculated and the persistence of symptoms at 6 and 12 months of delivery was determined. The association of IU at 2 months of delivery with maternal, fetal, and delivery-related factors was analyzed by obtaining odds radios (OR) and confidence intervals. Results: Of the 531 women seen 2 months after delivery, 41 were diagnosed with UI. At 12 months after delivery, 11 (26.8%) of the 41 women with UI had persistent symptoms. The prevalence of UI at 2 months after delivery was 7.7% (95% CI, 5.6- 10.3). A logistic regression model for UI at 2 months (dependent variable), in which the independent variables of type of delivery, maternal age, and weight and head circumference of the newborn were introduced, revealed that UI was associated with vaginal delivery (OR = 14.4; 95% CI, 1.9-107.2). Conclusions: Vaginal delivery is a known risk factor for UI and our results confirm the impact of this route of delivery in clinical practice in a general hospital. Although severe cases persist, there is substantial reduction in symptoms in the first 12 months (AU)