Health-related quality of life in women aged 20-64 years with urinary incontinence.

INTRODUCTION AND HYPOTHESIS: Urinary incontinence (UI) in women is a frequent and invisible clinical situation that affects several aspects in the lives of patients. The aim of this study is to assess the impact of urinary incontinence on different dimensions of quality of life. METHODS: Cross-sectional observational study. The sample brings together 381 women living in the Metropolitan Region of Chile, who answered a survey between June 2020 and June 2021, with questions about the sociodemographic situation, obstetric history and the EQ5D-3L questionnaire Chilean version and urinary incontinence variables. For the analysis of association between variables were used a correlation coefficient and logistic regressions. RESULTS: The mean age of the sample was 39.9 (SD: 12.6) years, with 68.5% of multiparous women and 42.5% had a history of vaginal delivery. Fifty percent of the respondents belong to a medium-high socioeconomic level according to the health insurance proxy. The analysis adjusted for age, health insurance and obstetrics variables showed that women with a frequency of moderate/severe urine loss had a 72% greater probability of suffering from moderate/severe pain/discomfort compared to women with nothing/little urine loss. In turn, the self-perception of affectation of urine loss was significantly associated with problems in the dimensions of mobility, anxiety/depression and health status. CONCLUSIONS: This research contributes with evidence that makes visible the affectation on physical and psychological dimensions in women with urinary incontinence, allowing decision-makers to prioritize resources and design health programs that include clinical management.

Impact of the COVID-19 pandemic on breast cancer screening indicators in a Spanish population-based program: a cohort study

BackgroundTo assess the effect of the COVID-19 pandemic on performance indicators in the population-based breast cancer screening program of Parc de Salut Mar (PSMAR), Barcelona, Spain. MethodsWe conducted a before-and-after, quasi-experimental study to evaluate participation, recall, false-positives, cancer detection rate, and cancer characteristics in our screening population from March 2020 to March 2021 compared with the four previous rounds (2012-2019). Using independent logistic regression models, we estimated the adjusted odds ratios (aOR) of each of the performance indicators for the COVID-19 period, controlling by type of screening (prevalent or incident), socioeconomic index, family history of breast cancer, and menopausal status. We analyzed 144,779 observations from 47,571 women. ResultsDuring the COVID-19 period, the odds of participation were 11% lower in first-time invitees (aOR=0.89[95%CI=0.84-0.96]) and in those who had previously participated regularly and irregularly (aOR=0.65 [95%CI=0.61-0.69] and aOR=0.93 [95%CI=0.85-1.03], respectively). Participation showed a modest increase in women not attending any of the previous rounds (aOR=1.07 [95%CI=0.99-1.17]). The recall rate slightly decreased in both prevalent and incident screening (aOR=0.89 [95%CI=0.78-1.01] and aOR=0.89 [95%CI=0.79-1.00], respectively). No significant differences were observed in false-positives (prevalent - aOR=1.07 [95%CI=0.92-1.24] and incident screening -aOR=0.94 [95%CI=0.82-1.08]), cancer detection rate (aOR=0.91 [95%CI=0.69-1.18]), or cancer stages. ConclusionsThe COVID-19 pandemic negatively affected screening attendance, especially in previous participants and newcomers. We found no marked differences in recall, false-positives, or cancer detection, indicating the programs resilience. There is a need for further evaluations of interval cancers and potential diagnostic delays.

Composition of the immunoglobulin G glycome associates with the severity of COVID-19

A large variation in the severity of disease symptoms is one of the key open questions in COVID-19 pandemics. The fact that only a small subset of people infected with SARS-CoV-2 develop severe disease suggests that there have to be some predisposing factors, but biomarkers that reliably predict disease severity have not been found so far. Since overactivation of the immune system is implicated in a severe form of COVID-19 and the IgG glycosylation is known to be involved in the regulation of different immune processes, we evaluated the association of inter-individual variation in IgG N-glycome composition with the severity of COVID-19. The analysis of 166 severe and 167 mild cases from hospitals in Spain, Italy and Portugal revealed statistically significant differences in the composition of the IgG N-glycome. The most notable difference was the decrease in bisecting N-acetylglucosamine (GlcNAc) in severe patients from all three cohorts. IgG galactosylation was also lower in severe cases in all cohorts, but the difference in galactosylation was not statistically significant after correction for multiple testing. To our knowledge, this is the first study exploring IgG N-glycome variability in COVID-19 severity.

Effects of environmental factors on severity and mortality of COVID-19

BackgroundMost respiratory viruses show pronounced seasonality, but for SARS-CoV-2 this still needs to be documented. MethodsWe examined the disease progression of COVID-19 in 6,914 patients admitted to hospitals in Europe and China. In addition, we evaluated progress of disease symptoms in 37,187 individuals reporting symptoms into the COVID Symptom Study application. FindingsMeta-analysis of the mortality risk in eight European hospitals estimated odds ratios per one day increase in the admission date to be 0.981 (0.973-0.988, p<0.001) and per increase in ambient temperature of one degree Celsius to be 0.854 (0.773-0.944, p=0.007). Statistically significant decreases of comparable magnitude in median hospital stay, probability of transfer to Intensive Care Unit and need for mechanical ventilation were also observed in most, but not all hospitals. The analysis of individually reported symptoms of 37,187 individuals in the UK also showed the decrease in symptom duration and disease severity with time. InterpretationSeverity of COVID-19 in Europe decreased significantly between March and May and the seasonality of COVID-19 is the most likely explanation. Mucosal barrier and mucociliary clearance can significantly decrease viral load and disease progression, and their inactivation by low relative humidity of indoor air might significantly contribute to severity of the disease.

Effect of radiologist experience on the risk of false-positive results in breast cancer screening programs.

OBJECTIVES: To evaluate the effect of radiologist experience on the risk of false-positive results in population-based breast cancer screening programmes. METHODS: We evaluated 1,440,384 single-read screening mammograms, corresponding to 471,112 women aged 45-69 years participating in four Spanish programmes between 1990 and 2006. The mammograms were interpreted by 72 radiologists. RESULTS: The overall percentage of false-positive results was 5.85% and that for false-positives resulting in an invasive procedure was 0.38%. Both the risk of false-positives overall and of false-positives leading to an invasive procedure significantly decreased (p < 0.001) with greater reading volume in the previous year: OR 0.77 and OR 0.78, respectively, for a reading volume 500-1,999 mammograms and OR 0.59 and OR 0.60 for a reading volume of >14,999 mammograms with respect to the reference category (<500). The risk of both categories of false-positives was also significantly reduced (p < 0.001) as radiologists' years of experience increased: OR 0.96 and OR 0.84, respectively, for 1 year's experience and OR 0.72 and OR 0.73, respectively, for more than 4 years' experience with regard to the category of <1 year's experience. CONCLUSION: Radiologist experience is a determining factor in the risk of a false-positive result in breast cancer screening.