Urinary incontinence in gynecological oncology patients
The objective of this study was to investigate the prevalence and significance of urinary incontinence (UI) symptoms in gynecological oncology (GO) patients and to test the gynecologists' proficiency in eliciting these symptoms. A prospective survey using questionnaires was designed. Two faculty practice offices in the United States were chosen for the study. Forty GO patients and 40 general gynecology patients were selected from the most recent outpatient appointments of the two hospitals. We used the Urogenital Distress Inventory and the Incontinence Impact Questionnaire to elicit UI symptoms in GO patients and compared the results with their medical records. A control group, selected from a general gynecological practice, was included for comparison. The main outcome measures were to investigate the prevalence and detection rates of UI in GO patients. GO patients were significantly more likely to report UI symptoms on the questionnaire than their gynecologist was able to elicit during a consultation (P < 0.001). The survey found that 60% (24/40) of the GO patients reported at least one symptom of UI, with 23% complaining of 'severe' symptoms. Of those patients who reported the symptoms on questionnaire, only 5% (2/40) were detected at the initial physician assessment (P < 0.01). Eighteen percent of the GO patients reported that the UI symptoms adversely affected their quality of life. The prevalence of symptoms was not associated with the primary cancer site. There was no difference in detection rates between the two practice settings. In a multivariate analysis, there was no factor that emerged as the best discriminator for a positive response to the questionnaire. A significant proportion of GO patients report severe UI symptoms that are not detected by gynecologic oncologists or gynecologists during routine consultations
Effects of ginseng on secretory IgA, performance, and recovery from interval exercise
PURPOSE: This study examined the efficacy of ginseng to modulate secretory immunoglobulin A (SIgA), exercise performance, and recovery from repeated bouts of strenuous physical exertion. METHODS: Using a double-blind, placebo-controlled, randomized design, 38 active healthy adults supplemented their diets with a standardized ginseng concentrate (400 mg.d-1 of G115; equivalent to 2 g of Panax ginseng C.A. Meyer root material) or placebo (lactose) for 8 wk. Before and after the intervention, each subject performed three consecutive 30-s Wingate tests interspersed with 3-min recovery periods under controlled laboratory conditions. SIgA secretion rate (S-SIgA) and the relation of SIgA to total protein were calculated from measures of saliva flow rate (SFR), and absolute SIgA and salivary protein concentrations in timed, whole unstimulated saliva samples collected before and after exercise testing. Peak and mean mechanical power output (W.kg-1) was measured with an infrared-beam optical-sensor array, and exercise recovery heart rate (HRR) was determined electrocardiographically. RESULTS: Twenty-seven subjects (12 placebo, 15 ginseng) completed the study. Compared with rest, S-SIgA, SIgA:protein ratio, and SFR were lower after exercise at baseline (P < 0.05). Similarly, both peak and mean mechanical power output declined (P < 0.01) across consecutive Wingate tests. Postintervention minus preintervention change scores for salivary parameters, exercise performance, and HRR were similar between ginseng- and placebo-treated groups (P > 0.05). CONCLUSION: These findings do not support the hypothesis that ginseng may affect mucosal immunity as indicated by changes in secretory IgA at rest and after an exercise induced state of homeostatic disturbance. Supplementation with ginseng fails to improve physical performance and heart rate recovery of individuals undergoing repeated bouts of exhausting exercise.
Clinical and patient estimation of fetal weight vs. ultrasound estimation
OBJECTIVE: To compare clinical and patient estimation of fetal weight to ultrasound estimation. STUDY DESIGN: Prospective study of clinical, patient and ultrasound estimation of fetal weight at term. RESULTS: A total of 200 pregnant women participated. There was no statistically significant difference between clinical and sonographic estimates of fetal weight: of the estimates, 64.0% were within 10% of the actual birth weight vs. 62.5% (P > .2). There was no statistically significant difference between patient and sonographic estimates of fetal weight: of the estimates, 53.5% were within 10% of the actual birth weight vs. 62.5%, respectively (P < .1). Senior resident clinical and sonographic estimates of fetal weight were superior to junior resident estimates: 75.2% of clinical estimates were within 10% of the actual birth weight vs. 59.2% (P < .03), and 73.1% of sonographic estimates were within 10% of the actual birth weight vs. 58.3% (P < .05). Nulliparous and multiparous patients were equally accurate in estimating fetal weight: 48.1% of estimates were within 10% of birth weight vs. 57.4% (P > .2). CONCLUSION: Sonographic estimation of fetal weight offers no advantage over clinical or patient estimation of fetal weight at term. Senior resident clinical and sonographic estimates are superior to junior resident estimates. Parity has no effect on patient accuracy in estimating fetal weight