Metabolic side effects in persons with schizophrenia during mid- to long-term treatment with antipsychotics: a network meta-analysis of randomized controlled trials

Metabolic side effects of antipsychotic drugs can have serious health consequences and may increase mortality. Although persons with schizophrenia often take these drugs for a long time, their mid- to long-term metabolic effects have been studied little so far. This study aimed to evaluate the mid- to long-term metabolic side effects of 31 antipsychotics in persons with schizophrenia by applying a random-effects Bayesian network meta-analysis. We searched the Cochrane Schizophrenia Group's Study-Based Register of Trials (up to April 27, 2020) and PubMed (up to June 14, 2021). We included published and unpublished, open and blinded randomized controlled trials with a study duration >13 weeks which compared any antipsychotic in any form of administration with another antipsychotic or with placebo in participants diagnosed with schizophrenia. The primary outcome was weight gain measured in kilograms. Secondary outcomes included "number of participants with weight gain", fasting glucose, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides. We identified 137 eligible trials (with 35,007 participants) on 31 antipsychotics, with a median follow-up of 45 weeks. Chlorpromazine produced the most weight gain (mean difference to placebo: 5.13 kg, 95% credible interval, CrI: 1.98 to 8.30), followed by clozapine (4.21 kg, 95% CrI: 3.03 to 5.42), olanzapine (3.82 kg, 95% CrI: 3.15 to 4.50), and zotepine (3.87 kg, 95% CrI: 2.14 to 5.58). The findings did not substantially change in sensitivity and network meta-regression analyses, although enriched design, drug company sponsorship, and the use of observed case instead of intention-to-treat data modified the mean difference in weight gain to some extent. Antipsychotics with more weight gain were often also among the drugs with worse outcome in fasting glucose and lipid parameters. The confidence in the evidence ranged from low to moderate. In conclusion, antipsychotic drugs differ in their propensity to induce metabolic side effects in mid- to long-term treatment. Given that schizophrenia is often a chronic disorder, these findings should be given more consideration than short-term data in drug choice.

Versatile atomic force microscopy setup combined with micro-focused X-ray beam

Micro-focused X-ray beams produced by third generation synchrotron sources offer new perspective of studying strains and processes at nanoscale. Atomic force microscope setup combined with a micro-focused synchrotron beam allows precise positioning and nanomanipulation of nanostructures under illumination. In this paper, we report on integration of a portable commercial atomic force microscope setup into a hard X-ray synchrotron beamline. Details of design, sample alignment procedure, and performance of the setup are presented.

[Not like toilet reading- C. W. Hufeland and his publisher Brockhaus]

This is to remember Christoph Wilhelm Hufeland (1762-1836) who at his time was one of the most influential German physicians and whose ideas are living even nowadays. Three letters to Brockhaus that have been found recently document an ambivalent attitude towards this publisher.

Vertically stacked quantum dot pairs fabricated by nanohole filling

Strain-free, vertically coupled GaAs quantum dots (QDs) with an ultra-low density below 1 × 10(7) cm(-2) are fabricated by filling of self-assembled nanoholes with a GaAs/AlGaAs/GaAs layer sequence. The sizes of the two QDs, forming a QD pair (QDP), as well as the AlGaAs tunnel-barrier between the dots are tuned independently. We present atomic force microscopy studies of the QDP formation steps. We have performed photoluminescence studies of single QDPs with varied dot size and tunnel-barrier thickness. The data indicate non-resonant tunnelling between the dots. Furthermore, we apply the quantum confined Stark effect to tune the photoluminescence energy by up to 25 meV.

Thermal conductance of ballistic point contacts

We study the thermal conductance of ballistic point contacts. These contacts are realized as few nanometer long pillars in so-called air-gap heterostructures (AGHs). The pillar length is orders of magnitude smaller than the mean free path of the phonons up to room temperature. Because of the small dimension and the low density of the pillars, the thermal conductance of the AGHs is several orders of magnitude reduced in comparison to bulk structures. The measurement results are in quantitative agreement with a simple model that is based on the Boltzmann transport equation.

Spin wave diffraction and perfect imaging of a grating

We study the diffraction of Damon-Eshbach-type spin waves incident on a one-dimensional grating realized by microslits in a thin Permalloy film. By means of time-resolved scanning Kerr microscopy, we observe unique diffraction patterns behind the grating which exhibit replications of the spin wave field at the slits. We show that these spin wave images, with details finer than the wavelength of the incident Damon-Eshbach spin wavelength, arise from the strongly anisotropic spin wave dispersion.

Anmerkungen zu den „Leitlinien für den sorgfältigen Umgang mit antimikrobiell wirksamen Tierarzneimitteln“ (Antibiotika-Leitlinien)

Die Bundestierärztekammer und die Arbeitsgruppe Tierarzneimittel (AGTAM) der Länderarbeitsgemeinschaft Verbraucherschutz haben 2010 die Leitlinien für den sorgfältigen Umgang mit antimikrobiell wirksamen Tierarzneimitteln in aktualisierter Fassung veröffentlicht. Für Tierärzte besteht Therapiefreiheit, doch muss eine Behandlung dem aktuellen Stand der Veterinärmedizin entsprechen. Der aktuelle Stand der Wissenschaft kann unterschiedliche Interpretationen umfassen, sofern diese von einer anerkannten Hochschule oder sonstigen Personen in der Wissenschaft vertreten werden. Der Stand der veterinärmedizinischen Wissenschaft wird nicht allein durch die Antibiotika-Leitlinien, sondern durch die gesamten anerkannten wissenschaftlichen Veröffentlichungen bestimmt. Die Antibiotika-Leitlinien haben keinen Gesetzescharakter. Sie definieren die optimale Vorgehensweise bei der Anwendung von Antibiotika, können aber nicht unmittelbar „Mindestanforderungen bei der Anwendung von Antibiotika bei Tieren“ festlegen. Grundlage der tierärztlichen Behandlung ist die klinische Untersuchung im konkreten Fall. Die weiterführende Labordiagnostik (Erregernachweis und Antibiogramm) stellt ein Hilfsinstrument dar, das im Ermessen und nach Erforderlichkeit durch den Tierarzt genutzt wird. Wie anhand von Beispielen aufgezeigt wird, lässt sich nicht bei jedem klinischen Fall eine Sensitivitätstestung der Erreger vornehmen. Es erscheint wünschenswert, die tierartspezifischen Teile vom allgemeinen Teil der Leitlinien abzutrennen und weiter auszuformulieren, wobei die Regeln der evidenzbasierten Medizin angewendet werden sollten.

[Comments on the Guidelines for the Prudent Use of Antibacterial Veterinary Pharmaceuticals (Guidelines for Antibiotics)]

In 2010 the German Bundestierärztekammer (Federal Chamber of Veterinarians) and the AGTAM (Working Group "Veterinary Pharmaceuticals") published the Guidelines for the prudent use of antibacterial veterinary pharmaceuticals in an updated version. Within the limits of therapeutic freedom, veterinarians are committed to take into account the latest scientific findings in veterinary medicine. These findings may, however, include conflicting interpretations if such an approach is expressed by an accredited university or anywhere else in the field of science. Hence, the state of science in veterinary medicine is not only defined by the Guidelines for Antibiotics, rather, the complete recognized scientific literature has to be considered. The Guidelines for Antibiotics are not legally-binding rules. They define the best approach and not the minimum standard for the use of antibiotics. The clinical examination provides the basis for medical treatment in each specific case. Further laboratory diagnostics represent an additional supportive instrument that is used by the veterinarian at his discretion depending on the necessity. Laboratory tests of bacterial sensitivity (identification of pathogens and antibiogram) may become necessary within the framework of diagnostics. As examples demonstrate, laboratory tests of bacterial sensitivity cannot be performed in every clinical case. It appears to be desirable to further discuss the use of antibacterial veterinary pharmaceuticals in the species-specific attachments in more concrete and specific terms, taking into consideration the standards of evidence-based medicine.

In vitro induced CD8+ regulatory T cells inhibit skin inflammation

CD8(+) regulatory T cells appear impaired in number and/or function in some autoimmune diseases. However, the role of CD8(+) regulatory T cells in the pathogenesis of skin inflammation and psoriasis remains unknown. In this study, we set out to analyze the capability of CD8(+) regulatory T cells to inhibit skin inflammation in a murine model and to determine the frequency of CD8(+) regulatory T cells in patients with psoriasis. We demonstrate that murine fully competent CD8(+) regulatory T cells can be induced by stimulating naïve CD8(+) T cells in the presence of TGF-β and retinoic acid (RA). Importantly, in vitro induced CD8(+) regulatory T cells significantly suppressed skin inflammation in vivo. Furthermore, we found that the frequency of regulatory CD8(+)CD25(+)Foxp3(+) T cells is decreased in peripheral blood but increased in lesional psoriatic skin of patients with psoriasis. Thus, our study suggests a previously unappreciated role of CD8(+)CD25(+)Foxp3(+) T cells in skin disorders, and induction of these cells in vitro may be an effective immunotherapy for skin inflammation.

Single-dot Spectroscopy of GaAs Quantum Dots Fabricated by Filling of Self-assembled Nanoholes

We study the optical emission of single GaAs quantum dots (QDs). The QDs are fabricated by filling of nanoholes in AlGaAs and AlAs which are generated in a self-assembled fashion by local droplet etching with Al droplets. Using suitable process parameters, we create either uniform QDs in partially filled deep holes or QDs with very broad size distribution in completely filled shallow holes. Micro photoluminescence measurements of single QDs of both types establish sharp excitonic peaks. We measure a fine-structure splitting in the range of 22-40μeV and no dependence on QD size. Furthermore, we find a decrease in exciton-biexciton splitting with increasing QD size.

Optical Properties of GaAs Quantum Dots Fabricated by Filling of Self-Assembled Nanoholes

Experimental results of the local droplet etching technique for the self-assembled formation of nanoholes and quantum rings on semiconductor surfaces are discussed. Dependent on the sample design and the process parameters, filling of nanoholes in AlGaAs generates strain-free GaAs quantum dots with either broadband optical emission or sharp photoluminescence (PL) lines. Broadband emission is found for samples with completely filled flat holes, which have a very broad depth distribution. On the other hand, partly filling of deep holes yield highly uniform quantum dots with very sharp PL lines.

CD4+Foxp3+ regulatory T cell expansion induced by antigen-driven interaction with intestinal epithelial cells independent of local dendritic cells

BACKGROUND

Regulatory T cells (T(regs)) have potential anti-inflammatory effects and are likely to be important in the pathogenesis of chronic inflammatory bowel disease (IBD). However, the induction and expansion of T(regs) at sites of mucosal inflammation are not yet fully understood and may involve antigen presentation by local dendritic cells (DCs) and/or intestinal epithelial cells (IECs).

METHODS

To determine the unique ways in which the gut induces or expands T(regs), a transgenic mouse model that is based on the specific expression of a model autoantigen (influenza haemagglutinin (HA)) in the intestinal epithelium (VILLIN-HA) was used. Gut-associated DCs and IECs isolated from these mice were phenotypically and functionally characterised for the potential to interact with HA-specific T(regs) in vitro and in vivo.

RESULTS

Intestinal self-antigen expression leads to peripheral expansion of antigen-specific CD4(+)Foxp3(+) T(regs). Although gut-associated DCs can induce antigen-specific CD4(+)Foxp3(+) T cell proliferation, in vivo depletion of DCs did not preclude proliferation of these cells. Interestingly, antigen presentation by primary IECs is sufficient to expand antigen-specific CD4(+)Foxp3(+) T(regs) efficiently. This is dependent on major histocompatibility complex class II, but, in contrast to DCs, is unlikely to require transforming growth factor beta and retinoic acid.

CONCLUSION

This study provides experimental evidence for a new concept in mucosal immunity: in contrast to current thinking, expansion of T(regs) can be achieved independently of local DCs through antigen-specific IEC-T cell interactions.

In vitro-generated regulatory T cells induced by Foxp3-retrovirus infection control murine contact allergy and systemic autoimmunity

Regulatory T cells are promising candidates for the modulation of inflammation and autoimmunity. To generate regulatory T cells in vitro, we have infected naïve CD4+CD25- T cells with a retrovirus encoding the transcription factor Foxp3. Foxp3-infected T cells are similar to naturally occurring regulatory T cells as evidenced by surface marker expression and function. To investigate the effects of Foxp3-infected T cells on contact hypersensitivity (CHS) responses, sensitized mice were injected with Foxp3- or control virus-infected T cells. Only injection of Foxp3-infected T cells into sensitized mice significantly inhibited CHS compared to controls, indicating that Foxp3-infected T cells are suppressive in vivo. These findings prompted treatment of autoimmune-prone CD40L transgenic (tg) mice, which develop a severe systemic autoimmune disease including autoreactive T cells and autoantibodies, with Foxp3-infected T cells. Interestingly, injections of Foxp3-infected T cells into CD40L tg mice inhibited the ongoing development of autoimmune dermatitis and activation of cytotoxic CD8+ T cells. Strikingly, treatment with Foxp3-infected T cells reduced serum concentrations of antinuclear antibodies in CD40L tg mice, which was paralleled with reduced renal immunoglobulin depositions and increased kidney function. Together, these findings indicate that newly in vitro-generated regulatory T cells can be successfully used to treat inflammatory and ongoing autoimmune disorders.

CD4+ T cell mediated intestinal immunity: chronic inflammation versus immune regulation

BACKGROUND

Several studies have suggested that chronic inflammatory bowel disease may be a consequence of antigen specific recognition by appropriate T cells which expand and induce immunopathology.

AIMS

We wished to investigate whether autoreactive CD4+ T cells can initiate the disease on recognition of enterocyte specific antigens directly and if induction of mucosal tolerance occurs.

METHODS

Transgenic mice (VILLIN-HA) were generated that showed specific expression of haemagglutinin from influenza virus A exclusively in enterocytes of the intestinal epithelium. To investigate the impact of enterocyte specific haemagglutinin expression in an autoimmune environment, we mated VILLIN-HA mice with T cell receptor (TCR)-HA mice expressing an alpha/beta-TCR, which recognises an MHC class II restricted epitope of haemagglutinin, and analysed the HA specific T cells for induction of autoimmunity or tolerance.

RESULTS

In VILLIN-HAxTCR-HA mice, incomplete central deletion of HA specific lymphocytes occurred. Peripheral HA specific lymphocytes showed an activated phenotype and increased infiltration into the intestinal mucosa, but not into other organs of double transgenic mice. Enterocyte specific lamina propria lymphocytes showed a dose dependent proliferative response on antigen stimulation whereas the proliferative capacity of intraepithelial lymphocytes was reduced. Mucosal lymphocytes from VILLIN-HAxTCR-HA mice secreted lower amounts of interferon gamma and interleukin (IL)-2 but higher levels of tumour necrosis factor alpha, monocyte chemoattractant protein 1, and IL-6. Mucosal immune reactions were accompanied by broad changes in the gene expression profile with expression of proinflammatory genes, but strikingly also a remarkable set of genes discussed in the context of peripheral induction of regulatory T cells, including IL-10, Nrp-1, and Foxp3.

CONCLUSIONS

Enterocyte specific antigen expression is sufficient to trigger a specific CD4+ T cell response leading to mucosal infiltration. In our model, progression to overt clinical disease was counteracted most likely by induction of regulatory T cells.

Spectroscopy of few-electron collective excitations in charge-tunable artificial atoms

We report the investigation of electronic excitations in InGaAs self-assembled quantum dots using resonant inelastic light scattering. The dots can be charged via a gate by N=1, em leader,6 electrons. We observe excitations, which are identified as transitions of electrons, predominantly from the s to the p shell (s-p transitions) of the quasiatoms. We find that the s-p transition energy decreases and the observed band broadens, when the p shell is filled with 1 to 4 electrons. By a theoretical model, which takes into account the full Coulomb interaction in the few-electron artificial atom, we can confirm the experimental results to be an effect of the Coulomb interaction in the quantum dot.

Neutron spectrometry in mixed fields: proportional counter spectrometers

Proton recoil proportional counters have been successfully used in many laboratories worldwide for more than 30 years in order to measure high-resolution neutron energy spectra. The method is well elaborated and understood, nevertheless high expertise is required for its proper application. Table 4.1 summarises typical basic data for proton recoil proportional counters and the requirements for their application. It is noteworthy that any limiting parameter can vary to a certain degree depending on the quality of the detectors used (design, gas purity, response functions, etc) and their response matrices, the data analysis and the unfolding procedures applied with a correct evaluation of the uncertainties involved. It is also important to lend a critical eye to details during measurements (e.g. environmental and electronics problems) as well as in subsequent analysis and unfolding (e.g. oscillations due to unfolding artefacts or inadequacies in detector response matrices). It is recommended that any spectrometry system (procedures for measurement and data evaluation) should be tested and validated in well-known neutron fields e.g. 252Cf standard fission or 241Am-Be. One should, however, expect that, due to different room scatter conditions, deviations from the ISO spectra may occur, especially for low neutron energies. In order to demonstrate the capability of the recoil proton counter technique, two examples of typical neutron spectra are shown in Figures 4.20 and 4.21, both measured in mixed neutron-gamma fields at nuclear research reactors.

Hsp72 induction: a potential molecular mediator of the delay phenomenon

The molecular basis of enhanced ischemic tissue survival in flaps preconditioned by surgical delay is poorly understood. Because elevated expression of so-called heat shock or stress proteins has been shown to protect tissues/organs against ischemic injury, the authors examined whether the levels of the most highly induced stress protein-hsp72-were elevated in delayed muscle flaps using a rat muscle flap model. Bilateral latissimus dorsi muscle flaps based on the thoracodorsal vessels were elevated in 16 male Sprague-Dawley rats. For each animal, one side was selected randomly to undergo preconditioning by surgical delay for a 7-day period prior to elevation. Delay was accomplished by preserving the thoracodorsal pedicle and a single large distal intercostal perforating vessel. After bilateral flap elevation, latissimus dorsi tissue was harvested from proximal, central, and distal flap segments 0, 1, 3, and 7 days postoperatively (N = 4 for each group), and was analyzed for the expression of hsp72 via Western blot analysis. At the time of harvest, flap viability was assessed by staining with nitroblue tetrazolium. Flap perfusion was measured prior to muscle elevation and harvest using laser Doppler flowmetry. The results demonstrate that delayed muscle flaps had significantly greater total perfusion (p < 0.05) and survival (p < 0.03) 1, 3, and 7 days after elevation compared with the acutely elevated control tissue. Western blot analysis revealed that tissues harvested from the delayed flaps expressed substantially higher levels of hsp72 compared with the acutely elevated control samples. Segmental analysis also revealed a proximal > middle > distal expression of hsp72 in the delayed flaps (p < 0.05). Flap preconditioning by surgical delay increases the expression of hsp72. Moreover, regional differences in hsp72 gene expression are associated with differences in perfusion and survival of delayed muscle flaps. These results indicate that hsp72 may play a substantial role in mediating the delay phenomenon.

CCAAT-enhancer binding protein alpha is expressed in activated microglial cells after brain injury

Microglial cells play important roles in brain injury and repair and are implicated in diseases such as Alzheimer's disease, Creutzfeldt-Jacob disease, multiple sclerosis, the Aids Dementia Complex and stroke. Despite their importance in neuropathology, the underlying molecular basis for the activation of microglia after brain injury is not understood. We show, using RT-PCR, in situ hybridisation, immunocytochemistry, and electrophoretic mobility shift assay, that the CCAAT-enhancer binding protein alpha (C/EBP alpha), a sequence specific DNA-binding protein, is induced in microglial cells, but not astrocytes or neurons, after hypoxic-ischemic brain injury. These results suggest that C/EBP alpha might regulate gene expression and consequentially have a role in the activation and/or proliferation of microglia following brain injury.

A monoclonal antibody to inclusion body disease of cranes virus enabling specific immunohistochemistry and competitive ELISA

Inclusion body disease of cranes (IBDC) herpesvirus kills some infected cranes and persists in convalescent animals. To enable further study and rapid identification of carrier animals, we developed a monoclonal antibody (MAb) to IBDC virus and used it in immunohistochemistry and a competitive enzyme-linked immunosorbent assay (ELISA). We used conventional techniques to make murine MAbs directed against IBDC virus purified from infected duck embryo cells. Hybridomas reacting in an ELISA with IBDC virus but not uninfected duck embryo cells were characterized by radioimmunoprecipitation, in situ immunohistochemistry, and competitive ELISA with neutralizing and nonneutralizing crane sera. MAb 2C11 immunoprecipitated 59-, 61-, and 110-kD proteins from IBDC virus-infected but not uninfected cells and stained glutaraldehyde-fixed IBDC virus plaques but not surrounding uninfected duck embryo cells in vitro. Antibody 2C11 did not react with duck embryo cells infected with falcon herpesvirus, psittacine herpesvirus, infectious laryngotracheitis, pigeon herpesvirus, or duck plague virus. A competitive ELISA using antibody 2C11 identified most sera that were positive in the neutralization test. This antibody will be useful in further characterizing IBDC virus, its pathogenesis, and its natural history.

A sensitive method for the detection of murine C-type retroviruses

A RT-PCR assay was developed for group-specific detection of murine C-type retroviruses using a nested set of degenerated primers. To distinguish exogenous viruses from related, but silent endogenous viruses, a DNAse I pretreatment of supernatants is applied. This is followed by a heat inactivation/denaturation step. The PCR method is ultrasensitive. which enables the detection of 100 attogram of MoMuLV proviral DNA or up to 1-10 infectious mouse C-type retroviruses in 10 microl supernatant of infected cells. The high specificity of the method allows the differentiation between mouse C-type retroviruses and related retroviruses of the A, B, and D type and C-type retroviruses found in other species. It serves as a valuable tool for the screening of animal cell cultures for contaminations with mouse retroviruses, e.g. hybridomas or recombinant cell lines producing foreign proteins.

Severe human infections caused by Vibrio metschnikovii

Vibrio metschnikovii is largely distributed in the aquatic environment; human infections are rarely observed. A fatal case of septicemia in a patient with liver cirrhosis, renal insufficiency, and diabetes is described. A second case in a 82-year-old woman with septicemia, respiratory problems, and infected leg lesions is reported; she was successfully treated.

The constipated serviceman: prevalence among deployed U.S. troops

The prevalence of constipation in deployed servicemen was determined in a sample of military personnel aboard the USS Iwo Jima LPH 2 during Operation Desert Shield. Results were obtained from a bowel function questionnaire issued to 500 deployed marines and sailors. When constipation is defined as no bowel movement for greater than 3 days, 3.9% of the Marine/sailor personnel are constipated when in their home environment as compared to 6.0% when they are aboard ship and 30.2% while in the field. Alternatively, when constipation is defined as the presence of certain anorectal complaints (hard stools, straining, painful defecation, and bleeding with defecation), the incidence is 7.2% when at home as compared to 10.4% aboard ship and 34.1% in the field. These results confirm that whether constipation is defined as infrequent bowel movements or presence of symptoms of constipation, significantly more servicemen will be constipated when in the field as compared to their home environment. Since approximately one-third of Navy/Marine Corps personnel deployed in a field environment will be constipated, preventive measures ought to be evaluated.

Prenatal diagnosis by in situ hybridization on uncultured amniocytes: reduced sensitivity and potential risk of misdiagnosis in blood-stained samples

Maternal cell contamination was assessed in 18 macroscopically blood-stained amniotic fluid samples from male fetuses. The samples were analysed by double-target fluorescent in situ hybridization (ISH) with Y and X chromosome-specific probes. The only sample with an aberrant karyotype (47,XY, + 18) was also analysed by hybridization with a chromosome 18-specific probe. An interpretation of extensive maternal cell contamination was made in two samples, one of which was the sample with trisomy 18. ISH with the chromosome 18-specific probe on this latter sample showed that the sensitivity of the ISH method for chromosome enumeration of uncultured amniotic fluid samples may be reduced in blood-stained samples. It was calculated that by using ISH for chromosome enumeration of the two extensively contaminated samples, a case of trisomy 21 might have been overlooked in both samples, while a case of trisomy 18 might only have been overlooked in one of the samples. It is concluded that ISH should not be used for chromosome enumeration of uncultured amniotic fluid samples that are macroscopically blood-stained without further technical developments.

Prevalence and severity of urinary incontinence in ambulatory adults: an UPRNet study

BACKGROUND

Although urinary incontinence (UI) is a common and costly problem, its prevalence and severity in ambulatory patients is not well established. The main objectives of this study were to define the prevalence and severity of urinary incontinence in adult men and women who came to a primary care office for health care, to determine if these patients had ever told a health care provider about this problem, and to determine if they would be interested in treatment if it were available and effective.

METHODS

Men and women aged 20 years and over who came to family physicians' offices seeking health care for any reason during an 11-week period were the subjects of a survey by an anonymous questionnaire. Five family practice offices in UPRNet (the Upper Peninsula Research Network), a research network in Michigan, participated. We defined "current urinary incontinence" as any degree of incontinence in the past 12 months.

RESULTS

Of the 2830 study participants, 33% had current urinary incontinence (95% confidence interval [CI] 31% to 35%). Incontinence was experienced by 11% of the men and 43% of the women. Urinary incontinence constituting a social or hygienic problem was reported by 5% of the men and 23% of the women (17% overall). Of those with current UI, 72% had not told a health care provider. Of the patients who had not told a physician, 37% said they would seek care if they knew tests and effective treatment were available.

CONCLUSIONS

Urinary incontinence is a common problem among those seen in primary care settings, and its presence is often not known to the health care provider.