Prevalence of urinary incontinence among women in Saudi Arabia: a cross-sectional study

OBJECTIVE

Urinary incontinence is defined as involuntary loss of urine, a common health condition that is more frequent in women. It disturbs the affected individuals and interferes with their daily activities. This study aimed to estimate the prevalence of urinary incontinence among Saudi women in the western area of the Kingdom of Saudi Arabia.

SUBJECTS AND METHODS

A descriptive cross-sectional design was used for this study. A survey was administered to Saudi women in the western area of the Kingdom of Saudi Arabia ranging in age from 18 to 70 years. The data were collected using the Arabic version of the Questionnaire for Urinary Incontinence Diagnosis. Descriptive statistics were generated by calculating numbers and percentages of information on the prevalence of incontinence in women. p-values < 0.05 were considered statistically significant.

RESULTS

The prevalence of urinary incontinence was 44.2%, with the urge type being the most reported. Stress urinary incontinence was reported by 155 women (15.4%), urgency urinary incontinence by 257 women (25.6%), and mixed urinary incontinence by 102 women (10.15%).

CONCLUSIONS

Urinary incontinence is prevalent in women in Western Saudi Arabia. Age, multiparty obesity, and vaginal surgery are significant risk factors influencing its occurrence.

Artificial Intelligence machine learning and conventional physical therapy for upper limb outcome in patients with stroke: a systematic review and meta-analysis

OBJECTIVE

The goal of this study was to compare the effect of different artificial intelligence (AI) machine learning and conventional therapy (CT) on upper limb impairments in patients with stroke.

MATERIALS AND METHODS

PubMed, PubMed Central, Google Scholar, MEDLINE, Cochrane Library, Web of Science, Research Gate, and Wiley Online Library were searched. Descriptive statistics about variables were reported to calculate standardized mean differences in outcomes of motor control (the primary outcome), functional independence, upper extremity performance, and muscle tone. The Physiotherapy Evidence Database (PEDro) Scale was used to assess qualitative papers. The primary outcomes of AI and CT have been included in the meta-analyses.

RESULTS

Ten papers with a total of 481 stroke patients were included and upper limb rehabilitation, upper limb functioning, and basic manual dexterity were examined. The heterogeneity test of the whole included measures (I2=45%) was medium. There were significant differences between the included measures (p-value=0.03) with a total SMD of 0.10 [0.01, 0.19]. According to the test for subgroup difference, it was found that there was a highly significant difference between the subgroups of the included measures (p-value=0.01) and the heterogeneity test (I2=59.8%).

CONCLUSIONS

AI is a feasible and safe method in post-stroke rehabilitation and improves upper-extremity function compared to CT. Significant AI post-treatment effects on upper-limb impairments have been observed. The findings showed that higher-quality evidence was detected in six assessment scales. However, a lower quality of evidence was detected in other scales. This indicated large or very large and consistent estimates of the treatment effects, and researchers were confident about the results. Therefore, the included observational studies are likely to provide an overestimate of the true effect.

Abstract P1-06-03: Serial evolution of hormone receptor status and mutational profile among patients with metastatic breast cancer

Introduction: Tumor heterogeneity presents a significant impediment to identifying appropriate treatments for patients. Genetic mutations and hormone receptors are frequently used as a guide for selecting appropriate targeted or hormonal therapies, however it is possible that these markers may change over time, leading to reduced effectiveness of these treatments. In this study, we review the results of serial and paired biopsies to identify receptor switch in estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) status as well as to identify changes in clinically relevant mutations, including spatial and temporal heterogeneity.

Methods: We identified a total of 237 patients initially presenting with ER+/HER2 negative breast cancer and who had multiple biopsies during the course of their treatment, including at least one in the metastatic setting. ER, PR, and HER2 status for each of these serial biopsies was gathered from chart reviews. HER2 results by both IHC and FISH were collected. PIK3CA mutations were also assessed by Snapshot utilizing multiplexed PCR of common hotspot mutations using DNA derived from formalin-fixed, paraffin-embedded (FFPE) tissue.

Results: From a total of 213 patients with known ER status for multiple serial biopsies, we identified 9.4% (N=20) who had at least one change in ER status over time. From a total of 198 patients who had documented PR status for multiple biopsies, 40.4% (N=80) had at least one change in PR status. Changes in HER2 status were similarly assessed, with 6.7% of patients having at least one change by IHC and 4.4% of patients having at least one change by FISH. Of those patients exhibiting changes in ER status, 6 were noted to have multiple changes over time. Of those with changes in PR status, 18 had multiple changes over time. Changes in hormone receptor status were also noted to occur between serial biopsies in the metastatic setting. A total of 128 patients had ER results available for multiple metastatic specimens, of which 8.6% (N=11) had at least one change in ER status. A total of 116 patients had PR results available for multiple metastatic biopsies, of which 38.8% (N=45) had at least one change in PR status. Changes were also noted in the metastatic setting in HER2 (IHC) with a frequency of 8.7% and in HER2 (FISH) with a frequency of 4.7%. A subset of 108 patients were identified as harboring a mutation in PIK3CA. Within this population, 9.6% of patients had at least one change in ER status over time and 34.1% had at least one change in PR status. 9.0% exhibited at least one change in HER2 (IHC) and 6.5% in HER2 (FISH). Serial changes in genotype, from pre- and post-treatment biopsies, were also detected using NGS based Foundation Medicine platform, including acquired alterations in the ESR1 and PI3K pathway.

Conclusion: Serial changes in hormone receptor status and mutation profile are not uncommon among patients initially diagnosed with ER+/HER2 negative breast cancer, and some patients have been noted to have multiple changes over time. Further studies are needed to understand the mechanistic underpinnings governing the emergence of these alterations and their relationship to therapeutic resistance in breast cancer.

Citation Format: Henderson L, Brachtel E, Fitzgerald D, Gadd M, Specht M, Thabet A, Gurski J, Sgroi D, Moy B, Isakoff S, Bardia A, Juric D. Serial evolution of hormone receptor status and mutational profile among patients with metastatic breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-06-03.

Comparative assessment of three image reconstruction techniques for image quality and radiation dose in patients undergoing abdominopelvic multidetector CT examinations

OBJECTIVE

To compare image quality and radiation dose of abdominal CT examinations reconstructed with three image reconstruction techniques.

METHODS

In this Institutional Review Board-approved study, contrast-enhanced (CE) abdominopelvic CT scans from 23 patients were reconstructed using filtered back projection (FBP), adaptive statistical iterative reconstruction (ASiR) and iterative reconstruction in image space (IRIS) and were reviewed by two blinded readers. Subjective (acceptability, sharpness, noise and artefacts) and objective (noise) measures of image quality were recorded for each image data set. Radiation doses in CT dose index (CTDI) dose-length product were also calculated for each examination type and compared. Imaging parameters were compared using the Wilcoxon signed rank test and a paired t-test.

RESULTS

All 69 CECT examinations were of diagnostic quality and similar for overall acceptability (mean grade for ASiR, 3.9±0.3; p=0.2 for Readers 1 and 2; IRIS, 3.9±0.4, p=0.2; FBP, 3.8±0.9). Objective noise was considerably lower with both iterative techniques (p<0.0001 and 0.0016 for ASiR and IRIS). Recorded mean radiation dose, i.e. CTDI(vol), was 24% and 10% less with ASiR (11.4±3.4 mGy; p<0.001) and IRIS (13.5±3.7 mGy; p=0.06), respectively, than with FBP: 15.0±3.5 mGy.

CONCLUSION

At the system parameters used in this study, abdominal CT scans reconstructed with ASiR and IRIS provide diagnostic images with reduced image noise and 10-24% lower radiation dose than FBP.

ADVANCES IN KNOWLEDGE

CT images reconstructed with FBP are frequently noisy on lowering the radiation dose. Newer iterative reconstruction techniques have different approaches to produce images with less noise; ASiR and IRIS provide diagnostic abdominal CT images with reduced image noise and radiation dose compared with FBP. This has been documented in this study.