Urinary frequency is a common complaint in the elderly and can be due to many different causes. To clarify the aetiology of frequency, patient-maintained frequency-volume charts were evaluated as a diagnostic tool. We studied 215 patients who complained of frequency. They were divided into 2 groups based on age: 85 were over 65 years of age (elderly group) and 130 were less than 64 years old (adult group). Compared with the adults, elderly patients had a smaller urinary volume during waking hours and a larger volume during sleeping hours, with more frequent episodes of voiding and a smaller volume voided during the latter period. Analysis of the cause of frequency led to the patients being subdivided into 6 diagnostic categories. Among elderly patients, nocturnal polyuria (37%) and an unstable bladder (34%) were frequent causes. In adult patients an unstable bladder (28%) and polyuria due to excessive fluid intake (23%) were most common. As a result of our findings, 108 patients were advised not to be concerned about their micturition and/or restriction of fluid intake. Seventy-six patients (35%) required anticholinergic medication. Frequency-volume charts, together with a detailed medical history, provide useful information on the diagnosis and treatment of frequency.
The prevalence of sarcopenia was 28% in patients with RA whose disease activity was mild. Low BMI, high fat mass and high MMP3 were independently associated with sarcopenia. MMP3 might be a useful marker for sarcopenia in patients with RA.
Aim: Frailty is defined as the degradation of physical and cognitive function in older adults. The relationship between frailty and disease activity in patients with rheumatoid arthritis is unclear. Factors related to frailty in Japanese rheumatoid arthritis patients were investigated in a cross-sectional analysis.Methods: Of 100 patients who entered the prospective, observational Correlation research of sarcopenia, skeletal muscle and disease activity in rheumatoid arthritis (CHIKARA) study, 95 completed a frailty check list (maximal score 25), and were classified as frail (8-25 points), pre-frail (4-7 points) and normal (0-3 points). The relationship with disease activity was investigated in the frailty, pre-frailty and normal groups. Relationships between clinical variables and frailty were evaluated by univariate and multiple logistic regression analyses.Results: The prevalences of frailty, pre-frailty and normal were 18.9%, 38.9% and 42.2%, respectively. The disease activity score 28 erythrocyte sedimentation rate, matrix metalloproteinase 3 and modified health assessment questionnaire were higher in the frailty group. In remission, 66.6% were normal and 6.7% had frailty, but with moderate and high disease activity, 13.3% were normal and 46.7% had frailty. On univariate analysis, factors positively related to frailty were age, locomotive syndrome, disease activity score 28 erythrocyte sedimentation rate, matrix metalloproteinase 3, use of biological disease-modifying antirheumatic drugs or targeted synthetic disease-modifying antirheumatic drugs, Steinbrocker class and modified health assessment questionnaire; and the leg muscle score and grip strength were negatively related. Matrix metalloproteinase 3 was the only independent factor on multivariate logistic analysis. In patients aged >60 years, this tendency was similar.
PURPOSE.To investigate the effect of trabeculectomy on the waveform changes of laser speckle flowgraphy (LSFG) in the optic nerve head (ONH) in patients with glaucoma.METHODS. Forty-eight eyes of 48 patients with open angle glaucoma were included in this prospective study. LSFG was performed before and 1, 3, and 6 months after trabeculectomy. Longitudinal changes in average mean blur rate (MBR), blow out score (BOS), resistivity index (RI), falling rate, skew, acceleration time index, and blow out time in the tissue area of the ONH were analyzed by using mixed-effects models.RESULTS. Intraocular pressure (IOP) decreased and ocular perfusion pressure increased significantly at each postoperative time point (P < 0.001, each). BOS increased (P < 0.001, each) and RI decreased (P < 0.001, each) significantly at each postoperative time point, although average MBR and other waveform parameters did not change significantly. Multivariate analyses revealed that younger age (coefficients ¼ À0.13 and 0.0014, P ¼ 0.006 and 0.03 for BOS change and RI change, respectively), worse baseline mean deviation of visual fields (coefficients ¼ À0.18 and 0.0026, P ¼ 0.009 and 0.005), larger IOP reduction (coefficients ¼ À0.29 and 0.0037, P < 0.001, each), and larger pulse rate increase (coefficients ¼ 0.17 and À0.0024, P < 0.001, each) are significantly associated with postoperative BOS increase and RI decrease.
CONCLUSIONS.Given that postoperative BOS increased and RI decreased with the average MBR remaining unchanged, IOP reduction by trabeculectomy may contribute to stable blood flow throughout the duration of the heartbeat in the tissue area of the ONH.
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