JAMA news releases are made available to the public after 3 pm US Central time on the first 4 Tuesdays of each month. The Archives Journals news releases are made available to the public after 3 pm Central time on Mondays. We also provide a list of previous news releases.
THIS WEEK'S CONTENT
JAMA NEWS RELEASES
(Embargoed for Release: 3:00 p.m. CT, Tuesday, September 16, 2008)
JAMA NEWS RELEASES
INCONTINENCE AFFECTS A SUBSTANTIAL PROPORTION OF WOMEN; PREVALENCE INCREASES WITH AGE
ADULTS WITH AORTIC VALVE DISORDER EXPERIENCE SUBSEQUENT CARDIAC EVENTS, BUT NO REDUCTION IN SURVIVAL RATES
INFORMATION CONTAINED IN THESE NEWS RELEASES IS PROTECTED BY COPYRIGHT. JOURNAL ATTRIBUTION IS REQUIRED.
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Embargoed for Release: 3:00 p.m. CT, Tuesday, September 16, 2008
Media Advisory: To contact Ingrid Nygaard, M.D., M.S., call Christopher Nelson at 801-581-7387.
INCONTINENCE AFFECTS A SUBSTANTIAL PROPORTION OF WOMEN; PREVALENCE INCREASES WITH AGE
CHICAGO—Nearly one-quarter of women surveyed, and more than one-third of older women, report at least one pelvic floor disorder, which includes urinary and fecal incontinence and the shifting of a pelvic organ, according to a study in the September 17 issue of JAMA. These disorders become more prevalent with increasing age and weight.
Pelvic floor disorders include urinary and fecal incontinence, pelvic organ prolapse (when a pelvic organ, such as the uterus, drops [prolapses] from its normal spot and pushes against the walls of the vagina), and other sensory and emptying abnormalities of the lower urinary and gastrointestinal tracts. Because no single national population-based survey has assessed the prevalence of major pelvic floor disorders in U.S. women, the national burden related to these diseases remains unknown, according to background information in the article.
Ingrid Nygaard, M.D., M.S., of the University of Utah School of Medicine, Salt Lake City, and colleagues conducted a study to provide prevalence estimates of symptomatic pelvic floor disorders in women. The study included 1,961 nonpregnant women (age 20 years or older) who participated in the 2005-2006 National Health and Nutrition Examination Survey, a nationally representative survey of the U.S. population. Women were interviewed in their homes and then underwent standardized physical examinations in a mobile examination center. Urinary and fecal incontinence and pelvic organ prolapse symptoms were assessed.
The researchers found that overall, 23.7 percent of women reported symptoms of at least 1 pelvic floor disorder. Of these, 15.7 percent experienced urinary incontinence, 9.0 percent experienced fecal incontinence and 2.9 percent experienced symptomatic pelvic organ prolapse. The proportion of women who reported at least 1 pelvic floor disorder increased with age (9.7 percent in women age 20 to 39 years, 26.5 percent in women age 40 to 59 years, 36.8 percent in women age 60 to 79 years, and 49.7 percent in women age 80 years or older).
Overweight and obese women were more likely to report at least 1 pelvic floor disorder than normal weight women: prevalence was 15.1 percent for underweight/normal weight, 26.3 percent for overweight, and 30.4 percent for obese women. Also, the more children a woman had given birth to increased the likelihood of at least 1 pelvic floor disorder. Race/ethnicity and education were not significantly associated with having a pelvic floor disorder.
“These data represent the first nationwide, population-based estimates of the 3 primary pelvic floor disorders in women in the United States derived from a single source,” the authors write. “By 2030, more than one-fifth of women will be 65 years or older. As the population of older women increases, the national burden related to pelvic floor disorders in terms of health care costs, lost productivity, and decreased quality of life will be substantial.”
“Given the burden pelvic floor disorders place on U.S. women and the health care system, research is needed to further understand their pathophysiology, prevention, and treatment.”
(JAMA. 2008;300[11]:1311-1316. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For More Information: Contact the JAMA/Archives Media Relations Department at 312/464-JAMA (5262) or email: mediarelations{at}jama-archives.org.
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Embargoed for Release: 3:00 p.m. CT, Tuesday, September 16, 2008
Media Advisory: To contact Samuel C. Siu, M.D., S.M., call Jennifer Little at 416-946-8423.
ADULTS WITH AORTIC VALVE DISORDER EXPERIENCE SUBSEQUENT CARDIAC EVENTS, BUT NO REDUCTION IN SURVIVAL RATES
CHICAGO—Young adults with a bicuspid aortic valve, a congenital heart abnormality, experience subsequent cardiac events but do not appear to have lower survival rates compared to the general population, according to a study in the September 17 issue of JAMA.
A bicuspid aortic valve in the heart is a valve that has only two flaps (cusps) that open and close, instead of three, and is the most common congenital cardiac abnormality in the adult population. Prior studies have reported significant death and illness in patients with bicuspid aortic valve related to the development of aortic valve dysfunction and inflammation of the heart valves, according to background information in the article. Cardiac outcomes in a contemporary population of adults with bicuspid aortic valve have not been determined.
Nikolaos Tzemos, M.D., of the University of Toronto, and Samuel C. Siu, M.D., S.M., of the University of Western Ontario, Canada, and colleagues examined the cardiac outcomes and disease progression in 642 adults, average age 35 years, with bicuspid aortic valve who were followed up for an average period of 9 years.
One or more primary cardiac events (cardiac death, intervention on the aortic valve or ascending aorta [first section of the aorta], aortic tearing or aneurysm, or congestive heart failure requiring hospital admission) occurred in 161 patients (25 percent), which included intervention on aortic valve or ascending aorta in 142 patients (22 percent), aortic tearing or aneurysm in 11 patients (2 percent), or congestive heart failure requiring hospital admission in 16 patients (2 percent).
Independent predictors of primary cardiac events were age older than 30 years, moderate or severe aortic narrowing, and moderate or severe aortic regurgitation (flowing of blood back into the heart).
There was a total of 28 deaths (4 percent), of which 17 were cardiac-related (3 percent) and 11 were not related to a cardiac cause. The cardiac death rate was 0.3 percent per patient-year of follow-up. When compared with age- and sex-matched population estimates, the overall mortality was not significantly different between the bicuspid aortic valve group and in the population estimates. The 5-year average survival was 97 percent in both the bicuspid aortic valve group and in the population estimates. The 10-year survival was similar in both the bicuspid aortic valve group (96 percent) and in the population estimates (97 percent).
“Outcome differences between present and prior studies can be attributed to differences in the era that patients were examined, the population that was examined, the frequency of cardiac events associated with high mortality (aortic [tearing] and endocarditis [inflammation of the endocardium and heart valves]), and advances in perioperative management,” the authors write.
“Young adults with bicuspid aortic valve have a high likelihood of eventually requiring interventions on the aortic valve and/or aorta and will need serial surveillance of aortic valve and aortic dimensions.”
(JAMA. 2008;300[11]:1317-1325. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For More Information: Contact the JAMA/Archives Media Relations Department at 312/464-JAMA (5262) or email: mediarelations{at}jama-archives.org.
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