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- Helbig, AJ, et al.
(författare)
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Genetic differentiation and hybridization between greater and lesser spotted eagles (Accipitriformes : Aquila clanga, A-pomarina)
- 2005
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Ingår i: Journal of Ornithology. - : Springer Science and Business Media LLC. - 2193-7192 .- 2193-7206. ; 146:3, s. 226-234
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Tidskriftsartikel (refereegranskat)abstract
- Greater and lesser spotted eagles (Aquila clanga, A. pomarina) are two closely related forest eagles overlapping in breeding range in east-central Europe. In recent years a number of mixed pairs have been observed, some of which fledged hybrid young. Here we use mitochondrial (control region) DNA sequences and AFLP markers to estimate genetic differentiation and possible gene flow between these species. In a sample of 83 individuals (61 pomarina, 20 clanga, 2 F1-hybrids) we found 30 mitochondrial haplotypes which, in a phylogenetic network, formed two distinct clusters differing on average by 3.0% sequence divergence. The two species were significantly differentiated both at the mitochondrial and nuclear (AFLP) genetic level. However, five individuals with pomarina phenotype possessed clanga-type mtDNA, suggesting occasional gene flow. Surprisingly, AFLP markers indicated that these "mismatched" birds (originating from Germany, E Poland and Latvia) were genetically intermediate between the samples of individuals in which mtDNA haplotype and phenotype agreed. This indicates that mismatched birds were either F1 or recent back-cross hybrids. Mitochondrial introgression was asymmetrical (no pomarina haplotype found in clanga so far), which may be due to assortative mating by size. Gene flow of nuclear markers was estimated to be about ten times stronger than for mtDNA, indicating a sex-bias in hybrid fertility in accordance with Haldane's rule. Hybridization between the two species may be more frequent and may occur much further west than hitherto assumed. This is supported by the recent discovery of a mixed pair producing at least one fledgling in NE Germany.
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- Irwin, D. E., et al.
(författare)
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Impact of overactive bladder symptoms on employment, social interactions and emotional well-being in six European countries
- 2006
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Ingår i: BJU Int. - 1464-4096. ; 97:1, s. 96-100
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To determine the impact of overactive bladder (OAB) symptoms on issues related to employment, social interactions, and emotional well-being in a population aged 40-64 years. SUBJECTS AND METHODS: The study comprised a cross-sectional population-based survey of 11 521 individuals aged 40-64 years, conducted in France, Germany, Italy, Spain, Sweden, and the UK. The survey involved a two-stage screening procedure. Initially, individuals with any lower urinary tract symptoms were identified. Those whose only symptom/(s) was suggestive of a urinary tract infection, stress incontinence, or prostate obstruction were excluded from further study. Respondents were asked questions about the impact that their symptoms had on their emotional well-being, social interactions and productivity at home and at work. RESULTS: Of those with OAB, approximately 32% (1272) reported that having these symptoms made them feel depressed, and 28% reported feeling very stressed. There were statistically significant differences in reported feelings of stress and depression when OAB symptoms were stratified by OAB with incontinence (OAB+) vs those with OAB with no incontinence (OAB-), with values for emotional stress of OAB+ 36.4% vs OAB- 19.6%, for depression of OAB+ 39.8% vs OAB- 23.3%. Participants with OAB+ were significantly more likely than those with OAB- to express worry about having accidents and concern about participating in activities away from home because of their bladder symptoms. In addition, those with OAB+ were significantly more likely to report that these bladder symptoms were a source of great concern and made them feel uncomfortable in social situations compared to those with OAB-. Men were significantly more likely than women to report OAB+ having an impact on their daily work life, including worry about interrupting meetings, impact on decisions about work location and hours, and voluntary termination or early retirement. This effect was primarily in men reporting OAB+. CONCLUSION: OAB symptoms have a significant effect on the emotional well-being and productivity of those affected, both at home and at work.
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- Irwin, D. E., et al.
(författare)
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Overactive bladder is associated with erectile dysfunction and reduced sexual quality of life in men
- 2008
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Ingår i: Journal of Sexual Medicine. - : Oxford University Press (OUP). - 1743-6109 .- 1743-6095. ; 5:12, s. 2904-10
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Tidskriftsartikel (refereegranskat)abstract
- Introduction. The prevalence of sexual dysfunction, including erectile dysfunction (ED), is greater in men with lower urinary tract symptoms (LUTS), including overactive bladder (OAB), than in men without LUTS. Aim. To evaluate the prevalence of ED, the impact of urinary symptoms on sexual activity and sexual enjoyment, and sexual satisfaction in men with OAB. Methods. A nested case-control analysis was performed on data from a subset of men with (cases) and without (controls) OAB frequency-matched for age (5-year age strata) and country from the EPIC study. Respondents were asked about OAB symptoms (using the 2002 International Continence Society [ICS] definitions) and sexual activity. Sexually active respondents were asked about ED, sexual enjoyment, and overall satisfaction with their sex lives. Conditional logistic regression was used to assess factors associated with ED. Main Outcome Measures. The percentage of cases and controls reporting ED, a reduction in the frequency of sexual activity or enjoyment of sexual activity because of urinary symptoms, and overall satisfaction with their sex lives was determined for cases and controls. Results. A total of 502 cases and 502 controls were matched for age strata and country. Significantly more cases (14%) reported reduced sexual activity because of urinary symptoms compared with controls (4%; P
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- Irwin, D. E., et al.
(författare)
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Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study
- 2006
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Ingår i: Eur Urol. - : Elsevier BV. - 0302-2838. ; 50:6
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Estimate the prevalence of urinary incontinence (UI), overactive bladder (OAB), and other lower urinary tract symptoms (LUTS) among men and women in five countries using the 2002 International Continence Society (ICS) definitions. METHODS: This population-based, cross-sectional survey was conducted between April and December 2005 in Canada, Germany, Italy, Sweden, and the United Kingdom using computer-assisted telephone interviews. A random sample of men and women aged >/= 18 yr residing in the five countries and who were representative of the general populations in these countries was selected. Using 2002 ICS definitions, the prevalence estimates of storage, voiding, and postmicturition LUTS were calculated. Data were stratified by country, age cohort, and gender. RESULTS: A total of 19,165 individuals agreed to participate; 64.3% reported at least one LUTS. Nocturia was the most prevalent LUTS (men, 48.6%; women, 54.5%). The prevalence of storage LUTS (men, 51.3%; women, 59.2%) was greater than that for voiding (men, 25.7%; women, 19.5%) and postmicturition (men, 16.9%; women, 14.2%) symptoms combined. The overall prevalence of OAB was 11.8%; rates were similar in men and women and increased with age. OAB was more prevalent than all types of UI combined (9.4%). CONCLUSIONS: The EPIC study is the largest population-based survey to assess prevalence rates of OAB, UI, and other LUTS in five countries. To date, this is the first study to evaluate these symptoms simultaneously using the 2002 ICS definitions. The results indicate that these symptoms are highly prevalent in the countries surveyed.
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- Irwin, D. E., et al.
(författare)
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Prevalence, Severity, and Symptom Bother of Lower Urinary Tract Symptoms among Men in the EPIC Study: Impact of Overactive Bladder
- 2009
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Ingår i: European Urology. - : Elsevier BV. - 0302-2838. ; 56:1, s. 14-20
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Lower urinary tract symptoms (LUTS) are prevalent among men. OBJECTIVE: To describe the prevalence, severity, and symptom bother of LUTS in all men and men with overactive bladder (OAB) symptoms in the EPIC study. DESIGN, SETTING, AND PARTICIPANTS: A secondary analysis of data from EPIC, a multinational population-based survey of 19 165 adults, was performed. Current International Continence Society definitions were used for individual LUTS and OAB; OAB cases were defined as men reporting urgency. MEASUREMENTS: Participants were asked about the presence of individual LUTS and associated symptom bother. LUTS severity was measured using the International Prostate Symptom Score (IPSS). RESULTS AND LIMITATIONS: There was substantial overlap of storage, voiding, and postmicturition symptoms among all men (n=7210) and in men with OAB symptoms (n=502); men with OAB symptoms were more likely to experience multiple LUTS subtypes. Among both populations, nocturia was the most commonly reported symptom, except for urgency (the hallmark symptom) among men with OAB symptoms; terminal dribble and sensation of incomplete emptying were the most common voiding and postmicturition symptoms. The prevalence of all LUTS increased with age among the general population; only storage LUTS increased with age among men with OAB symptoms. Number of LUTS and mean IPSS increased with age in both populations but were higher among men with OAB symptoms at all ages; the proportion reporting moderate-severe LUTS was higher than the general population (30% vs 6%). The proportion of men with OAB symptoms reporting symptom bother increased with urgency severity and severity and number of LUTS. LUTS severity may have been underestimated by the IPSS, which does not assess incontinence. CONCLUSIONS: Men with LUTS commonly experience coexisting storage, voiding, and postmicturition symptoms, emphasizing the need for comprehensive urologic assessments. Men with OAB symptoms reported more LUTS and greater severity than the general population. Symptom bother was related to number of LUTS and urgency severity.
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- Irwin, D. E., et al.
(författare)
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Symptom bother and health care-seeking behavior among individuals with overactive bladder
- 2008
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Ingår i: European Urology. - : Elsevier BV. - 0302-2838. ; 53:5, s. 1029-37
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To estimate symptom bother and health care seeking among individuals with overactive bladder (OAB; ie, cases) using current International Continence Society definitions. METHODS: This was a nested case-controlled analysis of data from the EPIC study, a population-based, cross-sectional survey of adults in five countries. Cases and matched controls were asked about risk factors, use of coping techniques, and health care seeking for urinary symptoms. Cases were asked about symptom bother and assessed with the Overactive Bladder-Validated 8 and Patient Perception of Bladder Condition instruments. RESULTS: Among cases (n=1434), 54% reported symptom bother; rates were similar between men (54%) and women (53%). Significantly more men with urinary incontinence (UI) reported bother (77%) than women with UI (67%; p
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- Irwin, D. E., et al.
(författare)
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The economic impact of overactive bladder syndrome in six Western countries
- 2009
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Ingår i: BJU International. - 1464-410X. ; 103:2, s. 202-9
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To calculate up-to-date estimates of the economic impact of overactive bladder syndrome (OAB) with and without urgency urinary incontinence (UUI) on the health sector of six countries (Canada, Germany, Italy, Spain, Sweden and the UK), as OAB is a significant health concern for adults aged >18 years living in Western countries. MATERIALS AND METHODS: The prevalence data derived from the EPIC study were combined with healthcare resource-use data to derive current direct and indirect 1-year or annual cost of illness estimates for OAB including UUI in Canada, Germany, Italy, Spain, Sweden and the UK. This model estimates the direct healthcare costs attributed to OAB, as well as the impact of work absenteeism. RESULTS: The estimated average annual direct cost of OAB per patient ranged between 262 in Spain and 619 in Sweden. The estimated total direct cost burden for OAB per country ranges between 333 million in Sweden and 1.2 billion in Germany and the total annual direct cost burden of OAB in these six countries is estimated at 3.9 billion. In addition, nursing home costs were estimated at 4.7 billion per year and it was estimated that work absenteeism related to OAB costs 1.1 billion per year. CONCLUSIONS: The cost of illness for OAB is a substantial economic and human burden. This study may under-estimate the true economic burden, as not all costs for sequelae associated with OAB have been included. Cost-effective treatments and management strategies that can reduce the burden of OAB and in particular UUI have the potential to significantly reduce this economic burden.
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- Irwin, D. E., et al.
(författare)
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Understanding the elements of overactive bladder: questions raised by the EPIC study
- 2008
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Ingår i: BJU International. - 1464-410X. ; 101:11, s. 1381-7
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To compare the prevalence of frequency and nocturia and the bother they impose in a population-based sample of men and women using current International Continence Society (ICS) definitions of lower urinary tract symptoms (LUTS) and commonly used alternative definitions of these LUTS to emphasize the importance of standardizing the definitions when evaluating overactive bladder (OAB) syndrome; we also describe the spectrum of LUTS and bother they impose in this population with OAB. SUBJECTS AND METHODS: Several validated disease-specific measures were used in a population-based, cross-sectional telephone survey of adults aged >or=18 years in five countries. The population with OAB was defined as those participants who answered 'yes' to questions about urgency or urgency urinary incontinence according to ICS standards. The prevalence of daytime frequency and nocturia within the OAB population was examined using two different criteria for each symptom. Frequency was defined using the current ICS definition (i.e. subject's perception of whether they urinated too often during the day) or more than eight daytime voids. Nocturia was defined according to the ICS definition of having to wake once or more per night to void and using the threshold of waking twice or more per night to urinate. Urinary symptom bother within the OAB population was compared using the different criteria for frequency and nocturia. RESULTS: In all, 1434 participants (502 men and 932 women) were classified as having OAB; 31% of men and 25% of women with OAB had daytime frequency consistent with the ICS definition. The ICS-defined frequency identified a population with a varied distribution of reported daytime voiding frequencies; most respondents reported frequencies below the threshold of nine daytime voids. The ICS-defined daytime frequency was reported as bothersome by more than half of the OAB population (46% of men, 66% of women). Of the OAB population, approximately 75% reported one or more nocturia episodes per night, and approximately 40% reported two or more per night. The proportion of the OAB population that was bothered by nocturia increased markedly as the number of nocturia episodes increased. Among those with OAB, the most prevalent combination of OAB symptoms was urgency and nocturia. More than half of those with OAB reported urgency combined with three or more other LUTS (including voiding and postmicturition symptoms), and the number of LUTS reported increased with age. The proportion of the population reporting symptom bother increased as the number of reported LUTS in that population increased. CONCLUSIONS: The ICS definitions for daytime frequency as 'the subject's perception of urinating too often' and for nocturia as 'one or more episodes per night' adequately described bladder symptoms within the OAB population when assessed by the level of symptom bother. Urgency was uncommon in isolation and did not alone impose as high a level of bother as when combined with other LUTS. In this population, the most predominant manifestation of OAB was a combination of urgency with one or more other OAB symptoms. Symptom bother became more common as the number of symptoms reported increased. LUTS other than the defining symptoms of OAB were also highly prevalent within the OAB population.
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