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The objective of this subset analysis was to evaluate and compare the efficacy and tolerability of two combination treatments for men with moderate-to-severe lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH). Data were from a real-world, open-label, prospective, and multicenter study performed in outpatient urology clinics. Men with moderate-to-severe LUTS/BPH received 6-month treatment with tamsulosin (TAM) in combination with either the hexanic extract of S. repens (HESr) or a 5-alpha-reductase inhibitor (5ARI). Changes in urinary symptoms and quality of life were measured using the IPSS and BII questionnaires, respectively. Treatment tolerability was assessed by recording adverse effects (AEs). Patients in the two study groups were matched using iterative and propensity score matching approaches. After iterative matching, data were available from 136 patients (n = 68 treated with TAM + 5ARI, n = 68 with TAM + HESr). After 6 months of treatment, mean (SD) IPSS total score improved by 7.7 (6.3) and 6.7 (5.0) points in the TAM + 5ARI and TAM + HESr groups, respectively (p = 0.272); mean BII total scores improved by 3.1 (2.9) and 2.9 (2.4) points (p = 0.751), respectively. AEs were reported by 26.5% and 10.3% of patients in the same groups, mostly affecting sexual function (p < 0.027). When used in a real-world setting to treat patients with moderate-severe LUTS/BPH, 6-month treatment with TAM + HESr was as effective as TAM + 5ARI, but with better tolerability.

Background: There is no conclusive evidence about the association between physical fitness (PF) and health related quality of life (HRQOL) in older adults. Aim: To seek for an association between PF and HRQOL in non-disabled community-dwelling Chilean older adults. Material and Methods: One hundred and sixteen subjects participated in the study. PF was assessed using the Senior Fitness Test (SFT) and hand grip strength (HGS). HRQOL was assessed using eight dimensions provided by the SF-12v2 questionnaire. Binary multivariate logistic regression models were carried out considering the potential influence of confounder variables. Results: Non-adjusted models, indicated that subjects with better performance in arm curl test (ACT) were more likely to score higher on vitality dimension (OR > 1) and those with higher HGS were more likely to score higher on physical functioning, bodily pain, vitality and mental health (OR > 1). The adjusted models consistently showed that ACT and HGS predicted a favorable perception of vitality and mental health dimensions respectively (OR > 1). Conclusions: HGS and ACT have a predictive value for certain dimensions of HRQOL., Trabajo financiado por el Fondo Nacional de Investigación en Salud (FONIS), código de proyecto SA12I2229.

Objetivos: Conocer el porcentaje de pacientes con vejiga hiperactiva (VH) que acuden a consultas de urología o ginecología y que presentan patologías asociadas que complican su condición clínica. Métodos: Estudio epidemiológico, de corte transversal, multicéntrico, en práctica clínica habitual en el que se incluyeron a 1.659 pacientes con VH, en consultas de urología o ginecología. Se recogieron datos demográficos, antropométricos, presencia de trastornos crónicos (hipertensión, diabetes, accidentes cerebro-vasculares, cardiopatía isquémica, enfermedades respiratorias, deterioro cognitivo, catarata o glaucoma, disminución de la movilidad y estreñimiento), presencia de patologías asociadas (caídas, infecciones del tracto urinario inferior, infecciones de la piel en el área genital, depresión, disfunción sexual y trastornos del sueño), presencia de síntomas de incontinencia urinaria y su impacto en la vida según puntuación del ICIQ-UI SF. Resultados: La edad media (D.E.) de la muestra estudiada fue 59,2 (12,9) años y el 73,6% eran mujeres. La mayoría vivían en el ámbito urbano (67,3%), tenían estudios primarios o no tenían estudios (56,8%) y tenían trabajo activo o eran amas de casa (66,2%). Las patologías asociadas a la VH más frecuentes fueron las infecciones en la piel del área genital, las infecciones del tracto urinario inferior y los trastornos del sueño. En los varones es más frecuente la disfunción sexual; y en las mujeres, las infecciones urinarias y de la piel del área genital y la depresión. El impacto en el paciente de estos trastornos, se evidencia por la mayor puntuación en el cuestionario ICIQ-UI SF de los pacientes que los padecen, respecto a los que no. Conclusiones: La presencia de patologías asociadas en pacientes con VH, es frecuente tanto en varones como en mujeres y se asocia a mayor impacto en la vida del paciente. Parece relevante prestar atención a su detección en la historia clínica del paciente que consulta por síntomas de VH y/o incontinencia urinaria. Objectives: To estimate the percentage of patients with Overactive Bladder (OB) attending urology or gynaecology outpatient clinics who show associated diseases which complicate their clinical state and quality of life. Methods: This is an epidemiologic, cross-sectional and multi-centre real world trial. 1,659 patients with OB were studied in urology or gynaecology outpatient clinics. Demographic data, anthropometric data, presence of chronic diseases (hypertension, diabetes, cerebrovascular disease, ischemic cardiopathy, chronic obstructive pulmonary disease, cognitive damaged, cataract, movement disability and constipation), presence of associated diseases (falls, lower urinary tract infections, genital skin infections, depression, sexual dysfunction and sleep disorders), presence of urinary incontinence symptoms and impact on quality of life according to ICIQ-UI SF score. Results: Mean age (S.D) of studied sample was 59.2 (12.9) years and 73.6% were female. Most patients lived in urban settings (67.3%), had primary studies or less (56.8%) and had active work or at home work (66.2%). Most frequent diseases associated to OB were genital skin infections, lower urinary tract infections and sleep disorders. Sexual dysfunction was more frequent in males than in females; lower urinary tract infections, genital skin infections and depression were more frequent in females than in males. Patients with these diseases showed higher ICIQ-UI SF scores than patients without them, indicating higher impact. Conclusions: Presence of associated diseases in patients with OB is frequent in males and females and it is associated to higher impact in patients' life. It seems relevant to pay attention in detecting them through the medical history of patients consulting about OB or urinary incontinence symptoms.

We investigated changes in symptoms and quality of life (QoL) in men with moderate-to-severe lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH) receiving the hexanic extract of Serenoa repens (HESr) and compared results with a matched group on watchful waiting (WW). Data was from a real-world, open-label, prospective, multicenter study. This sub-group analysis included patients with moderate-to-severe symptoms receiving either the HESr 320 mg/daily for six months (HESr) or who remained untreated for LUTS/BPH (WW). Changes in urinary symptoms and QoL were measured by IPSS and BII questionnaires. Two statistical approaches (iterative matching and propensity score pairing) were used to maximize between-group comparability at baseline. Tolerability was assessed in the HESr group. After iterative matching, data for analysis was available for 783 patients (102 WW, 681 HESr). IPSS scores improved by a mean (SD) of 3.8 (4.4) points in the HESr group and by 2.2 (4.5) points in the WW group (p = 0.002). Changes in BII score were 1.8 (2.4) points and 1.0 (2.2) points, respectively (p < 0.001). Three patients (0.9%) treated with the HESr reported mild adverse effects. Moderate-severe LUTS/BPH patients treated for six months with the HESr showed greater improvements in symptoms and QoL than matched patients on WW, with a very low rate of adverse effects.

En esta tesis doctoral se analizaron en primer lugar las propiedades psicométricas de la versión española del cuestionario de calidad de vida específico de sarcopenia (SarQoL®) en adultos ≥65 años, que mostró una buena consistencia interna, fiabilidad test-retest, validez concurrente y divergente, y capacidad discriminativa entre participantes con y sin sarcopenia. Posteriormente, se estudió la sarcopenia y obesidad en adultos mayores y su asociación con la calidad de vida relacionada con la salud (CVRS), duración y calidad del sueño, ansiedad y depresión, mostrando las siguientes asociaciones independientes: i) Menor fuerza muscular y velocidad de la marcha y mayor obesidad general se relacionaron con peor CVRS. ii) Mayores síntomas depresivos con sarcopenia, y peor calidad del sueño con mayor obesidad general (también con menor duración del sueño) y abdominal. iii) Peor calidad del sueño con menor velocidad de la marcha y mayor ansiedad con menor masa muscular. In this doctoral thesis the psychometric properties of the Spanish version of the sarcopenia specific quality of life questionnaire (SarQoL®) were firstly performed in ≥ 65 years old adults, showing good internal consistency, test-retest reliability, concurrent validity and divergent, and been able to discriminate between participants with and without sarcopenia. Secondly, sarcopenia and obesity and their association with health-related quality of life (HRQOL), sleep quality and duration, and the level of anxiety and depression, showing the following independent associations: i) Lower muscle strength and gait speed were related to worse HRQOL. ii) Greater depressive symptoms were associated with sarcopenia and worse sleep quality were linked to greater general (together with lower sleep duration) and abdominal obesity. iii) worse sleep quality and higher levels of anxiety were associated with lower gait speed and decreased muscle mass respectively. Tesis Univ. Jaén. Departamento de Ciencias de la Salud. Leída el 5 de marzo de 2020.