Hidden Condition Research Articles

“Why them, why me, why us?” The experiences of parents of children with lysosomal acid lipase deficiency: an interpretative phenomenological analysis study

BackgroundLysosomal acid lipase deficiency (LALD) is an ultra-rare, inherited metabolic disease within the category of lysosomal storage disorders, affecting an infant’s ability to metabolise cholesterol. Developments in treatment, including Enzyme Replacement Therapy, have proven successful, with some children living for a number of years with treatment, although the future still remains unknown. The aim of this study was to explore the lived experiences of parents of children with LALD.Main textParticipants were recruited from across the United Kingdom between 2020 and 2021. Eight parents (five mothers and three fathers) whose child had a confirmed diagnosis of LALD were interviewed. Data collected from the semi-structured interviews were audio-record, transcribed and analysed using Interpretative Phenomenological Analysis (IPA). Three superordinate and nine subordinate themes emerged from the data: (1) Uncertainty—a double-edged sword (plunged into an uncertain world, living life with worry and walking the tightrope of stability), (2) Powerless against a shared battle with LALD (a helpless parent, a joint battle, protection against distress and a vulnerable parent needing help) and 3) Accepting a life with LALD (coming to terms with a diagnosis of LALD and a hidden condition).ConclusionsThe findings of this study highlight that the diagnosis of LALD proves to be a very challenging and emotionally distressing time in parents’ lives, with increased uncertainty about what the future will hold for their child. This study signified the importance of healthcare pathways and service provisions to support parents and their children throughout diagnosis and beyond.

Compromised interhemispheric transfer of information partially mediates cognitive function deficits in adolescents with fetal alcohol syndrome.

Prenatal alcohol exposure (PAE) has been associated with compromised interhemispheric transfer of tactile stimuli in childhood and structural changes to the corpus callosum (CC). In this study, we used a finger localization task (FLT) to investigate whether interhemispheric transfer deficits persist in adolescence; whether effects of PAE on perceptual reasoning, working memory, and executive function are mediated by deficits in interhemispheric transfer of information; and whether CC size in childhood predicts FLT performance in adolescence. Participants, aged 16 to 17years, were from the Cape Town Longitudinal Cohort, whose mothers were recruited during pregnancy and interviewed regarding their alcohol use using the timeline follow-back method. Diagnoses of fetal alcohol syndrome (FAS) and partial FAS (PFAS) were determined by two expert dysmorphologists; nonsyndromal exposed children were designated as heavily exposed (HE); those born to abstainers or light drinkers, as controls. The FLT was administered to 74 participants (12 FAS, 16 PFAS, 14 HE and 32 controls). CC size at age 9 to 12years was available for 35 participants (7 FAS, 13 PFAS, 5 HE and 10 control). Although the degree of PAE was similar in the FAS, PFAS, and HE groups, only the adolescents with FAS showed more transfer-related errors than controls in conditions in which one finger was stimulated. FLT performance mediated the effects of FAS on perceptual reasoning and executive function. In the subsample for which neuroimaging data from childhood were available, there was an association among adolescents with PAE of smaller CC volumes with more transfer-related errors on the one-finger/hand hidden condition, suggesting that CC damage previously seen in childhood continues to impact function through adolescence. This study provides evidence of compromised interhemispheric transfer of information in adolescents with FAS, while those with PFAS or heavy exposed nonsyndromal individuals are apparently spared. It is the first to show that PAE effects on important aspects of cognitive function are partially mediated by deficits in the interhemispheric transfer of information.

Compensatory Hyperinsulinemia is a Hidden Risk Factor for Type 2 Diabetes: CARDIA 30-year Follow Up

Introduction: Compensatory hyperinsulinemia (CH) is the heightened beta-cell response to early insulin resistance. It maintains glucose, triglycerides, HDL-cholesterol and HbA1c within normal limits. Thus, individuals with CH do not meet the criteria for prediabetes or metabolic syndrome and elude screening for diabetes risk. Hypothesis: CH is an independent risk factor for type 2 diabetes. Methods: We conducted a retrospective analysis of the Coronary Artery Risk Development in Young Adults (CARDIA) study cohort. The parent study enrolled 5,115 participants, ages 18-30 years at baseline, with 30-year follow up. For the retrospective study, the exclusion criteria were hyperglycemia, hypertriglyceridemia, low HDL-cholesterol, pregnancy, not-fasting or diabetes at baseline. Data for 3,507 participants were analyzed using Cox regression models including CH and canonical diabetes risk factors. The top tertile of fasting insulin (9.9 uIU/mL) was the CH cut point. The primary outcome was time-to-incident-diabetes. Effect sizes were hazard ratios (HR) with 95% confidence intervals (CI). Results: In a confounder-adjusted Cox model, CH was associated with incident diabetes: HR 1.79, 95% CI: 1.41, 2.28, p<0.0001. After including an interaction variable between CH and BMI categories, the CH hazard ratios were significant, but markedly different for normal weight (HR 1.45, 95% CI: 1.04, 2.03, p=0.0290) and overweight/obese (HR 2.28, 95% CI: 1.59, 3.26, p<0.0001) participants. This finding was confirmed using models stratified by BMI category. Conclusion: After adjusting for confounders, baseline CH was a diabetes risk factor in apparently healthy CARDIA participants. New screening strategies are needed to identify young adults with this early, hidden condition.

Natural Endotoxemia in Dogs-A Hidden Condition That Can Be Treated with a Potential Probiotic Containing Bacillus subtilis, Bacillus licheniformis and Pediococcus acidilactici: A Study Model.

Simple SummaryDigestive problems are a frequently occurring condition in dogs. Their manifestations can be clinically visible or, in some cases, hidden at the level of the digestive tract. Such a condition is represented by naturally occurring endotoxemia that may, or may not, have a clinical manifestation. However, as it is a little-studied condition in dogs, there are not enough data to diagnose it and its manifestation may be neglected in clinical practice. Probiotics are believed to be an alternative method that can be included in the treatment scheme for gastrointestinal (GI) problems. By their mechanism of action, those formulas may be able to improve or stop the symptoms of different digestive problems and also target the source of the problem. Probiotics can be considered to be host-friendly treatments, with beneficial effects for general health status. As probiotics do not represent aggressive treatments and have few or no side effects, using this type of alternative treatment can increase the animals’ welfare. The aim of the present study was to characterize naturally occurring endotoxemia in dogs and assess the effect of a probiotic formula on this condition. We suggest that this hidden condition can be treated with probiotics as an alternative that is friendlier for animals.Spore-based Bacillus spp. products are considered to have a higher probiotic potential compared to products containing only lactic acid bacteria because their viability in the gastrointestinal (GI) tract is higher, even when GI environmental conditions are unfavorable. The aim of this study was to assess the effect of a Bacillus subtilis, Bacillus licheniformis and Pediococcus acidilactici spore-based potential probiotic on the natural levels of postprandial endotoxemia. A total of 11 dogs completed the study: group 1—healthy dogs: n = 5; group 2—dogs with apparent dysbiosis: n = 6. For 30 days, the dogs were fed the probiotic product; clinical examinations and blood sampling were done before and after completion of the probiotic treatment. Endotoxin levels were assessed pre-meal, 6 h and 12 h post-meal, before initiation and after completion of the treatment. The results showed a decrease in endotoxin levels after treatment, especially 12 h post-meal (group 1: 20.60%; group 2: 44.93%). This study reports new information with regard to natural endotoxemia levels in dogs and suggests that a multi-strain formula (spore-based) consisting of B. subtilis, B. licheniformis and P. acidilactici is able to diminish endotoxin values.

Neurodiversity and Maternity 1. Hidden Barriers to Healthcare Access

Autism is a hidden condition, and the barriers to healthcare access faced by autistic people are similarly hidden. Barriers such as communication differences, differences in pain registry and expression and sensory differences are not just present for autistics with high support needs but can have an impact across the autistic spectrum. Here Joanna Grace introduces a series of three articles focusing on why it is important for practitioners to be aware of the impact of neurodivergence on the experience of care in order for these barriers to be overcome.

Influence of virtual reality visual feedback on the illusion of movement induced by tendon vibration of wrist in healthy participants.

IntroductionIllusion of movement induced by tendon vibration is an effective approach for motor and sensory rehabilitation in case of neurological impairments. The aim of our study was to investigate which modality of visual feedback in Virtual Reality (VR) associated with tendon vibration of the wrist could induce the best illusion of movement.MethodsWe included 30 healthy participants in the experiment. Tendon vibration inducing illusion of movement (wrist extension, 100Hz) was applied on their wrist during 3 VR visual conditions (10 times each): a moving virtual hand corresponding to the movement that the participants could feel during the tendon vibration (Moving condition), a static virtual hand (Static condition), or no virtual hand at all (Hidden condition). After each trial, the participants had to quantify the intensity of the illusory movement on a Likert scale, the subjective degree of extension of their wrist and afterwards they answered a questionnaire.ResultsThere was a significant difference between the 3 visual feedback conditions concerning the Likert scale ranking and the degree of wrist’s extension (p<0.001). The Moving condition induced a higher intensity of illusion of movement and a higher sensation of wrist’s extension than the Hidden condition (p<0.001 and p<0.001 respectively) than that of the Static condition (p<0.001 and p<0.001 respectively). The Hidden condition also induced a higher intensity of illusion of movement and a higher sensation of wrist’s extension than the Static condition (p<0.01 and p<0.01 respectively). The preferred condition to facilitate movement’s illusion was the Moving condition (63.3%).ConclusionsThis study demonstrated the importance of carefully selecting a visual feedback to improve the illusion of movement induced by tendon vibration, and the increase of illusion by adding VR visual cues congruent to the illusion of movement. Further work will consist in testing the same hypothesis with stroke patients.

72 Prevalence of Reported and Unreported Vertebral Fractures in Ctpas in Older Adults Above 75 Years

Abstract Introduction Identifying vertebral fractures is prudent in the diagnosis of osteoporosis as they occur early in this hidden condition. Unfortunately, due to their unspecific presentation, only 25% are clinically recognised. Computerised Tomography Pulmonary Angiogram (CTPA) are frequently requested to confirm pulmonary thromboembolisms, but could also aid in detecting clinically silent vertebral fractures. Current literature suggests that less than one-third of incidental vertebral fractures are reported. The aim of this study is to measure the prevalence of vertebral fractures in CTPA and its relevance to clinical outcomes. Methods This is retrospective observational study based on the analysis of existing CTPA for acutely unwell patients admitted to medical assessment unit or A &amp; E across three acute sites within Aneurin Bevan University Health board, Wales, UK between January and December 2015. All CTPA reports were reviewed for fragility factures and CTPA images were reassessed for any unreported vertebral fractures. Age and gender were recorded for all patients. Analysis was done for all patients in respect to subsequent fragility fractures and mortality. Difference of proportion test was used to compare two groups with and without vertebral fractures. Results 179 CTPA were reviewed, 161 patients were included for further analysis. 14.3% (n=23/161) were reported to have a vertebral fracture, however only 8.7% (n=14/161) of reports used the correct terminology of ‘fracture’. On subsequent review, an additional 24.2% (n=39/161) vertebral fractures were noted. Therefore, overall prevalence of vertebral fractures was 38.5% (n=62/161). Only 9.1% (n=9/99) of patients without a vertebral fracture developed a subsequent fragility fracture. In comparison, 22.5% (n=14/62) of patients with a previous vertebral fracture sustained a new fragility fracture over next 4 years and this was significantly higher (p = 0.017). Overall mortality over 4 years follow-up was significantly higher for patients with vertebral fractures (64.5%, n=40/62) as compared to those without fractures (43.4%, n=43/99, p = 0.009). Only 48.4% (n=30/62) received osteoporosis treatment. Conclusions Vertebral fractures could be underreported by radiologists, likely due to human factors as they might be concentrating on the clinical scenario to exclude a pulmonary embolism. However, considering a significant higher mortality in patients with underlying vertebral fracture, it justifies that radiologists could be asked to examine sagittal view in the bone window for possible underlying vertebral fractures, to ensure osteoporosis is treated to guidance.

Children's use of majority information is influenced by pragmatic inferences and task domain.

Do children always conform to a majority's testimony, or do the pragmatics of that testimony matter? We investigated the influence of pragmatics on conforming to a majority across 2 domains: when learning about object labels and when learning about causal relationships. Four- and 5-year-olds (N = 250) were given a choice between an object endorsed by a 3-person majority, or one endorsed by a single minority informant. Within each domain, there were 4 pragmatic conditions, each with modified testimony so that the majority either explicitly provided an opinion about or pragmatically implied their opinion about the alternative object chosen by the minority. In the unendorsed condition, informants explicitly unendorsed the unchosen object. In the implied condition, informants said nothing about the unchosen object. In the ignorance condition, informants explicitly expressed ignorance about the unchosen object, and in the hidden condition, the chosen object was the only one present at the time of the endorsement. We found that children were most likely to endorse the majority object in the unendorsed condition, in which the majority's opinion was explicitly stated, and least likely in the hidden condition, in which only one object at a time was present, with the other 2 conditions intermediate. Children's preference for majority testimony also depended on the task domain, with a stronger preference for the majority in the language task than causal task. Children might not simply have a majority bias; rather, they use majority information differently depending on the pragmatics and task demands. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

'I was exhausted trying to figure it out': The experiences of females receiving an autism diagnosis in middle to late adulthood.

Females often receive autism spectrum condition diagnoses later than males, leaving needs misunderstood. This study aimed to explore the lived experiences of female adults diagnosed with an autism spectrum condition in middle to late adulthood. Eleven autistic females diagnosed over the age of 40 years completed semi-structured interviews, analysed using Interpretative Phenomenological Analysis. Four superordinate themes emerged: A hidden condition (pretending to be normal and fitting in; mental health and mislabelling), The process of acceptance (initial reactions and search for understanding; re-living life through a new lens), The impact of others post-diagnosis (initial reactions; stereotyped assumptions), and A new identity on the autism spectrum (negotiating relationships, connections and community; changing well-being and views of the self; the meaning of diagnosis). Findings highlight several factors not previously identified that affect late diagnosis in females, including widespread limited understandings of others. Diagnosis was experienced by several participants as facilitating transition from being self-critical to self-compassionate, coupled with an increased sense of agency. Participants experienced a change in identity that enabled greater acceptance and understanding of the self. However, this was painful to adjust to at such a late stage.

Consistency between subjectively and objectively measured hazard perception skills among young male drivers

Young male drivers have lower hazard perception skills (HPS) than older and more experienced drivers and a tendency to overestimate their skills in hazardous situations. Both factors contribute to an over-representation in traffic accidents. Based on a sample of 63 drivers aged 18–24, this study compares the consistency of HPS measured by objective and subjective measures and the link between these measures is the key contribution of the study. Both visible and hidden hazards are included. Objective measures of HPS include responsiveness and eye movements while driving in a driving simulator. Subjective measures of HPS include self-reports derived based on the Hazard Perception Questionnaire (HPQ), Driving Skill Questionnaire (DSQ), and Brief Sensation Seeking Scale (BSSS). Results show that drivers who respond to the hazards on time, as compared to drivers who do not respond, have higher scores on subjective measures of HPS and higher driving skills in the visible but not in the hidden condition. Eye movement analysis confirms the difference and shows that response in time to hazards indicate higher HPS and young drivers are poor at detecting hidden hazards. Drivers with a response in time locate the hazard faster, have more fixations, but dwell less on the hazard. At the same time, those who do not respond have a later first fixation and fewer but longer fixations on the hazard. High sensation seeking drivers respond to visible hazards on time, suggesting that sensation seeking does not affect HPS negatively when the hazard is visible. To enhance the HPS among young drivers, the results of this study suggest that specific hazard perception training is relevant, especially for hazards that require more advanced HPS.

From Mental Illness to Mental Health: Improving Access to Care

From Mental Illness to Mental Health: Improving Access to Care

Abstract 365: Change in Saturation of Oxygen and Patent Foramen Ovale in Postural Orthostatic Tachycardia Syndrome

Background: Postural Orthostatic Tachycardia Syndrome (POTS) is a constellation of signs and symptoms that occurs when the patient stands upright. It affects primarily young women. On the other hand, PFO is a hidden condition that doesn’t cause signs and symptoms in most cases. Method: 331 POTS patients were randomly selected during the period of June 2014 to April 2016 from our clinic and they underwent PFO test. In addition to that, patients underwent tilt test with SPO2 recordings every 2 minutes until 10 minutes to calculate the change in SpO2 of that period of time. Results: Out of 331 patients, 292 patients were females (88%; n=292 age 32.48 ± 10.78), 39 patients were males (12%; n=39 age 28.87 ± 11.69). 136 patients (41%) had no drop in their SPO2 and 17 of 136 patients had positive(+) PFO test (Grade 1 PFO in 4 patients, Grade 2 PFO in 2 patients, Grade 3 PFO in 3 patients and Grade 4 PFO in 8 patients). 77 patients (23%) had a drop of 1% in their SPO2 and 11 of 77 patients had + PFO test (Grade 1 PFO in 3 patients, Grade 2 PFO in 1 patient, Grade 3 PFO in 2 patients and Grade 4 PFO in 5 patients). 46 patients (14%) had a drop of 2% in their SPO2 and 10 of 46 patients had + PFO test (Grade 1 PFO in 2 patients, Grade 3 PFO in 2 patients and Grade 4 PFO in 6 patients). 16 patients (5%) had a drop of 3% in their SPO2 and 3 of 16 patients had + PFO test (Grade 1 PFO in 1 patient, Grade 2 PFO in 1 patient, Grade 3 PFO in 1 patient). 9 patients (3%) had a drop of 4% in their SPO2 and 1 of 9 patients had + PFO test (Grade 2). 5 patients (1.5%) had a drop of 5% in their SPO2 and 2 out of 5 patients had + PFO test (Grade 1 PFO in 1 patient and Grade 4 PFO in 1 patient). 2 patients (0.6%) had a drop of 6% in their SPO2 and both of them had + PFO test (Grade 2 PFO in 1 patient, Grade 4 PFO in 1 patient). 40 patients (12%) had a rise in their SPO2 and 4 of 40 patients had + PFO test (Grade 2 PFO in 2 patients, Grade 3 PFO in 1 patient and Grade 4 PFO 1 patient). Conclusion: Our research results demonstrated that 15% of patients with POTS have PFO. Though orthodeoxia is relatively uncommon, this study demonstrated orthodeoxia in 59% of patients. Only 2% patients showed orthodeoxia of &gt;5%, but further studies should be done to define the clinical significance of the study.

Business engagement in a civil society: Transitioning towards a dementia-friendly visitor economy

Dementia is a growing global health condition primarily, though not exclusively, associated with ageing populations. This paper examines dementia awareness and the perspectives of businesses and organisations in the visitor economy, given that people with the early stages of dementia remain consumers of leisure and tourism experiences. It adopts the concept of the civil society where people are treated in a fair and equitable manner irrespective of their abilities and state of health to promote equality of opportunity. As an exploratory study, it evaluates the awareness, perception and experience of businesses in developing a dementia-friendly visitor economy. It focuses on dementia as a ‘hidden condition’ with a focus on the attractions sector to develop a greater understanding of how to embrace dementia as part of a civil society. The research highlights the implications for the wider visitor economy with dementia set to grow globally in scale and significance.

Fostering empirical examination after proof construction in secondary school geometry

In contrast to existing research that has typically addressed the process from example generation to proof construction, this study aims at enhancing empirical examination after proof construction leading to revision of statements and proofs in secondary school geometry. The term “empirical examination” refers to the use of examples or diagrams to investigate whether a statement is true or a proof is valid. Although empirical examination after proof construction is significant in school mathematics in terms of cultivating students’ critical thinking and achieving authentic mathematical practice, how this activity can be fostered remains unclear. This paper shows the strength of a particular kind of mathematical task, proof problems with diagrams, and teachers’ roles in implementing the tasks, by analysing two classroom-based interventions with students in the eighth and ninth grades. In the interventions, the tasks and the teachers’ actions successfully prompted the students to discover a case rejecting a proof and a case refuting a statement, modify the proof, properly restrict the domain of the statement by disclosing its hidden condition, and invent a more general statement that was true even for the refutation of the original statement.

The Prevalence Of Different Comorbidities Among Patients Reporting To Preanaesthetic Clinic In A Tertiary Care Hospital: A Prospective Observational study

Introduction : The role of anaesthesiologist has changed from providing anaesthesia during surgery to the role of perioperative physician. The aim of preoperative assessment is to identify prevailing comorbidity, assessment of control of pre-existing disease and optimising patient for surgery. In order to provide safe anaesthesia it is of prime importance to identify the presence of disease in preoperative period. Aim : To determine the prevalence of different comorbidities among patients reporting to preanaesthetic clinic (PAC). Result : A total 5124 patients were studied in a period of 6 months. A total of 1724 comorbodities were identified in 1274 patients. Out of these 1374 diseases were identified for the first time in PAC. The most common abnormality detected was ECG changes. Discussion : Identification of pre-existing comorbidities in the preoperative clinic is imperative for optimal management of patient. Knowledge of pre-existing disease will help to formulate screening strategies in the preanaesthetic clinic. Conclusion : The finding of this study demonstrates the importance of a pre anesthetic clinic in detecting hidden co morbid condition in a sizeable patient population.

Sickle cell comes out of the shadows.

A feedback tool aims to shed light on this ‘hidden condition’, reports Jennifer Trueland

The magnitude of placebo analgesia effects depends on how they are conceptualized

ObjectivePlacebo effects are usually calculated as the difference between placebo treatments and no treatments. Recently, placebo-like effects have been investigated using open and hidden administrations of active treatments. The aim of the study was to directly compare the two types of placebo effects and examine how they are influenced by personality traits. MethodsIn a within-subject, randomized, blinded, balanced placebo trial design study with 48 healthy volunteers, we compared placebo and placebo-like effects and tested if expectancy, absorption and suggestibility correlated with these effects. Subjects completed the Tellegen Absorption Scale and the Sensory Suggestibility Scale, and pain was induced by injections of hypertonic saline into the masseter muscle. Participants received four injections of hypertonic saline with lidocaine or matching placebo in randomized order: open treatment, hidden treatment, placebo and control. The placebo effect was defined as the difference in pain between the placebo and the control condition and the placebo-like effect as the difference in pain between the open and hidden condition. ResultsPlacebo effects were significant both in the traditional paradigm: mean placebo effect AUC 1626mm2 (95% CI 958–2293) and the open–hidden paradigm: mean placebo-like effect AUC 801mm2 (95% CI 134–1469), but there was a significant difference between the magnitude of the two effects (p=0.049). Absorption and suggestibility did not predict the placebo or the placebo-like effect. Estimated expected pain relief correlated with placebo effects but not placebo-like effects. ConclusionThe magnitude of placebo effects differs depending on how they are conceptualized and calculated.

The relationship between event-based prospective memory and ongoing task performance in chimpanzees (Pan troglodytes).

Prospective memory is remembering to do something at a future time. A growing body of research supports that prospective memory may exist in nonhuman animals, but the methods used to test nonhuman prospective memory differ from those used with humans. The current work tests prospective memory in chimpanzees using a method that closely approximates a typical human paradigm. In these experiments, the prospective memory cue was embedded within an ongoing task. Tokens representing food items could be used in one of two ways: in a matching task with pictures of items (the ongoing task) or to request a food item hidden in a different location at the beginning of the trial. Chimpanzees had to disengage from the ongoing task in order to use the appropriate token to obtain a higher preference food item. In Experiment 1, chimpanzees effectively matched tokens to pictures, when appropriate, and disengaged from the ongoing task when the token matched the hidden item. In Experiment 2, performance did not differ when the target item was either hidden or visible. This suggested no effect of cognitive load on either the prospective memory task or the ongoing task, but performance was near ceiling, which may have contributed to this outcome. In Experiment 3, we created a more challenging version of the task. More errors on the matching task occurred before the prospective memory had been carried out, and this difference seemed to be limited to the hidden condition. This finding parallels results from human studies and suggests that working memory load and prospective memory may have a similar relationship in nonhuman primates.

Urinary retention

Urinary retention, defined as the inability to void, is a common medical problem. If unidentified and/or untreated, it may become a serious condition that can lead to kidney damage or urosepsis, compromising the patient's life. Acute urinary retention (AUR) is usually easy to identify and to treat as patients usually complain of hypogastric pain and anuria. Proper bladder drainage with urethral or suprapubic catheter is the first line of treatment, with posterior studies to determine the cause of retention. Chronic urinary retention (CUR) is often much more difficult to identify. It is invariably linked to increased post-void residual urine (PVR), but its asymptomatic nature makes it often a hidden condition. There is a wide range of intrinsic and extrinsic, obstructive and non-obstructive causes affecting the lower urinary tract, which can lead to urinary retention. Due to the differences in urinary physiology and in order to simplify diagnosis and management, these are usually studied separately in men and in women. Management consists of a variety of options depending on the cause of retention, including conservative treatment, drug therapy and several forms of surgery. In this review, we make an overview of the main causes of acute and chronic urinary retention in men and women, focusing on the main aspects of diagnosis and management.

Life management and quality of life issues for those with urinary incontinence

The phrase urinary incontinence conjures up many images, none of which can be said to be positive. Incontinence is often a hidden condition, secreted by many and often feared as it can result in a loss of independence and quality of life. However, not all who suffer from incontinence seek treatment, and many who have, have found the results to be less than satisfying and have turned to other non‐clinical resources for support. This study presents insight into the life management and quality of life of those responding to an invitation to participate in a Continence Comprehensive Health and Life Assessment survey. Seventy‐three percent currently do not undergo treatment for bladder problems, and 28% state they have never sought treatment. The respondents report a variety of problems that affect everyday living, and ordinary activities. Although urinary incontinence may affect life activities, this should not be interpreted as a complete lack of bladder management. Of those surveyed, only 29% stated they cannot manage their bladder problems to maintain the activity level they would like.