Night-time Frequencies Research Articles

The Efficacy of Compression Stockings on Patients With Nocturia: A Single-Arm Pilot Study

Objectives: Behavioral treatment for nocturia includes wearing compression stockings. However, a reading of the cited literature for evidence shows that there is not enough research data to support this recommendation, and it is controversial. The present study aimed to investigate and supplement evidence on the effects of wearing compression stockings during the daytime in patients with nocturia.Methods: This was a single-arm prospective study to investigate the effects of compression stockings on nocturia for four weeks. Patients were asked to record a frequency-volume chart and complete various questionnaires at baseline and after four weeks, and also provide feedback on treatment satisfaction. The primary endpoint was a change in night-time frequency in the frequency-volume chart from the baseline to the end of treatment.Results: Thirty-four patients (19 men and 15 women; age: 72.3 ± 12.6 years) were included. Two patients dropped out because of pain associated with wearing compression stockings and one due to a refusal to wear compression stockings every day. Therefore 31 patients were analyzed. In the frequency-volume chart, night-time and 24-hour frequencies significantly decreased by 0.5 and 1.1 episodes, respectively (P = 0.004 and P = 0.035, respectively). The hours of undisturbed sleep significantly increased by 0.8 h (P = 0.013). No significant differences were observed in nocturnal or 24-h urine volumes, the number of urgency or urinary incontinence episodes, the mean or maximum voided volume, the nocturnal polyuria index, or the first night-time voided volume. The total overactive bladder symptom score significantly decreased (P = 0.006). Significant reductions were also observed in all overactive bladder symptom score subscores, except for the daytime frequency score.Conclusion: The present results suggest the effectiveness of wearing compression stockings during the day was satisfactory in most patients with nocturia, and the treatment was safely continued in patients who experienced no pain when wearing the stockings. Based on the results of this study, we believe that it is worth considering as a treatment for nocturia.

Use of the International Consultation on Incontinence Questionnaires Bladder Diary in Men Seeking therapy for Lower Urinary Tract Symptoms

BackgroundCompletion rates and correspondence to other measures need to be established for the International Consultation on Incontinence Questionnaire (ICIQ) bladder diary (ICIQ-BD) in the assessment of male lower urinary tract symptoms (LUTS). ObjectiveTo evaluate ICIQ-BD completion rates, frequency, volume, and sensation reporting for men. Design, setting, and participantsBaseline data from the Urodynamics for Prostate Surgery Trial; Randomised Evaluation of Assessment Methods (UPSTREAM) randomised controlled trial evaluating 820 men at 26 UK hospitals, looking at the ICIQ-BD, uroflowmetry, International Prostate Symptom Score, and ICIQ symptom score for male LUTS (ICIQ-MLUTS), were assessed. Outcome measurements and statistical analysisThe ICIQ-BD, IPSS, ICIQ-MLUTS, and uroflowmetry data at baseline obtained from UPSTREAM were assessed. Correlations were analysed by Pearson’s correlation coefficient, and comparison between groups were performed using paired or unpaired t tests or Tukey’s test. All statistical tests were two sided and the strength of evidence was presented using p values. Results and limitationsOf the participants, 25.0% (205/820) provided complete voiding and bedtime information for 3 d, 41.2% (338/820) omitted bedtime information, and the remainder omitted some or all voiding information. Median values (minimum – maximum) of 24-h, daytime, and night-time frequencies were 9.7 (3.3–24.0), 7.7 (3.3–22.7), and 1.7 (0.0–5.7), respectively. The mean voided volume per micturition for day and night times were 175.8 ± 74.2 and 264.4 ± 150.7 ml (p < 0.001), respectively. For fully completed diaries, day- and night-time frequency showed a weak-to-moderate correlation with symptom score questionnaires. More severe nocturia was generally reported in symptom scores than in the ICIQ-BD. In patients with high bother for increased daytime frequency (symptom), the mean daytime frequency (ICIQ-BD) was 9.6 ± 3.2 versus 7.6 ± 2.2 for low bother (p < 0.001). High bother for nocturia showed night-time frequency of 2.3 ± 1.2 versus 1.5 ± 1.1 for low bother (p < 0.001). For fully and partially completed diaries, ICIQ-BD sensation scores correlated weakly with symptom scores. Voided volumes from the bladder diary and uroflowmetry correlated weakly. ConclusionsTwo-thirds of men (543/820) fully completed voiding information in the ICIQ-BD, but many omitted bedtime information, limiting the ability to quantify nocturia and diagnose nocturnal polyuria. Patient summaryMost men with urinary symptoms complete a bladder diary fully but may fail to indicate bedtimes. Extra information from a diary helps support symptom questionnaires to explain a patient’s urinary habits.

Impact of artificial light on night-time singing behaviour of the swifts

In this study, we explored the effect of artificial light on night-time singing behaviour of the swifts in Summer Palace, Beijing, China. In the summer of 2015, we tested the night-time singing frequencies of the swifts under full-spectrum white, 437.5 nm violet, and 622.5 nm orange light at 5 mW/m2, 20 mW/m2, and 50 mW/m2. It revealed that white and orange light significantly increased the average singing frequency, while violet light pronouncedly raised the singing frequency only at 50 mW/m2. The variations in impacting rhythms of the tested light sources leave references for bird-friendly exterior lighting schemes.

Revisiting global satellite observations of stratospheric cirrus clouds

Abstract. As knowledge about the cirrus clouds in the lower stratosphere is limited, reliable long-term measurements are needed to assess their characteristics, radiative impact and important role in upper troposphere and lower stratosphere (UTLS) chemistry. We used 6 years (2006–2012) of Michelson Interferometer for Passive Atmospheric Sounding (MIPAS) measurements to investigate the global and seasonal distribution of stratospheric cirrus clouds and compared the MIPAS results with results derived from the latest version (V4.x) of the Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observations (CALIPSO) data. For the identification of stratospheric cirrus clouds, precise information on both the cloud top height (CTH) and the tropopause height is crucial. Here, we used lapse rate tropopause heights estimated from the ERA-Interim global reanalysis. Considering the uncertainties of the tropopause heights and the vertical sampling grid, we define CTHs more than 0.5 km above the tropopause as stratospheric for CALIPSO data. For MIPAS data, we took into account the coarser vertical sampling grid and the broad field of view so that we considered cirrus CTHs detected more than 0.75 km above the tropopause as stratospheric. Further sensitivity tests were conducted to rule out sampling artefacts in MIPAS data. The global distribution of stratospheric cirrus clouds was derived from night-time measurements because of the higher detection sensitivity of CALIPSO. In both data sets, MIPAS and CALIPSO, the stratospheric cirrus cloud occurrence frequencies are significantly higher in the tropics than in the extra-tropics. Tropical hotspots of stratospheric cirrus clouds associated with deep convection are located over equatorial Africa, South and Southeast Asia, the western Pacific, and South America. Stratospheric cirrus clouds were more often detected in December–February (15 %) than June–August (8 %) in the tropics (±20∘). At northern and southern middle latitudes (40–60∘), MIPAS observed about twice as many stratospheric cirrus clouds (occurrence frequencies of 4 %–5 % for MIPAS rather than about 2 % for CALIPSO). We attribute more frequent observations of stratospheric cirrus clouds with MIPAS to the higher detection sensitivity of the instrument to optically thin clouds. In contrast to the difference between daytime and night-time occurrence frequencies of stratospheric cirrus clouds by a factor of about 2 in zonal means in the tropics (4 % and 10 %, respectively) and at middle latitudes for CALIPSO data, there is little diurnal cycle in MIPAS data, in which the difference of occurrence frequencies in the tropics is about 1 percentage point in zonal mean and about 0.5 percentage point at middle latitudes. The difference between CALIPSO day and night measurements can also be attributed to their differences in detection sensitivity. Future work should focus on better understanding the origin of the stratospheric cirrus clouds and their impact on radiative forcing and climate.

The Best of Both Worlds: An Example Mixed Methods Approach to Understand Men's Preferences for the Treatment of Lower Urinary Tract Symptoms.

Discrete choice experiments (DCEs) are widely used to quantify individuals' preferences for healthcare. Guidelines recommend the design of DCEs should be informed by qualitative research. However, only a few studies go beyond guidelines by fully presenting qualitative and quantitative research jointly together in a mixed methods approach (MMA). Using an example study about men's preferences for medical treatment of lower urinary tract symptoms (LUTS), we demonstrate how qualitative research can complement DCEs to gain a rich understanding of individuals' preferences. We were the first to combine online discussion groups (ODGs) with an online DCE. A thematic analysis of the ODGs and a conceptual map provided insights into men's quality of life (QoL) with LUTS and relevant treatment attitudes. This was used to design the DCE. Men's willingness to pay (WTP) for these attributes was estimated. Findings from ODGs and DCE were compared to understand WTP and preference heterogeneity. Men mostly valued medicine that reduced urgency and night-time frequencies of urination but avoided sexual side effects. We find heterogeneity in the effect of sexual side effects on men's preferences. The ODGs suggest this is because several men may be sexually inactive due to their age, being widowed or having comorbidities. The ODGs also raised concern about men's awareness of LUTS. We argue that the insights gained into men's preferences for treatment and how LUTS affects men's QoL could not have been obtained by either the qualitative research or the DCE alone.

First morning voided volume as a valuable tool for evaluating patients with overactive bladder

ObjectiveThis study aims to assess whether first morning voided volume (FMV) can be used as a tool to evaluate the symptom severity of patients with an overactive bladder (OAB). Materials and methodsWe prospectively recruited patients with OAB symptoms from January 2009 to April 2010. All the patients completed a 3-day frequency–volume chart, including the measure of FMV and the Overactive Bladder Symptom Score (OABSS) questionnaire. All patients underwent either conventional pressure-flow urodynamic study or videourodynamic study. We analyzed the correlation between FMV, urodynamic studies, and symptom severity. ResultsA total of 102 patients, including 43 men and 59 women, were recruited in the study. FMV was significantly correlated to the daily mean voided volume (p < 0.001) and cystometric capacity (p = 0.026). It was also negatively correlated to the subscores for daytime frequency (p = 0.013) and nighttime frequency (p < 0.001) on OABSS. However, no significant correlation was observed between FMV and the total score of OABSS. FMV showed a fair agreement with the maximum voided volume, which can predict small-volume bladders (kappa = 0.42 ± 0.08, p < 0.001), whereas the agreement between cystometric capacity and maximum voided volume was poor (kappa = 0.096 ± 0.05, p = 0.08). ConclusionIn patients with OAB, FMV can represent the severity of day- and nighttime frequencies. FMV was also shown to have a better ability in predicting small-volume bladders compared to the cystometric capacity. The measure of FMV may be helpful for patients who have poor compliance with regard to recording the frequency–volume chart.

Comparison of the Melatonin Receptor Agonist Ramelteon and the Non-Benzodiazepine Hypnotic Zolpidem for Nocturia

To examine the efficacy of the melatonin receptor agonist ramelteon for nocturia, it was compared with zolpidem, a conventional non-benzodiazepine hypnotic. A total of 50 patients with nocturia (32 urinations/night) were enrolled. Subjects assigned odd numbers or even numbers were respectively prescribed 8 mg of ramelteon (n = 27; mean age: 75 years) or 5 mg of zolpidem (n = 23; mean age: 73 years) once a day before sleeping for 4 weeks. The daytime and nighttime frequencies of urination, as well as the results of global self-assessment by the patients, were compared between the two groups before and after 4 weeks of treatment. Both ramelteon and zolpidem caused a significant decrease of nocturia to about once per night after 4 weeks. The global self-assessment rating at 4 weeks was “good” or “fair” for more patients in the zolpidem group than in the ramelteon group, while the rating was “excellent” or “no change” for more patients in the ramelteon group. There were no serious adverse events in either group. Ramelteon was safe and effective for nocturia, achieving similar results to zolpidem. However, responders and non-responders to ramelteon were more clearly distinguished. Ramelteon might be effective for patients with sleep disturbance and nocturia because of low melatonin levels. Therefore, as diagnostic therapy for identification of nocturia caused by sleep disturbance and melatonin deficiency, ramelteon should be administered to patients who do not respond to alpha-1 antagonists and/or anticholinergic agents.

Time and spatial variations of the foF2(night)/foF2(day) values

The ratio of daytime and nighttime values of the foF2 critical frequency is analyzed on the basis of the data of 35 ionospheric stations of the eastern hemisphere and 7 stations of the western hemisphere. The analysis confirms the results of Danilov [Danilov, A.D. Variations in the ratio of nighttime and daytime critical frequencies of the F2 layer. Geomagn. Aeronomy, 47 (6), 551–561 (in Russian) 2007; Danilov, A.D. Time and spatial variations in the ratio of nighttime and daytime critical frequencies of the F2 layer, J. Atmos. Sol-Terr. Phys. 70, 1201–1212, 2008.] that after about 1980, a systematic behavior of this ratio with time is observed: an increase with time (a positive trend) or a decrease with time (a negative trend). The sign of this trend is shown to be governed by the signs of the magnetic declination D and magnetic inclination I at the given ionospheric station. This fact makes it possible to assume that the above indicated trend is caused by long-term variations in the zonal component V ny of the horizontal wind in the thermosphere, the latter component contributing into the vertical drift velocity W.

Time and spatial variations in the ratio of nighttime and daytime critical frequencies of the F2 layer

The ratio of daytime and nighttime values of the foF2 critical frequency is analyzed on the basis of the data of 28 ionospheric stations of the Eastern Hemisphere. It is found that after about 1980, three types of behaviors of this ratio with time are observed: an increase with time (a positive trend), a decrease with time (a negative trend) and the absence of pronounced changes (a zero trend). The sign of this trend is shown to be governed by the signs of the magnetic declination D and magnetic inclination I at the given ionospheric station. This fact makes it possible to assume that the above-indicated trend is caused by long-term variations in the zonal component V ny of the horizontal wind in the thermosphere, the latter component contributing into the vertical drift velocity W. The causes of the systematic changes in the thermospheric circulation regime after 1980 are not yet known.

Time and spatial variations in the ratio of nighttime and daytime critical frequencies of the F 2 layer

The ratio of daytime and nighttime values of the foF2 critical frequency is analyzed on the basis of the data of 28 ionospheric stations in the Eastern Hemisphere. It is found that three types of time variations in this ratio are observed after 1980: an increase with time (a positive trend), a decrease with time (a negative trend), and the absence of pronounced changes (a zero trend). The sign of this trend is shown to be governed by the signs of the magnetic declination D and magnetic inclination I at the given ionospheric station. This fact makes it possible to assume that the above trend is caused by long-term variations in the zonal component V ny of the horizontal wind in the thermosphere, the latter component contributing into the vertical drift velocity W. The causes of the systematic changes in the thermospheric circulation regime after 1980 are still unknown; however, it is quite probable that they are related to anthropogenic changes in the atmosphere.

The Impact of Technical Factors on Outcome of Restorative Proctocolectomy for Familial Adenomatous Polyposis

This study was designed to assess the impact of technical factors on functional outcomes and complications in patients undergoing restorative proctocolectomy for familial adenomatous polyposis. This was a descriptive study on 189 patients undergoing restorative proctocolectomy in a single tertiary referral center between 1977 and 2003. Primary outcomes were major complications, pouch function, and neoplastic transformation in the anal transitional zone. Pouch construction was J-reservoir (60 percent), W-reservoir (34 percent), or S-reservoir (6 percent), with double-stapled (31 percent) or handsewn anastomosis with mucosectomy (69 percent). Overall pouch survival was 96 percent at five years and 89 percent at ten years, with no differences according to pouch design or anastomotic technique. The incidence of pelvic sepsis was unaffected by anastomotic technique (stapled vs. handsewn; 12 vs. 13 percent) or type of reservoir (J- vs. W- vs. S-pouch; 16 vs. 9 vs. 10 percent). Fistula formation was independent of anastomotic technique (stapled vs. handsewn; 8 vs. 8 percent) and type of reservoir (J- vs. W- vs. S-pouch; 9 vs. 7 vs. 0 percent). The night-time and 24-hour bowel frequencies were similar with the two anastomotic techniques and types of reservoirs. The incidence of polyps at the anal transitional zone was lower with handsewn than with stapled anastomosis (19 vs. 38 percent; P=0.047). Restorative proctocolectomy in patients with familial adenomatous polyposis has good functional outcomes and an acceptable rate of complications, which are independent of choice of technique. Handsewn ileoanal anastomosis with mucosectomy seems to reduce the incidence of subsequent neoplasia in the anal transitional zone but does not eliminate the risk of cancer.

Long‐term clinical results and quality of life after insertion of a self‐expanding flexible endourethral prosthesis

To evaluate the safety and efficacy of the Urolume self-expanding flexible endourethral stent, based on a long-term follow-up, and to determine its role amongst the various modalities of treatment available for the relief of bladder outlet obstruction (BOO) arising from benign prostatic hyperplasia (BPH). From January 1991 to April 1992, the Urolume wallstent (American Medical Systems, USA) was placed successfully in each of 62 patients (aged 50-89 years) who had significant subjective and objective evidence of BOO. The stent was placed as a daycase procedure under general anaesthesia. Pre-operatively, each patient was assessed fully in an out-patient clinic by symptoms, a flow rate measurement and a rectal examination. Post-operatively, patients were assessed using transrectal ultrasonography, cystoscopy, symptoms and flow rate measurement, and after 5 years, the International Prostate Symptom Score and satisfaction score were obtained. After 5 years, 27 (39%) patients survived and 10 (14%) died with their Urolume stent intact; 22 (32%) completed the follow-up and five refused or were lost to follow-up. Day and night-time frequencies and flow rates improved continuously. Complete epithelialization occurred in 16 of the 22 patients assessed. Of those in whom the Urolume was removed, 20 are alive and five dead. The effectiveness of the Urolume in improving symptoms and flow rates in patients with BPH was confirmed. However, the high failure rate arose largely from inexperience in selection and deployment. There are no absolute criteria to predict a successful outcome. This study confirms the Urolume as a safe device. Most patients whose symptoms settled in the first year maintained a good flow rate and a significant improvement in symptoms for 5 years; their quality of life at the last follow-up was good.

Night-time ionization in the lower ionosphere—I: Recombination processes

Both height and time variations of the effective recombination coefficient at night for the lower ionosphere are obtained from ionospheric data involving the use of radio waves over a wide range of frequencies. The experimental data used include measurements on ionospheric absorption at 18.3 Mc/s and 150 kc/s; hourly values of the night-time E-region critical frequencies for Watheroo, phase height observation at 16 kc/s, and virtual height measurements at 60 kc/s and 150 kc/s. It is found that although at levels near 80 km the effective recombination coefficient increases appreciably immediately after sunset, at higher levels the coefficient decreases. There are both height and time variations of the coefficient. Theoretical interpretation of these results is based on the idea, recently put forward by Nicolet, that an appreciable number of atomic ions of low ionization potential exist in the lower ionosphere. While the positive molecular ions disappear rapidly through dissociative recombination with electrons, the positive atomic ions disappear very slowly.

Solar tides in the F2 region from the study of night-time critical frequencies

Abstract Night-time critical frequency variations at 25 ionospheric stations are analysed by season and by latitude for semi-diurnal solar tidal terms. The amplitude and phase of the vertical drift velocity of electrons so found are consistent with accepted tidal theory, and an estimate of the height-gradient of the vertical drift is obtained. Two parallel analyses are made, on the alternative assumptions that decay proceeds according to a recombination law or to an attachment law. The low values found for the decay coefficients preclude any decision as to which of these two decay processes is actually operative.