Urinary incontinence Archive

Research we're watching

A unique diabetes drug shows heart-related benefits in people with diabetes who also have recently worsening heart failure or kidney disease, according to two new studies.

The drug, sotagliflozin (Zynquista), belongs to a class of drugs called SGLT2 inhibitors, which cause the kidneys to release more sugar into the urine. The drug is also an SGLT1 inhibitor, meaning it decreases sugar absorption in the intestines. This dual action lowers high blood sugar, the hallmark of diabetes. In people with kidney disease, sotagliflozin lowered the total number of deaths from cardiovascular disease and hospitalizations and urgent visits for heart failure by about 26% compared with a placebo. In a second study, which included people with recently worsening heart failure, those taking the drug had a 33% decrease in those same heart-related measures compared with a placebo.

Gout, a debilitating form of arthritis, is on the rise compared with rates in prior decades. Obesity is probably a significant factor in this increase. Now, a new study suggests that three-quarters of gout cases in men might be completely avoidable by following certain protective health habits.

Falls rank among the top causes of death and injuries among the elderly, and the risk increases significantly in older people being treated for cancer. Now, investigators are reporting that a newer class of drugs for advanced prostate cancer is associated with a significant increase in fall risk. Called androgen receptor inhibitors, or ARIs, these […]

The pandemic may be making life harder for those in abusive relationships, but help is available.

A woman experiencing abuse at the hands of an intimate partner often feels isolated and alone. But the truth is, she has a lot of company. As many as one in three women in the United States has experienced intimate partner violence (IPV), which is violence involving a current or former spouse, partner, significant other, boyfriend or girlfriend, says Eve M. Valera, an associate professor in psychiatry at Harvard Medical School. This number includes women from all different ages and backgrounds.

Those who experience IPV may be left with lingering health effects, including mental health disorders such as anxiety, depression, or post-traumatic stress disorder. IPV is also linked to a number of physical symptoms and conditions, according to the federal Office on Women's Health, such as digestive problems, migraine headaches, arthritis, asthma, chronic pain, sexual problems, and heart problems. Another area of growing concern for many researchers is the potential for cognitive changes caused by traumatic brain injuries linked to abuse, says Valera.

Research we're watching

Can your current or past menstrual cycle offer clues about your longevity? A study published Oct. 3, 2020, in The BMJ linked irregular or long menstrual cycles (defined as 40 days or more) throughout adolescence and adulthood to a higher risk of early death (before age 70), compared with that seen in women who had normal or short menstrual cycles. The study authors, who used data from nearly 80,000 women who participated in the Nurses' Health Study II, found that the association was stronger for deaths from heart and blood vessel disease and in women who smoked.

Women in the study were, on average, 38 years old and had no history of cardiovascular disease, cancer, or diabetes when the study began. Researchers asked them to recall the regularity and length of their menstrual cycles at various times in their life. The researchers followed the women for 24 years, noting deaths from various causes over time. The association of early death with irregular or long menstrual cycles persisted even after they corrected for other factors, such as lifestyle and family history.

New calculators can estimate the chance your cancer might — or might not — become more aggressive.

Active surveillance is a popular option for men with low-risk prostate cancer, defined as a tumor that is confined to the prostate gland and unlikely to grow or spread. It involves monitoring prostate-specific antigen (PSA) levels in the blood for changes and having regular digital rectal exams to look for abnormal areas on your prostate.

During active surveillance, you have a PSA test and a digital rectal exam every six months and prostate biopsies approximately every other year. If your PSA level rises, your doctor will likely recommend a prostate MRI or an immediate prostate biopsy to see if the cancer has become more aggressive. If so, you and your doctor can decide whether to continue with active surveillance and have another biopsy six months or a year later, or move ahead to treatment, such as radiation, hormonal therapy, or surgery.

Ask the doctor

Q. I read that the death rate from COVID-19 is going down, but that people who recover from the infection still can remain sick for a long time. Is that true?

A. It is true, but we don't yet know how big the problem is: COVID-19 has been with us for only a year, and there hasn't been enough time to know the long-term effects.

In the journals

Many men with prostate cancer who have a radical prostatectomy (prostate removal) receive radiation therapy afterward to wipe out any residual cancer cells. Alternatively, men can choose to delay radiotherapy and be monitored for evidence of prostate cancer activity, such as a rising blood level of prostate-specific antigen (PSA). If PSA testing or an imaging test like an MRI shows cancer, these men can then consider radiation therapy.

According to the findings of an analysis published online Sept. 28, 2020, by The Lancet, there is no clear benefit of immediate radiation over monitoring with later radiation therapy as necessary. Since some men will never need radiotherapy, this means that by forgoing immediate treatment, they can avoid potential side effects like incontinence and bowel problems.