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Elderly and urinary symptoms

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https://www.readbyqxmd.com/read/28546233/a-case-of-confusion-paraneoplastic-encephalomyelitis-in-an-elderly-patient-suspected-of-having-urinary-tract-infection-associated-delirium
#1
Chris McKinnon, Simmie Manchanda
Acute confusion is a common symptom of physical illness in the older patient. In the majority, it is transient and resolves on treatment of precipitants. In a subset of patients, however, neurological decline is progressive, raising concern about a serious underlying cause. We describe the case of a 71-year-old woman who developed progressive cognitive impairment following insertion of a permanent pacemaker for sinoatrial arrests. An initial diagnosis of delirium secondary to a urinary tract infection was suspected; however, the patient became increasingly confused despite treatment...
May 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28542707/-urinary-tract-infection-requiem-for-a-heavyweight
#2
Thomas E Finucane
"Urinary tract infection" ("UTI") is an ambiguous, expansive, overused diagnosis that can lead to marked, harmful antibiotic overtreatment. "Significant bacteriuria," central to most definitions of "UTI," has little significance in identifying individuals who will benefit from treatment. "Urinary symptoms" are similarly uninformative. Neither criterion is well defined. Bacteriuria and symptoms remit and recur spontaneously. Treatment is standard for acute uncomplicated cystitis and common for asymptomatic bacteriuria, but definite benefits are few...
May 19, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28530080/-cataract-surgery-complications-in-males-treated-with-alpha-1-antagonists-for-benign-prostatic-hyperplasia
#3
REVIEW
Tamar Pedut Kloizman, Raneen Shehadeh Mashour
Intraoperative floppy iris syndrome (IFIS) was first described by Chang and Campbell in 2005. The characteristics of this syndrome include: 1. Floppy iris that billows in reaction to intraocular fluid currents during standard phacoemulsification procedure; 2. Flaccid iris stroma that tends to prolapse through well-constructed surgical incisions; 3. Insufficient pupillary mydriasis despite proper pharmacologic preparation and progressive pupillary constriction during the operation. Surgical procedures with IFIS have since been noted to have an exceptionally high rate of complications, some of which can be vision threatening...
September 2016: Harefuah
https://www.readbyqxmd.com/read/28529023/clinical-efficacy-of-transrectal-ultrasound-guided-prostate-biopsy-in-men-younger-than-50-years-old-with-an-elevated-prostate-specific-antigen-concentration-4-0%C3%A2-ng-ml
#4
Chin-Heng Lu, Tzu-Ping Lin, She Huei Shen, Yi-Hsiu Huang, Hsiao-Jen Chung, Junne-Yih Kuo, William J S Huang, Howard H H Wu, Yen-Hwa Chang, Alex T L Lin, Kuang-Kuo Chen
BACKGROUND: Prostate cancer (PCa) is not commonly found in men younger than 50 years of age. However, serum prostate-specific antigen (PSA) concentration has been examined more frequently at a younger age in Asia partially due to an increased awareness of prostate cancer. The purpose of our study was to investigate the efficacy and complication of PSA-triggered transrectal ultrasonography-guided prostate (TRUSP) biopsies. We retrospectively reviewed TRUSP biopsies in young men with elevated PSA concentration in Taipei Veterans General Hospital...
May 18, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/28479770/vitamin-d-deficiency-and-lower-urinary-tract-symptoms-in-males-above-50-years-of-age
#5
Mohamed Abdemonem Elshazly, Mohamed Farag Sultan, Hamdy Abdelmawla Aboutaleb, Shady Mohamed Salem, Mohamed Sayedahmed Aziz, Tarek Mohamed Abd Elbaky, Eid Abdelrasoul Elsherif, Maher Mohamed Gawish, Feras Tarek Alajrawi, Fahd Abdulla Algady Elgadi, Awad Husein Thaher, Mohamed Ahmed Shebl, Adel Mohamed Allam, Elija Kehinde
CONTEXT: Lower urinary tract symptoms (LUTSs) in elderly males are usually related to benign prostatic hyperplasia (BPH) in the majority of cases. It is estimated that BPH affects half of men above the age of 50 years. Recently, a relationship between Vitamin D deficiency and LUTS in elderly males has been reported. AIMS: The aim of this study was to analyze Vitamin D levels in males aged above 50 years presenting with LUTS. SETTINGS AND DESIGN: This is a prospective case-control study...
April 2017: Urology Annals
https://www.readbyqxmd.com/read/28459143/testosterone-deficiency-and-nocturia-a-review
#6
REVIEW
Kazuyoshi Shigehara, Koji Izumi, Atsushi Mizokami, Mikio Namiki
Nocturia causes lack of sleep and excessive daytime somnolence, reducing overall well-being, vitality, productivity, and mental health. Nocturia is significantly associated with testosterone deficiency, lower urinary tract symptoms (LUTS), and sleep disorders. The development of LUTS is commonly associated with testosterone deficiency in elderly men, and recent studies have suggested that testosterone has an ameliorative effect on nocturia. In hypogonadal men with nocturia, a negative feedback cycle can arise, in which testosterone deficiency leads to the development of nocturia, and nocturia contributes to the decline in testosterone levels...
April 2017: World Journal of Men's Health
https://www.readbyqxmd.com/read/28446014/noninvasive-medical-tools-for-evaluating-voiding-pattern-in-real-life
#7
REVIEW
Kwonsoo Chun, Su Jin Kim, Sung Tae Cho
Voiding dysfunction is a common disease that contributes to a lower quality of life and has an increased prevalence in the elderly population. Noninvasive and objective methods such as uroflowmetry (UFM) and voiding diaries (VDs) are essential for exact diagnosis and effective treatment of this condition because patients with different causes of voiding dysfunction can complain of the same lower urinary tract symptoms. Further, different treatment options can be determined based on the diagnosis made from these symptoms...
April 2017: International Neurourology Journal
https://www.readbyqxmd.com/read/28446010/development-of-decision-support-formulas-for-the-prediction-of-bladder-outlet-obstruction-and-prostatic-surgery-in-patients-with-lower-urinary-tract-symptom-benign-prostatic-hyperplasia-part-i-development-of-the-formula-and-its-internal-validation
#8
Min Soo Choo, Changwon Yoo, Sung Yong Cho, Seong Jin Jeong, Chang Wook Jeong, Ja Hyeon Ku, Seung-June Oh
PURPOSE: As the elderly population increases, a growing number of patients have lower urinary tract symptom (LUTS)/benign prostatic hyperplasia (BPH). The aim of this study was to develop decision support formulas and nomograms for the prediction of bladder outlet obstruction (BOO) and for BOO-related surgical decision-making, and to validate them in patients with LUTS/BPH. METHODS: Patient with LUTS/BPH between October 2004 and May 2014 were enrolled as a development cohort...
April 2017: International Neurourology Journal
https://www.readbyqxmd.com/read/28428671/correlation-of-subjective-symptoms-in-patients-with-benign-prostatic-hyperplasia-and-erectile-dysfunction
#9
Amel Kardasevic, Snjezana Milicevic
INTRODUCTION: Epidemiological studies suggest a link between the symptoms of lower urinary tract (LUTS) caused by benign prostatic hyperplasia (BPH) and erectile dysfunction (ED). Increasing expected period of life, justify the interest of establishing correlations LUTS / BPH and ED in order to find more efficient ways of treating these pathologies. GOAL: The objective was to evaluate the correlation of symptoms in LUTS/BPH with the degree of ED. PATIENTS AND METHODS: The study was conducted as a prospective study which involved males aged 40-60 yr with present symptoms of LUTS/BPH...
February 2017: Medical Archives
https://www.readbyqxmd.com/read/28413383/prostate-cancer-how-young-is-too-young
#10
Sahil Gupta, Arjun Gupta, Ashish K Saini, Kaustav Majumder, Kalpana Sinha, Anurag Chahal
Prostate cancer is the most common non-cutaneous malignancy in men. It is generally considered a cancer of the elderly, and the median age of presentation is 68 years. However 10% of new diagnoses in the USA occur in men aged ≤ 55 years. This may be due to more prevalent screening nowadays, and may also reflect the diagnosis of an increasingly recognized but underappreciated entity, i.e. early-onset prostate cancer. Patients with early onset prostate cancer pose unique challenges. Current data suggest that early-onset prostate cancer is a distinct phenotype-from both an etiological and clinical perspective- that deserves further attention...
January 2017: Current Urology
https://www.readbyqxmd.com/read/28401955/incontinence-in-the-elderly-normal-ageing-or-unaddressed-pathology
#11
REVIEW
William Gibson, Adrian Wagg
The prevalence of urinary incontinence and other lower urinary tract symptoms (LUTS) increases in association with increasing age. This effect is more noticeable in men after the seventh decade of life and, in women, postmenopausally. However, the changes in the lower urinary tract, peripheral nervous system and central nervous system that underpin this observation are both multifactorial and inadequately understood; much debate exists regarding whether these observed changes are pathological or are a part of the 'normal' ageing process; with both health professionals and older people often holding the view that incontinence is an expected part of normal ageing...
April 11, 2017: Nature Reviews. Urology
https://www.readbyqxmd.com/read/28378111/validation-of-overactive-bladder-questionnaire-1-week-recall-version-in-medically-complex-elderly-patients-with-overactive-bladder
#12
Alexandra I Barsdorf, Martin Carlsson, Andrew G Bushmakin, Sheila Quinn, Joseph C Cappelleri, Andreas Pleil
INTRODUCTION: The 33-item Overactive Bladder questionnaire (OAB-q; 1-week recall version) has been psychometrically validated in middle-aged, generally healthy patients with overactive bladder. The present analysis was conducted to determine the psychometric validity of the OAB-q in medically complex elderly patients. METHODS: OAB-q structure was evaluated using a second-order confirmatory factor analysis (CFA) model with five domains and one aggregated domain, using pooled data from two clinical trials (786 observations) for urgency urinary incontinence (UUI)...
April 4, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28376105/video-urodynamic-characteristics-of-non-neurogenic-idiopathic-underactive-bladder-in-men-a-comparison-of-men-with-normal-tracing-and-bladder-outlet-obstruction
#13
Yuan-Hong Jiang, Hann-Chorng Kuo
OBJECTIVE: Underactive bladder is frequently encountered in elderly patients. It may result from detrusor underactivity (DU) or low detrusor contractility due to a urethral sphincter inhibitory effect. This study analyzed the video-urodynamic study (VUDS) characteristics of patients with underactive bladder in a large cohort of men with lower urinary tract symptoms (LUTS). METHODS: Male patients with LUTS who had failed the initial treatment were consecutively enrolled...
2017: PloS One
https://www.readbyqxmd.com/read/28359848/traditional-chinese-medicine-therapy-reduces-the-catheter-indwelling-risk-in-dementia-patients-with-difficult-voiding-symptoms
#14
Shun-Ku Lin, Po-Hung Lin, Ren-Jun Hsu, Heng-Chang Chuang, Jui-Ming Liu
ETHNOPHARMACOLOGICAL RELEVANCE: Dementia is an international health issue in elder people. Indwelling catheters to address voiding problems in patients with dementia introduce risks of urinary tract infection or urethral trauma. Traditional Chinese medicine (TCM) is widely used to treat difficult voiding symptoms in Taiwan. We investigated the long-term clinical effects of TCM for reducing the risk of indwelling catheterization in dementia patients with difficult voiding symptoms. MATERIALS AND METHODS: We used National Health Insurance Research Database to conduct a retrospective study of dementia patients with difficult voiding symptoms between 1997 and 2012 in Taiwan...
May 5, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/28180932/-management-of-urinary-incontinence-in-a%C3%A2-geriatric-rehabilitation-department-global-urinary-incontinence-assessment-incorporating-the-international-consultation-on-incontinence-questionnare-urinary-incontinence-short-form-iciq-ui-sf
#15
Sigrid Ege
Although it is generally agree that older people have a high prevalence of urinary incontinence with a significant influence on health and quality of life, there is no standardized generally accepted assessment. The pathophysiology of urinary incontinence in frail elderly people requires a broad medical and functional scope to address the multifactorial nature of urinary incontinence, especially to identify treatable, potentially reversible conditions. To incorporate the multiple aspects into the daily routine, we developed a global urinary incontinence assessment at the Clinic for Geriatric Rehabilitation of the Robert Bosch Hospital including the validated International Consultation on Incontinence Questionnare - Urinary Incontinence Short Form (ICIQ-UI SF), a symptom score and results of a comprehensive geriatric assessment for mobility and cognition...
February 8, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28147376/solifenacin-in-the-elderly-results-of-an-observational-study-measuring-efficacy-tolerability-and-cognitive-effects
#16
Christian Hampel, Dietmar Betz, Maximilian Burger, Christoph Nowak, Monika Vogel
INTRODUCTION: The study aimed to evaluate the efficacy and safety of solifenacin in older patients with overactive bladder (OAB). MATERIALS AND METHODS: Observational data on patients aged ≥70 years and the prescribed flexible dose of solifenacin for OAB were collected at 294 offices of German general practitioners. Baseline and week 12 data included type and severity of OAB symptoms, adverse events, quality of life, and change in cognitive function per Mini Mental State Examination (MMSE)...
2017: Urologia Internationalis
https://www.readbyqxmd.com/read/28145214/-faecolithiasis-straightforward-to-detect-but-often-missed
#17
B Katerberg, F Ter Borg
Faecal impaction is a problem which is becoming more prevalent now that the number of elderly patients is increasing. When not detected and treated inadequately, it can lead to symptoms such as diarrhoea, faecal incontinence and other serious problems like anorexia, vomiting and rectal ulcers with bleeding or even a bowel perforation. We describe two patients with serious and less common complications of faecolithiasis. Patient A, a 79-year-old woman with signs of dementia, presented with faecal incontinence and unexplained worsening of her cognitive symptoms leading to a situation where she could no longer live in her own home...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28053897/effects-of-a-supplement-combining-pycnogenol-%C3%A2-and-l-arginine-aspartate-on-lower-urinary-dysfunction-compared-with-saw-palmetto-extract
#18
Hiroshi Yagi, Ryo Sato, Kojiro Nishio, Gaku Arai, Shigehiro Soh, Hiroshi Okada
OBJECTIVES: Lower urinary tract symptoms (LUTS) and sexual dysfunction (SDys) are common problems that affect quality of life (QOL) in elderly men. In addition to prescribed drugs, many over-the-counter medications including supplements are used to treat QOL diseases. Phosphodiesterase inhibitors are reported to be effective for both LUTS and SDys by increasing nitric oxide levels. French maritime pine bark extract Pycnogenol(®), which is a potent nitric oxide donor, is reported to be effective for SDys...
January 2017: Journal of Traditional and Complementary Medicine
https://www.readbyqxmd.com/read/28051247/supplementation-with-high-titer-cranberry-extract-anthocran%C3%A2-for-the-prevention-of-recurrent-urinary-tract-infections-in-elderly-men-suffering-from-moderate-prostatic-hyperplasia-a-pilot-study
#19
A Ledda, G Belcaro, M Dugall, B Feragalli, A Riva, S Togni, L Giacomelli
OBJECTIVE: Recently, cranberry extracts have been tested as a nutritional supplementation in the prevention of lower urinary tract symptoms (LUTS) as well as recurrent urinary tract infections (UTIs) in subjects at risk, with mixed results. However, evidence of efficacy should be considered only for well-characterized and standardized products in a more selected study population. Moreover, the efficacy of these interventions in elderly must be further investigated. The aim of this pilot, registry study was to evaluate the prophylactic effects of an oral supplementation containing a highly concentrated and standardized cranberry extract reproducing the natural total profile of cranberry fruits, in elderly men with benign prostatic hyperplasia (BPH), suffering from recurrent UTIs, over a 2-months follow-up...
December 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28010989/mesh-graft-or-standard-repair-for-women-having-primary-transvaginal-anterior-or-posterior-compartment-prolapse-surgery-two-parallel-group-multicentre-randomised-controlled-trials-prospect
#20
Cathryn Ma Glazener, Suzanne Breeman, Andrew Elders, Christine Hemming, Kevin G Cooper, Robert M Freeman, Anthony Rb Smith, Fiona Reid, Suzanne Hagen, Isobel Montgomery, Mary Kilonzo, Dwayne Boyers, Alison McDonald, Gladys McPherson, Graeme MacLennan, John Norrie
BACKGROUND: The use of transvaginal mesh and biological graft material in prolapse surgery is controversial and has led to a number of enquiries into their safety and efficacy. Existing trials of these augmentations are individually too small to be conclusive. We aimed to compare the outcomes of prolapse repair involving either synthetic mesh inlays or biological grafts against standard repair in women. METHODS: We did two pragmatic, parallel-group, multicentre, randomised controlled trials for our study (PROSPECT [PROlapse Surgery: Pragmatic Evaluation and randomised Controlled Trials]) in 35 centres (a mix of secondary and tertiary referral hospitals) in the UK...
January 28, 2017: Lancet
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