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https://www.readbyqxmd.com/read/28653467/improving-management-of-urinary-tract-infections-in-older-adults-a-paradigm-shift-or-therapeutic-nihilism
#1
EDITORIAL
Christopher J Crnich, Robin L Jump, David A Nace
No abstract text is available yet for this article.
June 27, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28649851/avoidance-of-urinary-catheterization-to-minimize-in-hospital-complications-after-transcatheter-aortic-valve-implantation-an-observational-study
#2
Sandra B Lauck, Jae-Yung Kwon, David A Wood, Jennifer Baumbusch, Tone M Norekvål, Nay Htun, Leo Stephenson, John G Webb
BACKGROUND: Contemporary transcatheter aortic valve implantation (TAVI) devices and approach present opportunities to review historical practices initially informed by early treatment development and cardiac surgery. The avoidance of urinary catheterization in the older TAVI population is a strategy to minimize in-hospital complications. The purpose of the study was to explore elimination-related complications following the phased implementation of a default strategy of avoiding urinary catheterization in patients undergoing transfemoral (TF) TAVI...
June 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28648651/the-impact-of-functional-status-on-the-outcomes-of-endovascular-lower-extremity-revascularization-for-critical-limb-ischemia-in-the-elderly
#3
Isidore Dinga Madou, Martin D Slade, Kristine C Orion, Timur Sarac, Cassius Iyad Ochoa Chaar
INTRODUCTION: Functional status is an important predictor of outcomes after infrainguinal bypass surgery. There is little data on the effect of functional status on the outcomes of endovascular LE interventions, especially in the elderly frail population. METHODS: This is a retrospective analysis of the American College of Surgeons - National Surgical Quality Improvement Program (ACS-NSQIP) files for the years 2011-2013 to assess the impact of functional status on outcome after endovascular intervention for critical limb ischemia...
June 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28647723/a-retrospective-cohort-study-of-high-impact-users-among-patients-with-cerebrovascular-conditions
#4
Ahsan Rao, Alice Jones, Alex Bottle, Ara Darzi, Paul Aylin
OBJECTIVE: To apply group-based trajectory modelling (GBTM) to the hospital administrative data to evaluate, model and visualise trends and changes in the frequency of long-term hospital care use of the subgroups of patients with cerebrovascular conditions. DESIGN: A retrospective cohort study of patients with cerebrovascular conditions. SETTINGS: Secondary care of all patients with cerebrovascular conditions admitted to English National Hospital Service hospitals...
June 24, 2017: BMJ Open
https://www.readbyqxmd.com/read/28647562/post-operative-complications-of-spina-bifida-patients-undergoing-urological-laparotomy-a-multi-institutional-analysis
#5
Christopher J Loftus, David C Moore, Joshua A Cohn, Douglas F Milam, Roger R Dmochowski, Dan Wood, Melissa R Kaufman, Hadley M Wood
OBJECTIVE: To characterize peri-operative morbidity and mortality of adult spina bifida patients undergoing laparotomy. METHODS: We retrospectively studied the post-operative complications of 59 operations of spina bifida patients undergoing abdominal laparotomies for urological indications at three institutions. We evaluated post-operative complications using the Clavien-Dindo classification scale. RESULTS: The overall complication rate was 91...
June 21, 2017: Urology
https://www.readbyqxmd.com/read/28641715/urinary-tract-infections-due-to-nontyphoidal-salmonella
#6
Yuri Gorelik, Mical Paul, Yuval Geffen, Mogher Khamaisi
BACKGROUND: We sought to establish the characteristics of symptomatic nontyphoidal Salmonella (NTS) urinary tract infection (UTI) without concomitant gastroenteritis (GE) as a separate clinical entity. MATERIALS AND METHODS: We conducted a retrospective cohort single-center study and reviewed all cases of NTS bacteriuria between 1995 and 2016. Patients were assigned to a group according to their clinical presentation, namely, symptomatic NTS UTI without GE, GE with NTS bacteriuria or isolated asymptomatic NTS bacteriuria...
June 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28631830/overactive-bladder-symptoms-after-midurethral-sling-surgery-in-women-risk-factors-and-management
#7
Tom Marcelissen, Philip Van Kerrebroeck
INTRODUCTION: Overactive bladder syndrome (OAB) including urgency and urgency urinary incontinence (UUI) occurs frequently after stress urinary incontinence (SUI) surgery. It is important to identify the risk factors for the occurrence of OAB symptoms in order to adequately inform the patient before surgery. Furthermore, when facing OAB after sling surgery it is crucial to know how to manage these symptoms. METHODS: We conducted a literature review in order to assess the risk factors and management of OAB symptoms after SUI surgery...
June 20, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28631577/the-impact-of-opioid-medications-on-subsequent-fractures-in-discharged-emergency-department-patients-with-peripheral-vertigo
#8
Keerat Grewal, Peter C Austin, Moira K Kapral, Hong Lu, Clare L Atzema
BACKGROUND: Vertigo is common in the emergency department (ED). Most aetiologies are peripheral and do not require hospitalization, but many patients still fear falling. Some patients may be taking opioid analgesic medications (for other reasons); the risk of falls leading to fractures among patients with vertigo could be potentiated by the simultaneous use of opioids. OBJECTIVES: To examine the risk of fractures in discharged ED patients with peripheral vertigo who were being prescribed opioids during the same time period...
June 20, 2017: CJEM
https://www.readbyqxmd.com/read/28631216/safety-and-tolerability-of-empagliflozin-in-patients-with-type-2-diabetes-pooled-analysis-of-phase-i-iii-clinical-trials
#9
Sven Kohler, Cordula Zeller, Hristo Iliev, Stefan Kaspers
INTRODUCTION: We characterized the safety and tolerability of empagliflozin in patients with type 2 diabetes (T2DM) randomized 1:1:1 to placebo, empagliflozin 10 mg, or empagliflozin 25 mg in clinical trials. METHODS: Pooled data were analyzed from patients with T2DM treated with placebo (N = 4203), empagliflozin 10 mg (N = 4221), or empagliflozin 25 mg (N = 4196) in 15 randomized phase I-III trials plus four extension studies. Adverse events (AEs) were assessed descriptively in participants who took at least one dose of study drug...
June 19, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28624753/treatment-of-asymptomatic-uti-in-older-delirious-medical-in-patients-a-prospective-cohort-study
#10
Monidipa Dasgupta, Chris Brymer, Sameer Elsayed
BACKGROUND: Despite clinical practice guidelines, asymptomatic bacteriuria (ASB) in older people is frequently treated. A common reason for treating ASB is a change in mental status. OBJECTIVE: To determine how often asymptomatic UTI is treated in older medically ill delirious individuals and its association with functional recovery. METHODS: Consecutive older medical in-patients were screened for delirium, and followed in hospital. Treatment for asymptomatic UTI was defined as documented treatment for a possible urinary tract infection with antibiotics, without concurrent infectious or urinary symptoms...
May 31, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28595971/bladder-debris-on-renal-and-bladder-ultrasound-a-significant-predictor-of-positive-urine-culture
#11
Joseph W McQuaid, Michael P Kurtz, Tanya Logvinenko, Caleb P Nelson
BACKGROUND: Renal and bladder ultrasound (RBUS) is recommended in evaluation of children after an initial, febrile urinary tract infection. Although it is not uncommon to observe debris within the bladder lumen on sonography, the significance of this finding is uncertain. Debris may be interpreted as an indication of ongoing infection, but there have been no studies to date investigating the association of bladder debris with a positive culture. OBJECTIVE: The aim of this study was to evaluate the association of bladder debris noted at the time of RBUS with positive urine culture results obtained from a catheterized specimen, among patients undergoing RBUS and voiding cystourethrogram (VCUG) on the same day...
May 26, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28594717/long-term-risk-of-urinary-adverse-events-in-curatively-treated-patients-with-rectal-cancer-a-population-based-analysis
#12
Mary R Kwaan, Yunhua Fan, Stephanie Jarosek, Sean P Elliott
BACKGROUND: Treatment modalities for rectal cancer, including radiation, are associated with urinary adverse effects. OBJECTIVE: The purpose of this study was to determine the influence of surgery and radiation therapy for rectal cancer on long-term urinary complications. DESIGN: Using the Surveillance Epidemiology and End Results-Medicare data set from the United States, patients with rectal cancer older than 66 years of age who underwent rectal resection between 1992 and 2007 were stratified into treatment groups that accounted for surgical resection and the timing of radiation therapy, if used...
July 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28562167/previously-identified-common-post-injury-adverse-events-in-traumatic-spinal-cord-injury-validation-of-existing-literature-and-relation-to-selected-potentially-modifiable-comorbidities-a-prospective-canadian-cohort-study
#13
Travis E Marion, Carly S Rivers, Dilnur Kurban, Christiana L Cheng, Nader Fallah, Juliet Batke, Marcel F Dvorak, Charles G Fisher, Brian K Kwon, Vanessa K Noonan, John Street
Adverse events (AEs) are common during care in patients with traumatic spinal cord injury (tSCI). Increased risk of AEs is linked to patient factors including pre--existing comorbidities. Our aim was to examine the relationships between patient factors and common post--injury AEs, and identify potentially modifiable comorbidities. Adults with tSCI admitted at a Level I acute specialized spine centre between 2006--2014 who were included in the Rick Hansen SCI Registry (RHSCIR) and had AE data collected using the Spine Adverse Events Severity (SAVES) system were included...
May 31, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28561794/antibiotic-resistance-and-virulence-phenotypes-of-recent-bacterial-strains-isolated-from-urinary-tract-infections-in-elderly-patients-with-prostatic-disease
#14
Cristina Delcaru, Paulina Podgoreanu, Ionela Alexandru, Nela Popescu, Luminiţa Măruţescu, Coralia Bleotu, George Dan Mogoşanu, Mariana Carmen Chifiriuc, Marinela Gluck, Veronica Lazăr
Acute bacterial prostatitis is one of the frequent complications of urinary tract infection (UTI). From the approximately 10% of men having prostatitis, 7% experience a bacterial prostatitis. The purpose of this study was to investigate the prevalence of uropathogens associated with UTIs in older patients with benign prostatic hyperplasia and to assess their susceptibility to commonly prescribed antibiotics as well as the relationships between microbial virulence and resistance features. Uropathogenic Escherichia coli was found to be the most frequent bacterial strain isolated from patients with benign prostatic hyperplasia, followed by Enterococcus spp...
May 31, 2017: Pathogens
https://www.readbyqxmd.com/read/28554926/long-term-antibiotics-for-prevention-of-recurrent-urinary-tract-infection-in-older-adults-systematic-review-and-meta-analysis-of-randomised-trials
#15
Haroon Ahmed, Freya Davies, Nick Francis, Daniel Farewell, Christoper Butler, Shantini Paranjothy
OBJECTIVE: To address clinical uncertainties about the effectiveness and safety of long-term antibiotic therapy for preventing recurrent urinary tract infections (UTIs) in older adults. DESIGN: Systematic review andmeta-analysis of randomised trials. METHOD: We searched Medline, Embase, The Cumulative Index to Nursing and Allied Health Literature(CINAHL), and the Cochrane Register of Controlled Trials from inception to August 2016. Eligible studies compared long-term antibiotic therapy with non-antibiotic therapy or placebo in men or women aged over 65, or in postmenopausal women, with recurrent UTIs...
May 29, 2017: BMJ Open
https://www.readbyqxmd.com/read/28546233/a-case-of-confusion-paraneoplastic-encephalomyelitis-in-an-elderly-patient-suspected-of-having-urinary-tract-infection-associated-delirium
#16
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
#17
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/28537494/survival-from-traumatic-injury-does-not-end-at-hospital-discharge-hospital-acquired-infections-increase-post-discharge-mortality
#18
Nitasha Dhiman, Ram C Rimal, Mark Hamill, Katie M Love, Daniel Lollar, Bryan Collier
BACKGROUND: Hospital-acquired infections (HAI) in trauma patients increase inpatient morbidity and mortality. However, their impact on long-term mortality is not well understood. PATIENTS AND METHODS: A retrospective trauma registry analysis of all patients admitted to an academic level I trauma center between July 1, 2008 and December 31, 2012 was performed. Patients included survived to discharge and were 18 years of age or older. Age, gender, Injury Severity Score (ISS), ventilator use, history of chronic obstructive pulmonary disease (COPD), and HAI were reviewed...
July 2017: Surgical Infections
https://www.readbyqxmd.com/read/28522577/shorter-leukocyte-telomere-length-is-associated-with-higher-risk-of-infections-a-prospective-study-of-75-309-individuals-from-the-general-population
#19
Jens Helby, Børge G Nordestgaard, Thomas Benfield, Stig E Bojesen
In the general population, older age is associated with short leukocyte telomere length and with high risk of infections. In a recent study of allogeneic hematopoietic cell transplantation for severe aplastic anemia, long donor leukocyte telomere length was associated with improved survival in the recipients. These findings suggest that leukocyte telomere length could possibly be a marker of immune competence. Therefore, we tested the hypothesis that shorter leukocyte telomere length is associated with higher risk of infectious disease hospitalization and infection related death...
May 18, 2017: Haematologica
https://www.readbyqxmd.com/read/28507449/perirenal-fat-stranding-is-not-a-powerful-diagnostic-tool-for-acute-pyelonephritis
#20
Hirotaka Fukami, Yoichi Takeuchi, Saeko Kagaya, Yoshie Ojima, Ayako Saito, Hiroyuki Sato, Ken Matsuda, Tasuku Nagasawa
PURPOSE: Pyelonephritis, an upper urinary tract infection, is a serious infection that often requires hospitalization. However, the accurate diagnosis of acute pyelonephritis can be difficult, especially among older individuals who can present with unusual symptoms. Imaging with computed tomography (CT) is not unusual in the diagnosis of pyelonephritis, with some clinicians regarding perirenal fat stranding (PFS) as a characteristic finding. However, the sensitivity and specificity of PFS in diagnosing pyelonephritis are currently unknown...
2017: International Journal of General Medicine
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