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Urinary tract infection elderly

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https://www.readbyqxmd.com/read/29305250/diagnosis-and-treatment-of-urinary-tract-infections-across-age-groups
#1
REVIEW
Christine M Chu, Jerry L Lowder
Urinary tract infections (UTI) are the most common outpatient infections, but predicting the probability of UTI through symptoms and test results can be complex. The most diagnostic symptoms of UTI include change in frequency, dysuria, urgency, and presence or absence of vaginal discharge, but UTIs may present differently in older women. Dipstick urinalysis is popular for its availability and usefulness, but results must be interpreted in context of the patient's pretest probability based on symptoms and characteristics...
January 2, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29249687/male-incontinence-the-etiology-or-basis-of-treatment
#2
REVIEW
Austin G Hester, Alexander Kretschmer, Gopal Badlani
CONTEXT: Elderly men are an increasing proportion of the aging population in the 21st century. Urinary incontinence reduces the quality of life and increases the burden of care for the aging population. OBJECTIVE: The primary objective of this review is to explore the etiopathology of common causes of incontinence in aging male patients. The focus is on the algorithm of the initial evaluation of these patients from both a primary care and a urologic standpoint. EVIDENCE ACQUISITION: A nonsystematic review of the literature was performed in September 2017...
December 14, 2017: European Urology Focus
https://www.readbyqxmd.com/read/29246012/characterization-of-the-urinary-microbiota-of-elderly-women-and-the-effects-of-type-2-diabetes-and-urinary-tract-infections-on-the-microbiota
#3
Fengping Liu, Zongxin Ling, Yonghong Xiao, Qing Yang, Li Zheng, Ping Jiang, Lanjuan Li, Wei Wang
Evidence shows that urine has complex bacterial profiles with considerable variation between individuals. Aging and age-related conditions can lead to the changes to the composition of urine, which means that the available nutrition for bacteria in the bladder changes with age. We explored the characteristics of the urinary microbiota of elderly women and whether these are associated with age-related conditions such as diabetes and urinary tract infections. An elderly and a non-elderly cohort of women were included...
November 21, 2017: Oncotarget
https://www.readbyqxmd.com/read/29212999/-a-case-of-hyperammonemia-resulting-from-urinary-tract-infection-caused-by-urease-producing-bacteria-in-a-parkinson-s-disease-patient-with-drug-induced-urinary-retention
#4
Masahiro Yasunishi, Akihiro Koumura, Yuichi Hayashi, Shohei Nishida, Takashi Inuzuka
A 71-year-old woman with a 9-year history of Parkinson's disease was admitted to our hospital emergently because of consciousness disturbance. Her consciousness level was 200 on the Japan coma scale (JCS), and she presented with tenderness and distension of the lower abdomen. Brain computed tomography showed normal findings. Blood tests showed an increased ammonia level (209 μg/dl) with normal AST and ALT levels. We catheterized the bladder for urinary retention. Five hours after admission, the blood ammonia level decreased to 38 μg/dl, and her consciousness level improved dramatically...
2017: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
https://www.readbyqxmd.com/read/29201813/risk-factors-and-functional-impact-of-medical-complications-in-stroke
#5
Bo-Ram Kim, Jongmin Lee, Min Kyun Sohn, Deog Young Kim, Sam-Gyu Lee, Yong-Il Shin, Gyung-Jae Oh, Yang-Soo Lee, Min Cheol Joo, Eun Young Han, Yun-Hee Kim
Objective: To determine the incidence and risk factors for medical complications in Korean patients suffering from stroke and the impact of such complications on post-stroke functional outcomes. Methods: We assessed patients enrolled in a prospective cohort study. All recruited patients had suffered a first acute stroke episode and been admitted to nine university hospitals in Korea between August 2012 and June 2015. We analyzed patient and stroke characteristics, comorbidities, prevalence of post-stroke medical complications, and functional outcomes at time of discharge and 3, 6, and 12 months after stroke onset...
October 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/29191263/persistent-and-severe-hypoglycemia-associated-with-trimethoprim-sulfamethoxazole-in-a-frail-diabetic-man-on-polypharmacy-a-case-report-and-literature-review%C3%A2
#6
Raffaella Rossio, Sara Arcudi, Flora Peyvandi, Stefania Piconi
OBJECTIVE: Trimethoprim-sulfamethoxazole (co-trimoxazole) is a commonly used broad-spectrum antibiotic, but it can be associated with potentially serious adverse effects, often not recognized by clinicians. This is a relevant problem in elderly patients, who are particularly susceptible to adverse drug reactions. Moreover, multiple medications taken by older people increase the risk for adverse drug reactions and drug-drug interactions. CASE REPORT: We report the case of an 85-year-old man with diabetes mellitus who attended the emergency room with severe hypoglycemia that persisted despite multiple intravenous bolus doses and continuous infusion of glucose...
November 30, 2017: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29165097/a-predictive-model-of-the-prevalence-of-delirium-in-elderly-subjects-admitted-to-nursing-homes
#7
Pilar Perez-Ros, Francisco Miguel Martinez-Arnau, Susana Baixauli-Alacreu, Jose Fermin Garcia-Gollarte, Francisco Tarazona-Santabalbina
INTRODUCTION: Delirium is common in geriatric patients admitted to nursing homes, with an incidence of 22-79% among long-term residents. AIM: To establish a predictive model of the risk of delirium episodes in a sample of elderly people living in nursing homes. MATERIAL AND METHODS: A retrospective, cross-sectional case-control study covering a period of 12 consecutive months (April 2014 - March 2015) was carried out. The included cases had suffered at least one episode of delirium during the study period...
November 20, 2017: Endocrine, Metabolic & Immune Disorders Drug Targets
https://www.readbyqxmd.com/read/29164173/factors-related-to-the-severity-of-delirium-in-the-elderly-patients-with-infection
#8
R A Tuty Kuswardhani, Yosef Samon Sugi
Objective: Delirium is a common neuropsychiatric syndrome in the elderly characterized by concurrent impairments in cognition and behavior. Infection is one of the most important risk factors for delirium. The objective of this study is to elaborate the factors related to the severity of delirium in the elderly patients with infection. Method: An observational study on the relationship of several clinical parameters and the severity of delirium in elderly patients (more than 60 years) with infection was conducted at Geriatric Inpatient Ward, Sanglah Hospital...
January 2017: Gerontology & Geriatric Medicine
https://www.readbyqxmd.com/read/29089174/clinical-outcomes-of-elderly-patients-with-bloodstream-infections-due-to-extended-spectrum-%C3%AE-lactamase-producing-enterobacteriaceae-in-an-italian-internal-medicine-ward
#9
Simone Meini, Raffaele Laureano, Carlo Tascini, Fabio Arena, Lucia Fani, Anna Frullini, Maria Teresa Passaleva, Anna Teresa Roberts, Dario Mannini, Francesco Sbrana, Andrea Ripoli, Gian Maria Rossolini
PURPOSE: Infections caused by ESBL-producing Enterobacteriaceae (ESBL-EB) are a major health problem, but data regarding elderly patients is lacking. METHODS: We performed a retrospective observational study quantifying the effects of antimicrobial treatment and primary infection site on clinical outcomes in an historical case series of 42 patients aged 80.7±10years admitted to an Internal Medicine ward in Italy for ESBL-EB bloodstream infections (BSI). RESULTS: At multivariate risk analysis, we found that urinary tract as primary infection site (RR=0...
October 28, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29049488/concentration-of-potentially-preventable-spending-among-high-cost-medicare-subpopulations-an-observational-study
#10
Jose F Figueroa, Karen E Joynt Maddox, Nancy Beaulieu, Robert C Wild, Ashish K Jha
Background: Little is known about whether potentially preventable spending is concentrated among a subset of high-cost Medicare beneficiaries. Objective: To determine the proportion of total spending that is potentially preventable across distinct subpopulations of high-cost Medicare beneficiaries. Design: Beneficiaries in the highest 10% of total standardized individual spending were defined as "high-cost" patients, using a 20% sample of Medicare fee-for-service claims from 2012...
November 21, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29043211/native-valve-endocarditis-caused-by-achromobacter-xylosoxidans-a-case-report-and-review-of-literature
#11
Caio Godoy Rodrigues, Jairo Rays, Marcia Yoshie Kanegae
Achromobacter xylosoxidans is a Gram-negative aerobic bacterium first described by Yabuuchi and Ohyama in 1971. A. xylosoxidans is frequently found in aquatic environments. Abdominal, urinary tract, ocular, pneumonia, meningitis, and osteomyelitis are the most common infections. Infective endocarditis is rare. As far as we know, until now, only 19 cases have been described, including this current report. We report the case of community-acquired native valve endocarditis caused by A. xylosoxidans in an elderly patient without a concomitant diagnosis of a malignancy or any known immunodeficiency...
July 2017: Autopsy & Case Reports
https://www.readbyqxmd.com/read/29042390/effect-of-point-of-care-susceptibility-testing-in-general-practice-on-appropriate-prescription-of-antibiotics-for-patients-with-uncomplicated-urinary-tract-infection-a-diagnostic-randomised-controlled-trial
#12
Anne Holm, Gloria Cordoba, Tina Møller Sørensen, Lisbeth Rem Jessen, Niels Frimodt-Møller, Volkert Siersma, Lars Bjerrum
OBJECTIVES: To investigate the effect of adding point-of-care (POC) susceptibility testing to POC culture on appropriate use of antibiotics as well as clinical and microbiological cure for patients with suspected uncomplicated urinary tract infection (UTI) in general practice. DESIGN: Open, individually randomised controlled trial. SETTING: General practice. PARTICIPANTS: Women with suspected uncomplicated UTI, including elderly patients above 65, patients with recurrent UTI and patients with diabetes...
October 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/29025285/safety-and-efficacy-of-canagliflozin-in-elderly-patients-with-type-2-diabetes-mellitus-a-1-year-post-marketing-surveillance-in-japan
#13
Maki Goda, Tomoko Yamakura, Kazuyo Sasaki, Takumi Tajima, Makoto Ueno
Objective To evaluate the safety and efficacy of canagliflozin in elderly patients with type 2 diabetes mellitus (T2DM) in clinical settings. Methods We conducted a 1-year post-marketing surveillance (PMS) of canagliflozin in almost all the elderly patients (≥65 years old) with T2DM who began taking canagliflozin during the first 3 months after its launch in Japan. The main outcomes included the incidences of adverse drug reactions (ADRs), serious ADRs and the changes of laboratory tests as well as efficacy variables...
October 13, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29020203/empirical-antibiotic-treatment-does-not-improve-outcomes-in-catheter-associated-urinary-tract-infection-prospective-cohort-study
#14
Tanya Babich, Oren Zusman, Michal Elbaz, Haim Ben-Zvi, Mical Paul, Leonard Leibovici, Tomer Avni
Background: Catheter associated urinary tract infection (CAUTI) is the most common healthcare-associated acquired infection. We aimed to describe the short- and long-term survival of patients with CAUTI and the impact of the empirical antibiotic treatment on survival rates. Methods: In this prospective observational study we included consecutive adult patients with a chronic indwelling catheter-associated UTI and sepsis hospitalized in medical departments. The primary outcomes were 30-days all-cause mortality and long-term survival at end of the follow-up...
November 13, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28976384/-infective-endocarditis-in-elderly-patients
#15
Serap Şimşek Yavuz
Infective endocarditis (IE) is a rare disease, but it is still associated with high mortality and elderly represent a growing proportion of patients with this disease. At the moment, more than one third of the IE patients is over 70 years old in developed countries. Although mean age of patients with endocarditis is still between 40 and 50 years old in our country, it is a fact that more elderly patients with IE will be seen in the coming years because of the prolongation of the life span and the increase in the proportion of the elderly...
September 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28973289/early-postoperative-complications-for-elderly-patients-undergoing-single-level-decompression-for-lumbar-disc-herniation-ligamentous-hypertrophy-or-neuroforaminal-stenosis
#16
Arpan V Prabhu, Bryan A Lieber, Jenson K Henry, Nitin Agarwal, Monir Tabbosha, David O Okonkwo
BACKGROUND: Lumbar decompression for disc herniation is frequently performed on elderly patients, and this trend will continue as the population ages. Clinical reports on the complications of lumbar discectomy show good results and cost effectiveness in young or middle-aged patients. OBJECTIVE: To assess and compare the morbidity of single-level lumbar disc surgery for radicular pain in a cohort of patients greater than 80 yr of age to that of a middle-aged cohort...
July 18, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28889761/safety-issues-associated-with-using-medication-to-treat-overactive-bladder
#17
REVIEW
George Araklitis, Linda Cardozo
The mainstay of overactive bladder treatment is the use of anticholinergic medication with its common side effects well known. This review focused on three less well-known safety issues when treating OAB. Areas covered: Patients with increased anticholinergic load are at risk of cognitive decline, dementia or even death. The elderly are particularly at risk due to polypharmacy. Botulinum toxin carries the risk of high urinary residuals, urinary tract infection and need to self catheterise. The use of vaginal oestrogens may improve OAB symptoms, but there is concern in those with a history of breast cancer...
November 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28873266/prospective-cohort-study-of-risk-factors-for-extended-spectrum-%C3%A3-lactamase-producing-escherichia-coli-urinary-tract-infections-in-elderly-patients-admitted-to-hospital
#18
Arturo Artero, Ana Esparcia, Juan Alberola, Manuel Madrazo, José M Nogueira, José M Eiros
BACKGROUND: Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli are currently common in community-onset infections, limiting therapeutic options. In this work we aim to identify the prevalence of and risk factors for ESBL-producing E. coli in elderly patients with urinary tract infections (UTI) admitted to hospital. METHODS: Prospective cohort study on elderly patients with E. coli UTI admitted to a university hospital in Spain, from January 2013 to December 2015...
September 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28871572/early-complications-after-living-donor-nephrectomy-analysis-of-the-swiss-organ-living-donor-health-registry
#19
Felix Burkhalter, Uyen Huynh-Do, Karine Hadaya, Maurice Matter, Thomas Müller, Isabelle Binet, Christa Nolte, Juerg Steiger
BACKGROUND: We evaluated the prospectively collected data about the incidence of early peri- and postoperative complications, and potential risk factors for adverse outcomes after living kidney donation in Switzerland. METHODS: Peri- and postoperative events were prospectively recorded on a questionnaire by the local transplant teams of all Swiss transplant centres and evaluated by the Swiss Organ Living Donor Health Registry. Complications were classified according to the Clavien grading system...
September 5, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28857797/a-comparison-of-three-frailty-indices-in-predicting-morbidity-and-mortality-after-on-pump-aortic-valve-replacement
#20
Gary Esses, Evie Andreopoulos, Hung-Mo Lin, Shipra Arya, Stacie Deiner
BACKGROUND: Aortic valve replacement is a high-risk surgery (3%-5%, 30-day mortality) performed on approximately 30,000 elderly patients a year in the United States. Currently, preoperative risk assessment is based on a composite of medical examination and a subjective evaluation for frailty ("eyeball test"). Objective frailty assessment using validated indices has the potential to improve risk stratification. The purpose of this study was to (1) establish whether frailty can predict 30-day mortality and composite morbidity in patients undergoing aortic valve replacement and (2) compare the predictive ability of 3 frailty indices in this population...
January 2018: Anesthesia and Analgesia
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