Urinary Tract Infections in the Elderly

Gibson, William; Wagg, Adrian

doi:10.1007/s11884-015-0304-9

Cited by 3 publications

(2 citation statements)

References 46 publications

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“…One suggested reason for this inaccuracy, the usage of UTI as an acceptable cause for hospitalisations of frail older adults with an uncertain diagnosis [58], should also be considered in Finland. Thus, the increase in UTI hospitalisations likely reflects the accumulation of risk factors, such as an ageing population, diabetes and obesity [59, 60]. Further, the limitations of ADL might mediate the link between UTIs [61] in the elderly and increased ACSC rates [23] through delays in accessing health centres.…”

Section: Discussionmentioning

confidence: 99%

Trajectory modelling of ambulatory care sensitive conditions in Finland in 1996–2013: assessing the development of equity in primary health care through clustering of geographic areas – an observational retrospective study

Satokangas

Lumme

Arffman

et al. 2019

BMC Health Serv Res

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Background Due to stagnating resources and an increase in staff workload, the quality of Finnish primary health care (PHC) is claimed to have deteriorated slowly. With a decentralised PHC organisation and lack of national stewardship, it is likely that municipalities have adopted different coping strategies, predisposing them to geographic disparities. To assess whether these disparities emerge, we analysed health centre area trajectories in hospitalisations due to ambulatory care sensitive conditions (ACSCs). Methods ACSCs, a proxy for PHC quality, comprises conditions in which hospitalisation could be avoided by timely care. We obtained ACSCs of the total Finnish population aged ≥20 for the years 1996–2013 from the Finnish Hospital Discharge Register, and divided them into subgroups of acute, chronic and vaccine-preventable causes, and calculated annual age-standardised ACSC rates by gender in health centre areas. Using these rates, we conducted trajectory analyses for identifying health centre area clusters using group-based trajectory modelling. Further, we applied area-level factors to describe the distribution of health centre areas on these trajectories. Results Three trajectories – and thus separate clusters of health centre areas – emerged with different levels and trends of ACSC rates. During the study period, chronic ACSC rates decreased (40–63%) within each of the clusters, acute ACSC rates remained stable and vaccine-preventable ACSC rates increased (1–41%). While disparities in rate differences in chronic ACSC rates between trajectories narrowed, in the two other ACSC subgroups they increased. Disparities in standardised rate ratios increased in vaccine-preventable and acute ACSC rates between northern cluster and the two other clusters. Compared to the south-western cluster, 13–16% of health centre areas, in rural northern cluster, had 47–92% higher ACSC rates – but also the highest level of morbidity, most limitations on activities of daily living and highest PHC inpatient ward usage as well as the lowest education levels and private health and dental care usage. Conclusions We identified three differing trajectories of time trends for ACSC rates, suggesting that the quality of care, particularly in northern Finland health centre areas, may have lagged behind the general improvements. This calls for further investments to strengthen rural area PHC. Electronic supplementary material The online version of this article (10.1186/s12913-019-4449-7) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Trajectory modelling of ambulatory care sensitive conditions in Finland in 1996–2013: assessing the development of equity in primary health care through clustering of geographic areas – an observational retrospective study

Satokangas

Lumme

Arffman

et al. 2019

BMC Health Serv Res

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“…11 Assim, dos 65 aos 70 anos ocorre um aumento da incidência de ITU entre 2 a 4%, podendo ser superior a 22% depois dos 80 anos. [21][22] Os gérmenes mais prevalentes nas ITU destes doentes continuam a ser as bactérias aeróbias gram-negativas, sendo a E. coli responsável por cerca de 64% dos casos, seguida do E. faecalis, K. pneumoniae e P. mirabilis. 18,23 A taxa de resistência aos antibióticos é elevada nos residentes em ERPI.…”

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Perfil de suscetibilidade aos antibióticos na infeção urinária dos residentes em estruturas residenciais para idosos

Passadouro

Fonseca

Figueiredo

et al. 2019

RPMGF

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Ethanol: striking the cardiovascular system by harming the gut microbiota

Silva

Elias-Oliveira

McCarthy

et al. 2021

American Journal of Physiology-Heart and Circulatory Physiology

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Ethanol consumption represents a significant public health problem, and excessive ethanol intake is a risk factor for cardiovascular disease (CVD), one of the leading causes of death and disability worldwide. The mechanisms underlying the effects of ethanol on the cardiovascular system are complex and not fully comprehended. The gut microbiota and their metabolites are indispensable symbionts essential for health and homeostasis and therefore, have emerged as potential contributors to ethanol-induced cardiovascular system dysfunction. By mechanisms that are not completely understood, the gut microbiota modulates the immune system and activates several signaling pathways that stimulate inflammatory responses, which in turn, contribute to the development and progression of CVD. This review summarizes preclinical and clinical evidence on the effects of ethanol in the gut microbiota and discusses the mechanisms by which ethanol-induced gut dysbiosis leads to the activation of the immune system and cardiovascular dysfunction. The crosstalk between ethanol consumption and the gut microbiota and its implications are detailed. In summary, an imbalance in the symbiotic relationship between the host and the commensal microbiota in a holobiont, as seen with ethanol consumption, may contribute to CVD. Therefore, manipulating the gut microbiota, by using antibiotics, probiotics, prebiotics and fecal microbiota transplantation might prove a valuable opportunity to prevent/mitigate the deleterious effects of ethanol and improve cardiovascular health and risk prevention.

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Urinary Tract Infections in the Elderly

Cited by 3 publications

References 46 publications

Trajectory modelling of ambulatory care sensitive conditions in Finland in 1996–2013: assessing the development of equity in primary health care through clustering of geographic areas – an observational retrospective study

Trajectory modelling of ambulatory care sensitive conditions in Finland in 1996–2013: assessing the development of equity in primary health care through clustering of geographic areas – an observational retrospective study

Perfil de suscetibilidade aos antibióticos na infeção urinária dos residentes em estruturas residenciais para idosos

Ethanol: striking the cardiovascular system by harming the gut microbiota

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