An Approach to Urinary Incontinence for Dermatologists

2016 ◽  
Vol 21 (1) ◽  
pp. 15-22 ◽  
Author(s):  
Malika Ladha ◽  
Adrian Wagg ◽  
Marlene Dytoc
Keyword(s):  
Urinary Incontinence ◽  
Clinical Management ◽  
Skin Condition ◽  
Related Disorder ◽  
Initial Management ◽  
Age Related ◽  
Underlying Causes ◽  
Inflammatory Skin

Incontinence-associated dermatitis (IAD) is a condition often encountered by dermatologists. IAD is an inflammatory skin condition secondary to prolonged urine exposure—it is a dermatologic sequela of urinary incontinence. Incontinence should not be dismissed simply as an age-related disorder; rather, it is due to a number of pathologic conditions that can be either reversible or manageable. It is thus critical to identify and treat the underlying causes of urinary incontinence. Clinical management of this common medical issue restores normality to patients’ lives while also preventing future dermatologic complications. In this article, we aim to provide dermatologists with an overview of IAD and an approach to the diagnosis and initial management of urinary incontinence.

scholarly journals Screening for Sarcopenia (Physical Frailty) in the COVID-19 Era

2021 ◽  
Vol 2021 ◽  
pp. 1-16
Author(s):  
Amira Mohammed Ali ◽  
Hiroshi Kunugi
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Muscle Strength ◽  
Radiation Risk ◽  
Protective Measure ◽  
Considerable Proportion ◽  
Muscle Loss ◽  
Related Disorder ◽  
Age Related ◽  
Obesity And Diabetes

Although the numbers of aged populations have risen considerably in the last few decades, the current coronavirus disease 2019 (COVID-19) has revealed an extensive vulnerability among these populations. Sarcopenia is an age-related disorder that increases hospitalization, dependencies, and mortality in older adults. It starts to develop in midlife or even earlier as a result of unbalanced diet/poor nutrition and low levels of physical activity, in addition to chronic disorders such as obesity and diabetes mellitus. Given that social isolation is adopted as the most protective measure against COVID-19, the level of physical activity and the intake of adequate diet have considerably declined, especially among older adults—denoting an increased possibility for developing sarcopenia. Research also shows a higher vulnerability of sarcopenic people to COVID-19 as well as the development of wasting disorders such as sarcopenia and cachexia in a considerable proportion of symptomatic and recovering COVID-19 patients. Muscular wasting in COVID-19 is associated with poor prognosis. Accordingly, early detection and proper management of sarcopenia and wasting conditions in older adults and COVID-19 patients may minimize morbidity and mortality during the current COVID-19 crisis. This review explored different aspects of screening for sarcopenia, stressing their relevance to the detection of altered muscular structure and performance in patients with COVID-19. Current guidelines recommend prior evaluation of muscle strength by simple measures such as grip strength to identify individuals with proven weakness who then would be screened for muscle mass loss. The latter is best measured by MRI and CT. However, due to the high cost and radiation risk entailed by these techniques, other simpler and cheaper techniques such as DXA and ultrasound are given preference. Muscle loss in COVID-19 patients was measured during the acute phase by CT scanning of the pectoralis muscle simultaneously during a routine check for lung fibrosis, which seems to be an efficient evaluation of sarcopenia among those patients with no additional cost. In recovering patients, muscle strength and physical performance have been evaluated by electromyography and traditional tests such as the six-minute walk test. Effective preventive and therapeutic interventions are necessary in order to prevent muscle loss and associated physical decline in COVID-19 patients.

The CCL7-CCL2-CCR2 Axis Regulates Age-Related Alterations in ADSCs 

2021 ◽  
Author(s):  
Keya Li ◽  
Guiying Shi ◽  
Xuepei Lei ◽  
Yiying Huang ◽  
Xinyue Li ◽  
...  
Keyword(s):  
Autologous Transplantation ◽  
Hippo Signaling ◽  
Related Disorder ◽  
Promising Strategy ◽  
Age Related ◽  
Minimum Number ◽  
And Function ◽  
The Relationship ◽  
Harmful Effects

Abstract Background and ObjectivesAdipose-tissue derived stem cells (ADSCs) autologous transplantation have been a promising strategy for aging-related disorder. But the relationship between ADSCs senescence and organismal aging were still no consistent conclusions. Toward this end, we analyzed the senescence properties of ADSCs from different age donors to furthermore understand the differences of cells between young and senile donors and verify the influence of organismal aging on the proliferation and function of ADSCs in vitro, providing the theoretical basis for the clinical application of autologous ADSCs transplantation.Methods and ResultsWe detected the characteristics, function, gene expression, apoptosis, cell cycle, SA-β-gal staining, and transcription features of ADSCs from 1-month mice and 20-month mice. ADSCs from old donors had some senescence-associated changes with less ability to proliferation than ADSCs from 1-month mice. Differentiation ability, cell surface markers, and SA-β-Gal staining did not differ across donor age, while cells exhibit a more remarkable age-related changes through continuous passages. According to the results of transcriptome analysis, the CCL7-CCL2-CCR2 axis and Hippo signaling pathway would be considered as its possible mechanisms. ConclusionsOur study reveals that ADSCs from old donors have some age-related alterations. The CCL7-CCL2-CCR2 which lies behind this change would be a potential target for gene therapy to reduce harmful effects of ADSCs from old donors. To make autologous transplantation work better, we would recommend that ADSCs should be cryopreserved in youth with minimum number of passages.

Fatigue

2021 ◽  
pp. 685-697
Author(s):  
Sriram Yennurajalingam ◽  
Eduardo Bruera
Keyword(s):  
Palliative Care ◽  
Sleep Disturbances ◽  
Common Factors ◽  
Symptomatic Treatment ◽  
Shortness Of Breath ◽  
Initial Management ◽  
Pain Anxiety ◽  
Underlying Causes ◽  
Recent Activity ◽  
Anxiety Depression

Fatigue is the most frequent, complex, multidimensional, and debilitating symptom in patients with advanced life-limiting diseases. In cancer patients, it is defined as ‘distressing persistent, subjective sense of physical, emotional, and/or cognitive tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual functioning’. In the majority of patients receiving palliative care, the aetiology of fatigue is multifactorial. The most common factors associated with fatigue include anorexia/cachexia, pain, anxiety, depression, shortness of breath, sleep disturbances, anaemia, and inflammation. Routine screening for fatigue is essential for optimal assessment of fatigue. Initial management should aim towards identification and treatment of the reversible/underlying causes However, if there are no reversible causes identified or if the fatigue is not responsive to specific treatments, symptomatic treatment should be considered.

scholarly journals Utility of the Serum Cystatin C Level for Diagnosis of Osteoporosis among Middle-Aged and Elderly People

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Satoshi Tanaka ◽  
Kei Ando ◽  
Kazuyoshi Kobayashi ◽  
Tetsuro Hida ◽  
Kenyu Ito ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Elderly People ◽  
Cystatin C ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Related Disorder ◽  
Diagnosis Of Osteoporosis ◽  
Bone Status ◽  
Age Related ◽  
Significant Difference

Purpose. Osteoporosis is a common age-related disorder leading to increased bone fragility and risk of fracture. Early diagnosis of osteoporosis is a vital step in providing early therapeutic intervention. Serum cystatin C is a marker of early renal dysfunction, a predictor of cardiovascular and inflammatory diseases, and an inhibitor of the differentiation of osteoclast precursor cells. The purpose of this study was to evaluate the relationship between serum cystatin C and osteoporosis. Methods. We enrolled 46 subjects who attended a health checkup and underwent measurement of bone status by quantitative ultrasound and determination of the level of serum cystatin C. A comparative study was conducted between those with and without osteoporosis for all subjects collectively and in two subgroups aged <65 and ≥65 years. Results. Serum cystatin C levels were strongly correlated with age, creatinine, and bone status data, with significant negative correlations with stiffness, T-score, and percentage of young adult mean. Among patients with osteoporosis, serum cystatin C was significantly higher even after adjustment for age and sex, whereas no significant difference was noted in creatinine. For patients aged ≥ 65 years, serum cystatin C was significantly higher in subjects with osteoporosis, although there was no significant difference in age between normal subjects and those with osteoporosis. Conclusions. To the best of our knowledge, this is the first study to demonstrate an association between serum cystatin C and osteoporosis. Serum cystatin C is significantly higher in osteoporosis and in particular may be a useful marker for osteoporosis among middle and elderly people aged ≥ 65 years. Measurement of serum cystatin C can be carried out easily and may contribute to early diagnosis and treatment of osteoporosis.

scholarly journals Chosen Vascular Risk Markers in Pseudoexfoliation Syndrome: An Age-Related Disorder

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Hanna Lesiewska ◽  
Agnieszka Łukaszewska-Smyk ◽  
Grażyna Odrowąż-Sypniewska ◽  
Magdalena Krintus ◽  
Aneta Mańkowska-Cyl ◽  
...  
Keyword(s):  
Density Lipoprotein ◽  
Vascular Diseases ◽  
Hdl Cholesterol ◽  
High Sensitivity ◽  
Serum Levels ◽  
Pseudoexfoliation Syndrome ◽  
C Reactive Protein ◽  
Related Disorder ◽  
Reactive Protein ◽  
Age Related

Purpose. To evaluate lipids and C-reactive protein serum levels in patients with pseudoexfoliation syndrome (PEX) in the Polish population. Methods. 96 patients were studied with PEX and 79 control subjects. Total cholesterol, triglycerides, high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein (LDL)-cholesterol, non-HDL-cholesterol and CRP serum levels, and TG/HDL-C and TC/HDL-C indexes were assessed. Results. There were no significant differences in concentration of lipids and values of TC/HDL-C, TG/HDL-C, and non-HDL-C between PEX and control groups. High-sensitivity C-reactive protein was not increased in patients with PEX. Conclusions. Our results cast doubt on the opinion on the possible PEX and vascular diseases relation. Further studies on this subject are mandatory.

Urinary incontinence principles

2017 ◽  
Author(s):  
Christopher R. Chapple ◽  
Nadir I. Osman
Keyword(s):  
Urinary Incontinence ◽  
Neural Control ◽  
Well Being ◽  
Initial Management ◽  
Lost Productivity ◽  
Life Threatening ◽  
The Individual ◽  
Aetiological Spectrum ◽  
Broad Overview

Urinary incontinence (UI) is a highly prevalent and bothersome problem that affects men and women of all ages. The aetiological spectrum of UI is wide, encompassing dysfunctions of the lower urinary tract, its neural control, the pelvic floor as well as other factors such as the side effects of pharmacotherapy. Although not life-threatening, UI frequently impacts upon the quality of life, psychological and emotional well-being of affected individuals. Additionally, UI imposes a tremendous economic burden on both the individual and the wider society in costs of nursing care, treatments, and lost productivity. The purpose of this chapter is to provide a broad overview of the epidemiology, aetiopathophysiology of UI, and to discuss the approach to the assessment, investigation, and initial management of the patient presenting with UI.

Disorders of the prepuce

2017 ◽  
Author(s):  
Ahmed A Darwish ◽  
Kim A.R Hutton
Keyword(s):  
Surgical Intervention ◽  
Rare Condition ◽  
Skin Condition ◽  
Venous Stasis ◽  
Unknown Aetiology ◽  
Penile Shaft ◽  
Balanitis Xerotica Obliterans ◽  
Inflammatory Skin ◽  
Relative Deficiency

The foreskin is adherent to the glans and is non-retractile at birth. As the preputial adhesions separate the foreskin then gradually becomes retractile so that by three years of age the foreskin is at least partially retractile in 90% of boys. The term ‘physiological’ phimosis refers to a foreskin which is supple, unscarred, but persistently non-retractile. Less than 1% of boys with a physiological phimosis will have a persisting phimosis by the age of 17 years. ‘Pathological’ phimosis refers to scarring of the prepuce due to balanitis xerotica obliterans (BXO), a cicatrizing inflammatory skin condition of unknown aetiology. Paraphimosis is a rare condition in which the retracted prepuce becomes trapped behind the glans, leading to venous stasis and oedematous swelling. ‘Congenital’ megaprepuce is characterized by a capacious preputial sac, phimosis, and a relative deficiency of penile shaft skin. Surgical intervention is advisable for both functional and cosmetic reasons.

Eczema and the older person

2020 ◽  
Vol 25 (9) ◽  
pp. 451-459
Author(s):  
Linda Nazarko
Keyword(s):  
Older Adults ◽  
Older People ◽  
Physical Health ◽  
Skin Condition ◽  
Common Condition ◽  
Older Person ◽  
Poor Physical Health ◽  
Age Related ◽  
Different Types ◽  
Age Related Changes

Age-related changes lead to an increase in skin problems, and around 70% of older people have a treatable skin condition. However, ageing and poor physical health can make it difficult for older people to care for their skin. Eczema, a chronic inflammatory skin condition, where the skin becomes red, inflamed, itchy and scaly, can develop easily in older adults. This can, in turn, become infected and cause discomfort and health problems. This article explains how ageing affects the skin, how eczema can develop and how it can be treated, also touching upon the different types of eczema. It aims to equip community nurses with knowledge about this common condition and how to recognise and manage it.

scholarly journals The Role of Free Radicals in Autophagy Regulation: Implications for Ageing

2018 ◽  
Vol 2018 ◽  
pp. 1-19 ◽  
Author(s):  
M. Pajares ◽  
A. Cuadrado ◽  
N. Engedal ◽  
Z. Jirsova ◽  
M. Cahova
Keyword(s):  
Control Systems ◽  
Redox Homeostasis ◽  
Biological Macromolecules ◽  
Complex Relationship ◽  
Cellular Functions ◽  
Related Disorder ◽  
Redox Signalling ◽  
Age Related ◽  
Integral Role

Reactive oxygen and nitrogen species (ROS and RNS, resp.) have been traditionally perceived solely as detrimental, leading to oxidative damage of biological macromolecules and organelles, cellular demise, and ageing. However, recent data suggest that ROS/RNS also plays an integral role in intracellular signalling and redox homeostasis (redoxtasis), which are necessary for the maintenance of cellular functions. There is a complex relationship between cellular ROS/RNS content and autophagy, which represents one of the major quality control systems in the cell. In this review, we focus on redox signalling and autophagy regulation with a special interest on ageing-associated changes. In the last section, we describe the role of autophagy and redox signalling in the context of Alzheimer’s disease as an example of a prevalent age-related disorder.

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