Urinary tract dysfunction in Parkinson’s disease: a review

Choe

Antimicrob Agents Chemother

et al. 2013

i This study aimed to (i) investigate the antimicrobial susceptibilities of bacteria that cause urinary tract infections (UTIs) in outpatient and inpatient settings and (ii) evaluate the risk factors for emerging antimicrobial drug resistance in UTIs in South Korea. In total, 3,023 samples without duplication were collected from females between 25 and 65 years of age who had been diagnosed with a urinary tract infection. Multicenter patient data were collected using a Web-based electronic system and then evaluated. The isolation rates of Escherichia coli, Klebsiella pneumoniae, and Enterococcus faecium in the outpatient setting were 78.1, 4.7, and 1.3%, respectively; in the inpatient setting, the isolation rates of these microorganisms were 37.8, 9.9, and 14.8%, respectively. The susceptibilities of E. coli to amikacin, amoxicillin-clavulanic acid, cefotaxime, cefoxitin, ciprofloxacin, piperacillin-tazobactam, and imipenem in the outpatient setting were 99.4, 79.8, 89.4, 92.8, 69.8, 96.9, and 100.0%, respectively; in the inpatient setting, the susceptibilities to these antibiotics were 97.8, 73.9, 73.7, 82.1, 53.6, 93.2, and 100.0%, respectively. The most unique and common risk factor for emerging antimicrobial-resistant E. coli, K. pneumoniae, and E. faecium was previous exposure to antimicrobials. On the basis of these data, the use of fluoroquinolones should be reserved until culture data are available for the treatment of UTIs in South Korea. The present study will serve as a useful reference for Far Eastern Asia.

Section: Discussionmentioning

confidence: 99%

Antimicrobial Susceptibility Pattern and Epidemiology of Female Urinary Tract Infections in South Korea, 2010-2011

Choe

Antimicrob Agents Chemother

et al. 2013

“…Urinary tract symptoms, such as nocturia, increased urgency and frequency of urination, and incontinence are nearly as common in PD patients as are sleep disturbances (Yeo et al, 2012). In one study, over 75% of PD patients complained of nocturia, while between 30 and 35% of patients complained of either urinary urgency or frequency (Ragab and Mohammed, 2011).…”

Section: Dysfunction In the Circadian System May Contribute To The Etmentioning

confidence: 99%

Circadian dysfunction may be a key component of the non-motor symptoms of Parkinson's disease: Insights from a transgenic mouse model

Willison

Kudo

Loh

et al. 2013

Experimental Neurology

Sleep disorders are nearly ubiquitous among patients with Parkinson’s disease (PD), and they manifest early in the disease process. While there are a number of possible mechanisms underlying these sleep disturbances, a primary dysfunction of the circadian system should be considered as a contributing factor. Our laboratory’s behavioral phenotyping of a well-validated transgenic mouse model of PD reveals that the electrical activity of neurons within the master pacemaker of the circadian system, the suprachiasmatic nuclei (SCN), is already disrupted at the onset of motor symptoms, although the core features of the intrinsic molecular oscillations in the SCN remain functional. Our observations suggest that the fundamental circadian deficit in these mice lies in the signaling output from the SCN, which may be caused by known mechanisms in PD etiology: oxidative stress and mitochondrial disruption. Disruption of the circadian system is expected to have pervasive effects throughout the body and may itself lead to neurological and cardiovascular disorders. In fact, there is much overlap in the non-motor symptoms experienced by PD patients and in the consequences of circadian disruption. This raises the possibility that the sleep and circadian dysfunction experienced by PD patients may not merely be a subsidiary of the motor symptoms, but an integral part of the disease. Furthermore, we speculate that circadian dysfunction can even accelerate the pathology underlying PD. If these hypotheses are correct, more aggressive treatment of the circadian misalignment and sleep disruptions in PD patients early in the pathogenesis of the disease may be powerful positive modulators of disease progression and patient quality of life.

“…32 Urinary tract infection—another infectious complication—can be attributed to PD-related bladder dysfunction that can cause multiple urinary symptoms including urgency, frequency, nocturia, and urinary retention. 33 Frequent bladder scans to check for retention and higher vigilance in monitoring for urinary infection may be useful to avoid urinary tract infection and treat it as promptly as possible.…”

Section: Discussionmentioning

confidence: 99%

Outcomes After Non-neurological Surgery in Patients With Parkinson's Disease

et al. 2016

Patients with Parkinson disease (PD) were known to have increased risk of complications during hospitalization. The purpose of this study is to validate the global features of postoperative adverse outcomes for patients with PD.Using reimbursement claims from Taiwan's National Health Insurance Research Database, we conducted a nationwide retrospective cohort study of 6455 patients with preoperative PD receiving major surgery during 2008 to 2012. With a propensity score matching procedure, 12,910 surgical patients without PD were selected for comparison. The adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for 9 major postoperative complications and 30-day postoperative mortality associated with preoperative PD were calculated in the multivariate logistic regressions.Patients with PD had increased risk of postoperative pulmonary embolism (OR 2.72, 95% CI 1.45–5.10), stroke (OR 1.77, 95% CI 1.53–2.05), pneumonia (OR 1.98, 95% CI 1.70–2.31), urinary tract infection (OR 1.52, 95% CI 1.35–1.70), septicemia (OR 1.54, 95% CI 1.37–1.73), acute renal failure (OR 1.36, 95% CI 1.07–1.73), and mortality (OR 1.45, 95% CI 1.06–1.98). The association between preoperative PD and postoperative adverse events was significant in both sexes and every age group. Low income, ≥65 years of age, surgery not in medical center, highest quartile of PD medication users, and more medical conditions worsen the risk of postoperative adverse events in patients with PD.This study showed increased postoperative complications and mortality in patients with PD. Our findings suggest that revision of postoperative care protocols for this population is urgently needed.