Iäkkäiden virtsaamisvaivat ja niiden hoito

•Virtsaamisvaivat ovat iäkkäillä yleisiä. Ne heikentävät elämänlaatua.•Vaivoja selvitetään kyselykaavakkeilla. Lisäksi naiselle tehdään gynekologinen tutkimus ja miehen eturauhanen tunnustellaan.•Rakkolihas voi olla liika-aktiivinen tai aktiivisuus voi olla heikkoa. Heikkouteen voi liittyä tyhjenemisvaikeutta, vaikkei alavirtsatie olisi tukossa.•Vaivojen taustalla voi olla myös lääke.•Virtsankarkailussa ensisijaisia ovat lääkkeettömät hoidot. Urologisista toimenpiteistä on tavallisimmin hyötyä eturauhassairauksissa ja gynekologisista toimenpiteistä laskeumissa sekä ponnistusvirtsankarkailussa

Impact of hexamine addition to a nitrite-based additive on fermentation quality, Clostridia and Saccharomyces cerevisiae in a white lupin-wheat silage

BACKGROUND Nitrite and hexamine are used as silage additives because of their adverse effects on Clostridia and Clostridia spores. The effect of sodium nitrite and sodium nitrite/hexamine mixtures on silage quality was investigated. A white lupin-wheat mixture was treated with sodium nitrite (NaHe0) (900 g t(-1) forage), or mixtures of sodium nitrite (900 g t(-1)) and hexamine. The application rate of hexamine was 300 g t(-1) (NaHe300) or 600 g t(-1) (NaHe600). Additional treatments were the untreated control (Con), and formic acid (FA) applied at a rate of 4 L t(-1) (1000 g kg(-1)). RESULTS Additives improved silage quality noticeably only by reducing silage ammonia content compared with the control. The addition of hexamine to a sodium nitrite solution did not improve silage quality compared with the solution containing sodium nitrite alone. The increasing addition of hexamine resulted in linearly rising pH values (P <0.001) and decreasing amounts of lactic acid (P <0.01). Sodium nitrite based additives were more effective than formic acid in preventing butyric acid formation. Additives did not restrict the growth of Saccharomyces cerevisiae compared to the control. CONCLUSION The addition of hexamine did not improve silage quality compared with a solution of sodium nitrite. (c) 2018 Society of Chemical IndustryPeer reviewe

The association of HLA-G polymorphism with oral and genital HPV infection in men

The host genetic factors that influence the natural history of human papillomavirus (HPV) infection in men are not well known. Our aim was to evaluate the role of human leukocyte antigen (HLA)-G polymorphism in oral and genital HPV infection in men. Altogether, 130 men from the Finnish Family HPV Study, with a 6-year follow-up, were included in the analyses. HLA-G alleles were tested by direct sequencing. Oral, urethral, and semen samples were collected and analyzed for 24 different HPV genotypes. Unconditional logistic regression was used to determine associations between HLA-G alleles and genotypes with HPV infection and its outcomes. Overall, eight different HLA-G alleles were identified with 15 different HLA-G genotype combinations. The most common HLA-G allele among the men was G*01:01:01 (86.2%, n = 112) followed by G*01:01:02 (36.2%, n = 47). Allele G*01:01:02 showed to be protective against any- and high-risk (HR) oral HPV (OR range of 0.20-0.24, 95% CI range of 0.06-0.85). Men having allele G*01:01:01 showed a reduced risk for incident (OR 0.30, 95% CI 0.11-0.84) and persistent (OR 0.24, 95% CI 0.08-0.69) oral infections. Allele G*01:01:03 was associated with increased risk for urethral HR-HPV infections (OR 4.94, 95% CI 1.34-18.27). Among self-reported demographic data, genotype G*01:01:01/01:01:03 was associated with an increased risk for oral warts (OR 8.00, 95% CI 1.23-51.89) and allele G*01:03:01 increased the risk of pollen and/or animal allergy (OR 13.59, 95% CI 1.57-117.25). To conclude, HLA-G polymorphism in men largely impacts the outcome of an oral HPV infection and seems to associate with self-reported allergies.Peer reviewe

Urinary and double incontinence in older women with hip fracture - risk of death and predictors of incident symptoms among survivors in a 1-year prospective cohort study

Objectives: To investigate the association of urinary incontinence (UI) and double incontinence (DI, concurrent UI and fecal incontinence) with one-year mortality among older female hip fracture patients and to identify predictors of incident UI and DI. Design: A prospective cohort study Setting and subjects: 1,468 female patients aged ≥ 65 treated for their first hip fracture during the period 2007–2019 Methods: Continence status was elicited at baseline and one-year post-fracture. Age- and multivariable-adjusted Cox proportional hazards and multinomial logistic regression models were used to determine the associations of incontinence with one-year mortality and to examine the associations of baseline predictors with incident UI and DI respectively. Results: Of the women with no incontinence, UI and DI, 78 (13%), 159 (23%) and 60 (34%), died during follow-up. UI (HR 1.72, 95% CI 1.31–2.26) and DI (HR 2.61, 95% CI 1.86–3.66) were associated with mortality after adjusting for age. These associations lost their predictive power in multivariable analysis while age over 90, living in an institution, impaired mobility, poor nutrition, polypharmacy, and late removal of urinary catheter remained associated with mortality. Of continent women, 128 (21%) developed UI and 23 (4%) DI during follow-up. In multivariable analysis, impaired mobility was associated with incident UI (OR 2.56, 95% CI 1.48–4.44) and DI (OR 4.82, 95% CI 1.70–13.7), as well as living in an institution (OR 3.44, 95% CI 1.56–7.61 and OR 3.90, 95% CI 1.17–13.0). Conclusions and Implications: Underlying vulnerability likely explains differences in mortality between continence groups and development of incident UI and DI.publishedVersionPeer reviewe

Factors associated with urinary and double incontinence in a geriatric post-hip fracture assessment in older women

Background: Incontinence and hip fractures are common in older people, especially women, and associated with multiple adverse effects. Incontinence is a risk factor for falls. Aims: We aimed to investigate the prevalence of urinary (UI) and double incontinence (DI, concurrent UI and faecal incontinence), and to identify factors associated with UI and DI 6 months post-fracture. Methods: A prospective real-life cohort study was conducted consisting of 910 women aged >= 65 who were treated for their first hip fracture in Seinajoki Central Hospital, Finland, between May 2008 and April 2018. Continence status was elicited at baseline and 6 months postoperatively at our geriatric outpatient clinic where all participants underwent a multidisciplinary comprehensive geriatric assessment (CGA) consisting of an evaluation of cognition, nutrition, mood, mobility, and functional ability. Results: At baseline, 47% of the patients were continent, 45% had UI and 8% had DI, and at follow up, 38%, 52%, and 11%, respectively. The mean age of the patients was 82.7 +/- 6.8. Both UI and DI were associated with functional disability and other factors related to frailty. The associations were particularly prominent for patients with DI who also had the worst performance in the domains of CGA. We identified several modifiable risk factors: depressive mood (odds ratio [OR] 1.81; 95% confidence interval [CI] 1.16-2.84) and constipation (OR 1.48, 95% CI 1.02-2.13) associated with UI and, late removal of urinary catheter (OR 2.33, 95% CI 1.31-4.14), impaired mobility (OR 2.08, 95% CI 1.05-4.15), and poor nutrition (OR 2.31, 95% CI 1.11-4.79) associated with DI. ​​​​​​​Conclusions: This study demonstrates a high prevalence of UI and DI in older women with hip fracture and modifiable risk factors, which should be targeted in orthogeriatric management and secondary falls prevention. Patients with DI were found to be an especially vulnerable group.</p

HLA-G Alleles Impact the Perinatal Father–Child HPV Transmission

The host factors that influence father-to-child human papillomavirus (HPV) transmission remain unknown. This study evaluated whether human leukocyte antigen (HLA)-G alleles are important in father-to-child HPV transmission during the perinatal period. Altogether, 134 father–newborn pairs from the Finnish Family HPV Study were included. Oral, semen and urethral samples from the fathers were collected before the delivery, and oral samples were collected from their offspring at delivery and postpartum on day 3 and during 1-, 2- and 6-month follow-up visits. HLA-G alleles were tested by direct sequencing. Unconditional logistic regression was used to determine the association of the father–child HLA-G allele and genotype concordance with the father–child HPV prevalence and concordance at birth and during follow-up. HLA-G allele G*01:01:03 concordance was associated with the father’s urethral and child’s oral high-risk (HR)-HPV concordance at birth (OR 17.00, 95% CI: 1.24–232.22). HLA-G allele G*01:04:01 concordance increased the father’s oral and child’s postpartum oral any- and HR-HPV concordance with an OR value of 7.50 (95% CI: 1.47–38.16) and OR value of 7.78 (95% CI: 1.38–43.85), respectively. There was no association between different HLA-G genotypes and HPV concordance among the father–child pairs at birth or postpartum. To conclude, the HLA-G allele concordance appears to impact the HPV transmission between the father and his offspring.Peer reviewe

The association of HLA-G polymorphism with oral and genital HPV infection in men

The host genetic factors that influence the natural history of human papillomavirus (HPV) infection in men are not well known. Our aim was to evaluate the role of human leukocyte antigen (HLA)-G polymorphism in oral and genital HPV infection in men. Altogether, 130 men from the Finnish Family HPV Study, with a 6-year follow-up, were included in the analyses. HLA-G alleles were tested by direct sequencing. Oral, urethral, and semen samples were collected and analyzed for 24 different HPV genotypes. Unconditional logistic regression was used to determine associations between HLA-G alleles and genotypes with HPV infection and its outcomes. Overall, eight different HLA-G alleles were identified with 15 different HLA-G genotype combinations. The most common HLA-G allele among the men was G*01:01:01 (86.2%, n = 112) followed by G*01:01:02 (36.2%, n = 47). Allele G*01:01:02 showed to be protective against any- and high-risk (HR) oral HPV (OR range of 0.20-0.24, 95% CI range of 0.06-0.85). Men having allele G*01:01:01 showed a reduced risk for incident (OR 0.30, 95% CI 0.11-0.84) and persistent (OR 0.24, 95% CI 0.08-0.69) oral infections. Allele G*01:01:03 was associated with increased risk for urethral HR-HPV infections (OR 4.94, 95% CI 1.34-18.27). Among self-reported demographic data, genotype G*01:01:01/01:01:03 was associated with an increased risk for oral warts (OR 8.00, 95% CI 1.23-51.89) and allele G*01:03:01 increased the risk of pollen and/or animal allergy (OR 13.59, 95% CI 1.57-117.25). To conclude, HLA-G polymorphism in men largely impacts the outcome of an oral HPV infection and seems to associate with self-reported allergies

Valkolupiinin soveltuvuus säilörehuksi

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