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Urinary Tract Analysis Essay

The urinary tract uses urination as a cleaning mechanism, which acts as host defense against bacterial growth and infection. When urine is released from the urethra, any microbes that may have previously entered or were introduced into the sterile environment of the urinary tract are washed away and released from the body. However, sometimes bacteria is able to enter the urethra, colonize, and infect before the cleaning mechanism can take place. If the infection reaches the bladder, the consequences are more severe.

Urinary tract infections are common among sexually active individuals, women, those who ndergo a urinary tract surgery, and the elderly populations (Ronald, 2003). Urinary tract infections, or UTIS, are infections caused by various bacteria, which are often referred to as bacteriuria, entering into the urethra and then being able to colonize throughout the urinary tract. Of these bacteria, the most common are E. coli, which is the biggest contributor, and Staphylococcus saprophyticus (Ronald, 2003). The bacteria can be introduced into the urethra though a variety of methods.

These include poor hygiene practices, not urinating when necessary, and the insertion of foreign objects, such as atheters. UTIS can present a variety of symptoms or can be asymptomatic, which is common (Nicolle & Yoshikawa, 2000). The bacteriuria is often able to colonize the urethra without causing any symptoms because of the inability to infect on the level that the immune response would be inflammation (Omli et al. , 2008). Asymptomatic UTIS can also be confused with symptomatic UTI in patients that exhibit signs of other infections.

If symptoms are present, they tend to vary due to a variety of factors which include age, sex, and physical condition of a person. For all ages, fever is a sign of infection (Omli et al. 2008). The average adult and younger tend to have symptoms that include pain and burning during urination whereas the older population has different signs of the infection. Elderly usually do not experience pain or burning due to the loss of pain receptors. Because the do not feel the pain, they usually are unaware of the infection. Elderly usually experience cloudy, strong smelling urine that shows signs of blood once the infection has reached the bladder.

In some cases it has been shown that UTI in elderly are linked to delirium (Balogun, & Philbrick, 2014). This often make proper diagnosis of UTIS in lderly problematic (Omli et al. , 2008). Various research has pointed to the elderly being more susceptible to developing Urinary Tract Infections. Of all infections the elderly encounter, UTI’s account for 25% of them (Balogun, & Philbrick, 2014). The reasons for this will be discussed further in the next paragraph, but are due mostly to illnesses that include neurogenic bladder and incontinence interventions that are initiated (Nicolle & Yoshikawa, 2000).

Urinary tract infections are the most common type of infections to occur in patients in long-term care facilities, i. e. the elderly (Nicolle & Yoshikawa, 2000). This is possible because in another study done it was found that bacteriuria can be present in as high as 50% of nursing home residents (Omli et al. , 2008). Increase catheter use also puts elderly at risk for UTIS. In nursing homes, about 80% of UTIS are linked to catheter use (Omli et al. , 2008). In one study it was found that 9% of elderly that had a catheter put into place developed a UTI though they did not previously have one (Hazelett, 2006).

In the same study, 28% of elderly hospital patients were catheterized because of a UTI (Hazelett, 2006). There are many factors that put the elderly opulation at such a great risk for developing UTIS. As implied earlier, elderly are more likely to be incontinent or require the use of catheters which increases likelihood for infection to occur. This is because of the altering of the urogenital tract that many elderly experience.

Post void residual, which is urine that is left in the bladder after urination, can also attribute to UTI occurrence (Omli et al. 2008). This can be caused from a bladder outlet obstruction which can be both from urogenital changes and the introduction of a catheter. These increase the likelihood f bacteriuria being introduced into the urogenital tract and not being removed by the self-cleaning mechanism of urination. Care settings that have high presence of bacteria not a part of the normal microbiota also put the elderly at risk for contracting bacteriuria. Fortunately, precautions can be taken to decrease the likelihood of Urinary Tract Infection occurrence.

These can be as simple as urinating when necessary and learning the proper techniques to clean one’s self- front to back as not to introduce bacteria from the anus to the urethra. Cranberry pills and food items containing cranberry help to treat and prevent UTIS, have anti-adhesin qualities against UTI causing bacteriuria (Glickman-Simon et al. , 2015). This is helpful and preventative because these cranberry items block against the adhesion of the bacteriuria’s fimbriae and adhesin molecules. In the case of E. coli, this is the type 1 fimbriae and the adhesin FimH.

Antibiotics can also be used to treat those presenting with a UTI but are often avoided in elderly patients because it makes them more susceptible to other infections occurring. Instead, prophylactic antibiotics can be used before the insertion of a catheter or if here is a chance of a UTI developing. It is important to weigh the risks and benefits of treating a UTI verse letting it run its course and allowing for the host defenses to rid itself of the infection instead. Urinary tract infections are only one of the many issues that the elderly population encounters.

Many different types of neurological diseases tend to occur due to the degradation of the brain, neural tract, and other systems of the body that start to occur with aging. The most common diseases are dementia, Alzheimer’s, and Parkinson’s disease which can be hereditary or environmental (Harbo, et al. , 2009). Of these, Parkinson’s isease commonly manifests earlier, starting from between 50-65 years of age and occurs in approximately 1% of the population over the age of 60 (Kapoor et al. , 2013).

Parkison’s disease, or PD, is commonly caused by the environmental factors of aging but has been found to be familial as well through various genetic studies (Harbo et al. , 2009). It is recommended that anyone with Parkinson’s in their family is tested and receives a molecular diagnosis to see if they are dominant or recessive carriers (Harbo et al. , 2009). Parkinson’s can be defined as a slow progressing, neurological disorder that eads to negative impacts on both motor and non-motor functions, with varying degrees among those diagnosed (Jankovic, 2008).

Cell degradation in the brain occurs with aging. PD patients face degradation and loss of dopaminergic neurons located in the substantia nigra (Tsujimura et al. , 2004). Lewy body development also occurs which inhibit dopamine production in the substantia nigra (Tsujimura et al. , 2004). Dopamine helps to regulate the body’s systems. Due to the decrease of available dopamine all systems of the body- internal and external- are slowed. This slowing includes muscular and urinary systems. There are four signs that one usually exhibits to be diagnosed with Parkinson’s disease (Jankovic, 2008).

They are as follows: tremor at rest, rigidity, bradykinesia, and postural instability. They can present differently over the course of the disease but once they are exhibited they cannot be diminished, they can only be stabilized or become worse. Bradykinesia is a basal ganglia disorder. This is often the first recognizable sign of Parkinson’s disease before a neurological examination can be performed. Bradykinesia is related to dopamine deficiency, which is supported by the observable neuronal density decrease n the substantia nigra (Jankovic, 2008).

This disorder slows movement, both internally and externally, and cause loss of spontaneous movements (Jankovic, 2008). This feature of Parkinson’s will also impaired swallowing, decreased blinking, speech impairments, and a decrease in facial expressions, or hypomimia (Jankovic, 2008). Those expressing bradykinesia may not be able to perform basic action such as opening their eyes or being able to speaking words. Sometimes these can be triggered by an external factor. Bradykinesia alone cannot lead to a person with symptoms to be diagnosed with Parkinson’s isease, it must be accompanied by the other three to degree.

Tremors at rest begin in the distal part of the bilateral upper extremities, but can later progress to involve other parts of the body such as legs and jaw (Jankovic, 2008). It has been found that 69% of patients exhibited signs of tremor at rest at the start of their disease (Jankovic, 2008). The tremor at rest manifests first in bilateral upper extremities and is caused by depletion of dopamine that increases oscillation in basal ganglia and cerebello-thalamo-cortical circuits, thus causing the tremor to occur. A resting tremor will stop during action as well as uring sleep (Jankovic, 2008).

The third component in identifying a person with Parkinson’s disease is rigidity. This is the stiffness of the limbs which normally occurs around limbs in Parkinson’s patients (Jankovic, 2008). The stiffness of limbs is caused by the muscles being in a constantly contracted state. The stiffness usually manifests around the shoulders, elbows and neck and can eventually spread to the hips, legs, and knees. Once this happens the patient will be unable to stand or walk and will likely become bedridden. The last sign of Parkinson’s is postural instability.

This often transpires later after Parkinson’s disease starts to manifests, or is the last of all the signs to develop. It occurs because of the loss the postural reflexes (Jankovic, 2008). Those who have postural instability often demonstrate either a forwards or backwards lean. The manifestation of postural instability leads to a greater risk of falling as well as hip fractures (Jankovic, 2008). There are other symptoms of PD that include non-motor symptoms that can be both autonomic and metal dysfunction (Campos et al. , 2015). Autonomic symptoms would include bladder and bowel issues or changes.

Mental ysfunctions include cognitive changes and mood changes. It is important that medications for the big four symptoms of Parkinson’s do not worsen these symptoms. There have been some studies that use holistic treatments to help keep the some quality of life of PD patients and inhibit the disease progression. One study done found Tai Chi to be beneficial as a treatment. Tai Chi helped to improve strength and balance as well as aiding core muscles, which led to PD symptoms being more manageable (Glickman-Simon et al. , 2015).

Tai Chi was also linked to a higher perception of health (Glickman-Simon et al. 015) which has been known to help patients with various diseases to have a better mental state and control over the disease. Medications are helpful for patients with Parkinson’s disease but not to cure the disease. Medications will only slow process of degradation. Some of the most commonly used medications are Carbidopa and Levodopa. These increase dopamine availability in brain, which can help inhibit progression but not halt it. Once a function is destroyed it cannot be regenerated. For example, once speech is impaired from bradykinesia a PD patient will no longer to be able to speak even after medication is given.

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