What You Need to Know About Urinary Tract Infections

More than half of U.S. women will experience at least one urinary tract infection (UTI) in their lifetimes, while a quarter will have a subsequent infection. Recurrent urinary tract infections are defined as two or more infections in six months or three or more in a year.

Despite the prevalence of the painful condition, women are fearful and frustrated with limited management options, according to Cedars-Sinai research published in the Journal of Urology.

Women who participated in the study were critical of healthcare providers for failing to understand their experiences while over-prescribing antibiotics as a treatment option.

“We were inspired to conduct the study due to the large number of women coming to us feeling hopeless and helpless when it came to the management of their UTIs,” said lead author Victoria Scott, MD, a urologist at the Female Pelvic Medicine and Reconstructive Surgery clinic at Cedars-Sinai.

To help give voice to those suffering with recurrent urinary tract infections, researchers led a focus group study of 29 women who experienced recurrent UTIs to learn about gaps in their care. UTIs are infections of any part of the urinary tract, including the kidneys, ureters, bladder or the urethra. The term is most commonly used to describe a bladder infection.

One of the biggest concerns expressed by study participants revolved around the frequent prescribing of antibiotics and fears of the potential adverse and long-term effects of the medication.

“Many of the participants were aware of the risks of bacteria developing resistance to antibiotics,” Scott said.

“They also were aware of the ‘collateral damage’ of antibiotics and disruption they can have on the normal balance of good and bad bacteria throughout the body.”

The focus group discussions also reported concern with the medical system and limited research efforts to investigate new non-antibiotic management strategies.

Participants voiced frustration and resentment toward their medical providers for “throwing antibiotics” at them without presenting alternative options for treatment and prevention, and for not understanding their experience. In addition, many women described seeking advice from herbalists and acupuncture practitioners, as well as from peers in online forums and chatrooms.

Treatment and Prevention

Although studies show that antibiotics are often the most effective treatment option for urinary tract infections, research also shows that up to 40% of bladder infections can be cleared with non-prescription steps that can include increased water intake and pain relief medications such as ibuprofen.

Taking these steps when UTI symptoms initially develop and urine test results are pending can be important for avoiding unnecessary antibiotics and ensuring that appropriate antibiotics are prescribed when needed.

Among steps women can take to avoid a urinary tract infection are drinking water, taking cranberry supplements or a low-dose antibiotic after sexual intercourse, and using vaginal estrogen for those who are postmenopausal.

While over-the-counter treatments are preferred by many, Scott recommends seeing a doctor if a fever develops or symptoms persist beyond a day, as antibiotic therapy can be crucial for some infections to ensure they don’t spread from the bladder to the kidneys.

“Antibiotics are amazing drugs and in certain settings are lifesaving,” Scott said. “There are absolutely some instances in which antibiotics are necessary, but it’s also important for women to be educated regarding all their options.”

Those who experience recurrent urinary tract infections should seek evaluation by a specialist. Some women will benefit from undergoing a kidney ultrasound or a cystoscopy, which uses a small camera that can be inserted into the urethra to give a view of the urethra and bladder to rule out anatomic abnormalities.

Scott notes that while less common, men also can experience urinary tract infections.

Improving Care

Some healthcare providers might not think that a single episode of a urinary tract infection could have a significant impact on a patient’s life. But when UTIs recur, often without warning, they can have a negative impact on social life, work, families and relationships.

The study recommended that physicians modify management strategies to address women’s concerns and to devote more research to improving non-antibiotic options for prevention and treatment of recurrent urinary tract infections, as well as management strategies that better empower patients.

“Unfortunately, we see many women who blame themselves for developing UTIs. It’s important to understand that UTIs are a very common problem and should not invoke shame” Scott said. “If you are experiencing recurrent UTIs I encourage you to connect with a doctor who specializes in female pelvic medicine and reconstructive surgery to work together to come up with individualized prevention and management strategies.”

Source: Cedars-Sinai Medical Center

In Pictures: Omlette Breakfast Sets

MIND Diet May Guard Against Alzheimer’s


Enlarge image . . . . .

The MIND diet may help older people ward off Alzheimer’s disease, a new study finds.

Developed by the late Martha Clare Morris, who was a Rush University nutritional epidemiologist, and her colleagues, the MIND diet is a hybrid of the Mediterranean and DASH diets.

People in the study who followed the MIND diet even later in life did not develop thinking problems, researchers say.

“Some people have enough plaques and tangles in their brains to have a postmortem diagnosis of Alzheimer’s disease, but they do not develop clinical dementia in their lifetime,” said researcher Dr. Klodian Dhana, an assistant professor in the division of geriatrics and palliative medicine at Rush Medical College in Chicago. “Some have the ability to maintain cognitive function despite the accumulation of these pathologies in the brain, and our study suggests that the MIND diet is associated with better cognitive functions independently of brain pathologies related to Alzheimer’s disease.”

For the study, researchers followed nearly 600 people who completed annual evaluations and tests to see if they had memory and thinking problems. Starting in 2004, participants were given an annual food frequency questionnaire about how often they ate 144 food items in the past year.

The MIND diet has 15 components, including 10 brain-healthy food groups and five unhealthy groups that include, red meat, butter and stick margarine, cheese, pastries and sweets and fried or fast food.

The MIND diet is rich in whole grains, green leafy and other vegetables every day. People are also encouraged to have a glass of wine and snack on nuts, and eat beans every other day or so, eat poultry and berries at least twice a week and fish at least once a week.

But people must watch their consumption of unhealthy foods, including limiting butter to less than 1 1/2 teaspoons a day and eating less than one serving a week of sweets and pastries, whole fat cheese, and fried or fast food.

“We found that a higher MIND diet score was associated with better memory and thinking skills independently of Alzheimer’s disease pathology and other common age-related brain pathologies. The diet seemed to have a protective capacity and may contribute to cognitive resilience in the elderly,” Dhana said in a university news release.

“Diet changes can impact cognitive functioning and risk of dementia, for better or worse,” he continued. “There are fairly simple diet and lifestyle changes a person could make that may help to slow cognitive decline with aging, and contribute to brain health.”

The report was published recently in the Journal of Alzheimer’s Disease.

Source: HealthDay

Omelette Arnold Bennett

Ingredients

1 oz butter
4 oz cooked smoked haddock, flaked
2 tablespoons single cream
3 eggs, separated
1 tablespoon milk
salt
freshly ground black pepper
2 tablespoons grated Parmesan or Cheddar cheese
1 oz butter
2 tablespoons single cream
watercress, to garnish

Method

  1. Heat the butter in an omelette pan and add the cooked flaked haddock and cream. Cook for 2-3 minutes and leave on one side.
  2. Beat the egg yolks with the milk. Add salt and pepper.
  3. Whisk the egg whites until just holding their shape. Using a large metal spoon, fold them into the yolks with the haddock mixture and half the cheese.
  4. Reheat the omelette pan, add 1 oz butter and, when frothing, pour in the egg mixture. Cook until just setting, then slide the omelette on to a heatproof plate.
  5. Sprinkle the rest of the cheese over the surface of the omelette and then pour over the cream. Flash under a hot grill and serve at once garnished with watercress.

Makes 2 servings.

Source: Encyclopedia of Creative Cookery


Today’s Comic