Falls in older aged adults in 22 European countries: incidence, mortality and burden of disease from 1990 to 2017.

INTRODUCTION: Falls in older aged adults are an important public health problem. Insight into differences in fall-related injury rates between countries can serve as important input for identifying and evaluating prevention strategies. The objectives of this study were to compare Global Burden of Disease (GBD) 2017 estimates on incidence, mortality and disability-adjusted life years (DALYs) due to fall-related injury in older adults across 22 countries in the Western European region and to examine changes over a 28-year period. METHODS: We performed a secondary database descriptive study using the GBD 2017 results on age-standardised fall-related injury in older adults aged 70 years and older in 22 countries from 1990 to 2017. RESULTS: In 2017, in the Western European region, 13 840 per 100 000 (uncertainty interval (UI) 11 837-16 113) older adults sought medical treatment for fall-related injury, ranging from 7594 per 100 000 (UI 6326-9032) in Greece to 19 796 per 100 000 (UI 15 536-24 233) in Norway. Since 1990, fall-related injury DALY rates showed little change for the whole region, but patterns varied widely between countries. Some countries (eg, Belgium and Netherlands) have lost their favourable positions due to an increasing fall-related injury burden of disease since 1990. CONCLUSIONS: From 1990 to 2017, there was considerable variation in fall-related injury incidence, mortality, DALY rates and its composites in the 22 countries in the Western European region. It may be useful to assess which fall prevention measures have been taken in countries that showed continuous low or decreasing incidence, death and DALY rates despite ageing of the population.

Microbiological Etiology of Chronic Skin Lesions in Type 2 Diabetic Subjects.

INTRODUCTION: Skin lesions represent lesions that result in loss of tissues and their joints and often this cutaneous process is a primary or secondary consequence of structural changes in the same skin surface. Type 2 diabetic subjects developing chronic skin lesions in the lower limbs in the western world are steadily increasing. We conducted a study on the etiologic incidence of chronic skin lesions in type II diabetic subjects in the lower limbs compared to subjects with chronic skin lesions (controls). MATERIALS AND METHODS: Thirty subjects (group "A") with Chronic Skin Lesions (CSL controls) (19 F-11M, mean age 67.5±7.2) in the lower limbs were admitted to our study according to a randomization scheme and compared a thirty (group "B") type II diabetic patients (18F-12M, mean age 73.5±4.9) with chronic skin lesions (CSL). These two groups "A" and "B" have been studied and compared on the basis of infectious etiology responsible for the infectious skin process. RESULT: In the subjects of the "A" group we found a positive bacteriological colony test of 9 examinations corresponding to the total 30.0%. In the group called "B" we obtained a colony test positive of 12 subjects over 30 corresponding to 40.0% of the examinations. For the number of bacterial species identified in the "A" group we obtained 7 monomicrobial and 2 poly microbial bacteriological tests, while in the "B" group we observed 3 mono microbial and 9 poly microbial tests. All bacteriological isolates showed "in vitro" sensitivity to satisfactory aminoglycosides with MICs range of 0.78- 1.56mg/L. CONCLUSIONS: Data from this study show a different etiology among diabetic subjects than nondiabetic subjects. In fact, in the "B" group, more poly microbial bacteriological findings are found in positive culture studies with subjects in group "A". This phenomenon confirms an alteration of the skin microbiome of diabetic subjects with modification of the "opportunistic role" of some species of the skin bacterial flora.

Aging Eye Microbiota in Dry Eye Syndrome in Patients Treated with Enterococcus faecium and Saccharomyces boulardii.

BACKGROUND: Aging and oxidative stress seem to play a key role in the onset and progression of ocular surface diseases. Dry Eye Syndrome (DES) is a multifactorial disease of the tears and ocular surface in which symptoms may interfere with the ability to work and carry out daily functions. METHODS: This clinical trial was a pilot study to evaluate the effects of supplementation with mixture (Saccharomyces boulardii MUCL 53837 and Enterococcus faecium LMG S-28935) on the tear film. Following the run-in period subjects were randomized in two groups: group A (n.30 subjects) and group B (n.30 subjects). Group A (control) treated only with substitute tear and group B treated with substitute tear + mixture (probiotic). RESULTS: The data obtained in the two study groups A and B were, respectively the following: Schirmer I: 9.2±0.2 vs. 12.8±0.4 (p< 0.001); Schirmer II: 3.6±0.1 vs. 4.6±0.2 (p<0.001); BUT 3.8±0.3 vs. 6.2±0.2 (p<0.001). Culture test showed initial bacterial growth in group "A" (placebo) 27 out of 60 samples tested, corresponding to 45.0% and "B" after treatment (probiotic) was found positive culture whit growth of bacteria in 18 tests equal to 30.0%. The total numbers of isolations of aerobic and anaerobic bacteria found group A and B after treatment. A reduction of 23 to 16 strains of aerobic and anaerobic isolates from 13 to 7 has been found. CONCLUSION: The administration of probiotics strains was effective in reducing DES. In light of these results, we have identified our probiotic (Saccharomyces boulardii MUCL 53837 and Enterococcus faecium LMG S-28935) activity integration with the action of tear substitutes, along with standardization of clinical parameters of the tear film and microbiological activity in restoring of the microbiota ocular surface subject with DES.