Gender differences in benzodiazepines prescription in old age patients

2016 ◽  
Vol 33 (S1) ◽  
pp. s279-s279 ◽  
Author(s):  
M. Martinez-Cengotitabengoa ◽  
A. Besga ◽  
C. Bermudez-Ampudia ◽  
A. Garcia-Alocen ◽  
I. Gonzalez-Ortega ◽  
...  
Keyword(s):  
Gender Differences ◽  
Elderly Patients ◽  
Half Life ◽  
Emergency Service ◽  
The Elderly ◽  
Considerable Proportion ◽  
Men And Women ◽  
Number Of Patients ◽  
Adult Dose ◽  
Competing Interest

ObjectivesTo assess the prescription of benzodiazepines (BZD) in elderly patients, and to explore any gender differences.MethodsSix hundred and fifty-four patients (≥ 65) admitted in an emergency service of a general hospital due to a fall. BZD use information was collected (dose, half-life profile).ResultsBZD are significantly more prescribed to women (47.6%) than men (36.1%) (X2 = 8.097, P = 0.004). We conducted a logistic regression analysis using as dependent variable taking or not BZD and sex as the independent one, covariating the model by age. We noted that sex remains significant despite enter the age variable in the model (OR = 1.5, P = 0.013). A total of 21.6% of patients consumed intermediate or long half-life BZDs, appearing a greater tendency to prescribe such BZD to women (X2 = 3.606, P = 0.058). In the 58.0% of prescriptions, prescribed dose was higher than the recommended for the elderly. The percentage is significantly higher for men (70.0%) than women (53.1%). Furthermore, a total of 54 prescriptions (15.8%) were even higher than the recommended adult dose, with no significant differences between men and women.ConclusionsWe found evidence of a higher prescription of BZD in women independently of age. Despite not being recommended, prescription of intermediate or long half-life BZD continues, in a slightly higher manner in women. BZD are prescribed above the recommended dose for elderly in a large number of patients, especially in men. A considerable proportion of elderly patients (15.8%) consume BZD doses even higher than the recommended for adults.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Elderly victims of falls seen by prehospital care: gender differences

2014 ◽  
Vol 17 (1) ◽  
pp. 3-16 ◽  
Author(s):  
William Campo Meschial ◽  
Dorotéia Fátima Pelissari de Paula Soares ◽  
Nelson Luiz Batista de Oliveira ◽  
Alice Milani Nespollo ◽  
Wesley Alexandre da Silva ◽  
...  
Keyword(s):  
Gender Differences ◽  
Elderly Patients ◽  
Exploratory Study ◽  
Prehospital Care ◽  
The Elderly ◽  
Cross Sectional ◽  
Significance Level ◽  
Care Services ◽  
Preventive Actions ◽  
Type Of Injury

OBJECTIVE: To identify elderly who are victims of falls, according to gender, who received care from prehospital services of Maringá, Paraná. METHODS: A cross-sectional exploratory study carried out with 1,444 elderly patients who suffered falls in Maringá in the period from 2006 to 2008. Data were gathered from prehospital care services, typed and processed using the Epi Info 6.04d(r). The χ² test was used to compare the falls in relation to gender (significance level = 0.05). RESULTS: The number of falls according to gender presented similar percentages, 51.0% for males and 49.0% for females. Significant differences between genders were observed regarding age (p < 0.001), presence of alcohol breath (p < 0.001), type of fall (p < 0.001), place of fall (p < 0.001), treatment at hospital (p = 0.023), number of injuries (p = 0.014), type of injury (p < 0.001) and injury location (p <0.001). CONCLUSION: These results show that falls happen differently among the elderly when considering gender. It highlights the importance of understanding these differences in detail and the circumstances in which the fall occurred, since this knowledge is key to plan preventive actions.

scholarly journals Comminuted Patella Fracture in Elderly Patients: A Systematic Review and Case Report

2017 ◽  
Vol 8 (3) ◽  
pp. 135-144 ◽  
Author(s):  
Brent Matthews ◽  
Kaushik Hazratwala ◽  
Sergio Barroso-Rosa
Keyword(s):  
Case Report ◽  
Elderly Patients ◽  
Treatment Options ◽  
The Elderly ◽  
Fracture Pattern ◽  
Patella Fracture ◽  
Level Of Evidence ◽  
Fixation Failure ◽  
Number Of Patients ◽  
Mesh Augmentation

Objectives: To review comminuted patella fracture in the elderly patients and examine the surgical options to avoid complications such as fixation failure and poor functional outcome. To provide an example of mesh augmentation in comminuted patella fracture in the elderly patients. Data Sources: A literature review was conducted by the authors independently using Ovid, Medline, Cochrane, PubMed, and Clinical Key in English. We aimed to review data on patients older than 65 with comminuted patella fracture. Search conducted between July and December 2015. Study Selection: Search terms included patella fracture, elderly, and fixation failure. Abstracts were included if they were a case report, cohort series, or randomized control trial. Further inclusion criteria were that they were available in full text and included patient age(s), operative details, follow-up, and outcome discussion. Data Extraction: Each study was assessed according to its level of evidence, number of patients, age of patients, fracture patterns described, complications of treatment, and results summarized. Data Synthesis: Paucity of data and heterogeneity of studies limited statistical analysis. Data are presented as a review table with the key points summarized. Conclusion: In patella fracture, age >65 years and comminuted fracture pattern are predictors of increased fixation failure and postoperative stiffness, warranting special consideration. There is a trend toward improved functional outcomes when augmented fixation using mesh or plates is used in this group. Further level 1 studies are required to compare and validate new treatment options and compared them to standard surgical technique of tension band wire construct.

scholarly journals The Relationship between Smoking and Sublingual Varices in the Elderly

2021 ◽  
Vol 36 (4) ◽  
pp. e288-e288
Author(s):  
Niusha Barzideh ◽  
Arezoo Alaee ◽  
Arash Azizi
Keyword(s):  
Older Adults ◽  
Cigarette Smoking ◽  
Elderly Patients ◽  
Varicose Veins ◽  
The Elderly ◽  
Control Group ◽  
Case Group ◽  
Chi Square ◽  
Number Of Patients ◽  
And Control

Objectives: We investigated the existence of any connection between smoking and sublingual varices (SLV) in the older population. Methods: This case-control study was conducted in 2019 on adults > 65 years old at Kahrizak Charity Nursing Home, Alborz, Iran. We conducted clinical examination and inspection of 222 elderly patients. Both the case group and control group contained the same number of patients (n = 111). SLV were classified as grade 0 (few or none visible) and grade 1 (moderate or severe). The case group included patients with SLV and the control group consisted of those older adults without SLV and who were matched with the case group based on age, gender, blood pressure, denture wearing, and varicose veins in their legs. Cigarette smoking habits were investigated in both groups. Smokers were considered those who smoked at least one cigarette per day for more than six months. Chi-square and odds ratio (OR) were used to statistically analyze the exposure of participants to smoking in both groups. Results: Among 222 participants, 21.6% and 5.4% were smokers in the case and control groups, respectively. The results of our data analysis revealed that SLV were significantly associated with smoking (p < 0.001, OR = 4). Conclusions: Elderly patients with SLV are more likely to be cigarette smokers. Therefore, cigarette smoking cessation programs are recommended for older adults in society.

Gender Differences in Complicated Grief among the Elderly

1996 ◽  
Vol 32 (4) ◽  
pp. 303-317 ◽  
Author(s):  
Andrew J. Bierhals ◽  
Holly G. Prigerson ◽  
Amy Fasiczka ◽  
Ellen Frank ◽  
Mark Miller ◽  
...  
Keyword(s):  
Gender Differences ◽  
Analysis Of Variance ◽  
Complicated Grief ◽  
The Elderly ◽  
Stage Theory ◽  
Men And Women ◽  
Temporal Course ◽  
Over Time

The resolution of grief has been frequently posited to progress through stages. Seventy-one widows and twenty-six widowers bereaved from five months to thirty-seven years were studied to determine if their resolution of grief-related symptoms could be mapped onto a stage theory of grief and to examine if men and women follow the same temporal course. An analysis of variance was used to test for differences in complicated grief symptoms over time and between widows and widowers. Widowers bereaved three years or longer were found to have increased bitterness. By contrast, widows who were bereaved three years and beyond were found to have lower levels of complicated grief. These preliminary findings suggest that grief may not resolve in stages and that symptoms of complicated grief may not decline significantly over time. Rather symptoms of complicated grief appear to remain stable at least for the first three years of bereavement for both men and women but, thereafter, among widowers tend to increase and among widows to decrease.

scholarly journals Pathologic and Clinical Characteristics of Elderly Patients With Breast Cancer: A Retrospective Analysis of a Multicenter Study (Anatolian Society of Medical Oncology)

2014 ◽  
Vol 99 (1) ◽  
pp. 2-7 ◽  
Author(s):  
Ali İnal ◽  
Tulay Akman ◽  
Sebnem Yaman ◽  
Selcuk Cemil Ozturk ◽  
Caglayan Geredeli ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Retrospective Study ◽  
Elderly Patients ◽  
Older Patients ◽  
The Elderly ◽  
Lymph Node Involvement ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Number Of Patients ◽  
Er Positive

Abstract There is very little information about breast cancer characteristics, treatment choices, and survival among elderly patients. The purpose of this multicenter retrospective study was to examine the clinical, pathologic, and biologic characteristics of 620 breast cancer patients age 70 years or older. Between June 1991 and May 2012, 620 patients with breast cancer, recruited from 16 institutions, were enrolled in the retrospective study. Patients had smaller tumors at diagnosis; only 15% of patients had tumors larger than 5 cm. The number of patients who had no axillary lymph node involvement was 203 (32.7%). Ninety-three patients (15.0%) had metastatic disease at diagnosis. Patients were characterized by a higher fraction of pure lobular carcinomas (75.3%). The tumors of the elderly patients were also more frequently estrogen receptor (ER) positive (75.2%) and progesterone receptor (PR) positive (67.3%). The local and systemic therapies for breast cancer differed according to age. An association between age and overall survival has not been demonstrated in elderly patients with breast cancer. In conclusion, the biologic behavior of older patients with breast cancer differs from younger patients, and older patients receive different treatments.

scholarly journals Perioperative pain management in elderly patients with а proximal femoral fracture: evidence review

Pain medicine ◽  
2020 ◽  
Vol 4 (4) ◽  
pp. 42-49
Author(s):  
Anastasiia Romanenko ◽  
Юрій Кучин ◽  
Катерина Бєлка ◽  
Ігор Токар
Keyword(s):  
Hip Fracture ◽  
Pain Management ◽  
Elderly Patients ◽  
Femoral Fracture ◽  
Adverse Drug Events ◽  
Perioperative Period ◽  
The Elderly ◽  
Proximal Femoral Fracture ◽  
Nerve Blocks ◽  
Number Of Patients

The purpose of this article is to compare different methods of analgesia during perioperative period in elderly patients with а proximal femoral fracture. The incidence of hip fracture is high and also rises with the age, for example, In Great Britain, number of patients with a hip fracture will be approximately 100 000 in 2033, and it’s also associated with significant healthcare financing. Nevertheless, effective pain management is a big challenge for clinicians because of considerable problems in geriatric patients, including age, physiological changes in the elderly, preexisting comorbidities, cognitive impairment, high risk of delirium, problems with rehabilitation and probability of an independent life [12].   Opioids are still the main option for hip fracture pain management, despite differences in pharmacokinetics and pharmacodynamics in elderly patients, which are correlated with high frequency of side effects. Opioid-related adverse drug events are associated with worse patient outcomes such as morbidity, mortality and length of stay increase. Therefore, peripheral nerve blocks as part of multimodal analgesic technique can provide more effective pain control after hip fracture. Comprehensive literature searches focus on the use of peripheral nerves blocks as preoperative analgesia, as postoperative analgesia or as a supplement to general anesthesia for hip fracture surgery.

scholarly journals Hemodynamic evaluation of elderly patients during laparoscopic cholecystectomy

2018 ◽  
Vol 45 (2) ◽  
Author(s):  
LUIZ PAULO JACOMELLI RAMOS ◽  
RODRIGO BARCELLOS ARAÚJO ◽  
MARIA DO CARMO VALENTE CASTRO ◽  
MARIA ROBERTA MENEGUETTI SERAVALLI RAMOS ◽  
JOSÉ ANTONIO CUNHA-E-SILVA ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Laparoscopic Cholecystectomy ◽  
Ejection Fraction ◽  
Elderly Patients ◽  
The Elderly ◽  
Statistical Correlation ◽  
Hemodynamic Changes ◽  
Number Of Patients ◽  
Elective Laparoscopic Cholecystectomy ◽  
The Mean

ABSTRACT Objective: to demonstrate hemodynamic changes during laparoscopic cholecystectomy in elderly patients with trans-esophageal echocardiography. Methods: we studied 31 elderly patients (aged 60 years or older), ASA I or II, who underwent elective laparoscopic cholecystectomy under general, standardized anesthesia, with cardiovascular parameters measured using transesophageal echocardiography at three different times: before the pneumoperitoneum (T1), after CO2 insufflation (T2) and at deflation (T3). We statistically evaluated changes in systolic, diastolic and mean blood pressure, heart rate, cardiac output and index, and ejection fraction. Results: although small, only the diastolic blood pressure (DBP) and ejection fraction (EF) variations were statistically significant. The mean ± standard deviation of DBP in mmHg at the different times were: T1=67.5±10.3; T2=73.6±12.4; and T3=66.7±9.8. And for EF, in percentage (%) they were: T1=66.7±10.4; T2=63.2±9.9; and T3=68.1±8.4. There was no statistical correlation between hemodynamic variations, age and number of patients’ comorbidities. Conclusion: laparoscopic cholecystectomy causes few hemodynamic changes that are well tolerated by the majority of the elderly patients; prior impairment of ventricular function represents a threat in elderly patients during surgery; there appears to be a lower hemodynamic effect caused by the pneumoperitoneum than by the patient’s positioning in a reverse Trendelemburg during surgery.

Changes in the trend of anti-psychotics prescription in elderly patients in a general hospital in Singapore 2005–2013

2017 ◽  
Vol 41 (S1) ◽  
pp. S762-S762
Author(s):  
L. Tan ◽  
R. Kinson
Keyword(s):  
Elderly Patients ◽  
General Hospital ◽  
The Elderly ◽  
Descriptive Study ◽  
Health Sciences ◽  
Black Box ◽  
Cerebrovascular Events ◽  
Safety Warning ◽  
Black Box Warnings ◽  
Competing Interest

ObjectivesThis was a descriptive study of the prescription trend of anti-psychotics for elderly patients in a general hospital in Singapore.MethodsElderly patients aged >65 who received at least 1 prescription of anti-psychotics during 2005, 2007, 2009, 2011 and 2013 in Tan Tock Seng Hospital, Singapore, were selected. Data was obtained from the hospital computerized prescription records.ResultsThe total number of elderly patients who received anti-psychotics increased from 865 in 2005 to 1990 in 2013. Following the official warning issued by the health sciences authority in 2004 regarding the increased risks of cerebrovascular events in elderly patients taking olanzapine and risperidone, prescriptions for risperidone reduced between 2005 to 2013 (20.74% vs. 11.79%, 95% CI: 0.07–0.10, P < 0.0001). However, the percentage of prescriptions of other atypical anti-psychotics such as quetiapine increased from 27.47% to 58.48% (95% CI: 0.29–0.33, P < 0.0001), in 2005 and 2013 respectively, and prescriptions for olanzapine remained relatively stable at 6.65% in 2005 and 8.94% in 2013 (P > 0.05). With the black box warnings extended to typical anti-psychotics 3 years later, the percentage of prescriptions of typical anti-psychotics decreased between 2005 to 2013, e.g. haloperidol (33.19% vs. 13.39%, 95% CI: 0.17–0.22; P < 0.0001), sulpiride (6.58% vs. 2.83%, 95% CI: 0.03–0.05, P < 0.0001) and chlorpromazine (3.85% vs. 1.85%, 95% CI: 0.01–0.03, P < 0.0001).ConclusionsAfter the first safety warning the percentage of prescriptions for risperidone dropped significantly, and there was a significant increase for quetiapine. The percentage of haloperidol, sulpiride and chlorpromazine prescriptions declined after both warnings. Anti-psychotics use in the elderly continues to be prevalent.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Glioblastoma in the elderly: making sense of the evidence

2015 ◽  
Vol 3 (2) ◽  
pp. 77-86 ◽  
Author(s):  
Matthew Mason ◽  
Normand Laperriere ◽  
Wolfgang Wick ◽  
David A. Reardon ◽  
Annika Malmstrom ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Dna Methyltransferase ◽  
Methylation Status ◽  
Malignant Neoplasm ◽  
The Elderly ◽  
Best Supportive Care ◽  
Methylguanine Dna Methyltransferase ◽  
Making Sense ◽  
Number Of Patients ◽  
Management Recommendations

AbstractGlioblastoma is a highly malignant neoplasm, notorious for its poor prognosis. The median age of diagnosis is 64 years, with an increasing number of patients diagnosed over the age of seventy. Managing elderly patients with this condition is challenging. Management pathways may include surgery, radiotherapy, chemotherapy, and best supportive care. Many clinical trials in oncology exclude elderly patients, including some of those for malignant brain tumors, leaving less evidence to guide treatment in these patients. Recent advances in molecular diagnostics and biomarkers, such as 06-methylguanine-DNA-methyltransferase (MGMT) promoter methylation status, may help guide optimal treatment selection. Focusing on available randomized data, this review provides a practical overview of the evidence for treating newly diagnosed glioblastoma in the elderly, including management recommendations.

Relationship Between the Administration of Selected Medications and Falls in Hospitalized Elderly Patients

1995 ◽  
Vol 29 (4) ◽  
pp. 354-358 ◽  
Author(s):  
Barry J Gales ◽  
Susan M Menard
Keyword(s):  
Heart Failure ◽  
Elderly Patients ◽  
Half Life ◽  
The Elderly ◽  
Disease States ◽  
Hospitalized Elderly ◽  
Benzodiazepine Use ◽  
Hospitalized Elderly Patients ◽  
The Relationship ◽  
Digoxin Therapy

Objective: To examine the relationship between administration of selected medications and falls experienced by hospitalized elderly patients. Benzodiazepines and other medications previously associated with falls in elderly patients residing in the community and nursing homes were the primary focus. Design: Retrospective case control. Setting: Private, not-for-profit, 575-bed acute care hospital. Participants: A total of 100 patients who had fallen and 100 control patients, aged at least 70 years, admitted during the same 17-month time period. Main Outcome Measures: We examined the relationship between falls and patient demographics, underlying disease states, number of concurrent disease states, and length of hospitalization. Possible associations between the administration of narcotics, benzodiazepines, antidepressants, antipsychotics, other sedating agents, antihypertensives, diuretics, nitrates, and digoxin 48 hours prior to the fall or reference day were explored. The relationships between benzodiazepine half-life, dosage, administration frequency, cumulative dose, and falls were also examined. Results: Demographically the groups were similar except that patients who had fallen were hospitalized significantly longer (mean 18.8 vs 12.2 d; p < 0.00001) than control patients. Benzodiazepines were received by more (40% vs 20%, odds ratio = 2.67) patients who had fallen than control patients. The use of long (>24 h) half-life benzodiazepines was similar in patients who had fallen (48%) and control patients (45%). Long half-life benzodiazepines were commonly administered (65%) to patients who had fallen in doses greater than that recommended for the elderly. Benzodiazepine use, expressed as milligrams of diazepam equivalents received during the 48-hour study, was higher in patients who had fallen than in control patients (15.00 ± 17.80 vs 9.73 ± 6.58 mg), but this was not statistically significant (p = 0.1030). Congestive heart failure (37% vs 24%), digoxin therapy (35% vs 22%), or administration of 3 or more psychoactive agents (17% vs 4%) were all more common in patients who had fallen than in control patients. Conclusions: Falls experienced by the elderly patients in our acute care institution were associated with the presence of congestive heart failure along with digoxin therapy, benzodiazepine use, or the use of at least 3 psychoactive agents.

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