What characteristics indicate concomitant posterior pelvic injury in pubic ramus fractures in the elderly?

Among pelvic serious injuries is the so-called “open book” injury of the pelvis, with Sacroiliac Joint Disruption (SIJD) in combination with upper pubic ramus or anterior column fracture, contralateral or ipsilateral, or both. This combination of pelvic injury could be classified according Young and Burgess classification as LCIII or CM type (Combined Mechanism) and as 61-B3.1 61-B3.2 following AO/OTA classification. Specifically, the upper pubic ramus fracture can be classified according to Nakatani classification as type I medial of the foramen, type II within the foramen and type III lateral to the foramen. The difficulty to deal with these fractures is how to close and reduct the pubic symphysis in mechanically stable way since there is fracture in one or both the upper pubic ramus. The existence of these fractured elements, in this type of pelvis injury allow a lot of degrees of freedom which must be managed from the surgeon in the proper sequence. The incision and the approach are also mandatory for successfully treating these lesions. Anterior Intrapelvic Approach (AIP) or Stoppa approach in conjunction with the first window of ilioinguinal approach is the most appropriate surgical exposure for reduction and fixation.

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Mutual exclusivity of neck of femur and pubic ramus fractures in the elderly. Is it a fact?

Current Orthopaedic Practice ◽

10.1097/bco.0b013e31829fbff4 ◽

2013 ◽

Vol 24 (6) ◽

pp. 651-652

Author(s):

Harinder Gakhar ◽

Salim Punjabi ◽

Naveed Ahmed ◽

Ajay Sharma

Keyword(s):

The Elderly ◽

Mutual Exclusivity ◽

Neck Of Femur ◽

Pubic Ramus

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Cell surface changes during aging of human bladder epithelium examined by lectin probes and SEM

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100162429 ◽

1990 ◽

Vol 48 (3) ◽

pp. 966-967

Author(s):

J. Jacob ◽

M.F.M. Ismail

Keyword(s):

The Elderly ◽

Ultrastructural Changes ◽

Pokeweed Mitogen ◽

Asymmetric Structure ◽

Luminal Surface ◽

Bladder Epithelium ◽

Aldehyde Groups ◽

Cell Surface Changes ◽

Phosphate Buffered Saline ◽

Surface Changes

Ultrastructural changes have been shown to occur in the urinary bladder epithelium (urothelium) during the life span of humans. With increasing age, the luminal surface becomes more flexible and develops simple microvilli-like processes. Furthermore, the specialised asymmetric structure of the luminal plasma membrane is relatively more prominent in the young than in the elderly. The nature of the changes at the luminal surface is now explored by lectin-mediated adsorption visualised by scanning electron microscopy (SEM).Samples of young adult (21-31 y old) and elderly (58-82 y old) urothelia were fixed in buffered 2% glutaraldehyde for 10 m and washed with phosphate buffered saline (PBS) containing Ca++ and Mg++ at room temperature. They were incubated overnight at 4°C in 0.1 M ammonium chloride in PBS to block any remaining aldehyde groups. The samples were then allowed to stand in PBS at 37°C for 2 h before incubation at 37°C for 30 m with lectins. The lectins used were concanavalin A (Con A), wheat germ agglutinin (WGA), phytohaemagglutinin (PHA) and pokeweed mitogen (PWM) at a concentration of 500 mg/ml in PBS at pH 7.A.

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The effect of dental geriatric curricula on attitudes toward the elderly

Journal of Dental Education ◽

10.1002/j.0022-0337.1988.52.9.tb02232.x ◽

1988 ◽

Vol 52 (9) ◽

pp. 516-518 ◽

Cited By ~ 2

Author(s):

J Mann ◽

TJ Bomberg ◽

JM Holtzman ◽

DB Berkey

Keyword(s):

The Elderly

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Speech-Language Pathologists' Attitudes Toward Aging and the Elderly

Contemporary Issues in Communication Science and Disorders ◽

10.1044/cicsd_30_f_146 ◽

2003 ◽

Vol 30 (Fall) ◽

pp. 146-155 ◽

Cited By ~ 5

Author(s):

Jeff Searl ◽

Rodney M. Gabel

Keyword(s):

The Elderly ◽

Speech Language Pathologists ◽

Attitudes Toward Aging

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Pharmacology Issues Related to Dementia Syndrome of Depression in Elderly Residents of Long-Term Care Settings

Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders ◽

10.1044/nnsld25.2.61 ◽

2015 ◽

Vol 25 (2) ◽

pp. 61-69

Author(s):

Angel L. Ball ◽

Adina S. Gray

Keyword(s):

Depressive Symptoms ◽

The Elderly ◽

Environmental Communication ◽

Pharmacological Intervention ◽

Team Approach ◽

Discussion Paper ◽

Term Care ◽

Anticholinergic Medications ◽

Inappropriate Treatment ◽

Dementia Syndrome

Pharmacological intervention for depressive symptoms in institutionalized elderly is higher than the population average. Among the patients on such medications are those with a puzzling mix of symptoms, diagnosed as “dementia syndrome of depression,” formerly termed “pseudodementia”. Cognitive-communicative changes, potentially due to medications, complicate the diagnosis even further. This discussion paper reviews the history of the terminology of “pseudodementia,” and examines the pharmacology given as treatment for depressive symptoms in the elderly population that can affect cognition and communication. Clinicians can reduce the risk of misdiagnosis or inappropriate treatment by having an awareness of potential side effects, including decreased attention, memory, and reasoning capacities, particularly due to some anticholinergic medications. A team approach to care should include a cohesive effort directed at caution against over-medication, informed management of polypharmacology, enhancement of environmental/communication supports and quality of life, and recognizing the typical nature of some depressive signs in elderly institutionalized individuals.

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