scholarly journals Swallowing in Patients with Mental Disability - Analysis of 189 Swallowing Video Endoscopies

2018 ◽  
Vol 23 (01) ◽  
pp. 025-030
Author(s):  
Sulene Pirana ◽  
Marcela Oliveira ◽  
Fabiana Pissini ◽  
Raíssa Andrade

Introduction Feeding, swallowing and breathing are fundamental activities for the survival and well-being of humans; these functions are performed by the most complex neuromuscular unit of the human body, which, when altered, may raise morbidity and mortality rates. Objective To evaluate deglutition in patients with mental disability in order to determine the incidence and the severity of dysphagia. Methods A total of 189 institutionalized adult patients with mental disability were analyzed using a 3.2 mm flexible fiberscope (Machida, Japan 1995). The following food consistencies were tested: pasty, thickened liquid and liquid. Results Among the total of 189 patients, 101 (53.4%) were female aged between 14 and 55 years old. Most of them 120 (63.5%) had profound mental deficiency, 58 (30.7%) had severe mental deficiency, 9 (4.8%) had moderate mental deficiency, and 2 (1.1%) had mild mental deficiency. Gender and the degree of mental deficiency did not influence significantly the degree of dysphagia. Age, degree of disability and interaction between age groups and degrees of disability influenced significantly the degree of dysphagia. Younger patients are more likely to present more severe dysphagia. Stabilization occurs between 31 and 40 years of age, and above this age, a greater chance of less severe dysphagia, because the increase in the degree of mental deficiency decreases the probability of more severe dysphagia. Conclusion The population that mostly presented severe dysphagia was characterized by being mostly female, with profound mental deficiency, with an average age of 36.7 years. There was no relationship between gender and the degree of mental disability concerning the degree of dysphagia.

2010 ◽  
Vol 138 (9) ◽  
pp. 1215-1226 ◽  
Author(s):  
C. L. FISCHER WALKER ◽  
R. E. BLACK

SUMMARYDiarrhoea is a leading cause of morbidity and mortality yet diarrhoea specific incidence and mortality rates for older children, adolescents, and adults have not been systematically calculated for many countries. We conducted a systematic literature review to generate regional incidence rates by age and to summarize diarrhoea specific mortality rates for regions of the world with inadequate vital registration data. Diarrhoea morbidity rates range from 29·9 episodes/100 person-years for adults in the South East Asian region to 88·4 episodes/100 person-years in older children in the Eastern Mediterranean region and have remained unchanged in the last 30 years. Diarrhoea mortality rates decline as the child ages and remain relatively constant during adulthood. These data are critical for improving estimates worldwide and further highlight the need for improved diarrhoea specific morbidity and mortality data in these age groups.


2002 ◽  
Vol 20 (3) ◽  
pp. 770-775 ◽  
Author(s):  
Sally S. Ingram ◽  
Pearl H. Seo ◽  
Robert E. Martell ◽  
Elizabeth C. Clipp ◽  
Martha E. Doyle ◽  
...  

PURPOSE: Comprehensive geriatric assessment (CGA) has aided the medical community greatly in understanding the quality-of-life issues and functional needs of older patients. With its professional team assessment approach, however, CGA may be time consuming and costly. The goal of the present study was to assess the ability of cancer patients to complete a self-administered CGA and then to characterize cancer patients across multiple domains and age groups. PATIENTS AND METHODS: Two hundred sixty-six male outpatient oncology patients at the Durham Veterans Affairs Medical Center were asked to fill out a survey assessing 10 domains (demographics, comorbid conditions, activities of daily living, functional status, pain, financial well being, social support, emotional state, spiritual well-being, and quality of life). RESULTS: Seventy-six percent of the patients who received their surveys and kept their appointments returned the assessment tool. Older oncology patients had significantly less education (P < .0001), income (P = .05), frequent exercise (P = .01), and chance of being disease free (P = .003) than younger patients. Other findings in older patients were a higher rate of marriage (P = .02), more difficulty in taking medications (P = .05), and less cigarette (P = .03) and alcohol (P = .03) use. Members of all age cohorts reported a sense of social support, with younger patients deriving this more from family and friends than older patients, and older patients deriving social support more from membership in religious communities than younger patients. No differences were found across age groups for number and impact of comorbid illnesses, number of medications, basic and instrumental activities of daily living, pain, overall health rating, financial adequacy, anxiety, depression, and quality of life. CONCLUSION: CGA can be conducted in an outpatient cancer community using a self-report format. Despite the fact that this population varied demographically across age groups and is limited to veterans, this study demonstrated remarkable similarities between younger and older cancer patients in terms of functional status, health states, and quality of life.


2020 ◽  
Author(s):  
Stefano Granieri ◽  
Elisa Reitano ◽  
Francesca Bindi ◽  
Federica Renzi ◽  
Fabrizio Sammartano ◽  
...  

Abstract BackgroundMotorcyclists are often victims of road traffic incidents. Though elderly patients seem to have worse survival outcomes and sustain more severe injuries than younger patients, concordance in the literature for this does not exist. The aim of the study is to evaluate the impact of age and injury severity on the mortality of patients undergoing motorcycle trauma. MethodsData of 1725 patients consecutively admitted to our Trauma Center were selected from 2002 to 2016 and retrospectively analyzed. The sample was divided into three age groups: ≤ 17 years, 18-54 years and ≥ 55 years. Mortality rates were analyzed for the overall population and patients with Injury Severity Score (ISS) ≥ 25. Differences in survival among age groups were evaluated with Log-Rank test and multivariate logistic regression models were created to identify independent predictors of mortality.ResultsA lower survival rate was detected in patients older than 55 years (83,6% vs 94,7%; p = 0.049) and in those sustaining critical injuries (ISS ≥ 25, 61% vs 83% p = 0.021). Age (p =0,027; OR: 1,03), ISS (p <0,001; OR: 1,09), Revised Trauma Score (RTS) (p <0,001; OR: 0,47) resulted independent predictors of death. Multivariate analysis identified head (p <0,001; OR: 2,04), chest (p <0,001; OR: 1,54), abdominal (p <0,001; OR: 1,37) and pelvic (p =0,014; OR: 1,26) injuries as independent risk factors related to mortality as well. Compared to the theoretical probability of survival, patients of all age groups showed a survival advantage when managed at a level I Trauma Center.ConclusionsWe detected anatomical injury distributions and mortality rates among three age groups. Patients aging more than 55 years had an increased risk of death, with a prevalence of severe chest injuries, while younger patients sustained more severe head trauma. Age represented an independent predictor of death. Management of these patients at a Level I Trauma Center may lead to improved outcomes.


1988 ◽  
Vol 2 (2) ◽  
pp. 71-74 ◽  
Author(s):  
Anthony Ayiomamitis

Pancreatic carcinoma accounts for approximately one of every 20 deaths from cancer and one out of every 30 new cases of cancer in Canada. It is among the 10 leading causes of death from cancer and the 10 leading sites of newly diagnosed cases for a number of age groups. Age standardized mortality rates have risen sharply in both males (2.0 to 9.5 deaths per 100,000 population per year) and females (2.2 to 5.7 deaths per 100.000 population per year) during 1931 ro 1985 (P < 0.0001). The increase in standarized rates, 0.14 and 0.07 additional deaths per 100,000 population per year in males and females, respectively, is attributable to significant increases in age specific rates for males and females aged 35 to 44, 45 to 54, 55 to 64, 65 to 74, 75 co 84 and over 85 years old ( P ≤ 0.0005) in whom rates have risen by as much as 2.5 additional deaths per 100,000 population per year. Although age standardized incidence rnte5 have risen marginally in males (P = 0.085), age specific rates in males aged 0 to 24 years have risen significantly (P = 0.01 ). In contrast, standarized incidence races have risen sharply in females (0.12 additional new cases per 100,000 population per year; P = 0.0007), which was also characteristic of age specific rates for women aged 45 to 54, 55 ro 64, 65 to 74 and 75 to 84 years old (P < 0.03) where rates have risen by 0.15 to 1.65 additional new cases per 100,000 population per year. Recent age specific incidence and mortality rates indicate that morbidity and mortality rates rise sharply after age 45, when rates double between successive 10-year age groups, and peak for males and females aged more than 85 years.


2020 ◽  
Author(s):  
Stefano Granieri ◽  
Elisa Reitano ◽  
Francesca Bindi ◽  
Federica Renzi ◽  
Fabrizio Sammartano ◽  
...  

Abstract Background Motorcyclists are often victims of road traffic incidents. Though elderly patients seem to have worse survival outcomes and sustain more severe injuries than younger patients, concordance in the literature for this does not exist. The aim of the study is to evaluate the impact of age and injury severity on the mortality of patients undergoing motorcycle trauma. Methods Data of 1725 patients consecutively admitted to our Trauma Center were selected from 2002 to 2016 and retrospectively analyzed. The sample was divided into three age groups: ≤ 17 years, 18-54 years and ≥ 55 years. Mortality rates were analyzed for the overall population and patients with Injury Severity Score (ISS) ≥ 25. Differences in survival among age groups were evaluated with Log-Rank test and multivariate logistic regression models were created to identify independent predictors of mortality. Results A lower survival rate was detected in patients older than 55 years (83,6% vs 94,7%; p = 0.049) and in those sustaining critical injuries (ISS ≥ 25, 61% vs 83% p = 0.021). Age ( p =0,027; OR: 1,03), ISS ( p <0,001; OR: 1,09), Revised Trauma Score (RTS) ( p <0,001; OR: 0,47) resulted independent predictors of death. Multivariate analysis identified head ( p <0,001; OR: 2,04), chest ( p <0,001; OR: 1,54), abdominal ( p <0,001; OR: 1,37) and pelvic ( p =0,014; OR: 1,26) injuries as independent risk factors related to mortality as well. Compared to the theoretical probability of survival, patients of all age groups showed a survival advantage when managed at a level I Trauma Center. Conclusions We detected anatomical injury distributions and mortality rates among three age groups. Patients aging more than 55 years had an increased risk of death, with a prevalence of severe chest injuries, while younger patients sustained more severe head trauma. Age represented an independent predictor of death. Management of these patients at a Level I Trauma Center may lead to improved outcomes.


1989 ◽  
Vol 71 (6) ◽  
pp. 858-863 ◽  
Author(s):  
Matthew A. Howard ◽  
Alan S. Gross ◽  
Ralph G. Dacey ◽  
H. Richard Winn

✓ Reports prior to 1980 describe overall mortality rates for acute subdural hematomas (SDH's) ranging from 40% to 90% with poor outcomes observed in all age groups. Recently, improved results have been reported with rapid diagnosis and surgical treatment. A relatively large number of older patients (34 patients over 65 years old) were treated recently at Harborview Medical Center, enabling a retrospective comparison with similarly treated younger patients (33 patients aged 18 to 40 years). Clinical information and computerized tomography morphometric data were obtained. Patients in the younger group were most often injured in motor-vehicle accidents (15 cases), whereas falls were most frequent in the older group (19 cases). Patients in both groups were rapidly resuscitated in the field; more than 30% were treated within 1 hour after the time of injury. Injury severity, determined by the admission Glasgow Coma Scale score, was similar for the two groups. Mean acute SDH volume was significantly larger in the older patients than in the younger group (mean ± standard deviation: 96.2 ± 117.2 vs. 21.6 + 27.7 cu cm), as was the amount of midline shift (1.2 ± 1.69 vs. 0.6 ± 0.75 cm). Surgical treatments were similar, but outcomes were dramatically different for the younger and older patients. Mortality rates were more than four times higher in older patients than in younger ones (74% vs. 18%). Three older patients and 25 younger patients were functional survivors. Old age, a larger SDH volume, and a larger midline shift all correlated with a poor outcome. The results of this study suggest that the pathophysiology of acute SDH varies with age, and that currently employed resuscitation and treatment methods have differentially improved the outcome for younger patients.


Crisis ◽  
2011 ◽  
Vol 32 (4) ◽  
pp. 178-185 ◽  
Author(s):  
Maurizio Pompili ◽  
Marco Innamorati ◽  
Monica Vichi ◽  
Maria Masocco ◽  
Nicola Vanacore ◽  
...  

Background: Suicide is a major cause of premature death in Italy and occurs at different rates in the various regions. Aims: The aim of the present study was to provide a comprehensive overview of suicide in the Italian population aged 15 years and older for the years 1980–2006. Methods: Mortality data were extracted from the Italian Mortality Database. Results: Mortality rates for suicide in Italy reached a peak in 1985 and declined thereafter. The different patterns observed by age and sex indicated that the decrease in the suicide rate in Italy was initially the result of declining rates in those aged 45+ while, from 1997 on, the decrease was attributable principally to a reduction in suicide rates among the younger age groups. It was found that socioeconomic factors underlined major differences in the suicide rate across regions. Conclusions: The present study confirmed that suicide is a multifaceted phenomenon that may be determined by an array of factors. Suicide prevention should, therefore, be targeted to identifiable high-risk sociocultural groups in each country.


2003 ◽  
Vol 8 (3) ◽  
pp. 131-147 ◽  
Author(s):  
Gian Vittorio Caprara ◽  
Mariagiovanna Caprara ◽  
Patrizia Steca

Three cross-sectional studies examined stability and change in personality over the course of life by measuring the relations linking age to personality traits, self-efficacy beliefs, values, and well-being in large samples of Italian male and female participants. In each study, relations between personality and age were examined across several age groups ranging from young adulthood to old age. In each study, personality constructs were first examined in terms of mean group differences accrued by age and gender and then in terms of their correlations with age across gender and age groups. Furthermore, personality-age correlations were also calculated, controlling for the demographic effects accrued by marital status, education, and health. Findings strongly indicated that personality functioning does not necessarily decline in the later years of life, and that decline is more pronounced in males than it is in females across several personality dimensions ranging from personality traits, such as emotional stability, to self-efficacy beliefs, such as efficacy in dealing with negative affect. Findings are discussed in terms of their implications for personality theory and social policy.


2013 ◽  
Vol 18 (3) ◽  
pp. 158-168 ◽  
Author(s):  
Emily Frankenberg ◽  
Katharina Kupper ◽  
Ruth Wagner ◽  
Stephan Bongard

This paper reviews research on young migrants in Germany. Particular attention is given to the question of how Germany’s history of migration, immigration policies, and public attitude toward migrants influence the transcultural adaptation of children and adolescents from different ethnic backgrounds. We combine past research with the results of new empirical studies in order to shed light on migrants’ psychological and sociocultural adaptation. Studies comparing young migrants and their German peers in terms of psychological well-being, life satisfaction, and mental health outcome suggest higher rates of emotional and behavioral problems among migrants of most age groups. With regard to adolescent populations between the ages of 14 and 17 years, however, the existence of differences between migrants and natives appears to be less clear. Research has also yielded inconsistent findings regarding the time trajectory of transcultural adaptation among adolescents. The coincidence of acculturation and age-related change is discussed as a possible source of these inconsistencies. Further, we provide an overview of risk and protective factors such as conflicting role expectations and ethnic discrimination, which may cause heightened vulnerability to adverse adaptation outcomes in some groups. Large-scale studies have repeatedly shown migrants of all age groups to be less successful within the German school system, indicating poor sociocultural adaptation. Possible explanations, such as the idiosyncrasies of the German school system, are presented. Our own studies contribute to the understanding of young migrants’ adaptation process by showing that it is their orientation to German culture, rather than the acculturation strategy of integration, that leads to the most positive psychological and sociocultural outcomes. The paper concludes by discussing implications for future cross-cultural research on young migrants and by suggesting recommendations for multicultural policies.


2013 ◽  
Vol 25 (3) ◽  
pp. 118-128 ◽  
Author(s):  
Florian Rehbein ◽  
Dirk Baier

In recent years, a variety of epidemiological studies have provided empirical data on the prevalence of video game addiction (GA) in different age groups. However, few studies investigated the causes of GA and could explain why video game playing as a widespread phenomenon leads to a comparatively small percentage of addicted players. Additionally, the existing longitudinal studies mainly consider psychological trait variables and neglect the possible explanatory value of predictors in socialization regarding media availability, media use, and family and everyday school life. In this paper, the results of a two-wave longitudinal study comprising a sample of students from Grades 4 to 9 (N = 406) are presented. The data show that 15-year-old video game addicts had already exhibited a number of specific risk factors at the age of 10. Students from single-parent families seem to be particularly at risk, as are students with low experienced school well-being and with a weaker social integration in class. The data also indicate that problematic use of video games in childhood increases the risk of GA in adolescence. Male students are especially vulnerable for developing GA. The results of this study are an important contribution to understanding risk factors for GA in adolescents, thereby laying the groundwork for effective prevention measures.


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