scholarly journals Psychiatric Aspects of Geriatric Crisis Intervention

1978 ◽  
Vol 23 (4) ◽  
pp. 201-207 ◽  
Author(s):  
H. Grauer ◽  
D. Frank
Keyword(s):  
General Hospital ◽  
Crisis Intervention ◽  
Geriatric Patients ◽  
Physical Illness ◽  
Close Relative ◽  
Control Group ◽  
Precipitating Factors ◽  
Schizophrenic Psychosis ◽  
Psychiatric Crisis ◽  
Jewish General Hospital

Data on 64 geriatric patients treated by the Psychiatric Crisis Team at the Jewish General Hospital were reviewed. A control group of non-geriatric patients was selected at random for comparison. The average age of the geriatric group was 69.4 years compared to 33 in the control group. Women predominated in the geriatric group. Precipitating factors were more easily delineated in the geriatric group. Physical illness, loss of a close relative and relocation were the most common precipitating events in the geriatric group. Depression, psychotic and neurotic, was the predominant diagnosis in the older group and schizophrenic psychosis in the control group. Compared to the control group, the geriatric patients were discharged sooner and were more easily managed. Only two geriatric patients required institutionalization. The study supports the value of prompt and comprehensive geriatric crisis intervention.

scholarly journals Impact of Sensitization of Family Caregivers upon Treatment Compliance among Geriatric Patients Suffering from Elder Abuse and Neglect

Healthcare ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 226
Author(s):  
Rishabh Garg ◽  
Khurshid Mattoo ◽  
Lakshya Kumar ◽  
Imran Khalid ◽  
Fawaz Baig ◽  
...  
Keyword(s):  
Family Caregivers ◽  
Treatment Satisfaction ◽  
Geriatric Patients ◽  
Elder Abuse ◽  
Treatment Compliance ◽  
Control Group ◽  
Elder Abuse And Neglect ◽  
Abuse And Neglect ◽  
Group B ◽  
The Impact

Geriatric patients in various outpatient department (OPDs) have been found to agonize from elder abuse and neglect (EAN). Such suffering imposes depressive states within individuals, which in turn affects treatment compliance. The objective of this study was to evaluate the impact of sensitization (psychotherapeutic) of family caregivers (FCGs) upon two denture treatment parameters (maintenance and treatment satisfaction) among EAN patients and compare the differences in outcome with non-abused patients. A survey of completely edentulous subjects (n = 860, aged 41–80 years) provided a sampling frame of 332 EAN patients from which 150 patients (including FCGs) fulfilling the study criteria were distributed (simple random, convenient) into two groups (Group A—control, Group B—test). FCG sensitization for subjects in Group B was performed by a clinical psychologist in 2–4 short (30 min) sessions. Demographic characteristics (frequency) were measured using a self-reported questionnaire, denture maintenance was measured using a denture hygiene index (scores), and treatment satisfaction was analyzed on a 10-point visual analog scale. Relevant data were calculated for means and absolute/relative frequencies. Any difference between two groups was estimated using an unpaired t-test while the level of relationship was determined by Karl Pearson’s test at a p-value of < 0.05. The results showed highest frequency (38.6%) for neglect, with elder neglect (EN) being most common (38.14% alone and 14% in combination). EN was found more if the FCG was a son (52%), in the age group (21–30 years), and with low education and low income (75%). Patients whose FCGs were counselled (Group B) demonstrated low denture plaque scores (mean = 1.38 ± 0.618), while demonstrating comparatively higher scores in six different parameters of treatment satisfaction. Differences between the two groups for both parameters were also found to be statistically significant. Psychotherapeutic counselling in the form of FCG sensitization brings better results of denture maintenance and treatment satisfaction.

scholarly journals The incidence of mental disorder increases after hip fracture in older people: a nationwide cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ling-Yin Kuo ◽  
Po-Ting Hsu ◽  
Wen-Tien Wu ◽  
Ru-Ping Lee ◽  
Jen-Hung Wang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hip Fracture ◽  
Geriatric Patients ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Control Group ◽  
Research Database ◽  
Fracture Group ◽  
Related Risk ◽  
And Control

Abstract Background People living with dementia seem to be more likely to experience delirium following hip fracture. The association between mental disorders (MD) and hip fracture remains controversial. We conducted a nationwide study to examine the prevalence of MD in geriatric patients with hip fractures undergoing surgery and conducted a related risk factor analysis. Material and methods This retrospective cohort study used data from Taiwan’s National Health Insurance Research Database between 2000 and 2012 and focused on people who were older than 60 years. Patients with hip fracture undergoing surgical intervention and without hip fracture were matched at a ratio of 1:1 for age, sex, comorbidities, and index year. The incidence and hazard ratios of age, sex, and multiple comorbidities related to MD and its subgroups were calculated using Cox proportional hazards regression models. Results A total of 1408 patients in the hip fracture group and a total of 1408 patients in the control group (no fracture) were included. The overall incidence of MD for the hip fracture and control groups per 100 person-years were 0.8 and 0.5, respectively. Among MD, the incidences of transient MD, depression, and dementia were significantly higher in the hip fracture group than in the control group. Conclusions The prevalence of newly developed MD, especially transient MD, depression, and dementia, was higher in the geriatric patients with hip fracture undergoing surgery than that in the control group. Prompt and aggressive prevention protocols and persistent follow-up of MD development is highly necessary in this aged society.

scholarly journals Precipitating factors of porphyria cutanea tarda in Brazil with emphasis on hemochromatosis gene (HFE) mutations. Study of 60 patients

2013 ◽  
Vol 88 (4) ◽  
pp. 530-540 ◽  
Author(s):  
Fatima Mendonca Jorge Vieira ◽  
Maria Cristina Nakhle ◽  
Clarice Pires Abrantes-Lemos ◽  
Eduardo Luiz Rachid Cancado ◽  
Vitor Manoel Silva dos Reis
Keyword(s):  
Hepatitis C ◽  
Alcohol Abuse ◽  
Porphyria Cutanea Tarda ◽  
Hereditary Hemochromatosis ◽  
Control Group ◽  
Hfe Gene ◽  
Precipitating Factors ◽  
Serological Tests ◽  
Hfe Mutations ◽  
Precipitating Factor

BACKGROUND: Porphyria cutanea tarda is the most common form of porphyria, characterized by the decreased activity of the uroporphyrinogen decarboxylase enzyme. Several reports associated HFE gene mutations of hereditary hemochromatosis with porphyria cutanea tarda worldwide, although up to date only one study has been conducted in Brazil. OBJECTIVES: Investigation of porphyria cutanea tarda association with C282Y and H63D mutations in the HFE gene. Identification of precipitating factors (hepatitis C, HIV, alcoholism and estrogen) and their link with HFE mutations. METHODS: An ambispective study of 60 patients with PCT was conducted during the period from 2003 to 2012. Serological tests for hepatitis C and HIV were performed and histories of alcohol abuse and estrogen intake were investigated. HFE mutations were identified with real-time PCR. RESULTS: Porphyria cutanea tarda predominated in males and alcohol abuse was the main precipitating factor. Estrogen intake was the sole precipitating factor present in 25% of female patients. Hepatitis C was present in 41.7%. All HIV-positive patients (15.3%) had a history of alcohol abuse. Allele frequency for HFE mutations, i.e., C282Y (p = 0.0001) and H63D (p = 0.0004), were significantly higher in porphyria cutanea tarda patients, compared to control group. HFE mutations had no association with the other precipitating factors. CONCLUSIONS: Alcohol abuse, hepatitis C and estrogen intake are prevalent precipitating factors in our porphyria cutanea tarda population; however, hemochromatosis in itself can also contribute to the outbreak of porphyria cutanea tarda, which makes the research for HFE mutations necessary in these patients

Morbidity following Sudden and Unexpected Bereavement

1984 ◽  
Vol 144 (1) ◽  
pp. 84-88 ◽  
Author(s):  
Tom Lundin
Keyword(s):  
High Risk ◽  
Risk Group ◽  
Psychiatric Morbidity ◽  
High Risk Group ◽  
Close Relative ◽  
Control Group

SummaryWith the help of data on the registered days of sickness per year, a study was made of a group of relatives (n = 32) who had suffered sudden and unexpected bereavement to determine whether this resulted in an increase in morbidity in the two-year period following the loss, compared with the previous two years. A comparison was made with a control group of relatives who had also suffered bereavement but where the deaths were not unexpected. Increased morbidity, especially psychiatric morbidity, was found following sudden and unexpected bereavement but not in the control group. It is concluded that persons exposed to sudden and unexpected loss of a close relative are subject to increased psychiatric morbidity and should be regarded as a high-risk group.

scholarly journals Predictive Factors for Positive HIV Test Results in a Hospital Setting

2021 ◽  
Vol 16 (3) ◽  
Author(s):  
Sulmaz Ghahramani ◽  
Hassan Joulaei ◽  
Amir Human Hoveidaei ◽  
Mohammad Reza Rajabi ◽  
Kamran Bagheri Lankarani
Keyword(s):  
Risk Factors ◽  
Hospital Admission ◽  
Hiv Testing ◽  
General Hospital ◽  
Hospital Setting ◽  
Hiv Positive ◽  
Control Group ◽  
Test Results ◽  
Hiv Test ◽  
Test Result

Background: Hospital admission for any reason provides the situation for voluntary HIV testing and consultation. Identifying the predictors of positivity may lead to a cost-effective method while enhancing professionalism. Objectives: To find the predictors of HIV-positive test result in a general hospital in Shiraz compared to a control group. Methods: In this case-control study, the records of all patients who received HIV testing upon their hospitalization in a general hospital in Shiraz, south of Iran, from January 2017 to the end of December 2017 were reviewed. For each HIV-positive case, at least one control from the same ward in the hospital with negative HIV test result was randomly selected. Based on the best-fitted model of logistic regression, the probability of positive HIV test results was estimated for each participant according to the risk factors, and a receiver operating characteristic (ROC) curve was drawn. Results: Out of 7333 persons who accepted to be tested, 77 patients tested positive for HIV, of whom 55 (71.4%) were male with the mean age of 41.5 ± 9.5 years. None of the HIV-positive patients were intravenous drug users, nor had they a history of imprisonment. The odds ratio (OR) was 21 for hepatitis-positive patients (hepatitis B and/or C) compared to negative ones, which was seven times higher in opium addicts than non-opium addicts. We developed a model using age, sex, opium addiction, and HBV and HCV status to predict the probability of being positive for HIV with an AUC of 0.853 (95% confidence interval 0.797 to 0.909). Conclusions: Hospital admission could be an appropriate momentum for providing voluntary counseling and testing. Infection with HBV and HCV are important risk factors for HIV infection, and additional testing should be offered, especially to these patients.

A General Hospital Patient is Not a NUT

1979 ◽  
Vol 9 (1-2) ◽  
pp. 67-74 ◽  
Author(s):  
D.J.W. Striimpfer
Keyword(s):  
General Hospital ◽  
Physical Illness ◽  
Psychological Problems ◽  
Physical Disorder ◽  
Academic Training ◽  
Psychological Disturbance ◽  
Affective Distress ◽  
Psychological Reactions ◽  
Adaptive Value ◽  
Hospital Patients

Psychological problems of general hospital patients are related to physical illness and disability, and/or physical disorder produced by affective distress. The typical emphasis on psychopathology during academic training, and the orientation towards psychiatry during internships maladapt clinical psychologists for work with such patients. This argument is supported by diverse illustrations: psychological disturbance in pregnant women, psychological problems of patients in intensive care units, the inappropriateness of a psychopathological approach to the psychological aspects of coronary heart disease, and the adaptive value of denial in some instances of physical illness. Psychological reactions to medical conditions can be understood better in terms of developmental crisis. Implications for training are mentioned.

scholarly journals Infection Versus Hematoma Following Surgical Treatment of Proximal Femoral Fractures in Geriatric Patients

2018 ◽  
Vol 9 ◽  
pp. 215145851775051 ◽  
Author(s):  
Franz Müller ◽  
Michael Galler ◽  
Christina Roll ◽  
Bernd Füchtmeier
Keyword(s):  
Staphylococcus Aureus ◽  
Surgical Treatment ◽  
Geriatric Patients ◽  
Femoral Fractures ◽  
Morbidity And Mortality ◽  
Control Group ◽  
Postoperative Phase ◽  
High Morbidity ◽  
Proximal Femoral Fractures

Introduction: The surgical treatment of proximal femoral fractures predominantly involves geriatric patients and is associated with high morbidity and mortality. However, analyses on postoperative infections or hematoma are rare. Methods: Patients requiring surgical revision due to infection (n = 90) or hematoma (n = 77) in the postoperative phase were identified from an electronic database of 2000 consecutive patients surgically treated for proximal femoral fractures between 2006 and 2014. Demographic and clinical data were retrieved, including information on the pathogens in patients with infection. A follow-up on morbidity and mortality was conducted via telephone for at least 2 years postsurgery. Results: The follow-up rate was 100%, and the mean age was 81.9 years. The incidence rate of infection was 4.1% (90/2000), and women were commonly affected. Staphylococcus aureus and Staphylococcus epidermidis were the most commonly detected pathogens (35.5% and 25.5%, respectively). Mixed infections were observed in 15 patients, and Methicillin-resistant Staphylococcus aureus infections were observed in only 4 patients. A total of 77 (85.6%) infections occurred within 30 days postsurgery. The implant was preserved in 76 (84.4%) patients, and resection arthroplasty was required in 14 patients. Dementia and pertrochanteric fractures were significantly more common in the infection than in the hematoma group. Although infections were associated with high mortality rates for up to 2 years postsurgery, the rates did not significantly differ from those in the hematoma control group. Conclusion: One of every 2 patients who developed an infection following the surgical treatment of a proximal femoral fracture died within 2 years postsurgery. In addition, infections were significantly associated with dementia. Avoiding postoperative infection should be a high priority in the surgical treatment of proximal femoral fractures.

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