scholarly journals The Role of Spinal Orthoses in Osteoporotic Vertebral Fractures of the Elderly Population (Age 60 Years or Older): Systematic Review

2020 ◽  
pp. 219256822094803
Author(s):  
Barry Ting Sheen Kweh ◽  
Hui Qing Lee ◽  
Terence Tan ◽  
Joost Rutges ◽  
Travis Marion ◽  
...  

Study Design: Systematic review. Objective: Spinal orthoses have been generally used in the management of osteoporotic vertebral fractures in the elderly population with purported positive biomechanical and functional effects. To our knowledge, this is the first systematic review of the literature examining the role of spinal orthoses in osteoporotic elderly patients who sustain low energy trauma vertebral fractures. Methods: A systematic literature review adherent to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted. Methodical searches utilizing MEDLINE, EMBASE, Google Scholar, and Cochrane Databases was performed. Results: Of the 2019 articles initially retrieved, 7 published articles (4 randomized controlled trials and 3 prospective cohort studies) satisfied the inclusion criteria. Five studies reported improvement in quantitative measurements of spinal column stability when either a rigid or semirigid orthosis was used, while 1 study was equivocal. The studies also showed the translation of biomechanical benefit into significant functional improvement as manifested by improved postural stability and reduced body sway. Subjective improvement in pain scores and quality of life was also noted with bracing. Conclusion: The use of spinal orthoses in neurologically intact elderly patients aged 60 years and older with osteoporotic compression vertebral fractures results in improved biomechanical vertebral stability, reduced kyphotic deformity, enhanced postural stability, greater muscular strength and superior functional outcomes.

2010 ◽  
Vol 00 (04) ◽  
pp. 85
Author(s):  
Valeria Magarotto ◽  
Antonio Palumbo ◽  
◽  

Multiple myeloma (MM) is the second most frequent malignancy of the blood. It is more common among the elderly population, with <28% of patients 65–74 years of age and 37% >75 years of age. Before the introduction of novel agents, melphalan and prednisone (MP) was the best treatment for patients not eligible for autologous stem cell transplantation (ASCT). Steroids provide other options but with a higher toxicity, especially in elderly patients. Currently, the association of thalidomide with MP (MPT) represents the gold standard of treatment for patients ineligible for ASCT. Bortezomib and lenalidomide associated with MP provided effective and safe alternatives. High-dose dexamethasone combined with the new drugs is effective, but very toxic for elderly patients. Trials that combine low-dose dexamethasone with thalidomide, lenalidomide and bortezomib plus other agents such as doxorubicin and cyclophosphamide are ongoing. The role of transplantation is controversial in myeloma patients >65 years of age because elderly patients are fragile and the choice of therapy must take into account the likelihood of co-morbidities. Reducing the dose of the standard drug – eventually prolonging the duration of the treatment and administering prophylaxis – allows effective treatment of MM, without important or life-threatening toxicities.


Author(s):  
Yeshwanth Subash ◽  
Jagadeesh B. ◽  
Ravikrishna R. ◽  
Prabhu Manickam

<p class="abstract"><strong>Background:</strong> <span lang="EN-GB">Femoral neck fractures are common injuries in the elderly population and are associated with high rates of morbidity and mortality. The aim of surgical intervention in these elderly patients is to restore them to the pre-fracture status as rapidly as possible. The aim of this study was to evaluate the role of total hip arthroplasty as a primary option in the management of these fractures and to compare the results with studies of other authors as available in literature</span><span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-GB">45 patients with femoral neck fractures treated with cemented total hip arthroplasty were studied from January 2011 to January 2013 and were followed up for a minimum period of two years</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-GB">There were 18 males and 27 females ranging from 60 to 75 years of age. Mean age was 64.6 years. Majority (80%) of the fractures were completely displaced, Garden type 4 fractures followed by type 3 in 20% of cases. The most common mode of injury was a simple slip and fall. Excellent results were seen in 17 patients, good results in 24 patients and fair results in 4 patients. No poor results were seen</span><span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-GB">Cemented total hip arthroplasty is a very useful procedure for the primary treatment of femoral neck fractures in elderly patients. This procedure markedly improves the functional status of the patients and gives good functional results</span><span lang="EN-IN">.</span></p>


2021 ◽  
Vol 14 (3) ◽  
pp. 233
Author(s):  
Piera Federico ◽  
Emilio Francesco Giunta ◽  
Annalisa Pappalardo ◽  
Andrea Tufo ◽  
Gianpaolo Marte ◽  
...  

Hepatocellular carcinoma (HCC) is the primary tumour of the liver with the greatest incidence, particularly in the elderly. Additionally, improvements in the treatments for chronic liver diseases have increased the number of elderly patients who might be affected by HCC. Little evidence exists regarding HCC in old patients, and the elderly are still underrepresented and undertreated in clinical trials. In fact, this population represents a complex subgroup of patients who are hard to manage, especially due to the presence of multiple comorbidities. Therefore, the choice of treatment is mainly decided by the physician in the clinical practice, who often tend not to treat elderly patients in order to avoid the possibility of adverse events, which may alter their unstable equilibrium. In this context, the clarification of the optimal treatment strategy for elderly patients affected by HCC has become an urgent necessity. The aim of this review is to provide an overview of the available data regarding the treatment of HCC in elderly patients, starting from the definition of “elderly” and the geriatric assessment and scales. We explain the possible treatment choices according to the Barcelona Clinic Liver Cancer (BCLC) scale and their feasibility in the elderly population.


2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S267-S267
Author(s):  
Jong Hun Kim ◽  
Byung Chul Chun ◽  
Joon Young Song ◽  
Hyo Youl Kim ◽  
In-Gyu Bae ◽  
...  

Abstract Background The national immunization program (NIP) of annual influenza vaccination to the elderly population (≥65 years of age) in the Republic of Korea (ROK) has been implemented since 1987. Recently, the 23-valent pneumococcal polysaccharide vaccine (PPV23) through the NIP has been provided to the elderly population in the ROK since May 2013. The aim of this study was to assess PPV23 and influenza vaccine (IV) effectiveness in preventing pneumococcal pneumonia (PP) among elderly patients ≥65 years of age. Methods A case–control study using a hospital-based cohort was conducted. Cases of PP including bacteremic PP and nonbacteremic PP were collected from 14 hospitals in the pneumococcal diseases surveillance program from March 2013 to October 2015. Controls matched by age and sex in the same hospital were selected. Demographic, clinical information, and vaccination histories were collected. Previous immunization was categorized into “vaccinated” if a patient had received vaccines as follows: PPV23 (4 weeks to 5 years) and IV (2 weeks to 6 months) prior to the diagnosis of PP for case patients and prior to the hospital admission for control patients. Adjusted odds ratio (OR) was calculated, controlling for underlying medical conditions. Vaccine effectiveness was defined as (1 – OR) × 100. Results During the study period, a total of 661 cases (104 bacteremic PP cases and 557 nonbacteremic PP cases) and 661 controls were enrolled for analyses. For overall patients ≥65 years of age, there was no significant vaccine effectiveness against PP. For young elderly patients with 65–74 years, IV alone (1.2%, [95% confidence interval (CI) −95.3% to 50.0%]) and PPV23 alone (21.9%, [95% CI −39.0% to 56.1%]) were not effective. However, significant vaccine effectiveness of PPV23 plus IV against PP was noted (54.4%, [95% CI 6.9–77.7%], P = 0.031). For older elderly patients ≥75 years of age, no significant vaccine effectiveness was observed. Conclusion Our study indicates that PPV23 plus IV may be effective in preventing PP among young elderly patients with 65–74 years, suggesting additive benefits of influenza plus PPV23 vaccination. Further studies are required to confirm the persistent additive protective effectiveness. Disclosures All authors: No reported disclosures.


2021 ◽  
Vol 1 ◽  
pp. 1425-1436
Author(s):  
Dyah Pratiwi ◽  
Dyah Putri Aryati

AbstractThe increasing elderly population in Indonesia continues to grow. The elderly are individuals who experience physiological, psychological, and social changes. Therefore, the elderly is vulnerable to violence. Elder abuse persists in various areas in Indonesia. However, cases of elder abuse are often hidden because they are considered unimportant and the victims do not know where to report it. The purpose of this study was to describe the incidence of acts of violence in the elderly. The methodused in this study was a literature review by searching for articles in the PubMed and Google scolar database with the keyword: Elderly or Aged or Geriatric or Elder and Abuse or Violence with article limits from 2011-2020. There were five articles found. They had been critically reviewed using Strobe instruments. The results based on the five articles analysed showed some characteristics. Most of the respondents were 60-69 years old (50%), female (60%), education literate or primary (63%), married (67%), lived with other (59%), the elderly do not experience violence2.286, elderly experience violence 807, the type of violence that wa soften experienced by the elderly namely psychological violence is found to be (40%). Based on the five articles analysed, it can be concluded that the most violence experienced by the elderly is psychological violence. Therefore, the role of nurses is needed to provide services for families to prevent acts of violence in the elderly.Keywords: Elderly; persecution, violence AbstrakPeningkatan penduduk lansia di Indonesia terus bertambah. Lansia merupakan salah satu individu yang mengalami perubahan secara fisiologis, psikologis dan sosial sehingga lansia rentan mengalami tindakan kekerasan. Kekerasan terhadap lansia masih terjadi diberbagai wilayah di Indonesia. Namun, kasus kekerasan lansia kerap disembunyikan karena dianggap tidak penting dan korban tidak mengetahui lembaga yang dapat menerima laporan. Tujuan penelitian ini untuk mengetahui gambaran kejadian tindakan kekerasan pada lansia. Metode yang digunakan penelitian ini menggunakan literature review dengan mencari artikel pada database Pubmed dan Googlescholar dengan kata kunci :Elderly OR Aged OR Geriatric OR Elder AND Abuse ORViolencedengan batasan artikel dari 2011-2020 didapatkan 5 artikel yang telah dilakukan telaah kritis dengan menggunakan instrument Strobe. Hasil berdasarkan lima artikel yang dianalisa menunjukkan bahwa data karakteristik usia responden mayoritas 60-69 tahun yaitu (50%), berjenis kelamin perempuan sebanyak (60%), pendidikan literate or primarysebanyak (63%), berstatus menikah yaitu (67%), lived with other sebanyak (59%), lansia yang tidak mengalami kekerasan sebanyak 2.286, lansia yang mengalami kekerasan sebanyak 807 dan jenis kekerasan yang sering dialami lansia yaitu kekerasan psikologis didapatkan (40%). Berdasarkan dari kelima artikel yang dianalisa dapat disimpulkan bahwa kekerasan yang paling banyak dialami lansia yaitu kekerasan psikologis. Oleh sebab itu diperlukan peran perawat untuk memberikan pelayanan bagi keluarga untuk mencegah terjadinya tindakan kekerasan pada lansia.Kata kunci: Kekerasan; penganiayaan; usia lanjut


2013 ◽  
pp. 12-19
Author(s):  
Patrizia Zoboli ◽  
Giuseppe Chesi ◽  
Fabrizio Boni ◽  
Federica Maselli ◽  
Lisa Zambianchi

BACKGROUND Internal medicine specialists are often asked to evaluate a patient before surgery. Perioperative risk evaluation for elderly patients is important, because complications increase with age. The increasing age of the general population increases the probabilities of surgery in the older patients. The manifestation of a surgical problem, is more likely to be severe and complicated in the elderly patients. In fact, emergency surgery treatment occurs more frequently in the elderly (e.g., it is much more common to see intestinal obstruction complicating colorectal cancer in the elderly compared with a younger population). Old age is an independent factor for long hospital stay after surgery. The role of the preoperative medical consultant is to identify and evaluate a patient’s current medical status and provide a clinical risk profile, in order to decide whether further tests are indicated prior to surgery, and to optimise the patient’s medical condition in the attempt of reducing the risk of complications. The medical consultant must know which medical condition could eventually influence the surgery, achieve a good contact and communication between the medical and surgical team, in order to obtain the best management planning. AIM OF THE STUDY This paper focuses on the rational use of antibiotic prophylaxis and on the treatment of the complications of post-surgery infections (e.g., pulmonary complication, peritonitis, intra-abdominal infection). Specific aspects of pre-operative risk evaluation and peri and post-operative management are discussed. CONCLUSIONS The internal medicin specialist in collaboration with the surgical team is necessary in the peri and post-surgery management.


Blood ◽  
1988 ◽  
Vol 71 (6) ◽  
pp. 1726-1730
Author(s):  
KA Melez ◽  
LF Fries ◽  
BS Bender ◽  
T Quinn ◽  
MM Frank

Decreased immune functions have been suggested as a cause for the increased incidence of autoimmunity, malignancy, and infection in the elderly population. To assess the possible role of changes in macrophage function in the aging process we studied the Fc receptor- mediated clearance of IgG-coated erythrocytes in 56 healthy normal volunteers by following the removal of radiolabeled autologous erythrocytes. An age-related decrease in Fc-mediated clearance rates in both female and male subjects was found, which suggests a physiological decline of this macrophage function in older individuals.


2021 ◽  
Vol 9 (8) ◽  
pp. 1733-1736
Author(s):  
Ajay Kumar Nigwal ◽  
Lajwanti Keswani ◽  
Rajesh Kumar Malviya ◽  
Arvind Kumar Yadav

Cardiovascular disease such as hypertension will be the largest cause of death and disability in India by 2020. The prevalence of hypertension is increasing globally and currently, more than 1 billion people have hypertension. About 26.4% of the world adult population in 2000 had hypertension and 29.2% were projected to have this con- dition by 2025. Elevated blood pressure affects 1 billion individuals and causes an estimated 10.4 million deaths per year. Thus, hypertension is needed to be studied. Though a lot of potent antihypertensive drugs are available today none of them is free from untoward adverse effects. Especially the elderly population poorly tolerates these drugs. The global incidence of hypertension is increasing day by day and is a very common problem nowadays. Ayurveda has classified the causes of disease into three main categories: - 1. Asatmendriyartha Samyoga 2. Pragyaparada and 3. Parinama (Kaala), these three main causes of disease enable different kinds of diseases to manifest. Firstly, they lead to the imbalance of body /or mind by vitiation the Tridosha. The consequence of the imbalance is a disturbance of the basic biological principles. Hypertension is a lifestyle disorder. Ayurveda causes of lifestyle disorders are mainly Pragyaparada. Pragyaparadha is the main cause of all noncommunicable dis- eases (NCDs) such as diabetes, cancer, hypertension etc. Keywords: Asatmendriyartha, Pragyaparada, Parinama, Trividha Rogaayatanas, Hypertension.


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