Microvascular Decompression for Trigeminal Neuralgia in the Elderly: A Review of the Safety and Efficacy

Neurosurgery ◽  
2004 ◽  
Vol 55 (4) ◽  
pp. 840-850 ◽  
Author(s):  
Keyoumars Ashkan ◽  
Henry Marsh
Keyword(s):  
Trigeminal Neuralgia ◽  
Microvascular Decompression ◽  
Older Patients ◽  
Treatment Options ◽  
Length Of Hospital Stay ◽  
The Elderly ◽  
Outcome Data ◽  
Control Group ◽  
Control Groups ◽  
And Control

Abstract OBJECTIVE: To critically examine the efficacy and safety of microvascular decompression (MVD) for trigeminal neuralgia (TN) in elderly patients. METHODS: We performed a retrospective review of medical records, followed by prospective follow-up. The outcome data from 44 MVD operations for TN performed in 40 consecutive patients with a mean age of 65 years (range, 60–75 yr) in the period 1991 to 2001 were compared with those from 40 younger control subjects (mean age, 46 yr; range, 20–59 yr) operated on during the same period. RESULTS: The median time from diagnosis of TN to MVD in the older patients was 7 years (range, 1–22 yr), compared with 3 years (range, 3 mo to 20 yr) in the younger group (P = 0.02). With the exception of one, all patients in this study were classified as American Society of Anesthesiologist Grade 1 or 2. Initial pain relief was achieved in 98 and 100% of the patients in the study and control groups, respectively. There were no operative mortalities or life-threatening morbidities. Transient facial numbness and diplopia occurred in both groups. Headaches, nausea, and vomiting were more frequent in the younger patients, whereas wound infection and confusion were more common in the older patients. The mean length of hospital stay was 5.4 days (range, 3–10 d) for the older patients, compared with 5.3 days (range, 3–9 d) for the control group (P = 0.4). After average follow-ups of 30 and 33 months, the pain recurred in 24 and 27% of the patients in the elderly and control groups, respectively. CONCLUSION: MVD is underused in the elderly despite being both safe and effective. Fitness and not age should be the key in deciding the treatment options. It is proposed that any patient with medically refractory TN who is fit for general anesthesia should be given the opportunity to choose MVD.

Microvascular decompression for trigeminal neuralgia in elderly patients

2008 ◽  
Vol 108 (4) ◽  
pp. 689-691 ◽  
Author(s):  
Raymond F. Sekula ◽  
Edward M. Marchan ◽  
Lynn H. Fletcher ◽  
Kenneth F. Casey ◽  
Peter J. Jannetta
Keyword(s):  
Trigeminal Neuralgia ◽  
Elderly Patients ◽  
Microvascular Decompression ◽  
The Elderly ◽  
Outcome Data ◽  
Control Group ◽  
Younger Patients ◽  
Telephone Interviews ◽  
Second Tier

Object Although microvascular decompression (MVD) for patients with medically refractory trigeminal neuralgia (TN) is widely accepted as the treatment of choice, other “second-tier” treatments are frequently offered to elderly patients due to concerns regarding fitness for surgery. The authors sought to determine the safety and effectiveness of MVD for TN in patients older than 75 years of age. Methods The authors performed a retrospective review of medical records and conducted follow-up telephone interviews with the patients. The outcome data from 25 MVD operations for TN performed in 25 patients with a mean age of 79.4 years (range 75–88 years) were compared with those of a control group of 25 younger patients with a mean age of 42.3 years (range 17–50 years) who underwent MVDs during the same 30-month period from July 2000 to December 2003. Results Initial pain relief was achieved in 96% of the patients in both groups (p = 1.0). There were no operative deaths in either group. After an average follow-up period of 44 and 52 months, 78 and 72% of patients in the elderly and control groups, respectively, remained pain free without medication (p = 0.74). Conclusions Microvascular decompression is an effective treatment for elderly patients with TN. The authors' experience suggests that the rate of complications and death after MVD for TN in elderly patients is no different from the rate in younger patients.

scholarly journals The Effect of Positive Thinking Training on Anxiety and Happiness in the Elderly: a Quasi- Experimental Study

2021 ◽  
Author(s):  
Anis Pourdavarani ◽  
Jamileh Farokhzadian ◽  
Mansooreh Azizzadeh Forouz ◽  
Sedigheh Khodabandeh Shahraki
Keyword(s):  
Experimental Study ◽  
Skills Training ◽  
The Elderly ◽  
Anxiety And Depression ◽  
Control Group ◽  
Positive Thinking ◽  
Control Groups ◽  
Quasi Experimental ◽  
The Mean ◽  
And Control

Abstract Background: Anxiety and depression are the most common psychological disorders in the aging period. One of the ways to deal with anxiety and depression and increase happiness in the elderly is to train positive thinking. Therefore, the present study aimed to investigate positive thinking skills training on anxiety and happiness in the elderly.Methods: In this quasi-experimental study, 48 elderly people referred to two comprehensive health service centers in Kerman in southeastern Iran were selected by convenience sampling method and randomly assigned into intervention groups (n = 24) and control (n = 24). The data collection tools included the Beck Anxiety Inventory and the Oxford Happiness Inventory. Questionnaires were filled out before the intervention, then positive thinking training was held in eight sessions of 90 minutes. After training program, the was conducted one month after it, the follow-up tools.Results: The results showed that the mean score of anxiety before positive thinking training was (13.58 ± 8.61) and (19.25± 11.67) in the intervention and the control group, respectively. After positive thinking training, the mean scores were (4.50 ±4.07) and (15.54±9.04) in the intervention and control group, respectively. After the intervention, which significantly reduced anxiety the intervention, group (t= 8.10, P<0.001). The mean score of happiness before the test was (26.58±12.40) and (37.91 ± 5.57) in the intervention and control groups, respectively. However, the posttest happiness scores of the intervention and control groups were (62.91± 4.66) and (35.62 ±10.62), respectively. The results showed that implementing positive thinking training increased happiness significantly (t=-4.08, P<0.001).Conclusion: Since positive thinking training effect reducing anxiety and increasing happiness in the elderly. Due to the growing trend of the elderly population, the positive thinking training approach can be used as a suitable, cost-effective, and efficient method in reducing anxiety and increasing happiness in the elderly.

scholarly journals Effect of an aged wearing suit on nursing student’s knowledge and attitude

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Zahra Mandegari Bamakan ◽  
Khadijeh Nasiriani ◽  
Farzan Madadizadeh ◽  
Fatemeh Keshmiri
Keyword(s):  
Nursing Students ◽  
The Elderly ◽  
Control Group ◽  
Control Groups ◽  
Significant Difference ◽  
Before And After ◽  
The Mean ◽  
Knowledge And Attitude ◽  
And Control ◽  
Experimental Group

Abstract Background The knowledge and attitude of health care providers are important and influential factors in providing care services to the elderly and need to be considered during the training course. Simulation in geriatric nursing education can be an opportunity for learners to experience the restrictions of the elderly. The present study was conducted to determine the effect of training through simulation on the attitude and knowledge of nursing students in elderly care. Methods This study was quasi-experimental with two experimental and control groups of pre and post-test, which was conducted on 70 nursing students of the 5th semester (two groups of 35 people). For the experimental group, the elderly simulation suit was worn for two hours, which was designed by the researcher and created sensory, physical, and motor restrictions similar to the elderly for students. Before and after the study, Kogan’s attitudes toward older people scale and Palmore’s “facts on aging quiz” were completed by students. The data were analyzed using an independent t-test and paired t-test using SPSS version 16 software. Results The mean scores of students’ knowledge in the experimental and control groups had no significant difference at the beginning of the study (p < 0.05). But the mean scores of knowledge in the experimental group before and after the intervention was (9.2 ± 2.6) and (15.3 ± 3.5), respectively, and in the control group before and after the intervention was (10.4 ± 2.9) and (11.3 ± 2.6), respectively, which had a statistically significant difference (p = 0.0001). The mean scores of students’ attitudes in the experimental and control groups had no significant difference at the beginning of the study (p < 0.05). The mean scores of attitude in the experimental group before and after the intervention was (114.69 ± 8.4) and (157.31 ± 10.7), respectively and in the control group before and after the intervention was (113.34 ± 13.6) and (108.5 ± 16.6), respectively, which was significantly different (p = 0.0001). Conclusions Based on the findings, the experience of aging restrictions through simulation has improved the knowledge and attitude of nursing students towards the elderly. Nursing education requires the growth of attitudinal skills, individuals’ beliefs, and creating empathy among them, so creating simulation opportunities can assist nursing students in the educational processes.

scholarly journals PENGARUH TERAPI BEAPREASI (KOMBINASI SENAM OTAK DENGAN RELAKSASI BENSON) TERHADAP KUALITAS TIDUR PADA LANJUT USIA DENGAN INSOMNIA

2019 ◽  
Vol 3 (1) ◽  
pp. 8
Author(s):  
Wulansari Wulansari ◽  
Mukhamad Mustain ◽  
Fiktina Vifri Ismiriyam
Keyword(s):  
Sleep Quality ◽  
Pittsburgh Sleep Quality Index ◽  
The Elderly ◽  
Control Group ◽  
Control Groups ◽  
Post Test ◽  
The Mean ◽  
Improve Sleep Quality ◽  
And Control ◽  
Experimental Group

AbstrakKualitas tidur pada lansia yang mengalami insomnia sangat bervariasi  yaitu ada yang baik dan ada yang buruk.  Salah satu keluhan tidur lansia adalah Insomnia , dimana ini  merupakan suatu proses degenerasi pada lansia menyebabkan waktu tidur yang efektif semakin berkurang, dan menyebabkan tidak tercapainya kualitas tidur yang adekuat.  Intervensi yang diberikan dapat disisipkan dalan kegiatan Posbindu. Salah satu Intervensi yang dapat diberikan adalah terapi beapreasi. Penelitian ini bertujuan untuk mengetahui  ada atau tidaknya pengaruh terapi Beapreasi terhadap kualitas tidur pada lansia dengan insomnia di  Posbindu Kemuning Kelurahan Candirejo Ungaran. Design penelitian yang digunakan adalah quasi experiment pre-test post-test with control group dan dilakukan pada 128 responden yang terbagi kedalam kelompok eksperimen dan kelompok kontrol,  masing-masing kelompok terdiri dari 64 responden . Metode  yang digunakan untuk menentukan responden adalah teknik purposive sampling. Penilaian Kualitas tidur di ukur dengan kuesioner PSQI dan dilakukan 2 kali pengukuran yaitu sebelum dan sesudah diberikan terapi Beapreasi. Penelitian menunjukkan bahwa rerata nilai PSQI pada kelompok eksperimen sebelum dilakukan intervensi sebesar 6.27 dan rerata  nilai PSQI pada kelompok kontrol sebesar 5.15. Selanjutnya rerata nilai PSQI pada kelompok eksperimen setelah  dilakukan intervensi sebesar 3.67, sedangkan  rerata  nilai PSQI kelompok kontrol  sebesar  5,73. Terdapat perbedaan nilai PSQI pada kelompok eksperimen dan kontrol dengan nilai p 0.00, nilai p < 0.05 sehingga ada pengaruh yang bermakna dari pemberian terapi beapreasi terhadap peningkatan  kualitas tidur. Intervensi terapi Beapreasi dapat meningkatkan kualitas tidur pada lansia yang mengalami insomnia . Terapi Beapreasi dapat dijadikan salah satu intervensi mandiri perawat dalam  merawat lansia yang mengalami insomnia dalam upaya meningkatkan kualitas tidur pada lansia.  Kata kunci: Terapi beapreasi , kualitas tidur, PSQI (the pittsburgh sleep quality index), lansia insomnia, posbindu Abstract The Effect of Breapreasi  Therapy (combain for brain Gym and benson relaxation) on Sleep Quality in the Elderly with Insomnia. Sleep quality in the elderly who experience insomnia varies greatly, there are good and some are bad. One of the complaints of elderly sleep is Insomnia, which is a degeneration process in the elderly which causes effective sleep time to decrease, and causes inadequate quality sleep. The intervention provided can be inserted in the activities of Posbindu. One of the interventions that can be given is therapy of beapreasi. This study aims to determine whether or not there is an effect of beapreasi therapy on sleep quality in the elderly with insomnia at Posbindu Kemuning, Candirejo Village, Ungaran. The research design used was quasi experiment pre-test post-test with control group and carried out on 128 respondents divided into experimental groups and control groups, each group consisting of 64 respondents. The method used to determine respondents is purposive sampling technique. Assessment of sleep quality was measured by the PSQI questionnaire and carried out 2 measurements, namely before and after being given therapy Beapreasi. The study showed that the mean PSQI value in the experimental group before intervention was 6.27 and the mean PSQI value in the control group was 5.15. Then the mean PSQI value in the experimental group after intervention was 3.67, while the mean PSQI value of the control group was 5.73. There are differences in the PSQI values in the experimental and control groups with a value of p 0.00, the value of p <0.05 so that there is a significant effect of the provision of beapreasi therapy on improving sleep quality. Beapreasi therapy interventions can improve sleep quality in elderly who experience insomnia. Beapreasi therapy can be used as one of the nurse's independent interventions in treating elderly people who experience insomnia in an effort to improve sleep quality in the elderly. Keywords: Beapreasi therapy, sleep quality, psqi (the pittsburgh sleep quality index), elderly insomnia, posbindu

Deprescribing Medications Among Older People to Reduce Polypharmacy at a Comprehensive Academic Medical Center

2021 ◽  
Vol 36 (4) ◽  
pp. 208-216
Author(s):  
Stella Ye ◽  
Sarah Boyko ◽  
Melissa Patel ◽  
Kruti Shah ◽  
Sara Turbow ◽  
...  
Keyword(s):  
Older People ◽  
Acute Care ◽  
Medical Center ◽  
Academic Medical Center ◽  
The Elderly ◽  
Control Group ◽  
Control Groups ◽  
Care For The Elderly ◽  
Academic Medical ◽  
And Control

OBJECTIVE: To evaluate deprescribing of select high-risk medications (HRMs) in an Acute Care for the Elderly (ACE) unit with pharmacist involvement compared with usual care in older people. DESIGN: Retrospective, single-center case-control study. SETTING: Medical-surgical units at an urban academic medical center. PARTICIPANTS: Patients 65 years of age and older admitted April-June 2019, with 1 or more of the following target HRMs prior to admission were included in the study: acid suppressants, antipsychotics, or insulin. Patients admitted to the ACE unit were included in the case group; all other patients were randomly matched by HRMs in a 2:1 ratio into the control group. INTERVENTIONS: The Acute Care for the Elderly pharmacist reviewed patients' medications to identify and deprescribe select HRMs. Deprescribing was defined as discontinuation, dose or frequency reduction. RESULTS: A total of 47 patients with 56 HRMs and 89 patients with 126 HRMs were included in the case and control groups, respectively. The primary outcome of HRMs deprescribed were similar between the case and control groups (21.4% and 25.4%; P = 0.56). Among the HRMs deprescribed (discontinued, dose or frequency reduced), 83.2% were complete discontinuations in case patients and 34.4% were complete discontinuations in control patients.

Effect of Electroacupuncture on the Inflammatory Response in Patients with Acute Pancreatitis: An Exploratory Study

2015 ◽  
Vol 33 (2) ◽  
pp. 115-120 ◽  
Author(s):  
Shi-Feng Zhu ◽  
Hui Guo ◽  
Rong-Rong Zhang ◽  
Yumei Zhang ◽  
Juan Li ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Inflammatory Responses ◽  
Length Of Hospital Stay ◽  
Control Group ◽  
Serum Concentrations ◽  
C Reactive Protein ◽  
Control Groups ◽  
Reactive Protein ◽  
Registration Number ◽  
And Control

Objectives To examine the effects of electroacupuncture (EA) on inflammatory responses in patients with acute pancreatitis (AP). Methods Eighty patients with mild or severe AP were randomly allocated to a control group or an EA group. All patients were managed conservatively. In addition, the EA group received acupuncture for 30 min per day for 7 days at bilateral points ST36, LI4, TE6, ST37 and LR3. Interleukin (IL)-6, IL-10 and C-reactive protein (CRP) levels were measured on admission and on day 7. The time to re-feeding and length of stay in hospital were also recorded. Results A total of 58 patients provided complete data. The characteristics of the patients in the EA and control groups were similar. After 7 days the serum concentrations of IL-10 were higher in the EA group than in the control group (mild AP: 6.2±1.2 vs 5.2±0.9 pg/mL, p<0.05; severe AP: 14.9±7.8 vs 7.9±6.3 pg/mL, p<0.05). For patients with severe AP, the CRP level in the EA group was lower than in the control group (p<0.05). Conclusions EA may reduce the severity of AP by inducing anti-inflammatory effects and reducing the time to re-feeding; however, it did not reduce the length of hospital stay. Trial Registration Number ChiCTR-TRC-13003572.

Conjugated Linoleic Acid Causes a Marked Increase in Liver α-Tocopherol and Liver α-Tocopherol Transfer Protein in C57BL/6 J Mice

2010 ◽  
Vol 80 (1) ◽  
pp. 65-73 ◽  
Author(s):  
Pei-Min Chao ◽  
Wan-Hsuan Chen ◽  
Chun-Huei Liao ◽  
Huey-Mei Shaw
Keyword(s):  
Antioxidant Enzymes ◽  
Linoleic Acid ◽  
Conjugated Linoleic Acid ◽  
Thiobarbituric Acid ◽  
Control Group ◽  
Thiobarbituric Acid Reactive Substances ◽  
Control Groups ◽  
Protein Levels ◽  
Transfer Protein ◽  
And Control

Conjugated linoleic acid (CLA) is a collective term for the positional and geometric isomers of a conjugated diene of linoleic acid (C18:2, n-6). The aims of the present study were to evaluate whether levels of hepatic α-tocopherol, α-tocopherol transfer protein (α-TTP), and antioxidant enzymes in mice were affected by a CLA-supplemented diet. C57BL/6 J mice were divided into the CLA and control groups, which were fed, respectively, a 5 % fat diet with or without 1 g/100 g of CLA (1:1 mixture of cis-9, trans-11 and trans-10, cis-12) for four weeks. α-Tocopherol levels in plasma and liver were significantly higher in the CLA group than in the control group. Liver α-TTP levels were also significantly increased in the CLA group, the α-TTP/β-actin ratio being 2.5-fold higher than that in control mice (p<0.01). Thiobarbituric acid-reactive substances were significantly decreased in the CLA group (p<0.01). There were no significant differences between the two groups in levels of three antioxidant enzymes (superoxide dismutase, glutathione peroxidase, and catalase). The accumulation of liver α-tocopherol seen with the CLA diet can be attributed to the antioxidant potential of CLA and the ability of α-TTP induction. The lack of changes in antioxidant enzyme protein levels and the reduced lipid peroxidation in the liver of CLA mice are due to α-tocopherol accumulation.

Sri Lankan Cleft Lip and Palate Study Model Analysis: Clefts of the Secondary Palate

1993 ◽  
Vol 30 (2) ◽  
pp. 227-230 ◽  
Author(s):  
Andrew Mccance ◽  
David Roberts-Harry ◽  
Martyn Sherriff ◽  
Michael Mars ◽  
William J.B. Houston
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Model Analysis ◽  
Control Group ◽  
Tooth Size ◽  
Sri Lankan ◽  
Control Groups ◽  
Secondary Palate ◽  
Comparable Control ◽  
And Control

The study models of a group of adult Sri Lankan patients with clefts of the secondary palate were investigated. Tooth-size and arch-dimension comparisons were made with a comparable control group. Significant differences were found between the cleft and control groups in tooth sizes, chord lengths, and arch widths. The cleft group dimensions were generally smaller than those of the control group. Overjets were larger in the cleft group.

THE EFFECT OF APPLYING ANIMAL CARTOON PICTURES ON STUDENTS’ ACHIEVEMENT IN WRITING NARRATIVE TEXT

2017 ◽  
Vol 6 (1) ◽  
Author(s):  
Hasanul Arifin Zul And Masitowarni Siregar
Keyword(s):  
T Test ◽  
Narrative Text ◽  
Control Group ◽  
First Year ◽  
Writing Achievement ◽  
Control Groups ◽  
Post Test ◽  
Written Test ◽  
And Control ◽  
Experimental Group

This thesis is focused on the investigation of the effect of applying animal cartoon pictures on students’ achievement in writing narrative text. This study aims to find whether applying animal cartoon pictures significantly affect the students’ writing achievement or not. The data in this study were obtained by administering a written test. The population was the 2015/2016 first year (grade XI) of SMA Swasta Nusantara Lubuk Pakam and 66 students were taken as the sample by using random sampling. The sample was divided into two groups, experimental and control groups. The experimental group was taught by applying animal cartoon pictures while the control group without animal cartoon pictures (x = lecturing). The data were taken the scores from the pre-test and post-test to both experimental and control groups. These data were analyzed by using t-test. The result of computing the t-test obviously showed that t-observed is higher than t-table (5.21 >1,67) with the degree of freedom 64 (df =N-2) at the level significance 0,05 one tail test. It showed that the application of animal cartoon pictures significantly affected the students of SMA Swasta Nusantara Lubuk Pakam achievement in writing narrative text.

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