scholarly journals Features of multimorbidity in elderly and senile people with hypertension

2021 ◽  
Vol 26 (4) ◽  
pp. 3940
Author(s):  
V. V. Popov ◽  
I. A. Novikova ◽  
M. V. Trokhova
Keyword(s):  
Medical Records ◽  
Rating Scale ◽  
Clinical Status ◽  
The Elderly ◽  
Cerebrovascular Diseases ◽  
Cardiovascular Comorbidities ◽  
High Prevalence ◽  
Artery Disease ◽  
Ischemic Attack ◽  
Senile Patient

Aim. To reveal the features of multimorbidity in elderly and senile people with hypertension (HTN).Material and methods. A total of 70 elderly and senile hypertensive patients were examined at one of the Arkhangelsk outpatient clinics (from 60 to 90 years old; mean age — 69,14±1,34 years), including those aged 60-74 years (n=56; (80,0%) and 75 years and older (n=14; 20,0%). We assessed the questionnaire survey data, the outpatient medical records, the clinical status, and the cumulative illness rating scale for geriatrics (CIRS-G).Results. The analysis showed a high prevalence of multimorbidity in elderly and senile people with HTN, which was found in all patients. On average, an elderly patient with HTN has 6 diseases that are pathogenetically interrelated and unrelated, while a senile patient has 8 diseases. The most common comorbidities were gastrointestinal (81,43%), musculoskeletal (77,14%) and endocrine (77,14%) diseases. Among the cardiovascular comorbidities in the elderly with HTN, the following were more common: heart failure (54,29%), coronary artery disease (angina pectoris — 41,43%) and cerebrovascular diseases (28,57%) (stroke/transient ischemic attack, vascular encephalopathy). Patients with HTN took an average of 6 different drugs at the same time. There was moderate comorbidity level in the elderly patients and a high one in those of senile age.Conclusion. In elderly and senile patients with HTN, there is a high prevalence of multimorbidity, which must be taken into account when preventing polypharmacy.

Validity of the Elderly Behavior Assessment for Relatives (EBAR)

2000 ◽  
Vol 16 (1) ◽  
pp. 77-83 ◽  
Author(s):  
Lina Pezzuti ◽  
Caterina Laicardi ◽  
Marco Lauriola
Keyword(s):  
Cognitive Functioning ◽  
Mini Mental State Examination ◽  
Rating Scale ◽  
Good Health ◽  
The Elderly ◽  
Behavior Assessment ◽  
Elderly Persons ◽  
Behavior Rating Scale ◽  
Components Analysis ◽  
State Examination

Summary: An Elderly Behavior Assessment for Relatives (EBAR), updating the GERRI ( Schwartz, 1983 ), was administered to relatives (or significant others) of 349 elderly persons, from 60 to over 80 years of age, living at home, in good health and without cognitive impairment. A trained psychologist administered subjects the Life Satisfaction for Elderly Scale (LSES), the Instrumental Activity of Daily Living (IADL), the Mini Mental State Examination (MMSE), and personally answered to an overall elderly behavior rating scale (RA). EBAR items were first examined. The more attractive and less discriminative statements were excluded. A principal components analysis was carried out on the remaining EBAR items. Three factors were extracted. After varimax rotation they were tentatively labeled: Everyday Cognitive Functioning, Depression, and Hostility. Factor-driven EBAR subscales were designed, taking into account simpler items in the factor matrix. Results provide evidence for EBAR construct validity. Everyday Cognitive Functioning is connected to the IADL and the RA scores; Depression is very highly related to the LSES; Hostility is weakly related to RA, IADL, and MMSE, indicating that the scale needs further investigation.

Transient Ischemic Attack in the Elderly

2015 ◽  
Vol 16 (2) ◽  
pp. 56-62
Author(s):  
Meyung-Kug Kim ◽  
Bong-Goo Yoo
Keyword(s):  
Transient Ischemic Attack ◽  
The Elderly ◽  
Ischemic Attack

COGNITIVE DEFICIENCY AT ISCHEMIC OM STROKE

2020 ◽  
Vol 1 (1) ◽  
pp. 55-57
Author(s):  
Dildora Khaydarova ◽  
◽  
Hilola Davronova ◽  
Asliddin Akbarov ◽  
Keyword(s):  
Social Problems ◽  
Cerebrovascular Diseases ◽  
Cerebral Stroke ◽  
Number Of Patients ◽  
High Prevalence ◽  
The World ◽  
Cognitive Deficiency ◽  
Complications And Mortality

Cerebrovascular diseases remain one of the most pressing medical and social problems in many countries of the world, due to their high prevalence, severity of complications and mortality. In Uzbekistan, the number of patients with cerebral stroke is quite large -about 40-45 thousandcases of cerebral stroke are registered annually

scholarly journals 551. Convalescent plasma early in disease course improves survival in COVID-19

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S341-S342
Author(s):  
Varidhi Nauriyal ◽  
Anita Shallal ◽  
Amit T Vahia ◽  
Linoj Samuel ◽  
Robert Tibbetts ◽  
...  
Keyword(s):  
Scale Score ◽  
Medical Records ◽  
Clinical Status ◽  
Ordinal Scale ◽  
Optimal Timing ◽  
Care Hospital ◽  
Future Studies ◽  
Patient Gender ◽  
Significant Difference ◽  
Pcr Test

Abstract Background Convalescent plasma (CP) has been described as a potential therapy for coronavirus disease 2019 (COVID-19). Given paucity of data, we sought to describe characteristics of CP recipients in survivors and non-survivors. Methods We conducted retrospective review of electronic medical records which included any patient with a positive SARS-CoV-2 PCR test who received CP at an 890-bed quaternary care hospital in Southeast Michigan between March-May 2020. Data collected included: demographics, co-morbidities, mSOFA score on admission, laboratory values, and treatment. Outcomes assessed included inflammatory markers and clinical status based on an 8-point ordinal scalea. These values were recorded on admission, the date of CP (day 1), day 3, 7, and day 30 post-CP. Patient outcomes were stratified by ordinal scale score and compared using Mann-Whitney U tests to examine differences in clinical characteristics: scale of 1–4 (“meaningful survivor”), 5–7 (“survivor”), and 8 (“non-survivor”). Results Results of our study are summarized in Table 1 and 2. Non-survivors were older than survivors (62 vs 71 years; p=0.026). There was no statistically significant difference between patient gender, race, number of days from positive PCR test to CP, treatments, and co-morbidities. There was a trend toward higher mSOFA score on admission in non-survivors (p=0.056). A lower ordinal scale score on the date of receiving CP was significantly associated with meaningful survivorship (6 vs 7, p=0.005). Comparisons of Characteristics Based on Ordinal Scale at Day 30 Comparisons of Outcomes Based on Ordinal Scale at Day 30 Conclusion Patients who have a lower ordinal scale score on the date of CP administration are most likely to have meaningful survivorship at day 30. Future studies should evaluate optimal timing and outcomes for CP therapy in COVID-19. Disclosures All Authors: No reported disclosures

scholarly journals Orthostatic Hypotension and Falls in Hospitalized Older Adults

2021 ◽  
pp. 105477382098668
Author(s):  
Kathleen Schell ◽  
Denise Lyons ◽  
Barry Bodt
Keyword(s):  
Older Adults ◽  
Orthostatic Hypotension ◽  
Electronic Medical Records ◽  
Fall Prevention ◽  
Medical Records ◽  
The Elderly ◽  
Chi Square ◽  
Convenience Sample ◽  
Chi Square Test ◽  
Hospitalized Older Adults

The aim of this retrospective study was to determine the prevalence of orthostatic hypotension (OH) among a convenience sample of older adults on two Acute Care of the Elderly (ACE) units of the ChristianaCare™ in Delaware. Another aim was to determine if subjects with documented OH experienced falls. Retrospective de-identified data was obtained from electronic medical records for the years 2015 to 2018. Among all patients who had valid first orthostatic vital sign (OVS) readings ( n = 7,745), 39.2% had orthostatic hypotension on the first reading. Among the patients, 42.8% were found to be hypotensive during OVS. Thirty-one (0.9%) of those with OH fell at some point during their stay. The odds ratio for falls in the presence of OH was 1.34 with a 95% confidence interval (0.82, 2.21), but a chi-square test failed to find significance ( p = .2494). The results could not determine if OVS should be mandatory in fall prevention protocols.

EXPRESS: Evolving Ischemic Stroke Subtypes in 15 years: A hospital-based observational study

2021 ◽  
pp. 174749302110059
Author(s):  
Yiu Ming Bonaventure Ip ◽  
Lisa Au ◽  
Yin Yan Anne Chan ◽  
Florence Fan ◽  
Hing Lung Ip ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Recurrence Rate ◽  
Small Vessel Disease ◽  
Mainland China ◽  
Cardioembolic Stroke ◽  
Large Artery ◽  
Risk Factor Control ◽  
Stroke Subtypes ◽  
Artery Disease ◽  
Ischemic Attack

Background: Depicting the time trends of ischemic stroke subtypes may inform healthcare resource allocation on etiology-based stroke prevention and treatment. Aim: To reveal the evolving ischemic stroke subtypes from 2004 to 2018. Methods: We determined the stroke etiology of consecutive first-ever transient ischemic attack or ischemic stroke patients admitted to a regional hospital in Hong Kong from 2004 to 2018. We analyzed the age-standardized incidences and the 2-year recurrence rate of major ischemic stroke subtypes. Results: Among 6940 patients admitted from 2004 to 2018, age-standardized incidence of ischemic stroke declined from 187.0 to 127.4 per 100,000 population (p<0.001), driven by the decrease in large artery disease (43.0 to 9.67 per 100,000 population (p<0.001)) and small vessel disease (71.9 to 45.7 per 100,000 population (p<0.001)). Age-standardized incidence of cardioembolic stroke did not change significantly (p=0.2). Proportion of cardioembolic stroke increased from 20.4% in 2004-2006 to 29.3% in 2016-2018 (p<0.001). 2-year recurrence rate of intracranial atherothrombotic stroke reduced from 19.3% to 5.1% (p<0.001) with increased prescriptions of statin (p<0.001) and dual anti-platelet therapy (<0.001). In parallel with increased anticoagulation use across the study period (p<0.001), the 2-year recurrence of AF-related stroke reduced from 18.9% to 6% (p<0.001). Conclusion: Etiology-based risk factor control might have led to the diminishing stroke incidences related to atherosclerosis. To tackle the surge of AF-related strokes, arrhythmia screening, anticoagulation usage and mechanical thrombectomy service should be reinforced. Comparable preventive strategies might alleviate the enormous stroke burden in mainland China.

404 Sleep-Disordered Breathing In Native Hawaiians/Pacific Islanders With Associated Comorbidities And Adherence To Therapy

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A160-A161
Author(s):  
Darin Ryujin ◽  
Krishna Sundar ◽  
Allyson Gilles
Keyword(s):  
Sleep Disordered Breathing ◽  
Demographic Data ◽  
Ethnic Origin ◽  
Pacific Islanders ◽  
Native Hawaiians ◽  
University Of Utah ◽  
High Prevalence ◽  
Artery Disease ◽  
Disordered Breathing

Abstract Introduction Sleep-disordered breathing in Native Hawaiians and Pacific Islanders (NHPIs), its relationship to type 2 diabetes mellitus (DM), chronic renal, and heart disease, is not well known. NHPIs comprise only 1.3% of Utah’s population, but have the highest rates of DM and deaths due to diabetic kidney disease in Utah. This study assessed the nature of sleep-disordered breathing, its association with demographic variables, and comorbidities, and adherence patterns to positive airway pressure (PAP) therapy. Methods University of Utah sleep clinics patient databases from 2014 were evaluated to identify NHPIs using first/last names. Electronic medical records were reviewed to confirm patient ethnic origin, demographic data, and comorbidities. The most recent PAP downloads were obtained. Results Of 106 NHPIs were identified, data available for 104 patients (71 males, 33 females) was analyzed. Mean age of males was 47 + 13 years and females 48±13 years. Prevalence rates of obesity were 13% (female 9%, male 15%) with BMI≥30, 33% (female 24%, male 23%) with BMI≥35, and 49% (female 58%, Male 23%) with BMI≥40). Majority of patients had severe OSA (61% males with AHI≥30; 39% females with ≥ 30), with overall mean AHI of 47±38. A high prevalence of comorbidities was noted: 61% hypertension (male 58%; female 67%), diabetes 54% (male 48%, female 67%), renal disease 20% (male 21%, female 18%), coronary artery disease 13% (male 14%, female 9%), and congestive heart failure 13% (male 15%, female 9%). Prevalence of lung disease was low 13% (male 9%, female 18%). Conclusion NHPIs evaluated for sleep-disordered breathing have high rates of obesity, severe OSA, and concerning comorbidities. PAP adherence in this group was poor compared to overall adherence for patients seen in University of Utah sleep clinics (~70%). Further research is required to assess the relationships between OSA, associated comorbidities, and disease outcomes. Addressing low rates of PAP adherence in this population may afford opportunities to improve health outcomes. Support (if any) n/a

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