scholarly journals A study on the ease of placement of spinal needle in relation to height, weight and BMI in a geriatric population of Eastern India

2018 ◽  
Vol 6 (7) ◽  
pp. 2508
Author(s):  
Anirban Sadhu ◽  
Santanu Kumar Khanra ◽  
Hironmoy Mondal ◽  
Rudradev Meyur
Keyword(s):  
Spinal Anaesthesia ◽  
Statistical Tests ◽  
Young Patients ◽  
Significant Risk ◽  
The Elderly ◽  
Spinal Needle ◽  
Geriatric Population ◽  
Time Period ◽  
Common Causes ◽  
The Impact

Background: Spinal anaesthesia is the procedure of choice for infraumbilical surgery worldwide. This is usually very easy in young patients but fraught with difficulties in the elderly. Such difficulties may lead to pain, haematoma and infection, all of which pose a significant risk in the elderly. Hence it is imperative to study the common causes of such problems faced during introduction of the spinal needle for the same This will ensure a better management of the problem. The study was done to assess the impact of height, weight and BMI on the ease of introduction of spinal needle for anaesthesia in patients above 65 years of age.Methods: A 500 patients above 65 years of age were selected for the study based on some well-defined inclusion and exclusion criteria. The time period for the study was 1 year. Their height, weight and BMI were then recorded. Then the number of redirections and level (s) required for successful placement of spinal needle were noted for each patient. ≤3 redirections and <1 levels were considered as easy placement of spinal needle. The latter were tabulated separately against the height, weight and BMI of each patient. Relevant statistical tests were also done to ascertain the significance of the findings.Results: Patients with lesser height, weight and BMI took <3 redirections and <1 level for placement of spinal needle and these were statistically significant.Conclusions: Spinal anaesthesia is relatively easy in elderly patients with lesser height, weight and BMI.

Performance of healthy elderly with Alzheimer's disease at an early stage in executive function and language

2011 ◽  
Vol 26 (S2) ◽  
pp. 498-498
Author(s):  
M.T. Santos ◽  
G.C. Couto ◽  
J.C. Achieri ◽  
C.A. Júnior
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Early Stage ◽  
The Elderly ◽  
Screening Tests ◽  
Healthy Elderly ◽  
Initial Stage ◽  
Significant Difference ◽  
Common Causes ◽  
The Impact

Dementia are increasingly prevalent in population. The most common causes of dementia is Alzheimer's disease (AD). Screening tests have been used for the premature diagnosis of Alzheimer Disease (AD), specifically in the executive functions and language, which are compromised at an initial stage. However, the necessity standardized means and validated for our middle, to show oneself a pressing subject.ObjectiveTo analyze the impact of the length of sentences in the abstraction of proverbs in the Screening Test for Alzheimer's disease with Proverbs (TRDAP), healthy elderly and with Alzheimer's disease at early stage.MethodSurvey document in the database, analyzing the responses of the elderly (abstract or concrete interpretation of proverbs), relating the length of sentences (sayings) of stage B of TRDAP with the diagnosis of Alzheimer's disease and the interference of age and schooling.ResultsHealthy older people showed greater capacity for abstraction than those with AD. There was Significant differences, in the sayings 1 (p = 0.033) and 2 (p = 0.001), corresponding to lower sentences, which did not occur with the proverb 3. As for age no verified significant difference among the healthy and only saying 3 in AD patients, however schooling differenced the healthy.ConclusionElderly with Alzheimer's disease at an initial stage have lower performance in the comprehension of ambiguous sentences, interpretation and abstraction of proverbs, corroborating with the data of the literature. The size of these sentences appears to be inversely proportional to the correctness of interpretation in elderly patients with and without AD.

The Impact of Regionalization of Pancreaticoduodenectomy for Pancreatic Cancer in North Carolina since 2004

2014 ◽  
Vol 80 (6) ◽  
pp. 561-566 ◽  
Author(s):  
Ryan Z. Swan ◽  
David J. Niemeyer ◽  
Ramanathan M. Seshadri ◽  
Kyle J. Thompson ◽  
Amanda Walters ◽  
...  
Keyword(s):  
North Carolina ◽  
Significant Risk ◽  
High Volume ◽  
Major Morbidity ◽  
The North ◽  
Time Period ◽  
Improved Outcomes ◽  
Before And After ◽  
Low Volume ◽  
The Impact

Pancreaticoduodenectomy (PD) carries a significant risk. High-volume centers (HVCs) provide improved outcomes and regionalization is advocated. Rapid regionalization could, however, have detrimental effects. North Carolina has multiple HVCs, including an additional HVC added in late 2006. We investigated regionalization of PD and its effects before, and after, the establishment of this fourth HVC. The North Carolina Hospital Discharge Database was queried for all PDs performed during 2004 to 2006 and 2007 to 2009. Hospitals were categorized by PD volume as: low (one to nine/year), medium (10 to 19/year), and high (20/year or more). Mortality and major morbidity was assessed by comparing volume groups across time periods. Number of PDs for cancer increased 91 per cent (129 to 246 cases) at HVCs, whereas decreasing at low-volume (62 to 58 cases) and medium-volume (80 to 46 cases) centers. Percentage of PD for cancer performed at HVCs increased significantly (47.6 to 70.3%) while decreasing for low- and medium-volume centers ( P < 0.001). Mortality was significantly less at HVCs (2.8%) compared with low-volume centers (10.3%) for 2007 to 2009. Odds ratio for mortality was significantly lower at HVCs during 2004 to 2006 (0.31) and 2007 to 2009 (0.34). Mortality for PD performed for cancer decreased from 6.6 to 4.6 per cent ( P = 0.31). Major morbidity was not significantly different between groups within either time period; however, there was a significant increase in major morbidity at low-volume centers ( P = 0.018). Regionalization of PD for cancer is occurring in North Carolina. Mortality was significantly lower at HVCs, and rapid regionalization has not detracted from the superior outcomes at HVCs.

scholarly journals Do Younger Patients with Muscle-Invasive Bladder Cancer have Better Outcomes?

2019 ◽  
Vol 8 (9) ◽  
pp. 1459 ◽  
Author(s):  
Florian Janisch ◽  
Hang Yu ◽  
Malte W. Vetterlein ◽  
Roland Dahlem ◽  
Oliver Engel ◽  
...  
Keyword(s):  
Cox Regression ◽  
Care Center ◽  
Tertiary Care ◽  
Tumor Biology ◽  
Survival Rates ◽  
Multivariable Analysis ◽  
Young Patients ◽  
The Elderly ◽  
Cancer Of The Bladder ◽  
The Impact

Urothelial cancer of the bladder (UCB) is usually a disease of the elderly. The influence of age on oncological outcomes remains controversial. This study aims to investigate the impact of age on UCB outcomes in Europe focusing particularly on young and very young patients. We collected data of 669 UCB patients treated with RC at our tertiary care center. We used various categorical stratifications as well as continuous age to investigate the association of age and tumor biology as well as endpoints with descriptive statistics and Cox regression. The median age was 67 years and the mean follow-up was 52 months. Eight patients (1.2%) were ≤40 years old and 39 patients (5.8%) were aged 41–50 years, respectively. In multivariable analysis, higher continuous age and age above the median were independent predictors for disease recurrence, and cancer-specific and overall mortality (all p-values ≤ 0.018). In addition, patients with age in the oldest tertile group had inferior cancer-specific and overall survival rates compared to their younger counterparts. Young (40–50 years) and very young (≤40 years) patients had reduced hazards for all endpoints, which, however, were not statistically significant. Age remains an independent determinant for survival after RC. Young adults did, however, not have superior outcomes in our analyses. Quality of life and complications are endpoints that need further evaluation in patients undergoing RC.

scholarly journals 556 - The Impact of COVID-19 pandemic on elderly’s mental health

2021 ◽  
Vol 33 (S1) ◽  
pp. 96-97
Author(s):  
Sofia Ramos Ferreira ◽  
Daniela Pereira ◽  
Horácio Firmino
Keyword(s):  
Mental Health ◽  
Elderly Population ◽  
Current Knowledge ◽  
The Elderly ◽  
World Health ◽  
Negative Consequences ◽  
Physical And Mental Health ◽  
Geriatric Population ◽  
Health Organization ◽  
The Impact

Background:Since the disease caused by the SARS-Cov-2 virus was declared a pandemic by the World Health Organization, countries around the globe adopted measures of social distancing to limit the spread of the virus. Although social distancingmeasures are essential preventive mechanisms, they can promote feelings of loneliness and influence the onset or exacerbation of psychiatric disorders. Current knowledge about the impact of COVID-19 on mental health - and in particular on mental health of the geriatric population - is still scarce.Research Objective:The present review aimed to analyze the COVID-19 pandemic impact on the elderly´s mental health and to suggest measures that can mitigate this impact.Method:A non-systematic review of the literature, through bibliographic research in Pubmed and Embase databases - using the keywords “COVID-19", “SARS-CoV-2", “Coronavirus”, “Aging”, “Older adults”, “Elderly”, “Quarantine” and “Mental health” -was performed.Preliminary results of the ongoing study:The available literature points towards a likely increase in mental disorders as a result of the COVID-19 pandemic. This phenomena may be particularly relevant in the elderly population. Several measures – pharmacological and non-pharmacological – can help to maintain the physical and mental health of the elderly.Conclusion:The COVID-19 pandemic had an important impact in elderly’s mental health. This subject should be addressed by profissionals/caregivers and measures tominimize negative consequences are in order.

Impact of Frailty and Age on Clinical Outcomes in Patients Who Underwent Endovascular Therapy

2021 ◽  
pp. 152660282110677
Author(s):  
Ken Nishikawa ◽  
Soichiro Ebisawa ◽  
Takashi Miura ◽  
Tamon Kato ◽  
Kanzaki Yusuke ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Endovascular Therapy ◽  
Young Patients ◽  
The Elderly ◽  
Cardiovascular Death ◽  
Major Amputation ◽  
Clinical Frailty Scale ◽  
Treatment Indications ◽  
Artery Disease ◽  
The Impact

Purpose: Information on the relationship between frailty and the outcome of endovascular therapy (EVT) in elderly patients with lower extremity peripheral artery disease (PAD) is scarce. This study aimed to reveal the impact of frailty on the prognosis of super-elderly patients who underwent EVT. Materials and Methods: From August 2015 to August 2016, 335 consecutive patients who underwent EVT were enrolled in the I-PAD registry from 7 institutes in Nagano prefecture. Among them, we categorized 323 patients into 4 groups according to age and the presence or absence of frailty as follows: elderly with frailty (age ≥ 75, Clinical Frailty Scale [CFS] ≥ 5), elderly without frailty (age ≥ 75, CFS ≤ 4), young with frailty (age < 75, CFS ≥ 5), and young without frailty (age < 75, CFS ≤ 4); we analyzed them accordingly. The primary endpoints were major adverse cardiovascular and limb events (MACLE), defined as a composite of cardiovascular death, myocardial infarction, stroke, admission for heart failure, major amputation, and revascularization. The secondary endpoint was cardiovascular death. Results: The median follow-up period was 2.7 years. In the elderly with frailty, elderly without frailty, young with frailty, and young without frailty groups, the freedom rates from MACLE were 34.9%, 55.7%, 35.4%, and 63.0%, respectively (p<0.001) and from all-cause death were 43.5%, 73.4%, 50.7%, and 90.9%, respectively (p<0.001). The freedom rates from MACLE were significantly higher among elderly patients with frailty than among young patients without frailty (55.7% vs 35.4%, p=0.01). In multivariate analysis, frailty was independently associated with MACLE incidence. Conclusion: Frailty as defined by CFS might be a predictor of MACLE incidence in patients with PAD who underwent EVT. By considering treatment indications for patients with PAD by focusing on frailty rather than age, we may examine whether EVT policies are appropriate and manage patient and caregiver expectations for potential improvement in functional outcomes. Further studies are expected to investigate whether changes in frailty after EVT change prognosis.

scholarly journals COLONOSCOPY COMPLICATIONS IN THE ELDERLY: the impact of age and multimorbidity

2013 ◽  
Vol 50 (4) ◽  
pp. 251-256
Author(s):  
Francine de Cristo STEIN ◽  
Naira Hossepian Salles de Lima HOJAIJ ◽  
Jose Guilherme Nogueira da SILVA ◽  
Luana Vilarinho BORGES ◽  
Wilson JACOB-FILHO ◽  
...  
Keyword(s):  
Bowel Preparation ◽  
Retrospective Cohort ◽  
Gastrointestinal Endoscopy ◽  
Rating Scale ◽  
Significant Risk ◽  
The Elderly ◽  
Primary Objective ◽  
Charlson Index ◽  
American Society ◽  
The Impact

ContextAge has been considered an independent risk factor for colonoscopy complications, especially when associated with multimorbidity.ObjectivesThe primary objective was to verify the relationships between age, multimorbidity and colonoscopy complications in the elderly.MethodsA retrospective cohort including patients of 60 years or older who had undergone a colonoscopy. Data relating to age, multimorbidities according to the cumulative illness scale for geriatrics and the Charlson index and complications related to bowel preparation and procedure (sedation and exam) were collected.ResultsOf the 207 patients (mean age 70.47 ± 7.04) with appropriate indication for colonoscopy according to the American Society for Gastrointestinal Endoscopy, 43 (20.77%) patients had some colonoscopy complications: 1 (0.48%) with the sedation (apnea), 4 (1.93%) with the procedure (abdominal pain and bacteremia) and 38 (18.35%) with the bowel preparation (acute renal failure, hypotension). Individuals ≥80 years had an RR = 3.4 (1.2-10.1),P = 0.025, and those with a Charlson index 3 had an RR = 5.2 (1.6-16.8), P = 0.006, for complications. The cumulative illness rating scale for geriatrics was not associated with complications (P = 0.45).ConclusionThere was a significant risk of complications in ≥80 years and in the group with a Charlson index 3. The cumulative illness rating scale for geriatrics was not a good predictor of risk in this sample.

scholarly journals Impact of Co-creation Footwear Workshops on Older Women in Elderly Centers in Hong Kong

2019 ◽  
Vol 14 (1) ◽  
pp. 25
Author(s):  
Mei-ying Kwan ◽  
Kit-lun Yick ◽  
Yan-yan Wong
Keyword(s):  
Hong Kong ◽  
Older Women ◽  
Design Process ◽  
User Involvement ◽  
The Elderly ◽  
Design Features ◽  
Geriatric Population ◽  
Psychological Impacts ◽  
Risk Of Falls ◽  
The Impact

Background: The use of appropriate footwear could reduce the risk of falls among the geriatric population. However, the elderly are generally reluctant to accept new footwear designs particularly with the incorporation of fabrication materials and functional design features that are perceived to be less comfortable. Co-creation activities that encourage user involvement during the product design process and development can therefore address this issue and provide unique benefits and better value for users, increase acceptance, and even lead to positive perception as well as positive psychological impacts, thereby increasing the practical use of newly designed footwear. Objective: This study aims to investigate the impact of hands-on footwear workshops on perceived functionality of geriatric footwear for older women. Method: Footwear co-design workshops for older women were carried out in two elderly centers in Hong Kong. Twenty-one healthy females between 64 and 80 years old (mean: 71; SD: 4.2), were recruited. Subjects were invited to decorate the prescribed geriatric footwear prototype and discuss their ideas on footwear design in a group of three. They were surveyed after completing the footwear decoration. Main outcome measures: The perceptions of the subjects on the geriatric footwear and related design features were analysed. Results: The questionnaire survey shows positive results in the psychological value of the workshops for older women. The participants express high levels of satisfaction with the co-design process and a strong sense of achievement with the newly designed geriatric footwear. The acceptance and awareness of the functions of the footwear are greatly enhanced. Conclusions: The co-design approach has positive psychological impacts on the elderly and their acceptance of the final product. This approach also better meets the aesthetic needs of the users.

scholarly journals The prior infection with SARS-CoV-2 study (PICOV) in nursing home residents and staff - study protocol description and presentation of preliminary findings on symptoms.

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Maria E. Goossens ◽  
Kristof Y. Neven ◽  
Pieter Pannus ◽  
Cyril Barbezange ◽  
Isabelle Thomas ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Nursing Home Residents ◽  
The Elderly ◽  
Population Characteristics ◽  
Past Infection ◽  
Geriatric Population ◽  
Staff Members ◽  
Tract Infections ◽  
The Impact

Abstract Background The COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has presented itself as one of the most important health concerns of the 2020’s, and hit the geriatric population the hardest. The presence of co-morbidities and immune ageing in the elderly lead to an increased susceptibility to COVID-19, as is the case for other influenza-like illnesses (ILI) or acute respiratory tract infections (ARI). However, little is known, about the impact of a previous or current infection on the other in terms of susceptibility, immune response, and clinical course. The aim of the “Prior Infection with SARS-COV-2” (PICOV) study is to compare the time to occurrence of an ILI or ARI between participants with a confirmed past SARS-CoV-2 infection (previously infected) and those without a confirmed past infection (naïve) in residents and staff members of nursing homes. This paper describes the study design and population characteristics at baseline. Methods In 26 Belgian nursing homes, all eligible residents and staff members were invited to participate, resulting in 1,226 participants. They were classified as naïve or previously infected based on the presence of detectable SARS-CoV-2 antibodies and/or a positive RT-qPCR result before participation in the study. Symptoms from a prior SARS-CoV-2 infection between March and August 2020 were compared between previously infected residents and staff members. Results Infection naïve nursing home residents reported fewer symptoms than previously infected residents: on average 1.9 and 3.1 symptoms, respectively (p = 0.016). The same effect was observed for infection naïve staff members and previously infected staff members (3.1 and 6.1 symptoms, respectively; p <0.0001). Moreover, the antibody development after a SARS-CoV-2 infection differs between residents and staff members, as previously infected residents tend to have a higher rate of asymptomatic cases compared to previously infected staff members (20.5% compared to 12.4%; p <0.0001). Conclusions We can postulate that COVID-19 disease development and symptomatology are different between a geriatric and younger population. Therefore, the occurrence and severity of a future ILI and/or ARI might vary from resident to staff.

scholarly journals Human alveolar lining fluid from the elderly promotes Mycobacterium tuberculosis growth in alveolar epithelial cells and bacterial translocation into the cytosol

2021 ◽  
Author(s):  
Angelica M. Olmo-Fontanez ◽  
Julia M. Scordo ◽  
Andreu Garcia-Vilanova ◽  
Diego J. Maselli ◽  
Jay Peters ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Epithelial Cells ◽  
Bacterial Translocation ◽  
Elderly Population ◽  
Cell Activation ◽  
Significant Risk ◽  
The Elderly ◽  
Alveolar Epithelial Cells ◽  
Alveolar Epithelial ◽  
The Impact

The elderly population is at significant risk of developing respiratory diseases, including tuberculosis (TB) caused by the airborne Mycobacterium tuberculosis (M.tb). Once M.tb reaches the alveolar space, it contacts alveolar lining fluid (ALF) which dictates host cell interactions. We previously determined that age-associated dysfunctionality in human ALF soluble innate components lead to accelerated M.tb growth within human alveolar macrophages. Here we determined the impact of human ALF on M.tb infection of alveolar epithelial cells (ATs), another critical cellular determinant of infection. We observed that E-ALF-exposed M.tb had significantly increased intracellular growth in ATs compared to adult ALF (A-ALF)-exposed bacteria. Despite this, there were no alterations in AT inflammatory mediators or cell activation. However, exposure to E-ALF altered endosomal trafficking of M.tb, driving bacterial translocation to both endosomal and cytosolic compartments in ATs. Our results indicate that exposure of M.tb to E-ALF promotes translocation of bacteria into the AT cytosol as a potential favorable niche for rapid bacterial growth and at the same time dampens ATs immune responses. Thus, our findings highlight the influence of the elderly lung mucosa on M.tb infection of ATs, an unexplored contributing factor to the elderly population increased susceptibility of developing active TB disease.

scholarly journals The Effect of Age and Education Level as a Source of Information on Internet Use in Preoperative Patients

2020 ◽  
Author(s):  
Yasin Tire ◽  
Eyüp Aydoğan ◽  
Abdullah Celep ◽  
Aydın Mermer
Keyword(s):  
Social Media ◽  
Elderly Patients ◽  
Internet Use ◽  
Middle Age ◽  
Young Patients ◽  
The Elderly ◽  
The Internet ◽  
The Impact ◽  
Source Of Information ◽  
Internet And Social Media

Most patients rely on the internet to access a medical information source. Patients undergoing surgery use the internet and social media to gain information about anesthesia and surgery. In our study, it has dealt with the use of the internet and social media for news in patients who will undergo surgery and the impact of age and education on this situation. Every patient who came to our clinic for surgery between August 1, 2019 and December 31, 2019 was asked to complete a survey preoperatively. This questionnaire includes questions about internet use. The rate of using the internet as the source of anesthesia information was 24.3% in young patients, this rate found to be 7% in the middle age patients, and none of the elderly patients used the internet as the source of anesthesia information. In terms of operation information, the rate of those using internet as a source of information in the young patients was 29.7%, whereas it was 14% in the middle age patients, and the rate was 5.3% in the elderly patients. Some of the patients (21%) who came to the clinic used internet and social media as a source of information. This study has been found useful in the sense that anesthesiologists and surgeons send information about themselves on the internet and be accessible via social media.

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