scholarly journals Optimization of Surgical Treatment of Cholelithiasis and its Complications in Patients with High Operative-Anesthesiological Risk

2019 ◽  
Vol 12 (1) ◽  
pp. 23-28
Author(s):  
Pyotr Mikhaylovich Nazarenko ◽  
Dmitry Petrovich Nazarenko ◽  
Maxim Borisovich Polyansky ◽  
Levan Lorikovich Kvachakhiya ◽  
Yana Vladimirovna Maslova ◽  
...  
Keyword(s):  
Acute Cholecystitis ◽  
Bile Ducts ◽  
Gallstone Disease ◽  
Foley Catheter ◽  
Age Groups ◽  
The Elderly ◽  
Aged Patients ◽  
Acute Calculous Cholecystitis ◽  
The Third ◽  
The Status

The ratio of the prevalence of the gallstone disease (GSD) in the elderly and senile age groups compared with young and middle-aged patients can reach 3:4. The main complication of the GSD is acute cholecystitis, which is observed in more than 90% of patients. However, the most dangerous complication is considered to be obstructive choledocholithiasis, which leads to the development of mechanical jaundice and cholangitis in 10 - 35% of cases. The aim of the researchwas to propose an algorithm for the treatment of the GSD complicated by acute cholecystitis and obstructive choledocholithiasis in elderly and senile patients with severe concomitant pathology. Methods.The study is based on the analysis of the results of examination and treatment of 47 patients with GSD complicated by acute calculous cholecystitis and obstructive choledocholithiasis. All patients were divided into 3 groups. The first group included 17 patients in whom, in addition to acute cholecystitis, choledocholithiasis with concretion infringement in the BSDK was detected. The second group included 24 patients in whom, in addition to acute cholecystitis, obstructive choledocholithiasis and cholangitis were diagnosed. The third group included 6 patients in whom for some reason choledocholithiasis was not diagnosed at the first stage or it occurred later as a complication of cholecystostomy. Results.For patients of the first group the endoscopic papillosphincterotomy on stone was performed followed by cholangiography to find out the status of the bile ducts. Patients of the second underwent percutaneous transhepatic choledochostomy at the first stage. Patients of the third group were injected a Foley catheter into the cavity of the gallbladder through the cholecystostomy opening and the cavity of the gallbladder was sealed. Saline solution was injected into the lumen of the gallbladder and its ducts under the pressure of 250 mm. aq. art. This led to the dilatation of the lumen of the bile ducts. Conclusions.The proposed algorithm allows radical treatment of the GSD complicated by choledocholithiasis and cholangitis. The differentiated approach to the transpapillary solution of choledocholithiasis allows to minimize the risk of post-manipulation pancreatitis. AAPST allows to cure choledocholithiasis when endoscopic papillosphincterotomy is dangerous or not feasible.

scholarly journals AGE ASPECTS OF MORPHOLOGICAL CHANGES OF GALLBLADDER SHEATHS IN ACUTE CHOLECYSTITIS

2017 ◽  
Vol 25 (3) ◽  
pp. 52-54 ◽  
Author(s):  
M. B. Polyansky ◽  
D. P. Nazarenko ◽  
T. A. Ishunina
Keyword(s):  
Acute Cholecystitis ◽  
Acute Inflammation ◽  
Morphological Changes ◽  
Gallstone Disease ◽  
Age Groups ◽  
Lymphocytic Infiltration ◽  
The Elderly ◽  
Surface Epithelium ◽  
Cross Sectional ◽  
Younger Age

In this study, the analysis of morphological changes of the gallbladder was carried in patients with acute cholecystitis of four age groups: young (25-44), middle (45-59), old (60-74) and senile (75-89) age. In patients older than 50 years the more pronounced growth of dense connective tissue (p=0,028) and a higher degree of lymphocytic infiltration (p=0,045) was observed in the adventitia as compared to women younger than 50 years. In patients of the elderly and senile age in the mucosa the number of macrophages was higher than in women of the young and middle age (p= 0,03). In the old age group, the cross-sectional area of the nuclei of the surface epithelium was significantly higher than young women (p=0,018). These changes point to chronic protracted course of gallstone disease in women of older age groups and acute inflammation in patients of the younger age.

scholarly journals Psychological and pedagogical aspects of interaction between students and retro-students in the educational process at the Institute of the third age

2019 ◽  
Vol 70 ◽  
pp. 06011
Author(s):  
Anatoly P. Smantser ◽  
Tatiana A. Sidorchuk ◽  
Мaria А. Sidorchuk
Keyword(s):  
Interpersonal Relations ◽  
Life Experiences ◽  
Age Groups ◽  
The Elderly ◽  
Educational Process ◽  
The Third ◽  
Strategic Direction ◽  
The Social ◽  
To Receive ◽  
Intergenerational Interaction

The article deals with the features of intergenerational interaction of students of different ages within a single educational environment and an ambiguous attitude to the social and psychological experience of generations. Empirical research has shown that within the framework of a gerontological unit all age groups of students have an opportunity to receive a qualitatively new social experience on a permanent basis in professional, cultural, leisure and volunteer fields. It should be noted that the younger generation has a positive attitude to retro students; they want to and can become retro students’ mentors, helping the elderly to master modern competencies. Retro students, despite the difficulties of interpersonal relations, are ready as mentors to share their knowledge, social and life experiences with young people. The results presented in the article have shown that the most promising forms of cooperation between students and retro-students are master classes in various areas, and creation of gerontological faculties at universities is the strategic direction of gerontology education.

Patterns of Expenditure in Healthcare for Elderly in Shanghai

China Report ◽  
2020 ◽  
Vol 56 (3) ◽  
pp. 334-353
Author(s):  
Zhu Bifan ◽  
Li Fen ◽  
Wang Linan ◽  
Wang Changying ◽  
Jin Chunlin
Keyword(s):  
Elderly Care ◽  
Age Groups ◽  
The Elderly ◽  
Pattern Of Care ◽  
Younger Adults ◽  
Care For The Elderly ◽  
The Status ◽  
Integration Of Services ◽  
Health Accounts ◽  
System Of Health Accounts

This study aims to summarise the characteristics of elderly care system and analyse expenditures of healthcare for the elderly in Shanghai. The authors use medical records of 2015 and health account results of 2014 based on System of Health Accounts 2011 to describe the pattern of care expenditures for elderly. Individuals aged 60 years and above account for 19.5 per cent of Shanghai’s population but utilise 52.2 per cent of all outpatient visits and 45.3 per cent of all hospitalisations. Almost two-thirds of their medical expenditures occur in hospitals and 16 per cent in community health centres, corresponding to the status of resource allocation. The out-of-pocket payment ratio of the elderly is lower than that of the younger adults, which is attributable to the preferential reimbursement polices set by the insurance schemes. The leading causes of expenditures are cardiovascular disease, neoplasms and respiratory diseases. Care for the elderly costs more, and the elderly use more services than other age groups. The article recommends the monitoring of irrational utilisation of services, strengthening of primary level care and integration of services across different facilities to streamline care for elderly in Shanghai.

scholarly journals Analysis of Characteristics, Methods of Suicide, and Clinical Outcomes in Elderly Suicide Attempters in South Korea by Age Subgroup

2020 ◽  
Keyword(s):  
Risk Factors ◽  
South Korea ◽  
Clinical Outcomes ◽  
Age Groups ◽  
The Elderly ◽  
Substance Exposure ◽  
South Korean ◽  
The Third ◽  
Elderly Suicide ◽  
Methods Of Suicide

Introduction: As the elderly comprise 14.3% of the South Korean population, suicide among the elderly has become a significant public concern. Methods: This study retrospectively analyzed data from the Emergency Department-Based Injury In-depth Surveillance nationwide of South Korea. Patients aged ≥ 65years old who intentionally caused self-injury were included. These elderly patients were subdivided into age groups, and their associated characteristics and correlation between suicide attempt methods and the clinical outcomes were analyzed. Results: A total of 5,333 cases were analyzed. The mean age of the subjects was 75.1 years old, comprising 3,039 males (57.0%) and 2,294 females (43.0%). Substance exposure was the most frequent method across all age groups. In terms of risk factors of admission, drowning, hanging, and asphyxia showed the following results: OR 2.372 for the first group; OR 2.224 for the second group; and OR 5.606 for the third group. Fall/slip was identified as a risk factor of admission in the first and second groups (OR 5.016 for the first group; OR 5.101 for the second group). In terms of risk factors of mortality, drowning, hanging, and asphyxia showed the following results: OR 9.066 for the first group; OR 7.320 for the second group; and OR 7.135 for the third group. With regard to fall/slip, the results were OR 14.596 for the first group; OR 10.096 for the second group; and OR 24.167 for the third group. Conclusions: This study showed that clinical outcomes were different according to the suicide-related characteristics and chosen suicide method. Based on these results, it is necessary to prepare measures to prevent suicide of the elderly in the future.

FUNCTIONAL CHARACTERISTICS OF ELDERLY WOMEN IN RELATION TO THEIR AGE AND MEDICAL CONDITION

2018 ◽  
pp. 95-105
Author(s):  
Sergey Vladimirovich SHPAGIN ◽  
Esedulla Mallaalievich OSMANOV ◽  
Rustam Rinatovich MANYAKOV
Keyword(s):  
Physical Training ◽  
Vital Capacity ◽  
Elderly Women ◽  
Medical Condition ◽  
Age Groups ◽  
The Elderly ◽  
Age Group ◽  
Functional Characteristics ◽  
The Third ◽  
Common Opinion

At the present time there is no common opinion on the methods and means for improving elderly women. Moreover, the nature and intensity of the physical training in relation to the age and medical condition of the elderly women are to be clarified. In this regard, in order to develop scientifically-based programs for the integrated health-improving physical training of elderly women, it is necessary to establish their functional characteristics, depending on their age, taking into account their medical condition. Taking into account the medical condition, the elderly women were distributed by cluster analysis into four age groups: 56–62 years, 63–68 years, 69–72 years, 73–75 years. It has been established that, according to indicators, the vital capacity of lungs and the forced vital capacity of lungs do not significantly differ only between the third and fourth age groups of women. According to the Stange and Genci test scores, there were no significant differences between the first and second age groups of women, and between the third and fourth age group of women. Among women of the first age group, the average strength of the force and the compression force of the hand is significantly higher than in other age groups, among women of the fourth age group, significantly lower than in women from other age groups. The indicators of the resting heart rate index in all studied groups do not differ, but the scatter indicator decreases with age, which indicates a decrease in the lability of the cardiovascular system. The received data can be used for development of programs on complex improving physical training of a researched category of persons.

Systemic immune-inflammation index to predict prognosis of elderly patients with newly diagnosed solid tumors.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e14517-e14517
Author(s):  
Chan Li ◽  
Wei Tian ◽  
Feng Zhao ◽  
Meng Li ◽  
Qin Ye ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Solid Tumors ◽  
Age Groups ◽  
Blood Platelet ◽  
The Elderly ◽  
Newly Diagnosed ◽  
Individual Values ◽  
Aged Patients ◽  
Immune Inflammation ◽  
One Year

e14517 Background: Cancer in the elderly has become a common problem due in part to the increase in life expectancy. Compared to younger counterparts, the biological characteristics of tumors and their responsiveness to therapy may differ in elderly patients, and the elderly also can have a decreased tolerance to anticancer therapy. In addition, there is less evidence from clinical trials to guide physicians in treating aged patients with solid tumors. It would be highly useful to have a simple and powerful indicator of their prognosis. In this paper we evaluated the predictive value of the Systemic Immune-inflammation Index, SII, in determining the one-year survival in elderly patients with newly diagnosed solid tumors. Methods: Data from 118 patients, 70 to 89 years of age with newly diagnosed solid tumors in 2014 were retrospectively analyzed. The patients were divided into two groups according to age: (1) 70-75 years of age and (2) over 75 years of age. We calculated SII from the equation, SII = P x N/L, where P, N and L are the preoperative peripheral blood platelet, neutrophil and lymphocyte counts per liter respectively. The optimum cutoff point for SII for a favorable prognosis was determined to be 390×109 cells/L. For evaluation of SII as a prognostic indicator, the patients were divided into high SII ( > 390×109 cells /L) and low SII (≤ 390×109 cells/L) groups. Individual values were used to determine the relationship between SII and one-year survival in the two age groups. Results: A high SII > 390×109 cells/L was correlated with poor one-year survival (χ² = 7.658, P = 0.006). Patients with low SII had improved survival. Conclusions: SII was a robust indicator of one-year survival in elderly patients with newly diagnosed solid tumors. Patients in the high SII group showed poor prognosis compared to patients with a low SII score. [Table: see text]

scholarly journals The Social Status of the elderly from a Comparative Perspective: distinctions of Post-communist Countries

2021 ◽  
Vol 27 (4) ◽  
pp. 8-31
Author(s):  
Maksim Rudnev
Keyword(s):  
Older People ◽  
Social Status ◽  
Age Groups ◽  
The Elderly ◽  
European Social Survey ◽  
Communist Regime ◽  
The Social ◽  
The World ◽  
The Status ◽  
Communist Countries

Social status reflects the hierarchical position of social groups within society, their prestige as perceived by members of their society. The existing literature shows that age groups differ in their status considerably across countries, and that their status is linked to socio-economic modernization. This study investigates the determinants of elderly people’s status in post-communist countries in comparison to other countries. Using two large international datasets — from the World Values Survey (58 countries) and European Social Survey (29 countries) — as well as multilevel regressions, we found that elderly people in post-communist countries were at the bottom of the status hierarchy. Compared to other regions of the world, this low status was only in part explained by country modernization level, implying that some other factors may have had an effect. Moreover, only in postcommunist countries the perceived status of older people decreased with respondent’s age. We suggest that the low status of older people in post-communist countries was caused by the social and economic transformations that followed the fall of the communist regime — which led to the older generation losing human capital — and then exacerbated by the ageist legacy of the Soviet industrialist ideology. Finally, we insist that the very low status of older people is a problem of society as a whole rather than this particular age group.

scholarly journals Nature and Magnitude of COVID-19 First Wave in Tamil Nadu, India

2021 ◽  
Vol 9 (4) ◽  
Author(s):  
P Devi Priya
Keyword(s):  
Tamil Nadu ◽  
Middle Age ◽  
Age Groups ◽  
The Elderly ◽  
Third Wave ◽  
Age Group ◽  
Group 13 ◽  
The Third ◽  
First Case ◽  
Second Wave

The first case of COVID-19 Tamil Nadu was confirmed on 7th March 2020 in Chennai after aninternational travel from Muscat. The specific objectives of the study were to analyze the trends inCOVID 19 in Tamil Nadu from March 2020 to January 2021 and examine the pattern of it sex-wiseamong the age groups. The risk of COVID-19 was accessed with the computation of positive testrate, prevalence rate and fatality rate. The prevalence rates were highest in August, with a slightdownfall in September 2020 in the state. The positivity test rate was high in June and July. Then itstarted declining and has been one percent in January. About 83 percent of the occurrence of thevirus was among the middle age group, 13 percent among the elderly and four percent among thechildren. Intensifying immunity boosters, personal and public hygiene, vaccination on a large scaleprobably would contain the second wave and prohibit the third wave for the survival of humanity

scholarly journals An observational study of Senior Citizen at Senior Citizen Home of Tanahun District of Nepal

2019 ◽  
Vol 8 ◽  
pp. 51-53
Author(s):  
Poonam Pokhrel Sapkota
Keyword(s):  
Population Aging ◽  
Elderly Care ◽  
Group Discussion ◽  
Age Groups ◽  
Senior Citizen ◽  
The Elderly ◽  
Old People ◽  
The Status ◽  
Care Of Elderly ◽  
Multi Disciplinary Team

Background: All countries have to face the population aging sooner depending on their degree of development; however, elderly care is predicted to soon become a major concern for developing countries such as Nepal. Methodology: A qualitative study was conducted in a senior citizen home of Tanahun district. General health check­ up of the 30 elderly followed by 2 focus group discussion and one Kll with provider was done to know the status of elderly and their perception towards senior citizen home. Results: Majority of the elderly were abandoned by their family members due to financial sufferings, and some of them left their home in search of their own comfort zone. Majority of them got old aged allowance which is the only way of financial security. They were living happily in the home though they missed their family in some occasion because they could have spent their leisure time by sharing their emotions and feelings with same age groups. Conclusions: Concept of senior citizen home has to be broaden up from the living home of poor old people to relaxing comfort home for elderly. Good management and facility should be incorporated with multi disciplinary team to take care of elderly to spend dignified life in senior citizen home as well.

scholarly journals Chyle leak following laparoscopic cholecystectomy: a rare complication

2010 ◽  
Vol 92 (7) ◽  
pp. e12-e14 ◽  
Author(s):  
Petrut Gogalniceanu ◽  
Sanjay Purkayastha ◽  
Duncan Spalding ◽  
Emmanouil Zacharakis
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Current Literature ◽  
Rare Complication ◽  
Gallstone Disease ◽  
Chyle Leak ◽  
Diagnosis And Management ◽  
The Third ◽  
Chyle Leakage

Gallstone disease is a highly prevalent condition which is commonly and safely treated by laparoscopic cholecystectomy. We present the third reported case of chyle leakage following laparoscopic cholecystectomy in the setting of acute cholecystitis. The report reviews current literature on the prevalence, diagnosis and management of this condition.

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